پیاورد سلامت (Oct 2022)
Retrospective Analysis The Development of the Program for Reforming the Structure of the Headquarters of Medical Sciences Universities in Iran
Abstract
Background and Aim: Reforming the structure of medical universities and its continuous adaptation to the mission of the organization and new functions is an undeniable necessity. The purpose of this article was to explain how to implement this policy. Materials and Methods: The current qualitative study was conducted in 2020 retrospectively based on Kingdon’s multiple streams model. Data collection was done using two methods: individual interviews and document review. Sampling of the managers and experts of the administrative development and transformation centers of the Ministry of Health and 12 universities of Medical Sciences as well as vice-chancellors of the universities was done in a purposeful and snowball method until data saturation was reached by conducting 19 individual interviews. Data analysis were done with framework and content analysis methods, and using MAXQDA 2020 software. Results: The low of structural problems included quantitative and qualitative changes in new tasks in the environmental units of universities, interference and parallel work in the tasks of university units, and bargainings for restructuring by universities. The policy low included the obligation to make structural changes in the upstream laws and documents, including the Fifth Development Plan, and the cooperation of all stakeholders. The political process included the implementation of the Health Transformation and the Family Physician Plan, and the support of relevant policymakers and the approval of the law of becoming a university trustee in the law of the fifth plan of economic development and also gaining the all-round support of the stakeholders. Conclusion: The medical sciences universities, as the headquarters arm of the Ministry of Health at the provincial level, need to have flexible structure in line with the needs of their surrounding units. In luential context factors in policy-making the reform of the structure of the headquarters of universities/colleges, in addition to the stream of structural problems, the main of which was the change in the duties of the units, along with the political determination created in the Ministry of Health, led to the simultaneous occurrence of three streams of problems, Politics and politics and finally opening the window of opportunity and changing the structure and organization of the headquarters of medical sciences universities.
