International financial institutions and human rights: implications for public health.

PubMed

Stubbs, Thomas; Kentikelenis, Alexander

2017-01-01

Serving as lender of last resort to countries experiencing unsustainable levels of public debt, international financial institutions have attracted intense controversy over the past decades, exemplified most recently by the popular discontent expressed in Eurozone countries following several rounds of austerity measures. In exchange for access to financial assistance, borrowing countries must settle on a list of often painful policy reforms that are aimed at balancing the budget. This practice has afforded international financial institutions substantial policy influence on governments throughout the world and in a wide array of policy areas of direct bearing on human rights. This article reviews the consequences of policy reforms mandated by international financial institutions on the enjoyment of human rights, focusing on the International Monetary Fund and World Bank. It finds that these reforms undermine the enjoyment of health rights, labour rights, and civil and political rights, all of which have deleterious implications for public health. The evidence suggests that for human rights commitments to be met, a fundamental reorientation of international financial institutions' activities will be necessary.

The Track of Policies for Educational Equality and Its Implications in Korea

ERIC Educational Resources Information Center

Jo, Seog Hun

2013-01-01

Most countries have taken equality of education as a paramount issue, but policy initiatives have not taken the same patterns across the nations. This paper addressed the features of equality policies and their changes in South Korea through an array of target groups and types of policy measures. According to a contingency approach, Korea relied…

United States aid policy and induced abortion in sub-Saharan Africa.

PubMed

Bendavid, Eran; Avila, Patrick; Miller, Grant

2011-12-01

To determine whether the Mexico City Policy, a United States government policy that prohibits funding to nongovernmental organizations performing or promoting abortion, was associated with the induced abortion rate in sub-Saharan Africa. Women in 20 African countries who had induced abortions between 1994 and 2008 were identified in Demographic and Health Surveys. A country's exposure to the Mexico City Policy was considered high (or low) if its per capita assistance from the United States for family planning and reproductive health was above (or below) the median among study countries before the policy's reinstatement in 2001. Using logistic regression and a difference-in-difference design, the authors estimated the differential change in the odds of having an induced abortion among women in high exposure countries relative to low exposure countries when the policy was reinstated. The study included 261,116 women aged 15 to 44 years. A comparison of 1994-2000 with 2001-2008 revealed an adjusted odds ratio for induced abortion of 2.55 for high-exposure countries versus low-exposure countries under the policy (95% confidence interval, CI: 1.76-3.71). There was a relative decline in the use of modern contraceptives in the high-exposure countries over the same time period. The induced abortion rate in sub-Saharan Africa rose in high-exposure countries relative to low-exposure countries when the Mexico City Policy was reintroduced. Reduced financial support for family planning may have led women to substitute abortion for contraception. Regardless of one's views about abortion, the findings may have important implications for public policies governing abortion.

Impact, regulation and health policy implications of physician migration in OECD countries

PubMed Central

Forcier, Mélanie Bourassa; Simoens, Steven; Giuffrida, Antonio

2004-01-01

Background In the face of rising demand for medical services due to ageing populations, physician migration flows are increasingly affecting the supply of physicians in Organisation for Economic Co-operation and development (OECD) countries. This paper offers an integrated perspective on the impact of physician migration on home and host countries and discusses international regulation and policy approaches governing physician migration. Methods Information about migration flows, international regulation and policies governing physician migration were derived from two questionnaires sent to OECD countries, a secondary analysis of EUROSTAT Labour Force Surveys, a literature review and official policy documents of OECD countries. Results OECD countries increasingly perceive immigration of foreign physicians as a way of sustaining their physician workforce. As a result, countries have entered into international agreements regulating physician migration, although their success has been limited due to the imposition of licensing requirements and the protection of vested interests by domestic physicians. OECD countries have therefore adopted specific policies designed to stimulate the immigration of foreign physicians, whilst minimising its negative impact on the home country. Measures promoting immigration have included international recruitment campaigns, less strict immigration requirements and arrangements that foster shared learning between health care systems. Policies restricting the societal costs of physician emigration from developing countries such as good practice guidelines and taxes on host countries have not yet produced their expected effect or in some cases have not been established at all. Conclusions Although OECD countries generally favour long-term policies of national self-sufficiency to sustain their physician workforce, such policies usually co-exist with short-term or medium-term policies to attract foreign physicians. As this is likely to continue, there is a need to create a global framework that enforces physician migration policies that confer benefits on home and host countries. In the long term, OECD countries need to put in place appropriate education and training policies rather than rely on physician migration to address their future needs. PMID:15257752

Traveling Policies: Mobility, Transformation and Continuities in Higher Education Public Policy

ERIC Educational Resources Information Center

Britez, Rodrigo G.

2012-01-01

This article presents an assessment of the impact and implications of the international mobilities operating in the national public policy environment. In fact, patterns of transformations that take place in national higher education systems are generating diverse and complex outcomes in different countries, in ways that may preclude a simple…

The migration of nurses: trends and policies.

PubMed Central

Buchan, James; Sochalski, Julie

2004-01-01

This paper examines the policy context of the rise in the international mobility and migration of nurses. It describes the profile of the migration of nurses and the policy context governing the international recruitment of nurses to five countries: Australia, Ireland, Norway, the United Kingdom, and the United States. We also examine the policy challenges for workforce planning and the design of health systems infrastructure. Data are derived from registries of professional nurses, censuses, interviews with key informants, case studies in source and destination countries, focus groups, and empirical modelling to examine the patterns and implications of the movement of nurses across borders. The flow of nurses to these destination countries has risen, in some cases quite substantially. Recruitment from lower-middle income countries and low-income countries, as defined by The World Bank, dominate trends in nurse migration to the United Kingdom, Ireland, and the United States, while Norway and Australia, primarily register nurses from other high-income countries. Inadequate data systems in many countries prevent effective monitoring of these workforce flows. Policy options to manage nurse migration include: improving working conditions in both source and destination countries, instituting multilateral agreements to manage the flow more effectively, and developing compensation arrangements between source and destination countries. Recommendations for enhancements to workforce data systems are provided. PMID:15375448

Data sets on pensions and health: Data collection and sharing for policy design

PubMed Central

Lee, Jinkook

2015-01-01

A growing number of countries are developing or reforming pension and health policies in response to population ageing and to enhance the welfare of their citizens. The adoption of different policies by different countries has resulted in several natural experiments. These offer unusual opportunities to examine the effects of varying policies on health and retirement, individual and family behaviour, and well-being. Realizing these opportunities requires harmonized data-collection efforts. An increasing number of countries have agreed to provide data harmonized with the Health and Retirement Study in the United States. This article discusses these data sets, including their key parameters of pension and health status, research designs, samples, and response rates. It also discusses the opportunities they offer for cross-national studies and their implications for policy evaluation and development. PMID:26229178

Frames of Reference: A Metaphor for Analyzing and Interpreting Attitudes of Environmental Policy Makers and Policy Influencers

PubMed

Swaffield

1998-07-01

/ The concept of frame of reference offers a potentially useful analytical metaphor in environmental management. This is illustrated by a case study in which attitudes of individuals involved in the management of trees in the New Zealand high country are classified into seven distinctive frames of reference. Some practical and theoretical implications of the use of the frame metaphor are explored, including its potential contribution to the emerg- ing field of communicative planning. KEY WORDS: Frames of reference; Environmental policy analysis; Metaphor; New Zealand high country

CO2 embodied in international trade with implications for global climate policy.

PubMed

Peters, Glen P; Hertwich, Edgar G

2008-03-01

The flow of pollution through international trade flows has the ability to undermine environmental policies, particularly for global pollutants. In this article we determine the CO2 emissions embodied in international trade among 87 countries for the year 2001. We find that globally there are over 5.3 Gt of CO2 embodied in trade and that Annex B countries are net importers of CO2 emissions. Depending on country characteristics--such as size variables and geographic location--there are considerable variations in the embodied emissions. We argue that emissions embodied in trade may have a significant impact on participation in and effectiveness of global climate policies such as the Kyoto Protocol. We discuss several policy options to reduce the impact of trade in global climate policy. If countries take binding commitments as a part of a coalition, instead of as individual countries, then the impacts of trade can be substantially reduced. Adjusting emission inventories for trade gives a more consistent description of a country's environmental pressures and circumvents many trade related issues. It also gives opportunities to exploit trade as a means of mitigating emissions. Not least, a better understanding of the role that trade plays in a country's economic and environmental development will help design more effective and participatory climate policy post-Kyoto.

The ethics of intellectual property rights in an era of globalization.

PubMed

Shah, Aakash Kaushik; Warsh, Jonathan; Kesselheim, Aaron S

2013-01-01

Since the 1980s, developed countries, led by the United States and the countries of the European Union, have sought to incorporate intellectual property rights provisions into global trade agreements. These countries successfully negotiated the World Trade Organization's 1994 Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS), which required developing countries to adopt intellectual property provisions comparable to developed countries. In this manuscript, we review the policy controversy surrounding TRIPS and examine the two main ethical arguments articulated in its support--a theory of natural rights and a utilitarian argument. We contend that these theories provide insufficient bases for an intellectual property rights regime that compromises access to essential medicines in the developing world. While the policy community has engaged in active debate around the policy effects of TRIPS, scholars have not thoroughly considered the full ethical underpinnings of those policy arguments. We believe that a more robust understanding of the ethical implications of the agreement should inform policy discussions in the future. © 2013 American Society of Law, Medicine & Ethics, Inc.

Convention on the rights of persons with disabilities, assistive technology and information and communication technology requirements: where do we stand on implementation?

PubMed

Gould, Martin; Leblois, Axel; Cesa Bianchi, Francesca; Montenegro, Viviana

2015-07-01

This article presents 2013 data from a survey provided by G3ict and Disabled Peoples International (DPI). The Progress Report identifies the degree that each of the CRPD dispositions on ATs and ICTs accessibility are enacted in local laws, policies and regulations and their impacts. The initial methodology used to develop the survey involved several steps. First, a systematic review of CRPD AT and ICT technology requirements was conducted. Second, 57 variables were identified. Third, variables were grouped into three clusters representing countries': (a) legal, regulatory and programmatic commitments; (b) capacity to implement; and (c) actual implementation results. Surveys were completed by experts in a total of 74 countries. With respect to select CRPD AT and ICT dispositions, respondent countries report an: (a) average degree of compliance within their general legal and regulatory framework at 66%; (b) average 29% of the capacity to implement; and (c) average degree of implementation and impact of 42%. Implications for Rehabilitation Survey results reflect low levels of ratifying countries implementation of laws, policies or programs that promote awareness-raising and training programs about the CRPD and its AT and ICT technology requirements. Implication 1: CRPD ratifying countries need to promote disability-inclusive AT and ICT policies and programs identified as priority areas by key stakeholders Implication 2: Government leaders and key policymakers need to address gaps in capacity building such as professional training of professionals in the areas of AT and ICT accessibility and programming through disability-inclusive cooperative development practices.

Joint Implications for Contracted Logistics

DTIC Science & Technology

2007-03-30

authority with the host nation country and policy on using UCMJ for contracted personnel. As tailored theater policies are developed and contracting...responsibility, this paper recommends better joint training, leader development and joint enablers for contracting operations. JOINT...U.S. Joint Forces Command (JFCOM) are analyzing Congressional and DOD policy to develop procedures and force structure to support contractor

Language-in-Education Policy in Low-Income, Postcolonial Contexts: Towards a Social Justice Approach

ERIC Educational Resources Information Center

Tikly, Leon

2016-01-01

The article considers how language-in-education policy in low-income, postcolonial countries may be better understood from a social justice perspective and some of the implications for policy, practice and research that arise from this. The article starts with a critical overview of the two dominant approaches towards conceptualising…

School Policy: Implications of Recent Research for Human Capital Investments in South Asia and Other Developing Countries

ERIC Educational Resources Information Center

Hanushek, Eric A.

2009-01-01

Concentration on school attainment goals without close attention to school quality has hurt developing countries. Recent evidence shows that individual incomes, the distribution of income, and economic growth rates are all closely related to the cognitive skills of the population. While direct evidence from developing countries is thin, the…

Social Policy Report, 1998.

ERIC Educational Resources Information Center

Thomas, Nancy G., Ed.

1998-01-01

These four quarterly reports for 1998 provide a forum for scholarly reviews and discussions of developmental research and its implications for the policies affecting children. The first issue focuses on fathering. The main article addresses perspectives of fathers' involvement in children's lives in developing countries, specifically, issues of a…

Fertility trends and prospects in East and South-East Asian countries and implications for policies and programmes.

PubMed

Leete, R

1991-01-01

Fertility trends and prospects for east and southeast Asian countries including cities in China, Taiwan, the Republic of Korea, Thailand, Indonesia, Malaysia, the Philippines, Myanmar, and Viet Nam are described. Additional discussion focuses on family planning methods, marriage patterns, fertility prospects, theories of fertility change, and policy implications for the labor supply, labor migrants, increased female participation in the labor force (LFP), human resource development, and social policy measures. Figures provide graphic descriptions of total fertility rates (TFRS) for 12 countries/areas for selected years between 1960-90, TFR for selected Chinese cities between 1955-90, the % of currently married women 15-44 years using contraception by main method for selected years and for 10 countries, actual and projected TFR and annual growth rates between 1990-2020 for Korea and Indonesia. It is noted that the 1st southeast Asian country to experience a revolution in reproductive behavior was Japan with below replacement level fertility by 1960. This was accomplished by massive postponement in age at marriage and rapid reduction in marital fertility. Fertility was controlled primarily through abortion. Thereafter every southeast Asian country experienced fertility declines. Hong Kong, Penang, Shanghai, Singapore, and Taipei and declining fertility before the major thrust of family planning (FP). Chinese fertility declines were reflected in the 1970s to the early 1980s and paralleled the longer, later, fewer campaign and policy which set ambitious targets which were strictly enforced at all levels of administration. Korea and Taiwan's declines were a result of individual decision making to restrict fertility which was encouraged by private and government programs to provide FP information and subsidized services. The context was social and economic change. Indonesia's almost replacement level fertility was achieved dramatically through the 1970s and 1980s by institutional change in ideas about families and schooling and material welfare, changes in the structure of governance, and changes in state ideology. Thailand's decline began in the 1960s and is attributed to social change, change in cultural setting, demand, and FP efforts. Modest declines characterize Malaysia and the Philippines, which have been surpassed by Myanmar and Viet Nam. The policy implications are that there are shortages in labor supply which can be remedied with labor migration, pronatalist policy, more capital intensive industries, and preparation for a changing economy.

Russian Foreign Policy. Sources and Implications

DTIC Science & Technology

2009-01-01

Press, 2007b; Mikhail Demurin, “Rossiia i Strany Sng : Tsivilizatsionnyi’ Vyzov [Russia and the Countries of the CIS: A Civilizational Calling...Sovermennik, No. 9, September 2007, pp. 163–180. Demurin, Mikhail, “Rossiia i Strany Sng : Tsivilizatsionnyi’ Vyzov [Russia and the Countries of the CIS

Federalism and decentralization: impact on international and Brazilian health policies.

PubMed

Leite, Valéria Rodrigues; de Vasconcelos, Cipriano Maia; Lima, Kenio Costa

2011-01-01

This article discusses the implications of decentralization in the light of international and Brazilian federalism, and its effects on public health policy. In a comparative analysis among countries, the authors find there is no single model; rather, each country has a unique structure of institutions and norms that have important implications for the operation of its health system. Brazil shares some similarities with other countries that have adopted a decentralized system and is assuming features ever closer to U.S. federalism, with a complex web of relationships. The degree of inequality among Brazilian municipalities and states, along with the budgetary imbalances caused by the minimal levels of resource utilization, undermines Brazil's constitutional principles and, consequently, its federalism. To ensure the constitutional mandate in Brazil, it is essential, as in other countries, to create a stable source of funds and increase the volume and efficiency of spending. Also important are investing in the training of managers, improving information systems, strengthening the principles of autonomy and interdependence, and defining patterns of cooperation within the federation.

Patient access to medicines in two countries with similar health systems and differing medicines policies: Implications from a comprehensive literature review.

PubMed

Babar, Zaheer-Ud-Din; Gammie, Todd; Seyfoddin, Ali; Hasan, Syed Shahzad; Curley, Louise E

2018-04-13

Countries with similar health systems but different medicines policies might result in substantial medicines usage differences and resultant outcomes. The literature is sparse in this area. To review pharmaceutical policy research in New Zealand and Australia and discuss differences between the two countries and the impact these differences may have on subsequent medicine access. A review of the literature (2008-2016) was performed to identify relevant, peer-reviewed articles. Systematic searches were conducted across the six databases MEDLINE, PubMed, Science Direct, Springer Links, Scopus and Google Scholar. A further search of journals of high relevance was also conducted. Using content analysis, a narrative synthesis of pharmaceutical policy research influencing access to medicines in Australia and New Zealand was conducted. The results were critically assessed in the context of policy material available via grey literature from the respective countries. Key elements regarding pharmaceutical policy were identified from the 35 research papers identified for this review. Through a content analysis, three broad categories of pharmaceutical policy were found, which potentially could influence patient access to medicines in each country; the national health system, pricing and reimbursement. Within these three categories, 9 subcategories were identified: national health policy, pharmacy system, marketing authorization and regulation, prescription to non-prescription medicine switch, orphan drug policies, generic medicine substitution, national pharmaceutical schedule and health technology assessment, patient co-payment and managed entry agreements. This review systematically evaluated the current literature and identified key areas of difference in policy between Australia and NZ. Australia appears to cover and reimburse a greater number of medicines, while New Zealand achieves much lower prices for medicines than their Australian counterparts and has been more successful in controlling national pharmaceutical expenditure. Delays in patient access to new therapies in New Zealand have considerable implications for overall patient access to medicines; however, higher patient co-payments and relative pharmaceutical expenditure in Australia and its effect upon patient access to medicines must also be considered. Copyright © 2018 Elsevier Inc. All rights reserved.

