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The purpose of this paper is to provide a dynamic model for implementing performance-based budgeting (PBB) in Ministry of Health and Medical Education (MOHME) in Iran.

The insights from PBB, organizational theory and theory of system were integrated based on system dynamic approach. The primary data were gathered in a two-step process through in-depth interviews and focus groups. The data gathered from the interviews were analyzed using thematic analysis and were considered as a basis for modeling based on system dynamic. The dynamic model was verified in the MOHME of Iran based on the data gathered from the focus group.

An analytical implementation model was adopted for the PBB, including comprehensive variables at both external (country) and internal (organizational) levels and accordingly the relationships were established among these variables based on system dynamics (SD). In addition, verifying this model in the MOHME of Iran sets the stage for gaining a deeper understanding of what is required for successful implementation of PBB.

This paper introduces an efficient modeling methodology based on SD, which explains how soft methodology can be used in management science for designing an implementation model of PBB in healthcare sector of Iran.

Despite the potential benefits of total quality management (TQM), many healthcare organisations encountered difficulties in its implementation. The purpose of this paper is to explore the barriers to successful implementation of TQM in healthcare organisations of Iran.

This study involved a mixed research design. In-depth interviews were conducted with TQM practitioners to explore TQM implementation obstacles in Iranian healthcare organisations. In addition, this study involved survey-based research on the obstacles associated with successful TQM transformation.

TQM implementation and its impact depend on the ability of managers to adopt and adapt its values and concepts in professional healthcare organisations. Unsuccessful TQM efforts in Iranian healthcare organisations can be attributed to the non-holistic approach adopted in its implementation, inadequate knowledge of managers’ about TQM implementation, frequent top management turnover, poor planning, vague and short-termed improvement goals, lack of consistent managers’ and employees’ commitment to and involvement in TQM implementation, lack of a corporate quality culture, lack of team orientation, lack of continuous education and training and lack of customer focus. Human resource problems, cultural and strategic problems were the most important obstacles to TQM successful implementation, respectively.

Understanding the factors that are likely to obstruct TQM implementation would enable managers to develop more viable strategies for achieving business excellence.

Understanding the factors that are likely to obstruct TQM implementation will help organisations in planning better TQM models.

The purpose of this paper is to investigate the factors that have resulted in the effective implementation of accrual accounting reforms in the Central Government of Tanzania.

The paper relies on the ideas of institutional theory and some aspects of decision-usefulness so as to delineate the external pressures enforcing the Government of Tanzania to embrace accrual accounting and the factors complicating its implementation at organisational level (within government entities). The authors draw on quantitative techniques and the explanatory and cross-sectional survey research strategies and methods for data analysis.

Our findings suggest that the coercive pressures from donors and auditors along with the normative pressures surfaced by the training of employees generate a significant impact on designing the effective administrative model of accrual accounting. In a lesser extent, pressures from the National Board of Accountants and Auditors and cultural factors are positively correlated to the implementation of accrual accounting in the Tanzanian context. Of the factors the authors examined, the management changes are proved to be least effective. Unawareness of the key stakeholders has caused weak political and regulatory commitments. Accrual accounting implementation is further exacerbated by inadequate technical and personnel competence. Ultimately, the implementation of the accrual accounting has increased significant managerial accountability though a major segment of such behaviour is unexplained by the factors the authors employed in the study.

The effective implementation of accrual accounting relies on improvements in cultural and human-related issues. What is important to understand is that accrual accounting is more of a management reform incorporating changes in broader aspects of institutional and accountability mechanisms, rather than just an adoption of particular accounting technologies. Without such broader changes, accrual accounting reforms can be detrimental providing the technocrats and government officials with a space for manipulating financial information, Tanzania serving as an example.

The study highlights the case of an emerging economy in which accrual accounting is actually in effect and has impacted on managerial accountability, but is struggling to engender intended results and outcomes at organisational level.

Reducing health inequalities between the poor and the rich is one of the challenges that the Iranian healthcare sector is facing. One of the goals of the Iranian Government in the Healthcare Sector Evolution Plan (HSEP) is claimed to be creating an opportunity for the poor to use inexpensive services. The purpose of this paper is to provide an analysis of the status of the poor in the HSEP. Based on this evaluation, the authors will provide policy recommendations to improve the benefits of the HSEP for the poor people.

