Letter to the editor
Mohammad Ali Jalilvand1, Behrooz Madahian1 and Zahra Afshar Hosseinabadi2
1Student Research Committee, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran. 2Organizational Development and Administrative Transformation Department, Kerman University of Medical Sciences, Kerman, Islamic Republic of Iran (Correspondence to Zahra Hosseinabadi:
Keywords: refugee, migrant health, Afghanistan, Iran
Citation: Jalilvand MA, Madahian B, Hosseinabadi ZA. Addressing refugee health challenges in Islamic Republic of Iran. East Mediterr Health J. 2025;31(8):523. https://doi.org/10.26719/2025.31.8.523.
Received: 18/03/2025; Accepted: 15/05/2025
Copyright © Authors 2025; Licensee: World Health Organization. EMHJ is an open-access journal. This paper is available under the Creative Commons Attribution Non-Commercial ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo).
Dear Editor,
Healthcare is recognized as a human right and everyone, regardless of their residency status, should have access to it. Refugees are people who have fled their countries to escape conflict, violence or persecution and have sought safety in another country (1). Following the 2021 instability in Afghanistan, Islamic Republic of Iran became host to the world’s largest refugee population, with an estimated 3.8 million Afghan refugees (2). Immigrant populations, especially refugees, have various health needs, which are often not met due to certain challenges.
Although Islamic Republic of Iran ratified the 1951 Geneva Convention and 1967 Protocol regarding social rights that apply to refugees (3), there are no clear regulations regarding their access to health and medical services. In some cases, non-Iranians face certain restrictions, which delay or limit access to health services. For example, the fourth development plan limits access to health insurance for illegal immigrants, and 80% of Afghan refugees in Islamic Republic of Iran do not have residence permit, therefore, creating a barrier to health service access (2,4).
In Islamic Republic of Iran, primary health care is available to refugees, however, non-communicable and chronic disease and mental illness services are not available to them. This is probably due to insufficient financial and human resources and the lack of a comprehensive plan for migrant health (5). Refugees are therefore largely exposed to malnutrition due to poverty.
Afghan refugees mostly live in densely populated shelters at the outskirts of large cities. Although the Iranian Ministry of Health has tried to provide health facilities in these refugee shelters, there are still problems with accessing health services (2).
International sanctions and financial crisis have contributed to the poor economic situation in Islamic Republic of Iran. This situation severely affects the provision of health care services to Iranians and the refugees alike. The United Nations estimates that 75% of the financial needs of refugees are unmet (2). Despite the large number of refugees, the Iranian health system as well as aid and refugee organizations such as the United Nations High Commissioner for Refugees have not yet developed a comprehensive plan for supporting the health of refugees in Islamic Republic of Iran.
Considering the foregoing, we recommended a comprehensive national-level research on the use of health services by refugees and immigrants in Islamic Republic of Iran, to better understand their health needs and be able to develop an appropriate plan at the national level to cater to the needs.
References
- UNHCR. Who we protect? Refugees. Geneva:UNHCR, 2025. https://www.unhcr.org/about-unhcr/who-we-protect.
- UNHCR. Factsheet about Iran refugees. Geneva:UNHCR, 2024. https://reliefweb.int/attachments/67bd68a8-cf2a-456d-a401-63c7baba1441/UNHCR%20quarterly%20factsheet%20IRAN-January-September-2024.pdf.
- UNHCR. United Nations in Iran. Tehran: UNHCR, 2020. https://iran.un.org/sites/default/files/2020-06/6201_unhcr_iran_factsheet_english.pdf.
- Islamic Consultative Assembly. Fourth five-year economic development plan. Tehran: Islamic Consultative Assembly. 2004. https://rc.majlis.ir/fa/law/show/94202 ]in persian[.
- Bakhtiari A, Takian A, Olyaeemanesh A, Behzadifar M, Takbiri A, Sazgarnejad S, et al. Health system response to refugees' and migrants' health in Iran: A strengths, weaknesses, opportunities, and threats analysis and policy recommendations. Int J Public Health 2023;68:1606268 https://pmc.ncbi.nlm.nih.gov/articles/PMC10568312/.
