Actors in conflict of interest in Iran's health system: Ranking and policy recommendations for conflict of interest management

• Published in: World medical and health policy 2023-12, Vol.15 (4), p.476-488
• Main Authors: Khanjankhani, Khatere, Takian, Amirhossein, Shamsi Gooshki, Ehsan, Mohammadi, Seyed‐Mehrdad, Arab, Mohammad
• Format: Article
• Language: English
• Subjects: actores políticos; Civil society; conflict of interest; Conflict resolution; conflicto de intereses; Conflicts of interest; Criteria; Drugs; Food; fuzzy TOPSIS; Health; health system; Iran; Irán; Legislatures; Literature reviews; Management; NGOs; Nongovernmental organizations; policy actors; Ratings & rankings; sistema de salud; Statistics; 伊朗; 利益冲突; 卫生系统; 政策行动者; 模糊TOPSIS
• ISSN: 1948-4682; 2153-2028; 1948-4682
• DOI: 10.1002/wmh3.561

We conducted this study to rank conflict of interest (COI) actors in Iran's health system. Based on a review of relevant literature, we extracted a list of 27 actors within seven categories who play roles in the COI in the health system. We considered three criteria for ranking the actors: the actor's interest, power, and authority concerning COI. Each actor scored one to five on the Likert scale in every criteria. Using descriptive statistics, each actor's mean and standard deviation of its scores were calculated in these three indicators. The actors were ranked using the fuzzy TOPSIS method. The results showed the leading players in abusing the COI in the health system of Iran are the “Food and Drug Organization” and the “Parliament.” The role and capacity of civil society and nongovernmental organizations as essential arms of oversight and transparency should not be overlooked. The government needs to enhance its efforts, we envisage, to utilize the capability of these actors by opening a dialog with them and providing the necessary training for COI. Key points The Food and Drug Organization and the Parliament are the leading players in conflict of interest (COI) management in the Iranian health system. As the central legislative body in the country, the Parliament might have the most significant effect on COI management through appropriate and transparent law‐making. It is necessary to consider mechanisms for selecting people with the least COI in policy and decision‐making positions. The government needs to foster its efforts to make the best use of the energy and capability of civil society to manage COI. 本研究对伊朗卫生系统中的利益冲突（COI）行动者进行排名。基于一项相关的文献综述，作者提取了一份包含七个分类的27名行动者名单，这些行动者在卫生系统的利益冲突中发挥作用。我们考量了行动者排名的三个标准:行动者在利益冲突方面的利益、权力和权威。使用李克特量表对每项标准中的每名行动者进行打分，得分为1到5分。使用描述性统计，计算了每名行动者在这三个指标中得分的均值和标准差。使用模糊TOPSIS方法对行动者进行排名。结果显示，伊朗卫生系统中滥用利益冲突的主要行动者是“食品药品组织”和“议会”。不应忽视公民社会和非政府组织作为监督和透明度的重要部门所发挥的作用和能力。我们推测，政府需要加强努力，通过与公民社会和非政府组织展开对话并为利益冲突提供必要的培训，进而利用这些行动者的能力。 Este estudio clasifica a los actores de conflicto de intereses (CDI) en el sistema de salud de Irán. Con base en una revisión de la literatura relevante, los autores extrajeron una lista de 27 actores dentro de siete categorías que desempeñan roles en el conflicto de intereses en el sistema de salud. Consideramos tres criterios para clasificar a los actores: el interés del actor, el poder y la autoridad en relación con el conflicto de intereses. Cada actor obtuvo una puntuación de uno a cinco en la escala de Liker