Abstract
Background: Reforms of health system in developing countries are performed in financial supply of health services, allocation of sources to health system, presentation of services and justice. In all cases, non-governmental sector can play role by participation of governmental and private sectors as one of strong executive options.
Method: This is a qualitative study and data was obtained from documents (tender and contracts) of branches affiliated to medical science university of Shiraz and observation and interview with 15 knowledgeable persons such as experts and staff managers, managers of hospitals and contractors. Data were summarized and analyzed by qualitative method of “framework analysis”.
Findings: Challenges of implementation of health system reform in outsourced units of health services in Shiraz are summarized in four main themes and ten subthemes as follows:
1- challenges of employers (hospital/ health & treatment centers) 2- challenges of rules and regulations 3- challenges of the book “relative values of tariffs for presenting services 4- challenges of implementation of reform plan in health system.
Discussion and conclusion: Outsourcing has been ignored in implementation of health reform plan. It is noteworthy that policy makers of health try to facilitate presentation of services in outsourced units by reforming laws and formulating clear instructions and they should use opinions of these service providers.
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