WorldWideScience

Sample records for health policy instrument

  1. [National planning of health policy in Brazil: strategies and instruments in the 2000s].

    Science.gov (United States)

    Machado, Cristiani Vieira; Baptista, Tatiana Wargas de Faria; de Lima, Luciana Dias

    2010-08-01

    This paper discusses the national planning of health policy between 2003 and 2010, in the light of the development of state planning in Brazil and Lula's administration. Firstly an historical overview is presented of the key moments for national planning, regarding its effects on health care. The governmental context is then described with a review of the strategies and instruments in health planning over recent years. The methodology involved a bibliographic and documental review - including the Multi-year Plans, the National Health Plan, the Health Pact and the More Health program - considering their intention, contents and development processes. The results indicate that national health planning has been condensed in order to enable better direction of the policy. Two key moments in federal health planning were identified: between 2003 and 2006 a managerial and participative line was followed; between 2007 and 2010, the managerial line was kept allied to an effort to tie health policy to the development model. Despite the advances, health planning has displayed limitations, such as: restrictions in health financing, which has compromised the execution of the plans; failure to tackle structural problems in the health care system; and the fragile territorial organization.

  2. Civil monetary penalties--weapon against fraud or instrument of health policy?

    Science.gov (United States)

    Barton, H M

    1989-06-01

    Most physicians are aware of the highly publicized aspects of government health care regulation, including attempts at mandatory physician assignment and recoupment of services deemed medically unnecessary. There is less awareness of the potential pitfalls of civil monetary penalties, as many physicians believe they are primarily applicable to false claim allegations. However, the use of civil monetary penalties is increasing as Congress creates new bases of liability. This development leads to the question: Are civil monetary penalties a weapon against fraud or an instrument of federal policy?

  3. Health impact assessment as an instrument to examine the health implications of education policies.

    Science.gov (United States)

    Pharr, J; Gakh, M; Coughenour, C; Clark, S

    2017-04-01

    Health impact assessment (HIA) is a systematic process that can be used by public health professionals to examine the potential health effects of a policy, plan, program, or project that originates outside of the health sector. This article presents a case study of how an interdisciplinary team utilized an HIA to analyze the potential health impact of full-day kindergarten (FDK) on communities in Nevada. Case study. With stakeholder and community engagement, we conducted a multistage HIA that included qualitative and quantitative data collection and analysis, a review of existing literature, and projections. The team considered several pathways through which FDK could impact health in Nevada: (1) school performance; (2) physical development (physical activity and nutrition education); and (3) access to school-based meals and health screenings. Findings indicated that access to FDK could enhance opportunities for Nevada's children to harness school-based services, increase physical activity, and promote nutrition education. In addition, based on existing research that suggests relationships between (1) FDK attendance and 3rd and 5th grade math and reading standardized test scores and (2) 3rd and 5th grade test scores and high school graduation, as well as available state and national data, we estimated that access to FDK could increase high school graduation in Nevada by 499-820 students per year. This HIA demonstrated that access to FDK could impact both student and adult health in Nevada. Our engagement of public health professionals along with stakeholders and the community in the HIA process demonstrated that HIAs can be an important tool for public health professionals to examine the effects on community health of policies, programs, plans or projects that arise outside of the health sector. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  4. Information for mental health systems: an instrument for policy-making and system service quality.

    Science.gov (United States)

    Lora, A; Lesage, A; Pathare, S; Levav, I

    2017-08-01

    Information is crucial in mental healthcare, yet it remains undervalued by stakeholders. Its absence undermines rationality in planning, makes it difficult to monitor service quality improvement, impedes accountability and human rights monitoring. For international organizations (e.g., WHO, OECD), information is indispensable for achieving better outcomes in mental health policies, services and programs. This article reviews the importance of developing system level information with reference to inputs, processes and outputs, analyzes available tools for collecting and summarizing information, highlights the various goals of information gathering, discusses implementation issues and charts the way forward. Relevant publications and research were consulted, including WHO studies that purport to promote the use of information systems to upgrade mental health care in high- and low-middle income countries. Studies have shown that once information has been collected by relevant systems and analyzed through indicator schemes, it can be put to many uses. Monitoring mental health services, represents a first step in using information. In addition, studies have noted that information is a prime resource in many other areas such as evaluation of quality of care against evidence based standards of care. Services data may support health services research where it is possible to link mental health data with other health and non-health databases. Information systems are required to carefully monitor involuntary admissions, restrain and seclusion, to reduce human rights violations in care facilities. Information has been also found useful for policy makers, to monitor the implementation of policies, to evaluate their impact, to rationally allocate funding and to create new financing models. Despite its manifold applications, Information systems currently face many problems such as incomplete recording, poor data quality, lack of timely reporting and feedback, and limited

  5. Economic Policy Instruments

    DEFF Research Database (Denmark)

    Klemmensen, Børge

    2007-01-01

    Økonomiske instrumenter begrundes med behovet for politiske indgreb, der muliggør internaliseringen af omkostningerne ved de miljøpåvirkninger, produktion and levevis afstedkommer, således at hensyntagen til miljøet bliver en del af virksomheders og husholdningers omkostninger og dermed en tilsky...

  6. Economic Policy Instruments

    DEFF Research Database (Denmark)

    Klemmensen, Børge

    2007-01-01

    Økonomiske instrumenter begrundes med behovet for politiske indgreb, der muliggør internaliseringen af omkostningerne ved de miljøpåvirkninger, produktion and levevis afstedkommer, således at hensyntagen til miljøet bliver en del af virksomheders og husholdningers omkostninger og dermed en...

  7. Socio-economic characteristics and the effect of taxation as a health policy instrument

    DEFF Research Database (Denmark)

    Smed, Sinne; Jensen, Jørgen Dejgård; Denver, Sigrid

    2007-01-01

    . Focusing on the consumption of saturated fats, fibre and sugar; it is generally found that the impact of price instruments is stronger for lower social classes than in other groups of the population. With regard to age groups, it is mostly the youngest that decrease their demand for saturated fat...

  8. The Instruments of Transport Policy

    Directory of Open Access Journals (Sweden)

    Gordana Štefančić

    2006-09-01

    Full Text Available The work proposes the transport policy instruments, suchas the infrastructure measures, management measures and informationprovision measures as the means that could reduceor eliminate transport problems. All these measures have beenfollowed through the provisions for passenger cars, provisionsfor public transport, provisions for cyclists and pedestrians andprovisions regarding transport. A range of solutions is given toreduce congestion, improve accessibility and improve the trafficconditions for those who depend on public transport along withthe improvement of environmental conditions.

  9. [Possibilities and limitations of fiscal policies as health instruments: taxes on harmful consumption. SESPAS Report 2010].

    Science.gov (United States)

    López Nicolás, Angel; Viudes de Velasco, Arántzazu

    2010-12-01

    This article discusses the possibilities of indirect taxation as a mechanism that alters the relative prices of goods and services and hence encourages citizens to adopt healthy lifestyles. We review the case of smoking and unhealthy diet. These two cases were chosen because these are the two lifestyle factors with the greatest impact on morbidity and mortality in Spain and because they highlight the possibilities of tax policy (smoking) and its limitations (unhealthy diet). After discussion of these issues, we recommend gradually increasing the level of the minimum special tax on cigarettes and avoiding erosion of its value by inflation, as well as aligning the level of the minimum special tax on fine cut tobacco with that borne by cigarettes, to avoid the already perceived shift of demand toward the former variety. The main recommendation for the case of unhealthy diet is to obtain a more solid evidence base than that currently available on the relationship between food prices and body mass index in Spain. The scarce evidence available for the USA nevertheless suggests that the possibilities of price-based policies to reduce the problems of overweight and obesity are highly limited. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  10. The Choice of Innovation Policy Instruments

    DEFF Research Database (Denmark)

    Borrás, Susana; Edquist, Charles

    The purpose of this article is to discuss the different types of instruments of innovation policy, to examine how governments and public agencies in different countries and different times have used these instruments differently, to explore the political nature of instrument choice and design (and....... These mixes are often called “policy mix”. The problem-oriented nature of the design of instrument mixes is what makes innovation policy instruments ‘systemic’....

  11. Design of economic incentive instruments in nutrition policy

    DEFF Research Database (Denmark)

    Jensen, Jørgen Dejgård

    2011-01-01

    • Economic incentives are instruments to improve diets and reduce the fraction of people exposed to diet-related health risks • Proper targeting and design of economic incentive instruments is important, if such instruments should be efficient and feasible policy measures in the improvement of di...... of dietary behaviour in industrialised countries • From a cost-effectiveness perspective, there are considerable potential for optimizing the targeting and design of economic incentive instruments in nutritional policy...

  12. Policy Instruments for Sustainable Food Consumption

    DEFF Research Database (Denmark)

    Reisch, Lucia; Lorek, Sylvia; Bietz, Sabine

    to steer consumers’ choices subtly into more sustainable and healthier food choices (Thaler & Sunstein, 2008). After discussing the backdrop to the paper, we look at the scope and scale of current and desirable policy instruments in the sustainable food domain. We join others in calling for a sustainable......The food policy domain highlights the complexity of the sustainability of food consumption. In addition to the ecological, social and economic aspects of food consumption, public health concerns are an integral factor in efforts to ensure the sustainable development of the food sector (Reisch et al...

  13. Design of economic incentive instruments in nutrition policy

    DEFF Research Database (Denmark)

    Jensen, Jørgen Dejgård

    2011-01-01

    • Economic incentives are instruments to improve diets and reduce the fraction of people exposed to diet-related health risks • Proper targeting and design of economic incentive instruments is important, if such instruments should be efficient and feasible policy measures in the improvement of di...

  14. The Choice of Innovation Policy Instruments

    DEFF Research Database (Denmark)

    Borrás, Susana; Edquist, Charles

    The purpose of this article is to discuss the different types of instruments of innovation policy, to examine how governments and public agencies in different countries and different times have used these instruments differently, to explore the political nature of instrument choice and design (and...... associated issues), and to elaborate a set of criteria for the selection and design of the instruments in relation to the formulation of innovation policy. The article argues that innovation policy instruments must be designed and combined into mixes in ways that address the problems of the innovation system....... These mixes are often called “policy mix”. The problem-oriented nature of the design of instrument mixes is what makes innovation policy instruments ‘systemic’....

  15. The Choice of Innovation Policy Instruments

    DEFF Research Database (Denmark)

    Borrás, Susana; Edquist, Charles

    2013-01-01

    The purpose of this article is to discuss the different types of instruments of innovation policy, to examine how governments and public agencies in different countries and different times have used these instruments differently, to explore the political nature of instrument choice and design (and...... associated issues), and to elaborate a set of criteria for the selection and design of the instruments in relation to the formulation of innovation policy. The article argues that innovation policy instruments must be designed and combined into mixes in ways that address the problems of the innovation system....... These mixes are often called “policy mix”. The problem-oriented nature of the design of instrument mixes is what makes innovation policy instruments ‘systemic’....

  16. Optimising the effect of policy instruments

    DEFF Research Database (Denmark)

    Pedersen, Anders Branth; Nielsen, Helle Ørsted; Christensen, Tove

    2012-01-01

    as a case, this paper examines whether non-economic rationales may trump economic ones in farmer decisions, and, unlike previous research, we quantify how widespread non-economic values are compared to more economic values. Data derive from a survey (1164 responses) of Danish conventional farmers' decision...... to policy instruments; farmers who focus on yield indicate less responsiveness to economic policy instruments. The results imply that it is important to implement a broad array of policy instruments to match different farmer rationales....

  17. Policy Instruments towards a Sustainable Waste Management

    Directory of Open Access Journals (Sweden)

    Tomas Forsfält

    2013-02-01

    Full Text Available The aim of this paper is to suggest and discuss policy instruments that could lead towards a more sustainable waste management. The paper is based on evaluations from a large scale multi-disciplinary Swedish research program. The evaluations focus on environmental and economic impacts as well as social acceptance. The focus is on the Swedish waste management system but the results should be relevant also for other countries. Through the assessments and lessons learned during the research program we conclude that several policy instruments can be effective and possible to implement. Particularly, we put forward the following policy instruments: “Information”; “Compulsory recycling of recyclable materials”; “Weight-based waste fee in combination with information and developed recycling systems”; “Mandatory labeling of products containing hazardous chemicals”, “Advertisements on request only and other waste minimization measures”; and “Differentiated VAT and subsidies for some services”. Compulsory recycling of recyclable materials is the policy instrument that has the largest potential for decreasing the environmental impacts with the configurations studied here. The effects of the other policy instruments studied may be more limited and they typically need to be implemented in combination in order to have more significant impacts. Furthermore, policy makers need to take into account market and international aspects when implementing new instruments. In the more long term perspective, the above set of policy instruments may also need to be complemented with more transformational policy instruments that can significantly decrease the generation of waste.

  18. Networks as Policy Instruments for Innovation

    Science.gov (United States)

    Beers, Pieter J.; Geerling-Eiff, Florentien

    2014-01-01

    Purpose: The purpose of this article is to compare the effectiveness of facilitated networks to other policy instruments for agricultural innovation. Design/ methodology/ approach: In an exploratory study of the Dutch agricultural policy context, we conducted semi-structured interviews with ten experts on networks and innovation. Policy…

  19. Networks as Policy Instruments for Innovation

    Science.gov (United States)

    Beers, Pieter J.; Geerling-Eiff, Florentien

    2014-01-01

    Purpose: The purpose of this article is to compare the effectiveness of facilitated networks to other policy instruments for agricultural innovation. Design/ methodology/ approach: In an exploratory study of the Dutch agricultural policy context, we conducted semi-structured interviews with ten experts on networks and innovation. Policy…

  20. Cost-effective design of economic instruments in nutrition policy.

    Science.gov (United States)

    Jensen, Jørgen D; Smed, Sinne

    2007-04-04

    This paper addresses the potential for using economic regulation, e.g. taxes or subsidies, as instruments to combat the increasing problems of inappropriate diets, leading to health problems such as obesity, diabetes 2, cardiovascular diseases etc. in most countries. Such policy measures may be considered as alternatives or supplements to other regulation instruments, including information campaigns, bans or enhancement of technological solutions to the problems of obesity or related diseases. 7 different food tax and subsidy instruments or combinations of instruments are analysed quantitatively. The analyses demonstrate that the average cost-effectiveness with regard to changing the intake of selected nutritional variables can be improved by 10-30 per cent if taxes/subsidies are targeted against these nutrients, compared with targeting selected food categories. Finally, the paper raises a range of issues, which need to be investigated further, before firm conclusions about the suitability of economic instruments in nutrition policy can be drawn.

  1. Cost-effective design of economic instruments in nutrition policy

    Directory of Open Access Journals (Sweden)

    Smed Sinne

    2007-04-01

    Full Text Available Abstract This paper addresses the potential for using economic regulation, e.g. taxes or subsidies, as instruments to combat the increasing problems of inappropriate diets, leading to health problems such as obesity, diabetes 2, cardiovascular diseases etc. in most countries. Such policy measures may be considered as alternatives or supplements to other regulation instruments, including information campaigns, bans or enhancement of technological solutions to the problems of obesity or related diseases. 7 different food tax and subsidy instruments or combinations of instruments are analysed quantitatively. The analyses demonstrate that the average cost-effectiveness with regard to changing the intake of selected nutritional variables can be improved by 10–30 per cent if taxes/subsidies are targeted against these nutrients, compared with targeting selected food categories. Finally, the paper raises a range of issues, which need to be investigated further, before firm conclusions about the suitability of economic instruments in nutrition policy can be drawn.

  2. Problematizations in Health Policy

    Directory of Open Access Journals (Sweden)

    Carol Bacchi

    2016-06-01

    Full Text Available This article directs attention to the significance, for health promotion advocates, of reflecting on how “problems” are constituted, or brought into existence, as particular sorts of problems, within policies and policy proposals. To this end, it introduces a poststructural analytic strategy called “What’s the Problem Represented to be?” (WPR approach, and contrasts this perspective to the ways in which “problems” are commonly conceptualized in health policy analyses (e.g., “a problem stream,” “wicked problems”. Such a perspective offers a significant rethinking of the conventional emphasis on agenda setting and policy-making processes in considering the meaning of success or failure in health policy initiatives. The starting point is a close analysis of items that are “successful,” in the sense that they make the political agenda, to see how representations of “problems” within selected policies limit what is talked about as possible or desirable, or as impossible and undesirable. This form of analysis thus enables critical reflections on the substantive content of policy initiatives in health policy. The article takes a step back from policy process theories, frameworks, and models to offer reflections at the level of paradigms. Highlighting potential dangers and limitations in positivism, interpretivism, and critical realism, it uses international, Australian, and South Australian examples in health policy to explore what poststructural policy analysis contributes to understanding the broad political influences shaping contemporary modes of rule.

  3. Policy Instruments for Sustainable Food Consumption

    DEFF Research Database (Denmark)

    Reisch, Lucia; Lorek, Sylvia; Bietz, Sabine

    ., 2010). The intention of this discussion paper is to summarize the main policy instruments and assessment tools currently employed in relation to sustainable food consumption, thereby providing background information for the second CORPUS “Policy Meets Research” workshop which is to be held as part...... to steer consumers’ choices subtly into more sustainable and healthier food choices (Thaler & Sunstein, 2008). After discussing the backdrop to the paper, we look at the scope and scale of current and desirable policy instruments in the sustainable food domain. We join others in calling for a sustainable...... with recommendations on actions that consumers (in their role as market actors and consumer citizens), NGOs, the media, the food industry, retailers and governments can take in a shared pursuit of more sustainable food consumption and production....

  4. Federalism and health policy.

    Science.gov (United States)

    Nathan, Richard P

    2005-01-01

    This paper presents a cyclical theory of U.S. federalism and social policy: Many social policy initiatives are tested and refined at the state level, especially during conservative periods, and later morph into national policies. The paper describes such federalism cycles and offers an interpretation of why and how they occur, focusing on Medicaid. State activism has preserved and expanded Medicaid through policy innovation and resistance to retrenchment, especially in conservative periods, by taking advantage of the flexibility the program provides. I conclude that Medicaid's incremental/partnership approach is appropriate and feasible to build on for a future expansion of health care coverage.

  5. Population and health policies

    OpenAIRE

    Schultz, T.Paul

    2009-01-01

    The program evaluation literature for population and health policies is in flux, with many disciplines documenting biological and behavioral linkages from fetal development to late life mortality, chronic disease, and disability, though their implications for policy remain uncertain. Both macro- and microeconomics seek to understand and incorporate connections between economic development and the demographic transition. The focus here is on research methods, findings, and questions that econo...

  6. Cost-effective design of economic instruments in nutrition policy

    DEFF Research Database (Denmark)

    Jensen, Jørgen Dejgård; Smed, Sinne

    2007-01-01

    This paper addresses the potential for using economic regulation, e.g. taxes or subsidies, as instruments to combat the increasing problems of inappropriate diets, leading to health problems such as obesity, diabetes 2, cardiovascular diseases etc. in most countries. Such policy measures may...... be considered as alternatives or supplements to other regulation instruments, including information campaigns, bans or enhancement of technological solutions to the problems of obesity or related diseases. 7 different food tax and subsidy instruments or combinations of instruments are analysed quantitatively....... The analyses demonstrate that the average cost-effectiveness with regard to changing the intake of selected nutritional variables can be improved by 10–30 per cent if taxes/subsidies are targeted against these nutrients, compared with targeting selected food categories. Finally, the paper raises a range...

  7. Cost-effective design of economic instruments in nutrition policy

    DEFF Research Database (Denmark)

    Jensen, Jørgen Dejgård; Smed, Sinne

    2007-01-01

    This paper addresses the potential for using economic regulation, e.g. taxes or subsidies, as instruments to combat the increasing problems of inappropriate diets, leading to health problems such as obesity, diabetes 2, cardiovascular diseases etc. in most countries. Such policy measures may....... The analyses demonstrate that the average cost-effectiveness with regard to changing the intake of selected nutritional variables can be improved by 10–30 per cent if taxes/subsidies are targeted against these nutrients, compared with targeting selected food categories. Finally, the paper raises a range...... of issues, which need to be investigated further, before firm conclusions about the suitability of economic instruments in nutrition policy can be drawn....

  8. eHealth Policy

    CERN Document Server

    Capello, Fabio

    2014-01-01

    The rising of a new technological era has brought within it opportunities and threats the health systems worldwide have to deal with. In such a changed scenario the role of decision-makers is crucial to identify the real and perceived needs of the population and those areas on intervention in which eHealth can help to improve the quality and efficacy of care. Therefore, in-depth analysis of the state of the art both in industrialized and in developing countries is paramount. Many in fact are constraints that mine the designing and implementation of electronic systems for health. Only if policymakers understand the real implication of eHealth and the complexities of the human being, working model could be introduced. Otherwise the systems proposed will follow the same schemes that have produced failures so far. It implies also that the mutated role of the patient had to be known, together with his expectations and needs. Nevertheless, in a globalize world, a policy for eHealth have to consider also those facto...

  9. Research and health policy

    Directory of Open Access Journals (Sweden)

    Abu Bakar Suleiman

    2013-04-01

    Full Text Available Healthcare investment is critically important for thehealth and well-being of the population, and differenthealth systems are developed to meet the needs andpriorities of each country. What has become clear hasbeen that despite major advances in medicine, scienceand technology, there are major issues related toaccess and equity as well as quality and patient safetyin healthcare services. The issue of patient safety washighlighted by the reports of the Institute of Medicine,USA1,2 and this had received worldwide attention.It is also an irony that despite being in an age ofmajor advances in medicine, science and technology,with the acceptance of evidence-based medicine,so much of medicine and healthcare delivered is oflittle or no proven value. This poses a major challengeon health policy, and on how this can be addressed inany health reform process that focuses on improvingaccess, equity, efficiency and effectiveness in healthcareservices.

  10. The role of multi-target policy instruments in agri-environmental policy mixes.

    Science.gov (United States)

    Schader, Christian; Lampkin, Nicholas; Muller, Adrian; Stolze, Matthias

    2014-12-01

    The Tinbergen Rule has been used to criticise multi-target policy instruments for being inefficient. The aim of this paper is to clarify the role of multi-target policy instruments using the case of agri-environmental policy. Employing an analytical linear optimisation model, this paper demonstrates that there is no general contradiction between multi-target policy instruments and the Tinbergen Rule, if multi-target policy instruments are embedded in a policy-mix with a sufficient number of targeted instruments. We show that the relation between cost-effectiveness of the instruments, related to all policy targets, is the key determinant for an economically sound choice of policy instruments. If economies of scope with respect to achieving policy targets are realised, a higher cost-effectiveness of multi-target policy instruments can be achieved. Using the example of organic farming support policy, we discuss several reasons why economies of scope could be realised by multi-target agri-environmental policy instruments.

  11. Databases as policy instruments. About extending networks as evidence-based policy

    Directory of Open Access Journals (Sweden)

    Stoevelaar Herman

    2007-12-01

    Full Text Available Abstract Background This article seeks to identify the role of databases in health policy. Access to information and communication technologies has changed traditional relationships between the state and professionals, creating new systems of surveillance and control. As a result, databases may have a profound effect on controlling clinical practice. Methods We conducted three case studies to reconstruct the development and use of databases as policy instruments. Each database was intended to be employed to control the use of one particular pharmaceutical in the Netherlands (growth hormone, antiretroviral drugs for HIV and Taxol, respectively. We studied the archives of the Dutch Health Insurance Board, conducted in-depth interviews with key informants and organized two focus groups, all focused on the use of databases both in policy circles and in clinical practice. Results Our results demonstrate that policy makers hardly used the databases, neither for cost control nor for quality assurance. Further analysis revealed that these databases facilitated self-regulation and quality assurance by (national bodies of professionals, resulting in restrictive prescription behavior amongst physicians. Conclusion The databases fulfill control functions that were formerly located within the policy realm. The databases facilitate collaboration between policy makers and physicians, since they enable quality assurance by professionals. Delegating regulatory authority downwards into a network of physicians who control the use of pharmaceuticals seems to be a good alternative for centralized control on the basis of monitoring data.

  12. Policy networks across portfolio boundaries: An analysis of integrated public health policy in Dutch municipalities

    NARCIS (Netherlands)

    Peters, D.T.J.M.

    2016-01-01

    Regardless efforts by the (municipal) public health sector, public health still faces major problems. The involvement of other policy sectors is generally assumed as necessary. Because, in contrast to the public health sector, they have policy instruments to address the environmental determinants of

  13. Policy networks across portfolio boundaries: An analysis of integrated public health policy in Dutch municipalities

    NARCIS (Netherlands)

    Peters, D.T.J.M.

    2016-01-01

    Regardless efforts by the (municipal) public health sector, public health still faces major problems. The involvement of other policy sectors is generally assumed as necessary. Because, in contrast to the public health sector, they have policy instruments to address the environmental determinants of

  14. Monetary Policy Instruments and Bank Risks in China

    OpenAIRE

    Zhongyuan Geng; Xue Zhai

    2013-01-01

    The authors use a panel data regression model to examine the effects of main monetary policy instruments on commercial bank risks in China from 1998 to 2011. The interest rate has a positive effect on bank risk while the interest rate margin, the reserve requirement ratio and open market operation have a negative effect. Among the three monetary policy instruments, the reserve requirement ratio has the greatest effect on bank risk, the interest rate (the interest rate margin) the second large...

  15. Monetary Policy Instruments and Bank Risks in China

    OpenAIRE

    Zhongyuan Geng; Xue Zhai

    2013-01-01

    The authors use a panel data regression model to examine the effects of main monetary policy instruments on commercial bank risks in China from 1998 to 2011. The interest rate has a positive effect on bank risk while the interest rate margin, the reserve requirement ratio and open market operation have a negative effect. Among the three monetary policy instruments, the reserve requirement ratio has the greatest effect on bank risk, the interest rate (the interest rate margin) the second large...

  16. Instruments for measuring mental health recovery: a systematic review.

    Science.gov (United States)

    Sklar, Marisa; Groessl, Erik J; O'Connell, Maria; Davidson, Larry; Aarons, Gregory A

    2013-12-01

    Persons in recovery, providers, and policymakers alike are advocating for recovery-oriented mental health care, with the promotion of recovery becoming a prominent feature of mental health policy in the United States and internationally. One step toward creating a recovery-oriented system of care is to use recovery-oriented outcome measures. Numerous instruments have been developed to assess progress towards mental health recovery. This review identifies instruments of mental health recovery and evaluates the appropriateness of their use including their psychometric properties, ease of administration, and service-user involvement in their development. A literature search using the Medline and Psych-INFO databases was conducted, identifying 21 instruments for potential inclusion in this review, of which thirteen met inclusion criteria. Results suggest only three instruments (25%) have had their psychometric properties assessed in three or more unique samples of participants. Ease of administration varied between instruments, and for the majority of instruments, development included service user involvement. This review updates and expands previous reviews of instruments to assess mental health recovery. As mental health care continues to transform to a recovery-oriented model of service delivery, this review may facilitate selection of appropriate assessments of mental health recovery for systems to use in evaluating and improving the care they provide.

  17. Risk Implications of Energy Policy Instruments

    DEFF Research Database (Denmark)

    Kitzing, Lena

    papers and a working paper), based on a combination of micro-economic and policy analysis. Financial theory is used for the quantitative analysis of investment problems under uncertainty, including mean-variance portfolio theory, real option analysis, Monte Carlo simulations and time series analysis...... of the development. Overall, this dissertation contributes with model development in the area of support scheme analysis, using several innovative approaches for partial models that produce easily and quickly applicable results. Thus, tools are provided that help in the design of RES support policies, e.g. when......In many countries in Europe and the rest of the world, electricity systems are on the verge of a new era: they are transforming from begin CO2-intensive and centralised towards becoming sustainable and more integrated. The role of policy makers in this transition is evident: ambitious targets...

  18. Oral health policies in Brazil

    Directory of Open Access Journals (Sweden)

    Gilberto Alfredo Pucca Junior

    2009-06-01

    Full Text Available Since Oral Health policies in Brazil have been constructed according to circumstances and possibilities, they should be understood within a given context. The present analysis contextualizes several issues of the Brazilian Oral Health Policy, called "Smiling Brazil", and describes its present stage of development. Today it involves re-organizing basic oral health care by deploying Oral Health Teams within the Family Health strategy, setting up Centers of Dental Specialists within an Oral Health network as a secondary care measure, setting up Regional Laboratories of Dental Prosthesis and a more extensive fluoridation of the public water supply.

  19. Trade policy and public health.

    Science.gov (United States)

    Friel, Sharon; Hattersley, Libby; Townsend, Ruth

    2015-03-18

    Twenty-first-century trade policy is complex and affects society and population health in direct and indirect ways. Without doubt, trade policy influences the distribution of power, money, and resources between and within countries, which in turn affects the natural environment; people's daily living conditions; and the local availability, quality, affordability, and desirability of products (e.g., food, tobacco, alcohol, and health care); it also affects individuals' enjoyment of the highest attainable standard of health. In this article, we provide an overview of the modern global trade environment, illustrate the pathways between trade and health, and explore the emerging twenty-first-century trade policy landscape and its implications for health and health equity. We conclude with a call for more interdisciplinary research that embraces complexity theory and systems science as well as the political economy of health and that includes monitoring and evaluation of the impact of trade agreements on health.

  20. Manifestations of integrated public health policy in Dutch municipalities.

    Science.gov (United States)

    Peters, Dorothee; Harting, Janneke; van Oers, Hans; Schuit, Jantine; de Vries, Nanne; Stronks, Karien

    2016-06-01

    Integrated public health policy (IPHP) aims at integrating health considerations into policies of other sectors. Since the limited empirical evidence available may hamper its further development, we systematically analysed empirical manifestations of IPHP, by placing policy strategies along a continuum of less-to-more policy integration, going from intersectoral action (IA) to healthy public policy (HPP) to health in all policies (HiAP). Our case study included 34 municipal projects of the Dutch Gezonde Slagkracht Programme (2009-15), which supports the development and implementation of IPHP on overweight, alcohol and drug abuse, and smoking. Our content analysis of project application forms and interviews with all project leaders used a framework approach involving the policy strategies and the following policy variables: initiator, actors, policy goals, determinants and policy instruments. Most projects showed a combination of policy strategies. However, manifestations of IPHP in overweight projects predominantly involved IA. More policy integration was apparent in alcohol/drugs projects (HPP) and in all-theme projects (HiAP). More policy integration was related to broad goal definitions, which allowed for the involvement of actors representing several policy sectors. This enabled the implementation of a mix of policy instruments. Determinants of health were not explicitly used as a starting point of the policy process. If a policy problem justifies policy integration beyond IA, it might be helpful to start from the determinants of health (epidemiological reality), systematically transform them into policy (policy reality) and set broad policy goals, since this gives actors from other sectors the opportunity to participate.

  1. Lifelong Learning: Concept, Policy, Instruments and Implementation

    Directory of Open Access Journals (Sweden)

    Metin TOPRAK

    2012-01-01

    Full Text Available European Union has started an education & training initiative under the umbrella of lifelong learning to achieve the 2020 Agenda targets. Th is initiative has nearly half of a century time horizon, and all designed policies and measures have been consolidated under this initiative. Turkish Education authorities have been monitoring this European eff ort closely and made important legal and institutional regulations in recent couple of years. Th is study examines the primary aspects of lifelong learning in detail: conceptual and philosophical background; recognition strategies; the place of formal, non-formal and informal learning in the lifelong learning approach; financing and measurement ways of lifelong learning; and variety of perspectives of international institutions. In addition, education and training strategy of the Europe’s 2020 vision of lifelong learning is also evaluated in detail. Th e human resources vision of the Europe considers education, occupation and economic activities together to allow authorities to plan the future of the European societies. Th e updating mechanisms of this approach are designed both domestically at national and internationally at European levels. It is concluded, in this study, that the lifelong learning policy and implementation of the Europe should be taken as benchmark.

  2. Policy Instruments for Eco-Innovation in Asian Countries

    Directory of Open Access Journals (Sweden)

    Eun Kyung Jang

    2015-09-01

    Full Text Available Eco-innovation globally emerged as an effort to implement sustainable development. States and firms established and implemented policies and strategies for eco-innovation as one route to achieving sustainable development. Eco-innovation has been facilitated in developed countries, specifically OECD members and European countries, through action plans. Recently, eco-innovation policies have emerged in developing countries. Thus, this study analyzes eco-innovation policies in Asian countries. Policies related to eco-innovation in 17 Asian countries were investigated using policy instrument categories. National policies for eco-innovation were interpreted and compared with development stage classifications. The results indicate that there are similar and different policy approaches to eco-innovation in Asian countries. Given the balance between a technology push (supply side and a market pull (demand side in policy instruments for eco-innovation, 17 countries were identified by four categories: leaders, followers, loungers, and laggards. The results provide insight for designing national strategies for eco-innovation in Asia’s developing countries. Therefore, this research contributes to facilitating and diffusing eco-innovation toward sustainability in Asia.

  3. Health policy and case management.

    Science.gov (United States)

    Mark, D D

    2000-01-01

    The purpose of this article is to analyze the performance of and support for case management using a policy framework in order to increase case managers' awareness of policy making and facilitate successful planning for future policy initiatives. Feldstein's (1996) theory of opposing legislative outcomes indicates that legislation can be viewed on a continuum, ranging from legislation that meets the needs of the public to legislation considered to be in the self-interest of the participants and legislators. The current health care system requires that case managers working for publicly funded health care organizations balance the need for stewardship of U.S. tax dollars and the health care needs of consumers. It is apparent from the literature that case managers are successfully achieving this balance. However, certain conditions should exist that allow for case manager decision-making that promotes effective and efficient utilization of health care resources. Case managers must work within the context of the health care policy environment. Realizing that it is more likely that the conflicts between stewardship and the provision of health care services will continue, case managers' knowledge and influence regarding policy making becomes imperative in order to ensure that these conflicting goals do not become mutually exclusive.

  4. The territorial logic in brazilian health policy

    Directory of Open Access Journals (Sweden)

    Eliane Cristina Lopes Brevilheri

    2014-06-01

    Full Text Available This article aims to reflect on the territorial dimension has been addressed in the current Brazilian health policy. Provides an initial approximation of the theoretical discussion about the category territory and its implications for social policy. Then we analyze how this category was included in the principles and guidelines of the National Health System, deployed in key programs and normative instruments of health policy from 1990. It is concluded that: the territorial dimension was present from conception through SUS guideline regionalization of activities and services. In the main programs implemented in the 1990s, the territorial dimension had a character cutouts geographical and normative instruments gave centrality to the process of decentralization. However, from the 2000s, the regionalization strategy, pointing to the territorial perspective, gains greater significance. However, we still need to overcome the logic purely political-administrative and act so as to identify the real needs of the people, their potential, diversity and particularities, towards "used territory" referred to Milton Santos.

  5. Health Services Procurement Policy

    OpenAIRE

    Department of Health

    2000-01-01

    The Healthcare Materials Management Board (HMMB) was established following the report to the Materials Management Advisory Group on procurement and materials management in the health sector Download the Report here

  6. Policy Instruments for Groundwater Management in the Netherlands

    NARCIS (Netherlands)

    Hellegers, P.J.G.J.; Ierland, van E.C.

    2003-01-01

    In the Netherlands agriculture and nature have conflicting interests with respect to groundwater management. Insight into the suitability of policy instruments to achieve optimal groundwater level and extraction management in the Netherlands is, however, missing. In this paper the suitability of pol

  7. Health Reform Requires Policy Capacity

    Directory of Open Access Journals (Sweden)

    Pierre-Gerlier Forest

    2015-05-01

    Full Text Available Among the many reasons that may limit the adoption of promising reform ideas, policy capacity is the least recognized. The concept itself is not widely understood. Although policy capacity is concerned with the gathering of information and the formulation of options for public action in the initial phases of policy consultation and development, it also touches on all stages of the policy process, from the strategic identification of a problem to the actual development of the policy, its formal adoption, its implementation, and even further, its evaluation and continuation or modification. Expertise in the form of policy advice is already widely available in and to public administrations, to well-established professional organizations like medical societies and, of course, to large private-sector organizations with commercial or financial interests in the health sector. We need more health actors to join the fray and move from their traditional position of advocacy to a fuller commitment to the development of policy capacity, with all that it entails in terms of leadership and social responsibility

  8. Pragmatics of policy: the compliance of dutch environmental policy instruments to European union standards.

    Science.gov (United States)

    Kruitwagen, Sonja; Reudink, Melchert; Faber, Albert

    2009-04-01

    Despite a general decrease in Dutch environmental emission trends, it remains difficult to comply with European Union (EU) environmental policy targets. Furthermore, environmental issues have become increasingly complex and entangled with society. Therefore, Dutch environmental policy follows a pragmatic line by adopting a flexible approach for compliance, rather than aiming at further reduction at the source of emission. This may be politically useful in order to adequately reach EU targets, but restoration of environmental conditions may be delayed. However, due to the complexity of today's environmental issues, the restoration of environmental conditions might not be the only standard for a proper policy approach. Consequently this raises the question how the Dutch pragmatic approach to compliance qualifies in a broader policy assessment. In order to answer this question, we adapt a policy assessment framework, developed by Hemerijck and Hazeu (Bestuurskunde 13(2), 2004), based on the dimensions of legitimacy and policy logic. We apply this framework for three environmental policy assessments: flexible instruments in climate policy, fine-tuning of national and local measures to meet air quality standards, and derogation for the Nitrate Directive. We conclude with general assessment notes on the appliance of flexible instruments in environmental policy, showing that a broad and comprehensive perspective can help to understand the arguments to put such policy instruments into place and to identify trade-offs between assessment criteria.

  9. Analyzing public health policy: three approaches.

    Science.gov (United States)

    Coveney, John

    2010-07-01

    Policy is an important feature of public and private organizations. Within the field of health as a policy arena, public health has emerged in which policy is vital to decision making and the deployment of resources. Public health practitioners and students need to be able to analyze public health policy, yet many feel daunted by the subject's complexity. This article discusses three approaches that simplify policy analysis: Bacchi's "What's the problem?" approach examines the way that policy represents problems. Colebatch's governmentality approach provides a way of analyzing the implementation of policy. Bridgman and Davis's policy cycle allows for an appraisal of public policy development. Each approach provides an analytical framework from which to rigorously study policy. Practitioners and students of public health gain much in engaging with the politicized nature of policy, and a simple approach to policy analysis can greatly assist one's understanding and involvement in policy work.

  10. Health education and public policy.

    Science.gov (United States)

    Service, A

    1986-01-01

    The UK's Minister for Health has again raised the debate about the role of health educators, and in particular that of the Health Education Council, in what is termed public policy work. 1 possible definition of public policy work as regards health education is that aspect that seeks to establish certain health promoting principles as part of the conscious factors always to be considered by individuals, by opinion leaders, by manufacturers, by employers and trade unions, by service providers, by local authorities, and by central government in their plans and decisions. The Health Education Council (HEC) has no power to make or impose public policy; the Department of Health and Social Security (DHSS) has that task. The world of health education providers includes the Health Education Officers working for the Health Authorities and with the Education Authorities, an increasing number of important academic workers in the field, the HEC, the Scottish Health Education Group (SHEG), the DHSS, and some of the members of various professions who provide health education to the public as part of their daily work. Most of the HEC's work consists of providing these people with health educational tools. If the HEC begins to do more in the public policy field, it will not be at the cost of providing health educational tools. At the HEC a staff of 4 liaison workers is responsible for keeping field workers informed about future and imminent HEC work programs. They also assess needs and ideas by holding periodic meetings with Health Education Officers and others in various parts of the country. HEC's efforts have contributed substantially to increasing attention to preventive health measures on the part of the DHSS, parliamentary committees, the Royal Colleges, other professional bodies, and the media. In regard to the future, several paths deserve exploration as part of the HEC's education of decision-makers and opinion-formers. These include: local authorities, relevant

  11. Public Spending on Health as Political Instrument?

    DEFF Research Database (Denmark)

    Fielding, David; Freytag, Andreas; Münch, Angela

    2014-01-01

    The paper argues that the type of the political regime does not only drive public spending on health, but that dependent on the type of regime inequality in health status within its population is fostered by applying selective strategies. An empirical analysis is conducted for 132 low- and middle...... income states for the years 1995-2010. A simple political economic framework is implemented in order to analyse the rational of policy makers in implementing effective health care provision....

  12. Climate change policy instruments in a least regrets context

    Energy Technology Data Exchange (ETDEWEB)

    Lenstra, W.J.; Bonney, M. [Ministry of Housing, The Hague (Netherlands). Spatial Planning and Environment

    1995-12-31

    The Dutch CO{sub 2} target - which was set down in the National Environmental Policy Plan Plus (NMP-plus) and sent to Parliament in 1990 - is to reduce emissions by 3 to 5 % in 2000 relative to 1989/1990. The second National Environmental Policy Plan (NMP-2), issued in December 1993, confirmed this target but also concluded that policies will have to be enhanced and additional measures taken in order to achieve it. The measures developed in NMP-plus assumed that real energy prices would rise substantially during the 1990`s. However, the prices are at their lowest level since the early 1970`s and official projections now assume that real energy prices will remain more or less constant between 1990 and 2000. Under these conditions, application of existing policy instruments will have to be intensified and additional policy instruments will have to be deployed in order to attain even the 3 % emission reduction target for CO{sub 2}. In December 1993 the Government`s second National Environmental Policy Plan and second Memorandum on Energy Conservation indicated how policy efforts in the area of climate change will be enhanced. Targets were set for improving energy efficiency in different sectors in the period 1989-2000: 23 % for households, 23 % for non-residential buildings, 19 % for industry, 26 % for agriculture, 10 % for transport and 26 % for power stations. The overall efficiency improvement (including renewables) will lead to energy consumption of 2865 PJ in 2000 (550 PJ less than what it would have been without the policy measures; slightly more than what it was in 1990). Energy efficiency (including renewables) will be responsible for roughly two thirds of the CO{sub 2} reduction needed, with the remainder coming from transport, recycling, reduced coal use, afforestation and structural changes

  13. Direct payments as an instrument of the environmental policy

    Directory of Open Access Journals (Sweden)

    Adrian Sadłowski

    2011-01-01

    Full Text Available Agriculture is the area of human activity that is accompanied by the formation of positive and negative external environmental effects. In order to motivate farmers to conduct production activities in a way that reduces the negative impact of these activities on the environment, the so-called principle of cross compliance has been incorporated into the direct support system. This study characterises the area payments as an instrument of the environmental policy and is a review of the European Commission’s different proposals for the reform of direct payments through the prism of environmental functions of this instrument.

  14. Monetary Policy in China (1994-2004): Targets, Instruments and their Effectiveness

    OpenAIRE

    Geiger, Michael

    2006-01-01

    China's monetary policy disposes of two sets of monetary policy instruments: Instruments of the central bank, the People's Bank of China (PBC) and non-monetary policy instruments. Additionally, the PBC's instruments include price-based indirect and quantity-based direct instruments. The simultaneous usage of these instruments leads to various distortions that ultimately prevent the interest rate channel of monetary transmission from functioning. Moreover, the strong influences of quantity-bas...

  15. Wind power in Argentina: Policy instruments and economic feasibility

    Energy Technology Data Exchange (ETDEWEB)

    Recalde, M. [CONICET-UNS. 12 de Octubre y San Juan, 8000 Bahia Blanca (Argentina)

    2010-06-15

    Despite its great wind endowment, Argentina has not still succeeded in increasing wind power share in its wholesale market. However, the energy supply problem that this country is facing from 2004 on seems to open an opportunity for wind energy projects. A wide range of legislation has recently emerged. In this context, this paper discusses whether policy instruments in the Argentinean regulatory frame contribute to economic feasibility for wind power projects or not. To this purpose, we study wind installed capacity, Argentinean wind potential, the different promotion tools used worldwide and those employed in Argentina. Finally, we realize a feasibility study for a typical project. We found, that in spite of its high wind potential, economic feature, related to policy instruments, have been a boundary to the development of wind energy into the energy mix. (author)

  16. Does poverty reduce mental health? An instrumental variable analysis.

    Science.gov (United States)

    Hanandita, Wulung; Tampubolon, Gindo

    2014-07-01

    That poverty and mental health are negatively associated in developing countries is well known among epidemiologists. Whether the relationship is causal or associational, however, remains an open question. This paper aims to estimate the causal effect of poverty on mental health by exploiting a natural experiment induced by weather variability across 440 districts in Indonesia (N = 577,548). Precipitation anomaly in two climatological seasons is used as an instrument for poverty status, which is measured using per capita household consumption expenditure. Results of an instrumental variable estimation suggest that poverty causes poor mental health: halving one's consumption expenditure raises the probability of suffering mental illness by 0.06 point; in terms of elasticity, a 1% decrease in consumption brings about 0.62% more symptoms of common mental disorders. This poverty effect is approximately five times stronger than that obtained prior to instrumenting and is robust to alternative distributional assumption, model specification, sample stratification and estimation technique. An individual's mental health is also negatively correlated with district income inequality, suggesting that income distribution may have a significant influence upon mental health over and above the effect of poverty. The findings imply that mental health can be improved not only by influencing individuals' health knowledge and behaviour but also by implementing a more equitable economic policy.

  17. Cluster Policy As an Instrument of Public Management: Regional Aspect

    Directory of Open Access Journals (Sweden)

    Cherkasova Tatiana, P.

    2016-07-01

    Full Text Available The paper presents the research results related to the effectiveness of the new public management instruments of innovative development, which is a regional cluster policy. The experience of implementation of cluster policy in the Rostov region is analyzed, problems are identified and priorities are defined, the solution of which will allow to increase the competitiveness of the region. The identified problems should be carried out in two stages: at the first stage (2016–2017 it is important to complete the implementation of measures to improve the regulatory framework of the Rostov region in the field of cluster and innovation development, investment and socio-economic policy; in the second (2018–2020 to conduct activities aimed at the formation of public authorities of the region a favorable economic and legal conditions for development of cluster infrastructure. Scheme of innovation cluster with government participation that satisfies the principles of public administration is proposed.

  18. APPLICABILITY OF CERTAIN PUBLIC MARKETING INSTRUMENTS IN THE PROMOTION OF PUBLIC POLICIES

    Directory of Open Access Journals (Sweden)

    Tatiana-Camelia DOGARU

    2012-01-01

    Full Text Available All governments are judged depending he results supplied to society (more children educated, trains more on time, population health, but also on how well it supplies these results. The impulse towards promoting public policies, and the main motivation of the fact that they represent the core of the governmental activities, is found in the tension between the free market and the public sector. Promoting public policies derived from the need to earn the citizens’ support for implementing public policies. The paper objectives are: understanding the public marketing instruments and the analysis of the applicability of public marketing to public administration, of marketing instruments in promoting public policies. The general context of the work refers to marketing instruments, as object and subject of influence for the public policies process, knowing that marketing techniques have a considerable potential for facilitating the acceptance of public policies and of the programs meant for their implementation. In view of reaching the objectives of this paper, we used bibliographic research, the qualitative research and document analysis, as central data collection methods.

  19. [Intensify the development of public policy has the health: approaches strategic for the authorities of health public].

    Science.gov (United States)

    Guyon, Ak'ingabe

    2012-11-06

    Health promotion is one of the essential functions of public health authorities. The first pillar of health promotion is the elaboration of healthy public policy. Using the theoretical foundations of the healthy public policy concept, it can be demonstrated that public health authorities are able to develop, at their own scale, healthy public policies. Three strategic approaches are proposed in order to support public health authorities in strengthening their healthy public policy actions. First, better understand the tools or policy instruments (economic, regulation, information and persuasion) at their disposal. Second, take stock of the many types of legitimacy (theoretical, legislative, administrative and scientific) available to public health authorities as they develop healthy public policy. Third, consider the potential scientific roles that can be adopted while using the various policy instruments. These approaches can represent a pragmatic and structuring support for public health authorities wanting to strengthen their healthy public policy actions.

  20. Are national policies on global health in fact national policies on global health governance? A comparison of policy designs from Norway and Switzerland.

    Science.gov (United States)

    Jones, Catherine M; Clavier, Carole; Potvin, Louise

    2017-03-01

    Since the signing of the Oslo Ministerial Declaration in 2007, the idea that foreign policy formulation should include health considerations has gained traction on the United Nations agenda as evidenced by annual General Assembly resolutions on global health and foreign policy. The adoption of national policies on global health (NPGH) is one way that some member states integrate health and foreign policymaking. This paper explores what these policies intend to do and how countries plan to do it. Using a most similar systems design, we carried out a comparative study of two policy documents formally adopted in 2012. We conducted a directed qualitative content analysis of the Norwegian White Paper on Global health in foreign and development policy and the Swiss Health Foreign Policy using Schneider and Ingram's policy design framework. After replicating analysis methods for each document, we analysed them side by side to explore the commonalities and differences across elements of NPGH design. Analyses indicate that NPGH expect to influence change outside their borders. Targeting the international level, they aim to affect policy venues, multilateral partnerships and international institutions. Instruments for supporting desired changes are primarily those of health diplomacy, proposed as a tool for negotiating interests and objectives for global health between multiple sectors, used internally in Switzerland and externally in Norway. Findings suggest that NPGH designs contribute to constructing the global health governance system by identifying it as a policy target, and policy instruments may elude the health sector actors unless implementation rules explicitly include them. Research should explore how future NPGH designs may construct different kinds of targets as politicised groups of actors on which national governments seek to exercise influence for global health decision-making.

  1. The Food and Health Policy Game.

    Science.gov (United States)

    Jones, Lesley

    1984-01-01

    Describes the Food and Health Policy Game, an educational board game designed primarily for community health physicians and health education officers, to show how a food and health policy might be implemented to promote healthy diets and preventive medicine by the National Health Service. (MBR)

  2. Macropsychology, policy, and global health.

    Science.gov (United States)

    MacLachlan, Malcolm

    2014-11-01

    In this article I argue for the development of a macro perspective within psychology, akin to that found in macroeconomics. Macropsychology is the application of psychology to factors that influence the settings and conditions of our lives. As policy concerns the strategic allocation of resources—who gets what and why?—it should be an area of particular interest for macropsychology. I review ways in which psychology may make a contribution to policy within the field of global health. Global health emphasizes human rights, equity, social inclusion, and empowerment; psychology has much to contribute to these areas, both at the level of policy and practice. I review the sorts of evidence and other factors that influence policymakers, along with the content, process, and context of policymaking, with a particular focus on the rights of people with disabilities in the low- and middle-income countries of Africa and Asia. These insights are drawn from collaborations with a broad range of practitioners, governments, United Nations agencies, civil society organizations, the private sector and researchers. Humanitarian work psychology is highlighted as an example of a new area of psychology that embraces some of the concerns of macropsychology. The advent of "big data" presents psychology with an opportunity to ask new types of questions, and these should include "understanding up," or how psychological factors can contribute to human well-being, nationally and globally. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  3. A SHARIA RETURN AS AN ALTERNATIVE INSTRUMENT FOR MONETARY POLICY

    Directory of Open Access Journals (Sweden)

    Ashief Hamam

    2011-09-01

    Full Text Available Rapid development in Islamic financial industry has not been supported by sharia monetary policy instruments. This study looks at the possibility of sharia returns as the instrument. Using both error correction model and vector error correction model to estimate the data from 2002(1 to 2010(12, this paper finds that sharia return has the same effect as the interest rate in the demand for money. The shock effect of sharia return on broad money supply, Gross Domestic Product, and Consumer Price Index is greater than that of interest rate. In addition, these three variables are more quickly become stable following the shock of sharia return. Keywords: Sharia return, islamic financial system, vector error correction modelJEL classification numbers: E52, G15

  4. Research in energy conversion technologies. Policy instruments and uncertainty

    Energy Technology Data Exchange (ETDEWEB)

    Straathof, B.; Van Zon, A.

    2002-01-01

    The effects of uncertainty and of various policy instruments on the length and attractiveness of private research projects are studied. Research expenditure can be regained from quasi-rents that are earned by exploiting patents on the fruits of research. The accumulation of knowledge is modeled as a Poisson process. Within the context of the model, we show that firms shorten the duration of research projects when uncertainty in knowledge accumulation increases or when, for example, the validity of patents is prolonged. The underlying mechanisms are due to Jensen's Inequality and a real-option effect. Furthermore, we develop a smooth pasting condition for a class of Poisson processes.

  5. Choosing environmental policy instruments: An assessment of the 'environmental dimension' of EU energy policy

    Directory of Open Access Journals (Sweden)

    Kai Schulze

    2011-11-01

    Full Text Available Although they have formerly constituted distinct traditions in the European integration process, EU regulatory activities in environmental and energy policy have now become highly interwoven. Environmental concerns increasingly influence the formulation of the EU’s energy policy, especially given the twofold challenge of securing sufficient energy supply whilst also addressing the necessity of combating climate change. In this context, a key question is, how exactly does the EU approach environmental policy objectives as part of its energy policy? Is the ‘environmental dimension’ of EU energy policy subject to a different regulatory approach than EU environmental policy in general? This paper addresses these questions from a neo-functionalist perspective by comparing the different types of policy instruments adopted by the EU in the two interrelated areas over the past four decades. Overall, this work finds that the EU continues to rely heavily on traditional command and control regulation in the context of air pollution control, whereas the environmental dimension of EU energy policy is frequently controlled by new, less interventionist forms of governance.

  6. Rwanda Journal of Health Sciences: Editorial Policies

    African Journals Online (AJOL)

    Rwanda Journal of Health Sciences: Editorial Policies ... The Rwanda Journal of Health Sciences, a publication of Kigali Health Institute publishes original research, ... Professor Faye Dong, University of Illinois at Urbana-Champaign, USA

  7. Understanding health policy leaders’ training needs

    Science.gov (United States)

    Smith, L. Lerissa; Volny Darko, Renée; McKool, Marissa; Yan, Fengxia; Heiman, Harry

    2017-01-01

    Purpose We assessed the training needs of health policy leaders and practitioners across career stages; identified areas of core content for health policy training programs; and, identified training modalities for health policy leaders. Methods We convened a focus group of health policy leaders at varying career stages to inform the development of the Health Policy Leaders’ Training Needs Assessment tool. We piloted and distributed the tool electronically. We used descriptive statistics and thematic coding for analysis. Results Seventy participants varying in age and stage of career completed the tool. “Cost implications of health policies” ranked highest for personal knowledge development and “intersection of policy and politics” ranked highest for health policy leaders in general. “Effective communication skills” ranked as the highest skill element and “integrity” as the highest attribute element. Format for training varied based on age and career stage. Conclusions This study highlighted the training needs of health policy leaders personally as well as their perceptions of the needs for training health policy leaders in general. The findings are applicable for current health policy leadership training programs as well as those in development. PMID:28333982

  8. Childhood Diabesity: International Applications for Health Education and Health Policy

    Science.gov (United States)

    Pinzon-Perez, Helda; Kotkin-Jaszi, Suzanne; Perez, Miguel A.

    2010-01-01

    Health policy has a direct impact on health education initiatives, health care delivery, resource allocation, and quality of life. Increasing rates in the epidemics of obesity and obesity-dependent diabetes mellitus (aka diabesity) suggest that health policy changes should be included in health education and disease prevention strategies. Health…

  9. Leprosy: International Public Health Policies and Public Health Eras

    Directory of Open Access Journals (Sweden)

    Niyi Awofeso

    2011-09-01

    Full Text Available Public health policies continue to play important roles in national and international health reforms. However, the influence and legacies of the public health eras during which such policies are formulated remain largely underappreciated. The limited appreciation of this relationship may hinder consistent adoption of public health policies by nation-states, and encumber disinvestment from ineffective or anachronistic policies. This article reviews seven public health eras and highlights how each era has influenced international policy formulation for leprosy control—“the fertile soil for policy learning”. The author reiterates the role of health leadership and health activism in facilitating consistency in international health policy formulation and implementation for leprosy control.

  10. Establishing green roof infrastructure through environmental policy instruments.

    Science.gov (United States)

    Carter, Timothy; Fowler, Laurie

    2008-07-01

    Traditional construction practices provide little opportunity for environmental remediation to occur in urban areas. As concerns for environmental improvement in urban areas become more prevalent, innovative practices which create ecosystem services and ecologically functional land cover in cities will be in higher demand. Green roofs are a prime example of one of these practices. The past decade has seen the North American green roof industry rapidly expand through international green roof conferences, demonstration sites, case studies, and scientific research. This study evaluates existing international and North American green roof policies at the federal, municipal, and community levels. Green roof policies fall into a number of general categories, including direct and indirect regulation, direct and indirect financial incentives, and funding of demonstration or research projects. Advantages and disadvantages of each category are discussed. Salient features and a list of prompting standards common to successfully implemented green roof strategies are then distilled from these existing policies. By combining these features with data collected from an experimental green roof site in Athens, Georgia, the planning and regulatory framework for widespread green roof infrastructure can be developed. The authors propose policy instruments be multi-faceted and spatially focused, and also propose the following recommendations: (1) Identification of green roof overlay zones with specifications for green roofs built in these zones. This spatial analysis is important for prioritizing areas of the jurisdiction where green roofs will most efficiently function; (2) Offer financial incentives in the form of density credits and stormwater utility fee credits to help overcome the barriers to entry of the new technology; (3) Construct demonstration projects and institutionalize a commitment greening roofs on publicly-owned buildings as an effective way of establishing an educated

  11. Establishing Green Roof Infrastructure Through Environmental Policy Instruments

    Science.gov (United States)

    Carter, Timothy; Fowler, Laurie

    2008-07-01

    Traditional construction practices provide little opportunity for environmental remediation to occur in urban areas. As concerns for environmental improvement in urban areas become more prevalent, innovative practices which create ecosystem services and ecologically functional land cover in cities will be in higher demand. Green roofs are a prime example of one of these practices. The past decade has seen the North American green roof industry rapidly expand through international green roof conferences, demonstration sites, case studies, and scientific research. This study evaluates existing international and North American green roof policies at the federal, municipal, and community levels. Green roof policies fall into a number of general categories, including direct and indirect regulation, direct and indirect financial incentives, and funding of demonstration or research projects. Advantages and disadvantages of each category are discussed. Salient features and a list of prompting standards common to successfully implemented green roof strategies are then distilled from these existing policies. By combining these features with data collected from an experimental green roof site in Athens, Georgia, the planning and regulatory framework for widespread green roof infrastructure can be developed. The authors propose policy instruments be multi-faceted and spatially focused, and also propose the following recommendations: (1) Identification of green roof overlay zones with specifications for green roofs built in these zones. This spatial analysis is important for prioritizing areas of the jurisdiction where green roofs will most efficiently function; (2) Offer financial incentives in the form of density credits and stormwater utility fee credits to help overcome the barriers to entry of the new technology; (3) Construct demonstration projects and institutionalize a commitment greening roofs on publicly-owned buildings as an effective way of establishing an educated

  12. Structural adjustment and health policy in Africa.

    Science.gov (United States)

    Loewenson, R

    1993-01-01

    World Bank/International Monetary Fund Structural Adjustment Programs (SAPs) have been introduced in over 40 countries of Africa. This article outlines their economic policy measures and the experience of the countries that have introduced them, in terms of nutrition, health status, and health services. The evidence indicates that SAPs have been associated with increasing food insecurity and undernutrition, rising ill-health, and decreasing access to health care in the two-thirds or more of the population of African countries that already lives below poverty levels. SAPs have also affected health policy, with loss of a proactive health policy framework, a widening gap between the affected communities and policy makers, and the replacement of the underlying principle of equity in and social responsibility for health care by a policy in which health is marketed commodity and access to health care becomes an individual responsibility. The author argues that there is a deep contradiction between SAPs and policies aimed at building the health of the population. Those in the health sector need to contribute to the development and advocacy of economic policies in which growth is based on human resource development, and to the development of a civic environment in Africa that can ensure the implementation of such policies.

