Governance Model of the Iranian Healthcare System with a Network Approach (Based on the Foundation's Data Theory)

Authors
hamed soleimani
Fattah sharifzadeh
davood hosseinpour
Mir Ali Seyed Naghavi
Public Management Department, Allameh Tabataba'i University
Abstract
Introduction

Considering the complexity of services in the health system, which requires the interaction of different people and organizations, weaknesses in network governance models lead to various conflicts and challenges. Considering the challenges of governance in a country's health system, it is necessary to determine a model of health governance using a network approach in the context of a country.

Materials and Methods

The current research is applied in terms of its purpose, which was carried out using a mixed approach with an exploratory design. The method of qualitative analysis is used in the qualitative part to identify the factors affecting the governance of a network using the foundational data theory method. In the quantitative part, for the validity of the model and determining the relationship between the identified factors, confirmatory factor analysis and the structural equation model are used. In this study, MAXQDA software will be used for data analysis.

Results

By analyzing the interviews and reviewing previous studies, six main themes: external factors; antecedents; requirements; platforms and context; functions, and applications; The results and partners (institutions) influencing the network governance of the health system were extracted in each dimension along with their subcategories.

Conclusion

The results obtained in this research showed that health can no longer be considered a mere partial goal for which the responsibility of a single ministry is sufficient to achieve, but the participation of other health actors and activists alongside the Ministry of Health is mandatory is and an increasing trend. It is evident that there are more and deeper interactions between different actors in the health system. In addition, according to the results of the research, it can be said that paying attention to the issue of health is described as the center of all-round development and an important examples of justice. Therefore, the implementation of the network governance model in this area is perhaps the main driver for advancing comprehensive development. In addition, the establishment of network governance can lead to an increase in people's satisfaction with the government and acceptance of the central government by the public.
Keywords
Governance
Network governance
Health system
Data theory foundation
1. Abd Rahim A, Abdul Manaf R, Juni M H, Ibrahim N. Health system governance for the integration of mental health services into primary health care in the sub-Saharan Africa and South Asia region: A systematic review. INQUIRY: The Journal of Health Care Organization, Provision, and Financing. 2021; p. 004695802110285.
2. Aldrich R, Committee W, Fe S, Community C, Division S, Fe S, et al. Trust is key to collaboration in managed care health service delivery networks. Public Administration Review.2014;599–600.
3. Ali Khani R, Rasouli MR, Ali Ahmadi AR .The influence of key factors on the optimal network governance model in the health system: a structural equation modeling approach, Health Management, No. 74. 2017;19-34. [Persian]
4. Alwani Seyed M. Good governance of a network of civil society activists, development and transformation management, period 1. 2008;1-5. [Persian]
5. Asaduzzaman1, M. & Virtanen, P. “Governance Theories and Models”. https:// www. researchgate.2016.net/ publication/308911311.
6. Bahlouli H. Promotion of wisdom and the place of governance in policy-making and health development planning: a critique of existing conditions, online magazine of Iran's public policy-making website. (electronic resource). 2018. [Persian]
7. Danai Fard H, Network public administration in Iran: theoretical and practical principles, requirements, management researches in Iran (Humanities Lecturer), 17th period, number 2 (80 series). 2012. [Persian]
8. Etemadi et al. Network governance theory as basic pattern for promoting financial support system of the poor in Iranian health system, BMC Health Services Research, (2021) 21:556..
9. Khajeh Naini, Ashtarian, Mohammadi Kangrani network analysis of the decision-making stage in Iran's nanotechnology policy, Management Research in Iran, Volume 18, Number Two, 84. 2013. [Persian]
10. Klijn, E. H. & Koppenjan, J. Governance networks in the public sector London: Routledge, Taylor & Francis Group.2016; 40(4), 587-606.
11. Macdonald, D., Johnson, R., & Lingard, B. Globalisation, neoliberalisation, and network governance: an international study of outsourcing in health and physical education. Discourse: Studies in the Cultural Politics of Education 2020; 41(2), 169-186.
12. Mohammadiha, Hale, Memarzadeh, Gholamreza, and Azimi, Parham. Designing a model for improving the country's health system with an emphasis on governance strategies. Piyavard Salamat. 2021;15(3), 272-290. SID. https://sid.ir/paper/1019246/fa. [Persian]
13. Mossadegh Rad AM, Rahimi Tabar P. The governance model of the health system, Razi Journal of Medical Sciences, Volume 26, Number 9. 2018;28-10. [Persian]
14. Kapucu, N., & Hu, Q. The development of network governance and its relevance for public affairs education. Journal of Public Affairs Education, 1–9. 2020. doi:10.1080/15236803.2020.183985
15. Salarianzadeh MH, Latifi Jalise S .governance structure challenges in the Ministry of Health, Treatment and Medical Education based on the network structure model, Hakim Health System Research Journal, Volume 23, Number 2. 2019. [Persian]
16. Tenbensel, T., Silwal, P. and Walton, L. "Overwriting New Public Management with New Public Governance in New Zealand's approach to health system improvement", Journal of Health Organization and Management. 2021; Vol. 35 No. 8, pp. 1046-1061.
17. Van den Oord, S., Vanlaer, N., Marynissen, H., Brugghemans, B., Van Roey, J., Albers, S & Kenis, P. Network of networks: preliminary lessons from the Antwerp Port Authority on crisis management and network governance to deal with the COVID‐19 pandemic. Public Administration Review. 2020; 880-894.
18. WHO.The World Health Report 2000: Health Systems: Improving Performance.Geneva: World Health Organization, 2000.
19. Wilson, E. Towards Accountability in Democratic Network Governance (Doctoral dissertation), 2015.