طراحی و اعتبارسنجی الگوی پارادایمی حکمرانی سبز در وزارت بهداشت، درمان و آموزش پزشکی ایران

جواد  ظفری راد; علیرضا مزیدی; الهه  معصومی

Authors

Javad ZafariRad Department of Management, Ali.C., Islamic Azad University, Aliabad Katoul, Iran Author https://orcid.org/0009-0001-8420-2237
Alireza Mazidi Department of Management, Ali.C., Islamic Azad University, Aliabad Katoul, Iran Corresponding author https://orcid.org/0000-0002-0673-780X
Elaheh Masoumi Department of Management, Ali.C., Islamic Azad University, Aliabad Katoul, Iran Author https://orcid.org/0009-0008-7028-405X

Keywords:

Management, Green Governance, Ministry of Health and Medical Education

Abstract

This study aimed to design and validate a comprehensive indigenous paradigmatic model for explaining green governance in the Iranian Ministry of Health and Medical Education. An exploratory mixed-methods design comprising qualitative and quantitative phases was employed. In the qualitative phase, Strauss and Corbin’s systematic grounded theory approach was applied to semi-structured interviews with 25 health-system experts selected through purposive snowball sampling, with theoretical saturation achieved at the 20th interview. Data were analyzed through open, axial, and selective coding to develop the paradigmatic model. In the quantitative phase, the population consisted of 7,095 managers, deputies, and employees of North Khorasan Universities of Medical Sciences, from whom 365 participants were selected through simple random sampling. Data were collected using a researcher-developed questionnaire. The proposed model was validated through partial least squares structural equation modeling using SPSS and SmartPLS. Structural model analysis indicated that causal factors had a significant positive effect on green governance (β=0.840, t=60.803, p<0.001). Green governance (β=0.276, t=4.697), contextual factors (β=0.268, t=4.010), and intervening factors (β=0.231, t=4.606) significantly affected green governance strategies (all p<0.001). Strategies, in turn, significantly predicted green governance outcomes (β=0.583, t=17.577, p<0.001). All hypothesized indirect effects were also statistically significant. The R² values for green governance, strategies, and outcomes were 0.706, 0.398, and 0.339, respectively, while the overall goodness-of-fit index was 0.481. The validated model demonstrates that effective green governance in the health system requires simultaneous reinforcement of causal and contextual drivers, appropriate management of intervening conditions, and implementation of integrated strategies related to policymaking, organizational culture, technology, monitoring, intersectoral collaboration, and green investment. The significant mediating role of strategies further indicates that translating structural and policy capacities into health, economic, environmental, and organizational outcomes depends on effective implementation of green governance strategies.

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