Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 45 11 2016 12 21 1399 1410 Gholamhossein SALEHI ZALANI Center for Health Human Resources Research & Studies, Ministry of Health and Medical Education, Tehran, Iran Mahboubeh BAYAT Dept. of Health Management and Economics, School of Public Health, International Campus, Tehran University of Medical Sciences, Tehran, Iran Azad SHOKRI Health Services Management of Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran S. Elmira MIRBAHAEDDIN Center for Human Resources Research & Studies, Ministry of Health and Medical Education, Tehran, Iran Vahid RASI Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran Samira ALIREZAEI Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran Fatemeh MANAFI Dept. of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2016 11 26 2016 11 26 Background: This study aimed to use a mixed-method approach to investigate affecting factors on the performance of Community Health Workers (CHW) in Iran’s villages. Methods: This study was conducted during 2014-2015 with a mixed method in three phases of literature review, Delphi technique and developing a rich picture. Overall, in order to finalize the affecting factors and their relationships between qualitative content analysis, Delphi technique, AHP technique and Focus Group Discussion were used, respectively. Results: Affecting factors on CHW performance were divided into four main categories, 10 sub-themes and 35 contents. Increase in the level of people’s awareness, disease patterns, demographic structure and lifestyle were placed in four priorities respectively on the basis of importance. Conclusion: To the most extent CHW cannot face current needs of rural communities. It challenges equitable access to healthcare services and also conflicts with the primary philosophy of CHW presence in rural areas. CHW can be used in two forms; either as an assistant to rural family physicians or with the same previous functions.     https://ijph.tums.ac.ir/index.php/ijph/article/view/8341 https://ijph.tums.ac.ir/index.php/ijph/article/download/8341/5350