Insufficient evidence on the effectiveness of family physician program in Iran: a systematic review of existing literature

The Family Physician Program (FPP), initiated by the Iranian Ministry of Health in 2005 for rural areas and expanded to select urban regions in 2011, aimed to enhance community access to healthcare services. This systematic review aimed to examine empirical research evaluating the impact of the FPP on health indicators in both rural and urban settings in Iran. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a comprehensive search across four international databases (ISI/Web of Science, PubMed, Embase, and Scopus) and three Iranian databases (Magiran, Irandoc, and Scientific Information Database). We identified peer-reviewed studies that investigated the effects of FPP on various health indicators. The risk of bias was assessed using a nine-item quality assessment tool developed by Hawker. Data were synthesized narratively through content analysis. Our search yielded 963 titles, of which 28 studies met the inclusion criteria for full-text review. The findings from these studies were contradictory regarding the FPP’s impact on access to and utilisation of healthcare services, the prevention and control of non-communicable diseases, maternal and child mortality rates, financial protection, and the satisfaction of healthcare recipients and providers. While most existing studies have concentrated on access to healthcare services, the available evidence regarding the effectiveness of the FPP in Iran remains inconclusive. As a result, firm conclusions about the overall impact of the FPP cannot yet be established. Generating more robust evidence would contribute to more informed decision-making on the continuation and possible refinement of the program. Therefore, further national-level studies are recommended to provide clearer insights into the outcomes and broader implications of the FPP in Iran.