Corruption in the physiotherapy sector in Iran: common drivers and potential combating strategies

Background: Globally, there is an unprecedented demand for physical rehabilitation services due to, among others, an increase in non-communicable diseases, and the ageing of the population. Iran is no exception and epidemiological trends suggest that population needs for physiotherapy services will rise significantly. However, inadequate insurance coverage, weak stewardship, the predominant role of the private sector in service delivery, and inappropriate supervision have created a favourable environment for corrupt practices in the Iranian physiotherapy sector. Objectives: To identify drivers of corruption and potential combating strategies for the physiotherapy sector from the perspective of key stakeholders: physiotherapists, academics, and health policymakers. Methods: In-depth semi-structured interviews were performed to explore physiotherapists', academics', and health policymakers' perceptions about corruption in Iranian physiotherapy sector. The individuals were recruited using purposive and snowball sampling. Thematic content analysis was used to analyse transcripts and identify relevant themes. Results: On the whole, 22 individuals (5 physiotherapists, 8 academics, and 9 health policymakers) agreed to take part in the interviews. Several drivers and determinants of corruption in the physiotherapy sector as well as potential combating strategies were identified across five categories: (1) government regulator function, (2) payer function, (3) providers function, (4) suppliers function, and (5) patients function. Conclusions: Corruption represents a real threat in the physiotherapy sector in Iran impeding accessibility and utilisation of rehabilitation services and therefore is a serious barrier to the achievement of Sustainable Developments Goals. Development and adoption of effective anti-corruption strategies are therefore necessary.