Family doctors are keen on giving the best care to their patients. Public health is keen on maximizing the health of the population. Here in Canada, public health can sometimes seem like a separate entity from family medicine. Patients will tell you that public health tells us to immunize our children, breastfeed our babies, and shut down restaurants that don’t meet standards. Family doctors are the ones that you see when you get sick, for medication review, and for annual checkups.
However, the worlds of family medicine and public health are far more intertwined than it seems from the outside. How could we better integrate primary care and public health? Does Canada do it the right way? To answer this question, we need to look at how primary care and public health are coordinated around the world. Each blog in this series will feature a brief look at how it’s done in another country. In this series of blog posts, will look at how the integration of family medicine and public health differs vastly around the world.The final blog post will feature a summary of what we can learn from other nations.
In Iran, community health workers are called behvarzan (from the Farsi words ‘beh’ – good, and ‘varz’ – skill). Individuals from a community are trained to provide basic health care to their surrounding community. Often, a husband and wife will work together to accomplish this. They work in ‘health houses’ and provide services such as vaccinations, administering medications, child/maternal health, and ensuring proper water sanitation, among other things. There are over 1,400 health houses serving the rural population in Iran. Each of the health houses report and refer to a rural health centre that is staffed by general practitioners and other health care professionals. The program began in 1981. Since then, Iranian public health has improved substantially. Immunization rates have tripled, infant mortality rates have been halved, and family planning has been transformed. The health houses have been so successful that the concept has now been modified for Iran’s urban communities.
Check out more about Iran’s behvarzans here: http://www.who.int/bulletin/volumes/86/8/08-030808/en/
- Panel discussion: “The Intersection of Family Medicine and Public Health Around the World”. http://livestream.com/SchulichSchoolofMedicineandDentistry/
“The family physician cares for the individual within the context of the family, for the family within the context of the community, and for the community in the context of public health, irrespective of race, culture, or class” – WONCA (World Organization of Family Doctors)