en Health System Health System Debate Article Debate Article Over the last 4 decades, many initiatives have been implemented to accomplish equitable accessible health care for all Iranian citizens. The latest reform to address universal health coverage (UHC) is Health Transformation Plan (HTP), which resulted in significant improvements in health outcomes. Nevertheless, several challenges in the fields of sustainability of resources, service delivery, and health governance continued to exist. These challenges should be addressed in next steps to achieve the defined goals. To tackle these challenges, a number of practical solutions can be proposed, including making health financing more resilient, defining and implementing cost control policies and cost-effective package of services, changing the current method of providers’ payment, and ensuring good governance in the health system. Heath Care Reform, National Health Programs, Health Policy, Iran 46 51 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-2445-2&slc_lang=en&sid=1 Haniye Sadat Sajadi hsajjadi@tums.ac.ir 200319475328460062883 200319475328460062883 No National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran Elham Ehsani-Chimeh ehsanielham@yahoo.com 200319475328460062884 200319475328460062884 No National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran Reza Majdzadeh rezamajd@tums.ac.ir 200319475328460062885 200319475328460062885 Yes Knowledge Utilization Research Center, Community Based Participatory Research Center and School of Public Health, Tehran University of Medical Sciences, Tehran, Iran