ArticleBMC public health2025
Performance evaluation and ranking of health non-governmental organizations in iran: a nationwide assessment of governance and operational performance, and social health impact.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionEvaluating the performance of Non-Governmental Organizations (NGOs) is a critical step in identifying their capacities and improving their effectiveness. The present study aimed to evaluate and rank health NGOs in Iran based on their intervention in social health, focusing on their contributions to addressing health challenges and promoting community well-being.
methodsThis cross-sectional study included all health NGOs affiliated with medical universities and healthcare service providers across the country. Performance was evaluated using a validated 56-item checklist, covering seven domains: International Relations, Communication Strategies, Volunteer Utilization, Education and Awareness, Successful Models, Transparency/Accountability, and Financial Participation. The level of compliance with specified indicators in the evaluation form was assessed by evaluators approved by the Ministry of Health. After calculating the total scores, each NGO was ranked accordingly. Provincial clustering incorporated socioeconomic and healthcare access variables. The K-means clustering method was used to categorize NGOs into groups based on their performance scores, implemented using STATA-17 software.
resultsA total of 980 health NGOs were evaluated and categorized into five performance clusters using K-means clustering. The ranking distribution revealed: 94 one-star NGOs (9.6%, mean score = 19.55 ± 6.44), 209 two-star (21.3%, 37.09 ± 4.44), 329 three-star (33.6%, 50.33 ± 3.54), 281 four-star (28.7%, 62.48 ± 3.79), and 67 five-star NGOs (6.8%, 79.61 ± 6.55). Performance varied significantly by operational level, with national-level NGOs achieving the highest average score (64.6), followed by provincial (49.38) and district-level organizations (47.51). Three-way ANOVA confirmed significant relationships between performance scores and structural variables (type of licensing authority, provincial cluster, and activity scope; P < 0.001).
conclusionThis study highlights the vital role of NGOs in addressing health challenges and promoting social health. The evaluation and ranking of 980 health NGOs revealed significant differences in performance, with the type of licensing authority playing a crucial role in determining outcomes. NGOs operating at the national level demonstrated the highest performance, underscoring the importance of broader operational scopes and resource availability. Collaborative efforts between NGOs and governmental institutions are essential to enhance social health outcomes and ensure comprehensive healthcare coverage. These findings emphasize the need for targeted support, capacity-building initiatives, and policy reforms to strengthen the effectiveness of NGOs in the health sector.
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