Stewardship′s illnesses in health system of Iran

Abstract

The World Health Report 2000 (WHR 2000) identified four core functions that all health systems should carry out in some way, regardless of how they are organized or where they are. They were financing, resource generation, service delivery and stewardship. Stewardship according to WHR 2000, is the most important and key function of health system in generating good performance and responsibility of the government, usually done through the Ministry of Health, is defined as the careful and responsible management of the well-being of the population, emphasizes the trust and legitimacy with which its activities are viewed by the general public. In this review article, library and internet search were used. In order to search the databases - Springer, Pubmed, Elsevier, ISI web of sciences, Scopus and Google scholar have been used. Six domains/sub-functions that collectively are thought to constitute effective health system stewardship are generation of intelligence, formulating strategic policy framework, ensuring tools for implementation powers; incentives; and sanctions, building coalitions/building partnerships, ensuring a fit between policy objectives and organizational structure and culture, ensuring accountability; responsibility and answerability to the population and consumer protection. The assumption is that, collectively, the better these sub-functions are carried out, the more effective health system stewardship will be and the higher attainment of intrinsic goals. Therefore, to perform better in the healthcare system and create the best and fairest health system, effective stewardship must be developed.