Has the Social Determinants of Health Approach Been Established Yet at the Ministry of Health and Medical Education of I.R. Iran?

The discourse regarding social determinants of health at the international level seeks to see if the health system can improve community health indicators equitably by providing medical services and advising people to follow a healthy lifestyle. In our country, there are different views on the application of this approach. Opponents see this approach as ineffective whilst proponents are implementing components of this approach. This study sought to assess the criteria for implementing the approach using social determinants of health.

This qualitative study was done via reviewing resources, interviews and group discussions. The results are summarized in two main sections and deployment patterns included five components of a sustainable system (purpose and plan, structure, procedure and standard, management style, and resources).

The social determinants of health approach, assuming the weight of the five components to be equal, was found to be 68%. The highest implementation score  related to the three components of structure, procedure and standard, and resources. The lowest score related to management style.

It is suggested that a comprehensive health roadmap of the country be at hand by 2025; the tasks and expectations of the executive organizations, the private sector and non-governmental organizations are specified to improve the social determinants of health in the Seventh socio-economic and cultural development plan of Iran. Additionally, auditing and ranking the performance of provinces as well as districts with regard to implementation of this approach can promote healthy competition between provincial and district governorates, as well as participation of the public in the institutions to be created. In this regard, the Ministry of Health and Medical Education, with the aim of social accountability and role modeling, must first determine and implement its share and role in cooperation to improve these determinants.