Implications derived from the strengths and weaknesses observed in Iran's primary healthcare programmes during the COVID-19 pandemic: a qualitative interview study.

Background: The COVID-19 outbreak at the end of 2019 severely impacted global healthcare systems, especially primary healthcare services. This paper aimed to identify the implications derived from the strengths and weaknesses observed in Iran's primary healthcare (PHC) programmes during the pandemic.

Methods: This was a qualitative study conducted in 2021. 13 semistructured interviews were held with Iranian healthcare policymakers and executive managers, selected via snowball sampling, using the World Health Organization's analytical framework. Finally, a thematic analysis was conducted on the interview data.

Results: The thematic analysis of the findings yielded five major themes: revision of healthcare financing, redefining education and research in primary healthcare, redefinition of primary healthcare, development of a new model for family medicine, and community engagement.

Conclusion: Addressing vertical inequality in Iran's healthcare system was delineated to be crucial. Meanwhile, multiple strategies including enhancing family physicians' knowledge and skills, decentralising decision-making, empowering them and involving communities in healthcare planning were presented to improve PHC and family medicine. Further empirical research is needed.