Abstract
Background Iraq’s healthcare system faces significant challenges, especially in rural areas. Access to health care is limited, infrastructure is underdeveloped, and vulnerable populations face significant barriers to accessing essential services. Strengthening primary healthcare (PHC) is vital for achieving universal health coverage (UHC).
Aim This paper analyses Iraq’s health system using the World Health Organization’s Health System Building Blocks Framework and proposes prioritising PHC to enable equitable access to care.
Method A situational analysis was conducted using the WHO Health System Building Blocks Framework. The analysis examined service delivery, health workforce, financing, and leadership and governance. Data from the Iraqi Ministry of Health and international reports were used to identify system gaps and compare successful PHC-focused health systems in countries like Costa Rica, Jordan, and Thailand.
Results The analysis found that Iraq has a severe shortage of healthcare professionals, with only 10 healthcare workers per 10 000 people, significantly lower than the WHO recommendation of 25 per 10 000. Rural regions are disproportionately affected, with fewer facilities and healthcare staff. Out-of-pocket healthcare costs account for 48–81% of total health expenditure. Only 12% of Iraqis are covered by private health insurance, leaving the majority vulnerable to financial hardship. PHC facilities lack essential medicines and medical equipment, and maternal mortality remains high at 65 per 100 000 live births.
Conclusion To achieve UHC, Iraq must prioritise investments in PHC infrastructure, increase the number of healthcare workers, and ensure equitable access to care across all regions. Successful international models highlight that PHC can meet 80–90% of healthcare needs.
