{"title":"Public health system response to emerging infectious respiratory outbreaks in Iran.","authors":"Zahra Afshar Hosseinabadi, Nasrin Shaarbafchizadeh, Mostafa Amini-Rarani","doi":"10.1080/16549716.2025.2491199","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Emerging infectious respiratory diseases present significant challenges to public health systems worldwide. The recent COVID-19 pandemic has revealed critical weaknesses in Iran's healthcare infrastructure, particularly regarding surveillance and testing capabilities. During the pandemic, Iran faced severe consequences, including a high death toll and overwhelming demands on its healthcare system. This situation highlights the urgent need for a stronger public health system in the country.</p><p><strong>Objective: </strong>This study identifies interventions implemented in Iran's public health system during respiratory disease pandemics, their context, mechanisms and outcome.</p><p><strong>Methods: </strong>A qualitative realist study was conducted using semi-structured interviews with 21 public health experts across various sectors. Data were analyzed through content-directed analysis using the CIMO (Context-Intervention-Mechanism-Outcome) approach and the SPRP (Strategic Preparedness and Response Plan) framework. Data collection occurred from March to June 2024.</p><p><strong>Results: </strong>Analysis revealed that factors such as individual behaviors, social capital, institutional settings, and political pressures significantly influenced intervention outcomes. Key interventions included enhanced risk communication strategies and the establishment of specialized respiratory disease centers. However, bureaucratic inefficiencies and resource limitations hindered effective responses. Additionally, continued investment in local diagnostic production is essential for maintaining national laboratory and vaccination capabilities.</p><p><strong>Conclusions: </strong>The findings underscore the necessity for systemic reforms in Iran's public health framework to enhance preparedness for future pandemics. The realist approach provided insights into the complexities of intervention effectiveness, emphasizing the importance of context in shaping health outcomes. Strengthening primary healthcare and fostering inter-sectoral collaboration are essential for building a more resilient public health system capable of addressing emerging respiratory diseases effectively.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"18 1","pages":"2491199"},"PeriodicalIF":2.2000,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Global Health Action","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/16549716.2025.2491199","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/29 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Emerging infectious respiratory diseases present significant challenges to public health systems worldwide. The recent COVID-19 pandemic has revealed critical weaknesses in Iran's healthcare infrastructure, particularly regarding surveillance and testing capabilities. During the pandemic, Iran faced severe consequences, including a high death toll and overwhelming demands on its healthcare system. This situation highlights the urgent need for a stronger public health system in the country.
Objective: This study identifies interventions implemented in Iran's public health system during respiratory disease pandemics, their context, mechanisms and outcome.
Methods: A qualitative realist study was conducted using semi-structured interviews with 21 public health experts across various sectors. Data were analyzed through content-directed analysis using the CIMO (Context-Intervention-Mechanism-Outcome) approach and the SPRP (Strategic Preparedness and Response Plan) framework. Data collection occurred from March to June 2024.
Results: Analysis revealed that factors such as individual behaviors, social capital, institutional settings, and political pressures significantly influenced intervention outcomes. Key interventions included enhanced risk communication strategies and the establishment of specialized respiratory disease centers. However, bureaucratic inefficiencies and resource limitations hindered effective responses. Additionally, continued investment in local diagnostic production is essential for maintaining national laboratory and vaccination capabilities.
Conclusions: The findings underscore the necessity for systemic reforms in Iran's public health framework to enhance preparedness for future pandemics. The realist approach provided insights into the complexities of intervention effectiveness, emphasizing the importance of context in shaping health outcomes. Strengthening primary healthcare and fostering inter-sectoral collaboration are essential for building a more resilient public health system capable of addressing emerging respiratory diseases effectively.
期刊介绍：
Global Health Action is an international peer-reviewed Open Access journal affiliated with the Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine at Umeå University, Sweden. The Unit hosts the Umeå International School of Public Health and the Umeå Centre for Global Health Research.
Vision: Our vision is to be a leading journal in the global health field, narrowing health information gaps and contributing to the implementation of policies and actions that lead to improved global health.
Aim: The widening gap between the winners and losers of globalisation presents major public health challenges. To meet these challenges, it is crucial to generate new knowledge and evidence in the field and in settings where the evidence is lacking, as well as to bridge the gaps between existing knowledge and implementation of relevant findings. Thus, the aim of Global Health Action is to contribute to fuelling a more concrete, hands-on approach to addressing global health challenges. Manuscripts suggesting strategies for practical interventions and research implementations where none already exist are specifically welcomed. Further, the journal encourages articles from low- and middle-income countries, while also welcoming articles originated from South-South and South-North collaborations. All articles are expected to address a global agenda and include a strong implementation or policy component.
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