Provide a Framework for Explaining Policy Conflict in Iran's Health Policy-making System with a Mixed Approach

Document Type : Research Paper

Authors

1 PhD Candidate, Department of Public Administration, Faculty of Economics, Management and Administrative Sciences, Semnan University, Semnan, Iran.

2 Assistant Prof, Department of Public Administration, Faculty of Economics, Management and Administrative Sciences, Semnan University, Semnan, Iran.

3 Assistant Prof., Department of Public Administration, Faculty of Economics, Management and Administrative Sciences, Semnan University, Semnan, Iran.

4 Associate Prof., Department of Epidemiology, Health Productivity Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Objective: Policy conflict is defined as the non-compliance of the policy with the principles and standards of policy or the lack of coordination between two or more policies with each other or with upstream documents, which causes the performance to deviate from the policy goal and unpleasant consequences. The purpose of this study is to provide a framework for explaining policy conflict in the Iranian health policy system.
Methods: To answer the main research question, which is the elements affecting the policy conflict in the policy-making process of the Iranian health system? A mixed approach was used. To perform the Delphi method, the opinions of 13 experts were received in the form of three rounds of questionnaires. Then, the effect or variability of the variables was determined through a fuzzy Dematel questionnaire and in the next step, the structural equation modeling method was used.
Results: Conflict variables of health system policies including settings of internal elements of policy, typology of actors, ideological characteristics, performance contexts, environmental characteristics, conflict resolution tools, conflict identification channels, conflict resolution strategies and finally conflict resolution consequences were identified. Using quantitative methods, the relationships and directions between the variables and the intensity of their effect were determined in the context of line conflict.
Conclusion: The conclusion is that health policymakers while teaching scientific standards of policy management, should identify the factors influencing each decision situation and use appropriate strategies to manage policy conflict to create policies with the least non-functional conflict and the most coherence and synergy

