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Table 5 Proposed interventions and their levels

From: Intersectoral collaboration in the management of non-communicable disease’s risk factors in Iran: stakeholders and social network analysis

Level

Proposed Intervention

Appropriateness

Feasibility

Paradigm

1. Continuous insistence and emphasis on health in all policies in the approaches of the Councils to attract attention and change the attitudes and values of key council members (changing the values of key individuals)

High

Medium

2. Planning to reform and improve the organizational culture with health values in councils and members (ministries) (changing organizational values)

High

Low

3. Frequently challenging hypotheses, values, and priorities that are harmful to health in supreme councils

High

Very low

4. Identifying the educational and social centers in which council members were trained before reaching their positions and inject health-oriented principles into the training of these centers and communities

Medium

Low

Goals

1. Developing new health-related goals for supreme councils to improve community health

High

Medium

2. Preparing the essential prerequisites for achieving the national health goals related to the responsibilities of each council and delivering them to the secretariat of the supreme councils

High

High

System structure

1. To membership in supreme councils with significant effect over health determinants

High

High

2. Using weighted ballots in supreme councils with more weight of votes of the representative of the Ministry of Health in health-oriented affairs

Very High

Low

3. Combining supreme councils (with relevant specialized committees), for example, combining councils dealing with welfare, social affairs, and community health

High

Low

4. Expanding health secretariats in other ministries and directing them to influence representatives of relevant ministries in supreme councils

High

Medium

5. Improving the communication structure of the representative of the Ministry of Health in the supreme councils with the management body and units, offices, and specialized centers of the MoHME

Medium

High

6. Creating a database and developing the health-based information flow system related to the tasks and mission of each council

Medium

High

7. Establishing inter-ministerial committees and working groups at the level of experts in the sub-councils

High

Medium

Feedback and delays

1. Monitoring policies and approvals of councils to respond immediately to possible undesirable approvals

Medium

Medium

2. Creating negative feedback loops (e.g., legal and punitive action against harmful approvals)

High

Medium

3. Defining index-based critical values to provide negative feedback on councils (Like a thermostat, it prevents the system from collapsing and keeps it within safe boundaries)

High

Medium

4. Controlling and slowing down positive feedback loops in the relationship between councils and their members (for example, ministers use their influence on council members to advance their programs that harm public health)

High

Low

5. Organizing lectures, meetings, and specialized publications related to councils and their field of work

Low

High

6. Providing feedback on the effects of the activities of high councils and ministries and organizations to people and specialized communities to create sensitivity and awareness in society

Low

Medium

7. Creating feedback loops in places that did not exist before and involving a wide range of stakeholders in feedback

Medium

High

Structural elements

1. Allocating a special workforce to deal with the affairs of each council in the MoHME

Medium

High

2. Using human resources training (representative of the MoHME and following team in councils) to improve leadership skills, promote cooperation, and manage conflict of interest situations

High

High

3. Extracting policies and inter-sectoral interventions of national health programs and network them with supreme councils

Low

High

4. Trying to commit commitment to allocate resources to members of the councils until the commitment to goals without the operational program

Medium

Medium

5. Prioritize public health issues related to supreme councils based on disease burden and mortality or approximate time for reform

High

High

6. Establishing a health-oriented point in the process of reviewing, approving, and evaluating policies in councils

High

Medium