This paper is based on a qualitative study conducted in 2017. The research sample includes policymakers, experts and scholars at the macro-level of the Iranian healthcare system who were well-aware of the financial support for the poor. Overall, 35 semi-structured interviews were carried out. Data were analyzed based on the thematic analysis method.

The effects of the HSEP on the poor were studied in terms of their positive outcomes and challenges. Despite the achievements of the HSEP for all people, the most important challenge was the lack of targeted state subsidies for the poor. These subsidies should have included free insurance coverage, reducing inpatient payment and allocation of a separate budget for the poor.

Adopting some policies to target public health subsidies toward the poor such as free insurance specific for the poor (based on means testing), as well as user fee exemption and waivers could improve access to health services for them in Iran. In addition, separate funding for such policies, strengthening health prevention and health care services for marginalized populations, and improving their health literacy could help ensure the poor’s benefiting more from the health care services.

The purpose of this study is to understand the efforts of key social actors in influencing the reform of Iranian public universities budgeting system, from incremental to performance-based budgeting (PBB), the tensions that arose as competing efforts of institutional change were undertaken, and ultimately the impact of these efforts on the extent to which the Iranian government transitioned to a system of PBB in public universities.

Data comprises of semi-structured interviews with managers and experts involved in the budget setting process and an analysis of budgetary policy documents, reports and archival material such as legislation. An institutional work lens is employed to interpret the findings.

While actors advocating the change were engaged in institutional work directed at disrupting the old budgetary rules by disassociating the rules moral foundations and creating new budgetary rules (through new legislation), universities undertook subtle resistance by engaging in extended evaluation of the new proposed PBB rules thereby maintaining the old budgetary rules. The reforms undertaken to introduce PBB in Iranian universities achieved minimal success whereby incremental budgeting continued to constitute by far a larger percentage of the budget allocation formula for university budgets. This finding illustrates change and continuity in university budgetary systems resulting from institutional work of actors competing to control the basis of resource allocation under the proposed PBB system by proposing contradicting models.

The findings highlight the importance of understanding the interplay of institutional work undertaken by competing social actors as they seek to advance their goals in shaping budgetary reforms in the public-sector. Such an understanding may inform policy makers who intend to introduce major reforms in public-sector budgeting approaches.

Unlike prior studies that largely focused on how organization-level budgeting practices responded to changes in public budgeting rules (i.e. at the site of implementation of the rules), this paper highlights how strategies of change and resistance are played out at the site of setting budgetary norms.

Health-related issues are widely covered in news agencies by medical and health journalists. The quantity, format and quality of their coverage influence the general public as well as policymakers and professions. Current studies and observations suggest that news agencies are more dominated by medical topics (disease, symptoms, epidemiology, treatment and medicines) than general public health issues (risk prevention, health protection, education and promotion). This study explores the causes of the current situation in Iran and generates solutions for supporting health-promoting media that may also prove beneficial for other countries.

A qualitative study was conducted to explore the coverage of health-related topics in selected news agencies. Stakeholders, including health journalists, health professionals and public relations staff at the Iranian Ministry of Health and Medical Education were interviewed. Data were collected until data saturation was reached. The transcripts of all the 17 interviews conducted were analyzed using conventional content analysis.

Four groups of causes were identified, including individual factors, organizational factors, socioeconomic factors and the different nature of medicine and public health. The participants proposed several solutions that were classified into three categories, including the empowerment of stakeholders through capacity development, organizational change and mutual communication and culture change.

Creating health-promoting media is a complex but urgent task, and providing a comprehensive and deep understanding of the dynamic interdependencies of the multiple factors at play in it and developing and implementing the most effective interventions for it requires a systematic approach.

The purpose of this paper is to discuss the challenges facing Iranian women in the workforce. While Iranian women's participation in higher education is exceptionally high, their participation in the workforce, especially the public sector, is low.

The paper compares the bureaucratic structures in public organizations with the “ideal” type of bureaucracy as defined by Weber (1922). Moreover, occupational segregation, which limits women's choices, is examined as another barrier for Iranian women's participation in the workforce.

The paper argues that the main reason for the low participation of women in public organizations is the ill-structured bureaucracies in these organizations. Also, occupational segregation limits the career choices of Iranian women. Some of the challenges caused by these two factors are the result of discriminative rules and regulations.

