Aghapour Baharak, Kheirouri Sorayya, Alizadeh Mohammad, Khodayari-Zarnaq Rahim
Department of Community Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Nutrition, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
Front Nutr. 2023 Aug 23;10:1249402. doi: 10.3389/fnut.2023.1249402. eCollection 2023.
Iran has a higher prevalence of vitamin D deficiency (VDD) than the global level. This study aimed to assess VDD prevention policies in Iran through a policy analysis of agenda setting using the multiple streams framework (MSF).
Using Kingdon's MSF model, this qualitative analytical study performed a policy analysis on vitamin D-related policies in Iran. The policy documents were reviewed, and in-depth interviews were conducted with stakeholders ( = 27) using the framework analysis method. To categorize data and extract the related themes, MAXQDA version 10 was used.
According to Kingdon's MSF theory, the problem stream included the high prevalence of VDD among Iranian infants (23.3%), adolescents (76%), and adults (59.1%). The policy stream was identified to focus on preventing programs for non-communicable diseases in the health sector. The political stream indicated that national and international support could provide a political climate for this issue.
According to our results, a window of opportunity for policymaking on VDD prevention has opened. However, there are some challenges related to the implementation of these policies. These include the dominance of a treatment-based view rather than a prevention-based approach in the health sector, economic problems, and restricted access to health services due to the outbreak of coronavirus disease 2019 (COVID-19). To strengthen and implement VDD prevention policies, the stakeholders need support from high-level policymakers.
伊朗维生素D缺乏症（VDD）的患病率高于全球水平。本研究旨在通过使用多源流框架（MSF）对议程设置进行政策分析，评估伊朗的VDD预防政策。
本定性分析研究采用金登的MSF模型，对伊朗与维生素D相关的政策进行政策分析。对政策文件进行了审查，并使用框架分析法对利益相关者（n = 27）进行了深入访谈。为了对数据进行分类并提取相关主题，使用了MAXQDA 10版本。
根据金登的MSF理论，问题流包括伊朗婴儿（23.3%）、青少年（76%）和成年人（59.1%）中VDD的高患病率。政策流被确定为侧重于卫生部门的非传染性疾病预防项目。政治流表明，国家和国际支持可以为这个问题提供政治氛围。
根据我们的结果，VDD预防政策制定的机会之窗已经打开。然而，这些政策的实施存在一些挑战。这些挑战包括卫生部门中基于治疗的观点而非基于预防的方法占主导地位、经济问题以及由于2019年冠状病毒病（COVID-19）爆发导致获得卫生服务的机会受限。为了加强和实施VDD预防政策，利益相关者需要高层政策制定者的支持。
