This study evaluated the progress of Iran’s health system reforms aimed at achieving universal health coverage over the past three decades. Conducted between 2016 and 2017, the research used qualitative interviews with 30 senior policymakers and health providers to capture their perspectives on reform effectiveness. Findings revealed two dominant themes—an adverse situational context and a chaotic healthcare system—highlighting that reforms were often fragmented, reactive, and inconsistently applied. The lack of a coherent and comprehensive framework, combined with challenging political and economic conditions, limited the success of these initiatives. The study recommends adopting gradual, well-planned reforms aligned with a long-term strategy that considers contextual realities and engages key stakeholders.