The paper contributes to the limited knowledge concerning the issues faced by Iranian women attempting to enter and progress in public organizations. While literature suggests that western women also face the same challenges in organizations, the unique characteristics of Iranian public organizations calls for separate analysis of these barriers in the Iranian context. By introducing readers to this unique subgroup of employees, the paper represents a starting point to an important area of research.

According to the importance of strategic purchasing as an effective tool for resource allocation and service procurement, this study examines national laws, regulations and other related documents related to the strategic purchasing of health services related to the advanced medical equipment in Iran.

It was a national qualitative document analysis conducted in 2019 applying content analysis approach. The four-step Scott method was used to include the documents in terms of authenticity, credibility, representation and meaningfulness. After retrieving the related documents, they were coded with the implicit and explicit approach. MAXQDA₁₀ was used for content analysis.

The findings show that according to the framework of effective factors on the strategic purchasing of health services, seven main factors are determined as the main essential factors in purchasing advanced medical equipment. These factors consist of health care providers, health service buyers, purchaser and service provider contracts, payment mechanisms, organization and management evaluation of health technology including expensive medical equipment and technology-related.

The study had some limitations as follows: the proposed method should be tested and its feasibility has to be investigated through appropriate tools for Iranian insurance companies and those with the similar settings.

The results of this study can shed more light for policy makers affiliated in Ministry of Health as the main service provider, Ministry of Welfare and the insurance agencies as the main purchasers of health services on paying attention to these seven main themes extracted from the upstream documents and laws and regulations of the Islamic Republic of Iran.

The strategic purchasing of expensive high technology-based medical equipment is a necessity for Iranian public health insurance organizations that is emphasized in national documents in the way of implementing this necessity.

This study examines all the laws and regulations and all related documents in the strategic purchasing of health services related to advanced medical equipment, giving an analysis of the most important challenges and requirements of implementing strategic purchasing in the health services provision sector with expensive medical equipment.

In May 2014, a new reform in the health sector of Iran was implemented called “health evolution plan.” In the first phase of this reform, the government reduced out-of-pocket payments for service delivery by paying subsidies to the services and after that a revision was done to the medical services values book to improve equity and increase motivation of health professions. One of the affected services in this reform was coronary artery bypass surgery. The purpose of this paper is to show the effects of HEP on costs of coronary artery bypass surgery.

A before-after study was done for this purpose and 167 patients’ total costs and out-of-pocket payments were calculated for the years 2013 (before) and 2014 (after) the reform in three private hospitals of Rasht city, Iran. Econometrics models were estimated after adjustment of confounding variables.

The results of this study showed that surgery costs increased significantly from $1,643.3 to 2,119.5. Nursing and other costs increased significantly from $290.3 to 414.2 and anesthetize costs increased from $619.2 to 947.01. The results of regression model showed that total costs increased $3,008.6 after adjustment of confounders (p-value=0.037). However, no significant changes were found for out-of-pocket payments and out-of-pocket percentage.

The study findings revealed that HTP was not successful enough in financial protection in the private sector.

The purpose of this paper is to analyze HRM practices in Iran in view of underlying cultural, political and economic factors.

The paper is organized in three major parts. The first part deals with HRM concept and Iranian social context. The second part presents methodology and data analysis. The third part discusses results and illustrates HRM practices in Iranian organizations. The study involves in‐depth interviews with four Iranian managers and data collected from 82 respondents through Likert‐type questionnaires (n=82, rate of response=44 per cent).

The findings in the paper shed light on the main HRM functions in the Iranian public sector. Staffing is marked by pervasiveness of networking, entitlement, compliance with Islamic/revolutionary criteria and high job security. Compensation is described by features such as fixed pay, ascription/seniority‐based reward, and hierarchical pay structure. Training and development programs are found to be unplanned and spontaneous. Finally, the paper shows that the appraisal function receives little attention and tends to be based on subjective and behavioral criteria.

The paper shows that the study is limited in terms of HRM functions, sector and sample size. Further research may make comparison between large/state‐owned and small/private organizations.

The findings in the paper might be valuable for MNEs, NGOs, international negotiators, expatriate managers, investors and those who are concerned with this part of the world.

The paper presents a convenient approach in assessing HRM variations. The combination of qualitative and quantitative data provides a thick description of HRM enriched by secondary data and previous research. Given some commonalities between Iran and other developing countries, the findings might be of potential interest in comparative studies dealing with management transferability.