Journal of Rafsanjan University of Medical Sciences
Volume 25, Issue 4 (7-2026)
JRUMS 2026, 25(4): 433-442 |
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Rahmani A, Salari M, Rezaeian M. The Application of the Nutcracker Effect in Health Policymaking: A Strategy for Integrating Community Participation and Government Policy in Health Programs. JRUMS 2026; 25 (4) :433-442
URL: http://journal.rums.ac.ir/article-1-8014-en.html
URL: http://journal.rums.ac.ir/article-1-8014-en.html
School of Health, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
Abstract: (18 Views)
Executive Summary: Many health programs fail to achieve full success due to the gap between policymakers and the actual needs of communities. The Nutcracker Effect emphasizes the integration of two approaches: "top-down" from the level of policymakers and decisionmakers toward the community and "bottom-up" from the level of the community and civil society organizations. This model shows that the simultaneous collaboration of government, implementing organizations, and the public can enhance the effectiveness of health policies. This policy brief, while introducing the Nutcracker Effect, presents strategies for improving health policymaking, increasing public participation, and promoting health equity. This process will contribute to the design of community-based programs, resource allocation, and the strengthening of local capacity in different regions.
Key words: Nutcracker effect, Health equity, Health policymaking, Policy brief
Funding: This study did not receive any funds.
Conflict of interest: None declared.
Ethical Considerations (Code of Ethics): Not applicable.
Authors' contributions
- Conceptualization: Mohsen Rezaeian
- Methodology: Abdollah Rahmani, Mohsen Rezaeian
- Data collection: Abdollah Rahmani, Mehrnoosh Salari
- Formal analysis: Abdollah Rahmani
- Supervision: Mohsen Rezaeian
- Project administration: Mohsen Rezaeian
- Writing-original draft: Abdollah Rahmani, Mehrnoosh Salari, Mohsen Rezaeian
- Writing-review & editing: Mehrnoosh Salari, Mohsen Rezaeian
Key words: Nutcracker effect, Health equity, Health policymaking, Policy brief
Funding: This study did not receive any funds.
Conflict of interest: None declared.
Ethical Considerations (Code of Ethics): Not applicable.
Authors' contributions
- Conceptualization: Mohsen Rezaeian
- Methodology: Abdollah Rahmani, Mohsen Rezaeian
- Data collection: Abdollah Rahmani, Mehrnoosh Salari
- Formal analysis: Abdollah Rahmani
- Supervision: Mohsen Rezaeian
- Project administration: Mohsen Rezaeian
- Writing-original draft: Abdollah Rahmani, Mehrnoosh Salari, Mohsen Rezaeian
- Writing-review & editing: Mehrnoosh Salari, Mohsen Rezaeian
Type of Study: Research |
Subject:
Statistics& Epidemiology
Received: 2026/06/7 | Accepted: 2026/09/7 | Published: 2026/07/31
Received: 2026/06/7 | Accepted: 2026/09/7 | Published: 2026/07/31
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