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.

Health Policy as a Specific Area of Social Policy

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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.

Policy development and challenges of global mental health: a systematic review of published studies of national-level mental health policies.

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Zhou, Wei; Yu, Yu; Yang, Mei; Chen, Lizhang; Xiao, Shuiyuan

2018-05-18

Mental health policy can be an essential and powerful tool to improve a population's mental health. However, around one third of countries do not possess a mental health policy, and there are large disparities in population coverage rates between high- and low-income countries. The goal of this study is to identify the transition and implementation challenges of mental health policies in both high-income countries (HICs) as well as middle- and low-income countries (MLICs). PubMed, Cochrane Library and Campbell Library were searched from inception to 31 December 2017, for studies on implemented mental health policies at the national level. Abstracts and the main texts of papers were double screened, and extracted data were analysed through thematic synthesis. A total of 93 papers were included in this study, covering 24 HICs, 28 MLICs and 5 regions. Studies on mental health policies, especially those of MLICs, kept increasing, but MLICs were still underrepresented in terms of publication quantity and study frequency. Based on the included studies, nine policy domains were summarized: service organizing, service provision, service quality, human resources, legislation and human rights, advocacy, administration, surveillance and research, and financing and budgeting. HICs incrementally enriched their policy content in all domains over centuries of development; following HICs' experience, mental health policies in MLICs have boomed since the 1990s and quickly extended to all domains. Implementation problems in HICs were mainly related to service organizing and service provision; for MLICs, more severe implementation problems converged on financing and budgeting, administration and human resources. Mental health policy developments in both HICs and MLICs present a process of diversification and enrichment. In terms of implementation, MLICs are faced with more and greater challenges than HICs, especially in funding, human resources and administration. Therefore, future

The impact of austerity on the health workforce and the achievement of human resources for health policies in Ireland (2008-2014).

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Williams, Des; Thomas, Steve

2017-09-11

The global economic crisis saw recessionary conditions in most EU countries. Ireland's severe recession produced pro-cyclical health spending cuts. Yet, human resources for health (HRH) are the most critical of inputs into a health system and an important economic driver. The aim of this article is to evaluate how the Irish health system coped with austerity in relation to HRH and whether austerity allowed and/or facilitated the implementation of HRH policy. The authors employed a quantitative longitudinal trend analysis over the period 2008 to 2014 with Health Service Executive (HSE) staff database as the principal source. For the purpose of this study, heath service employment is defined as directly employed whole-time equivalent public service staffing in the HSE and other government agencies. The authors also examined the heath sector pay bill and sought to establish linkages between the main staff database and pay expenditure, as given in the HSE Annual Accounts and Financial Statements (AFS), and key HRH policies. The actual cut in total whole-time equivalent (WTE) of directly employed health services human resources over the period 2008 to 2014 was 8027 WTE, a reduction of 7.2% but substantially less than government claims. There was a degree of relative protection for frontline staffing decreasing by 2.9% between 2008 and 2014 and far less than the 18.5% reduction in other staff. Staff exempted from the general moratorium also increased by a combined 12.6%. Counter to stated policy, the decline in staffing of non-acute care was over double than in acute care. Further, the reduction in directly employed staff was to a great extent matched by a marked increase in agency spending. The cuts forced substantial HRH reductions and yet there was some success in pursuing policy goals, such as increasing the frontline workforce while reducing support staff and protection of some cadres. Nevertheless, other policies failed such as moving staff away from acute settings

Using the World Health Organization's 4S-Framework to Strengthen National Strategies, Policies and Services to Address Mental Health Problems in Adolescents in Resource-Constrained Settings

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Cabral de Mello Meena

2011-09-01

Full Text Available Abstract Background Most adolescents live in resource-constrained countries and their mental health has been less well recognised than other aspects of their health. The World Health Organization's 4-S Framework provides a structure for national initiatives to improve adolescent health through: gathering and using strategic information; developing evidence-informed policies; scaling up provision and use of health services; and strengthening linkages with other government sectors. The aim of this paper is to discuss how the findings of a recent systematic review of mental health problems in adolescents in resource-constrained settings might be applied using the 4-S Framework. Method Analysis of the implications of the findings of a systematic search of the English-language literature for national strategies, policies, services and cross-sectoral linkages to improve the mental health of adolescents in resource-constrained settings. Results Data are available for only 33/112 [29%] resource-constrained countries, but in all where data are available, non-psychotic mental health problems in adolescents are identifiable, prevalent and associated with reduced quality of life, impaired participation and compromised development. In the absence of evidence about effective interventions in these settings expert opinion is that a broad public policy response which addresses direct strategies for prevention, early intervention and treatment; health service and health workforce requirements; social inclusion of marginalised groups of adolescents; and specific education is required. Specific endorsed strategies include public education, parent education, training for teachers and primary healthcare workers, psycho-educational curricula, identification through periodic screening of the most vulnerable and referral for care, and the availability of counsellors or other identified trained staff members in schools from whom adolescents can seek assistance for

Trade policy and public health.

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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.

Human resources for health in Europe

National Research Council Canada - National Science Library

McKee, Martin; Dubois, Carl-Ardy; Nolte, Ellen

2006-01-01

... systems in the field of personnel. The authors also identify which strategies are most likely to lead to the optimal management of health professionals in the future. Human Resources for Health in Europe is key reading for health policymakers and postgraduates taking courses in health services management, health policy and health economics. It is also ...

The impact of the financial crisis on human resources for health policies in three southern-Europe countries.

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Correia, Tiago; Dussault, Gilles; Pontes, Carla

2015-12-01

The public health sector has been the target of austerity measures since the global financial crisis started in 2008, while health workforce costs have been a source of rapid savings in most European Union countries. This article aims to explore how health workforce policies have evolved in three southern European countries under external constraints imposed by emergency financial programmes agreed with the International Monetary Fund, Central European Bank and European Commission. The selected countries, Greece, Portugal and Cyprus, show similarities with regard to corporatist systems of social protection and comprehensive welfare mechanisms only recently institutionalized. Based on document analysis of the Memoranda of Understanding agreed with the Troika, our results reveal broadly similar policy responses to the crisis but also important differences. In Cyprus, General Practitioners have a key position in reducing public expenditure through gatekeeping and control of users' access, while Portugal and Greece seeks to achieve cost containment by constraining the decision-making powers of professionals. All three countries lack innovation as well as monitoring and assessment of the effects of the financial crisis in relation to the health workforce. Consequently, there is a need for health policy development to use human resources more efficiently in healthcare. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

How do external donors influence national health policy processes? Experiences of domestic policy actors in Cambodia and Pakistan.

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Khan, Mishal S; Meghani, Ankita; Liverani, Marco; Roychowdhury, Imara; Parkhurst, Justin

2018-03-01

Although concerns have historically been raised about the influence of external donors on health policy process in recipient countries, remarkably few studies have investigated perspectives and experiences of domestic policymakers and advisers. This study examines donor influence at different stages of the health policy process (priority setting, policy formulation, policy implementation and monitoring and evaluation) in two aid-dependent LMICs, Cambodia and Pakistan. It identifies mechanisms through which asymmetries in influence between donors and domestic policy actors emerge. We conducted 24 key informant interviews-14 in Pakistan and 10 in Cambodia-with high-level decision-makers who inform or authorize health priority setting, allocate resources and/or are responsible for policy implementation, identifying three routes of influence: financial resources, technical expertise and indirect financial and political incentives. We used both inductive and deductive approaches to analyse the data. Our findings indicate that different routes of influence emerged depending on the stage of the policy process. Control of financial resources was the most commonly identified route by which donors influenced priority setting and policy implementation. Greater (perceived) technical expertise played an important role in donor influence at the policy formulation stage. Donors' power in influencing decisions, particularly during the final (monitoring and evaluation) stage of the policy process, was mediated by their ability to control indirect financial and political incentives as well as direct control of financial resources. This study thus helps unpack the nuances of donor influence over health policymaking in these settings, and can potentially indicate areas that require attention to increase the ownership of domestic actors of their countries' health policy processes. © The Author(s) 2017. Published by Oxford University Press in association with The London School of

Advocacy coalitions involved in California's menu labeling policy debate: Exploring coalition structure, policy beliefs, resources, and strategies.

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Payán, Denise D; Lewis, LaVonna B; Cousineau, Michael R; Nichol, Michael B

2017-03-01

Advocacy coalitions often play an important role in the state health policymaking process, yet little is known about their structure, composition, and behavior. In 2008, California became the first state to enact a menu labeling law. Using the advocacy coalition framework, we examine different facets of the coalitions involved in California's menu labeling policy debate. We use a qualitative research approach to identify coalition members and explore their expressed beliefs and policy arguments, resources, and strategies by analyzing legislative documents (n = 87) and newspaper articles (n = 78) produced between 1999 and 2009. Between 2003 and 2008, six menu labeling bills were introduced in the state's legislature. We found the issue received increasing media attention during this period. We identified two advocacy coalitions involved in the debate-a public health (PH) coalition and an industry coalition. State organizations acted as coalition leaders and participated for a longer duration than elected officials. The structure and composition of each coalition varied. PH coalition leadership and membership notably increased compared to the industry coalition. The PH coalition, led by nonprofit PH and health organizations, promoted a clear and consistent message around informed decision making. The industry coalition, led by a state restaurant association, responded with cost and implementation arguments. Each coalition used various resources and strategies to advance desired outcomes. PH coalition leaders were particularly effective at using resources and employing advocacy strategies, which included engaging state legislators as coalition members, using public opinion polls and information, and leveraging media resources to garner support. Policy precedence and a local policy push emerged as important policymaking strategies. Areas for future research on the state health policymaking process are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Advocacy Coalitions involved in California’s Menu Labeling Policy Debate: Exploring Coalition Structure, Policy Beliefs, Resources, and Strategies

Science.gov (United States)

Payán, Denise D.; Lewis, LaVonna B.; Cousineau, Michael R.; Nichol, Michael B.

2017-01-01

Advocacy coalitions often play an important role in the state health policymaking process, yet little is known about their structure, composition, and behavior. In 2008, California became the first state to enact a menu labeling law. Using the advocacy coalition framework, we examine different facets of the coalitions involved in California’s menu labeling policy debate. We use a qualitative research approach to identify coalition members and explore their expressed beliefs and policy arguments, resources, and strategies by analyzing legislative documents (n=87) and newspaper articles (n=78) produced between 1999 and 2009. Between 2003 and 2008, six menu labeling bills were introduced in the state’s legislature. We found the issue received increasing media attention during this period. We identified two advocacy coalitions involved in the debate—a public health (PH) coalition and an industry coalition. State organizations acted as coalition leaders and participated for a longer duration than elected officials. The structure and composition of each coalition varied. PH coalition leadership and membership notably increased compared to the industry coalition. The PH coalition, led by nonprofit PH and health organizations, promoted a clear and consistent message around informed decision making. The industry coalition, led by a state restaurant association, responded with cost and implementation arguments. Each coalition used various resources and strategies to advance desired outcomes. PH coalition leaders were particularly effective at using resources and employing advocacy strategies, which included engaging state legislators as coalition members, using public opinion polls and information, and leveraging media resources to garner support. Policy precedence and a local policy push emerged as important policymaking strategies. Areas for future research on the state health policymaking process are discussed. PMID:28161674

Mental health research in Brazil: policies, infrastructure, financing and human resources

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Mari Jair de Jesus

2006-01-01

Full Text Available The objective of this descriptive study was to map mental health research in Brazil, providing an overview of infrastructure, financing and policies mental health research. As part of the Atlas-Research Project, a WHO initiative to map mental health research in selected low and middle-income countries, this study was carried out between 1998 and 2002. Data collection strategies included evaluation of governmental documents and sites and questionnaires sent to key professionals for providing information about the Brazilian mental health research infrastructure. In the year 2002, the total budget for Health Research was US$101 million, of which US$3.4 million (3.4 was available for Mental Health Research. The main funding sources for mental health research were found to be the São Paulo State Funding Agency (Fapesp, 53.2% and the Ministry of Education (CAPES, 30.2%. The rate of doctors is 1.7 per 1,000 inhabitants, and the rate of psychiatrists is 2.7 per 100,000 inhabitants estimated 2000 census. In 2002, there were 53 postgraduate courses directed to mental health training in Brazil (43 in psychology, six in psychiatry, three in psychobiology and one in psychiatric nursing, with 1,775 students being trained in Brazil and 67 overseas. There were nine programs including psychiatry, neuropsychiatry, psychobiology and mental health, seven of them implemented in Southern states. During the five-year period, 186 students got a doctoral degree (37 per year and 637 articles were published in Institute for Scientic Information (ISI-indexed journals. The investment channeled towards postgraduate and human resource education programs, by means of grants and other forms of research support, has secured the country a modest but continuous insertion in the international knowledge production in the mental health area.

Self-care as a health resource of elders

DEFF Research Database (Denmark)

Høy, Bente; Wagner, Lis; Hall, Elisabeth O.C.

2007-01-01

into self-care as a significant health resource of elders with different health status. It suggests that an elder's self-care ability is determined by the interaction of various sub-resources and conditions and emphasizes the constantly evolving nature of self-care. The framework may be of use in clinical...... practice, policy-making and research into health care of frail or robust elders.......AIM: To review the literature related to self-care and health promotion for elders and to develop an understanding of self-care as a health resource. BACKGROUND: Self-care may improve health and prevent illness and disabilities in elders. Although studies of self-care are numerous, the significance...

Modeling and Recognizing Policy Conflicts with Resource Access Requests on Protected Health Information

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Raik Kuhlisch

2017-07-01

Full Text Available This article discusses potential clashes between different types of security policies that regulate resource access requests on clinical patient data in hospitals by employees. Attribute-based Access Control (ABAC is proposed as a proper means for such regulation. A proper representation of ABAC policies must include a handling of policy attributes among different policy types. In this article, we propose a semantic policy model with predefined policy conflict categories. A conformance verification function detects erroneous, clashing or mutually susceptible rules early during the policy planning phase. The model and conflicts are used in a conceptual application environment and evaluated in a technical experiment during an interoperability test event.

[Human resources for health in Chile: the reform's pending challenge].

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Méndez, Claudio A

2009-09-01

Omission of human resources from health policy development has been identified as a barrier in the health sector reform's adoption phase. Since 2002, Chile's health care system has been undergoing a transformation based on the principles of health as a human right, equity, solidarity, efficiency, and social participation. While the reform has set forth the redefinition of the medical professions, continuing education, scheduled accreditation, and the introduction of career development incentives, it has not considered management options tailored to the new setting, a human resources strategy that has the consensus of key players and sector policy, or a process for understanding the needs of health care staff and professionals. However, there is still time to undo the shortcomings, in large part because the reform's implementation phase only recently has begun. Overcoming this challenge is in the hands of the experts charged with designing public health strategies and policies.

School Mental Health Resources and Adolescent Mental Health Service Use

Science.gov (United States)

Green, Jennifer Greif; McLaughlin, Katie A.; Alegría, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A,; Kessler, Ronald C.

2014-01-01

Objective Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to increase service use. This paper examines associations of school resources with past-year mental health service use among students with 12-month DSM-IV mental disorders. Method Data come from the U.S. National Comorbidity Survey Adolescent Supplement (NCS-A), a national survey of adolescent mental health that included 4,445 adolescent-parent pairs in 227 schools in which principals and mental health coordinators completed surveys about school resources-policies for addressing student emotional problems. Adolescents and parents completed the Composite International Diagnostic Interview and reported mental health service use across multiple sectors. Multilevel multivariate regression was used to examine associations of school mental health resources and individual-level service use. Results Roughly half (45.3%) of adolescents with a 12-month DSM-IV disorder received past-year mental health services. Substantial variation existed in school resources. Increased school engagement in early identification was significantly associated with mental health service use for adolescents with mild/moderate mental and behavior disorders. The ratio of students-to-mental health providers was not associated with overall service use, but was associated with sector of service use. Conclusions School mental health resources, particularly those related to early identification, may facilitate mental health service use and influence sector of service use for youths with DSM disorders. PMID:23622851

Analysis of policy implications and challenges of the Cuban health assistance program related to human resources for health in the Pacific

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Asante Augustine D

2012-05-01

Full Text Available Abstract Background Cuba has extended its medical cooperation to Pacific Island Countries (PICs by supplying doctors to boost service delivery and offering scholarships for Pacific Islanders to study medicine in Cuba. Given the small populations of PICs, the Cuban engagement could prove particularly significant for health systems development in the region. This paper reviews the magnitude and form of Cuban medical cooperation in the Pacific and analyses its implications for health policy, human resource capacity and overall development assistance for health in the region. Methods We reviewed both published and grey literature on health workforce in the Pacific including health workforce plans and human resource policy documents. Further information was gathered through discussions with key stakeholders involved in health workforce development in the region. Results Cuba formalised its relationship with PICs in September 2008 following the first Cuba-Pacific Islands ministerial meeting. Some 33 Cuban health personnel work in Pacific Island Countries and 177 Pacific island students are studying medicine in Cuba in 2010 with the most extensive engagement in Kiribati, the Solomon Islands, Tuvalu and Vanuatu. The cost of the Cuban medical cooperation to PICs comes in the form of countries providing benefits and paying allowances to in-country Cuban health workers and return airfares for their students in Cuba. This has been seen by some PICs as a cheaper alternative to training doctors in other countries. Conclusions The Cuban engagement with PICs, while smaller than engagement with other countries, presents several opportunities and challenges for health system strengthening in the region. In particular, it allows PICs to increase their health workforce numbers at relatively low cost and extends delivery of health services to remote areas. A key challenge is that with the potential increase in the number of medical doctors, once the local students

African Health Economics and Policy Research Capacity Building ...

International Development Research Centre (IDRC) Digital Library (Canada)

African Health Economics and Policy Research Capacity Building and Dissemination. As African countries move toward universal health coverage, it is clear there is a shortage of African experts with applied research skills in health financing such as fiscal space analysis, needs-based resource allocation methods, and ...

Renewable resource policy when distributional impacts matter

International Nuclear Information System (INIS)

Horan, R.D.; Shortle, J.S.; Bulte, E.H.

1999-01-01

The standard assumption in bioeconomic resource models is that optimal policies maximize the present value of economic surplus to society. This assumption implies that regulatory agencies should not be concerned with the distributional consequences of management strategies. Both contemporary welfare-theoretic and rent-seeking approaches suggests distributional issues are important in designing resource management policies. This paper explores resource management when the managing agency has preferences defined over the economic welfare of various groups with a direct economic interest in the use of resources. Policy schemes consistent with this approach are derived and compared with standard results. 42 refs

Maximising available resources: Equality and human rights proofing Irish fiscal policy

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Murphy Mary P.

2017-08-01

Full Text Available The paper examines various rationales for applying equality and human rights proofing mechanisms to fiscal policy. The principle of using available resources to the maximum to progressively realise human rights, and not to erode the revenue capacity of developing nations to do likewise, is at the heart of emerging human rights norms. To date, Irish budgetary processes and major policy statements such as the Commission on Taxation or the draft outline National Plan on Business and Human Rights Strategy have not engaged with the principles of maximising available resources or extraterritoriality. Proofing fiscal policy is also relevant from the perspective of fiscal welfare where taxation instruments, traditionally used as a revenue-gathering mechanism, are increasingly used as distributional mechanisms to achieve policy outcomes in pensions, health, housing and employment, with important equality and distributive dimensions, particularly from gender, age and socioeconomic perspectives. A number of practical institutional mechanisms and evaluative questions can guide equality and human rights proofing of fiscal policy, but commitments to maximise resources to realise rights also need to be promoted through a public discourse which sees taxation as potential investment in society rather than a burden or cost on the economy.

Human resources for health planning and management in the Eastern Mediterranean region: facts, gaps and forward thinking for research and policy

OpenAIRE

El-Jardali, Fadi; Jamal, Diana; Abdallah, Ahmad; Kassak, Kassem

2007-01-01

Abstract Background The early decades of the 21st century are considered to be the era of human resources for health (HRH). The World Health Report (WHR) 2006 launched the Health Workforce Decade (2006–2015), with high priority given for countries to develop effective workforce policies and strategies. In many countries in the Eastern Mediterranean Region (EMR), particularly those classified as Low and Low-Middle Income Countries (LMICs), the limited knowledge about the nature, scope, composi...

Measuring Geographic Inequalities: Dealing with Multiple Health Resources by Data Envelopment Analysis.

Science.gov (United States)

Dlouhý, Martin

2018-01-01

The existence of geographic differences in health resources, health expenditures, the utilization of health services, and health outcomes have been documented by a lot of studies from various countries of the world. In a publicly financed health system, equal access is one of the main objectives of the national health policy. That is why inequalities in the geographic allocation of health resources are an important health policy issue. Measures of inequality express the complexity of variation in the observed variable by a single number, and there is a variety of inequality measures available. The objective of this study is to develop a measure of the geographic inequality in the case of multiple health resources. The measure uses data envelopment analysis (DEA), which is a non-parametric method of production function estimation, to transform multiple resources into a single virtual health resource. The study shows that the DEA originally developed for measuring efficiency can be used successfully to measure inequality. For the illustrative purpose, the inequality measure is calculated for the Czech Republic. The values of separate Robin Hood Indexes (RHIs) are 6.64% for physicians and 3.96% for nurses. In the next step, we use combined RHI for both health resources. Its value 5.06% takes into account that the combinations of two health resources serve regional populations.

Measuring Geographic Inequalities: Dealing with Multiple Health Resources by Data Envelopment Analysis

Science.gov (United States)

Dlouhý, Martin

2018-01-01

The existence of geographic differences in health resources, health expenditures, the utilization of health services, and health outcomes have been documented by a lot of studies from various countries of the world. In a publicly financed health system, equal access is one of the main objectives of the national health policy. That is why inequalities in the geographic allocation of health resources are an important health policy issue. Measures of inequality express the complexity of variation in the observed variable by a single number, and there is a variety of inequality measures available. The objective of this study is to develop a measure of the geographic inequality in the case of multiple health resources. The measure uses data envelopment analysis (DEA), which is a non-parametric method of production function estimation, to transform multiple resources into a single virtual health resource. The study shows that the DEA originally developed for measuring efficiency can be used successfully to measure inequality. For the illustrative purpose, the inequality measure is calculated for the Czech Republic. The values of separate Robin Hood Indexes (RHIs) are 6.64% for physicians and 3.96% for nurses. In the next step, we use combined RHI for both health resources. Its value 5.06% takes into account that the combinations of two health resources serve regional populations. PMID:29541631

Pakistan's maternal and child health policy: analysis, lessons and the way forward.

Science.gov (United States)

Siddiqi, S; Haq, I U; Ghaffar, A; Akhtar, T; Mahaini, R

2004-07-01

An estimated 400,000 infant and 16,500 maternal deaths occur annually in Pakistan. These translate into an infant mortality rate and maternal mortality ratio that should be unacceptable to any state. Disease states including communicable diseases and reproductive health (RH) problems, which are largely preventable account for over 50% of the disease burden. The analysis of Pakistan's maternal and child health (MCH) and family planning (FP) policy covers the period 1990-2002, and focuses on macroeconomic influences, priority programs and gaps, adequacy of resources, equity and organizational aspects, and the process of policy formulation. The overall MCH/FP policy is well directed. MCH/FP has been a priority in all policies; resource allocation, although unacceptably low, has substantially increased during the last decade; and there is a progressive shift from MCH to the reproductive health (RH) agenda. Areas in need of improvement include greater use of evidence as a basis for policy; increased priority to nutrition programs, measures to reduce neonatal and perinatal mortality, provision of emergency obstetric care, availability of skilled birth attendants, and a clear policy on integrated management of childhood illnesses. Enhanced planning capacity, development of a balanced human resource, improved governance to reduce staff absenteeism and frequent transfers, and a greater role of the private sector in the provision of services are some organizational aspects that need the governments' consideration. There are several lessons to be learnt: (i) Ministries of Health need sustained stewardship and well-documented evidence to protect cuts in resource allocation; (ii) frequent policy announcement sends inappropriate signals to managers and weakens on-going implementation; (iii) MCH/FP policies unless informed by evidence and participation of interest groups are unlikely to address gaps in programs; (iv) distributional and equity objectives of MCH/FP be addressed

Strategies to enhance the impact of research on human resources for health on policy making

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Taghreed Adam

2011-06-01

Full Text Available Despite global recognition of the importance of human resources for health (HRH in achieving health system goals, very little is known about what works, for whom and under what circumstances, especially for low-income and middleincome countries. Several important events and reports have called for increased funding and capacity for HRH research in recent years and several initiatives have started as a result. Progress has been slow, however. The following strategies can be most valuable in ensuring the relevance of the generated evidence for decision making and its contribution to stronger health systems. The first is to promote national processes to set priorities for HRH research with active participation from decision makers. The second is to make conscious efforts to scale up primary research to address priority questions and to develop sustainable mechanisms to evaluate the impact of current or new HRH strategies to feed into the policy making process. The third is to invest in the development of systematic reviews to synthesize available evidence and in the adaptation of the underlying methods to make them more responsive to the type of questions and the nature of research involving HRH issues. The fourth and most important is to consistently use a systems approach in framing and addressing research questions. While a narrow approach may be more attractive and simple, health systems and the problems facing them are not. Increasing the body of evidence that takes into account the complexity of health systems, and particularly human resources for health, will advance knowledge in this area and will make big strides in the quality and usefulness of the generated evidence.

Practicing natural resource management with a policy orientation

Science.gov (United States)

Clark, Tim W.

1992-07-01

All natural resource managers want to contribute to successful conservation programs. Having and applying an explicit policy orientation is indispensable. The policy sciences are described and a case is made that, if natural resource managers utilize this set of conceptual and applied tools in their natural resource work, their effectiveness could be enhanced. The policy sciences offer a contextual, problem-oriented, and multimethod approach to meeting complex problems. Two kinds of knowledge are needed to solve problems—substantive knowledge about the resource and process knowledge about the decision and policy processes used to derive courses of management action. The interplay of science, analysis, and politics are examined. The wildlife management community is used to illustrate many points, including the important role implementation plays in the overall policy process.

Evironmental health policy in ukraine after the Chernobyl accident

International Nuclear Information System (INIS)

Page, G.W.; Bobyleva, O.A.; Naboka, M.V.

1995-01-01

The 1986 accident at the Chernobyl nuclear power plant in Ukraine produced severe environmental health problems. This paper reports on the environmental health conditions in Ukraine after the accident and the health policy approaches employed to respond to the environmental conditions and health problems. Crisis conditions and a period of rapid change in Ukraine contributed to the difficulties of developing and implementing policy to address serious environmental health problems. Despite these difficulties, Ukraine is taking effective action. The paper describes the primary environmental health problem areas and the efforts taken to solve them. The effect of intense public fear of radiation on policymaking is described. The paper discusses the ability of public fear to distort health policy towards certain problems, leaving problems of greater importance with fewer resources. 35 refs., 1 fig

State and Health (1900-2013: Political Stability and Resources

Directory of Open Access Journals (Sweden)

Carla Leão

2016-02-01

Full Text Available Portuguese public health policies do not surpass eighty years in terms of concerted decision-making, and it is inappropriate to speak of a national health policy before the second half of the twentieth century. This article describes the pathway of policymaking from 1900 to 2013, concerning Portuguese Welfare State emergence. It systematises the main stages of the Portuguese health policies, and analyses its stronger lines, highlighting the relationship between political stability, resources and the State's intervention, strongly related to the emergence of the Welfare State. It summarises the milestones of health policy decisions and describes each of them since 1910. A larger description of changes occurred after the democratic regime and the origins of the Welfare State, embodied in the creation of the National Health Service are given, emphasising the process of epidemiological transition, the decline of infant mortality rate and the growth of life expectancy average levels.

A resource for developing an evidence synthesis report for policy-making

DEFF Research Database (Denmark)

Eklund Karlsson, Leena; Takahashi, Ryoko

to public health questions by summarizing the best available global and local findings from peer-reviewed and grey literature, as well as policy options, and proposes general directions, strategies and actions for consideration. This resource has been developed to outline key approaches, methods...

Trade policies, institutions and the natural resource curse

NARCIS (Netherlands)

Arezki, R.; van der Ploeg, F.

2010-01-01

We offer new cross-country evidence on the natural resource curse. We investigate the impact of the interaction of natural resource abundance and policies on growth. We find that the resource curse is less severe in countries with less restrictive trade policies and good institutions. However, we

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

Can conditional health policies be justified? A policy analysis of the new NHS dental contract reforms.

Science.gov (United States)

Laverty, Louise; Harris, Rebecca

2018-06-01

Conditional policies, which emphasise personal responsibility, are becoming increasingly common in healthcare. Although used widely internationally, they are relatively new within the UK health system where there have been concerns about whether they can be justified. New NHS dental contracts include the introduction of a conditional component that restricts certain patients from accessing a full range of treatment until they have complied with preventative action. A policy analysis of published documents on the NHS dental contract reforms from 2009 to 2016 was conducted to consider how conditionality is justified and whether its execution is likely to cause distributional effects. Contractualist, paternalistic and mutualist arguments that reflect notions of responsibility and obligation are used as justification within policy. Underlying these arguments is an emphasis on preserving the finite resources of a strained NHS. We argue that the proposed conditional component may differentially affect disadvantaged patients, who do not necessarily have access to the resources needed to meet the behavioural requirements. As such, the conditional component of the NHS dental contract reform has the potential to exacerbate oral health inequalities. Conditional health policies may challenge core NHS principles and, as is the case with any conditional policy, should be carefully considered to ensure they do not exacerbate health inequities. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Intersectoral action on SDH and equity in Australian health policy.

Science.gov (United States)

Fisher, Matthew; Baum, Frances E; MacDougall, Colin; Newman, Lareen; McDermott, Dennis; Phillips, Clare

2017-12-01

Intersectoral action between public agencies across policy sectors, and between levels of government, is seen as essential for effective action by governments to address social determinants of health (SDH) and to reduce health inequities. The health sector has been identified as having a crucial stewardship role, to engage other policy sectors in action to address the impacts of their policies on health. This article reports on research to investigate intersectoral action on SDH and health inequities in Australian health policy. We gathered and individually analysed 266 policy documents, being all of the published, strategic health policies of the national Australian government and eight State/Territory governments, current at the time of sampling in late 2012-early 2013. Our analysis showed that strategies for intersectoral action were common in Australian health policy, but predominantly concerned with extending access to individualized medical or behavioural interventions to client groups in other policy sectors. Where intersectoral strategies did propose action on SDH (other than access to health-care), they were mostly limited to addressing proximal factors, rather than policy settings affecting the distribution of socioeconomic resources. There was little evidence of engagement between the health sector and those policy sectors most able to influence systemic socioeconomic inequalities in Australia. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Reflections on the ethics of recruiting foreign-trained human resources for health

Directory of Open Access Journals (Sweden)

Labonté Ronald

2011-01-01

Full Text Available Abstract Background Developed countries' gains in health human resources (HHR from developing countries with significantly lower ratios of health workers have raised questions about the ethics or fairness of recruitment from such countries. By attracting and/or facilitating migration for foreign-trained HHR, notably those from poorer, less well-resourced nations, recruitment practices and policies may be compromising the ability of developing countries to meet the health care needs of their own populations. Little is known, however, about actual recruitment practices. In this study we focus on Canada (a country with a long reliance on internationally trained HHR and recruiters working for Canadian health authorities. Methods We conducted interviews with health human resources recruiters employed by Canadian health authorities to describe their recruitment practices and perspectives and to determine whether and how they reflect ethical considerations. Results and discussion We describe the methods that recruiters used to recruit foreign-trained health professionals and the systemic challenges and policies that form the working context for recruiters and recruits. HHR recruiters' reflections on the global flow of health workers from poorer to richer countries mirror much of the content of global-level discourse with regard to HHR recruitment. A predominant market discourse related to shortages of HHR outweighed discussions of human rights and ethical approaches to recruitment policy and action that consider global health impacts. Conclusions We suggest that the concept of corporate social responsibility may provide a useful approach at the local organizational level for developing policies on ethical recruitment. Such local policies and subsequent practices may inform public debate on the health equity implications of the HHR flows from poorer to richer countries inherent in the global health worker labour market, which in turn could influence

Reflections on the ethics of recruiting foreign-trained human resources for health.

Science.gov (United States)

Runnels, Vivien; Labonté, Ronald; Packer, Corinne

2011-01-20

Developed countries' gains in health human resources (HHR) from developing countries with significantly lower ratios of health workers have raised questions about the ethics or fairness of recruitment from such countries. By attracting and/or facilitating migration for foreign-trained HHR, notably those from poorer, less well-resourced nations, recruitment practices and policies may be compromising the ability of developing countries to meet the health care needs of their own populations. Little is known, however, about actual recruitment practices. In this study we focus on Canada (a country with a long reliance on internationally trained HHR) and recruiters working for Canadian health authorities. We conducted interviews with health human resources recruiters employed by Canadian health authorities to describe their recruitment practices and perspectives and to determine whether and how they reflect ethical considerations. We describe the methods that recruiters used to recruit foreign-trained health professionals and the systemic challenges and policies that form the working context for recruiters and recruits. HHR recruiters' reflections on the global flow of health workers from poorer to richer countries mirror much of the content of global-level discourse with regard to HHR recruitment. A predominant market discourse related to shortages of HHR outweighed discussions of human rights and ethical approaches to recruitment policy and action that consider global health impacts. We suggest that the concept of corporate social responsibility may provide a useful approach at the local organizational level for developing policies on ethical recruitment. Such local policies and subsequent practices may inform public debate on the health equity implications of the HHR flows from poorer to richer countries inherent in the global health worker labour market, which in turn could influence political choices at all government and health system levels.

