Figure 2 defines the key issues identified in our review, which are related to the concepts of SHD, its goals, pillars and principals; positive peace; good governance; components of institutional approach components, and their relations.

Definitions of main concepts [6, 21,22,23,24]

Development that can last forever or for the specified duration would be called sustainable development [25]. One of its most often cited definitions describes the concept as “development that meets the needs of the present without compromising the ability of future generations to meet their own needs” [22]. It allows society to engage with the environment in a way that does not endanger the resource for the future. In line with the underlying pillars of sustainable development i.e., people, planet, prosperity, partnership, and peace, the United Nations’ SDGs is an ambitious action plan to end poverty and put the world on a path to peace and prosperity based on the participation of all people in a healthy planet (Fig. 3). It aims to make the world a sustainable and resilient place for development over the next 15 years, through fostering a spirit of partnership among governments, the private sector, academia and civil society organizations [21, 22].

The pillars and its goals of sustainable development [26]

SDGs’ goals and targets were set to end poverty, hunger, disease, and violence, protect the planet, and ensure prosperity for all citizens without any exception [27]. SDG 16 has declared the importance of promoting peaceful and inclusive societies, providing justice for all, and building effective, responsive and inclusive institutions at all levels to achieve sustainable development [21]. Achieving these targets requires adoption of some fundamental strategies, i.e., investing in prevention, renewing the institutions, and empowering people for an inclusive and sustainable future. As one of the most innovative aspects of the development framework, SDG 16 focus is on building safe and resilient cities, increasing justice, advancing government’s accountability, reducing corruption and empowering people (Fig. 4) [24].

There are two important concepts in this definition, peace and responsive institutions. As one of its five main pillars, achieving sustainable development would be impossible without peace [24]. Negative peace is the absence of direct violence and war, while positive peace is about the absence of indirect and structural violence such as exploitation, hunger, malnutrition, and corruption [28], which are essential for institutionalization. Furthermore, SDG 16 underpins the other sixteen SDGs, all of which also rest on institutions that are inclusive and capable of responding to the needs of the public transparently and accountably [24]. There is actually no one definition of ‘institution’. Rather, it is a universal agreement and constant patterns of responding to social needs, without frequent and short-term changes. Institutionalization has an effective role in maintaining human rights, environmental protection, stable economic conditions, and resources mobilization in providing basic services, which might lead to sustainable development in societies, eventually [21].

Positive Peace is defined as “the attitudes, institutions and structures that create and sustain peaceful societies”. It can be used as the basis for measuring a country’s resilience - its ability to absorb, adapt and recover from shocks [29]. In the modern world, peace is a crucial component of sustainability and vice versa, especially in the context of rapid global changes. It is a precursor for achieving sustainability, particularly the sustainable use of resources, which is in turn associated with constructive conflict resolution [30].

Positive peace comprises eight pillars including: well-functioning government, sound business environment, equitable distribution of resources, acceptance of the rights of others, good relations with neighbors, free flow of information, high levels of human capital, and low levels of corruption, each of which represents a complex set of social dynamics that may lead to high levels of resilience and adaptability to change [23].

Peace and sustainability are intricate notions with various meanings. Sustainability is also a vague notion and as value-laden as peace. The nexus of peace and sustainability has received growing interest in recent decades. Figure 5 shows the positive relationship between the dimensions of sustainability and the pillars of peace. The environmental aspect of sustainability, emphasizes the equitable allocation of resources [30]. Conflicts have immediate adverse impact on the environment. For example, warring parties may exploit scarce natural resources for detrimental purposes, such as funding their activities, thereby exacerbating the conflict. Furthermore, inappropriate use of natural resources can lead to inequitable allocation and access, which is a major cause of many conflicts, such as the one in South Sudan [31].

The social aspect addresses matters concerning high human capital (through learning and other types of social interactions) and respect for the rights of others (especially of disadvantaged groups in society) [30]. Social sustainability refers to social processes that foster social capital and well-being intra/intergenerational. The ecosystem’s deterioration undermines its provision of resources and services, which may consequently imposes stress on the people who depend on them and their social relations. The ecosystem and human well-being are mutually dependent, such that preserving ecological well-being is vital to avoid poverty. Environmental change has a greater impact on the poor and the populations affected by conflict [32].

The economic aspect requires good connections with neighbors (particularly inter-state economic and political partnership) and a stable business environment (in terms of harmonizing business interests with peace and sustainability aims) [30]. Peace and conflict prevention are crucial for economic development. In a globalized economy, the private sector can play a role in, and also gain from, peace. Multinational enterprises participate in peacebuilding activities to mitigate investment risks in post-conflict societies, which then improves their profitability and competitive advantage [33]. On the contrary, some argue that the globalized economy has adversely affected the environment and eroded social capital by interrupting local community practices and interactions. Multinational corporations are mainly concerned with maximizing benefits rather than pursuing altruistic and normative goals [34].

Lastly, the institutional aspect shows the significance of democratic processes that include effective government, low corruption, and free information exchange [30]. A well-functioning government that operates democratically and effectively is best suited to cooperate with international partners to execute peace and sustainability projects due to its political legitimacy and capacity for institutional reform [35].

