The Views of Stakeholders about the Challenges of Rural Family Physician in Kurdistan Province: A Qualitative Study

Abstract

Background and Objectives: The Family Physician (FP) plan was implemented in rural areas and cities with a population of less than 20000 in 2005. The purpose of this study was to explain the challenges and obstacles of¬ the Rural Family Physician Program in Kurdistan Province from the perspective of stakeholders. Methods: This qualitative study was conducted using 30 semi-structured interviews and 5 focused group discussions (FGD) with stakeholders of the FP plan from June 2017 to Jan 2018. The participants were selected through a purposive sampling method with maximum variation. The contents of the interviews and FGD were categorized by the content analysis method using MAXQDA10 software (V. 10). Results: The challenges and obstacles of the FP plan were categorized into 16 subcategories and 5 main categories. The main categories were stewardship challenges, service delivery challenges, cultural and educational challenges, human resource challenges, and infrastructure challenges. The most important subcategories of these challenges included weaknesses in policy-making, formation of laws and regulations, weaknesses in insurance performance, weaknesses in intra-sector coordination, weaknesses in the referral system, weaknesses in communicating the plan to the community, low survival of physicians, inadequate motivational mechanisms, and weaknesses in the information system. Conclusion: The rural FP plan faces many challenges that require multi-dimensional interventions. Identifying the challenges of the FP plan from the perspective of its stakeholders can help to gradually improve the plan.

Keywords

• family physician
• challenges
• referral system
• qualitative study
• kurdistan