Journal of Rafsanjan University of Medical Sciences
مجله دانشگاه علوم پزشکی رفسنجان
JRUMS
Medical Sciences
http://journal.rums.ac.ir
69
journal69
1735-3165
2008-7268
10.66224/jrums
fa
jalali
1405
4
1
gregorian
2026
7
1
25
4
online
1
fulltext
fa
کاربرد مدل فندقشکن در سیاستگذاری سلامت: راهکاری برای تلفیق مشارکت مردمی و سیاستگذاری دولتی در برنامههای بهداشتی
The Application of the Nutcracker Effect in Health Policymaking: A Strategy for Integrating Community Participation and Government Policy in Health Programs
آمار و اپيدميولوژي
Statistics& Epidemiology
پژوهشي
Research
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" style="position:absolute; left:0; text-align:left; margin-left:20px; margin-top:2px; width:467.05pt; height:159.5pt; z-index:-251649536; v-text-anchor:top"> <w:wrap anchorx="margin"> </w:wrap></v:roundrect><b><span lang="AR-SA" style="font-size:11.5pt"><span style="line-height:110%"><span style="font-family:"B Nazanin"">خلاصه اجرایی</span></span></span></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:120%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><span lang="AR-SA" style="font-size:11.5pt"><span style="line-height:120%"><span style="font-family:"B Nazanin"">بسیاری از برنامههای سلامت به دلیل فاصله میان سیاستگذاران و نیازهای واقعی جامعه با موفقیت کامل اجرا نمیشوند. مدل فندقشکن بر تلفیق دو رویکرد "بالا به پایین" یعنی از سطح سیاستگذاران و تصمیمگیرندگان به سمت جامعه و "پایین به بالا" یعنی از سطح جامعه و تشکلات مدنی تأکید دارد. این مدل نشان میدهد که همکاری همزمان دولت، سازمانهای اجرایی و مردم میتواند اثربخشی سیاستهای سلامت را افزایش دهد. این خلاصه سیاستی ضمن معرفی مدل فندقشکن، راهکارهایی برای بهبود سیاستگذاری سلامت، افزایش مشارکت مردمی و ارتقاء عدالت در سلامت ارائه میدهد. این فرایند به طراحی برنامههای جامعهمحور و تخصیص منابع و همچنین تقویت ظرفیت بومی مناطق کمک خواهد کرد.</span></span></span><b><span dir="LTR" style="font-size:9.5pt"><span style="line-height:120%"></span></span></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:120%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span lang="AR-SA" style="font-size:11.5pt"><span style="line-height:120%"><span style="font-family:"B Nazanin"">واژههای کلیدی:</span></span></span></b><span lang="AR-SA" style="font-size:11.5pt"><span style="line-height:120%"><span style="font-family:"B Nazanin""> مدل فندقشکن، عدالت در سلامت، سیاستگذاری سلامت، خلاصه سیاستی</span></span></span></span></span></span></span></span><br>
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<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><a name="_Hlk114425361"><b><span style="font-size:9.0pt"><span style="line-height:140%">Executive Summary</span></span></b></a><b><span style="font-size:9.0pt"><span style="line-height:140%">: </span></span></b><span style="font-size:9.0pt"><span style="line-height:140%">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.</span></span><span dir="RTL" lang="AR-SA" style="font-size:9.0pt"><span style="line-height:140%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">Key words:</span></span></b><span style="font-size:9.0pt"><span style="line-height:140%"> Nutcracker effect, Health equity, Health policymaking, Policy brief</span></span><span style="font-size:7.0pt"><span style="line-height:140%"></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><span dir="RTL" lang="AR-SA" style="font-size:7.0pt"><span style="line-height:140%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">Funding:</span></span></b><span style="font-size:9.0pt"><span style="line-height:140%"> This study did not receive any funds.</span></span><span dir="RTL" lang="AR-SA" style="font-size:9.0pt"><span style="line-height:140%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">Conflict of interest:</span></span></b><span style="font-size:9.0pt"><span style="line-height:140%"> None declared.</span></span><span dir="RTL" lang="AR-SA" style="font-size:9.0pt"><span style="line-height:140%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">Ethical Considerations (Code of Ethics):</span></span></b><span style="font-size:9.0pt"><span style="line-height:140%"> Not applicable.</span></span><span dir="RTL" lang="AR-SA" style="font-size:9.0pt"><span style="line-height:140%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">Authors' contributions</span></span></b><b><span dir="RTL" lang="AR-SA" style="font-size:9.0pt"><span style="line-height:140%"><span style="font-family:"B Nazanin""></span></span></span></b></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">- Conceptualization: </span></span></b><span style="font-size:9.0pt"><span style="line-height:140%">Mohsen Rezaeian</span></span><span dir="RTL" lang="AR-SA" style="font-size:9.0pt"><span style="line-height:140%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">- Methodology:</span></span></b><b> </b><span style="font-size:9.0pt"><span style="line-height:140%">Abdollah Rahmani, Mohsen Rezaeian</span></span><span dir="RTL" lang="AR-SA" style="font-size:9.0pt"><span style="line-height:140%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">- Data collection: </span></span></b><span style="font-size:9.0pt"><span style="line-height:140%">Abdollah Rahmani, Mehrnoosh Salari</span></span><span dir="RTL" lang="AR-SA" style="font-size:9.0pt"><span style="line-height:140%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">- Formal analysis: </span></span></b><span style="font-size:9.0pt"><span style="line-height:140%">Abdollah Rahmani</span></span><span dir="RTL" lang="AR-SA" style="font-size:9.0pt"><span style="line-height:140%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">- Supervision: </span></span></b><span style="font-size:9.0pt"><span style="line-height:140%">Mohsen Rezaeian</span></span><span dir="RTL" lang="AR-SA" style="font-size:9.0pt"><span style="line-height:140%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">- Project administration: </span></span></b><span style="font-size:9.0pt"><span style="line-height:140%">Mohsen Rezaeian</span></span><span dir="RTL" lang="AR-SA" style="font-size:9.0pt"><span style="line-height:140%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">- Writing-original draft: </span></span></b><span style="font-size:9.0pt"><span style="line-height:140%">Abdollah Rahmani, Mehrnoosh Salari, Mohsen Rezaeian</span></span><span dir="RTL" lang="AR-SA" style="font-size:9.0pt"><span style="line-height:140%"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span></span><br>
<span style="font-size:10pt"><span style="line-height:140%"><span style="tab-stops:-45.0pt"><span style="text-autospace:none"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:9.0pt"><span style="line-height:140%">- Writing-review & editing:</span></span></b><b> </b><span style="font-size:9.0pt"><span style="line-height:140%">Mehrnoosh Salari, Mohsen Rezaeian</span></span></span></span></span></span></span><br>
مدل فندقشکن, عدالت در سلامت, سیاستگذاری سلامت, خلاصه سیاستی
Nutcracker effect, Health equity, Health policymaking, Policy brief
433
442
http://journal.rums.ac.ir/browse.php?a_code=A-10-7321-1&slc_lang=fa&sid=1
Abdollah
Rahmani
عبدالله
رحمانی