Financial Literacy and Economic Outcomes: Evidence and Policy Implications.

PubMed

Mitchell, Olivia S; Lusardi, Annamaria

2015-01-01

This paper reviews what we have learned over the past decade about financial literacy and its relationship to financial decision-making around the world. Using three questions, we have surveyed people in several countries to determine whether they have the fundamental knowledge of economics and finance needed to function as effective decision-makers. We find that levels of financial literacy are low not only in the United States. but also in many other countries including those with well-developed financial markets. Moreover, financial illiteracy is particularly acute for some demographic groups, especially women and the less-educated. These findings are important since financial literacy is linked to borrowing, saving, and spending patterns. We also offer new evidence on financial literacy among high school students drawing on the 2012 Programme for International Student Assessment implemented in 18 countries. Last, we discuss the implications of this research for policy.

Financial Literacy and Economic Outcomes: Evidence and Policy Implications

PubMed Central

Mitchell, Olivia S.; Lusardi, Annamaria

2017-01-01

This paper reviews what we have learned over the past decade about financial literacy and its relationship to financial decision-making around the world. Using three questions, we have surveyed people in several countries to determine whether they have the fundamental knowledge of economics and finance needed to function as effective decision-makers. We find that levels of financial literacy are low not only in the United States. but also in many other countries including those with well-developed financial markets. Moreover, financial illiteracy is particularly acute for some demographic groups, especially women and the less-educated. These findings are important since financial literacy is linked to borrowing, saving, and spending patterns. We also offer new evidence on financial literacy among high school students drawing on the 2012 Programme for International Student Assessment implemented in 18 countries. Last, we discuss the implications of this research for policy. PMID:28553655

Comparative water law, policies, and administration in Asia: Evidence from 17 countries

NASA Astrophysics Data System (ADS)

Araral, Eduardo; Yu, David J.

2013-09-01

Conventional wisdom suggests that improving water governance is the key to solving water insecurity in developing countries but there are also many disagreements on operational and methodological issues. In this paper, we build on the work of Saleth and Dinar and surveyed 100 water experts from 17 countries in Asia to compare 19 indicators of water laws, policies, and administration among and within countries from 2001 to 2010. We present the results of our study in a comparative dashboard and report how water governance indicators vary with a country's level of economic development, which ones do not and how and why some indicators change overtime in some countries. We have two main results. First, our initial findings suggest the possibility of water Kuznet's curve, i.e., certain water governance indicators vary with a country's level of economic development. However, more studies are needed given the caveats and limitations of our study. Second, the results have practical value for policy makers and researchers for benchmarking with other countries and tracking changes within their countries overtime. We conclude with implications for a second-generation research agenda on water governance.

United States aid policy and induced abortion in sub-Saharan Africa

PubMed Central

Avila, Patrick; Miller, Grant

2011-01-01

Abstract Objective To determine whether the Mexico City Policy, a United States government policy that prohibits funding to nongovernmental organizations performing or promoting abortion, was associated with the induced abortion rate in sub-Saharan Africa. Methods Women in 20 African countries who had induced abortions between 1994 and 2008 were identified in Demographic and Health Surveys. A country’s exposure to the Mexico City Policy was considered high (or low) if its per capita assistance from the United States for family planning and reproductive health was above (or below) the median among study countries before the policy’s reinstatement in 2001. Using logistic regression and a difference-in-difference design, the authors estimated the differential change in the odds of having an induced abortion among women in high exposure countries relative to low exposure countries when the policy was reinstated. Findings The study included 261 116 women aged 15 to 44 years. A comparison of 1994–2000 with 2001–2008 revealed an adjusted odds ratio for induced abortion of 2.55 for high-exposure countries versus low-exposure countries under the policy (95% confidence interval, CI: 1.76–3.71). There was a relative decline in the use of modern contraceptives in the high-exposure countries over the same time period. Conclusion The induced abortion rate in sub-Saharan Africa rose in high-exposure countries relative to low-exposure countries when the Mexico City Policy was reintroduced. Reduced financial support for family planning may have led women to substitute abortion for contraception. Regardless of one’s views about abortion, the findings may have important implications for public policies governing abortion. PMID:22271944

Decentralization and primary health care: some negative implications in developing countries.

PubMed

Collins, C; Green, A

1994-01-01

Decentralization is a highly popular concept, being a key element of Primary Health Care policies. There are, however, certain negative implications of decentralization that must be taken into account. These are analyzed in this article with particular reference to developing countries. The authors criticize the tendency for decentralization to be associated with state limitations, and discuss the dilemma of relating decentralization, which is the enhancement of the different, to equity, which is the promotion of equivalence. Those situations in which decentralization can strengthen political domination are described. The authors conclude by setting out a checklist of warning questions and issues to be taken into account to ensure that decentralization genuinely facilitates the Primary Health Care orientation of health policy.

Changing global essential medicines norms to improve access to AIDS treatment: lessons from Brazil.

PubMed

Nunn, A; Fonseca, E Da; Gruskin, S

2009-01-01

Brazil's large-scale, successful HIV/AIDS treatment programme is considered by many to be a model for other developing countries aiming to improve access to AIDS treatment. Far less is known about Brazil's important role in changing global norms related to international pharmaceutical policy, particularly international human rights, health and trade policies governing access to essential medicines. Prompted by Brazil's interest in preserving its national AIDS treatment policies during World Trade Organisation trade disputes with the USA, these efforts to change global essential medicines norms have had important implications for other countries, particularly those scaling up AIDS treatment. This paper analyses Brazil's contributions to global essential medicines policy and explains the relevance of Brazil's contributions to global health policy today.

Speaking of Internationalisation: An Analysis Policy of Discourses on Internationalisation of Higher Education in Post-Apartheid South Africa

ERIC Educational Resources Information Center

McLellan, Carlton E.

2008-01-01

This article explores the policy implications of internationalisation of higher education in post-apartheid South Africa. It uses several of the country's policy documents and analyses what they infer about the process of internationalisation and its role in the transformation of South African higher education and society. The particular policy…

The economic impact of a new animal disease: same effects in developed and developing countries?

PubMed

Rich, K M; Niemi, J K

2017-04-01

Animal disease outbreaks generate a range of economic and non-economic impacts. While a significant number of research studies have estimated the effects of various diseases in a variety of contexts, examining the differential impacts and implications associated with the introduction of a novel disease into a developing country, as opposed to a developed one, is a rich area for further research. In this paper, the authors highlight some of the key dimensions and implications associated with the impacts of new diseases, how they differ in different contexts, and their implications for public policy.

Patterns, Trends and Policy Implications of Private Spending on Skills Development in Mexico and the United States

ERIC Educational Resources Information Center

Székely, Miguel; Mendoza, Pamela

2017-01-01

This paper explores families' investment in skills development through education in a high-inequality, low-education quality country such as Mexico, comparing it to a lower-inequality, higher-quality education country such as the United States. The paper uses a series of Household Income and Expenditure Surveys for both countries spanning around…

Administrative Computing in the USA and The Netherlands: Implications for Other Countries.

ERIC Educational Resources Information Center

Bluhm, Harry P.

1990-01-01

Examines the planning, policy, and organizational approaches taken by the United States and the Netherlands to use the computer as an administrative tool. Discusses applications in these countries to manage school finances, personnel data, administrative offices, plant operations, support services, and student data and implementation suggestions.…

U.S. commercial space policies - Implications for developing countries

NASA Technical Reports Server (NTRS)

Gillam, Isaac T., IV; Stone, Barbara A.

1987-01-01

Recent U.S. policy developments on the commercial use of space are summarized and their international implications are considered. Attention is given to successful applications of technology developed in space, including an implantable cancer medication system, an implantable defibrillator, an ultrasonic residual stress monitor, and aquaculture treatment techniques. NASA projects involving bioengineering and rehabilitation applications are summarized, and plans to investigate high-temperature superconductors in space are addressed. Recent agreements entred into by NASA for space commercial studies are reviewed.

Fighting terrorism in Africa: Benchmarking policy harmonization

NASA Astrophysics Data System (ADS)

Asongu, Simplice A.; Tchamyou, Vanessa S.; Minkoua N., Jules R.; Asongu, Ndemaze; Tchamyou, Nina P.

2018-02-01

This study assesses the feasibility of policy harmonization in the fight against terrorism in 53 African countries with data for the period 1980-2012. Four terrorism variables are used, namely: domestic, transnational, unclear and total terrorism dynamics. The empirical evidence is based on absolute beta catch-up and sigma convergence estimation techniques. There is substantial absence of catch-up. The lowest rate of convergence in terrorism is in landlocked countries for regressions pertaining to unclear terrorism (3.43% per annum for 174.9 years) while the highest rate of convergence is in upper-middle-income countries in domestic terrorism regressions (15.33% per annum for 39.13 years). After comparing results from the two estimation techniques, it is apparent that in the contemporary era, countries with low levels of terrorism are not catching-up their counterparts with high levels of terrorism. As a policy implication, whereas some common policies may be feasibly adopted for the fight against terrorism, the findings based on the last periodic phase (2004-2012) are indicative that country-specific policies would better pay-off in the fight against terrorism than blanket common policies. Some suggestions of measures in fighting transnational terrorism have been discussed in the light of an anticipated surge in cross-national terrorism incidences in the coming years.

The Alcohol Environment Protocol: A new tool for alcohol policy.

PubMed

Casswell, Sally; Morojele, Neo; Williams, Petal Petersen; Chaiyasong, Surasak; Gordon, Ross; Gray-Philip, Gaile; Viet Cuong, Pham; MacKintosh, Anne-Marie; Halliday, Sharon; Railton, Renee; Randerson, Steve; Parry, Charles D H

2018-01-04

To report data on the implementation of alcohol policies regarding availability and marketing, and drink driving, along with ratings of enforcement from two small high-income to three high-middle income countries, and one low-middle income country. This study uses the Alcohol Environment Protocol, an International Alcohol Control study research tool, which documents the alcohol policy environment by standardised collection of data from administrative sources, observational studies and interviews with key informants to allow for cross-country comparison and change over time. All countries showed adoption to varying extents of key effective policy approaches outlined in the World Health Organization Global Strategy to Reduce the Harmful Use of Alcohol (2010). High-income countries were more likely to allocate resources to enforcement. However, where enforcement and implementation were high, policy on availability was fairly liberal. Key Informants judged alcohol to be very available in both high- and middle-income countries, reflecting liberal policy in the former and less implementation and enforcement and informal (unlicensed) sale of alcohol in the latter. Marketing was largely unrestricted in all countries and while drink-driving legislation was in place, it was less well enforced in middle-income countries. In countries with fewer resources, alcohol policies are less effective because of lack of implementation and enforcement and, in the case of marketing, lack of regulation. This has implications for the increase in consumption taking place as a result of the expanding distribution and marketing of commercial alcohol and consequent increases in alcohol-related harm. © 2018 The Authors Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.

Parenthood and Happiness: Effects of Work-Family Reconciliation Policies in 22 OECD Countries.

PubMed

Glass, Jennifer; Simon, Robin W; Andersson, Matthew A

2016-11-01

The recent proliferation of studies examining cross-national variation in the association between parenthood and happiness reveal accumulating evidence of lower levels of happiness among parents than nonparents in most advanced industrialized societies. Conceptualizing parenting as a stressor buffered by institutional support, we hypothesize that parental status differences in happiness are smaller in countries providing more resources and support to families. Our analyses of the European Social Surveys (ESS) and International Social Survey Programme (ISSP) reveal considerable variation in the parenthood gap in happiness across countries, with the U.S. showing the largest disadvantage of parenthood. We also find that more generous family policies, particularly paid time off and childcare subsidies, are associated with smaller disparities in happiness between parents and non-parents. Moreover, the policies that augment parental happiness do not reduce the happiness of nonparents. Our results shed light on macro-level causes of emotional processes, with important implications for public policy.

Changes in the policy environment for infant and young child feeding in Vietnam, Bangladesh, and Ethiopia, and the role of targeted advocacy.

PubMed

Harris, Jody; Frongillo, Edward A; Nguyen, Phuong H; Kim, Sunny S; Menon, Purnima

2017-06-13

There is limited literature examining shifts in policy environments for nutrition and infant and young child feeding (IYCF) over time, and on the potential contribution of targeted advocacy to improved policy environments in low- and middle-income countries. This study tracked changes in the policy environment over a four-year period in three countries, and examined the role of targeted nutrition and IYCF advocacy strategies by a global initiative. Qualitative methods, including key informant interviews, social network mapping, document and literature review, and event tracking, were used to gather data on nutrition and IYCF policies and programs, actor networks, and perceptions and salience of nutrition as an issue in 2010 and 2014 in Bangladesh, Ethiopia, and Vietnam. Theoretical frameworks from the policy sciences were used to analyze policy change over time, and drivers of change, across countries. The written policy environment improved to differing extents in each country. By 2014, the discourse in all three countries mirrored international priorities of stunting reduction and exclusive breastfeeding. Yet competing nutrition priorities such as acute malnutrition, food insecurity, and nutrition transitions remained in each context. Key actor groups in each country were government, civil society, development partners and the private sector. Infant formula companies, in particular, emerged as key players against enforcement of IYCF legislation. The role of a targeted IYCF advocacy and policy support initiative was well-recognized in supporting multiple facets of the policy environment in each country, ranging from alliances to legislation and implementation support. Despite progress, however, government commitment to funding, implementation, and enforcement is still emerging in each country, thus challenging the potential impact of new and improved policies. Targeted policy advocacy can catalyze change in national nutrition and IYCF policy environments, especially actor commitment, policy guidance, and legislation. Implementation constraints - financing, capacity and commitment of systems, and competing priorities and actors - are essential to address to sustain further progress. The lack of pressing political urgency for nutrition and IYCF, and the uncertain role of international networks in national policy spaces, has implications for the potential for change.

What happens to drinking when alcohol policy changes? A review of five natural experiments for alcohol taxes, prices, and availability.

PubMed

Nelson, Jon P; McNall, Amy D

2017-05-01

Natural experiments are an important alternative to observational and econometric studies. This paper provides a review of results from empirical studies of alcohol policy interventions in five countries: Denmark, Finland, Hong Kong, Sweden, and Switzerland. Major policy changes were removal of quotas on travelers' tax-free imports and reductions in alcohol taxes. A total of 29 primary articles are reviewed, which contain 35 sets of results for alcohol consumption by various subpopulations and time periods. For each country, the review summarizes and examines: (1) history of tax/quota policy interventions and price changes; (2) graphical trends for alcohol consumption and liver disease mortality; and (3) empirical results for policy effects on alcohol consumption and drinking patterns. We also compare cross-country results for three select outcomes-binge drinking, alcohol consumption by youth and young adults, and heavy consumption by older adults. Overall, we find a lack of consistent results for consumption both within- and across-countries, with a general finding that alcohol tax interventions had selective, rather than broad, impacts on subpopulations and drinking patterns. Policy implications of these findings are discussed.

Changing global essential medicines norms to improve access to AIDS treatment: Lessons from Brazil

PubMed Central

Nunn, A.; Fonseca, E. Da; Gruskin, S.

2009-01-01

Brazil's large-scale, successful HIV/AIDS treatment programme is considered by many to be a model for other developing countries aiming to improve access to AIDS treatment. Far less is known about Brazil's important role in changing global norms related to international pharmaceutical policy, particularly international human rights, health and trade policies governing access to essential medicines. Prompted by Brazil's interest in preserving its national AIDS treatment policies during World Trade Organisation trade disputes with the USA, these efforts to change global essential medicines norms have had important implications for other countries, particularly those scaling up AIDS treatment. This paper analyses Brazil's contributions to global essential medicines policy and explains the relevance of Brazil's contributions to global health policy today. PMID:19333805

Evaluating the efficiency of nuclear energy policies: an empirical examination for 26 countries.

PubMed

Gozgor, Giray; Demir, Ender

2017-08-01

The decarbonization of the global economy is an urgent concern. As a potential solution, it can be important to understand the efficiency of nuclear energy policies. For this purpose, the paper analyzes whether there is a unit root in nuclear energy consumption in 26 countries and it uses the unit root tests with two endogenous (unknown) structural breaks. The paper finds that nuclear energy consumption is stationary around a level and the time trend in 25 of 26 countries and nuclear energy consumption contains a unit root only in France. The paper also discusses the potential implications of the findings.

