title: Structural and contextual dimensions of Iranian primary health care system at local level.
abstract: BACKGROUND
  In recent years, family physician plan was established as the main strategy of health system in Iran, while organizational structure of the primary health care system has remained the same as thirty years ago.
  
  
  OBJECTIVE
  This study was performed to illustrate structural and contextual dimensions of organizational structure and relationship between them in Iranian primary health care system at local level.
  
  
  METHODS
  A cross-sectional quantitative study was conducted from January to June 2013, during which 121 questionnaires were distributed among senior and junior managers of city health centers at Medical Sciences universities in Iran. Validity of the questionnaire was confirmed by experts (CVI = 0.089 and CVR more than 0.85) and Cronbach α was utilized for reliability (α = 0.904). We used multistage sampling method in this study and analysis of the data was performed by SPSS software using different tests.
  
  
  RESULTS
  Local level of primary health care system in Iran had mechanical structure, but in contextual dimensions the results showed different types. There was a significant relationship between structural and contextual dimensions (r = 0.642, P value < 0.001). Goals and culture dimensions had strongest effects on structural dimensions.
  
  
  CONCLUSIONS
  Because of the changes in goals and strategies of Iranian health system in recent years, it is urgently recommended to reform the current structure to increase efficiency and effectiveness of the system.
authors.affiliation: International Campus, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Zanganeh Baygi
authors.affiliation: International Campus, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Hesam
authors.initials: H
authors.lastname: Seyedin
authors.affiliation: Department of Biostatistics, Faculty of Public Health, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Salehi
authors.affiliation: Health Management and Economics Research Centre, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Jafari Sirizi
keywords: Health Services Administration; Iran; Organizational Culture; Organizational Structure; Primary Health Care