Designing health system scenarios at the national level

Background and Objective: Building a favorable future for the health system is strongly emphasized in the upstream documents, but the nature of the future is fraught with uncertainty and has a fundamental feature such as invisibility. Today, the health system of the country is witness-oriented and has linear and deterministic thinking. Scenarios are the best learning tool for managing uncertainty, which makes it possible to re-read the structure and boundaries of existing health systems, as well as to understand the nature and role of stakeholders in pursuing sustainable health systems. The purpose of this study is to help mobilize material and human resources through the scriptwriting process to build a favorable future that the key actors of this system can plan so that in the future citizens can be physically comfortable in addition to equitable health care. Achieve psychological, spiritual and social as well. Materials and Methods: In this study, using in-depth interview tools and a questionnaire governing the Maktor software with 25 health system experts in the 2019 and relying on the process of scriptwriting at the University of Norway in four steps of analyzing trends and actors in the field of health as The first step is to determine the drivers as the second step, the development of scenarios as the third step, and finally the evaluation and strategic recommendation as the fourth step to design the scenarios of the health system at the national level. Results: The findings include four scenarios. The goal of the first scenario as a desirable scenario, Equity in the collective dimension and wellbeing in the individual dimension, in the second scenario as a possible scenario, the goal of that Equity in the collective dimension and ignoring wellbeing in the individual dimension, in the third scenario as a possible scenario goal of wellbeing in the dimension Individual and neglect of Equity in the collective dimension, and finally the fourth scenario as a scenario of disaster in which there is neither wellbeing in the individual dimension nor Equity in the collective dimension. Conclusion: In order to move away from the disaster scenario and approach the desired scenario, the country’s health system needs to change the paradigm from therapist to caregiver in such a way that multiple care promotes health, disease prevention, and treatment. Diseases and rehabilitation are integrated and, in this integration, the most important policy will be health promotion.