An Exemplary Governance Model in Iran’s Health System: Identification and Analysis of Influential Dimensions

Subject Areas : Health information management

saeed hamzeh ¹ , Reza Rostamzadeh ^{2 *} , Mahrokh Lotfollahi Haggi ³ , Karim Esgandari ⁴

1 - Department of Public Administration, Ur.C., Islamic Azad University, Urmia, Iran
2 - Department of Management, Ur.C., Islamic Azad University, Urmia, Iran
3 - Department of Management, Ur.C., Islamic Azad University, Urmia, Iran
4 - Department of Public Administration, Payam Noor University, Tehran, Iran

Received: 2025-08-29 Accepted : 2025-10-04 Published : 2025-10-21

Keywords: Exemplary governance, Health system, Ethical conduct.,

Abstract :

Background: Exemplary governance in health systems plays a pivotal role in enhancing system performance and ensuring equitable access to health services. This study aimed to design a comprehensive model of exemplary governance in Iran’s health system and analyze its key influencing dimensions.

Methods: This research employed a mixed-methods approach. The qualitative phase followed a developmental objective, while the quantitative phase adopted an applied perspective. The qualitative sample comprised published literature on health system governance from reputable databases. The quantitative phase included 360 employees from healthcare centers of the Social Security Organization in northwestern Iran, selected from the provinces of West Azerbaijan, East Azerbaijan, and Ardabil. Data were collected using a researcher-made questionnaire based on dimensions identified through the meta-synthesis technique. Analyses were performed using the meta-synthesis approach and structural equation modeling via SMART PLS and MAXQDA software.

Results: Findings revealed that exemplary governance in the health system consists of eight main dimensions: analytical and decision-making capabilities, communication factors, infrastructure, strategic actions, culture, general characteristics, organizational/managerial factors, and organizational policies. Structural model testing in a larger sample indicated that the dimensions of culture, communication factors, and general characteristics had the highest correlation with exemplary governance in the health system.

Conclusion: The results emphasize that achieving exemplary governance in health requires balanced attention to all dimensions. Neglecting any dimension may hinder the attainment of governance goals and ideals. Therefore, health managers and policymakers should implement strategies that prioritize equitable access to health services, transparency, accountability, and ethical conduct to strengthen exemplary governance in the health system.

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