Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Health Res Policy Syst. 2019 Jul 19;17(1):69. doi: 10.1186/s12961-019-0466-6.
A huge number of people living with HIV/AIDS lives in developing countries. Thus, strengthening health systems in these countries is a prerequisite for improving disease prevention and care. After three decades of HIV/AIDS policy-making in Iran, conducting a comprehensive analysis on the policy process seems to be essential. In the present study, we aimed to analyse the HIV/AIDS policy-making process in Iran from 1986 to 2016.
This was a theory-based, multi-method and retrospective study. Interviewing of key informants and review of policy documents were concurrently conducted to identify and include further key informants (39 participants) and documents in the study. Framework analysis was used to analyse data.
The mean age of participants working in HIV/AIDS policy-making was of 48 years and participants had a mean of 14 years of working experience. Findings were categorized as contextual factors, content of HIV/AIDS policies, actors involved in the policy process, and evidence use in the policy process. Contextual effective factors on the HIV/AIDS policy-making process were categorized into five major themes, namely situational factors, structural-managerial factors, socioeconomic factors, political and legal factors, and international factors. The HIV/AIDS phenomenon in Iran was identified to be deeply rooted in the culture and traditions of society. The HIV/AIDS policy content has, recently, been crystallized in the national strategic plans and harm reduction policies of the country. The policy process has been conducted with a solely governmental top-down approach and is now suffering from poor evidence and lack of sufficient consideration of contextual factors.
There is a great need for change in the approach of government towards the issue and to increase the participation of non-governmental sectors and civil society in the policy process.
大量艾滋病毒/艾滋病感染者生活在发展中国家。因此，加强这些国家的卫生系统是改善疾病预防和护理的前提。在伊朗制定艾滋病毒/艾滋病政策三十年后，对政策过程进行全面分析似乎是必要的。在本研究中，我们旨在分析 1986 年至 2016 年期间伊朗的艾滋病毒/艾滋病政策制定过程。
这是一项基于理论、多方法和回顾性的研究。同时进行了关键知情人访谈和政策文件审查，以确定和纳入研究中的进一步关键知情人（39 名参与者）和文件。使用框架分析来分析数据。
参与艾滋病毒/艾滋病政策制定的参与者的平均年龄为 48 岁，平均工作经验为 14 年。研究结果分为背景因素、艾滋病毒/艾滋病政策的内容、政策过程中涉及的行为体以及政策过程中的证据使用。艾滋病毒/艾滋病政策制定过程中的背景有效因素分为五个主要主题，即情境因素、结构-管理因素、社会经济因素、政治和法律因素以及国际因素。伊朗的艾滋病毒/艾滋病现象被认为深深植根于社会的文化和传统之中。艾滋病毒/艾滋病政策的内容最近已经在国家战略计划和该国的减少伤害政策中得到体现。该政策过程一直采用纯粹的政府自上而下的方法，现在面临证据不足和对背景因素缺乏充分考虑的问题。
政府在处理这一问题的方法上需要进行重大变革，增加非政府部门和民间社会在政策过程中的参与。