Science Education and Test-Based Accountability: Reviewing Their Relationship and Exploring Implications for Future Policy

ERIC Educational Resources Information Center

Anderson, Kevin J. B.

2012-01-01

Assuming that quality science education plays a role in economic growth within a country, it becomes important to understand how education policy might influence science education teaching and learning. This integrative research review draws on Cooper's methodology (Cooper, 1982; Cooper & Hedges, 2009) to synthesize empirical findings on the…

Saving for Learning. Strand 2: An International Comparison. Research Report.

ERIC Educational Resources Information Center

Biggar, Sharon

This report compares education systems, incentives, and evidence of saving for education in four countries--Denmark, Japan, New Zealand, and the United States--with implications for the United Kingdom. The report's objective is to identify evidence of saving for education in each comparator country, along with government policies and mechanisms…

Child Development in Developing Countries: Child Rights and Policy Implications

ERIC Educational Resources Information Center

Britto, Pia Rebello; Ulkuer, Nurper

2012-01-01

The Multiple Indicator Cluster Survey was used to provide information on feeding practices, caregiving, discipline and violence, and the home environment for young children across 28 countries. The findings from the series of studies in this Special Section are the first of their kind because they provide information on the most proximal context…

A Comparative Assessment of Higher Education Financing in Six Arab Countries

ERIC Educational Resources Information Center

El-Araby, Ashraf

2011-01-01

This study analyses the policies for financing higher education in six Arab countries: Egypt, Jordan, Lebanon, Morocco, Syria, and Tunisia. It assesses the adequacy of spending on higher education, the efficiency with which resources are utilized, and the equity implications of resource allocations. Based on six detailed case studies, this…

Policy implementation for methicillin-resistant Staphylococcus aureus in seven European countries: a comparative analysis from 1999 to 2015.

PubMed

Kinoshita, Takuya; Tokumasu, Hironobu; Tanaka, Shiro; Kramer, Axel; Kawakami, Koji

2017-01-01

Background : Policies to reduce methicillin-resistant Staphylococcus aureus (MRSA) infections, both healthcare-acquired (HA-MRSA) and livestock-associated (LA-MRSA) are implemented Europe-wide, but evaluations are difficult for countries yet to implement such policies. A descriptive study was conducted, describing multinational MRSA rates and policy implementation, focusing on MRSA mandatory surveillance. We also investigated antibiotic use and MRSA rates and the use of veterinary antibiotics. Methods : This study used Europe-wide surveillance data on infectious diseases (EARS-Net), antibiotic consumption (ESAC-Net), and veterinary medicine (ESVAC). We visualized LA- and HA-MRSA related policies and MRSA rates from 1999 to 2015 in seven European countries. Changes in MRSA rates after implementation of an MRSA mandatory surveillance policy were investigated by setting each country as rate of 1.0 and compared countries with and without such policy. Correlations between antibiotic use and MRSA rates from 1999 to 2012 were investigated using defined daily dose. Sales data were used to investigate veterinary antibiotic use. Results : MRSA rates were 1-45.4% across the seven countries between 1999 and 2015. MRSA rates changed between 0.61 and 0.24 after the implementation of mandatory surveillance policies within a 6-12 year span. The rate of decrease rate in implemented and non-implemented countries ranged from 10% in Spain to 76% in the UK. The correlation between MRSA rate and cephalosporin consumption was r  = 0.419, and for fluoroquinolones r  = 0.305. Mean annual sales of veterinary cephalosporin and quinolone antibiotics were lowest in the UK (0.8 mg/PCU) and highest in Spain (9.7 mg/PCU) between 2009 and 2014. Conclusions : There were similar but different health policy implications in the seven countries regarding LA- and HA-MRSA. Although causation could not be defined, some policies such as mandatory surveillance may be helpful for countries that have yet to implement an MRSA policy. Further investigations are needed to evaluate each policies.

Attitudes and beliefs about secondhand smoke and smoke-free policies in four countries: findings from the International Tobacco Control Four Country Survey.

PubMed

Hyland, Andrew; Higbee, Cheryl; Borland, Ron; Travers, Mark; Hastings, Gerard; Fong, Geoffrey T; Cummings, K Michael

2009-06-01

This paper describes the varying levels of smoking policies in nationally representative samples of smokers in four countries and examines how these policies are associated with changes in attitudes and beliefs about secondhand smoke over time. We report data on 5,788 respondents to Wave 1 of the International Tobacco Control Four Country Survey who were employed at the time of the survey. A cohort of these respondents was followed up with two additional survey waves approximately 12 months apart. Respondents' attitudes and beliefs about secondhand smoke as well as self-reported policies in their workplace and in bars and restaurants in their community were assessed at all waves. The level of comprehensive smoke-free policies in workplaces, restaurants, and bars increased over the study period for all countries combined and was highest in Canada (30%) and lowest in the United Kingdom (0%) in 2004. In both cross-sectional and longitudinal analyses, stronger secondhand smoke policies were associated with more favorable attitudes and support for comprehensive regulations. The associations were the strongest for smokers who reported comprehensive policies in restaurants, bars, and their workplace for all three survey waves. Comprehensive smoke-free policies are increasing over time, and stronger policies and the public education opportunities surrounding their passage are associated with more favorable attitudes toward secondhand smoke regulations. The implication for policy makers is that, although the initial debate over smoke-free policies may be tumultuous, once people understand the rationale for implementing smoke-free policies and experience their benefits, public support increases even among smokers, and compliance with smoke-free regulations increases over time.

Cultural Beliefs regarding People with Disabilities in Namibia: Implications for the Inclusion of People with Disabilities

ERIC Educational Resources Information Center

Haihambo, Cynthy; Lightfoot, Elizabeth

2010-01-01

Namibia is a southern African country with national level policies promoting community inclusion and inclusive education. Despite these policies, people with disabilities are often excluded from schools and community life. This study explores the nuanced cultural beliefs about the causes of disability in Namibia, and the impacts of such beliefs on…

Malaysia's social policies on mental health: a critical theory.

PubMed

Mubarak, A Rahamuthulla

2003-01-01

This article aims to review the social policies on mental health and mental illness in Malaysia. Using critical theory, major policy issues pertaining to mental health and mental illness such as mental health legislation, prevalence rates and quality of services available to the people with mental health problems are discussed in detail. Implications of these issues on persons with mental health problems are critically evaluated. The paper highlights that the other countries in ASEAN region also require similar review by policy literature.

Trade in Educational Services: An Overview of GATS and Policy Implications for Higher Agricultural Education in India

ERIC Educational Resources Information Center

Soam, S. K.; Sastry, R. Kalpana; Rashmi, H. B.

2007-01-01

Higher education is a service that contributes to national development, integration and regional cohesion. Agricultural education in particular has been viewed in many developing countries as a significant contributor to sustainable development and poverty alleviation. In view of its public mandate, higher education in most countries is regulated…

Assisted reproduction: a comparative review of IVF policies in two pro-natalist countries.

PubMed

Balabanova, Ekaterina; Simonstein, Frida

2010-06-01

Policies on reproduction have become an increasingly important tool for governments seeking to meet the so-called demographic 'challenge' created by the combination of low fertility and lengthening life expectancies. However, the tension between the state and the market in health care is present in all countries around the world due to the scare resources available and the understandable importance of the health issues. The field of assisted reproduction, as part of the health care system, is affected by this tension with both-the state's and the market's involvements-carrying important implications. Bulgaria and Israel share the same size of population, are markedly paternalistic and both have strong pro-natalist cultures by which large families are expected. For a range of reasons the two countries contrast sharply, however, in terms of their capacity to intervene in the health system, and also in terms of the political will to act on matters of reproduction. This paper examines how assisted reproduction, as reflected by present policies in both countries, influences women's welfare and considers whose interests the practices of assisted reproduction in these countries actually serve. By reviewing some of the present data on women's status in Bulgaria and Israel and assessing both states' policies and involvement in assisted reproduction this paper helps to identify some of the intended and unintended consequences of assisted reproduction policies in different countries.

Applying behavioural economics to health systems of low- and middle-income countries: what are policymakers' and practitioners' views?

PubMed

Trujillo, Antonio J; Glassman, Amanda; Fleisher, Lisa K; Nair, Divya; Duran, Denizhan

2015-07-01

Interest in behavioural economics has soared in recent years, particularly because of its application to several areas of public policy, now including international development, education, and health. Yet, little is known about how the policy and political implications of behavioural economics are perceived among stakeholders. Using an innovative vignette-based online survey, we assessed the opinions of 520 policymakers and practitioners around the world about health policy recommendations emanating from behavioural economics principles that are relevant to low- and middle-income country settings. We also determined the sources of disagreement among the respondents. The results suggest that there is strong support for health policies based on the concepts of framing choices to overcome present bias, providing periodic information to form habits, and messaging to promote social norms. There is less support for policies which use cash rewards as extrinsic motivators either to change individual behaviour related to the management of chronic conditions or to mitigate risky sexual behaviour. The sources of disagreement for these policy prescriptions derive mainly from normative concerns and perceived lack of effectiveness of such interventions. Addressing these disagreements may require developing a broader research agenda to explore the policy and political implications of these prescriptions. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Air pollution and rural biomass fuels in developing countries: A pilot village study in India and implications for research and policy

NASA Astrophysics Data System (ADS)

Smith, Kirk R.; Aggarwal, A. L.; Dave ^✠, R. M.

The results of a pilot study in four Indian villages of personal exposure to total suspended particulates (TSP) and particulate benzo(a)pyrene (BaP) of women cooking on simple stoves using traditional biomass fuels are presented together with socioeconomic and fuel-use determinations. TSP exposures averaged nearly 7 mg m -3 and BaP about 4000 ng m -3 during the cooking period which occupied 10% of the year. The factors affecting indoor air pollution exposures in rural areas of developing countries are categorized and discussed by reference to the few published field measurements. Comparisons are made with other common exposures in urban and occupational settings. The sparse information indicates that rural exposures are relatively high. Subjects for future research are outlined and general policy implications mentioned.

Policy implications of trends in Turkey's meat sector with respect to 2023 vision.

PubMed

Yavuz, Fahri; Bilgic, Abdulbaki; Terin, Mustafa; Guler, Irfan O

2013-12-01

Turkey has become one of the leading emerging economies in the world being second after China as the highest economically growing country with 8.9% economic growth rate in 2010. Forecasting impacts of this development in coming 10 years might have very important policy implications for the meat sector in the framework of 2013 vision of Turkey. In this study, annual time series data which contain several key variables of meat sector in last 26 years (1987-2012) are used to forecast the variables of the coming twelve years (2013-2024) to drive policy implications by considering the impacts of high economic growths, crises and major policy changes. Forecasted future values of the variables for 2023 in the sector are assessed and compared with recent national and international values to drive policy implications. The results show that the economic growth results in the increase in per capita income and thus increased demand for meat seemed to foster the meat sector. Therefore, these macroeconomic indicators need to be better in addition to improvements at micro level for establishing competitive meat sector and thus reaching aimed consumption level of meat. Copyright © 2013 Elsevier Ltd. All rights reserved.

Parenthood and Happiness: Effects of Work-Family Reconciliation Policies in 22 OECD Countries

PubMed Central

Glass, Jennifer; Simon, Robin W.; Andersson, Matthew A

2016-01-01

The recent proliferation of studies examining cross-national variation in the association between parenthood and happiness reveal accumulating evidence of lower levels of happiness among parents than nonparents in most advanced industrialized societies. Conceptualizing parenting as a stressor buffered by institutional support, we hypothesize that parental status differences in happiness are smaller in countries providing more resources and support to families. Our analyses of the European Social Surveys (ESS) and International Social Survey Programme (ISSP) reveal considerable variation in the parenthood gap in happiness across countries, with the U.S. showing the largest disadvantage of parenthood. We also find that more generous family policies, particularly paid time off and childcare subsidies, are associated with smaller disparities in happiness between parents and non-parents. Moreover, the policies that augment parental happiness do not reduce the happiness of nonparents. Our results shed light on macro-level causes of emotional processes, with important implications for public policy. PMID:28082749

Training Implications of Technological Change in Manufacturing in New Industrial Countries: The Case of Ireland. Training Policies Discussion Paper No. 14.

ERIC Educational Resources Information Center

International Labour Office, Geneva (Switzerland).

This report on Ireland is one in a series of studies for a research project designed to identify training and education policies pursued by governments and individual firms that have contributed to innovation, technological adaptation, and skill development in manufacturing. Part 1 describes Ireland's economic, social, and educational structure…

Dispatches from Flyover Country: Four Appraisals of Impacts of Trump's Immigration Policy on Families, Schools, and Communities

ERIC Educational Resources Information Center

Hamann, Edmund T.; Morgenson, Cara

2017-01-01

A university professor and high school ESL teacher, both based in Lincoln Nebraska, each write two short essays that detail implications of the Trump administration immigration policies for students, teachers, schools, and communities. The first two dispatches come from the transition period (after Trump won but while Obama still presided) while…

Privatisation Policies and Postprivatisation Control Devices in India's Higher Education: Evidence from a Regional Study and Implications for Developing Countries

ERIC Educational Resources Information Center

Narayana, M. R.

2006-01-01

This article focuses on economic analysis of privatisation policies and postprivatisation control devices in India's higher education. As a case study, the experiences of Karnataka State in collegiate education under general higher education are emphasised. A change in public financing, rather than a shift of public ownership and management to…

PISA and Global Educational Governance--A Critique of the Project, Its Uses and Implications

ERIC Educational Resources Information Center

Sjøberg, Svein

2015-01-01

The PISA project has steadily increased its influence on the educational discourse and educational policies in the now 70 participating countries. The educational debate has become global, and the race to improve PISA-rankings has become high priority in many countries. For governments the PISA-test is a high-stake test. Governments are blamed for…

The Educational Implications of Introducing a NQF for Developing Countries

ERIC Educational Resources Information Center

Young, Michael

2011-01-01

The one-year research project on the implementation of NQFs in developing countries was launched by the ILO 2009 in collaboration with the ETF. This article reviews some of the educational issues that arose from the project. The findings of the case studies raise issues that are important for how future research and policy on NQFs is taken…

The Emergence of a Binational Mexico-US Workforce: Implications for Farm Labor Workforce Security.

ERIC Educational Resources Information Center

Kissam, Edward; Intili, Jo Ann; Garcia, Anna

The U.S. agricultural labor market is already, in many respects, a binational one, and it will become increasingly one in which workers who are born in Mexico will follow a variety of worklife trajectories that take them back and forth between both countries. Recognition of this reality has important implications for policy development and program…

International nurse migration: lessons from the Philippines.

PubMed

Brush, Barbara L; Sochalski, Julie

2007-02-01

Developed countries facing nursing shortages have increasingly turned to aggressive foreign nurse recruitment, primarily from developing nations, to offset their lagging domestic nurse supplies and meet growing health care demands. Few donor nations are prepared to manage the loss of their nurse workforce to migration. The sole country with an explicit nurse export policy and the world's leading donor of nurse labor - the Philippines - is itself facing serious provider maldistribution and countrywide health disparities. Examining the historical roots of Philippines nurse migration provides lessons from which other nurse exporting countries may learn. The authors discuss factors that have predicated nurse migration and policies that have eased the way. Furthermore, the authors analyze how various stakeholders influence migratory patterns, the implications of migration for nurses and the public in their care, and the challenges that future social policy and political systems face in addressing global health issues engendered by unfettered recruitment of nurses and other health workers.

Managing menstruation in the workplace: an overlooked issue in low- and middle-income countries.

PubMed

Sommer, Marni; Chandraratna, Sahani; Cavill, Sue; Mahon, Therese; Phillips-Howard, Penelope

2016-06-06

The potential menstrual hygiene management barriers faced by adolescent girls and women in workplace environments in low- and middle-income countries has been under addressed in research, programming and policy. Despite global efforts to reduce poverty among women in such contexts, there has been insufficient attention to the water and sanitation related barriers, specifically in relation to managing monthly menstruation, that may hinder girls' and women's contributions to the workplace, and their health and wellbeing. There is an urgent need to document the specific social and environmental barriers they may be facing in relation to menstrual management, to conduct a costing of the implications of inadequate supportive workplace environments for menstrual hygiene management, and to understand the implications for girls' and women's health and wellbeing. This will provide essential evidence for guiding national policy makers, the private sector, donors and activists focused on advancing girls' and women's rights.

International experiences of promoting generics use and its implications to China.

PubMed

Sun, Jing

2013-05-01

To summarize international experiences in promoting use of generics and to extract essence for China's reference. This is a commentary of two systematic reviews about policies to promote use of generics and its implications to China. Price, reimbursement, and generic substitution policies in European countries, and approaches in low and middle income countries in promoting market competition, appropriate intellectual property right protection strategy, and necessary demand side incentives, are all meaningful for China to contain soaring pharmaceutical expenditures, and to maintain the achievements and outcomes of the national health system reform. Effective promotion of generics use must be practice based on the real situation. Tailor-made and comprehensive measures are needed to address both demand and supply sides barriers before achieving tangible cost containment effect without unexpected side effects. © 2013 Wiley Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.

