Volume 28, Issue 6 (1-2026)
J Arak Uni Med Sci 2026, 28(6): 512-518 |
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Chezani Sharahi N, Hosseini S M, Alimohammadzadeh K, Hassan Shaban Khamseh A, Bahadori M. Identifying and Explaining the Challenges of Health System Planning in Iran: A Qualitative Study. J Arak Uni Med Sci 2026; 28 (6) :512-518
URL: http://jams.arakmu.ac.ir/article-1-8129-en.html
URL: http://jams.arakmu.ac.ir/article-1-8129-en.html
Nahid Chezani Sharahi1 
, Seyed Mojtaba Hosseini2 , Khalil Alimohammadzadeh3 , Ali Hassan Shaban Khamseh4 , Mohammadkarim Bahadori5
, Seyed Mojtaba Hosseini2 , Khalil Alimohammadzadeh3 , Ali Hassan Shaban Khamseh4 , Mohammadkarim Bahadori5
1- Department of Health Services Management, NT.C., Islamic Azad University, Tehran, Iran
2- Department of Health Services Management, NT.C., Islamic Azad University, Tehran, Iran ,Hosseinisch@yahoo.com
3- Department of Health Services Management, NT. C., Islamic Azad University. Health Economics Policy Research Center, TeMS. C., Islamic Azad University, Tehran, Iran
4- Department of Health Services Management, Ministry of Health, Treatment and Medical Education, Tehran, Iran
5- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
2- Department of Health Services Management, NT.C., Islamic Azad University, Tehran, Iran ,
3- Department of Health Services Management, NT. C., Islamic Azad University. Health Economics Policy Research Center, TeMS. C., Islamic Azad University, Tehran, Iran
4- Department of Health Services Management, Ministry of Health, Treatment and Medical Education, Tehran, Iran
5- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
Abstract: (349 Views)
Introduction: Health system planning, as a core function of health governance, plays a crucial role in resource allocation, performance improvement, and equity promotion. Despite recent reforms, evidence suggests that planning processes in Iran’s health system still face significant structural, managerial, and implementation challenges. This study aimed to identify and explain the key challenges of health system planning in Iran.
Methods: qualitative study was conducted using a thematic analysis approach. Seventeen participants—including senior and middle managers, faculty members, and health planning experts at national and university levels—were selected through purposive sampling with maximum variation. Data were collected via semi-structured interviews over eight months and analyzed using MAXQDA version 20. Credibility, transferability, dependability, and confirmability were ensured to strengthen the trustworthiness of the findings.
Results: Thematic analysis led to the identification of 160 initial codes, 36 organized themes, and 9 overarching themes. The main categories of challenges included: human resources, leadership and governance, processes and regulations, inter- and intra-sectoral coordination, budgeting and financing, physical infrastructure and equipment, health information and technology, service delivery, and sociopolitical–cultural–economic factors. Major issues were found in managerial transparency, cross-sectoral collaboration, financial constraints, and the lack of systematic monitoring and evaluation mechanisms.
Conclusions: The Iranian health planning system suffers from centralization, structural ambiguities, limited stakeholder participation, and weak information systems. Strengthening evidence-informed policymaking, enhancing transparency and accountability, and reforming governance structures are essential for improving the effectiveness and efficiency of health system planning.
Methods: qualitative study was conducted using a thematic analysis approach. Seventeen participants—including senior and middle managers, faculty members, and health planning experts at national and university levels—were selected through purposive sampling with maximum variation. Data were collected via semi-structured interviews over eight months and analyzed using MAXQDA version 20. Credibility, transferability, dependability, and confirmability were ensured to strengthen the trustworthiness of the findings.
Results: Thematic analysis led to the identification of 160 initial codes, 36 organized themes, and 9 overarching themes. The main categories of challenges included: human resources, leadership and governance, processes and regulations, inter- and intra-sectoral coordination, budgeting and financing, physical infrastructure and equipment, health information and technology, service delivery, and sociopolitical–cultural–economic factors. Major issues were found in managerial transparency, cross-sectoral collaboration, financial constraints, and the lack of systematic monitoring and evaluation mechanisms.
Conclusions: The Iranian health planning system suffers from centralization, structural ambiguities, limited stakeholder participation, and weak information systems. Strengthening evidence-informed policymaking, enhancing transparency and accountability, and reforming governance structures are essential for improving the effectiveness and efficiency of health system planning.
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