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Purpose: This paper aims to propose a policy prioritization framework in view of a layered scenario building along with key stakeholder analysis and has been applied in a case study to determine the priority of Iran environmental policies at the horizon of 2030. A creative framework that covers future scenarios and allows for a more accurate and intelligent policy assessment and prioritization. Design/methodology/approach: The general environmental policies of the Islamic Republic of Iran are evaluated, and observation policies in social area were identified. Causal layered analysis (CLA) is applied for policy prioritization based on layered probable scenarios and key stakeholder role consideration. The Multiple-criteria decision-making (MCDM) is also used for ranking General Environmental Policies by the technique for order of preference by similarity to ideal solution (TOPSIS). Findings: Four uncertainties were obtained in different layers based on the CLA analysis, resulting in the creation of four main scenario and 16 discrete scenarios. Finally, Iran's environmental policies were prioritized given the probable scenarios and the centralized policies on the social and political domains. The proposed model will be effective in policy-making in multilateral atmosphere to prioritize policies and alternative macro-strategies. Originality/value: This paper shows that foresight and especially developed scenarios provide intelligent, efficient and effective planning and policy-making, and in addition to illustrating surrounding changes and probable future imagery, it generates common understanding and inter-subjective knowledge by increasing participation of various officials and stakeholders. [ABSTRACT FROM AUTHOR]

An integrated approach to the key elements of rural spatial policy-making -including places, people and activities- in the formulation of laws, programs and policies; promotes sustainable rural development. Lack of integrated vision, while having a sectorial approach, in the process of formulating rural development programs in Iran, has caused serious challenge to the sustainable development of these areas. The aim of this paper is analyzing the qualitative content of spatial policies of rural development in Iran. The present paper is a fundamental research in terms of nature; and a developmental research, in terms of purpose. Data analyzing method in this paper is based on qualitative-content-oriented Analysis. Spatial policy subjects, include place-based policies, physical sustainable development, and the institutionalization of sustainable development policies. These categories include 11 indicators (subcategories), constituting the conceptual framework of the research. Qualitative-content Analysis of spatial policies, based on the 11 indicators or sub-categories of the research, 143 codes were obtained, after extracting the unit of meaning, compressing the sentences, and encoding. These codes were categorized in different categories (categories and indicators), respecting their conceptual and thematic relationship. Results showed that of total of 143 codes extracted, the index of planning nature, budgeting, and making Sustainable Development National Strategy, with 21 codes (14.68%) ranked in the first; three indicators of economic dimensions, physical-infrastructural dimensions, and coordination of sectors and Different levels (national and local), ranked the second place with 18 codes (12.58%); and finally the indicator of backwarded-regions protection, with 15 codes (10.48%) ranked the third place. Therefore, the orientation of spatial policies for rural development is towards planning and budgeting factors, physical-infrastructural dimensions, economic, and backwarded regions supporting, while the share of social and environmental factors and the participation of NGOs and the private sector in the formulation of these policies, is little. The Innovational aspect of this paper is its comprehensive analysis of policy-making documents - including five-year development plans, general policies of these plans, general laws and system policies (33 related documents)- using spatial policy indicators. [ABSTRACT FROM AUTHOR]

Background: The process of medical tariffs setting in Iran remains to be a contentious issue and is heavily criticized by many stakeholders. This paper explores the experience of setting health care services tariffs in the Iranian health care system over the last five decades. Methods: We analyzed data collected through literature review and reviews of the official documents developed at the various levels of the Iranian health system using inductive and deductive content analysis. Twenty-two face-to-face semi-structured interviews supplemented the analysis. Data were analysed and interpreted using 'policy triangle' and 'garbage can' models. Results: Our comprehensive review of changes in the medical tariff setting provides valuable lessons for major stakeholders. Most changes were implemented in a sporadic, inadequate, and a non-evidence-based manner. Disparities in tariffs between public and private sectors continue to exist. Lack of clarity in tariffs setting mechanisms and its process makes negotiations between various stakeholders difficult and can potentially become a source of a corrupt income. Such clarity can be achieved by using fair and technically sound tariffs. Technical aspects of tariff setting should be separated from the political negotiations over the overall payment to the medical professionals. Transparency regarding a conflict of interest and establishing punitive measures against those violating the rules could help improving trust in the doctor-patient relationship. Conclusion: Use of evidence-informed models and methods in medical tariff setting could help to strike the right balance in the process of health care services provision to address health system objectives. A sensitive application of policy models can offer significant insights into the nature of medical tariff setting and highlight existing constraints and opportunities. This study generates lessons learned in tariffs setting, particularly for low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to develop a framework for nursing managers to participate in the health policy‐making process. Background: Nursing managers must be involved in the health policy process to provide appropriate health services, focus on nursing professional excellence, and improve the performance of the health system. Methods: This multimethod research was based on the Delphi study and experts' panel. Faculty members of the nursing, health policy, health services management, and nursing managers working at hospitals were selected via purposive sampling. The data collection tool was a demographic form and an open‐ended questionnaire in the first round and a structured questionnaire in the next round. In the two rounds of Delphi, experts discussed and rated items of nursing managers' participation framework in the health policy‐making process. At the expert panel session, the framework was finalized with a 12‐part checklist. The data were analysed quantitatively using SPSS software version 22. Results: A total of 28 items were entered into the Delphi study. Experts who met the inclusion criteria responded to rounds 1 (n = 20) and 2 (n = 16). Following the two rounds of the Delphi study, 27 items were selected and discussed by experts using a 12‐part checklist related to the framework. The final participation framework was divided into five sections: Barriers, facilitators, advantages, disadvantages, and factors affecting the participation of nursing managers in the health policy‐making process. Conclusion: In our findings, the relationship between the components of the framework and policy cycle was shown, which should be considered to lay the groundwork for participation. This can lead to health promotion, accountability, and financial participation in the health system, which can improve the proactive involvement of nursing managers in the health policy‐making process. Implications for Nursing Management: The proposed framework can be utilized across the spectrum of nursing, including practice, leadership, and education to enhance the participation of nursing managers in health policy activity. [ABSTRACT FROM AUTHOR]