Health policy making for street children: challenges and strategies.

Science.gov (United States)

Abdi, Fatemeh; Saeieh, Sara Esmaelzadeh; Roozbeh, Nasibeh; Yazdkhasti, Mansoureh

2017-08-17

Background The phenomenon of street children is a bio-psychological and social issue that not only harms children, but also endangers the health of a society. In line with the national programs for the development and promotion of street children's health in Iran, health policy making and essential strategies for this group of children will be presented in this paper. This paper will discuss the main issues and challenges of street children's health and, also, health policy and guidelines for this population. Methods In this review study, the keywords; street children, health, challenges, policy, and health policy making were searched through PubMed, SID, Iranmedex, World Health Organization (WHO), Emro, the Cochran Library, Medline and Google scholar to collect data. The search resulted in 84 related resources from which 48 cases that were more relevant to this research and covered the issue more comprehensively, were used. All data published during 2002-2015 have been included in this paper. Results Key concepts including street children and their health, health policy, strategies to improve the health of street children, health policy approaches for street children, the WHO's strategies, and social support program for street children must be considered in the health policy making processes for street children, as precise identification of the relevant information makes planning more effective in health policy making for this group of children. Conclusion The phenomenon of street children is a growing problem in the world and it has turned into a serious concern in many countries including Iran. The findings of this study can be used for identifying necessary measures in order to use research outcomes more effectively in policy making processes and reforming street children's health policies in Iran.

Governance of global health research consortia: Sharing sovereignty and resources within Future Health Systems.

Science.gov (United States)

Pratt, Bridget; Hyder, Adnan A

2017-02-01

Global health research partnerships are increasingly taking the form of consortia that conduct programs of research in low and middle-income countries (LMICs). An ethical framework has been developed that describes how the governance of consortia comprised of institutions from high-income countries and LMICs should be structured to promote health equity. It encompasses initial guidance for sharing sovereignty in consortia decision-making and sharing consortia resources. This paper describes a first effort to examine whether and how consortia can uphold that guidance. Case study research was undertaken with the Future Health Systems consortium, performs research to improve health service delivery for the poor in Bangladesh, China, India, and Uganda. Data were thematically analysed and revealed that proposed ethical requirements for sharing sovereignty and sharing resources are largely upheld by Future Health Systems. Facilitating factors included having a decentralised governance model, LMIC partners with good research capacity, and firm budgets. Higher labour costs in the US and UK and the funder's policy of allocating funds to consortia on a reimbursement basis prevented full alignment with guidance on sharing resources. The lessons described in this paper can assist other consortia to more systematically link their governance policy and practice to the promotion of health equity. Copyright © 2016 Elsevier Ltd. All rights reserved.

Leasing policies for the extractive resources

Science.gov (United States)

Attanasi, E.D.; Johnson, S.R.

1976-01-01

Much of the available analysis of policies for the disposal of publicly held resources is based on comparatively straightforward extensions of the neoclassical pricing and allocation theory. As such, these analyses have to a large extent not fully incorporated the fact that firms normally acquire rights to these resources in sealed tender markets. In this paper, a simple bidding model is used to show that the choice of disposal policies can influence the firm's bid and also the public revenues obtained from the sale of the resource. It is additionally shown that the implications of such policy choices are conditioned by the firm's attitudes towards risk. Finally, it is argued that a modification of existing prescriptions may be necessary if a more realistic specification of the disposal problem taking account of the sealed tender market in which rights are obtained, is considered. ?? 1976 Annals of Regional Science.

What impact do Global Health Initiatives have on human resources for antiretroviral treatment roll-out? A qualitative policy analysis of implementation processes in Zambia

Directory of Open Access Journals (Sweden)

Hanefeld Johanna

2009-02-01

Full Text Available Abstract Background Since the beginning of the 21st century, development assistance for HIV/AIDS has increasingly been provided through Global Health Initiatives, specifically the United States Presidential Emergency Plan for AIDS Relief, the Global Fund to Fight HIV, TB and Malaria and the World Bank Multi-country AIDS Programme. Zambia, like many of the countries heavily affected by HIV/AIDS in southern Africa, also faces a shortage of human resources for health. The country receives significant amounts of funding from GHIs for the large-scale provision of antiretroviral treatment through the public and private sector. This paper examines the impact of GHIs on human resources for ART roll-out in Zambia, at national level, in one province and two districts. Methods It is a qualitative policy analysis relying on in-depth interviews with more than 90 policy-makers and implementers at all levels. Results Findings show that while GHIs do not provide significant funding for additional human resources, their interventions have significant impact on human resources for health at all levels. While GHIs successfully retrain a large number of health workers, evidence suggests that GHIs actively deplete the pool of skilled human resources for health by recruiting public sector staff to work for GHI-funded nongovernmental implementing agencies. The secondment of GHI staff into public sector facilities may help alleviate immediate staff shortages, but this practice risks undermining sustainability of programmes. GHI-supported programmes and initiatives add significantly to the workload of existing public sector staff at all levels, while incentives including salary top-ups and overtime payments mean that ART programmes are more popular among staff than services for non-focal diseases. Conclusion Research findings suggest that GHIs need to actively mediate against the potentially negative consequences of their funding on human resources for health. Evidence

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.

Integrating science and policy in natural resource management: lessons and opportunities from North America.

Science.gov (United States)

Roger N. Clark; Errol E. Meidinger

1998-01-01

Relations between science and policy concerning many issues (e.g., health, energy, natural resources) have been changing worldwide. Public pressure to resolve such complex and often controversial issues has resulted in policymakers and policy implementers seeking better knowledge on which to base their decisions. As a result, scientists have become more actively...

Evaluation of health resource utilization efficiency in community health centers of Jiangsu Province, China.

Science.gov (United States)

Xu, Xinglong; Zhou, Lulin; Antwi, Henry Asante; Chen, Xi

2018-02-20

While the demand for health services keep escalating at the grass roots or rural areas of China, a substantial portion of healthcare resources remain stagnant in the more developed cities and this has entrenched health inequity in many parts of China. At its conception, China's Deepen Medical Reform started in 2012 was intended to flush out possible disparities and promote a more equitable and efficient distribution of healthcare resources. Nearly half a decade of this reform, there are uncertainties as to whether the attainment of the objectives of the reform is in sight. Using a hybrid of panel data analysis and an augmented data envelopment analysis (DEA), we model human resources, material, finance to determine their technical and scale efficiency to comprehensively evaluate the transverse and longitudinal allocation efficiency of community health resources in Jiangsu Province. We observed that the Deepen Medical Reform in China has led to an increase concern to ensure efficient allocation of community health resources by health policy makers in the province. This has led to greater efficiency in health resource allocation in Jiangsu in general but serious regional or municipal disparities still exist. Using the DEA model, we note that the output from the Community Health Centers does not commensurate with the substantial resources (human resources, materials, and financial) invested in them. We further observe that the case is worst in less-developed Northern parts of Jiangsu Province. The government of Jiangsu Province could improve the efficiency of health resource allocation by improving the community health service system, rationalizing the allocation of health personnel, optimizing the allocation of material resources, and enhancing the level of health of financial resource allocation.

Human resource policy and Danish multinational companies

DEFF Research Database (Denmark)

Fleming, Daniel; Søborg, Henrik

A study of Danish multinational companies' human resource policy in their subsidiaries in Malaysia and Singapore.The sample of companies consists of 8 Danish multinational companies with activities in both Malaysia and Singapore.......A study of Danish multinational companies' human resource policy in their subsidiaries in Malaysia and Singapore.The sample of companies consists of 8 Danish multinational companies with activities in both Malaysia and Singapore....

An assessment of mental health policy in Ghana, South Africa, Uganda and Zambia

Directory of Open Access Journals (Sweden)

Mwanza Jason

2011-04-01

Full Text Available Abstract Background Approximately half of the countries in the African Region had a mental health policy by 2005, but little is known about quality of mental health policies in Africa and globally. This paper reports the results of an assessment of the mental health policies of Ghana, South Africa, Uganda and Zambia. Methods The WHO Mental Health Policy Checklist was used to evaluate the most current mental health policy in each country. Assessments were completed and reviewed by a specially constituted national committee as well as an independent WHO team. Results of each country evaluation were discussed until consensus was reached. Results All four policies received a high level mandate. Each policy addressed community-based services, the integration of mental health into general health care, promotion of mental health and rehabilitation. Prevention was addressed in the South African and Ugandan policies only. Use of evidence for policy development varied considerably. Consultations were mainly held with the mental health sector. Only the Zambian policy presented a clear vision, while three of four countries spelt out values and principles, the need to establish a coordinating body for mental health, and to protect the human rights of people with mental health problems. None included all the basic elements of a policy, nor specified sources and levels of funding for implementation. Deinstitutionalisation and the provision of essential psychotropic medicines were insufficiently addressed. Advocacy, empowerment of users and families and intersectoral collaboration were inadequately addressed. Only Uganda sufficiently outlined a mental health information system, research and evaluation, while only Ghana comprehensively addressed human resources and training requirements. No country had an accompanying strategic mental health plan to allow the development and implementation of concrete strategies and activities. Conclusions Six gaps which could

Health as foreign policy: harnessing globalization for health.

Science.gov (United States)

Fidler, David P

2006-12-01

This paper explores the importance for health promotion of the rise of public health as a foreign policy issue. Although health promotion encompassed foreign policy as part of 'healthy public policy', mainstream foreign policy neglected public health and health promotion's role in it. Globalization forces health promotion, however, to address directly the relationship between public health and foreign policy. The need for 'health as foreign policy' is apparent from the prominence public health now has in all the basic governance functions served by foreign policy. The Secretary-General's United Nations (UN) reform proposals demonstrate the importance of foreign policy to health promotion as a core component of public health because the proposals embed public health in each element of the Secretary-General's vision for the UN in the 21st century. The emergence of health as foreign policy presents opportunities and risks for health promotion that can be managed by emphasizing that public health constitutes an integrated public good that benefits all governance tasks served by foreign policy. Any effort to harness globalization for public health will have to make health as foreign policy a centerpiece of its ambitions, and this task is now health promotion's burden and opportunity.

Trade policy governance: What health policymakers and advocates need to know.

Science.gov (United States)

Jarman, Holly

2017-11-01

Trade policies affect determinants of health as well as the options and resources available to health policymakers. There is therefore a need for health policymakers and related stakeholders in all contexts to understand and connect with the trade policymaking process. This paper uses the TAPIC (transparency, accountability, participation, integrity, capacity) governance framework to analyze how trade policy is commonly governed. I conclude that the health sector is likely to benefit when transparency in trade policymaking is increased, since trade negotiations to date have often left out health advocates and policymakers. Trade policymakers and negotiators also tend to be accountable to economic and trade ministries, which are in turn accountable to economic and business interests. Neither tend to appreciate the health consequences of trade and trade policies. Greater accountability to health ministries and interests, and greater participation by them, could improve the health effects of trade negotiations. Trade policies are complex, requiring considerable policy capacity to understand and influence. Nevertheless, investing in understanding trade can pay off in terms of managing future legal risks. Copyright © 2017. Published by Elsevier B.V.

Human Resources for Health in Rural China : an Assessment of the ...

International Development Research Centre (IDRC) Digital Library (Canada)

Recent official documents pertaining to healthcare delivery system reform in China have focused mainly on infrastructure, equipment, management, insurance and drug policies. There has been little if any attention paid to human resources for health. Given the time and resources required to train qualified primary care ...

Workplace Policies and Mental Health among Working-Class, New Parents.

Science.gov (United States)

Perry-Jenkins, Maureen; Smith, JuliAnna Z; Wadsworth, Lauren Page; Halpern, Hillary Paul

2017-01-01

Little research has explored linkages between workplace policies and mental health in working-class, employed parents, creating a gap in our knowledge of work-family issues across social class levels. The current U.S. study addresses this gap by employing hierarchical linear modeling techniques to examine how workplace policies and parental leave benefits predicted parents' depressive symptoms and anxiety in a sample of 125, low-income, dual-earner couples interviewed across the transition to parenthood. Descriptive analyses revealed that, on average, parents had few workplace policies, such as schedule flexibility or child care supports, available to them. Results revealed, however, that, when available, schedule flexibility was related to fewer depressive symptoms and less anxiety for new mothers. Greater child care supports predicted fewer depressive symptoms for fathers. In terms of crossover effects, longer maternal leave predicted declines in fathers' anxiety across the first year. Results are discussed with attention to how certain workplace policies may serve to alleviate new parents' lack of time and resources (minimize scarcity of resources) and, in turn, predict better mental health during the sensitive period of new parenthood.

Strategic Workforce Planning for Health Human Resources: A Nursing Case Analysis.

Science.gov (United States)

Baumann, Andrea; Crea-Arsenio, Mary; Akhtar-Danesh, Noori; Fleming-Carroll, Bonnie; Hunsberger, Mabel; Keatings, Margaret; Elfassy, Michael David; Kratina, Sarah

2016-01-01

Background Health-care organizations provide services in a challenging environment, making the introduction of health human resources initiatives especially critical for safe patient care. Purpose To demonstrate how one specialty hospital in Ontario, Canada, leveraged an employment policy to stabilize its nursing workforce over a six-year period (2007 to 2012). Methods An observational cross-sectional study was conducted in which administrative data were analyzed to compare full-time status and retention of new nurses prepolicy and during the policy. The Professionalism and Environmental Factors in the Workplace Questionnaire® was used to compare new nurses hired into the study hospital with new nurses hired in other health-care settings. Results There was a significant increase in full-time employment and a decrease in part-time employment in the study hospital nursing workforce. On average, 26% of prepolicy new hires left the study hospital within one year of employment compared to 5% of new hires during policy implementation. The hospital nurses scored significantly higher than nurses employed in other health-care settings on 5 out of 13 subscales of professionalism. Conclusions Decision makers can use these findings to develop comprehensive health human resources guidelines and mechanisms that support strategic workforce planning to sustain and strengthen the health-care system.

Exploring Health-Promotion and Policy Synergies in Education in Bhutan

DEFF Research Database (Denmark)

Yezer, Yezer; Schmidt, Johannes Dragsbæk; Christensen, Line Kikkenborg

and the actual wish for keeping up tradition and a specific culturalized understanding of knowledge and well-being production by the government? The paper is divided into five sections. The introduction has outlined the context and the nexus between health and education; some theoretical remarks about the links......Paper for the International Workshop “Development Challenges in Bhutan”, Aalborg University, Copenhagen, 29-30 May, 2013 Abstract This contribution focuses on how the existing resources and policy objectives for social development activities within the area of health promotion through education...... is utilized and whether intentions conflict with outcomes. It will furthermore explore whether there are relevant synergies in the policy flow from center to local levels in terms of delivering efficient health through educational policies. The focus lies on the implementation level of health in education...

[Human resources for health in Ecuador's new model of care].

Science.gov (United States)

Espinosa, Verónica; de la Torre, Daniel; Acuña, Cecilia; Cadena, Cristina

2017-06-08

Describe strategies implemented by Ecuador's Ministry of Public Health (MPH) to strengthen human resources for health leadership and respond to the new model of care, as a part of the reform process in the period 2012-2015. A documentary review was carried out of primary and secondary sources on development of human resources for health before and after the reform. In the study period, Ecuador developed a new institutional and regulatory framework for developing human resources for health to respond to the requirements of a model of care based on primary health care. The MPH consolidated its steering role by forging strategic partnerships, implementing human resources planning methods, and making an unprecedented investment in health worker training, hiring, and wage increases. These elements constitute the initial core for development of human resources for health policy and a health-services study program consistent with the reform's objectives. Within the framework of the reform carried out from 2012 to 2015, intersectoral work by the MPH has led to considerable achievements in development of human resources for health. Notable achievements include strengthening of the steering role, development and implementation of standards and regulatory instruments, creation of new professional profiles, and hiring of professionals to implement the comprehensive health care model, which helped to solve problems carried over from the years prior to the reform.

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.

Health care in Canada: a citizen's guide to policy and politics

National Research Council Canada - National Science Library

Fierlbeck, Katherine

2011-01-01

... outlines the basic framework of the health care system with reference to speci fi c areas such as administration and governance, public health, human resources, drugs and drug policy, and mental health. She also discusses alternative models in other countries such as Britain, the United States, and France. As health care becomes increasingly complex...

Electoral reform and public policy outcomes in Thailand: the politics of the 30-Baht health scheme.

Science.gov (United States)

Selway, Joel Sawat

2011-01-01

How do changes in electoral rules affect the nature of public policy outcomes? The current evidence supporting institutional theories that answer this question stems almost entirely from quantitative cross-country studies, the data of which contain very little within-unit variation. Indeed, while there are many country-level accounts of how changes in electoral rules affect such phenomena as the number of parties or voter turnout, there are few studies of how electoral reform affects public policy outcomes. This article contributes to this latter endeavor by providing a detailed analysis of electoral reform and the public policy process in Thailand through an examination of the 1997 electoral reforms. Specifically, the author examines four aspects of policy-making: policy formulation, policy platforms, policy content, and policy outcomes. The article finds that candidates in the pre-1997 era campaigned on broad, generic platforms; parties had no independent means of technical policy expertise; the government targeted health resources to narrow geographic areas; and health was underprovided in Thai society. Conversely, candidates in the post-1997 era relied more on a strong, detailed national health policy; parties created mechanisms to formulate health policy independently; the government allocated health resources broadly to the entire nation through the introduction of a universal health care system, and health outcomes improved. The author attributes these changes in the policy process to the 1997 electoral reform, which increased both constituency breadth (the proportion of the population to which politicians were accountable) and majoritarianism.

Australia modifies resource rent, uranium mining policies

International Nuclear Information System (INIS)

Anon.

1984-01-01

Current Australian government business and economic policies as they affect the mining industry are discussed. The distribution of constitutional and taxing powers in Australia between state and commonwealth governments and possible inappropriate taxes and other policies can have an adverse effect on resource development. The effects of these policies on both coal and uranium mining are discussed

State Electricity Regulatory Policy and Distributed Resources: Distributed Resources and Electric System Reliability

Energy Technology Data Exchange (ETDEWEB)

Cowart, R.; Harrington, C.; Moskovitz, D.; Shirley, W.; Weston, F.; Sedano, R.

2002-10-01

Designing and implementing credit-based pilot programs for distributed resources distribution is a low-cost, low-risk opportunity to find out how these resources can help defer or avoid costly electric power system (utility grid) distribution upgrades. This report describes implementation options for deaveraged distribution credits and distributed resource development zones. Developing workable programs implementing these policies can dramatically increase the deployment of distributed resources in ways that benefit distributed resource vendors, users, and distribution utilities. This report is one in the State Electricity Regulatory Policy and Distributed Resources series developed under contract to NREL (see Annual Technical Status Report of the Regulatory Assistance Project: September 2000-September 2001, NREL/SR-560-32733). Other titles in this series are: (1) Accommodating Distributed Resources in Wholesale Markets, NREL/SR-560-32497; (2) Distributed Resources and Electric System Re liability, NREL/SR-560-32498; (3) Distribution System Cost Methodologies for Distributed Generation, NREL/SR-560-32500; (4) Distribution System Cost Methodologies for Distributed Generation Appendices, NREL/SR-560-32501.

From Waste Management to Resource Efficiency—The Need for Policy Mixes

Directory of Open Access Journals (Sweden)

Henning Wilts

2016-07-01

Full Text Available Treating waste as a resource and the design of a circular economy have been identified as key approaches for resource efficiency. Despite ambitious targets, policies and instruments that would enable a transition from a conventional waste management to an integrated and comprehensive resource management are still missing. Moreover, this will require innovative policy mixes which do not only address different end-of-pipe approaches but integrate various resource efficiency aspects from product design to patterns of production and consumption. Based on the results of a project funded by the Seventh Framework Programme for Research and Technological Development named “POLFREE—Policy Options for a resource efficient economy”, this paper addresses several aspects of the conceptualization of policy mixes with regard to waste as a specific resource efficiency challenge. The guiding research interest of this paper is the combination of policies necessary to create a full circular economy. In a first step, the present waste policy frameworks, institutions and existing incentives at national level are examined in order to disclose regulatory and policy gaps. Based on this, the second part of the paper describes and analyses specific waste-related resource efficiency instruments with regard to their potential impacts under the constraints of various barriers. Based on the assessment of the country analyses and the innovative instruments, the paper draws conclusions on waste policy mixes and political needs.

Can social inclusion policies reduce health inequalities in sub-Saharan Africa?--A rapid policy appraisal.

Science.gov (United States)

Rispel, Laetitia C; de Sousa, César A D Palha; Molomo, Boitumelo G

2009-08-01

The global resurgence of interest in the social determinants of health provides an opportunity for determined action on unacceptable and unjust health inequalities that exist within and between countries. This paper reviews three categories of social inclusion policies: cash-transfers; free social services; and specific institutional arrangements for programme integration in six selected countries--Botswana, Mozambique, South Africa, Ethiopia, Nigeria, and Zimbabwe. The policies were appraised as part of the Social Exclusion Knowledge Network (SEKN) set up under the auspices of the World Health Organization's Commission on Social Determinants of Health. The paper highlights the development landscape in sub-Saharan Africa and presents available indicators of the scale of inequity in the six countries. A summary of the policies appraised is presented, including whether or what the impact of these policies has been on health inequalities. Cross-cutting benefits include poverty alleviation, notably among vulnerable children and youths, improved economic opportunities for disadvantaged households, reduction in access barriers to social services, and improved nutrition intake. The impact of these benefits, and hence the policies, on health status can only be inferred. Among the policies reviewed, weaknesses or constraints were in design and implementation. The policy design weaknesses include targeting criteria, their enforcement and latent costs, inadequate participation of the community and failure to take the cultural context into account. A major weakness of most policies was the lack of a monitoring and evaluation system, with clear indicators that incorporate system responsiveness. The policy implementation weaknesses include uneven regional implementation with rural areas worst affected; inadequate or poor administrative and implementation capacity; insufficient resources; problems of fraud and corruption; and lack of involvement of civil servants, exacerbating

Social goals, health policy and the dynamics of development as bases for health education.

Science.gov (United States)

Wang, V L

1977-01-01

Among the most powerful social forces in this century is self determination of nations and of people. The relatively recent phenomenon of community participation in health decisions in some countries is but one aspect of the larger societal value. We can assume that self care, mutual care and collaborative involvement between providers and citizens flow from the concept of self determination. Although the pace is uneven and varies greatly among different communities and in different countries, there is a global movement towards health by the people. This is reflected in the decline of professional dominance of the health field as people in communities assume greater responsiblity for tasks previously monopolized by the health professionals. At the macro level, communities are making decisions in the allocation of resources for health and setting health priorities. At the macro level, health education is increasingly concerned in assisting consumers to develop skills in self diagnosis, self help and self care. However, if health is a human right, it must also be appropriated responsibly by those who claim it. Many healthy problems have their roots in community life. Today, major reductions in death and disability cannot be expected from curative services; instead, future progress will have to result from changes in the environment and lifestyle. Environmental changes will require in turn the cooperation of non-health sectors. Traditionally, professionals and others in these sectors have been reluctant to touch health planning and health policy due to medical dominance and a general attitude that health care belongs to the health professions. A primary task in health education is therefore to build stable linkages with other workers and the public in order that health status may be improved by finding areas of common concern and by institutionalizing joint efforts in seeking solutions through multipurpose planning. In-service training and continuing education for

Finding electronic information for health policy advocacy: a guide to improving search results.

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Olsan, Tobie H; Bianchi, Carolanne; White, Pamela; Glessner, Theresa; Mapstone, Pamela L

2011-12-01

The success of advanced practice registered nurses' (APRNs') health policy advocacy depends on staying well informed about key issues. Searching for high-quality health policy information, however, can be frustrating and time consuming. Busy clinicians need strategies and tips to reduce information overload and to access synthesized research for evidence-based health policy. This article therefore offers APRNs practical guidelines and resources for searching electronic health policy information. Scholarly databases and Internet sites. Electronic health policy information is generated by a wide variety of public and private organizations and disseminated in hundreds of journals and Web pages. Specialty search tools are needed to retrieve the unindexed gray literature, which includes government documents, agency reports, fact sheets, standards, and statistics not produced by commercial publishers. Further, Internet users need to examine search results with a critical eye for information quality. Expertise in searching electronic health policy information is a prerequisite for developing APRNs' leadership in political arenas to influence health policy and the delivery of healthcare services. ©2011 The Author(s) Journal compilation ©2011 American Academy of Nurse Practitioners.

Challenges and opportunities for policy decisions to address health equity in developing health systems: case study of the policy processes in the Indian state of Orissa

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Gopalan Saji S

2011-11-01

Full Text Available Abstract Introduction Achieving health equity is a pertinent need of the developing health systems. Though policy process is crucial for planning and attaining health equity, the existing evidences on policy processes are scanty in this regard. This article explores the magnitude, determinants, challenges and prospects of 'health equity approach' in various health policy processes in the Indian State of Orissa - a setting comparable with many other developing health systems. Methods A case-study involving 'Walt-Gilson Policy Triangle' employed key-informant interviews and documentary reviews. Key informants (n = 34 were selected from the departments of Health and Family Welfare, Rural Development, and Women and Child Welfare, and civil societies. The documentary reviews involved various published and unpublished reports, policy pronouncements and articles on health equity in Orissa and similar settings. Results The 'health policy agenda' of Orissa was centered on 'health equity' envisaging affordable and equitable healthcare to all, integrated with public health interventions. However, the subsequent stages of policy process such as 'development, implementation and evaluation' experienced leakage in the equity approach. The impediment for a comprehensive approach towards health equity was the nexus among the national and state health priorities; role, agenda and capacity of actors involved; and existing constraints of the healthcare delivery system. Conclusion The health equity approach of policy processes was incomprehensive, often inadequately coordinated, and largely ignored the right blend of socio-medical determinants. A multi-sectoral, unified and integrated approach is required with technical, financial and managerial resources from different actors for a comprehensive 'health equity approach'. If carefully geared, the ongoing health sector reforms centered on sector-wide approaches, decentralization, communitization and involvement of

Behavioral health problems, ex-offender reentry policies, and the "Second Chance Act".

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Pogorzelski, Wendy; Wolff, Nancy; Pan, Ko-Yu; Blitz, Cynthia L

2005-10-01

The federal "Second Chance Act of 2005" calls for expanding reentry services for people leaving prison, yet existing policies restrict access to needed services for those with criminal records. We examined the interaction between individual-level characteristics and policy-level restrictions related to criminal conviction, and the likely effects on access to resources upon reentry, using a sample of prisoners with Axis I mental disorders (n=3073). We identified multiple challenges related to convictions, including restricted access to housing, public assistance, and other resources. Invisible punishments embedded within existing policies were inconsistent with the call for second chances. Without modification of federal and state policies, the ability of reentry services to foster behavioral health and community reintegration is limited.

Global health and foreign policy.

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Feldbaum, Harley; Lee, Kelley; Michaud, Joshua

2010-01-01

Health has long been intertwined with the foreign policies of states. In recent years, however, global health issues have risen to the highest levels of international politics and have become accepted as legitimate issues in foreign policy. This elevated political priority is in many ways a welcome development for proponents of global health, and it has resulted in increased funding for and attention to select global health issues. However, there has been less examination of the tensions that characterize the relationship between global health and foreign policy and of the potential effects of linking global health efforts with the foreign-policy interests of states. In this paper, the authors review the relationship between global health and foreign policy by examining the roles of health across 4 major components of foreign policy: aid, trade, diplomacy, and national security. For each of these aspects of foreign policy, the authors review current and historical issues and discuss how foreign-policy interests have aided or impeded global health efforts. The increasing relevance of global health to foreign policy holds both opportunities and dangers for global efforts to improve health.

Global Health and Foreign Policy

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Feldbaum, Harley; Lee, Kelley; Michaud, Joshua

2010-01-01

Health has long been intertwined with the foreign policies of states. In recent years, however, global health issues have risen to the highest levels of international politics and have become accepted as legitimate issues in foreign policy. This elevated political priority is in many ways a welcome development for proponents of global health, and it has resulted in increased funding for and attention to select global health issues. However, there has been less examination of the tensions that characterize the relationship between global health and foreign policy and of the potential effects of linking global health efforts with the foreign-policy interests of states. In this paper, the authors review the relationship between global health and foreign policy by examining the roles of health across 4 major components of foreign policy: aid, trade, diplomacy, and national security. For each of these aspects of foreign policy, the authors review current and historical issues and discuss how foreign-policy interests have aided or impeded global health efforts. The increasing relevance of global health to foreign policy holds both opportunities and dangers for global efforts to improve health. PMID:20423936

Challenges in Australian policy processes for disinvestment from existing, ineffective health care practices.

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Elshaug, Adam G; Hiller, Janet E; Tunis, Sean R; Moss, John R

2007-10-31

Internationally, many health care interventions were diffused prior to the standard use of assessments of safety, effectiveness and cost-effectiveness. Disinvestment from ineffective or inappropriately applied practices is a growing priority for health care systems for reasons of improved quality of care and sustainability of resource allocation. In this paper we examine key challenges for disinvestment from these interventions and explore potential policy-related avenues to advance a disinvestment agenda. We examine five key challenges in the area of policy driven disinvestment: 1) lack of resources to support disinvestment policy mechanisms; 2) lack of reliable administrative mechanisms to identify and prioritise technologies and/or practices with uncertain clinical and cost-effectiveness; 3) political, clinical and social challenges to removing an established technology or practice; 4) lack of published studies with evidence demonstrating that existing technologies/practices provide little or no benefit (highlighting complexity of design) and; 5) inadequate resources to support a research agenda to advance disinvestment methods. Partnerships are required to involve government, professional colleges and relevant stakeholder groups to put disinvestment on the agenda. Such partnerships could foster awareness raising, collaboration and improved health outcome data generation and reporting. Dedicated funds and distinct processes could be established within the Medical Services Advisory Committee and Pharmaceutical Benefits Advisory Committee to, a) identify technologies and practices for which there is relative uncertainty that could be the basis for disinvestment analysis, and b) conduct disinvestment assessments of selected item(s) to address existing practices in an analogous manner to the current focus on new and emerging technology. Finally, dedicated funding and cross-disciplinary collaboration is necessary to build health services and policy research capacity

Evidence for informing health policy development in Low-income Countries (LICs): perspectives of policy actors in Uganda.

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Nabyonga-Orem, Juliet; Mijumbi, Rhona

2015-03-08

Although there is a general agreement on the benefits of evidence informed health policy development given resource constraints especially in Low-Income Countries (LICs), the definition of what evidence is, and what evidence is suitable to guide decision-making is still unclear. Our study is contributing to filling this knowledge gap. We aimed to explore health policy actors' views regarding what evidence they deemed appropriate to guide health policy development. Using exploratory qualitative methods, we conducted interviews with 51 key informants using an in-depth interview guide. We interviewed a diverse group of stakeholders in health policy development and knowledge translation in the Uganda health sector. Data were analyzed using inductive content analysis techniques. Different stakeholders lay emphasis on different kinds of evidence. While donors preferred international evidence and Ministry of Health (MoH) officials looked to local evidence, district health managers preferred local evidence, evidence from routine monitoring and evaluation, and reports from service providers. Service providers on the other hand preferred local evidence and routine monitoring and evaluation reports whilst researchers preferred systematic reviews and clinical trials. Stakeholders preferred evidence covering several aspects impacting on decision-making highlighting the fact that although policy actors look for factual information, they also require evidence on context and implementation feasibility of a policy decision. What LICs like Uganda categorize as evidence suitable for informing policy encompasses several types with no consensus on what is deemed as most appropriate. Evidence must be of high quality, applicable, acceptable to the users, and informing different aspects of decision-making. © 2015 by Kerman University of Medical Sciences.

Evidence for Informing Health Policy Development in Low- Income Countries (LICS: Perspectives of Policy Actors in Uganda

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Juliet Nabyonga-Orem

2015-05-01

Full Text Available Background Although there is a general agreement on the benefits of evidence informed health policy development given resource constraints especially in Low-Income Countries (LICs, the definition of what evidence is, and what evidence is suitable to guide decision-making is still unclear. Our study is contributing to filling this knowledge gap. We aimed to explore health policy actors’ views regarding what evidence they deemed appropriate to guide health policy development. Methods Using exploratory qualitative methods, we conducted interviews with 51 key informants using an indepth interview guide. We interviewed a diverse group of stakeholders in health policy development and knowledge translation in the Uganda health sector. Data were analyzed using inductive content analysis techniques. Results Different stakeholders lay emphasis on different kinds of evidence. While donors preferred international evidence and Ministry of Health (MoH officials looked to local evidence, district health managers preferred local evidence, evidence from routine monitoring and evaluation, and reports from service providers. Service providers on the other hand preferred local evidence and routine monitoring and evaluation reports whilst researchers preferred systematic reviews and clinical trials. Stakeholders preferred evidence covering several aspects impacting on decision-making highlighting the fact that although policy actors look for factual information, they also require evidence on context and implementation feasibility of a policy decision. Conclusion What LICslike Uganda categorize as evidence suitable for informing policy encompasses several types with no consensus on what is deemed as most appropriate. Evidence must be of high quality, applicable, acceptable to the users, and informing different aspects of decision-making.

