Networking Primary Health Care: Mississippi Discovers the Iranian Health System
By Kamel Shadpour and Pejman Shadpour
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“A wonderful illustration of the benefits to global health when a recognition of shared challenges and the ability to learn from one another drives the partnership.” Roger I. Glass, M.D., Ph.D., Director, Fogarty International Center, National Institutes of Health, Bethesda, Maryland USA
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Networking Primary Health Care - Kamel Shadpour
A wonderful illustration of the benefits to global health when a recognition of shared challenges and the ability to learn from one another drives the partnership.
Roger I. Glass, M.D., Ph.D.
Director, Fogarty International Center
Associate Director for International Research
National Institutes of Health
Bethesda, Maryland USA
Dr. Kamel Shadpour has dedicated himself ever since 1980 to develop the Primary health care system in Iran. He literally visited far stretched villages in most of the provinces, studying their routes of communications, their needs, discussing the health care needs of the population with the community, advocating good health practices, teaching the population and the health workers. Very few countries in the world have been able to provide access to care to 95% of the population, within a well-balanced referral system and at a relatively low, inexpensive, affordable and sustainable manner. Iran should, in all modesty, be proud of its accomplishments.
Nabil M Kronfol M.D., Dr. P.H.
President
Lebanese HealthCare Management Association
Beirut, Lebanon
I have monitored health care and health status in the Mississippi Delta region for forty years, and have been profoundly disappointed by the recent lack of progress. The level of human suffering that continues to exist is a moral issue that demands new efforts. I believe this health house network model adapted from Iran, with its vertical integration with existing centers, practices, and community hospitals, and use of new types of community health workers at a time of major health personnel shortages in the area, offers much for the region and our nation. This would be true health care reform for a population that has desperately needed it for many years.
H. Jack Geiger, M.D., M. Sci.Hyg. Sc.D. (hon)
Arthur C. Logan Professor Emeritus of Community Medicine
City University of New York Medical School
Sophie Davis School of Biomedical Education
New York, New York USA
It is my pleasure to provide this letter of endorsement for the manuscript
Networking primary health care - Mississippi discovers the Iranian health care system, by Kamel and Pejman Shadpour. The book describes with fascinating insights, thorough knowledge of facts, and a very clear and direct style the birth and establishment of the modern Iranian primary health care system. The general outline of the Iran success story is well known, and is rooted in the paradigms of the primary health care approach. The value added of this book lies in the clear and accessible explanations of how precisely this was accomplished in practice, thus providing scholars, health services managers and health planners with concrete guidance and a user-friendly reference. I recommend unhesitatingly this book to all the people interested in learning more about the Iran experience with primary health care, as well as all those seeking to improve the equity and effectiveness of the primary health systems of their own country.
Dr. Mubashar Sheikh
Executive Director
Global Health Workforce Alliance
World Health Organization
Geneva, Switzerland
line1a.jpgNetworking Primary Health Care: Mississippi Discovers the Iranian Health System
Copyright © 2015 Pejman Shadpour
No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying and recording, or in any information or retrieval system without the prior written permission of the Author.
ISBN - 978-1-5323-0092-9 (electronic)
ISBN - 978-1-4951-7682-1 (paperback)
Published by:
Oxford International Development Group
P.O. Box 190
Oxford, MS 38655 USA
line2a.jpgNetworking Primary Health Care
Mississippi discovers the Iranian Health System
Written by
Kamel Shadpour, MD MPH
WHO-A.T. Shousha Award Laureate
Family Health Specialist
Senior Health Expert
Pejman Shadpour, MD
Associate Professor of Urology
Iran University of Medical
Sciences (IUMS)
Edited by
James Miller
Managing Director
Oxford International Development Group
Oxford, Mississippi USA
FOREWORD
During a business research trip to Europe in 2004, I had the serendipitous opportunity to meet informally with members of a delegation from Iran’s Ministry of Labor and Social Affairs. Our cordial discussions over several days covered a wide range of issues of common interest and shared ideals while acknowledging our two governments were stuck in a geopolitical quagmire stemming from over a half-century of mutual distrust and conflict. However, the main takeaway for me was the American and Iranian people had much in common, and we should find ways to build bridges of collaboration, better understanding, and mutual respect.
Those discussions included Iran’s post-revolution period and development of its Primary Health Care (PHC) system; one that had made tremendous strides in improving the lives of their rural population. I was painfully aware of the stark contrast between their success story and the health-access problems we faced in the impoverished rural Mississippi Delta region - and was inspired to learn more. The Iranians had accomplished almost miraculous results, especially in view of the most difficult wartime circumstances, recession and critical lack of health care professionals. Given the chance, I felt certain there were many things we Americans could learn from their experiences. A few years later, that opportunity arrived.
In late 2007, our company completed an assessment of a financially ailing rural Mississippi hospital where the symptoms of distress had to be viewed in the context of the overall systemic failures in the Delta region, and, by extension, the nation. Health statistics and access to healthcare services within rural areas and small communities in the Mississippi Delta has been problematic for decades. Many Delta counties in Mississippi, as well as the neighboring states of Arkansas and Louisiana, only have one or two doctors and a few nurses to serve residents that often are isolated by geographical barriers and distributed over large areas. The result is the poorest of the nation’s low-income areas often do not receive the care they need to prevent or effectively treat chronic diseases and other conditions, and data for these three states clearly underscores the consequences of lack of preventive care and access. Bottom line, as in many communities across the U.S., the hospital emergency room had become the primary care doctor for the impoverished and working poor and the place of last resort when those undiagnosed diseases had gone untreated, even though many were not only