Requirement areas, challenges, and recommendations for promoting health diplomacy in the Iranian health system: a scoping review

Despite positive achievements in several areas, the implementation of health diplomacy in the Iranian health system faces numerous challenges and inconsistencies that require systematic attention. This scoping review aimed to identify the essential areas of health diplomacy within the Iranian health system, explore the associated challenges, and provide recommendations for promoting health diplomacy. This scoping review was conducted using the methodological framework proposed by Arksey and O’Malley. International online databases, including PubMed, Scopus, and Web of Science, as well as Persian-language databases, including Magiran and the Scientific Information Database (SID), were systematically searched without a time limit up to 31 August 2025. Two authors independently extracted data from the selected studies using a standardized data extraction form. The extracted findings were synthesized narratively and inductively organized into categories and subcategories based on their conceptual similarities and differences. Of the 5,545 studies identified from the data sources, 15 met the inclusion criteria and were included in the review. Natural hazards, such as the COVID-19 pandemic; educational and scientific activities in medical sciences; cooperation in the provision of health services; and health-related issues constituted the main areas of health diplomacy in Iran. Health diplomacy in Iran is influenced by both national and international challenges. Recommendations for addressing national challenges include macro-level internal, managerial, and structural measures. Additionally, measures to overcome international challenges and leverage fundamental drivers within the Iranian health system are essential. The findings of this study have broad implications for informing policymakers, managers, and the scientific community within the health system about the challenges and key drivers of health diplomacy and international engagement. A comprehensive understanding of the significance of health diplomacy can facilitate the effective achievement of broader objectives and maximize its potential benefits within the Iranian health system.