Policy Conflict Management in the Health System Policy-making Process Elements, Effects and Solutions

Document Type : Original Article


1 PhD Candidate, Department of Public Administration, Faculty of Economics, Management and Administrative Sciences, Semnan University

2 Assistant Prof, Department of Public Administration, Faculty of Economics, Management and Administrative Sciences, Semnan University

3 Associate Prof, Health Productivity Research Center, Tehran University of Medical Sciences


The purpose of this study is to present the elements affecting the formation, potential effects and strategies of policy conflict management. To answer the main research question, which is the elements affecting the management of policy conflict in the policy-making process of the Iranian health system? A qualitative approach and Delphi methods and content analysis were used. To implement the Delphi method, the opinions of 13 experts were received in the form of three rounds of questionnaires. The network of general policy conflict management themes was identified with 111 basic themes, 14 organizing themes and 3 comprehensive themes. The research findings were extracted from the Elements of conflict formation including the type of actors, ideological characteristics of the role-makers, performance contexts, environmental characteristics and design of internal elements of the policy. Findings from the effects of conflict including social, process, governance and reflection effects were also identified. Evidence-based decision making, participatory development, deepening transparency, legal regulation and conflict of interest management were also identified as policy conflict management solutions.


  • 1 - ابراهیمی، سیدعباس؛ عین­علی، محسن (1398). ارائه چارچوبی برای تبیین تسخیر خط­مشی­های عمومی با کاربست روش تحلیل مضمون و مدل­سازی ساختاری-تفسیری. مدیریت دولتی، 11 (3)، 403-430.

    2 - ابراهیمی، سیدعباس؛ دانایی­فرد، حسن (1393). طراحی مدل خط­مشی‌گذاری مبتنی بر شواهد در نظام سلامت ایران (پژوهشی کیفی). پژوهش‌های مدیریت عمومی، (24)7، 24-5.

    3 - احمدی، هانیه (1390). فهم دلایل عدم انسجام )ناهمسویی( خط‌مشی‌های عمومی در ایران: روش دلفی؛ پایان‌نامه کارشناسی

    ارشد. دانشکده علوم انسانی؛ دانشگاه تربیت مدرس.

    4 - حاجی هاشمی، زهرا؛ الوانی، مهدی؛ اخوان علوی، سیدحسین؛ دانایی فرد، حسن (1399). بررسی عوامل تعارض خط‌مشی‌گذاری حوزه محیط‌زیست و صنعت در ایران. فصلنامه سیاست‌گذاری عمومی، دوره 6 ، شماره 4 ، صفحات 89-109

    5 - حسنقلی‌پور، حکیمه؛ امیری، مجتبی؛ پورعزت، علی اصغر (1396). توسعه مدل ارزشیابی خط‌مشی نگهداشت اثربخش اعضای هیئت علمی در آموزش عالی. مدیریت دولتی، دوره 9، شماره 3، 489-516

    6 - عابدی جعفری، حسن؛ تسلیمی، محمدسعید؛ فقیهی، ابوالحسن؛ شیخ زاده، محمد (1390). تحلیل مضمون و شبکه مضامین:  روشی ساده و کارآمد برای تبیین الگوهای موجود در داده­های کیفی. اندیشه مدیریت راهبردی، (5)2، 151-198.

    7 - وکیلیان, حسن؛ درخشان, داور (1399). راهکارهای پیشگیری و مدیریت تعارض منافع در نظام قضایی با رویکرد تطبیقی. مجله حقوقی دادگستری، 84(109)، 271-291.