[31]Among these pillars, effective government has been recognized as interrelated with achieving positive peace. Positive peace not only provides the favorable conditions for achieving good governance, but also it has been the result of good governance being established [36]. Governance systems promote peace when they are inclusive, participatory, and accountable, and have the capacity to provide a wide range of public goods. In this regard, increasing peace results in spending more on both education and health [37]. Consequently, since health and peace are closely related and both are basic human rights, one cannot exist without the other [38].

The relations between sustainability and positive peace [30]

Institutions can have a large influence in forming policy choices, involving stakeholders and conveying decisions [39]. They specify who has the right to act and to make decisions that affect everyone, they make actors’ actions consistent and transparent, and connect those who have power to those who are impacted by decisions [40]. Institutionalization, from this viewpoint, is possibly a very efficient way of regulation. It establishes steadiness and order in defined fields, without requiring frequent authoritative actions [1]. It is a lasting process in which a set of actions becomes a vital and sustainable part of a formal system, and “alters the organization in a stable way” so that its parts are fully assimilated into standard practice and used over time [41]. It depends on the involvement of senior politicians specifically, but also demands the active contribution of other stakeholders at all levels of the political and administrative systems, and of development partners [42]. Reaching institutionalization concept, in many ways, shows the efficiency of governance, and is one of the important means of creating good governance. This mechanism is often marked by major features which ensures that law is followed, the perspective of all stakeholders is considered, the voice of civil society are listened, strong regulatory system is regarded, and inclusion is achieved (Fig. 6) [4].

Elements of institutionalization (Source: Authors)

Good governance broadly relates to institutional matters, social fairness and inclusiveness. It is linked to “a set of qualitative features relating to processes of rulemaking and their institutional bases”. It embodies values such as increased participation, transparency, responsibility, and public access to suitable information. It also assists to fight corruption and protect both fundamental human rights and the rule of law [43]. The sustainable development agenda is evidently dedicated to good governance and its essential role. Goal 16 indicates “effective governance institutions and systems that are responsive to public needs deliver essential services and promote inclusive growth”. Institutions are the basics for good governance. Besides, good governance includes relations between state and people. To put it briefly, good governance can be attained by applying institutionalization approach, which helps governments to perform better, more responsibly and more efficiently in dealing with development programs, and also establishes a favorable environment for sustainable development mechanisms to operate. The quality of participation is essential for governance processes, which means that the political, social and economic priorities are based on a wide agreement in society and that the decision-making process listens to the voices of the excluded, poorest and most vulnerable [21]. Rule of law as another good governance principle entails several elements, such as judicial independence, legal equality of citizens, and the entitlement of citizens to pursue legal actions against their governments [44]. Rule of law is strong when people support it not out of fear but because they benefit from its effectiveness. It requires the cooperation of state and society, and is based on complex and deeply rooted social processes, not just legal penalties and sanctions [45]. Accountability is a key component of good governance, which implies the obligation to answer for decisions or actions. It depends on institutional design and political energy, and requires the participation of various actors in demanding and providing explanations. Accountability also entails the assurance of safety, honesty, and responsiveness for those who seek and offer accountability [45] Good governance can result in societies that exhibit characteristics of peace, stability and resilience, where the provision of services is aligned with the demands of the communities, incorporating the perspectives of the most disadvantaged and marginalized groups (Fig. 7) [21] [21].

Indicators of good governance (Source: Authors)

Governments, by effective decision-making based on accountability, transparency, and participation, are responsible to attain sustainable development and make tangible improvements to their citizens’ quality of life and well-being. Appropriate and contextual institutionalization is the key, we advocate, to reach sustainable development in any setting. Institutionalization in health refers to the process of establishing and embedding health policies, programs, and practices within a system, organization, or community. Institutionalization can enhance the sustainability, effectiveness, and efficiency of health interventions, as well as the accountability and responsiveness of health actors. To achieve institutionalization in health, various factors need to be considered, such as the political, economic, social, and cultural context, the stakeholders’ interests and power relations, the evidence base and innovation potential, and the monitoring and evaluation mechanisms [6]. Figure 8 summarizes our findings, in a format of a proposed conceptual framework, to underpin the role of institutionalization in the health system to achieve sustainable development. This conceptual framework presents all the main components examined in this study and their interrelations within the health system context. To develop this framework, all the sustainable development goals and their connections with its five pillars were illustrated. The research question is derived from the 16th Sustainable Development Goal (SDG 16), which pertains to peace. The concept of positive peace was derived from SDG 16 and its eight components were demonstrated. Having accountable and transparent institutions is one of the targets of SDG 16, which is the foundation and relevance of this paper for achieving it in the health system, aiming to reach sustainable health development. Good governance requires transparent and democratic institutions and an institutional approach as the means to achieving it, while sustainable and resilient societies, where all groups participate extensively in decision-making are the ends of implementing good governance [4]. Peace and sustainable development are the objectives of good governance, which necessitates the presence of good governance as a precondition for their attainment [46].

The institutionalization framework (Source: Authors)