A Successful implementation of an idea to a nationally approved plan: Analyzing Iran's National Health Roadmap using the Kingdon model of policymaking

Abstract

Introduction: Hospital beds, human resources, and medical equipment are the costliest elements in the health system and play an essential role at the time of treatment. In this paper, different phases of the NEDA 2026 project and its methodological approach were presented and its formulation process was analysed using the Kingdon model of policymaking. Methods: Iran Health Roadmap (NEDA 2026) project started in March 2016 and ended in March 2017. The main components of this project were hospital beds, clinical human resources, specialist personnel, capital medical equipment, laboratory facilities, emergency services, and service delivery model. Kingdon model of policymaking was used to evaluate NEDA 2026 development and implementation. In this study, all activities to accomplish each step in the Kingdon model was described. Results: The followings were done to accomplish the goals of each step: collecting experts’ viewpoint (problem identification and definition), systematic review of the literature, analysis of previous experiences, stakeholder analysis, economic analysis, and feasibility study (solution appropriateness analysis), three-round Delphi survey (policy survey and scrutinization), and intersectoral and interasectoral agreement (policy legislation). Conclusion: In the provision of an efficient health service, various components affect each other and the desired outcome, so they need to be considered as parts of an integrated system in developing a roadmap for the health system. Thus, this study demonstrated the cooperation process at different levels of Iran’s health system to formulate a roadmap to provide the necessary resources for the health sector for the next 10 years and to ensure its feasibility using the Kingdon policy framework.

Supply-and-demand projections for the health workforce at a provincial level from 2015 to 2025 in Ilam, Iran

“…In the study by Hashemi et al in Iran in 2016, the rate of midwifery per 100,000 of the population in Ilam province was among the highest in the country (n=51) followed by Mazandaran (n=48) and Semnan (n=48). 25 In their study about the inequality in the distribution of healthcare resources in Iran, Lofty et al found that the highest ratio of manpower number per 1000 population was in Ilam province. 29 It should be mentioned that this study does not consider the misdistribution of health workers within Ilam province.…”

“…This common criterion is used for the calculation of workload and the number of employees needed to do it. 25 Studies show that FTE in Iran for midwifery, general medicine and nursing were all >1 (1.2, 1.28 and 1.39, respectively). In this study, to predict the demand for the health workforce in 2026, the FTE was therefore considered as 1.2 for these three job titles.…”

“…For the purpose of estimating the demand for the health workforce, we used the Iran Health Road Map 2025. 25 This map uses benchmarking for the estimation of demand for the health workforce. The required health workers were estimated per 100,000 of the population.…”

Implementation Process of Strategic Planning at District General Hospital

“…Developing resources takes time and requires a large investment. Human resources are one of the most important inputs of the healthcare system, having a large impact on public health outcomes and constituting the bulk of funding in the health sector (Hashemi et al, 2018). Based on the interviews and document analysis, the District General Hospital of Dr. (H.C.) Ir.…”

A Framework for Future Analysis of Ophthalmology Fellowships in Iran: Call for Action, Implications and Recommendations

“…[ 11 ] Successful balanced expansion of the quantity of available ophthalmologists which requires substantial investment and continued research is a prerequisite for enhancing the ophthalmic care services system and improving public health outcomes. [ 9 , 11 ]…”