Implementing a Joint Operational Plan in Medical Sciences Universities: A Qualitative Policy Analysis in Iran

Abstract

Background: The joint operational plan was introduced by Iran’s Ministry of Health and Medical Education in 2015 as a way to improve the quality and efficiency of healthcare services by promoting collaboration and coordination among medical sciences universities. The plan aimed to address issues related to overlapping responsibilities, duplication of efforts, and resource constraints among universities. Objectives: This study was conducted to analyze this policy intervention and explore its challenges and opportunities. Methods: Using a qualitative policy analysis approach, this study collected data through documentary analysis and semi-structured interviews with stakeholders at various health system levels. Research participants were selected using purposive and snowball sampling methods. The collected data were analyzed using the framework analysis approach, supported by the policy triangle framework and heuristic model. Results: The policy analysis results yielded 14 categories and 29 sub-categories grouped into four overarching themes: Content, context, process, and actors/stakeholders. The content theme included categories such as the plan’s goals, the linkage between the plan’s goals and upstream policy documents, and the consistency between the plan’s goals and the visions and missions of medical universities. The context theme included structural characteristics, economic and financial factors, and social and cultural situations. The process theme included the issue’s priority, service delivery, policy design and formulation, implementation approach, and assessment and evaluation. The actors/stakeholders theme included categories such as the owner and leader of the policy, political support, and ambiguity in assigning responsibilities. Conclusions: While enforcing a joint operational plan in medical universities can boost performance and foster competition, it may also hinder universities’ ability to pursue innovative interventions and activities outside the plan. To address this issue, stakeholders from various health system levels should work together to modify the plan’s development and implementation process. Effective use of planning tools is crucial for ensuring that medical universities and the health system achieve their goals.