Exploring the challenges of the Iranian parliament about passing laws for resource allocation in healthcare: a qualitative study

BACKGROUND: Awareness about the process of law making and the factors that affect the legislative process have an important role in improving legislations that are approved by parliaments. OBJECTIVE: This study aimed to explore and analyze the process of development and enactment of law in Iran’s parliament, and factors that might affect the enactment of laws that are related to the allocation and distribution of health sector resources in Iran. METHODS: In this case study, data were collected through review of literature and national documents, and experts’ interviews. Interviews were performed with selected members of parliament (MPs), ex members of parliament and professionals from the Ministry of Health and Medical Education (MOHME) (15 persons). MAX QDA 10 was used for coding and constructing themes. Data were analyzed in five steps (familiarization, developing a conceptual framework, coding, indexing, and interpretation) using a content analysis with inductive and deductive approaches. RESULTS: The main factors that could affect the approval and enactment of legislations related to allocation of healthcare resources in the Iranian parliament were categorized in seven themes including: Importance of issue, resource availability, legislator’s awareness about the topic, lobbying and unofficial relations with influential officials, mentioning strong reasons by MOHME, weakness of previous laws, and positive feedback related to the same laws. CONCLUSION: Although the process of law making in parliament, and implementation of them in health organizations have legal stages, the study showed that several key factors affect this trend. In fact, it is suggested the health policy makers and MPs consider extending a range of factors to improve the process of law making and the efficiency of legislation related to allocation of healthcare resources.