Evolution of Iran’s health research system over the past 50 years: a narrative review

BACKGROUND: A substantial growth has been reported in Iran’s health research output over the last recent decades, throughout the times of economic, social, and political instability. This study reviewed the existing literature to provide a better understanding of the evolution of Iran’s health research system over this period. METHODS: A narrative review of studies addressing health research system (HRS) in Iran was performed. The search strategy and categorization of the retrieved data was informed by the HRS framework of the World Health Organization (WHO). This framework proposes four functions for HRS: (i) stewardship; (ii) financing; (iii) creating and sustaining resources; and (iv) producing and using research. Searches in MEDLINE through PubMed (using MeSH terms) complemented with semantic searches through PubMed and Google Scholar were conducted. RESULTS: After removing the duplicates, 805 articles were retrieved, of which 601 were irrelevant, and 204 were reviewed. CONCLUSIONS: Iran has made substantial progress in different components of its HRS over the last few decades, such as starting a discourse surrounding health research ethics, priority-setting, and placing monitoring mechanisms while increasing the capacity for conducting and publishing research. However, there is still room for improvements, or even a need for fundamental changes, in several components, such as regarding increasing the research budget and improving the funding allocation mechanisms; improving the education curriculum; and promoting the use of evidence. The findings emphasized that improvement of HRS functions requires addressing context-specific problems. This review provides essential lessons to share with other low- and middle-income countries and international organizations, eg, the WHO.