Conservation of resources theory and research use in health systems.

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Alvaro, Celeste; Lyons, Renée F; Warner, Grace; Hobfoll, Stevan E; Martens, Patricia J; Labonté, Ronald; Brown, Richard E

2010-10-20

Health systems face challenges in using research evidence to improve policy and practice. These challenges are particularly evident in small and poorly resourced health systems, which are often in locations (in Canada and globally) with poorer health status. Although organizational resources have been acknowledged as important in understanding research use resource theories have not been a focus of knowledge translation (KT) research. What resources, broadly defined, are required for KT and how does their presence or absence influence research use?In this paper, we consider conservation of resources (COR) theory as a theoretical basis for understanding the capacity to use research evidence in health systems. Three components of COR theory are examined in the context of KT. First, resources are required for research uptake. Second, threat of resource loss fosters resistance to research use. Third, resources can be optimized, even in resource-challenged environments, to build capacity for KT. A scan of the KT literature examined organizational resources needed for research use. A multiple case study approach examined the three components of COR theory outlined above. The multiple case study consisted of a document review and key informant interviews with research team members, including government decision-makers and health practitioners through a retrospective analysis of four previously conducted applied health research studies in a resource-challenged region. The literature scan identified organizational resources that influence research use. The multiple case study supported these findings, contributed to the development of a taxonomy of organizational resources, and revealed how fears concerning resource loss can affect research use. Some resources were found to compensate for other resource deficits. Resource needs differed at various stages in the research use process. COR theory contributes to understanding the role of resources in research use, resistance to

Values in Health Policy – A Concept Analysis

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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

Maximizing the benefit of health workforce secondment in Botswana: an approach for strengthening health systems in resource-limited settings

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Grignon JS

2014-05-01

Full Text Available Jessica S Grignon,1,2 Jenny H Ledikwe,1,2 Ditsapelo Makati,2 Robert Nyangah,2 Baraedi W Sento,2 Bazghina-werq Semo1,2 1Department of Global Health, University of Washington, Seattle, WA, USA; 2International Training and Education Center for Health, Gaborone, Botswana Abstract: To address health systems challenges in limited-resource settings, global health initiatives, particularly the President's Emergency Plan for AIDS Relief, have seconded health workers to the public sector. Implementation considerations for secondment as a health workforce development strategy are not well documented. The purpose of this article is to present outcomes, best practices, and lessons learned from a President's Emergency Plan for AIDS Relief-funded secondment program in Botswana. Outcomes are documented across four World Health Organization health systems' building blocks. Best practices include documentation of joint stakeholder expectations, collaborative recruitment, and early identification of counterparts. Lessons learned include inadequate ownership, a two-tier employment system, and ill-defined position duration. These findings can inform program and policy development to maximize the benefit of health workforce secondment. Secondment requires substantial investment, and emphasis should be placed on high-level technical positions responsible for building systems, developing health workers, and strengthening government to translate policy into programs. Keywords: human resources, health policy, health worker, HIV/AIDS, PEPFAR

Human resource for health reform in peri-urban areas: a cross-sectional study of the impact of policy interventions on healthcare workers in Epworth, Zimbabwe.

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Taderera, Bernard Hope; Hendricks, Stephen James Heinrich; Pillay, Yogan

2017-12-16

The need to understand how healthcare worker reform policy interventions impact health personnel in peri-urban areas is important as it also contributes towards setting of priorities in pursuing the universal health coverage goal of health sector reform. This study explored the impact of post 2008 human resource for health reform policy interventions on healthcare workers in Epworth, a peri-urban community in Harare, Zimbabwe, and the implications towards health sector reform policy in peri-urban areas. The study design was exploratory and cross-sectional and involved the use of qualitative and quantitative methods in data collection, presentation, and analysis. A qualitative study in which data were collected through a documentary search, five key informant interviews, seven in-depth interviews, and five focus group discussions was carried out first. This was followed by a quantitative study in which data were collected through a documentary search and 87 semi-structured sample interviews with healthcare workers. Qualitative data were analyzed thematically whilst descriptive statistics were used to examine quantitative data. All data were integrated during analysis to ensure comprehensive, reliable, and valid analysis of the dataset. Three main factors were identified to help interpret findings. The first main factor consisted policy result areas that impacted most successfully on healthcare workers. These included the deployment of community health workers with the highest correlation of 0.83. Policy result areas in the second main factor included financial incentives with a correlation of 0.79, training and development (0.77), deployment (0.77), and non-financial incentives (0.75). The third factor consisted policy result areas that had the lowest satisfaction amongst healthcare workers in Epworth. These included safety (0.72), equipment and tools of trade (0.72), health welfare (0.65), and salaries (0.55). The deployment of community health volunteers impacted

Public policy and medical tourism: ethical implications for the Egyptian health care system.

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Haley, Bob

2011-01-01

Egypt's medical tourism industry has been experiencing tremendous growth. However, Egypt continues to lack the necessary investment in its public health system to effectively care for its population. Current policy and the emergence of medical tourism have led to unequal health care access, resulting in high a prevalence of infectious diseases and lack of resources for its most vulnerable populations. As a new Egyptian government emerges, it is important for policymakers to understand the critical issues and ethical concerns of existing health policy. This understanding may be used to propose new policy that more effectively allocates to care for Egypt's population.

Can Social Inclusion Policies Reduce Health Inequalities in Sub-Saharan Africa?—A Rapid Policy Appraisal

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Palha de Sousa, César A.D; Molomo, Boitumelo G

2009-01-01

The global resurgence of interest in the social determinants of health provides an opportunity for determined action on unacceptable and unjust health inequalities that exist within and between countries. This paper reviews three categories of social inclusion policies: cash-transfers; free social services; and specific institutional arrangements for programme integration in six selected countries—Botswana, Mozambique, South Africa, Ethiopia, Nigeria, and Zimbabwe. The policies were appraised as part of the Social Exclusion Knowledge Network (SEKN) set up under the auspices of the World Health Organization's Commission on Social Determinants of Health. The paper highlights the development landscape in sub-Saharan Africa and presents available indicators of the scale of inequity in the six countries. A summary of the policies appraised is presented, including whether or what the impact of these policies has been on health inequalities. Cross-cutting benefits include poverty alleviation, notably among vulnerable children and youths, improved economic opportunities for disadvantaged households, reduction in access barriers to social services, and improved nutrition intake. The impact of these benefits, and hence the policies, on health status can only be inferred. Among the policies reviewed, weaknesses or constraints were in design and implementation. The policy design weaknesses include targeting criteria, their enforcement and latent costs, inadequate parti-cipation of the community and failure to take the cultural context into account. A major weakness of most policies was the lack of a monitoring and evaluation system, with clear indicators that incorporate system responsiveness. The policy implementation weaknesses include uneven regional implementation with rural areas worst affected; inadequate or poor administrative and implementation capacity; insufficient resources; problems of fraud and corruption; and lack of involvement of civil servants, exacerbating

Prevalence of health promotion policies in sports clubs in Victoria, Australia.

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Dobbinson, Suzanne Jane; Hayman, Jane Amanda; Livingston, Patricia Mary

2006-06-01

In recent years, some health agencies offered sponsorship to sporting associations to promote healthy environments by encouraging clubs to develop health-related policies. However, the extent to which these sponsorship contracts reach their stated aims is of concern. This study aimed to quantify levels of policy development and practice in sports clubs for each of five key health areas, namely smoke-free facilities, sun protection, healthy catering, responsible serving of alcohol and sports injury prevention. Representatives from 932 Victorian sports clubs were contacted by telephone with 640 clubs (69%) participating in the survey. Results suggested that the establishment of written policies on the key health areas by sports clubs varied widely by affiliated sport and health area: 70% of all clubs with bar facilities had written policies on responsible serving of alcohol, ranging from 58% of tennis clubs to 100% of diving and surfing clubs. In contrast, approximately one-third of sports clubs had a smoke-free policy, with 36% of tennis, 28% of country football and 28% of men's cricket clubs having policy. Moreover, 34% of clubs overall had established sun protection policy, whereas clubs competing outside during summer months, [diving (86%) and life-saving (81%)] were most likely to have a written sun protection policy. Injury prevention policies were established in 30% of sports clubs, and were most common among football (56%), diving (43%) and life-saving (41%). This study suggests that policy development for health promotion can be achieved in sports clubs when it is well supported by health agencies and consideration is given to the appropriateness of the specific behaviours to be encouraged for a given sport. Communication between associations and clubs needs to be monitored by health agencies to ensure support and resources for policy development to reach the club level.

Leprosy: International Public Health Policies and Public Health Eras

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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.

Health financing for universal coverage and health system performance: concepts and implications for policy.

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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.

Ethical tensions associated with the promotion of public health policy in health visiting: a qualitative investigation of health visitors' views.

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Greenway, Julie Catherine; Entwistle, Vikki Ann; terMeulen, Ruud

2013-04-01

To explore whether and how health visitors experience ethical tensions between the public health agenda and the need to be responsive to individual clients. Current health policy in England gives health visitors a key role in implementing the government's public health agenda. Health visitors are also required by their Professional Code to respond to the health-related concerns and preferences of their individual clients. This may generate tensions. A total of 17 semi-structured individual interviews covering participants' experiences of implementing public health interventions and perceptions of the ethical tensions involved were conducted. Interviews were audio-recorded, transcribed and analysed thematically using a Framework approach. Health visitors raised a number of ethical concerns, which they attributed to organisational resource allocation and the introduction of protocols and targets relating to public health goals. They did not always regard it as appropriate to raise topics that employing organisations had identified as public health priorities with particular clients for whom they were not priorities, or who had other more pressing needs. They noted that resources that were allocated towards reaching public health targets were unavailable for clients who needed support in other areas. Organisational protocols designed to monitor performance put pressure on health visitors to prioritise achieving targets and undermined their ability to exercise professional judgement when supporting individual clients. This had implications for health visitors' sense of professionalism. Health visitors saw trusting relationships as key to effective health visiting practice, but the requirement to implement public health priorities, combined with a lack of resources in health visiting, eroded their ability to form these. Policies need to be evaluated with regard to their impact upon a broader range of processes and outcomes than public health goals. The erosion of health

Wellness programme and health policy development at a large faith ...

African Journals Online (AJOL)

The study's primary recommendations include: taking its employees' cultural and social norms into consideration; addressing issues related to capacity and ... list of recommendations for other resource-constrained NGOs that also wish to develop and implement wellness programmes and health policies in their workplace.

Addressing Geriatric Oral Health Concerns through National Oral Health Policy in India

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Abhinav Singh

2015-01-01

Full Text Available There is an escalating demand for geriatric oral healthcare in all developed and developing countries including India. Two-thirds of the world’s elderly live in developing countries. This is a huge population that must receive attention from policy-makers who will be challenged by the changing demands for social and health services including oral health services. Resources are limited thus rather than being aspirational in wanting to provide all treatment needed for everybody, this critique presents a road map of how we might answer the present and future geriatric oral health concerns in a most efficient manner in a developing country. Viewing the recent Indian demographic profile and the trends in oral health, pertinent policy subjects have been discussed concerning the oral health needs of the elderly and also the associated challenges which include strategies to improve quality of life, strategies to train and educate the dental workforce and above all the role of healthcare systems towards realization of better aged society in India and other developing countries

Human Resources for Health Challenges in Nigeria and Nurse Migration.

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Salami, Bukola; Dada, Foluke O; Adelakun, Folake E

2016-05-01

The emigration of sub-Saharan African health professionals to developed Western nations is an aspect of increasing global mobility. This article focuses on the human resources for health challenges in Nigeria and the emigration of nurses from Nigeria as the country faces mounting human resources for health challenges. Human resources for health issues in Nigeria contribute to poor population health in the country, alongside threats from terrorism, infectious disease outbreaks, and political corruption. Health inequities within Nigeria mirror the geographical disparities in human resources for health distribution and are worsened by the emigration of Nigerian nurses to developed countries such as the United States and the United Kingdom. Nigerian nurses are motivated to emigrate to work in healthier work environments, improve their economic prospects, and advance their careers. Like other migrant African nurses, they experience barriers to integration, including racism and discrimination, in receiving countries. We explore the factors and processes that shape this migration. Given the forces of globalization, source countries and destination countries must implement policies to more responsibly manage migration of nurses. This can be done by implementing measures to retain nurses, promote the return migration of expatriate nurses, and ensure the integration of migrant nurses upon arrival in destination countries. © The Author(s) 2016.

Understanding health policy leaders' training needs.

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Carey Roth Bayer

Full Text Available 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.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.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.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.

High performance work systems: the gap between policy and practice in health care reform.

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Leggat, Sandra G; Bartram, Timothy; Stanton, Pauline

2011-01-01

Studies of high-performing organisations have consistently reported a positive relationship between high performance work systems (HPWS) and performance outcomes. Although many of these studies have been conducted in manufacturing, similar findings of a positive correlation between aspects of HPWS and improved care delivery and patient outcomes have been reported in international health care studies. The purpose of this paper is to bring together the results from a series of studies conducted within Australian health care organisations. First, the authors seek to demonstrate the link found between high performance work systems and organisational performance, including the perceived quality of patient care. Second, the paper aims to show that the hospitals studied do not have the necessary aspects of HPWS in place and that there has been little consideration of HPWS in health system reform. The paper draws on a series of correlation studies using survey data from hospitals in Australia, supplemented by qualitative data collection and analysis. To demonstrate the link between HPWS and perceived quality of care delivery the authors conducted regression analysis with tests of mediation and moderation to analyse survey responses of 201 nurses in a large regional Australian health service and explored HRM and HPWS in detail in three casestudy organisations. To achieve the second aim, the authors surveyed human resource and other senior managers in all Victorian health sector organisations and reviewed policy documents related to health system reform planned for Australia. The findings suggest that there is a relationship between HPWS and the perceived quality of care that is mediated by human resource management (HRM) outcomes, such as psychological empowerment. It is also found that health care organisations in Australia generally do not have the necessary aspects of HPWS in place, creating a policy and practice gap. Although the chief executive officers of health

Incoherent policies on universal coverage of health insurance and promotion of international trade in health services in Thailand.

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Pachanee, Cha-aim; Wibulpolprasert, Suwit

2006-07-01

The Thai government has implemented universal coverage of health insurance since October 2001. Universal access to antiretroviral (ARV) drugs has also been included since October 2003. These two policies have greatly increased the demand for health services and human resources for health, particularly among public health care providers. After the 1997 economic crisis, private health care providers, with the support of the government, embarked on new marketing strategies targeted at attracting foreign patients. Consequently, increasing numbers of foreign patients are visiting Thailand to seek medical care. In addition, the economic recovery since 2001 has greatly increased the demand for private health services among the Thai population. The increasing demand and much higher financial incentives from urban private providers have attracted health personnel, particularly medical doctors, from rural public health care facilities. Responding to this increasing demand and internal brain drain, in mid-2004 the Thai government approved the increased production of medical doctors by 10,678 in the following 15 years. Many additional financial incentives have also been applied. However, the immediate shortage of human resources needs to be addressed competently and urgently. Equity in health care access under this situation of competing demands from dual track policies is a challenge to policy makers and analysts. This paper summarizes the situation and trends as well as the responses by the Thai government. Both supply and demand side responses are described, and some solutions to restore equity in health care access are proposed.

How to do (or not to do) … translation of national health accounts data to evidence for policy making in a low resourced setting.

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Price, Jennifer A; Guinness, Lorna; Irava, Wayne; Khan, Idrish; Asante, Augustine; Wiseman, Virginia

2016-05-01

For more than a decade, the Organization for Economic Co-operation and Development (OECD), the World Health Organization (WHO) and the World Bank have promoted the international standardization of National Health Accounts (NHA) for reporting global statistics on public, private and donor health expenditure and improve the quality of evidence-based decision-making at country level. A 2010-2012 World Bank review of NHA activity in 50 countries found structural and technical constraints (rather than cost) were key impediments to institutionalizing NHA in many low- and middle-income countries (LMICs). Pilot projects focused resources on data production, neglecting longer-term capacity building for analysing the data, developing ownership among local stakeholders and establishing routine production, utilization and dissemination of NHA data. Hence, genuine institutionalization of NHA in most LMICs has been slow to materialize. International manuals focus on the production of NHA data and do not include practical, incremental and low-cost strategies to guide countries in translating the data into evidence for policy-making. The main aim of this article is to recommend strategies for bridging this divide between production and utilization of NHA data in low-resource settings. The article begins by discussing the origins and purpose of NHA, including factors currently undermining their uptake. The focus then turns to the development and application of strategies to assist LMICs in 'unlocking' the hidden value of their NHA. The article draws on the example of Fiji, a country currently attempting to integrate their NHA data into policy formulation, despite minimal resources, training and familiarity with economic analysis of health systems. Simple, low cost recommendations such as embedding health finance indicators in planning documents, a user-friendly NHA guide for evaluating local health priorities, and sharing NHA data for collaborative research have helped translate

Conservation of resources theory and research use in health systems

Directory of Open Access Journals (Sweden)

Hobfoll Stevan E

2010-10-01

Full Text Available Abstract Background Health systems face challenges in using research evidence to improve policy and practice. These challenges are particularly evident in small and poorly resourced health systems, which are often in locations (in Canada and globally with poorer health status. Although organizational resources have been acknowledged as important in understanding research use resource theories have not been a focus of knowledge translation (KT research. What resources, broadly defined, are required for KT and how does their presence or absence influence research use? In this paper, we consider conservation of resources (COR theory as a theoretical basis for understanding the capacity to use research evidence in health systems. Three components of COR theory are examined in the context of KT. First, resources are required for research uptake. Second, threat of resource loss fosters resistance to research use. Third, resources can be optimized, even in resource-challenged environments, to build capacity for KT. Methods A scan of the KT literature examined organizational resources needed for research use. A multiple case study approach examined the three components of COR theory outlined above. The multiple case study consisted of a document review and key informant interviews with research team members, including government decision-makers and health practitioners through a retrospective analysis of four previously conducted applied health research studies in a resource-challenged region. Results The literature scan identified organizational resources that influence research use. The multiple case study supported these findings, contributed to the development of a taxonomy of organizational resources, and revealed how fears concerning resource loss can affect research use. Some resources were found to compensate for other resource deficits. Resource needs differed at various stages in the research use process. Conclusions COR theory contributes to

Provincial resource development research policy

Energy Technology Data Exchange (ETDEWEB)

Flock, D L

1976-01-01

In Alberta, there is an abundance of oil, natural gas, and coal. But only a small portion of the Alberta oil sands and coal resources are commercially accessible to surface-mining techniques. It is quite apparent that some in-situ technological breakthrough will be required, which will mean a concerted research effort at the provincial level. It is the purpose of this paper to present certain concepts and recommendations for a coordinated provincial resource development research policy for the Province of Alberta. Research as discussed in this paper covers basic and applied research and development. (MCW)

Effects of Social, Economic, and Labor Policies on Occupational Health Disparities

Science.gov (United States)

Siqueira, Carlos Eduardo; Gaydos, Megan; Monforton, Celeste; Slatin, Craig; Borkowski, Liz; Dooley, Peter; Liebman, Amy; Rosenberg, Erica; Shor, Glenn; Keifer, Matthew

2018-01-01

Background This article introduces some key labor, economic, and social policies that historically and currently impact occupational health disparities in the United States. Methods We conducted a broad review of the peer-reviewed and gray literature on the effects of social, economic, and labor policies on occupational health disparities. Results Many populations such as tipped workers, public employees, immigrant workers, and misclassified workers are not protected by current laws and policies, including worker’s compensation or Occupational Safety and Health Administration enforcement of standards. Local and state initiatives, such as living wage laws and community benefit agreements, as well as multiagency law enforcement contribute to reducing occupational health disparities. Conclusions There is a need to build coalitions and collaborations to command the resources necessary to identify, and then reduce and eliminate occupational disparities by establishing healthy, safe, and just work for all. PMID:23606055

The strategy of a european health policy of the who member states

International Nuclear Information System (INIS)

Johansen, K.S.

1992-01-01

The policy of Health for All is a challenge by the World Health Organization to its Member States to ensure each citizen an e conomically and socially productive life . The Regional Office for Europe created an expanded version of this policy, known as European Health for All, which urged each Member State to alter its policies to achieve the targets set out therein. This policy calls for more equity and social justice in health, for prevention of disease and promoting health and quality of life and for improving the human environment. One of the most important items is the call for delivering quality of care for everyone, by using a clear system for measuring the outcomes of care. Quality of care must apply equally to all parts of the cycle, from health promotion, prevention, diagnosis, treatment and rehabilitation. For quality development and assurance in the area of imaging and the role of dosimetry, the Health for All set a goal of ensuring optimal outcome from available resources. To reach this goal, it is necessary to set standards for guiding health outcome indicators in order to systematically assess health technologies

Health at the center of health systems reform: how philosophy can inform policy.

Science.gov (United States)

Sturmberg, Joachim P; Martin, Carmel M; Moes, Mark M

2010-01-01

Contemporary views hold that health and disease can be defined as objective states and thus should determine the design and delivery of health services. Yet health concepts are elusive and contestable. Health is neither an individual construction, a reflection of societal expectations, nor only the absence of pathologies. Based on philosophical and sociological theory, empirical evidence, and clinical experience, we argue that health has simultaneously objective and subjective features that converge into a dynamic complex-adaptive health model. Health (or its dysfunction, illness) is a dynamic state representing complex patterns of adaptation to body, mind, social, and environmental challenges, resulting in bodily homeostasis and personal internal coherence. The "balance of health" model-emergent, self-organizing, dynamic, and adaptive-underpins the very essence of medicine. This model should be the foundation for health systems design and also should inform therapeutic approaches, policy decision-making, and the development of emerging health service models. A complex adaptive health system focused on achieving the best possible "personal" health outcomes must provide the broad policy frameworks and resources required to implement people-centered health care. People-centered health systems are emergent in nature, resulting in locally different but mutually compatible solutions across the whole health system.

Developing effective policy strategies to retain health workers in rural Bangladesh: a policy analysis.

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Rawal, Lal B; Joarder, Taufique; Islam, Sheikh Md Shariful; Uddin, Aftab; Ahmed, Syed Masud

2015-05-20

Retention of human resources for health (HRH), particularly physicians and nurses in rural and remote areas, is a major problem in Bangladesh. We reviewed relevant policies and provisions in relation to HRH aiming to develop appropriate rural retention strategies in Bangladesh. We conducted a document review, thorough search and review of relevant literature published from 1971 through May 2013, key informant interviews with policy elites (health policy makers, managers, researchers, etc.), and a roundtable discussion with key stakeholders and policy makers. We used the World Health Organization's (WHO's) guidelines as an analytical matrix to examine the rural retention policies under 4 domains, i) educational, ii) regulatory, iii) financial, and iv) professional and personal development, and 16 sub-domains. Over the past four decades, Bangladesh has developed and implemented a number of health-related policies and provisions concerning retention of HRH. The district quota system in admissions is in practice to improve geographical representation of the students. Students of special background including children of freedom fighters and tribal population have allocated quotas. In private medical and nursing schools, at least 5% of seats are allocated for scholarships. Medical education has a provision for clinical rotation in rural health facilities. Further, in the public sector, every newly recruited medical doctor must serve at least 2 years at the upazila level. To encourage serving in hard-to-reach areas, particularly in three Hill Tract districts of Chittagong division, the government provides an additional 33% of the basic salary, but not exceeding US$ 38 per month. This amount is not attractive enough, and such provision is absent for those working in other rural areas. Although the government has career development and promotion plans for doctors and nurses, these plans are often not clearly specified and not implemented effectively. The government is

Global mHealth policy arena: status check and future directions.

Science.gov (United States)

Malvey, Donna M; Slovensky, Donna J

2017-01-01

In this review, we examine an important piece of the mHealth puzzle that has received scant attention-health policy. The question is whether health policy ultimately will serve to unite nations in advancing global mHealth or, as Mars and Scott suggested in 2010, keep nations isolated and ultimately making their policy decisions in "eHealth silos". Such a non-collaborative approach seriously hampers the potential for using mobile health technologies to deliver health care across borders, assuring individuals access to affordable, convenient, and quality healthcare in underserved regions. From a global perspective, mHealth policy review is difficult as some important policies may be subsumed in comprehensive planning and strategy documents. Political, environmental, economic, organizational, and technology disparities across nations represent a significant impediment to developing mHealth products and services that can be deployed globally. To date, there is modest evidence that such challenges are being addressed. Even though payers can encourage adoption of mHealth with financial incentives for use, it appears that payment or reimbursement tends to be a roadblock for almost all nations, whether they are emerging or developed. If payment for mHealth services is not guaranteed, business models will not be sustainable and providers will have fewer opportunities for scalability. Furthermore, because mHealth policies typically are subject to some type of government scrutiny and oversight, many product developers and entrepreneurs may turn elsewhere for their investments. Global resource scarcity also challenges optimal mHealth deployment, and governments seek to ensure improved population health outcomes as return on their mHealth investments. Unfortunately, such justification is difficult as evaluation methods simply have not kept pace with mHealth technology capability. Requisite measurement tools are sorely lacking when it comes to evaluating efficacy of mHealth

Policies for Resource Efficient and Effective Solutions : A review of concepts, current policy landscape and future policy considerations for the transition to a Circular Economy

OpenAIRE

Milios, Leonidas

2016-01-01

This report presents basic concepts around resources, resource efficiency and the Circular Economy. The limitations and the opportunities within the Circular Economy are identified and clearly presented. The current policy landscape in the EU as well as in Sweden is thoroughly analysed and a set of policy areas with a significant untapped potential for resource efficiency is identified. The policy areas which have been underutilised so far include policies for re-use, repair and remanufacturi...

Energy Policy Case Study - California: Renewables and Distributed Energy Resources

Energy Technology Data Exchange (ETDEWEB)

Homer, Juliet S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Bender, Sadie R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Weimar, Mark R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2016-09-19

The purpose of this document is to present a case study of energy policies in California related to power system transformation and renewable and distributed energy resources (DERs). Distributed energy resources represent a broad range of technologies that can significantly impact how much, and when, electricity is demanded from the grid. Key policies and proceedings related to power system transformation and DERs are grouped into the following categories: 1.Policies that support achieving environmental and climate goals 2.Policies that promote deployment of DERs 3.Policies that support reliability and integration of DERs 4.Policies that promote market animation and support customer choice. Major challenges going forward are forecasting and modeling DERs, regulatory and utility business model issues, reliability, valuation and pricing, and data management and sharing.

The utilization of research evidence in Health Workforce Policies: the perspectives of Portuguese and Brazilian National Policy-Makers.

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Craveiro, Isabel; Hortale, Virginia; Oliveira, Ana Paula Cavalcante de; Dal Poz, Mario; Portela, Gustavo; Dussault, Gilles

2018-03-01

The production of knowledge on Human Resources for Health (HRH) issues has increased exponentially since 2000 but integration of the research in the policy-making process is often lagging. We looked at how research on HRH contributes or not to inform policy decisions and interventions affecting the health workforce in Portugal and Brazil. We designed a comparative case study of semi-structured interviews with present and past national decision-makers, policy advisors and researchers. Issues explored included the existence of a national HRH policy and the use, or non-use, of research evidence by policy makers and reasons to do so. Interviews were audio recorded, transcribed, anonymized and analysed thematically. Policy-makers in Brazil recognize a greater use of evidence in the process of defining HRH policy when compared to Portugal's. But the existence of formal instruments to support policy development is not sufficient to ensure that policies are informed by evidence. In both countries the importance of the use of evidence in the formulation of policies was recognized by policy-makers. However, the influence of other factors, such as political pressures from various lobby groups and from the media and the policy short timeframe which requires rapid responses, is predominant.

Mental health policy process: a comparative study of Ghana, South Africa, Uganda and Zambia

Directory of Open Access Journals (Sweden)

Kigozi Fred

2010-08-01

Full Text Available Abstract Background Mental illnesses are increasingly recognised as a leading cause of disability worldwide, yet many countries lack a mental health policy or have an outdated, inappropriate policy. This paper explores the development of appropriate mental health policies and their effective implementation. It reports comparative findings on the processes for developing and implementing mental health policies in Ghana, South Africa, Uganda and Zambia as part of the Mental Health and Poverty Project. Methods The study countries and respondents were purposively selected to represent different levels of mental health policy and system development to allow comparative analysis of the factors underlying the different forms of mental health policy development and implementation. Data were collected using semi-structured interviews and document analysis. Data analysis was guided by conceptual framework that was developed for this purpose. A framework approach to analysis was used, incorporating themes that emerged from the data and from the conceptual framework. Results Mental health policies in Ghana, South Africa, Uganda and Zambia are weak, in draft form or non-existent. Mental health remained low on the policy agenda due to stigma and a lack of information, as well as low prioritisation by donors, low political priority and grassroots demand. Progress with mental health policy development varied and respondents noted a lack of consultation and insufficient evidence to inform policy development. Furthermore, policies were poorly implemented, due to factors including insufficient dissemination and operationalisation of policies and a lack of resources. Conclusions Mental health policy processes in all four countries were inadequate, leading to either weak or non-existent policies, with an impact on mental health services. Recommendations are provided to strengthen mental health policy processes in these and other African countries.

State Electricity Regulatory Policy and Distributed Resources: Accommodating Distributed Resources in Wholesale Markets

Energy Technology Data Exchange (ETDEWEB)

Weston, F.; Harrington, C.; Moskovitz, D.; Shirley, W.; Cowart, R.; Sedano, R.

2002-10-01

Distributed resources can provide cost-effective reliability and energy services - in many cases, obviating the need for more expensive investments in wires and central station electricity generating facilities. Given the unique features of distributed resources, the challenge facing policymakers today is how to restructure wholesale markets for electricity and related services so as to reveal the full value that distributed resources can provide to the electric power system (utility grid). This report looks at the functions that distributed resources can perform and examines the barriers to them. It then identifies a series of policy and operational approaches to promoting DR in wholesale markets. This report is one in the State Electricity Regulatory Policy and Distributed Resources series developed under contract to NREL (see Annual Technical Status Report of the Regulatory Assistance Project: September 2000-September 2001, NREL/SR-560-32733). Other titles in this series are: (1) Distributed Resource Distribution Credit Pilot Programs - Revealing the Value to Consumers and Vendors, NREL/SR-560-32499; (2) Distributed Resources and Electric System Reliability, NREL/SR-560-32498; (3) Distribution System Cost Methodologies for Distributed Generation, NREL/SR-560-32500; (4) Distribution System Cost Methodologies for Distributed Generation Appendices, NREL/SR-560-32501

Petro-state constraints on health policy: guidelines for workable reform in Venezuela.

Science.gov (United States)

Trujillo, Antonio J

2004-01-01

This article reviews the performance of the Venezuelan health care sector and suggests guidelines for workable health policy under difficult conditions. Two special circumstances constrain policy options. First, Venezuelans share a traditional value, solidarity, which includes a strong desire for equity. Reforms must comply with this norm to succeed. Second, foreign sales of state-controlled oil constitute the bulk of the government budget and the gross domestic product (GDP). Petroleum market fluctuations expose the country to extreme economic cycles. In response, policy making and stakeholders adopt a rentier attitude, focusing on preserving or enlarging entitlements to government oil monies. The side effects of this largesse include poor productivity, a weak private sector, a widespread sense of entitlement without accountability, and a crippled state which controls most of the available resources yet is unable to effectively tax, regulate, steer the economy, or pursue long-term policies. The health care sector shares these problems. As a result, Venezuela's health systems are fragmented, poorly coordinated, excessively centralized, inequitable, and ineffective. Policies to improve public health and public and private medical care must take into account these constraints.

Understanding human resource management practices in Botswana's public health sector.

Science.gov (United States)

Seitio-Kgokgwe, Onalenna Stannie; Gauld, Robin; Hill, Philip C; Barnett, Pauline

2016-11-21

Purpose The purpose of this paper is to assess the management of the public sector health workforce in Botswana. Using institutional frameworks it aims to document and analyse human resource management (HRM) practices, and make recommendations to improve employee and health system outcomes. Design/methodology/approach The paper draws from a large study that used a mixed methods approach to assess performance of Botswana's Ministry of Health (MOH). It uses data collected through document analysis and in-depth interviews of 54 key informants comprising policy makers, senior staff of the MOH and its stakeholder organizations. Findings Public health sector HRM in Botswana has experienced inadequate planning, poor deployment and underutilization of staff. Lack of comprehensive retention strategies and poor working conditions contributed to the failure to attract and retain skilled personnel. Relationships with both formal and informal environments affected HRM performance. Research limitations/implications While document review was a major source of data for this paper, the weaknesses in the human resource information system limited availability of data. Practical implications This paper presents an argument for the need for consideration of formal and informal environments in developing effective HRM strategies. Originality/value This research provides a rare system-wide approach to health HRM in a Sub-Saharan African country. It contributes to the literature and evidence needed to guide HRM policy decisions and practices.

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.

Enhancing the contribution of research to health care policy-making: a case study of the Dutch Health Care Performance Report.