Keywords


Abbasi, A., Motazedian, R., Mirzaei, M. (2016). Investigating the barriers to the implementation of public policies in government organizations. Human Resource Management Research, 6 (2), 127-142. (in Persian)
Abbasi, T., Ahmadi, H. (2017). Development of a model for measuring the coherence of science, research and technology policies in Iran. Journal of Public Policy, 3 (2), 117-133. (in Persian)
Aboalmaali, F.S., Daneshfard, K., & Pourezzat, A.A. (2020). A Pattern to Recognition of Triggering Element of Open Government Implementation in Iran's Public Organizations (Case Study: Ministry of Interior). Journal of Public Administration, 12(1), 145-174.
(in Persian)
Ahmadi, H. (2011). Understanding the reasons for incoherence (inequality) of public policy in Iran: Delphi method. Master Thesis. Faculty of Humanities; Tarbiat Modares University, Tehran. (in Persian)
Alvani, M., Haji Hashemi, Z., Akhavan Alavi, S. H., Danaeifard, H. (2020). Investigating the factors of conflict planning in the field of environment and industry in Iran. Public Policy, 6 (4), 89-109. (in Persian)
Baridam, B. B., & Govender, I. (2017, July). Policy conflict: Information and communication technology application in healthcare delivery. In 2017 Computing Conference (pp. 1054-1057). IEEE.
Daneshfard, K., Aramesh, K. (2015). Challenges of policy-making in the public policy-making process. National Conference on New Approaches in Management, Economics and Accounting. (in Persian)
Dunlop, N., Indulska, J., & Raymond, K. (2002, September). Dynamic conflict detection in policy-based management systems. In Proceedings. Sixth International Enterprise Distributed Object Computing (pp. 15-26). IEEE.
Ebrahimi, S.A., & Eynali, M. (2019). Developing a Framework to Explain the Public Policies
Capture Using Thematic Analysis and Interpretive Structural Modeling (ISM). Journal of Public Administration, 11(3), 403-430. (in Persian)
Forester, J. (2009). Dealing with differences: Dramas of mediating public disputes. New York, NY: Oxford University Press.
Fredriksson, M., Gustafsson, I. B., & Winblad, U. (2019). Cuts without conflict: the use of political strategy in local health system retrenchment in Sweden. Social Science & Medicine, 237, 112464.
Gholipour, R., Danaei fard, H., Amiri, A., Atarodi, M. (2015). Conceptualizing Policy Gap Phenomena in Cultural Policy Making Process. Majlis and Rahbord, 22(81), 91-125.
 (in Persian)
Golverdi, M., Danaeefard, H., Rahmati, M.H., Babashahi, J. (2020). Exploring and Analyzing the Consequences of Alienation of Implementers from Public Policies in Iran. Journal of Public Administration, 12(3), 379-403. (in Persian)
Hassan Gholipour, H., Amiri, M., Pourezzat, A.A. (2017). Development of a policy model for evaluating the effective maintenance of faculty members in higher education. Public Administration, 9 (3), 489-516. (in Persian)
Heidbreder, B., Grasse, N., Ihrke, D. and Cherry, B.D. (2011), Determinants of Policy Conflict in Michigan Municipalities. State and Local Government Review, 43(1). DOI: 10.1177/0160323X10397618
Heikkila, T, & Weible, C. M. (2017). Unpacking the intensity of policy conflict: a study of Colorado’s oil and gas subsystem. Policy Sciences, 50(2), 179-193.
Hsu, C. C., & Sandford, B. A. (2007). The Delphi technique: making sense of consensus. Practical Assessment, Research, and Evaluation, 12(1), 10.
Ihrke, D. M., & Scott Niederjohn, M. (2005). Conflict on city councils in Wisconsin. Journal of Urban Affairs, 27(4), 453-462.
Jowett, M., Dale, E., Griekspoor, A., Kabaniha, G., Mataria, A., Bertone, M. P., & Witter, S. (2020). Health financing policy & implementation in fragile & conflict-affected settings: a synthesis of evidence and policy recommendations.
Kaatz, J. B., French, P. E., & Prentiss-Cooper, H. (1999). City council conflict as a cause of psychological burnout and voluntary turnover among city managers. State and Local Government Review, 31(3), 162-172.
Karger, H., Midgley, J., Kindle, P. A., & Brown, C. B. (2007). Controversial issues in social policy. ISBN-13: 978-0205528462
Knight, J. (1992). Institutions and social conflict. New York, NY: Cambridge University Press.
Matland, R. E. (1995). Synthesizing the implementation literature: The ambiguity-conflict model of policy implementation. Journal of public administration research and theory, 5(2), 145-174.
Newberry, S. (2020). Policy conflict: The influence of fiscal targets on reform of New Zealand's natural disaster fund. Financial Accountability & Management, 36(2), 189-206.
Saedi, A., Mousavi, S.N. & Ahang, F. (2020). Political Entrepreneurship: The Analysis of Its Implications Area to Policy Making. Journal of Public Administration, 12(4), 672-692. (in Persian)
Saaty, T. L. 1980. The analytic hierarchy process. McGraw-Hill, Inc., New York.
Sharp, E. B. (1997). Policy process. Handbook of research on urban politics and policy in the United States, ed. RK Vogel, 275-289.
Svara, J. H. (1990). Official leadership in the city: Patterns of conflict and cooperation. Oxford University Press on Demand. ISBN-13: 978-0195057621.
Tiembre, I., Benie, J., Coulibaly, A., Dagnan, S., Ekra, D., Coulibaly, S., & Tagliante-Saracino, J. (2011). Impact of armed conflict on the health care system of a sanitary district in Cote d'Ivoire. Medecine tropicale: revue du Corps de sante colonial, 71(3), 249-252.
Tilly, C., & Tarrow, S. G. (2015). Contentious politics. Oxford University Press.
Weible, C. M., & Heikkila, T. (2017). Policy conflict framework. Policy Sciences, 50(1), 23-40.
Welch, D. D. (2014). A guide to ethics and public policy: Finding our way. New York, NY: Routledge.
Wolf, E. E. A. (2019). Dismissing the “vocal minority”: How policy conflict escalates when policymakers label resisting citizens. Policy Studies Journal. https://doi.org/10.1111/psj.12370
Yordy, J., You, J., Park, K., Weible, C. M., & Heikkila, T. (2019). Framing contests and policy conflicts over gas pipelines. Review of Policy Research, 36(6), 736-756.