The Necessity of Paradigm Shift in Iran's Health System to Achieve Comprehensive Health in Iranian Society


 
 
 
 
 
 
The Article Abstract is not available. 
 
 
 
 
 
 
 
 
  


One of the essential components of development and social welfare is ensuring the health of society and health promotion so that it is emphasized as one of the dimensions of sustainable development (1). Ensuring health is a significant prerequisite of achieving comprehensive development in various aspects, including political, economic, social, and cultural(2). Health is a national capital that is constantly exposed to environmental risks. Noteworthy, the health of individuals is helpful for the whole society (3).
Different governance methods have various approaches to health (4). For instance, in some countries, such as the United States, the government is not mandated to ensure health for all(5). On the other hand, in some countries, such as Cuba, the government is mandated to ensure the health of citizens (6). Based on the overall approach of countries towards health, welfare, and power, they have established various structures with different outcomes in the field of health (7).
After World War II, liberalism and socialism were two dominant governance frameworks; yet, some countries chose mixed governance (8). In Iran, the dominant framework of the health system is inclined towards humanism and biomedical health, with an overemphasis on providing healthcare services by an extensive network of providers (9).
National development plans are focused on the expansion of medical services while prioritizing the private sector. The fourth national development plan has emphasized the concept of health equity. In addition, the fifth and sixth programs did not emphasize some new concepts such as health equity, social determinants of health, and health promotion. The only high-level document that noted the concept of comprehensive health is the overall health policies of the supreme leader. In most countries, the overall governance structure of the health system is proportional to the discourse layer. To reduce conflicts in better performance, each country needs to pay attention to its discourse on forming structures (10).
Therefore, by recognizing external factors affecting health, the overall structure of the Iran health system should shift its focus from sole investment in the provision of medical services towards a broader range of social, cultural, economic, political, and environmental factors. Development programs should also emphasize two approaches of determinants of health and health promotion with a sociological view towards human and social components of health. The health The Necessity of Paradigm Shift … 60 promotion approach also emphasizes the empowerment of people in society and their role, and, in this approach, the main goal of policymaking is to realize public health-oriented policies and creating context that support people's health to help them have a healthy life.
The inter-sectoral interventions and social participation in health promotion are the keys to achieve these goals. Expansion of international relations, particularly the consequences of globalization, has changed health views. As a universal and inclusive view, the comprehensive health approach contains the role of power at the international, government, and societal levels and follows an integrated systemic view at the national and international levels to realize health.
In a nutshell, coordination and addressing health issues, the steward of the Iran health system should follow new approaches to produce evidence on effective and efficient inter-sectoral leadership for targeted and effective advocacy.Due to the increase in costs, increasing expectations at the community level, it is recommended to provide appropriate guidance for managers and policy makers to strengthen the relationship between the governing paradigm and the performance of the health system by developing research on the governing paradigm.