Designing a Model of Exalted Governance in the National Health System

Background: What distinguishes Exalted governance from other forms of governance is its strong emphasis on Islamic principles and values. In this regard, the present study was conducted with the aim of designing a model of Exalted governance in the Social Security Organization of the Northwest region of Iran. Methods: This study employed a mixed-methods approach including a combination of quantitative and qualitative methods. The qualitative population consisted of scholarly publications related to health system governance retrieved from reputable academic databases. In the quantitative phase, the population comprised healthcare centers affiliated with the Social Security Organization in the northwest region of Iran. A sample of 360 participants was selected from the management staff of the Social Security Organization’s healthcare departments in the provinces of West Azerbaijan, East Azerbaijan, and Ardabil. A researcher-developed questionnaire was used to collect data. The analysis was conducted using the meta-synthesis approach and structural equation modeling, with Smart PLS 3 and MaxQDA 2022 software. Results: The results identified eight dimensions of Exalted health governance: analytical and decision-making abilities, communication factors, infrastructure, strategic actions, organizational culture, general characteristics, organizational/managerial elements, and organizational policies. Conclusion: These findings clearly demonstrate that achieving Exalted governance within the Social Security Organization of the Northwest region is not possible without a strategic and prioritized focus on key dimensions such as organizational culture, communication structures, and general characteristics. Accordingly, health sector managers and policymakers must implement targeted and well-planned actions in each of these areas.