Structural Analysis of Health Policy Management and Implementation in Iran: Presenting an Applied Model of Health Development within the Seventh Development Plan
Keywords:
Health system, primary health care, Seventh Development Plan, Health policy, ustice in healthAbstract
This study aimed to structurally analyze the implementation of health policies in Iran and propose a comprehensive, practical model for health development within the framework of the Seventh Development Plan. This applied research employed a descriptive-survey design. The study population consisted of 225 managers and experts involved in implementing the National Health Care Policy Document, selected through purposive sampling. Data were collected using a researcher-made questionnaire validated for content and construct validity and confirmed reliability (Cronbach’s alpha = 0.91). Statistical analysis was performed using SPSS and LISREL, including the Kolmogorov–Smirnov test and structural equation modeling (SEM). Data analysis led to the identification and validation of four core dimensions in implementing the National Health Care Policy Document: (1) development and implementation of clinical guidelines and standardization of services, (2) establishment of the family physician program and referral system, (3) recording health data in the Iranian Electronic Health Record (EHR) system, and (4) launching the Health Rules Database. SEM results indicated excellent model fit, with standardized factor loadings ranging from 0.62 to 0.79, confirming the model’s structural validity and robustness. The proposed model provides an integrated, data-driven, and justice-oriented framework for advancing health policy implementation in Iran. By fostering intersectoral coordination, strengthening digital health infrastructure, and aligning with the Seventh Development Plan, this model can improve service efficiency, reduce unnecessary costs, and promote equitable access to healthcare, paving the way for a transformative shift in Iran’s health system.
Downloads
References
Abdollah Taba, H., Sajadi, H., Sam Aram, E., & Taj Mazinani, A. A. (2021). The Institutional Context of the Health System and Its Transformations in Iran. Social Welfare, 21(81), 87-127. http://refahj.uswr.ac.ir/browse.php?a_id=3792&slc_lang=en&sid=1&ftxt=1&html=1
Aboulhasani, M. S., Ziaoddini, M., & Nikbakhsh, M. A. (2023). Identification and Prioritization of Factors Leading to the Failure of Health System Policy Implementation Using Failure Mode and Effects Analysis and Analytic Hierarchy Process. Quarterly Journal of Management Strategies in Health System, 8(3), 114-131. https://doi.org/10.18502/mshsj.v8i3.14464
Aghaei, G., Danesh Fard, K., & Memarzadeh, G. (2023). Pathology of the Implementation System of Social Welfare Policies in Iran. Social Welfare, 23(89), 383-339. https://doi.org/10.32598/refahj.23.89.4029.1
Amir Ahmadi, R., Naeimi, M. R., & Eshraghi, H. R. (2020). A Sociological Explanation of the Participatory Actions of Benefactors in the Health System. Social Welfare, 20(79), 335-368. http://refahj.uswr.ac.ir/browse.php?a_id=3656&sid=1&slc_lang=en&ftxt=0
Azimi, M. (2020). Design and Validation of a Curriculum Model for Health Education and Promotion in Primary School Based on the Assumptions of the Health System. Quarterly Journal of Curriculum Studies in Iran, 15(59), 31-62. https://www.jcsicsa.ir/article_127109.html
Bian, s., Nduneseokwu, c. K., li, C., & Harder, M. K. (2021). Drift in policy implementation: Incentives thwarted in a recycling programmer. Waste Management & Research, 00, 1-10. https://journals.sagepub.com/doi/abs/10.1177/0734242X211025193
Clark, B. Y., Zingale, N., Logan, J., & Brudney, J. (2019). A framework for using crowdsourcing in government. In Social Entrepreneurship: Concepts, Methodologies, Tools, and Applications (pp. 405-425). https://www.igi-global.com/chapter/a-framework-for-using-crowdsourcing-in-government/224763
Ebrahimi, S. A., Farhadi Nejad, M., & Bakihashemi, S. M. M. (2020). Policy Analysis in the Health System Based on the Advocacy Coalition Framework: A Case Study of the Health System Transformation Plan. Strategic Studies, 23(2), 95-112. https://quarterly.risstudies.org/article_114581.html
Klenk, T. (2025). Towards Digital Era Governance? Examining Health Policy Through the Lens of Public Administration / Digital Era Governance in Der Gesundheitspolitik? Eine Analyse Von Gesundheitsreformen Aus Verwaltungswissenschaftlicher Perspektive. Der Moderne Staat – Zeitschrift Für Public Policy Recht Und Management, 17(2-2024), 263-282. https://doi.org/10.3224/dms.v17i2.05