  13. Globalisation and Governance: Educational Policy Instruments and Regulatory Arrangements

    Science.gov (United States)

    Mok, Ka-Ho

    2005-07-01

    For more than a decade, the economic, social, political and cultural effects of globalisation have been central topics of debate. Those who see globalisation as a combination of economic transactions and worldwide telecommunications tend to believe that its impact is profound, inasmuch as it is fundamentally altering the way in which we live and creating hybrid cultural styles. No country is immune from the effects of globalisation, and controversy continues to reign about its positive and negative consequences. The present study identifies and examines numerous challenges posed by globalisation and their implications for educational restructuring, with special attention being given to new forms of governance; the relation between the state, the market and civil society; and governmental policy instruments for education.

  14. Population proposed as a fourth policy instrument in AAF-SAP.

    Science.gov (United States)

    1991-01-01

    The African Alternative Framework for Structural Adjustment Programmes proposed four policy instruments for adjustment with transformation in African countries. The first three were the use of a multiple exchange rate system, a differential interest rate policy, and agricultural production subsidies. The fourth proposed policy maintained that the simultaneous implementation of population programs and development programs is advantageous to both efforts. The integration of population factors in the development process was proposed to take place through four sets of activities: 1) the determination of a conceptual framework; 2) using the conceptual framework to derive the demographic objectives to be attained in the course of implementing the development plan; 3) training personnel; and 4) disseminating population information. Thus, a national development program based on this framework would work to minimize and/or eliminate poverty, unemployment, and income inequality and would focus on health, education, malnutrition, and family cohesion.

  15. Accelerating green building growth with old & new policy instruments

    Directory of Open Access Journals (Sweden)

    Ar. Namrata Mahal

    2016-08-01

    Full Text Available India is progressively moving towards the sustainability requirements of the real estate and infrastructure sector. The remarkable benefits like resource optimization, more efficient & lower impact on environment, health and well-being of the occupants and many more, have compelled government bodies across the nation to formally and regularly pursue these outcomes through various legislative instruments. Given that building sector belongs to a complex industrial chain involving wide-ranging actors, variety of instruments imbued by the political agenda are used to achieve certain degree of sustainability. The most commonly used instruments are economic incentives, rating systems, energy audit program, technology transfer program, information and education campaign and so on. Furthermore, given that India is a country that undoubtedly thrives on its diversity. Integrating diversity of concepts and strategies and utilizing the benefits that each level of government can provide, may complicate and dilute the desired impact. This paper enlists possible tools in the Indian context and within the ambit of the existing governance framework that could be adopted and increased exponentially at both levels, national and state

  16. "Smart regulation": Can policy instrument design solve forest policy aims of expansion and sustainability in Flanders and the Netherlands?

    NARCIS (Netherlands)

    Gossum, Van P.; Arts, B.J.M.; Verheyen, K.

    2012-01-01

    The current study investigates with a multiple case study the relation between instrument design and policy success. The conclusion is that the instrument mix matters. The Flemish interventionist approach, which focuses more on traditional instruments, was not as effective as the Dutch stimulating

  17. Health and Wellness Policy Ethics

    Directory of Open Access Journals (Sweden)

    Frank J. Cavico

    2013-01-01

    Full Text Available This perspective is an ethical brief overview and examination of “wellness” policies in the modern workplace using practical examples and a general application of utilitarianism. Many employers are implementing policies that provide incentives to employees who lead a “healthy” lifestyle. The authors address how these policies could adversely affect “non-healthy” employees. There are a wide variety of ethical issues that impact wellness policies and practices in the workplace. The authors conclude that wellness programs can be ethical, while also providing a general reflective analysis of healthcare challenges in order to reflect on the externalities associated with such policies in the workplace.

  18. Health and Wellness Policy Ethics

    Science.gov (United States)

    Cavico, Frank J.; Mujtaba, Bahaudin G.

    2013-01-01

    This perspective is an ethical brief overview and examination of “wellness” policies in the modern workplace using practical examples and a general application of utilitarianism. Many employers are implementing policies that provide incentives to employees who lead a “healthy” lifestyle. The authors address how these policies could adversely affect “non-healthy” employees. There are a wide variety of ethical issues that impact wellness policies and practices in the workplace. The authors conclude that wellness programs can be ethical, while also providing a general reflective analysis of healthcare challenges in order to reflect on the externalities associated with such policies in the workplace. PMID:24596847

  19. A model for training public health workers in health policy: the Nebraska Health Policy Academy.

    Science.gov (United States)

    Brandert, Kathleen; McCarthy, Claudine; Grimm, Brandon; Svoboda, Colleen; Palm, David; Stimpson, Jim P

    2014-05-15

    There is growing recognition that health goals are more likely to be achieved and sustained if programs are complemented by appropriate changes in the policies, systems, and environments that shape their communities. However, the knowledge, skills, and abilities needed to create and implement policy are among the major needs identified by practitioners at both the state and local levels. This article describes the structure and content of the Nebraska Health Policy Academy (the Academy), a 9-month program developed to meet the demand for this training. The Academy is a competency-based training program that aims to increase the capacity of Nebraska's state and local public health staff and their community partners to use public health policy and law as a public health tool. Our initiative allows for participation across a large, sparsely populated state; is grounded in adult learning theory; introduces the key principles and practices of policy, systems, and environmental change; and is offered free of charge to the state's public health workforce. Challenges and lessons learned when offering workforce development on public health policy efforts are discussed.

  20. Health Policy as a Specific Area of Social Policy

    Directory of Open Access Journals (Sweden)

    Dominika Pekarová

    2017-08-01

    Full Text Available Purpose and Originality: The aim of the article was to analyse the work of the health policy which is a very specific part of social policy. In the work we focus on its financing, which is a very important issue in the health care. We try to show, what is the role of the state in the health care system as well as the creation of resources and control costs in the health sector. The work is finding such as financing health care in Slovakia and in other selected countries, and which could be changed for the best operation. Method: The analysis was carried out on the basis of the information which I drew from books and Internet resources. The work is divided into two parts. Contains 9 tables and 3 charts. The first chapter is devoted to a general description of social policy, its funding, with a focus on health policy than its specific area. The second chapter analyses the financing systems of health policy in Slovakia and in selected countries. Results: The results showed that the Slovak health care makes is trying hard to catch up with the level of the best health care systems. However, there are countries, which are doing much worse than us, in terms of funding. Society: It is important to properly invest money but also communication between states. To get help on health and to ensure that citizens know states the best conditions of health care. Limitations / further research: This work is focused on how to bring closer health care and its financing in several different countries economically. IN doing so some other aspects such as what is best level of services, etc. were put aside.

  1. Health in all policies as a priority in Finnish health policy: a case study on national health policy development.

    Science.gov (United States)

    Melkas, Tapani

    2013-03-01

    This article describes national level development towards a Health in All Policies approach in Finland over the past four decades. In the early 1970s, improving public health became a political priority, and the need to influence key determinants of health through sectors beyond the health sector became evident. The work began with policy on nutrition, smoking and accident prevention. Intersectoral health policy was developed together with the World Health Organization (WHO). When Finland joined the European Union in 1995, some competencies were delegated to the EU which complicated national intersectoral work. The priority in the EU is economy, but the Constitution's requirement to protect health in all policies gives legal backing for including health consideration in the EU-level work. To promote that, Finland adopted 'Health in All Policies' (HiAP) as the health theme for its EU Presidency in 2006. The intersectoral work on health has developed from tackling single health problems, through large-scale programmes, further to systematic work based on legislation and permanent structures. In the 2000s, work at local level was strengthened by introducing more focused and tighter legislation and by providing expert support for implementation. Recently, emphasis has been on broad objectives and Governmental intersectoral programmes, and actors outside the administrative machinery. Great improvements in the population health have been gained over the past few decades. However, health inequalities across social groups have remained unacceptably large. Major decisions on economic policy with varying impacts by the social groups have been made without health impact assessment, or ignoring assessments conducted.

  2. The Nurse in Health Policy and Politics

    OpenAIRE

    Planas Campmany, Carme; Martínez Méndez, Roser; Bullich Marin, Ingrid; Calvo Valencia, Elena M.

    2017-01-01

    Demographic trends, population projections and emerging health problems have a direct impact on health systems. These changes happen immersed in a socioeconomic environment and a constant concern for sustainability and solvency of the health and social systems. In this context, health promotion, preventive interventions and care for people with or at risk of chronic health problems gain relevance in public health policies. This suggests that nurses will have to assume an inc...

  3. Framing health and foreign policy: lessons for global health diplomacy

    Directory of Open Access Journals (Sweden)

    Labonté Ronald

    2010-08-01

    Full Text Available Abstract Global health financing has increased dramatically in recent years, indicative of a rise in health as a foreign policy issue. Several governments have issued specific foreign policy statements on global health and a new term, global health diplomacy, has been coined to describe the processes by which state and non-state actors engage to position health issues more prominently in foreign policy decision-making. Their ability to do so is important to advancing international cooperation in health. In this paper we review the arguments for health in foreign policy that inform global health diplomacy. These are organized into six policy frames: security, development, global public goods, trade, human rights and ethical/moral reasoning. Each of these frames has implications for how global health as a foreign policy issue is conceptualized. Differing arguments within and between these policy frames, while overlapping, can also be contradictory. This raises an important question about which arguments prevail in actual state decision-making. This question is addressed through an analysis of policy or policy-related documents and academic literature pertinent to each policy framing with some assessment of policy practice. The reference point for this analysis is the explicit goal of improving global health equity. This goal has increasing national traction within national public health discourse and decision-making and, through the Millennium Development Goals and other multilateral reports and declarations, is entering global health policy discussion. Initial findings support conventional international relations theory that most states, even when committed to health as a foreign policy goal, still make decisions primarily on the basis of the 'high politics' of national security and economic material interests. Development, human rights and ethical/moral arguments for global health assistance, the traditional 'low politics' of foreign policy, are

  4. Framing health and foreign policy: lessons for global health diplomacy.

    Science.gov (United States)

    Labonté, Ronald; Gagnon, Michelle L

    2010-08-22

    Global health financing has increased dramatically in recent years, indicative of a rise in health as a foreign policy issue. Several governments have issued specific foreign policy statements on global health and a new term, global health diplomacy, has been coined to describe the processes by which state and non-state actors engage to position health issues more prominently in foreign policy decision-making. Their ability to do so is important to advancing international cooperation in health. In this paper we review the arguments for health in foreign policy that inform global health diplomacy. These are organized into six policy frames: security, development, global public goods, trade, human rights and ethical/moral reasoning. Each of these frames has implications for how global health as a foreign policy issue is conceptualized. Differing arguments within and between these policy frames, while overlapping, can also be contradictory. This raises an important question about which arguments prevail in actual state decision-making. This question is addressed through an analysis of policy or policy-related documents and academic literature pertinent to each policy framing with some assessment of policy practice. The reference point for this analysis is the explicit goal of improving global health equity. This goal has increasing national traction within national public health discourse and decision-making and, through the Millennium Development Goals and other multilateral reports and declarations, is entering global health policy discussion. Initial findings support conventional international relations theory that most states, even when committed to health as a foreign policy goal, still make decisions primarily on the basis of the 'high politics' of national security and economic material interests. Development, human rights and ethical/moral arguments for global health assistance, the traditional 'low politics' of foreign policy, are present in discourse but do

  5. Digital Education Governance: Data Visualization, Predictive Analytics, and "Real-Time" Policy Instruments

    Science.gov (United States)

    Williamson, Ben

    2016-01-01

    Educational institutions and governing practices are increasingly augmented with digital database technologies that function as new kinds of policy instruments. This article surveys and maps the landscape of digital policy instrumentation in education and provides two detailed case studies of new digital data systems. The Learning Curve is a…

  6. Designs on governance : development of policy instruments and dynamics in governance

    NARCIS (Netherlands)

    Voß, Jan-Peter

    2007-01-01

    The thesis analyses the role of policy instruments for dynamics of governance, using case studies on ‘emissisons trading’ and ‘network access regulation in the utilities’. It opens by observing a paradox: Policy instruments are criticised for misrepresenting the complex and contested reality of

  7. Digital Education Governance: Data Visualization, Predictive Analytics, and "Real-Time" Policy Instruments

    Science.gov (United States)

    Williamson, Ben

    2016-01-01

    Educational institutions and governing practices are increasingly augmented with digital database technologies that function as new kinds of policy instruments. This article surveys and maps the landscape of digital policy instrumentation in education and provides two detailed case studies of new digital data systems. The Learning Curve is a…

  8. Valve Health Monitoring System Utilizing Smart Instrumentation

    Science.gov (United States)

    Jensen, Scott L.; Drouant, George J.

    2006-01-01

    The valve monitoring system is a stand alone unit with network capabilities for integration into a higher level health management system. The system is designed for aiding in failure predictions of high-geared ball valves and linearly actuated valves. It performs data tracking and archiving for identifying degraded performance. The data collection types are cryogenic cycles, total cycles, inlet temperature, body temperature torsional strain, linear bonnet strain, preload position, total travel and total directional changes. Events are recorded and time stamped in accordance with the IRIG B True Time. The monitoring system is designed for use in a Class 1 Division II explosive environment. The basic configuration consists of several instrumentation sensor units and a base station. The sensor units are self contained microprocessor controlled and remotely mountable in three by three by two inches. Each unit is potted in a fire retardant substance without any cavities and limited to low operating power for maintaining safe operation in a hydrogen environment. The units are temperature monitored to safeguard against operation outside temperature limitations. Each contains 902-928 MHz band digital transmitters which meet Federal Communication Commission's requirements and are limited to a 35 foot transmission radius for preserving data security. The base-station controller correlates data from the sensor units and generates data event logs on a compact flash memory module for database uploading. The entries are also broadcast over an Ethernet network. Nitrogen purged National Electrical Manufactures Association (NEMA) Class 4 enclosures are used to house the base-station

  9. Office of Rural Health Policy

    Science.gov (United States)

    ... Information Hub Rural Health Research Gateway Rural Community Health Gateway White House Rural Council  Eligibility Analyzer Contact Us Subscribe to FORHP weekly announcement for rural health grantees and stakeholders by e-mail Subscribe to ...

  10. Choice policies in Northern European health systems.

    Science.gov (United States)

    Vrangbaek, Karsten; Robertson, Ruth; Winblad, Ulrika; Van de Bovenkamp, Hester; Dixon, Anna

    2012-01-01

    This paper compares the introduction of policies to promote or strengthen patient choice in four Northern European countries - Denmark, England, the Netherlands and Sweden. The paper examines whether there has been convergence in choice policies across Northern Europe. Following Christopher Pollitt's suggestion, the paper distinguishes between rhetorical (discursive) convergence, decision (design) convergence and implementation (operational) convergence (Pollitt, 2002). This leads to the following research question for the article: Is the introduction of policies to strengthen choice in the four countries characterised by discursive, decision and operational convergence? The paper concludes that there seems to be convergence among these four countries in the overall policy rhetoric about the objectives associated with patient choice, embracing both concepts of empowerment (the intrinsic value) and market competition (the instrumental value). It appears that the institutional context and policy concerns such as waiting times have been important in affecting the timing of the introduction of choice policies and implementation, but less so in the design of choice policies. An analysis of the impact of choice policies is beyond the scope of this paper, but it is concluded that further research should investigate how the institutional context and timing of implementation affect differences in how the choice policy works out in practice. © Cambridge University Press 2012

  11. Assessment of health risks of policies

    Energy Technology Data Exchange (ETDEWEB)

    Ádám, Balázs, E-mail: badam@cmss.sdu.dk [Unit for Health Promotion Research, Faculty of Health Sciences, University of Southern Denmark, Niels Bohrs Vej 9, DK-6700 Esbjerg (Denmark); Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen (Hungary); Molnár, Ágnes, E-mail: MolnarAg@smh.ca [Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen (Hungary); Centre for Research on Inner City Health, Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael' s Hospital, Victoria 209, Rm. 3-26.22, M5B 1C6 Toronto, Ontario (Canada); Ádány, Róza, E-mail: adany.roza@sph.unideb.hu [Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, P.O. Box 9, H-4012 Debrecen (Hungary); Bianchi, Fabrizio, E-mail: Fabriepi@ifc.cnr.it [Unit of Environmental Epidemiology, Institute of Clinical Physiology, National Council of Research, Moruzzi 1, 56124 Pisa (Italy); Bitenc, Katarina, E-mail: katarina.bitenc@ivz-rs.si [National Institute of Public Health, Trubarjeva 2, SI-1000 Ljubljana (Slovenia); Chereches, Razvan, E-mail: razvan.m.chereches@gmail.com [Faculty of Political, Administrative and Communication Sciences, Babes-Bolyai University, Strada Mihail Kogalniceanu 1, 3400 Cluj (Romania); Cori, Liliana, E-mail: liliana.cori@ifc.cnr.it [Unit of Environmental Epidemiology, Institute of Clinical Physiology, National Council of Research, Moruzzi 1, 56124 Pisa (Italy); Fehr, Rainer, E-mail: rainer.fehr@uni-bielefeld.de [NRW Centre for Health, Westerfeldstr. 35-37, 33611 Bielefeld (Germany); Kobza, Joanna, E-mail: koga1@poczta.onet.pl [Public Health Department, Silesian Medical University, 18 Medykow Street, 40-752 Katowice (Poland); Kollarova, Jana, E-mail: janakollarova@yahoo.com [Department of Health Promotion, Regional Public Health Authority, Ipelska 1, 04011 Kosice (Slovakia); and others

    2014-09-15

    The assessment of health risks of policies is an inevitable, although challenging prerequisite for the inclusion of health considerations in political decision making. The aim of our project was to develop a so far missing methodological guide for the assessment of the complex impact structure of policies. The guide was developed in a consensual way based on experiences gathered during the assessment of specific national policies selected by the partners of an EU project. Methodological considerations were discussed and summarized in workshops and pilot tested on the EU Health Strategy for finalization. The combined tool, which includes a textual guidance and a checklist, follows the top-down approach, that is, it guides the analysis of causal chains from the policy through related health determinants and risk factors to health outcomes. The tool discusses the most important practical issues of assessment by impact level. It emphasises the transparent identification and prioritisation of factors, the consideration of the feasibility of exposure and outcome assessment with special focus on quantification. The developed guide provides useful methodological instructions for the comprehensive assessment of health risks of policies that can be effectively used in the health impact assessment of policy proposals. - Highlights: • Methodological guide for the assessment of health risks of policies is introduced. • The tool is developed based on the experiences from several case studies. • The combined tool consists of a textual guidance and a checklist. • The top-down approach is followed through the levels of the full impact chain. • The guide provides assistance for the health impact assessment of policy proposals.

  12. International institutions and China's health policy.

    Science.gov (United States)

    Huang, Yanzhong

    2015-02-01

    This article examines the role of international institutional actors in China's health policy process. Particular attention is paid to three major international institutional actors: the World Bank, the World Health Organization, and the Global Fund to Fight AIDS, Tuberculosis and Malaria. Through process tracing and comparative case studies, the article looks at how international institutions contribute to policy change in China and seeks to explain different outcomes in the relationship between international institutions and China's health policies. It finds that despite the opaque and exclusive authoritarian structure in China, international institutions play a significant role in the country's domestic health governance. By investing their resources and capabilities selectively and strategically, international institutions can change the preferences of government policy makers, move latent public health issues to the government's agenda, and affect the timing of government action and the content of policy design. Furthermore, the study suggests that different outcomes in the relationship between China's health policies and global health governance can be explained through the seriousness of the externalities China faces.

  13. Multilevel modelling and public health policy

    NARCIS (Netherlands)

    Leyland, Alastair H.; Groenewegen, Peter P.

    2003-01-01

    Background: Multilevel modelling is a statistical technique that extends ordinary regression analysis to the situation where the data are hierarchical. Such data form an increasingly common evidence base for public health policy, and as such it is important that policy makers should be aware of this

  14. Multilevel modelling and public health policy.

    NARCIS (Netherlands)

    Leyland, A.H.; Groenewegen, P.P.

    2003-01-01

    BACKGROUND: Multilevel modelling is a statistical technique that extends ordinary regression analysis to the situation where the data are hierarchical. Such data form an increasingly common evidence base for public health policy, and as such it is important that policy makers should be aware of this

  15. [Regionalization in health: an instrument for jurisdictional planning].

    Science.gov (United States)

    Romero-Guerrero, X R; Perham-Zellmer, K A; Vázquez-Calderón, R H; Díaz-Gois, A; García-Martínez, F E; Gómez-Solís, R A; Montijo-Quevedo, R E; Aguirre-Garza, J S; Izquierdo-Avalos, M G; Hernández-Tezoquipa, I

    1992-01-01

    This study carried out the regionalization of Sanitary Jurisdiction No. III seated in Cuautla, Morelos, consisting of 16 of a total of 33 municipalities in the state of Morelos. This regionalization was carried out through the delination of areas sharing similar socioeconomical and demographic characteristics (SED). Subsequently, the major health hazards and the intraregional distribution of human health resources (physicians and nurses) and infrastructure services (institutional health centers) were identified for each region. The aim of this work was to devise an instrument for a better understanding of and approach to health problems at a juridictional level and to pave the way for health planning that would be congruent with regional characteristics and needs. Health sector efforts would be directed towards the promotion of preventive health care with greater efficiency and equity. In order to regionalize the jurisdiction, 17 SED indicators were studied in each of the 16 municipalities. Analysis was performed using the Principal Components Method (MCP) and an epidemiologic score. As a result, the sanitary jurisdiction was divided into three regions: Region I, with the best SED conditions, Region II, with moderate SED conditions and Region III with the lowest SED conditions. The results of this study show that there is an inverse relationship between the intraregional distribution of health resources with respect to the delineated regions and the health resources with respect to the delineated regions and the health needs and problems found in each one. Region III showed the worst SED conditions and the highest incidence of disease. It proved to be the region which had the greatest lack of material and human health resources, the latter having the lowest technical training level in all of the jurisdiction. In contrast. Region I had the best SED conditions and the lowest incidence of disease. It also had the highest number of material and human health resources

  16. STATE BUDGET AND FISCAL POLICY INSTRUMENTS TO ACHIEVE ITS

    Directory of Open Access Journals (Sweden)

    Haralambie George Alin

    2010-12-01

    Full Text Available This paper presents the tools for carrying out the fiscal budget in Romania. An effective fiscal policy involves increasing budget revenues and reduce their costs of collection. Public expenditure, taxes and debt are tools of fiscal policy to achieve economic stability budget. They are also presented the inter dependencies between fiscal policy and budget.

  17. Economic instruments and clean water: Why institutions and policy design matter

    DEFF Research Database (Denmark)

    Andersen, Mikael Skou

    2001-01-01

    Since market-like policy instruments are usually applied within existing rules, institutions, and policy processes, the policy and administrative contexts in which they operate become important. These contexts are quite different from country to country, often more so than policymakers are aware ...

  18. Economic instruments and clean water: Why institutions and policy design matter

    DEFF Research Database (Denmark)

    Andersen, Mikael Skou

    1994-01-01

    Since market-like policy instruments are usually applied within existing rules, institutions, and policy processes, the policy and administrative contexts in which they operate become important. These contexts are quite different from country to country, often more so than policymakers are aware of...

  19. Innovation Policy of the European Union: Concept Strategic Update and Instruments Improvement

    Directory of Open Access Journals (Sweden)

    Belal Hassouna

    2013-01-01

    Full Text Available The article characterizes formation of EU innovation policy and its conceptual update, which has strategic character and is concerned with the social and economic model change, determines differences between EU innovation policy and national politics and the forms of its implementation, detects major changes of EU innovation policy instruments, which were the result of support concept and innovation regulations change.

  20. Economic instruments and waste policies in the Netherlands: Inventory and options for extended use

    NARCIS (Netherlands)

    Oosterhuis, F.; Bartelings, H.; Linderhof, V.G.M.; Beukering, van P.J.M.

    2009-01-01

    In recent years, the interest in the use of economic instruments in environmental policy has been growing, reflecting increasing awareness of their potential cost-effectiveness as well as the need to diversify the ‘policy toolbox’. Waste policy is no exception to this tendency. The present study exp

  1. Arctic health policy: contribution of scientific data.

    Science.gov (United States)

    Berner, James E; Gilman, Andrew

    2003-08-01

    In Western Hemisphere arctic regions, scientific findings in humans, wildlife, and the environment have resulted in major governmental policy formulations. Government policy resulted in establishment of an effective international organization to address scientifically identified problems, including health disparities in arctic indigenous populations. Western scientific data and indigenous knowledge from initial international programs led to international agreements restricting certain persistent organic pollutants. In recent years, scientific data, and indigenous traditional knowledge, have resulted in governmental policy in the United States, Canada, and Nordic countries that includes the full participation of indigenous residents in defining research agendas, interpreting data, communicating information, and local community policy formulation.

  2. Health inequality - determinants and policies

    DEFF Research Database (Denmark)

    Diderichsen, Finn; Andersen, Ingelise; Manual, Celie;

    2012-01-01

    The review ”Health inequality – determinants and policies” identifies key-areas to be addressed with the aim to reduce the social inequality in health. The general life expectancy has steadily been increasing, but the data reveals marked social inequalities in health as well as life expectancy....... The review seeks to identify the causes of this social inequality. The analysis finds 12 areas of great importance for the inequality in health. This is i.e. early child development, schooling and education, the health behavior of the population, and the role of the health system. Within each of the 12 areas...

  3. Seven Foundational Principles of Population Health Policy.

    Science.gov (United States)

    Bhattacharya, Dru; Bhatt, Jay

    2017-02-13

    In 2016, Keyes and Galea issued 9 foundational principles of population health science and invited further deliberations by specialists to advance the field. This article presents 7 foundational principles of population health policy whose intersection with health care, public health, preventive medicine, and now population health, presents unique challenges. These principles are in response to a number of overarching questions that have arisen in over a decade of the authors' collective practice in the public and private sectors, and having taught policy within programs of medicine, law, nursing, and public health at the graduate and executive levels. The principles address an audience of practitioners and policy makers, mindful of the pressing health care challenges of our time, including: rising health-related expenditures, an aging population, workforce shortages, health disparities, and a backdrop of inequities rooted in social determinants that have not been adequately translated into formal policies or practices among the key stakeholders in population health. These principles are meant to empower stakeholders-whether it is the planner or the practitioner, the decision maker or the dedicated caregiver-and inform the development of practical tools, research, and education.

  4. Health Policies and Economic Blocks

    OpenAIRE

    André Medici; Bernardo Barros Weaver

    2006-01-01

    This paper analyzes the roles of health goods and services markets within the regional integration process. It is a known fact that the consolidation of integrated markets is slower regarding social goods and services (as health and education) than among other goods and services (e.g. durable and non-durable consumption goods). The paper discusses the nature of the health sector and its global dimension, showing the peculiar features of health goods and services marked by economic complexity ...

  5. Applying Behavioral Economics to Public Health Policy

    Science.gov (United States)

    Matjasko, Jennifer L.; Cawley, John H.; Baker-Goering, Madeleine M.; Yokum, David V.

    2016-01-01

    Behavioral economics provides an empirically informed perspective on how individuals make decisions, including the important realization that even subtle features of the environment can have meaningful impacts on behavior. This commentary provides examples from the literature and recent government initiatives that incorporate concepts from behavioral economics in order to improve health, decision making, and government efficiency. The examples highlight the potential for behavioral economics to improve the effectiveness of public health policy at low cost. Although incorporating insights from behavioral economics into public health policy has the potential to improve population health, its integration into government public health programs and policies requires careful design and continual evaluation of such interventions. Limitations and drawbacks of the approach are discussed. PMID:27102853

  6. Values in Health Policy - A Concept Analysis.

    Science.gov (United States)

    Shams, Lida; Akbari Sari, Ali; Yazdani, Shahram

    2016-08-17

    Despite the significant role "values" play in decision-making no definition or attributes regarding the concept have been provided in health policy-making. This study aimed to clarify the defining attributes of a concept of value and its irrelevant structures in health policy-making. We anticipate our findings will help reduce the semantic ambiguities associated with the use of "values" and other concepts such as principles, criteria, attitudes, and beliefs. An extensive search of literature was carried out using electronic data base and library. The overall search strategy yielded about 1540 articles and 450 additional records. Based on traditional qualitative research, studies were purposefully selected and the coding of articles continued until data saturation was reached. Accordingly, 31 articles, 2 books, and 5 other documents were selected for the review. We applied Walker and Avant's method of concept analysis in studying the phenomenon. Definitions, applications, attributes, antecedents, and consequences of the concept of "value in health policy-making" were extracted. We also identified similarities and differences that exist between and within them. We identified eight major attributes of "value in health policy-making": ideological origin, affect one's choices, more resistant to change over time, source of motivation, ability to sacrifice one's interest, goal-oriented nature for community, trans-situational and subjectivity. Other features pinpointed include alternatives, antecedents, and consequences. Alternative, antecedents and consequences case may have more or fewer attributes or may lack one of these attributes and at the same time have other distinctive ones. Despite the use of the value framework, ambiguities still persist in providing definition of the concept value in health policy-making. Understanding the concept of value in health policy-making may provide extra theoretical support to decision-makers in their policy-making process, to help

  7. GOOD DRUG POLICY IS GOOD PUBLIC HEALTH POLICY

    Institute of Scientific and Technical Information of China (English)

    Kasia Malinowska-Sempruch

    2010-01-01

    @@ 1 Introduction At present, there is a myriad of contradictions between international illicit drug policy and good, evidence-based public health policy. Largely to blame are the unrealistic goals which policymakers set themselves ten years ago when Pino Arlacchi, the Executive Director of the United Nations Office on Drugs and Crime (UNODC), announced plans to create a drug-free world' and to eliminate or significantly reduce the illicit cultivation of the coca bush, the cannabis plant and the opium poppy by the year 2008[1].

  8. Programs and instruments of the energy policy and climate policy. EEG versus emissions trading?; Programme und Instrumente der Energie- und Klimapolitik. EEG versus Emissionshandel?

    Energy Technology Data Exchange (ETDEWEB)

    Schafhausen, Franzjosef [Bundesministerium fuer Umwelt, Naturschutz und Reaktorsicherheit, Berlin (Germany)

    2011-11-15

    The fundamental question behind the theme of the contribution under consideration is as old as the independent environmental policy in Germany. The battle undulates between fundamentally different schools. On the one side, there are representatives of a one-dimensional theory in which a single instrument is sufficient to solve a defined problem. On the other hand, there is the thesis that the existing obstacles and barriers have such a wide range of expression that one instrument is not sufficient to overcome all hurdles. This position advises the use of adjusted combinations of instruments in order to realize comprehensive and very ambitious targets. Under this aspect the author of the contribution under consideration reports on (a) the main reasons for the use of a combination of instruments; (b) the targets of the German climate protection policy; (c) the energy concept of the Federal Government.

  9. Are Sexual and Reproductive Health Policies Designed for All? Vulnerable Groups in Policy Documents of Four European Countries and Their Involvement in Policy Development.

    Science.gov (United States)

    Ivanova, Olena; Dræbel, Tania; Tellier, Siri

    2015-08-12

    Health policies are important instruments for improving population health. However, experience suggests that policies designed for the whole population do not always benefit the most vulnerable. Participation of vulnerable groups in the policy-making process provides an opportunity for them to influence decisions related to their health, and also to exercise their rights. This paper presents the findings from a study that explored how vulnerable groups and principles of human rights are incorporated into national sexual and reproductive health (SRH) policies of 4 selected countries (Spain, Scotland, Republic of Moldova, and Ukraine). It also aimed at discussing the involvement of vulnerable groups in SRH policy development from the perspective of policy-makers. Literature review, health policy analysis and 5 semi-structured interviews with policy-makers were carried out in this study. Content analysis of SRH policies was performed using the EquiFrame analytical framework. The study revealed that vulnerable groups and core principles of human rights are differently addressed in SRH policies within 4 studied countries. The opinions of policy-makers on the importance of mentioning vulnerable groups in policy documents and the way they ought to be mentioned varied, but they agreed that a clear definition of vulnerability, practical examples, and evidences on health status of these groups have to be included. In addition, different approaches to vulnerable group's involvement in policy development were identified during the interviews and the range of obstacles to this process was discussed by respondents. Incorporation of vulnerable groups in the SRH policies and their involvement in policy development were found to be important in addressing SRH of these groups and providing an opportunity for them to advocate for equal access to healthcare and exercise their rights. Future research on this topic should include representatives of vulnerable communities which could

  10. Health Educators as Environmental Policy Advocates.

    Science.gov (United States)

    Miner, Kimberly J.; Baker, Judith A.

    1993-01-01

    Health educators must complement individual-level change with communitywide policy and legislative initiatives, focusing on environmental issues such as air pollution, ozone layer depletion, and toxic waste disposal. Recent increases in discomfort and disease related to the physical environment call for immediate action from health professionals…

  11. Professional Assistance in Implementing School Health Policies

    Science.gov (United States)

    Boot, Nicole; van Assema, Patricia; Hesdahl, Bert; de Vries, Nanne

    2010-01-01

    Purpose: The purpose of this study was to evaluate the role of a school health promotion (SHP) advisor in the implementation of the six steps of the Dutch "Schoolbeat" approach, aimed at establishing health promotion policies and activities in secondary schools. Design/methodology/approach: In total, 80 school board members, and 18…

  12. Evaluating Diabetes Health Policies Using Natural Experiments

    Science.gov (United States)

    Ackermann, Ronald T.; Duru, O. Kenrik; Albu, Jeanine B.; Schmittdiel, Julie A.; Soumerai, Stephen B.; Wharam, James F.; Ali, Mohammed K.; Mangione, Carol M.; Gregg, Edward W.

    2016-01-01

    The high prevalence and costs of type 2 diabetes makes it a rapidly evolving focus of policy action. Health systems, employers, community organizations, and public agencies have increasingly looked to translate the benefits of promising research interventions into innovative polices intended to prevent or control diabetes. Though guided by research, these health policies provide no guarantee of effectiveness and may have opportunity costs or unintended consequences. Natural experiments use pragmatic and available data sources to compare specific policies to other policy alternatives or predictions of what would likely have happened in the absence of any intervention. The Natural Experiments for Translation in Diabetes (NEXT-D) Study is a network of academic, community, industry, and policy partners, collaborating to advance the methods and practice of natural experimental research, with a shared aim of identifying and prioritizing the best policies to prevent and control diabetes. This manuscript describes the NEXT-D Study group's multi-sector natural experiments in areas of diabetes prevention or control as case examples to illustrate the selection, design, analysis, and challenges inherent to natural experimental study approaches to inform development or evaluation of health policies. PMID:25998925

  13. Health economics and health policy: experiences from New Zealand.

    Science.gov (United States)

    Cumming, Jacqueline

    2015-06-01

    Health economics has had a significant impact on the New Zealand health system over the past 30 years. In this paper, I set out a framework for thinking about health economics, give some historical background to New Zealand and the New Zealand health system, and discuss examples of how health economics has influenced thinking about the organisation of the health sector and priority setting. I conclude the paper with overall observations about the role of health economics in health policy in New Zealand, also identifying where health economics has not made the contribution it could and where further influence might be beneficial.

  14. The right to health, health systems development and public health policy challenges in Chad.

    Science.gov (United States)

    Azétsop, Jacquineau; Ochieng, Michael

    2015-02-15

    in an integrated vision of society as a place for multi-level interactions, where government plays its role by equitably providing institutions and services that ensure people's welfare. Inter-sectoral collaboration, which calls for a conceptual shift in health and public policy, can be instrumental in improving health systems through concerted efforts of various governmental institutions and civil society.

  15. Public health workforce: challenges and policy issues

    Directory of Open Access Journals (Sweden)

    Beaglehole Robert

    2003-07-01

    Full Text Available Abstract This paper reviews the challenges facing the public health workforce in developing countries and the main policy issues that must be addressed in order to strengthen the public health workforce. The public health workforce is diverse and includes all those whose prime responsibility is the provision of core public health activities, irrespective of their organizational base. Although the public health workforce is central to the performance of health systems, very little is known about its composition, training or performance. The key policy question is: Should governments invest more in building and supporting the public health workforce and infrastructure to ensure the more effective functioning of health systems? Other questions concern: the nature of the public health workforce, including its size, composition, skills, training needs, current functions and performance; the appropriate roles of the workforce; and how the workforce can be strengthened to support new approaches to priority health problems. The available evidence to shed light on these policy issues is limited. The World Health Organization is supporting the development of evidence to inform discussion on the best approaches to strengthening public health capacity in developing countries. WHO's priorities are to build an evidence base on the size and structure of the public health workforce, beginning with ongoing data collection activities, and to map the current public health training programmes in developing countries and in Central and Eastern Europe. Other steps will include developing a consensus on the desired functions and activities of the public health workforce and developing a framework and methods for assisting countries to assess and enhance the performance of public health training institutions and of the public health workforce.

  16. Physical inactivity as a policy problem: applying a concept from policy analysis to a public health issue.

    Science.gov (United States)

    Rütten, Alfred; Abu-Omar, Karim; Gelius, Peter; Schow, Diana

    2013-03-07

    Despite the recent rapid development of policies to counteract physical inactivity (PI), only a small number of systematic analyses on the evolution of these policies exists. In this article we analyze how PI, as a public health issue, "translates" into a policy-making issue. First, we discuss why PI has become an increasingly important public health issue during the last two decades. We then follow Guy Peters and conceptualize PI as a "policy problem" that has the potential to be linked to policy instruments and policy impact. Analysis indicates that PI is a policy problem that i) is chronic in nature; ii) involves a high degree of political complexity; iii) can be disaggregated into smaller scales; iv) is addressed through interventions that can be difficult to "sell" to the public when their benefits are not highly divisible; v) cannot be solved by government spending alone; vi) must be addressed through a broad scope of activities; and vii) involves interdependencies among both multiple sectors and levels of government.We conclude that the new perspective on PI proposed in this article might be useful and important for i) describing and mapping policies to counteract PI in different contexts; ii) evaluating whether or not existing policy instruments are appropriate to the policy problem of PI, and iii) explaining the factors and processes that underlie policy development and implementation. More research is warranted in all these areas. In particular, we propose to focus on comparative analyses of how the problem of PI is defined and tackled in different contexts, and on the identification of truly effective policy instruments that are designed to "solve" the PI policy problem.

  17. Physical inactivity as a policy problem: applying a concept from policy analysis to a public health issue

    Science.gov (United States)

    2013-01-01

    Despite the recent rapid development of policies to counteract physical inactivity (PI), only a small number of systematic analyses on the evolution of these policies exists. In this article we analyze how PI, as a public health issue, “translates” into a policy-making issue. First, we discuss why PI has become an increasingly important public health issue during the last two decades. We then follow Guy Peters and conceptualize PI as a “policy problem” that has the potential to be linked to policy instruments and policy impact. Analysis indicates that PI is a policy problem that i) is chronic in nature; ii) involves a high degree of political complexity; iii) can be disaggregated into smaller scales; iv) is addressed through interventions that can be difficult to “sell” to the public when their benefits are not highly divisible; v) cannot be solved by government spending alone; vi) must be addressed through a broad scope of activities; and vii) involves interdependencies among both multiple sectors and levels of government. We conclude that the new perspective on PI proposed in this article might be useful and important for i) describing and mapping policies to counteract PI in different contexts; ii) evaluating whether or not existing policy instruments are appropriate to the policy problem of PI, and iii) explaining the factors and processes that underlie policy development and implementation. More research is warranted in all these areas. In particular, we propose to focus on comparative analyses of how the problem of PI is defined and tackled in different contexts, and on the identification of truly effective policy instruments that are designed to “solve” the PI policy problem. PMID:23496998

  18. Mobilization: An Instrument of United States Strategic Policy.

    Science.gov (United States)

    1984-03-01

    Bipartisanship ," World Policy Journal 1 (Fall 1983):128. 87 -A for the emergence o the United States as the leading ni-loon in the postwar world, then...34Lifting the Curse of Bipartisanship ." World Policy Journal I (Fall 1983):127-157. * Feiwel, George R. Classroom lecture presented at the v-I Postgraduate

  19. Manifestations of integrated public health policy in Dutch municipalities

    NARCIS (Netherlands)

    Peters, D.; Harting, J.; van Oers, H.; Schuit, J.; de Vries, N.; Stronks, K.

    2014-01-01

    Integrated public health policy (IPHP) aims at integrating health considerations into policies of other sectors. Since the limited empirical evidence available may hamper its further development, we systematically analysed empirical manifestations of IPHP, by placing policy strategies along a contin

  20. Manifestations of integrated public health policy in Dutch municipalities

    NARCIS (Netherlands)

    Peters, D.; Harting, J.; van Oers, J.A.M.; Schuit, J.; Stronks, K.

    2016-01-01

    Integrated public health policy (IPHP) aims at integrating health considerations into policies of other sectors. Since the limited empirical evidence available may hamper its further development, we systematically analysed empirical manifestations of IPHP, by placing policy strategies along a contin

  1. A Dental Education Perspective on Dental Health Policy.

    Science.gov (United States)

    Morris, Alvin L.

    1985-01-01

    Two issues related to dental health policy are examined: the contribution of dental education to the process by which dental health policy is established, and the nature of dental education's response to established policies. (MLW)

  2. Manifestations of integrated public health policy in Dutch municipalities

    NARCIS (Netherlands)

    Peters, D.; Harting, J.; van Oers, J.A.M.; Schuit, J.; Stronks, K.

    2016-01-01

    Integrated public health policy (IPHP) aims at integrating health considerations into policies of other sectors. Since the limited empirical evidence available may hamper its further development, we systematically analysed empirical manifestations of IPHP, by placing policy strategies along a

  3. Manifestations of integrated public health policy in Dutch municipalities

    NARCIS (Netherlands)

    Peters, D.; Harting, J.; van Oers, J.A.M.; Schuit, J.; Stronks, K.

    2016-01-01

    Integrated public health policy (IPHP) aims at integrating health considerations into policies of other sectors. Since the limited empirical evidence available may hamper its further development, we systematically analysed empirical manifestations of IPHP, by placing policy strategies along a contin

  4. Public Attitudes Towards Policy Instruments for Congestion Mitigation in Shanghai

    Institute of Scientific and Technical Information of China (English)

    Chen Hongfeng; Xiao Pu; Feng Xiangzhao; Li Fen

    2008-01-01

    Congestion causes many externalities for the society, including time delays, excessive fuel consumption, air pollution, noise and safety concerns. In Shanghai, various policy options have been explored, piloted or applied; however, not all of them may be understood and accepted by the public. A survey was conducted to investigate people's attitudes towards several policy options. The main findings reveal that Shanghai residents are resistant to certain policies, such as congestion charges, higher parking charges in congested areas and car restrictions. Instead, they favor public transport provisions. The paper suggests that there is a case for promoting public transport and more efficient trips when the car ownership is still low, and for investing in a policy of educating the public on the 'true' costs and causes of congestion before embarking on an intensive policy of congestion charges or restrictions.

  5. Health, nutrition, and public policy

    NARCIS (Netherlands)

    Frenk, J.; Coutre, le J.; Bladeren, van P.J.; Blum, S.

    2010-01-01

    The relationship between health and the economy is complex and hardly a matter of unidirectional cause and consequence. With health increasingly being understood as a stimulus for the economy, nutrition directly assumes the status of an economic identifier. This paper discusses the growing complexit

  6. Health, nutrition, and public policy

    NARCIS (Netherlands)

    Frenk, J.; Coutre, le J.; Bladeren, van P.J.; Blum, S.

    2010-01-01

    The relationship between health and the economy is complex and hardly a matter of unidirectional cause and consequence. With health increasingly being understood as a stimulus for the economy, nutrition directly assumes the status of an economic identifier. This paper discusses the growing

  7. The fit between health impact assessment and public policy: practice meets theory.

    Science.gov (United States)

    Harris, Patrick; Sainsbury, Peter; Kemp, Lynn

    2014-05-01

    The last decade has seen increased use of health impact assessment (HIA) to influence public policies developed outside the Health sector. HIA has developed as a structured, linear and technical process to incorporate health, broadly defined, into policy. This is potentially incongruent with complex, non-linear and tactical policy making which does not necessarily consider health. HIA research has however not incorporated existing public policy theory to explain practitioners' experiences with HIA and policy. This research, therefore, used public policy theory to explain HIA practitioners' experiences and investigate 'What is the fit between HIA and public policy?' Empirical findings from nine in-depth interviews with international HIA practitioners were re-analysed against public policy theory. We reviewed the HIA literature for inclusion of public policy theories then compared these for compatibility with our critical realist methodology and the empirical data. The theory 'Policy Cycles and Subsystems' (Howlett et al., 2009) was used to re-analyse the empirical data. HIAs for policy are necessarily both tactical and technical. Within policy subsystems using HIA to influence public policy requires tactically positioning health as a relevant public policy issue and, to facilitate this, institutional support for collaboration between Public Health and other sectors. HIA fits best within the often non-linear public policy cycle as a policy formulation instrument. HIA provides, tactically and technically, a space for practical reasoning to navigate facts, values and processes underlying the substantive and procedural dimensions of policy. Re-analysing empirical experiential data using existing public policy theory provided valuable explanations for future research, policy and practice concerning why and how HIA fits tactically and technically with the world of public policy development. The use of theory and empiricism opens up important possibilities for future

  8. Health indicators profiles: an instrument for comparation.

    NARCIS (Netherlands)

    Deckers, J.G.M.

    2003-01-01

    As part of the European Commission Health Monitoring Programma, health indicators have been developed which contribute to the establishment of an European health monitoring system. Epidemiological information of this system will be derived from various information sources. To study the appropriatene

  9. Agri-environmental policy measures in Israel: the potential of using market-oriented instruments.

    Science.gov (United States)

    Amdur, Liron; Bertke, Elke; Freese, Jan; Marggraf, Rainer

    2011-05-01

    This paper examines the possibilities of developing agri-environmental policy measures in Israel, focusing on market-oriented instruments. A conceptual framework for developing agri-environmental policy measures is presented, first in very broad lines (mandatory regulations, economic instruments and advisory measures) and subsequently focusing on economic instruments, and specifically, on market-oriented ones. Two criteria of choice between the measures are suggested: their contribution to improving the effectiveness of the policy; and the feasibility of their implementation. This is the framework used for analyzing agri-environmental measures in Israel. Israel currently implements a mix of mandatory regulations, economic instruments and advisory measures to promote the agri-environment. The use of additional economic instruments may improve the effectiveness of the policy. When comparing the effectiveness of various economic measures, we found that the feasibility of implementation of market-oriented instruments is greater, due to the Israeli public's preference for strengthening market orientation in the agricultural sector. Four market-oriented instruments were practiced in a pilot project conducted in an Israeli rural area. We found that in this case study, the institutional feasibility and acceptance by stakeholders were the major parameters influencing the implementation of the market-oriented instruments, whereas the instruments' contribution to enhancing the ecological or economic effectiveness were hardly considered by the stakeholders as arguments in favor of their use.

  10. A comparative analysis of the effects of economic policy instruments in promoting environmentally sustainable transport

    DEFF Research Database (Denmark)

    Elvik, Rune; Ramjerdi, Farideh

    2014-01-01

    This paper presents a comparative analysis of the effects of economic policy instruments in promoting environmentally sustainable transport. Promoting environmentally sustainable transport is defined as follows: (1) Reducing the volume of motorised travel; (2) Transferring travel to modes...... generating less external effects, and (3) Modifying road user behaviour in a way that will reduce external effects of transport. External effects include accidents, congestion, traffic noise and emissions to air. Four economic policy instruments are compared: (1) Prices of motor fuel; (2) Congestion charges......; (3) Toll schemes; (4) Reward systems giving incentives to reduce driving or change driver behaviour. The effects of these policy instruments are stated in terms of elasticities. All four economic policy instruments have negative elasticities, which means that they do promote environmentally...

  11. Are Sexual and Reproductive Health Policies Designed for All? Vulnerable Groups in Policy Documents of Four European Countries and Their Involvement in Policy Development

    Directory of Open Access Journals (Sweden)

    Olena Ivanova

    2015-10-01

    Full Text Available Background Health policies are important instruments for improving population health. However, experience suggests that policies designed for the whole population do not always benefit the most vulnerable. Participation of vulnerable groups in the policy-making process provides an opportunity for them to influence decisions related to their health, and also to exercise their rights. This paper presents the findings from a study that explored how vulnerable groups and principles of human rights are incorporated into national sexual and reproductive health (SRH policies of 4 selected countries (Spain, Scotland, Republic of Moldova, and Ukraine. It also aimed at discussing the involvement of vulnerable groups in SRH policy development from the perspective of policymakers. Methods Literature review, health policy analysis and 5 semi-structured interviews with policy-makers were carried out in this study. Content analysis of SRH policies was performed using the EquiFrame analytical framework. Results The study revealed that vulnerable groups and core principles of human rights are differently addressed in SRH policies within 4 studied countries. The opinions of policy-makers on the importance of mentioning vulnerable groups in policy documents and the way they ought to be mentioned varied, but they agreed that a clear definition of vulnerability, practical examples, and evidences on health status of these groups have to be included. In addition, different approaches to vulnerable group’s involvement in policy development were identified during the interviews and the range of obstacles to this process was discussed by respondents. Conclusion Incorporation of vulnerable groups in the SRH policies and their involvement in policy development were found to be important in addressing SRH of these groups and providing an opportunity for them to advocate for equal access to healthcare and exercise their rights. Future research on this topic should include

  12. Recognizing rhetoric in health care policy analysis.

    Science.gov (United States)

    Russell, Jill; Greenhalgh, Trisha; Byrne, Emma; McDonnell, Janet

    2008-01-01

    Critiques of the 'naïve rationalist' model of policy-making abound in the sociological and political science literature. Yet academic debate on health care policy-making continues to be couched in the dominant discourse of evidence-based medicine, whose underlying assumptions--that policies are driven by facts rather than values and these can be clearly separated; that 'evidence' is context-free, can be objectively weighed up and placed unproblematically in a 'hierarchy'; and that policy-making is essentially an exercise in decision science--have constrained both thinking and practice. In this paper, drawing on theoretical work from political science and philosophy, and innovative empirical work in the health care sector, we argue that health care is well overdue for a re-defining of what policy-making is. Policy-making is the formal struggle over ideas and values, played out by the rhetorical use of language and the enactment of social situations. While the selection, evaluation and implementation of research evidence are important in the policy-making process, they do not equate to that process. The study of argument in the construction of policy has the potential to illuminate dimensions of the process that are systematically occluded when policy-making is studied through a naïve rationalist lens. In particular, a rhetorical perspective highlights the struggle over ideas, the 'naming and framing' of policy problems, the centrality of audience and the rhetorical use of language in discussion to increase the audience's adherence to particular framings and proposals. Rhetorical theory requires us to redefine what counts as 'rationality'--which must extend from what is provably true (by logic) and probably true (by Bayesian reasoning) to embrace, in addition, that which is plausibly true (i.e. can convince a reasonable audience). Future research into health care policy-making needs to move beyond the study of 'getting evidence into practice' and address the

  13. Global health: governance and policy development.

    Science.gov (United States)

    Kelley, Patrick W

    2011-06-01

    Global health policy is now being influenced by an ever-increasing number of nonstate and non-intergovernmental actors to include influential foundations, multinational corporations, multi-sectoral partnerships, and civil society organizations. This article reviews how globalization is a key driver for the ongoing evolution of global health governance. It describes the massive increases in bilateral and multilateral investments in global health and it highlights the current global and US architecture for performing global health programs. The article closes describing some of the challenges and prospects that characterize global health governance today.

  14. The stigmatization dilemma in public health policy

    DEFF Research Database (Denmark)

    Ploug, Thomas; Holm, Søren; Gjerris, Mickey

    2015-01-01

    Background Multi-resistant bacteria pose an increasing and significant public health risk. As awareness of the severity of the problem grows, it is likely that it will become the target for a range of public health interventions. Some of these can intentionally or unintentionally lead...... to stigmatization of groups of citizens. Discussion The article describes the phenomenon of stigmatization within the health care area by discussing the concept in relation to AIDS and psychiatric diagnosis. It unfolds the ethical aspects of using stigmatization as a public health instrument to affect unwanted...... behaviours e.g. smoking. Moreover it discusses stigmatization as an unintended albeit expected side effect of public health instruments potentially used to counter the challenge of multi-resistant bacteria with particular reference to the Danish case of the growing problems with Methicillin...

  15. Privacy policies for health social networking sites.

    Science.gov (United States)

    Li, Jingquan

    2013-01-01

    Health social networking sites (HSNS), virtual communities where users connect with each other around common problems and share relevant health data, have been increasingly adopted by medical professionals and patients. The growing use of HSNS like Sermo and PatientsLikeMe has prompted public concerns about the risks that such online data-sharing platforms pose to the privacy and security of personal health data. This paper articulates a set of privacy risks introduced by social networking in health care and presents a practical example that demonstrates how the risks might be intrinsic to some HSNS. The aim of this study is to identify and sketch the policy implications of using HSNS and how policy makers and stakeholders should elaborate upon them to protect the privacy of online health data.

  16. The use of economic instruments for environmental policy: a half-hearted affair

    DEFF Research Database (Denmark)

    Andersen, Mikael Skou

    1995-01-01

    of regulations and particular policy-instruments affect the use and design of economic instruments. The outcome has been green taxes that are often fiscally biased , which are too low compared with the externalities they should price and which address the smaller rather than the larger polluters, granting...

  17. The importance of institutions in the design and implementation of economic instruments in environmental policy

    DEFF Research Database (Denmark)

    Andersen, Mikael Skou

    1995-01-01

    The role of institutions has been clearly identified as a crucial element in the design, implementation and effectiveness of economic instruments. The purpose of this paper is to help understand these interactions and identify issues which should be addressed in evaluation of policy instruments....

  18. Central bank instruments, fiscal policy regimes, and the requirements for equilibrium determinacy

    NARCIS (Netherlands)

    Schabert, A.

    2006-01-01

    This paper examines the role of the monetary instrument choice for local equilibrium determinacy under sticky prices and different fiscal policy regimes. Corresponding to Benhabib et al.'s results for interest rate feedback rules [Benhabib, J., Schmitt-Grohé, S., Uribe, M., 2001. Monetary policy and

  19. Environmental potentials of policy instruments to mitigate nutrient emissions in Chinese livestock production

    NARCIS (Netherlands)

    Zheng, C.; Liu, Y.; Bluemling, B.; Mol, A.P.J.; Chen, J.

    2015-01-01

    To minimize negative environmental impact of livestock production, policy-makers face a challenge to design and implement more effective policy instruments for livestock farmers at different scales. This research builds an assessment framework on the basis of an agent-based model, named ANEM, to exp

  20. Central bank instruments, fiscal policy regimes, and the requirements for equilibrium determinacy

    NARCIS (Netherlands)

    Schabert, A.

    2006-01-01

    This paper examines the role of the monetary instrument choice for local equilibrium determinacy under sticky prices and different fiscal policy regimes. Corresponding to Benhabib et al.'s results for interest rate feedback rules [Benhabib, J., Schmitt-Grohé, S., Uribe, M., 2001. Monetary policy and

  1. Environmental potentials of policy instruments to mitigate nutrient emissions in Chinese livestock production.

    Science.gov (United States)

    Zheng, Chaohui; Liu, Yi; Bluemling, Bettina; Mol, Arthur P J; Chen, Jining

    2015-01-01

    To minimize negative environmental impact of livestock production, policy-makers face a challenge to design and implement more effective policy instruments for livestock farmers at different scales. This research builds an assessment framework on the basis of an agent-based model, named ANEM, to explore nutrient mitigation potentials of five policy instruments, using pig production in Zhongjiang county, southwest China, as the empirical filling. The effects of different policy scenarios are simulated and compared using four indicators and differentiating between small, medium and large scale pig farms. Technology standards, biogas subsidies and information provisioning prove to be the most effective policies, while pollution fees and manure markets fail to environmentally improve manure management in pig livestock farming. Medium-scale farms are the more relevant scale category for a more environmentally sound development of Chinese livestock production. A number of policy recommendations are formulated as conclusion, as well as some limitations and prospects of the simulations are discussed.

  2. 78 FR 42945 - Health Information Technology Policy Committee Vacancy

    Science.gov (United States)

    2013-07-18

    ... From the Federal Register Online via the Government Publishing Office GOVERNMENT ACCOUNTABILITY OFFICE Health Information Technology Policy Committee Vacancy AGENCY: Government Accountability Office... Reinvestment Act of 2009 (ARRA) established the Health Information Technology Policy Committee (Health...

  3. 77 FR 27774 - Health Information Technology Policy Committee Vacancy

    Science.gov (United States)

    2012-05-11

    ... From the Federal Register Online via the Government Publishing Office GOVERNMENT ACCOUNTABILITY OFFICE Health Information Technology Policy Committee Vacancy AGENCY: Government Accountability Office... Reinvestment Act of 2009 (ARRA) established the Health Information Technology Policy Committee (Health...

  4. Central banks' use in East Asia of money market instruments in the conduct of monetary policy

    OpenAIRE

    Robert F. Emery

    1992-01-01

    The paper examines the greater use in the past decade of money market instruments in the conduct of monetary policy by the central banks, or their equivalent, in six of the main East Asian developing economies. Some of these economies have been successful in using various money market instruments to control liquidity, while others have been much less successful. A common theme in the case of the successful economies has been one of employing money market instruments that have yields based on ...

  5. Central banks' use in East Asia of money market instruments in the conduct of monetary policy

    OpenAIRE

    Robert F. Emery

    1992-01-01

    The paper examines the greater use in the past decade of money market instruments in the conduct of monetary policy by the central banks, or their equivalent, in six of the main East Asian developing economies. Some of these economies have been successful in using various money market instruments to control liquidity, while others have been much less successful. A common theme in the case of the successful economies has been one of employing money market instruments that have yields based on ...

  6. [Policy counselling through public health reporting?].

    Science.gov (United States)

    Brand, H; Michelsen, K

    2007-10-01

    For about 20 years public health reporting has increasingly been developed as a resource in health policy counselling. Both with regard to its use as well as its further development it is important to reflect on the possibilities and limits of this resource. A basis for this is provided by theories, models and hypotheses derived from the discussion about scientific policy counselling. In early conceptual reflections on the organisation of health reporting a technocratic use was rejected. This is reflected by the ideas and views about the institutional embedding of health reporting activities. Against the background of diverging opinions about the political dimensions of health reporting activities, reflections were guided by the decisionistic and pragmatic model of the "scientification of politics". Public health reporting must provide the possibility for being used in a flexible way in order to add a pragmatistic component to its decisionistic and strategic uses. For action-oriented, pragmatistic and scientific policy counselling through the health reporting discipline it is important to link "information about politically relevant facts" with the "targeted processing of knowledge geared towards problems in the field of decision-making processes" (expertise).

