Introduction: The Urban Family Physician Program (UFPP) in Iran was designed to strengthen primary healthcare, improve equitable access, and reduce unnecessary referrals. However, its implementation (particularly in small cities like Arsanjan) faces multidimensional challenges. This study aimed to identify and analyze the barriers to implementing the UFPP from the perspective of frontline healthcare providers in Arsanjan.
Methods: A qualitative study using thematic analysis was conducted in 2024–2025. Semi-structured interviews were carried out with nine participants (five family physicians and four health monitors) selected through purposive sampling. Data collection continued until theoretical saturation was reached. Interviews were transcribed verbatim and analyzed with MAXQDA software (version 10) and using Braun and Clarke’s (2006) thematic analysis framework, with validation by two independent researchers.
Results: Analysis revealed five main themes: (1) Inadequate continuing education, including irrelevant, non-practical, and poorly advertised training sessions; (2) Insufficient infrastructure, such as inefficient health information systems and inappropriate physical facilities; (3) Financial barriers, including delayed payments, opaque deductions, and significant salary disparities between public and private sectors; (4) Ineffective population-based policies, notably the unrealistic assignment of 3,500 individuals per service unit and the absence of maternity leave for private-sector female physicians; and (5) Human resource challenges, including staff shortages, low motivation and poorly defined roles.
Conclusion: Effective implementation of the UFPP in Arsanjan requires systemic reforms across educational, financial, infrastructural, human resource, and population-policy domains. Without addressing these interrelated barriers, the program risks remaining a superficial intervention with limited real-world impact.