Challenges of Health Centers to Achieve Participatory Governance

 
The significance of participatory governance has grown in recent years. The purpose of establishing health organizations was to increase citizen participation in the field of health. In practice, this plan encountered numerous obstacles. This study aimed to evaluate and investigate the obstacles health clubs face in achieving participatory governance.
This is a qualitative investigation that employs in-depth interviews and focused group discussions. Interviews were conducted with 22 experts, policymakers, administrators, health center service providers, and residents of four Tehran districts. The data in this investigation were classified using the Emerson and Nabatchi participatory governance model.
 Iran’s cultural barriers to participatory governance consist of individualism and a lack of collaboration. Social barriers consist of a lack of trust between the public sector and the general public, competition between various stakeholders, self-interest in participation, and diminished reciprocal moral obligations. In the field of system, the dynamic obstacles to cooperation include a lack of common understanding of the problem among different stakeholders, a lack of consensus in decision-making, a disregard for everyone’s interests, lobbying, an inability to hear all voices, competition among stakeholders, and a lack of justification by the municipal body for the significance of public participation. The ineffectiveness of formal leadership in the public sector in conflict management, guiding leadership, and a tool-based approach to participation are among the leadership challenges.
Participatory governance is the basis for the establishment of health centers, one of the obstacles they must overcome to succeed. Challenges must also be addressed in the decision-making process, shared comprehension, common motivation of stakeholders, formal leadership, financial and information structure, and information flow among stakeholders.