In the realm of global healthcare systems, Health Technology Assessment (HTA) serves as a vital instrument for informed decision-making. Nevertheless, its incorporation in settings such as low- and middle-income countries, including Iran, presents various challenges. This study delves into the intricate political environment surrounding HTA deployment in Iran, highlighting the varying roles, interests, and interactions of pivotal stakeholders. By addressing the lack of insight into these political dimensions, the study seeks to equip policymakers and healthcare practitioners with practical knowledge to navigate and effectively implement HTA processes.
Exploration of Stakeholder Roles and Dynamics
The researchers employed a qualitative approach, conducting in-depth semi-structured interviews with 19 stakeholders across six categories: interest groups, political leaders, donors, financial decision-makers, beneficiaries, and bureaucracies. Purposive sampling ensured a comprehensive cross-sectional representation. Thematic analysis guided the data evaluation, anchored in Campos and Reich’s political analysis framework, all while upholding the methodological standards outlined in the COREQ checklist.
Barriers Hindering Effective Implementation
Several significant barriers emerged, hindering HTA implementation in Iran. Among these are limited political will, conflicting priorities, and challenges in inter-agency coordination. Concerns regarding equity and access further complicate the process. Interest groups like physicians and pharmacists voiced apprehensions about losing clinical autonomy and facing restricted access to innovative treatments. Political leaders grappled with prioritizing HTA amidst wider healthcare and economic considerations. Donors emphasized alignment with national goals and sustainability, while financial decision-makers lauded HTA’s potential to optimize resources but shared concerns over budget constraints. Beneficiaries called for increased transparency and inclusion, and bureaucracies highlighted the necessity for enhanced leadership and capacity building.
Key inferences indicate that:
- Interest groups fear loss of professional autonomy.
- Effective inter-agency coordination is critical yet challenging.
- Donors focus on integration with national priorities.
- Financial constraints markedly affect HTA utilization.
- Bureaucrats demand stronger leadership and capacity-building initiatives.
To achieve effective HTA integration in Iran’s health system, robust political leadership, stakeholder engagement, and organizational capacity building are crucial. Actionable steps involve fortifying inter-agency collaboration, promoting transparent and inclusive decision-making, aligning donor contributions with national health objectives, and investing in workforce training to enhance technical capacity within government agencies. Addressing these strategic areas enhances HTA’s incorporation, ensuring resources are allocated efficiently and equitably.
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