  7. Simulation modeling of health care policy.

    Science.gov (United States)

    Glied, Sherry; Tilipman, Nicholas

    2010-01-01

    Simulation modeling of health reform is a standard part of policy development and, in the United States, a required element in enacting health reform legislation. Modelers use three types of basic structures to build models of the health system: microsimulation, individual choice, and cell-based. These frameworks are filled in with data on baseline characteristics of the system and parameters describing individual behavior. Available data on baseline characteristics are imprecise, and estimates of key empirical parameters vary widely. A comparison of estimated and realized consequences of several health reform proposals suggests that models provided reasonably accurate estimates, with confidence bounds of approximately 30%.

  8. Local Economic Development. New generation of actors, policies and instruments

    OpenAIRE

    Helmsing, A.H.J.

    2001-01-01

    This is a summary report prepared for the UNCDF symposium on Decentralized Local Governance in Africa. The author explains how conditions for local economic development has changed, by distinguishing two sets of forces of change. The first refers to fundamental changes in development policy, while the second in the context of local development refers to what Dicken (1998) called the new 'geo-economy'.

  9. Public policy frameworks for improving population health.

    Science.gov (United States)

    Tarlov, A R

    1999-01-01

    Four conceptual frameworks provide bases for constructing comprehensive public policy strategies for improving population health within wealthy (OECD) nations. (1) Determinants of population health. There are five broad categories: genes and biology, medical care, health behaviors, the ecology of all living things, and social/societal characteristics. (2) Complex systems: Linear effects models and multiple independent effects models fail to yield results that explain satisfactorily the dynamics of population health production. A different method (complex systems modeling) is needed to select the most effective interventions to improve population health. (3) An intervention framework for population health improvement. A two-by-five grid seems useful. Most intervention strategies are either ameliorative or fundamentally corrective. The other dimension of the grid captures five general categories of interventions: child development, community development, adult self-actualization, socioeconomic well-being, and modulated hierarchical structuring. (4) Public policy development process: the process has two phases. The initial phase, in which public consensus builds and an authorizing environment evolves, progresses from values and culture to identification of the problem, knowledge development from research and experience, the unfolding of public awareness, and the setting of a national agenda. The later phase, taking policy action, begins with political engagement and progresses to interest group activation, public policy deliberation and adoption, and ultimately regulation and revision. These frameworks will be applied to help understand the 39 recommendations of the Independent Inquiry into Inequalities in Health, the Sir Donald Acheson Report from the United Kingdom, which is the most ambitious attempt to date to develop a comprehensive plan to improve population health.

  10. Global health diplomacy: advancing foreign policy and global health interests.

    Science.gov (United States)

    Michaud, Josh; Kates, Jennifer

    2013-03-01

    Attention to global health diplomacy has been rising but the future holds challenges, including a difficult budgetary environment. Going forward, both global health and foreign policy practitioners would benefit from working more closely together to achieve greater mutual understanding and to advance respective mutual goals.

  11. Health policy perception and health behaviours: a multilevel analysis and implications for public health psychology.

    NARCIS (Netherlands)

    Lengerke, T. von; Vinck, J.; Rütten, A.; Reitmeir, P.; Abel, T.; Kannas, L.; Lüschen, G.; Rodríguez Diaz, J.A.; Zee, J. van der

    2004-01-01

    Associations of health policy perception with health behaviours are analysed. Policy perception is differentiated in information about programmes and appraisal of health policy’s contribution to policy goals, and conceptualized on the level of: (1) individuals; and (2) populations (as a social clima

  12. A review of health-related workplace productivity loss instruments.

    Science.gov (United States)

    Lofland, Jennifer H; Pizzi, Laura; Frick, Kevin D

    2004-01-01

    The objective of this review was to identify health-related workplace productivity loss survey instruments, with particular emphasis on those that capture a metric suitable for direct translation into a monetary figure. A literature search using Medline, HealthSTAR, PsycINFO and Econlit databases between 1966 and 2002, and a telephone-administered survey of business leaders and researchers, were conducted to identify health-related workplace productivity measurement survey instruments. This review was conducted from the societal perspective. Each identified instrument was reviewed for the following: (i). reliability; (ii). content validity; (iii). construct validity; (iv). criterion validity; (v). productivity metric(s); (vi). instrument scoring technique; (vii). suitability for direct translation into a monetary figure; (viii). number of items; (ix). mode(s) of administration; and (x). disease state(s) in which it had been tested. Reliability and validity testing have been performed for 8 of the 11 identified surveys. Of the 11 instruments identified, six captured metrics that are suitable for direct translation into a monetary figure. Of those six, one instrument measured absenteeism, while the other five measured both absenteeism and presenteeism. All of the identified instruments except for one were available as paper, self-administered questionnaires and many were available in languages other than English. This review provides a comprehensive overview of the published, peer-reviewed survey instruments available to measure health-related workplace productivity loss. As the field of productivity measurement matures, tools may be developed that will allow researchers to accurately calculate lost productivity costs when performing cost-effectiveness and cost-benefit analyses. Using data captured by these instruments, society and healthcare decision makers will be able to make better informed decisions concerning the value of the medications, disease management and

  13. Policy instruments to decrease the climate impact of housing, personal transport and food. Detailed instrument descriptions; Ohjauskeinoja asumisen, henkiloeliikenteen ja ruoan ilmastovaikutusten hillintaeaen. Yksityiskohtaiset ohjauskeinokuvaukset

    Energy Technology Data Exchange (ETDEWEB)

    Heiskanen, E.; Perrels, A.; Nissinen, A.; Berghaell, E.; Liesimaa, V.; Mattinen, M. (eds.)

    2012-03-15

    Reducing consumption volumes or introducing climate conscious consumption patterns can be efficient ways to mitigate climate change. Twenty existing policy instruments affecting the greenhouse gas emissions of housing, passenger traffic and food are described in this report of the KUILU-project. The policy instruments and the possibilities to develop effective instrument packages were discussed in two expert workshops, the results of which are presented in annexes of this report. There are already several policy instruments that target on housing and passenger traffic. Their differences in estimated emission reductions are large, which can ease the prioritization and selection of the instruments for further development. So far, only one policy instrument exists that aims to reduce the climate impacts of food choices, namely a Council of State Decision of Principle on Promoting Sustainability in Public Purchasing. However, it includes several measures that can be used to influence private companies and citizens, and thus it opens the field of policy instrument for mitigation of climate impacts of food. According to the expert survey, the most effective policy instrument involved in the analysis was building regulations, and the four most effective instruments after this were the following: gradated procurement tax of cars based on emissions, gradation of car tax, taxation of transport fuels, energy taxes of housing, and the effect of ecodesign directive on appliances. The effectiveness of policy instruments related to food was assessed to be on average level. The five least effective instruments were: EU energy label, voluntary energy experts, the tax of beverage packing, energy certificates, and subsidies for energy efficiency reparation in buildings. However, the expert opinions on the effectiveness of the policy instruments varied significantly. After this report, the KUILU project continued with an analysis of the policy instrument packages and with suggestions

  14. Policy instruments to decrease the climate impact of housing, personal transport and food. Detailed instrument descriptions; Ohjauskeinoja asumisen, henkiloeliikenteen ja ruoan ilmastovaikutusten hillintaeaen. Yksityiskohtaiset ohjauskeinokuvaukset

    Energy Technology Data Exchange (ETDEWEB)

    Heiskanen, E.; Perrels, A.; Nissinen, A.; Berghaell, E.; Liesmaa, V.; Mattinen, M. (eds.)

    2012-07-01

    Reducing consumption volumes or introducing climate conscious consumption patterns can be efficient ways to mitigate climate change. Twenty existing policy instruments affecting the greenhouse gas emissions of housing, passenger traffic and food are described in this report of the KUILU-project. The policy instruments and the possibilities to develop effective instrument packages were discussed in two expert workshops, the results of which are presented in annexes of this report. There are already several policy instruments that target on housing and passenger traffic. Their differences in estimated emission reductions are large, which can ease the prioritization and selection of the instruments for further development. So far, only one policy instrument exists that aims to reduce the climate impacts of food choices, namely a Council of State Decision of Principle on Promoting Sustainability in Public Purchasing. However, it includes several measures that can be used to influence private companies and citizens, and thus it opens the field of policy instrument for mitigation of climate impacts of food. According to the expert survey, the most effective policy instrument involved in the analysis was building regulations, and the four most effective instruments after this were the following: gradated procurement tax of cars based on emissions, gradation of car tax, taxation of transport fuels, energy taxes of housing, and the effect of ecodesign directive on appliances. The effectiveness of policy instruments related to food was assessed to be on average level. The five least effective instruments were: EU energy label, voluntary energy experts, the tax of beverage packing, energy certificates, and subsidies for energy efficiency reparation in buildings. However, the expert opinions on the effectiveness of the policy instruments varied significantly. After this report, the KUILU project continued with an analysis of the policy instrument packages and with suggestions

  15. Education and Health Care Policies in Ghana

    Directory of Open Access Journals (Sweden)

    Ziblim Abukari

    2015-10-01

    Full Text Available Education and health care policies in Ghana since independence have been universalist in approach providing free universal health care and free basic and tertiary education until the early 1980s. Precipitated primarily by a severe drought, stagnant economic growth, mismanagement, and political instability, Ghana undertook major economic reforms with prodding from the World Bank and International Monetary Fund in a bid to salvage the economy. These economic measures included cost recovery and cutback spending in education and health sectors. However, in recent years, purposive targeted interventions have been pursued to address inequalities in education and health care. These new programs include the Education Capitation Grant, school feeding program, and the National Health Insurance Scheme (NHIS, which are propelling Ghana toward the achievement of the Millennium Development Goals. The prospects of these programs in addressing disparities in access to education and health care in the country and recommendations for improved delivery are discussed.

  16. Determinants of health policy impact: comparative results of a European policymaker study.

    Science.gov (United States)

    Rütten, Alfred; Lüschen, Günther; von Lengerke, Thomas; Abel, Thomas; Kannas, Lasse; Rodríguez Diaz, Josep A; Vinck, Jan; van der Zee, Jouke

    2003-01-01

    This article will use a new theoretical framework for the analysis of health policy impact introduced by Rütten et al. (2003). In particular, it will report on a comparative European study of policymakers' perception and evaluation of specific determinants of the policy impact, both in terms of output (implemented measures) and outcome (health behaviour change). Policy determinants investigated are goals, resources, obligations and opportunities as related to the policymaking process. Theory is applied to a comparative analysis of prevention and health promotion policy in Belgium, Finland, Germany. The Netherlands, Spain and Switzerland. The study is MED2-part of a project that has developed a Methodology for the Analysis of the Rationality and Effectiveness of Prevention and Health Promotion Strategies (MAREPS) within the EU-BIO-program. A mail survey of 719 policymakers on the executive and administrative level selected by a focused sample procedure was conducted. This survey used policymakers' experience and evaluative expertise to analyse determinants of policy output and outcome. Regression analyses reveal differential predictive power of policy goals, resources, obligations, as well as of political, organisational and public opportunities. For instance, whereas resources, concreteness of goals, and public opportunities have significant importance for health outcome of policy, obligations and organisational opportunities significantly predict policy output. Results are discussed in terms of rationality and effectiveness of health policy. They indicate that six sensitising constructs derived from the theoretical framework represent equivalent structures across nations. They comprise a validated instrument that can be used for further comparative health policy research.

  17. Navigating public health chemicals policy in Australia: a policy maker's and practitioner's guide.

    Science.gov (United States)

    Capon, Adam; Smith, Wayne; Gillespie, James A

    2013-03-01

    Chemicals are ubiquitous in everyday life. Environmental health practitioners rely on a complex web of regulators and policy bodies to ensure the protection of public health, yet few understand the full extent of this web. A lack of understanding can hamper public health response and impede policy development. In this paper we map the public health chemicals policy landscape in Australia and conclude that an understanding of this system is essential for effective environmental health responses and policy development.

  18. Transport policy and health inequalities: a health impact assessment of Edinburgh's transport policy.

    Science.gov (United States)

    Gorman, D; Douglas, M J; Conway, L; Noble, P; Hanlon, P

    2003-01-01

    Health impact assessment (HIA) can be used to examine the relationships between inequalities and health. This HIA of Edinburgh's transport policy demonstrates how HIA can examine how different transport policies can affect different population groupings to varying degrees. In this case, Edinburgh's economy is based on tourism, financial services and Government bodies. These need a good transport infrastructure, which maintains a vibrant city centre. A transport policy that promotes walking, cycling and public transport supports this and is also good for health. The HIA suggested that greater spend on public transport and supporting sustainable modes of transport was beneficial to health, and offered scope to reduce inequalities. This message was understood by the City Council and influenced the development of the city's transport and land-use strategies. The paper discusses how HIA can influence public policy.

  19. Human resources for health policies: a critical component in health policies

    Directory of Open Access Journals (Sweden)

    Dussault Gilles

    2003-04-01

    Full Text Available Abstract In the last few years, increasing attention has been paid to the development of health policies. But side by side with the presumed benefits of policy, many analysts share the opinion that a major drawback of health policies is their failure to make room for issues of human resources. Current approaches in human resources suggest a number of weaknesses: a reactive, ad hoc attitude towards problems of human resources; dispersal of accountability within human resources management (HRM; a limited notion of personnel administration that fails to encompass all aspects of HRM; and finally the short-term perspective of HRM. There are three broad arguments for modernizing the ways in which human resources for health are managed: • the central role of the workforce in the health sector; • the various challenges thrown up by health system reforms; • the need to anticipate the effect on the health workforce (and consequently on service provision arising from various macroscopic social trends impinging on health systems. The absence of appropriate human resources policies is responsible, in many countries, for a chronic imbalance with multifaceted effects on the health workforce: quantitative mismatch, qualitative disparity, unequal distribution and a lack of coordination between HRM actions and health policy needs. Four proposals have been put forward to modernize how the policy process is conducted in the development of human resources for health (HRH: • to move beyond the traditional approach of personnel administration to a more global concept of HRM; • to give more weight to the integrated, interdependent and systemic nature of the different components of HRM when preparing and implementing policy; • to foster a more proactive attitude among human resources (HR policy-makers and managers; • to promote the full commitment of all professionals and sectors in all phases of the process. The development of explicit human resources

  20. A method for the deliberate and deliberative selection of policy instrument mixes for climate change adaptation

    Directory of Open Access Journals (Sweden)

    Heleen L. P. Mees

    2014-06-01

    Full Text Available Policy instruments can help put climate adaptation plans into action. Here, we propose a method for the systematic assessment and selection of policy instruments for stimulating adaptation action. The multi-disciplinary set of six assessment criteria is derived from economics, policy, and legal studies. These criteria are specified for the purpose of climate adaptation by taking into account four challenges to the governance of climate adaptation: uncertainty, spatial diversity, controversy, and social complexity. The six criteria and four challenges are integrated into a step-wise method that enables the selection of instruments starting from a generic assessment and ending with a specific assessment of policy instrument mixes for the stimulation of a specific adaptation measure. We then apply the method to three examples of adaptation measures. The method's merits lie in enabling deliberate choices through a holistic and comprehensive set of adaptation specific criteria, as well as deliberative choices by offering a stepwise method that structures an informed dialog on instrument selection. Although the method was created and applied by scientific experts, policy-makers can also use the method.

  1. New environmental policy instruments to realize forest expansion in Flanders (northern Belgium): A base for smart regulation?

    NARCIS (Netherlands)

    Gossum, Van P.; Ledene, L.; Arts, B.J.M.; Vreese, De R.; Langenhove, Van G.; Verheyen, K.

    2009-01-01

    This paper evaluates the current instrument mix, designs options for smart regulation and estimates the support base of new instruments for the forest expansion policy in Flanders (northern Belgium). The framework applied is a combination of theories on instrument choice (ICT), policy transfer and l

  2. A TRANSDISCIPLINARY APPROACH TO HEALTH POLICY RESEARCH AND EVALUATION.

    Science.gov (United States)

    Wan, Thomas T H

    2014-01-01

    An integrated perspective consists of macro- and micro-level approaches to health policy research and evaluation is presented. Analytical strategies are suggested for policy analysis, targeting on health disparities at individual and population levels. This systems approach enables investigators to view how scientific public policy analysis can be implemented to assess policy impacts. In this special issue, five papers are introduced.

  3. Public health nutrition and food policy.

    Science.gov (United States)

    Caraher, Martin; Coveney, John

    2004-08-01

    Food in its many manifestations allows us to explore the global control of health and to examine the ways in which food choice is moulded by many interests. The global food market is controlled by a small number of companies who operate a system that delivers 'cheap' food to the countries of the developed world. This 'cheap' food comes at a price, which externalises costs to the nation state in terms of health consequences (diabetes, coronary heart disease and other food-related diseases) and to the environment in terms of pollution and the associated clean-up strategies. Food policy has not to any great extent dealt with these issues, opting instead for an approach based on nutrition, food choice and biomedical health. Ignoring wider elements of the food system including issues of ecology and sustainability constrains a broader understanding within public health nutrition. Here we argue that public health nutrition, through the medium of health promotion, needs to address these wider issues of who controls the food supply, and thus the influences on the food chain and the food choices of the individual and communities. Such an upstream approach to food policy (one that has been learned from work on tobacco) is necessary if we are seriously to influence food choice.

  4. Identifying Special Operations as a Distinct Foreign Policy Instrument

    DEFF Research Database (Denmark)

    Johnsen, Anton Asklund

    2017-01-01

    This chapter briefly discusses political premises for the question asked and secondly provides a condensed research review that relate to the question. The author discusses questions on civilian control and the advancement of special operations and finds it specifically important for SOF to be able...... to clarify and explain what special operations strategic qualities exactly are. The author then elaborates on specific elements of special operations with a point of departure in the “cognitive maps of SOF” as formulated in the research question. The author recommends that in order to influence policy...... on special operations, it is essential to have insight into the instrument’s capabilities and limitations, as this provides the prerequisites for sound contextual strategic analysis....

  5. 78 FR 7784 - Health Information Technology Policy Committee Nomination Letters

    Science.gov (United States)

    2013-02-04

    ... From the Federal Register Online via the Government Publishing Office GOVERNMENT ACCOUNTABILITY OFFICE Health Information Technology Policy Committee Nomination Letters AGENCY: Government... Recovery and Reinvestment Act of 2009 (ARRA) established the Health Information Technology Policy...

  6. EFFECTIVENESS AND LIMITATIONS OF MONETARY POLICY INSTRUMENTS IN ROMANIA AND THE EUROPEAN UNION

    Directory of Open Access Journals (Sweden)

    Zina CIORAN

    2014-12-01

    Full Text Available The complexity of the monetary phenomenon as well as the effects that it induces in the social and economic life of the countries around the world have represented and still represent the subject of much controversy and dispute. The current forms of the monetary circulation organization in different countries, internationally as well, represent the result of a continuous process of changes and innovations in the monetary area. The purpose of this article is to present aspects of the monetary policy and its instruments which have evolved according to the historical conditions of each period. The paper is also a presentation of effectiveness and limits of the monetary policy instruments and their role in solving the current economic problems for which the governments seek solutions. As a consequence to the analysis, it can be seen that in most cases it uses a mixture of monetary policy instruments because, when acting in a complementary way, they have a higher efficiency.

  7. Cancellation of Nongroup Health Insurance Policies

    Science.gov (United States)

    2013-11-19

    1302 Essential Health Benefits (X) √ §1302 Minimum Actuarial Value (X) √ §1302 Maximum Out-of-Pocket Limits (X) √ Source: CRS analysis of ACA...also not possible to develop reliable estimates on the number of individuals who renewed policies through “early renewal” or who will be offered...must provide at least 30 days’ prior notice to the individual before coverage may be rescinded. Source: CRS analysis of relevant federal law and

  8. Policy Capacity for Health Reform: Necessary but Insufficient: Comment on "Health Reform Requires Policy Capacity".

    Science.gov (United States)

    Adams, Owen

    2015-09-04

    Forest and colleagues have persuasively made the case that policy capacity is a fundamental prerequisite to health reform. They offer a comprehensive life-cycle definition of policy capacity and stress that it involves much more than problem identification and option development. I would like to offer a Canadian perspective. If we define health reform as re-orienting the health system from acute care to prevention and chronic disease management the consensus is that Canada has been unsuccessful in achieving a major transformation of our 14 health systems (one for each province and territory plus the federal government). I argue that 3 additional things are essential to build health policy capacity in a healthcare federation such as Canada: (a) A means of "policy governance" that would promote an approach to cooperative federalism in the health arena; (b) The ability to overcome the "policy inertia" resulting from how Canadian Medicare was implemented and subsequently interpreted; and (c) The ability to entertain a long-range thinking and planning horizon. My assessment indicates that Canada falls short on each of these items, and the prospects for achieving them are not bright. However, hope springs eternal and it will be interesting to see if the July, 2015 report of the Advisory Panel on Healthcare Innovation manages to galvanize national attention and stimulate concerted action.

  9. Making Things Happen: Community Health Nursing and the Policy Arena.

    Science.gov (United States)

    Williams, Carolyn A.

    1983-01-01

    It is important that nurses, particularly those who consider themselves community health nursing specialists, assign a high priority to participation in the formation of health policy and broader public policy. To put subsequent remarks about policy into perspective, it is useful to consider the case for seeing community health nursing as…

  10. The Politics of Healthy Policies: Redesigning health impact assessment to integrate health in public policy

    NARCIS (Netherlands)

    M.P.M. Bekker (Marleen)

    2007-01-01

    textabstractPublic health issues, such as obesity, lung disease from air pollution or mental health complaints from living in an unsafe neighbourhood, are complex, intractable policy problems. The causes are dispersed at the individual and the collective level among different societal sector

  11. Environmental Policy Instruments and Eco-innovation: An Overview of Recent Studies

    Directory of Open Access Journals (Sweden)

    Ángeles Pereira Sánchez

    2015-10-01

    Full Text Available In this paper we conduct a systematic literature review with the aim of understanding the effectiveness of environmental policy instruments, in particular, command and control, marketbased instruments and voluntary schemes, in promoting eco-innovation. This study analyzes the information presented in selected papers, mainly from peer-reviewed journals, covering the period 2005-2012. The sample is based on 40 papers traced through a keyword search in Scopus database, representing the main academic journals related to the subject. A few more sources were added after reviewing the list of references from the main papers. The literature reviewed adopts different approaches and pursues several objectives to understand the relationship between policy instruments and eco-innovation. We find overall evidence that stringency is a key feature of policies for determining the effects of environmental technological change. It is argued that command and control instrument boosts eco-innovation, but continuity in investments depends more on the expected severity of future regulation. Empirical studies confirm that market-based instruments promote more incremental innovation and diffusion of existing technologies than radical innovation. In general, instruments based on economic incentives need to be complemented with stringent controls to be more effective. We conclude that complementarities between measures focused on developers and demanders are necessary in order to foster eco-innovation

  12. SHPPS 2006: School Health Policies and Programs Study--Nutrition

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2007

    2007-01-01

    The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports study results in the following areas, as they relate to nutrition: (1) Health Education; (2) Health Services and Mental Health and…

  13. Social capital to strengthen health policy and health systems.

    Science.gov (United States)

    Ogden, Jessica; Morrison, Ken; Hardee, Karen

    2014-12-01

    This article recounts the development of a model for social capital building developed over the course of interventions focused on HIV-related stigma and discrimination, safe motherhood and reproductive health. Through further engagement with relevant literature, it explores the nature of social capital and suggests why undertaking such a process can enhance health policy and programmes, advocacy and governance for improved health systems strengthening (HSS) outcomes. The social capital process proposed facilitates the systematic and effective inclusion of community voices in the health policy process-strengthening programme effectiveness as well as health system accountability and governance. Because social capital building facilitates communication and the uptake of new ideas, norms and standards within and between professional communities of practice, it can provide an important mechanism for integration both within and between sectors-a process long considered a 'wicked problem' for health policy-makers. The article argues that the systematic application of social capital building, from bonding through bridging into linking social capital, can greatly enhance the ability of governments and their partners to achieve their HSS goals.

  14. Improving adolescent health policy: incorporating a framework for assessing state-level policies.

    Science.gov (United States)

    Brindis, Claire D; Moore, Kristin

    2014-01-01

    Many US policies that affect health are made at the state, not the federal, level. Identifying state-level policies and data to analyze how different policies affect outcomes may help policy makers ascertain the usefulness of their public policies and funding decisions in improving the health of adolescent populations. A framework for describing and assessing the role of federal and state policies on adolescent health and well-being is proposed; an example of how the framework might be applied to the issue of teen childbearing is included. Such a framework can also help inform analyses of whether and how state and federal policies contribute to the variation across states in meeting adolescent health needs. A database on state policies, contextual variables, and health outcomes data can further enable researchers and policy makers to examine how these factors are associated with behaviors they aim to impact.

  15. Global health in foreign policy--and foreign policy in health? Evidence from the BRICS.

    Science.gov (United States)

    Watt, Nicola F; Gomez, Eduardo J; McKee, Martin

    2014-09-01

    Amidst the growing literature on global health, much has been written recently about the Brazil, Russia, India, China, South Africa (BRICS) countries and their involvement and potential impact in global health, particularly in relation to development assistance. Rather less has been said about countries' motivations for involvement in global health negotiations, and there is a notable absence of evidence when their motivations are speculated on. This article uses an existing framework linking engagement in global health to foreign policy to explore differing levels of engagement by BRICS countries in the global health arena, with a particular focus on access to medicines. It concludes that countries' differing and complex motivations reinforce the need for realistic, pragmatic approaches to global health debates and their analysis. It also underlines that these analyses should be informed by analysis from other areas of foreign policy.

  16. Who Is a Stream? Epistemic Communities, Instrument Constituencies and Advocacy Coalitions in Public Policy-Making

    Directory of Open Access Journals (Sweden)

    Ishani Mukherjee

    2015-08-01

    Full Text Available John Kingdon’s Multiple Streams Framework (MSF was articulated in order to better understand how issues entered onto policy agendas, using the concept of policy actors interacting over the course of sequences of events in what he referred to as the “problem”, “policy” and “politics” “streams”. However, it is not a priori certain who the agents are in this process and how they interact with each other. As was common at the time, in his study Kingdon used an undifferentiated concept of a “policy subsystem” to group together and capture the activities of various policy actors involved in this process. However, this article argues that the policy world Kingdon envisioned can be better visualized as one composed of distinct subsets of actors who engage in one specific type of interaction involved in the definition of policy problems: either the articulation of problems, the development of solutions, or their enactment. Rather than involve all subsystem actors, this article argues that three separate sets of actors are involved in these tasks: epistemic communities are engaged in discourses about policy problems; instrument constituencies define policy alternatives and instruments; and advocacy coalitions compete to have their choice of policy alternatives adopted. Using this lens, the article focuses on actor interactions involved both in the agenda-setting activities Kingdon examined as well as in the policy formulation activities following the agenda setting stage upon which Kingdon originally worked. This activity involves the definition of policy goals (both broad and specific, the creation of the means and mechanisms to realize these goals, and the set of bureaucratic, partisan, electoral and other political struggles involved in their acceptance and transformation into action. Like agenda-setting, these activities can best be modeled using a differentiated subsystem approach.

  17. Who Is a Stream? Epistemic Communities, Instrument Constituencies and Advocacy Coalitions in Public Policy-Making

    Directory of Open Access Journals (Sweden)

    Ishani Mukherjee

    2015-08-01

    Full Text Available John Kingdon’s Multiple Streams Framework (MSF was articulated in order to better understand how issues entered onto policy agendas, using the concept of policy actors interacting over the course of sequences of events in what he referred to as the “problem”, “policy” and “politics” “streams”. However, it is not a priori certain who the agents are in this process and how they interact with each other. As was common at the time, in his study Kingdon used an undifferentiated concept of a “policy subsystem” to group together and capture the activities of various policy actors involved in this process. However, this article argues that the policy world Kingdon envisioned can be better visualized as one composed of distinct subsets of actors who engage in one specific type of interaction involved in the definition of policy problems: either the articulation of problems, the development of solutions, or their enactment. Rather than involve all subsystem actors, this article argues that three separate sets of actors are involved in these tasks: epistemic communities are engaged in discourses about policy problems; instrument constituencies define policy alternatives and instruments; and advocacy coalitions compete to have their choice of policy alternatives adopted. Using this lens, the article focuses on actor interactions involved both in the agenda-setting activities Kingdon examined as well as in the policy formulation activities following the agenda setting stage upon which Kingdon originally worked. This activity involves the definition of policy goals (both broad and specific, the creation of the means and mechanisms to realize these goals, and the set of bureaucratic, partisan, electoral and other political struggles involved in their acceptance and transformation into action. Like agenda-setting, these activities can best be modeled using a differentiated subsystem approach.

  18. Health Status Measurement Instruments in Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Yves Lacasse

    1997-01-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is associated with primary respiratory impairment, disability and handicap, as well as with secondary impairments not necessarily confined to the respiratory system. Because the primary goals of managing patients with COPD include relief of dyspnea and the improvement of health-related quality of life (HRQL, a direct measurement of HRQL is important. Fourteen disease-specific and nine generic questionnaires (four health profiles and five utility measures most commonly used to measure health status in patients with COPD were reviewed. The measures were classified according to their domain of interest, and their measurement properties - specifications, validity, reliability, responsiveness and interpretability - were described. This review suggests several findings. Currently used health status instruments usually refer to the patients’ perception of performance in three major domains of HRQL - somatic sensation, physical and occupational function, and psychological state. The choice of a questionnaire must be related to its purpose, with a clear distinction being made between its evaluative and discriminative function. In their evaluative function, only a few instruments fulfilled the criteria of responsiveness, and the interpretability of most questionnaires is limited. Generic questionnaires should not be used alone in clinical trials as evaluative instruments because of their inability to detect change over time. Further validation and improved interpretability of existing instruments would be of greater benefit to clinicians and scientists than the development of new questionnaires.

  19. [Therapeutic abortion, unjustified absence in health policy].

    Science.gov (United States)

    Chávez-Alvarado, Susana

    2013-07-01

    Although abortion for health reasons is not considered a crime in Peru, the State does not allow its inclusion in public policy, thus violating women's right to terminate a pregnancy when it affects their health. When examining the article in the Criminal Code which decriminalizes this type of abortion, provisions are identified which protect women and set the conditions to offer this type of service. This document sets the debate about the arguments used by the Peruvian State for not approving a therapeutic abortion protocol which would regulate the provision and financing of therapeutic abortion in public services, and explains why this obligation should be complied with, based on the conceptual framework of "health exception" In addition, it presents two cases brought before the judicial court in which the Peruvian State was found guilty of violating the human rights of two adolescents to whom a therapeutic abortion was denied.

  20. Public Health and International Drug Policy

    Science.gov (United States)

    Csete, Joanne; Kamarulzaman, Adeeba; Kazatchkine, Michel; Altice, Frederick; Balicki, Marek; Buxton, Julia; Cepeda, Javier; Comfort, Megan; Goosby, Eric; Goulão, João; Hart, Carl; Horton, Richard; Kerr, Thomas; Lajous, Alejandro Madrazo; Lewis, Stephen; Martin, Natasha; Mejía, Daniel; Mathiesson, David; Obot, Isidore; Ogunrombi, Adeolu; Sherman, Susan; Stone, Jack; Vallath, Nandini; Vickerman, Peter; Zábranský, Tomáš; Beyrer, Chris

    2016-01-01

    Executive summary In September 2015, the member states of the United Nations endorsed sustainable development goals (SDG) for 2030 that aspire to human rights-centered approaches to ensuring the health and well-being of all people. The SDGs embody both the UN Charter values of rights and justice for all and the responsibility of states to rely on the best scientific evidence as they seek to better humankind. In April 2016, these same states will consider control of illicit drugs, an area of social policy that has been fraught with controversy, seen as inconsistent with human rights norms, and for which scientific evidence and public health approaches have arguably played too limited a role. The previous UN General Assembly Special Session (UNGASS) on drugs in 1998 – convened under the theme “a drug-free world, we can do it!” – endorsed drug control policies based on the goal of prohibiting all use, possession, production, and trafficking of illicit drugs. This goal is enshrined in national law in many countries. In pronouncing drugs a “grave threat to the health and well-being of all mankind,” the 1998 UNGASS echoed the foundational 1961 convention of the international drug control regime, which justified eliminating the “evil” of drugs in the name of “the health and welfare of mankind.” But neither of these international agreements refers to the ways in which pursuing drug prohibition itself might affect public health. The “war on drugs” and “zero-tolerance” policies that grew out of the prohibitionist consensus are now being challenged on multiple fronts, including their health, human rights, and development impact. The Johns Hopkins – Lancet Commission on Drug Policy and Health has sought to examine the emerging scientific evidence on public health issues arising from drug control policy and to inform and encourage a central focus on public health evidence and outcomes in drug policy debates, such as the important deliberations of

  1. Environmental policy instruments in an international duopoly with feedback investment strategies

    NARCIS (Netherlands)

    Feenstra, T; Kort, PM; de Zeeuw, A

    2001-01-01

    This paper analyses the effects of the environmental policy instruments taxes and standards on the investment behaviour of firms in the context of an international duopoly. Two production factors are considered: the capital stock and a polluting input. The government of each country values high prof

  2. Voluntary agreements with white certificates for energy efficiency improvement as a hybrid policy instrument

    NARCIS (Netherlands)

    Oikonomou, V.; Patel, M. K.; van der Gaast, W.; Rietbergen, M.

    2009-01-01

    In this paper we examine the implementation of a combined policy scheme that consists of a traditional instrument, the voluntary agreements (VAs), and an innovative one, the white certificates (WhC). The basic structure of this scheme is that energy suppliers who undertake an energy efficiency oblig

  3. From heterogeneity to harmonization? Recent trends in European health policy

    Directory of Open Access Journals (Sweden)

    Thomas Gerlinger

    2007-01-01

    Full Text Available In the European Union (EU, health policy and the institutional reform of health systems have been treated primarily as national affairs, and health care systems within the EU thus differ considerably. However, the health policy field is undergoing a dynamic process of Europeanization. This process is stimulated by the orientation towards a more competitive economy, recently inaugurated and known as the Lisbon Strategy, while the regulatory requirements of the European Economic and Monetary Union are stimulating the Europeanization of health policy. In addition, the so-called open method of coordination, representing a new mode of regulation within the European multi-level system, is applied increasingly to the health policy area. Diverse trends are thus emerging. While the Lisbon Strategy goes along with a strategic upgrading of health policy more generally, health policy is increasingly used to strengthen economic competitiveness. Pressure on Member States is expected to increase to contain costs and promote market-based health care provision.

  4. Strengthening the evidence-policy interface for patient safety: enhancing global health through hospital partnerships.

    Science.gov (United States)

    Syed, Shamsuzzoha B; Dadwal, Viva; Storr, Julie; Riley, Pamela; Rutter, Paul; Hightower, Joyce D; Gooden, Rachel; Kelley, Edward; Pittet, Didier

    2013-10-16

    Strengthening the evidence-policy interface is a well-recognized health system challenge in both the developed and developing world. Brokerage inherent in hospital-to-hospital partnerships can boost relationships between "evidence" and "policy" communities and move developing countries towards evidence based patient safety policy. In particular, we use the experience of a global hospital partnership programme focused on patient safety in the African Region to explore how hospital partnerships can be instrumental in advancing responsive decision-making, and the translation of patient safety evidence into health policy and planning. A co-developed approach to evidence-policy strengthening with seven components is described, with reflections from early implementation. This rapidly expanding field of enquiry is ripe for shared learning across continents, in keeping with the principles and spirit of health systems development in a globalized world.

  5. Policy Capacity Is Necessary but Not Sufficient; Comment on “Health Reform Requires Policy Capacity”

    Directory of Open Access Journals (Sweden)

    Sheldon Gen

    2015-12-01

    Full Text Available Policy capacity focuses on the managerial and organizational abilities to inform policy decisions with sound research and analysis, and facilitate policy implementation with operational efficiency. It stems from a view of the policy process that is rational and positivistic, in which optimal policy choices can be identified, selected, and implemented with objectivity. By itself, however, policy capacity neglects the political aspects of policy-making that can dominate the process, even in health policies. These technical capabilities are certainly needed to advance reforms in health policies, but they are not sufficient. Instead, they must be complemented with public engagement and policy advocacy to ensure support from the public that policies are meant to serve.

  6. Health policy implications of the holistic health movement.

    Science.gov (United States)

    Salmon, J W; Berliner, H S

    1980-01-01

    A forthright rebellion against the philosophical and clinical orientations of scientific medicine has occurred in the United States during the 1970s. This rebellion includes a growing number of people engaged in self-care practices in attempts to alter their health status through "lifestyle" adjustments, as well as a diverse amalgamation of practitioners (both medical and otherwise), who offer a wide range of therapies outside the mainstream of modern medical practice. Holistic health care has lately become the rubric under which these therapies are grouped. Scientific medicine is the term commonly used to refer to procedures officially sanctioned by the organized medical profession. In the late 19th century, scientific medicine emerged as an advance beyond allopathic medicine after germ theory provided an explanation and, later treatment for infectious diseases. Financial support by private philantropic foundations came in the wake of the Flexner Report on medical education, which provoked a reorganization of medical education in the United States. The subsequent hegemony of scientific medicine thus became assured. To date, few policy analysts have attempted to assess holism and its health policy implications. This article delineates several of the more important policy issues raised by the holistic movement, a phenomenon that represents a challenge to the present organization of health care institutions as well as to scientific medicine.

  7. SHPPS 2006: School Health Policies and Programs Study--Asthma

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2007

    2007-01-01

    The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and practices at the state, district, school, and classroom levels. This brief contains information on asthma relative to health education, physical education and activity, and health services. Included is data on the…

  8. Thoughts About Health Policy Content in Baccalaureate Nursing Programs.

    Science.gov (United States)

    Waddell, Ashley; Adams, Jeffrey M; Fawcett, Jacqueline

    2016-10-01

    We describe a framework used to analyze health policy content in baccalaureate nursing program courses that combines the conceptual model for nursing and health policy and the Adams influence model to account for knowledge and skills needed for health policy work. Our analysis of health policy content in courses in one baccalaureate nursing program focused on what policies were emphasized and how educational content supported the development of personal influence. The analysis revealed course content focused on public sources of health policies and lack of overt course content about policies from organizational and professional sources. Additionally, we identified little course content about the development of personal influence skills except for communication and message articulation components. As the nursing profession continues to build influence in the policy arena, educators must continue to prepare future nurses for such work. © The Author(s) 2016.

  9. Evaluating the Health Impact of Large-Scale Public Policy Changes: Classical and Novel Approaches.

    Science.gov (United States)

    Basu, Sanjay; Meghani, Ankita; Siddiqi, Arjumand

    2017-03-20

    Large-scale public policy changes are often recommended to improve public health. Despite varying widely-from tobacco taxes to poverty-relief programs-such policies present a common dilemma to public health researchers: how to evaluate their health effects when randomized controlled trials are not possible. Here, we review the state of knowledge and experience of public health researchers who rigorously evaluate the health consequences of large-scale public policy changes. We organize our discussion by detailing approaches to address three common challenges of conducting policy evaluations: distinguishing a policy effect from time trends in health outcomes or preexisting differences between policy-affected and -unaffected communities (using difference-in-differences approaches); constructing a comparison population when a policy affects a population for whom a well-matched comparator is not immediately available (using propensity score or synthetic control approaches); and addressing unobserved confounders by utilizing quasi-random variations in policy exposure (using regression discontinuity, instrumental variables, or near-far matching approaches).

  10. Globalisation, health and foreign policy: emerging linkages and interests

    Science.gov (United States)

    Owen, John Wyn; Roberts, Olivia

    2005-01-01

    A discussion of the growing links between the issues of globalisation, health and foreign policy. This article examines the effect this has on health, development and foreign policy communities in the UK and internationally and considers what steps the policy community must take to address the challenges and opportunities of this new relationship. PMID:16053520

  11. Healthy public policy--is health impact assessment the cornerstone?

    Science.gov (United States)

    Metcalfe, O; Higgins, C

    2009-04-01

    The 8th International Health Impact Assessment Conference, entitled 'Healthy public policy--is health impact assessment the cornerstone?', was hosted by the Institute of Public Health in Ireland (IPH). At the event, IPH sponsored a keynote speech to set the context of the conference and outline the importance of healthy public policy. This article presents an overview of healthy public policy and the barriers to its adoption in policy-making. Health impact assessment is one such tool to overcome the barriers, and the authors recommend the methodology as the cornerstone to healthy public policy.

  12. Cost-effectiveness analysis of policy instruments for greenhouse gas emission mitigation in the agricultural sector.

    Science.gov (United States)

    Bakam, Innocent; Balana, Bedru Babulo; Matthews, Robin

    2012-12-15

    Market-based policy instruments to reduce greenhouse gas (GHG) emissions are generally considered more appropriate than command and control tools. However, the omission of transaction costs from policy evaluations and decision-making processes may result in inefficiency in public resource allocation and sub-optimal policy choices and outcomes. This paper aims to assess the relative cost-effectiveness of market-based GHG mitigation policy instruments in the agricultural sector by incorporating transaction costs. Assuming that farmers' responses to mitigation policies are economically rationale, an individual-based model is developed to study the relative performances of an emission tax, a nitrogen fertilizer tax, and a carbon trading scheme using farm data from the Scottish farm account survey (FAS) and emissions and transaction cost data from literature metadata survey. Model simulations show that none of the three schemes could be considered the most cost effective in all circumstances. The cost effectiveness depends both on the tax rate and the amount of free permits allocated to farmers. However, the emissions trading scheme appears to outperform both other policies in realistic scenarios.

  13. Towards health in all policies for childhood obesity prevention.

    Science.gov (United States)

    Hendriks, Anna-Marie; Kremers, Stef P J; Gubbels, Jessica S; Raat, Hein; de Vries, Nanne K; Jansen, Maria W J

    2013-01-01

    The childhood obesity epidemic can be best tackled by means of an integrated approach, which is enabled by integrated public health policies, or Health in All Policies. Integrated policies are developed through intersectoral collaboration between local government policy makers from health and nonhealth sectors. Such intersectoral collaboration has been proved to be difficult. In this study, we investigated which resources influence intersectoral collaboration. The behavior change wheel framework was used to categorize motivation-, capability-, and opportunity-related resources for intersectoral collaboration. In-depth interviews were held with eight officials representing 10 non-health policy sectors within a local government. Results showed that health and non-health policy sectors did not share policy goals, which decreased motivation for intersectoral collaboration. Awareness of the linkage between health and nonhealth policy sectors was limited, and management was not involved in creating such awareness, which reduced the capability for intersectoral collaboration. Insufficient organizational resources and structures reduced opportunities for intersectoral collaboration. To stimulate intersectoral collaboration to prevent childhood obesity, we recommend that public health professionals should reframe health goals in the terminology of nonhealth policy sectors, that municipal department managers should increase awareness of public health in non-health policy sectors, and that flatter organizational structures should be established.

  14. Towards Health in All Policies for Childhood Obesity Prevention

    Directory of Open Access Journals (Sweden)

    Anna-Marie Hendriks

    2013-01-01

    Full Text Available The childhood obesity epidemic can be best tackled by means of an integrated approach, which is enabled by integrated public health policies, or Health in All Policies. Integrated policies are developed through intersectoral collaboration between local government policy makers from health and nonhealth sectors. Such intersectoral collaboration has been proved to be difficult. In this study, we investigated which resources influence intersectoral collaboration. The behavior change wheel framework was used to categorize motivation-, capability-, and opportunity-related resources for intersectoral collaboration. In-depth interviews were held with eight officials representing 10 non-health policy sectors within a local government. Results showed that health and non-health policy sectors did not share policy goals, which decreased motivation for intersectoral collaboration. Awareness of the linkage between health and nonhealth policy sectors was limited, and management was not involved in creating such awareness, which reduced the capability for intersectoral collaboration. Insufficient organizational resources and structures reduced opportunities for intersectoral collaboration. To stimulate intersectoral collaboration to prevent childhood obesity, we recommend that public health professionals should reframe health goals in the terminology of nonhealth policy sectors, that municipal department managers should increase awareness of public health in non-health policy sectors, and that flatter organizational structures should be established.

  15. [The ALANAM statement on public health policy].

    Science.gov (United States)

    Goic, Alejando; Armas, Rodolfo

    2010-12-01

    The ALANAM (Association of Latin American National Academies of Medicine) statement on public health policy, issued following its 19th Congress, held October 28–30, 2010, in Santiago, Chile, declares that cardiovascular diseases, cancer, accidents and violence are the leading causes of death in the region, while in several of its member nations, emergent and re-emergent infectious diseases, malnutrition, and mother-child illnesses remain prevalent. The statement calls attention to the lack of functioning water supply and sewage systems in many villages and rural areas. After describing the social causes of the present state of public health in Latin America (poverty levels reaching upwards of 44% of the total population, or some 110 million people), it calls on governments, first, to spare no efforts in the task of eradicating extreme poverty in the short-term, and poverty in the long-term. Second, considering that about 15 million 3-to-6 year-olds have no access to education, it recommends extending educational services to these children, and to improve the quality of existing pre-school and primary education. Third, the statement calls for universal health care coverage and for equal access to good quality medical care for everyone, and for programs aimed at promoting healthy personal habits and self-care. In this regard, it also recommends that disease prevention programs be sustained over time, that national sanitary objectives be defined, and that its results be periodically reviewed. Fourth, it recommends that primary health care be extended to everyone, and that it be enhanced by improving coverage and coordination with secondary and tertiary level health care institutions. The statement lays special stress on the need for adopting public health policies aimed at lowering the cost of medicines; to this end, it calls for the creation of an official list of generic drugs. The statement ends by calling on governments to support public health research as a

  16. Corporate philanthropy, lobbying, and public health policy.

    Science.gov (United States)

    Tesler, Laura E; Malone, Ruth E

    2008-12-01

    To counter negative publicity about the tobacco industry, Philip Morris has widely publicized its philanthropy initiatives. Although corporate philanthropy is primarily a public relations tool, contributions may be viewed as offsetting the harms caused by corporate products and practices. That such donations themselves have harmful consequences has been little considered. Drawing on internal company documents, we explored the philanthropy undertaken as part of Philip Morris's PM21 image makeover. Philip Morris explicitly linked philanthropy to government affairs and used contributions as a lobbying tool against public health policies. Through advertising, covertly solicited media coverage, and contributions to legislators' pet causes, Philip Morris improved its image among key voter constituencies, influenced public officials, and divided the public health field as grantees were converted to stakeholders.

  17. Radiation protection policies to protect public health

    Energy Technology Data Exchange (ETDEWEB)

    Muckerheide, J. [Commonwealth Massachusetts, Needham, MA (United States)

    1995-12-31

    Scientific data from plant, animal, and human populations more strongly find radiation essential to life, i.e., suppressing background radiation is debilitating and that moderately enhanced radiation doses have positive effects, than that low-moderate radiation dose has adverse effects. {close_quote} Federal radiation protection policy will be in the public interest and save hundreds of billions of dollars at no public health cost when known dose effects to exposed populations are applied to ensure no adverse health effects, with safety margins, and when appropriate research is funded (and public benefits from new radiation and nuclear science and technology applications are enabled) at the sole cost of reduced federal power and influence.

  18. Corporate Philanthropy, Lobbying, and Public Health Policy

    Science.gov (United States)

    Tesler, Laura E.

    2008-01-01

    To counter negative publicity about the tobacco industry, Philip Morris has widely publicized its philanthropy initiatives. Although corporate philanthropy is primarily a public relations tool, contributions may be viewed as offsetting the harms caused by corporate products and practices. That such donations themselves have harmful consequences has been little considered. Drawing on internal company documents, we explored the philanthropy undertaken as part of Philip Morris's PM21 image makeover. Philip Morris explicitly linked philanthropy to government affairs and used contributions as a lobbying tool against public health policies. Through advertising, covertly solicited media coverage, and contributions to legislators’ pet causes, Philip Morris improved its image among key voter constituencies, influenced public officials, and divided the public health field as grantees were converted to stakeholders. PMID:18923118

  19. Adapting public policy theory for public health research: A framework to understand the development of national policies on global health.

    Science.gov (United States)

    Jones, Catherine M; Clavier, Carole; Potvin, Louise

    2017-03-01

    National policies on global health appear as one way that actors from health, development and foreign affairs sectors in a country coordinate state action on global health. Next to a burgeoning literature in which international relations and global governance theories are employed to understand global health policy and global health diplomacy at the international level, little is known about policy processes for global health at the national scale. We propose a framework of the policy process to understand how such policies are developed, and we identify challenges for public health researchers integrating conceptual tools from political science. We developed the framework using a two-step process: 1) reviewing literature to establish criteria for selecting a theoretical framework fit for this purpose, and 2) adapting Real-Dato's synthesis framework to integrate a cognitive approach to public policy within a constructivist perspective. Our framework identifies multiple contexts as part of the policy process, focuses on situations where actors work together to make national policy on global health, considers these interactive situations as spaces for observing external influences on policy change and proposes policy design as the output of the process. We suggest that this framework makes three contributions to the conceptualisation of national policy on global health as a research object. First, it emphasizes collective action over decisions of individual policy actors. Second, it conceptualises the policy process as organised interactive spaces for collaboration rather than as stages of a policy cycle. Third, national decision-making spaces are opportunities for transferring ideas and knowledge from different sectors and settings, and represent opportunities to identify international influences on a country's global health policy. We discuss two sets of challenges for public health researchers using interdisciplinary approaches in policy research.

  20. Instrumentality in health care: a response to Adam Oliver.

    Science.gov (United States)

    Tanenbaum, Sandra J

    2015-07-01

    In his paper, 'Incentivizing improvements in health care delivery', Adam Oliver discusses recent efforts to manage the performance of health care workers in the United States and United Kingdom. Overall, the results of performance management seem to be mixed, but Oliver's discussion hints at a more fundamental question about this approach, specifically: what are the limits of a focused instrumentality in a context as rich, fluid and collaborative as the delivery of health care? Might performance management schemes actually frustrate the efforts of conscientious health care workers? Indicators make few allowances for the heterogeneity of treatment effects or patient values or preferences. Health care workers may also face pressure to appear to satisfy indicators that are actually impossible to satisfy.

  1. China’s National Health Policies: An Ontological Analysis

    Science.gov (United States)

    Dai, Guobin; Deng, Fang; Ramaprasad, Arkalgud; Syn, Thant

    2016-01-01

    The health care system in China is facing a multitude of challenges owing to the changing demographics of the country, the evolving economics of health care, and the emerging epidemiology of health as well as diseases. China’s many national health care policies are documented in Chinese text documents. It is necessary to map the policies synoptically, systemically, and systematically to discover their emphases and biases, assess them, and modify them in the future. Using a logically constructed ontology of health care policies based on the common bodies of knowledge as a lens, we map the current policies to reveal their ‘bright’, ‘light’, and ‘blind/blank’ spots. The ontological map will help (a) develop a roadmap for future health care policies in China, and (b) compare and contrast China’s health care policies with other countries’. PMID:28210417

  2. Oral health policy forum: developing dental student knowledge and skills for health policy advocacy.

    Science.gov (United States)

    Yoder, Karen M; Edelstein, Burton L

    2012-12-01

    This article describes the planning, sequential improvements, and outcomes of Indiana University School of Dentistry's annual Oral Health Policy Forum. This one-day forum for fourth-year dental students was instituted in 2005 with the Indiana Dental Association and the Children's Dental Health Project to introduce students to the health policy process and to encourage their engagement in advocacy. Following a keynote by a visiting professor, small student groups develop arguments in favor and in opposition to five oral health policy scenarios and present their positions to a mock or authentic legislator. The "legislator" critiques these presentations, noting both effective and ineffective approaches, and the student deemed most effective by fellow students receives a gift award. During the afternoon, students tour the Indiana State House, observe deliberations, and meet with legislators. In 2009, 92 percent of students reported a positive impression of the forum, up from 60 percent in 2005. Half (49 percent) in 2009 indicated that they were more inclined to become involved with the political process following the forum, up from 21 percent in 2005. Dental students' feedback became increasingly positive as the program was refined and active learning opportunities were enhanced. This model for engaging students in policy issues important to their professional careers is readily replicable by other dental schools.

  3. Effect of taxes and climate policy instruments on harvesting of managed forests and on tropical deforestation

    Energy Technology Data Exchange (ETDEWEB)

    Barua, Sepul K.

    2011-07-01

    This dissertation examines the effects of taxes and policy instruments that aim to regulate climate services from forests. It consists of a summary section and four articles. Articles (1) and (2) examine the effects of taxes on management decisions in the context of managed boreal forests distinguished by forest-owners amenity preferences and also their age. Articles (3) and (4) examine the role of carbon-based policy instruments in the presence of taxes on land incomes in curbing tropical deforestation. Article (1) reveals that the intensity of forest-owners preferences for forest amenities affects the non-neutrality of forest taxes pertaining to forest harvesting. Therefore, the effects of taxes depend on this intensity. This highlights the importance of developing methods to measure forest-owners amenity preferences quantitatively. Article (2) shows that the age of forest-owners governs their propensity to consume as opposed to leave bequests. Furthermore, it shown that the effects of capital income and inheritance taxes vary across different age-groups of forest-owners. Article (3) demonstrates that taxes on forestry and cash-crop incomes, per se, may be ineffective in curbing tropical forest loss. The carbon payments may complement these taxes, and an effective policy to combat tropical deforestation should jointly target forestry and cash-crop sectors. Article (4) demonstrates the link between carbon compensation policies and land income taxation. An optimal carbon compensation scheme may require that national governments are allowed to use different compensation rates from that applied globally when passing national level compensations on to the local level. These results suggest that existing policies such as taxation should be accounted for in the analysis and design of international carbon policy instruments that aim at enhancing forests role in climate change mitigation. (orig.)

  4. Family Economic Security Policies and Child and Family Health.

    Science.gov (United States)

    Spencer, Rachael A; Komro, Kelli A

    2017-03-01

    In this review, we examine the effects of family economic security policies (i.e., minimum wage, earned income tax credit, unemployment insurance, Temporary Assistance to Needy Families) on child and family health outcomes, summarize policy generosity across states in the USA, and discuss directions and possibilities for future research. This manuscript is an update to a review article that was published in 2014. Millions of Americans are affected by family economic security policies each year, many of whom are the most vulnerable in society. There is increasing evidence that these policies impact health outcomes and behaviors of adults and children. Further, research indicates that, overall, policies which are more restrictive are associated with poorer health behaviors and outcomes; however, the strength of the evidence differs across each of the four policies. There is significant diversity in state-level policies, and it is plausible that these policy variations are contributing to health disparities across and within states. Despite increasing evidence of the relationship between economic policies and health, there continues to be limited attention to this issue. State policy variations offer a valuable opportunity for scientists to conduct natural experiments and contribute to evidence linking social policy effects to family and child well-being. The mounting evidence will help to guide future research and policy making for evolving toward a more nurturing society for family and child health and well-being.

  5. Consumer preferences for reduced packaging under economic instruments and recycling policy.

    Science.gov (United States)

    Yamaguchi, Keiko; Takeuchi, Kenji

    2016-02-01

    This study was conducted using a web-based survey and bidding game in contingent valuation method to evaluate consumer preferences for packaging with less material. Results revealed that people who live in a municipality implementing unit-based pricing of waste have a higher willingness-to-pay (WTP) for a product. Economic instruments can affect the purchase of products with reduced packaging because a higher disposal cost increases the attractiveness of source reduction. However, unit-based pricing combined with plastic separation for recycling reduces WTP. This result suggests that recycling policy weakens the effect of economic instruments on source reduction of waste.

  6. SHPPS 2006: School Health Policies and Programs Study--Overview

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2007

    2007-01-01

    The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. SHPPS 2006 was designed to answer the following questions: (1) What are the characteristics of each school health program component at the state,…

  7. Ideological vs. Instrumental Barriers to Accessing Formal Mental Health care in the Developing World: Focus on South-eastern Nigeria.

    Science.gov (United States)

    Ikwuka, Ugo; Galbraith, Niall; Manktelow, Ken; Chen-Wilson, Josephine; Oyebode, Femi; Muomah, Rosemary C; Igboaka, Anuli

    2016-01-01

    The striking gaps in formal mental health care in the developing world are largely traceable to Instrumental and Ideological Barriers. Focusing on south-eastern Nigeria, the study aimed to establish the relative weight, significance and determinants of these barriers for prioritised policy interventions. Multistage sampling method was used to select participants (n = 706) to whom questionnaires were administered. Ideological Barriers (cultural and mental health literacy constraints) were more significantly perceived (84.8%) than Instrumental Barriers (systemic and financial impediments) (56.6%). The study demonstrated the primacy of improved knowledge in plugging the gap in conventional mental health care in a region ironically defined more by systemic and material poverty. This is instructive for prioritised policy interventions with an indication that even if facilities and socio-economic status improve, services will likely be underused without greater improvement in people's conceptualisation of mental illness. It equally underscored the need for cultural competence in mental health service provision.

