Identifying and prioritizing good governance affairs in the country's health system

Today, due to the numerous issues that exist in the health sector, the government alone is not able to improve the conditions and it is necessary to use the capacity of the private sector and civil society to improve the health sector. Therefore, the aim of this research is to identify and prioritize good governance affairs in health system. 

The current research is applied-developmental in terms of purpose. After examining the theoretical foundations and previous researches, the governance issues of the health system were identified. Then, using the fuzzy Delphi method and asking the opinions of 13 experts who were selected purposefully, the final variables were designed. Finally, in order to validate the model, 169 health department managers in Tehran city were asked for their opinions using a questionnaire and the data were analyzed with confirmatory factor analysis and Smart PLS software. 

Based on the findings, strategic orientation strategies, balanced and integrated management, value orientation and ethical orientation, optimal management of financial resources, promotion of administrative health and development of knowledge resources were identified for governance affairs. Also, for contractual affairs, strategies including development of technical knowledge, development of executive and operational platform and management of service provision capacity, and for partnership matters, strategy of development of stakeholders' participation were identified. Also, all the identified matters were confirmed by factor analysis method and the coefficient of determination for governance, contractual and partnership affairs was calculated as 0.674,0.605 and 0.551 respectively, which are suitable values. 

Good governance in the health system is a combination of governance, contractual and partnership affairs. In order to move in the direction of improving the health system, it is necessary to pay serious attention to these affairs at the same time and to use the capacity of the private sector and civil society in addition to the government's capacity.