Asadi Louyeh Ataollah, Takian Amirhossein, Ahmadi Batoul, Arab Mohammad, Davoudi Kiakalayeh Ali
Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Department of Health Policy, Management & Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2025 May 12;39:66. doi: 10.47176/mjiri.39.66. eCollection 2025.
The social approach to health (TSATH) is necessary for maintaining and promoting health status in societies toward achieving sustainable development goals (SDGs). Despite various attempts, the health sector in Iran is behind in the meaningful implementation of TSATH. This study analyzed the policy of TSATH in Iran.
This was a qualitative study. The participants in the research included 36 experts and senior managers of health-related organizations in Iran who were selected using a targeted and snowball method. We used 3 methods for data collection: in-depth interviews, focus group discussions, and document review. Inspired by Walt & Gilson's policy triangle and stage heuristic framework, we conducted a thematic analysis and used MAXQDA software Version 19 for data management.
TSATH was an immediate political decision in Iran. We found insufficient social participation and intersectoral collaboration, conflict of interest, inadequate evidence-based policy-making as well as necessary resources among the most important barriers to implementing the policy of TSATH.
Institutionalizing TSATH requires long-term, evidence-based planning and effective participation of all stakeholders. Providing the necessary resources and infrastructure, appropriate context and good steering, accountability, and creating a sustainable livelihood program, especially for the lowest-income deciles of society, are key measures to improve TSATH.
社会健康方法(TSATH)对于社会维持和促进健康状况以实现可持续发展目标(SDGs)而言是必要的。尽管做出了各种尝试,但伊朗的卫生部门在切实实施TSATH方面仍滞后。本研究分析了伊朗的TSATH政策。
这是一项定性研究。研究参与者包括伊朗卫生相关组织的36名专家和高级管理人员,他们采用目标性和滚雪球式方法选取。我们使用了三种数据收集方法:深入访谈、焦点小组讨论和文件审查。受沃尔特和吉尔森的政策三角及阶段启发式框架的启发,我们进行了主题分析,并使用MAXQDA 19版软件进行数据管理。
TSATH在伊朗是一项即时性政治决策。我们发现社会参与和部门间协作不足、利益冲突、循证决策不充分以及必要资源匮乏是实施TSATH政策的最重要障碍。
将TSATH制度化需要进行长期、循证规划,并让所有利益相关者有效参与。提供必要资源和基础设施、营造适当环境并进行良好指导、问责,以及制定可持续生计计划,尤其是针对社会最低收入十分位数人群的计划,是改善TSATH的关键措施。