502 July-August 2005 Family Medicine Background The Iranian Primary Health Care System

The current primary health care system in the Islamic Republic of Iran was established with an emphasis on improving access to health care for the disadvantaged and reducing the gap between health outcomes in rural and urban areas. During the past 2 decades, Iranian public health policy has led to great reductions in health disparities between higher-income urban populations and the rural poor. For example, in 1974 the infant mortality rate was 120 per 1,000 live births for rural areas, and 62 per 1,000 for urban areas. By 2000, these figures had declined to 30 and 28, respectively.1 Many of these positive changes are attributed to the establishment in 1985 of a joint Ministry of Health and Medical Education.2,3 The merger made it clear that “community needs must be given primary consideratio