• Masoud Behzadifar, Meysam Behzadifar, Sanaz Heidarvand, Hasan Abolghasem Gorji, Aidin Aryankhesal, Sharare Taheri Moghadam, Roghayeh Mohammadibakhsh, and Nicola Luigi Bragazzi.
• Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran.
• Fam Pract. 2018 Dec 12; 35 (6): 652660652-660.

BackgroundA good level of health requires the establishment of primary health care. Family physician policy (FPP) is probably one of such initiatives, which enables societies attaining the universal health coverage.ObjectiveThe present study is the first systematic review and meta-synthesis that seeks to provide a more comprehensive understanding of the challenges for FPP in Iran.MethodSeveral international scholarly databases (namely, ISI/Web of Sciences, PubMed/MEDLINE via Ovid, Embase, PsycINFO, Scopus and CINAHL via EBSCO), as well as three Iranian databases [MagIran, Irandoc and Scientific Information Database (SID) databases], were mined from January 2006 to December 2017. The Noblit & Hare approach was used to analyse the selected studies.ResultsBased on the study inclusion criteria, seven studies were retained. Initially, 133 codes were identified. In the second step, two of the authors examined the codes and merged themes based on their similarities and shared meaning. New codes were created through discussion. In the next and final step, eight themes emerged, namely, (i) financing; (ii) motivational factors; (iii) education; (iv) referral system; (v) performance evaluation; (vi) problems with health policy; (vii) health information system; and (viii) culture-building for proper policy implementation.ConclusionAlthough more than 10 years have passed since the implementation of FPP in Iran, and despite its positive effects on health, there are still challenges in implementing this policy, which makes it difficult to achieve its objectives. Health decision- and policy-makers in Iran should address these challenges and use all available capacities to face them.

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