The relevance of systematic reviews on pharmaceutical policy to low- and middle-income countries.

PubMed

Gray, Andrew Lofts; Suleman, Fatima

2015-10-01

Low- and middle-income countries (LMICs) rely on available evidence when devising and implementing pharmaceutical policies. Aim of the review To provide a critical overview of systematic reviews of pharmaceutical policies, with particular focus on the relevance of such reviews in low- and middle-income countries. A search for systematic reviews (SRs) of studies of the interventions of interest was conducted until May 2009 in MEDLINE, EconLit, CINAHL, the Cochrane site, ProQuest, EMBASE, JOLIS, ISI Web of Science, International Pharmaceutical Abstracts, International Network for Rational Use of Drugs, National Technical Information Service, Public Affairs Information Service, SourceOECD, the System for Information on Grey Literature in Europe, and the WHO library database. The search was updated to July 2013, based on the yields of the initial search strategy. 20 SRs that met all inclusion criteria were retrieved in full text. Four SRs were subsequently rejected on the basis of quality considerations and the findings of 16 SRs were extracted and their applicability in LMICs considered. Of these, 5 were Cochrane Reviews. All included SRs were published in English. SRs related to registration and classification policies, marketing policies, prescribing policies, reimbursement policies, policies on price and payments, co-payments and caps and multi-component policies were retrieved. No SRs related to patent and profit policies, sales and dispensing policies, policies that regulate the provision of health insurance, or policies on patient information were retrieved. Only one of the systematic reviews retrieved utilised a study conducted in a developing country. The direct applicability of the evidence from these SRs in LMICs is limited. However, as middle-income countries move towards universal health coverage, the multi-component policies that govern reimbursement for medicines, and which impose caps on payments and co-payments by patients, may become more applicable. As such they will have direct implications for the practice of clinical pharmacy in such settings. Considerable effort will be needed to systemically review the available primary evidence from studies conducted in developing country settings, where such data exist.

[The Citizen Constitution and the 25th anniversary of the Brazilian Unified National Health System (SUS)].

PubMed

Paim, Jairnilson Silva

2013-10-01

This article, celebrating the 25th anniversary of Brazil's 1988 Constitution, aims to review the country's social policy development, discuss political projects, and analyze challenges for the sustainability of the Unified National Health System (SUS). Based on public policymaking studies, the article revisits the origins of liberal social policy, focused on social assistance, and analyzes the hegemony of U.S. policies targeting poverty and their repercussions for universal policies. After identifying the formulation of political projects in Brazil's democratic transition, it discusses their implications during the various Administrations since 1988, along with the difficulties faced by the National Health System. The article concludes that the political forces occupying government in the last two decades have failed to present a project for the country on the same level as those who drafted the Citizen Constitution.

Mental health system development profiles and indicators of scientific and technology innovation.

PubMed

Vilela Chaves, Catari; Moro, Sueli

2009-06-01

In this paper, mental health is discussed in the context of the system of innovation in health care. A set of mental illnesses is investigated in order to broaden our understanding of how they can be connected to the health innovation system. Two country typologies are investigated. The first typology uses the Grade of Membership approach to group 112 countries with similar policies, programs, legislation, treatment and mental health funding methods for 2001. The second is the hierarchical cluster approach, which uses scientific papers and patents from 118 countries as proxies for science and technology in 2001. The results indicate the presence of some countries in two extreme groups. On the one hand, countries with the best performance in the field of mental health have the best mental health infrastructure and are also ranked first in science and technology in this area. On the other hand, countries with the worst performance in the field of mental health also have the worst mental health infrastructure and are in the worst position in science and technology. By analyzing the international data on scientific publications and mental health systems, we find that as countries become more advanced, they significantly increase their scientific production as well as their focus on the health sector. These two movements make it possible for countries to build their own catching-up processes, focused on the health system. Accordingly, it is expected that mental health care can benefit from that strengthening in the health care sector. IMPLICATION FOR HEALTH CARE PROVISION AND USE: This paper identifies which countries need to improve their mental health and science and technology infrastructures. IMPLICATION FOR HEALTH POLICIES: The main policy recommendation refers to the strengthening of the health innovation system. This policy was chosen because, statistically speaking, according to the crisp sets and the fuzzy sets theories, this evaluation, made with data from general and especially mental health care, indicates that competence in the mental health care area requires a strong presence in terms and an emphasis on overall health. A main research issue should be the comparison of the results of this work with those from the new database published by the World Health Organization (WHO). In this way, it will be possible to observe whether or not countries have improved their infrastructure in mental health care.

Research Self-Efficacy Sources and Research Motivation in a Foreign Language University Faculty in Mexico: Implications for Educational Policy

ERIC Educational Resources Information Center

Reyes-Cruz, María del Rosario; Perales-Escudero, Moisés Damián

2016-01-01

The research self-efficacy and motivation of foreign language (FL) faculty in periphery countries is under-researched, yet there is a need to understand the impact of public policies that drive such faculty to conduct research. This paper reports a qualitative case study investigating research self-efficacy and research motivation in a group of…

Training Implications of Technological Change in Manufacturing in New Industrial Countries: The Case of Yugoslavia. Training Policies Discussion Paper No. 15.

ERIC Educational Resources Information Center

Matejic, Vlastimir; Kamhi, Meri

This report is a study of the training implications of technological change in manufacturing in Yugoslavia. Part 1 analyzes the general technological and educational infrastructure in Yugoslavia. The sources of technology as well as the present state and future prospects of technological research are described. Education is discussed in terms of…

STATISTICS AND INTELLIGENCE IN DEVELOPING COUNTRIES: A NOTE.

PubMed

Kodila-Tedika, Oasis; Asongu, Simplice A; Azia-Dimbu, Florentin

2017-05-01

The purpose of this study is to assess the relationship between intelligence (or human capital) and the statistical capacity of developing countries. The line of inquiry is motivated essentially by the scarce literature on poor statistics in developing countries and an evolving stream of literature on the knowledge economy. A positive association is established between intelligence quotient (IQ) and statistical capacity. The relationship is robust to alternative specifications with varying conditioning information sets and control for outliers. Policy implications are discussed.

Argentina: Its Physical-Cultural Backgrounds and Implications for United States Foreign Policy

ERIC Educational Resources Information Center

Vent, Herbert J.

1974-01-01

This article provides a short history of political events in Argentina and a look at the people, geography, and economy of the country in order to consider current relations between Argentina and the United States. (JH)

Policy directions in urban health in developing countries--the slum improvement approach.

PubMed

Harpham, T; Stephens, C

1992-07-01

The urban development, or housing, sector has a longer experience of addressing the problems of the urban poor in developing countries than the health sector. In recent years the policy of 'slum improvement', which involves both sectors, has attracted the support of international donors. This article documents the development of the slum improvement approach and addresses key issues of the approach which have implications for health planning: covering the poorest dwellers; relocation; land tenure; gentrification; debt burdens and the impact on women. Questions about the approach which still need answering are defined and a summary of the constraints in slum improvement and potential solutions is presented.

Achieving workforce growth in UK nursing: policy options and implications.

PubMed

Buchan, James

2009-01-01

This paper examines how the National Health Service (NHS) in the UK achieved significant nursing workforce growth during the period between 2000 and 2006 and discusses the policy implications of the methods used to achieve this staffing growth. Data analysis, literature review and policy analysis. NHS nurse staffing growth was approximately 25% over the period 1997-2007, with most growth occurring in the years between 1999 and 2005. Whilst increases in intakes to home-based pre-registration education was a factor in achieving growth, the pace and level of growth which occurred was only possible by using active international recruitment, which was adopted as a deliberate national policy. The numbers of nurses and midwives entering the UK from other countries increased rapidly from 1999 onwards, to a peak in 2002, and then reduced markedly in the period from 2005 onwards. The policy of supporting international recruitment shifted rapidly in late 2005/2006 when financial difficulties hit the NHS and staffing growth was curtailed. Active international recruitment can contribute to health sector staffing growth, assuming the recruiting country has the resources to recruit and can tap into international markets, but it may not be effective in addressing all types of skills shortages. If it is not well linked to other components of workforce planning it may cause difficulties of over expansion, as well as raising broader issues of the ethics and impact.

Outdoor cooking prevalence in developing countries and its implication for clean cooking policies

NASA Astrophysics Data System (ADS)

Langbein, Jörg; Peters, Jörg; Vance, Colin

2017-11-01

More than 3 billion people use wood fuels for their daily cooking needs, with detrimental health implications related to smoke emissions. Best practice global initiatives emphasize the dissemination of clean cooking stoves, but these are often expensive and suffer from interrupted supply chains that do not reach rural areas. This emphasis neglects that many households in the developing world cook outdoors. Our calculations suggest that for such households, the use of less expensive biomass cooking stoves can substantially reduce smoke exposure. The cost-effectiveness of clean cooking policies can thus be improved by taking cooking location and ventilation into account.

Kenya AIDS Indicator Surveys 2007 and 2012: implications for public health policies for HIV prevention and treatment.

PubMed

Maina, William K; Kim, Andrea A; Rutherford, George W; Harper, Malayah; K'Oyugi, Boniface O; Sharif, Shahnaaz; Kichamu, George; Muraguri, Nicholas M; Akhwale, Willis; De Cock, Kevin M

2014-05-01

AIDS Indicator Surveys are standardized surveillance tools used by countries with generalized HIV epidemics to provide, in a timely fashion, indicators for effective monitoring of HIV. Such data should guide responses to the HIV epidemic, meet program reporting requirements, and ensure comparability of findings across countries and over time. Kenya has conducted 2 AIDS Indicator Surveys, in 2007 (KAIS 2007) and 2012-2013 (KAIS 2012). These nationally representative surveys have provided essential epidemiologic, sociodemographic, behavioral, and biologic data on HIV and related indicators to evaluate the national HIV response and inform policies for prevention and treatment of the disease. We present a summary of findings from KAIS 2007 and KAIS 2012 and the impact that these data have had on changing HIV policies and practice.

Fallacies Affecting Policy and Practice in the Teaching of English as a Foreign Language in State Primary Schools in Asia

ERIC Educational Resources Information Center

Hayes, David

2017-01-01

This article discusses the impact of the worldwide trend to introduce English as a foreign language (EFL) into primary schools at ever younger ages. This trend has gained momentum in recent years, affecting millions of children in countries throughout Asia. A policy decision of this kind has far-reaching implications but it is often made without…

A scoping review of training and deployment policies for human resources for health for maternal, newborn, and child health in rural Africa.

PubMed

Murphy, Gail Tomblin; Goma, Fastone; MacKenzie, Adrian; Bradish, Stephanie; Price, Sheri; Nzala, Selestine; Rose, Annette Elliott; Rigby, Janet; Muzongwe, Chilweza; Chizuni, Nellisiwe; Carey, Amanda; Hamavhwa, Derrick

2014-12-16

Most African countries are facing a human resources for health (HRH) crisis, lacking the required workforce to deliver basic health care, including care for mothers and children. This is especially acute in rural areas and has limited countries' abilities to meet maternal, newborn, and child health (MNCH) targets outlined by Millennium Development Goals 4 and 5. To address the HRH challenges, evidence-based deployment and training policies are required. However, the resources available to country-level policy makers to create such policies are limited. To inform future HRH planning, a scoping review was conducted to identify the type, extent, and quality of evidence that exists on HRH policies for rural MNCH in Africa. Fourteen electronic health and health education databases were searched for peer-reviewed papers specific to training and deployment policies for doctors, nurses, and midwives for rural MNCH in African countries with English, Portuguese, or French as official languages. Non-peer reviewed literature and policy documents were also identified through systematic searches of selected international organizations and government websites. Documents were included based on pre-determined criteria. There was an overall paucity of information on training and deployment policies for HRH for MNCH in rural Africa; 37 articles met the inclusion criteria. Of these, the majority of primary research studies employed a variety of qualitative and quantitative methods. Doctors, nurses, and midwives were equally represented in the selected policy literature. Policies focusing exclusively on training or deployment were limited; most documents focused on both training and deployment or were broader with embedded implications for the management of HRH or MNCH. Relevant government websites varied in functionality and in the availability of policy documents. The lack of available documentation and an apparent bias towards HRH research in developed areas suggest a need for strengthened capacity for HRH policy research in Africa. This will result in enhanced potential for evidence uptake into policy. Enhanced alignment between policy-makers' information needs and the independent research agenda could further assist knowledge development and uptake. The results of this scoping review informed an in-depth analysis of relevant policies in a sub-set of African countries.

Introduction: The provision of animal health services in a changing world.

PubMed

de Haan, C

2004-04-01

In the future, animal health services in developing countries will need to operate in a continuously changing policy, institutional and commercial environment. Firstly, the changing policies and priorities of national policy-makers regarding public and private sector roles, reinforced in Africa by the donors, have reduced funding and support for the large number of tasks that animal health services have traditionally performed, and there is continuing pressure from policy-makers to focus on what the public sector can do best. Secondly, poverty reduction has become one of the main criteria guiding the allocation of official development assistance, which has major implications for the main target clientele of veterinary services. Thirdly, population growth, increasing income and urbanisation are causing a marked increase in demand for livestock products in the developing world. As a result, the entire livestock commodity chain is undergoing major structural changes, which has significant implications for the definition and control of food safety standards. Fourthly, globalisation, and increasing trade and travel have greatly increased the risk of disease transmission between different countries and continents. Veterinary institutions in the developing world need to adapt to these challenges. They will have to be able to focus on the essential public sector roles. At the same time they must deliver those essential services to the poor, and provide the policy framework to ensure that the inevitable structural changes in the commodity chain take place in an equitable and sustainable fashion, with an acceptable level of health risk for the consumer. According to the weight given to these different objectives, changes in the institutional set-up need to be considered. This issue of the Scientific and Technical Review addresses these challenges. It begins by reviewing the basic economic characteristics underlying the provision of animal health services, and then examines the alternative delivery systems that are emerging in the developing world and their strengths and weaknesses. The implications for food safety and trade are specifically highlighted. Also included are the practical experiences of countries, from all along the development continuum, that have introduced alternative systems. This paper deals with implications for the future, and while the growing importance of veterinary care for companion animals is acknowledged, the focus is on veterinary services for food animals.

Ethiopia's Grand Renaissance Dam: Implications for Downstream Riparian Countries

NASA Astrophysics Data System (ADS)

Zhang, Y.; Block, P. J.; Hammond, M.; King, A.

2013-12-01

Ethiopia has begun seriously developing their significant hydropower potential by launching construction of the Grand Ethiopian Renaissance Dam (GERD) on the Blue Nile River to facilitate local and regional growth. Although this has required substantial planning on Ethiopia's part, no policy dictating the reservoir filling rate strategy has been publicly issued. This filling stage will have clear implications on downstream flows in Sudan and Egypt, complicated by evaporative losses, climate variability, and climate change. In this study, various filling policies and future climate states are simultaneously explored to infer potential streamflow reductions at Lake Nasser, providing regional decision-makers with a set of plausible, justifiable, and comparable outcomes. Schematic of the model framework Box plots of 2017-2032 percent change in annual average streamflow at Lake Nasser for each filling policy constructed from the 100 time-series and weighted precipitation changes. All values are relative to the no dam policy and no changes to future precipitation.

Analysis of prices paid by low-income countries - how price sensitive is government demand for medicines?

PubMed

Srivastava, Divya; McGuire, Alistair

2014-07-30

Access to medicines is an important health policy issue. This paper considers demand structures in a selection of low-income countries from the perspective of public authorities as the evidence base is limited. Analysis of the demand for medicines in low-income countries is critical for effective pharmaceutical policy where regulation is less developed, health systems are cash constrained and medicines are not typically subsidised by a public health insurance system This study analyses the demand for medicines in low-income countries from the perspective of the prices paid by public authorities. The analysis draws on a unique dataset from World Health Organization (WHO) and Health Action International (HAI) using 2003 data on procurement prices of medicines across 16 low-income countries covering 48 branded drugs and 18 therapeutic categories. Variation in prices, the mark-ups over marginal costs and estimation of price elasticities allows assessment of whether these elasticities are correlated with a country's national income. Using the Ramsey pricing rule, the study's findings suggest that substantial cross-country variation in prices and mark-ups exist, with price elasticities ranging from -1 to -2, which are weakly correlated with national income. Government demand for medicines thus appears to be price elastic, raising important policy implications aimed at improving access to medicines for patients in low-income countries.

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

PubMed Central

2011-01-01

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 political choices at all government and health system levels. PMID:21251293

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

PubMed

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.

Comment on the implications of external price referencing of pharmaceuticals in Middle East countries.

PubMed

Carapinha, João L

2016-01-01

External Price Referencing (EPR) is frequently used by countries to control pharmaceutical prices but studies to substantiate its use in the Middle East (ME) is lacking. The paper by Kalo et al set-out to fill this lacuna through three objectives: i) to document the use of EPR in 7 ME countries, ii) to assess whether pharmaceutical EPR resulted in a narrow price corridor for patented pharmaceuticals, and iii) to analyse factors influencing pharmaceutical prices. This comment discusses why the paper fell short of achieving these objectives and over-stated the results. Despite a thought-provoking contribution, objective 1 presented few new insights on EPR mechanisms, objective 2 deployed an inappropriate research design, and the policy implications of objective 3 are voided given the choice of explanatory variables.