  8. Positioning women's and children's health in African union policy-making: a policy analysis.

    Science.gov (United States)

    Toure, Kadidiatou; Sankore, Rotimi; Kuruvilla, Shyama; Scolaro, Elisa; Bustreo, Flavia; Osotimehin, Babatunde

    2012-02-16

    With limited time to achieve the Millennium Development Goals, progress towards improving women's and children's health needs to be accelerated. With Africa accounting for over half of the world's maternal and child deaths, the African Union (AU) has a critical role in prioritizing related policies and catalysing required investments and action. In this paper, the authors assess the evolution of African Union policies related to women's and children's health, and analyze how these policies are prioritized and framed. The main method used in this policy analysis was a document review of all African Union policies developed from 1963 to 2010, focusing specifically on policies that explicitly mention health. The findings from this document review were discussed with key actors to identify policy implications. With over 220 policies in total, peace and security is the most common AU policy topic. Social affairs and other development issues became more prominent in the 1990s. The number of policies that mentioned health rose steadily over the years (with 1 policy mentioning health in 1963 to 7 in 2010).This change was catalysed by factors such as: a favourable shift in AU priorities and systems towards development issues, spurred by the transition from the Organization of African Unity to the African Union; the mandate of the African Commission on Human and People's Rights; health-related advocacy initiatives, such as the Campaign for the Accelerated Reduction of Maternal Mortality in Africa (CARMMA); action and accountability requirements arising from international human rights treaties, the Millennium Development Goals (MDGs), and new health-funding mechanisms, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria.Prioritization of women's and children's health issues in AU policies has been framed primarily by human rights, advocacy and accountability considerations, more by economic and health frames looking at investments and impact. AU policies related

  9. Positioning women's and children's health in African union policy-making: a policy analysis

    Directory of Open Access Journals (Sweden)

    Toure Kadidiatou

    2012-02-01

    Full Text Available Abstract Background With limited time to achieve the Millennium Development Goals, progress towards improving women's and children's health needs to be accelerated. With Africa accounting for over half of the world's maternal and child deaths, the African Union (AU has a critical role in prioritizing related policies and catalysing required investments and action. In this paper, the authors assess the evolution of African Union policies related to women's and children's health, and analyze how these policies are prioritized and framed. Methods The main method used in this policy analysis was a document review of all African Union policies developed from 1963 to 2010, focusing specifically on policies that explicitly mention health. The findings from this document review were discussed with key actors to identify policy implications. Results With over 220 policies in total, peace and security is the most common AU policy topic. Social affairs and other development issues became more prominent in the 1990s. The number of policies that mentioned health rose steadily over the years (with 1 policy mentioning health in 1963 to 7 in 2010. This change was catalysed by factors such as: a favourable shift in AU priorities and systems towards development issues, spurred by the transition from the Organization of African Unity to the African Union; the mandate of the African Commission on Human and People's Rights; health-related advocacy initiatives, such as the Campaign for the Accelerated Reduction of Maternal Mortality in Africa (CARMMA; action and accountability requirements arising from international human rights treaties, the Millennium Development Goals (MDGs, and new health-funding mechanisms, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria. Prioritization of women's and children's health issues in AU policies has been framed primarily by human rights, advocacy and accountability considerations, more by economic and health frames

  10. Inclusion of vulnerable groups in health policies: Regional policies on health priorities in Africa

    Directory of Open Access Journals (Sweden)

    Margie Schneider

    2013-01-01

    Full Text Available Background: If access to equitable health care is to be achieved for all, policy documents must mention and address in some detail different needs of groups vulnerable to not accessing such health care. If these needs are not addressed in the policy documents, there is little chance that they will be addressed at the stage of implementation.Objectives: This paper reports on an analysis of 11 African Union (AU policy documents to ascertain the frequency and the extent of mention of 13 core concepts in relation to 12 vulnerable groups, with a specific focus on people with disabilities.Method: The paper applied the EquiFrame analytical framework to the 11 AU policy documents. The 11 documents were analysed in terms of how many times a core concept was mentioned and the extent of information on how the core concept should be addressed at the implementation level. Each core concept mention was further analysed in terms of the vulnerable group in referred to.Results: The analysis of regional AU policies highlighted the broad nature of the reference made to vulnerable groups, with a lack of detailed specifications of different needs of different groups. This is confirmed in the highest vulnerable group mention being for ‘universal’. The reading of the documents suggests that vulnerable groups are homogeneous in their needs, which is not the case. There is a lack of recognition of different needs of different vulnerable groups in accessing health care.Conclusion: The need for more information and knowledge on the needs of all vulnerable groups is evident. The current lack of mention and of any detail on how to address needs of vulnerable groups will significantly impair the access to equitable health care for all.

  11. Working environment interventions – Bridging the gap between policy instruments and practice

    DEFF Research Database (Denmark)

    Hasle, Peter; Limborg, Hans Jørgen; Nielsen, Klaus T.

    2014-01-01

    In spite of progress in intervention research, our understanding of the transformation of knowledge from the research into national working environment programmes is limited. Research in state regulation is mainly aimed at compliance and efficiency of public administration, while little attention...... is paid to why and how public and private organisations subsequently are to improve their working environment. This paper suggests a model which can bridge this gap. It is based on a combination of theories about basic policy instruments (regulation, incentives and information) with realistic analysis...... analysis of the case shows how various actors, including the authorities, employers, unions and bi-partite committees, developed a programme combining the policy instruments over a considerable period of time and that all three institutional mechanisms affected the outcome. This integration of various...

  12. Dental indications for the instrumental functional analysis in additional consideration of health-economic aspects

    Directory of Open Access Journals (Sweden)

    Willich, Stefan N.

    2010-01-01

    Full Text Available Background: Besides clinical and radiological examination instrumental functional analyses are performed as diagnostic procedures for craniomandibular dysfunctions. Instrumental functional analyses cause substantial costs and shows a considerable variability between individual dentist practices. Objectives: On the basis of published scientific evidence the validity of the instrumental functional analysis for the diagnosis of craniomandibular dysfunctions compared to clinical diagnostic procedures; the difference of the various forms of the instrumental functional analysis; the existence of a dependency on additional other factors and the need for further research are determined in this report. In addition, the cost effectiveness of the instrumental functional analysis is analysed in a health-policy context, and social, legal and ethical aspects are considered. Methods: A literature search is performed in over 27 databases and by hand. Relevant companies and institutions are contacted concerning unpublished studies. The inclusion criteria for publications are (i diagnostic studies with the indication “craniomandibular malfunction”, (ii a comparison between clinical and instrumental functional analysis, (iii publications since 1990, (iv publications in English or German. The identified literature is evaluated by two scientists regarding the relevance of content and methodical quality.Results: The systematic database search resulted in 962 hits. 187 medical and economic complete publications are evaluated. Since the evaluated studies are not relevant enough to answer the medical or health economic questions no study is included. Discussion: The inconsistent terminology concerning craniomandibular dysfunctions and instrumental functional analyses results in a broad literature search in databases and an extensive search by hand. Since no relevant results concerning the validity of the instrumental functional analysis in comparison to the clinical

  13. Dental indications for the instrumental functional analysis in additional consideration of health-economic aspects

    Science.gov (United States)

    Tinnemann, Peter; Stöber, Yvonne; Roll, Stephanie; Vauth, Christoph; Willich, Stefan N.; Greiner, Wolfgang

    2010-01-01

    Background Besides clinical and radiological examination instrumental functional analyses are performed as diagnostic procedures for craniomandibular dysfunctions. Instrumental functional analyses cause substantial costs and shows a considerable variability between individual dentist practices. Objectives On the basis of published scientific evidence the validity of the instrumental functional analysis for the diagnosis of craniomandibular dysfunctions compared to clinical diagnostic procedures; the difference of the various forms of the instrumental functional analysis; the existence of a dependency on additional other factors and the need for further research are determined in this report. In addition, the cost effectiveness of the instrumental functional analysis is analysed in a health-policy context, and social, legal and ethical aspects are considered. Methods A literature search is performed in over 27 databases and by hand. Relevant companies and institutions are contacted concerning unpublished studies. The inclusion criteria for publications are (i) diagnostic studies with the indication “craniomandibular malfunction”, (ii) a comparison between clinical and instrumental functional analysis, (iii) publications since 1990, (iv) publications in English or German. The identified literature is evaluated by two scientists regarding the relevance of content and methodical quality. Results The systematic database search resulted in 962 hits. 187 medical and economic complete publications are evaluated. Since the evaluated studies are not relevant enough to answer the medical or health economic questions no study is included. Discussion The inconsistent terminology concerning craniomandibular dysfunctions and instrumental functional analyses results in a broad literature search in databases and an extensive search by hand. Since no relevant results concerning the validity of the instrumental functional analysis in comparison to the clinical functional analysis

  14. Reviewing and reforming policy in health enterprise information security

    Science.gov (United States)

    Sostrom, Kristen; Collmann, Jeff R.

    2001-08-01

    Health information management policies usually address the use of paper records with little or no mention of electronic health records. Information Technology (IT) policies often ignore the health care business needs and operational use of the information stored in its systems. Representatives from the Telemedicine & Advanced Technology Research Center, TRICARE and Offices of the Surgeon General of each Military Service, collectively referred to as the Policies, Procedures and Practices Work Group (P3WG), examined military policies and regulations relating to computer-based information systems and medical records management. Using a system of templates and matrices created for the purpose, P3WG identified gaps and discrepancies in DoD and service compliance with the proposed Health Insurance Portability and Accountability Act (HIPAA) Security Standard. P3WG represents an unprecedented attempt to coordinate policy review and revision across all military health services and the Office of Health Affairs. This method of policy reform can identify where changes need to be made to integrate health management policy and IT policy in to an organizational policy that will enable compliance with HIPAA standards. The process models how large enterprises may coordinate policy revision and reform across broad organizational and work domains.

  15. Industrial Policy of BRICS Countries as an Instrument of State Capitalism

    Directory of Open Access Journals (Sweden)

    Martina Jiránková

    2017-03-01

    Full Text Available The article deals with industrial policy in the BRICS countries, which is an important instrument of their development. First, the importance of industrial policy is stated. There are numerous approaches to it: the extreme ones are the neoliberal approach, advocating no interventions of the state in the market; the other extreme is interventions either directly by subsidies to chosen branches or indirectly by building institutional surroundings which are comfortable for industrial development. The development of theoretical approaches to industrial policy is also discussed: from structuralists to new structuralists, who try to connect a market as the main mechanism with an industrial policy. Industrial policies practised in Brazil, Russia, India, China and South Africa are then described. Some statistical data are given which illustrate the position of the BRICS countries in the present-day world as for their industrial performance. China seems to be the relatively most successful in this respect. Finally, some questions concerning state capitalism and industrial policy are discussed.

  16. Ultrasonic wave-based structural health monitoring embedded instrument

    Energy Technology Data Exchange (ETDEWEB)

    Aranguren, G.; Monje, P. M., E-mail: pedromaria.monje@ehu.es [Electronic Design Group, Faculty of Engineering of Bilbao, University of the Basque Country, Bilbao (Spain); Cokonaj, Valerijan [AERnnova Engineering Solutions Ibérica S.A., Madrid (Spain); Barrera, Eduardo; Ruiz, Mariano [Instrumentation and Applied Acoustic Research Group of the Technical University of Madrid, Madrid (Spain)

    2013-12-15

    Piezoelectric sensors and actuators are the bridge between electronic and mechanical systems in structures. This type of sensor is a key element in the integrity monitoring of aeronautic structures, bridges, pressure vessels, wind turbine blades, and gas pipelines. In this paper, an all-in-one system for Structural Health Monitoring (SHM) based on ultrasonic waves is presented, called Phased Array Monitoring for Enhanced Life Assessment. This integrated instrument is able to generate excitation signals that are sent through piezoelectric actuators, acquire the received signals in the piezoelectric sensors, and carry out signal processing to check the health of structures. To accomplish this task, the instrument uses a piezoelectric phased-array transducer that performs the actuation and sensing of the signals. The flexibility and strength of the instrument allow the user to develop and implement a substantial part of the SHM technique using Lamb waves. The entire system is controlled using configuration software and has been validated through functional, electrical loading, mechanical loading, and thermal loading resistance tests.

  17. Ultrasonic wave-based structural health monitoring embedded instrument.

    Science.gov (United States)

    Aranguren, G; Monje, P M; Cokonaj, Valerijan; Barrera, Eduardo; Ruiz, Mariano

    2013-12-01

    Piezoelectric sensors and actuators are the bridge between electronic and mechanical systems in structures. This type of sensor is a key element in the integrity monitoring of aeronautic structures, bridges, pressure vessels, wind turbine blades, and gas pipelines. In this paper, an all-in-one system for Structural Health Monitoring (SHM) based on ultrasonic waves is presented, called Phased Array Monitoring for Enhanced Life Assessment. This integrated instrument is able to generate excitation signals that are sent through piezoelectric actuators, acquire the received signals in the piezoelectric sensors, and carry out signal processing to check the health of structures. To accomplish this task, the instrument uses a piezoelectric phased-array transducer that performs the actuation and sensing of the signals. The flexibility and strength of the instrument allow the user to develop and implement a substantial part of the SHM technique using Lamb waves. The entire system is controlled using configuration software and has been validated through functional, electrical loading, mechanical loading, and thermal loading resistance tests.

  18. Combining climate and energy policies: synergies or antagonism? Modeling interactions with energy efficiency instruments

    Energy Technology Data Exchange (ETDEWEB)

    Lecuyer, Oskar [EDF R and D - Efese, 1 av du General de Gaulle, 92141 Clamart (France)] [CIRED, 45 bis av de la Belle-Gabrielle, 94736 Nogent-sur-Marne (France); Bibas, Ruben [CIRED, 45 bis av de la Belle-Gabrielle, 94736 Nogent-sur-Marne (France)

    2012-01-15

    In addition to the already present Climate and Energy package, the European Union (EU) plans to include a binding target to reduce energy consumption. We analyze the rationales the EU invokes to justify such an overlapping and develop a minimal common framework to study interactions arising from the combination of instruments reducing emissions, promoting renewable energy (RE) production and reducing energy demand through energy efficiency (EE) investments. We find that although all instruments tend to reduce GHG emissions and although a price on carbon tends also to give the right incentives for RE and EE, the combination of more than one instrument leads to significant antagonisms regarding major objectives of the policy package. The model allows to show in a single framework and to quantify the antagonistic effects of the joint promotion of RE and EE. We also show and quantify the effects of this joint promotion on ETS permit price, on wholesale market price and on energy production levels. (authors)

  19. Energy efficiency in existing detached housing. Danish experiences with different policy instruments

    Energy Technology Data Exchange (ETDEWEB)

    Gram-Hanssen, K.; Haunstrup Christensen, T. (Aalborg Univ., Danish Building Research Institute, Hoersholm (Denmark))

    2011-07-01

    This report contains a memo written as an input to the German project Enef-haus on energy-efficient restoration of single-family houses in Germany. The memo contains a summary of the Danish experiences divided into three main sections: first is a short historic overview of the Danish energy policy indicating when different relevant instruments have been introduced to increase the energy efficiency of privately owned single-family houses. Second is a short introduction to the Danish housing sector and its energy supplies. The third and main part of the report is an examination of the most recent and relevant instruments concluding both on the results concerning the impact of the instruments especially on owners of single-family houses and on more general experiences with their implementation. Finally the memo concludes on the general lessons that can be learned from the Danish experiences. (Author)

  20. Instrumentation

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Journal Scope:Instrumentation is a high quality open access peer reviewed research journal.Authors are solicited to contribute to these journals by submitting articles that illustrate most up-to-date research results,projects,surveying works and industrial experiences that describe significant advances in the instrumental science.The mission of the Instrumentation is

  1. The mental health system in Brazil: Policies and future challenges

    Directory of Open Access Journals (Sweden)

    Razzouk Denise

    2008-09-01

    Full Text Available Abstract Background The aim of this paper is to assess the mental health system in Brazil in relation to the human resources and the services available to the population. Methods The World Health Organization Assessment Instrument for Mental Health Systems (WHO AIMS was recently applied in Brazil. This paper will analyse data on the following sections of the WHO-AIMS: a mental health services; and b human resources. In addition, two more national datasets will be used to complete the information provided by the WHO questionnaire: a the Executive Bureau of the Department of Health (Datasus; and b the National Register of Health Institutions (CNS. Results There are 6003 psychiatrists, 18,763 psychologists, 1985 social workers, 3119 nurses and 3589 occupational therapists working for the Unified Health System (SUS. At primary care level, there are 104,789 doctors, 184, 437 nurses and nurse technicians and 210,887 health agents. The number of psychiatrists is roughly 5 per 100,000 inhabitants in the Southeast region, and the Northeast region has less than 1 psychiatrist per 100,000 inhabitants. The number of psychiatric nurses is insufficient in all geographical areas, and psychologists outnumber other mental health professionals in all regions of the country. The rate of beds in psychiatric hospitals in the country is 27.17 beds per 100,000 inhabitants. The rate of patients in psychiatric hospitals is 119 per 100,000 inhabitants. The average length of stay in mental hospitals is 65.29 days. In June 2006, there were 848 Community Psychosocial Centers (CAPS registered in Brazil, a ratio of 0.9 CAPS per 200,000 inhabitants, unequally distributed in the different geographical areas: the Northeast and the North regions having lower figures than the South and Southeast regions. Conclusion The country has opted for innovative services and programs, such as the expansion of Psychosocial Community Centers and the Return Home program to deinstitutionalize

  2. Electoral impact of public policies Case Study: Elections as an instrument of civic participation in public policies in Kosovo

    Directory of Open Access Journals (Sweden)

    Dr.Sc. Ibrahim Gashi

    2013-06-01

    Full Text Available Being aware of the role of electoral systems as the most important mechanisms of fostering political interaction in a political system of a certain democratic society, it is our intention to study and theoretically and practically analyze the establishment and functioning of the electoral system in Kosovo, in the temporal context of the last decade. Before that thought, several standard theoretical modalities attributable to electoral systems are to be set, with a view of explaining the role and functions of the electoral systems in consolidating basic attributes of a mature democracy. In our case studies, amongst the most important attributes under analysis are: elections, as an instrument of civil participation in public policies. Furthermore, in studying the function of elections, we shall make efforts to elaborate on the level of political culture in Kosovo, creation of authority and legitimacy, and the extent of maturity of Kosovar society itself. Since Kosovo has been under international administration for more than ten years, the analysis of the electoral system in Kosovo is found to be sui generis, and this fact allows for an extraordinary understanding of the role of elections as an instrument of citizens for participating in public policies and public life in Kosovo. In attaining such goals, we shall focus on the analysis of all cycles of elections held in Kosovo since 2001, and up to the constitutional reforms ongoing related to electoral reforms in Kosovo.

  3. The inter-section of political history and health policy in Asia--the historical foundations for health policy analysis.

    Science.gov (United States)

    Grundy, John; Hoban, Elizabeth; Allender, Steve; Annear, Peter

    2014-09-01

    One of the challenges for health reform in Asia is the diverse set of socio-economic and political structures, and the related variability in the direction and pace of health systems and policy reform. This paper aims to make comparative observations and analysis of health policy reform in the context of historical change, and considers the implications of these findings for the practice of health policy analysis. We adopt an ecological model for analysis of policy development, whereby health systems are considered as dynamic social constructs shaped by changing political and social conditions. Utilizing historical, social scientific and health literature, timelines of health and history for five countries (Cambodia, Myanmar, Mongolia, North Korea and Timor Leste) are mapped over a 30-50 year period. The case studies compare and contrast key turning points in political and health policy history, and examines the manner in which these turning points sets the scene for the acting out of longer term health policy formation, particularly with regard to the managerial domains of health policy making. Findings illustrate that the direction of health policy reform is shaped by the character of political reform, with countries in the region being at variable stages of transition from monolithic and centralized administrations, towards more complex management arrangements characterized by a diversity of health providers, constituency interest and financing sources. The pace of reform is driven by a country's institutional capability to withstand and manage transition shocks of post conflict rehabilitation and emergence of liberal economic reforms in an altered governance context. These findings demonstrate that health policy analysis needs to be informed by a deeper understanding and questioning of the historical trajectory and political stance that sets the stage for the acting out of health policy formation, in order that health systems function optimally along their own

  4. Policy Capacity in the Learning Healthcare System; Comment on “Health Reform Requires Policy Capacity”

    Directory of Open Access Journals (Sweden)

    William Gardner

    2015-12-01

    Full Text Available Pierre-Gerlier Forest and his colleagues make a strong argument for the need to expand policy capacity among healthcare actors. In this commentary, I develop an additional argument in support of Forest et al view. Forest et al rightly point to the need to have embedded policy experts to successfully translate healthcare reform policy into healthcare change. Translation of externally generated innovation policy into local solutions is only one source of healthcare system change. We also need to build learning healthcare systems that can discover new health solutions at the frontline of care. Enhanced policy capacity staffing in those organizations will be key to building continuously learning health systems.

  5. Increasing HPV vaccination through policy for public health benefit.

    Science.gov (United States)

    Brandt, Heather M; Pierce, Jennifer Young; Crary, Ashley

    2016-06-02

    Vaccines against specific types of human papillomavirus (HPV) linked to cancer and other diseases have been met with mixed acceptance globally and in the United States. Policy-level interventions have been shown to be effective in increasing public health benefit. Government policies and mandates may result in improved HPV vaccination coverage and reduced disease burden, and alternative policies that improve unhindered access to HPV vaccination may allow success as well. The purpose of this commentary is to summarize policy efforts to maximize the public health benefit of HPV vaccination. We examine selected examples of HPV vaccination policy in global contexts and in the United States.

  6. Adaptation of WHOQOL as health-related quality of life instrument to develop a vision-specific instrument.

    Directory of Open Access Journals (Sweden)

    Dandona Lalit

    2000-01-01

    Full Text Available The WHOQOL instrument was adapted as a health-related QOL instrument for a population-based epidemiologic study of eye diseases in southern India, the Andhra Pradesh Eye Disease Study (APEDS. A follow-up question was added to each item in WHOQOL to determine whether the decrease in QOL was due to any health reasons including eye-related reasons. Modifications in WHOQOL and translation in local language were done through the use of the focus groups including health professionals and people not related to health care. The modified instrument has 28 items across 6 domains of the WHOQOL and was translated into the local language, Telugu, using the pragmatic approach. It takes 10-20 minutes to be administered by a trained interviewer. Reliability was within acceptable range. This health-related QOL instrument is being used in the population-based study APEDS to develop a vision-specific QOL instrument which could potentially be used to assess the impact of visual impairment on QOL across different cultures and for use in evaluating eye-care interventions. This health-related QOL instrument could also be used to develop other disease-specific instruments as it allows assessment of the extent to which various aspects of QOL are affected by a variety of health problems.

  7. Adaptation of WHOQOL as health-related quality of life instrument to develop a vision-specific instrument.

    Science.gov (United States)

    Dandona, R; Dandona, L; McCarty, C A; Rao, G N

    2000-03-01

    The WHOQOL instrument was adapted as a health-related QOL instrument for a population-based epidemiologic study of eye diseases in southern India, the Andhra Pradesh Eye Disease Study (APEDS). A follow-up question was added to each item in WHOQOL to determine whether the decrease in QOL was due to any health reasons including eye-related reasons. Modifications in WHOQOL and translation in local language were done through the use of the focus groups including health professionals and people not related to health care. The modified instrument has 28 items across 6 domains of the WHOQOL and was translated into the local language, Telugu, using the pragmatic approach. It takes 10-20 minutes to be administered by a trained interviewer. Reliability was within acceptable range. This health-related QOL instrument is being used in the population-based study APEDS to develop a vision-specific QOL instrument which could potentially be used to assess the impact of visual impairment on QOL across different cultures and for use in evaluating eye-care interventions. This health-related QOL instrument could also be used to develop other disease-specific instruments as it allows assessment of the extent to which various aspects of QOL are affected by a variety of health problems.

  8. Presidential Immigration Policies: Endangering Health and Well-being?

    DEFF Research Database (Denmark)

    Ó Cathaoir, Katharina Eva; O Gostin, Lawrence

    2017-01-01

    President Trump has issued executive orders transforming US immigration policy, potentially harming patient health and well-being. Are the president’s orders lawful and ethical, and what are the effects on the health system?...

  9. Mitigation and health: Climate policy not so costly

    Science.gov (United States)

    Buonocore, Jonathan

    2014-10-01

    Climate change mitigation can benefit human health by reducing air pollution. Research now shows that the economic value of health improvements can substantially outweigh mitigation costs, and that more flexible policies could have higher benefits.

  10. Psychiatric and Medical Health Care Policies in Juvenile Detention Facilities

    Science.gov (United States)

    Pajer, Kathleen A.; Kelleher, Kelly; Gupta, Ravindra A.; Rolls, Jennifer; Gardner, William

    2007-01-01

    A study aims to examine the existing health care policies in U.S. juvenile detention centres. The results conclude that juvenile detention facilities have many shortfalls in providing care for adolescents, particularly mental health care.

  11. Stress, Cognitive Appraisal and Psychological Health: Testing Instruments for Health Professionals.

    Science.gov (United States)

    Gomes, A Rui; Teixeira, Pedro M

    2016-04-01

    The job of health professionals, including nurses, is considered inherently stressful, and thus, it is important to improve and develop specific measures that are sensitive to the demands that health professionals face. This study analysed the psychometric properties of three instruments that focus on the professional experiences of nurses in aspects related to occupational stress, cognitive appraisal and mental health issues. The evaluation protocol included the Stress Questionnaire for Health Professionals (SQHP), the Cognitive Appraisal Scale (CAS) and the General Health Questionnaire-12 (GHQ-12). Validity and reliability issues were considered with statistical analysis (i.e., confirmatory factor analysis, convergent validity and composite reliability) that revealed adequate values for all of the instruments, namely a six-factor structure for the SQHP, a five-factor structure for the CAS and a two-factor structure for the GHQ-12. In conclusion, this study proposes three consistent instruments that may be useful for analysing nurses' adaptation to work contexts.

  12. How Can We Bring Public Health in All Policies? Strategies for Healthy Societies

    Science.gov (United States)

    Bert, Fabrizio; Scaioli, Giacomo; Gualano, Maria Rosaria; Siliquini, Roberta

    2015-01-01

    New scenarios are emerging in the European and worldwide context: the ageing of society, the climate changes, the increasing of health inequalities and the financial crisis. In this context, the scientific community and the decision-makers agree on the role of health in all policies (HiAP) strategy in improving the population’s health. The HiAP takes into account factors not strictly related to health but with important health consequences. To bring public health in all policies a change is needed, but there are some obstacles to overcome: for instance, the lack of evidence regarding the governance tools and frameworks for HiAP, the difficulty of convincing stakeholders and producing a cultural change in the political positioning of decision-makers. Consequently, it is necessary: i) to implement stronger and responsible decision-support approaches, such as health impact assessment and health technology assessment; ii) to encourage and coordinate all relevant sectors in playing their part in reducing health gaps within the European Union; iii) to strengthen cooperation and make better use of existing networks and existing public health and related institutions. The final aim will be to monitor the impact of the health determinants in order to promote the effective implementation of HiAP approach. Significance for public health This paper makes public health professionals aware of the pivotal role that they could play in reducing health inequalities and in helping to overcome the crisis of the European health systems. It discusses how, thanks to a systematic approach based on new instruments like health impact assessment and health technology assessment, and thanks also to a stronger cooperation among stakeholders and policy makers, it is possible to monitor the health determinants and consequently to bring health in all policies. PMID:25918692

  13. Corporate philanthropy, political influence, and health policy.

    Directory of Open Access Journals (Sweden)

    Gary J Fooks

    Full Text Available BACKGROUND: The Framework Convention of Tobacco Control (FCTC provides a basis for nation states to limit the political effects of tobacco industry philanthropy, yet progress in this area is limited. This paper aims to integrate the findings of previous studies on tobacco industry philanthropy with a new analysis of British American Tobacco's (BAT record of charitable giving to develop a general model of corporate political philanthropy that can be used to facilitate implementation of the FCTC. METHOD: Analysis of previously confidential industry documents, BAT social and stakeholder dialogue reports, and existing tobacco industry document studies on philanthropy. RESULTS: The analysis identified six broad ways in which tobacco companies have used philanthropy politically: developing constituencies to build support for policy positions and generate third party advocacy; weakening opposing political constituencies; facilitating access and building relationships with policymakers; creating direct leverage with policymakers by providing financial subsidies to specific projects; enhancing the donor's status as a source of credible information; and shaping the tobacco control agenda by shifting thinking on the importance of regulating the market environment for tobacco and the relative risks of smoking for population health. Contemporary BAT social and stakeholder reports contain numerous examples of charitable donations that are likely to be designed to shape the tobacco control agenda, secure access and build constituencies. CONCLUSIONS AND RECOMMENDATIONS: Tobacco companies' political use of charitable donations underlines the need for tobacco industry philanthropy to be restricted via full implementation of Articles 5.3 and 13 of the FCTC. The model of tobacco industry philanthropy developed in this study can be used by public health advocates to press for implementation of the FCTC and provides a basis for analysing the political effects of

  14. Burden of disease in Japan: using national and subnational data to inform local health policy.

    Science.gov (United States)

    Gilmour, Stuart; Liao, Yi; Bilano, Ver; Shibuya, Kenji

    2014-05-01

    The Global Burden of Disease (GBD) study has been instrumental in guiding global health policy development since the early 1990s. The GBD 2010 project provided rich information about the key causes of mortality, disability-adjusted life years, and their associated risk factors in Japan and provided a unique opportunity to incorporate these data into health planning. As part of the latest update of this project, GBD 2013, the Japanese GBD collaborators plan to update and refine the available burden of disease data by incorporating sub-national estimates of the burden of disease at the prefectural level. These estimates will provide health planners and policy makers at both the national and prefectural level with new, more refined tools to adapt local public health initiatives to meet the health needs of local populations. Moreover, they will enable the Japanese health system to better respond to the unique challenges in their rapidly aging population and as a complex combination of non-communicable disease risk factors begin to dominate the policy agenda. Regional collaborations will enable nations to learn from the experiences of other nations that may be at different stages of the epidemiological transition and have different exposure profiles and associated health effects. Such analyses and improvements in the data collection systems will further improve the health of the Japanese, maintain Japan's excellent record of health equity, and provide a better understanding of the direction of health policy in the region.

  15. Policy instruments for development of wind power in Sweden; Styrmedel foer vindkraftens utveckling i Sverige

    Energy Technology Data Exchange (ETDEWEB)

    Aastrand, Kerstin; Neij, Lena

    2003-07-01

    It is often believed that energy policy and policy instruments can play a significant role in the transition towards sustainable energy by stimulating and accelerating the development and deployment of new energy technologies. However, despite the known need for, and benefits of, new energy technologies their market introduction and expansion is often slow. Wind power has been on the political agenda since the 1970s in several European countries as well as in other countries throughout the world. However, the technology and market development of wind power has been very different in these countries. Despite three decades of policy intervention the installed capacity in Sweden was only 265 MW in 2000, compared with 6,107 MW in Germany, 2,836 MW in Spain and 2,341 MW in Denmark. This report analyses the effects of policy instruments on wind power development in Sweden and identifies possible reasons why wind power has not been installed to a greater extent. The analysis is based on an empirical example of a socio technological system-based approach to evaluation of technology and market development for new energy technologies; i.e. an approach focused on the technological system including the actors, institutions and organizations that build, drive and utilise it and the economic and legal framework that regulates it. The aim is to assess the impact on technology and market development and to discuss the relatively late and slow wind power development in Sweden. The report also examines the achievement of governmental energy policy goals. Using the socio-technological systems approach we analyse Swedish policy programmes and wind power development between 1975 and 2000. The political and economic framework is identified. The discussion of the political and economic frameworks is limited to public policy goals and policy instruments. The policy focus is set to policy instruments aimed for technology and market development of wind power, such as research and

  16. How federalism shapes public health financing, policy, and program options.

    Science.gov (United States)

    Ogden, Lydia L

    2012-01-01

    In the United States, fiscal and functional federalism strongly shape public health policy and programs. Federalism has implications for public health practice: it molds financing and disbursement options, including funding formulas, which affect allocations and program goals, and shapes how funding decisions are operationalized in a political context. This article explores how American federalism, both fiscal and functional, structures public health funding, policy, and program options, investigating the effects of intergovernmental transfers on public health finance and programs.

  17. The impact of social science research on health policy.

    Science.gov (United States)

    Orosz, E

    1994-11-01

    The relationship between research and health policy is discussed from a policy process perspective, describing communication problems in the course of policy formulation, implementation and evaluation. Policy process is often expected by researchers to be rational, having logical sequence of steps and the objective evaluation of alternatives based on scientific knowledge. In fact, policies are often formulated without clear problem identification or based on wrong assumption. The timing of research and policy-making differs. Policy-makers need to respond quickly. Evaluations may be regarded by politicians as embarrassing if they point to a need for significant change. It is not satisfactory to consider only research and policy-making: their relationship is influenced by the media, different interest groups and by the general public. Health policy formulation is embedded in the general policy environment of particular societies. Some countries have a long tradition of consensus-building, while in others health reforms have been formulated and introduced in a centralized way. Traditional bio-medical thinking influences health policy-makers. The importance of social and political acceptability tends to be overlooked. The paper emphasizes that we are experiencing an era of scarcity of resources and growing tension concerning allocation decisions. Existing institutions provide insufficient incentives for policy-makers and researchers to promote public dialogue about such issues. The paper concludes that there is a need for new approaches to policy development and implementation, new structures in policy-making, changes in research financing and co-operation between disciplines and new structures for public participation in policy-making. Research should facilitate more open and democratic dialogue about policy options and the consequences of alternative choices.

  18. Social media for public health: an exploratory policy analysis.

    Science.gov (United States)

    Fast, Ingrid; Sørensen, Kristine; Brand, Helmut; Suggs, L Suzanne

    2015-02-01

    To accomplish the aims of public health practice and policy today, new forms of communication and education are being applied. Social media are increasingly relevant for public health and used by various actors. Apart from benefits, there can also be risks in using social media, but policies regulating engagement in social media is not well researched. This study examined European public health-related organizations' social media policies and describes the main components of existing policies. This research used a mixed methods approach. A content analysis of social media policies from European institutions, non-government organizations (NGOs) and social media platforms was conducted. Next, individuals responsible for social media in their organization or projects completed a survey about their social media policy. Seventy-five per cent of institutions, NGOs and platforms had a social media policy available. The primary aspects covered within existing policies included data and privacy protection, intellectual property and copyright protection and regulations for the engagement in social media. Policies were intended to regulate staff use, to secure the liability of the institution and social responsibility. Respondents also stressed the importance of self-responsibility when using social media. This study of social media policies for public health in Europe provides a first snapshot of the existence and characteristics of social media policies among European health organizations. Policies tended to focus on legal aspects, rather than the health of the social media user. The effect of such policies on social media adoption and usage behaviour remains to be examined. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  19. Social determinants of health and health equity policy research: exploring the use, misuse, and nonuse of policy analysis theory.

    Science.gov (United States)

    Embrett, Mark G; Randall, G E

    2014-05-01

    Despite a dramatic growth in SDH/HE (social determinants of health/health equity) public policy research and demonstrated government interest in promoting equity in health policies, health inequities are actually growing among some populations and there is little evidence that "healthy public policies" are being adopted and implemented. Moreover, these issues are typically failing to even reach governments' policy agendas, which is a critical step towards serious debate and the identification of policy options. This systematic review pursues three main objectives. First, is to identify barriers to SDH/HE issues reaching the government policy agenda. Second, to evaluate the characteristics of peer-reviewed research articles that utilize common policy analysis theories. And third, to determine the extent to which the SDH/HE literature utilizes common policy analysis theories. Our systematic review, conducted in June 2012, identified 6200 SDH/HE related articles in the peer-reviewed literature; however, only seven articles explicitly used a commonly recognized policy analysis theory to inform their analysis. Our analysis revealed that the SDH/HE policy literature appears to be focused on advocacy rather than analysis and that the use of policy analysis theory is extremely limited. Our results also suggest that when such theories are incorporated into an analysis they are often not comprehensively employed. We propose explanations for this non-use and misuse of policy analysis theory, and conclude that researchers may have greater influence in helping to get SDH/HE issues onto government policy agendas if they gain a greater understanding of the policy process and the value of incorporating policy analysis theories into their research. Using a policy analysis lens to help identify why healthy public policies are typically not being adopted is an important step towards moving beyond advocacy to understanding and addressing some of the political barriers to reforms

  20. COMMENTARY: GLOBALIZATION, HEALTH SECTOR REFORM, AND THE HUMAN RIGHT TO HEALTH: IMPLICATIONS FOR FUTURE HEALTH POLICY.

    Science.gov (United States)

    Schuftan, Claudio

    2015-01-01

    The author here distills his long-time personal experience with the deleterious effects of globalization on health and on the health sector reforms embarked on in many of the more than 50 countries where he has worked in the last 25 years. He highlights the role that the "human right to health" framework can and should play in countering globalization's negative effects on health and in shaping future health policy. This is a testimonial article.

  1. Retaining physicians in Lithuania: integrating research and health policy.

    Science.gov (United States)

    Starkiene, Liudvika; Macijauskiene, Jurate; Riklikiene, Olga; Stricka, Marius; Padaiga, Zilvinas

    2013-04-01

    Many of the strategic planning studies worldwide have made recommendations to the policy makers on the steps to be taken in eliminating the perceived shortages of physician workforce or in improving their distribution and retention. Policy makers have also considered various policy interventions to ensure adequate numbers of physicians. This study reviewed the research evidence and health policy decisions taken from 2000 to 2010 in Lithuania and evaluated the chronological links over time between scientific recommendations and policy decisions. From the analysis it would seem that Lithuania's success in retaining physicians between 2000 and 2010 was influenced by the timely implementation of particular research recommendations, such as increased salaries and increased enrolment to physician training programmes. In addition were the health policy interventions such as health sector reform, change in the legal status of medical residents and establishment of professional re-entry programmes. Based on this evidence it is recommended that policy makers in Lithuania as well as in other countries should consider comprehensive and systematic health policy approaches that combine and address various aspects of physician training, retention, geographic mal-distribution and emigration. Implementation of such an inclusive policy however is impossible without the integration of research into strategic decision making in workforce planning and effective health policy interventions.

  2. [Developing a national health policy: a realistic ambition].

    Science.gov (United States)

    Lopez, Alain

    2012-01-01

    The current national health policy in France is almost impossible to pin down and define, spread as it is across thirty or so schemes and a hundred or so targets set by a law adopted in 2004. Yet the current legislation defines the national health policy as a standard reference for public policies developed and implemented by the Ministry of Health and associated bodies. In addition, the current policy involves little consultation and is not systematically monitored and evaluated. Developing an interdepartmental health policy combining several intervention strategies and using different regulation tools may seem like an impossible task. It may also seem somewhat imprudent when it claims to define priorities and strategies. In order to overcome these difficulties and inherent contradictions, we need to develop a policy based on three key elements (a strategy, plans and policies, and policy decentralization and devolution). However, it is not enough to merely develop a framework; it is also important to define the steering and oversight plan, the consultation process and a monitoring and evaluation system. The foundations of a policy based on these principles have already been laid. The authorities simply need to continue along the lines of recent policy developments, including the creation of regional agencies (ARS), the creation of a national steering committee, and the various public health plans developed over the last 20 years.

  3. Mental health policy--stumbling in the dark?

    Science.gov (United States)

    Crosbie, David W

    2009-02-16

    Over the past 15 years, governments have agreed to a series of National Mental Health Plans. These national strategies and plans have set goals and discussed the importance of monitoring and evaluation. Despite this ongoing national collaborative framework, Australia's mental health policy lacks real accountability and relies largely on limited mental health service systems data. The lack of outcome data represents a critical gap in knowledge for mental health policy, planning and practice. Resistance from current stakeholders and a lack of investment in research and monitoring capacity are preventing more rigorous ongoing monitoring of mental health policy. The new Rudd Government appears to be shifting the emphasis towards measuring the outcomes of national policy in health, housing and employment. Measuring such outcomes will guide government decision making and ultimately improve mental health services.

  4. Economic crisis and health policy in the Netherlands.

    Science.gov (United States)

    Juffermans, P

    1984-01-01

    Beginning with a brief historical overview of health policy in the Netherlands from 1945-1960 (a period of restoration of the capitalist economy after World War II) until 1960-1970 (a period of capitalist expansion), this paper discusses the health policy of the Dutch state under the present conditions of economic crisis. The main characteristics of this policy are growing state intervention, reorganization of the decision-making process, deinstitutionalization of health care, a laissez-faire policy with regard to services in the so-called first echelon of the health sector, reprivatization of health costs, and an ideological emphasis on individual responsibility for health and self-care. The paper concludes with a discussion of the various strategies proposed for the health sector by the Left and the connection between prevention and social struggle.

  5. Instrumentation

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    Journal Scope:Instrumentation is a high quality open access peer reviewed research journal.Authors are solicited to contribute to these journals by submitting articles that illustrate most up-to-date research results,projects,surveying works and industrial experiences that describe significant advances in the instrumental science.The mission of the Instrumentation is to provide a platform for the researchers,academicians,

  6. World Health Organization global policy for improvement of oral health--World Health Assembly 2007

    DEFF Research Database (Denmark)

    Petersen, Poul Erik

    2008-01-01

    and the promotion of oral health needs to be integrated with chronic disease prevention and general health promotion as the risks to health are linked. The World Health Assembly (WHA) and the Executive Board (EB) are supreme governance bodies of WHO and for the first time in 25 years oral health was subject...... to discussion by those bodies in 2007. At the EB120 and WHA60, the Member States agreed on an action plan for oral health and integrated disease prevention, thereby confirming the approach of the Oral Health Programme. The policy forms the basis for future development or adjustment of oral health programmes...

  7. Promoting LGBT health and wellbeing through inclusive policy development.

    Science.gov (United States)

    Mulé, Nick J; Ross, Lori E; Deeprose, Barry; Jackson, Beth E; Daley, Andrea; Travers, Anna; Moore, Dick

    2009-05-15

    In this paper we argue the importance of including gender and sexually diverse populations in policy development towards a more inclusive form of health promotion. We emphasize the need to address the broad health and wellbeing issues and needs of LGBT people, rather than exclusively using an illness-based focus such as HIV/AIDS. We critically examine the limitations of population health, the social determinants of health (SDOH), and public health goals, in light of the lack of recognition of gender and sexually diverse individuals and communities. By first acknowledging the unique health and social care needs of LGBT people, then employing anti-oppressive, critical and intersectional analyses we offer recommendations for how to make population health perspectives, public health goals, and the design of public health promotion policy more inclusive of gender and sexual diversity. In health promotion research and practice, representation matters. It matters which populations are being targeted for health promotion interventions and for what purposes, and it matters which populations are being overlooked. In Canada, current health promotion policy is informed by population health and social determinants of health (SDOH) perspectives, as demonstrated by Public Health Goals for Canada. With Canada's multicultural makeup comes the challenge of ensuring that diverse populations are equitably and effectively recognized in public health and health promotion policy.

  8. Promoting LGBT health and wellbeing through inclusive policy development

    Directory of Open Access Journals (Sweden)

    Daley Andrea

    2009-05-01

    Full Text Available Abstract In this paper we argue the importance of including gender and sexually diverse populations in policy development towards a more inclusive form of health promotion. We emphasize the need to address the broad health and wellbeing issues and needs of LGBT people, rather than exclusively using an illness-based focus such as HIV/AIDS. We critically examine the limitations of population health, the social determinants of health (SDOH, and public health goals, in light of the lack of recognition of gender and sexually diverse individuals and communities. By first acknowledging the unique health and social care needs of LGBT people, then employing anti-oppressive, critical and intersectional analyses we offer recommendations for how to make population health perspectives, public health goals, and the design of public health promotion policy more inclusive of gender and sexual diversity. In health promotion research and practice, representation matters. It matters which populations are being targeted for health promotion interventions and for what purposes, and it matters which populations are being overlooked. In Canada, current health promotion policy is informed by population health and social determinants of health (SDOH perspectives, as demonstrated by Public Health Goals for Canada. With Canada's multicultural makeup comes the challenge of ensuring that diverse populations are equitably and effectively recognized in public health and health promotion policy.

  9. Measuring social exclusion in routine public health surveys: construction of a multidimensional instrument.

    Directory of Open Access Journals (Sweden)

    Addi P L van Bergen

    Full Text Available INTRODUCTION: Social exclusion is considered a major factor in the causation and maintenance of health inequalities, but its measurement in health research is still in its infancy. In the Netherlands the Institute for Social Research (SCP developed an instrument to measure the multidimensional concept of social exclusion in social and economic policy research. Here, we present a method to construct a similar measure of social exclusion using available data from public health surveys. METHODS: Analyses were performed on data from the health questionnaires that were completed by 20,877 adults in the four largest cities in the Netherlands. From each of the four questionnaires we selected the items that corresponded to those of the SCP-instrument. These were entered into a nonlinear canonical correlation analysis. The measurement properties of the resulting indices and dimension scales were assessed and compared to the SCP-instrument. RESULTS: The internal consistency of the indices and most of the dimension scales were adequate and the internal structure of the indices was as expected. Both generalisabiliy and construct validity were good: in all datasets strong associations were found between the index and a number of known risk factors of social exclusion. A limitation of content validity was that the dimension "lack of normative integration" could not be measured, because no relevant items were available. CONCLUSIONS: Our findings indicate that a measure for social exclusion can be constructed with available health questionnaires. This provides opportunities for application in public health surveillance systems in the Netherlands and elsewhere in the world.

  10. Are migrants health policies aimed at improving access to quality healthcare? An analysis of Spanish policies.

    Science.gov (United States)

    Vázquez, María Luisa; Terraza-Núñez, Rebeca; S-Hernández, Silvia; Vargas, Ingrid; Bosch, Lola; González, Andrea; Pequeño, Sandra; Cantos, Raquel; Martínez, Juan Ignacio; López, Luís Andrés

    2013-12-01

    Although until April 2012, all Spanish citizens regardless of their origin, residence status and work situation were entitled to health care, available evidence suggested inadequate access for immigrants. Following the Aday and Andersen model, we conducted an analysis of policy elements that affect immigrants' access to health care in Spain, based on documentary analysis of national policies and selected regional policies related to migrant health care. Selected documents were (a) laws and plans in force at the time containing migrant health policies and (b) evaluations. The analysis included policy principles, objectives, strategies and evaluations. Results show that the national and regional policies analyzed are based on the principle that health care is a right granted to immigrants by law. These policies include strategies to facilitate access to health care, reducing barriers for entry to the system, for example simplifying requirements and raising awareness, but mostly they address the necessary qualities for services to be able to attend to a more diverse population, such as the adaptation of resources and programs, or improved communication and training. However, limited planning was identified in terms of their implementation, necessary resources and evaluation. In conclusion, the policies address relevant barriers of access for migrants and signal improvements in the health system's responsiveness, but reinforcement is required in order for them to be effectively implemented.

  11. Policies on Conflicts of Interest in Health Care Guideline Development: A Cross-Sectional Analysis

    Science.gov (United States)

    Morciano, Cristina; Basevi, Vittorio; Faralli, Carla; Hilton Boon, Michele; Tonon, Sabina; Taruscio, Domenica

    2016-01-01

    Objective To assess whether organisations that develop health care guidelines have conflict of interest (COI) policies and to review the content of the available COI policies. Methods Survey and content analysis of COI policies available in English, French, Spanish, and Italian conducted between September 2014 and June 2015. A 24-item data abstraction instrument was created on the basis of guideline development standards. Results The survey identified 29 organisations from 19 countries that met the inclusion criteria. From these organisations, 19 policies were eligible for inclusion in the content analysis. Over one-third of the policies (7/19, 37%) did not report or did not clearly report whether disclosure was a prerequisite for membership of the guideline panel. Strategies for the prevention of COI such as divestment were mentioned by only two organisations. Only 21% of policies (4/19) used criteria to determine whether an interest constitutes a COI and to assess the severity of the risk imposed. Conclusions The finding that some organisations, in contradiction of widely available standards, still do not have COI policies publicly available is concerning. Also troubling were the findings that some policies did not clearly report critical steps in obtaining, managing and communicating disclosure of relationships of interest. This in addition to the variability encountered in content and accessibility of COI policies may cause confusion and distrust among guideline users. It is in the interest of guideline users and developers to design an agreed-upon, comprehensive, clear, and accessible COI policy. PMID:27846255

  12. Policy Instruments to Improve Energy Performance of Existing Owner Occupied Dwellings

    Directory of Open Access Journals (Sweden)

    Lorraine Colette Murphy

    2016-11-01

    Full Text Available The aim of this thesis is to add knowledge to the role and impact of policy instruments in meeting energy performance ambition in the existing owner occupied housing stock. The focus was instruments available in the Netherlands in 2011 and 2012. These instruments represented the ‘on the ground’ efforts to meet climate change targets and many continue to do so today in the same or slightly altered forms. At international level there is a recognized need to keep global temperatures within the range of 1.5 - 2°C above pre-industrial levels (Carrington, 2016. At European level, the 2020 package contains a series of binding legislation to help the EU meet its more immediate climate and energy targets. 2020 targets include 20% reduction in greenhouse gas emission, 20% of EU energy obtained from renewable sources and 20% improvement in energy efficiency. 2020 targets for the Netherlands are a 20% reduction in greenhouse gas emissions and a 14% increase in energy generation from renewable sources (Vringer et al., 2014. A raft of policies has been produced over the last number of decades from international to local level to orientate action towards targets. At European level the Energy Performance of Buildings Directive (EPBD drives efforts at reducing energy among one of the biggest players, the building sector. By requiring a mandatory certificate at the point of sale and rent of buildings and making regulatory demands on existing buildings the EPBD upped the ante of what could be expected from the building sector, but especially the existing dwelling stock. National governments have already been tackling existing dwellings for decades propelled by the energy crisis and later by climate change policy. Information campaigns, subsidies, energy taxes, energy loans and tailored advice are among the instruments that have been available to homeowners to carry out works on their dwellings to reduce energy consumption. In recent

  13. Assessing Patient Participation in Health Policy Decision-Making in Cyprus

    Directory of Open Access Journals (Sweden)

    Kyriakos Souliotis

    2016-08-01

    Full Text Available Although the importance of patient participation in the design and evaluation of health programs and services is well-documented, there is scarcity of research with regard to patient association (PA participation in health policy decision-making processes. To this end, the present study aimed to validate further a previously developed instrument as well as to investigate the degree of PA participation in health policy decision-making in Cyprus. A convenient sample of 114 patients-members of patients associations took part in the study. Participants were recruited from an umbrella organization, the Pancyprian Federation of Patient Associations and Friends (PFPA. PA participation in health policy decision-making was assessed with the Health Democracy Index (HDI, an original 8-item tool. To explore its psychometric properties, Cronbach α was computed as regards to its internal consistency, while its convergent validity was tested against a self-rated question enquiring about the degree of PA participation in health policy decision-making. The findings revealed that the HDI has good internal consistency and convergent validity. Furthermore, PAs were found to participate more in consultations in health-related organizations and the Ministry of Health (MoH as well as in reforms or crucial decisions in health policy. Lower levels were documented with regard to participation in hospital boards, ethics committees in clinical trials and health technology assessment (HTA procedures. Overall, PA participation levels were found to be lower than the mid-point of the scale. Targeted interventions aiming to facilitate patients’ involvement in health policy decision-making processes and to increase its impact are greatly needed in Cyprus.

  14. Food and beverage policies and public health ethics.

    Science.gov (United States)

    Resnik, David B

    2015-06-01

    Government food and beverage policies can play an important role in promoting public health. Few people would question this assumption. Difficult questions can arise, however, when policymakers, public health officials, citizens, and businesses deliberate about food and beverage policies, because competing values may be at stake, such as public health, individual autonomy, personal responsibility, economic prosperity, and fairness. An ethically justified policy strikes a reasonable among competing values by meeting the following criteria: (1) the policy serves important social goal(s); (2) the policy is likely to be effective at achieving those goal(s); (3) less burdensome options are not likely to be effective at achieving the goals; (4) the policy is fair.

  15. Instrumentation

    Energy Technology Data Exchange (ETDEWEB)

    Decreton, M

    2001-04-01

    SCK-CEN's research and development programme on instrumentation involves the assessment and the development of sensitive measurement systems used within a radiation environment. Particular emphasis is on the assessment of optical fibre components and their adaptability to radiation environments. The evaluation of ageing processes of instrumentation in fission plants, the development of specific data evaluation strategies to compensate for ageing induced degradation of sensors and cable performance form part of these activities. In 2000, particular emphasis was on in-core reactor instrumentation applied to fusion, accelerator driven and water-cooled fission reactors. This involved the development of high performance instrumentation for irradiation experiments in the BR2 reactor in support of new instrumentation needs for MYRRHA, and for diagnostic systems for the ITER reactor.

  16. Invited Commentary: Using Financial Credits as Instrumental Variables for Estimating the Causal Relationship Between Income and Health.

    Science.gov (United States)

    Pega, Frank

    2016-05-01

    Social epidemiologists are interested in determining the causal relationship between income and health. Natural experiments in which individuals or groups receive income randomly or quasi-randomly from financial credits (e.g., tax credits or cash transfers) are increasingly being analyzed using instrumental variable analysis. For example, in this issue of the Journal, Hamad and Rehkopf (Am J Epidemiol. 2016;183(9):775-784) used an in-work tax credit called the Earned Income Tax Credit as an instrument to estimate the association between income and child development. However, under certain conditions, the use of financial credits as instruments could violate 2 key instrumental variable analytic assumptions. First, some financial credits may directly influence health, for example, through increasing a psychological sense of welfare security. Second, financial credits and health may have several unmeasured common causes, such as politics, other social policies, and the motivation to maximize the credit. If epidemiologists pursue such instrumental variable analyses, using the amount of an unconditional, universal credit that an individual or group has received as the instrument may produce the most conceptually convincing and generalizable evidence. However, other natural income experiments (e.g., lottery winnings) and other methods that allow better adjustment for confounding might be more promising approaches for estimating the causal relationship between income and health.

  17. [Human rights, an opportunity for public policies in health].

    Science.gov (United States)

    Franco-Giraldo, Alvaro; Alvarez-Dardet, Carlos

    2008-01-01

    Human rights outlined a better scenario for public policies in health. For it requires intersectoral and interdisciplinary approach. This article emphasizes the perspective of public health policies based on human rights, clarifies the relationship of public policies with the exercise of human rights, beyond the right to health. It recognizes the need to implement genuinely democratic and participatory mechanisms. It considers the universal declaration of human rights and other institutional expressions about the same as the international covenant on economic, social and cultural rights, discusses the ranking of the same and defend its entirety on the determinants of health through its cohesion and political factor. It defines a framework for public health and human rights that trend by strengthening social rights, as a new area of operation, based on public policies to address the determinants of health, upholding social justice, beyond the health field and the biological and behavioural risk factors to decisions arising from political power, exceeds medical solutions and access to health services. In conclusion, it promoting respect for human rights by greater understanding of them and strengthens the importance of indirect health policies (such as food, environment and health, violence gender) and the role of international policies in the global world.

  18. A comparative review of governments' views on objectives and policy instruments in the field of population and development.

    Science.gov (United States)

    1982-01-01

    It is possible to assess population policies through statements and decisions taken by governments as they reflect the views and commitments of political authorities in the field of population and development. Cases in the following African countries are reviewed with focus on objectives and policy instruments: Algeria; Angola; Benin; Botswana; Cape Verde; Central African Republic; Congo; Djibouti; Egypt; Ethiopia; Guinea; Gabon; Gambia; Ghana; Equatorial Guinea; Guinea-Bissau; Ivory Coast; Kenya; Lesotho; Liberia; Libyan Arab Jamahiriya; Madagascar; Malawi; Mali; Mauritania; Mauritius; Morocco; Mozambique; Niger; Nigeria; Rwanda; Sao Tome and Principe; Senegal; Seychelles; Sierra Leone; Somalia; Sudan; Swaziland; Togo; Tunisia; Uganda; United Republic of Cameroon; Tanzania; Upper Volta; Zaire; Zambia; and Zimbabwe. The information presented was drawn from the following publications: UN Population Division, "Population Policy Briefs: Current Situation in Developing Countries and Selected Territories," and UNFPA, "Population Programs and Projects," Volume 2, 1980-1981. On the basis of this review the following conclusions are drawn, which could indicate areas in which technical assistance to the Economic Commission for Africa (ECA) member States would be required: among the 50 country members of ECA, 34 countries (68%) have as a development objective the reduction of mortality, and in particular, maternal and child mortality; the 2nd important objective is stabilizing or improving spatial distribution of population, and 44% of the 50 countries have adopted this objective which involves the distribution of population from 1 place to another within a country; the 3rd important objective consists of restricting the migratory flow from rural areas to urban areas; the countries of Botswana, Egypt, Ghana, Kenya, Lesotho, Mauritius, Morocco, Rwanda, Seychelles, Swaziland, and Tunisia adopted the objective of reducing the rate of population growth; 34% of African countries

  19. Economics and Health Reform: Academic Research and Public Policy.

    Science.gov (United States)

    Glied, Sherry A; Miller, Erin A

    2015-08-01

    Two prior studies, conducted in 1966 and in 1979, examined the role of economic research in health policy development. Both concluded that health economics had not been an important contributor to policy. Passage of the Affordable Care Act offers an opportunity to reassess this question. We find that the evolution of health economics research has given it an increasingly important role in policy. Research in the field has followed three related paths over the past century-institutionalist research that described problems; theoretical research, which proposed relationships that might extend beyond existing institutions; and empirical assessments of structural parameters identified in the theoretical research. These three strands operating in concert allowed economic research to be used to predict the fiscal and coverage consequences of alternative policy paths. This ability made economic research a powerful policy force. Key conclusions of health economics research are clearly evident in the Affordable Care Act.

  20. The evolution of health-policy making in Italy.

    Science.gov (United States)

    France, George; Taroni, Francesco

    2005-01-01

    An analysis of the dynamics of health care policy in Italy suggests that in recent years the pace of change in the health care system has accelerated. Although the basic features of universalism, comprehensiveness, and funding from general taxation have remained remarkably constant, the capacity to innovate policy tools and their settings and to take account of domestic and international experience seems to have increased. The political will and capacity to combat entrenched interests may also have increased, although implementation is still weak. The imperative to contain public expenditure has heavily conditioned health policy and will continue to do so. This has occurred mainly at the national level, but as the principal locus of health-policy making progressively shifts to the regions, so too will the constraining effect of this imperative move downward. If the decentralization process continues, problems could arise due to interregional differences in capacities to formulate and implement appropriate policies and to tackle special interest groups.

  1. A qualitative analysis of environmental policy and children's health in Mexico

    Directory of Open Access Journals (Sweden)

    Ramirez Martha

    2010-03-01

    Full Text Available Abstract Background Since Mexico's joining the North American Free Trade Agreement (NAFTA and the Organization for Economic Cooperation and Development (OECD in 1994, it has witnessed rapid industrialization. A byproduct of this industrialization is increasing population exposure to environmental pollutants, of which some have been associated with childhood disease. We therefore identified and assessed the adequacy of existing international and Mexican governance instruments and policy tools to protect children from environmental hazards. Methods We first systematically reviewed PubMed, the Mexican legal code and the websites of the United Nations, World Health Organization, NAFTA and OECD as of July 2007 to identify the relevant governance instruments, and analyzed the approach these instruments took to preventing childhood diseases of environmental origin. Secondly, we interviewed a purposive sample of high-level government officials, researchers and non-governmental organization representatives, to identify their opinions and attitudes towards children's environmental health and potential barriers to child-specific protective legislation and implementation. Results We identified only one policy tool describing specific measures to reduce developmental neurotoxicity and other children's health effects from lead. Other governance instruments mention children's unique vulnerability to ozone, particulate matter and carbon monoxide, but do not provide further details. Most interviewees were aware of Mexican environmental policy tools addressing children's health needs, but agreed that, with few exceptions, environmental policies do not address the specific health needs of children and pregnant women. Interviewees also cited state centralization of power, communication barriers and political resistance as reasons for the absence of a strong regulatory platform. Conclusions The Mexican government has not sufficiently accounted for children's unique

  2. A different route to health: implications of transport policies

    Energy Technology Data Exchange (ETDEWEB)

    Dora, Carlos [World Health Organisation, European Centre for Environment and Health, Rome (Italy)

    1999-06-19

    This paper presents a review of the health implications of transport policies covering the health benefits of walking and cycling, the high level of accidents and injuries related to cars, the impact of road transport on climate change and air pollution, the noise factor, and psychosocial effects due to busy streets discouraging walking and cycling. The need to evaluate the health costs of transport policies is examined. (uk)

  3. Voluntary agreements as instruments for international environmental policy; Frivillege avtaler som internasjonalt miljoepolitisk verkemiddel

    Energy Technology Data Exchange (ETDEWEB)

    Torvanger, Asbjoern

    1997-12-31

    According to this report, voluntary agreements have a potential as instruments for environmental policy. Such agreements can be national or international. Through an international voluntary agreement the authorities in one country may make contracts with factories in another country about emission reductions against some kind of compensation. A supranational organisation of voluntary agreements may ensure equal environmental political conditions for factories in different countries and be a useful means for the regulation of environmental problems of regional or global extent. It is most realistic to establish a supranational system of voluntary agreements in a group of countries that have already institutionalized their relations, such as the European Union. 14 refs., 1 table

  4. Experience with agreements as an instrument in the climate policy; Erfaringer med avtaler som klimapolitisk virkemiddel

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-03-26

    This report discusses the experience with the use of agreements between industry and authorities in the climate and energy conservation policies in selected countries. The main purpose is to survey agreements in selected OECD countries and to evaluate the experience gained with this political instrument. Special emphasis is placed on Denmark and the Netherlands. The agreements are mainly aiming at energy conservation. In Norway, the agreements are at present primarily of relevance for emissions from the processing industries. But the experience gained in other countries on the practical realization of the agreements are relevant to Norway. 5 refs.

