As a part of developing person-centered primary health care systems, services must be adaptable to the needs and demands of both urban and rural conditions in order to effectively serve as the first point of contact. Primary care delivery systems in urban areas face unique challenges in serving as the first point of contact for communities, such as different disease patterns, lifestyle circumstances, cultural values and historical roots, and availability of resources.1 For this reason, countries like Ethiopia and Iran have adopted a stratified approach to primary care delivery.

In Iran, following the success of the rural community health program, urban community health workers (CHWs) - called Moraghebe-Salamat -  were established in the 1990s as complementary frontline workers to rural community health workers - called Beharvz - in order to better meet the needs of urban populations. Iran’s urban community health program partners CHWs with counterparts from different disciplines (including mental health specialists, nutritionists, environmental and occupational health experts, and midwives) to enable the team-based provision of a variety of services. Like the rural CHW model, urban CHWs are typically native to their working area which has been seen to be essential for establishing trust in services and understanding the needs and demands of the community.2

References:

  1. Behdjat H, Rifkin SB, Tarin E, Sheikh MR. A new role for Women Health Volunteers in urban Islamic Republic of Iran. East Mediterr Health J. 2009 Oct;15(5):1164–73.
  2. Spigel L, Schwarz D, Bitton A. Islamic Republic of Iran. World Health Organization; 2018. Report No.: WHO/HIS/SDS/2018.27.