    • Baridam, B. B., & Govender, I. (2017, July). Policy conflict: Information and communication technology application in healthcare delivery. In 2017 Computing Conference (pp. 1054-1057). IEEE.
    • Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative research in psychology, 3(2), 77-101.
    • Corbin, J., & Strauss, A. (2014). Basics of qualitative research: Techniques and procedures for developing grounded theory. Sage publications.
    • Davis, M., & Stark, A. (Eds.). (2001). Conflict of Interest in the Professions. Oxford University Press on Demand.
    • Dunlop, N., Indulska, J., & Raymond, K. (2002, September). Dynamic conflict detection in policy-based management systems. In Proceedings. Sixth International Enterprise Distributed Object Computing (pp. 15-26). IEEE
    • Forester, J. (2009). Dealing with differences: Dramas of mediating public New York, NY: Oxford University Press.
    • Fredriksson, M., Gustafsson, I. B., & Winblad, U. (2019). Cuts without conflict: the use of political strategy in local health system retrenchment in Sweden. Social Science & Medicine, 237, 112464.
    • Jowett, M., Dale, E., Griekspoor, A., Kabaniha, G., Mataria, A., Bertone, M. P., & Witter, S. (2020). Health financing policy & implementation in fragile & conflict-affected settings: a synthesis of evidence and policy recommendations
    • Heidbreder, B. et al. (2011), Determinants of Policy Conflict in Michigan Municipalities. State and Local Government Review, 43(1). DOI: 10.1177/0160323X10397618
    • Heikkila, T, & Weible, C. M. (2017). Unpacking the intensity of policy conflict: a study of Colorado’s oil and gas subsystem. Policy Sciences, 50(2), 179-193.
    • Jones, B. D., & Baumgartner, F. R. (2012). From there to here: Punctuated equilibrium to the general punctuation thesis to a theory of government information processing. Policy Studies Journal, 40(1), 1–20.
    • Kaatz, J. B., French, P. E., & Prentiss-Cooper, H. (1999). City council conflict as a cause of psychological burnout and voluntary turnover among city managers.
    • Knight, J. (1992). Institutions and social conflict. New York, NY: Cambridge University Press.
    • Matland, R. E. (1995). Synthesizing the implementation literature: The ambiguity-conflict model of policy implementation. Journal of public administration research and theory, 5(2), 145-174.
    • May, P.J; Jones, B.D; Beem, B.E; Neff Sharum, E.A; Poague, M.K (2005), "Policy Coherence and Component Driven Policymaking". Arctic Policy in Canada and the United States. Policy Studies Journal, 33 (1), pp. 37–63
    • Newberry, S. (2020). Policy conflict: The influence of fiscal targets on reform of New Zealand's natural disaster fund. Financial Accountability & Management, 36(2), 189-206
    • Ostrom, E. (2005). Understanding institutional diversity. Princeton University Press.
    • Svara, J. H. (1990). Official leadership in the city: Patterns of conflict and cooperation. Oxford University Press on Demand. ISBN-13: 978-0195057621
    • Schneider, A. L., & Ingram, H. M. (1997). Policy design for democracy. University Press of Kansas.
    • Tarrow, S. (2013). Contentious politics. The Wiley‐Blackwell encyclopedia of social and political movements.
    • Tjosvold, D. (2008). The conflict‐positive organization: It depends upon us. Journal of Organizational Behavior: The International Journal of Industrial, Occupational and Organizational Psychology and Behavior, 29(1), 19-28.
    • Tiembre, I., Benie, J., Coulibaly, A., Dagnan, S., Ekra, D., Coulibaly, S., & Tagliante-Saracino, J. (2011). Impact of armed conflict on the health care system of a sanitary district in Cote d'Ivoire. Medecine tropicale: revue du Corps de sante colonial, 71(3), 249-252.
    • Weible, C. M., & Heikkila, T. (2017). Policy conflict framework. Policy Sciences, 50(1), 23-40.
    • Welch, D. D. (2014). A guide to ethics and public policy: Finding our way. New York, NY: Routledge.
    • Wolf, E. E. A. (2019). Dismissing the “vocal minority”: How policy conflict escalates when policymakers label resisting citizens. Policy Studies Journal. https://doi.org/10.1111/psj.12370
    • Yordy, J., You, J., Park, K., Weible, C. M., & Heikkila, T. (2019). Framing contests and policy conflicts over gas pipelines. Review of Policy Research, 36(6), 736-756.