Comparing the Rehabilitation Structures in the Health Systems of Iran, Germany, Japan, Canada, Turkey, and South Africa
Authors:   Department of Health Services Management, Faculty of Medical Sciences and Technologies, Science and Research Branch, Islamic Azad University, Tehran, Iran., Farahbod Mojgan , Masoudi Asl Iravan ,   Department of Health Services Management, School of Management and Communication, Iran University of Medical Sciences, Tehran, Iran., Jamaloddin Tabibi Seyyed ,   Department of Health Services Management, Faculty of Medical Sciences and Technologies, Science and Research Branch, Islamic Azad University, Tehran, Iran., Kamali Mohammad ,   Department of Basic Rehabilitation Sciences, Faculty of Rehabilitation Sciences, Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran.
Published: May 2023

Objective Because of the increasing number of people with disabilities and the lack of awareness of disability prevention methods in developing countries, creating a proper rehabilitation structure and providing appropriate services are among the important goals of every health system. Conducting comparative studies is one of the research methods for reviewing the structure of the rehabilitation system in the country’s health system. This study aimed to compare the rehabilitation structure in Iran with 5 other countries. Materials & Methods This research is a comparative study conducted in 2022. In this study, sampling was purposeful. Five countries of Germany, Japan, Canada, Turkey, and South Africa were compared in terms of organizational and health management, financial and legal components, and social policy components with Iran. Reliable databases and related resources in the rehabilitation structure were used to collect data. In this study, the obtained data were analyzed using the Bereday model containing four stages: Description, interpretation, proximity, and comparison. The findings were evaluated in a comparative table. Results The findings indicated that in terms of organization and health management, the Ministry of Health should be responsible for health management and rehabilitation, but in Iran, in addition to the Ministry of Health, the Red Crescent, the Martyr Foundation, and Exceptional Education Organization are also involved in the management of rehabilitation. Financial issues and problems are significant barriers for people with disabilities to access rehabilitation services in these countries. In Iran, a large part of these costs is paid from the pockets of families. Regarding legal components in Iran, as in other countries, specific rules exist to provide services to people with disabilities. But sometimes, these rules are not properly implemented. From the sociodemographic perspective, Iran has an aging population, welcomes immigrants, and holds diverse cultures. The access of all people in need of rehabilitation in this diverse population to the services needed is limited. In terms of policy components, regulating national health policy requires review and, if necessary, changes in existing health system policies. Conclusion The existence of a specific position for rehabilitation in the Iranian health system, provision of services, and management of rehabilitation affairs by a single organization such as the Ministry of Health, as well as proper implementation of laws and policies, can lead to structural improvement and management of the health system and rehabilitation. Financial obstacles and problems to rehabilitation services should be reduced, and government and insurance must cover most of the costs of rehabilitation services. Also, a review of national health policies and legislation in the country should be done to improve the access of all people with disabilities to health and rehabilitation services. Therefore, it is necessary to fundamentally review and reform the structure, value, and process of providing rehabilitation services.