Equity in health: Developing a needs-based resource allocation formula for the public health care system of Iran

Evidence from both developed and developing countries suggests that inappropriate allocation of resources contribute greatly to inequities in health. In many countries, policy-makers have come under pressure to abandon historical funding models which were widely perceived as inequitable and to develop explicit alternatives that would redress inequities within and between the geographic areas. This has exposed the mechanisms for allocation of public sector health resources to greater scrutiny. Many needs-based models for resource allocation in recent decades were developed on the basis of the equality of access principle.

  In Iran significant steps have been taken at the national level to channel resources towards services that can improve the most vulnerable groups in the different regions of the country. Yet the current system of geographic resource allocation may be an impediment to attaining this goal. Resources are currently allocated to provinces and districts largely based on the size of inpatient facilities and numbers of staff in post. Indeed evidence show that the allocations have no significant positive relationship to health need and may even is inversely related to general deprivation of the area. The aim of this study is developing a needs-based formula for redistribution of resources on the public health care system of Iran.

A thorough review on needs-based resource allocation for health care in some different developed and developing countries were conducted. The context of Iran was evaluated in terms of health needs to find out the best need indicators considering the availability of information. The different models of resource allocations in the countries were compared to find out their similarities and differences and also strengthening and weaknesses. Considering the results from the evaluation of the models and the conceptual understanding of the situation in Iran, a proposal formula to allocate resources is developed.