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Health is a human right and a fundamental building block of sustainable development, economic prosperity and poverty reduction. To realize people’s right to health, evaluating the situation of the right and its determinants is necessary. This paper aims to analyze Iran’s conduct in realizing its population’s right to health.

A qualitative case study design involving a structured review of relevant laws, policy documents, reports and academic literature was undertaken. The data were collected from electronic databases and the official Web pages of the United Nations (UN) and Iran’s Government and analyzed by a framework suggested by the UN.

Iran’s law and policies intend to combat health inequalities and to provide an adequate standard of living for everyone, particularly disadvantaged groups and individuals. However, not all laws and policies protecting disadvantaged groups are adequately implemented. There are disparities in health status and access to health care among different socio-economic groups. International economic sanctions and government policies decreased people’s ability to access the necessities of life including health care. Moreover, social determinants of health, such as cultural beliefs regarding women’s rights have not been addressed sufficiently in the country’s laws.

This study includes a broad range of subjects and provides an overview of the health-care system of Iran. However, more detail is needed to describe every aspect of the right to health. It was not feasible to address them all in this paper and needs more research. In addition, as with the majority of qualitative studies, the design of the current study is subject to limitations. Firstly, the research quality of narrative reviews is dependent on the researcher’ skills and more easily can be influenced by his/her personal biases. Second, the rigor is more difficult to maintain, assess and demonstrate. Nevertheless, narrative studies often complement quantitative studies and are informative.

To fulfill the right to health, Iran should improve affordability and quality of care and the situation of the determinants of health. The gaps in people’s access to health care need to be identified, and all necessary means and scarce resources be allocated to remove access barriers and to improve the situation of disadvantaged people. The adoption of relatively low-cost targeted programs, the proper management of resources and the prevention of unnecessary costs are suggested.

In light of the recent changes in the internal audit (IA) landscape, the role of auditors has undergone a significant transformation. This paper aims to investigate the effects of applying Lean Six Sigma (LSS) techniques on the effectiveness and efficiency of IA.

The study used a quantitative approach, surveying Iranian internal auditors with a sample size of 384 participants. Data analysis involved confirmatory factor analysis and structural equation modeling.

The analyses demonstrate a significant association between LSS application and IA effectiveness and efficiency. In addition, an exploratory analysis indicates that the application of LSS techniques by less experienced internal auditors had a reverse effect on IA function quality as a component of IA competency. However, IA motivation factors, including education and position, did not mediate the impact of LSS on IA effectiveness and efficiency.

This study was conducted with Iranian internal auditors, which may limit the generalizability of the findings to other countries. However, the primary academic implication of this research lies in its novel perspective on emphasizing the concept of continuous improvement in IA through the use of LSS techniques. By focusing on the need for internal auditors to add value to the business in new ways, this research contributes to the literature on IA quality.

This study has significant implications for the effective management of IA departments. By promoting the application of LSS techniques in IA, lean auditing is enhanced, and IA can create value by improving the quality of its functions. Moreover, IA regulators can benefit from this study as it emphasizes providing guidance and training on LSS techniques to enhance IA skills.

This research is pioneering in applying LSS methodology to enhance the effectiveness and efficiency of internal auditing. It also considers the integration of lean thinking into current audit practices, making it unique and valuable in internal auditing research.