Science.gov (United States)

Hegger, Ingrid; Marks, Lisanne K; Janssen, Susan W J; Schuit, Albertine J; van Oers, Hans A M

2016-01-01

The Dutch Health Care Performance Report, issued by the National Institute of Public Health and the Environment, aims to monitor health care performance in The Netherlands. Both the National Institute and the Ministry of Health wish to increase the contribution of the Report to health care policy-making. Our aim was to identify ways to achieve that. We used contribution mapping as a theoretical framework that recognizes alignment of research as crucial to managing contributions to policy-making. To investigate which areas need alignment efforts by researchers and/or policy-makers, we interviewed National Institute researchers and policy-makers from the Ministry of Health and assessed the process for developing the 2010 Report. We identified six areas where alignment is specifically relevant for enhancing the contributions of future versions of the Dutch Health Care Performance Report: well-balanced information for different ministerial directorates; backstage work; double role actors; reports of other knowledge institutes; data collection/generation and presentation forms. The contribution of health care performance reporting to policy-making is complex and requires continuous alignment efforts between researchers and policy-makers. These efforts should form an inseparable part of health care performance reporting and although this demands considerable resources, it is worth considering since it may pay back in better contributions to policy-making. © The Author(s) 2015.

Health Manpower Planning and Employment Policies for Turkey

Directory of Open Access Journals (Sweden)

Bulent Kilic

2007-12-01

Full Text Available Health manpower planning in health care should be done strategically while considering the following factors: health care needs and demands for community, health care organizations' objectives, goals and resources, goal of a high quality health workforce of sufficient size which has been appropriately distributed, their full employment realized within the appropriate time frame. A good health manpower planning consists of eight components: quantity (size, quality (skill, distribution, timing, employment, necessity, goals and resources. According to the calculations in this article, it must be 1515 people per general practitioner (GP and 1333 people per midwife. There must be 44.755 GP and 50.866 midwife for primary level in Turkey. However there are 51.530 GP and 41.513 midwife in Turkey in 2002. In this situation there is no more need for GP but there is a big need for 10.000 midwife as totally and actually 30.000 midwife for working at health centres for Turkey. As a result, this article discusses the shortcomings of Health Ministry's employment policies in Turkey. It is suggested that in the short run concepts such as physician unemployment, under-employment and flexible work hours will become frequently discussed in Turkey health care public discourse. [TAF Prev Med Bull 2007; 6(6.000: 501-514

Health Manpower Planning and Employment Policies for Turkey

Directory of Open Access Journals (Sweden)

Bulent Kilic

2007-12-01

Full Text Available Health manpower planning in health care should be done strategically while considering the following factors: health care needs and demands for community, health care organizations' objectives, goals and resources, goal of a high quality health workforce of sufficient size which has been appropriately distributed, their full employment realized within the appropriate time frame. A good health manpower planning consists of eight components: quantity (size, quality (skill, distribution, timing, employment, necessity, goals and resources. According to the calculations in this article, it must be 1515 people per general practitioner (GP and 1333 people per midwife. There must be 44.755 GP and 50.866 midwife for primary level in Turkey. However there are 51.530 GP and 41.513 midwife in Turkey in 2002. In this situation there is no more need for GP but there is a big need for 10.000 midwife as totally and actually 30.000 midwife for working at health centres for Turkey. As a result, this article discusses the shortcomings of Health Ministry's employment policies in Turkey. It is suggested that in the short run concepts such as physician unemployment, under-employment and flexible work hours will become frequently discussed in Turkey health care public discourse. [TAF Prev Med Bull. 2007; 6(6: 501-514

Health policy evolution in Lao People's Democratic Republic: context, processes and agency.

Science.gov (United States)

Jönsson, Kristina; Phoummalaysith, Bounfeng; Wahlström, Rolf; Tomson, Göran

2015-05-01

During the last 20 years Lao People's Democratic Republic has successfully developed and adopted some 30 health policies, strategies, decrees and laws in the field of health. Still, the implementation process remains arduous. This article aims at discussing challenges of health policy development and effective implementation by contextualizing the policy evolution over time and by focusing particularly on the National Drug Policy and the Health Care Law. Special attention is given to the role of research in policymaking. The analysis was guided by the conceptual framework of policy context, process, content and actors, combined with an institutional perspective, and showed that effective implementation of a health policy is highly dependent on both structures and agency of those involved in the policy process. The National Drug Policy was formulated and adopted in a short period of time in a resource-scarce setting, but with dedicated policy entrepreneurs and support of concerned international collaborators. Timely introduction of operational health systems research played a crucial role to support the implementation, as well as the subsequent revision of the policy. The development of the Health Care Law took several years and once adopted, the implementation was delayed by institutional legacies and issues concerning the choice of institutional design and financing, despite strong support of the law among the policymakers. Among many factors, timing of the implementation appeared to be of crucial importance, in combination with strong leadership. These two examples show that more research, that problematizes the complex policy environment in combination with improved communication between researchers and policymakers, is necessary to inform about measures for effective implementation. A way forward can be to strengthen the domestic research capacity and the international research collaboration regionally as well as globally. Published by Oxford University Press

The future of European health policies.

Science.gov (United States)

Koivusalo, Meri Tuulikki

2005-01-01

The role of the European Union in health policies is changing. The European social model is under threat due to shifts in E.U. policies on liberalization of service provision, limited public budgets, a focus on the health sector as a productive sector in the context of broader European policies and the Lisbon strategy, and changes in the context of the new Constitutional Treaty. These changes are evident in a new reflection paper on European health strategy and its focus. E.U. health policies are at a critical juncture. The danger is that the current processes will lead European health policies and the health systems of member states more in the direction of U.S. health policies and the commercialization of health systems than toward improvement of the current situation.

Economic transition policies in Chinese resource-based cities: An overview of government efforts

International Nuclear Information System (INIS)

Li, Huijuan; Long, Ruyin; Chen, Hong

2013-01-01

Resource-based cities in China have made momentous contributions to the development of the national economy for decades. However, with the depletion of natural resources, their sustainable development is challenging and transition is important. The Chinese government has made great efforts to help resource-based cities. The purpose of this study is to investigate transition policies and their implementation. Firstly, we reviewed previous studies and summarized the essential elements of some successful resource-based cities, which are useful experiences for Chinese resource-based cities. Secondly, we studied the development of resource-based cities over the past 10 years with a focus on economic development, industrial structure, government revenue and environmental conditions. We found that resource-based cities were less developed compared to other cities. The main reasons are the after-effects of a planned economy, an unreasonable tax system, planning mistakes and misguided resources exploitation policies. Thirdly, we analyzed several aspects of the policy responses after the introduction of transition policies, including designating 69 resource-exhausted cities, supporting cities with funds and projects, formulating transition plans and evaluating transition performance. However, there are some deficiencies in the process of policy implementation. Finally, some recommendations were provided to improve transition performance and sustainable development for resource-based cities. - Highlights: ► Analyze the development of Chinese resource-based cities from four aspects. ► Analyze the causes of less development in resource-based cities. ► Investigate policies and their responses to transformation. ► Provide recommendations to improve transformation performance and sustainable development

Empowering health personnel for decentralized health planning in India: The Public Health Resource Network

Directory of Open Access Journals (Sweden)

Prasad Vandana

2009-07-01

though often isolated health workers. It interacts with, and works to empower, health personnel within the government health system as well as civil society, to meaningfully participate in and strengthen decentralized planning processes and outcomes. Structured as an innovative distance-learning course spread over 12 to 18 months of coursework and contact programmes, the Public Health Resource Network comprises 14 core modules and five optional courses. The technical content and contact programmes have been specifically developed to build perspectives and technical knowledge of participants and provide them with a variety of options that can be immediately put into practice within their work environments and everyday roles. The thematic areas of the course modules range from technical knowledge related to maternal and child health and communicable and noncommunicable diseases; programmatic and systemic knowledge related to health planning, convergence, health management and public-private partnerships; to perspective-building knowledge related to mainstreaming gender issues and community participation. Currently the Public Health Resource Network has been launched in four states of India – Chhattisgarh, Jharkhand, Bihar and Orissa – in its first phase, and reaches out to more than 500 participants with diverse backgrounds. The initiative has received valuable support from central and state government departments of health, state training institutes, the National Rural Health Mission – the current comprehensive health policy in the country – and leading civil society organizations.

Empowering health personnel for decentralized health planning in India: The Public Health Resource Network.

Science.gov (United States)

Kalita, Anuska; Zaidi, Sarover; Prasad, Vandana; Raman, V R

2009-07-20

workers. It interacts with, and works to empower, health personnel within the government health system as well as civil society, to meaningfully participate in and strengthen decentralized planning processes and outcomes. Structured as an innovative distance-learning course spread over 12 to 18 months of coursework and contact programmes, the Public Health Resource Network comprises 14 core modules and five optional courses. The technical content and contact programmes have been specifically developed to build perspectives and technical knowledge of participants and provide them with a variety of options that can be immediately put into practice within their work environments and everyday roles. The thematic areas of the course modules range from technical knowledge related to maternal and child health and communicable and noncommunicable diseases; programmatic and systemic knowledge related to health planning, convergence, health management and public-private partnerships; to perspective-building knowledge related to mainstreaming gender issues and community participation. Currently the Public Health Resource Network has been launched in four states of India--Chhattisgarh, Jharkhand, Bihar and Orissa--in its first phase, and reaches out to more than 500 participants with diverse backgrounds. The initiative has received valuable support from central and state government departments of health, state training institutes, the National Rural Health Mission--the current comprehensive health policy in the country--and leading civil society organizations.

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

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

Framework for assessing the capacity of a health ministry to conduct health policy processes--a case study from Tajikistan.

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Mirzoev, Tolib N; Green, Andrew; Van Kalliecharan, Ricky

2015-01-01

An adequate capacity of ministries of health (MOH) to develop and implement policies is essential. However, no frameworks were found assessing MOH capacity to conduct health policy processes within developing countries. This paper presents a conceptual framework for assessing MOH capacity to conduct policy processes based on a study from Tajikistan, a former Soviet republic where independence highlighted capacity challenges. The data collection for this qualitative study included in-depth interviews, document reviews and observations of policy events. Framework approach for analysis was used. The conceptual framework was informed by existing literature, guided the data collection and analysis, and was subsequently refined following insights from the study. The Tajik MOH capacity, while gradually improving, remains weak. There is poor recognition of wider contextual influences, ineffective leadership and governance as reflected in centralised decision-making, limited use of evidence, inadequate actors' participation and ineffective use of resources to conduct policy processes. However, the question is whether this is a reflection of lack of MOH ability or evidence of constraining environment or both. The conceptual framework identifies five determinants of robust policy processes, each with specific capacity needs: policy context, MOH leadership and governance, involvement of policy actors, the role of evidence and effective resource use for policy processes. Three underlying considerations are important for applying the capacity to policy processes: the need for clear focus, recognition of capacity levels and elements, and both ability and enabling environment. The proposed framework can be used in assessing and strengthening of the capacity of different policy actors. Copyright © 2013 John Wiley & Sons, Ltd.

National health policies: sub-Saharan African case studies (1980-1990).

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Dugbatey, K

1999-07-01

changes in the sub-Saharan African region as a whole and in some of the case countries in particular. Political leadership has changed in Ghana and Cote d'Ivoire with some course corrections in Ghana's health plans. Health sector financing in the region has become more dependent on external donors. The World Bank leads the external donor community in promoting policy-based lending. The complexity of a number of health problems has changed while the problems themselves remain the same as before. Essentially, building viable public health infrastructures to address basic public health needs must still be high on the agenda of action for most governments in the region. Thus, notwithstanding some course corrections and reasonable shifts in priorities, all the PHC principles are still applicable, indeed, much needed in the sub-Saharan African region. This study's findings, underscoring the fact that significant improvements in health are possible even where financial resources are limited, still hold true.

Translating research for health policy: researchers' perceptions and use of social media.

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Grande, David; Gollust, Sarah E; Pany, Maximilian; Seymour, Jane; Goss, Adeline; Kilaru, Austin; Meisel, Zachary

2014-07-01

As the United States moves forward with health reform, the communication gap between researchers and policy makers will need to be narrowed to promote policies informed by evidence. Social media represent an expanding channel for communication. Academic journals, public health agencies, and health care organizations are increasingly using social media to communicate health information. For example, the Centers for Disease Control and Prevention now regularly tweets to 290,000 followers. We conducted a survey of health policy researchers about using social media and two traditional channels (traditional media and direct outreach) to disseminate research findings to policy makers. Researchers rated the efficacy of the three dissemination methods similarly but rated social media lower than the other two in three domains: researchers' confidence in their ability to use the method, peers' respect for its use, and how it is perceived in academic promotion. Just 14 percent of our participants reported tweeting, and 21 percent reported blogging about their research or related health policy in the past year. Researchers described social media as being incompatible with research, of high risk professionally, of uncertain efficacy, and an unfamiliar technology that they did not know how to use. Researchers will need evidence-based strategies, training, and institutional resources to use social media to communicate evidence. Project HOPE—The People-to-People Health Foundation, Inc.

Health resources in a 200,000 urban Indian population argues the need for a policy on private sector health services.

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Furtado, Kheya Melo; Kar, Anita

2014-04-01

There are limited primary data on the number of urban health care providers in private practice in developing countries like India. These data are needed to construct and test models that measure the efficacy of public stewardship of private sector health services. This study reports the number and characteristics of health resources in a 200 000 urban population in Pune. Data on health providers were collected by walking through the 15.46 sq km study area. Enumerated data were compared with existing data sources. Mapping was carried out using a Global Positioning System device. Metrics and characteristics of health resources were analyzed using ArcGIS 10.0 and Statistical Package for the Social Sciences, Version 16.0 software. Private sector health facilities constituted the majority (424/426, 99.5%) of health care services. Official data sources were only 39% complete. Doctor to population ratios were 2.8 and 0.03 per 1000 persons respectively in the private and public sector, and the nurse to doctor ratio was 0.24 and 0.71, respectively. There was an uneven distribution of private sector health services across the area (2-118 clinics per square kilometre). Bed strength was forty-fold higher in the private sector. Mandatory registration of private sector health services needs to be implemented which will provide an opportunity for public health planners to utilize these health resources to achieve urban health goals.

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

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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.

Key challenges of human resources for health in India

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Priya Sinha

2016-01-01

and Conclusion The study provided insight into factors further leading to scarcity of human resources for health as attrition/emigration, which has received attention lately and more needs to be done for initiatives and policies to control attrition/emigration. It highlighted talent management strategy is used as effective retention tool by organizations across the world to deal with attrition/emigration. The study recommends study and analyses use of the talent management practices as effective retention tool for human resources for health in India. This needs comprehensive study of talent management practices useful in controlling attrition/emigration and promoting retention decision of employees.

Big Data for Public Health Policy-Making: Policy Empowerment.

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Mählmann, Laura; Reumann, Matthias; Evangelatos, Nikolaos; Brand, Angela

2018-04-04

Digitization is considered to radically transform healthcare. As such, with seemingly unlimited opportunities to collect data, it will play an important role in the public health policy-making process. In this context, health data cooperatives (HDC) are a key component and core element for public health policy-making and for exploiting the potential of all the existing and rapidly emerging data sources. Being able to leverage all the data requires overcoming the computational, algorithmic, and technological challenges that characterize today's highly heterogeneous data landscape, as well as a host of diverse regulatory, normative, governance, and policy constraints. The full potential of big data can only be realized if data are being made accessible and shared. Treating research data as a public good, creating HDC to empower citizens through citizen-owned health data, and allowing data access for research and the development of new diagnostics, therapies, and public health policies will yield the transformative impact of digital health. The HDC model for data governance is an arrangement, based on moral codes, that encourages citizens to participate in the improvement of their own health. This then enables public health institutions and policymakers to monitor policy changes and evaluate their impact and risk on a population level. © 2018 S. Karger AG, Basel.

Flows of financial resources for health research and development in Brazil, 2000-2002.

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Vianna, Cid Manso de Mello; Caetano, Rosângela; Ortega, José Antonio; Façanha, Luiz Otávio de Figueiredo; Mosegui, Gabriela Bittencourt Gonzalez; Siqueira, Marien; Costa, Tiago Barros

2007-02-01

To map and measure the flows of financial resources for health research and development in Brazil for the years 2000-2002. After adapting the methodology developed for the Center for Economic Policy Research, data were collected on the sources and uses of resources for health research and development. The annual average value of resources apportioned to health research and development was approximately 573 million US dollars. The public sector as a whole invested 417.3 million US dollars and the health department 51.1 million US dollars. Expressed in percentages, the public sector invested 4.15% of the health department's budget although the Ministry of Health assigned only 0.3% of its budget to health research in the country. The universities and the research institutes are the main users of the resources allocated to health research and development, receiving 91.6% of the total public spending, while the private sector receives a small share of around 0.69% of the total. The private sector invested 135.6 million US dollars per year, and the international organizations 20.1 million US dollars per year. Besides measuring the financial resources made available for health research and development, the results allowed the filling of gaps in national information; the identification of the flows of applied financial resources; and the testing and adaptation of the proposed methodology, generating information suitable for international comparisons.

Health policy and integrated mental health care in the SADC region: strategic clarification using the Rainbow Model.

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van Rensburg, André Janse; Fourie, Pieter

2016-01-01

Mental illness is a well-known challenge to global development, particularly in low-to-middle income countries. A key health systems response to mental illness is different models of integrated health care, especially popular in the South African Development Community (SADC) region. This complex construct is often not well-defined in health policy, hampering implementation efforts. A key development in this vein has been the Rainbow Model of integrated care, a comprehensive framework and taxonomy of integrated care based on the integrative functions of primary care. The purpose of this study was to explore the nature and strategic forms of integrated mental health care in selected SADC countries, specifically how integrated care is outlined in state-driven policies. Health policies from five SADC countries were analysed using the Rainbow Model as framework. Electronic copies of policy documents were transferred into NVivo 10, which aided in the framework analysis on the different types of integrated mental health care promoted in the countries assessed. Several Rainbow Model components were emphasised. Clinical integration strategies (coordination of person-focused care) such as centrality of client needs, case management and continuity were central considerations, while others such as patient education and client satisfaction were largely lacking. Professional integration (inter-professional partnerships) was mentioned in terms of agreements on interdisciplinary collaboration and performance management, while organisational integration (inter-organisational relationships) emerged under the guise of inter-organisational governance, population needs and interest management. Among others, available resources, population management and stakeholder management fed into system integration strategies (horizontally and vertically integrated systems), while functional integration strategies (financial, management and information system functions) included human resource

Policies and practices of countries experiencing a crisis in Human Resources for Health : A tracking survey

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van den Broek, Ankie; Gedik, Gulin; dal Poz, Mario; Dieleman, M.A.

2010-01-01

In order to understand and monitor the progress in developing and implementing HRH policies in the 57 countries experiencing a critical deficit in the health workforce, this tracking survey provides an overview of the current situation in terms of HRH policies, plans, capacities and processes. The

Making health policy: networks in research and policy after 1945.

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Berridge, Virginia

2005-01-01

Science and policy in health and medicine have interacted in new ways in Britain since 1945. The relationship between research and policy has a history. The changing role of social medicine, the rise of health services research and "customer contractor" policies in government have been important. The relationship between research and policy has been analysed by different schools of thought. This chapter categorises them as several groups: "evidence-based", "journalism", "sociology of scientific knowledge" and "science policy studies". The chapters in the book illuminate aspects of these changing relationships. The role of chronic disease epidemiology, of new networks in public health, of media-focussed activism, and of health technology and its advocates have been more important than political interest.

Situating School District Resource Decision Making in Policy Context

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Spain, Angeline K.

2016-01-01

Decentralization and deregulation policies assume that local educational leaders make better resource decisions than state policy makers do. Conceptual models drawn from organizational theory, however, offer competing predictions about how district central office administrators are likely to leverage their professional expertise in devolved…

Governance in managing public health resources in Brazilian municipalities.

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Avelino, George; Barberia, Lorena G; Biderman, Ciro

2014-09-01

This study contributes to the health governance discussion by presenting a new data set that allows for comparisons of the management of health resources among Brazilian municipalities. Research on Brazil is particularly important as the provision of health services was decentralized in 1988 and since then municipalities have been given greater responsibilities for the management of fiscal resources for public health service provision. Based on detailed information on corruption practices (such as over-invoicing, illegal procurement and fake receipts) from audit reports of health programmes in 980 randomly selected Brazilian municipalities, this study deepens understanding of the relationship between health governance institutions and the incidence of corruption at the local level by exploring the extent to which horizontal and vertical accountabilities contribute to reducing the propensity of municipal government officials to divert public health resources for private gain. The results of our multiple regression analysis suggest that the experience of health municipal councils is correlated with reductions in the incidence of corruption in public health programmes. This impact is significant over time, with each additional year of health council experience reducing corruption incidence levels by 2.1% from baseline values. The findings reported in this study do not rely on the subjectivity of corruption measures which usually conflate the actual incidence of corruption with its perception by informants. Based on our results, we provide recommendations that can assist policy makers to reduce corruption. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

Integrating policy, disintegrating practice: water resources management in Botswana

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Swatuk, Larry A.; Rahm, Dianne

Botswana is generally regarded as an African ‘success story’. Nearly four decades of unabated economic growth, multi-party democracy, conservative decision-making and low-levels of corruption have made Botswana the darling of the international donor community. One consequence of rapid and sustained economic development is that water resources use and demands have risen dramatically in a primarily arid/semi-arid environment. Policy makers recognize that supply is limited and that deliberate steps must be taken to manage demand. To this end, and in line with other members of the Southern African Development Community (SADC), Botswana devised a National Water Master Plan (NWMP) and undertook a series of institutional and legal reforms throughout the 1990s so as to make water resources use more equitable, efficient and sustainable. In other words, the stated goal is to work toward Integrated Water Resources Management (IWRM) in both policy and practice. However, policy measures have had limited impact on de facto practice. This paper reflects our efforts to understand the disjuncture between policy and practice. The information presented here combines a review of primary and secondary literatures with key informant interviews. It is our view that a number of constraints-cultural, power political, managerial-combine to hinder efforts toward sustainable forms of water resources use. If IWRM is to be realized in the country, these constraints must be overcome. This, however, is no small task.

Implementing Health Policy: Lessons from the Scottish Well Men's Policy Initiative.

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Douglas, Flora; van Teijlingen, Edwin; Smith, Cairns; Moffat, Mandy

2015-01-01

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. 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. 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.

Science, Technology and Natural Resources Policy: Overcoming Congressional Gridlock

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McCurdy, K. M.

2015-12-01

The current status of Science, Technology and Natural Resources (STNR) policy in the United States provides an ideal context to examine the influence of committee seniority within the public policy process. Exemplars of the Policy Entrepreneur have been individuals in leadership positions, whether executive or legislative. The role of junior committee members in shaping policy innovation is less well understood, and is frequently masked either in cross-sectional research designs or in case studies. The House Natural Resources committee seniority patterns are compared to the House of Representatives Chamber data from 1975 to 2015. This expanse of congressional time captures both the policy innovation of the Class of 1974 who helped transform the public lands by pursuing a preservation agenda, along with the contemporaneous gridlock caused by disagreements about reducing the size of the federal government, a policy agenda championed and sustained by the Class of 1994. Several types of political actors have served as policy entrepreneurs, President Kennedy and Secretary of Interior Udall shepherding the Wilderness Act of 1964 from the Executive branch, or in the 111th Congress Committee chairmen Senator Christopher Dodd and Representative Barney Frank, having announced their retirements, spent their final Congress shaping the consensus that produced the Wall Street Reform and Consumer Protection Act of 2010. A less studied policy phenomenon relies on "packing the committee" to outvote the leadership. This tactic can be used by the party leadership to overcome recalcitrant senior committee members, as was the case for Democrats in the House Interior and Insular Affairs Committee shift to preservation in the 1970s, or the tactic can be employed from the grassroots, as may be happening in the case of the House Natural Resources Committee in the 114th Congress. A policy making process analog to rivers is more appropriate than a mechanistic model. As there are multiple

Trade policy and health: from conflicting interests to policy coherence.

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Blouin, Chantal

2007-03-01

Policy incoherence at the interface between trade policy and health can take many forms, such as international trade commitments that strengthen protection of pharmaceutical patents, or promotion of health tourism that exacerbates the shortage of physicians in rural areas. Focusing on the national policy-making process, we make recommendations regarding five conditions that are necessary, but not sufficient, to ensure that international trade policies are coherent with national health objectives. These conditions are: space for dialogue and joint fact-finding; leadership by ministries of health; institutional mechanisms for coordination; meaningful engagement with stakeholders; and a strong evidence base.

Approaches to developing the capacity of health policy analysis institutes: a comparative case study

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Bennett Sara

2012-03-01

Full Text Available Abstract Objectives To review and assess (i the factors that facilitate the development of sustainable health policy analysis institutes in low and middle income countries and (ii the nature of external support for capacity development provided to such institutes. Methods Comparative case studies of six health policy analysis institutes (3 from Asia and 3 from Africa were conducted. In each region an NGO institute, an institute linked to government and a university based institute were included. Data collection comprised document review, semi-structured interviews with stakeholders and discussion of preliminary findings with institute staff. Findings The findings are organized around four key themes: (i Financial resources: three of the institutes had received substantial external grants at start-up, however two of these institutes subsequently collapsed. At all but one institute, reliance upon short term, donor funding, created high administrative costs and unpredictability. (ii Human resources: the retention of skilled human resources was perceived to be key to institute success but was problematic at all but one institute. In particular staff often moved to better paid positions elsewhere once having acquired necessary skills and experience, leaving remaining senior staff with heavy workloads. (iii Governance and management: board structures and roles varied according to the nature of institute ownership. Boards made important contributions to organizational capacity through promoting continuity, independence and fund raising. Routine management systems were typically perceived to be strong. (iv Networks: linkages to policy makers helped promote policy influences. External networks with other research organizations, particularly where these were longer term institutional collaborations helped promote capacity. Conclusions The development of strong in-country analytical and research capacity to guide health policy development is critical, yet

Human resource leadership: the key to improved results in health

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O'Neil Mary L

2008-06-01

Full Text Available Abstract This article is the lead article in the Human Resources for Health journal's first quarterly feature. The series of seven articles has been contributed by Management Sciences for Health (MSH under the theme of leadership and management in public health and will be published article by article over the next few weeks. The journal has invited Dr Manuel M. Dayrit, Director of the WHO Department of Human Resources for Health and former Minister of Health for the Philippines to launch the feature with an opening editorial to be found in the journal's blog. This opening article describes the human resource challenges that managers around the world report and analyses why solutions often fail to be implemented. Despite rising attention to the acute shortage of health care workers, solutions to the human resource (HR crisis are difficult to achieve, especially in the poorest countries. Although we are aware of the issues and have developed HR strategies, the problem is that some old systems of leading and managing human resources for health do not work in today's context. The Leadership Development Program (LDP is grounded on the belief that good leadership and management can be learned and practiced at all levels. The case studies in this issue were chosen to illustrate results from using the LDP at different levels of the health sector. The LDP makes a profound difference in health managers' attitudes towards their work. Rather than feeling defeated by a workplace climate that lacks motivation, hope, and commitment to change, people report that they are mobilized to take action to change the status quo. The lesson is that without this capacity at all levels, global policy and national HR strategies will fail to make a difference.

Resource Efficiency. What does it mean and why is it relevant? Policy Brief

Energy Technology Data Exchange (ETDEWEB)

Jansen, J.C. [ECN Policy Studies, Petten (Netherlands)

2013-04-15

The European Commission has launched a Resource-Efficient Europe as one of its seven flagship initiatives under the Europe 2020 Strategy and has published the document 'Roadmap to a Resource-Efficient Europe'. The Roadmap specifies a proposed pathway to action for a resource efficient Europe. This document sets out to describe the essence of the resource efficiency concept and to sketch the relevance of EU resource efficiency policy for application at EU member state level with special reference to the Netherlands. The following questions will be addressed: What is resource efficiency?; How does it relate to sustainability and environmental footprint?; What is the relevance of EU resource efficiency policy for the member states?; Which aspects of resource efficiency are relevant for the Netherlands?; and To what extent is resource efficiency reflected in current Dutch policies?.

[Facilitators and barriers to implementation of intercultural health policy in Chile].

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Pérez, Camila; Nazar, Gabriela; Cova, Félix

2016-02-01

Objective To identify elements that either facilitate or hinder implementation of Chile's intercultural health policy. Methods A descriptive study was conducted with the participation of health services users from the Mapuche ethnic group, biomedical health professionals, intercultural facilitators, and key informants in two health facilities serving towns with a high density of Mapuche population. The information was obtained through semi-structured interviews that were analyzed thematically. Results Factors identified as facilitating the implementation of this policy include laws and regulations pertaining to the rights of indigenous peoples, the empowerment of users around their rights, the formation of implementation teams, the presence of professionals of Mapuche origin in health facilities, and the existence of processes for systematization of the work carried out. The asymmetric relationship between the Mapuche people and the state, and between the Mapuche health system and the biomedical model, constitutes a fundamental barrier. Other obstacles include the lack of theoretical and practical clarity around the concept of intercultural health and a lack of resources. Conclusions Despite the facilitators identified and the achievements to date, meaningful progress in implementation of an intercultural health policy is limited by barriers that are hard to change. These include the usual forms of government planning and the hegemony of the biomedical model.

Challenges for sustainable resource use : Uncertainty, trade and climate policies

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Bretschger, L.; Smulders, Sjak A.

2012-01-01

We integrate new challenges to thinking about resource markets and sustainable resource use policies in a general framework. The challenges, emerging from six papers that JEEM publishes in a special issue, are (i) demand uncertainty and stockpiling, (ii) international trade and resource dependence,

Politics, policies and processes: a multidisciplinary and multimethods research programme on policies on the social determinants of health inequity in Australia.

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Baum, Fran; Friel, Sharon

2017-12-21

The development and implementation of multisectoral policy to improve health and reduce health inequities has been slow and uneven. Evidence is largely focused on the facts of health inequities rather than understanding the political and policy processes. This 5-year funded programme of research investigates how these processes could function more effectively to improve equitable population health. The programme of work is organised in four work packages using four themes (macroeconomics and infrastructure, land use and urban environments, health systems and racism) related to the structural drivers shaping the distribution of power, money and resources and daily living conditions. Policy case studies will use publicly available documents (policy documents, published evaluations, media coverage) and interviews with informants (policy-makers, former politicians, civil society, private sector) (~25 per case). NVIVO software will be used to analyse the documents to see how 'social and health equity' is included and conceptualised. The interview data will include qualitative descriptive and theory-driven critical discourse analysis. Our quantitative methodological work assessing the impact of public policy on health equity is experimental that is in its infancy but promises to provide the type of evidence demanded by policy-makers. Our programme is recognising the inherently political nature of the uptake, formulation and implementation of policy. The early stages of our work indicate its feasibility. Our work is aided by a Critical Policy Reference Group. Multiple ethics approvals have been obtained with the foundation approval from the Social and Behavioural Ethics Committee, Flinders University (Project No: 6786).The theoretical, methodological and policy engagement processes established will provide improved evidence for policy-makers who wish to reduce health inequities and inform a new generation of policy savvy knowledge on social determinants. © Article author

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

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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.

Health Care Organizations and Policy Leadership: Perspectives on Nonsmoker-Only Hiring Policies.

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McDaniel, Patricia A; Malone, Ruth E

2018-02-01

To explore employers' decisions to base hiring policies on tobacco or nicotine use and community perspectives on such policies, and analyze the implications for organizational identity, community engagement, and health promotion. From 2013 to 2016, 11 executives from six health care organizations and one non-health-care organization with nonsmoker-only hiring policies were interviewed about why and how their policies were created and implemented, concerns about the policies, and perceptions of employee and public reactions. Focus groups were conducted with community members (n = 51) who lived in or near cities where participating employers were based, exploring participants' opinions about why an employer would stop hiring smokers and their support (or not) for such a policy. Most employers excluded from employment those using all forms of nicotine. Several explained their adoption of the policy as a natural extension of a smoke-free campus and as consistent with their identity as health care organizations. They regarded the policy as promoting health. No employer mentioned engaging in a community dialogue before adopting the policy or reported efforts to track the policy's impact on rejected applicants. Community members understood the cost-saving appeal of such policies, but most opposed them. They made few exceptions for health care organizations. Policy decisions undertaken by health care organizations have influence beyond their immediate setting and may establish precedents that others follow. Nonsmoker-only hiring policies may fit with a health care organization's institutional identity but may not be congruent with community values or promote public health.

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

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

2017-01-01

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.

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

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Clavier, Carole; Potvin, Louise

2017-01-01

Background 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. Methods 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. Results 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. Conclusion 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. PMID:28589007

Food system policy, public health, and human rights in the United States.

Science.gov (United States)

Shannon, Kerry L; Kim, Brent F; McKenzie, Shawn E; Lawrence, Robert S

2015-03-18

The US food system functions within a complex nexus of social, political, economic, cultural, and ecological factors. Among them are many dynamic pressures such as population growth, urbanization, socioeconomic inequities, climate disruption, and the increasing demand for resource-intensive foods that place immense strains on public health and the environment. This review focuses on the role that policy plays in defining the food system, particularly with regard to agriculture. It further examines the challenges of making the food supply safe, nutritious, and sustainable, while respecting the rights of all people to have access to adequate food and to attain the highest standard of health. We conclude that the present US food system is largely unhealthy, inequitable, environmentally damaging, and insufficiently resilient to endure the impacts of climate change, resource depletion, and population increases, and is therefore unsustainable. Thus, it is imperative that the US embraces policy reforms to transform the food system into one that supports public health and reflects the principles of human rights and agroecology for the benefit of current and future generations.

