Health System Governance Evaluation: A Scoping Review.

Background: Governance is one of the critical functions of the health system. Good governance of the health system leads to better performance and outcomes. Evaluation is the first step to improving health system governance. Therefore, this research aimed to identify evaluation tools for health system governance. Methods: In the current scoping review, we searched all documents related to health system governance evaluation indexed in Medline, EMBASE, ProQuest, Scopus, Cochrane Library, Science Direct databases, and Google Scholar search engines to 2022, extracted, and assessed. Finally, documents were selected and analyzed by thematic analysis. Results: Thirty tools were found to evaluate health system governance. Among the proposed tools, 11 specific tools have been designed just for health system governance evaluation, while others have governance as a component of health system evaluation. Health system governance's significant components are health policy-making, strategic planning, organizing, stewardship, and control. Indicators such as accountability, participation, transparency, equity, efficiency, accountability, corruption control, effectiveness, ethic, the rule of law, and sustainability could be used to evaluate the health system governance. Conclusion: Different tools have been used to evaluate governance worldwide, and each governance evaluation tool has different components suitable for governance evaluation. However, these tools cannot fully evaluate governance and have shortcomings. A comprehensive evaluation of governance and sharing lessons denrael will affect the health system's capacity and ability to provide quality, safe and effective health services. It will lead to the stability of the health system.

Future of myocardial infarction mortality in Iran: a scenario-based study.

This study defines futures myocardial infarction landscapes and proposes a few policy options to reduce the burden of cardiovascular diseases using the scenario development method. We identified the effective drivers of myocardial infarction by reviewing the literature and completed the returned list with "experts" opinions. The results were classified using the STEEP (Social, Technological, Environmental, Economic, and Political) framework. We plotted the critical uncertainties in a two-dimensional ranking of "effect" and "uncertainty" levels. Eleven drivers with uncertainty and high potential impact were selected and categorized into three groups: Political Development, Access to health services, and Self-Care. Scenarios were developed, and 3 scenarios (optimistic, pessimistic, and possible) were selected based on scoring. For each scenario, policy options were formulated. Utilizing the capacity of Non-Governmental Organizations and charities and strengthening restrictive and punitive legislation was chosen as policy options for addressing possible scenarios. Building infrastructure and improving prevention services, designing and regenerating curative infrastructure were selected as optimal strategies for addressing issues related to the optimistic scenario. Strengthening restrictive and punitive legislation related to community health and population empowerment were proposed as critical policy options for health improvement regarding the pessimistic scenario. Increasing people's participation, strengthening infrastructure and punitive policies can be effective in Myocardial infarction mortality prevention policies in Iran.

Preventive Community-Based Strategies of Cardiovascular Diseases in Iran: A Multi-Method Study.

BACKGROUND: Community-based strategies for preventing non-communicable diseases, particularly cardiovascular diseases, are of great importance. AIMS: This study aimed to formulate a policy brief to identify and prioritize community-based strategies to prevent cardiovascular disease in Iran. METHODS: This multi-method study was conducted over three phases. In the first phase, rapid review, community-based strategies which mentioned to people's participation had been identified. PubMed and Scopus had been searched. In the second phase, a focus group discussion (FGD) was held by the participation of 15 experts from different disciplines to have been summarized and finalized the community-based strategies to prevent cardiovascular disease as policy options. Content analysis method was used. In the third phase, policy options were prioritized. In addition, the points of interest and the appropriate budget were suggested for each policy option by using the Delphi method with the participation of 15 experts. RESULTS: Community-based approach includes six strategies: engagement of non-governmental and charitable organizations, use of health marketing strategies, activating the role of community health workers, implementing of mobile health programs, social prescribing, and peripheral medicine.||| Utilizing Community health workers, using mobile health and engaging NGOs and charities were ported in higher levels. In all policy options, public-private partnership as the best investment as well as the Ministry of Health as the best focal point were proposed. CONCLUSION: Implementing multiple prevention strategies in the form of public engagement, incorporating prevention programs delivered by community health workers and increasing public-private partnership financial support may be effective in reducing cardiovascular disease.