Sustainable financing in Iran’s health system: a policy analysis of agenda-setting through Kingdon’s multiple streams framework

BACKGROUND AND OBJECTIVE: Sustainable financing is essential for Iran's health system to achieve universal health coverage and improve healthcare quality. It involves gathering and managing financial resources for health services, aiming to enhance access to quality care while keeping costs manageable. These financing needs to address current health system demands without burdening the government and public, while also boosting healthcare quality. The study explores how to prioritize sustainable financing using the Kingdon multiple streams model. MATERIALS AND METHODS: This qualitative study looks at how a sustainable financing program is set up in Iran's health system using Kingdon's multiple streams model. It identifies three main areas: issues (problem stream), solutions (policy stream), and political will (political stream). Data were gathered through interviews and analyzed for themes. RESULTS: Sustainable financing in Iran's health system faces major challenges in three areas: problems, policies, and politics. Key issues include a lack of financial resources, high healthcare costs, unequal access to care, low government funding, and poor resource management. Other challenges are high out-of-pocket expenses, limited insurance coverage, and reliance on oil revenue. Proposed solutions are to improve resource tracking, increase public health budgets, encourage community involvement, and use modern technology. The government must recognize these issues to build political commitment for sustainable financing, prioritizing resilience and effectiveness. DISCUSSION AND CONCLUSION: The collaboration between the World Health Organization, the Islamic Consultative Assembly, and health entities in Iran shows the alignment of problems, policies, and politics. By addressing financial issues and involving stakeholders, they create opportunities for sustainable health financing, improve community health, and strengthen the healthcare system.