  5. Health care models guiding mental health policy in Kenya 1965 - 1997

    Directory of Open Access Journals (Sweden)

    Jenkins Rachel

    2010-04-01

    Full Text Available Abstract Background Mental health policy is needed to set the strategy and direction for the provision of mental health services in a country. Policy formulation does not occur in a vacuum, however, but is influenced by local and international factors in the health sector and other sectors. Methods This study was carried out in 1997 to examine the evolution of mental health policy in Kenya between 1965 and 1997 in the context of changing international concepts of health and development. Qualitative content analysis of policy documents was combined with interviews of key policy makers. Results The study showed that during the period 1965-1997 the generic health policy in Kenya changed from one based on the Medical Model in the 1960s and 1970s to one based on the Primary Health Care Model in the late 1970s and the 1980s and finally to one based on the Market Model of health care in the 1990s. The mental health policy, on the other hand, evolved from one based on the Medical Model in the 1960s to one based on the Primary Health Care Model in the 1990s, but did not embrace the Market Model of health care. This resulted in a situation in the 1990s where the mental health policy was rooted in a different conceptual model from that of the generic health policy under which it was supposed to be implemented. This "Model Muddlement" may have impeded the implementation of the mental health policy in Kenya. Conclusions Integration of the national mental health policy with the general health policy and other sector policies would be appropriate and is now underway.

  6. Beyond the art of governmentality: unmasking the distributional consequences of health policies.

    Science.gov (United States)

    Coyte, Peter C; Holmes, Dave

    2006-06-01

    The aim of this article is to critique health policy discourses that are taken for granted. This perspective will allow for the identification of 'exclusionary' health policies, which we define as policies that are thought to offer universal benefit, despite yielding adverse effects for significant groups of people in society. As such, policies that are said to be designed 'for all' frequently benefit only a subset of the population. Our intent is to highlight the distributional consequences of certain health policies that are largely institutionalized in contemporary society. We believe that these distributional effects are explicit representations of power in society and that institutions may provide individual 'choice' and 'freedom' that, in turn, yields separation as an outcome, a separating equilibrium. Specifically, if those who benefit from policies of partition are numerous and are to obtain significant advantage or incur limited costs, or if those who are adversely affected are scarce (or hidden), or the size of these adverse effects are small (or perceived to be minor), then partition becomes more likely as a 'legitimate', but exclusionary, instrument of public policy.

  7. Are Sexual and Reproductive Health Policies Designed for All?

    DEFF Research Database (Denmark)

    Ivanova, Olena; Dræbel, Tania; Tellier, Siri

    2015-01-01

    for them to influence decisions related to their health, and also to exercise their rights. This paper presents the findings from a study that explored how vulnerable groups and principles of human rights are incorporated into national sexual and reproductive health (SRH) policies of 4 selected countries...... in this study. Content analysis of SRH policies was performed using the EquiFrame analytical framework. RESULTS: The study revealed that vulnerable groups and core principles of human rights are differently addressed in SRH policies within 4 studied countries. The opinions of policy-makers on the importance...

  8. Health care policy development: a critical analysis model.

    Science.gov (United States)

    Logan, Jean E; Pauling, Carolyn D; Franzen, Debra B

    2011-01-01

    This article describes a phased approach for teaching baccalaureate nursing students critical analysis of health care policy, including refinement of existing policy or the foundation to create new policy. Central to this approach is the application of an innovative framework, the Grand View Critical Analysis Model, which was designed to provide a conceptual base for the authentic learning experience. Students come to know the interconnectedness and the importance of the model, which includes issue selection and four phases: policy focus, colleagueship analysis, evidence-based practice analysis, and policy analysis and development.

  9. Implementing health policy: lessons from the Scottish Well Mens policy initiative

    Directory of Open Access Journals (Sweden)

    Flora Douglas

    2015-12-01

    Full Text Available Background: Little is known about how health professionals translate national government health policy directives into action. This paper examines that process using the so-called Well Men's Services (WMS policy initiative as a ‘real world’ case study. The WMS were launched by the Scottish Government to address men's health inequalities. Our analysis aimed to develop a deeper understanding of policy implementation as it naturally occurred, used an analytical framework that was developed to reflect the ‘rational planning' principles health professionals are commonly encouraged to use for implementation purposes. Methods and materials: A mixed-methods qualitative enquiry using a data archive generated during the WMS policy evaluation was used to critically analyze (post hoc the perspectives of national policy makers, and local health and social care professionals about the: (a ‘policy problem’, (b interventions intended to address the problem, and (c anticipated policy outcomes. Results and conclusions: This analysis revealed four key themes: (1 ambiguity regarding the policy problem and means of intervention; (2 behavioral framing of the policy problem and intervention; (3 uncertainty about the policy evidence base and outcomes, and; (4 a focus on intervention as outcome. This study found that mechanistic planning heuristics (as a means of supporting implementation fails to grapple with the indeterminate nature of population health problems. A new approach to planning and implementing public health interventions is required that recognises the complex and political nature of health problems; the inevitability of imperfect and contested evidence regarding intervention, and, future associated uncertainties.

  10. Economic and policy instrument analyses in support of the scrap tire recycling program in Taiwan.

    Science.gov (United States)

    Chang, Ni-Bin

    2008-02-01

    Understanding the cost-effectiveness and the role of economic and policy instruments, such as the combined product tax-recycling subsidy scheme or a tradable permit, for scrap tire recycling has been of crucial importance in a market-oriented environmental management system. Promoting product (tire) stewardship on one hand and improving incentive-based recycling policy on the other hand requires a comprehensive analysis of the interfaces and interactions in the nexus of economic impacts, environmental management, environmental valuation, and cost-benefit analysis. This paper presents an assessment of the interfaces and interactions between the implementation of policy instruments and its associated economic evaluation for sustaining a scrap tire recycling program in Taiwan during the era of the strong economic growth of the late 1990s. It begins with an introduction of the management of the co-evolution between technology metrics of scrap tire recycling and organizational changes for meeting the managerial goals island-wide during the 1990s. The database collected and used for such analysis covers 17 major tire recycling firms and 10 major tire manufacturers at that time. With estimates of scrap tire generation and possible scale of subsidy with respect to differing tire recycling technologies applied, economic analysis eventually leads to identify the associated levels of product tax with respect to various sizes of new tires. It particularly demonstrates a broad perspective of how an integrated econometric and engineering economic analysis can be conducted to assist in implementing policy instruments for scrap tire management. Research findings indicate that different subsidy settings for collection, processing, and end use of scrap tires should be configured to ameliorate the overall managerial effectiveness. Removing the existing boundaries between designated service districts could strengthen the competitiveness of scrap tires recycling industry, helping to

  11. Social and health policies or interventions to tackle health inequalities in European cities : a scoping review

    NARCIS (Netherlands)

    Pons-Vigues, Mariona; Diez, Elia; Morrison, Joana; Salas-Nicas, Sergio; Hoffmann, Rasmus; Burstrom, Bo; van Dijk, Jitse P.; Borrell, Carme

    2014-01-01

    Background: Health inequalities can be tackled with appropriate health and social policies, involving all community groups and governments, from local to global. The objective of this study was to carry out a scoping review on social and health policies or interventions to tackle health inequalities

  12. Report mapping legal and policy instruments of the EU for human rights and democracy support, FRAME Deliverable 12.1

    NARCIS (Netherlands)

    Churruca Muguruza, C.; Isa, F. G.; San José, D. G.; Fernández Sánchez, P. A.; Márquez Carrasco, C.; Muñoz Nogal, E.; Nagore Casas, M.; Timmer, Alexandra

    2014-01-01

    This report is devoted to the mapping of legal and policy instruments of the EU for human rights and democracy support. In particular, it highlights the EU´s human rights priorities in terms of themes and vulnerable groups in its external action based on a review of EU policy documents and literatur

  13. Assessing EU’s Transatlantic Regulatory Powers Using the Choice of Policy Instruments as Measurement of Preference Attainment

    DEFF Research Database (Denmark)

    Löfgren, Karl; Lynggaard, Kennet

    2015-01-01

    To what extent is the European Union exercising global regulatory power? This paper investigates this question through a comparative study of two significant global policy fields: data-protection and banking with a special focus on the preferences and choice of policy instruments. Of particular...

  14. Policy Surveillance: A Vital Public Health Practice Comes of Age.

    Science.gov (United States)

    Burris, Scott; Hitchcock, Laura; Ibrahim, Jennifer; Penn, Matthew; Ramanathan, Tara

    2016-08-16

    Governments use statutes, regulations, and policies, often in innovative ways, to promote health and safety. Organizations outside government, from private schools to major corporations, create rules on matters as diverse as tobacco use and paid sick leave. Very little of this activity is systematically tracked. Even as the rest of the health system is working to build, share, and use a wide range of health and social data, legal information largely remains trapped in text files and pdfs, excluded from the universe of usable data. This article makes the case for the practice of policy surveillance to help end the anomalous treatment of law in public health research and practice. Policy surveillance is the systematic, scientific collection and analysis of laws of public health significance. It meets several important needs. Scientific collection and coding of important laws and policies creates data suitable for use in rigorous evaluation studies. Policy surveillance addresses the chronic lack of readily accessible, nonpartisan information about status and trends in health legislation and policy. It provides the opportunity to build policy capacity in the public health workforce. We trace its emergence over the past fifty years, show its value, and identify major challenges ahead. Copyright © 2016 by Duke University Press.

  15. Constructing public oral health policies in Brazil: issues for reflection

    Directory of Open Access Journals (Sweden)

    Catharina Leite Matos Soares

    2012-01-01

    Full Text Available This paper addresses the construction of public oral health policies in Brazil by reviewing the available literature. It includes a discussion of the social responses given by the Brazilian State to oral health policies and the relationship of these responses with the ideological oral health movements that have developed globally, and that have specifically influenced oral health policies in Brazil. The influence of these movements has affected a series of hegemonic practices originating from both Market Dentistry and Preventive and Social Dentistry in Brazil. Among the state activities that have been set into motion, the following stand out: the drafting of a law to regulate the fluoridation of the public water supply, and the fluoridation of commercial toothpaste in Brazil; epidemiological surveys to analyze the status of the Brazilian population's oral health; the inclusion of oral health in the Family Health Strategy (Estratégia de Saúde da Família - ESF; the drawing up of the National Oral Health Policy, Smiling Brazil (Brasil Sorridente. From the literature consulted, the progressive expansion of state intervention in oral health policies is observed. However, there remains a preponderance of hegemonic "dental" practices reproduced in the Unified Public Health Service (Sistema Único de Saúde - SUS and the Family Health Strategy.

  16. Framing and the health policy process: a scoping review.

    Science.gov (United States)

    Koon, Adam D; Hawkins, Benjamin; Mayhew, Susannah H

    2016-07-01

    Framing research seeks to understand the forces that shape human behaviour in the policy process. It assumes that policy is a social construct and can be cast in a variety of ways to imply multiple legitimate value considerations. Frames provide the cognitive means of making sense of the social world, but discordance among them forms the basis of policy contestation. Framing, as both theory and method, has proven to generate considerable insight into the nature of policy debates in a variety of disciplines. Despite its salience for understanding health policy debates; however, little is known about the ways frames influence the health policy process. A scoping review using the Arksey and O'Malley framework was conducted. The literature on framing in the health sector was reviewed using nine health and social science databases. Articles were included that explicitly reported theory and methods used, data source(s), at least one frame, frame sponsor and evidence of a given frame's effect on the health policy process. A total of 52 articles, from 1996 to 2014, and representing 12 countries, were identified. Much of the research came from the policy studies/political science literature (n = 17) and used a constructivist epistemology. The term 'frame' was used as a label to describe a variety of ideas, packaged as values, social problems, metaphors or arguments. Frames were characterized at various levels of abstraction ranging from general ideological orientations to specific policy positions. Most articles presented multiple frames and showed how actors advocated for them in a highly contested political process. Framing is increasingly an important, yet overlooked aspect of the policy process. Further analysis on frames, framing processes and frame conflict can help researchers and policymakers to understand opaque and highly charged policy issues, which may facilitate the resolution of protracted policy controversies.

  17. Instrumentation

    Energy Technology Data Exchange (ETDEWEB)

    Decreton, M

    2002-04-01

    SCK-CEN's R and D programme on instrumentation involves the development of advanced instrumentation systems for nuclear applications as well as the assessment of the performance of these instruments in a radiation environment. Particular emphasis is on the use of optical fibres as umbilincal links of a remote handling unit for use during maintanance of a fusion reacor, studies on the radiation hardening of plasma diagnostic systems; investigations on new instrumentation for the future MYRRHA accelerator driven system; space applications related to radiation-hardened lenses; the development of new approaches for dose, temperature and strain measurements; the assessment of radiation-hardened sensors and motors for remote handling tasks and studies of dose measurement systems including the use of optical fibres. Progress and achievements in these areas for 2001 are described.

  18. Sustainability and power in health promotion: community-based participatory research in a reproductive health policy case study in New Mexico.

    Science.gov (United States)

    Mendes, Rosilda; Plaza, Veronica; Wallerstein, Nina

    2016-03-01

    Health promotion programs are commonly viewed as value-free initiatives which seek to improve health, often through behavior change. An opposing view has begun to emerge that health promotion efforts, especially ones seeking to impact health policy and social determinants of health, are vulnerable to political contexts and may depend on who is in power at the time. This community-based participatory research study attempts to understand these interactions by applying a conceptual model focused on the power context, diverse stakeholder roles within this context, and the relationship of political levers and other change strategies to the sustainability of health promotion interventions aimed at health policy change. We present a case study of a health promotion coalition, New Mexico for Responsible Sex Education (NMRSE), as an example of power dynamics and change processes. Formed in 2005 in response to federal policies mandating abstinence-only education, NMRSE includes community activists, health promotion staff from the New Mexico Department of Health, and policy-maker allies. Applying an adapted Mayer's 'power analysis' instrument, we conducted semi-structured stakeholder interviews and triangulated political-context analyses from the perspective of the stakeholders.We identified multiple understandings of sustainability and health promotion policy change, including: the importance of diverse stakeholders working together in coalition and social networks; their distinct positions of power within their political contexts; the role of science versus advocacy in change processes; the particular challenges for public sector health promotion professionals; and other facilitators versus barriers to action. One problem that emerged consisted of the challenges for state employees to engage in health promotion advocacy due to limitations imposed on their activities by state and federal policies. This investigation's results include a refined conceptual model, a power

  19. Instrumentation

    Energy Technology Data Exchange (ETDEWEB)

    Decreton, M

    2000-07-01

    SCK-CEN's research and development programme on instrumentation aims at evaluating the potentials of new instrumentation technologies under the severe constraints of a nuclear application. It focuses on the tolerance of sensors to high radiation doses, including optical fibre sensors, and on the related intelligent data processing needed to cope with the nuclear constraints. Main achievements in these domains in 1999 are summarised.

  20. The California Health Policy Research Program - supporting policy making through evidence and responsive research.

    Science.gov (United States)

    Roby, Dylan H; Jacobs, Ken; Kertzner, Alex E; Kominski, Gerald F

    2014-08-01

    This article explores the creation, design, and execution of a university-based collaboration to provide responsive research and evidence to a group of diverse health care, labor, and consumer stakeholders through convening a funded series of deliberative meetings, research briefs, peer-reviewed journal articles, ad hoc data analyses, and policy analyses. Funded by the California Endowment, the California Health Policy Research Program was created by researchers at the University of California, Berkeley Center for Labor Research and Education, and the UCLA Center for Health Policy Research. The collaboration not only allowed new research and analyses to be used by stakeholders and policy makers in decision making but also allowed university researchers to receive input on the important health policy issues of the day. The guidance of stakeholders in the research and policy analysis process was vital in driving meaningful results during an important time in health policy making in California. The manuscript discusses lessons learned in building relationships with stakeholders; meeting research and analytic needs; engaging stakeholders and policy makers; building capacity for quick-turnaround data collection and analysis, dissemination and publication; and maintaining the collaboration.

  1. Cost-effective policy instruments for greenhouse gas emission reduction and fossil fuel substitution through bioenergy production in Austria

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, Johannes, E-mail: johannes.schmidt@boku.ac.at [Institute for Sustainable Economic Development, University of Natural Resources and Life Sciences, Peter Jordan Strasse 82, A-1190 Vienna (Austria); Leduc, Sylvain [International Institute for Applied Systems Analysis, Schlossplatz 1, A-2361 Laxenburg (Austria); Dotzauer, Erik [Maelardalen University, P.O. Box 883, SE-72123 Vaesteras (Sweden); Schmid, Erwin [Institute for Sustainable Economic Development, University of Natural Resources and Life Sciences, Peter Jordan Strasse 82, A-1190 Vienna (Austria)

    2011-06-15

    Climate change mitigation and security of energy supply are important targets of Austrian energy policy. Bioenergy production based on resources from agriculture and forestry is an important option for attaining these targets. To increase the share of bioenergy in the energy supply, supporting policy instruments are necessary. The cost-effectiveness of these instruments in attaining policy targets depends on the availability of bioenergy technologies. Advanced technologies such as second-generation biofuels, biomass gasification for power production, and bioenergy with carbon capture and storage (BECCS) will likely change the performance of policy instruments. This article assesses the cost-effectiveness of energy policy instruments, considering new bioenergy technologies for the year 2030, with respect to greenhouse gas emission (GHG) reduction and fossil fuel substitution. Instruments that directly subsidize bioenergy are compared with instruments that aim at reducing GHG emissions. A spatially explicit modeling approach is used to account for biomass supply and energy distribution costs in Austria. Results indicate that a carbon tax performs cost-effectively with respect to both policy targets if BECCS is not available. However, the availability of BECCS creates a trade-off between GHG emission reduction and fossil fuel substitution. Biofuel blending obligations are costly in terms of attaining the policy targets. - Highlights: > Costs of energy policies and effects on reduction of CO{sub 2} emissions and fossil fuel consumption. > Particular focus on new bioenergy production technologies such as second generation biofuels. > Spatially explicit techno-economic optimization model. > CO{sub 2} tax: high costs for reducing fossil fuel consumption if carbon capture and storage is available. > Biofuel policy: no significant reductions in CO{sub 2} emissions or fossil fuel consumption.

  2. Meeting the challenge: using policy to improve children's health.

    Science.gov (United States)

    Brush, Charles Adam; Kelly, Maggie M; Green, Denise; Gaffney, Marcus; Kattwinkel, John; French, Molly

    2005-11-01

    We reflect on the proceedings of a symposium at a conference of the Centers for Disease Control and Prevention National Center on Birth Defects and Developmental Disabilities. We present examples of bridging the gap between science and policy to achieve improvements in children's health through case studies in early hearing detection and intervention, folic acid fortification to prevent birth defects, sleep positioning recommendations to reduce infant mortality, and workplace lactation support programs. We discuss case studies that present different policy strategies (public health law and voluntary practices) for improving public health. These case studies demonstrate both the power of policy as a tool for improving children's health and the challenges of communicating public health research to policy decisionmakers.

  3. Public health understandings of policy and power: lessons from INSITE.

    Science.gov (United States)

    Fafard, Patrick

    2012-12-01

    Drug addiction is a major public health problem, one that is most acutely felt in major cities around the globe. Harm reduction and safe injection sites are an attempt to address this problem and are at the cutting edge of public health policy and practice. One of the most studied safe injection sites is INSITE located in Vancouver, British Columbia. Using INSITE as a case study, this paper argues that knowledge translation offers a limited framework for understanding the development of public health policy. This paper also argues that the experience of INSITE suggests that science and social justice, the meta-ideas that lie at the core of the public health enterprise, are an inadequate basis for a theory of public health policy making. However, on a more positive note, INSITE also shows the value of concepts drawn from the ways in which political science analyzes the policy process.

  4. Health impact assessment of transport policies in Rotterdam

    DEFF Research Database (Denmark)

    Tobollik, Myriam; Keuken, Menno; Sabel, Clive E;

    2016-01-01

    BACKGROUND: Green house gas (GHG) mitigation policies can be evaluated by showing their co-benefits to health. METHOD: Health Impact Assessment (HIA) was used to quantify co-benefits of GHG mitigation policies in Rotterdam. The effects of two separate interventions (10% reduction of private vehicle......: The evaluation of planned interventions, related to climate change policies, targeting only the transport sector can result in small co-benefits for health, if the analysis is limited to air pollution and noise. This urges to expand the analysis by including other impacts, e.g. physical activity and well...

  5. Policy and evidence in Canadian health human resources planning.

    Science.gov (United States)

    Wilson, C Ruth

    2013-01-01

    The health human resources supply in Canada swings reactively between over- and under-supply. There are numerous policy actors in this arena, each of whom could contribute to good data collection and an agreed-on process for decision-making. This could form the basis for evidence-informed policy. Absent these tools for pan-Canadian health human resources policy development, smaller health jurisdictions are experimenting with quality improvement initiatives which, when properly evaluated, can discover useful methods of aligning patient and community needs with healthcare resources.

  6. The economic impact of adolescent health promotion policies and programs.

    Science.gov (United States)

    Aratani, Yumiko; Schwarz, Susan Wile; Skinner, Curtis

    2011-12-01

    Adolescence is a critical period in the human lifecycle, a time of rapid physical and socioemotional growth and a time when individuals establish lifestyle habits and health behaviors that often endure into and have lasting effects in adulthood. Adolescent health promotion programs play a critical role in helping youth establish healthy lifestyles. In this article, we present a socio-ecological model as a framework for identifying effective policy and program areas that have a positive impact on adolescent health behaviors. Our discussion focuses on 4 key areas: reproductive health; obesity prevention; mental health and substance use, including smoking; and injury and violence prevention. We proceed with an overview of the current status of state-led adolescent health promotion policies and programs from a newly created policy database and then examine the evidence on the cost of preventable adolescent health problems and the cost-effectiveness of health promotion programs and policies. We conclude by discussing the threat posed to adolescent health promotion services and state-led policy initiatives by proposed and implemented federal and state-level budget cuts and examine the possible health and economic repercussions of reducing or eliminating these programs.

  7. Changing hospital policy from the wards: an introduction to health policy education.

    Science.gov (United States)

    Jacobsohn, Vanessa; DeArman, Maria; Moran, Patrick; Cross, Jennette; Dietz, Deidre; Allen, Rebekah; Bachofer, Sally; Dow-Velarde, Lily; Kaufman, Arthur

    2008-04-01

    Although the need for physician participation in critiquing and setting health policies is great, physician participation in health policy activities is low. Many barriers hamper physician involvement, from limited time to ignorance of their potential roles, to minimal exposure to the issue during medical education. University of New Mexico School of Medicine family medicine residents and students on ward teams were trained to ask specific questions on rounds that framed individual patient encounters as windows into broader community health and policy issues. Teams selected problems on which to intervene, with the intent of influencing hospital policies to improve health care and outcomes. Ten projects were completed in six months, four of which are presented. Resident and student accomplishments included (1) identifying a free drug formulary at the Health Care for the Homeless pharmacy to reduce readmission rates of discharged homeless patients, (2) expanding hospital outpatient pharmacy hours to reduce preventable emergency room visits for medications, (3) expanding the hospital social service workforce to address the overwhelming need to discharge indigent patients needing extended care, and (4) certifying residents and faculty to provide outpatient buprenorphine treatment as a harm-reduction intervention for opiate-addicted patients, thereby reducing preventable hospitalizations for overdose or for medical complications from illicit opiate use. Hospital health policy is made more accessible to learners if issues that generate policy discussions emerge from their daily learning environment, if learners can intervene to improve those policies within a limited timeframe, and if faculty mentors are available to guide their interventions.

  8. Municipal Risk Atlases in Mexico as policy instruments for territorial regulation

    Directory of Open Access Journals (Sweden)

    Naxhelli Ruiz Rivera

    2015-12-01

    Full Text Available Municipal Risk Atlases are one of the policy instruments that Mexican government has prioritized in the last few years in order to consolidate the territorial regulation of human settlements in the country. This paper reviews the legal, institutional conceptual and methodological developments of these documents and analyzes its current scope and limitations within the Program of Risk Prevention in Human Settlements (PRAH, which had been designed and implemented by the Ministry of Social Development (SEDESOL between 2010 and 2012, and by the Ministry of Urban, Territorial and Agrarian Development (SEDATU from 2013. The objective of the paper is to understand the conditions under which the Municipal Risk Atlases have been produced to regulate human settlements in risk-prone areas, as one of many juridical instruments that operate in the fields of land use planning and natural hazards provisions. In the first place, we review different approaches that have been used by different agents within the federal government to produce cartographic information to identify and reduce disaster risk. That includes the different concepts and methodologies used to identify different risk components (such as ‘vulnerability’, ‘affected systems’, ‘disturbances’ but also under which institutional context each of them emerge, how they relate to each other and how are they integrated with other policy devices.

  9. The Institutionalization of Universal Health Policy in Costa Rica and Current Challenges

    OpenAIRE

    2013-01-01

    Objective: To analyze the role of the Ministry of Health in Costa Rican public policy. Methods: The analysis is a case study comparing two periods (1950 - 1990 and 1990 - 2010) using qualitative data collection instruments, including review of literature and institutional documents as well as in-depth interviews and focus group discussions, all with data triangulation. Results: The analysis found important differences between two periods: before the 1990s,consecutive governments were strongly...

  10. The Institutionalization of Universal Health Policy in Costa Rica and Current Challenges

    OpenAIRE

    Jorine Muiser

    2013-01-01

    Objective: To analyze the role of the Ministry of Health in Costa Rican public policy. Methods: The analysis is a case study comparing two periods (1950 - 1990 and 1990 - 2010) using qualitative data collection instruments, including review of literature and institutional documents as well as in-depth interviews and focus group discussions, all with data triangulation. Results: The analysis found important differences between two periods: before the 1990s,consecutive governments were strongly...

  11. Health in All Policies? The case of policies to promote bicycle use in the Netherlands.

    Science.gov (United States)

    den Broeder, Lea; Scheepers, Eline; Wendel-Vos, Wanda; Schuit, Jantine

    2015-05-01

    To gather insight on how Health in All Policies (HiAP) is applied in practice, we carried out a case study on transport policies intended to stimulate a shift from car use to bicycling. We reviewed 3 years (2010, 2011, and 2012) of national budgets and policy documents in the Netherlands, followed by two focus group sessions and a second round of document analysis. We found to our surprise, given the country's history of bicycle promotion, that no HiAP approaches for bicycle promotion remain in place in national transport policies. The Netherlands may face serious challenges in the near future for facilitating bicycle use. Inclusion of health goals requires that the health sector work towards acquiring a better understanding of core values in other sector's policies.

  12. Measuring use of research evidence in public health policy: a policy content analysis.

    Science.gov (United States)

    Zardo, Pauline; Collie, Alex

    2014-05-23

    There are few Australian studies showing how research evidence is used to inform the development of public health policy. International research has shown that compensation for injury rehabilitation can have negative impacts on health outcomes. This study examined transport injury compensation policy in the Australian state of Victoria to: determine type and purpose of reference to information sources; and to identify the extent of reference to academic research evidence in transport related injury rehabilitation compensation policy. Quantitative content analysis of injury rehabilitation compensation policies (N = 128) from the Victorian state government transport accident compensation authority. The most commonly referenced types of information were Internal Policy (median = 6 references per policy), Clinical/Medical (2.5), and Internal Legislation (1). Academic Research Evidence was the least often referenced source of information. The main purpose of reference to information was to support injury treatment and rehabilitation compensation claims decision-making. Transport injury compensation policy development is complex; with multiple sources of information cited including legislation, internal policy, external policy and clinical/medical evidence. There is limited use of academic research evidence in Victorian state government injury treatment and rehabilitation compensation policies. Decisions regarding compensation for injury treatment and rehabilitation services could benefit from greater use of academic research evidence. This study is one of the first to examine the use of research evidence in existing Australian public health policy decision-making using rigorous quantitative methods. It provides a practical example of how use of research evidence in public health policy can be objectively measured.

  13. The Oregon Public Health Policy Institute: Building Competencies for Public Health Practice.

    Science.gov (United States)

    Luck, Jeff; Yoon, Jangho; Bernell, Stephanie; Tynan, Michael; Alvarado, Carla Sarai; Eversole, Tom; Mosbaek, Craig; Beathard, Candice

    2015-08-01

    The Oregon Public Health Policy Institute (PHPI) was designed to enhance public health policy competencies among state and local health department staff. The Oregon Health Authority funded the College of Public Health and Human Sciences at Oregon State University to develop the PHPI curriculum in 2012 and offer it to participants from 4 state public health programs and 5 local health departments in 2013. The curriculum interspersed short instructional sessions on policy development, implementation, and evaluation with longer hands-on team exercises in which participants applied these skills to policy topics their teams had selected. Panel discussions provided insights from legislators and senior Oregon health experts. Participants reported statistically significant increases in public health policy competencies and high satisfaction with PHPI overall.

  14. The Oregon Public Health Policy Institute: Building Competencies for Public Health Practice

    Science.gov (United States)

    Yoon, Jangho; Bernell, Stephanie; Tynan, Michael; Alvarado, Carla Sarai; Eversole, Tom; Mosbaek, Craig; Beathard, Candice

    2015-01-01

    The Oregon Public Health Policy Institute (PHPI) was designed to enhance public health policy competencies among state and local health department staff. The Oregon Health Authority funded the College of Public Health and Human Sciences at Oregon State University to develop the PHPI curriculum in 2012 and offer it to participants from 4 state public health programs and 5 local health departments in 2013. The curriculum interspersed short instructional sessions on policy development, implementation, and evaluation with longer hands-on team exercises in which participants applied these skills to policy topics their teams had selected. Panel discussions provided insights from legislators and senior Oregon health experts. Participants reported statistically significant increases in public health policy competencies and high satisfaction with PHPI overall. PMID:26066925

  15. Informed policies for Europe’s health workforce of tomorrow.

    NARCIS (Netherlands)

    Batenburg, R.

    2010-01-01

    Although it is widely acknowledged that health workforce planning is critical for health care systems, it is probably one of the least strategically planned resources. One could argue that there are good reasons for this: demand and supply of the health labour market are in constant flux, and policy

  16. Tobacco control, global health policy and development: towards policy coherence in global governance.

    Science.gov (United States)

    Collin, Jeff

    2012-03-01

    The WHO Framework Convention on Tobacco Control (FCTC) demonstrates the international political will invested in combating the tobacco pandemic and a newfound prominence for tobacco control within the global health agenda. However, major difficulties exist in managing conflicts with foreign and trade policy priorities, and significant obstacles confront efforts to create synergies with development policy and avoid tensions with other health priorities. This paper uses the concept of policy coherence to explore congruence and inconsistencies in objectives, policy, and practice between tobacco control and trade, development and global health priorities. Following the inability of the FCTC negotiations to satisfactorily address the relationship between trade and health, several disputes highlight the challenges posed to tobacco control policies by multilateral and bilateral agreements. While the work of the World Bank has demonstrated the potential contribution of tobacco control to development, the absence of non-communicable diseases from the Millennium Development Goals has limited scope to offer developing countries support for FCTC implementation. Even within international health, tobacco control priorities may be hard to reconcile with other agendas. The paper concludes by discussing the extent to which tobacco control has been pursued via a model of governance very deliberately different from those used in other health issues, in what can be termed 'tobacco exceptionalism'. The analysis developed here suggests that non-communicable disease (NCD) policies, global health, development and tobacco control would have much to gain from re-examining this presumption of difference.

  17. Tobacco control, global health policy and development: towards policy coherence in global governance

    Science.gov (United States)

    Collin, Jeff

    2015-01-01

    The WHO Framework Convention on Tobacco Control (FCTC) demonstrates the international political will invested in combating the tobacco pandemic and a newfound prominence for tobacco control within the global health agenda. However, major difficulties exist in managing conflicts with foreign and trade policy priorities, and significant obstacles confront efforts to create synergies with development policy and avoid tensions with other health priorities. This paper uses the concept of policy coherence to explore congruence and inconsistencies in objectives, policy, and practice between tobacco control and trade, development and global health priorities. Following the inability of the FCTC negotiations to satisfactorily address the relationship between trade and health, several disputes highlight the challenges posed to tobacco control policies by multilateral and bilateral agreements. While the work of the World Bank has demonstrated the potential contribution of tobacco control to development, the absence of non-communicable diseases from the Millennium Development Goals has limited scope to offer developing countries support for FCTC implementation. Even within international health, tobacco control priorities may be hard to reconcile with other agendas. The paper concludes by discussing the extent to which tobacco control has been pursued via a model of governance very deliberately different from those used in other health issues, in what can be termed ‘tobacco exceptionalism’. The analysis developed here suggests that non-communicable disease (NCD) policies, global health, development and tobacco control would have much to gain from re-examining this presumption of difference. PMID:22345267

  18. Public participation in the process of local public health policy, using policy network analysis.

    Science.gov (United States)

    Park, Yukyung; Kim, Chang-Yup; You, Myoung Soon; Lee, Kun Sei; Park, Eunyoung

    2014-11-01

    To assess the current public participation in-local health policy and its implications through the analysis of policy networks in health center programs. We examined the decision-making process in sub-health center installations and the implementation process in metabolic syndrome management program cases in two districts ('gu's) of Seoul. Participants of the policy network were selected by the snowballing method and completed self-administered questionnaires. Actors, the interactions among actors, and the characteristics of the network were analyzed by Netminer. The results showed that the public is not yet actively participating in the local public health policy processes of decision-making and implementation. In the decision-making process, most of the network actors were in the public sector, while the private sector was a minor actor and participated in only a limited number of issues after the major decisions were made. In the implementation process, the program was led by the health center, while other actors participated passively. Public participation in Korean public health policy is not yet well activated. Preliminary discussions with various stakeholders, including civil society, are needed before making important local public health policy decisions. In addition, efforts to include local institutions and residents in the implementation process with the public officials are necessary to improve the situation.

  19. Utilisation of medical technology assessment in health policy

    NARCIS (Netherlands)

    van den Heuvel, WJA; Wieringh, R; van den Heuvel, LPM

    1997-01-01

    Objective: To assess the contribution of medical technology assessment (MTA) to health policy decision making, the question has to be answered whether MTA is actually being used in decision-making processes and what factors are related to its utilisation. Design: We investigated recent Dutch policy

  20. Local enactments of national health promotion policies: A Danish case

    DEFF Research Database (Denmark)

    Wimmelmann, Camilla Lawaetz

    2017-01-01

    organisational levels. Visiting, observing and interviewing 15 policy workers from 10 municipalities during a two-year period, this study investigated what happened to a Danish national health promotion policy as it was put into practice and managed in the Danish municipalities. The analysis reveals...

  1. Environmental Public Health Policy for Asbestos in Schools: Unintended Consequences.

    Science.gov (United States)

    Corn, Jacqueline Karnell

    This book explores the history of asbestos in schools and buildings and how this issue shaped the development of public health policy. It provides insight into past policy including how and why action was taken and who caused it to be taken; it also offers guidance for the scientific and regulatory communities in the future. While explaining…

  2. Engaging trainees in shaping the future of health policy.

    Science.gov (United States)

    Atkinson, Stephen; Sachedina, Nabihah; King, Judith; Mak, Matthew; Morganstein, Louise; Mytton, Oliver T; Thomas, Justyn

    2011-04-01

    This paper presents an analysis of the views and ideas generated at a recent health policy discussion for doctors in training. This provides an illustration of the creativity and enthusiasm that trainees can bring to the policy sphere by providing unique insights and a fresh perspective.

  3. Making sense of the global health crisis: policy narratives, conflict, and global health governance.

    Science.gov (United States)

    Ney, Steven

    2012-04-01

    Health has become a policy issue of global concern. Worried that the unstructured, polycentric, and pluralist nature of global health governance is undermining the ability to serve emergent global public health interests, some commentators are calling for a more systematic institutional response to the "global health crisis." Yet global health is a complex and uncertain policy issue. This article uses narrative analysis to explore how actors deal with these complexities and how uncertainties affect global health governance. By comparing three narratives in terms of their basic assumptions, the way they define problems as well as the solutions they propose, the analysis shows how the unstructured pluralism of global health policy making creates a wide scope of policy conflict over the global health crisis. This wide scope of conflict enables effective policy-oriented learning about global health issues. The article also shows how exclusionary patterns of cooperation and competition are emerging in health policy making at the global level. These patterns threaten effective learning by risking both polarization of the policy debate and unanticipated consequences of health policy. Avoiding these pitfalls, the analysis suggests, means creating global health governance regimes that promote openness and responsiveness in deliberation about the global health crisis.

  4. Policy for therapeutic acupuncture in an academic health center: a model for standard policy development.

    Science.gov (United States)

    Myklebust, Monica; Colson, James; Kaufman, Jacqueline; Winsauer, Jeffery; Zhang, Yu Quin; Harris, Richard E

    2006-12-01

    Acupuncture as a therapeutic modality offers multiple applications. Its effectiveness coupled with its general acceptance by conventional health care professionals makes it one of the first complementary and alternative medicine (CAM) modalities to be incorporated in an integrative approach to care. However, few centers that offer acupuncture have written standard policies to regulate its use. This lack of standard policies may impede provision of quality care, serve as a barrier to cross-institutional data collection and clinical application of that data, and may put health care professionals and institutions at risk when credentialing or malpractice liability has not been clearly addressed. Here we present a policy for acupuncture, created by a diverse group of health care professionals at the University of Michigan Health System. It may function as a generalizable template for standard policy development by institutions incorporating acupuncture.

  5. Functional Foods in Macedonia: Consumers’ Perspective and Public Health Policy

    Directory of Open Access Journals (Sweden)

    Igor Spiroski

    2013-12-01

    Conclusion: On average, Macedonian consumers have a positive attitude and high expectations of functional foods. Public health policies still lag when compared to comprehensive approach of the food industry in market placement of these products.

  6. Multinational surveys for monitoring eHealth policy implementations

    DEFF Research Database (Denmark)

    Gilstad, Heidi; Faxvaag, Arild; Hyppönen, Hannele;

    2014-01-01

    Development of multinational variables for monitoring eHealth policy implementations is a complex task and requires multidisciplinary, knowledgebased international collaboration. Experts in an interdisciplinary workshop identified useful data and pitfalls for comparative variable development...

  7. Analysis of maternal and child health policies in Malawi: The ...

    African Journals Online (AJOL)

    maternal and child health policies, we adopted a mixed qualitative research method, whereby a number ... research designs as well as a variety of methods of data collection and analysis. .... A purposive sampling technique was used to select ...

  8. Building bridges between health economics research and public policy evaluation.

    Science.gov (United States)

    Debrand, Thierry; Dourgnon, Paul

    2010-12-01

    The Institut de Recherche et Documentation en Economie de la Santé (IRDES) Workshop on Applied Health Economics and Policy Evaluation aims at disseminating health economic research's newest findings and enhancing the community's capacity to address issues that are relevant to public policy. The 2010 program consisted of 16 articles covering a vast range of topics, such as health insurance, social health inequalities and health services research. While most of the articles embedded theoretical material, all had to include empirical material in order to favor more applied and practical discussions and results. The 2010 workshop is to be the first of a series of annual workshops in Paris gathering together researchers on health economics and policy evaluation. The next workshop is to be held at IRDES in June 2011.

  9. Health policy--why research it and how: health political science.

    Science.gov (United States)

    de Leeuw, Evelyne; Clavier, Carole; Breton, Eric

    2014-09-23

    The establishment of policy is key to the implementation of actions for health. We review the nature of policy and the definition and directions of health policy. In doing so, we explicitly cast a health political science gaze on setting parameters for researching policy change for health. A brief overview of core theories of the policy process for health promotion is presented, and illustrated with empirical evidence. The key arguments are that (a) policy is not an intervention, but drives intervention development and implementation; (b) understanding policy processes and their pertinent theories is pivotal for the potential to influence policy change; (c) those theories and associated empirical work need to recognise the wicked, multi-level, and incremental nature of elements in the process; and, therefore, (d) the public health, health promotion, and education research toolbox should more explicitly embrace health political science insights. The rigorous application of insights from and theories of the policy process will enhance our understanding of not just how, but also why health policy is structured and implemented the way it is.

  10. Availability and quality of mobile health app privacy policies.

    Science.gov (United States)

    Sunyaev, Ali; Dehling, Tobias; Taylor, Patrick L; Mandl, Kenneth D

    2015-04-01

    Mobile health (mHealth) customers shopping for applications (apps) should be aware of app privacy practices so they can make informed decisions about purchase and use. We sought to assess the availability, scope, and transparency of mHealth app privacy policies on iOS and Android. Over 35,000 mHealth apps are available for iOS and Android. Of the 600 most commonly used apps, only 183 (30.5%) had privacy policies. Average policy length was 1755 (SD 1301) words with a reading grade level of 16 (SD 2.9). Two thirds (66.1%) of privacy policies did not specifically address the app itself. Our findings show that currently mHealth developers often fail to provide app privacy policies. The privacy policies that are available do not make information privacy practices transparent to users, require college-level literacy, and are often not focused on the app itself. Further research is warranted to address why privacy policies are often absent, opaque, or irrelevant, and to find a remedy.

  11. Rapid assessment of infrastructure of primary health care facilities – a relevant instrument for health care systems management

    OpenAIRE

    2015-01-01

    Background Health care infrastructure constitutes a major component of the structural quality of a health system. Infrastructural deficiencies of health services are reported in literature and research. A number of instruments exist for the assessment of infrastructure. However, no easy-to-use instruments to assess health facility infrastructure in developing countries are available. Present tools are not applicable for a rapid assessment by health facility staff. Therefore, health informatio...

  12. Measuring use of research evidence in public health policy: a policy content analysis

    OpenAIRE

    Zardo, Pauline; Collie, Alex

    2014-01-01

    Background There are few Australian studies showing how research evidence is used to inform the development of public health policy. International research has shown that compensation for injury rehabilitation can have negative impacts on health outcomes. This study examined transport injury compensation policy in the Australian state of Victoria to: determine type and purpose of reference to information sources; and to identify the extent of reference to academic research evidence in transpo...

  13. BRAZILIAN HIGHER EDUCATION - considerations for policy evaluation in health

    Directory of Open Access Journals (Sweden)

    Claudia Maffini Griboski

    2012-01-01

    Full Text Available This paper focuses on the front of the Brazilian higher education practices of evaluation, highlighting the importance of its use in academic management and institutional guarantee for the permanent monitoring of the quality of supply. With this objective discusses the trajectory of the evaluation policy of higher education with an emphasis on construction of the current National Assessment of Higher Education (Sinaes. From this perspective, conducts exploratory research with a descriptive analysis of the constituent elements of Sinaes, instruments and indicators, and evaluation results of the cycle in 2004, 2007 and 2010 in order to characterize and compare the evolution of courses in health and design improvements in its development. Finally, the comparison of these results, especially the nursing courses, the remarkable expansion in the period, shows its importance as an inducer of changing personal and professional attitudes of teachers and others involved in the educational process. It also enables the IES, proposing changes to the curriculum to meet the prospect of improving the training of students, contributing to the establishment of the evaluation culture in higher education to society to ensure reliable results on the quality and credibility of the courses offered.

  14. Instruments

    Energy Technology Data Exchange (ETDEWEB)

    Buehrer, W. [Paul Scherrer Inst. (PSI), Villigen (Switzerland)

    1996-12-31

    The present paper mediates a basic knowledge of the most commonly used experimental techniques. We discuss the principles and concepts necessary to understand what one is doing if one performs an experiment on a certain instrument. (author) 29 figs., 1 tab., refs.

  15. Instrumentation

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Journal Scope:Instrumentation is a high quality open access peer reviewed research journal,Authors are solicited to contribute to these journals by submitting articles that illustrate most up-to-date research results,projects,surveying works and industrial

  16. The Relationship between School Health Councils and School Health Policies and Programs in US Schools

    Science.gov (United States)

    Brener, Nancy D.; Kann, Laura; McManus, Tim; Stevenson, Beth; Wooley, Susan F.

    2004-01-01

    This study analyzed data from the School Health Policies and Programs Study (SHPPS) 2000 to examine the relationship between school health councils and selected school health policies and programs. SHPPS 2000 collected data from faculty and staff in a nationally representative sample of schools. About two-thirds (65.7%) of US schools have school…

  17. Let's dance: Organization studies, medical sociology and health policy.

    Science.gov (United States)

    Currie, Graeme; Dingwall, Robert; Kitchener, Martin; Waring, Justin

    2012-02-01

    This Special Issue of Social Science & Medicine investigates the potential for positive inter-disciplinary interaction, a 'generative dance', between organization studies (OS), and two of the journal's traditional disciplinary foundations: health policy and medical sociology. This is both necessary and timely because of the extent to which organizations have become a neglected topic within medical sociology and health policy analysis. We argue there is need for further and more sustained theoretical and conceptual synergy between OS, medical sociology and health policy, which provides, on the one-hand a cutting-edge and thought-provoking basis for the analysis of contemporary health reforms, and on the other hand, enables the development and elaboration of theory. We emphasize that sociologists and policy analysts in healthcare have been leading contributors to our understanding of organizations in modern society, that OS enhances our understanding of medical settings, and that organizations remain one of the most influential actors of our time. As a starting point to discussion, we outline the genealogy of OS and its application to healthcare settings. We then consider how medical sociology and health policy converge or diverge with the concerns of OS in the study of healthcare settings. Following this, we focus upon the material environment, specifically the position of business schools, which frames the generative dance between OS, medical sociology and health policy. This sets the context for introducing the thirteen articles that constitute the Special Issue of Social Science & Medicine. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. Gold Medal for Finnish Health in All Policies Book

    Directory of Open Access Journals (Sweden)

    Ray Lewis

    2014-02-01

    Full Text Available This article is a review of the book “Health in All Policies: Seizing opportunities, implementing policies” edited by Kimmo Leppo, Eeva Ollila, Sebastián Peña, Matthias Wismar, and Sarah Cook. This book (printed and online publication was published by the Finnish Ministry of Social Affairs and Health, Finland in 2013 (1. The book is freely available at http://www.euro.who.int/__data/assets/pdf_file/0007/188809/Health-in-All-Policies-final.pdf. The main features, structure, and highlighted contents of the book are briefly sketched out in this review. The book promotes understanding of a Health in All Policies (HiAP approach, the history, and the scientific evidence of effectiveness available to apply the HiAP concept in order to overcome challenges faced by policy-makers. HiAP is a relatively novel approach which arises from the traditional idea that health is not only medicine (2. The book offers lessons to policy-makers and managers on how to apply the HiAP approach. It further highlights the health sector’s role in developing healthy public policies. In addition, the book provides examples of structures to foster collaboration, coherence, and participation among stakeholders from different government portfolios and responsibilities. The book further provides invaluable insights for politicians, researchers, and civil society advocates.

  19. Family policy and inequalities in health in different welfare states.

    Science.gov (United States)

    Fosse, Elisabeth; Bull, Torill; Burström, Bo; Fritzell, Sara

    2014-01-01

    This article focuses on differences in health and welfare outcomes for families with children in three European countries, discussed in relation to national policies for child and family welfare. Data consist of policy documents and cross-national surveys. The document analysis was based on policy documents that described government policies. The statistical analyses utilize data from the European Social Survey. For the analyses in this article, a sub-sample of child families was selected from the countries Slovenia, Sweden, and the United Kingdom. Data showed that England's policy has mainly addressed socially disadvantaged groups and areas. Sweden and Slovenia are mainly developing universal policies. The United Kingdom has high scores for subjective general health, but a steep income gradient in the population. Parents in England experience the highest level of at-risk-of-poverty. Sweden generally scores well on health outcomes and on level of at-risk-of-poverty, and the gradient in self-rated general health is the mildest. Slovenia has the weakest economy, but low levels of inequality and low child at-risk-for-poverty scores. The Slovenian example suggests that not only the level of economic wealth, but also its distribution in the population, has bearings on health and life satisfaction, not least on the health of children.

  20. Immigration and Health: Law, Policy, and Ethics.

    Science.gov (United States)

    Parmet, Wendy E; Sainsbury-Wong, Lorianne; Prabhu, Maya

    2017-03-01

    Immigration poses numerous challenges for health professionals and public health lawyers. This article reviews these challenges. We begin by offering some background on immigration and health and then explain some of the reasons why immigrants are less likely than natives to have health insurance. Next we turn to a discussion of some of the particular challenges relating to the health care of refugees. We conclude by analyzing and rejecting some of the arguments that are made for discriminating against immigrants with respect to the provision of public health benefits and services.

  1. Health and foreign policy: influences of migration and population mobility.

    Science.gov (United States)

    Macpherson, Douglas W; Gushulak, Brian D; Macdonald, Liane

    2007-03-01

    International interest in the relationship between globalization and health is growing, and this relationship is increasingly figuring in foreign policy discussions. Although many globalizing processes are known to affect health, migration stands out as an integral part of globalization, and links between migration and health are well documented. Numerous historical interconnections exist between population mobility and global public health, but since the 1990s new attention to emerging and re-emerging infectious diseases has promoted discussion of this topic. The containment of global disease threats is a major concern, and significant international efforts have received funding to fight infectious diseases such as malaria, tuberculosis and HIV/AIDS (human immunodeficiency virus/acquired immune deficiency syndrome). Migration and population mobility play a role in each of these public health challenges. The growing interest in population mobility's health-related influences is giving rise to new foreign policy initiatives to address the international determinants of health within the context of migration. As a result, meeting health challenges through international cooperation and collaboration has now become an important foreign policy component in many countries. However, although some national and regional projects address health and migration, an integrated and globally focused approach is lacking. As migration and population mobility are increasingly important determinants of health, these issues will require greater policy attention at the multilateral level.

  2. Behavioral economics and health policy: understanding Medicaid's failure.

    Science.gov (United States)

    Richman, Barak D

    2005-03-01

    This Article employs a behavioral economic analysis to understand why Medicaid has failed to improve the health outcomes of its beneficiaries. It begins with a formal economic model of health care consumption and then systematically incorporates a survey of psychosocial variables to formulate explanations for persistent health disparities. This methodology suggests that consulting the literature in health psychology and intertemporal decision theory--empirical sources generally excluded from orthodox economic analysis--provides valuable material to explain certain findings in health econometrics. More significantly, the lessons from this behavioral economic approach generate useful policy considerations for Medicaid policymakers, who largely have neglected psychosocial variables in implementing a health insurance program that rests chiefly on orthodox economic assumptions. The Article's chief contributions include an expansion of the behavioral economic approach to include a host of variables in health psychology, a behavioral refinement of empirical health economics, a behavioral critique of Medicaid policy, and a menu of suggested Medicaid reforms.

  3. Stewardship in mental health policy: inspiration, influence, institution?

    Science.gov (United States)

    Brown, Lawrence D; Isett, Kimberley R; Hogan, Michael

    2010-06-01

    The venerable but amorphous concept of stewardship has lately gained prominence in discussions of public policy and management and is sometimes offered as a "strategy" with a distinctive potential to mobilize effective public leadership in the service of broad social missions. In this article we explore how stewardship may be useful to the theory and practice of mental health policy, and, reciprocally, how examples from mental health policy may elucidate the dynamics of stewardship. After examining its key political ingredients--authority, advocacy, and analysis--we discuss the practical challenges in moving stewardship from moral inspiration to institutional reality.

  4. Health Policy for Persons with Intellectual Disability: Experiences from Israel

    Directory of Open Access Journals (Sweden)

    Ilana Halperin

    2005-01-01

    Full Text Available Intellectual disability (ID is a life-long disability characterized by impaired cognitive and adaptive skills. Over the past few decades, a shift has occurred in the conceptualization and treatment of people with ID and research in health policy and health-care delivery has become increasingly global with a notable disparity between the developed and developing world. This review presents a literature overview of global health policy for ID with the intent to focus specifically on the policy and treatment within Israel. The methodology involved sites visits to care centers, discussions with stakeholders in health policy, and a literature review. We believe that Israel is in a unique position between a developed and developing culture. In particular, the distinct problems faced by the Arab and Bedouin community in terms of ID must be formally accounted for in Israel's future policies. Research from the developing world would be instructive to this end. The global approach in this presentation led to certain policy recommendations that take into account the uniqueness of Israel's position from a social, economic, religious, and demographic perspective. It is the hope that this paper will lead to an increased awareness of the challenges faced by persons with ID and their providers in all sectors of Israeli society and that the necessary policy recommendations will ultimately be adopted.

  5. Mental health policy in Eastern Europe: a comparative analysis of seven mental health systems.

    Science.gov (United States)

    Dlouhy, Martin

    2014-01-27

    The objective of this international comparative study is to describe and compare the mental health policies in seven countries of Eastern Europe that share their common communist history: Bulgaria, the Czech Republic, Hungary, Moldova, Poland, Romania, and Slovakia. The health policy questionnaire was developed and the country-specific information was gathered by local experts. The questionnaire includes both qualitative and quantitative information on various aspects of mental health policy: (1) basic country information (demography, health, and economic indicators), (2) health care financing, (3) mental health services (capacities and utilisation, ownership), (4) health service purchasing (purchasing organisations, contracting, reimbursement of services), and (5) mental health policy (policy documents, legislation, civic society). The social and economic transition in the 1990s initiated the process of new mental health policy formulation, adoption of mental health legislation stressing human rights of patients, and a strong call for a pragmatic balance of community and hospital services. In contrast to the development in the Western Europe, the civic society was suppressed and NGOs and similar organizations were practically non-existent or under governmental control. Mental health services are financed from the public health insurance as any other health services. There is no separate budget for mental health. We can observe that the know-how about modern mental health care and about direction of needed reforms is available in documents, policies and programmes. However, this does not mean real implementation. The burden of totalitarian history still influences many areas of social and economic life, which also has to be taken into account in mental health policy. We may observe that after twenty years of health reforms and reforms of health reforms, the transition of the mental health systems still continues. In spite of many reform efforts in the past, a

  6. Climate Change and Public Health Policy.

    Science.gov (United States)

    Smith, Jason A; Vargo, Jason; Hoverter, Sara Pollock

    2017-03-01

    Climate change poses real and immediate impacts to the public health of populations around the globe. Adverse impacts are expected to continue throughout the century. Emphasizing co-benefits of climate action for health, combining adaptation and mitigation efforts, and increasing interagency coordination can effectively address both public health and climate change challenges.

  7. Health care technology as a policy issue

    NARCIS (Netherlands)

    Banta, H.D.

    1994-01-01

    Health care technology has become an increasingly visible issue in many countries, primarily because of the rising costs of health care. In addition, many questions concerning quality of care are being raised. Health care technology assessment has been seen as an aid in addressing questions

  8. On Health Policy and Management (HPAM): mind the theory-policy-practice gap.

    Science.gov (United States)

    Chinitz, David P; Rodwin, Victor G

    2014-12-01

    We argue that the field of Health Policy and Management (HPAM) ought to confront the gap between theory, policy, and practice. Although there are perennial efforts to reform healthcare systems, the conceptual barriers are considerable and reflect the theory-policy-practice gap. We highlight four dimensions of the gap: 1) the dominance of microeconomic thinking in health policy analysis and design; 2) the lack of learning from management theory and comparative case studies; 3) the separation of HPAM from the rank and file of healthcare; and 4) the failure to expose medical students to issues of HPAM. We conclude with suggestions for rethinking the field of HPAM by embracing broader perspectives, e.g. ethics, urban health, systems analysis and cross-national analyses of healthcare systems.

  9. On Health Policy and Management (HPAM: Mind the Theory-Policy-Practice Gap

    Directory of Open Access Journals (Sweden)

    David Chinitz

    2014-12-01

    Full Text Available We argue that the field of Health Policy and Management (HPAM ought to confront the gap between theory, policy, and practice. Although there are perennial efforts to reform healthcare systems, the conceptual barriers are considerable and reflect the theory-policy-practice gap. We highlight four dimensions of the gap: 1 the dominance of microeconomic thinking in health policy analysis and design; 2 the lack of learning from management theory and comparative case studies; 3 the separation of HPAM from the rank and file of healthcare; and 4 the failure to expose medical students to issues of HPAM. We conclude with suggestions for rethinking the field of HPAM by embracing broader perspectives, e.g. ethics, urban health, systems analysis and cross-national analyses of healthcare systems.

  10. The Swedish national public health policy report 2010.

    Science.gov (United States)

    Linell, Anita; Richardson, Matt X; Wamala, Sarah

    2013-02-01

    In 2003, the Swedish Parliament adopted a cross-sectorial national public health policy based on the social determinants of health, with an overarching aim--to create societal conditions that will ensure good health, on equal terms, for the entire population--and eleven objective domains. At that time the policy was globally unique, and serves as guidance for public health practice at the national, regional and local levels. The development of the public health policy and the determinants of health are presented regularly in various reports by the Swedish National Institute of Public Health. This supplement is a condensed version of the 174-page Public Health Policy Report 2010, the second produced since the national policy was adopted in 2003. In order to provide a holistic approach to analysing implemented measures and providing new recommendations within the eleven objective domains of the Swedish national public health policy, we have divided these in three strategic areas. These are: Good Living Conditions, Health-Promoting Living Environments and Living Habits, and Alcohol, Illicit Drugs, Doping, Tobacco and Gambling, each described in the respective introductions for Chapters 3-5. The production of the report was supported by a common analytical model that clarified the societal prerequisites for health in the eleven objective domains. These are factors that can be influenced by political actions in order to create a change. Economic analyses have also been developed to provide a priority basis for political decisions. Analyses of the development of public health determinants were based on data from the National Public Health Survey and data delivered from about 15 various national agencies. Measures that have been implemented between 2004 and 2009 are analysed in details, as the basis for new recommendations for future measures. The introduction describes Swedish public health policy in the new millennium and how it has developed, the role of the Swedish

  11. Social, state and political society: Reflections on Mental Health Policy

    Directory of Open Access Journals (Sweden)

    Sofia Laurentino

    2014-06-01

    Full Text Available This article intends to develop a historical, theoretical and critical debate about mental health, as a social policy, resulting from the dialectical relationship between state and civil society. The adopted methodology is qualitative, consisting on a bibliographical and reflexive review, through which it aims to evaluate positions of various authors on the subject. A discussion of the historical development of the Mental Health policy in Brazil was made, emphasizing the presence of various social movements, such as the Workers in Mental Health Movement, the Sanitary Reform Movement, the Psychiatric Reform Movement and the Anti-Asylum Movement. Therefore, it is verified that society has great ability to fight for effective social policies, in order to mitigate the destructive effects of capitalism. It is concluded that, although social policy is incapable of overcoming the social order, it includes significant changes to the recognition and assurance of rights to the people deprived of wealth and power in society.

