Iran: Organisation of Services

Comprehensive pre-service and in-service training of community-based providers can help contribute to successful implementation of task shifting between providers. Iran has demonstrated this through the robust training that accompanies the country’s national community-based care strategy that was first implemented in 1979. Community-based providers – called Behvarz - are employed by the health system, and in 2007 there were approximately 31,000 Behvarz serving 28 million people.1 To support this program, Iran has a District Behvarz Training Centre that is responsible for recruitment, administration of entrance exams and interviews, implementation of training and exams, supervision and support during training, and provision of a safe learning environment. Behvarz first receive a two-year pre-service training that is structured to promote both theoretical and practical knowledge, including hands-on experiential learning in Health Houses and Rural Health Centers. The Behvarz curricula is updated regularly, and in certain areas, Behvarz receive supplementary training to adapt to local health needs. Behvarz reported high satisfaction with pre-service training, particularly in regard to the training environment, relationships with trainers, and trainer competence.1 Following pre-service training, Behvarz receive in-service training that is typically administered by doctors or other health workers. The high-quality Behvarz training in Iran is facilitated by the nationally-coordinated CHW policies and allocated financial support for all aspects of training. Additionally, CHWs have benefited from rapidly adapting curricula and training materials that match their expected competencies and skills and reflect the local reality of health care needs in the communities they serve.1


  1. Javanparast S, Baum F, Labonte R, Sanders D, Rajabi Z, Heidari G. The experience of community health workers training in Iran: a qualitative study. BMC Health Serv Res. 2012 Aug 31;12:291.