Introduction: Cross-border health challenges between neighboring countries require effective cooperation mechanisms, particularly during crises such as mass gatherings, epidemics, and security disruptions. Despite the growing importance of health diplomacy between Iran and Iraq, especially during border crises, systematic, evidence-based studies identifying the key determinants of effective health-oriented interactions remain limited. This study aimed to identify and prioritize the factors influencing health-oriented interactions between Iran and Iraq during border crises to support evidence-based health diplomacy policymaking.
Methods: This applied study employed a mixed-methods approach with a sequential exploratory design. In the qualitative phase, semi-structured interviews were conducted with 15 experts and policymakers in border health using purposive sampling, and the data were analyzed through thematic analysis. In the quantitative phase, a researcher-developed questionnaire was completed by 20 specialists, and multi-criteria decision-making analysis was performed using the TOPSIS method.
Results: The qualitative phase identified 32 key factors, which were organized into four main thematic domains. Subsequent quantitative analysis using the TOPSIS method prioritized these factors and revealed that five factors achieved the highest rankings, including the development of joint health crisis protocols and rapid health data exchange systems.
Conclusion: Findings indicate that integrating policy–governance measures with infrastructure–operations is essential to strengthen border health security during crises. A joint crisis management framework and a pilot data exchange system at key border points are recommended.