The problems that the new vice president of health must take seriously / Satisfaction with health services is declining

Saeed Meskini Mod, family doctor of Zahedan University of Medical Sciences, in an interview with Fars Health reporter, said: What the new deputy health minister should pay more attention to in the ministry that is related to people’s lives and health.
Health and prevention is an issue that neglecting it can cause a lot of costs for the people and the government.

He added: “Perhaps in the past 40 years, the health system has rarely seen a minister of health who, after receiving the opinions of those who care about the health system and examining the performance of the country’s health sector, has boldly realized the neglect in the field of health and proceeded to replace the deputy health minister.” It has been one year since he became the chancellor.

Referring to the change of the Deputy Minister of Health, this family doctor said: This early change means that the satisfaction of the people and health service providers in the country’s health sector during this period has not only not improved, but on the contrary, it has declined. has put

In response to the question, what is the role of the deputy health minister in this sensitive ministry that deals with the lives and health of citizens, he pointed out: based on the principles of macro-management, in health systems like Iran’s, which are based on pyramidal structures, the role of Ras Haram (Deputy of Health) is not hidden as one of the executive leaders of the country’s programs. But few have paid attention to the leadership role of health processes in the pyramidal structures of the Ministry of Health.

He added: What people and service providers touch is regardless of the hierarchy of existing pyramid structures and before they understand who is the boss, they understand the quality of service delivery at the end of the service processes and their level of satisfaction is higher. It is affected by the change of owners of the existing processes rather than the change of the head of the pyramid.

Meshkini stated: If the processes were optimal, after receiving the service, people would leave the place with satisfaction from the same provider (physician, doctor, midwife, health expert, etc.), but if there was dissatisfaction in the hierarchy, they would first go to After that, the service provider complains to the health and treatment network of the city, and if the level of dissatisfaction with the service has led to a complication or crisis in their health, they take the matter to the province and sometimes even to the representative of the people in the Islamic Council. They say that this case may also open the issue of a question raised by the representative of that city to the Minister of Health in the parliament. All these events may happen without people knowing who the main owners of the disruption in the health service process were? And who should they complain about?

He reminded: In some countries, such as Sweden, which have a horizontal structure and the owners of the health processes are local, the role of the top of the health pyramid in the Ministry of Health is the leadership of the process owners, so the dissatisfaction of the people and service providers is simply reflected on the owner of the processes. And responsibility and accountability are clear. But in our country, which has a pyramid structure, the owners of the processes are located in the administrative hierarchy in the central headquarters of the Ministry of Health and medical sciences universities, and they are usually pale and without responsibility and accountability. Because the responsibility and accountability is directed to the Deputy Minister of Health, but the processes are explained, determined and continued by the middle management and the expert body of the relevant headquarters, and in fact, they are the owners of the process in the country’s health system, who should be accountable.

The family doctor of Zahedan University of Medical Sciences emphasized: You can see that in this end of the spectrum, no one complains about the owners of the processes and they still remain in a safe cocoon. The fact is that the large amount of daily affairs of Ras Haram (Vice President of Health) combined with the lack of complete coverage of numerous process matters in terms of form and substance, will never make it possible to reform the process system in a short period of time. For this reason, entrusting the relevant processes to the previous owners of the processes (middle managers) is a long-standing tradition and a mistake that has happened many times by the deputy health officials, especially in the headquarters of this ministry. This weakness is exactly the place that causes the lack of success of the deputies.

He continued: It is natural that people do not notice the change in the quality of services at the end of the processes with the change of the health deputy. With this point of view, if in order to increase the satisfaction of people and service providers, the new vice president of health intends to modify the processes in the form of the existing pyramid structure, in his opinion, he should give special priority to the following issues so as not to suffer the fate of the previous vice presidents:

1- Paying attention to today’s challenges of the country’s health system, which includes the lack of integration and correlation of service processes with each other, as well as the governing management of these processes in order to solve each of the problems of the health system.

2- Changing the owners of a process that has been lasting for years with the replacement of deputies and is still inefficient because with the change of the deputy of health, the dissatisfaction of the people and service providers has continued. In fact, these people are directly involved, but they have never been held accountable due to lack of responsibility.

3- Supervision of relevant processes through five control buttons (providing financial resources, payment system, proper organization, determining own regulations and systematic control of the behavior of process actors)

4- Documenting and improving the processes, integration, intelligentization, execution and implementation of strategic health programs in the country in sync with the national regulatory and operational management.

5- Hearing constructive criticisms from experts, veterans and sympathizers of the health system instead of receiving destructive compliments from middle managers, who try their best to remain in their position by changing the deputy.

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