To read this content please select one of the options below:

Stewardship of noncommunicable diseases in Iran: a qualitative study

Taha Nasiri (Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran) (Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran)
Shahram Yazdani (Department of Medical Education, School of Management and Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran)
Lida Shams (Department of Health Management, Policy and Economic, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran)
Amirhossein Takian (Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran) (Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran) (Health Equity Research Centre (HERC), Tehran University of Medical Sciences, Tehran, Iran)

International Journal of Health Governance

ISSN: 2059-4631

Article publication date: 16 March 2021

Issue publication date: 4 June 2021




Noncommunicable diseases (NCDs) count for over 80% of premature death worldwide. More than 76% of the total burden of diseases in Iran is devoted to NCDs. In line with the World Health Organization action plan, Iran has developed its national action plan that led to establishment of the National Committee for Prevention and Control of NCDs (INCDC), whose aim is 30% mortality reduction attributed to NCDs by 2030. The stewardship of health system is the cornerstone of performing and sustaining meaningful actions toward prevention and control of NCDs. The literature is tiny on how to materialize the stewardship and governance of health system. The purpose of this article is to report the findings of a national study that aimed to identity functions and subfunctions of stewardship of NCDs and its related risk factors in Iran.


This is a qualitative study. The authors conducted interviews with 18 purposefully selected interviewees until the authors reached saturation. Thematic content analysis was used for analysis and MAXQDA 10 was employed for data management. The difficulty of coordinating with interviewers and health policymakers in the field slowed the process of research progress.


The authors identified seven themes and categorized them as main functions for appropriate stewardship of NCDs in Iran, including intelligence generation; strategic framework; evidence-based policies/decisions; system design; resource allocation/development; capacity-building and enforcement/alignment; and categorized them as important.

Practical implications

The seven themes presented as stewardship functions include concepts and practical examples of the experiences and performance of leading countries in the field of NCDs control that can help policymakers and health managers for better descion-making.


Iran adopted its national action plan in 2015 and WHO selected Iran as a fast-track country in 2017. The study confirmed that to achieve the global targets, appropriate and contextual stewardship for any specific setting is fundamental. Iran needs to improve its stewardship for prevention and control of NCDs and implement its national action plan. Therefore, the functions and policies outlined in this article for the proper performance of NCDs can improve more meaningful practices in this area in Iran and many other countries.



Declarations: Ethics approval and consent to participate: This study was a part of a research project in health policy at Tehran University of Medical Sciences (TUMS) – Iran. We received ethical clearance from TUMS' ethical committee (code number: IR.TUMS.VCR.REC.1395). We observed confidentiality and ensured participants. I confirm whether informed consent was obtained from study participants with written.Consent for publication: Not applicableAvailability of data and material: Data in this study were obtained from qualitative interviews and its interviews are availableCompeting interests: The authors declare that they have no competing interestsAuthors' contributions: TN conducted the interviews and initial analysis. AT was the project supervisor. SY and LS read the manuscript and contributed to its intellectual development. AT is guarantor.


Nasiri, T., Yazdani, S., Shams, L. and Takian, A. (2021), "Stewardship of noncommunicable diseases in Iran: a qualitative study", International Journal of Health Governance, Vol. 26 No. 2, pp. 179-198.



Emerald Publishing Limited

Copyright © 2021, Emerald Publishing Limited

Related articles