Policy Analysis of Institutionalization of the Social Approach to Health in Iran.

Background: The social approach to health (TSATH) is necessary for maintaining and promoting health status in societies toward achieving sustainable development goals (SDGs). Despite various attempts, the health sector in Iran is behind in the meaningful implementation of TSATH. This study analyzed the policy of TSATH in Iran.

Methods: This was a qualitative study. The participants in the research included 36 experts and senior managers of health-related organizations in Iran who were selected using a targeted and snowball method. We used 3 methods for data collection: in-depth interviews, focus group discussions, and document review. Inspired by Walt & Gilson's policy triangle and stage heuristic framework, we conducted a thematic analysis and used MAXQDA software Version 19 for data management.

Results: TSATH was an immediate political decision in Iran. We found insufficient social participation and intersectoral collaboration, conflict of interest, inadequate evidence-based policy-making as well as necessary resources among the most important barriers to implementing the policy of TSATH.

Conclusion: Institutionalizing TSATH requires long-term, evidence-based planning and effective participation of all stakeholders. Providing the necessary resources and infrastructure, appropriate context and good steering, accountability, and creating a sustainable livelihood program, especially for the lowest-income deciles of society, are key measures to improve TSATH.