In government-controlled media, serving governments' economic, political, or ideological interests often diverts media health policies from their primary target of promoting public health, making them ineffective. Understanding the growth of this diversion in countries' political and social contexts over a long period demands a multi-layer historical analysis. Thus, to explore the roots of this diversion in government-controlled media, we examined the development process of health policy making in Iranian mass media. We conducted and analyzed interviews with 21 media experts and health policy makers through causal layered analysis, including litany, system, discourse, and metaphor layers. Results indicate that the "absence of stable management" and "health programs' low quality" undermined achievements of health policy making, including establishing the Health Policy Council and two health channels. We identified "lack of comprehensive strategy," "policymakers' inadequate knowledge," "insufficient financing," and "extensive government intervention" as underlying social causes of ineffective health programs. In addition, the Islamic ideological approach to health issues has been revealed as the dominant discourse. Interview data imply that conflicts between modern medicine and Iran's traditional medical knowledge make it difficult for media health policy makers to achieve their strategic aims. This study provides insights into the challenges of health policy making in government-controlled mass media.
