Health system profile - Islamic Republic of Iran - What is GIS - World ...

Health Systems Profile- Islamic Republic of Iran Regional Health Systems Observatory- EMRO
2. Identification and selection of population for intervention which should be around
35,000 or about 7,000 households with minimum possibility of migration;
3. Constitution of a board comprising the academics, community leaders and officials of
local government, health care authorities and civil society including NGOs;
4. Constitution of the specialized subcommittees;
5. Drawing the priorities’ list based on needs and the standard criteria; and
6. Designing the interventions and implementing and evaluating the same.
The progress has been made that 13 universities are involved in the intervention, and
each of these has developed a pilot project. The project is likely to be expanded to more
universities. A website has also been designed to display the process and the outcomes
of the research projects.
In addition, the Universities of Medical Science and Health Services are also involved in
conducting research on various health system issues. Furthermore Iran is the recipient of
the majority of research grants from EMRO. However, the general observation is that
there exists a weak capacity for undertaking the health systems research in the country.
5.5 Accountability Mechanisms
The issue is viewed from two aspects; financial and administrative accountability. Iran
has an inventory of health related rules and regulations, numbering over 650. These are
often followed quite religiously. The financial accountability is enforced by Audit
Department of the Economic Ministry. It has a representative, called Financial Controller,
in different offices expending the budget. Till recently the budget authorized to the
universities of medical sciences would also be controlled by the Financial Controller, but
with the promulgation of Article 49 of the 4th Development Plan the universities are out
of their control and should have internal audit. The financial audit is considered very
serious business. But there is no system for auditing the performance in order to
determine the efficiency and effectiveness of an institution.
The administrative accountability is ensured through hierarchical arrangements. That is,
the officer in charge is responsible for the subordinates and there are quite tough rules
for hiring and firing. Further, given that many services are being outsourced and private
sector is being involved, the hitherto governance of individuals in the public sector is
being transferred to regulating and implementing the contractual partners from the
private sector. In addition to the hierarchical regulation there are board structures
operating at various levels. For example, in the Ministry of Health there is a Council of
Deputies and each Deputy Minister has Council of Directors/Director General, while in
each university there is a Council of Deputy Chancellors to discuss and make decisions.
Also these forums act as watchdogs for different sections of the Ministry.
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