Actor-network and stakeholder analysis in preventing health goods smuggling in Iran

The prevention of health goods smuggling requires the involvement of stakeholders from various sectors, including the executive, judicial, and legislative bodies. This may increase numerous challenges in designing, formulating, implementing, and evaluating any corrective interventions. The aim of this study is therefore to identify and analyze the network of stakeholders and actors having a likely voice and part in preventing the smuggling of health goods (PSHG) in Iran. We conducted actor network analysis in three phases: actor identification, actor classification, and actor relationship analysis. The participants were selected using purposive sampling from the executive, judiciary, and legislature bodies. We categorized the qualitative data using thematic analysis, and analyzed quantitative data using matrix drawing and actor-network analysis, facilitated by Gephi (version 0.9.7) and Excel (2013) software. The study identified 60 actors with different levels of status, power, interest, and awareness. The most powerful and supportive actors were the security and judicial institutions and the Central Headquarters to Combat the Smuggling of Goods and Currency (CHCSGC). Despite their significant influence, neither citizens nor the private sector showed a willingness to take steps toward preventing the smuggling of medical goods. Other actors had moderate or low levels of support and power in policies to prevent the smuggling of health goods. The Social Network Analysis (SNA) showed that the density of social networks was low, indicating a lack of cooperation and adequate interaction among those actors. Given the complex and multi-faceted nature of smuggling phenomenon, the policy makers and managers should take cognizance of the all actors’ diversity, roles and interactions. Subsequently, uncovering the reasons behind the players’ reluctance to participate, especially for such a critical issue, could strengthen the preventive actions towards smuggling, followed by a framework for meaningful stakeholder engagement, and appropriate support and incentive mechanisms.