Background: As one of the key aspects of policymaking in healthcare, making reforms has long been considered as a significant subject by many countries, and governments have paid close attention to the important role of implementing efficient reforms in their health systems. In Iran, healthcare policy is highly centralized and decision makers have always been seeking for solutions to improve equality and productivity. The aim of this research was to identify the affecting factors in this area of policymaking and to develop a model of healthcare decentralization for Iran. Methods: In this study, in order to design a theoretical and feasible model of decentralization for healthcare, a descriptive-survey approach was used and qualitative research methods were employed. In the first phase, we used meta-synthesis and at the second stage, data were analyzed through thematic analysis. Results: We initially reviewed 31 remarkable studies in the field of healthcare decentralization. Then, nine studies were selected as the final selection to carry out meta-synthesis analysis. After the final prerequisite factors for a successful decentralization in healthcare were extracted and categorized, a questionnaire was designed based on these factors to conduct interviews. Thematic analysis was used to analyze data from interviews with 15 healthcare experts and decision makers including former and current executive managers at the ministry of Health and Medical Education. Conclusion: We identified the main factors of decentralization in the process of health policymaking. Based on these, we created a model of decentralization comprised of 12 stages, considering the main aspects of healthcare decentralization.
