Investigating the status of Health System Cooperation with City Councils and Municipalities in Iran (Documents’ Analysis)

Abstract

Background: The existence of partnerships between the health system and other organizations, especially city councils and municipalities, which have inherent and legal duties in this regard, is of particular importance in the promotion of public health. Objectives: The present study aimed to assess the status of Health System cooperation with City councils and municipalities in Iran based on rules and documents. Methods: Altheide’s document analysis model (sample selection, data collection, data organization, data analysis, and reporting) was used to prepare and analyze the documents pertaining to the status of Health System cooperation with city councils and municipalities. The documents were classified at three levels of national rules, policies, and guidelines; Ministry of Health (MOH) and city council approvals; and eventually Tehran municipality’s measures. Results: A total of 78 documents were analyzed, including 17 documents at the level of national rules, policies, and guidelines; 8 documents at the level of Ministry of Health and city council approvals; and 53 documents at the level of municipality’s measures. Conclusion: There are adequate legal capacities for designing, planning, executing, as well as creating interaction and cooperation between the health system and other organizations, especially city councils and municipalities. Moreover, the motives behind creating purposeful and scheduled cooperation and participation are evident among the officials of the health system and city councils and municipalities. Some mechanisms have been established for cross-sectoral cooperation between the health system and other health-related bodies. Nonetheless, these structures lack the necessary competence, appropriateness, and adequacy to create the desired partnership. Moreover, sufficient attention is not devoted to existing capacities in municipalities and the city council. Accordingly, it is necessary to have a fundamental review on the available structures and enough attention has to be paid to the evident and hidden legal capacities in city councils and municipalities, as well as the Ministry of Health, to design an appropriate structure, create competent interaction, and provide more cooperation between the two organizations.