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Barzegari J, Sehati M, Raeissi P, Reisi N. Providing Primary Health Care for Non-communicable Disease Patients During Pandemics: A Qualitative Study. J Research Health 2026; 16 (5) :531-538
URL: http://jrh.gmu.ac.ir/article-1-2963-en.html

The COVID-19 pandemic severely disrupted primary health care (PHC) for noncommunicable diseases (NCDs), causing delayed care and higher mortality globally. In Iran, over 5 million NCD patients are registered in the integrated health system (SIB), yet PHC utilization dropped sharply. This study aimed to examine challenges in PHC-based NCD care during the crisis and strategies for future emergencies. In 2021, a qualitative study was conducted using conventional content analysis. Semi-structured interviews were conducted with 11 experienced NCD program managers from Iranian universities of medical sciences and the Ministry of Health, selected via purposive sampling. Data collection continued until thematic saturation. Transcripts were analyzed using Graneheim and Lundman’s thematic content analysis in MAXQDA software, version 10. Trustworthiness was ensured through prolonged engagement, member checking, and peer debriefing. Thematic analysis revealed two overarching domains: challenges and strategies. Challenges were categorized into provider-related issues at the macrolevel (policy neglect, workforce reallocation, fragmented command, inadequate digital infrastructure) and microlevel (non-free services, prolonged follow-ups, equipment shortages, low motivation), alongside recipient-related factors (fear of infection, unhealthy lifestyle changes, psychological distress). Proposed strategies included fundamental transformation (dedicated NCD clinics, telemedicine, home-based care, strengthened self-care) and optimization of existing processes (private-sector collaboration, risk-stratified follow-up, task shifting, enhanced insurance coverage, proactive crisis planning).