  12. Innovative market-based policy instruments for waste management: A case study on shredder residues in Belgium.

    Science.gov (United States)

    Dubois, Maarten; Hoogmartens, Rob; Van Passel, Steven; Van Acker, Karel; Vanderreydt, Ive

    2015-10-01

    In an increasingly complex waste market, market-based policy instruments, such as disposal taxes, can give incentives for sustainable progress while leaving flexibility for innovation. However, implementation of disposal taxes is often criticised by domestic waste handlers that fear to be outcompeted by competitors in other countries. The article discusses three innovative market-based instruments that limit the impact on international competitiveness: Tradable recycling credits, refunded disposal taxes and differentiated disposal taxes. All three instruments have already been implemented for distinct environmental policies in Europe. In order to illustrate how these instruments can be used for waste policy, the literature review is complemented with a case study on shredder residues from metal-containing waste streams in Belgium. The analysis shows that a conventional disposal tax remains the most efficient, simple and transparent instrument. However, if international competition is a significant issue or if political support is weak, refunded and differentiated disposal taxes can have an added value as second-best instruments. Tradable recycling credits are not an appropriate instrument for use in small waste markets with market power. In addition, refunded taxes create similar incentives, but induce lower transactions costs. © The Author(s) 2015.

  13. Draft national health policy 2015: A critical appraisal

    Directory of Open Access Journals (Sweden)

    Faruque U Ahmed

    2016-01-01

    Full Text Available Revising a health policy of any country is a periodic procedure dependent on the change of demographic profile, current health status of the population including epidemiological changes in disease prevalence pattern, and progress made under the earlier policies. Along with it, newer research revelation of the natural history of the existing and emerging health problems, availability of newer technology as well as changing sociopolitical commitment to improve the health status of the population are the driving forces in the change of policy. Draft National Health Policy (NHP 2015 is an attempt for the same. A review of the draft has been undertaken. The chapter on introduction is crisp and clear. Situation analysis of the draft is sketchy and without any reference of sources. Shifting the health goal is without any basis, and the objectives defined for the policy change are incongruous with the introduction. A detailed description does not give a clear picture but rather confuses the reader as it talks of comprehensive universal health-care services to be provided with a holistic concept but maximum emphasis is made in the implementation of a national program. Private health-care services are an area to reckon but except for mere references on the involvement in private-public mode, nothing concrete is observed, especially in the primary care level. Involvement envisaged in the secondary and tertiary levels is nebulous. The implementation health insurance program as well as regulatory mechanISM with the existing is also not defined exclusively in the context of a newer health policy.

  14. Applying Health in All Policies to obesity in South Australia.

    Science.gov (United States)

    Newman, Lareen; Ludford, Isobel; Williams, Carmel; Herriot, Michele

    2016-03-01

    Public policy strategies impact on population health by acting on the effectiveness, availability and distribution of the social determinants of health. Reducing obesity and promoting healthy weight is a key focus of governments, health promoters and researchers, and can benefit from a systems approach with 'upstream' policy action beyond the health sector. Although the literature identifies many areas for hypothetical non-health policy action, and in particular relating to food and activity environments, few have identified practical, politically viable and relatively cost-free processes by which non-health sectors would want to commit to such action. This article details how the Government of South Australia used the Health in All Policies (HiAP) approach in the SA HiAP Healthy Weight Project. It mapped the core business and policy directions of 44 state departments against research on 'what works' to address obesity. Negotiations then developed high-level policy commitments to address factors promoting healthy weight which predominantly changed ways of working rather than requiring new expenditure and also assisted departments in meeting their own goals; departmental chief executives endorsed the commitments. By starting from departmental documents, and not restricting the project to departments with more 'obvious' obesity prevention potential, we gained commitment to a broader range of policy actions than identified elsewhere; for example, for prisons, environment and botanic gardens, housing and vocational education. The SA HiAP Healthy Weight Project provides one example of a workable, evidence-based systems approach to increase commitment to practical and politically viable opportunities across government to address the non-health environments supporting healthy weight.

  15. Nursing shaping and influencing health and social care policy.

    Science.gov (United States)

    Fyffe, Theresa

    2009-09-01

    This paper seeks to consider how nursing as a profession in the United Kingdom is developing its role in shaping and influencing policy using lessons learnt from a policy study tour undertaken in the United States of America and extensive experience as a senior nurse within the government, the health service and more recently within a Professional Organization. The nursing profession faces major changes in health and health care and nurses need to be visible in the public debate about future models of health and health care. This paper critically reviews recent UK and USA literature and policy with relevance to nursing. Strategies that support nurses and nursing to influence policy are in place but more needs to be done to address all levels of nursing in order to find creative solutions that promote and increase the participation of nurses in the political process and health policy. There are lessons to be learnt in the UK from the US nursing experience. These need to be considered in the context of the UK and devolution. Although much has been achieved in positioning nurses and nursing as an influencer in the arena of policy and political decision-making, there is a need for greater co-ordination of action to ensure that nursing is actively supported in influencing and shaping health and health care policy. All leaders and other stakeholders require to play their part in considering how the actions set out in this article can be taken forward and how gaps such as education, fellowship experience and media engagement can be addressed in the future.

  16. The Mass Media Influence on the Impact of Health Policy

    Directory of Open Access Journals (Sweden)

    Cătălin BABA

    2007-02-01

    Full Text Available The theme of this study is a distinct examination of the issues regarding health policy, social representations and mass media. The analysis of the mass media influence on the impact of health policy leads to a portrayal of the related programs and the way they are received by citizens through mass media. Owing to the mass media quality to be an indicator of democracy it is very important to study its role in setting people daily agenda considering how it is able to maintain and create trends merely through recurrent messages. The issues frequently conveyed by media industry influences citizens’ interest with regard to community, producing effects on public policy. We must bear in mind that the more persistent in media they are, the more relevant for community this issues will be. The authors of the study put forward a method through which diverse programmes can be analysed. A comparative analysis of mass media and citizens’ social representations and its findings provide information about the influence between them. According to agenda setting theory and many international studies on health policy the authors conclude that mass media institution highly influence the impact of the health policy in health. Moreover, it is important to mention that the impact refers to all the stages of a policy-making: beginning with the problem identification and ending with the evaluation of the implementation process.

  17. An exploration of the theoretical concepts policy windows and policy entrepreneurs at the Swedish public health arena.

    Science.gov (United States)

    Guldbrandsson, Karin; Fossum, Bjöörn

    2009-12-01

    In John Kingdon's Policy Streams Approach policy formation is described as the result of the flow of three 'streams', the problem stream, the policy stream and the politics stream. When these streams couple, a policy window opens which facilitate policy change. Actors who promote specific solutions are labelled policy entrepreneurs. The aim of this study was to test the applicability of the Policy Streams Approach by verifying whether the theoretical concepts 'policy windows' and 'policy entrepreneurs' could be discernable in nine specified cases. Content analyses of interviews and documents related to child health promoting measures in three Swedish municipalities were performed and nine case studies were written. The policy processes preceding the municipal measures and described in the case studies were scrutinized in order to find statements related to the concepts policy windows and policy entrepreneurs. All conditions required to open a policy window were reported to be present in eight of the nine case studies, as was the most important resource of a policy entrepreneur, sheer persistence. This study shows that empirical examples of policy windows and policy entrepreneurs could be identified in child health promoting measures in Swedish municipalities. If policy makers could learn to predict the opening of policy windows, the planning of public health measures might be more straightforward. This also applies to policy makers' ability to detect actors possessing policy entrepreneur resources.

  18. Development index: analysis of the basic instrument of Croatian regional policy

    Directory of Open Access Journals (Sweden)

    Ana Perišić

    2015-06-01

    Full Text Available The development level assessment and categorization of Croatian local and regional units is based on the value of the development index which is the main instrument of Croatian regional policy. The development index is a composite indicator calculated as a weighted average of five socio-economic indicators. The goal of this paper is to analyze the uncertainty and sensitivity of the development index that arise from the procedures and indicators used in its construction. This analysis is then used to propose useful guidelines for future impovements. The methodology of the Croatian regional development index has been critically reviewed, revealing problems of multicollinearity and the existence of outliers. An empirical and relatively more objective multivariate approach for weight selection has been proposed. The uncertainty and sensitivity analysis were conducted using Monte Carlo simulations and variance-based techniques. Instead of a unique point estimate for the development level of territorial units an alternative confidence interval approach was considered.

  19. Values in Health Policy – A Concept Analysis

    Science.gov (United States)

    Shams, Lida; Akbari Sari, Ali; Yazdani, Shahram

    2016-01-01

    Background: Despite the significant role "values" play in decision-making no definition or attributes regarding the concept have been provided in health policy-making. This study aimed to clarify the defining attributes of a concept of value and its irrelevant structures in health policy-making. We anticipate our findings will help reduce the semantic ambiguities associated with the use of "values" and other concepts such as principles, criteria, attitudes, and beliefs. Methods: An extensive search of literature was carried out using electronic data base and library. The overall search strategy yielded about 1540 articles and 450 additional records. Based on traditional qualitative research, studies were purposefully selected and the coding of articles continued until data saturation was reached. Accordingly, 31 articles, 2 books, and 5 other documents were selected for the review. We applied Walker and Avant’s method of concept analysis in studying the phenomenon. Definitions, applications, attributes, antecedents, and consequences of the concept of "value in health policy-making" were extracted. We also identified similarities and differences that exist between and within them. Results: We identified eight major attributes of "value in health policy-making": ideological origin, affect one’s choices, more resistant to change over time, source of motivation, ability to sacrifice one’s interest, goal-oriented nature for community, trans-situational and subjectivity. Other features pinpointed include alternatives, antecedents, and consequences. Alternative, antecedents and consequences case may have more or fewer attributes or may lack one of these attributes and at the same time have other distinctive ones. Conclusion: Despite the use of the value framework, ambiguities still persist in providing definition of the concept value in health policy-making. Understanding the concept of value in health policy-making may provide extra theoretical support to decision

  20. Values in Health Policy – A Concept Analysis

    Directory of Open Access Journals (Sweden)

    Lida Shams

    2016-11-01

    Full Text Available Background Despite the significant role “values” play in decision-making no definition or attributes regarding the concept have been provided in health policy-making. This study aimed to clarify the defining attributes of a concept of value and its irrelevant structures in health policy-making. We anticipate our findings will help reduce the semantic ambiguities associated with the use of “values” and other concepts such as principles, criteria, attitudes, and beliefs. Methods An extensive search of literature was carried out using electronic data base and library. The overall search strategy yielded about 1540 articles and 450 additional records. Based on traditional qualitative research, studies were purposefully selected and the coding of articles continued until data saturation was reached. Accordingly, 31 articles, 2 books, and 5 other documents were selected for the review. We applied Walker and Avant’s method of concept analysis in studying the phenomenon. Definitions, applications, attributes, antecedents, and consequences of the concept of “value in health policy-making” were extracted. We also identified similarities and differences that exist between and within them. Results We identified eight major attributes of “value in health policy-making”: ideological origin, affect one’s choices, more resistant to change over time, source of motivation, ability to sacrifice one’s interest, goal-oriented nature for community, trans-situational and subjectivity. Other features pinpointed include alternatives, antecedents, and consequences. Alternative, antecedents and consequences case may have more or fewer attributes or may lack one of these attributes and at the same time have other distinctive ones. Conclusion Despite the use of the value framework, ambiguities still persist in providing definition of the concept value in health policy-making. Understanding the concept of value in health policy-making may provide extra

  1. [Sanitary regulation as part of health policy in Brazil: gaps and challenges].

    Science.gov (United States)

    Maia, Christiane; Guilhem, Dirce

    2016-05-01

    Objective To outline and discuss the main challenges for sanitary regulation contained in the federal-level Brazilian health policy. Methods For the present qualitative study, based on the analysis of public policies, information was collected from documents and interviews. Document analysis provided a historical overview of the insertion of sanitary regulation into the Brazilian health policy between 1999 and 2009 (first decade of existence of the national health surveillance agency, Anvisa). In addition, 13 interviews were carried out with actors selected for their historical, technical, or academic role in the field. Content analysis was used to define themes emerging from the materials analyzed with a focus on the "content" category, which refers to strategic and operational guidelines of policy programs, projects, initiatives, and normative framework. Results Content analysis revealed five themes that reflect the challenges to sanitary regulation in Brazil: 1) objects under regulation treated as isolated cases; 2) a Brazilian-specific model of sanitary regulation that is different from other international models; 3) ignorance regarding the role of sanitary surveillance in health care; 4) absence of an information system; and 5) absence of performance indicators and assessment tools. Conclusions Sanitary surveillance must have a mission that is disentangled from inspection tasks to become an effective instrument of health protection. For that, an information system that brings the National Sanitary Surveillance System together toward major objectives is essential. The adoption of tools for assessment of action is also required, with the establishment of adequate indicators.

  2. HEALTH POLICY INTERVENTION IN SCHOOLS PROMOTE PHYSICAL ACTIVITIES AMONG THE PUPILS

    DEFF Research Database (Denmark)

    He, Chen; Mikkelsen, Bent Egberg

    Today, more and more children are overweight or obese than ever before. Schools can play a prominent role in easing the situation. Schools have a great potential through the curriculum, health promoting programming and transportation to preventing children from becoming obese and overweight....... However schools are complex social systems that does not necessarily by themselves adapt to this new health promoting role and thus committed management support is needed. Since schools are complex organizational structures convenient organizational structure are needed to formalize the praxis...... that stakeholders at schools should perform. Policies has become the preferred organizational instrument that management can use to frame the health promoting intentions. However since schools are expected to perform more and more educational obligations, policies seem to emerge in many sub domains of the schools...

  3. Public health policies to encourage healthy eating habits: recent perspectives

    Directory of Open Access Journals (Sweden)

    Gorski MT

    2015-09-01

    Full Text Available Mary T Gorski,1 Christina A Roberto2,3 1Interfaculty Initiative in Health Policy, Harvard University, Cambridge, 2Department of Social and Behavioral Sciences, 3Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA Abstract: There is an urgent need to address unhealthy dietary patterns at the population level. Poor diet and physical inactivity are key drivers of the obesity pandemic, and they are among the leading causes of preventable death and disability in nearly every country in the world. As countries grapple with the growing obesity prevalence, many innovative policy options to reduce overeating and improve diet quality remain largely unexplored. We describe recent trends in eating habits and consequences for public health, vulnerabilities to unhealthy eating, and the role for public health policies. We reviewed recent public health policies to promote healthier diet patterns, including mandates, restrictions, economic incentives, marketing limits, information provision, and environmental defaults. Keywords: food policy, diet, obesity, public health

  4. Privacy policies for health social networking sites

    OpenAIRE

    2013-01-01

    Health social networking sites (HSNS), virtual communities where users connect with each other around common problems and share relevant health data, have been increasingly adopted by medical professionals and patients. The growing use of HSNS like Sermo and PatientsLikeMe has prompted public concerns about the risks that such online data-sharing platforms pose to the privacy and security of personal health data. This paper articulates a set of privacy risks introduced by social networking in...

  5. Organisational Factors Affecting Policy and Programme Decision Making in a Public Health Policy Environment

    Science.gov (United States)

    Zardo, Pauline; Collie, Alex; Livingstone, Charles

    2015-01-01

    Organisational factors can affect the success of interventions aimed at increasing research use. Research is needed to identify organisational factors affecting research use in specific public health policy contexts. Qualitative interviews with decision makers from a specific public health context identified a range of organisational factors that…

  6. Health gain and economic evaluation of breastfeeding policies : Model simulation

    NARCIS (Netherlands)

    Buchner FL; Hoekstra J; Rossum CTM van; CVG

    2007-01-01

    A policy aiming at increasing the percentage of breasted infants can be seen as a preventive measure, which can save health care costs.A literature review shows that breastfeeding has beneficial health effects in both the short en the longer term. Convincing evidence is found for a protective effec

  7. A geographic information system for local public health policy

    NARCIS (Netherlands)

    J.A. van Oers (Johannes Anna Maria)

    1993-01-01

    textabstractThis book deals with the development and use of a geographic information system for local public health policy. Health differences between populations in different geographical areas, large (countries) or small (city-neighbourhoods) have always been a challenge to epidemiologists and pol

  8. Overview and Summary: School Health Policies and Programs Study 2006

    Science.gov (United States)

    Kann, Laura; Brener, Nancy D.; Wechsler, Howell

    2007-01-01

    Background: The School Health Policies and Programs Study (SHPPS) 2006 is the largest, most comprehensive assessment of school health programs in the United States ever conducted. Methods: The Centers for Disease Control and Prevention conducts SHPPS every 6 years. In 2006, computer-assisted telephone interviews or self-administered mail…

  9. On policy instruments for support of micro combined heat and power

    Energy Technology Data Exchange (ETDEWEB)

    Hawkes, A.D. [Centre for Energy Policy and Technology, Imperial College London, Exhibition Road, London SW7 2AZ (United Kingdom); Leach, M.A. [Centre for Environmental Strategy, Faculty of Engineering, University of Surrey, Guildford GU2 7XH (United Kingdom)

    2008-08-15

    The performance of residential micro combined heat and power (micro-CHP) - a technology to provide heat and some electricity to individual dwellings - is generally dependent on the magnitude of household thermal energy demand. Dwellings with larger and more consistent thermal consumption perform well economically and achieve greater greenhouse gas emissions savings. Consequently, the performance of micro-CHP is dependent on the level of thermal insulation in a dwelling. Therefore, emerging policy approaches regarding energy use in the residential sector, which generally support both energy efficiency measures such as thermal insulation and adoption of micro-CHP, may inadvertently incentivise micro-CHP installation where CO{sub 2} reductions are meagre or not cost-effective. This article examines this issue in terms of the changes in economic and environmental performance that occur for three micro-CHP technologies under changing patterns of residential thermal insulation in the United Kingdom. The results of this analysis are used to comment on the structure of policy instruments that support micro-CHP. It is found that simultaneous support for energy efficiency measures and micro-CHP can be justified, but care must be taken to ensure that the heat-to-power ratio and capacity of the micro-CHP system are appropriate for the expected thermal demand of the target dwelling. (author)

  10. Modelling and optimization of proof testing policies for safety instrumented systems

    Energy Technology Data Exchange (ETDEWEB)

    Torres-Echeverria, A.C. [Department of Automatic Control and System Engineering, University of Sheffield, Mappin Street, Sheffield S1 3JD (United Kingdom)], E-mail: a.torres@sheffield.ac.uk; Martorell, S. [Department of Chemical and Nuclear Engineering, Polytechnic University of Valencia, Cami de Vera sn, 4602, Valencia (Spain); Thompson, H.A. [Department of Automatic Control and System Engineering, University of Sheffield, Mappin Street, Sheffield S1 3JD (United Kingdom)

    2009-04-15

    This paper introduces a new development for modelling the time-dependent probability of failure on demand of parallel architectures, and illustrates its application to multi-objective optimization of proof testing policies for safety instrumented systems. The model is based on the mean test cycle, which includes the different evaluation intervals that a module goes periodically through its time in service: test, repair and time between tests. The model is aimed at evaluating explicitly the effects of different test frequencies and strategies (i.e. simultaneous, sequential and staggered). It includes quantification of both detected and undetected failures, and puts special emphasis on the quantification of the contribution of the common cause failure to the system probability of failure on demand as an additional component. Subsequently, the paper presents the multi-objective optimization of proof testing policies with genetic algorithms, using this model for quantification of average probability of failure on demand as one of the objectives. The other two objectives are the system spurious trip rate and lifecycle cost. This permits balancing of the most important aspects of safety system implementation. The approach addresses the requirements of the standard IEC 61508. The overall methodology is illustrated through a practical application case of a protective system against high temperature and pressure of a chemical reactor.

  11. Adding home health care to the discussion on health information technology policy.

    Science.gov (United States)

    Ruggiano, Nicole; Brown, Ellen L; Hristidis, Vagelis; Page, Timothy F

    2013-01-01

    The potential for health information technology to improve the efficiency and effectiveness of health care has resulted in several U.S. policy initiatives aimed at integrating health information technology into health care systems. However, home health care agencies have been excluded from incentive programs established through policies, raising concerns on the extent to which health information technology may be used to improve the quality of care for older adults with chronic illness and disabilities. This analysis examines the potential issues stemming from this exclusion and explores potential opportunities of integrating home health care into larger initiatives aimed at establishing health information technology systems for meaningful use.

  12. CrowdHEALTH: Holistic Health Records and Big Data Analytics for Health Policy Making and Personalized Health.

    Science.gov (United States)

    Kyriazis, Dimosthenis; Autexier, Serge; Brondino, Iván; Boniface, Michael; Donat, Lucas; Engen, Vegard; Fernandez, Rafael; Jimenez-Peris, Ricardo; Jordan, Blanca; Jurak, Gregor; Kiourtis, Athanasios; Kosmidis, Thanos; Lustrek, Mitja; Maglogiannis, Ilias; Mantas, John; Martinez, Antonio; Mavrogiorgou, Argyro; Menychtas, Andreas; Montandon, Lydia; Nechifor, Cosmin-Septimiu; Nifakos, Sokratis; Papageorgiou, Alexandra; Patino-Martinez, Marta; Perez, Manuel; Plagianakos, Vassilis; Stanimirovic, Dalibor; Starc, Gregor; Tomson, Tanja; Torelli, Francesco; Traver-Salcedo, Vicente; Vassilacopoulos, George; Wajid, Usman

    2017-01-01

    Today's rich digital information environment is characterized by the multitude of data sources providing information that has not yet reached its full potential in eHealth. The aim of the presented approach, namely CrowdHEALTH, is to introduce a new paradigm of Holistic Health Records (HHRs) that include all health determinants. HHRs are transformed into HHRs clusters capturing the clinical, social and human context of population segments and as a result collective knowledge for different factors. The proposed approach also seamlessly integrates big data technologies across the complete data path, providing of Data as a Service (DaaS) to the health ecosystem stakeholders, as well as to policy makers towards a "health in all policies" approach. Cross-domain co-creation of policies is feasible through a rich toolkit, being provided on top of the DaaS, incorporating mechanisms for causal and risk analysis, and for the compilation of predictions.

  13. Public health impacts of city policies to reduce climate change

    DEFF Research Database (Denmark)

    Sabel, Clive E; Hiscock, Rosemary; Asikainen, Arja;

    2016-01-01

    Background: Climate change is a global threat to health and wellbeing. Here we provide findings of an international research project investigating the health and wellbeing impacts of policies to reduce greenhouse gas emissions in urban environments. Methods:  Five European and two Chinese city...... authorities and partner academic organisations formed the project consortium. The methodology involved modelling the impact of adopted urban climate-change mitigation transport, buildings and energy policy scenarios, usually for the year 2020 and comparing them with business as usual (BAU) scenarios (where...... policies had not been adopted). Carbon dioxide emissions, health impacting exposures (air pollution, noise and physical activity), health (cardiovascular, respiratory, cancer and leukaemia) and wellbeing (including noise related wellbeing, overall wellbeing, economic wellbeing and inequalities) were...

  14. Social policies and the pathways to inequalities in health

    DEFF Research Database (Denmark)

    Whitehead, M; Burström, B; Diderichsen, Finn

    2000-01-01

    show that the health of lone mothers is poor in Sweden as well as in Britain and, most notably, that the magnitude of the differential between lone and couple mothers is of a similar order in Sweden as in Britain. This is despite the more favourable social policies in Sweden, which our results indicate...... have protected lone mothers from poverty and insecurity in the labour market to a much greater degree than the equivalent British policies over the 1980s and 1990s. Second, the pathways leading to the observed health disadvantage of lone mothers appear to be very different in the two countries...... in relation to the identified policy entry points. Overall, in Britain, around 50% of the health disadvantage of lone mothers is accounted for by the mediating factors of poverty and joblessness, whereas in Sweden these factors only account for between 3% and 13% of the health gap. The final section discusses...

  15. Reforming the health sector in Thailand: the role of policy actors on the policy stage.

    Science.gov (United States)

    Green, A

    2000-01-01

    This paper reports on exploratory research carried out into the processes of policy-making, and in particular health sector reform, in the health sector of Thailand. It is one of a set of studies examining health sector reform processes in a number of countries. Though in the period under study (1970-1996) there had been no single health sector reform package in Thailand, there was interest in a number of quarters in the development of such an initiative. It is clear, however, that despite recognition of the need for reform such a policy was far from being formulated, let alone implemented. The research, based on both documentary analysis and interviews, explores the reasons underpinning the failure of the policy process to respond to such a perceived need. The research findings suggest that the policy formation process in Thailand successfully occurs when there is a critical mass of support from strategic interest groups. The relative power of these interest groups is constantly changing. In particular the last two decades has seen a decline in the power of the bureaucratic élites (military and civilian) and a related rise in the power of the economic élites either directly or through their influence on political parties and government. Other critical groups include the media, NGOs and the professions. Informal policy groups are also significant. A number of implications for policy makers operating under such circumstances are drawn.

  16. Psychology and Health: Research, Practice, and Policy

    Science.gov (United States)

    Johnson, Norine G.

    2003-01-01

    Since World War II, American psychology's role in health care has significantly expanded. This was formally recognized in 2001 when the membership of the American Psychological Association (APA) approved a bylaw change in its mission statement to include the word health. An accumulating body of research demonstrates and recent reviews conclude…

  17. Policy processes underpinning universal health insurance in Vietnam.

    Science.gov (United States)

    Ha, Bui T T; Frizen, Scott; Thi, Le M; Duong, Doan T T; Duc, Duong M

    2014-12-01

    Background In almost 30 years since economic reforms or 'renovation' (Doimoi) were launched, Vietnam has achieved remarkably good health results, in many cases matching those in much higher income countries. This study explores the contribution made by Universal Health Insurance (UHI) policies, focusing on the past 15 years. We conducted a mixed method study to describe and assess the policy process relating to health insurance, from agenda setting through implementation and evaluation. Design The qualitative research methods implemented in this study were 30 in-depth interviews, 4 focus group discussions, expert consultancy, and 420 secondary data review. The data were analyzed by NVivo 7.0. Results Health insurance in Vietnam was introduced in 1992 and has been elaborated over a 20-year time frame. These processes relate to moving from a contingent to a gradually expanded target population, expanding the scope of the benefit package, and reducing the financial contribution from the insured. The target groups expanded to include 66.8% of the population by 2012. We characterized the policy process relating to UHI as incremental with a learning-by-doing approach, with an emphasis on increasing coverage rather than ensuring a basic service package and financial protection. There was limited involvement of civil society organizations and users in all policy processes. Intertwined political economy factors influenced the policy processes. Conclusions Incremental policy processes, characterized by a learning-by-doing approach, is appropriate for countries attempting to introduce new health institutions, such as health insurance in Vietnam. Vietnam should continue to mobilize resources in sustainable and viable ways to support the target groups. The country should also adopt a multi-pronged approach to achieving universal access to health services, beyond health insurance.

  18. Policy processes underpinning universal health insurance in Vietnam

    Directory of Open Access Journals (Sweden)

    Bui T. T. Ha

    2014-09-01

    Full Text Available Background: In almost 30 years since economic reforms or ‘renovation’ (Doimoi were launched, Vietnam has achieved remarkably good health results, in many cases matching those in much higher income countries. This study explores the contribution made by Universal Health Insurance (UHI policies, focusing on the past 15 years. We conducted a mixed method study to describe and assess the policy process relating to health insurance, from agenda setting through implementation and evaluation. Design: The qualitative research methods implemented in this study were 30 in-depth interviews, 4 focus group discussions, expert consultancy, and 420 secondary data review. The data were analyzed by NVivo 7.0. Results: Health insurance in Vietnam was introduced in 1992 and has been elaborated over a 20-year time frame. These processes relate to moving from a contingent to a gradually expanded target population, expanding the scope of the benefit package, and reducing the financial contribution from the insured. The target groups expanded to include 66.8% of the population by 2012. We characterized the policy process relating to UHI as incremental with a learning-by-doing approach, with an emphasis on increasing coverage rather than ensuring a basic service package and financial protection. There was limited involvement of civil society organizations and users in all policy processes. Intertwined political economy factors influenced the policy processes. Conclusions: Incremental policy processes, characterized by a learning-by-doing approach, is appropriate for countries attempting to introduce new health institutions, such as health insurance in Vietnam. Vietnam should continue to mobilize resources in sustainable and viable ways to support the target groups. The country should also adopt a multi-pronged approach to achieving universal access to health services, beyond health insurance.

  19. An analysis of policy success and failure in formal evaluations of Australia's national mental health strategy (1992-2012).

    Science.gov (United States)

    Grace, Francesca C; Meurk, Carla S; Head, Brian W; Hall, Wayne D; Harris, Meredith G; Whiteford, Harvey A

    2017-05-30

    Heightened fiscal constraints, increases in the chronic disease burden and in consumer expectations are among several factors contributing to the global interest in evidence-informed health policy. The present article builds on previous work that explored how the Australian Federal Government applied five instruments of policy, or policy levers, to implement a series of reforms under the Australian National Mental Health Strategy (NMHS). The present article draws on theoretical insights from political science to analyse the relative successes and failures of these levers, as portrayed in formal government evaluations of the NMHS. Documentary analysis of six evaluation documents corresponding to three National Mental Health Plans was undertaken. Both the content and approach of these government-funded, independently conducted evaluations were appraised. An overall improvement was apparent in the development and application of policy levers over time. However, this finding should be interpreted with caution due to variations in evaluation approach according to Plan and policy lever. Tabulated summaries of the success and failure of each policy initiative, ordered by lever type, are provided to establish a resource that could be consulted for future policy-making. This analysis highlights the complexities of health service reform and underscores the limitations of narrowly focused empirical approaches. A theoretical framework is provided that could inform the evaluation and targeted selection of appropriate policy levers in mental health.

  20. Public participation in regional health policy: a theoretical framework.

    Science.gov (United States)

    Thurston, Wilfreda E; MacKean, Gail; Vollman, Ardene; Casebeer, Ann; Weber, Myron; Maloff, Bretta; Bader, Judy

    2005-09-08

    How best to involve the public in local health policy development and decision-making is an ongoing challenge for health systems. In the current literature on this topic, there is discussion of the lack of rigorous evaluations upon which to draw generalizable conclusions about what public participation methods work best and for what kinds of outcomes. We believe that for evaluation research on public participation to build generalizable claims, some consistency in theoretical framework is needed. A major objective of the research reported on here was to develop such a theoretical framework for understanding public participation in the context of regionalized health governance. The overall research design followed the grounded theory tradition, and included five case studies of public participation initiatives in an urban regional health authority in Canada, as well as a postal survey of community organizations. This particular article describes the theoretical framework developed, with an emphasis on explaining the following major components of the framework: public participation initiatives as a process; policy making processes with a health region; social context as symbolic and political institutions; policy communities; and health of the population as the ultimate outcome of public participation. We believe that this framework is a good beginning to making more explicit the factors that may be considered when evaluating both the processes and outcomes of public participation in health policy development.

  1. Self-administered health literacy instruments for people with diabetes: systematic review of measurement properties.

    Science.gov (United States)

    Lee, Eun-Hyun; Kim, Chun-Ja; Lee, Jiyeon; Moon, Seung Hei

    2017-09-01

    The aims of this study were to identify all available self-administered instruments measuring health literacy in people with diabetes and to determine the current instrument that is the most appropriate for applying to this population in both practice and research. A systematic review of measurement properties. MEDLINE, EMBASE and CINAHL electronic databases from their inception up to 28 March 2016. The methodological quality of each included study was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments checklist. The reported results for measurement properties in the studies were assessed according to Terwee's quality criteria. Thirteen self-administered instruments measuring health literacy in people with diabetes were identified, of which six (44%) were diabetes-specific instruments. The instruments that covered the broadest contents of health literacy were the Health Literacy Scale and Health Literacy Questionnaire. The (test-retest) reliability, measurement error and responsiveness were not evaluated for any instrument, while internal consistency and hypothesis testing validity were the most frequently assessed measurement properties. With the current evidence, the Health Literacy Scale may be the most appropriate instrument for patients with diabetes in practice and research. However, the structural validity of this scale needs to be further established, particularly in other language versions. It is also recommended to use the Diabetes Numeracy Test-15 along with the Health Literacy Scale to complement the lack of numeracy measures in the Health Literacy Scale. © 2017 John Wiley & Sons Ltd.

  2. Brokering health policy: coalitions, parties, and interest group influence.

    Science.gov (United States)

    Heaney, Michael T

    2006-10-01

    Assuming a position as broker between disconnected interests is one way for an interest group to influence the making of federal health policy. This study demonstrates how groups use their connections with political parties and lobbying coalitions to augment their brokerage positions and enhance their influence over policy making. Evidence is drawn from statistical analysis of 263 interviews with health policy elites and a qualitative case study of the debate over the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. The results explain, in part, how interest groups play their brokerage roles as dispersed actors in a decentralized system, rather than as central mediators that intervene in a wide range of policy disputes.

  3. [Tobacco control policies and perinatal health].

    Science.gov (United States)

    Peelen, M J; Sheikh, A; Kok, M; Hajenius, P; Zimmermann, L J; Kramer, B W; Hukkelhoven, C W; Reiss, I K; Mol, B W; Been, J V

    2017-01-01

    Study the association between the introduction of tobacco control policies in the Netherlands and changes in perinatal outcomes. National quasi-experimental study. We used Netherlands Perinatal Registry data (now called Perined) for the period 2000-2011. We studied whether the introduction of smoke-free legislation in workplaces plus a tobacco tax increase and mass media campaign in January 2004, and extension of the smoke-free law to the hospitality industry accompanied by another tax increase and media campaign in July 2008, was associated with changes in perinatal outcomes. We studied all singleton births (gestational age: 24+0 to 42+6 weeks). Our primary outcome measures were: perinatal mortality, preterm birth and being small-for-gestational-age (SGA). Interrupted time series logistic regression analyses were performed to investigate changes in these outcomes occurred after the introduction of the aforementioned tobacco control policies (ClinicalTrials.gov: NCT02189265). Among 2,069,695 singleton births, 13,027 (0.6%) perinatal deaths, 116,043 (5.6%) preterm live-births and 187,966 (9.1%) SGA live-births were observed. The policies introduced in January 2004 were not associated with significant changes in any of the primary outcome measures. A -4.4% (95% CI: -6.4 to -2.4; p hospitality industry, a further tax increase and another media campaign. This translates to an estimated over 500 cases of SGA being averted per year. A reduction in SGA births, but not preterm birth or perinatal mortality, was observed in the Netherlands after extension of the smoke-free workplace law to include bars and restaurants, in conjunction with a tax increase and media campaign in 2008.

  4. Policy Capacity for Health Reform: Necessary but Insufficient; Comment on “Health Reform Requires Policy Capacity”

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    Owen Adams

    2016-01-01

    Full Text Available Forest and colleagues have persuasively made the case that policy capacity is a fundamental prerequisite to health reform. They offer a comprehensive life-cycle definition of policy capacity and stress that it involves much more than problem identification and option development. I would like to offer a Canadian perspective. If we define health reform as re-orienting the health system from acute care to prevention and chronic disease management the consensus is that Canada has been unsuccessful in achieving a major transformation of our 14 health systems (one for each province and territory plus the federal government. I argue that 3 additional things are essential to build health policy capacity in a healthcare federation such as Canada: (a A means of “policy governance” that would promote an approach to cooperative federalism in the health arena; (b The ability to overcome the ”policy inertia” resulting from how Canadian Medicare was implemented and subsequently interpreted; and (c The ability to entertain a long-range thinking and planning horizon. My assessment indicates that Canada falls short on each of these items, and the prospects for achieving them are not bright. However, hope springs eternal and it will be interesting to see if the July, 2015 report of the Advisory Panel on Healthcare Innovation manages to galvanize national attention and stimulate concerted action.

  5. A Third Way for Health Policy?

    Directory of Open Access Journals (Sweden)

    Alexander D. Peden

    2014-01-01

    Full Text Available Economics has hit the mainstream in the last decade with popular books like Freakonomics and The Undercover Economist reaching the masses. These authors have used their toolkits far beyond the narrow scope of money and finance and answered questions pertaining to anything from social policy to demographics to crime. Their appeal has largely been their ability to explain that small underlying forces can have major impacts, intended or otherwise, on many different areas of society. One recent book following this trend is Nudge, published in 2008 by University of Chicago academics Richard Thaler and Cass Sunstein. The book has attracted acclaim from both journals and the press, with The Financial Times naming it as one of the best business books for 2008. Nudge coins the term ‘choice architecture’, referring to the manner in which a range of alternatives is presented, which the authors contend is commonly overlooked as an integral part of many decisions we all face during the course of our day-to-day lives (1. When people take the time to judiciously research all alternatives before them, or use their reflective systems in the parlance of the book, they generally make objectively good decisions. Unfortunately, in practice people cannot or do not take the time to do so and instead use their automatic or gut thinking systems, leading to inferior outcomes. The first section of the book then compellingly demonstrates the evidence of its importance in a multitude of situations. There are many lessons to be learned along the way, applicable to both policy-makers and those who wish to critically examine some of their own choices in life. Among these, lessons is the fact that a large percentage of the population will stick with an easy default option without consideration of better alternatives, even when considering a life-altering decision such as retirement planning. There are even examples of people who fail to take advantage of subsidies to

  6. Assessment of health policy in Costa Rica--some preliminary remarks.

    Science.gov (United States)

    Eriksson, C G; Mohs, E; Eriksson, B

    1991-01-01

    Costa Rica is one of the world's success stories in primary health care. During the past 20 years the country has experienced a demographic and epidemiological transition. However, during the 80's the economic recession severely affected the country. The social, economic, political and geographic contexts are important for the assessment of health policy. The longstanding democracy, investments in public education and health all contribute to the peace and stability. Assessment of health policy needs both a quantitative and qualitative approach. The policy-making process--how policies are made, translated into action and evaluated--is a research challenge. The national health policy 1986-1990 includes commitment to Health for All strategy; development of the National Health Care System; strengthening of the health care infrastructure; consolidation of health achievements and undertaking of new problems and approaches on integral care for the population; community participation in all health care system activities; and health care priorities. Important research issues are the relationship between the needs of the population and health policy development and the impacts of health policy on the health of the population. A comprehensive study of policy-making includes studies of policy content, process, output and evaluation of impacts (including economy of health policy), and analysis for policy, i.e. information for policy making, process and policy advocacy. Recent successful health policy issues are child health and HIV/AIDS, while water pollution and traffic accidents have been more problematic policy issues.

  7. Using Standardized Health Consumer Indicators as a Policy Development Tool

    Directory of Open Access Journals (Sweden)

    Cătălin Ovidiu BABA

    2007-06-01

    Full Text Available This study describes the relations between the European Union standardized health indicators and the community-based health policy. One of the goals of the European Commission is to provide standardized information on health in order to make it comparable at a trans-national level. Hence, numerous projects aimed at developing health indicators, and improving databases relating to these were supported by the Program of Community Action in the Field of Public Health. In this paper the authors argue that standardized health indicators can provide more than a prototype for a future health monitoring system. Bearing in mind that the production of comparable information on health is based upon four different tasks (the analysis of data needs in a specific area, definition of indicators and quality assurance, reporting and analysis, and promotion of the results the authors assert that all of these tasks are important steps towards the development of community-based health policy. Thus, the main objective of this study is to analyze their utility as premises for policy development.

  8. Ethical health care policy: nursing's voice in allocation.

    Science.gov (United States)

    Sarikonda-Woitas, Candace; Robinson, Janet Hoey

    2002-01-01

    Nurse administrators must become more involved in the policy debates concerning universal access to care and allocation of health care resources. In order to promote nursing's agenda in the policy debates, nurses must be familiar with the numerous ethical issues that impact macroallocation decisions. This article explores the ethical viewpoint of the nursing profession as it relates to allocation decisions and examines how the ethical principles of the nursing profession, along with the ethical theories of egalitarianism and utilitarianism, can be used throughout the policy process to guide the development of a plan for universal access to care.

  9. Semantically Enriched Data Access Policies in eHealth.

    Science.gov (United States)

    Drozdowicz, Michał; Ganzha, Maria; Paprzycki, Marcin

    2016-11-01

    Internet of Things (IoT) requires novel solutions to facilitate autonomous, though controlled, resource access. Access policies have to facilitate interactions between heterogeneous entities (devices and humans). Here, we focus our attention on access control in eHealth. We propose an approach based on enriching policies, based on well-known and widely-used eXtensible Access Control Markup Language, with semantics. In the paper we describe an implementation of a Policy Information Point integrated with the HL7 Security and Privacy Ontology.

  10. Advanced instrumentation for acousto-ultrasonic based structural health monitoring

    Science.gov (United States)

    Smithard, Joel; Galea, Steve; van der Velden, Stephen; Powlesland, Ian; Jung, George; Rajic, Nik

    2016-04-01

    Structural health monitoring (SHM) systems using structurally-integrated sensors potentially allow the ability to inspect for damage in aircraft structures on-demand and could provide a basis for the development of condition-based maintenance approaches for airframes. These systems potentially offer both substantial cost savings and performance improvements over conventional nondestructive inspection (NDI). Acousto-ultrasonics (AU), using structurallyintegrated piezoelectric transducers, offers a promising basis for broad-field damage detection in aircraft structures. For these systems to be successfully applied in the field the hardware for AU excitation and interrogation needs to be easy to use, compact, portable, light and, electrically and mechanically robust. Highly flexible and inexpensive instrumentation for basic background laboratory investigations is also required to allow researchers to tackle the numerous scientific and engineering issues associated with AU based SHM. The Australian Defence Science and Technology Group (DST Group) has developed the Acousto Ultrasonic Structural health monitoring Array Module (AUSAM+), a compact device for AU excitation and interrogation. The module, which has the footprint of a typical current generation smart phone, provides autonomous control of four send and receive piezoelectric elements, which can operate in pitch-catch or pulse-echo modes and can undertake electro-mechanical impedance measurements for transducer and structural diagnostics. Modules are designed to operate synchronously with other units, via an optical link, to accommodate larger transducer arrays. The module also caters for fibre optic sensing of acoustic waves with four intensity-based optical inputs. Temperature and electrical resistance strain gauge inputs as well as external triggering functionality are also provided. The development of a Matlab hardware object allows users to easily access the full hardware functionality of the device and

  11. Applying Critical Discourse Analysis in Health Policy Research: Case Studies in Regional, Organizational, and Global Health.

    Science.gov (United States)

    Evans-Agnew, Robin A; Johnson, Susan; Liu, Fuqin; Boutain, Doris M

    2016-08-01

    Critical discourse analysis (CDA) is a promising methodology for policy research in nursing. As a critical theoretical methodology, researchers use CDA to analyze social practices and language use in policies to examine whether such policies may promote or impede social transformation. Despite the widespread use of CDA in other disciplines such as education and sociology, nursing policy research employing CDA methodology is sparse. To advance CDA use in nursing science, it is important to outline the overall research strategies and describe the steps of CDA in policy research. This article describes, using exemplar case studies, how nursing and health policy researchers can employ CDA as a methodology. Three case studies are provided to discuss the application of CDA research methodologies in nursing policy research: (a) implementation of preconception care policies in the Zhejiang province of China, (b) formation and enactment of statewide asthma policy in Washington state of the United States, and (c) organizational implementation of employee antibullying policies in hospital systems in the Pacific Northwest of the United States. Each exemplar details how CDA guided the examination of policy within specific contexts and social practices. The variations of the CDA approaches in the three exemplars demonstrated the flexibilities and potentials for conducting policy research grounded in CDA. CDA provides novel insights for nurse researchers examining health policy formation, enactment, and implementation. © The Author(s) 2016.

  12. Measuring Environmental Factors: Unique and Overlapping International Classification of Functioning, Disability and Health Coverage of 5 Instruments.

    Science.gov (United States)

    Heinemann, Allen W; Miskovic, Ana; Semik, Patrick; Wong, Alex; Dashner, Jessica; Baum, Carolyn; Magasi, Susan; Hammel, Joy; Tulsky, David S; Garcia, Sofia F; Jerousek, Sara; Lai, Jin-Shei; Carlozzi, Noelle E; Gray, David B

    2016-12-01

    To describe the unique and overlapping content of the newly developed Environmental Factors Item Banks (EFIB) and 7 legacy environmental factor instruments, and to evaluate the EFIB's construct validity by examining associations with legacy instruments. Cross-sectional, observational cohort. Community. A sample of community-dwelling adults with stroke, spinal cord injury, and traumatic brain injury (N=568). None. EFIB covering domains of the built and natural environment; systems, services, and policies; social environment; and access to information and technology; the Craig Hospital Inventory of Environmental Factors (CHIEF) short form; the Facilitators and Barriers Survey/Mobility (FABS/M) short form; the Home and Community Environment Instrument (HACE); the Measure of the Quality of the Environment (MQE) short form; and 3 of the Patient Reported Outcomes Measurement Information System's (PROMIS) Quality of Social Support measures. The EFIB and legacy instruments assess most of the International Classification of Functioning, Disability and Health (ICF) environmental factors chapters, including chapter 1 (products and technology; 75 items corresponding to 11 codes), chapter 2 (natural environment and human-made changes; 31 items corresponding to 7 codes), chapter 3 (support and relationships; 74 items corresponding to 7 codes), chapter 4 (attitudes; 83 items corresponding to 8 codes), and chapter 5 (services, systems, and policies; 72 items corresponding to 16 codes). Construct validity is provided by moderate correlations between EFIB measures and the CHIEF, MQE barriers, HACE technology mobility, FABS/M community built features, and PROMIS item banks and by small correlations with other legacy instruments. Only 5 of the 66 legacy instrument correlation coefficients are moderate, suggesting they measure unique aspects of the environment, whereas all intra-EFIB correlations were at least moderate. The EFIB measures provide a brief and focused assessment of ICF

  13. Policy perspectives on public health for Mexican migrants in California.

    Science.gov (United States)

    Morin, Stephen F; Carrillo, Héctor; Steward, Wayne T; Maiorana, Andre; Trautwein, Mark; Gómez, Cynthia A

    2004-11-01

    This analysis focuses on public policies that affect primary HIV prevention and access to HIV care for Mexican migrants residing in California. Policy or structural level interventions, as opposed to behavioral or psychologic interventions, help to shape the environment in which people live. We use a conceptual model for policy analysis in public health to understand better the challenges faced by Mexican migrants. We assess potential policy level interventions that may serve as barriers to or facilitators of primary HIV prevention and care for Mexican migrants. Among potential barriers, we discuss restrictions on public health services based on legal immigration status, limits placed on affirmative action in education, and laws limiting travel and immigration. Under potential facilitators, we discuss community and migrant health centers, language access laws, and the use of community-based groups to provide prevention and treatment outreach. We also report on the limited research evaluating the implications of these public policies and ways to organize for more responsive public policies.

  14. Public health: disconnections between policy, practice and research

    Directory of Open Access Journals (Sweden)

    Kok Gerjo

    2010-12-01

    Full Text Available Abstract Background Public health includes policy, practice and research but to sufficiently connect academic research, practice and public health policy appears to be difficult. Collaboration between policy, practice and research is imperative to obtaining more solid evidence in public health. However, the three domains do not easily work together because they emanate from three more or less independent 'niches'. Work cycles of each niche have the same successive steps: problem recognition, approach formulation, implementation, and evaluation, but are differently worked out. So far, the research has focused on agenda-setting which belongs to the first step, as expressed by Kingdon, and on the use of academic knowledge in policy makers' decision-making processes which belongs to the fourth step, as elaborated by Weiss. In addition, there are more steps in the policy-making process where exchange is needed. Method A qualitative descriptive research was conducted by literature search. We analyzed the four steps of the policy, practice and research work cycles. Next, we interpreted the main conflicting aspects as disconnections for each step. Results There are some conspicuous differences that strengthen the niche character of each domain and hamper integration and collaboration. Disconnections ranged from formulating priorities in problem statements to power roles, appraisal of evidence, work attitudes, work pace, transparency of goals, evaluation and continuation strategies and public accountability. Creating awareness of these disconnections may result in more compatibility between researchers, policy makers and practitioners. Conclusion We provide an analysis that can be used by public health services-related researchers, practitioners and policy makers to be aware of the risk for disconnections. A synthesis of the social, practical and scientific relevance of public health problems should be the starting point for a dialogue that seeks to

  15. Health policy considerations for our sexual minority patients.

    Science.gov (United States)

    O'Hanlan, Katherine A

    2006-03-01

    Homosexuality and transsexuality are still widely viewed by lay individuals as morally negative and deserving of legal proscription. Peer-reviewed data confirm that experiences of legal discrimination are associated with stress-related health problems, reduced utilization of health care, and financial and legal challenges for individuals and families, especially those with children. In the last 3 years, the American Psychiatric Association, American Psychological Association, and American Psychoanalytic Association have each reviewed the research on sexual orientation and identity, and each has confirmed that sexual orientation and gender identity do not correlate with mental illness or immorality. They have each endorsed laws that confer equality to sexual minorities, including nondiscrimination in employment, medical insurance coverage, adoption, and access to civil marriage. The American College of Obstetricians and Gynecologists (ACOG), by virtue of its history of advocacy for women's health, is in a position to promote policy and make similar recommendations, recognizing that sexual minority women's health and their family issues are an integral component of taking care of all women. The College should review the policies of America's premier mental health associations and consider including sexual orientation and gender identity in its own nondiscrimination policy, and ACOG should issue a policy statement in support of laws to provide safety from violence and discrimination, equal employment opportunities, equal health insurance coverage, and equal access to civil marriage.

  16. Evidence-based health policy-making, hospital funding and health insurance.

    Science.gov (United States)

    Palmer, G R

    2000-02-01

    An important goal of health services research is to improve the efficiency and effectiveness of health services through a quantitative and evidence-based approach. There are many limitations to the use of evidence in health policy-making, such as differences in what counts as evidence between the various disciplines involved, and a heavy reliance on theory in social science disciplines. Community and interest group values, ideological positions and political assessments inevitably intrude into government health policy-making. The importance of these factors is accentuated by the current absence of evidence on the impact of policy options for improving the health status of the community, and ensuring that efficiency and equity objectives for health services are also met. Analysis of recent hospital funding and private health insurance initiatives shows the limited role of evidence in the making of these decisions. Decision-making about health policy might be improved in the future by initiatives such as greater exposure of health professionals to educational inputs with a policy focus; increased contribution of doctors to health services research via special postgraduate programs; and establishing a national, multidisciplinary centre for health policy research and evaluation.

  17. Built environment change: a framework to support health-enhancing behaviour through environmental policy and health research.

    Science.gov (United States)

    Berke, Ethan M; Vernez-Moudon, Anne

    2014-06-01

    As research examining the effect of the built environment on health accelerates, it is critical for health and planning researchers to conduct studies and make recommendations in the context of a robust theoretical framework. We propose a framework for built environment change (BEC) related to improving health. BEC consists of elements of the built environment, how people are exposed to and interact with them perceptually and functionally, and how this exposure may affect health-related behaviours. Integrated into this framework are the legal and regulatory mechanisms and instruments that are commonly used to effect change in the built environment. This framework would be applicable to medical research as well as to issues of policy and community planning.

  18. Health-related claims on food labels in Australia: understanding environmental health officers' roles and implications for policy.

    Science.gov (United States)

    Condon-Paoloni, Deanne; Yeatman, Heather R; Grigonis-Deane, Elizabeth

    2015-01-01

    Health and related claims on food labels can support consumer education initiatives that encourage purchase of healthier foods. A new food Standard on Nutrition, Health and Related Claims became law in January 2013. Implementation will need careful monitoring and enforcement to ensure that claims are truthful and have meaning. The current study explored factors that may impact on environmental health officers' food labelling policy enforcement practices. The study used a mixed-methods approach, using two previously validated quantitative questionnaire instruments that provided measures of the level of control that the officers exercised over their work, as well as qualitative, semi-structured, in-depth interviews. Local government; Australia. Thirty-seven officers in three Australian states participated in semi-structured in-depth interviews, as well as completing the quantitative questionnaires. Senior and junior officers, including field officers, participated in the study. The officers reported a high level of autonomy and control of their work, but also a heavy workload, dominated by concerns for public health and food safety, with limited time for monitoring food labels. Compliance of labels with proposed health claims regulations was not considered a priority. Lipsky's theory of street-level bureaucracy was used to enhance understanding of officers' work practices. Competing priorities affect environmental health officers' monitoring and enforcement of regulations. Understanding officers' work practices and their perceptions of enforcement is important to increase effectiveness of policy implementation and hence its capacity to augment education initiatives to optimize health benefits.

  19. Federal funding of health policy in Brazil: trends and challenges

    Directory of Open Access Journals (Sweden)

    Cristiani Vieira Machado

    2014-01-01

    Full Text Available The article analyzes Federal funding of health policy in Brazil in the 2000s, focusing on the Ministry of Health’s budget implementation. Federal spending on health was less unstable between 2000 and 2002 and has expanded since 2006. However, it fluctuated as a share of both the Gross Domestic Product and Gross National Revenue. Federal intergovernmental transfers increased, exceeding 70% in 2007. Meanwhile, the proportion of Federal investments remained low, varying from 3.4% to 6.3%. The highest absolute amount of spending was on specialized outpatient and hospital care. The decade showed a proportionally greater increase in spending on pharmaceutical care. The growing allocation of Federal funds to States in the North and Northeast, especially for primary care and epidemiological surveillance, failed to offset the sharp regional inequalities in per capita Federal spending. The main characteristics of health funding limit Federal health policy governance and pose several challenges for the Brazilian Unified National Health System.

  20. Development of an Internet Security Policy for health care establishments.

    Science.gov (United States)

    Ilioudis, C; Pangalos, G

    2000-01-01

    The Internet provides unprecedented opportunities for interaction and data sharing among health care providers, patients and researchers. However, the advantages provided by the Internet come with a significantly greater element of risk to the confidentiality and integrity of information. This paper defines the basic security requirements that must be addressed in order to use the Internet to safely transmit patient and/or other sensitive Health Care information. It describes a suitable Internet Security Policy for Health Care Establishments and provides the set of technical measures that are needed for its implementation. The proposed security policy and technical approaches have been based on an extensive study of the related recommendations from the security and standard groups both in EU amid USA and our related work and experience. The results have been utilized in the framework of the Intranet Health Clinic project, where the use of the Internet for the transmission of sensitive Health Care information is of vital importance.

  1. Evidence and Health Policy: Using and Regulating Systematic Reviews.

    Science.gov (United States)

    Fox, Daniel M

    2017-01-01

    Systematic reviews have, increasingly, informed policy for almost 3 decades. In many countries, systematic reviews have informed policy for public and population health, paying for health care, increasing the quality and efficiency of interventions, and improving the effectiveness of health sector professionals and the organizations in which they work. Systematic reviews also inform other policy areas: criminal justice, education, social welfare, and the regulation of toxins in the environment. Although the production and use of systematic reviews has steadily increased, many clinicians, public health officials, representatives of commercial organizations, and, consequently, policymakers who are responsive to them, have been reluctant to use these reviews to inform policy; others have actively opposed using them. Systematic reviews could inform policy more effectively with changes to current practices and the assumptions that sustain these practices-assumptions made by researchers and the organizations that employ them, by public and private funders of systematic reviews, and by organizations that finance, set priorities and standards for, and publish them.

  2. Rethinking the evaluation and measurement of Health in all policies.

    Science.gov (United States)

    Bauman, Adrian E; King, Lesley; Nutbeam, Don

    2014-06-01

    Current international attention to Health in all policies (HiAP) has its origins in a more sophisticated understanding of the impact of public policies on health, and a recognition that policies across government have an impact on the social and environmental determinants of health and related inequalities in health. As an emerging field, there has been limited attention focused on comprehensive approaches to the evaluation of HiAP to date, and the research focus around HiAP has mainly examined the processes of cross-sectoral policy development, rather than their health-related impacts or outcomes. The purpose of this paper is to explore issues in assessing the implementation of HiAP and describe an expanded evaluation framework for assessing the potential intermediate and end-point effects of HiAP actions, using a planning logic model for 'complex programs'. This meets the needs of public sector policy-makers who express an interest in understanding the relationship between HiAP and health-related and social outcomes. The paper proposes applying a contribution analysis method to estimate and model the anticipated impacts of HiAP policies on intermediate and longer term outcomes, in advance of empirical studies of these outcomes, and as an innovative input into HiAP and evaluation planning. A broader long-term evaluation framework will enhance the political saliency of HiAP initiatives, especially from governments considering HiAP approaches in financially constrained environments. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. From "Public Health" to "Safeguarding Children": British Health Visiting in Policy, Practice and Research

    Science.gov (United States)

    Peckover, Sue

    2013-01-01

    This study examines the location of British health visiting in contemporary policy discourses concerned with public health and safeguarding children. It argues that professional identity and orientation can be understood through health visiting's long history of public health work with children and families, which has included an engagement with…

  4. Between marketing and financial support: Dutch municipal policy instruments to improve the quality of private housing stock

    NARCIS (Netherlands)

    Tambach, M.; Meijer, F.; Visscher, H.

    2011-01-01

    Dutch municipalities are faced with an ageing private housing stock, of which parts show a diversity of quality backlogs, including their energy quality. Dutch municipalities are in the process of developing a combination of communicative and economic policy instruments to seduce private homeowners

  5. Sound Arguments and Power in Evaluation Research and Policy-Making: A Measuring Instrument and Its Application.

    Science.gov (United States)

    Propper, Igno M. A. M.

    1993-01-01

    Proposes an instrument for assessing the extent to which either sound arguments or power are found in scientific and political discussions. Empirical research is described that investigated the relation between the quality of evaluation research and the quality of discussion in policy-making processes in which the research is used. (Contains 47…

  6. Between marketing and financial support: Dutch municipal policy instruments to improve the quality of private housing stock

    NARCIS (Netherlands)

    Tambach, M.; Meijer, F.; Visscher, H.

    2011-01-01

    Dutch municipalities are faced with an ageing private housing stock, of which parts show a diversity of quality backlogs, including their energy quality. Dutch municipalities are in the process of developing a combination of communicative and economic policy instruments to seduce private homeowners

  7. 'Doing more with less' or 'doing less with less'? Assessing EU cohesion policy's financial instruments for urban development

    NARCIS (Netherlands)

    Dabrowski, M.M.

