Background: Osteoarthritis   is a prevalent musculoskeletal disorder and a leading cause of disability among the elderly. In Iran, despite its high burden, Osteoarthritis prevention and management face significant policy and implementation challenges. This study aimed to identify and analyze contextual factors influencing Osteoarthritis -related policymaking in Iran using Leichter’s framework within the Walt and Gilson policy triangle.
Methods: This qualitative policy analysis study was conducted in 2023. Semi-structured interviews were conducted with 20 purposively selected key stakeholders, including physicians, policymakers, researchers, and insurance experts, until data saturation was achieved. Data were analyzed using the framework method and MAXQDA software (version 10). Trustworthiness was ensured through participant diversity, deviant case analysis, peer debriefing, and expert validation.
Results: Five key contextual domains were identified: (1) Situational factors, including population aging and rising NCDs; (2) Structural-managerial challenges, such as lack of operational policies, registries, and financial resources; (3) Socio-cultural barriers like traditional beliefs and low health literacy; (4) Political-legal constraints including policy neglect and sanctions; and (5) International influences, particularly the limited global attention to musculoskeletal disorders.
Conclusion: Osteoarthritis imposes a heavy burden on Iran’s health system, yet it remains absent from national health agendas and no comprehensive policy exists. Addressing these multifaceted contextual barriers is essential for developing and implementing effective Osteoarthritis policies.