Provincial Health Policy Secretariate: Coordinating and Brokering Structure for Comprehensive Health

Since health is a multidimensional issue and several factors affected on it، forming a structure which can manage these factors at provincial level is difficult but possible. Analysis of Stewardship function of Iranian Health system showed that an effective platform for operationalizing the national policies has not been provided in provinces yet; So، study the current situation of policy making and planning process and designing a model for provinces was necessary. This is a descriptive and analytic study which used system designation mathod. Information were gathered by reviewing scientific literatures of policy making systems، critical review of documents related the policy making and planning structures in universities of medical sciences (UMS) in the country and written survey of the chancellors. Synthesized information presented to steering committee، that had been selected after stakeholder analysis، and the principles and requirement of designation were agreed by them. Based on the principles، Components of the proposed system as «Provincial Health Policy Secretarite (PHPS)» including mission and goals، system process، procedures and standards، management style and financial، human and information resources prepared and finalized by running several focus group discussion sessions، presenting selected health experts and steering committee. Scattering of policy and decision making centers in UMSs، weakness of monitoring and evaluation of provincial health policies and programs، weakness of coordination of education، research and health services policies، weakness of evidence based policy making system in 3 levels of UMS، board of trustees and health and food security technical taskforce of the province، weakness of presence of key stakeholders in preparing policies in UMS are the most important improving opportunities of provincial health policy and planning system. Considering existing gaps، PHPS could operationalize brokering، supervising and surveillance roles of the chancellor (Vice Minister of Health at Province) and ensure the attainment of the three streams: following the standards of academic and community engagement، evidence based policies and plans and monitoring progress of provincial health indices improvement policies and plans among executive organizations. Several units effective on policy and planning in province should be coordinated. PHPS not only prevent the parallel structure but can improve the other structures functions as well. Formal implementation of PHPS in top chart of UMSs and training experts of the unit will help integrated policy and planning and facilitate to achieve the best health indices in the province and the country.