Strategies to Improve the Participation of Iranian Non-Governmental Organizations in Health Policymaking: A Systematic Review and Meta-Synthesis

Subject Areas : Public administration

shahla fathi ¹ , Hasan Givarian ^{2 *} , Mohammad Reza Rabiee Mandajin ³ , Mina Jamshidi Avanaki ⁴ , Vahid Araei ⁵

1 - Ph. D Student in Public Administration, Decision Making and Public Policy, Central Tehran Branch, Islamic Azad University, Tehran, Iran
2 - Associate Professor, Department of Public Administration, Faculty of Management, Central Tehran Branch, Islamic Azad University, Tehran, Iran
3 - Assistant Professor, Department of Public Administration, Faculty of Management, Central Tehran Branch, Islamic Azad University, Tehran, Iran
4 - Department of Public Administration, Central Tehran Branch, Islamic Azad University, Tehran, Iran.
5 - Department of Public Administration, Central Tehran Branch, Islamic Azad University, Tehran, Iran

Received: 2025-11-03 Accepted : 2025-11-16 Published : 2025-11-16

Keywords: : Non-Governmental Organizations, Health Policy, Participation, Systematic Review, Meta-Synthesis,

Abstract :

Introduction: The role of non-governmental organizations (NGOs) as representatives of civil society in health policymaking is crucial for identifying the real needs of the people, monitoring, and participating in decision-making. However, the effective participation of these organizations in Iran faces numerous challenges, including the lack of transparent legal structures, empowerment limitations, a deficit of trust, and weaknesses in evaluation systems. This study was conducted to identify strategies for improving this participation.

Methods: This study is a qualitative systematic review (meta-synthesis) based on the PRISMA 2020 guideline. A systematic search was conducted in Web of Science, Scopus, Embase, and PubMed databases in July 2025. Out of 1,764 identified studies, 24 eligible qualitative studies were selected based on inclusion and exclusion criteria. Data were analyzed using the Thomas and Harden method and MAXQDA 2022 software. Study quality was assessed using the SRQR checklist, and credibility was enhanced through triangulation and input from an advisory panel consisting of experts and NGO activists.

Findings: Based on a qualitative systematic review, the effective participation of Iranian NGOs in health policymaking necessitates the realization of seven key, interconnected strategies: First, the institutionalization of participation through defining a clear legal status and reducing bureaucratic barriers. Second, organizational empowerment by enhancing skills in policy analysis, management, and governance. Third, establishing structured and trust-based communication through formal dialogue channels and transparency. Fourth, developing networking and multisectoral collaborations to create synergy. Fifth, ensuring sustainable financing through transparent mechanisms and long-term contracts. Sixth, establishing an evidence-based monitoring and evaluation system for organizational learning. Seventh, promoting a culture of participation and public trust through social awareness and institutional accountability.

Conclusion: Effective participation of NGOs in Iran's health policymaking requires an integrated and multidimensional approach. Strengthening legal infrastructures, technical and managerial empowerment of NGOs, establishing institutional communication based on trust and transparency, developing collaborative networks, ensuring sustainable financing, implementing monitoring and evaluation systems, and ultimately promoting a culture of participation at the societal level are key pillars for institutionalizing this participation and moving towards participatory and effective health governance.

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