Exploring team working and shared leadership in multi-disciplinary cancer care.

PubMed

Willcocks, Stephen George

2018-02-05

Purpose The purpose of this paper is to explore the relevance of shared leadership to multi-disciplinary cancer care. It examines the policy background and applies concepts from shared leadership to this context. It includes discussion of the implications and recommendations. Design/methodology/approach This is a conceptual paper examining policy documents and secondary literature on the topic. While it focuses on the UK National Health Services, it is also relevant to other countries given they follow a broadly similar path with regard to multi-disciplinary working. Findings The paper suggests that shared leadership is a possible way forward for multi-disciplinary cancer care, particularly as policy developments are supportive of this. It shows that a shared perspective is likely to be beneficial to the further development of multi-disciplinary working. Research limitations/implications Adopting shared leadership needs to be explored further using appropriate empirical research. Practical implications The paper offers comments on the implications of introducing shared leadership and makes recommendations including being aware of the barriers to its implementation. Originality/value The paper offers an alternative view on leadership in the health-care context.

Research in Review. Malnutrition and Children's Development.

ERIC Educational Resources Information Center

Stevens, Joseph H., Jr.; Baxter, Delia H.

1981-01-01

Indicates how various degrees of malnutrition affect children's development. Reviews research conducted in several developing countries and the United States, and describes the nutritional status of children in the United States. Implications for nutrition programs, research and policy formation are pointed out. (Author/RH)

A qualitative review of existing national and international occupational safety and health policies relating to occupational sedentary behaviour.

PubMed

Coenen, Pieter; Gilson, Nicholas; Healy, Genevieve N; Dunstan, David W; Straker, Leon M

2017-04-01

Prolonged sedentary time is now recognised as an emergent ergonomics issue. We aimed to review current occupational safety and health policies relevant to occupational sedentary behaviour. An electronic search for documents was conducted on websites of ergonomics and occupational safety and health organisations from 10 countries and six international/pan-European agencies. Additionally, 43 informants (nine countries) were contacted and an international conference workshop held. 119 documents (e.g. legislation, guidelines, codes of practice) were identified. Using a qualitative synthesis, it was observed that many jurisdictions had legal frameworks establishing a duty of care for employers, designers/manufacturers/suppliers and employees. While no occupational authority policies focusing specifically on sedentary behaviour were found, relevant aspects of existing policies were identified. We highlight implications for ergonomics research and practice and recommend the development of policy to specifically address occupational sedentary behaviour and support workplace initiatives to assess and control the risks of this emergent hazard. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Social Determinants of Infant Mortality and Birth Outcomes in Western Developed Nations: A Cross-Country Systematic Review

PubMed Central

Kim, Daniel; Saada, Adrianna

2013-01-01

Infant mortality (IM) and birth outcomes, key population health indicators, have lifelong implications for individuals, and are unequally distributed globally. Even among western industrialized nations, striking cross-country and within-country patterns are evident. We sought to better understand these variations across and within the United States of America (USA) and Western Europe (WE), by conceptualizing a social determinants of IM/birth outcomes framework, and systematically reviewing the empirical literature on hypothesized social determinants (e.g., social policies, neighbourhood deprivation, individual socioeconomic status (SES)) and intermediary determinants (e.g., health behaviours). To date, the evidence suggests that income inequality and social policies (e.g., maternal leave policies) may help to explain cross-country variations in IM/birth outcomes. Within countries, the evidence also supports neighbourhood SES (USA, WE) and income inequality (USA) as social determinants. By contrast, within-country social cohesion/social capital has been underexplored. At the individual level, mixed associations have been found between individual SES, race/ethnicity, and selected intermediary factors (e.g., psychosocial factors) with IM/birth outcomes. Meanwhile, this review identifies several methodological gaps, including the underuse of prospective designs and the presence of residual confounding in a number of studies. Ultimately, addressing such gaps including through novel approaches to strengthen causal inference and implementing both health and non-health policies may reduce inequities in IM/birth outcomes across the western developed world. PMID:23739649

Distributional Orientation and Health Outcomes in OECD Countries.

PubMed

Safaei, Jalil

2015-01-01

This study uses data from the Organisation for Economic Co-operation and Development countries over the 2008-2010 period to construct indicators of "pro-primary" and "pro-secondary" distributions. The former is concerned with the original distribution of income through the market, whereas the latter is concerned with the redistribution efforts of the government. The study ranks these countries along these dimensions to create a distributional orientation map for such countries. It finds that the Scandinavian countries occupy the top rankings in terms of equity in pro-primary distribution, followed by countries with a Bismarckian welfare state regime. The Scandinavian countries also rank very high on equity in pro-secondary distribution, along with some of the top-ranking Bismarckian countries. More significantly, the study finds that the countries' health outcomes are associated more strongly with the pro-primary distributional stance than with the pro-secondary distributional stance. A key policy implication is that to achieve better and more equitable health, it is more effective to design a level playing field for market participants in the first place, than to try to mend inequities after the fact through remedial social policy. © The Author(s) 2015.

Understanding A + B bidding patterns and policy implications for ODOT project lettings.

DOT National Transportation Integrated Search

2014-10-01

A key challenge for Departments of Transportation around the country is to keep the cost of construction low : while ensuring that projects will be completed in a timely manner. Those goals can often be conflicting. The : purpose of this research pro...

Saudi Arabia: perspective on oil, foreign policy, and the Arab-Israeli conflict, 1970-1980

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kurdi, M.A.M.

1982-01-01

This study examines, through a descriptive and analytical approach, the Saudi perspective on its oil power and policies in world affairs and how the Arab-Israeli conflict affects these policies. A special emphasis on the United States-Saudi Arabian relationship is made, since Saudi Arabia looks at the United States as the key factor in the Arab-Israeli conflict. To serve this end, the dissertation is divided into three parts. Part one examines the economic and political reality of oil power, its implication and limitation. Also, this part examines the behavior and the policies of the oil companies, the oil-consuming countries, and themore » oil-producing countries after the structural change of the oil industry and the shift in control of production and prices from the hands of the oil companies to those of the oil-producing countries. Part two examines the Saudi Arabian economy, the role of oil in developing this economy, and the effect of Saudi development plans on Saudi oil policies. Part three examines Saudi foreign policy, especially its role in the Arab-Israeli conflict, with emphasis on the Saudi oil role in this regard. Also, this part examines the United States-Saudi Arabia relationship and interest, the United States interest in Israel, and, finally, how Riyadh sees these interests affecting United States policies in the Middle East.« less

Transforming long-term care pain management in north america: the policy-clinical interface.

PubMed

Hadjistavropoulos, Thomas; Marchildon, Gregory P; Fine, Perry G; Herr, Keela; Palley, Howard A; Kaasalainen, Sharon; Béland, François

2009-04-01

The undertreatment of pain in older adults who reside in long-term care (LTC) facilities has been well documented, leading to clinical guideline development and professional educational programs designed to foster better pain assessment and management in this population. Despite these efforts, little improvement has occurred, and we postulate that focused attention to public policy and cost implications of systemic change is required to create positive pain-related outcomes. Our goal was to outline feasible and cost-effective clinical and public policy recommendations designed to address the undermanagement of pain in LTC facilities. We arranged a 2-day consensus meeting of prominent United States and Canadian pain and public policy experts. An initial document describing the problem of pain undermanagement in LTC was developed and circulated prior to the meeting. Participants were also asked to respond to a list of relevant questions before arriving. Following formal presentations of a variety of proposals and extensive discussion among clinicians and policy experts, a set of recommendations was developed. We outline key elements of a transformational model of pain management in LTC for the United States and Canada. Consistent with previously formulated clinical guidelines but with attention to readily implementable public policy change in both countries, this transformational model of LTC has important implications for LTC managers and policy makers as well as major quality of life implications for LTC residents.

The Issue of Private Tuition: An Analysis of the Practice in Mauritius and Selected South-east Asian Countries

NASA Astrophysics Data System (ADS)

Foondun, A. Raffick

2002-11-01

Private tuition is an issue of growing concern and is practised in both developed and developing countries. Although it has certain positive effects, it imposes a considerable financial burden on parents and often gives rise to abuses. The present study, which focuses on the primary level, addresses a number of questions, such as the extent of the practice, its implications, the various forms that it takes, attitudes towards it, why children take private tuition, why teachers provide it, and policies to deal with the issue. The discussion ends with a plea for more research on private tuition in order to provide a basis for policies to address the problem.

How do policy advisors and practitioners prioritise the protection of children from secondhand smoke exposure in a country with advanced tobacco control policy?

PubMed

Ritchie, Deborah Doreen; Amos, Amanda; Shaw, April; O'Donnell, Rachel; Semple, Sean; Turner, Steve; Martin, Claudia

2015-01-01

The aim is to extend understanding of the policy and practice discourses that inform the development of national tobacco control policy to protect children from secondhand smoke exposure (SHSE) in the home, particularly in a country with successful implementation of smoke-free public places legislation. The Scottish experience will contribute to the tobacco control community, particularly those countries at a similar level of tobacco control, as normalising discourses about protecting children from SHSE are becoming more widespread. Case study design using qualitative interviews and focus groups (FGs) with policy makers, health and childcare practitioners during which they were presented with the findings of the Reducing Families' Exposure to Secondhand Smoke (REFRESH) intervention and discussed the implications for their policy and practice priorities. Scotland, UK PARTICIPANTS: Qualitative interviews and FGs were conducted with 30 policy makers and practitioners who were purposively recruited. Participants accepted the harm of SHSE to children; however, action is limited by political expedience due to-the perception of a shift of the public health priority from smoking to alcohol, current financial constraints, more immediate child protection concerns and continuing unresolved ethical arguments. In a country, such as Scotland, with advanced tobacco control strategies, there continue to be challenges to policy and practice development in the more contentious arena of the home. Children's SHSE in their homes is unequivocally accepted as an important health priority, but it is not currently perceived to be a top public health priority in Scotland. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Factors influencing malaria control policy-making in Kenya, Uganda and Tanzania.

PubMed

Mutero, Clifford M; Kramer, Randall A; Paul, Christopher; Lesser, Adriane; Miranda, Marie Lynn; Mboera, Leonard E G; Kiptui, Rebecca; Kabatereine, Narcis; Ameneshewa, Birkinesh

2014-08-08

Policy decisions for malaria control are often difficult to make as decision-makers have to carefully consider an array of options and respond to the needs of a large number of stakeholders. This study assessed the factors and specific objectives that influence malaria control policy decisions, as a crucial first step towards developing an inclusive malaria decision analysis support tool (MDAST). Country-specific stakeholder engagement activities using structured questionnaires were carried out in Kenya, Uganda and Tanzania. The survey respondents were drawn from a non-random purposeful sample of stakeholders, targeting individuals in ministries and non-governmental organizations whose policy decisions and actions are likely to have an impact on the status of malaria. Summary statistics across the three countries are presented in aggregate. Important findings aggregated across countries included a belief that donor preferences and agendas were exerting too much influence on malaria policies in the countries. Respondents on average also thought that some relevant objectives such as engaging members of parliament by the agency responsible for malaria control in a particular country were not being given enough consideration in malaria decision-making. Factors found to influence decisions regarding specific malaria control strategies included donor agendas, costs, effectiveness of interventions, health and environmental impacts, compliance and/acceptance, financial sustainability, and vector resistance to insecticides. Malaria control decision-makers in Kenya, Uganda and Tanzania take into account health and environmental impacts as well as cost implications of different intervention strategies. Further engagement of government legislators and other policy makers is needed in order to increase funding from domestic sources, reduce donor dependence, sustain interventions and consolidate current gains in malaria.

An outline of the need for psychology knowledge in health professionals: implications for community development and breast cancer prevention.

PubMed

Ahmadian, Maryam; Samah, Asnarulkhadi Abu; Saidu, Mohammed Bashir

2014-01-01

Knowledge of health and community psychology in health professionals influences psychosocial and community determinants of health and promoting participation in disease prevention at the community level. This paper appraises the potential of knowledge on psychology in health care professionals and its contribution to community empowerment through individual behavior change and health practice. The authors proposed a schematic model for the use of psychological knowledge in health professionals to promote participation in health interventions/disease prevention programs in developing countries. By implication, the paper provides a vision on policies towards supporting breast cancer secondary prevention efforts for community health development in Asian countries.

Zimbabwe: The Power Sharing Agreement and Implications for U.S. Policy

DTIC Science & Technology

2009-03-25

cholera outbreak that has infected more than 90,000. Deteriorating conditions in the country have led many Zimbabweans to immigrate to neighboring...12 Cholera Outbreak...collapse or the deteriorating humanitarian situation. A recent nationwide cholera outbreak affecting over 90,000 has drawn additional international

Lifetime health outcomes of breast-feeding: a comparison of the policy documents of five European countries.

PubMed

Martin-Bautista, Elena; Gage, Heather; von Rosen-von Hoewel, Julia; Jakobik, Viktoria; Laitinen, Kirsi; Schmid, Martina; Morgan, Jane; Williams, Peter; Decsi, Tamas; Campoy, Cristina; Koletzko, Berthold; Raats, Monique

2010-10-01

To (i) identify and describe prevailing infant feeding policy documents in five diverse European countries; (ii) analyse types of health outcomes for the infant that are associated with feeding breast milk rather than formula milk in the documents of different countries; and (iii) assess the extent to which documents reflect the WHO global recommendation of exclusive breast-feeding for 6 months. Documentary review and analysis. Five geographically dispersed countries of Europe (England, Finland, Germany, Hungary and Spain). Policy documents on infant feeding were identified; statements that linked choice between breast- and formula-feeding to a health outcome for the infant were extracted. Twenty-six documents (varied authorships, dates, length and character) were identified: four from England; two from Finland; nine from Germany; six from Hungary; and five from Spain. There was no consistency in the way in which health outcomes were cited as factors in the recommendations for breast- rather than formula-feeding. Seven documents contained no reference to the health implications of infant feeding choice. Of 203 statements in remaining documents citing health outcomes, 24.1 % mentioned general health effects, 32.5 % protection against infections, 31.5 % long-term conditions (e.g. diabetes, CVD) and 11.8 % mentioned allergy. Health outcomes were linked to exclusive breast-feeding in only 25 % of statements. Policy documents in the study countries varied in the extent to which they reflect the health outcomes for the baby of breast-feeding, and this may limit effective promotion by health professionals. There is scope to improve the process of bringing evidence and recommendations into policy documents.

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

PubMed Central

2012-01-01

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 return from Cuba, some PICs may face substantial rises in salary expenditure which could significantly strain already stretched government budgets. Finally, the Cuban engagement in the Pacific has implications for the wider geo-political and health sector support environment as the relatively few major bilateral donors, notably Australia (through AusAID) and New Zealand (through NZAID), and multilaterals such as the World Bank will need to accommodate an additional player with whom existing links are limited. PMID:22558940

Evidence-based alcohol policy in the Americas: strengths, weaknesses, and future challenges.

PubMed

Babor, Thomas F; Caetano, Raul

2005-01-01

The objectives of this article are to describe the evidence base for alcohol policy in the Americas, to evaluate the extent to which national policies are likely to have an impact on public health, and to identify areas where alcohol policies could be improved. The paper begins with a brief review of epidemiological surveys of the prevalence of alcohol problems in the Americas. This is followed by an analysis of 32 prevention strategies and interventions in terms of the evidence for their effectiveness, amount of research support, cost to implement, and other feasibility issues. Overall, the strategies and interventions with the greatest amount of empirical support are low blood alcohol concentration levels for driving while intoxicated, controls on alcohol availability, age limits on alcohol purchases, and relatively high alcohol prices. The implications of the evidence are next discussed in relation to alcohol policy initiatives in the Americas, based on an analysis of the extent to which strategies and interventions currently used in 25 countries of the Americas are likely to have a public health impact on alcohol-related problems. The countries that have adopted the policies with the highest expected impact overall are Colombia, Costa Rica, Venezuela, and El Salvador. Nevertheless, the analysis indicates that almost all the countries of the Americas could improve the likelihood of preventing alcohol-related problems. Policy efforts in the developing countries of Latin America should focus on improving countermeasures against driving while intoxicated, measures that alter the drinking context, and limits on physical availability. For the developed, high-income countries of North America the goal should be to prevent deterioration of current drinking patterns and to reduce the overall volume of drinking. Given the low to moderate cost of many of the policies reviewed in this article, it now seems possible for communities and nations to substantially reduce the alcohol-related burden of illness in the Americas.

Cross-country disparity in agricultural productivity: quantifying the role of modern seed adoption.

PubMed

O'Gorman, Melanie; Pandey, Manish

2010-01-01

Inequality of agricultural labour productivity across the developing world has increased substantially over the past 40 years. This article asks: to what extent did the diffusion of Green Revolution seed varieties contribute to increasing agricultural labour productivity disparity across the developing countries? We find that 22 per cent of cross-country variation in agricultural labour productivity can be attributed to the diffusion of high-yielding seed varieties across countries, and that the impact of such diffusion differed significantly across regions. We discuss the implications of these findings for policy directed at increasing agricultural labour productivity in the developing world.