Klijn, E. H., & Koppenjan, J. (2016). Governance networks in the public sector. Public Administration, 40(4), 587-606. https://doi.org/10.1332/030557312X655431
Koosha, M., Hezarjaribi, J., Allameh, H., Panahi, M. A., & Lalegani, A. (2025). Designing a Policy Model for Enhancing Social Health of the Elderly. Archives of Gerontology and Geriatrics Plus, 2(2), 1-10. https://doi.org/10.1016/j.aggp.2025.100149
Moradi Barliyan, M., & Tangestani, M. Q. (2023). Legal Requirements for the Effective Implementation of Development Program Laws in Iran: A Case Study of the Sixth Development Plan (Lessons for the Seventh Development Plan). Parliament and Strategy, 30(115), 59-90. https://nashr.majles.ir/m/article_588.html?lang=fa
Namusisi, N. (2024). Pharmacological and Lifestyle Interventions for Managing Osteoarthritis Pain in Elderly Patients. Journal of Scientific Research, 9(3), 33-37. https://doi.org/10.59298/IDOSRJSR/2024/9.3.333700
Nasiri, A. K., Abdollahi, B., Jafari Nia, S., & Kheirandish, M. (2021). Developing a Framework for Implementing Citizens' Rights Based on Public Policy Making in Iranian Government Organizations. Parliament and Strategy, 28(107), 359-386. https://nashr.majles.ir/article_472.html
Nasrollahi Azar, Y., Hatami, A., & Shahramnia, A. M. (2018). Institutionalism and Development: Challenges of the New Institutional Economics in Theoretical and Policy Domains Regarding Development Creation (A Critical Assessment). International Political Economy Studies, 1(1), 1-26. https://ipes.razi.ac.ir/article_1182.html?lang=fa
Noorzadeh, R., Fathi Vajar Gah, K., & Kizouri, A. H. (2010). Content Analysis of Superior and Specific Documents to Infer Policies of the Fifth Development Programs in Higher Education, Research, and Technology. Quarterly Journal of Research and Planning in Higher Education, 15(3), 29-50. https://www.sid.ir/paper/67907/fa
Nunez, C. V. (2025). Pandemic Times and Health Care Exclusion: Attitudes Toward Health Care Exclusion of Undocumented Immigrants. Journal of Health Politics Policy and Law, 50(1), 1-21. https://doi.org/10.1215/03616878-11513062
Parker, S., Schulmann, K., Bruen, C., & Burke, S. (2025). Health system reform in the context of COVID-19: a policy brief outlining lessons from Ireland's journey towards the goal of universal healthcare. Global Health Research and Policy, 10(1), 1-7. https://doi.org/10.1186/s41256-025-00407-z
Sadiq, A. R., Hakim, A., Haryono, B. S., & Hanafi, I. (2024). Policy Implementation Model of National Health Insurance Through Social Health Insurance Institution (BPJS) in Indonesia. Journal of Law and Sustainable Development, 12(1), e2448. https://doi.org/10.55908/sdgs.v12i1.2448
Safari, M. S., Bani Asad, R., Takian, A. H., & Azadi Ahmad Abadi, M. (2022). Evaluation of Primary Health Care Strategies in the Islamic Republic of Iran's Health System: A Study Based on Strategic Control. Strategic Management Thought, 16(3), 79-128. https://smt.isu.ac.ir/article_76568.html
Saif, A. M. (2021). The Necessity of Reform in the Development Planning System: On the Occasion of the Seventh Development Plan. https://amseif.ir/?p=11139
Sharifnia, M. M., Mirsepassi, N., & Faghihi, A. (2022). Pathology of the Formulation and Implementation of Monetary Resource Policies and Their Allocation in the Country's Banking System. Public Management Research, 15(60), 33-65. https://jmr.usb.ac.ir/article_7408.html
Smith, R. A., Girth, A. M., & Hutzel, M. (2021). Assessing organizational role and perceptions of programmatic success in policy implementation. Administration & society, 00, 1-35. https://doi.org/10.1177/00953997211011624
Soleimani, H., Sharif Zadeh, F., Hossein Pour, D., & Seyed Naqvi, M. A. (2022). The Governance Model of Iran's Health System from a Network Perspective (Based on Grounded Theory). Journal of Neyshabur University of Medical Sciences, 10(2), 86-102. https://www.sid.ir/paper/1393673/fa
Williams, D. S., Balaban, S., Ilhan, A., & Paker, H. (2022). A policy content analysis for evaluating urban adaptation justice in İstanbul. Environmental Science & Policy, 136, 476-485. https://doi.org/10.1016/j.envsci.2022.07.014
Downloads
Published
Submitted
Revised
Accepted
Issue
Section
License
Copyright (c) 2025 حسین محمودی (نویسنده); غلامرضا رحیمی; عباس سنگی نورپور, یوسف بیگ زاده (نویسنده)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