Public Policy and Health Informatics.

Science.gov (United States)

Bell, Katherine

2018-04-05

To provide an overview of the history of electronic health policy and identify significant laws that influence health informatics. US Department of Health and Human Services. The development of health information technology has influenced the process for delivering health care. Public policy and regulations are an important part of health informatics and establish the structure of electronic health systems. Regulatory bodies of the government initiate policies to ease the execution of electronic health record implementation. These same bureaucratic entities regulate the system to protect the rights of the patients and providers. Nurses should have an overall understanding of the system behind health informatics and be able to advocate for change. Nurses can utilize this information to optimize the use of health informatics and campaign for safe, effective, and efficient health information technology. Copyright © 2018 Elsevier Inc. All rights reserved.

Health Policy Training: A Review of the Literature.

Science.gov (United States)

Heiman, Harry J; Smith, L Lerissa; McKool, Marissa; Mitchell, Denise N; Roth Bayer, Carey

2015-12-23

The context within which health care and public health systems operate is framed by health policies. There is growing consensus about the need for increased health policy leadership and a health professional workforce prepared to assume these leadership roles. At the same time, there is strong evidence supporting the need for a broader policy lens and the need to intentionally target health disparities. We reviewed the published literature between 1983 and 2013 regarding health policy training. From 5124 articles identified, 33 met inclusion criteria. Articles varied across common themes including target audience, goal(s), health policy definition, and core curricular content. The majority of articles were directed to medical or nursing audiences. Most articles framed health policy as health care policy and only a small number adopted a broader health in all policies definition. Few articles specifically addressed vulnerable populations or health disparities. The need for more rigorous research and evaluation to inform health policy training is compelling. Providing health professionals with the knowledge and skills to engage and take leadership roles in health policy will require training programs to move beyond their limited health care-oriented health policy framework to adopt a broader health and health equity in all policies approach.

Health Policy Training: A Review of the Literature

Directory of Open Access Journals (Sweden)

Harry J. Heiman

2015-12-01

Full Text Available The context within which health care and public health systems operate is framed by health policies. There is growing consensus about the need for increased health policy leadership and a health professional workforce prepared to assume these leadership roles. At the same time, there is strong evidence supporting the need for a broader policy lens and the need to intentionally target health disparities. We reviewed the published literature between 1983 and 2013 regarding health policy training. From 5124 articles identified, 33 met inclusion criteria. Articles varied across common themes including target audience, goal(s, health policy definition, and core curricular content. The majority of articles were directed to medical or nursing audiences. Most articles framed health policy as health care policy and only a small number adopted a broader health in all policies definition. Few articles specifically addressed vulnerable populations or health disparities. The need for more rigorous research and evaluation to inform health policy training is compelling. Providing health professionals with the knowledge and skills to engage and take leadership roles in health policy will require training programs to move beyond their limited health care-oriented health policy framework to adopt a broader health and health equity in all policies approach.

The allocation of resources for animal health.

Science.gov (United States)

Howe, K S

2017-04-01

Economics is too important to be left to the experts. This paper is therefore mainly for animal health policy-makers who are not economists but want a better appreciation of how economics can contribute to resource allocation decisions. First, the methodology of economic analysis is outlined with the objective of dispelling criticisms of its simplifying assumption of rationality. Then, unusual in economics but more familiar to biological and veterinary scientists, the technical aspects of transforming resources into products are discussed. Economics' unique contribution is to establish criteria enabling society to obtain maximum value from the production and distribution of goods and services (products) from scarce resources. Animal disease reduces the efficiency of this process. Value is intangible, but people reveal how much they value (i.e. feel a want or need for) products by what they actually consume, in quality and quantity. Animal products, and so implicitly animals themselves, are an example. The strength of people's preferences is reflected both in the prices they pay for market goods and services, and by their political votes where markets do not exist. Importantly, there is a difference between financial value (what the consumer pays for a good or service) and economic value (the maximum amount of money they would be prepared to pay for it). Allocating resources for animal health creates both costs and benefits, financial and economic. Moreover, costs and benefits are both private and social because of externalities, a major consideration in infectious diseases. Where production decisions with animal health implications are made exclusively for private benefit, government has a role in providing incentives for animal sectors to act in ways that result in socially efficient outcomes.

How Resource Dynamics Explain Accumulating Developmental and Health Disparities for Teen Parents’ Children

Science.gov (United States)

Mollborn, Stefanie; Lawrence, Elizabeth; James-Hawkins, Laurie; Fomby, Paula

2014-01-01

This study examines the puzzle of disparities experienced by U.S. teen parents’ young children, whose health and development increasingly lag behind those of peers while their parents are simultaneously experiencing socioeconomic improvements. Using the nationally representative Early Childhood Longitudinal Study-Birth Cohort (2001–2007; N ≈ 8,600), we assess four dynamic patterns in socioeconomic resources that might account for these growing developmental and health disparities throughout early childhood and then test them in multilevel growth curve models. Persistently low socioeconomic resources constituted the strongest explanation, given that consistently low income, maternal education, and assets fully or partially account for growth in cognitive, behavioral, and health disparities experienced by teen parents’ children from infancy through kindergarten. That is, although teen parents gained socioeconomic resources over time, those resources remained relatively low, and the duration of exposure to limited resources explains observed growing disparities. Results suggest that policy interventions addressing the time dynamics of low socioeconomic resources in a household, in terms of both duration and developmental timing, are promising for reducing disparities experienced by teen parents’ children. PMID:24802282

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.

Impact of socially responsible human resources policies on intellectual capital

Directory of Open Access Journals (Sweden)

Jesus Barrena-Martínez

2016-03-01

Full Text Available Purpose: This research focuses on the benefits that social responsibility can report on the area of human resources, examined the impact of a socially responsible configuration of human resource policies and practices in the generation value process for the company, and more specifically in its intellectual capital. Design/methodology/approach: The study performed a regression analysis, testing the individual effects of socially responsible human resource policies on intellectual capital, broken down into three main variables such as human, social and organizational capital. Findings: The results shed light on how the introduction of socially responsible aspects in the management of human resources can facilitate the exchange of knowledge, skills and attitudes human--capital; lead to improvements in communication, trust, cooperation among employees social-capital and, in turn, generates an institutionalized knowledge encoded in the own organizational culture –organizational capital–. Research limitations/implications: The study only provides information from large companies with over 250 employees. Practical implications: There are important implications in the measure of corporate social responsibility concerns in the area of human resources. Social implications: Also important intangible effects on non-economic variables are confirmed, such as intellectual capital. Originality/value: The value of the study lies in its novelty, testing socially responsible configurations of human resources as well as the direct effects of different policies on intellectual capital.

Health policy, health systems research and analysis capacity ...

African Journals Online (AJOL)

Introduction: Health Policy and Systems Research and Analysis (HPSR&A) is an applied science that deals with complexity as it tries to provide lessons, tools and methods to understand and improve health systems and health policy. It is defined by the kinds of questions asked rather than a particular methodology.

Continuing nursing education policy in China and its impact on health equity.

Science.gov (United States)

Xiao, Lily Dongxia

2010-09-01

The aim of this study was to evaluate the mandatory continuing nursing education (MCNE) policy in China and to examine whether or not the policy addresses health equity. MCNE was instituted in 1996 in China to support healthcare reform was to include producing greater equity in health-care. However, the literature increasingly reports inequity in participation in MCNE, which is likely to have had a detrimental effect on the pre-existing discrepancies of education in the nursing workforce, and thereby failing to really address health equity. Despite a growing appeal for change, there is lack of critical reflection on the issues of MCNE policy. Critical ethnography underpinned by Habermas' Communicative Action Theory and Giddens' Structuration Theory were used to guide this study. Findings are presented in four themes: (i) inaccessibility of learning programs for nurses; (ii) undervaluation of workplace-based learning; (iii) inequality of the allocation of resources; and (iv) demands for additional support in MCNE from non-tertiary hospitals. The findings strongly suggest the need for an MCNE policy review based on rational consensus with stakeholders while reflecting the principles of health equity.

Examining the breastfeeding support resources of the public health nursing services in Ireland.

Science.gov (United States)

Mulcahy, Helen; Phelan, Agnes; Corcoran, Paul; Leahy-Warren, Patricia

2012-04-01

The aim of the study was to review breastfeeding support provided by Public Health Nurses in Ireland. The objectives were to identify the availability of appropriate guiding policies, educational preparation, attitude of Public Health Nurses and the availability and use of other supportive services. Breastfeeding rates in Ireland are among the lowest in Europe. The main source of formal support for breastfeeding mothers in the community in Ireland is from Public Health Nurses who can make referral to other non-statutory resources. The nature of this support is determined by policies guiding clinical practice and education that increases breastfeeding confidence and competence of all personnel. Consequently, an assessment of breastfeeding resources requires an analysis of all these variables. A large quantitative, cross-sectional study was conducted, involving Public Health Nurses and mothers. This paper represents the results from the perspective of Public Health Nurses. Directors of Public Health Nursing (n = 24) and Public Health Nurses (n = 204) completed self-report questionnaires by mail and online. Data were analysed using the Statistical Package for Social Sciences and reported using descriptive and inferential statistics. Public Health Nurses are well educated to support breastfeeding and have a positive attitude and a high degree of self-assessed confidence and competence. A wide variety of non-statutory support exists for breastfeeding but is not always used to their full potential. Standardising educational requirements for Public Health Nurses in supporting breastfeeding is an area that requires attention. Ultimately, service delivery in relation to supporting breastfeeding mothers would benefit from being more timely and responsive. Awareness of support resources is necessary for Public Health Nurses to make appropriate referrals for breastfeeding mothers. Furthermore, Directors of Public Health Nursing need to encourage the breastfeeding supportive

Resource price turbulence and macroeconomic adjustment for a resource exporter. A conceptual framework for policy analysis

International Nuclear Information System (INIS)

Cox, Grant M.; Harvie, Charles

2010-01-01

Increased global demand for energy and other resources, particularly from the rapidly developing economies of China and India and the opening up of global resource markets to global investors and speculative activity, has resulted in considerable recent turbulence in resource prices. The recent magnitude of change in resource prices, both positive and negative, and their macroeconomic implications is of considerable contemporary importance to both resource importing and exporting economies. For a resource exporting economy, such as that of Australia, the recent resource price boom has resulted in: increased government taxation revenue, increased employment and wages in the resource and resource related sectors, increased spending in the domestic economy that contributed to buoyant economic growth, increased resource exports to the booming economies of China and India and contributed to a stronger domestic currency with beneficial effects upon inflation. On the other hand these developments have had adverse effects on the non-resource sector by: subjecting it to more intense competition for limited resources, contributing to a loss of international competitiveness and reduced exports arising from a stronger exchange rate, reducing employment in the relatively more labour intensive non-resource sector, and contributing to an eventual slow down in the overall economy. These positive and negative effects, and the overall impact of a resource price boom, require a fundamentally closer analysis of the structure of the economy under scrutiny. In this context the policy response by government is likely to be pivotal in determining the overall macroeconomic outcomes from a resource price boom. The aim of this paper is to develop a generic analytical framework to appraise economic outcomes in the wake of a resource price boom for a resource producing and exporting economy. To this end a dynamic long run macroeconomic model is developed, emphasising the important role and

Resource allocation and budgetary mechanisms for decentralized health systems: experiences from Balochistan, Pakistan.

OpenAIRE

Green, A.; Ali, B.; Naeem, A.; Ross, D.

2000-01-01

This paper identifies key political and technical issues involved in the development of an appropriate resource allocation and budgetary system for the public health sector, using experience gained in the Province of Balochistan, Pakistan. The resource allocation and budgetary system is a critical, yet often neglected, component of any decentralization policy. Current systems are often based on historical incrementalism that is neither efficient nor equitable. This article describes technical...

Assessment of health risks of policies

International Nuclear Information System (INIS)

Ádám, Balázs; Molnár, Ágnes; Ádány, Róza; Bianchi, Fabrizio; Bitenc, Katarina; Chereches, Razvan; Cori, Liliana; Fehr, Rainer; Kobza, Joanna; Kollarova, Jana

2014-01-01

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

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.

Conditions for addressing environmental determinants of health behavior in intersectoral policy networks: A fuzzy set Qualitative Comparative Analysis.

Science.gov (United States)

Peters, D T J M; Verweij, S; Grêaux, K; Stronks, K; Harting, J

2017-12-01

Improving health requires changes in the social, physical, economic and political determinants of health behavior. For the realization of policies that address these environmental determinants, intersectoral policy networks are considered necessary for the pooling of resources to implement different policy instruments. However, such network diversity may increase network complexity and therefore hamper network performance. Network complexity may be reduced by network management and the provision of financial resources. This study examined whether network diversity - amidst the other conditions - is indeed needed to address environmental determinants of health behavior. We included 25 intersectoral policy networks in Dutch municipalities aimed at reducing overweight, smoking, and alcohol/drugs abuse. For our fuzzy set Qualitative Comparative Analysis we used data from three web-based surveys among (a) project leaders regarding network diversity and size (n = 38); (b) project leaders and project partners regarding management (n = 278); and (c) implementation professionals regarding types of environmental determinants addressed (n = 137). Data on budgets were retrieved from project application forms. Contrary to their intentions, most policy networks typically addressed personal determinants. If the environment was addressed too, it was mostly the social environment. To address environmental determinants of health behavior, network diversity (>50% of the actors are non-public health) was necessary in networks that were either small (policy networks in improving health behaviors by addressing a variety of environmental determinants. Copyright © 2017. Published by Elsevier Ltd.

Citizen science and natural resource governance: program design for vernal pool policy innovation

Directory of Open Access Journals (Sweden)

Bridie McGreavy

2016-06-01

Full Text Available Effective natural resource policy depends on knowing what is needed to sustain a resource and building the capacity to identify, develop, and implement flexible policies. This retrospective case study applies resilience concepts to a 16-year citizen science program and vernal pool regulatory development process in Maine, USA. We describe how citizen science improved adaptive capacities for innovative and effective policies to regulate vernal pools. We identified two core program elements that allowed people to act within narrow windows of opportunity for policy transformation, including (1 the simultaneous generation of useful, credible scientific knowledge and construction of networks among diverse institutions, and (2 the formation of diverse leadership that promoted individual and collective abilities to identify problems and propose policy solutions. If citizen science program leaders want to promote social-ecological systems resilience and natural resource policies as outcomes, we recommend they create a system for internal project evaluation, publish scientific studies using citizen science data, pursue resources for program sustainability, and plan for leadership diversity and informal networks to foster adaptive governance.

Local enactments of national health promotion policies

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...... the concrete enactments and their locally experienced effects, our understanding of national public health policies risks becoming detached from praxis and unproductive. Public health policy-makers must pay methodological and analytical attention to the policies' multimodality and their concrete locally......Governments of welfare states are firmly committed to public health, resulting in a substantial number of public health policies. Given the multi-level structure of most welfare systems, the influence of a public health policy is related to its ability to spread geographically and move across...

Shaping Policy Change in Population Health: Policy Entrepreneurs, Ideas, and Institutions.

Science.gov (United States)

Béland, Daniel; Katapally, Tarun R

2018-01-14

Political realities and institutional structures are often ignored when gathering evidence to influence population health policies. If these policies are to be successful, social science literature on policy change should be integrated into the population health approach. In this contribution, drawing on the work of John W. Kingdon and related scholarship, we set out to examine how key components of the policy change literature could contribute towards the effective development of population health policies. Shaping policy change would require a realignment of the existing school of thought, where the contribution of population health seems to end at knowledge translation. Through our critical analysis of selected literature, we extend recommendations to advance a burgeoning discussion in adopting new approaches to successfully implement evidence-informed population health policies. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Management of human resources in health care: the Canadian experience.

Science.gov (United States)

Adams, O

1992-07-01

Each of Canada's ten provinces has a publicly administered system of health insurance, funded by provincial and federal taxes, that is accessible to all citizens and covers all medically necessary services provided by physicians and hospitals. Canadians spend an estimated 9.2 percent of their gross national product on health care (about 2.8 percentage points below US spending), of which three quarters is public-sector spending. According to the Organization for Economic Cooperation and Development, Canada's health status is equal to or better than that of the United States, despite lower per capita health spending. About seven percent of the Canadian labour force works in health care, and attempts to introduce coordinated planning of human resources in health care have not as yet proceeded far. The predominant policy issue here is the supply and the role of physicians. It has been argued that entrenching within the system the fee-for-service method of paying physicians has created a disincentive to the delegation of responsibility to health personnel other than doctors. It is also argued that introduction of government-run health insurance provided the opportunity for human resource planning, but that the decision by governments to act only as the payer resulted in ad-hoc planning approaches. However, governments' concern over health care costs has led to a more direct role by them in the planning of the human resources in health. They are re-examining the autonomy and jurisdictional rights of the professions that deliver health care to Canadians.

Research Translation Strategies to Improve the Readability of Workplace Health Promotion Resources

Science.gov (United States)

Wallace, Alison; Joss, Nerida

2016-01-01

Without deliberate and resourced translation, research evidence is unlikely to inform policy and practice. This paper describes the processes and practical solutions used to translate evaluation research findings to improve the readability of print materials in a large scale worksite health programme. It is argued that a knowledge brokering and…

Consumer attitudes toward health policy and knowledge about health legislation.

Science.gov (United States)

Riska, E; Taylor, J A

1978-01-01

Consumer attitudes toward key issues affecting health policy decisions in the local community have been ignored both by local health policy makers and by medical sociologists. The authors report an empirical analysis of: (1) consumer attitudes towards federal intervention in health care; (2) consumer perceptions of the free market philosophy of health providers; (3) consumer perceptions of their involvement in health policy making; (4) consumer confidence in present systems of health services delivery; and (5) consumer awareness of recent major health legislation. It was found that consumers are poorly informed about recent health care legislation. The authors compared the attitudes of consumers with those held by local hospital board members toward health policy issues. The differences for all comparisons were statistically significant. The authors argue that hospital board members attribute problems in health services delivery to demand dysfunctions while consumers perceive the problems to be a result of supply dysfunctions. Thus, failure to include consumers on health policy boards guarantees the absence of a solution-oriented dialogue and promotes the continuing predominance of a provider-biased ideology.

Population mental health: evidence, policy, and public health practice

National Research Council Canada - National Science Library

Cohen, Neal L; Galea, Sandro

2011-01-01

... on population mental health with public mental health policy and practice. Issues covered in the book include the influence of mental health policies on the care and well-­ being of individuals with mental illness, the interconnectedness of physical and mental disorders, the obstacles to adopting a public health orientation to mental health/mental ill...

Australia's national men's health policy: masculinity matters.

Science.gov (United States)

Saunders, Margo; Peerson, Anita

2009-08-01

The development of Australia's first national men's health policy provides an important opportunity for informed discussions of health and gender. It is therefore a concern that the stated policy appears to deliberately exclude hegemonic masculinity and other masculinities, despite evidence of their major influence on men's health-related values, beliefs, perspectives, attitudes, motivations and behaviour. We provide an evidence-based critique of the proposed approach to a national men's health policy which raises important questions about whether the new policy can achieve its aims if it fails to acknowledge 'masculinity' as a key factor in Australian men's health. The national men's health policy should be a means to encourage gender analysis in health. This will require recognition of the influence of hegemonic masculinity, and other masculinities, on men's health. Recognising the influence of 'masculinity' on men's health is not about 'blaming' men for 'behaving badly', but is crucial to the development of a robust, meaningful and comprehensive national men's health policy.

Resource acquisition policy: Multiple account evaluation of electricity resource alternatives [and] resource acquisition strategy

International Nuclear Information System (INIS)

1994-06-01

British Columbia Hydro has been directed by the provincial government to develop evaluation procedures to rank electricity resource alternatives in terms of their social benefits and costs, and to acquire resources on the basis of need. The current state of development of social costing at BC Hydro is detailed along with its application to the multiple account evaluation of resources. In this evaluation, BC Hydro's corporate costs, customer cost, transfer payments to the province, direct costs incurred by provincial or regional governments or other Crown agences, direct environmental impact costs from air emissions and land/water use, community and social impact costs, and economic development impacts are taken into account. The BC Hydro resource acquisition strategy is also described as it was developed in response to provincial policy on electricity supply from independent power producers. This strategy includes a determination of need, a decision to acquire need-determined resources either by itself or from a private sector developer, and decisions to acquire resources in advance of need for reasons such as economic opportunity, long-term strategies, or load displacement. Background information is included on calculation of air emissions costs. An illustrative example is provided of the multiple account evaluation of several types of resource projects. 1 fig., 5 tabs

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. Copyright �

Developing and implementing mental health policy in Zanzibar, a low income country off the coast of East Africa.

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Jenkins, Rachel; Mussa, Mahmoud; Haji, Suleiman A; Haji, Mohammed S; Salim, Ahmed; Suleiman, Said; Riyami, Alya S; Wakil, Abdul; Mbatia, Joseph

2011-02-14

The Zanzibar Ministry of Health and Social Welfare, concerned about mental health in the country, requested technical assistance from WHO in 1997. This article describes the facilitation over many years by a WHO Collaborating Centre, of sustainable mental health developments in Zanzibar, one of the poorest countries in the world, using systematic approaches to policy design and implementation. Based on intensive prior situation appraisal and consultation, a multi-faceted set of interventions combining situation appraisal to inform planning; sustained policy dialogue at Union and state levels; development of policy and legislation, development of strategic action plans, establishment of intersectoral national mental health implementation committee, establishment of national mental health coordination system, integration of mental health into primary care, strengthening of primary-secondary care liaison, rationalisation and strengthening of secondary care system, ensuring adequate supply of medicines, use of good practice guidelines and health information systems, development of services for people with intellectual disability, establishment of formal mechanism for close liaison between the mental health services and other governmental, non-governmental and traditional sectors, mental health promotion, suicide prevention, and research and development. The policy and legislation introduced in 1999 have resulted in enhanced mental health activities over the ensuing decade, within a setting of extreme low resource. However, advances ebb and flow and continued efforts are required to maintain progress and continue mental health developments. Lessons learnt have informed the development of mental health policies in neighbouring countries. A multi-faceted and comprehensive programme can be effective in achieving considerable strengthening of mental health programmes and services even in extremely low resource settings, but requires sustained input and advocacy if gains are

Policy Options to Reduce Fragmentation in the Pooling of Health Insurance Funds in Iran.

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Bazyar, Mohammad; Rashidian, Arash; Kane, Sumit; Vaez Mahdavi, Mohammad Reza; Akbari Sari, Ali; Doshmangir, Leila

2016-02-11

There are fragmentations in Iran's health insurance system. Multiple health insurance funds exist, without adequate provisions for transfer or redistribution of cross subsidy among them. Multiple risk pools, including several private secondary insurance schemes, have resulted in a tiered health insurance system with inequitable benefit packages for different segments of the population. Also fragmentation might have contributed to inefficiency in the health insurance systems, a low financial protection against healthcare expenditures for the insured persons, high coinsurance rates, a notable rate of insurance coverage duplication, low contribution of well-funded institutes with generous benefit package to the public health insurance schemes, underfunding and severe financial shortages for the public funds, and a lack of transparency and reliable data and statistics for policy-making. We have conducted a policy analysis study, including qualitative interviews of key informants and document analysis. As a result we introduce three policy options: keeping the existing structural fragmentations of social health insurance (SHI)schemes but implementing a comprehensive "policy integration" strategy; consolidation of existing health insurance funds and creating a single national health insurance scheme; and reducing fragmentation by merging minor well-resourced funds together and creating two or three large insurance funds under the umbrella of the existing organizations. These policy options with their advantages and disadvantages are explained in the paper. © 2016 by Kerman University of Medical Sciences.

Policy Options to Reduce Fragmentation in the Pooling of Health Insurance Funds in Iran

Science.gov (United States)

Bazyar, Mohammad; Rashidian, Arash; Kane, Sumit; Vaez Mahdavi, Mohammad Reza; Akbari Sari, Ali; Doshmangir, Leila

2016-01-01

There are fragmentations in Iran’s health insurance system. Multiple health insurance funds exist, without adequate provisions for transfer or redistribution of cross subsidy among them. Multiple risk pools, including several private secondary insurance schemes, have resulted in a tiered health insurance system with inequitable benefit packages for different segments of the population. Also fragmentation might have contributed to inefficiency in the health insurance systems, a low financial protection against healthcare expenditures for the insured persons, high coinsurance rates, a notable rate of insurance coverage duplication, low contribution of well-funded institutes with generous benefit package to the public health insurance schemes, underfunding and severe financial shortages for the public funds, and a lack of transparency and reliable data and statistics for policy-making. We have conducted a policy analysis study, including qualitative interviews of key informants and document analysis. As a result we introduce three policy options: keeping the existing structural fragmentations of social health insurance (SHI)schemes but implementing a comprehensive "policy integration" strategy; consolidation of existing health insurance funds and creating a single national health insurance scheme; and reducing fragmentation by merging minor well-resourced funds together and creating two or three large insurance funds under the umbrella of the existing organizations. These policy options with their advantages and disadvantages are explained in the paper. PMID:27239868

What Factors Do Allied Health Take Into Account When Making Resource Allocation Decisions?

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Lane, Haylee; Sturgess, Tamica; Philip, Kathleen; Markham, Donna; Martin, Jennifer; Walsh, Jill; Hubbard, Wendy; Haines, Terry

2017-09-12

Allied health comprises multiple professional groups including dietetics, medical radiation practitioners, occupational therapists, optometrists and psychologists. Different to medical and nursing, Allied health are often organized in discipline specific departments and allocate budgets within these to provide services to a range of clinical areas. Little is known of how managers of allied health go about allocating these resources, the factors they consider when making these decisions, and the sources of information they rely upon. The purpose of this study was to identify the key factors that allied health consider when making resource allocation decisions and the sources of information they are based upon. Four forums were conducted each consisting of case studies, a large group discussion and two hypothetical scenarios to elicit data. A thematic content analysis commenced during post-forum discussions of key factors by forum facilitators. These factors were then presented to an expert working party for further discussion and refinement. Transcripts were generated of all data recordings and a detailed thematic analysis was undertaken by one author to ensure coded data matched the initial thematic analysis. Twelve factors affecting the decision-making of allied health managers and clinicians were identified. One of these factors was disendorsed by the expert working party. The 11 remaining factors can be considered to be key decision-making principles that should be consistently applied to resource allocation. These principles were clustered into three overarching themes of readiness, impact and appropriateness. Understanding these principles now means further research can be completed to more effectively integrate research evidence into health policy and service delivery, create partnerships among policy-makers, managers, service providers and researchers, and to provide support to answer difficult questions that policy-makers, managers and service providers

Designing evaluation studies to optimally inform policy: what factors do policy-makers in China consider when making resource allocation decisions on healthcare worker training programmes?

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Wu, Shishi; Legido-Quigley, Helena; Spencer, Julia; Coker, Richard James; Khan, Mishal Sameer

2018-02-23

In light of the gap in evidence to inform future resource allocation decisions about healthcare provider (HCP) training in low- and middle-income countries (LMICs), and the considerable donor investments being made towards training interventions, evaluation studies that are optimally designed to inform local policy-makers are needed. The aim of our study is to understand what features of HCP training evaluation studies are important for decision-making by policy-makers in LMICs. We investigate the extent to which evaluations based on the widely used Kirkpatrick model - focusing on direct outcomes of training, namely reaction of trainees, learning, behaviour change and improvements in programmatic health indicators - align with policy-makers' evidence needs for resource allocation decisions. We use China as a case study where resource allocation decisions about potential scale-up (using domestic funding) are being made about an externally funded pilot HCP training programme. Qualitative data were collected from high-level officials involved in resource allocation at the national and provincial level in China through ten face-to-face, in-depth interviews and two focus group discussions consisting of ten participants each. Data were analysed manually using an interpretive thematic analysis approach. Our study indicates that Chinese officials not only consider information about the direct outcomes of a training programme, as captured in the Kirkpatrick model, but also need information on the resources required to implement the training, the wider or indirect impacts of training, and the sustainability and scalability to other settings within the country. In addition to considering findings presented in evaluation studies, we found that Chinese policy-makers pay close attention to whether the evaluations were robust and to the composition of the evaluation team. Our qualitative study indicates that training programme evaluations that focus narrowly on direct training

Upending the social ecological model to guide health promotion efforts toward policy and environmental change.

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Golden, Shelley D; McLeroy, Kenneth R; Green, Lawrence W; Earp, Jo Anne L; Lieberman, Lisa D

2015-04-01

Efforts to change policies and the environments in which people live, work, and play have gained increasing attention over the past several decades. Yet health promotion frameworks that illustrate the complex processes that produce health-enhancing structural changes are limited. Building on the experiences of health educators, community activists, and community-based researchers described in this supplement and elsewhere, as well as several political, social, and behavioral science theories, we propose a new framework to organize our thinking about producing policy, environmental, and other structural changes. We build on the social ecological model, a framework widely employed in public health research and practice, by turning it inside out, placing health-related and other social policies and environments at the center, and conceptualizing the ways in which individuals, their social networks, and organized groups produce a community context that fosters healthy policy and environmental development. We conclude by describing how health promotion practitioners and researchers can foster structural change by (1) conveying the health and social relevance of policy and environmental change initiatives, (2) building partnerships to support them, and (3) promoting more equitable distributions of the resources necessary for people to meet their daily needs, control their lives, and freely participate in the public sphere. © 2015 Society for Public Health Education.

Efficient Attribute-Based Secure Data Sharing with Hidden Policies and Traceability in Mobile Health Networks

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Changhee Hahn

2016-01-01

Full Text Available Mobile health (also written as mHealth provisions the practice of public health supported by mobile devices. mHealth systems let patients and healthcare providers collect and share sensitive information, such as electronic and personal health records (EHRs at any time, allowing more rapid convergence to optimal treatment. Key to achieving this is securely sharing data by providing enhanced access control and reliability. Typically, such sharing follows policies that depend on patient and physician preferences defined by a set of attributes. In mHealth systems, not only the data but also the policies for sharing it may be sensitive since they directly contain sensitive information which can reveal the underlying data protected by the policy. Also, since the policies usually incur linearly increasing communication costs, mHealth is inapplicable to resource-constrained environments. Lastly, access privileges may be publicly known to users, so a malicious user could illegally share his access privileges without the risk of being traced. In this paper, we propose an efficient attribute-based secure data sharing scheme in mHealth. The proposed scheme guarantees a hidden policy, constant-sized ciphertexts, and traces, with security analyses. The computation cost to the user is reduced by delegating approximately 50% of the decryption operations to the more powerful storage systems.

Not on the radar: the impact of rural health realities on Canadian public policy and HHR migration from Sub-Saharan Africa.

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Kazanjian, Arminée; Apland, Lars E; Labonté, Ronald

2007-01-01

The policy environment of Health Human Resource (HHR) demands in rural and remote areas of Canada seems to compel health system planners either to ignore or only pay lip service to memoranda of understanding and other non-binding international agreements on ethical principles of recruitment. Despite common acknowledgement that the migration of health professionals from Sub-Saharan Africa (SSA) and the resultant loss of capacity to deliver health services are devastating for populations in that region, Canadian public policy consideration of the "brain drain" of health human resources from SSA seems cursory, at best. As a result, broadly based domestic HHR policies and international development policy objectives invariably seem to conflict and produce unsatisfactory results that continue to be detrimental to populations of source countries in the developing world, while doing little to alleviate the continued reliance of Canada's rural and remote "'gateways" on foreign-trained health professionals. A key challenge for Canadian public policy, at all levels of government, is to coordinate and find common ground, whereby brain drain issues and specific domestic Canadian HHR needs can be simultaneously and effectively addressed. This research explored the congruity between rural HHR policy principles and international development objectives in the context of federal, provincial, and territorial government relations in Canada.

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

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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

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

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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

State health policy for terrorism preparedness.

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Ziskin, Leah Z; Harris, Drew A

2007-09-01

State health policy for terrorism preparedness began before the terrorist attacks on September 11, 2001, but was accelerated after that day. In a crisis atmosphere after September 11, the states found their policies changing rapidly, greatly influenced by federal policies and federal dollars. In the 5 years since September 11, these state health policies have been refined. This refinement has included a restatement of the goals and objectives of state programs, the modernization of emergency powers statutes, the education and training of the public health workforce, and a preparation of the health care system to better care for victims of disasters, including acts of terrorism.

Pushing the boundaries of research on human resources for health: fresh approaches to understanding health worker motivation.

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Bhatnagar, Aarushi; Scott, Kerry; Govender, Veloshnee; George, Asha

2018-04-01

A country's health workforce plays a vital role not only in serving the health needs of the population but also in supporting economic prosperity. Moreover, a well-funded and well-supported health workforce is vital to achieving universal health coverage and Sustainable Development Goal 3 to ensure healthy lives and promote well-being for all at all ages. This perspective article highlights the potential of underutilized health policy and systems research (HPSR) approaches for developing more effective human resources for health policy. The example of health worker motivation is used to showcase four types of HPSR (exploratory, influence, explanatory and emancipatory) that move beyond describing the extent of a problem. Most of the current literature aiming to understand determinants and dynamics of motivation is descriptive in nature. While this is an important basis for all research pursuits, it often gives little information about mechanisms to improve motivation and strategies for intervention. Motivation is an essential determinant of health worker performance, particularly for those working in difficult conditions, such as those facing many health workers in low- and middle-income countries. Motivation mediates health workforce performance in multiple ways: internally governing health worker behaviour; informing decisions on becoming a health worker; workplace location and ability to perform; and influencing willingness to engage politically. The four fresh research approaches described can help policy-makers better understand why health workers behave the way they do, how interventions can improve performance, the mechanisms that lead to change, and strategies for empowering health workers to be agents of change themselves.

