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Table 2 The challenges of the Iranian HRS from a stewardship perspective

From: What the policy and stewardship landscape of a national health research system looks like in a developing country like Iran: a qualitative study

Features

Macro

At the national scale (not restricted to MOHME)

Meso

(Within the authority of MOHME)

Micro

Research bodies and researchers

Status

Status

Status

Leadership

Not clear

Defined structure with malfunctions

Nonfunctional

Not efficient

Vision

Not defined

Not defined

Not determined or expressed inefficiently

Not aligned with a big picture

Priority-setting

Not well defined

Not transparent

Not participatory

Not systematic

Not future-oriented

Not efficient

Not well defined

Not transparent

Not participatory

Not systematic

Not efficient

Not future-oriented

Not matched with national development needs

Not aligned with the big picture or not defined

Structure

Not harmonized/multiple actors

Overlapped scope of stakeholders

Inefficient in conflict of interest management

Under the influence of political dominance

Not agile

Inefficient

Centralized

Bureaucratic

Under the influence of political dominance

Not sustainable

Contradictory in conflict of interest management

Not agile

Not updated

Nonuniform

Dependent

Gap between theory and practice

Inadequate in conflict of interest management

Not agile

Regulation

Contradictory

Inefficient in:

• Incentives

• Intellectual property

• Capacity-building

• Public–private partnerships

• Enhancing international scientific relations

• Research structure development

Contradictory

Inefficient in:

• Research process management

• Enhancing transparency

Inefficient in:

Motivating researchers

Performance improvement

Research monitoring and evaluation

Not defined

Not well defined

Non harmonized

Not standardized

Not systematic

Not dynamic

Inefficient

Quantitative

One-dimensional

Not well defined

Not harmonized

Not standardized

Not systematic

Not dynamic

Inefficient

Quantitative

One-dimensional

Communication, networking and collaboration

Not defined (among critical stakeholders)

Not practical

Not well defined (among critical stakeholders)

Inefficient

Not practical

Not well defined (among research bodies and individuals)

Inefficient

Not practical

Evidence-based/informed decision-making

Not well defined

Not efficient

Less trusted

Nonfunctional

Not a priority

Not well defined

Not efficient

Less trusted

Nonfunctional

Not a priority

Not motivating

Not efficient in responding