The Library
Priority setting and implementation in a centralized health system : a case study of Kerman province in Iran
Tools
Khayatzadeh-Mahani, Akram, Fotaki, Marianna and Harvey, Gill (2013) Priority setting and implementation in a centralized health system : a case study of Kerman province in Iran. Health Policy and Planning , 28 (5). pp. 480-494. doi:10.1093/heapol/czs082 ISSN 0268-1080.
Research output not available from this repository.
Request-a-Copy directly from author or use local Library Get it For Me service.
Official URL: http://dx.doi.org/10.1093/heapol/czs082
Abstract
The question of how priority setting processes work remains topical, contentious and political in every health system across the globe. It is particularly acute in the context of developing countries because of the mismatch between needs and resources, which is often compounded by an underdeveloped capacity for decision making and weak institutional infrastructures. Yet there is limited research into how the process of setting and implementing health priorities works in developing countries. This study aims to address this gap by examining how a national priority setting programme works in the centralized health system of Iran and what factors influence its implementation at the meso and micro levels. We used a qualitative case study approach, incorporating mixed methods: in-depth interviews at three levels and a textual analysis of policy documents. The data analysis showed that the process of priority setting is non-systematic, there is little transparency as to how specific priorities are decided, and the decisions made are separated from their implementation. This is due to the highly centralized system, whereby health priorities are set at the macro level without involving meso or micro local levels or any representative of the public. Furthermore, the two main benefit packages are decided by different bodies (Ministry of Health and Medical Education and Ministry of Welfare and Social Security) and there is no co-ordination between them. The process is also heavily influenced by political pressure exerted by various groups, mostly medical professionals who attempt to control priority setting in accordance with their interests. Finally, there are many weaknesses in the implementation of priorities, resulting in a growing gap between rural and urban areas in terms of access to health services.
Item Type: | Journal Article | ||||||
---|---|---|---|---|---|---|---|
Subjects: | R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine | ||||||
Divisions: | Faculty of Social Sciences > Warwick Business School | ||||||
Library of Congress Subject Headings (LCSH): | Medical care - - Social aspects -- Iran, Medical policy -- Iran, Health services administration -- Iran, Health planning -- Iran, Health insurance -- Iran | ||||||
Journal or Publication Title: | Health Policy and Planning | ||||||
Publisher: | Oxford Univ Press | ||||||
ISSN: | 0268-1080 | ||||||
Official Date: | August 2013 | ||||||
Dates: |
|
||||||
Volume: | 28 | ||||||
Number: | 5 | ||||||
Page Range: | pp. 480-494 | ||||||
DOI: | 10.1093/heapol/czs082 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Restricted or Subscription Access | ||||||
Funder: | Iran. Vizārat-i Bihdāsht, Darmān va Āmūzish-i Pizhishkī [Ministry of Health and Medical Education] |
Request changes or add full text files to a record
Repository staff actions (login required)
View Item |