Iran Behvarz Program

An Iranian rural health care program built around large numbers of community-based paraprofessionals known as behvarz, drawn from the communities they serve and based in roughly 14,000 health houses spread across the country. Behvarz workers deliver preventive care directly into rural households, providing childhood vaccinations, monitoring child growth and development, and offering family planning counseling and methods as a routine part of their work. Between 1984 and 2000 the program was associated with dramatic improvements in Iran's maternal and child health outcomes: infant mortality was cut in half over the period, childhood immunization rates rose from about 20 percent to 95 percent, maternal mortality fell from 140 to 37 deaths per 100,000 live births between 1985 and 1996, and the share of rural women using contraception reached 67 percent by 2000, changes that positioned Iran's community health worker network as one of the more consequential rural primary health care models in the region.