Drivers, uncertainties, and future scenarios of the Iranian health system
Abstract Background Health promotion is an essential dimension of sustainable development in any country. It has a high degree of complexity, with numerous components interacting both inside and outside of the system, so having a systemic and forward-looking approach is essential to planning for the...
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | BMC Health Services Research |
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| Online Access: | https://doi.org/10.1186/s12913-022-08774-w |
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| author | Mozhgan Emami Ali Akbar Haghdoost Vahid Yazdi-Feyzabadi Mohammad Hossein Mehrolhassani |
| author_facet | Mozhgan Emami Ali Akbar Haghdoost Vahid Yazdi-Feyzabadi Mohammad Hossein Mehrolhassani |
| author_sort | Mozhgan Emami |
| collection | DOAJ |
| description | Abstract Background Health promotion is an essential dimension of sustainable development in any country. It has a high degree of complexity, with numerous components interacting both inside and outside of the system, so having a systemic and forward-looking approach is essential to planning for the future. Methods The research has been designed based on scenario-based planning in three main stages. The data gathering was qualitative by working group meetings and compiling an importance-uncertainty questionnaire to complete the cross-impact analysis matrix. The MicMac and scenario Wizard has been used for data analysis. Results The scoping review and upstream document evaluation lead to 54 key variables for analyzing the Iranian health system (HS). The MicMac analysis ends by determining seven key variables: power, politics, and communication network; lifestyle and behavioral factors; quality of human resources training and education; environmental and occupational risk factors, payment and tariff system, and allocation pattern; support society / individuals health; and services effectiveness, especially para-clinical and outpatient ones. Finally, six main scenario spaces are depicted using Scenario Wizard. collective equity was the priority of the HS vision in the desirable scenario, consisting of the most favorable state of the uncertainties. The second, third, and fourth scenarios are also considered desirable. In the disaster scenario, which is the most pessimistic type of consistent scenario in this study, health and equity are not significant either in the social or individual dimensions. In the sixth scenario, the individual dimension of health and equity is the most critical perspective of the HS. Conclusions Due to the unsustainability and high complexity of the Iran’s HS, the development and excellence of the HS governance based on the Iran context and health advocacy improvement (applying good governance); creating sustainable financial resources and rational consumption; and human resources training and education are three main principles leading the HS to the images of the desired scenarios. |
| first_indexed | 2024-04-13T08:09:49Z |
| format | Article |
| id | doaj.art-043e31ab45364a50a80121c1ec92153b |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-13T08:09:49Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-043e31ab45364a50a80121c1ec92153b2022-12-22T02:55:01ZengBMCBMC Health Services Research1472-69632022-11-0122111510.1186/s12913-022-08774-wDrivers, uncertainties, and future scenarios of the Iranian health systemMozhgan Emami0Ali Akbar Haghdoost1Vahid Yazdi-Feyzabadi2Mohammad Hossein Mehrolhassani3PhD by Research Student in Management Sciences (Health Policy), Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical SciencesEpidemiology, Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical SciencesHealth Policy, Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical SciencesDepartment of Health Management, Policy and Economics, Faculty of Management and Medical Information Sciences, Kerman University of Medical SciencesAbstract Background Health promotion is an essential dimension of sustainable development in any country. It has a high degree of complexity, with numerous components interacting both inside and outside of the system, so having a systemic and forward-looking approach is essential to planning for the future. Methods The research has been designed based on scenario-based planning in three main stages. The data gathering was qualitative by working group meetings and compiling an importance-uncertainty questionnaire to complete the cross-impact analysis matrix. The MicMac and scenario Wizard has been used for data analysis. Results The scoping review and upstream document evaluation lead to 54 key variables for analyzing the Iranian health system (HS). The MicMac analysis ends by determining seven key variables: power, politics, and communication network; lifestyle and behavioral factors; quality of human resources training and education; environmental and occupational risk factors, payment and tariff system, and allocation pattern; support society / individuals health; and services effectiveness, especially para-clinical and outpatient ones. Finally, six main scenario spaces are depicted using Scenario Wizard. collective equity was the priority of the HS vision in the desirable scenario, consisting of the most favorable state of the uncertainties. The second, third, and fourth scenarios are also considered desirable. In the disaster scenario, which is the most pessimistic type of consistent scenario in this study, health and equity are not significant either in the social or individual dimensions. In the sixth scenario, the individual dimension of health and equity is the most critical perspective of the HS. Conclusions Due to the unsustainability and high complexity of the Iran’s HS, the development and excellence of the HS governance based on the Iran context and health advocacy improvement (applying good governance); creating sustainable financial resources and rational consumption; and human resources training and education are three main principles leading the HS to the images of the desired scenarios.https://doi.org/10.1186/s12913-022-08774-wHealth systemSystems analysisUncertaintyDriversScenario planning |
| spellingShingle | Mozhgan Emami Ali Akbar Haghdoost Vahid Yazdi-Feyzabadi Mohammad Hossein Mehrolhassani Drivers, uncertainties, and future scenarios of the Iranian health system BMC Health Services Research Health system Systems analysis Uncertainty Drivers Scenario planning |
| title | Drivers, uncertainties, and future scenarios of the Iranian health system |
| title_full | Drivers, uncertainties, and future scenarios of the Iranian health system |
| title_fullStr | Drivers, uncertainties, and future scenarios of the Iranian health system |
| title_full_unstemmed | Drivers, uncertainties, and future scenarios of the Iranian health system |
| title_short | Drivers, uncertainties, and future scenarios of the Iranian health system |
| title_sort | drivers uncertainties and future scenarios of the iranian health system |
| topic | Health system Systems analysis Uncertainty Drivers Scenario planning |
| url | https://doi.org/10.1186/s12913-022-08774-w |
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