Institutional barriers to achieving good urban governance as a social determinant of health

Background: Most of the factors that affect the community health are out of health sector. The aim of this study was to investigate institutional barriers to achieving good urban governance as a social determinant of health. Methods: The present study was a descriptive-correlational in terms of nature and survey in terms of method. The statistical population of the study included employees of Isfahan Municipality in Isfahan (n=15085). Based on Krejcie and Morgan table, the sample size was estimated at 376 people. They were selected using stratified random sampling method proportional to sample size. To collect data, researcher-made 41 items questionnaire was used on the barriers to achieve good urban governance. Cronbach's alpha coefficient was calculated as higher than 0.7. Data analysis was performed using structural equation modeling in AMOS-23 software. Results: The results showed that the effect of physical/spatial, social fragmentation and functional barriers on good urban governance was also significant. Also, the effect of barrier variables in the theoretical area of planning and management, functional barriers in the system of urban administration and management and political-planning barriers on good urban governance was significant. Negative path coefficients indicated that these structures had an inverse effect on good urban governance. Conclusion: A total number of six barriers were recognized that the government and municipalities can consider them in policy-making to achieve good urban governance and provide the conditions for development and expansion of cities according to urban standards This could be led to better situation in social determinants of health and higher level of health in community level

Institutional barriers to the development and construction of urban hospitals

Background: Increasing urban population and the need for accountability and citizen orientation have led decision makers to use the desired methods in the area of urban management. This article identified the barriers to development and construction of hospitals in metropolitan of Isfahan. Methods: This study was descriptive-correlational in terms of method. 376 people were studied. They were selected using stratified random sampling method. To data collection, a researcher-made questionnaire was used. It included 41 questions in two dimensions of urban and regional barriers and planning and management. The construct validity of the research variable structure was confirmed by exploratory factor analysis. Cronbach's alpha coefficient was also estimated to be higher than 0.7. Data analysis was performed using confirmatory factor analysis in AMOS-23.  Results: The indicators shown that the model for measuring institutional obstacles to achieve good urban governance is suitable. The results showed that planning and management and urban and regional variables as institutional barriers have a significant impact on the construction of the hospital and it shows that these structures have a direct impact on these barriers. Therefore, it can be said that the influence of planning and management variables was more than other dimensions. Conclusion: Based on the observations can be shown that the policy makers should identify the obstacles facing the collaborative models and then provide a suitable platform for their organizations. In order to reduce planning and management obstacles, should be managed within the framework of plans and stakeholders should be involved in the decision-making process