The impacts of health transformation plan on physiotherapy sector in Iran: a qualitative study using five control knobs

Purpose To investigate physiotherapists', academics', and relevant decision- and policy-makers' experiences regarding the impacts of the Health Transformation Plan (HTP) on the physiotherapy sector in Iran. Materials and methods This qualitative study was conducted using in-depth semi-structured interviews. The participants were selected using both purposive and snowball sampling strategies with maximum diversity. The sampling procedure continued until data saturation was achieved. The collected data were analyzed using thematic content analysis in accordance with Braun and Clarke's methodology. Results The findings showed that the physiotherapy sector has faced several challenges after the implementation of HTP in five control knobs: (1) financing (a decline in the government budget and insufficient health insurance coverage), (2) payment (delayed payments and setting a tight ceiling for reimbursements), (3) behaviors (a decrease in the motivation of physiotherapists, the tendency toward misbehaviors such as absenteeism and providers' unwillingness to cooperate with insurance companies), (4) organization (difficulty in clinical education and ignoring the preventive effects of physiotherapy interventions), and (5) regulation (absence of stakeholders in political processes and inconsistency of upstream documents). Conclusion HTP has posed various challenges on the physiotherapy sector in Iran. Promoting the policymakers' awareness and aligning the health reforms such as HTP with the current upstream documents would diminish the existing challenges.