    2015-01-01

    In the context of a severe economic crisis and austerity, new ideas were put forward to reform cohesion policy to enhance its effectiveness and the return on investment. Among them, financial engineering instruments, such as JESSICA, expected to offer a means to ‘do more with less’ in this difficult

  8. Assessing State Models of Value-Added Teacher Evaluations: Alignment of Policy, Instruments, and Literature-Based Concepts

    Science.gov (United States)

    Hadfield, Timothy E.; Hutchison-Lupardus, Tammy R.; Snyder, Jennifer E.

    2012-01-01

    This problem-based learning project addressed the need to improve the construction and implementation of value-added teacher evaluation policies and instruments. State officials are constructing value-added teacher evaluation models due to accountability initiatives, while ignoring the holes and problems in its implementation. The team's…

  9. Building bridges between research, policy and practice in public health.

    Science.gov (United States)

    Bosi, Maria Lúcia Magalhães; Gastaldo, Denise

    2011-12-01

    The article examines core elements of the national and international discussion on the required integration between research, policy and practice in public health, and provides input for this integration. Some conceptual barriers and other barriers at different spheres that interfere with the desired integration are discussed. Evidence has shown that research, policy and practice in health are not continuous, homogenous areas but rather involve different levels and actors. Their processes develop in different grounds supported by a variety of actions, paradigms and interests that are not conflict-free. Thus, this integration is a major challenge given its complexity and multiplicity of objective and subjective aspects.

  10. [Valuating public health in some zoos in Colombia. Phase 1: designing and validating instruments].

    Science.gov (United States)

    Agudelo-Suárez, Angela N; Villamil-Jiménez, Luis C

    2009-10-01

    Designing and validating instruments for identifying public health problems in some zoological parks in Colombia, thereby allowing them to be evaluated. Four instruments were designed and validated along with the participation of five zoos. The instruments were validated regarding appearance, content, sensitivity to change, reliability tests and determining the tools' usefulness. An evaluation scale was created which assigned a maximum of 400 points, having the following evaluation intervals: 350-400 points meant good public health management, 100-349 points for regular management and 0-99 points for deficient management. The instruments were applied to the five zoos as part of the validation, forming a base-line for future evaluation of public health in them. Four valid and useful instruments were obtained for evaluating public health in zoos in Colombia. The five zoos presented regular public health management. The base-line obtained when validating the instruments led to identifying strengths and weaknesses regarding public health management in the zoos. The instruments obtained generally and specifically evaluated public health management; they led to diagnosing, identifying, quantifying and scoring zoos in Colombia in terms of public health. The base-line provided a starting point for making comparisons and enabling future follow-up of public health in Colombian zoos.

  11. The Case for "Environment in All Policies": Lessons from the "Health in All Policies" Approach in Public Health.

    Science.gov (United States)

    Browne, Geoffrey R; Rutherfurd, Ian D

    2017-02-01

    Both public health, and the health of the natural environment, are affected by policy decisions made across portfolios as diverse as finance, planning, transport, housing, education, and agriculture. A response to the interdependent character of public health has been the "health in all policies" (HiAP) approach. With reference to parallels between health and environment, this paper argues that lessons from HiAP are useful for creating a new integrated environmental management approach termed "environment in all polices" (EiAP). This paper covers the theoretical foundations of HiAP, which is based on an understanding that health is strongly socially determined. The paper then highlights how lessons learned from HiAP's implementation in Finland, California, and South Australia might be applied to EiAP. It is too early to learn from evaluations of HiAP, but it is apparent that there is no single tool kit for its application. The properties that are likely to be necessary for an effective EiAP approach include a jurisdiction-specific approach, ongoing and strong leadership from a central agency, independent analysis, and a champion. We then apply these properties to Victoria (Australia) to demonstrate how EiAP might work. We encourage further exploration of the feasibility of EiAP as an approach that could make explicit the sometimes surprising environmental implications of a whole range of strategic policies. Citation: Browne GR, Rutherfurd ID. 2017. The case for "environment in all policies": lessons from the "health in all policies" approach in public health. Environ Health Perspect 125:149-154; http://dx.doi.org/10.1289/EHP294.

  12. Health Policy and Management: in praise of political science. Comment on "On Health Policy and Management (HPAM): mind the theory-policy-practice gap".

    Science.gov (United States)

    Hunter, David J

    2015-03-12

    Health systems have entered a third era embracing whole systems thinking and posing complex policy and management challenges. Understanding how such systems work and agreeing what needs to be put in place to enable them to undergo effective and sustainable change are more pressing issues than ever for policy-makers. The theory-policy-practice-gap and its four dimensions, as articulated by Chinitz and Rodwin, is acknowledged. It is suggested that insights derived from political science can both enrich our understanding of the gap and suggest what changes are needed to tackle the complex challenges facing health systems.

  13. Health Policy and Management: In Praise of Political Science; Comment on “On Health Policy and Management (HPAM: Mind the Theory-Policy Practice Gap”

    Directory of Open Access Journals (Sweden)

    David J Hunter

    2015-06-01

    Full Text Available Health systems have entered a third era embracing whole systems thinking and posing complex policy and management challenges. Understanding how such systems work and agreeing what needs to be put in place to enable them to undergo effective and sustainable change are more pressing issues than ever for policy-makers. The theory-policy-practice-gap and its four dimensions, as articulated by Chinitz and Rodwin, is acknowledged. It is suggested that insights derived from political science can both enrich our understanding of the gap and suggest what changes are needed to tackle the complex challenges facing health systems.

  14. Laws, directives and policy instruments important for the development of the waste management system; Lagar, direktiv och styrmedel viktiga foer avfallssystemets utveckling

    Energy Technology Data Exchange (ETDEWEB)

    Nilsson, Karolina; Sundberg, Johan

    2010-01-15

    This report gives a survey and a description of present and future policy instruments that have been or will become important for the development of the waste management system. Policy instruments here refers to laws, directives, taxes/fees, national/local goals and other regulating measures that the society introduce to steer the development of the waste management system. This work can thus be used as a dictionary or a guideline for these measures. The investigation has two goals: 1. To give representatives of the Swedish waste management system a summary of important policy instruments for the future development of the waste management system. 2. To give Waste Refinery a summary of these policy instruments that can be used for the discussions of how the research within the centre should develop during stage 2. A large number of policy instruments have been found during the study. These instruments have been, most likely will become, or may become important for the development of the waste management system. Most of them are described in this report. The selection made is presented in Table 1. Focus for the selection has been policy instruments that are important for the research activities within Waste Refinery, meaning policy instruments that direct or indirect can change the use of thermal and/or biological treatment as well as techniques and methods supporting these treatment methods. [Table 1. Policy instruments that are presented in the report

  15. Nursing terminology as a work process instrument of nurses in collective health.

    Science.gov (United States)

    Cavalcante, Marília Daniella Machado Araújo; Larocca, Liliana Müller; Chaves, Maria Marta Nolasco; Cubas, Márcia Regina; Piosiadlo, Laura Christina Macedo; Mazza, Verônica de Azevedo

    2016-01-01

    To analyze the use of nursing terminology as an instrument of the nursing work process in Collective Health. Exploratory case study. For data collection was conducted a group interview with 24 nurses working in health units of a municipality in south central Paraná, Brazil. Data were analyzed in the light of interdependence between the structural, particular and singular dimensions contained in the Theory of Nursing Praxis Intervention in Collective Health. The situations interfering with improper use were the lack of knowledge about the origin and purpose of terminology, lack of training, and non-mandatory use. Although the nursing terminology is used as an instrument in the nursing work process in collective health, it requires training to be recognized as a classification system. At the same time, institutional policies should be employed to ensure the effective use of these instruments. Analisar a utilização de terminologia de enfermagem como instrumento do processo de trabalho do enfermeiro em Saúde Coletiva. Estudo de caso exploratório. Para coleta de dados foi realizada entrevista em grupo com 24 enfermeiros que atuam nas unidades de saúde de um município no centro-sul do Paraná, Brasil. Os dados foram analisados à luz da interdependência entre as dimensões estrutural, particular e singular contidas na Teoria da Intervenção Práxica de Enfermagem em Saúde Coletiva. As situações que interferiram na utilização inadequada foram o desconhecimento sobre origem e finalidade da terminologia, a falta de treinamento e a não obrigatoriedade de uso. A terminologia de enfermagem, apesar de utilizada como instrumento no processo de trabalho de enfermeiros em Saúde Coletiva, necessita de capacitação para ser reconhecida como sistema classificatório. Ao mesmo tempo, políticas institucionais devem ser empregadas no intuito de garantir a efetiva utilização destes instrumentos.

  16. [The health policy of the Paul Verlaine University-Metz].

    Science.gov (United States)

    Vaillant, Sylvie

    2010-01-01

    Students represent a population group that is for the most part in good health. However, students also face specific stresses and constraints that are likely to make it difficult for them to adapt to student life, and these adjustments can lead to unhealthy behaviours. Within Universities, the implementation of a coherent health policy must aim to positively impact on the development of both the professional and daily lives of young adults. The University of Paul Verlaine in Metz (France) has taken this perspective on board, and under the leadership of its social health department, the whole University has adopted a comprehensive policy for student well-being under the five action areas of the Ottawa Charter. This approach to well-being as a public policy strategy, through the Healthy Life policy, is central to all decisions taken at the Metz University and throughout the Regional Centre for Scholars and University Students (CROUS) in Lorraine. A number of facilities dedicated to students' health and well-being have been created in this supporting environment, and the engagement of students in the Healthy Life policy (some students 'relay' the information, others are 'peer educators') show that they are involved in the community life of the University. The introduction of teaching modules by the University's health department has given access to training to increase students' awareness of the concept of a holistic approach to health. Finally students have had improved access to healthcare services thanks to an increase in the number of activities provided by the student health department focusing on common problems experienced by university students.

  17. Social Determinants and Disparities in Health: Their Crucifixion, Resurrection, and Ultimate Triumph(?) in Health Policy.

    Science.gov (United States)

    House, James S

    2016-08-01

    David Mechanic has been a principal founder of modern sociological and social science approaches to health, especially in relation to health policy. These approaches have since the 1950s and 1960s resurrected ideas that had currency in the mid-nineteenth century but seemed crucified, dead, and buried by the rise of modern biomedicine from the mid-nineteenth century through the mid-twentieth century. Problems and lacunae in purely biomedical approaches to health in the later twentieth century, along with developments of new biopsychosocial approaches to health, have spawned a return toward ideas of Rudolf Virchow and mid-nineteenth-century social medicine that social determinants and disparities are major drivers of population health. Since individual health and population health constitute the major determinants of health care utilization and expenditures, social determinants and disparities in health are arguably the foundation of a new "demand-side" health policy that can resolve America's paradoxical health policy crisis of spending increasingly more than any nation on health care and insurance yet achieving increasingly worsening health outcomes relative to virtually all developed countries and some developing ones as well, something that current "supply-side" health policy, including Obamacare, cannot do, important as it is for expanding access to health insurance and care. Copyright © 2016 by Duke University Press.

  18. The potential of an instrument to identify social vulnerabilities and health needs: collective health knowledge and practices.

    Science.gov (United States)

    Nakamura, Eunice; Egry, Emiko Yoshikawa; Campos, Célia Maria Sivalli; Nichiata, Lúcia Yasuko Izumi; Chiesa, Anna Maria; Takahashi, Renata Ferreira

    2009-01-01

    To analyze an instrument that aims to understand the health-disease process, its potential to identify social vulnerabilities and health needs to enable the most appropriate interventions in a given territory. analysis of the data collection instrument--composed of closed and open questions to identify different profiles of social reproduction (ways of working and living)--used in the Project of Pedagogical Development and activities reported by students at a Collective Health Nursing department. The instrument enables health care professionals, especially those from Collective Health Nursing, to identify social vulnerabilities and health needs, and guide interventions in different contexts, according to the health promotion perspective. Thus, it reveals potential to transform current health practices, dynamism and constant innovation of these practices in different contexts, according to the 'radicality' that is characteristic of Collective Health.

  19. Instrumental- and Emotion-Focused Care Work During Physical Health Events: Comparing Gay, Lesbian, and Heterosexual Marriages.

    Science.gov (United States)

    Umberson, Debra; Thomeer, Mieke Beth; Kroeger, Rhiannon A; Reczek, Corinne; Donnelly, Rachel

    2017-05-01

    We consider emotion- and instrumental-focused care work and marital stress during significant physical health events in midlife gay, lesbian, and heterosexual marriages. We employ the factorial method, an extension of the actor-partner interdependence model, to analyze survey data from 808 midlife gay, lesbian, and heterosexual spouses in 404 unions. The amount of emotion- and instrumental-focused care work provided during physical health events, and the associations between care work and marital stress, depends on the gender of the respondent, gender of the spouse, and whether spouses are in a same-sex or different-sex union. For example, in both same- and different-sex marriages, women report providing more emotion-focused care work during their own health event than do men, and respondents report more health-related marital stress when the patient is a woman. Investigating how midlife same-sex and different-sex spouses care for each other during a spouse's health event expands understandings of gendered aging experiences within marriage. Findings can elucidate health policies and clinical strategies that best support the health of men and women in same- and different-sex marriages.

  20. [Public health policies in Chile: seeking to regain trust].

    Science.gov (United States)

    Cuadrado, Cristóbal

    2016-09-07

    Healthcare represents a key area in the public agenda. In the case of Chile, this central part of citizen demands has emerged with an increasing criticism of the health system, its actors and institutions, while a major democratic and legitimacy crisis in Chilean society unfolds. The starting point of this analysis is the link between the critical and widespread societal dissatisfaction with the legitimacy crisis in the health sector. There is an interdependence and parallelism between these two different aspects of the crisis. The analysis is built around the dimensions of trust and legitimacy as a potential driver of the conflict, taking as an analytical framework the socio-political matrix. Conceptual elements around the ideas of trust and legitimacy in public policies are reviewed. This article focuses on recent situations surrounding the dynamics of the Chilean health system such as the rise of the Instituciones de Salud Previsional (ISAPRE) and the market-driven health system, the failed health care reform of the last decade, conflicts of interest in the formulation of public policies, loss of legitimacy of healthcare authorities, and the role of the health professionals in this process. Finally, a discussion arises seeking to regain public trust as a central issue for the future development and sustainability of health policies.

  1. Policy statement--health equity and children's rights.

    Science.gov (United States)

    2010-04-01

    Many children in the United States fail to reach their full health and developmental potential. Disparities in their health and well-being result from the complex interplay of multiple social and environmental determinants that are not adequately addressed by current standards of pediatric practice or public policy. Integrating the principles and practice of child health equity-children's rights, social justice, human capital investment, and health equity ethics-into pediatrics will address the root causes of child health disparities. Promoting the principles and practice of equity-based clinical care, child advocacy, and child- and family-centered public policy will help to ensure that social and environmental determinants contribute positively to the health and well-being of children. The American Academy of Pediatrics and pediatricians can move the national focus from documenting child health disparities to advancing the principles and practice of child health equity and, in so doing, influence the worldwide practice of pediatrics and child health. All pediatricians, including primary care practitioners and medical and surgical subspecialists, can incorporate these principles into their practice of pediatrics and child health. Integration of these principles into competency-based training and board certification will secure their assimilation into all levels of pediatric practice.

  2. Comparison of nanoparticle measurement instruments for occupational health applications

    Energy Technology Data Exchange (ETDEWEB)

    Leskinen, J., E-mail: jani.leskinen@uef.fi [University of Eastern Finland, Fine Particle and Aerosol Technology Laboratory, Department of Environmental Science (Finland); Joutsensaari, J. [University of Eastern Finland, Department of Applied Physics (Finland); Lyyraenen, J. [VTT Technical Research Centre of Finland, Fine Particles (Finland); Koivisto, J. [Nanosafety Research Center, Finnish Institute of Occupational Health (Finland); Ruusunen, J. [University of Eastern Finland, Fine Particle and Aerosol Technology Laboratory, Department of Environmental Science (Finland); Jaervelae, M.; Tuomi, T. [Finnish Institute of Occupational Health (Finland); Haemeri, K. [University of Helsinki, Division of Atmospheric Sciences, Department of Physics (Finland); Auvinen, A. [VTT Technical Research Centre of Finland, Fine Particles (Finland); Jokiniemi, J. [University of Eastern Finland, Fine Particle and Aerosol Technology Laboratory, Department of Environmental Science (Finland)

    2012-02-15

    Nanoparticles are used in many applications because of their novel properties compared to bulk material. A growing number of employees are working with nanomaterials and their exposure to nanoparticles trough inhalation must be evaluated and monitored continuously. However, there is an ongoing debate in the scientific literature about what are the relevant parameters to measure to evaluate exposure to level. In this study, three types of nanoparticles (ammonium sulphate, synthesised TiO{sub 2} agglomerates and aerosolised TiO{sub 2} powder, modes in a range of 30-140 nm mobility size) were measured with commonly used aerosol measurement instruments: scanning and fast mobility particle sizers (SMPS, FMPS), electrical low pressure impactor (ELPI), condensation particle counter (CPC) together with nanoparticle surface area monitor (NSAM) to achieve information about the interrelations of the outputs of the instruments. In addition, the ease of use of these instruments was evaluated. Differences between the results of different instruments can mainly be attributed to the nature of test particles. For spherical ammonium sulphate nanoparticles, the data from the instruments were in good agreement while larger differences were observed for particles with more complex morphology, the TiO{sub 2} agglomerates and powder. For instance, the FMPS showed a smaller particle size, a higher number concentration and a narrower size distribution compared with the SMPS for TiO{sub 2} particles. Thus, the type of the nanoparticle was observed to influence the data obtained from these different instruments. Therefore, care and expertise are essential when interpreting results from aerosol measurement instruments to estimate nanoparticle concentrations and properties.

  3. Developing policy analytics for public health strategy and decisions-the Sheffield alcohol policy model framework.

    Science.gov (United States)

    Brennan, Alan; Meier, Petra; Purshouse, Robin; Rafia, Rachid; Meng, Yang; Hill-Macmanus, Daniel

    This paper sets out the development of a methodological framework for detailed evaluation of public health strategies for alcohol harm reduction to meet UK policy-makers needs. Alcohol is known to cause substantial harms, and controlling its affordability and availability are effective policy options. Analysis and synthesis of a variety of public and commercial data sources is needed to evaluate impact on consumers, health services, crime, employers and industry, so a sound evaluation of impact is important. We discuss the iterative process to engage with stakeholders, identify evidence/data and develop analytic approaches and produce a final model structure. We set out a series of steps in modelling impact including: classification and definition of population subgroups of interest, identification and definition of harms and outcomes for inclusion, classification of modifiable components of risk and their baseline values, specification of the baseline position on policy variables especially prices, estimating effects of changing policy variables on risk factors including price elasticities, quantifying risk functions relating risk factors to harms including 47 health conditions, crimes, absenteeism and unemployment, and monetary valuation. The most difficult model structuring decisions are described, as well as the final results framework used to provide decision support to national level policymakers in the UK. In the discussion we explore issues around the relationship between modelling and policy debates, valuation and scope, limitations of evidence/data, how the framework can be adapted to other countries and decisions. We reflect on the approach taken and outline ongoing plans for further development.

  4. Solidarity: a (new) ethic for global health policy.

    Science.gov (United States)

    Harmon, Shawn H E

    2006-12-01

    This article explores solidarity as an ethical concept underpinning rules in the global health context. First, it considers the theoretical conceptualisation of the value and some specific duties it supports (ie: its expression in the broadest sense and its derivative action-guiding duties). Second, it considers the manifestation of solidarity in two international regulatory instruments. It concludes that, although solidarity is represented in these instruments, it is often incidental. This fact, their emphasis on other values and their internal weaknesses diminishes the action-guiding impact of the solidarity rules. The global health and human subject research scene needs a completely new instrument specifically directed at means by which solidarity can be achieved, and a reformed infrastructure dedicated to realising that value.

  5. Personal responsibility within health policy: unethical and ineffective.

    Science.gov (United States)

    Friesen, Phoebe

    2016-09-22

    This paper argues against incorporating assessments of individual responsibility into healthcare policies by expanding an existing argument and offering a rebuttal to an argument in favour of such policies. First, it is argued that what primarily underlies discussions surrounding personal responsibility and healthcare is not causal responsibility, moral responsibility or culpability, as one might expect, but biases towards particular highly stigmatised behaviours. A challenge is posed for proponents of taking personal responsibility into account within health policy to either expand the debate to also include socially accepted behaviours or to provide an alternative explanation of the narrowly focused discussion. Second, a critical response is offered to arguments that claim that policies based on personal responsibility would lead to several positive outcomes including healthy behaviour change, better health outcomes and decreases in healthcare spending. It is argued that using individual responsibility as a basis for resource allocation in healthcare is unlikely to motivate positive behaviour changes, and is likely to increase inequality which may lead to worse health outcomes overall. Finally, the case of West Virginia's Medicaid reform is examined, which raises a worry that policies focused on personal responsibility have the potential to lead to increases in medical spending overall.

  6. Using social media to engage nurses in health policy development.

    Science.gov (United States)

    O'Connor, Siobhan

    2017-07-23

    To explore nurses' views on future priorities for the profession and to examine social media as an engagement tool to aid policy discussion and development. Nurses are often not directly involved in policy creation and some feel it is a process they cannot easily influence. A descriptive mixed methods study of a Twitter chat hosted by the Chief Nursing Officer for Scotland was undertaken. Data were gathered using an analytics platform and NCapture software. The framework approach aided thematic analysis to draw out themes. Sixty-four people took part in the Twitter chat (#CNOScot) and posted 444 tweets. Nurses called for investment in technology, nursing research, education and mental health. Primary care and advanced practice roles to support older adults with complex health and social care needs were also seen as vital to develop further. Social media can help reach and engage nurses in policy discussion and ensure there is better continuity between policy and practice but some groups risk being excluded using this digital medium. Nursing leaders should consider social media as one of many engagement strategies to ensure nurses and other stakeholders participate in policy debate that informs health strategy development. © 2017 The Authors. Journal of Nursing Management Published by John Wiley & Sons Ltd.

  7. Ship Compliance in Emission Control Areas: Technology Costs and Policy Instruments.

    Science.gov (United States)

    Carr, Edward W; Corbett, James J

    2015-08-18

    This paper explores whether a Panama Canal Authority pollution tax could be an effective economic instrument to achieve Emission Control Area (ECA)-like reductions in emissions from ships transiting the Panama Canal. This tariff-based policy action, whereby vessels in compliance with International Maritime Organisation (IMO) ECA standards pay a lower transit tariff than noncompliant vessels, could be a feasible alternative to petitioning for a Panamanian ECA through the IMO. A $4.06/container fuel tax could incentivize ECA-compliant emissions reductions for nearly two-thirds of Panama Canal container vessels, mainly through fuel switching; if the vessel(s) also operate in IMO-defined ECAs, exhaust-gas treatment technologies may be cost-effective. The RATES model presented here compares current abatement technologies based on hours of operation within an ECA, computing costs for a container vessel to comply with ECA standards in addition to computing the Canal tax that would reduce emissions in Panama. Retrofitted open-loop scrubbers are cost-effective only for vessels operating within an ECA for more than 4500 h annually. Fuel switching is the least-cost option to industry for vessels that operate mostly outside of ECA regions, whereas vessels operating entirely within an ECA region could reduce compliance cost with exhaust-gas treatment technology (scrubbers).

  8. Spanish security policy in the New Europe : Mediterranean dimension and European instruments

    Directory of Open Access Journals (Sweden)

    Esther Barbé

    1993-07-01

    Full Text Available The changes that have occurred in Europe in the last few years have left the bipolar order of the cold war behind, giving way to a system in process of transformation and one characterized by geographical indefinition.Two dominant tendencies appear in the New Europe : on one side the changes in the mental map (on some occasiones reliving former territorial conflicts and on the other the symbolism of the EC, a magnetic pole of attraction that has converted the Europe of the 90s into the defining axis of the new external frontier.This moving towards Central Europe and the East revives in Spain feelings of periphery and increasing uncertainty. Within this framework, Spanish security policy has centred itself on its particular, historical and geographcal objectives : the mediterranean dimension. Among the instruments two are highlighted as being of particular importance : the concept of security beyond military reach, including economic cooperation and the institutional reform of the future European defence through the development of the Maastricht Treaty.

  9. Waterpipe tobacco smoking impact on public health: implications for policy

    Directory of Open Access Journals (Sweden)

    Martinasek MP

    2015-08-01

    Full Text Available Mary P Martinasek,1 Linda M Gibson-Young,2 Janiece N Davis,3 Robert J McDermott41Public Health Department of Health Sciences and Human Performance, University of Tampa, Kennedy Boulevard, Tampa, FL, 2College of Nursing and Health Sciences, Texas A&M University: Corpus Christi, Corpus Christi, TX, 3Department of Health – Palm Beach County, West Palm beach, FL, 4Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USABackground: Given the increasing evidence of its negative health effects, including contributions to both infectious and chronic diseases, waterpipe tobacco smoking raises public health concerns beyond even those presented by traditional smoking. Methods: Identification of Clean Indoor Air Acts (CIAAs from each of the 50 United States and District of Columbia were retrieved and examined for inclusion of regulatory measures where waterpipe tobacco smoking is concerned. Several instances of exemption to current CIAAs policies were identified. The cumulative policy lens is presented in this study. Results: States vary in their inclusion of explicit wording regarding CIAAs to the point where waterpipe tobacco smoking, unlike traditional smoking products, is excluded from some legislation, thereby limiting authorities’ ability to carry out enforcement. Conclusion: Consistent, comprehensive, and unambiguous legislative language is necessary to prevent establishments where waterpipe tobacco smoking occurs from skirting legislation and other forms of regulatory control. Stricter laws are needed due to the increasing negative health impact on both the smoker and the bystander. Actions at both the federal and state levels may be needed to control health risks, particularly among youth and young adult populations.Keywords: health policy, waterpipe tobacco, hookah smoking, tobacco regulation

  10. Global health diplomacy: barriers to inserting health into Canadian foreign policy.

    Science.gov (United States)

    Runnels, Vivien; Labonté, Ronald; Ruckert, Arne

    2014-01-01

    Health opportunities and risks have become increasingly global in both cause and consequence. Governments have been slow to recognise the global dimensions of health, although this is beginning to change. A new concept - global health diplomacy (GHD) - has evolved to describe how health is now being positioned within national foreign policies and entering into regional or multilateral negotiations. Traditionally, health negotiations have been seen as 'low politics' in international affairs: however, attention is now being given to understanding better how health can increase its prominence in foreign policy priorities and multilateral forums. We sought to identify how these efforts were manifested in Canada, with a focus on current barriers to inserting health in foreign policy. We conducted individual interviews with Canadian informants who were well placed through their diplomatic experience and knowledge to address this issue. Barriers identified by the respondents included a lack of content expertise (scientific and technical understanding of health and its practice), insufficient diplomatic expertise (the practice and art of diplomacy, including legal and technical expertise), the limited ways in which health has become framed as a foreign policy issue, funding limitations and cuts for global health, and lack of cross-sectoral policy coordination and coherence, given the important role that non-health foreign policy interests (notably in trade and investment liberalisation) can play in shaping global health outcomes. We conclude with some reflections on how regime change and domestic government ideology can also function as a barrier to GHD, and what this implies for retaining or expanding the placement of health in foreign policy.

  11. Promoting cultural competence through a health policy course.

    Science.gov (United States)

    Kaplan, Louise

    2010-01-01

    A healthcare system designed to support a culturally competent work force can contribute to the elimination of health disparities. Various courses were revised as part of a multicultural transformation of a college of nursing curricula. The author discusses a health policy course revised to promote development of cultural competencies. Examples of topics, teaching strategies, and assignments for integrating concepts and content related to cultural competencies as well as comments from students that reflect their learning experiences are provided.

  12. Nursing leadership and health policy: a dialogue with nurse leaders.

    Science.gov (United States)

    Clarke, Pamela N; Swider, Susan; Bigley, Mary Beth

    2013-04-01

    National public health policy influencing the entire population is particularly exciting when nurses serve as key players informing the process. The leaders in this dialogue participated in the process by sharing their disciplinary knowledge and experience. They were selected to work with bureaucrats to design healthcare for the future. This dialogue among two nurse leaders demonstrates a path to top leadership in the United States. Swider and Bigley here share their stories of how they moved beyond clinical practice to involvement in their communities and the nation. Through public health and policy initiatives, both nurse leaders have helped shape healthcare to provide better patient-centered care at all levels. This dialogue not only shares their successes, but also sets the stage for others in nursing to use policy to transform healthcare for the future.

  13. [Health policies and politicized health? An analysis of sexual and reproductive health policies in Peru from the perspective of medical ethics, quality of care, and human rights].

    Science.gov (United States)

    Miranda, J Jaime; Yamin, Alicia Ely

    2008-01-01

    Health professionals view medical ethics as a discipline that provides the basis for more adequate patient care. In recent years the concepts of quality of care and human rights - with their attending discourses - have joined the concept of medical ethics among the paradigms to consider in care for humans both at the individual and health policy levels. The current study seeks to analyze such paradigms, based on a case study of sexual and reproductive health policies in Peru in the last 10 years.

  14. Health-Education Policy Interface: The Implementation of the Eat Well Be Active Policies in Schools

    Science.gov (United States)

    Leow, Anthony Chee Siong; Macdonald, Doune; Hay, Peter; McCuaig, Louise

    2014-01-01

    While grappling with their traditional core business of imbuing students with official curricular knowledge, schools have simultaneously, increasing demands to take on health promotion responsibilities. This paper examines the mandated implementation of the Eat Well Be Active (EWBA) Action Plan and its subsidiary "Smart" policies in…

  15. Locating regional health policy: Institutions, politics, and practices

    Science.gov (United States)

    Riggirozzi, Pia; Yeates, Nicola

    2015-01-01

    Poverty reduction and health became central in the agendas of Southern regional organisations in the last two decades. Yet, little is known about how these organisations address poverty, inclusion and social inequality, and how Southern regional formations are engaging in power constellations, institutions, processes, interests and ideological positions within different spheres of governance. This article reviews academic literatures spanning global social policy, regional studies and diplomacy studies, and the state of knowledge and understanding of the ‘place’ of regional actors in health governance as a global political practice therein. It identifies theoretical and thematic points of connection between disparate literatures and how these can be bridged through research focusing on the social policies of regional organisations and regional integration processes. This framework hence locates the contributions of each of the research articles of this Special Issue of Global Social Policy on the regional dimension of health policy and diplomacy in relation to Southern Africa and South America. It also highlights the ways in which the articles bring new evidence about how social relations of welfare are being (re)made over larger scales and how regional actors may initiate new norms to improve health rights in international arenas engaging in new forms of ‘regional’ diplomacy. PMID:26635495

  16. Policy interpretation network on children's health and environment.

    NARCIS (Netherlands)

    Hazel, P.J. van den; Zuurbier, M.; Bistrup, M.L.

    2006-01-01

    Aim: The main objective of PINCHE is to provide policy recommendations aiming at protecting children's health and environment based on completed scientific research. The project focused on four themes: indoor and outdoor air pollutants, carcinogens, neurotoxicants, and noise. The data were evaluated

  17. Healthy kids: Making school health policy a participatory learning process

    DEFF Research Database (Denmark)

    Stjernqvist, Nanna Wurr; Bruselius-Jensen, Maria; Høstgaard Bonde, Ane

    ’s prime objective, barriers potentially prevail if models do not consider the existing structures of the school. As part of the on-going project - Healthy Kids -, this presentation introduces a school health policy model, developed as an ‘add-in’ to the school curriculum and organisational practices...

  18. Measurement of health equity as a driver for impacting policies.

    Science.gov (United States)

    Rashad, Hoda; Khadr, Zeinab

    2014-06-01

    This paper proposes measurement tracks of health equity (HE) and presents practical illustrations to influence, inform and guide the uptake of equity-sensitive policies. It discusses the basic requirements that allow the effective use of the proposed measurement tracks. Egypt is used as a demonstration of this practice. The paper differentiates between the policy needs of two groups of countries. The first set of measurement tracks are specifically tailored to countries at the early stages of considering health equity, requiring support in placing HE on the policy agenda. Key messages for this group of countries are that the policy influence of measurement can be strengthened through the implementation of four self-reinforcing tracks that recognize the need to effectively use the available current databases prior to engaging in new data collection, emphasize the importance of a social justice reframing of the documented health inequities, present health inequity facts in simple visual messages and move beyond the why to what needs to be done and how. The tracks also recognizes that placing an issue on the policy agenda is a complex matter requiring reinforcement from many actors and navigation among competing forces and policy circles. For the second group of countries the paper discusses the monitoring framework. The key messages include the importance of moving toward a more comprehensive system that sustains the monitoring system which is embedded within affective participatory accountability mechanisms. The paper discusses the basic requirements and the institutional, financial, technical and human capacity-building considerations for implementing the proposed measurement tracks.

  19. Health financing for universal coverage and health system performance: concepts and implications for policy.

    Science.gov (United States)

    Kutzin, Joseph

    2013-08-01

    Unless the concept is clearly understood, "universal coverage" (or universal health coverage, UHC) can be used to justify practically any health financing reform or scheme. This paper unpacks the definition of health financing for universal coverage as used in the World Health Organization's World health report 2010 to show how UHC embodies specific health system goals and intermediate objectives and, broadly, how health financing reforms can influence these. All countries seek to improve equity in the use of health services, service quality and financial protection for their populations. Hence, the pursuit of UHC is relevant to every country. Health financing policy is an integral part of efforts to move towards UHC, but for health financing policy to be aligned with the pursuit of UHC, health system reforms need to be aimed explicitly at improving coverage and the intermediate objectives linked to it, namely, efficiency, equity in health resource distribution and transparency and accountability. The unit of analysis for goals and objectives must be the population and health system as a whole. What matters is not how a particular financing scheme affects its individual members, but rather, how it influences progress towards UHC at the population level. Concern only with specific schemes is incompatible with a universal coverage approach and may even undermine UHC, particularly in terms of equity. Conversely, if a scheme is fully oriented towards system-level goals and objectives, it can further progress towards UHC. Policy and policy analysis need to shift from the scheme to the system level.

  20. Public health genomics Relevance of genomics for individual health information management, health policy development and effective health services.

    Directory of Open Access Journals (Sweden)

    Angela Brand

    2006-12-01

    Full Text Available Healthcare delivery systems are facing fundamental challenges. New ways of organising theses systems based on the different needs of stakeholders’ are required to meet these challenges. While medicine is currently undergoing remarkable developments from its morphological and phenotype orientation to a molecular and genotype orientation, promoting the importance of prognosis and prediction, the discussion about the relevance of genome-based information and technologies for the health care system as a whole and especially for public health is still in its infancy. The following article discusses the relevance of genome-based information and technologies for individual health information management, health policy development and effective health services.

  1. Influence of macrosocial policies on women's health and gender inequalities in health.

    Science.gov (United States)

    Borrell, Carme; Palència, Laia; Muntaner, Carles; Urquía, Marcelo; Malmusi, Davide; O'Campo, Patricia

    2014-01-01

    Gender inequalities in health have been widely described, but few studies have examined the upstream sources of these inequalities in health. The objectives of this review are 1) to identify empirical papers that assessed the effect of gender equality policies on gender inequalities in health or on women's health by using between-country (or administrative units within a country) comparisons and 2) to provide an example of published evidence on the effects of a specific policy (parental leave) on women's health. We conducted a literature search covering the period from 1970 to 2012, using several bibliographical databases. We assessed 1,238 abstracts and selected 19 papers that considered gender equality policies, compared several countries or different states in 1 country, and analyzed at least 1 health outcome among women or compared between genders. To illustrate specific policy effects, we also selected articles that assessed associations between parental leave and women's health. Our review partially supports the hypothesis that Nordic social democratic welfare regimes and dual-earner family models best promote women's health. Meanwhile, enforcement of reproductive policies, mainly studied across US states, is associated with better mental health outcomes, although less with other outcomes. Longer paid maternity leave was also generally associated with better mental health and longer duration of breastfeeding.

  2. Risk policies and risk perceptions: a comparative study of environmental health risk policy and perception in six European countries

    NARCIS (Netherlands)

    Bröer, C.; Moerman, G.; Spruijt, P.; van Poll, R.

    2014-01-01

    This paper explores the influence that health risk policies have on the citizens’ perceptions of those health risks. Previously, detailed mixed methods research revealed that noise annoyance policies shaped noise perception. This idea is now applied to nine different environmental health risks in si

  3. A multi-criteria evaluation of policy instruments for climate change mitigation in the power generation sector of Trinidad and Tobago

    Energy Technology Data Exchange (ETDEWEB)

    Heinrich Blechinger, Philipp Friedrich, E-mail: p.blechinger@gmx.de [Department of Environmental and Economic Policy, Berlin Institute of Technology, H 50, Strasse des 17. Juni 135, Berlin 10623 (Germany); Shah, Kalim U., E-mail: kalim_shah@hotmail.com [Arthur Lok-Jack Graduate School of Business, University of the West Indies, P.O. Box 4874, Max Richards Drive, Uriah Butler Highway N.W., Mount Hope (Trinidad and Tobago); Faculty of Environmental Studies, York University, HNES 109, 4700 Keele St., Toronto, Ontario, M3J 1P3 (Canada)

    2011-10-15

    Even as small island developing states (SIDS) like Trinidad and Tobago (T and T) increase industrialization and grapple with the challenges of increased pollution, few studies provide guidance to policy makers of such countries on appropriate policy measures and instruments that can be implemented to mitigate greenhouse gas emissions. Here we apply a multi-criteria evaluation methodology to ascertain preferences for policy measures and instruments in the power generation sector. Four broad policy measures and twelve policy instruments are assessed on criteria of environmental performance, feasibility of implementation and political acceptability. This method proves useful in T and T, since typical to many SIDS, the intensive data required by other policy assessment methods is unavailable. Results indicate little difference in preference among the four policy measures thereby indicating that a multi-pronged approach on several policy fronts is required. The most preferred policy instruments to operationalize measures included provision of subsidies for energy saving technologies, creating an industry wide carbon trading scheme and implementing a feed-in tariff to increase the use of renewable energy sources. This study therefore provides specific insights for policy makers in Trinidad and Tobago while also providing power generation sector specific guidance to other rapidly industrializing small island developing states. - Highlights: > Application of the MCA as research method to evaluate policy instruments for SIDS. > Evaluation of the importance of evaluation criteria for greenhouse gas policy. > Difference in policy preferences among industry, academic and policy experts. > Results of panel evaluation of twelve greenhouse gas mitigation policy instruments. > Planning a way forward for greenhouse gas policy in Trinidad and Tobago.

  4. Policies for accelerating access to clean energy, improving health, advancing development, and mitigating climate change.

    Science.gov (United States)

    Haines, Andy; Smith, Kirk R; Anderson, Dennis; Epstein, Paul R; McMichael, Anthony J; Roberts, Ian; Wilkinson, Paul; Woodcock, James; Woods, Jeremy

    2007-10-06

    The absence of reliable access to clean energy and the services it provides imposes a large disease burden on low-income populations and impedes prospects for development. Furthermore, current patterns of fossil-fuel use cause substantial ill-health from air pollution and occupational hazards. Impending climate change, mainly driven by energy use, now also threatens health. Policies to promote access to non-polluting and sustainable sources of energy have great potential both to improve public health and to mitigate (prevent) climate disruption. There are several technological options, policy levers, and economic instruments for sectors such as power generation, transport, agriculture, and the built environment. However, barriers to change include vested interests, political inertia, inability to take meaningful action, profound global inequalities, weak technology-transfer mechanisms, and knowledge gaps that must be addressed to transform global markets. The need for policies that prevent dangerous anthropogenic interference with the climate while addressing the energy needs of disadvantaged people is a central challenge of the current era. A comprehensive programme for clean energy should optimise mitigation and, simultaneously, adaption to climate change while maximising co-benefits for health--eg, through improved air, water, and food quality. Intersectoral research and concerted action, both nationally and internationally, will be required.

  5. Policy Instruments for an Increased Supply of Energy Crops; Styrmedel foer ett utoekat utbud av biobraensle

    Energy Technology Data Exchange (ETDEWEB)

    Stenkvist, Maria; Widmark, Annika; Wiklund, Sven-Erik; Liljeblad, Anna

    2009-05-15

    At present, energy crops are not commonly used as fuel for heat and power production in Sweden, but as a result of increased competition for biomass, the interest for agricultural fuels such as willow, straw, reed canary grass and hemp increases. The purpose of this study is through a qualitative study that includes a literature study as well as case studies carried out by interviews, with respondents in the agriculture- and energy sectors highlight the conditions for increased production and use of energy crops. The main objective is to propose relevant policy instruments that could increase the production and use of energy crops. The purpose with the proposed policy instruments is that they should serve as a basis for discussions with politicians and authorities regarding the supply of bio fuels through the use of energy crops. The result of the study indicates that the main obstacle for increasing the production and use of energy crops is that the cultivation of energy crops today is unprofitable. To reduce the production costs it is necessary to improve the competitiveness of energy crops, primarily in relation to wood chips. The study shows that there is a potential for reduction of production costs through development of the logistics chain. Policy measures promoting the use of bio fuels exists today, but are not fully used to increase the share of energy crops in the bio fuel energy mix. The reason for this is that they are generally not as cost efficient as alternative bio fuels. It is important that competition issues are addressed, both regarding competition issues between different bio fuels, but also competition issues between various energy crops that exists today. Further obstacles to accelerate the introduction of energy crops at the market are high investment costs for establishment of some of the energy crops. From the analysis in this study, the following policy instruments are suggested in order to increase the production and the use of energy

  6. Crisis, neoliberal health policy, and political processes in Mexico.

    Science.gov (United States)

    Laurell, A C

    1991-01-01

    The Mexican case represents an orthodox neoliberal health policy in the context of the structural adjustment adopted by the Mexican government in 1983. The social costs of this strategy are very high, including an increase in unemployment, wage depression, regressive redistribution of wealth, and profound changes in social policies. These transformations are reflected in the health sector, where the four main axes of neoliberal policy--expenditure restrictions, targeting, decentralization, and privatization--have been implemented. This represents a change in social policy from a model based on citizens' social rights and the state's obligation to guarantee them, to a model characterized by selective public charity. This strategy has been imposed on society as a result of the Mexican corporative political regime based on a state party system. Since 1985, however, there has been a growing process of independent organization of civil society. This led in the presidential elections of 1988 to the defeat of the candidate of the governing party by the candidate of a popular-democratic opposition front. Although the government party imposed its candidate through electoral fraud, social mobilization against neoliberal policies continues in the midst of an important political crisis that can only be resolved by profound democratization of Mexican society.

  7. Health Promotion in Danish schools: local priorities, policies and practices

    DEFF Research Database (Denmark)

    Simovska, Venka; Nordin, Lone Lindegard; Madsen, Katrine Dahl

    2016-01-01

    of school-based health promotion is underpinned by high level policy documents, declarations and agreements between and within governments. International organizations, such as the World Health Organization, have long called upon governments throughout Europe and globally to incorporate health......-related knowledge, skills and attitudes in their education systems from an early age and to provide a foundation for the promotion of lifelong health and wellbeing (e.g. WHO, 1986; 1991; 1997; 1999; 2014). One question that could be asked in this respect is what happens when these political initiatives...... with the drive to increase the quality and effectiveness of health promotion in schools while remaining loyal to the main principles of the critical, socio-ecological paradigm of the Health Promoting Schools initiative (Green and Tones, 2010). In the following, we first present the conceptual framework, context...

  8. Policy Perspectives on Migration of Romanian Health Personnel

    Directory of Open Access Journals (Sweden)

    Irina CEHAN

    2012-12-01

    Full Text Available The phenomenon of international migration of healthcare professionals has increased in the last decade and, although it is not a reason for the world crisis of labour in area of healthcare in some countries, it is indeed a major element of human resource shortages. Romania is an example for a country where the significant scale of emigration of healthcare professionals has severely added to the crisis of the health system. So far, Romania has failed to formulate a comprehensive strategy to address the existing shortage of medical personnel and to retain medical professionals trained in the country. The analysis has shown that there is a need to improve the current policies to guarantee the access to healthcare services to everyone.This paper underlines the necessity of improving the Romanian existing policies in health system to address the problem of migration of health personnel, as it is fundamental for the functioning of the whole health system and also proposes some recommendations for future health policies.

  9. Social responsibility of nursing in policies of health humanization

    Directory of Open Access Journals (Sweden)

    Mercedes Trentini

    2011-07-01

    Full Text Available Background: new conceptions of the world have focused on restructuring health policies and designing a new healthcare model.Objective: to reflect on the humanization policy as part of health promotion with emphasis on nursing care.Content: The article mentions paradigm changes and refers to the biomedical model and the new condition of diversity in models of care practices for health promotion and co-responsibility of nursing in generating and sustaining the humanization of nursing care. It rethinks strategies and commitment to co-responsibility by nursing staff in promoting population health. Participation of nurses in promoting humanization care has shown signs of development in its acceptance, bonding healthcare service professionals and its users. An interview-conversation as a strategy for collecting information is highlighted, whether to care or to research based on a humanization framework.Conclusions: Sensitive listening, modality of dialogue, and the conversational interview method are relationship techniques and means to acquire skills for policy development in humanizing care in health promotion.

  10. Beyond leadership: political strategies for coordination in health policies.

    Science.gov (United States)

    Greer, Scott L; Lillvis, Denise F

    2014-05-01

    Health in All Policies (HiAP) promises to improve population health by harnessing the energies and activities of various sectors. Nevertheless, it faces well-documented bureaucratic obstacles and appears to require intersectoral governance if it is to be established. The basic problems of establishing intersectoral governance for HiAP are known to public administration and political science. On reading that literature, we find that the difficulty of establishing intersectoral governance for HiAP breaks down into two kinds of problems: that of establishing coordinated actions at all (coordination); and ensuring that they endure in changed political circumstances (durability). We further find that policymakers' solutions fall into three categories: visible ones of political will (e.g., plans and targets); bureaucratic changes such as the introduction of Health Impact Assessment or reorganization; and indirect methods such as data publication and support from outside groups to put pressure on the government. It can seem that Health in All Policies, like much of public health, depends on effective and committed policymakers but is vulnerable to changing political winds. The three kinds of strategies suggest how policymakers can, and do, create intersectoral governance that functions and persists, expanding the range of effective policy recommendations.

  11. Integrated mental health services in England: a policy paradox

    Directory of Open Access Journals (Sweden)

    Elizabeth England

    2005-10-01

    Full Text Available Purpose: The purpose of this paper is to examine the effects of health care policy on the development of integrated mental health services in England. Data sources: Drawing largely from a narrative review of the literature on adult mental health services published between January 1997 and February 2003 undertaken by the authors, we discuss three case studies of integrated care within primary care, secondary care and across the primary/secondary interface for people with serious mental illness. Conclusion: We suggest that while the central thrust of a raft of recent Government policies in England has been towards integration of different parts of the health care system, policy waterfalls and implementation failures, the adoption of ideas before they have been thoroughly tried and tested, a lack of clarity over roles and responsibilities and poor communication have led to an integration rhetoric/reality gap in practice. This has particular implications for people with serious mental health problems. Discussion: We conclude with suggestions for strategies that may facilitate more integrated working.

  12. Validation of the instrument of health literacy competencies for Chinese-speaking health professionals.

    Science.gov (United States)

    Chang, Li-Chun; Chen, Yu-Chi; Liao, Li-Ling; Wu, Fei Ling; Hsieh, Pei-Lin; Chen, Hsiao-Jung

    2017-01-01

    The study aimed to illustrate the constructs and test the psychometric properties of an instrument of health literacy competencies (IOHLC) for health professionals. A multi-phase questionnaire development method was used to develop the scale. The categorization of the knowledge and practice domains achieved consensus through a modified Delphi process. To reduce the number of items, the 92-item IOHLC was psychometrically evaluated through internal consistency, Rasch modeling, and two-stage factor analysis. In total, 736 practitioners, including nurses, nurse practitioners, health educators, case managers, and dieticians completed the 92-item IOHLC online from May 2012 to January 2013. The final version of the IOHLC covered 9 knowledge items and 40 skill items containing 9 dimensions, with good model fit, and explaining 72% of total variance. All domains had acceptable internal consistency and discriminant validity. The tool in this study is the first to verify health literacy competencies rigorously. Moreover, through psychometric testing, the 49-item IOHLC demonstrates adequate reliability and validity. The IOHLC may serve as a reference for the theoretical and in-service training of Chinese-speaking individuals' health literacy competencies.

  13. Validation of the instrument of health literacy competencies for Chinese-speaking health professionals

    Science.gov (United States)

    Chang, Li-Chun

    2017-01-01

    The study aimed to illustrate the constructs and test the psychometric properties of an instrument of health literacy competencies (IOHLC) for health professionals. A multi-phase questionnaire development method was used to develop the scale. The categorization of the knowledge and practice domains achieved consensus through a modified Delphi process. To reduce the number of items, the 92-item IOHLC was psychometrically evaluated through internal consistency, Rasch modeling, and two-stage factor analysis. In total, 736 practitioners, including nurses, nurse practitioners, health educators, case managers, and dieticians completed the 92-item IOHLC online from May 2012 to January 2013. The final version of the IOHLC covered 9 knowledge items and 40 skill items containing 9 dimensions, with good model fit, and explaining 72% of total variance. All domains had acceptable internal consistency and discriminant validity. The tool in this study is the first to verify health literacy competencies rigorously. Moreover, through psychometric testing, the 49-item IOHLC demonstrates adequate reliability and validity. The IOHLC may serve as a reference for the theoretical and in-service training of Chinese-speaking individuals’ health literacy competencies. PMID:28264036

  14. Public health policy and walking in England-analysis of the 2008 'policy window'.

    Science.gov (United States)

    Milton, Karen; Grix, Jonathan

    2015-07-05

    Although the government in England has a long-standing interest in walking promotion, this has not been accompanied by a coherent strategic plan or investment to support physical activity behaviour change. However, in 2008 the government announced its intention to invest £7 million into walking promotion. This article utilises Kingdon's Multiple Streams framework as an organising principle through which to interrogate the reasons behind the increased emphasis on walking promotion as part of the public health policy agenda in England. The research adopted a case study design. Data were obtained through document analysis of relevant policies and semi-structured interviews with experts in the walking sector, including both government and non-government representatives. Kingdon's Multiple Streams theory proposes that at certain points in time, 'policy windows' are created through the convergence of a problem, an appropriate solution, and a receptive political environment, and this policy window presents an opportunity for major policy change. The findings of this research suggest that the success of London in securing the 2012 Olympic and Paralympic Games was the primary trigger in the creation of a policy window for walking promotion in recent years. Despite previous interest in walking promotion from the health and transport sectors, it was the recent alignment with the sports agenda that led to increased political commitment. This raises concerns that the research evidence on the health benefits of physical activity and rising levels of inactivity in England, are insufficient to secure government support and investment, and that multi-sector lobbying and joined-up political action may be critical in advancing this agenda.

  15. 42 CFR 100.2 - Average cost of a health insurance policy.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Average cost of a health insurance policy. 100.2... VACCINE INJURY COMPENSATION § 100.2 Average cost of a health insurance policy. For purposes of determining..., less certain deductions. One of the deductions is the average cost of a health insurance policy,...

  16. Instruments for the regional sustainable development in Albania - Instruments for supporting the implementation of regional development policy

    Directory of Open Access Journals (Sweden)

    Manjola Duli

    2016-07-01

    Full Text Available Regional development is a cross-cutting issue. The current approach to regional development in Europe is place-based, in which multidimensional analyses are carried out and strategies and policies developed in relation to territorially defined socio-economic and environmental factors. In our study we have largely followed this approach, looking at long-term changes in a wide set of development indicators across Albania. As a result several regional typologies are presented as well as broad recommendations for regional development policy formulation. Albania has two levels of governance: national, county (qarks and local (municipalities. Directly elected bodies exist at central and local levels. Qark councils consist of delegated representatives from local units. Albania’s territory is organized into 12 counties and 61 local government units. There are neither administrative nor self-governing regions in Albania corresponding to NUTS 21 level classification. Qarks are the equivalent of NUTS 3 level. Currently in Albania there is no clear definition of a development region. In general it is perceived that qarks can be considered an appropriate level at which regional development is analyzed, promoted and monitored. Although we have followed this concept, both due to data available and no better practical alternative, there are clearly other possibilities which could surface in the medium-term perspective, for example: NUTS 2 delineation for Albania could lead to a situation when development issues will become also relevant at the macro level – practically the number of NUTS 2 regions in Albania could vary between 2 and 3 unless the country is allowed to stay one region; Territorial and administrative reforms could lead to a much smaller number of LGUs both at the basic municipality level and the qark level, especially that from a general RD perspective some of the qarks represent very small units, both in terms of population and size of the

  17. Nursing consultation and arterial hypertension in the Family Health Strategy: an instrument proposal

    OpenAIRE

    Larissa Codogno; Vanessa Pellegrino Toledo; Érika Christiane Marocco Duran

    2012-01-01

    This study aimed to elaborate an instrument for nursing consultations for hypertensive patients attended in the Family Health Strategy, based on Horta’s model. The instrument covers identification data, medical history, physical examination, diagnosis, expected results, prescription and nursing evolution. An instrument to guide nursing consultations with hypertensive patients allows the identification of individual and social variables that influence the evolution of hypertension, contributin...

  18. Using problem-based learning to teach health policy at the DNP level.

    Science.gov (United States)

    Hayne, Arlene N; Schlosser, Sharron P

    2014-01-01

    Nursing education recognizes the importance of graduate nurses understanding their roles as advocates, developers, implementers, and evaluators of health policies to impact the delivery of safe, patient-centered care. This article describes the use of problem-based learning as one approach to DNP health policy education. Students select a health problem and an associated health policy and use evidence-based practice, scholarly writing, and health services research to analyze the policy for efficiency, effectiveness, and equity.

  19. Human rights and correctional health policy: a view from Europe.

    Science.gov (United States)

    Rogan, Mary

    2017-03-13

    Purpose Correctional healthcare should promote the protection of human rights. The purpose of this paper is to bring a discussion of human rights into debates on how such policy should be best organized. Design/methodology/approach The paper achieves its aim by providing an analysis of European prison law and policy in the area of prison health, through assessing decisions of the European Court of Human Rights, as well as policies created by the European Committee for the Prevention of Torture. Findings The paper describes the position of the European Court of Human Rights on the topics of access to healthcare, ill health and release from prison, mental illness in prison, and the duty to provide rehabilitative programming for those seeking to reduce their level of "risk." It also argues that human rights law can be a source of practical reform, and that legal frameworks have much to offer healthcare leaders seeking to uphold the dignity of those in their care. Originality/value This paper will provide a rare example of the engagement of human rights law with correctional health policy. It provides practical recommendations arising out of an analysis of European human rights law in the area of prisons.

  20. Trends in public health policies addressing violence against women

    Directory of Open Access Journals (Sweden)

    Kattia Rojas Loría

    2014-08-01

    Full Text Available OBJECTIVE To analyze the content of policies and action plans within the public healthcare system that addresses the issue of violence against women. METHODS A descriptive and comparative study was conducted on the health policies and plans in Catalonia and Costa Rica from 2005 to 2011. It uses a qualitative methodology with documentary analysis. It is classified by topics that describe and interpret the contents. We considered dimensions, such as principles, strategies, concepts concerning violence against women, health trends, and evaluations. RESULTS Thirteen public policy documents were analyzed. In both countries’ contexts, we have provided an overview of violence against women as a problem whose roots are in gender inequality. The strategies of gender policies that address violence against women are cultural exchange and institutional action within the public healthcare system. The actions of the healthcare sector are expanded into specific plans. The priorities and specificity of actions in healthcare plans were the distinguishing features between the two countries. CONCLUSIONS The common features of the healthcare plans in both the counties include violence against women, use of protocols, detection tasks, care and recovery for women, and professional self-care. Catalonia does not consider healthcare actions with aggressors. Costa Rica has a lower specificity in conceptualization and protocol patterns, as well as a lack of updates concerning health standards in Catalonia.

  1. Trends in public health policies addressing violence against women

    Science.gov (United States)

    Loría, Kattia Rojas; Rosado, Teresa Gutiérrez; Espinosa, Leonor María Cantera; Marrochi, Leda María Marenco; Sánchez, Anna Fernández

    2014-01-01

    OBJECTIVE To analyze the content of policies and action plans within the public healthcare system that addresses the issue of violence against women. METHODS A descriptive and comparative study was conducted on the health policies and plans in Catalonia and Costa Rica from 2005 to 2011. It uses a qualitative methodology with documentary analysis. It is classified by topics that describe and interpret the contents. We considered dimensions, such as principles, strategies, concepts concerning violence against women, health trends, and evaluations. RESULTS Thirteen public policy documents were analyzed. In both countries’ contexts, we have provided an overview of violence against women as a problem whose roots are in gender inequality. The strategies of gender policies that address violence against women are cultural exchange and institutional action within the public healthcare system. The actions of the healthcare sector are expanded into specific plans. The priorities and specificity of actions in healthcare plans were the distinguishing features between the two countries. CONCLUSIONS The common features of the healthcare plans in both the counties include violence against women, use of protocols, detection tasks, care and recovery for women, and professional self-care. Catalonia does not consider healthcare actions with aggressors. Costa Rica has a lower specificity in conceptualization and protocol patterns, as well as a lack of updates concerning health standards in Catalonia. PMID:25210820

  2. Paradigmatic obstacles to improving the health of populations: implications for health policy

    Directory of Open Access Journals (Sweden)

    McKinlay John B.

    1998-01-01

    Full Text Available While there are promising developments in public health, most interventions (both at the individual and community levels remain focused on "downstream" tertiary treatments or one-on-one interventions. These efforts have their origins in the biomedical paradigm and risk factor epidemiology and the behavioral science research methods that serve as their handmaidens. This paper argues for a more appropriate balance of "downstream" efforts with a more appropriate whole population public health approach to health policy -what may be termed a social policy approach to healthy lifestyles rather than the current lifestyle approach to health policy. New, more appropriate research methods must be developed and applied to match these emerging levels of whole population intervention. We must avoid any disjunction between new upstream policy level interventions and the methods used to measure their effect -appropriate unto the intervention level must be the evaluation method thereof.

  3. Competition policy for health care provision in Germany.

    Science.gov (United States)

    Kifmann, Mathias

    2017-02-01

    Since the 1990s, Germany has introduced a number of competitive elements into its public health care system. Sickness funds were given some freedom to sign selective contracts with providers. Competition between ambulatory care providers and hospitals was introduced for certain diseases and services. As competition has become more intense, the importance of competition law has increased. This paper reviews these areas of competition policy. The problems of introducing competition into a corporatist system are discussed. Based on the scientific evidence on the effects of competition, key lessons and implications for future policy are formulated. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Caught in the middle: the contested politics of HIV/AIDS and health policy in Vietnam.

