How Does the Ministry of Health and Medical Education of Iran Protect the Public Benefits? Analysis of Stewardship Function and the Way Forward

Stewardship besides generation of resources, financing and service provision is a main function of health systems that can directly affects the other four functions. Stewardship includes decision making about priorities and ensuring to address them. Achieving better indices in the population health is related to effective stewardship. This study reviewed the roots of the health system problems by stewardship analysis and proposed betterment solutions in order to protect the public benefits.
This was a qualitative study. Stewardship conceptual framework and guide questions were developed using the scientific resources. Data were analyzed using the content analysis; and the situation was described. Root causes and proposed solutions were extracted from data of the focus group discussions with experts and pioneers of the health system.
All domains of stewardship including intelligence generation, policy formulation, setting vision and strategies and regulation and control had major problems. Some effective roots of the governance issues are: the absence of improving plan, week knowledge, attitude and skill of researchers, policy makers and managers. The proposed solutions to improve the stewardship’s function in the Ministry of Health and Medical Education include: - developing decision making dashboard for top managers; - composing policy making stakeholders network; - developing knowledge management system to utilize tacit knowledge and international experiences; - preparing a plan for achieving 2025 vision; - organizing the planning, implementation and evaluation system to the districts level and administrative units; - developing inter-sectoral coordination; - reviewing policies for supervising private sector and consumer protection.
Since the stewardship affects other three functions of the health system, lack of attention to this function will result in difficulties in achieving health goals and will waste resources in health sector. Traditionally, the Ministers of Health and Medical Education have missions in the areas of finance, resources generation and service provision; however, reviewing the past priorities have shown that less time and energy has been spent to improve the ministry of health governance. The main audiences of this study are Deputies of Health Minster Council and members of the Health Committee of Parliament. This evidence on the stewardship system can help them to manage the ministry of health rationally and responsively.