The Public Policy Process for Health Service Institutional Change in Iran: Theory and conceptual Framework of the Study

Abstract

Parsons (1995) states that ‘Policy analysis is an approach to public policy that aims to integrate and contextualize models and research from those disciplines which have a problem and policy orientation’. Theories about policy making are concerned with process as well as outcomes and numerous groups are concerned about the policy process, including policy-makers, donors and international organizations as well as policy analysts. In health, research needs to be broadened to examine not only policy content, but also the process by which policy is formulated and implemented. The purpose of this research is to clarify the policy process, particularly policy formulation for organizational change in Iranian health institutions and to review the role of stakeholders, including health sector unions and professional organizations over the period 1980 to 2000.. This research analyzes the political mechanisms for making and controlling health institutional policy in Iran and illustrates how Iran’s power centre, affiliated with its public culture, was able to endorse a health policy or exercise a veto over health policy in both government and private contexts, and then how it gradually lost its hegemony as the politically reformed state became more firmly established. The research is also intended to provide an overview of existing theory of public policy formulation and to adapt and develop such theory in order to provide the means by which the impacts of policies for institutional change of Iranian health sector can be understood. This research is planned as a qualitative study, employing both documentary analysis and in–depth interviews.