Jorjani Biomedicine Journal (Oct 2024)
Agenda setting analysis for social health policies of the ministry of health of Iran based on Kingdon\'s Multiple Streams Model
Abstract
Background: The Ministry of Health has prioritized social health interventions to enhance the social capital within health systems. This study analyzes the implementation of Iran's Ministry of Health's social health policies based on Kingdon's model. Methods: This qualitative study, conducted in 2022, utilized Kingdon's (2003) model as the research framework. Data were collected through in-depth personal interviews with 15 managers and scientific and executive experts from the Ministry of Health, the Ministry of Interior, the governorate, universities of medical sciences, and non-governmental organizations. Sampling was purposive, and interviews were analyzed using the frame analysis method. Results: The findings were categorized into three main themes and ten sub-themes which include the problem, policy, and the political stream. The problem stream, focus on definition of social health among stakeholders, addressing the nature of social health, exploring the impacts of social health on society members' roles, duties, and social activities, and clarifying communication regarding the concepts of social health for ministry managers and employees. The policy stream, emphasized on people's participation is a primary health care (PHC) principle, Laws highlighting the social dimension of health, and the potential utilization of NGO capacities within the country. The political stream highlighted the Social Vice-Chancellorship in the Ministry of Health with the onset of the 11th government, and the formation of the General Directorate of Non-governmental Organizations within the Social Vice-Chancellorship. Conclusion: Despite the critical need for social health policies and the requirements set by upstream laws, the complexity and multi-dimensionality of social health have hindered successful policy implementation. To attract interdisciplinary leadership and cross-sectoral support, it is recommended that a dedicated trustee within the Ministry of Health be appointed and practical measures for promoting healthy social behaviors be implemented by identifying and monitoring social health indicators be implemented.