[Research on social determinants of health and health inequalities: evidence for health in all policies].

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Borrell, Carme; Malmusi, Davide

2010-12-01

This article aims to review conceptual frameworks and some principles to be considered in research on social determinants of health and health inequalities. Some indicators of research on these issues in Spain are described. General expenditure on research and development in Spain is far from the Organisation for Economic Co-operation and Development mean. In addition, both globally and within Spain, the scientific production on health inequalities is very low, especially compared with other research areas. The budget for research on health inequalities is also reduced. A striking example is provided by analysis of the projects funded by the Marató de TV3, which seems to have little interest in funding research on health inequalities. However, both the scientific production and project financing on health inequalities have increased in the last decade. Finally, to advance research on health inequalities and its contribution to the incorporation of health in all policies, recommendations are made, which include redefining priorities, ensuring resources and promoting knowledge translation. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

Governance and human resources for health

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Dieleman Marjolein

2011-11-01

Full Text Available Abstract Despite an increase in efforts to address shortage and performance of Human Resources for Health (HRH, HRH problems continue to hamper quality service delivery. We believe that the influence of governance is undervalued in addressing the HRH crisis, both globally and at country level. This thematic series has aimed to expand the evidence base on the role of governance in addressing the HRH crisis. The six articles comprising the series present a range of experiences. The articles report on governance in relation to developing a joint vision, building adherence and strengthening accountability, and on governance with respect to planning, implementation, and monitoring. Other governance issues warrant attention as well, such as corruption and transparency in decision-making in HRH policies and strategies. Acknowledging and dealing with governance should be part and parcel of HRH planning and implementation. To date, few experiences have been shared on improving governance for HRH policy making and implementation, and many questions remain unanswered. There is an urgent need to document experiences and for mutual learning.

Governance and human resources for health.

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Dieleman, Marjolein; Hilhorst, Thea

2011-11-24

Despite an increase in efforts to address shortage and performance of Human Resources for Health (HRH), HRH problems continue to hamper quality service delivery. We believe that the influence of governance is undervalued in addressing the HRH crisis, both globally and at country level. This thematic series has aimed to expand the evidence base on the role of governance in addressing the HRH crisis. The six articles comprising the series present a range of experiences. The articles report on governance in relation to developing a joint vision, building adherence and strengthening accountability, and on governance with respect to planning, implementation, and monitoring. Other governance issues warrant attention as well, such as corruption and transparency in decision-making in HRH policies and strategies. Acknowledging and dealing with governance should be part and parcel of HRH planning and implementation. To date, few experiences have been shared on improving governance for HRH policy making and implementation, and many questions remain unanswered. There is an urgent need to document experiences and for mutual learning.

Building policy capacities: an interactive approach for linking knowledge to action in health promotion.

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Rütten, Alfred; Gelius, Peter

2014-09-01

This article outlines a theoretical framework for an interactive, research-driven approach to building policy capacities in health promotion. First, it illustrates how two important issues in the recent public health debate, capacity building and linking scientific knowledge to policy action, are connected to each other theoretically. It then introduces an international study on an interactive approach to capacity building in health promotion policy. The approach combines the ADEPT model of policy capacities with a co-operative planning process to foster the exchange of knowledge between policy-makers and researchers, thus improving intra- and inter-organizational capacities. A regional-level physical activity promotion project involving governmental and public-law institutions, NGOs and university researchers serves as a case study to illustrate the potential of the approach for capacity building. Analysis and comparison with a similar local-level project indicate that the approach provides an effective means of linking scientific knowledge to policy action and to planning concrete measures for capacity building in health promotion, but that it requires sufficiently long timelines and adequate resources to achieve adequate implementation and sustainability. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A microeconomic perspective on the role of efficiency and equity criteria in designing natural resource policy

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Geoff Kaine

2017-03-01

Full Text Available Deliberating on policy design to manage natural resources with clarity and precision is a difficult task, even for professional and highly experienced policy practitioners. These difficulties are exacerbated by confounding the crafting of policy instruments to change resource use (a behavioral matter related to resource management with the consequential issue of who bears the cost of changing resource use (an equity matter. The confounding of behavioral and equity issues is not surprising because equity is commonly suggested as a criterion in the literature on policy instrument choice, and inequity in access to resources may also be one of the initial drivers of policy intervention. Here, we restate the microeconomic analysis of "open access" resources and highlight the fundamental difference between efficiency (including allocative inefficiency and equity that emerges from that analysis. We then discuss the implications of this difference for the choice of policy instruments to resolve problems in natural resource management, at least for instruments that entail changing the behavior of primary producers. This discussion is centered on three key decisions for formulating policy: (1 choosing the preferred portfolio of uses for a natural resource, (2 choosing a policy instrument to change that portfolio, and (3 choosing a mechanism to distribute the costs of change fairly. To illustrate how these decisions may play out in a real-world example, we apply the decisions to a freshwater policy process in New Zealand. By articulating the distinction, microeconomics draws distinctions between efficiency and equity as policy objectives. Linking that distinction with the Tinbergen's principle regarding the matching of instruments to objectives, we aim to reduce the conflation of the decision-making criteria employed in policy formulation decisions. In doing so, we hope to assist policy makers to avoid policy failure by reducing the potential for the

Funds from non-renewable energy resources: Policy lessons from Alaska and Alberta

International Nuclear Information System (INIS)

Baena, César; Sévi, Benoît; Warrack, Allan

2012-01-01

We document the use of energy natural resource funds in Alaska and Alberta and analyze theirs characteristics for further implementation in resource-rich countries. Such funds allow dealing theoretically with intergenerational equity issues, corruption, and more general institutional problems. The performance of both funds is very different, depending on the management and composition choices but some policy lessons can be drawn from these two examples. Importantly, the role of a public dividend policy is highlighted as a way to bypass corrupted institutions and to enhance quality of life for poorest people. We also emphasize the need to deal with inflation to make the fund sustainable. - Highlights: ► We document the optimal intergenerational energy resource management using funds. ► We use Alaskan and Albertan experiences to provide policy lessons for future implementation of such funds. ► We emphasize the role of a public dividend policy

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

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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. © 2016 by Kerman University of Medical Sciences.

Strengthening human resources for health through information, coordination and accountability mechanisms: the case of the Sudan.

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Badr, Elsheikh; Mohamed, Nazar A; Afzal, Muhammad Mahmood; Bile, Khalif Mohamud

2013-11-01

Human resources for health (HRH) in the Sudan were limited by shortages and the maldistribution of health workers, poor management, service fragmentation, poor retention of health workers in rural areas, and a weak health information system. A "country coordination and facilitation" process was implemented to strengthen the national HRH observatory, provide a coordination platform for key stakeholders, catalyse policy support and HRH planning, harmonize the mobilization of resources, strengthen HRH managerial structures, establish new training institutions and scale up the training of community health workers. The national government of the Sudan sanctioned state-level governance of the health system but many states lacked coherent HRH plans and policies. A paucity of training institutions constrained HRH production and the adequate and equitable deployment of health workers in rural areas. The country coordination and facilitation process prompted the establishment of a robust HRH information system and the development of the technical capacities and tools necessary for data analysis and evidence-based participatory decision-making and action. The success of the country coordination and facilitation process was substantiated by the stakeholders' coordinated support, which was built on solid evidence of the challenges in HRH and shared accountability in the planning and implementation of responses to those challenges. The support led to political commitment and the mobilization of resources for HRH. The leadership that was promoted and the educational institutions that were opened should facilitate the training, deployment and retention of the health workers needed to achieve universal health coverage.

Human nutrition and adaptation in Brazilian Amazon fishing areas: contributions to health policies

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Gilberto Ferreira de Souza Aguiar

2006-08-01

Full Text Available The search for equity in access to services is presently an important principle in public policies for health in Brazil. Social inequalities in the Amazonia occur at high levels comparatively to the other regions in the country; and, within Amazonia, they particularly affect rural communities. The present study aims to appreciate associations between food and nutritional profile, adaptive strategies, and epidemiology in these communities, specially in areas of artisanal fishery, and also to suggest general lines of appropriated health policies. The construction of a context of equitable assistance and of sustainable health, without significant damage to biodiversity, depends on the capacity of public power in exploring the relationships between use and management of natural resources and the quality of life of riverine man.

Searching for sustainability within public health policy: insights from an injury prevention perspective.

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Errington, Gail; Evans, Catrin; Watson, Michael C

2017-04-01

Sustaining public health programmes in the long-term is key to ensuring full manifestation of their intended benefits. Although an increasing interest in sustainability is apparent within the global literature, empirical studies from within the European setting are few. The factors that influence sustainability are generally conceptualized at three levels: programme level, the immediate context and the wider environment. To-date attention has focused primarily on the former two. Using a community-based child injury prevention programme in England as an exemplar, this paper explores the concept of sustainability within the wider policy environment, and considers the impact of this on local programmes. A content review of global and UK national public health policies (1981-2014) relevant to child safety was undertaken. Interviews were held with senior representatives of global and UK agencies involved in developing child safety policy. Forty-nine policies were reviewed. The term 'sustain', or its derivatives, featured in 36 (73%) of these. Its' use however, related primarily to conservation of resources rather than continued programme operation. Potential mechanisms for supporting programme sustainability featured within some documents; however, the approach to sustainability was inconsistent between policies and over time. Policy stakeholders identified programme sustainability as relevant to their core business, but its' conceptualization varied according to individual interpretation. Programme sustainability is poorly addressed within global and UK-based public health policy. Strengthening a national and international policy focus on sustainability and incorporating sustainability into public health planning frameworks may create a more supportive environment for local programmes. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Common pathways toward informing policy and environmental strategies to promote health: a study of CDC's Prevention Research Centers.

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Neri, Elizabeth M; Stringer, Kate J; Spadaro, Antonia J; Ballman, Marie R; Grunbaum, Jo Anne

2015-03-01

This study examined the roles academic researchers can play to inform policy and environmental strategies that promote health and prevent disease. Prevention Research Centers (PRCs) engage in academic-community partnerships to conduct applied public health research. Interviews were used to collect data on the roles played by 32 PRCs to inform policy and environmental strategies that were implemented between September 2009 and September 2010. Descriptive statistics were calculated in SAS 9.2. A difference in roles played was observed depending on whether strategies were policy or environmental. Of the policy initiatives, the most common roles were education, research, and partnership. In contrast, the most prevalent roles the PRCs played in environmental approaches were research and providing health promotion resources. Academic research centers play various roles to help inform policy and environmental strategies. © 2014 Society for Public Health Education.

Current approaches to the European Health Policy

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Anda CURTA

2010-06-01

Full Text Available The purpose of this paper is to identify the key elements that define the new European health policy. We observed that the health policy actually appeared to be an enclave within the integration process. The development of health policy in the new Member States followed a common pattern. Therefore, the European health policy reflected a general desire on behalf of the members to have more clarity of the rules in this area, given the different interpretation of the rules by different Member States.The Lisbon Treaty does not bring substantive changes regarding the public health policy, therefore the Member States shall keep their competence in defining the organization and financing this domain. However, the EU2020 Strategy states that “Europe faces a moment of transformation”. Therefore, the “Europeanization” of health policy could lead to the positive developments that all EU citizens are expecting.

[Workplace health promotion in public health policies in Poland].

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Puchalski, Krzysztof; Korzeniowska, Elzbieta

2008-01-01

In this paper the author analyses how far in Poland the idea of workplace health promotion (WHP) does exist in the area of public health understood in its broadest sense. The analysis encapsulates the following issues: (a) the national legislative policy, (b) strategies, programs and projects concerning health issues launched or coordinated by the state or local administration, (c) grassroots initiatives for health promotion supported by local and regional administration, (d) civic projects or business strategies for health. In addition, the author emphasizes the marginalization of workplace health promotion and lack of cohesive policy in this field as well as, the fact that health problems of the working population arising from current demographic, technological, economic and social changes that could be dealt with through developing and implementing WHP projects are not yet fully perceived by public health policy makers.

The core determinants of health expenditure in the African context: some econometric evidence for policy.

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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 implications of country-specific elasticity estimates are given.

Developing and implementing mental health policy in Zanzibar, a low income country off the coast of East Africa

Directory of Open Access Journals (Sweden)

Suleiman Said

2011-02-01

Full Text Available Abstract Background The Zanzibar Ministry of Health and Social Welfare, concerned about mental health in the country, requested technical assistance from WHO in 1997. Aims This article describes the facilitation over many years by a WHO Collaborating Centre, of sustainable mental health developments in Zanzibar, one of the poorest countries in the world, using systematic approaches to policy design and implementation. Methods Based on intensive prior situation appraisal and consultation, a multi-faceted set of interventions combining situation appraisal to inform planning; sustained policy dialogue at Union and state levels; development of policy and legislation, development of strategic action plans, establishment of intersectoral national mental health implementation committee, establishment of national mental health coordination system, integration of mental health into primary care, strengthening of primary-secondary care liaison, rationalisation and strengthening of secondary care system, ensuring adequate supply of medicines, use of good practice guidelines and health information systems, development of services for people with intellectual disability, establishment of formal mechanism for close liaison between the mental health services and other governmental, non-governmental and traditional sectors, mental health promotion, suicide prevention, and research and development. Results The policy and legislation introduced in 1999 have resulted in enhanced mental health activities over the ensuing decade, within a setting of extreme low resource. However, advances ebb and flow and continued efforts are required to maintain progress and continue mental health developments. Lessons learnt have informed the development of mental health policies in neighbouring countries. Conclusions A multi-faceted and comprehensive programme can be effective in achieving considerable strengthening of mental health programmes and services even in extremely low

Public sector reform and demand for human resources for health (HRH

Directory of Open Access Journals (Sweden)

Lethbridge Jane

2004-11-01

Full Text Available Abstract This article considers some of the effects of health sector reform on human resources for health (HRH in developing countries and countries in transition by examining the effect of fiscal reform and the introduction of decentralisation and market mechanisms to the health sector. Fiscal reform results in pressure to measure the staff outputs of the health sector. Financial decentralisation often leads to hospitals becoming "corporatised" institutions, operating with business principles but remaining in the public sector. The introduction of market mechanisms often involves the formation of an internal market within the health sector and market testing of different functions with the private sector. This has immediate implications for the employment of health workers in the public sector, because the public sector may reduce its workforce if services are purchased from other sectors or may introduce more short-term and temporary employment contracts. Decentralisation of budgets and administrative functions can affect the health sector, often in negative ways, by reducing resources available and confusing lines of accountability for health workers. Governance and regulation of health care, when delivered by both public and private providers, require new systems of regulation. The increase in private sector provision has led health workers to move to the private sector. For those remaining in the public sector, there are often worsening working conditions, a lack of employment security and dismantling of collective bargaining agreements. Human resource development is gradually being recognised as crucial to future reforms and the formulation of health policy. New information systems at local and regional level will be needed to collect data on human resources. New employment arrangements, strengthening organisational culture, training and continuing education will also be needed.

Policy Capacity Meets Politics: Comment on "Health Reform Requires Policy Capacity".

Science.gov (United States)

Fafard, Patrick

2015-07-22

It is difficult to disagree with the general argument that successful health reform requires a significant degree of policy capacity or that all players in the policy game need to move beyond self-interested advocacy. However, an overly broad definition of policy capacity is a problem. More important perhaps, health reform inevitably requires not just policy capacity but political leadership and compromise. © 2015 by Kerman University of Medical Sciences.

Health imperatives in foreign policy: the case of Malaysia.

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Barraclough, Simon; Phua, Kai-Lit

2007-03-01

Malaysia's global, regional and bilateral international health relations are surveyed against the historical backdrop of the country's foreign policy. Malaysia has always participated in multilateral agencies, most notably the World Health Organization, as such agencies are part of the longstanding fabric of "good international citizenship". The threats of infectious diseases to human health and economic activity have caused an intensification and an organizational formalization of Malaysian health diplomacy, both regionally and bilaterally. Such diplomacy has also established a basis for developing a wider set of cooperative relationships that go beyond responding to the threat of pandemics. As Malaysia approaches "developed" status, its health sector is becoming increasingly integrated into the global economy through joint research and development ventures and transnational investment. At the same time, it will have the technological, financial and human resources to play an expanded altruistic role in global and regional health.

Development of evidence-based health policy documents in developing countries: a case of Iran.

Science.gov (United States)

Imani-Nasab, Mohammad Hasan; Seyedin, Hesam; Majdzadeh, Reza; Yazdizadeh, Bahareh; Salehi, Masoud

2014-02-07

Evidence-based policy documents that are well developed by senior civil servants and are timely available can reduce the barriers to evidence utilization by health policy makers. This study examined the barriers and facilitators in developing evidence-based health policy documents from the perspective of their producers in a developing country. In a qualitative study with a framework analysis approach, we conducted semi-structured interviews using purposive and snowball sampling. A qualitative analysis software (MAXQDA-10) was used to apply the codes and manage the data. This study was theory-based and the results were compared to exploratory studies about the factors influencing evidence-based health policy-making. 18 codes and three main themes of behavioral, normative, and control beliefs were identified. Factors that influence the development of evidence-based policy documents were identified by the participants: behavioral beliefs included quality of policy documents, use of resources, knowledge and innovation, being time-consuming and contextualization; normative beliefs included policy authorities, policymakers, policy administrators, and co-workers; and control beliefs included recruitment policy, performance management, empowerment, management stability, physical environment, access to evidence, policy making process, and effect of other factors. Most of the cited barriers to the development of evidence-based policy were related to control beliefs, i.e. barriers at the organizational and health system levels. This study identified the factors that influence the development of evidence-based policy documents based on the components of the theory of planned behavior. But in exploratory studies on evidence utilization by health policymakers, the identified factors were only related to control behaviors. This suggests that the theoretical approach may be preferable to the exploratory approach in identifying the barriers and facilitators of a behavior.

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

Policies of natural Resources Management and Environmental Economic Advantages - Attractions in Kosovo

Directory of Open Access Journals (Sweden)

Afrim Selimaj

2015-11-01

Full Text Available Ecosystem management is a recent alternative policy proposed by the Kosovo government to address a new generation of environmental issues. All Kosovo agency managements are currently exploring the concept of ecosystem management and their implications. Their activities are focused in the management of land and natural resources, by developing policy guidelines regarding the management of the ecosystem and the efforts undertaken that are only one layer of a larger phenomenon nationwide. Similar activities occur at the state and local levels, as well as within the NGO sector. In this sense, this paper addresses two questions: What is the policy of ecosystem management? Would Ecosystem management remain only a land management policy and resource?

Bridging Water Resources Policy and Environmental Engineering in the Classroom at Cornell University

Science.gov (United States)

Walter, M. T.; Shaw, S. B.; Seifert, S.; Schwarz, T.

2006-12-01

Current university undergraduate students in environmental sciences and engineering are the next generation of environmental protection practitioners. Recognizing this, Cornell's Biological and Environmental Engineering department has developed a popular class, Watershed Engineering (BEE 473), specifically designed to bridge the too-common gap between water resources policy and state-of-art science and technology. Weekly homework assignments are to design real-life solutions to actual water resources problems, often with the objective of applying storm water policies to local situations. Where appropriate, usually in conjunction with recent amendments to the Federal Clean Water Act, this course introduces water resource protection tools and concepts developed in the Cornell Soil and Water Lab. Here we present several examples of how we build bridges between university classrooms and the complex world of water resources policy.

A case study exploring the ethical and policy dimensions of allocating acute care resources to a dying patient.

Science.gov (United States)

Cooke, Mary; Hurley, Ciarán

2008-05-01

We aimed to identify policy, process and ethical issues related to allocation of National Health Service resources when patients with end-of-life illness are referred to acute care services. Sharing healthcare decisions denotes a different partnership between professionals and patients when patients are empowered to define their needs. Implementation of a transition from professional to patient decision-making appears to be dependent upon its interpretation by personnel delivering care using the local trust policy. The outcome of this is a reformation of responsibility for budget allocation, choice of acute care provider and selecting services, currently in the realm of primary care; be it the general practitioner, community practitioners, or the patient. We used a 'lens' approach to case study analysis in which the lens is constructed of a model of policy analysis and four principles of biomedical ethics. A patient's decision to decline care proposed by an Accident and Emergency department nurse and the nurse's response to that decision expose a policy that restricts the use of ambulance transport and with that, flexibility in responses to patients' decisions. End-of-life care partnership decisions require sensitivity and flexibility from all healthcare practitioners. We found that policy-based systems currently used to deliver care across the primary care - hospital care border are far from seamless and can lead to foreseeable problems. Health professionals responsible for the care of a patient at the end of life should consider the holistic outcomes of resource allocation decisions for patients. Government and health professional agenda suggest that patients should be given a greater element of control over their healthcare than has historically been the case. When patients take responsibility for their decisions, healthcare personnel should recognize that this signals a shift in the nature of the professional-patient relationship to one of partnership.

Development of Evidence-Based Health Policy Documents in Developing Countries: A Case of Iran

Science.gov (United States)

Imani-Nasab, Mohammad Hasan; Seyedin, Hesam; Majdzadeh, Reza; Yazdizadeh, Bahareh; Salehi, Masoud

2014-01-01

Background: Evidence-based policy documents that are well developed by senior civil servants and are timely available can reduce the barriers to evidence utilization by health policy makers. This study examined the barriers and facilitators in developing evidence-based health policy documents from the perspective of their producers in a developing country. Methods: In a qualitative study with a framework analysis approach, we conducted semi-structured interviews using purposive and snowball sampling. A qualitative analysis software (MAXQDA-10) was used to apply the codes and manage the data. This study was theory-based and the results were compared to exploratory studies about the factors influencing evidence-based health policymaking. Results: 18 codes and three main themes of behavioral, normative, and control beliefs were identified. Factors that influence the development of evidence-based policy documents were identified by the participants: behavioral beliefs included quality of policy documents, use of resources, knowledge and innovation, being time-consuming and contextualization; normative beliefs included policy authorities, policymakers, policy administrators, and co-workers; and control beliefs included recruitment policy, performance management, empowerment, management stability, physical environment, access to evidence, policy making process, and effect of other factors. Conclusion: Most of the cited barriers to the development of evidence-based policy were related to control beliefs, i.e. barriers at the organizational and health system levels. This study identified the factors that influence the development of evidence-based policy documents based on the components of the theory of planned behavior. But in exploratory studies on evidence utilization by health policymakers, the identified factors were only related to control behaviors. This suggests that the theoretical approach may be preferable to the exploratory approach in identifying the barriers

The complex remuneration of human resources for health in low-income settings: policy implications and a research agenda for designing effective financial incentives.

Science.gov (United States)

Bertone, Maria Paola; Witter, Sophie

2015-07-28

Human resources for health represent an essential component of health systems and play a key role to accelerate progress towards universal health coverage. Many countries in sub-Saharan Africa face challenges regarding the availability, distribution and performance of health workers, which could be in part addressed by providing effective financial incentives. Based on an overview of the existing literature, the paper highlights the gaps in the existing research in low-income countries exploring the different components of health workers' incomes. It then proposes a novel approach to the analysis of financial incentives and delineates a research agenda, which could contribute to shed light on this topic. The article finds that, while there is ample research that investigates separately each of the incomes health workers may earn (for example, salary, fee-for-service payments, informal incomes, "top-ups" and per diems, dual practice and non-health activities), there is a dearth of studies which look at the health workers' "complex remuneration", that is, the whole of the financial incentives available. Little research exists which analyses simultaneously all revenues of health workers, quantifies the overall remuneration and explores its complexity, its multiple components and their features, as well as the possible interaction between income components. However, such a comprehensive approach is essential to fully comprehend health workers' incentives, by investigating the causes (at individual and system level) of the fragmentation in the income structure and the variability in income levels, as well as the consequences of the "complex remuneration" on motivation and performance. This proposition has important policy implications in terms of devising effective incentive packages as it calls for an active consideration of the role that "complex remuneration" plays in determining recruitment, retention and motivation patterns, as well as, more broadly, the

Agricultural policy, food policy, and communicable disease policy.

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Grant, Wyn

2012-12-01

Food and agricultural policy is an essential element of a communicable disease policy. The European Union has developed a more systematic and broadly based interest in questions of food safety and animal health and welfare linked to modernization of the Common Agricultural Policy, reflected in a new treaty obligation on animal welfare. Following the bovine spongiform encephalopathy crisis, moves were made to create a European competency, but implementation and enforcement resources reside with the member states. The European Animal Health Strategy is meant to lead to an EU animal health law, but this has already been constrained by fiscal austerity. The development of such a law may lead to a lowest common denominator formula that does little to enhance consumer protection or improve animal welfare. This is an inherent risk with top-down forms of Europeanization; more attention should be paid to lessons to be learned from bottom-up initiatives of the type used to counteract the bovine diarrhea virus. There will always be a tension among what is good policy for reducing the incidence of communicable disease, policy that is popular with EU citizens, and policy that is acceptable to member states.

Improving the implementation of health workforce policies through governance : a review of case studies

NARCIS (Netherlands)

Dieleman, Marjolein; Shaw, Daniel Mp; Zwanikken, Prisca A C

2011-01-01

INTRODUCTION: Responsible governance is crucial to national development and a catalyst for achieving the Millennium Development Goals. To date, governance seems to have been a neglected issue in the field of human resources for health (HRH), which could be an important reason why HRH policy

Improving the implementation of health workforce policies through governance: a review of case studies

NARCIS (Netherlands)

Dieleman, M.; Shaw, D.M.P.; Zwanikken, P.

2011-01-01

Introduction: Responsible governance is crucial to national development and a catalyst for achieving the Millennium Development Goals. To date, governance seems to have been a neglected issue in the field of human resources for health (HRH), which could be an important reason why HRH policy

Human resource solutions--the Gateway Paper proposed health reforms in Pakistan.

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Nishtar, Sania

2006-12-01

The existence of appropriate institutional and human resource capacity underpins the viability and sustainability of a health reform process within a country. Building human resource capacity within the health sector involves building the capacity of health service providers, health managers and administers as well as the stewards of health. Although capacity building is linked to a generic process closely linked to the broader economic, social and developmental context, it has specific health system connotations which should be the focus of a concerted effort. These include quantitative issues, in-effective deployment and brain-drain, qualitative considerations which stem from gaps in the quality of undergraduate as well as discrepancies in the content and format of training and absence of this in service of training health professionals and gaps in regulation. As one of the fundamental corner stones of health reform the Gateway Paper calls attention to the need to avert these issues with the development of a well-defined policy in human resource development as an entry point. This should be based on an analysis of the human resource need and should clearly define career structures for all categories of healthcare providers, and articulate the mechanisms of their effective deployment. Creating a conducive an rewarding environment, institutionalizing personnel management reform which go beyond personnel actions and set standards of performance, and develop appropriate incentives around this, would be critical. It would also be important to pay due attention to the content and format of training at an undergraduate level, at a postgraduate level and with reference to ongoing education and the allied roles of continuing medical education programs and accreditation of health systems educational institutions. The Gateway Paper also lays stress on effective regulation to curb the practice of quackery.

Women, men and public health-how the choice of normative theory affects resource allocation.

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Månsdotter, Anna; Lindholm, Lars; Ohman, Ann

2004-09-01

Women live longer than men in almost all countries, but men are more privileged in terms of power, influence, resources and probably morbidity. This investigation aims at illustrating how the choice of normative framework affects judgements about the fairness in these sex differences, and about desired societal change. The selected theories are welfare economics, health sector extra-welfarism, justice as fairness and feminist justice. By means of five Swedish proposals aiming at improving the population's health or "sex equity", facts and values are applied to resource allocation. Although we do not claim a specific ethical foundation, it seems to us that the feminist criterion has great potential in public health policy. The overall conclusion is that the normative framework must be explicitly discussed and stated in issues of women's and men's health.

Health service planning contributes to policy dialogue around strengthening district health systems: an example from DR Congo 2008-2013.

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Rajan, Dheepa; Kalambay, Hyppolite; Mossoko, Mathias; Kwete, Dieudonné; Bulakali, Joseph; Lokonga, Jean-Pierre; Porignon, Denis; Schmets, Gerard

2014-10-31

This case study from DR Congo demonstrates how rational operational planning based on a health systems strengthening strategy (HSSS) can contribute to policy dialogue over several years. It explores the operationalization of a national strategy at district level by elucidating a normative model district resource plan which details the resources and costs of providing an essential health services package at district level. This paper then points to concrete examples of how the results of this exercise were used for Ministry of Health (MoH) decision-making over a time period of 5 years. DR Congo's HSSS and its accompanying essential health services package were taken as a base to construct a normative model health district comprising of 10 Health Centres (HC) and 1 District Hospital (DH). The normative model health district represents a standard set by the Ministry of Health for providing essential primary health care services. The minimum operating budget necessary to run a normative model health district is $17.91 per inhabitant per year, of which $11.86 is for the district hospital and $6.05 for the health centre. The Ministry of Health has employed the results of this exercise in 4 principal ways: 1.Advocacy and negotiation instrument; 2. Instrument to align donors; 3. Field planning; 4. Costing database to extract data from when necessary. The above results have been key in the policy dialogue on affordability of the essential health services package in DR Congo. It has allowed the MoH to provide transparent information on financing needs around the HSSS; it continues to help the MoH negotiate with the Ministry of Finance and bring partner support behind the HSSS.

A difficult balancing act: policy actors' perspectives on using economic evaluation to inform health-care coverage decisions under the Universal Health Insurance Coverage scheme in Thailand.

Science.gov (United States)

Teerawattananon, Yot; Russell, Steve

2008-03-01

In Thailand, policymakers have come under increasing pressure to use economic evaluation to inform health-care resource allocation decisions, especially after the introduction of the Universal Health Insurance Coverage (UC) scheme. This article presents qualitative findings from research that assessed a range of policymakers' perspectives on the acceptability of using economic evaluation for the development of health-care benefit packages in Thailand. The policy analysis examined their opinions about existing decision-making processes for including health interventions in the UC benefit package, their understanding of health economic evaluation, and their attitudes, acceptance, and values relating to the use of the method. Semistructured interviews were conducted with 36 policy actors who play a major role or have some input into health resource allocation decisions within the Thai health-care system. These included 14 senior policymakers at the national level, 5 hospital directors, 10 health professionals, and 7 academics. Policy actors thought that economic evaluation information was relevant for decision-making because of the increasing need for rationing and more transparent criteria for making UC coverage decisions. Nevertheless, they raised several difficulties with using economic evaluation that would pose barriers to its introduction, including distrust in the method, conflicting philosophical positions and priorities compared to that of "health maximization," organizational allegiances, existing decision-making procedures that would be hard to change, and concerns about political pressure and acceptability.

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.

The new health policy

National Research Council Canada - National Science Library

Gauld, Robin

2009-01-01

... Gauld brings together in one volume a comprehensive picture of the health policy challenges facing contemporary developed world health systems, as well as the strategies for tackling these. Individual chapters analyze: Challenges in health care funding and organization Quality and patient safety The application of information te...

[Connections between fiscal federalism and the funding of the Brazilian health care policy].

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de Lima, Luciana Dias

2007-01-01

In the Brazilian society's context of meager financial resources for health care, associated with structural features of fiscal federalism and with the current model of funding transfers for the Unified Health System's (SUS), important inequities directly impact political negotiations and the deployment of federal financing alternatives which are not directly linked to the supply and production of health care activities and services by states and municipalities. We observed that health policies, since the second half of the nineties, have developed their own mechanisms that, in the above mentioned context, tend to accommodate different interests and federative conflicts generated by structural factors and by institutional rules. However, the absence of an integrated planning program between the criteria to establish resource redistribution for financing the Unified Health System and the Brazilian Federation's fiscal sharing system, end up reinforcing certain asymmetric patterns and generating new imbalances, making the compensation of inequities difficult in public health spending at the sub-national domain.

Align, share responsibility and collaborate: potential considerations to aid in e-health policy development.

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Ragaban, Nouran; Day, Karen; Orr, Martin

2012-01-01

Policies that support strategic development and implementation are related to health ICT implementation successes. This research aimed to explore the question, 'Why have we not seen more successful ICT implementation in healthcare, and what does policy have to do with success?' Healthcare systems are faced with rising costs, increased prevalence of chronic diseases and diminishing resources. E-health initiatives have gained acceptance in addressing these crucial health sector issues. National governments and healthcare organisations are finding it necessary to have health Information and Communications Technology (ICT) systems in place. However, poorly developed health information policies, lack of a clear business plan and ineffective leadership contribute to failure of ICT implementation in healthcare. This study uses a Grounded Theory approach, in which a series of data gathering activities will be completed. The first author attended the Health Information Management & Systems Society (HIMSS) Policy Summit in the USA in 2011. Five Summit participants were approached individually and informally discussed the 'meaningful use' policy and how it influences ICT implementation in healthcare. Field notes were made and analysed for themes relating to the research question. There were three overlapping concepts that all of the participants indicated as primary considerations for policymakers. The alignment aspect stresses the need to align e-health initiatives with overall health policy, ensuring that e-health is incorporated with other healthcare investments. The shared responsibility theme involves the need for e-health initiatives to be recognised as a priority along all levels of government, i.e. local, state, federal, and national. This stresses the importance of health ICT development and implementation in a joint government direction. The last theme is collaboration with stakeholders, including clear division of tasks and clarity about technical and non

Policy Capacity Meets Politics; Comment on “Health Reform Requires Policy Capacity”

Directory of Open Access Journals (Sweden)

Patrick Fafard

2015-10-01

Full Text Available It is difficult to disagree with the general argument that successful health reform requires a significant degree of policy capacity or that all players in the policy game need to move beyond self-interested advocacy. However, an overly broad definition of policy capacity is a problem. More important perhaps, health reform inevitably requires not just policy capacity but political leadership and compromise.