    Science.gov (United States)

    Hirsch, Jennifer S; Giang, Le Minh; Parker, Richard G; Duong, Le Bach

    2015-02-01

    Drawing on the changing landscape of responses to HIV in Vietnam, this article describes the key players and analyzes the relationships between global players and local interests, including both the omnipresent state and an emerging civil society presence. We discuss the critical importance of timing for policy intervention and the role of health policy in shaping the broader social terrain. The interventions of external actors such as the US President's Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund were instrumental in improving both policies and programs at a critical juncture, when the national responses to the epidemic had been ineffective. At the same time, those global interventions met resistance and led to unintended consequences, both welcome and unwelcome. Furthermore, the looming specter of donor withdrawal and the very gradually emerging national ownership raise many questions about capacity for scale-up and sustainability of the significant achievements to date. Further monitoring and in-depth analysis of the Vietnamese responses to the HIV epidemic in the next few years or so, we contend, have the potential to provide unique insights into the challenges faced by developing countries caught in the complex webs of health politics and policies at both the global and the national levels.

  5. Democracy - the real 'ghost' in the machine of global health policy: Comment on "A ghost in the machine? politics in global health policy".

    Science.gov (United States)

    Harmer, Andrew

    2014-08-01

    Politics is not the ghost in the machine of global health policy. Conceptually, it makes little sense to argue otherwise, while history is replete with examples of individuals and movements engaging politically in global health policy. Were one looking for ghosts, a more likely candidate would be democracy, which is currently under attack by a new global health technocracy. Civil society movements offer an opportunity to breathe life into a vital, but dying, political component of global health policy.

  6. A systematic survey instrument translation process for multi-country, comparative health workforce studies

    NARCIS (Netherlands)

    Squires, A.; Aiken, L.H.; Heede, K. Van den; Sermeus, W.; Bruyneel, L.; Lindqvist, R.; Schoonhoven, L.; Stromseng, I.; Busse, R.; Brzostek, T.; Ensio, A.; Moreno-Casbas, M.; Rafferty, A.M.; Schubert, M.; Zikos, D.; Matthews, A.

    2013-01-01

    BACKGROUND: As health services research (HSR) expands across the globe, researchers will adopt health services and health worker evaluation instruments developed in one country for use in another. This paper explores the cross-cultural methodological challenges involved in translating HSR in the

  7. Advanced health biotechnologies in Thailand: redefining policy directions

    Directory of Open Access Journals (Sweden)

    Velasco Román Pérez

    2013-01-01

    Full Text Available Abstract Background Thailand faces a significant burden in terms of treating and managing degenerative and chronic diseases. Moreover, incidences of rare diseases are rising. Many of these—such as diabetes, cancer, and inherited inborn metabolic diseases—have no definite treatments or cure. Meanwhile, advanced health biotechnology has been found, in principle, to be an effective solution for these health problems. Methods Qualitative approaches were employed to analyse the current situation and examine existing public policies related to advanced health biotechnologies in Thailand. The results of this analysis were then used to formulate policy recommendations. Results Our research revealed that the system in Thailand in relation to advanced health biotechnologies is fragmented, with multiple unaddressed gaps, underfunding of research and development (R&D, and a lack of incentives for the private sector. In addition, there are no clear definitions of advanced health biotechnologies, and coverage pathways are absent. Meanwhile, false advertising and misinformation are prevalent, with no responsible bodies to actively and effectively provide appropriate information and education (I&E. The establishment of a specialised institution to fill the gaps in this area is warranted. Conclusion The development and implementation of a comprehensive national strategic plan related to advanced health biotechnologies, greater investment in R&D and I&E for all stakeholders, collaboration among agencies, harmonisation of reimbursement across public health schemes, and provision of targeted I&E are specifically recommended.

  8. RES-E-NEXT: Next Generation of RES-E Policy Instruments

    Energy Technology Data Exchange (ETDEWEB)

    Miller, M.; Bird, L.; Cochran, J.; Milligan, M.; Bazilian, M. [National Renewable Energy Laboratory, Golden, CO (United States); Denny, E.; Dillon, J.; Bialek, J.; O’Malley, M. [Ecar Limited (Ireland); Neuhoff, K. [DIW Berlin (Germany)

    2013-07-04

    The RES-E-NEXT study identifies policies that are required for the next phase of renewable energy support. The study analyses policy options that secure high shares of renewable electricity generation and adequate grid infrastructure, enhance flexibility and ensure an appropriate market design. Measures have limited costs or even save money, and policies can be gradually implemented.

  9. Information Flow and Health Policy Literacy: The Role of the Media

    Directory of Open Access Journals (Sweden)

    Sophya Yumakulov

    2012-08-01

    Full Text Available People increasingly can and want to obtain and generate health information themselves. With the increasing do-it-yourself sentiment comes also the desire to be more involved in one’s health care decisions. Patient driven health-care and health research models are emerging; terms such as participatory medicine and quantified-self are visible increasingly. Given the health consumer’s desire to be more involved in health data generation and health care decision making processes the authors submit that it is important to be health policy literate, to understanding how health policies are developed, what themes are discussed among health policy researchers and policy makers, to understand how ones demands would be discussed within health policy discourses. The public increasingly obtains their knowledge through the internet by searching web browsers for keywords. Question is whether the “health consumer” to come has knowledge of key terms defining key health policy discourses which would enable them to perform targeted searches for health policy literature relevant to their situation. The authors found that key health policy terms are virtually absent from printed and online news media which begs the question how the “health consumer” might learn about key health policy terms needed for web based searches that would allow the “health consumer” to access health policy discourses relevant to them.

  10. Financing national policy on oral health in Brazil in the context of the Unified Health System

    Directory of Open Access Journals (Sweden)

    Gilberto Alfredo Pucca Junior

    2010-01-01

    Full Text Available This article discusses the model of oral health care implemented in the Unified Health System of Brazil in the last decade. This model was conceived as a sub-sector policy that, over the years, has sought to improve the quality of life of the Brazilian population. Through a chronological line, the study presents the National Policy on Oral Health as a counter-hegemonic patient care model for the dentistry practices existing in the country before this policy was implemented. The reorganization of the levels of oral health care, the creation of reference facilities for secondary and tertiary care, through Centers of Dental Specialties and Regional Dental Prosthesis Laboratories, and the differential funding and decentralized management of financial resources were able to expand the actions of oral health for more than 90 million inhabitants. The evolution shown after the deployment of the National Oral Health Policy, as of 2004, demonstrates the greater integration of oral health care under the Unified Health System and provides feedback information to help this policy to continue to be prioritized by the Federal Government and receive more support from the state and local levels in the coming years.

  11. Scandals in health-care: their impact on health policy and nursing.

    Science.gov (United States)

    Hutchison, Jacqueline S

    2016-03-01

    Through an analysis of several high-profile scandals in health-care in the UK, this article discusses the nature of scandal and its impact on policy reform. The nursing profession is compared to social work and medicine, which have also undergone considerable examination and change as a result of scandals. The author draws on reports from public inquiries from 1945 to 2013 to form the basis of the discussion about policy responses following scandals in health-care. In each case, the nature of the scandal, the public and government discourses generated by events and the policy response to those failings are explored. These scandals are compared to the recent scandal at Mid Staffordshire Hospital. Conclusions are drawn about the impact of these events on the future of the profession and on health policy directions. Recent events have raised public anxieties about caring practices in nursing. Health policy reform driven by scandal may obscure the effect of under resourcing in health services and poses a very real threat to the continued support for state-run services. Understanding the socially constructed nature of scandal enables the nurse to develop a greater critical awareness of policy contexts in order that they can influence health service reform.

  12. The stigmatization dilemma in public health policy - the case of MRSA in Denmark

    DEFF Research Database (Denmark)

    Ploug, Thomas; Holm, Søren; Gjerris, Mickey

    2015-01-01

    to stigmatization of groups of citizens. Discussion The article describes the phenomenon of stigmatization within the health care area by discussing the concept in relation to AIDS and psychiatric diagnosis. It unfolds the ethical aspects of using stigmatization as a public health instrument to affect unwanted......-resistant Staphylococcus aureus (MRSA) within pig production. Summary We argue that using stigmatization as a direct means to achieve public health outcomes is almost always ethically illegitimate. Autonomy and dignity considerations count against it, and the cost-benefit analysis that might by some be taken to outweigh...... these considerations will be fundamentally uncertain. We further argue that interventions where stigmatization is a side-effect need to fulfil requirements of proportionality, and that they may fall prey to ‘the stigmatization dilemma’, i.e. the dilemma that arises when all policy options are potentially stigmatizing...

  13. [Instruments of health literacy used in nursing studies with hypertensive elderly].

    Science.gov (United States)

    Machado, Ana Larissa Gomes; Lima, Francisca Elisângela Teixeira; Cavalcante, Tahissa Frota; de Araújo, Thelma Leite; Vieira, Neiva Francenely Cunha

    2014-12-01

    This study aimed to analyze nursing research regarding the instruments used to evaluate health literacy in elderly hypertensive patients. This is an integrative literature review done in the databases LILACS, PubMed, CINAHL, Scopus, and Cochrane, in June 2013. The articles, electronically available, were selected for full-text review by nurses, who assessed health literacy of elderly with hypertension. Eight studies were selected for analysis and four different instruments were used in the research. The instruments were developed according to a methodology and they were all designed to evaluate the abilities of elderly regarding reading, numeracy, pronunciation and recognition of some health-related words. The nursing research analyzed in this study revealed the gaps in care related to measures aimed to increase patient's involvement in decision-making. Also, the instruments used for measuring health literacy showed limitations, and there is no gold standard test.

  14. Instruments of health literacy used in nursing studies with hypertensive elderly

    Directory of Open Access Journals (Sweden)

    Ana Larissa Gomes Machado

    Full Text Available This study aimed to analyze nursing research regarding the instruments used to evaluate health literacy in elderly hypertensive patients. This is an integrative literature review done in the databases LILACS, PubMed, CINAHL, Scopus, and Cochrane, in June 2013. The articles, electronically available, were selected for full-text review by nurses, who assessed health literacy of elderly with hypertension. Eight studies were selected for analysis and four different instruments were used in the research. The instruments were developed according to a methodology and they were all designed to evaluate the abilities of elderly regarding reading, numeracy, pronunciation and recognition of some health-related words. The nursing research analyzed in this study revealed the gaps in care related to measures aimed to increase patient's involvement in decision-making. Also, the instruments used for measuring health literacy showed limitations, and there is no gold standard test.

  15. Shaping the Health Policy Agenda: The Case of Safe Motherhood Policy in Vietnam

    Directory of Open Access Journals (Sweden)

    Bui Thi Thu Ha

    2015-11-01

    Full Text Available Background Maternal health remains a central policy concern in Vietnam. With a commitment to achieving the Millennium Development Goal (MDG 5 target of maternal mortality rate (MMR of 70/100 000 by 2015, the Ministry of Health (MoH issued the National Plan for Safe Motherhood (NPSM 2003-2010. In 2008, reproductive health, including safe motherhood (SM became a national health target program with annual government funding. Methods A case study of how SM emerged as a political priority in Vietnam over the period 2001-2008, drawing on Kingdon’s theory of agenda-setting was conducted. A mixed method was adopted for this study of the NPSM. Results Three related streams contributed to SM priority in Vietnam: (1 the problem of high MMR was officially recognized from high-quality research, (2 the strong roles of policy champion from MoH in advocating for the needs to reducing MMR as well as support from government and donors, and (3 the national and international events, providing favorable context for this issue to emerge on policy agenda. Conclusion This paper draws on the theory of agenda-setting to analyze the Vietnam experience and to develop guidance for SM a political priority in other high maternal mortality communities.

  16. Cuba: Time to Expand Health in All Policies.

    Science.gov (United States)

    Castell-Florit Serrate, Pastor; Más-Bermejo, Pedro

    2016-10-01

    The Adelaide Statement on Health in All Policies (2010), lays out equity-based principles designed to guide policymakers on incorporating health and well-being components into the development, implementation and evaluation of policy and practice while moving towards shared governance at all levels-local, regional, national and international. Special emphasis is placed on cross-sector coordination to achieve policy goals, while improving health and well-being for all.[1] In Cuba's case, experience in disaster preparedness, particularly for hurricanes, has shown good cross-sector coordination.[2] Zika serves as another recent example. First identified in Uganda in 1947, Zika, an emerging disease with outbreaks in Africa, Asia, the Pacific and the Americas and linked to neurological disorders in newborns, was declared a global health emergency by WHO on February 1, 2016.[3] In response, Cuba further stepped up measures for surveillance, prevention and control it had already announced in December 2015. Building on decades of experience fighting dengue, intensified efforts to stamp out Aedes aegypti and albopictus, the mosquitoes that transmit Zika (as well as dengue, chikungunya and yellow fever), and issued a national 11-point Zika Action Plan to prevent, detect and respond to these arboviral infections.

  17. ASTROMETRIC INSTRUMENT MODEL SOFTWARE TOOL FOR GAIA REAL-TIME INSTRUMENT HEALTH MONITORING AND DIAGNOSTIC

    Directory of Open Access Journals (Sweden)

    D. Busonero

    2014-01-01

    Full Text Available L o s o b j e t i v o s d e l a m i s i ́ o n e s p a c i a l d e m i c r o a r c o s e g u n d o d e p e n d e n d e l a s l i m i t a c i o n e s d e d e s e m p e ̃ n o a s o c i a d a s a l a c o n fi g u r a c i ́ o n i n s t r u m e n t a l s e l e c c i o n a d a y a l a s c o n d i c i o n e s d e o b s e r v a c i ́ o n . E n p a r t i c u l a r , l a v a r i a c i ́ o n d e la respuesta instrumental sobre el campo, con respecto a la longitud de onda y el tiempo, son potencialmente cr ́ıticos. Discutimos el impacto sobre la calidad de los datos y c ́omo los datos cient ́ıficos pueden ser utilizados para rastrear directamente y en tiempo real la respuesta astrom ́etrica instrumental de Gaia. Esta es una de las filosof ́ıas que impulsan el Modelo de Instrumento Astrom ́etrico (AIM, por sus siglas en ingl ́es. Mostramos l o s r e s u l t a d o s d e l a s c a m p a ̃ n a s d e p r u e b a l l e v a d a s a c a b o e n 2 0 1 3 .

  18. Law, public policy and mental health in the workplace.

    Science.gov (United States)

    Lippel, Katherine

    2011-01-01

    The first part of this article describes regulatory interventions, drawn from different Canadian jurisdictions, designed to reduce worker exposure to psychosocial hazards, including occupational violence, and to protect workers' mental health. It also addresses legislative provisions providing workers' compensation for mental health problems and regulatory provisions supporting the return to work of those who have been absent from work because of work-related mental health problems. The second part of the article, relying on illustrations from case law in which workers' compensation claims for mental health problems have been accepted, examines ways in which law and policy can actually contribute directly or indirectly to behaviours that may lead to increasing illness and disability associated with mental health problems. Copyright © 2011 Longwoods Publishing.

  19. What is the evidence base for public involvement in health-care policy?: results of a systematic scoping review.

    Science.gov (United States)

    Conklin, Annalijn; Morris, Zoë; Nolte, Ellen

    2015-04-01

    Public involvement in health-care policy has been advocated as a means to enhance health system responsiveness, yet evidence for its impact has been difficult to ascertain. To review the peer-reviewed empirical evidence on outcomes of public involvement in health-care policy. We systematically searched PsychINFO and PubMed from November 2000 to April 2010 for empirical studies that reported on original research only; studies in languages other than English, German or French were excluded. Data were extracted using a standardized evidence table with a priori determined headings. Nineteen studies were identified as eligible for inclusion in our review. We found that sound empirical evidence of the outcomes of public involvement activities in health care remains underdeveloped. The concept and the indicators used to examine and determine outcomes remain poorly specified and inconsistent, as does the reporting of the evidence. There was some evidence for the developmental role of public involvement, such as enhancing awareness, understanding and competencies among lay participants. Evidence for instrumental benefits of public involvement initiatives was less well documented. Despite the growing body of work on public involvement in health-care policy, evidence of its impact remains scarce; thus, firm conclusions about involvement activities that are appropriate and effective for policy development are difficult to draw. However, focus on outcomes risks missing the normative argument that involving the public in the health-care policy process may be seen to be of intrinsic value. © 2012 John Wiley & Sons Ltd.

  20. National health insurance policy in Nepal: challenges for implementation

    Directory of Open Access Journals (Sweden)

    Shiva Raj Mishra

    2015-08-01

    Full Text Available The health system in Nepal is characterized by a wide network of health facilities and community workers and volunteers. Nepal's Interim Constitution of 2007 addresses health as a fundamental right, stating that every citizen has the right to basic health services free of cost. But the reality is a far cry. Only 61.8% of the Nepalese households have access to health facilities within 30 min, with significant urban (85.9% and rural (59% discrepancy. Addressing barriers to health services needs urgent interventions at the population level. Recently (February 2015, the Government of Nepal formed a Social Health Security Development Committee as a legal framework to start implementing a social health security scheme (SHS after the National Health Insurance Policy came out in 2013. The program has aimed to increase the access of health services to the poor and the marginalized, and people in hard to reach areas of the country, though challenges remain with financing. Several aspects should be considered in design, learning from earlier community-based health insurance schemes that suffered from low enrollment and retention of members as well as from a pro-rich bias. Mechanisms should be built for monitoring unfair pricing and unaffordable copayments, and an overall benefit package be crafted to include coverage of major health services including non-communicable diseases. Regulations should include such issues as accreditation mechanisms for private providers. Health system strengthening should move along with the roll-out of SHS. Improving the efficiency of hospital, motivating the health workers, and using appropriate technology can improve the quality of health services. Also, as currently a constitution drafting is being finalized, careful planning and deliberation is necessary about what insurance structure may suit the proposed future federal structure in Nepal.

  1. Can free open access resources strengthen knowledge-based emerging public health priorities, policies and programs in Africa?

    Science.gov (United States)

    Tambo, Ernest; Madjou, Ghislaine; Khayeka-Wandabwa, Christopher; Tekwu, Emmanuel N.; Olalubi, Oluwasogo A.; Midzi, Nicolas; Bengyella, Louis; Adedeji, Ahmed A.; Ngogang, Jeanne Y.

    2016-01-01

    Tackling emerging epidemics and infectious diseases burden in Africa requires increasing unrestricted open access and free use or reuse of regional and global policies reforms as well as timely communication capabilities and strategies. Promoting, scaling up data and information sharing between African researchers and international partners are of vital importance in accelerating open access at no cost. Free Open Access (FOA) health data and information acceptability, uptake tactics and sustainable mechanisms are urgently needed. These are critical in establishing real time and effective knowledge or evidence-based translation, proven and validated approaches, strategies and tools to strengthen and revamp health systems.  As such, early and timely access to needed emerging public health information is meant to be instrumental and valuable for policy-makers, implementers, care providers, researchers, health-related institutions and stakeholders including populations when guiding health financing, and planning contextual programs. PMID:27508058

  2. Can free open access resources strengthen knowledge-based emerging public health priorities, policies and programs in Africa?

    Science.gov (United States)

    Tambo, Ernest; Madjou, Ghislaine; Khayeka-Wandabwa, Christopher; Tekwu, Emmanuel N; Olalubi, Oluwasogo A; Midzi, Nicolas; Bengyella, Louis; Adedeji, Ahmed A; Ngogang, Jeanne Y

    2016-01-01

    Tackling emerging epidemics and infectious diseases burden in Africa requires increasing unrestricted open access and free use or reuse of regional and global policies reforms as well as timely communication capabilities and strategies. Promoting, scaling up data and information sharing between African researchers and international partners are of vital importance in accelerating open access at no cost. Free Open Access (FOA) health data and information acceptability, uptake tactics and sustainable mechanisms are urgently needed. These are critical in establishing real time and effective knowledge or evidence-based translation, proven and validated approaches, strategies and tools to strengthen and revamp health systems.  As such, early and timely access to needed emerging public health information is meant to be instrumental and valuable for policy-makers, implementers, care providers, researchers, health-related institutions and stakeholders including populations when guiding health financing, and planning contextual programs.

  3. Health in all policies in the partnership for sustainable development.

    Science.gov (United States)

    Buss, Paulo M; Fonseca, Luiz Eduardo; Galvão, Luiz Augusto C; Fortune, Kira; Cook, Caitlin

    2016-09-01

    This article analyzes the dynamic interaction between the Health in All Policies (HiAP) agenda and the ongoing implementation of the 2030 Agenda for Sustainable Development. At the World Conference on Social Determinants of Health, held in Rio de Janeiro in October 2011, the Rio Political Declaration pledged to use HiAP as a mechanism to address health inequities. In 2014, the Ministers of Health of the Region of the Americas approved a regional Plan of Action of the Pan American Health Organization (PAHO) that sought to call attention to the health consequences and benefits of policies and actions developed by other sectors. The HiAP approach seeks to integrate activities across the pillars of the sustainable development governance framework (economic, social, and environmental development). Advocates of the process are challenged to consider, using guiding questions outlined at the close of this article, how to pursue action at the country level and in what ways the HiAP approach can contribute to timely and effective implementation of the Sustainable Development Goals (SDGs). The authors propose that coordination between the 2030 Agenda and the regional Plan of Action on HiAP can make an important contribution to the implementation of both processes in the Region.

  4. [The dialogues between anthropology and health: contributions to public policies].

    Science.gov (United States)

    Langdon, Esther Jean

    2014-04-01

    In order to examine the development of anthropological paradigms and their dialogue with medicine, I divide the discussion into two general, but non-exclusive, approaches: one that focuses on health and disease as social and cultural experience and construction, and another that examines health from an interactional and political perspective. For the first approach, I focus on North American and French theories that find resonance in the anthropological dialogue in Brazil. For the second political approach, the discussion originates in the dialogue among anthropologists in Latin America who have been developing models to contribute to an interdisciplinary approach necessary for health policies and intervention in health. The concepts of practices in self-care and intermedicality, among others, are explored due to their contribution in anthropology to public policies in health. These anthropologists have argued that health practices should be understood through the notions of autonomy, collectivity, agency and praxis, as opposed to the notions of the biomedical perspective characterized as being universalist, biological, individualist and a-historical.

  5. Childhood obesity: bringing children's rights discourse to public health policy.

    Science.gov (United States)

    Greenway, Julie

    2008-05-01

    Childhood obesity is widely understood as a public health issue, but is not commonly understood from a legal perspective. Children's rights discourse can add significant empowerment to public health-based policy, which alone lacks effectiveness in the face of commercial and other counteracting influences. The United Nations Convention on the Rights of the Child has the potential to be used by advocates for children's health to facilitate child health policies pertaining to the issue of childhood obesity. This is because children's rights, as defined in the articles of the convention, establish the essential conditions required by children to achieve optimal health and wellbeing. A rights-based approach may improve children's welfare by encouraging a less fragmented approach to the issue of childhood obesity. The articles of the convention can be used as a template for interdisciplinary collaboration, with a more coherent outcome possible. By articulating childhood obesity as a children's rights issue--not just a public health issue--a more effective strategy for addressing the problem can be developed and implemented.

  6. The health-promoting nurse as a health policy career expert and entrepreneur.

    Science.gov (United States)

    Whitehead, Dean

    2003-11-01

    A plethora of literature suggests that many nurses struggle in their attempts to develop a political role that allows them to directly influence and implement health policy activity. Nursing curricula are an integral part of ensuring that nurses are capable of taking on a more active role in initiating and developing health policy processes, through a broadening of the health promotion curriculum that focuses on socio-political approaches to health care provision. Despite this, the available literature suggests that the majority of nursing curricula are yet to fulfil this role. Such a role could be supported by attempts to define and promote a specific career route that develops nurses as health policy experts and entrepreneurs early on in their careers. This article aims to put forward a rationale for developing such a position in nursing education.

  7. Health in All Urban Policy: city services through the prism of health.

    Science.gov (United States)

    Corburn, Jason; Curl, Shasa; Arredondo, Gabino; Malagon, Jonathan

    2014-08-01

    In April, 2014, the City of Richmond, California, became one of the first and only municipalities in the USA to adopt a Health in All Policies (HiAP) ordinance and strategy. HiAP is increasingly recognized as an important method for ensuring policy making outside the health sector addresses the determinants of health and social equity. A central challenge facing HiAP is how to integrate community knowledge and health equity considerations into the agendas of policymakers who have not previously considered health as their responsibility or view the value of such an approach. In Richmond, the HiAP strategy has an explicit focus on equity and guides city services from budgeting to built and social environment programs. We describe the evolution of Richmond's HiAP strategy and its content. We highlight how this urban HiAP was the result of the coproduction of science policy. Coproduction includes participatory processes where different public stakeholders, scientific experts, and government sector leaders come together to jointly generate policy goals, health equity metrics, and policy drafting and implementation strategies. We conclude with some insights for how city governments might consider HiAP as an approach to achieve "targeted universalism," or the idea that general population health goals can be achieved by targeting actions and improvements for specific vulnerable groups and places.

  8. Policy Entrepreneurs and the Design of Public Policy: The Case of the National Health Insurance Law in Israel

    Directory of Open Access Journals (Sweden)

    NISSIM COHEN

    2012-07-01

    Full Text Available How do policy entrepreneurs implement in practice the things theory suggests they should do? This article suggests various insightsinto the influence of policy entrepreneurs on the formulation of public policy. Using a broad definition of the concept of policyentrepreneur, the article identifies the main characteristics of entrepreneurial activities, describes various strategies that the policyentrepreneur may employ, and develops a model of successful and effective policy entrepreneurship. Using an analysis of the designof the Israel National Health Law of 1994 as a case study, the article emphasizes the importance of policy entrepreneurs in thepublic policy arena and provides several insights into the conditions for their activity, their motivations and main strategies.

  9. Applying radiation health effects data to radiation protection policies

    Energy Technology Data Exchange (ETDEWEB)

    Muckerheide, James [Center for Nuclear Technology and Society at WPI, Worcester Polytechnic Institute, Worcester, MA (United States)

    2000-05-01

    Data from the peer-reviewed scientific literature establish a sound basis to define a low-dose, low-dose-rate, dose-response. These data include human health dose-response studies; immunologically 'whole' animal studies; and cellular and molecular biological studies of complete biological systems for the relevant immunological and physiological responses. Initiatives are required to constructively apply these data to both radiation research and radiation protection policies. First, current low level radiation health effects research must apply existing data to define research projects to integrate and confirm existing dose-response data, with specific emphasis on the biological bases that exist in definitive and reproducible cellular and biological dose-response. Second, dose-response assessment must identify and incorporate all existing substantial and confirmed data, including natural radiation sources, to establish the bases for radiation protection policy for interventions to protect public health and safety. A preliminary assessment of these data is applied to: 1) Specify research that can be constructively applied to describe radiation health effects dose-response. 2) Apply health effects dose-response to radiation and radioactivity applications policies to maximize radiation health effects interventions for occupational applications, medical applications, and other radiation and radioactive materials applications controls to cost-effectively assure public health and safety. An assessment of the proposed revisions to ICRP radiation protection policies is provided that associates the basis for administrative limits with the previous proposal of the US NRC for a 'Below Regulatory Concern' (BRC) policy. This proposal ignores the context of the fact that very low levels of radiation exposure are far within the variations of natural radiation exposures, and therefore can have no gross net consequences. The equivalent failure of the BRC proposal

  10. Strengthening the health workforce and rolling out universal health coverage: the need for policy analysis

    Directory of Open Access Journals (Sweden)

    Adam D. Koon

    2013-07-01

    Full Text Available This article opens a debate about how to think about moving forward with the emerging twin movements of human resources for health (HRH and universal health coverage (UHC. There is sufficient evidence to warrant these movements, but actors and the policy process significantly affect which policies are adopted and how they are implemented. How exactly this occurs in low- and middle-income countries (LMICs is not very well understood. Furthermore, it is not clear whether actors will mobilize for or against the emergent HRH and UHC agendas. Policy analysis should help illuminate potential strategies to account for multiple interests and divergent values in volatile stakeholder environments. We argue that not only should the movement for UHC be paired with current efforts to address the human resources crisis, but also, for both to succeed, we need to know more about how health policy works in LMICs.

  11. Public health terminology: Hindrance to a Health in All Policies approach?

    Science.gov (United States)

    Synnevåg, Ellen S; Amdam, Roar; Fosse, Elisabeth

    2017-09-01

    National public health policies in Norway are based on a Health in All Policies (HiAP) approach. At the local level, this means that public health, as a cross-sectional responsibility, should be implemented in all municipal sectors by integrating public health policies in municipal planning and management systems. The paper investigates these local processes, focusing on the use of public health terminology and how this terminology is translated from national to local contexts. We ask whether the terms 'public health' and 'public health work' are suitable when implementing an HiAP approach. A qualitative case study based on analyses of interviews and planning documents was performed in three Norwegian municipalities. The results present dilemmas associated with using public health terminology when implementing an HiAP approach. On the one hand, the terms are experienced as wide, complex, advanced and unnecessary. On the other hand, the terms are experienced as important for a systematic approach towards understanding public health ideology and cross-sectional responsibility. One municipality used alternative terminology. This paper promotes debate about the appropriateness of using the terms 'public health' and 'public health work' at the local level. It suggests that adaptation is suitable and necessary, unless it compromises knowledge, responsibility and a systematic approach. This study concludes that the use of terminology is a central factor when implementing the Norwegian Public Health Act at the local level.

  12. Linking Frailty Instruments to the International Classification of Functioning, Disability, and Health: A Systematic Review.

    Science.gov (United States)

    Azzopardi, Roberta Vella; Vermeiren, Sofie; Gorus, Ellen; Habbig, Ann-Katrin; Petrovic, Mirko; Van Den Noortgate, Nele; De Vriendt, Patricia; Bautmans, Ivan; Beyer, Ingo

    2016-11-01

    To date, the major dilemma concerning frailty is the lack of a standardized language regarding its operationalization. Considering the demographic challenge that the world is facing, standardization of frailty identification is indeed the first step in tackling the burdensome consequences of frailty. To demonstrate this diversity in frailty assessment, the available frailty instruments have been linked to the International Classification of Functioning, Disability, and Health (ICF): a standardized and hierarchically coded language developed by World Health Organization regarding health conditions and their positive (functioning) and negative (disability) consequences. A systematic review on frailty instruments was carried out in PubMed, Web of Knowledge, and PsycINFO. The items of the identified frailty instruments were then linked to the ICF codes. 79 original or adapted frailty instruments were identified and categorized into single (n = 25) and multidomain (n = 54) groups. Only 5 frailty instruments (indexes) were linked to all 5 ICF components. Whereas the ICF components Body Functions and Activities and Participation were frequently linked to the frailty instruments, Body Structures, Environmental and Personal factors were sparingly represented mainly in the multidomain frailty instruments. This review highlights the heterogeneity in frailty operationalization. Environmental and personal factors should be given more thought in future frailty assessments. Being unambiguous, structured, and neutral, the ICF language allows comparing observations made with different frailty instruments. In conclusion, this systematic overview and ICF translation can be a cornerstone for future standardization of frailty assessment.

  13. Explicit discrimination and health: development and psychometric properties of an assessment instrument

    Directory of Open Access Journals (Sweden)

    João Luiz Bastos

    2012-04-01

    Full Text Available OBJECTIVE: To develop an instrument to assess discrimination effects on health outcomes and behaviors, capable of distinguishing harmful differential treatment effects from their interpretation as discriminatory events. METHODS: Successive versions of an instrument were developed based on a systematic review of instruments assessing racial discrimination, focus groups and review by a panel comprising seven experts. The instrument was refined using cognitive interviews and pilot-testing. The final version of the instrument was administered to 424 undergraduate college students in the city of Rio de Janeiro, Southeastern Brazil, in 2010. Structural dimensionality, two types of reliability and construct validity were analyzed. RESULTS: Exploratory factor analysis corroborated the hypothesis of the instrument's unidimensionality, and seven experts verified its face and content validity. The internal consistency was 0.8, and test-retest reliability was higher than 0.5 for 14 out of 18 items. The overall score was higher among socially disadvantaged individuals and correlated with adverse health behaviors/conditions, particularly when differential treatments were attributed to discrimination. CONCLUSIONS: These findings indicate the validity and reliability of the instrument developed. The proposed instrument enables the investigation of novel aspects of the relationship between discrimination and health.

  14. SEQUenCE: a service user-centred quality of care instrument for mental health services.

    Science.gov (United States)

    Hester, Lorraine; O'Doherty, Lorna Jane; Schnittger, Rebecca; Skelly, Niamh; O'Donnell, Muireann; Butterly, Lisa; Browne, Robert; Frorath, Charlotte; Morgan, Craig; McLoughlin, Declan M; Fearon, Paul

    2015-08-01

    To develop a quality of care instrument that is grounded in the service user perspective and validate it in a mental health service. The instrument (SEQUenCE (SErvice user QUality of CarE)) was developed through analysis of focus group data and clinical practice guidelines, and refined through field-testing and psychometric analyses. All participants were attending an independent mental health service in Ireland. Participants had a diagnosis of bipolar affective disorder (BPAD) or a psychotic disorder. Twenty-nine service users participated in six focus group interviews. Seventy-one service users participated in field-testing: 10 judged the face validity of an initial 61-item instrument; 28 completed a revised 52-item instrument from which 12 items were removed following test-retest and convergent validity analyses; 33 completed the resulting 40-item instrument. Test-retest reliability, internal consistency and convergent validity of the instrument. The final instrument showed acceptable test-retest reliability at 5-7 days (r = 0.65; P Service Satisfaction Scale (r = 0.84, P service user perspective and suitable for routine use. It may serve as a useful tool in individual care planning, service evaluation and research. The instrument was developed and validated with service users with a diagnosis of either BPAD or a psychotic disorder; it does not yet have established external validity for other diagnostic groups. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  15. Humanization policy in primary health care: a systematic review

    Science.gov (United States)

    Nora, Carlise Rigon Dalla; Junges, José Roque

    2013-01-01

    OBJECTIVE To analyze humanization practices in primary health care in the Brazilian Unified Health System according to the principles of the National Humanization Policy. METHODS A systematic review of the literature was carried out, followed by a meta-synthesis, using the following databases: BDENF (nursing database), BDTD (Brazilian digital library of theses and dissertations), CINAHL (Cumulative Index to nursing and allied health literature), LILACS (Latin American and Caribbean health care sciences literature), MedLine (International health care sciences literature), PAHO (Pan-American Health Care Organization Library) and SciELO (Scientific Electronic Library Online). The following descriptors were used: Humanization; Humanizing Health Care; Reception: Humanized care: Humanization in health care; Bonding; Family Health Care Program; Primary Care; Public Health and Sistema Único de Saúde (the Brazilian public health care system). Research articles, case studies, reports of experiences, dissertations, theses and chapters of books written in Portuguese, English or Spanish, published between 2003 and 2011, were included in the analysis. RESULTS Among the 4,127 publications found on the topic, 40 studies were evaluated and included in the analysis, producing three main categories: the first referring to the infrastructure and organization of the primary care service, made clear the dissatisfaction with the physical structure and equipment of the services and with the flow of attendance, which can facilitate or make difficult the access. The second, referring to the health work process, showed issues about the insufficient number of professionals, fragmentation of the work processes, the professional profile and responsibility. The third category, referring to the relational technologies, indicated the reception, bonding, listening, respect and dialog with the service users. CONCLUSIONS Although many practices were cited as humanizing they do not produce changes

  16. Development of oral health policy in Nigeria: an analysis of the role of context, actors and policy process.

    Science.gov (United States)

    Etiaba, Enyi; Uguru, Nkoli; Ebenso, Bassey; Russo, Giuliano; Ezumah, Nkoli; Uzochukwu, Benjamin; Onwujekwe, Obinna

    2015-05-06

    In Nigeria, there is a high burden of oral health diseases, poor coordination of health services and human resources for delivery of oral health services. Previous attempts to develop an Oral Health Policy (OHP) to decrease the oral disease burden failed. However, a policy was eventually developed in November 2012. This paper explores the role of contextual factors, actors and the policy process in the development of the OHP and possible reasons why the current approved OHP succeeded. The study was undertaken across Nigeria; information gathered through document reviews and in-depth interviews with five groups of purposively selected respondents. Analysis of the policy development process was guided by the policy triangle framework, examining context, policy process and actors involved in the policy development. The foremost enabling factor was the yearning among policy actors for a policy, having had four failed attempts. Other factors were the presence of a democratically elected government, a framework for health sector reform instituted by the Federal Ministry of Health (FMOH). The approved OHP went through all stages required for policy development unlike the previous attempts. Three groups of actors played crucial roles in the process, namely academics/researchers, development partners and policy makers. They either had decision making powers or influenced policy through funding or technical ability to generate credible research evidence, all sharing a common interest in developing the OHP. Although evidence was used to inform the development of the policy, the complex interactions between the context and actors facilitated its approval. The OHP development succeeded through a complex inter-relationship of context, process and actors, clearly illustrating that none of these factors could have, in isolation, catalyzed the policy development. Availability of evidence is necessary but not sufficient for developing policies in this area. Wider socio

  17. Developing a conceptual framework of urban health observatories toward integrating research and evidence into urban policy for health and health equity.

    Science.gov (United States)

    Caiaffa, W T; Friche, A A L; Dias, M A S; Meireles, A L; Ignacio, C F; Prasad, A; Kano, M

    2014-02-01

    Detailed information on health linked to geographic, sociodemographic, and environmental data are required by city governments to monitor health and the determinants of health. These data are critical for guiding local interventions, resource allocation, and planning decisions, yet they are too often non-existent or scattered. This study aimed to develop a conceptual framework of Urban Health Observatories (UHOs) as an institutional mechanism which can help synthesize evidence and incorporate it into urban policy-making for health and health equity. A survey of a select group of existent UHOs was conducted using an instrument based on an a priori conceptual framework of key structural and functional characteristics of UHOs. A purposive sample of seven UHOs was surveyed, including four governmental, two non-governmental, and one university-based observatory, each from a different country. Descriptive and framework analysis methods were used to analyze the data and to refine the conceptual framework in light of the empirical data. The UHOs were often a product of unique historical circumstances. They were relatively autonomous and capable of developing their own locally sensitive agenda. They often had strong networks for accessing data and were able to synthesize them at the urban level as well as disaggregate them into smaller units. Some UHOs were identified as not only assessing but also responding to local needs. The findings from this study were integrated into a conceptual framework which illustrates how UHOs can play a vital role in monitoring trends in health determinants, outcomes, and equity; optimizing an intersectoral urban information system; incorporating research on health into urban policies and systems; and providing technical guidance on research and evidence-based policy making. In order to be most effective, UHOs should be an integral part of the urban governance system, where multiple sectors of government, the civil society, and businesses can

  18. The dynamics of technology diffusion and the impacts of climate policy instruments in the decarbonisation of the global electricity sector

    CERN Document Server

    Mercure, J -F; Foley, A M; Chewpreecha, U; Pollitt, H

    2013-01-01

    This paper presents an analysis of possible uses of climate policy instruments for the decarbonisation of the global electricity sector in a non-equilibrium economic and technology innovation-diffusion perspective. Emissions reductions occur through changes in technology and energy consumption; in this context, investment decision-making opportunities occur periodically, which energy policy can incentivise in order to transform energy systems and meet reductions targets. Energy markets are driven by innovation, dynamic costs and technology diffusion; yet, the incumbent systems optimisation methodology in energy modelling does not address these aspects nor the effectiveness of policy onto decision-making since the dynamics modelled take their source from the top-down `social-planner' assumption. This leads to an underestimation of strong technology lock-ins in cost-optimal scenarios of technology. Our approach explores the global diffusion of low carbon technology in connection to a highly disaggregated sector...

  19. Validation of online psychometric instruments for common mental health disorders: a systematic review.

    Science.gov (United States)

    van Ballegooijen, Wouter; Riper, Heleen; Cuijpers, Pim; van Oppen, Patricia; Smit, Johannes H

    2016-02-25

    Online questionnaires for measuring common mental health disorders such as depression and anxiety disorders are increasingly used. The psychometrics of several pen-and-paper questionnaires have been re-examined for online use and new online instruments have been developed and tested for validity as well. This study aims to review and synthesise the literature on this subject and provide a framework for future research. We searched Medline and PsycINFO for psychometric studies on online instruments for common mental health disorders and extracted the psychometric data. Studies were coded and assessed for quality by independent raters. We included 56 studies on 62 online instruments. For common instruments such as the CES-D, MADRS-S and HADS there is mounting evidence for adequate psychometric properties. Further results are scattered over different instruments and different psychometric characteristics. Few studies included patient populations. We found at least one online measure for each of the included mental health disorders and symptoms. A small number of online questionnaires have been studied thoroughly. This study provides an overview of online instruments to refer to when choosing an instrument for assessing common mental health disorders online, and can structure future psychometric research.

  20. Mitigation of adverse effects on competitiveness and leakage of unilateral EU climate policy: An assessment of policy instruments

    NARCIS (Netherlands)

    Antimiani, A.; Costantini, V.; Kuik, O.J.; Paglialunga, E.

    2016-01-01

    The European Union (EU) has developed a strategy to mitigate climate change by cutting greenhouse gas (GHG) emissions and fostering low carbon technologies. However, the risk of implementing unilateral policies is that distortive effects are generated at the global scale affecting world energy price

  1. Commentary: Moving towards policy coherence in trade and health.

    Science.gov (United States)

    Walls, Helen; Baker, Phillip; Smith, Richard

    2015-11-01

    International trade has brought economic benefits to many countries, but the association of trade and investment liberalisation with poor health outcomes concerns the public health community. The need to secure more 'healthy' trade is a recognised priority, especially as countries move from global to regional/bilateral trade agreements - with greater public health risks. However, a transition towards 'healthier trade' may be hindered by worldview differences between the trade and health communities. There is a tendency for health actors to perceive trade as a threat to population health, and for trade actors to view health as a constraint to trade objectives of reducing barriers to cross-border commercial flows and economic growth. Unless such differing worldviews can be aligned, finding ways forward for addressing public health in trade policy is likely to be difficult. Moving forward will involve understanding the values and drivers of the respective groups, and developing solutions palatable to their various interests. Given the power imbalances between the two areas, it is likely that the health community will have to make the first moves in this respect. This article outlines the key issues involved and suggests areas where such moves have been, and may be made.

  2. Swedish public health policy: Impact on regional and local public health practice and priorities.

    Science.gov (United States)

    Makenzius, Marlene; Wamala, Sarah

    2015-08-01

    We evaluated the Swedish National Public Health Policy to determine its impact on public health priorities and practice at regional and local levels between 2004 and 2013. We conducted a survey by questionnaire in February 2013 among Swedish county councils/regions (n=19/21), and municipalities (n=219/290). The National Public Health Policy facilitated systematic public health practice, particularly for planning, for high priority concerns, including conditions during childhood and adolescence, physical activity, and tobacco prevention. Respondents expressed need for a comprehensive monitoring system with comparable indicators nationwide and explicit measurable objectives. To ensure effective monitoring and follow-up, the measurable outcomes need direct relevance to decision making and high-priority public health issues addressing Sweden's "overarching public health goal" - to create societal conditions for good health on equal terms for the entire population.

  3. Human rights principles in developing and updating policies and laws on mental health.

    Science.gov (United States)

    Schulze, M

    2016-01-01

    The World Health Organization's Mental Health Action Plan 2013-2020 stipulates human rights as a cross-cutting principle (WHO, 2013) and foresees global targets to update policies as well as mental health laws in line with international and regional human rights instruments. The international human rights agreements repeatedly refer to health, including mental health. The most pertinent provisions related to mental health are enshrined in the 2006 Convention on the Rights of Persons with Disabilities (CRPD), which sets out human rights in an accessible and inclusive fashion to ensure the equal participation of persons with disabilities. The inconclusive description of disability in the treaty overtly refers to 'mental impairment' as part of an explicitly evolving understanding of disability. This text sketches some of the underlying concepts as they apply to the realm of mental health: non-discrimination of persons with disabilities and measures that should be taken to ensure accessibility in a holistic understanding; removal of social and attitudinal barriers as much as communication and intellectual barriers but also institutional hurdles. The CRPD's paradigm shift away from framing disability mainly through deficits towards a social understanding of disability as the result of interaction and focusing on capacity is the core on which the provision of mental health services at community level to enable participation in society shall be ensured. Questions of capacity, also to make decisions and the possible need for support in so doing, are sketched out.

  4. A welfare perspective on the fiscal-monetary policy mix: The role of alternative fiscal instruments

    OpenAIRE

    L. Marattin; Marzo, M.; P. Zagaglia

    2010-01-01

    The need of fiscal consolidation is likely to dominate the policy agenda in the next decade; starting from statistical evidence on the conduct of fiscal policy in the EMU area over the last decade, this paper addresses the optimality of alternative fiscal consolidation strategies. We explore the welfare properties. In this paper we explore the welfare properties of debt-targeting fiscal policy implemented through, alternatively, distortionary taxation on consumption, labour and capital income...

  5. Developing and testing a positive theory of instrument choice: Renewable energy policy in the fifty American states

    Science.gov (United States)

    Ciocirlan, Cristina E.

    The environmental economics literature consistently suggests that properly designed and implemented economic incentives are superior to command-and-control regulation in reducing pollution. Economic incentives, such as green taxes, cap-and-trade programs, tax incentives, are able to reduce pollution in a cost-effective manner, provide flexibility to industry and stimulate innovation in cleaner technologies. In the past few decades, both federal and state governments have shown increased use of economic incentives in environmental policy. Some states have embraced them in an active manner, while others have failed to do so. This research uses a three-step analysis. First, it asks why some states employ more economic incentives than others to stimulate consumption of renewable energy by the residential, commercial and industrial sectors. Second, it asks why some states employ stronger incentives than others. And third, it asks why certain states employ certain instruments, such as electricity surcharges, cap-and-trade programs, tax incentives or grants, while others do not. The first two analyses were conducted using factor analysis and multiple regression analysis, while the third analysis employed logistic regression models to analyze the data. Data for all three analyses were obtained from a combination of primary and secondary sources. To address these questions, a theory of instrument choice at the state level, which includes both internal and external determinants of policy-making, was developed and tested. The state level of analysis was chosen. States have proven to be pioneers in designing policies to address greenhouse gases (see, for instance, the recent cap-and-trade legislation passed in California). The theory was operationalized with the help of four models: needs/responsiveness, interest group influence, professionalism/capacity and innovation-and-diffusion. The needs/responsiveness model suggests that states tend to choose more and stronger economic

  6. Communicating contentious health policy: lessons from Ireland's workplace smoking ban.

    Science.gov (United States)

    Fahy, Declan; Trench, Brian; Clancy, Luke

    2012-05-01

    The Irish workplace smoking ban has been described as possibly a tipping point for public health worldwide. This article presents the first analysis of the newspaper coverage of the ban over the duration of the policy formation process. It adds to previous studies by analyzing how health communication strategists engaged, over time, with a newsworthy topic, viewed as being culturally controversial. It analyzes a sample of media content (n = 1,154) and firsthand accounts from pro-ban campaigners and journalists (n = 10). The analysis shows that the ban was covered not primarily as a health issue: Economic, political, social, democratic, and technical aspects also received significant attention. It shows how coverage followed controversy and examines how pro-ban campaigners countered effectively the anti-ban communication efforts of influential social actors in the economic and political spheres. The analysis demonstrates that medical-political sources successfully defined the ban's issues as centrally concerned with public health.

  7. Assessing the privacy policies in mobile personal health records.

    Science.gov (United States)

    Zapata, Belén Cruz; Hernández Niñirola, Antonio; Fernández-Alemán, José Luis; Toval, Ambrosio

    2014-01-01

    The huge increase in the number and use of smartphones and tablets has led health service providers to take an interest in mHealth. Popular mobile app markets like Apple App Store or Google Play contain thousands of health applications. Although mobile personal health records (mPHRs) have a number of benefits, important challenges appear in the form of adoption barriers. Security and privacy have been identified as part of these barriers and should be addressed. This paper analyzes and assesses a total of 24 free mPHRs for Android and iOS. Characteristics regarding privacy and security were extracted from the HIPAA. The results show important differences in both the mPHRs and the characteristics analyzed. A questionnaire containing six questions concerning privacy policies was defined. Our questionnaire may assist developers and stakeholders to evaluate the security and privacy of their mPHRs.

  8. Urban Health Educators' Perspectives and Practices regarding School Nutrition Education Policies

    Science.gov (United States)

    McCaughtry, Nate; Martin, Jeffrey J.; Fahlman, Mariane; Shen, Bo

    2012-01-01

    Although nutrition-related health education policies exist at national, state and local levels, the degree to which those policies affect the everyday practices of health education teachers who are charged with executing them in schools is often unclear. The purpose of this study was to examine the nutrition-related health education policy matrix…

  9. International Development of Health Manpower Policy. WHO Offset Publication No. 61.

    Science.gov (United States)

    Fulop, Tamas; Roemer, Milton I.

    This report: (1) identifies the main policies, objectives, and thrusts in the health manpower development (HMD) program of the World Health Organization (WHO); (2) identifies factors influencing or determining these policies, and examines how they have shaped the HMD program; (3) investigates how policy changes and achievements in health manpower…

  10. Urban Health Educators' Perspectives and Practices regarding School Nutrition Education Policies

    Science.gov (United States)

    McCaughtry, Nate; Martin, Jeffrey J.; Fahlman, Mariane; Shen, Bo

    2012-01-01

    Although nutrition-related health education policies exist at national, state and local levels, the degree to which those policies affect the everyday practices of health education teachers who are charged with executing them in schools is often unclear. The purpose of this study was to examine the nutrition-related health education policy matrix…

  11. Summing up the parts. Combining Policy Instruments for Least-Cost Climate Mitigation Strategies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    Meeting the enormous challenge of decarbonising world energy systems will require a rapid expansion of investment in clean technologies on a global scale. Mobilising these resources will be a daunting task, and it is important to undertake the transition at the lowest cost possible. This paper seeks to provide some guidance on climate change policy-making within real-world constraints, focusing on the justification of policies to supplement a carbon price, interactions between carbon pricing and supplementary policies, and management of these interactions to enable a least-cost policy response.

  12. Teachers' perception of oral health status. Design and validation of an evaluation instrument.

    Science.gov (United States)

    Bordoni, Noemi; Cadile, María del Carmen; Sotelo, Romelia; Squassi, Aldo

    2006-01-01

    The evaluation of health status is a complex process that requires the use of indicators that assess health both in terms of disease and of the impact the health-disease-care process has on the quality of life. The aim of the present study was to design and validate an instrument to evaluate teachers 'perceptions of oral health status. The sample comprised 78 teachers of 4 schools (province of Buenos Aires). DESIGN OF THE INSTRUMENT: (a) identification of the 5 categories that compose the instrument and can measure the object of study based on evidence; (b) creation of a questionnaire that contains 32 items by two researchers; (c) evaluation of the questionnaire by 5 professionals of 4 different professions to standardize criteria (Ventegodt et al, 2003) applying an ordinal scale. Items were reduced to 25 (Index of perception of oral health: IPOH). VALIDATION OF THE INSTRUMENT: the following parameters were evaluated: reliability employing the test-retest method at 30 days; internal consistency employing Cronbach's a coefficient (1951); content validity determined by two experts; construct validity employing the method of extreme groups (Student's t test). The established categories were knowledge on oral health, personal experience with oral health care, expectations regarding their students 'families, expectations regarding dentistry, satisfaction with his/her role as a teacher The instrument proved to be reliable as evidenced by a value of r = 0.80 in the test-retest method; a satisfactory intra-items consistency was evidenced by Cronbach's alpha coefficient value of 0.82. The differences between the results of the groups of teachers in the extreme groups were statistically significant (p = 2.2). The instrument designed to measure the teachers' perception of oral health status would be valid. It would be desirable to enlarge the sample and determine criterion validity by comparison with other instruments.

  13. Six challenges in modelling for public health policy.

    Science.gov (United States)

    Metcalf, C J E; Edmunds, W J; Lessler, J

    2015-03-01

    The World Health Organisation's definition of public health refers to all organized measures to prevent disease, promote health, and prolong life among the population as a whole (World Health Organization, 2014). Mathematical modelling plays an increasingly important role in helping to guide the most high impact and cost-effective means of achieving these goals. Public health programmes are usually implemented over a long period of time with broad benefits to many in the community. Clinical trials are seldom large enough to capture these effects. Observational data may be used to evaluate a programme after it is underway, but have limited value in helping to predict the future impact of a proposed policy. Furthermore, public health practitioners are often required to respond to new threats, for which there is little or no previous data on which to assess the threat. Computational and mathematical models can help to assess potential threats and impacts early in the process, and later aid in interpreting data from complex and multifactorial systems. As such, these models can be critical tools in guiding public health action. However, there are a number of challenges in achieving a successful interface between modelling and public health. Here, we discuss some of these challenges. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  14. Six challenges in modelling for public health policy

    Directory of Open Access Journals (Sweden)

    C.J.E. Metcalf

    2015-03-01

    Full Text Available The World Health Organisation's definition of public health refers to all organized measures to prevent disease, promote health, and prolong life among the population as a whole (World Health Organization, 2014. Mathematical modelling plays an increasingly important role in helping to guide the most high impact and cost-effective means of achieving these goals. Public health programmes are usually implemented over a long period of time with broad benefits to many in the community. Clinical trials are seldom large enough to capture these effects. Observational data may be used to evaluate a programme after it is underway, but have limited value in helping to predict the future impact of a proposed policy. Furthermore, public health practitioners are often required to respond to new threats, for which there is little or no previous data on which to assess the threat. Computational and mathematical models can help to assess potential threats and impacts early in the process, and later aid in interpreting data from complex and multifactorial systems. As such, these models can be critical tools in guiding public health action. However, there are a number of challenges in achieving a successful interface between modelling and public health. Here, we discuss some of these challenges.

  15. Promoting Health Through Policy and Systems Change: Public Health Students and Mentors on the Value of Policy Advocacy Experience in Academic Internships.

    Science.gov (United States)

    Marquez, Daniela; Pell, Dylan; Forster-Cox, Sue; Garcia, Evelyn; Ornelas, Sophia; Bandstra, Brenna; Mata, Holly

    2017-05-01

    Emerging professionals and new Certified Health Education Specialists often lack academic training in and actual experience in National Commission for Health Education Credentialing Area of Responsibility VII: Communicate, Promote, and Advocate for Health, Health Education/Promotion, and the Profession. For undergraduate and graduate students who have an opportunity to complete an internship or practicum experience, gaining experience in Competencies 7.2: Engage in advocacy for health and health education/promotion and 7.3: Influence policy and/or systems change to promote health and health education can have a profound impact on their career development and their ability to advocate for policies that promote health and health equity. Compelling evidence suggests that interventions that address social determinants of health such as poverty and education and those that change the context through improved policy or healthier environments have the greatest impact on public health, making it vital for emerging public health professionals to gain experience in policy advocacy and systems change. In this commentary, students and faculty from two large universities in the U.S.-Mexico border region reflect on the value of policy advocacy in academic internship/fieldwork experiences. Based on their experiences, they highly recommend that students seek out internship opportunities where they can participate in policy advocacy, and they encourage university faculty and practicum preceptors to provide more opportunities for policy advocacy in both classroom and fieldwork settings.

  16. Provisioning of Public Health Can Be Designed to Anticipate Public Policy Responses.

    Science.gov (United States)

    Li, Jing; Lindberg, Darla V; Smith, Rachel A; Reluga, Timothy C

    2017-01-01

    Public health policies can elicit strong responses from individuals. These responses can promote, reduce, and even reverse the expected benefits of the policies. Therefore, projections of individual responses to policy can be important ingredients in policy design. Yet our foresight of individual responses to public health investment remains limited. This paper formulates a population game describing the prevention of infectious disease transmission when community health depends on the interactions of individual and public investments. We compare three common relationships between public and individual investments and explain how each relationship alters policy responses and health outcomes. Our methods illustrate how identifying system interactions between nature and society can help us anticipate policy responses.

  17. Diffusion of innovation in mental health policy adoption: what should we ask about the quality of policy and the role of stakeholders in this process? Comment on "Cross-national diffusion of mental health policy".

    Science.gov (United States)

    Lee, Lucy

    2015-03-10

    In his recent study, Gordon Shen analyses a pertinent question facing the global mental health research and practice community today; that of how and why mental health policy is or is not adopted by national governments. This study identifies becoming a World Health Organization (WHO) member nation, and being in regional proximity to countries which have adopted a mental health policy as supportive of mental health policy adoption, but no support for its hypothesis that country recipients of higher levels of aid would have adopted a mental health policy due to conditionalities imposed on aid recipients by donors. Asking further questions of each may help to understand more not only about how and why mental health policies may be adopted, but also about the relevance and quality of implementation of these policies and the role of specific actors in achieving adoption and implementation of high quality mental health policies.

  18. Quantitative Research on Chinese Low-carbon Policy Texts from the Perspective of Policy Instruments%基于政策工具的中国低碳政策文本量化研究

    Institute of Scientific and Technical Information of China (English)

    罗敏; 朱雪忠

    2014-01-01

    低碳政策工具的合理运用是完善低碳政策,促进低碳经济发展的重要手段。低碳政策工具可分为规制型、经济激励型和社会型三大类。采用内容分析法,对近22年我国低碳政策工具进行计量分析。发现我国规制型政策工具缺乏灵活性且数量太多,易致政策失灵;产权拍卖类政策工具过于薄弱,削弱了经济激励型政策工具的资源配置功能;政府的引导和协调作用不充分,导致社会型政策工具执行不力。基于上述结论提出了改进我国低碳政策的建议。%The rational use of low-carbon policy instruments is an important means to improve low-carbon policies and to promote low-carbon economic development. The low-carbon policy instruments can be divided into regulatory policy instruments, economic incentive policy instruments, and social policy instruments. Based on content analysis method, we analyze low-carbon policy instruments in China in the past 22 years quantitatively. It is found that there are many problems with low-carbon policy instruments in China. Regulatory poli-cy instruments are inflexible and too many, which is prone to cause policy failure. The property auction types of policy instruments are too few, which weakens the resource allocation function of economic incentive policy instruments. The guiding and coordinating role of gov-ernment isn't sufficient, resulting in poor implementation of social policy instruments. Based on the above findings, we propose recom-mendations to improve China's low-carbon policies at last.

  19. The core determinants of health expenditure in the African context: some econometric evidence for policy.

    Science.gov (United States)

    Murthy, Vasudeva N R; Okunade, Albert A

    2009-06-01

    This paper, using cross-sectional data from 44 (83% of all) African countries for year 2001, presents econometric model estimates linking real per-capita health expenditure (HEXP) to a host of economic and non-economic factors. The empirical results of OLS and robust LAE estimators indicate that real per-capita GDP (PRGDP) and real per-capita foreign aid (FAID) resources are both core and statistically significant correlates of HEXP. Our empirical results suggest that health care in the African context is technically, a necessity rather than a luxury good (for the OECD countries). This suggests that the goal of health system in Africa is primarily 'physiological' or 'curative' rather than 'caring' or 'pampering'. The positive association of HEXP with FAID hints that external resource inflows targeting health could be instrumental for spurring economic progress in good policy environments. Most African countries until the late 1990s experienced economic and political instability, and faced stringent structural adjustment mandates of the major international financial institution lenders for economic development. Therefore, our finding a positive effect of FAID on HEXP could suggest that external resource inflows softened some of the macroeconomic fiscal deficit impacts on HEXP in the 2000s. Policy</