Agenda-setting for iron deficiency anaemia prevention and control policies in Iran by multiple streams framework

According to the WHO report and evaluations, Iran has a moderate prevalence of iron deficiency anaemia (IDA). The present study evaluates Iran's IDA prevention and control policies by analysing the agenda-setting policy using the multiple streams framework (MSF).

The present study used Kingdon's MSF model to analyse policies related to IDA in Iran qualitatively. First, the policy documents were reviewed (n = 12), and then in-depth interviews were conducted with key stakeholders (n = 33) using the framework analysis method. MAXQDA version 2020 was used to categorize the data codes of the interviews and extract related themes.

The main factors of the problem stream were the prevalence of IDA among Iranian pregnant women, children and adolescents and its risk factors in Iran. The policy stream focuses on mounting the staff in health centres, preventing non-communicable diseases and parasites in the health system, and promoting health programs, such as supplementation, education and fortification. The current political stream regarding IDA shows that national and international support can provide the right political atmosphere for this issue. There are challenges and obstacles related to implementing these policies in Iran, including the preference for treatment over prevention in the health sector, the existence of many economic problems and the limitation of distribution and access to health services owing to some unforeseen issues, such as sanctions or the spread of coronavirus disease 2019 (COVID-19).

The topic of IDA prevention policymaking has entered a new phase. Responsible organizations, such as the Ministry of Health, should emphasize more in allocating budgets for preventive programs, and key organizations, such as the WHO, should support low- and middle-income countries to empower them towards important preventive strategies.