Deficits in health market have forced governments to intervene in the market. The most important types of interventions implemented by governments are financing, delivering services in governments' structures, determining activities of nongovernmental providers as well as monitoring their performances, and training human resources. In addition, governments are required to reduce risks of diseases in communities through continuous monitoring of population health and intervening to reduce health hazards in environments.
Amount of money governments and people insert into health system represents the volume of resources allocated to health in societies. Comparing population health with resources allocated to health systems gives a clear perspective of efficiency of health systems. Such comparison helps to understand that societies in where there are similarities in resources allocated to health may differ from level of population health. This means that in addition to the volume of resources spent on health, utilization of resources is also important in achieving outcomes. Important health decisions or policies that governments take place and manner of utilization of these resources base the differences of performance of health systems in countries.
Policy makers adopt health policies to achieve certain desired outcomes. In order to improve health systems performances via these policies, firstly, the right outcomes should be followed; secondly, in practice, correct methods should be used to achieve these outcomes. Considering right outcomes as goals of health policy requires a coherent theoretical basis about concept of health, evaluation and analyses methods, related data and method to determine health policy goals (outcomes).
The occurrence of each outcome depends on a complex set of its underlying factors. Personal experiences as well as implicit analysis of observations leads to formation of causal relations between phenomena in human mind. Such experiences do not help to identify all underlying factors of occurrence of an outcome. Thus, if the policies are based on these concepts, they will not lead to the desired outcomes of policy makers. Unforeseen side effects of such policies may outweigh the positive consequences. Sources used for the failed policies should be considered wasted. Identification of all determinants of an outcome prior to intervening on it is practically impossible. Therefore, before adopting a policy, enough evidence for its success should be searched. The outcome of an implemented intervention is the outcome of all factors affecting it. Only in real condition, ability of intervention to achieve desired outcome can be judged. If such evidence is not available, it should be produced prior to implementing policy. Evidence-based policymaking avoids wasting resources and increases efficiency of health system through ensuring access to desired outcomes.
Understanding the necessity of health system reliance to robust theoretical foundations and evidence by health policymakers is a historical cornerstone for health system to move from traditional structure to an efficient theory- and evidence-based framework. In the recent years, Iran's health system has experienced this situation. This system experiences both successful evidence-based policies and side effects of policies based on the policymakers desires. More these experiences are reviewed, more the necessity of this movement is justified.
Discussing theoretical foundations of health system, because of its logic delicacies and complexities, and producing enough evidence for choosing efficient health policies will have the chance to grow within an academic environment. Therefore, reliance of executive and policymaking domains to academic institutions is necessary for development of health systems. Interaction of scholars with each other and with the health system is a unique way to develop theoretical and technical foundations to promote health system. Disseminating ideas and policy implementation information establishes such dyadic way; and the primary mission of scientific publications is to provide a platform for this interaction. The Hakim research journal, in terms of dependency to the ministry of health as the country's health policymaking institution, obliged itself to make such a situation. A journal can be both the production of a new approach and the creator of it. The change in the policy of the journal shows the decision of the ministry to change its approach. However, because of the young base of the theory- and evidence-based movement in the country, this journal tends to develop and strengthen this movement as its new mission. Based on this mission, we are gradually to change the subjects of the articles from routine articles to article related to policymaking. In this way, we hope to have supports of related executive and academic institutions.
According to the editorial board of the Hakim research journal, mission of the journal is to publish scientific findings and analyses that increase knowledge necessary to decision makings related to policymaking and management of country's health system. The main topics should have wide ranges including social determinants of health, health systems, assessment of national and regional health programs, resource allocation, and legal aspects of health programs implementations (mentioned topics are merely examples and do not include all domains). The target audiences of the journal are policymakers, health system managers, service providers, and all researchers who work in the above-mentioned fields.
Submitted manuscripts should be in the form of original article, policy analysis, economic assessment, systematic review and letter to the editor. While welcoming other aspects of medical sciences research, it is obvious that the above-mentioned issues are in the priority of publication in the Hakim Journal.