Primary health care performance of Iran’s family physician program: a scoping review to inform health policy and program improvement

Introduction Since the implementation of Iran’s Family Medicine Program (FMP) in 2005, numerous studies have evaluated its outcomes. However, Evidence on family physician performance and Family Physician Program performance remains fragmented. This review synthesized available evidence and identified key strengths and gaps.Theory The review was guided by primary health care performance frameworks developed by the World Health Organization (WHO) and the World Organization of Family Doctors (WONCA).Method A scoping review was conducted using the Arksey and O’Malley framework and PRISMA-ScR guidelines. International and national databases were searched for studies published between 2005 and 2025. Eligible studies were screened independently by two reviewers, and data were synthesized through thematic analysis.Results: Of 1,861 records identified, 37 studies met the inclusion criteria. Family physicians demonstrated satisfactory performance in hypertension and diabetes management, maternal and child health services, and doctor-patient communication. Prescribing practices improved in several settings. However, deficiencies persisted in osteoporosis and mental health care, antibiotic stewardship, referral documentation and feedback, and community engagement.Discussion The Iranian FMP performs relatively well in clinical care but face challenges in population health functions and system coordination. Strengthening training, referral systems, community participation, and standardized assessment frameworks may improve program effectiveness and support quality improvement.