Challenges Faced by NGOs in Substance Use Prevention: A Qualitative Study in Ardabil, Iran.

Introduction: Non-governmental organizations (NGOs) play a vital role in community-based interventions to prevent and manage substance use disorders. Despite their expanding role, NGOs encounter significant barriers that hinder their effectiveness in Iran. This study aimed to explore the key barriers faced by the NGOs involved in substance use prevention and control in Ardabil Province. Methods: A qualitative conventional content analysis was conducted in 2023, involving in-depth semi-structured interviews with key informants from nine NGOs and community-based organizations actively working in addiction prevention and treatment in Ardabil, northwestern Iran. Data were analyzed using the Graneheim and Lundman method, involving coding, categorization, and theme development. Data collection and analysis were performed concurrently. Results: Analysis revealed three major categories of challenges: (1) Structural and managerial issues, including poor governmental support and limited financial and human resources; (2) Sociocultural challenges, such as stigma towards addiction and low community participation; and (3) Systemic factors that facilitate addiction, including poor inter-sectoral coordination and inconsistent policies. Participants highlighted public distrust and weak collaboration as the major obstacles to effective intervention. Conclusion: Despite the recognized potential of NGOs to enhance community engagement and primary health care efforts in addiction control, they face significant organizational, social, and policy-level barriers in Iran. Strengthening institutional support and fostering greater collaboration between governmental and non-governmental sectors are essential for improving addiction prevention strategies. These findings underscore the need for policy reforms and capacity-building programs to empower NGOs in their mission.