Document Type : Original Article


Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran


INTRODUCTION: This study was designed and implemented with the purpose of identify and analyze
the stakeholders in Iran’s Health Insurance System (HInS).
MATERIALS AND METHODS: This study was a mixed method study. The study setting was in the
field and consists of all organizations in the HInS. The study steps designed according to the Kammi
Schmeer stakeholder analysis model. The information was collected through semi‑structured and
structured interviews with 16 stakeholder representatives. The data collection tool was checklist
and matrixes that determined the characteristics of the stakeholders. Analysis of data was done by
Maxqda10 and Mactor software.
RESULTS: A total of 34 stakeholders were identified that were involved in nine main activities of
HInS. Major stakeholders have governmental nature. The Government, the Planning and Budget
Organization, the Ministry of Health, the Welfare Ministry, the Higher Health Insurance Council,
and the Medical Council were stakeholders who have high financial, decision‑making, and political
power simultaneously. The Parliament and the Health Commission, the Government, the Planning
and Budget Organization, and the Ministry of Health were stakeholders that had the most influence
on other stakeholders. Most of stakeholders have same position to the objectives of the HInS. The
insurer organizations had opposed position with the objective of integrity of the funds.
CONCLUSIONS: Stakeholders of Iran’s HInS are multiple and involved in various activities that
sometimes they are overlapping and parallel.  Regarding the same position of the majority of
stakeholders to the objectives, reforms are possible, provided that influential stakeholders participate
in policies making.


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