Exploring the challenges and executive strategies of nursing services tariff setting in Islamic Republic of Iran :A qualitative study

Background : Nurses are a cornerstone of the healthcare system and play a key role in improving public health. Ensuring their well-being and satisfaction, particularly through fair compensation mechanisms, is crucial for policymakers. One such mechanism is the Nursing Services Tariff Law, which, despite its emphasis on justice, efficiency, quality, and accountability, remains in the early stages of implementation in Iran. This study aimed to explore the challenges and suggest corrective strategies for its effective execution. Methods: This qualitative study was conducted in 2025 using inductive content analysis based on Graneheim and Lundman’s seven-step approach. Data were collected through 27 in-depth semi-structured interviews with nurses and nursing managers, selected purposively from various levels within the healthcare system affiliated with Isfahan University of Medical Sciences. Results: Data analysis led to the emergence of three main themes: “Preparation for Birth,” “Infant Care,” and “Growth and Development,” encompassing six main categories and 32 subcategories. The theme “Preparation for Birth” included the categories of eager parents and a secure cradle. “Infant Care” comprised the categories of care experience and perception of pain. The theme “Growth and Development” referred to attention to vital signs and efforts toward maturity. Conclusion: The implementation of the nursing service tariff law in Iran is hindered by challenges such as a lack of transparency, inadequate training, calculation flaws, delayed payments, and unfair tariff distribution, affecting both nurse satisfaction and care quality. Addressing these issues requires revising guidelines, providing accurate implementation training, ensuring timely budgeting, and simplifying tariff calculations.