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

The Role of Paradigm Analysis in the Development of Policies for a Resource Efficient Economy

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Robin Vanner

2016-07-01

Full Text Available Policy makers are often called upon to navigate between scientists’ urgent calls for long-term concerted action to reduce the environmental impacts due to resource use, and the public’s concerns over policies that threaten lifestyles or jobs. Against these political challenges, resource efficiency policy making is often a changeable and even chaotic process, which has fallen short of the political ambitions set by democratically elected governments. This article examines the importance of paradigms in understanding how the public collectively responds to new policy proposals, such as those developed within the project DYNAmic policy MiXes for absolute decoupling of environmental impact of EU resource use from economic growth (DYNAMIX. The resulting proposed approach provides a framework to understand how different concerns and worldviews converge within public discourse, potentially resulting in paradigm change. Thus an alternative perspective on how resource efficiency policy can be development is proposed, which envisages early policies to lay the ground for future far-reaching policies, by altering the underlying paradigm context in which the public receive and respond to policy. The article concludes by arguing that paradigm change is more likely if the policy is conceived, framed, designed, analyzed, presented, and evaluated from the worldview or paradigm pathway that it seeks to create (i.e., the destination paradigm.

Canadian uranium policy and resource appraisal

International Nuclear Information System (INIS)

Merlin, H.B.

1976-01-01

This paper reviews the history of uranium production in Canada, leading up to the turn-around from a buyer's to a seller's market in early 1974. The specific objectives of Canada's new uranium policy, announced in that year, are then spelled out and explained. The paper also describes the producing uranium deposits in Canada, the definition of uranium resources and projected production capacity. Finally, there is a section on the proposed laws governing non-resident ownership provisions in the industry. (author)

Participatory construction of the State Health Promotion Policy: a case from Minas Gerais, Brazil.

Science.gov (United States)

Campos, Daniela Souzalima; Turci, Maria Aparecida; Melo, Elza Machado de; Guerra, Vanessa de Almeida; Nascimento, Carolina Guimarães Marra; Moreira, Conceição Aparecida; Paschoal, Ellen Mendes; Beltrão, Nathalia Ribeiro Mota; Silva, Kleber Rangel

2017-12-01

Minas Gerais started the development of the Minas Gerais Health Promotion Policy (POEPS-MG) based on the review of the National Health Promotion Policy (PNPS). This is a case report based on the documentary analysis of the material produced in the 38 workshops with a participation of 1.157 members across the State. The first workshop was intrasectoral and took place at the State Health Secretariat (SDH-MG). The second was an intersectoral workshop with the participation of several State Health Secretariats of Minas Gerais. The final workshop counted on the participation of State Regional Technical References. Another 35 workshops were developed in the 28 State Regional Administrations. Results were systematized and consolidated from the Analytical Matrix used in the PNPS, generating the base document of the POEPS-MG. It is important to highlight that, the specific regional requirements identified during the Policy's construction process reinforce the enriching moments of developing in an innovative, democratic and participative way actions that may provide some meanings to Health Promotion in the State of Minas Gerais. The State Policy seeks to bring life to the PNPS, adapting it to the reality of the territory and strengthening it - with the assurance of budgetary resources.

The social relations of health care and household resource allocation in neoliberal Nicaragua

Directory of Open Access Journals (Sweden)

Tesler Laura E

2010-05-01

Full Text Available Abstract Background With the transition to neoliberalism, Nicaragua's once-critically acclaimed health care services have substantially diminished. Local level social formations have been under pressure to try to bridge gaps as the state's role in the provision of health care and other vital social services has decreased. This paper presents a case study of how global and national health policies reverberated in the social relations of an extended network of female kin in a rural community during late 2002 - 2003. Methods The qualitative methods used in this ethnographic study included semi-structured interviews completed during bi-weekly visits to 51 households, background interviews with 20 lay and professional health practitioners working in the public and private sectors, and participant-observation conducted in the region's government health centers. Interviews and observational field notes were manually coded and iteratively reviewed to identify and conceptually organize emergent themes. Three households of extended kin were selected from the larger sample to examine as a case study. Results The ongoing erosion of vital services formerly provided by the public sector generated considerable frustration and tension among households, networks of extended kin, and neighbors. As resource allocations for health care seeking and other needs were negotiated within and across households, longstanding ideals of reciprocal exchange persisted, but in conditions of poverty, expectations were often unfulfilled, exposing the tension between the need for social support, versus the increasingly oppositional positioning of social network members as sources of competition for limited resources. Conclusions In compliance with neoliberal structural adjustment policies mandated by multilateral and bilateral agencies, government-provided health care services have been severely restricted in Nicaragua. As the national safety net for health care has been eroded

The social relations of health care and household resource allocation in neoliberal Nicaragua

Science.gov (United States)

2010-01-01

Background With the transition to neoliberalism, Nicaragua's once-critically acclaimed health care services have substantially diminished. Local level social formations have been under pressure to try to bridge gaps as the state's role in the provision of health care and other vital social services has decreased. This paper presents a case study of how global and national health policies reverberated in the social relations of an extended network of female kin in a rural community during late 2002 - 2003. Methods The qualitative methods used in this ethnographic study included semi-structured interviews completed during bi-weekly visits to 51 households, background interviews with 20 lay and professional health practitioners working in the public and private sectors, and participant-observation conducted in the region's government health centers. Interviews and observational field notes were manually coded and iteratively reviewed to identify and conceptually organize emergent themes. Three households of extended kin were selected from the larger sample to examine as a case study. Results The ongoing erosion of vital services formerly provided by the public sector generated considerable frustration and tension among households, networks of extended kin, and neighbors. As resource allocations for health care seeking and other needs were negotiated within and across households, longstanding ideals of reciprocal exchange persisted, but in conditions of poverty, expectations were often unfulfilled, exposing the tension between the need for social support, versus the increasingly oppositional positioning of social network members as sources of competition for limited resources. Conclusions In compliance with neoliberal structural adjustment policies mandated by multilateral and bilateral agencies, government-provided health care services have been severely restricted in Nicaragua. As the national safety net for health care has been eroded, the viability of local level

The social relations of health care and household resource allocation in neoliberal Nicaragua.

Science.gov (United States)

Tesler, Laura E

2010-05-22

With the transition to neoliberalism, Nicaragua's once-critically acclaimed health care services have substantially diminished. Local level social formations have been under pressure to try to bridge gaps as the state's role in the provision of health care and other vital social services has decreased. This paper presents a case study of how global and national health policies reverberated in the social relations of an extended network of female kin in a rural community during late 2002 - 2003. The qualitative methods used in this ethnographic study included semi-structured interviews completed during bi-weekly visits to 51 households, background interviews with 20 lay and professional health practitioners working in the public and private sectors, and participant-observation conducted in the region's government health centers. Interviews and observational field notes were manually coded and iteratively reviewed to identify and conceptually organize emergent themes. Three households of extended kin were selected from the larger sample to examine as a case study. The ongoing erosion of vital services formerly provided by the public sector generated considerable frustration and tension among households, networks of extended kin, and neighbors. As resource allocations for health care seeking and other needs were negotiated within and across households, longstanding ideals of reciprocal exchange persisted, but in conditions of poverty, expectations were often unfulfilled, exposing the tension between the need for social support, versus the increasingly oppositional positioning of social network members as sources of competition for limited resources. In compliance with neoliberal structural adjustment policies mandated by multilateral and bilateral agencies, government-provided health care services have been severely restricted in Nicaragua. As the national safety net for health care has been eroded, the viability of local level social formations and their ability to

Public Health and International Drug Policy

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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

public resources on policies that do not demonstrably impede the functioning of drug markets, and they miss opportunities to invest public resources wisely in proven health services for people often too frightened to seek services. To move toward the balanced policy that UN member states have called for, we offer the following recommendations: Decriminalisation: Decriminalise minor, non-violent drug offenses – use, possession, and petty sale – and strengthen health and social-sector alternatives to criminal sanctions.Reducing violence and discrimination in policing: Reduce the violence and other harms of drug policing, including phasing out the use of military forces in drug policing, better targeting of policing on the most violent armed criminals, allowing possession of syringes, not targeting harm reduction services to boost arrest totals, and eliminating racial and ethnic discrimination in policing.Reducing harms: Ensure easy access for all who need them to harm reduction services as a part of responding to drugs, recognizing the effectiveness and cost-effectiveness of scaling up and sustaining these services. OST, NSP, supervised injection sites, and access to naloxone – brought to a scale adequate to meet demand – should all figure in health services and should include meaningful participation of PWUD in planning and implementation. Harm reduction services are crucial in prison and pretrial detention and should be scaled up in these settings. The 2016 UNGASS should do better than the UN Commission on Narcotic Drugs (CND) in naming harm reduction explicitly and endorsing its centrality to drug policy.Treatment and care for PWUD: Prioritize PWUD in treatment for HIV, HCV, TB, and ensure that services are adequate to ensure access for all who need care. Ensure availability of humane and scientifically sound treatment for drug dependence, including scaled-up OST in the community as well as in prisons, rejecting compulsory detention and abuse in the name of

Addressing the challenges to health sector decentralization in Nepal: an inquiry into the policy and implementation processes.

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Dhakal, R; Ratanawijitrasin, S; Srithamrongsawat, S

2009-09-01

The objective of the study was to analyze the status and explore the challenges to decentralization policy implementation in Nepal. Thirty seven key informants rich in experience and knowledge, seven focus group discussions, observation of six health facilities and analysis of about 25 key policy documents provided the data for this study. The study identified the challenges to the implementation of decentralization reforms in the public health sector as: (i) centralised and weak management and programming practices of the government; (ii) weak legal and institutional framework; (iii) conflicting policy objectives; (iv) lack of implementation strategy; (v) poor financial and human resource management system; (vi) lack of adequate preparation for managing the reform; (vii) weak capacity at all levels; (viii) political instability. It was revealed that the implementation of the policy in Nepal was extremely poor as many of the important policy measures were either never initiated or they were only partially implemented. The challenges lie both at - policy design and implementation phase. Clear policy objectives, appropriate structure, sound planning, financing and human resources policy, adequate capacity, responsive information system, defined service packages, active participation of stakeholders and a conducive socio-political environment are considered imperative for successful implementation of the policy. Preparation for managing reform implementation at national and district levels is prerequisite for decentralization to work. Pushing for decentralization in a politically fragile environment may rather lead to further fragmentation, instead of strengthening government legitimacy.

Unequal Gain of Equal Resources across Racial Groups

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Shervin Assari

2018-01-01

Full Text Available The health effects of economic resources (eg, education, employment, and living place and psychological assets (eg, self-efficacy, perceived control over life, anger control, and emotions are well-known. This article summarizes the results of a growing body of evidence documenting Blacks’ diminished return, defined as a systematically smaller health gain from economic resources and psychological assets for Blacks in comparison to Whites. Due to structural barriers that Blacks face in their daily lives, the very same resources and assets generate smaller health gain for Blacks compared to Whites. Even in the presence of equal access to resources and assets, such unequal health gain constantly generates a racial health gap between Blacks and Whites in the United States. In this paper, a number of public policies are recommended based on these findings. First and foremost, public policies should not merely focus on equalizing access to resources and assets, but also reduce the societal and structural barriers that hinder Blacks. Policy solutions should aim to reduce various manifestations of structural racism including but not limited to differential pay, residential segregation, lower quality of education, and crime in Black and urban communities. As income was not found to follow the same pattern demonstrated for other resources and assets (ie, income generated similar decline in risk of mortality for Whites and Blacks, policies that enforce equal income and increase minimum wage for marginalized populations are essential. Improving quality of education of youth and employability of young adults will enable Blacks to compete for high paying jobs. Policies that reduce racism and discrimination in the labor market are also needed. Without such policies, it will be very difficult, if not impossible, to eliminate the sustained racial health gap in the United States.

Right place of human resource management in the reform of health sector.

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Hassani, Seyed Abas; Mobaraki, Hossein; Bayat, Maboubeh; Mafimoradi, Shiva

2013-01-01

In this paper the real role and place of human resource (HR) in health system reform will be discussed and determined within the whole system through the comprehensive Human Resource Management (HRM) model. Delphi survey and a questionnaire were used to 1) collect HR manager ideas and comments and 2) identify the main challenges of HRM. Then the results were discussed in an expert panel after being analyzed by content analysis method. Also, a deep focus study of recorded documents related to Health Human Resource Management was done. Then based on all achieved results, a rich picture was drawn to illustrate the right place of HRM in health sector. Finally, the authors revitalize the missed function of HRM within the health sector by drawing a holistic conceptual model. The most percentage of frequency about HR belongs to "Lack of reliable HR information system" (91%) and the least percentage of frequency belongs to "Low responsibility of HR" (28%). The most percentage of frequency about HR manager belongs to "Inattention to HR managers as key managers and consider them in background" (80%) and the least percentage of frequency belongs to "Lack of coordination between universities' policies" (30%). According to the conceptual framework, human resources employed in health system are viewed from two comprehensive approaches: instrumental approach and institutional. Unlike the common belief that looks HRM through the supportive approach, it is discussed that HRM not only has an instrumental role, but also do have a driver role.

State Electricity Regulatory Policy and Distributed Resources: Distributed Resource Distribution Credit Pilot Programs--Revealing the Value to Consumers and Vendors

Energy Technology Data Exchange (ETDEWEB)

Moskovitz, D.; Harrington, C.; Shirley, W.; Cowart, R.; Sedano, R.; Weston, F.

2002-10-01

Designing and implementing credit-based pilot programs for distributed resources distribution is a low-cost, low-risk opportunity to find out how these resources can help defer or avoid costly electric power system (utility grid) distribution upgrades. This report describes implementation options for deaveraged distribution credits and distributed resource development zones. Developing workable programs implementing these policies can dramatically increase the deployment of distributed resources in ways that benefit distributed resource vendors, users, and distribution utilities. This report is one in the State Electricity Regulatory Policy and Distributed Resources series developed under contract to NREL (see Annual Technical Status Report of the Regulatory Assistance Project: September 2000-September 2001, NREL/SR-560-32733). Other titles in this series are: (1) Accommodating Distributed Resources in Wholesale Markets, NREL/SR-560-32497; (2) Distributed Resources and Electric System Re liability, NREL/SR-560-32498; (3) Distribution System Cost Methodologies for Distributed Generation, NREL/SR-560-32500; (4) Distribution System Cost Methodologies for Distributed Generation Appendices, NREL/SR-560-32501.

48 CFR 1552.211-79 - Compliance with EPA Policies for Information Resources Management.

Science.gov (United States)

2010-10-01

... Policies for Information Resources Management. 1552.211-79 Section 1552.211-79 Federal Acquisition... Information Resources Management (OCT 2000) (a) Definition. Information Resources Management (IRM) is defined... includes both information itself, and the management of information and related resources such as personnel...

Combining Ecosystem Service and Critical Load Concepts for Resource Management and Public Policy

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Timothy J. Sullivan

2012-11-01

Full Text Available Land management and natural resource public policy decision-making in the United States can benefit from two resource damage/recovery concepts: ecosystem service (ES and critical load (CL. The purpose of this paper is to suggest an integrated approach to the application of ES and CL principles for public land management and natural resource policy decision-making. One well known example that is appropriate for ES and CL evaluation is examined here: the acidification of soil and drainage water by atmospheric deposition of acidifying sulfur and nitrogen compounds. A conceptual framework illustrates how the ES and CL approaches can be combined in a way that enhances the strengths of each. This framework will aid in the process of translating ES and CL principles into land management and natural resource policy decision-making by documenting the impacts of pollution on environmental goods and services that benefit humans.

National health financing policy in Eritrea: a survey of preliminary considerations

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Kirigia Joses

2012-08-01

Full Text Available Abstract Background The 58th World Health Assembly and 56th WHO Regional Committee for Africa adopted resolutions urging Member States to ensure that health financing systems included a method for prepayment to foster financial risk sharing among the population and avoid catastrophic health-care expenditure. The Regional Committee asked countries to strengthen or develop comprehensive health financing policies. This paper presents the findings of a survey conducted among senior staff of selected Eritrean ministries and agencies to elicit views on some of the elements likely to be part of a national health financing policy. Methods This is a descriptive study. A questionnaire was prepared and sent to 19 senior staff (Directors in the Ministry of Health, Labour Department, Civil Service Administration, Eritrean Confederation of Workers, National Insurance Corporation of Eritrea and Ministry of Local Government. The respondents were selected by the Ministry of Health as key informants. Results The key findings were as follows: the response rate was 84.2% (16/19; 37.5% (6/16 and 18.8% said that the vision of Eritrean National Health Financing Policy (NHFP should include the phrases ‘equitable and accessible quality health services’ and ‘improve efficiency or reduce waste’ respectively; over 68% indicated that NHFP should include securing adequate funding, ensuring efficiency, ensuring equitable financial access, protection from financial catastrophe, and ensuring provider payment mechanisms create positive incentives to service providers; over 80% mentioned community participation, efficiency, transparency, country ownership, equity in access, and evidence-based decision making as core values of NHFP; over 62.5% confirmed that NHFP components should consist of stewardship (oversight, revenue collection, revenue pooling and risk management, resource allocation and purchasing of health services, health economics research, and development of

National health financing policy in Eritrea: a survey of preliminary considerations.

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Kirigia, Joses Muthuri; Zere, Eyob; Akazili, James

2012-08-28

The 58th World Health Assembly and 56th WHO Regional Committee for Africa adopted resolutions urging Member States to ensure that health financing systems included a method for prepayment to foster financial risk sharing among the population and avoid catastrophic health-care expenditure. The Regional Committee asked countries to strengthen or develop comprehensive health financing policies. This paper presents the findings of a survey conducted among senior staff of selected Eritrean ministries and agencies to elicit views on some of the elements likely to be part of a national health financing policy. This is a descriptive study. A questionnaire was prepared and sent to 19 senior staff (Directors) in the Ministry of Health, Labour Department, Civil Service Administration, Eritrean Confederation of Workers, National Insurance Corporation of Eritrea and Ministry of Local Government. The respondents were selected by the Ministry of Health as key informants. The key findings were as follows: the response rate was 84.2% (16/19); 37.5% (6/16) and 18.8% said that the vision of Eritrean National Health Financing Policy (NHFP) should include the phrases 'equitable and accessible quality health services' and 'improve efficiency or reduce waste' respectively; over 68% indicated that NHFP should include securing adequate funding, ensuring efficiency, ensuring equitable financial access, protection from financial catastrophe, and ensuring provider payment mechanisms create positive incentives to service providers; over 80% mentioned community participation, efficiency, transparency, country ownership, equity in access, and evidence-based decision making as core values of NHFP; over 62.5% confirmed that NHFP components should consist of stewardship (oversight), revenue collection, revenue pooling and risk management, resource allocation and purchasing of health services, health economics research, and development of human resources for health; over 68.8% indicated cost

Strategies to strengthen public health inputs to water policy in response to climate change: an Australian perspective.

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Goater, Sarah; Cook, Angus; Hogan, Anthony; Mengersen, Kerrie; Hieatt, Arron; Weinstein, Philip

2011-03-01

Under current climate change projections, the capacity to provide safe drinking water to Australian communities will be challenged. Part of this challenge is the lack of an adaptive governance strategy that transcends jurisdictional boundaries to support integrated policy making, regulation, or infrastructural adaptation. Consequently, some water-related health hazards may not be adequately captured or forecast under existing water resource management policies to ensure safe water supplies. Given the high degree of spatial and temporal variability in climate conditions experienced by Australian communities, new strategies for national health planning and prioritization for safe water supplies are warranted. The challenges facing public health in Australia will be to develop flexible and robust governance strategies that strengthen public health input to existing water policy, regulation, and surveillance infrastructure through proactive risk planning, adopting new technologies, and intersectoral collaborations. The proposed approach could assist policy makers avert or minimize risk to communities arising from changes in climate and water provisions both in Australia and in the wider Asia Pacific region.

Data Speak: Influencing School Health Policy through Research

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Ryberg, Jacalyn Wickline; Keller, Teresa; Hine, Beverly; Christeson, Elisabeth

2003-01-01

School nurses occupy a unique position in relation to school health policy. In addition to facing the demands of promoting and maintaining the health of students, they collect the information that is used to document the implementation of school health policy. Effective school health policy is guided by reliable, credible data regarding what…

Federalism and health policy.

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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.

BOOK REVIEW OPEN EDUCATIONAL RESOURCES: Policy, Costs and Transformation

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Can GULER

2016-10-01

Full Text Available This book presents 15 case studies contributed by researchers and policy makers. The Open Educational Resources (OER implementations are expressed through different point of views. This book focused on three themes: policy, costs and transformation. Policy theme is related to the establishment of priorities for supporting the decisions made by an institution or organization. Costs theme explores the funding of OER, particularly in the sense of cost effectiveness. Transformation theme provides examples that demonstrate how OER can be used in ways that go beyond replication of current teaching and learning models. The editors in the Introduction elaborately describe these three themes.

Meeting human resources for health staffing goals by 2018: a quantitative analysis of policy options in Zambia

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Schroder Kate

2010-06-01

Full Text Available Abstract Background The Ministry of Health (MOH in Zambia is currently operating with fewer than half of the health workers required to deliver basic health services. The MOH has developed a human resources for health (HRH strategic plan to address the crisis through improved training, hiring, and retention. However, the projected success of each strategy or combination of strategies is unclear. Methods We developed a model to forecast the size of the public sector health workforce in Zambia over the next ten years to identify a combination of interventions that would expand the workforce to meet staffing targets. The key forecasting variables are training enrolment, graduation rates, public sector entry rates for graduates, and attrition of workforce staff. We model, using Excel (Office, Microsoft; 2007, the effects of changes in these variables on the projected number of doctors, clinical officers, nurses and midwives in the public sector workforce in 2018. Results With no changes to current training, hiring, and attrition conditions, the total number of doctors, clinical officers, nurses, and midwives will increase from 44% to 59% of the minimum necessary staff by 2018. No combination of changes in staff retention, graduation rates, and public sector entry rates of graduates by 2010, without including training expansion, is sufficient to meet staffing targets by 2018 for any cadre except midwives. Training enrolment needs to increase by a factor of between three and thirteen for doctors, three and four for clinical officers, two and three for nurses, and one and two for midwives by 2010 to reach staffing targets by 2018. Necessary enrolment increases can be held to a minimum if the rates of retention, graduation, and public sector entry increase to 100% by 2010, but will need to increase if these rates remain at 2008 levels. Conclusions Meeting the minimum need for health workers in Zambia this decade will require an increase in health

Factors associated with job satisfaction among commune health workers: implications for human resource policies.

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Tran, Bach Xuan; Van Hoang, Minh; Nguyen, Hinh Duc

2013-01-30

Job satisfaction among health workers is an important indicator in assessing the performance and efficiency of health services. This study measured job satisfaction and determined associated factors among health workers in 38 commune health stations in an urban district and a rural district of Hanoi, Vietnam. A total of 252 health workers (36 medical doctors and 216 nurses and technicians; 74% female) were interviewed. A job satisfaction measure was developed using factor analysis, from which four dimensions emerged, namely 'benefits and prospects,' 'facility and equipment,' 'performance,' and 'professionals.' The results demonstrate that respondents were least satisfied with the following categories: salary and incentives (24.0%), benefit packages (25.1%), equipment (35.7%), and environment (41.8%). The average satisfaction score was moderate across four domains; it was the highest for 'performance' (66.6/100) and lowest for 'facility and equipment' (50.4/100). Tobit-censored regression models, constructed using stepwise selection, determined significant predictors of job satisfaction including age, areas of work and expertise, professional education, urban versus rural setting, and sufficient number of staff. The findings highlight the need to implement health policies that focus on incentives, working conditions, workloads, and personnel management at grassroots level.

Age bias, but no gender bias, in the intra-household resource allocation for health care in rural Burkina Faso.

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Sauerborn, R; Berman, P; Nougtara, A

1996-10-01

Household survey data, time allocation data, and qualitative interviews were used to examine whether households allocate their resources for health care differently between age and gender groups. Households allocated significantly fewer resources to the health care of sick children compared to that of sick adults. In contrast there were no such differences with regard to gender. The underlying household rationale is to concentrate its resources spent for health care on productive members rather than to spread them equitably among all its sick members. While children are not productive, women were shown to contribute as much to household production as men, hence their health is valued equally with that of men. Unless we understand intra-household biases in resource allocation, policies will be undermined. Further research is needed to test the hypothesis for the households' preference of production maintenance over health maximization.

The mental health system in Brazil: Policies and future challenges

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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

Systematic reviews addressing identified health policy priorities in Eastern Mediterranean countries: a situational analysis.

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El-Jardali, Fadi; Akl, Elie A; Karroum, Lama Bou; Kdouh, Ola; Akik, Chaza; Fadlallah, Racha; Hammoud, Rawan

2014-08-20

Systematic reviews can offer policymakers and stakeholders concise, transparent, and relevant evidence pertaining to pressing policy priorities to help inform the decision-making process. The production and the use of systematic reviews are specifically limited in the Eastern Mediterranean region. The extent to which published systematic reviews address policy priorities in the region is still unknown. This situational analysis exercise aims at assessing the extent to which published systematic reviews address policy priorities identified by policymakers and stakeholders in Eastern Mediterranean region countries. It also provides an overview about the state of systematic review production in the region and identifies knowledge gaps. We conducted a systematic search of the Health System Evidence database to identify published systematic reviews on policy-relevant priorities pertaining to the following themes: human resources for health, health financing, the role of the non-state sector, and access to medicine. Priorities were identified from two priority-setting exercises conducted in the region. We described the distribution of these systematic reviews across themes, sub-themes, authors' affiliations, and countries where included primary studies were conducted. Out of the 1,045 systematic reviews identified in Health System Evidence on selected themes, a total of 200 systematic reviews (19.1%) addressed the priorities from the Eastern Mediterranean region. The theme with the largest number of systematic reviews included was human resources for health (115) followed by health financing (33), access to medicine (27), and role of the non-state sector (25). Authors based in the region produced only three systematic reviews addressing regional priorities (1.5%). Furthermore, no systematic review focused on the Eastern Mediterranean region. Primary studies from the region had limited contribution to systematic reviews; 17 systematic reviews (8.5%) included primary

Systematic reviews addressing identified health policy priorities in Eastern Mediterranean countries: a situational analysis

Science.gov (United States)

2014-01-01

Background Systematic reviews can offer policymakers and stakeholders concise, transparent, and relevant evidence pertaining to pressing policy priorities to help inform the decision-making process. The production and the use of systematic reviews are specifically limited in the Eastern Mediterranean region. The extent to which published systematic reviews address policy priorities in the region is still unknown. This situational analysis exercise aims at assessing the extent to which published systematic reviews address policy priorities identified by policymakers and stakeholders in Eastern Mediterranean region countries. It also provides an overview about the state of systematic review production in the region and identifies knowledge gaps. Methods We conducted a systematic search of the Health System Evidence database to identify published systematic reviews on policy-relevant priorities pertaining to the following themes: human resources for health, health financing, the role of the non-state sector, and access to medicine. Priorities were identified from two priority-setting exercises conducted in the region. We described the distribution of these systematic reviews across themes, sub-themes, authors’ affiliations, and countries where included primary studies were conducted. Results Out of the 1,045 systematic reviews identified in Health System Evidence on selected themes, a total of 200 systematic reviews (19.1%) addressed the priorities from the Eastern Mediterranean region. The theme with the largest number of systematic reviews included was human resources for health (115) followed by health financing (33), access to medicine (27), and role of the non-state sector (25). Authors based in the region produced only three systematic reviews addressing regional priorities (1.5%). Furthermore, no systematic review focused on the Eastern Mediterranean region. Primary studies from the region had limited contribution to systematic reviews; 17 systematic reviews

Study of health human resource migration in India

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Panneer Sigamani

2015-01-01

Full Text Available Background Human Resource for Health (HRH migration is an emerging concern in the development paradigm due to the critical importance to sustainability of health system in India. Being the largest human resource supplier to the world, it is important to analyze the consequences of the migration of HRH in the delivery of healthcare services to the country’s population. The study evidences limited to examine the size, distribution of the existing human resources or trends or patterns in migration. The consequences of migration have its implications to the healthcare delivery mechanism which needed to be critically analyzed. Review Methodology The methodology adopted in the paper is descriptive design. The critical review used to evaluate the existing evidence and to develop conceptual framework. The process involved the setting of the inclusion and exclusion criteria to select the articles. It included wide range of articles from the world development reports to specific studies oriented on the HRH scenario of the country. The search strategy comprised both form of studies qualitative and quantitative. The study utilizes the official data set published as report form. Main Findings The data on the migration in context of India, not systematically updated in the existing evidences. The availability of data on migration limits to few reports i.e.(World Health Organization WHO’s Joint Learning Initiatives and studies which combines census data of Organization for Economic Cooperation and Development (OECD and results in the number of foreign born health professionals. 1. A major proportion of the research studies reviewed describes the disparity in distribution of HRH between rural-urban and public-private. Few researches focused towards the policy environment of the source and destination country for the migration. 2. There is pool of literature explaining the factors of migration but it margins when to analyze the significant implications to

Big Data: transforming drug development and health policy decision making.

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Alemayehu, Demissie; Berger, Marc L

The explosion of data sources, accompanied by the evolution of technology and analytical techniques, has created considerable challenges and opportunities for drug development and healthcare resource utilization. We present a systematic overview these phenomena, and suggest measures to be taken for effective integration of the new developments in the traditional medical research paradigm and health policy decision making. Special attention is paid to pertinent issues in emerging areas, including rare disease drug development, personalized medicine, Comparative Effectiveness Research, and privacy and confidentiality concerns.

Enhancing Evidence-Based Public Health Policy: Developing and Using Policy Narratives.

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Troy, Lisa M; Kietzman, Kathryn G

2016-06-01

Academic researchers and clinicians have a critical role in shaping public policies to improve the health of an aging America. Policy narratives that pair personal stories with research statistics are a powerful tool to share knowledge generated in academic and clinical settings with policymakers. Effective policy narratives rely on a trustworthy and competent narrator and a compelling story that highlights the personal impact of policies under consideration and academic research that bolsters the story. Awareness of the cultural differences in the motivations, expectations, and institutional constraints of academic researchers and clinicians as information producers and U.S. Congress and federal agencies as information users is critical to the development of policy narratives that impact policy decisions. The current article describes the development and use of policy narratives to bridge cultures and enhance evidence-based public health policies that better meet the needs of older adults. [Journal of Gerontological Nursing, 42(6), 11-17.]. Copyright 2016, SLACK Incorporated.

Policy silences: why Canada needs a National First Nations, Inuit and Métis health policy.

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Lavoie, Josée G

2013-12-27

Despite attempts, policy silences continue to create barriers to addressing the healthcare needs of First Nations, Inuit and Métis. The purpose of this article is to answer the question, if what we have in Canada is an Aboriginal health policy patchwork that fails to address inequities, then what would a Healthy Aboriginal Health Policy framework look like? The data collected included federal, provincial and territorial health policies and legislation that contain Aboriginal, First Nation, Inuit and/or Métis-specific provisions available on the internet. Key websites included the Parliamentary Library, federal, provincial and territorial health and Aboriginal websites, as well as the Department of Justice Canada, Statistics Canada and the Aboriginal Canada Portal. The Indian Act gives the Governor in Council the authority to make health regulations. The First Nations and Inuit Health Branch (FNIHB) of Health Canada historically provided health services to First Nations and Inuit, as a matter of policy. FNIHB's policies are few, and apply only to Status Indians and Inuit. Health legislation in 2 territories and 4 provinces contain no provision to clarify their responsibilities. In provinces where provisions exist, they broadly focus on jurisdiction. Few Aboriginal-specific policies and policy frameworks exist. Generally, these apply to some Aboriginal peoples and exclude others. Although some Aboriginal-specific provisions exist in some legislation, and some policies are in place, significant gaps and jurisdictional ambiguities remain. This policy patchwork perpetuates confusion. A national First Nation, Inuit and Métis policy framework is needed to address this issue.

76 FR 27649 - HIV/AIDS Bureau Policy Notice 11-01 (Replaces Policy Notice 99-02)

Science.gov (United States)

2011-05-12

... Bureau Policy Notice 11-01 (Replaces Policy Notice 99- 02) AGENCY: Health Resources and Services.../AIDS Bureau (HAB) Policy Notice 99-02 established policies for the use of Ryan White HIV/AIDS Program... and short-term or emergency housing needs. Amendment 1 to Policy Notice 99-02, effective March 27...

State health agencies and the legislative policy process.