A New Approach of Measuring Hospital Performance for Low- and Middle-income Countries

PubMed Central

Sapkota, Vishnu Prasad; Supakankunti, Siripen

2015-01-01

Efficiency of the hospitals affects the price of health services. Health care payments have equity implications. Evidence on hospital performance can support to design the policy; however, the recent literature on hospital efficiency produced conflicting results. Consequently, policy decisions are uncertain. Even the most of evidence were produced by using data from high income countries. Conflicting results were produced particularly due to differences in methods of measuring performance. Recently a management approach has been developed to measure the hospital performance. This approach to measure the hospital performance is very useful from policy perspective to improve health system from cost-effective way in low and middle income countries. Measuring hospital performance through management approach has some basic characteristics such as scoring management practices through double blind survey, measuring hospital outputs using various indicators, estimating the relationship between management practices and outputs of the hospitals. This approach has been successfully applied to developed countries; however, some revisions are required without violating the fundamental principle of this approach to replicate in low- and middle-income countries. The process has been clearly defined and applied to Nepal. As the results of this, the approach produced expected results. The paper contributes to improve the approach to measure hospital performance. PMID:26617448

Structural adjustment and public spending on health: evidence from IMF programs in low-income countries.

PubMed

Kentikelenis, Alexander E; Stubbs, Thomas H; King, Lawrence P

2015-02-01

The relationship between health policy in low-income countries (LICs) and structural adjustment programs devised by the International Monetary Fund (IMF) has been the subject of intense controversy over past decades. While the influence of the IMF on health policy can operate through various pathways, one main link is via public spending on health. The IMF has claimed that its programs enhance government spending for health, and that a number of innovations have been introduced to enable borrowing countries to protect health spending from broader austerity measures. Critics have pointed to adverse effects of Fund programs on health spending or to systematic underfunding that does not allow LICs to address health needs. We examine the effects of Fund programs on government expenditures on health in low-income countries using data for the period 1985-2009. We find that Fund programs are associated with higher health expenditures only in Sub-Saharan African LICs, which historically spent less than any other region. This relationship turns negative in LICs in other regions. We outline the implications of these findings for health policy in a development context. Copyright © 2014 Elsevier Ltd. All rights reserved.

Al Qaeda’s Millenarian Doctrine: Implications for US Policy

DTIC Science & Technology

2010-03-15

the help of supernatural agencies.17 Cohn also describes millenarian movements as having unprecedented goals and who see their struggle “not as a... article of confederation or to establish three separate countries. Obvious disapproval may come from Turkey and Iran that do not wish to see an

Health and Schooling: Evidence and Policy Implications for Developing Countries.

ERIC Educational Resources Information Center

Gomes-Neto, Joao Batista; And Others

1997-01-01

Exploits a unique data set (EDRURAL) from three northeastern states of Brazil to investigate the complementarities of health with school attainment and cognitive achievement. The promotion models and value-added achievement models demonstrate the value of students' visual acuity. Achievement models highlight the role of good nutrition. Eye…

Primary and embedded steel imports to the U.S.: implications for the design of border tax adjustments.

PubMed

Izard, Catherine F; Weber, Christopher L; Matthews, H Scott

2010-09-01

Carbon Border Tax Adjustments (BTAs) are a politically popular strategy for avoiding competitive disadvantage problems when a country implements a unilateral climate change policy. A BTA taxes carbon embodied in imported goods in order to protect domestic industry and motivate other countries to implement climate change policy. To estimate the effectiveness of a BTA, is it is necessary to know which products are covered, where they were originally produced and ultimately exported from, and how the covered amount compares to total production in foreign countries. Using a scrap-adjusted, mixed-unit input-output model in conjunction with a multiregional input-output model, this analysis evaluates the effectiveness of BTAs for the case study of U.S. steel imports. Most imported steel by mass is embedded in finished products (60%), and 30% of that steel is produced in a different country than the one from which the final good is exported. Given the magnitudes involved and complexities of global supply chains, a BTA that protects domestic industry will be a challenge to implement. We propose a logistically feasible BTA structure that minimizes the information burden while still accounting for these complexities. However, the amount of steel imported to the U.S. is negligible (5%) compared to foreign production in BTA-eligible countries and is unlikely to motivate affected countries to impose an emissions reduction policy.

Climate change and developing-country cities: implications for environmental health and equity.

PubMed

Campbell-Lendrum, Diarmid; Corvalán, Carlos

2007-05-01

Climate change is an emerging threat to global public health. It is also highly inequitable, as the greatest risks are to the poorest populations, who have contributed least to greenhouse gas (GHG) emissions. The rapid economic development and the concurrent urbanization of poorer countries mean that developing-country cities will be both vulnerable to health hazards from climate change and, simultaneously, an increasing contributor to the problem. We review the specific health vulnerabilities of urban populations in developing countries and highlight the range of large direct health effects of energy policies that are concentrated in urban areas. Common vulnerability factors include coastal location, exposure to the urban heat-island effect, high levels of outdoor and indoor air pollution, high population density, and poor sanitation. There are clear opportunities for simultaneously improving health and cutting GHG emissions most obviously through policies related to transport systems, urban planning, building regulations and household energy supply. These influence some of the largest current global health burdens, including approximately 800,000 annual deaths from ambient urban air pollution, 1.2 million from road-traffic accidents, 1.9 million from physical inactivity, and 1.5 million per year from indoor air pollution. GHG emissions and health protection in developing-country cities are likely to become increasingly prominent in policy development. There is a need for a more active input from the health sector to ensure that development and health policies contribute to a preventive approach to local and global environmental sustainability, urban population health, and health equity.

Generating political priority for newborn survival in three low-income countries.

PubMed

Smith, Stephanie L; Shiffman, Jeremy; Kazembe, Abigail

2014-01-01

Deaths to babies in their first 28 days of life now account for more than 40% of global under-5 child mortality. High neonatal mortality poses a significant barrier to achieving the child survival Millennium Development Goal. Surmounting the problem requires national-level political commitment, yet only a few nation-states have prioritised this issue. We compare Bolivia, Malawi and Nepal, three low-income countries with high neonatal mortality, with a view to understanding why countries prioritise or neglect the issue. The three have had markedly different trajectories since 2000: attention grew steadily in Nepal, stagnated then grew in Malawi and grew then stagnated in Bolivia. The comparison suggests three implications for proponents seeking to advance attention to neglected health issues in low-income countries: the value of (1) advancing solutions with demonstrated efficacy in low-resource settings, (2) building on existing and emerging national priorities and (3) developing a strong network of domestic and international allies. Such actions help policy communities to weather political storms and take advantage of policy windows.

Common threads? Palliative care service developments in seven European countries.

PubMed

Clark, D; ten Have, H; Janssens, R

2000-11-01

Since the late 1960s hospice and palliative care services have been developing in many European countries. Although attention has been given to patterns of development in specific national contexts, so far we lack a comparative understanding of how these services are organized and delivered. Such a comparison poses certain practical and methodological difficulties. It does, however, allow a wider view of the current provision of palliative care in Europe, together with a consideration of implications for the future. We report on an analysis of palliative care developments in seven European countries which gave attention to early origins, patterns of provision, and structural and policy integration. We conclude that, despite different processes of development, the emergent discipline of palliative care now finds its most congenial home within the structures of the formal health care system. Accordingly, inequities between the seven countries can be more clearly identified, posing continuing challenges to policy makers and planners who operate with a European perspective.

Social implications of the Human Genome Project: Policy roundtable series and journals. Final progress report, March 15, 2001 - March 15, 2002

DOE Office of Scientific and Technical Information (OSTI.GOV)

Seiguer, Erica

2002-12-30

This report reflects the activities of the Harvard Health Caucus at Harvard Medical School that were supported, in part, by the Department of Energy. The following policy roundtables and panels were held: Spring 2001 Policy Roundtable Series: The social implications of the Human Genome Project; Spring 2002 Policy Roundtable Series: Managing globalization to improve health; 13 February 2002 Keynote Address: The globalization of health; 25 February 2002 Healthier or Wealthier: Which comes first in the new global era?; 28 February 2002 The crisis of neglected diseases: Creating R&D incentives for diseases of developing countries; 7 March 2002 Health care educationmore » in the developing world: Bridging global and local health care practices; 20 March 2002 Building a legal framework for global health: How can the US and UN work to reduce global disparities?; 25 April 2002 The role of mass media and tobacco control efforts. Caucus organizational information is also included.« less

Research Misconduct: The Peril of Publish or Perish

PubMed Central

Al-Adawi, Samir; Ali, Badreldin H.; Al-Zakwani, Ibrahim

2016-01-01

There is a spurt of interest in research productivity in the Gulf Cooperation Council (GCC) to lay the foundation for national development. From a global perspective, increased research productivity could conceivably be accompanied by an exponential increase in research misconduct (RM). Inevitably, erroneous or falsified data will be expected to adversely affect public health by misleading policy makers and clinicians alike into embarking on health policy and allocation of resources that are byproducts of RM. This will contribute significantly to the emerging crisis of confidence of the public in the integrity of scientific research. For a long time, RM has been considered only as plagiarism or data fabrication and falsification. However, the concept of RM nowadays encompasses more and, in this review, we discuss its possible implications in emerging economies, such as those of the GCC countries. We suggest that GCC countries ought to consider implementing remedial and punitive policies to deal with RM. PMID:26816563

Does economic, financial and institutional developments matter for environmental quality? A comparative analysis of EU and MEA countries.

PubMed

Abid, Mehdi

2017-03-01

The aim of this study is to test the hypothesis of the Environmental Kuznets Curve (EKC) with a sample of 58 MEA (Middle East & African) and 41 EU (European Union) countries for the period 1990 to 2011. The empirical analysis is carried out using the GMM-system method to solve the problem of endogenous variables. We focused on direct and indirect effects of institutional quality (through the efficiency of public expenditure, financial development, trade openness and foreign direct investment) and the income-emission relationship. We found a monotonically increasing relationship between CO 2 emissions and GDP in both MEA and EU regions. The policy implication is clear: in order to have sustainable positive economic performance and to reduce carbon dioxide emission in the country at the same time, policy makers should regulate and enhance the role and efficiency of domestic institutions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Nurse-Performed Endoscopy: Implications for the Nursing Profession in Australia.

PubMed

Duffield, Christine; Chapman, Susan; Rowbotham, Samantha; Blay, Nicole

2017-02-01

Increasing demands for health care globally often lead to discussions about expanding the involvement of nurses in a range of nontraditional roles. Several countries have introduced nurse endoscopists as a means of easing the burden of demand for a range of endoscopic procedures. A shortage of medical staff in Australia combined with increasing demand for endoscopy led to the implementation of nurse endoscopists as a pilot program in the state of Queensland, where a nurse practitioner model was implemented, and Victoria, where an advanced practice model was used. This article will discuss the implementation of and responses from the nursing, medical, and policy community to nurse-performed endoscopy in this country. Regarding health policy, access to cancer screening may be improved by providing nurses with advanced training to safely perform endoscopy procedures. Moreover, issues of nurse credentialing and payment need to be considered appropriate to each country's health system model.

The international dimensions of neuroethics.

PubMed

Lombera, Sofia; Illes, Judy

2009-08-01

Neuroethics, in its modern form, investigates the impact of brain science in four basic dimensions: the self, social policy, practice and discourse. In this study, we analyzed a set of 461 peer-reviewed articles with neuroethics content, published by authors from 32 countries. We analyzed the data for: (1) trends in the development of international neuroethics over time, and (2) how challenges at the intersection of ethics and neuroscience are viewed in countries that are considered developed by International Monetary Fund (IMF) standards, and in those that are developing. Our results demonstrate a steady increase in global participation in neuroethics from 1989 to 2005, characterized by an increase in numbers of articles published specifically on neuroethics, journals publishing these articles, and countries contributing to the literature. The focus from all countries was on the practice of brain science and the amelioration of neurological disease. Indicators of technology creation and diffusion in developing countries were specifically correlated with increases in publications concerning policy implications of brain science. Neuroethics is an international endeavor and, as such, should be sensitive to the impact that context has on acceptance and use of technological innovation.

THE INTERNATIONAL DIMENSIONS OF NEUROETHICS

PubMed Central

LOMBERA, SOFIA; ILLES, JUDY

2008-01-01

Neuroethics, in its modern form, investigates the impact of brain science in four basic dimensions: the self, social policy, practice and discourse. In this study, we analyzed a set of 461 peer-reviewed articles with neuroethics content, published by authors from 32 countries. We analyzed the data for: (1) trends in the development of international neuroethics over time, and (2) how challenges at the intersection of ethics and neuroscience are viewed in countries that are considered developed by International Monetary Fund (IMF) standards, and in those that are developing. Our results demonstrate a steady increase in global participation in neuroethics from 1989 to 2005, characterized by an increase in numbers of articles published specifically on neuroethics, journals publishing these articles, and countries contributing to the literature. The focus from all countries was on the practice of brain science and the amelioration of neurological disease. Indicators of technology creation and diffusion in developing countries were specifically correlated with increases in publications concerning policy implications of brain science. Neuroethics is an international endeavor and, as such, should be sensitive to the impact that context has on acceptance and use of technological innovation. PMID:18445073

Policy implications of medical tourism development in destination countries: revisiting and revising an existing framework by examining the case of Jamaica.

PubMed

Johnston, Rory; Crooks, Valorie A; Ormond, Meghann

2015-07-04

Medical tourism is now targeted by many hospitals and governments worldwide for further growth and investment. Southeast Asia provides what is perhaps the best documented example of medical tourism development and promotion on a regional scale, but interest in the practice is growing in locations where it is not yet established. Numerous governments and private hospitals in the Caribbean have recently identified medical tourism as a priority for economic development. We explore here the projects, activities, and outlooks surrounding medical tourism and their anticipated economic and health sector policy implications in the Caribbean country of Jamaica. Specifically, we apply Pocock and Phua's previously-published conceptual framework of policy implications raised by medical tourism to explore its relevance in this new context and to identify additional considerations raised by the Jamaican context. Employing case study methodology, we conducted six weeks of qualitative fieldwork in Jamaica between October 2012 and July 2013. Semi-structured interviews with health, tourism, and trade sector stakeholders, on-site visits to health and tourism infrastructure, and reflexive journaling were all used to collect a comprehensive dataset of how medical tourism in Jamaica is being developed. Our analytic strategy involved organizing our data within Pocock and Phua's framework to identify overlapping and divergent issues. Many of the issues identified in Pocock and Phua's policy implications framework are echoed in the planning and development of medical tourism in Jamaica. However, a number of additional implications, such as the involvement of international development agencies in facilitating interest in the sector, cyclical mobility of international health human resources, and the significance of health insurance portability in driving the growth of international hospital accreditation, arise from this new context and further enrich the original framework. The framework developed by Pocock and Phua is a flexible common reference point with which to document issues raised by medical tourism in established and emerging destinations. However, the framework's design does not lend itself to explaining how the underlying health system factors it identifies work to facilitate medical tourism's development or how the specific impacts of the practice are likely to unfold.

The role of the US in the geopolitics of climate policy and stranded oil reserves

NASA Astrophysics Data System (ADS)

Jaffe, Amy Myers

2016-10-01

Computer-assisted technological innovation and breakthroughs in drilling are revolutionizing the energy landscape, creating greater uncertainty about the future trends for oil use. These new dynamics are prompting major oil producers to reconsider the commercial value of their assets, potentially changing the long-term outlook for oil prices. A shift in investment and production strategy by major oil-producing countries and large multinational companies to pre-empt the risk of stranded assets would have significant implications on energy markets. This Perspective surveys the competitive forces at play that are able to shift the dynamics of the global oil market and discusses their implications for US climate and energy policy. A declining long-term oil price might imply that energy and climate scientists and policymakers should revisit the road map of the optimum policies to promote the transition to lower carbon energy and to defend technology gains already achieved.

National innovation policy and public science in Australia

NASA Astrophysics Data System (ADS)

Carter, Lyn

2017-12-01

In this paper, I have positioned myself with Kean Birch and explored some of the political-economic actors/actants of policy suites implicated in the biotechnologies and bioeconomy. In particular, I have considered Australia's recent National Innovation and Science Agenda and allied documents and entities (that is, Innovation and Science Australia, the National Science Statement and the 2016 National Research Infrastructure Roadmap) as one of the National Innovation Strategies in place now in OECD countries and beyond. In overview, these policy suites utilise the same high knowledge creation/low translation and commericalisation arguments as elsewhere to press for particular ideologically based `improvements' to public science. Mapping the terrain of these entities has revealed the innovation, biotechnology and bioeconomy policy space to be inordinately complex and challenging to navigate. Reviewing Australia's position enables the type of comparative work that contributes to a closer understanding of the largely neoliberal global economic imperatives shaping contemporaneity. Moreover, while these policy suites attempt to constitute and circulate particular visions of science education, their complex nature mitigates against science teachers/educators grappling with their implications.

