Health inequalities and development plans in Iran; An analysis of the past three decades (1984-2010)

Hossein Zare, Antonio J. Trujillo, Julia Driessen, Mojtaba Ghasemi, Gisselle Gallego

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


Introduction. Reducing inequalities in health care is one of the main challenges in all countries. In Iran as in other oil-exporting upper middle income countries, we expected to witness fewer inequalities especially in the health sector with the increase in governmental revenues. Methods. This study presents an inequalities assessment of health care expenditures in Iran. We used data from the Household Income and Expenditure Survey (HIES) in Iran from 1984-2010. The analysis included 308,735 urban and 342,532 rural households. Results: The results suggest heightened inequality in health care expenditures in Iran over the past three decades, including an increase in the gap between urban and rural areas. Furthermore, inflation has affected the poor more than the rich. The Kakwani progressivity index in all years is positive, averaging 0.436 in rural and 0.470 in urban areas during the time period of analysis. Compared to inequality in income distribution over the last 30 years, health expenditures continuously show more inequality and progressivity over the same period of time. Conclusions: According to the result of our study, during this period Iran introduced four National Development Plans (NDPs); however, the NDPs failed to provide sustainable strategies for reducing inequalities in health care expenditures. Policies that protect vulnerable groups should be prioritized.

Original languageEnglish (US)
Article number42
JournalInternational journal for equity in health
Issue number1
StatePublished - May 27 2014


  • Development plans
  • Gender inequalities
  • Gini
  • Health inequalities
  • Health services
  • Inequality
  • Kakwani
  • Out-of-pocket

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health


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