Abstract
INTRODUCTION: New Public Management (NPM) is a special management philosophy used by
governments.
OBJECTIVES: The aim of NPM is to increase efficiency, effectiveness and cost saving in public sector
through employing private sector characteristics and market mechanisms. Therefore, objective of this
study is to identify barriers and challenges to understand the limitations of implementing the NPM
model.
STUDY DESIGN: A qualitative study
STUDY SETTING: Managers of primary health care (PHC), East Azerbaijan, Iran.
METHODOLOGY: The researchers performed a series of semi-structured interviews with health
managers (n=30) and three focus group discussions with policy makers and district health managers
(n=9) in 2016. A questionnaire was used for collecting demographic characteristics and managers’
perspectives.
RESULTS: Lack of authority, executive bureaucracy, traditional budgeting system, poor payment
systems, inadequate resources were considered to be the most common managerial barriers to the
implementation of NPM. From the experts' view, the other factors that can affect poor implementation of
NPM reforms in public health complexes are as follow: a shortage of trained managers, centralized
decision-making process, organization's unwillingness to compete, lack of customer-oriented culture,
lack of supervisor support and feedback, disharmony between employee needs and appraisal goals,
absence of clear and independent performance dimensions, and biases in the process of evaluation.
CONCLUSION: Designing and implementing an NPM reform need to be based on the operational reality
and conditions of every country because most of the NPM programs in different countries are suffering
from non-implementation syndrome. Therefore, before implementing this reform, identifying managerial
barriers and challenges helps managers to execute the NPM in their desired sector properly.
Jafar Sadegh Tabrizi, Elaheh Hagh Goshayie, Leila Doshmangir, Mahmood Yousefi. (2018) The Barriers to Implementation of New Public Management Strategies in Iran’s Primary Health Care: A Qualitative Study, Journal of Liaquat University of Medical and Health Sciences, Volume-17, Issue-1.
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