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

PubMed

Schuftan, Claudio

2015-01-01

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

Newspaper Coverage of Intimate Partner Violence: Skewing Representations of Risk.

PubMed

Carlyle, Kellie E; Slater, Michael D; Chakroff, Jennifer L

2008-03-01

How media portray intimate partner violence (IPV) has implications for public perceptions and social policy. Therefore, to better understand these portrayals, this study content analyzes a nationally representative sample of newspaper coverage of IPV over a two-year-period and compares this coverage to epidemiological data in order to examine the implications of the discrepancies between coverage and social reality. Stratified media outlets across the country were used to obtain a representative sample of daily newspapers based on their designated market areas, resulting in 395 IPV-related articles. Results show that newspaper framing of IPV tends to be heavily skewed toward episodic framing. In addition, there are significant differences between our data and epidemiological estimates, particularly in the coverage of homicide and use of alcohol and illegal drugs, which may skew public perceptions of risk. Implications for public perceptions and social policy are discussed.

Fortresses and Icebergs: The Evolution of the Transatlantic Defense Market and the Implications for U.S. National Security Policy. Volume 2: Country Studies

DTIC Science & Technology

2009-01-01

CHILE ECUADOR PARAGUAY URUGUAY FALKLAND ISLANDS SOUTH GEORGIA ISLAND KENYA ETHIOPIA ERITREA SUDAN EGYPT NIGER MAURITANIA MALI NIGERIA SOMALIA NAMIBIA...painful economic reforms also began to bear fruit. The currency stabilized and budget deficits were brought under control as the country moved toward...the criteria of the Maastricht Treaty to adopt the single European currency in place of the zloty, but entry into the Euro- zone is scheduled for 2012

Advertising for all by the year 2000: public health implications for less developed countries.

PubMed

Wallack, L; Montgomery, K

1992-01-01

This paper argues that the development of global advertising has significant implications for the public health of less developed countries. These implications can be seen in three areas. First, it is clear that advertising and marketing of lethal or health-compromising products like alcohol and tobacco not only can increase the level of death and disease, but can also produce serious indirect effects upon families, communities, and entire societies. Second, advertising promotes a consumption ethic which can have far-reaching effects that go beyond individual behavior, significantly altering social relationships, and influencing public policies and allocation of scarce resources. Third, advertising can restrict the public's knowledge about health issues by substituting distorted and manipulative sales messages for vital, accurate health information. In addition, revenues from advertising are a primary support for many mass media systems and this further limits the presentation of critical information.

Support schemes and ownership structures - the policy context for fuel cell based micro-combined heat and power

NASA Astrophysics Data System (ADS)

Schroeder, Sascha Thorsten; Costa, Ana; Obé, Elisabeth

In recent years, fuel cell based micro-combined heat and power (mCHP) has received increasing attention due to its potential contribution to European energy policy goals, i.e., sustainability, competitiveness and security of supply. Besides technical advances, regulatory framework and ownership structures are of crucial importance in order to achieve greater diffusion of the technology in residential applications. This paper analyses the interplay of policy and ownership structures for the future deployment of mCHP. Furthermore, it regards the three country cases Denmark, France and Portugal. Firstly, the implications of different kinds of support schemes on investment risk and the diffusion of a technology are explained conceptually. Secondly, ownership arrangements are addressed. Then, a cross-country comparison on present support schemes for mCHP and competing technologies discusses the national implementation of European legislation in Denmark, France and Portugal. Finally, resulting implications for ownership arrangements on the choice of support scheme are explained. From a conceptual point of view, investment support, feed-in tariffs and price premiums are the most appropriate schemes for fuel cell mCHP. This can be used for improved analysis of operational strategies. The interaction of this plethora of elements necessitates careful balancing from a private- and socio-economic point of view.

The implications of trade liberalization for diet and health: a case study from Central America

PubMed Central

Thow, Anne Marie; Hawkes, Corinna

2009-01-01

Background Central America has undergone extensive trade liberalization over the past two decades, and has recently signed a Free Trade Agreement with the United States. The region is also experiencing a dual burden of malnutrition with the growth of dietary patterns associated with the global 'nutrition transition'. This study describes the relationship between trade liberalization policies and food imports and availability, and draws implications for diet and health, using Central America as a case study region. Methods Changes in tariff and non-tariff barriers for each country were documented, and compared with time-series graphs of import, production and availability data to show the outcome of changes in trade policy in relation to food imports and food availability. Results Changes in trade policy in Central America have directly affected food imports and availability via three avenues. First, the lowering of trade barriers has promoted availability by facilitating higher imports of a wide range of foods. Second, trade liberalization has affected food availability through promoting domestic meat production. Third, reductions in barriers to investment appear to be critical in expansion of processed food markets. This suggests that changes in trade policies have facilitated rising availability and consumption of meat, dairy products, processed foods and temperate (imported fruits) in Central America. Conclusion This study indicates that the policies of trade liberalization in Central American countries over the past two decades, particularly in relation to the United States, have implications for health in the region. Specifically, they have been a factor in facilitating the "nutrition transition", which is associated with rising rates of obesity and chronic diseases such as cardiovascular disease and cancer. Given the significant cost of chronic disease for the health care system, individuals and the wider community, it is critical that preventive health measures address such upstream determinants of poor nutrition. PMID:19638196

The implications of trade liberalization for diet and health: a case study from Central America.

PubMed

Thow, Anne Marie; Hawkes, Corinna

2009-07-28

Central America has undergone extensive trade liberalization over the past two decades, and has recently signed a Free Trade Agreement with the United States. The region is also experiencing a dual burden of malnutrition with the growth of dietary patterns associated with the global 'nutrition transition'. This study describes the relationship between trade liberalization policies and food imports and availability, and draws implications for diet and health, using Central America as a case study region. Changes in tariff and non-tariff barriers for each country were documented, and compared with time-series graphs of import, production and availability data to show the outcome of changes in trade policy in relation to food imports and food availability. Changes in trade policy in Central America have directly affected food imports and availability via three avenues. First, the lowering of trade barriers has promoted availability by facilitating higher imports of a wide range of foods. Second, trade liberalization has affected food availability through promoting domestic meat production. Third, reductions in barriers to investment appear to be critical in expansion of processed food markets. This suggests that changes in trade policies have facilitated rising availability and consumption of meat, dairy products, processed foods and temperate (imported fruits) in Central America. This study indicates that the policies of trade liberalization in Central American countries over the past two decades, particularly in relation to the United States, have implications for health in the region. Specifically, they have been a factor in facilitating the "nutrition transition", which is associated with rising rates of obesity and chronic diseases such as cardiovascular disease and cancer. Given the significant cost of chronic disease for the health care system, individuals and the wider community, it is critical that preventive health measures address such upstream determinants of poor nutrition.

A systematic review of reference pricing: implications for US prescription drug spending.

PubMed

Lee, Joy Li-Yueh; Fischer, Micahel A; Shrank, William H; Polinski, Jennifer M; Choudhry, Niteesh K

2012-11-01

Given rising pharmaceutical expenditures and the widespread use of reference pricing as a costcontainment instrument abroad, we systematically reviewed the evidence evaluating reference pricing policies. We performed a structured electronic search of peer-reviewed journals for studies published before that reported on the effects of reference pricing policies on medication use, payer and patient spending, and resource consumption. Our search yielded 16 studies describing 9 reference-pricing policies from 6 countries. Reference-pricing policies led to decreases in drug prices and increases in utilization of targeted medications, while also reducing payer and patient expenditures. In addition, these policies did not lead to increased use of medical services, such as physician office visits and hospitalization. These results suggest that reference pricing may be an attractive policy strategy for the US healthcare system.

The role of governance in implementing task-shifting from physicians to nurses in advanced roles in Europe, U.S., Canada, New Zealand and Australia.

PubMed

Maier, Claudia B

2015-12-01

Task-shifting from physicians to nurses is increasing worldwide; however, research on how it is governed is scarce. This international study assessed task-shifting governance models and implications on practice, based on a literature scoping review; and a survey with 93 country experts in 39 countries (response rate: 85.3%). Governance was assessed by several indicators, regulation of titles, scope of practice, prescriptive authority, and registration policies. This policy analysis focused on eleven countries with task-shifting at the Advanced Practice Nursing/Nurse Practitioner (APN/NP) level. Governance models ranged from national, decentralized to no regulation, but at the discretion of employers and settings. In countries with national or decentralized regulation, restrictive scope of practice laws were shown as barrier, up-to-date laws as enablers to advanced practice. Countries with decentralized regulation resulted in uneven levels of practice. In countries leaving governance to individual settings, practice variations existed, moreover data availability and role clarity was limited. Policy options include periodic reviews to ensure laws are up to date, minimum harmonization in decentralized contexts, harmonized educational and practice-level requirements to reduce practice variation and ensure quality. From a European Union (EU) perspective, regulation is preferred over non-regulation as a first step toward the recognition of qualifications in countries with similar levels of advanced practice. Countries early on in the process need to be aware that different governance models can influence practice. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Carbon emissions-income relationships with structural breaks: the case of the Middle Eastern and North African countries.

PubMed

El Montasser, Ghassen; Ajmi, Ahdi Noomen; Nguyen, Duc Khuong

2018-01-01

This article revisits the carbon dioxide (CO 2 ) emissions-GDP causal relationships in the Middle Eastern and North African (MENA) countries by employing the Rossi (Economet Theor 21:962-990, 2005) instability-robust causality test. We show evidence of significant causality relationships for all considered countries within the instability context, whereas the standard Granger causality test fails to detect causal links in any direction, except for Egypt, Iran, and Morocco. An important policy implication resulting from this robust analysis is that the income is not affected by the cuts in the CO 2 emissions for only two MENA countries, the UAE and Syria.

A TIMSS Primer. Lessons and Implications for U.S. Education.

ERIC Educational Resources Information Center

Stevenson, Harold W.

1998-01-01

Results are now available from the Third International Mathematics and Science Study (TIMSS) with its 5 main components, 41 cooperating countries, over 500,000 participants, and coverage of the full spectrum of mathematics and science from grades 4 through 12. American educators, parents, and policy makers have found the results to be both…

International Trade, Budget Deficits, and the Interest Rate.

ERIC Educational Resources Information Center

Feldstein, Martin

1985-01-01

A tight money policy, budget deficits, and greater after-tax profitability of investment in the United States have contributed to the strength of the dollar and to the flow of funds into this country. The consequence and implication of this are examined, both with respect to the past and near future. (Author/RM)

Understanding DACA and the Implications for Higher Education

ERIC Educational Resources Information Center

Venegas, Kristan; Cadena, Michelle; Galan, Carlos; Park, Elizabeth; Astudillo, Samantha; Avilez, Arely Acuña; Ward, James D.; Lanford, Michael; Tierney, William G.

2017-01-01

Recent federal immigration policy has focused on individuals who were brought to the U.S. by their guardians. In June 2012, former President Barack Obama signed an executive order to implement Deferred Action for Childhood Arrivals, widely known as DACA. DACA is organized to allow individuals who came to this country as children with an…

What's Missing in Longitudinal Studies Conducted in the U.S. with Implications for Mathematics Education?

ERIC Educational Resources Information Center

Headley, Marcia Gail; Swoboda, Christopher M.; Foote, Lori

2016-01-01

"What works" policies are the latest incarnation of best practices in educational research. Instituted by various organisations internationally, they define what kind of research counts as "evidence" for reform-oriented decision-making. While some countries rely on systematic analyses and meta-analyses, the U.S. favours primary…

Early-Life Origins of Life-Cycle Well-Being: Research and Policy Implications

ERIC Educational Resources Information Center

Currie, Janet; Rossin-Slater, Maya

2015-01-01

Mounting evidence across different disciplines suggests that early-life conditions can have consequences on individual outcomes throughout the life cycle. Relative to other developed countries, the United States fares poorly on standard indicators of early-life health, and this disadvantage may have profound consequences not only for population…

English Language Proficiency and Employment: A Case Study of Bangladeshi Graduates in Australian Employment Market

ERIC Educational Resources Information Center

Roshid, Mohammod Moninoor; Chowdhury, Raqib

2013-01-01

Recent literature has suggested that the relationship between globalisation and the English language implicates employability in the job market. Although the effects are uneven in different occupational groups and in different countries, such relationship is growing in significance to policy makers. This paper has explored the hitherto unstudied…

Communication for Development: A Personal Experience with Implications for Development Policy

ERIC Educational Resources Information Center

Agunga, Robert

2012-01-01

Purpose: Communication for Development (C4D) is a new academic discipline and profession for addressing human dimension concerns in development, such as local participation, integration and capacity building, which are the main issues limiting aid effectiveness. However, my experience in Malawi, one of the poorest countries in Africa and where a…

IMPLICATIONS OF GLOBAL PRICING POLICIES ON ACCESS TO INNOVATIVE DRUGS: THE CASE OF TRASTUZUMAB IN SEVEN LATIN AMERICAN COUNTRIES.

PubMed

Pichon-Riviere, Andres; Garay, Osvaldo Ulises; Augustovski, Federico; Vallejos, Carlos; Huayanay, Leandro; Bueno, Maria del Pilar Navia; Rodriguez, Alarico; de Andrade, Carlos José Coelho; Buendía, Jefferson Antonio; Drummond, Michael

2015-01-01

Differential pricing, based on countries' purchasing power, is recommended by the World Health Organization to secure affordable medicines. However, in developing countries innovative drugs often have similar or even higher prices than in high-income countries. We evaluated the potential implications of trastuzumab global pricing policies in terms of cost-effectiveness (CE), coverage, and accessibility for patients with breast cancer in Latin America (LA). A Markov model was designed to estimate life-years (LYs), quality-adjusted life-years (QALYs), and costs from a healthcare perspective. To better fit local cancer prognosis, a base case scenario using transition probabilities from clinical trials was complemented with two alternative scenarios with transition probabilities adjusted to reflect breast cancer epidemiology in each country. Incremental discounted benefits ranged from 0.87 to 1.00 LY and 0.51 to 0.60 QALY and incremental CE ratios from USD 42,104 to USD 110,283 per QALY (2012 U.S. dollars), equivalent to 3.6 gross domestic product per capita (GDPPC) per QALY in Uruguay and to 35.5 GDPPC in Bolivia. Probabilistic sensitivity analysis showed 0 percent probability that trastuzumab is CE if the willingness-to-pay threshold is one GDPPC per QALY, and remained so at three GDPPC threshold except for Chile and Uruguay (4.3 percent and 26.6 percent, respectively). Trastuzumab price would need to decrease between 69.6 percent to 94.9 percent to became CE in LA. Although CE in other settings, trastuzumab was not CE in LA. The use of health technology assessment to prioritize resource allocation and support price negotiations is critical to making innovative drugs available and affordable in developing countries.

Climate Change and Food Security: Health Impacts in Developed Countries

PubMed Central

Hooper, Lee; Abdelhamid, Asmaa; Bentham, Graham; Boxall, Alistair B.A.; Draper, Alizon; Fairweather-Tait, Susan; Hulme, Mike; Hunter, Paul R.; Nichols, Gordon; Waldron, Keith W.

2012-01-01

Background: Anthropogenic climate change will affect global food production, with uncertain consequences for human health in developed countries. Objectives: We investigated the potential impact of climate change on food security (nutrition and food safety) and the implications for human health in developed countries. Methods: Expert input and structured literature searches were conducted and synthesized to produce overall assessments of the likely impacts of climate change on global food production and recommendations for future research and policy changes. Results: Increasing food prices may lower the nutritional quality of dietary intakes, exacerbate obesity, and amplify health inequalities. Altered conditions for food production may result in emerging pathogens, new crop and livestock species, and altered use of pesticides and veterinary medicines, and affect the main transfer mechanisms through which contaminants move from the environment into food. All these have implications for food safety and the nutritional content of food. Climate change mitigation may increase consumption of foods whose production reduces greenhouse gas emissions. Impacts may include reduced red meat consumption (with positive effects on saturated fat, but negative impacts on zinc and iron intake) and reduced winter fruit and vegetable consumption. Developed countries have complex structures in place that may be used to adapt to the food safety consequences of climate change, although their effectiveness will vary between countries, and the ability to respond to nutritional challenges is less certain. Conclusions: Climate change will have notable impacts upon nutrition and food safety in developed countries, but further research is necessary to accurately quantify these impacts. Uncertainty about future impacts, coupled with evidence that climate change may lead to more variable food quality, emphasizes the need to maintain and strengthen existing structures and policies to regulate food production, monitor food quality and safety, and respond to nutritional and safety issues that arise. PMID:23124134

Climate change and food security: health impacts in developed countries.