Science.gov (United States)

Williams-Crowe, S M; Aultman, T V

1994-01-01

A new era of health care reform places increasing pressure on public health leaders and agencies to participate in the public policy arena. Public health professionals have long been comfortable in providing the scientific knowledge base required in policy development. What has been more recent in its evolution, however, is recognition that they must also play an active role in leading and shaping the debate over policy. A profile of effective State legislative policy "entrepreneurs" and their strategies has been developed to assist health agencies in developing such a leadership position. Based on the experiences of State legislative liaison officers, specific strategies for dealing with State legislatures have been identified and are organized into five key areas--agency organization, staff skills, communications, negotiation, and active ongoing involvement. A public health agency must be organized effectively to participate in the legislative policy process. Typically, effective agencies centralize responsibility for policy activities and promote broad and coordinated participation throughout the organization. Playing a key role in the agency's political interventions, the legislative liaison office should be staffed with persons possessing excellent interpersonal skills and a high degree of technical competence. Of central importance to effective legislative policy entrepreneurship is the ability to communicate the agency's position clearly. This includes setting forward a focused policy agenda, documenting policy issues in a meaningful manner, and reaching legislators with the proper information. Once a matter is on the legislative agenda, the agency must be prepared to negotiate and build broad support for the measure. Finally, public health agencies must be active policy players. To take advantage of new opportunities for action, the public health (policy) leader must monitor the political environment continually.By working to anticipate and formulate

Developing a Child and Youth Mental Health and Addictions Framework for Yukon as a Foundation for Policy Reform: Engaging Stakeholders Through a Policy and Research Partnership

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Gillian Mulvale

2016-09-01

Full Text Available In April 2015 the Yukon Government released a new child and youth mental health and addictions framework (CYMHAF to improve territory-wide access to basic mental health care and coordination of services for children and families. Yukon’s limited resource base and dispersed population challenges delivery of child and youth mental health and addictions services to small rural communities where needs are often high as a legacy of residential school policies. The objective of CYMHAF is to improve outcomes by identifying and capitalizing on current strengths, and reallocating existing resources to better meet the mental health needs of Yukon youth and families. Access, coordination and quality problems associated with existing services, growing public awareness of mental health issues, and a new national policy framework designed to assist provinces and territories, led Yukon policy makers to partner with researchers to capitalize on a Canadian Institutes of Health Research (CIHR strategic grant initiative. CYMHAF was based on extensive stakeholder engagement, best evidence and advice from key informants in other jurisdictions, and offers a cascading model of service delivery through which basic mental health care can be provided by existing health and human service workers in communities. These workers will be trained in child and youth mental health competencies, and will have electronic linkages and support to integrated teams of primary care providers who will be located in regional hubs once fully implemented, and to specialists in Whitehorse and out of Territory. Implementation is underway with some training of front line Health and Social Service and First Nations workers, a new mental wellness strategy for Yukon founded on CYMHAF scheduled for release in spring 2016, and may be accelerated by federal government promises of a new Health Accord and a new relationship with indigenous people.

Seven Foundational Principles of Population Health Policy.

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Bhattacharya, Dru; Bhatt, Jay

2017-10-01

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.

American Polonia’s Resources Of Ifluence And Us Foreign Policy

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I. D. Loshkariov

2017-01-01

Full Text Available The article analyzes resources of political influence on the foreign policy of the country of residence that Polish diaspora in the United States possesses. This analysis is useful for two reasons. Firstly, it will expand the focus of research in the study of pressure groups and their influence on the American foreign policy. Secondly, the Polish diaspora in the United States is rarely the object of research in migrant and ethnic lobbying, despite its the significant share of the country’s population. Analysis of the given resources that the Polish diaspora (American Polonia has leads to the following. Firstly, the foreign policy agenda of the Polish diaspora in the United States faces no strong opponents. This fact means the diaspora has sufficiently developed structural resource. In addition, the Polish diaspora possesses an organizational resource: its institutions are in close cooperation and are coordinated by the Polish American Congress. Secondly, the Polish diaspora in the US is a significant group of the population, especially in the states of Wisconsin, Michigan, Connecticut, New York and Illinois. However, its electoral and financial capacities are not used to the fullest extent. Finally, there are certain difficulties with the discursive political resource of Polish diaspora. The social and political perception provides of Polonia in the USA two opposing narratives. The first one stresses that it is important for the Americans of Polish descent to share such values as democracy, defending his position, including by military means. The second narrative is a reproduction of widespread stereotypes about Poles, including in the popular culture. Thus, institutions of the American Polonia face several tasks. The most important tasks are the search for new ways of political mobilization of the diaspora and the formation of a balanced image of Polish Americans in the social and political perception in the United States.

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

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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.

Promoting Health Through Policy and Systems Change: Public Health Students and Mentors on the Value of Policy Advocacy Experience in Academic Internships.

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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.

Sociopolitical determinants of international health policy.

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De Vos, Pol; Van der Stuyft, Patrick

2015-01-01

For decades, two opposing logics have dominated the health policy debate: a comprehensive health care approach, with the 1978 Alma Ata Declaration as its cornerstone, and a private competition logic, emphasizing the role of the private sector. We present this debate and its influence on international health policies in the context of changing global economic and sociopolitical power relations in the second half of the last century. The neoliberal approach is illustrated with Chile's health sector reform in the 1980s and the Colombian reform since 1993. The comprehensive "public logic" is shown through the social insurance models in Costa Rica and in Brazil and through the national public health systems in Cuba since 1959 and in Nicaragua during the 1980s. These experiences emphasize that health care systems do not naturally gravitate toward greater fairness and efficiency, but require deliberate policy decisions. © The Author(s) 2015 Reprints and permissions:]br]sagepub.co.uk/journalsPermissions.nav.

An analysis of policy levers used to implement mental health reform in Australia 1992-2012.

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

2015-10-24

Over the past two decades, mental health reform in Australia has received unprecedented government attention. This study explored how five policy levers (organisation, regulation, community education, finance and payment) were used by the Australian Federal Government to implement mental health reforms. Australian Government publications, including the four mental health plans (published in 1992, 1998, 2003 and 2008) were analysed according to policy levers used to drive reform across five priority areas: [1] human rights and community attitudes; [2] responding to community need; [3] service structures; [4] service quality and effectiveness; and [5] resources and service access. Policy levers were applied in varying ways; with two or three levers often concurrently used to implement a single initiative or strategy. For example, changes to service structures were achieved using various combinations of all five levers. Attempts to improve service quality and effectiveness were instead made through a single lever-regulation. The use of some levers changed over time, including a move away from prescriptive, legislative use of regulation, towards a greater focus on monitoring service standards and consumer outcomes. Patterns in the application of policy levers across the National Mental Health Strategy, as identified in this analysis, represent a novel way of conceptualising the history of mental health reform in Australia. An improved understanding of the strategic targeting and appropriate utilisation of policy levers may assist in the delivery and evaluation of evidence-based mental health reform in the future.

Human resources for health: global crisis and international cooperation.

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Portela, Gustavo Zoio; Fehn, Amanda Cavada; Ungerer, Regina Lucia Sarmento; Poz, Mario Roberto Dal

2017-07-01

From the 1990s onwards, national economies became connected and globalized. Changes in the demographic and epidemiological profile of the population highlighted the need for further discussions and strategies on Human Resources for Health (HRH). The health workforce crisis is a worldwide phenomenon. It includes: difficulties in attracting and retaining health professionals to work in rural and remote areas, poor distribution and high turnover of health staff particularly physicians, poor training of health workforces in new sanitation and demographic conditions and the production of scientific evidence to support HRH decision making, policy management, programs and interventions. In this scenario, technical cooperation activities may contribute to the development of the countries involved, strengthening relationships and expanding exchanges as well as contributing to the production, dissemination and use of technical scientific knowledge and evidence and the training of workers and institutional strengthening. This article aims to explore this context highlighting the participation of Brazil in the international cooperation arena on HRH and emphasizing the role of the World Health Organization in confronting this crisis that limits the ability of countries and their health systems to improve the health and lives of their populations.

An integrated approach to preventing cardiovascular disease: community-based approaches, health system initiatives, and public health policy.

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Karwalajtys, Tina; Kaczorowski, Janusz

2010-01-01

Cardiovascular disease (CVD) is largely the product of interactions among modifiable risk factors that are common in developed nations and increasingly of concern in developing countries. Hypertension is an important precursor to the development of CVD, and although detection and treatment rates have improved in recent years in some jurisdictions, effective strategies and policies supporting a shift in distribution of risk factors at the population level remain paramount. Challenges in managing cardiovascular health more effectively include factors at the patient, provider, and system level. Strategies to reduce hypertension and CVD should be population based, incorporate multilevel, multicomponent, and socioenvironmental approaches, and integrate community resources with public health and clinical care. There is an urgent need to improve monitoring and management of risk factors through community-wide, primary care-linked initiatives, increase the evidence base for community-based prevention strategies, further develop and evaluate promising program components, and develop new approaches to support healthy lifestyle behaviors in diverse age, socioeconomic, and ethnocultural groups. Policy and system changes are critical to reduce risk in populations, including legislation and public education to reduce dietary sodium and trans-fatty acids, food pricing policies, and changes to health care delivery systems to explicitly support prevention and management of CVD.

Broadening health policy education in medical school

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Nur A

2018-02-01

Full Text Available Ahmed Nur, Aqib Chaudry, Amar SodhaFaculty of Medicine, Imperial College London, London, UKWe read with great interest the article by Malik et al1 exploring medical studentparticipation in health policy roles. As medical students who recently completed anintercalated degree in healthcare management at Imperial College London, we spent alarge proportion of our time learning about health policy. Thus, we can offer a uniqueperspective on this issue.    We firstly commend the authors for identifying factors that act as barriers to medical student involvement in health policy roles. Noteworthy barriers impacting student involvement included: a lack of knowledge regarding health policy, an unawareness of opportunities available, and a lack of time. It was found that 43% identified lack of time as a barrier to their involvement in health policy.1 Bicket et al similarly found that time commitments and opportunity costs were the main drawbacks for students not pursuing their interests in leadership roles in medical school.2View the original paper by Malik and colleagues.

Health Policy, Ethics, and the Kansas Legislative Health Academy

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Maree, Gina; Schrandt, Suzanne; Soderquist, Chris; Steffensmeier, Tim; St. Peter, Robert

2015-01-01

We describe a unique program, the Kansas Legislative Health Academy, that brings together state legislators from across the political spectrum to build their capacity in advancing policies that can improve the health of Kansans. To that end, the academy helps legislators develop new skills to deliberate the ethics of health policy, use systems thinking to understand the long- and short-term effects of policy action and inaction, and engage in acts of civic leadership. The academy also seeks to foster an environment of respectful open dialogue and to build new cross-chamber and cross-party relationships. Among the most important outcomes cited by program participants is the value of sustained, personal interaction and problem solving with individuals holding differing political views. PMID:25607945

Health policy, ethics, and the Kansas Legislative Health Academy.

Science.gov (United States)

Blacksher, Erika; Maree, Gina; Schrandt, Suzanne; Soderquist, Chris; Steffensmeier, Tim; St Peter, Robert

2015-03-01

We describe a unique program, the Kansas Legislative Health Academy, that brings together state legislators from across the political spectrum to build their capacity in advancing policies that can improve the health of Kansans. To that end, the academy helps legislators develop new skills to deliberate the ethics of health policy, use systems thinking to understand the long- and short-term effects of policy action and inaction, and engage in acts of civic leadership. The academy also seeks to foster an environment of respectful open dialogue and to build new cross-chamber and cross-party relationships. Among the most important outcomes cited by program participants is the value of sustained, personal interaction and problem solving with individuals holding differing political views.

A review of management of infertility in Nigeria: framing the ethics of a national health policy

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Akinloye O

2011-08-01

Full Text Available Oluyemi Akinloye1,2, Ernest J Truter21Department of Chemical Pathology, Reproductive and Molecular Endocrinology Unit, College of Health Sciences, Ladoke Akintola University of Technology, Osogbo, Osun State, Nigeria; 2Department of Biomedical Sciences, Faculty of Health and Wellness Science, Cape Peninsula University of Technology, Bellville Campus, Cape Town, South AfricaAbstract: Infertility has recently been construed to be a serious problem in sub-Saharan Africa. This problem seems to be viewed as of low priority with reference to the effective and efficient allocation of available health resources by national governments as well as by international donors sponsoring either research or service delivery in the public health sector. In this paper the problem of infertility in Nigeria is surveyed with a view to assessing the ethical dimension of proposals to manage infertility as a public sector priority in health care delivery. The population/individual and public/private distinction in the formulation of health policy has ethical implications that cannot simply be ignored and are therefore engaged in critically assessing the problem of infertility. Cost–utility analysis (such as Quality Adjusted Life-Year composite index in the management of infertility in Nigeria entails the need for caution relevant to the country's efforts to achieve Millennium Development Goals. This should remain the case whether the ethical evaluation appeals to utilitarian or contractarian (Rawlsian principles. The "worst off" category of Nigerians includes (1 underweight children less than 5 years of age, with special concern for infants (0–1 years of age and (2 the proportion of the population below a minimum level of dietary consumption. The Rawlsian ethic implies that any Federal Ministry of Health policy aimed at establishing public programs for infertility management can be considered a "fair" allocation and expenditure if, and only if, the situation for

Factors associated with job satisfaction among commune health workers: implications for human resource policies

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Bach Xuan Tran

2013-01-01

Full Text Available Background: Job satisfaction among health workers is an important indicator in assessing the performance and efficiency of health services. Objective: This study measured job satisfaction and determined associated factors among health workers in 38 commune health stations in an urban district and a rural district of Hanoi, Vietnam. A total of 252 health workers (36 medical doctors and 216 nurses and technicians; 74% female were interviewed. A job satisfaction measure was developed using factor analysis, from which four dimensions emerged, namely ‘benefits and prospects,’ ‘facility and equipment,’ ‘performance,’ and ‘professionals.’ Results: The results demonstrate that respondents were least satisfied with the following categories: salary and incentives (24.0%, benefit packages (25.1%, equipment (35.7%, and environment (41.8%. The average satisfaction score was moderate across four domains; it was the highest for ‘performance’ (66.6/100 and lowest for ‘facility and equipment’ (50.4/100. Tobit-censored regression models, constructed using stepwise selection, determined significant predictors of job satisfaction including age, areas of work and expertise, professional education, urban versus rural setting, and sufficient number of staff. Conclusion: The findings highlight the need to implement health policies that focus on incentives, working conditions, workloads, and personnel management at grassroots level.

Health in All (Foreign) Policy: challenges in achieving coherence.

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Labonté, Ronald

2014-06-01

Health in All Policies (HiAP) approach is generally perceived as an intersectoral approach to national or sub-national public policy development, such that health outcomes are given full consideration by non-health sectors. Globalization, however, has created numerous 'inherently global health issues' with cross-border causes and consequences, requiring new forms of global governance for health. Although such governance often includes both state and non-state (private, civil society) actors in agenda setting and influence, different actors have differing degrees of power and authority and, ultimately, it is states that ratify intergovernmental covenants or normative declarations that directly or indirectly affect health. This requires public health and health promotion practitioners working within countries to give increased attention to the foreign policies of their national governments. These foreign policies include those governing national security, foreign aid, trade and investment as well as the traditional forms of diplomacy. A new term has been coined to describe how health is coming to be positioned in governments' foreign policies: global health diplomacy. To become adept at this nuanced diplomatic practice requires familiarity with the different policy frames by which health might be inserted into the foreign policy deliberations, and thence intergovernmental/global governance negotiations. This article discusses six such frames (security, trade, development, global public goods, human rights, ethical/moral reasoning) that have been analytically useful in assessing the potential for greater and more health-promoting foreign policy coherence: a 'Health in All (Foreign) Policies' approach. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Engagement of Sectors Other than Health in Integrated Health Governance, Policy, and Action.

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de Leeuw, Evelyne

2017-03-20

Health is created largely outside the health sector. Engagement in health governance, policy, and intervention development and implementation by sectors other than health is therefore important. Recent calls for building and implementing Health in All Policies, and continued arguments for intersectoral action, may strengthen the potential that other sectors have for health. This review clarifies the conceptual foundations for integral health governance, policy, and action, delineates the different sectors and their possible engagement, and provides an overview of a continuum of methods of engagement with other sectors to secure integration. This continuum ranges from institutional (re)design to value-based narratives. Depending on the lens applied, different elements can be identified within the continuum. This review is built on insights from political science, leadership studies, public health, empirical Health in All Policy research, knowledge and evidence nexus approaches, and community perspectives. Successful integration of health governance, policy, and action depends on integration of the elements on the continuum.

The greatest happiness of the greatest number? Policy actors' perspectives on the limits of economic evaluation as a tool for informing health care coverage decisions in Thailand.

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Teerawattananon, Yot; Russell, Steve

2008-09-26

This paper presents qualitative findings from an assessment of the acceptability of using economic evaluation among policy actors in Thailand. Using cost-utility data from two economic analyses a hypothetical case scenario was created in which policy actors had to choose between two competing interventions to include in a public health benefit package. The two competing interventions, laparoscopic cholecystectomy (LC) for gallbladder disease versus renal dialysis for chronic renal disease, were selected because they highlighted conflicting criteria influencing the allocation of healthcare resources. Semi-structured interviews were conducted with 36 policy actors who play a major role in resource allocation decisions within the Thai healthcare system. These included 14 policy makers at the national level, five hospital directors, ten health professionals and seven academics. Twenty six out of 36 (72%) respondents were not convinced by the presentation of economic evaluation findings and chose not to support the inclusion of a proven cost-effective intervention (LC) in the benefit package due to ethical, institutional and political considerations. There were only six respondents, including three policy makers at national level, one hospital director, one health professional and one academic, (6/36, 17%) whose decisions were influenced by economic evaluation evidence. This paper illustrates limitations of using economic evaluation information in decision making priorities of health care, perceived by different policy actors. It demonstrates that the concept of maximising health utility fails to recognise other important societal values in making health resource allocation decisions.

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

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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. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

33 CFR 157.415 - Bridge resource management policy and procedures.

Science.gov (United States)

2010-07-01

... HOMELAND SECURITY (CONTINUED) POLLUTION RULES FOR THE PROTECTION OF THE MARINE ENVIRONMENT RELATING TO TANK... Petroleum Oils § 157.415 Bridge resource management policy and procedures. (a) Not later than February 1...

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

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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.

Human resources for health planning and management in the Eastern Mediterranean region: facts, gaps and forward thinking for research and policy

Directory of Open Access Journals (Sweden)

Abdallah Ahmad

2007-03-01

Full Text Available Abstract Background The early decades of the 21st century are considered to be the era of human resources for health (HRH. The World Health Report (WHR 2006 launched the Health Workforce Decade (2006–2015, with high priority given for countries to develop effective workforce policies and strategies. In many countries in the Eastern Mediterranean Region (EMR, particularly those classified as Low and Low-Middle Income Countries (LMICs, the limited knowledge about the nature, scope, composition and needs of HRH is hindering health sector reform. This highlights an urgent need to understand the current reality of HRH in several EMR countries. The objectives of this paper are to: (1 lay out the facts on what we know about the HRH for EMR countries; (2 generate and interpret evidence on the relationship between HRH and health status indicators for LMICs and middle and high income countries (MHICs in the context of EMR; (3 identify and analyze the information gaps (i.e. what we do not know and (4 provide forward thinking by identifying priorities for research and policy. Methods The variables used in the analysis were: nurse and physician density, gross national income, poverty, female literacy, health expenditure, Infant Mortality Rate (IMR, Under 5 Mortality Rate (U5MR, Maternal Mortality Rate (MMR and Life Expectancy (LE. Univariate (charts, bivariate (Pearson correlation and multivariate analysis (linear regression was conducted using SPSS 14.0, besides a synthesis of HRH literature. Results Results demonstrate the significant disparities in physician and nurse densities within the EMR, particularly between LMICs and MHICs. Besides this, significant differences exist in health status indicators within the EMR. Results of the Pearson correlation revealed that physician and nurse density, as well as female literacy in EMR countries were significantly correlated with lower mortality rates and higher life expectancy. Results of the regression

African Health Sciences: Editorial Policies

African Journals Online (AJOL)

Provide a high quality journal in which health and policy and other ... and publication in the region including alternative means of health care financing, the ... by the African Health Journals Partnership Project that is funded by the US National ...

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.

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

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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.

Research priority setting for health policy and health systems strengthening in Nigeria: the policymakers and stakeholders perspective and involvement.

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Uneke, Chigozie Jesse; Ezeoha, Abel Ebeh; Ndukwe, Chinwendu Daniel; Oyibo, Patrick Gold; Onwe, Friday; Aulakh, Bhupinder Kaur

2013-01-01

Nigeria is one of the low and middle income countries (LMICs) facing severe resource constraint, making it impossible for adequate resources to be allocated to the health sector. Priority setting becomes imperative because it guides investments in health care, health research and respects resource constraints. The objective of this study was to enhance the knowledge and understanding of policymakers on research priority setting and to conduct a research priority setting exercise. A one-day evidence-to-policy research priority setting meeting was held. The meeting participants included senior and middle level policymakers and key decision makers/stakeholders in the health sector in Ebonyi State southeastern Nigeria. The priorities setting meeting involved a training session on priority setting process and conduction of priority setting exercise using the essential national health research (ENHR) approach. The focus was on the health systems building blocks (health workforce; health finance; leadership/governance; medical products/technology; service delivery; and health information/evidence). Of the total of 92 policymakers invited 90(97.8%) attended the meeting. It was the consensus of the policymakers that research should focus on the challenges of optimal access to health products and technology; effective health service delivery and disease control under a national emergency situation; the shortfalls in the supply of professional personnel; and the issues of governance in the health sector management. Research priority setting exercise involving policymakers is an example of demand driven strategy in the health policymaking process capable of reversing inequities and strengthening the health systems in LMICs.

HAPPIER: Health Resource Guide.

Science.gov (United States)

Pennsylvania State Dept. of Education, Harrisburg.

Based on findings of Project HAPPIER surveys and intended as a resource for health care providers and educators who serve the migrant community, this guide describes over 375 instructional materials in the areas of dental health, disease control, fitness, health promotion, human growth and development, hypertension, maternal and child care, mental…

Financial risks from ill health in Myanmar: evidence and policy implications.

Science.gov (United States)

Htet, Soe; Fan, Victoria; Alam, Khurshid; Mahal, Ajay

2015-05-01

The government of Myanmar, with support from international donors, plans to address household financial risks from ill health and expand coverage. But evidence to design policy is limited. WHS (World Health Survey) data for 6045 households were used to investigate the association of out-of-pocket (OOP) health spending, catastrophic expenditures, and household borrowing and asset sales associated with illness with key socioeconomic and demographic correlates in Myanmar. Households with elderly and young children and chronically ill individuals, poor households, and ethnic minorities face higher financial stress from illness. Rural households use less care, suggesting their lower OOP health spending may be at the cost of health. Poorer groups rely more on public sector health services than richer groups. Better targeting, increased budgetary allocations, and more effective use of resources via designing cost-effective benefits packages appear key to sustainably addressing financial risks from ill health in Myanmar. © 2014 APJPH.

Meeting the oral health needs of 12-year-olds in China: human resources for oral health.

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Sun, Xiangyu; Bernabé, Eduardo; Liu, Xuenan; Zheng, Shuguo; Gallagher, Jennifer E

2017-06-20

An appropriate level of human resources for oral health [HROH] is required to meet the oral health needs of population, and enable maximum improvement in health outcomes. The aim of this study was to estimate the required HROH to meet the oral health needs of the World Health Organization [WHO] reference group of 12-year-olds in China and consider the implications for education, practice, policy and HROH nationally. We estimated the need of HROH to meet the needs of 12-year-olds based on secondary analysis of the epidemiological and questionnaire data from the 3rd Chinese National Oral Health Survey, including caries experience and periodontal factors (calculus), dentally-related behaviour (frequency of toothbrushing and sugar intake), and social factors (parental education). Children's risk for dental caries was classified in four levels from low (level 1) to high (level 4). We built maximum and minimum intervention models of dental care for each risk level, informed by contemporary evidence-based practice. The needs-led HROH model we used in the present study incorporated need for treatment and risk-based prevention using timings verified by experts in China. These findings were used to estimate HROH for the survey sample, extrapolated to 12-year-olds nationally and the total population, taking account of urban and rural coverage, based on different levels of clinical commitment (60-90%). We found that between 40,139 and 51,906 dental professionals were required to deliver care for 12-year-olds nationally based on 80% clinical commitment. We demonstrated that the majority of need for HROH was in the rural population (72.5%). Over 93% of HROH time was dedicated to prevention within the model. Extrapolating the results to the total population, the estimate for HROH nationally was 3.16-4.09 million to achieve national coverage; however, current HROH are only able to serve an estimated 5% of the population with minimum intervention based on a HROH spending 90% of

Extending the scope of interprofessional education: Integrating insights from policy, management and economics for improved health outcomes

OpenAIRE

Shafqat Shehzad, PhD Health Economics

2016-01-01

This study explores the potential of bringing innovations in public health education by drawing insights from the specialised disciplines of Economics, Policy and Management for their applications in the health sector. Working with subject experts from these disciplines can enhance the understanding of a working health care system and the necessary improvements for better health outcomes. Sole reliance on one field or skewed allocation of resources in certain areas may not result in achieving...

Social Change and Health Policy in Venezuela

Directory of Open Access Journals (Sweden)

Nuramy J. Gutiérrez

2008-07-01

Full Text Available This work reviews social changes occurring in Venezuela during the last two decades, examining how they led to the development of a new health policy. Initially, the political context of the nineties is examined; this was a time when the neoliberal politics of the 1980’s had a demonstrable impact on the living conditions and health status of the population. By 1999 social and political events led to a new Constitution which provided the juridical and legal framework for a new health policy. The conceptualization of health and the model of health care which arose from the constitutional process are considered, as well as the reaction of the dominant economic and political sectors to the new policies imposed by constitutional mandate. The emergence of Barrio Adentro and other social missions is analyzed as an essential factor in the initiation of structural changes within the country and its health institutions. The Barrio Adentro program is described in detail, along with key steps in the development of the Venezuelan National Public Health System. Finally, the impact of these new health policies on the quality of life of the Venezuelan population is delineated.

A policy analysis of the problem of the reproductive health of women in the workplace.

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Kotch, J B; Ossler, C C; Howze, D C

1984-06-01

Many occupations in which women comprise the majority of the workforce involve exposure to biological, physical, and chemical hazards. Potential reproductive effects of work-related substances include impaired reproductive capacity, mutagenesis, teratogenesis, and transplacental carcinogenesis. However, female-dominated occupations tend to be only minimally regulated by the US Occupational Safety and Health Administration, and the corporate response to the issue of reproductive and fetal health has been to institute "protective discrimination policies" such as the demotion or exclusion of women of childbearing age from certain jobs. This article rates the effectiveness of alternate policy responses to increase women's occupational health and safety through use of a series of analysis criteria: equity, efficiency, preference satisfaction, right to privacy, avoidance of stigma, and unintended consequences. Policy options include the following: 1) do nothing, 2) leave current policies intact while supporting a research program to document the health consequences of specific occupational risks to women's reproductive health, 3) restrict women for who pregnancy is not ruled out from occupations or work areas known or suspected to be hazardous, 4) improve working conditions for all women, and 5) improve working conditions for all workers. Policy analysis suggests the working conditions of all workers should be improved. This alternative reduces inequity, eliminates stigma, maintains privacy, and honors preferences. Implementation of this policy would be expensive, requiring an increase in knowledge of the effects of industrial substances on female and male reproductive health, expansion of the technical capacity to control occupational hazards, and an increase in the resources of programs that monitor and regulate occupational health. However, this approach is in accord with growing concern that workers should not have to compromise their health to keep their jobs.

Unequal Gain of Equal Resources across Racial Groups.

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Assari, Shervin

2017-08-05

The health effects of economic resources (eg, education, employment, and living place) and psychological assets (eg, self-efficacy, perceived control over life, anger control, and emotions) are well-known. This article summarizes the results of a growing body of evidence documenting Blacks' diminished return, defined as a systematically smaller health gain from economic resources and psychological assets for Blacks in comparison to Whites. Due to structural barriers that Blacks face in their daily lives, the very same resources and assets generate smaller health gain for Blacks compared to Whites. Even in the presence of equal access to resources and assets, such unequal health gain constantly generates a racial health gap between Blacks and Whites in the United States. In this paper, a number of public policies are recommended based on these findings. First and foremost, public policies should not merely focus on equalizing access to resources and assets, but also reduce the societal and structural barriers that hinder Blacks. Policy solutions should aim to reduce various manifestations of structural racism including but not limited to differential pay, residential segregation, lower quality of education, and crime in Black and urban communities. As income was not found to follow the same pattern demonstrated for other resources and assets (ie, income generated similar decline in risk of mortality for Whites and Blacks), policies that enforce equal income and increase minimum wage for marginalized populations are essential. Improving quality of education of youth and employability of young adults will enable Blacks to compete for high paying jobs. Policies that reduce racism and discrimination in the labor market are also needed. Without such policies, it will be very difficult, if not impossible, to eliminate the sustained racial health gap in the United States. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open

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.

National responses to global health targets: exploring policy transfer in the context of the UNAIDS '90-90-90' treatment targets in Ghana and Uganda.

Science.gov (United States)

McRobie, Ellen; Matovu, Fred; Nanyiti, Aisha; Nonvignon, Justice; Abankwah, Daniel Nana Yaw; Case, Kelsey K; Hallett, Timothy B; Hanefeld, Johanna; Conteh, Lesong

2018-01-01

Global health organizations frequently set disease-specific targets with the goal of eliciting adoption at the national-level; consideration of the influence of target setting on national policies, programme and health budgets is of benefit to those setting targets and those intended to respond. In 2014, the Joint United Nations Programme on HIV/AIDS set 'ambitious' treatment targets for country adoption: 90% of HIV-positive persons should know their status; 90% of those on treatment; 90% of those achieving viral suppression. Using case studies from Ghana and Uganda, we explore how the target and its associated policy content have been adopted at the national level. That is whether adoption is in rhetoric only or supported by programme, policy or budgetary changes. We review 23 (14 from Ghana, 9 from Uganda) national policy, operational and strategic documents for the HIV response and assess commitments to '90-90-90'. In-person semi-structured interviews were conducted with purposively sampled key informants (17 in Ghana, 20 in Uganda) involved in programme-planning and resource allocation within HIV to gain insight into factors facilitating adoption of 90-90-90. Interviews were transcribed and analysed thematically, inductively and deductively, guided by pre-existing policy theories, including Dolowitz and Marsh's policy transfer framework to describe features of the transfer and the Global Health Advocacy and Policy Project framework to explain observations. Regardless of notable resource constraints, transfer of the 90-90-90 targets was evident beyond rhetoric with substantial shifts in policy and programme activities. In both countries, there was evidence of attempts to minimize resource constraints by seeking programme efficiencies, prioritization of programme activities and devising domestic financing mechanisms; however, significant resource gaps persist. An effective health network, comprised of global and local actors, mediated the adoption and adaptation

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.

Hospital management autonomy in Chile: the challenges for human resources in health.

Science.gov (United States)

Méndez, Claudio A; Torres A, M Cristina

2010-04-01

In Latin America, some health sector reforms have included steps to the implementation of autonomous hospitals. In Chile, the health system is implementing a reform that introduces a network of self-managed institutions. These organizations will be high complexity centers that involve greater technical diversity, cost centers and mechanisms to evaluate users' satisfaction. For human resources in health, the implementation of these centers creates challenges in the planning of service provision and a change from the traditional management style of the teams to one based on networks. These challenges include the estimation of gaps in medical specialists and in other professions in the health sector. In order to be successful with self-management, Chile needs to establish universal and local policies that address training and the organization of health service provisioning in these institutions.

Science–policy challenges for biodiversity, public health and urbanization: examples from Belgium

International Nuclear Information System (INIS)

Keune, H; De Blust, G; Van den Berge, K; Brosens, D; Van Herzele, A; Simoens, I; Kretsch, C; Gilbert, M; Linard, C; Flandroy, L; Versteirt, V; Hartig, T; De Keersmaecker, L; Eggermont, H; Dessein, J; Vanwambeke, S; Prieur-Richard, A H; Wittmer, H; Martens, P; Mathijs, E

2013-01-01

Internationally, the importance of a coordinated effort to protect both biodiversity and public health is more and more recognized. These issues are often concentrated or particularly challenging in urban areas, and therefore on-going urbanization worldwide raises particular issues both for the conservation of living natural resources and for population health strategies. These challenges include significant difficulties associated with sustainable management of urban ecosystems, urban development planning, social cohesion and public health. An important element of the challenge is the need to interface between different forms of knowledge and different actors from science and policy. We illustrate this with examples from Belgium, showcasing concrete cases of human–nature interaction. To better tackle these challenges, since 2011, actors in science, policy and the broader Belgian society have launched a number of initiatives to deal in a more integrated manner with combined biodiversity and public health challenges in the face of ongoing urbanization. This emerging community of practice in Belgium exemplifies the importance of interfacing at different levels. (1) Bridges must be built between science and the complex biodiversity/ecosystem–human/public health–urbanization phenomena. (2) Bridges between different professional communities and disciplines are urgently needed. (3) Closer collaboration between science and policy, and between science and societal practice is needed. Moreover, within each of these communities closer collaboration between specialized sections is needed. (letter)

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.

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