Provide a Framework for Explaining Policy Conflict in Iran's Health Policy-making System with a Mixed Approach

Abstract

Objective: Policy conflict is defined as the non-compliance of the policy with the principles and standards of policy or the lack of coordination between two or more policies with each other or with upstream documents, which causes the performance to deviate from the policy goal and unpleasant consequences. The purpose of this study is to provide a framework for explaining policy conflict in the Iranian health policy system. Methods: To answer the main research question, which is the elements affecting the policy conflict in the policy-making process of the Iranian health system? A mixed approach was used. To perform the Delphi method, the opinions of 13 experts were received in the form of three rounds of questionnaires. Then, the effect or variability of the variables was determined through a fuzzy Dematel questionnaire and in the next step, the structural equation modeling method was used. Results: Conflict variables of health system policies including settings of internal elements of policy, typology of actors, ideological characteristics, performance contexts, environmental characteristics, conflict resolution tools, conflict identification channels, conflict resolution strategies and finally conflict resolution consequences were identified. Using quantitative methods, the relationships and directions between the variables and the intensity of their effect were determined in the context of line conflict. Conclusion: The conclusion is that health policymakers while teaching scientific standards of policy management, should identify the factors influencing each decision situation and use appropriate strategies to manage policy conflict to create policies with the least non-functional conflict and the most coherence and synergy

Keywords

• policy conflict
• mix approach
• policy process
• policy conflict framework
• health system