Introduction: Policy making is one of the main and fundamental issues in the management of institutions and organizations which necessitates attention to its process and components. Therefore, this study aimed to evaluate the relationship between policy-making and university autonomy in macro medical universities of region 3. Material & Methods: The present applied study was conducted with an integrated approach (qualitative and quantitative) in Ilam province of Iran, in 2021. The statistical population in the qualitative part consisted of the professors of macro medical universities in region 1 among whom 15 individuals were selected for designing the policy-making and university autonomy questionnaires using the purposive sampling method, considering the saturation law. In the quantitative part, 320 subjects were selected using a stratified random sampling method from managers and deputies of departments, faculties, department heads, and faculty members of macro medical universities in the health sector of region 3 to examine the relationship between variables. In the qualitative part, the questionnaires were designed and finalized through the Delphi method in two rounds, the experts’ opinions obtained through semi-structured 70-min interviews, and the review of topics and study of theoretical foundations. In the quantitative section, a researcher-made questionnaire on university policy-making and university autonomy was used for data collection. The SPSS and PLS software were used to analyze the data through confirmatory factor analysis and structural equations. (Ethic code: 2084838744062451398162299017) Findings: The results showed that among the various dimensions of policymaking, the component of “university structure” had the greatest impact with R2=0.927, and among the components of university independence, leadership independence had the most impact with R2=0.942 and path coefficient=0.971. Discussion & Conclusion: Based on the path coefficients, a factor load of 0.644 was established between the two variables of policy-making and university autonomy which was above average and, therefore, significant. Moreover, since the t-statistic value of 16.247 was established out of the (-2.58, 2.58) range, it can be concluded that the relationship between policymaking and university autonomy in macro medical universities in region 3 was positive and meaningful. [ABSTRACT FROM AUTHOR]

Background: The institutionalization of evidence-informed health policy-making (EIHP) is complex and complicated. It is complex because it has many players and is complicated because its institutionalization will require many changes that will be challenging to make. Like many other issues, strengthening EIHP needs a road map, which should consider challenges and address them through effective, harmonized and contextualized strategies. This study aims to develop a road map for enhancing EIHP in Iran based on steps of planning.Methods: This study consisted of three phases: (1) identifying barriers to EIHP, (2) recognizing interventions and (3) measuring the use of evidence in Iran's health policy-making. A set of activities was established for conducting these, including foresight, systematic review and policy dialogue, to identify the current and potential barriers for the first phase. For the second phase, an evidence synthesis was performed through a scoping review, by searching the websites of benchmark institutions which had good examples of EIHP practices in order to extract and identify interventions, and through eight policy dialogues and two broad opinion polls to contextualize the list of interventions. Simultaneously, two qualitative-quantitative studies were conducted to design and use a tool for assessing EIHP in the third phase.Results: We identified 97 barriers to EIHP and categorized them into three groups, including 35 barriers on the "generation of evidence" (push side), 41 on the "use of evidence" (pull side) and 21 on the "interaction between these two" (exchange side). The list of 41 interventions identified through evidence synthesis and eight policy dialogues was reduced to 32 interventions after two expert opinion polling rounds. These interventions were classified into four main strategies for strengthening (1) the education and training system (6 interventions), (2) the incentives programmes (7 interventions), (3) the structure of policy support organizations (4 interventions) and (4) the enabling processes to support EIHP (15 interventions).Conclusion: The policy options developed in the study provide a comprehensive framework to chart a path for strengthening the country's EIHP considering both global practices and the context of Iran. It is recommended that operational plans be prepared for road map interventions, and the necessary resources provided for their implementation. The implementation of the road map will require attention to the principles of good governance, with a focus on transparency and accountability. Video abstract. [ABSTRACT FROM AUTHOR]

Background: A huge number of people living with HIV/AIDS lives in developing countries. Thus, strengthening health systems in these countries is a prerequisite for improving disease prevention and care. After three decades of HIV/AIDS policy-making in Iran, conducting a comprehensive analysis on the policy process seems to be essential. In the present study, we aimed to analyse the HIV/AIDS policy-making process in Iran from 1986 to 2016.Methods: This was a theory-based, multi-method and retrospective study. Interviewing of key informants and review of policy documents were concurrently conducted to identify and include further key informants (39 participants) and documents in the study. Framework analysis was used to analyse data.Results: The mean age of participants working in HIV/AIDS policy-making was of 48 years and participants had a mean of 14 years of working experience. Findings were categorized as contextual factors, content of HIV/AIDS policies, actors involved in the policy process, and evidence use in the policy process. Contextual effective factors on the HIV/AIDS policy-making process were categorized into five major themes, namely situational factors, structural-managerial factors, socioeconomic factors, political and legal factors, and international factors. The HIV/AIDS phenomenon in Iran was identified to be deeply rooted in the culture and traditions of society. The HIV/AIDS policy content has, recently, been crystallized in the national strategic plans and harm reduction policies of the country. The policy process has been conducted with a solely governmental top-down approach and is now suffering from poor evidence and lack of sufficient consideration of contextual factors.Conclusions: There is a great need for change in the approach of government towards the issue and to increase the participation of non-governmental sectors and civil society in the policy process. [ABSTRACT FROM AUTHOR]