Zahra Shafei, cultural researcher
Public health is one of the most important indicators of national development. It reflects not only the quality of life of a society, but also the ability of governments to establish social justice and provide effective public services. A comparison between Iran’s healthcare system today and the situation before the Islamic Revolution shows that the Islamic Republic has not only improved health indicators, but has also developed a model of justice, accessibility, and medical independence, even under the harshest sanctions in modern history. This transformation is not a matter of rhetoric; it is supported by documented evidence and measurable data.
Negligence and underdevelopment: Iran’s healthcare system before the Islamic Revolution
Before the Revolution, Iran’s healthcare system suffered from serious structural weaknesses. Ineffective policymaking, a fragile educational system, and a severe shortage of skilled professionals threatened public health and welfare. The lack of trained specialists and the weaknesses in medical education and treatment were among the most serious problems of the system.
Anthony Parsons, the former British ambassador to Iran, writes in his memoirs about the poor health conditions and shortage of doctors during that period: “At that time (around 1966), Iran had only eleven thousand doctors, while the country needed between forty and fifty thousand.” He adds that at least half of these doctors were concentrated in Tehran because private practice allowed them to earn more money. He also notes that the number of nurses and trained medical staff was low, and that training programs failed to produce meaningful results.
These flawed policies led to the arrival of Pakistani, Indian, and Bangladeshi doctors in Iran’s healthcare sector. Many lacked sufficient clinical training, had not acquired the necessary skills for proper patient care, did not speak Persian, and created serious cultural and communication problems. Iran ranked behind even very poor countries such as Fiji and Jamaica in doctor-to-population ratios, with only three doctors per ten thousand people.
As a result, even in Tehran, healthcare was expensive and unreliable. Medicine and treatment facilities were largely reserved for the wealthy. On July 2, 1977, the newspaper Ettela’at reported that the city of Ardakan, with a population of 70,000, did not even have a single pharmacy. The headline read: “The people of Ardakan must travel 120 kilometers to obtain medicine.”
Conditions in rural areas were far worse. The few health centers that existed lacked equipment and medicine, closed due to harsh weather and blocked roads, and often suspended services for long periods. In most villages and towns, childbirth was handled by traditional midwives who lacked proper training and basic hygienic knowledge. Pregnancy and childbirth were dangerous experiences, and maternal death was a constant risk. In 1976 alone, 255 mothers died during childbirth. Newborn care was also carried out without professional supervision, relying on traditional knowledge and extremely weak health infrastructure, sometimes without access to clean drinking water. In such conditions, infant and child mortality was often seen as an unavoidable reality.
This fragile system became deadly with the spread of infectious diseases. In a historic telegram from the people of Dezful to the prime minister, residents described the epidemic spread of typhoid and typhus in the city and reported that many people had become infected due to the lack of doctors and medicine.
Transformation after the Islamic Revolution
Four decades after the victory of the Islamic Revolution, this dark and dangerous situation has been transformed into one of the most significant achievements of the Islamic Republic. Through policies centered on justice and universal access, Iran’s healthcare system has reached a level where it is now recognized for innovation in treatment, pharmaceutical production, and medical industries.
The integration of medical education into the national healthcare system and the establishment of the Ministry of Health, Treatment, and Medical Education marked a major turning point. Over four decades, the number of medical schools increased from 9 to 68, and the number of physicians per capita grew fivefold compared to the pre-revolutionary period.
The expansion of the national healthcare network ensured more equal access to services. Health houses were established even in the most remote villages. Universal health insurance laws were adopted, and nationwide insurance coverage gradually expanded. Healthcare services became accessible and affordable for the general population.
These changes are reflected in key indicators such as life expectancy, which has reached 74 years, three years higher than the global average. Compared to the pre-revolutionary period, Iran has risen more than 60 ranks in global health indicators.
Women in Iran’s healthcare system and their contributions
Many Western healthcare systems face serious challenges such as male-centered medical models, the marginalization of women’s experiences, and gender bias in treatment. Iran followed a different path through targeted policies, particularly in women’s health.
After the Revolution, women entered medical professions on an unprecedented scale. They were trained as community health workers, midwives, physicians, nurses, and medical educators. Their widespread presence transformed Iran’s public healthcare system. The importance of women in all medical specialties was so significant that in 1989 the Imam Khamenei described it as a religious obligation, and has repeatedly stated this decree ever since:
“In some occupations, such as medicine, the presence of women is wajib kifai [a religious obligation that addresses no specific person and if it is performed by some duty-bound (mukallaf) Muslims, the others will no longer held accountable]. It is wajib [religiously obligatory] to have female doctors, so it is important for women to pursue medical training until there is an adequate number of female physicians.”
Restricting obstetrics and gynecology to female physicians increased women’s access to healthcare and significantly improved the quality of doctor–patient relationships. Women were able to speak openly and comfortably about physical and reproductive health issues, leading to more accurate diagnosis, more effective treatment, and greater trust in the healthcare system. Treatment became more humane and empathetic rather than distant and hierarchical.
Female professors and educators also played a key role in shaping new generations of healthcare workers with a deeper understanding of women’s bodies, pain, and needs, an understanding that is now widely recognized as lacking in many Western healthcare systems.
The presence of female healthcare workers in maternal care, child health, vaccination, family health education, and pregnancy monitoring in rural health networks was decisive. The sharp decline in maternal and infant mortality is directly linked to the increased presence of trained female professionals.
Today in Iran, pregnant women receive free prenatal care. Access to specialists and trained midwives in rural areas has expanded significantly. Infant mortality has improved by 29 global ranks and is now less than half the world average, with 11 deaths per 1,000 births. Programs promoting breastfeeding, proper complementary feeding, child growth monitoring, nutritional support for vulnerable mothers and children, food security initiatives in deprived regions, and near-universal childhood vaccination coverage have all contributed to improving maternal and child health.
All of these transformations were made possible by the Islamic Revolution. As Imam Khamenei stated:
“Revolution instilled a sense of dignity into our nation and our country. They tried to discourage our nation on many occasions. They tried to convince our people that they were incompetent. "Yes, you carried out a revolution, but you cannot run the country by yourselves. You cannot make progress. You cannot keep up with the world." Every scientific advance is a testimony to the competence of our nation.”
Today, Iran has shown that progress without dependency is possible through faith, self-reliance, and trust in the abilities of its youth. In less than five decades, the country has transformed from an importer and consumer into a producer and exporter in multiple sectors of the medical industry. Guided by Islamic principles, Iran has opened a new path for women and introduced a distinct model of healthcare rooted in dignity, independence, and social justice.
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