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Objective(s): Improving the non-medical performance of health systems is an integral part of increasing people's well-being, which is the general and ultimate mission of the health systems. Responsiveness is a response to the reasonable expectations of people about non-clinical aspects of the health system. This study aimed to evaluate the responsiveness of health system in Iran. Methods: Electronic databases including Scientific Information Database (SID), Magiran, PubMed, Scopus, Science Direct, Web of Science and Google Scholar were searched to retrieve relevant papers that have been published during 2000 to May 2023 using the keywords of health system, responsiveness and Iran. After a detailed review of related studies, finally 26 papers were included in the meta-analysis. Data were analyzed using Stata software and significance level of the tests was considered P˂0.05. Results: The overall responsiveness rate in Iran after combining the results of the selected studies was 0.65. Dimensions of human dignity and social support had the highest responsiveness score (0.68, and 0.67, respectively). Also, the right to choose with 0.51 and autonomy with 0.55 had the least responsiveness score. Additionally, social security and private hospitals had shown the highest level of responsiveness (0.74 and 0.71, respectively). Responsiveness in the studies conducted before the implementation of the health transformation plan (HTP) was evaluated as 0.66 and it was 0.62 after the HTP. Conclusion: The results of this study showed that Iran's health system has moderate responsiveness to the non-clinical needs of society. Considering the importance of responsiveness and its impact on the quality of life, improving the responsiveness of the country's health system is essential through effective planning and interventions.

Objective (s): health transformational plan was executed as one the most important plans by the ministry of health and medical education in order to reduce admission fees. In order to evaluate the effectiveness of this plan, this study was conducted with the goal of determining the health expenditures by households after implementation of this new plan. Methods: This cross-sectional study was conducted in Zahedan, Iran in year 2015 and 2016. The study conducted on 816 families including both rural and urban households. They were selected randomly by clustering method. Data were collected by in-person interviews using the World Health Survey. The Data were analyzed using descriptive and inferential statistics. Results: In 93.1% of instances the head of household were men (n = 760) and 78 families did not have any health insurance. After implementation of health transformational plan, 12.99 percent of families were still faced with catastrophic health expenditures. However, the rural families were facing more catastrophic expenditures compared to families living in urban areas. This catastrophic expenditures have a meaningful relation with many variables including dental care (OR: 4.99), drug fees (OR: 2.927), physiotherapy (OR: 2.927), outpatient expenditures (OR: 96. 639), having a family member who needs to be taken care of at home (OR: 3.186), and a family member who needs to be taken care of at a hospital (OR: 1.866). Conclusion: The results showed that a relatively large proportion of people in families in Zahedan still are facing catastrophic health related expenditures and health transformational plan has not been able to reach its goals in this city.