PubMed

Lake, Iain R; Hooper, Lee; Abdelhamid, Asmaa; Bentham, Graham; Boxall, Alistair B A; Draper, Alizon; Fairweather-Tait, Susan; Hulme, Mike; Hunter, Paul R; Nichols, Gordon; Waldron, Keith W

2012-11-01

Anthropogenic climate change will affect global food production, with uncertain consequences for human health in developed countries. We investigated the potential impact of climate change on food security (nutrition and food safety) and the implications for human health in developed countries. Expert input and structured literature searches were conducted and synthesized to produce overall assessments of the likely impacts of climate change on global food production and recommendations for future research and policy changes. Increasing food prices may lower the nutritional quality of dietary intakes, exacerbate obesity, and amplify health inequalities. Altered conditions for food production may result in emerging pathogens, new crop and livestock species, and altered use of pesticides and veterinary medicines, and affect the main transfer mechanisms through which contaminants move from the environment into food. All these have implications for food safety and the nutritional content of food. Climate change mitigation may increase consumption of foods whose production reduces greenhouse gas emissions. Impacts may include reduced red meat consumption (with positive effects on saturated fat, but negative impacts on zinc and iron intake) and reduced winter fruit and vegetable consumption. Developed countries have complex structures in place that may be used to adapt to the food safety consequences of climate change, although their effectiveness will vary between countries, and the ability to respond to nutritional challenges is less certain. Climate change will have notable impacts upon nutrition and food safety in developed countries, but further research is necessary to accurately quantify these impacts. Uncertainty about future impacts, coupled with evidence that climate change may lead to more variable food quality, emphasizes the need to maintain and strengthen existing structures and policies to regulate food production, monitor food quality and safety, and respond to nutritional and safety issues that arise.

Can education change the world? Education amplifies differences in liberalization values and innovation between developed and developing countries.

PubMed

Van Hiel, Alain; Van Assche, Jasper; De Cremer, David; Onraet, Emma; Bostyn, Dries; Haesevoets, Tessa; Roets, Arne

2018-01-01

The present study investigated the relationship between level of education and liberalization values in large, representative samples administered in 96 countries around the world (total N = 139,991). These countries show meaningful variation in terms of the Human Development Index (HDI), ranging from very poor, developing countries to prosperous, developed countries. We found evidence of cross-level interactions, consistently showing that individuals' level of education was associated with an increase in their liberalization values in higher HDI societies, whereas this relationship was curbed in lower HDI countries. This enhanced liberalization mindset of individuals in high HDI countries, in turn, was related to better scores on national indices of innovation. We conclude that this 'education amplification effect' widens the gap between lower and higher HDI countries in terms of liberalized mentality and economic growth potential. Policy implications for how low HDI countries can counter this gap are discussed.

ELSI practices in genomic research in East Asia: implications for research collaboration and public participation

PubMed Central

2014-01-01

Common infrastructures and platforms are required for international collaborations in large-scale human genomic research and policy development, such as the Global Alliance for Genomics and Health and the ‘ELSI 2.0’ initiative. Such initiatives may require international harmonization of ethical and regulatory requirements. To enable this, however, a greater understanding of issues and practices that relate to the ethical, legal and social implications (ELSI) of genomic research will be needed for the different countries and global regions involved in such research. Here, we review the ELSI practices and regulations for genomic research in six East Asian countries (China, Indonesia, Japan, Singapore, South Korea and Taiwan), highlighting the main similarities and differences between these countries, and more generally, in relation to Western countries. While there are significant differences in ELSI practices among these East Asian countries, there is a consistent emphasis on advancing genomic science and technology. In addition, considerable emphasis is placed on informed consent for participation in research, whether through the contribution of tissue samples or personal information. However, a higher level of engagement with interested stakeholders and the public will be needed in some countries. PMID:24944586

The impact on breastfeeding of labour market policy and practice in Ireland, Sweden, and the USA.

PubMed

Galtry, Judith

2003-07-01

In recent decades there has been a marked rise in the labour market participation of women with infants in many countries. Partly in response to this trend, there are calls for greater emphasis on infant and child health in research and policy development on parental leave and other work-family balancing measures. Yet achieving high rates of breastfeeding as a health objective has thus far received relatively little attention in this context. Biomedical literature outlines the important health benefits conferred by breastfeeding, including upon infants and young children among middle class populations in developed countries. International recommendations now advise exclusive breastfeeding for 6 months. However, research indicates that the timing of the mother's resumption of employment is a key factor influencing the duration of exclusive breastfeeding. There would thus appear to be considerable potential for labour policy and practice, particularly maternity/parental leave provisions, to positively influence breastfeeding practice. Taking the case studies of Ireland, Sweden, and the United States, this paper explores the implications of labour market and early childhood policy for breastfeeding practice. The equity tensions posed by the breastfeeding-maternal employment intersection are also examined. The paper concludes that both socio-cultural support and labour market/health/early childhood policy are important if high rates of both breastfeeding and women's employment are to be achieved in industrialised countries.

Measuring and preventing alcohol use and related harm among young people in Asian countries: a thematic review.

PubMed

Jiang, Heng; Xiang, Xiaojun; Hao, Wei; Room, Robin; Zhang, Xiaojie; Wang, Xuyi

2018-01-01

The paper reviews alcohol consumption patterns and alcohol-related social and health issues among 15-29-year old young people in Asian countries, and discusses strategies for preventing and controlling alcohol use and related harms. We searched Google Scholar, PubMed, and Web of Science for reports, reviews and journal articles published in English between 1st Jan 1990 and 31st August 2016. Forty-one reports, reviews and journal papers were identified and included in the final review. The current drinking levels and prevalence among young people are markedly different between eight included Asian countries, ranging from 4.2% in Malaysia to 49.3% in China. In a majority of the selected Asian countries, over 15% of total deaths among young men and 6% among young women aged 15-29 years are attributable to alcohol use. Alcohol use among young people is associated with a number of harms, including stress, family violence, injuries, suicide, and sexual and other risky behaviours. Alcohol policies, such as controlling sales, social supply and marketing, setting up/raising a legal drinking age, adding health warning labels on alcohol containers, and developing a surveillance system to monitor drinking pattern and risky drinking behaviour, could be potential means to reduce harmful use of alcohol and related harm among young people in Asia. The review reveals that drinking patterns and behaviours vary across eight selected Asian countries due to culture, policies and regional variations. The research evidence holds substantial policy implications for harm reduction on alcohol drinking among young people in Asian countries -- especially for China, which has almost no alcohol control policies at present.

Climate Change and Developing-Country Cities: Implications For Environmental Health and Equity

PubMed Central

Corvalán, Carlos

2007-01-01

Climate change is an emerging threat to global public health. It is also highly inequitable, as the greatest risks are to the poorest populations, who have contributed least to greenhouse gas (GHG) emissions. The rapid economic development and the concurrent urbanization of poorer countries mean that developing-country cities will be both vulnerable to health hazards from climate change and, simultaneously, an increasing contributor to the problem. We review the specific health vulnerabilities of urban populations in developing countries and highlight the range of large direct health effects of energy policies that are concentrated in urban areas. Common vulnerability factors include coastal location, exposure to the urban heat-island effect, high levels of outdoor and indoor air pollution, high population density, and poor sanitation. There are clear opportunities for simultaneously improving health and cutting GHG emissions most obviously through policies related to transport systems, urban planning, building regulations and household energy supply. These influence some of the largest current global health burdens, including approximately 800,000 annual deaths from ambient urban air pollution, 1.2 million from road-traffic accidents, 1.9 million from physical inactivity, and 1.5 million per year from indoor air pollution. GHG emissions and health protection in developing-country cities are likely to become increasingly prominent in policy development. There is a need for a more active input from the health sector to ensure that development and health policies contribute to a preventive approach to local and global environmental sustainability, urban population health, and health equity. PMID:17393341

DOE Office of Scientific and Technical Information (OSTI.GOV)

Marshall, Rachael E., E-mail: rmarsh01@uoguelph.ca; Farahbakhsh, Khosrow, E-mail: khosrowf@uoguelph.ca

Highlights: ► Five drivers led developed countries to current solid waste management paradigm. ► Many unique factors challenge developing country solid waste management. ► Limited transferability of developed country approaches to developing countries. ► High uncertainties and decision stakes call for post-normal approaches. ► Systems thinking needed for multi-scale, self-organizing eco-social waste systems. - Abstract: Solid waste management (SWM) has become an issue of increasing global concern as urban populations continue to rise and consumption patterns change. The health and environmental implications associated with SWM are mounting in urgency, particularly in the context of developing countries. While systems analyses largelymore » targeting well-defined, engineered systems have been used to help SWM agencies in industrialized countries since the 1960s, collection and removal dominate the SWM sector in developing countries. This review contrasts the history and current paradigms of SWM practices and policies in industrialized countries with the current challenges and complexities faced in developing country SWM. In industrialized countries, public health, environment, resource scarcity, climate change, and public awareness and participation have acted as SWM drivers towards the current paradigm of integrated SWM. However, urbanization, inequality, and economic growth; cultural and socio-economic aspects; policy, governance, and institutional issues; and international influences have complicated SWM in developing countries. This has limited the applicability of approaches that were successful along the SWM development trajectories of industrialized countries. This review demonstrates the importance of founding new SWM approaches for developing country contexts in post-normal science and complex, adaptive systems thinking.« less

Abortion law in Muslim-majority countries: an overview of the Islamic discourse with policy implications.

PubMed

Shapiro, Gilla K

2014-07-01

Religion plays a significant role in a patient’s bioethical decision to have an abortion as well as in a country’s abortion policy. Nevertheless, a holistic understanding of the Islamic position remains under-researched. This study first conducted a detailed and systematic analysis of Islam’s position towards abortion through examining the most authoritative biblical texts (i.e. the Quran and Sunnah) as well as other informative factors (i.e. contemporary fatwas, Islamic mysticism and broader Islamic principles, interest groups, and transnational Islamic organizations). Although Islamic jurisprudence does not encourage abortion, there is no direct biblical prohibition. Positions on abortion are notably variable, and many religious scholars permit abortion in particular circumstances during specific stages of gestational development. It is generally agreed that the least blameworthy abortion is when the life of the pregnant woman is threatened and when 120 days have not lapsed; however, there is remarkable heterogeneity in regards to other circumstances (e.g. preserving physical or mental health, foetal impairment, rape, or social or economic reasons), and later gestational development of the foetus. This study secondly conducted a cross-country examination of abortion rights in Muslim-majority countries. A predominantly conservative approach was found whereby 18 of 47 countries do not allow abortion under any circumstances besides saving the life of the pregnant woman. Nevertheless, there was substantial diversity between countries, and 10 countries allowed abortion ‘on request’. Discursive elements that may enable policy development in Muslim-majority countries as well as future research that may enhance the study of abortion rights are discussed. Particularly, more lenient abortion laws may be achieved through disabusing individuals that the most authoritative texts unambiguously oppose abortion, highlighting more lenient interpretations that exist in certain Islamic legal schools, emphasizing significant actors that support abortion, and being mindful of policy frames that will not be well-received in Muslim-majority countries.

Ecuador Country Analysis Brief

EIA Publications

2015-01-01

In Ecuador, the oil sector accounts for more than half of the country's export earnings and approximately two-fifths of public sector revenues. Resource nationalism and debates about the economic, strategic, and environmental implications of oil sector development are prominent issues in the politics of Ecuador and the policies of its government. Ecuador is the smallest producer in the Organization of the Petroleum Exporting Countries (OPEC) and it produced 556,000 barrels per day (bbl/d) of petroleum and other liquids in 2014, of which crude oil production was 555,000 bbl/d. A lack of sufficient domestic refining capacity to meet local demand has forced Ecuador to import refined products, limiting net oil revenue.

A review of EIAs on trade policy in China: Exploring the way for economic policy EIAs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mao, Xianqiang, E-mail: maoxq@bnu.edu.cn; Song, Peng, E-mail: songpeng_ee@163.com; Kørnøv, Lone, E-mail: lonek@plan.aau.dk

During the discussion on the “Environmental Protection Law Amendment (draft)” in 2011, it was decided to drop the proposed clauses related to environmental impact assessments (EIAs) on policy, which means that there remained no provisions for policy EIAs, and China's strategic environmental assessment system stayed limited to the planning level. However, considering that economic policy making is causing significant direct and indirect environmental problems and that almost every aspect of governmental policy has an economic aspect, EIAs on economic policies are of the utmost urgency. The purpose of this study is to review the EIA work that has been carriedmore » out on trade policy in China through four case studies, and illustrate how trade policy EIAs can be helpful in achieving better environmental outcomes in the area of trade. Through the trade policy EIA case studies we try to argue for the feasibility of conducting EIAs on economic policies in China. We also discuss the implications of the case studies from the point of view of how to proceed with EIAs on economic policy and how to promote their practice. - Highlights: • SEA system is incomplete and stays limited to the plan EIA level in China. • EIA on economic policy is of utmost importance for all the developing countries. • Four case studies of trade policy EIA in China are reviewed for policy implications. • Departmental competition for political power impedes economic policy EIAs in China. • Legislative regulation on policy EIA is the first thing needed to overcome barrier.« less

The health implications of deportation policy.

PubMed

Morris, Juliana E; Palazuelos, Daniel

2015-05-01

The United States detains and deports over 400,000 people annually. This large-scale effort has important consequences for the health of affected individuals and communities. A growing body of research suggests that deportation increases stress and mental illness, economic deprivation, and individual exposure to violence, while also contributing to destabilization and crime at the community level. The challenges to reintegration experienced by deportees are additional push factors that increase their desire to re-emigrate. Furthermore, the related destabilization of local communities also contributes to the push, not just for deportees, but for all affected people in the region. This phenomenon has important implications for the long-term effectiveness of current U.S. deportation policies, which may be contributing to destabilization in home countries and thus potentiating further unauthorized emigration to the U.S.

The impact and implications of undocumented immigration on individual and collective health in the United States.

PubMed

Hilfinger Messias, DeAnne K; McEwen, Marylyn Morris; Clark, Lauren

2015-01-01

A nation of immigrants, the United States currently has more foreign-born residents than any other country; approximately 28% of these foreign-born residents are undocumented immigrants--individuals who either entered or are currently residing in the country without valid immigration or residency documents. The complex and constantly changing social, political, and economic context of undocumented migration has profound effects on individuals, families, and communities. The lack of demographic and epidemiologic data on undocumented immigrants is a major public health challenge. In this article, we identify multiple dimensions of vulnerability among undocumented persons; examine how undocumentedness impacts health and health care access and utilization; and consider the professional, practice, and policy issues and implications for nurses. Copyright © 2015 Elsevier Inc. All rights reserved.

Sex Education beyond School: Implications for Practice and Research

ERIC Educational Resources Information Center

Yu, Juping

2010-01-01

The negative consequences of teenage sexual behaviour are issues of concern in Britain and many other western countries. Over one-quarter of British young people are reported to become sexually active prior to the age of 16 and the rate of teenage pregnancy remains one of the highest in Western Europe. Current UK Government policy on sex education…

Subjective Welfare, Well-Being, and Self-Reported Food Hypersensitivity in Four European Countries: Implications for European Policy

ERIC Educational Resources Information Center

Voordouw, Jantine; Antonides, Gerrit; Fox, Margaret; Cerecedo, Inmaculada; Zamora, Javier; de la Hoz Caballer, Belen; Rokicka, Ewa; Cornelisse-Vermaat, Judith; Jewczak, Maciej; Starosta, Pawel; Kowalska, Marek L.; Jedrzejczak-Czechowicz, Monika; Vazquez-Cortes, Sonia; Escudero, Cano; de Blok, Bertine Flokstra; Dubois, Anthony; Mugford, Miranda; Frewer, Lynn J.

2012-01-01

This study estimates the effects of food hypersensitivity on individuals' perceived welfare and well-being compared to non-food hypersensitive individuals. Study respondents were recruited in the Netherlands, Poland, Spain and UK. The difference in welfare between food hypersensitive respondents and those asymptomatic to foods was estimated using…

Cross-Border Educational Collaboration between Taiwan and China: The Implications for Educational Governance

ERIC Educational Resources Information Center

Chan, Sheng-Ju

2011-01-01

Taiwan has undertaken a series of cross-border collaboration with China for the past two decades. This paper aims to investigate the Taiwanese approach and policies of educational collaboration with China in a globalized context, where international competitiveness has become a great concern for most countries. It also examines how the Taiwanese…

The Neoliberal University and Agricultural Biotechnology: Reports from the Field

ERIC Educational Resources Information Center

Peekhaus, Wilhelm

2010-01-01

Following in the footsteps of a variety of previous research that elaborates on the current state of affairs in academia, this article sets out the argument that neoliberalism and its corresponding iterations of science and technology and research funding policies in this country have implications for the types of knowledge that can be generated…

Participation Politics: African Parents' Negotiation of Social Identities in School Governance and Its Policy Implications

ERIC Educational Resources Information Center

Brown, Byron A.; Duku, Ntombozuko S.

2008-01-01

Although there is evidence of parental participation in school governance in South Africa, the question of how these parents manage their participation in these affairs is largely unanswered. This question represents one of the major exclusions in the existing reflections on the school governance debate in the country. Using a qualitative…

Qvo Vadis Magister Artium? Policy Implications of Executive Master's Programmes in an Israeli Research University

ERIC Educational Resources Information Center

Yogev, Abraham

2010-01-01

During recent decades master's studies have mainly become professional, but in some countries, like Israel, they still are a stepping stone toward doctorate studies. Changes in that respect may however occur due to recent university marketization processes. Using Tel Aviv University as a case study, we focus on the executive master's programmes…

AIDS Treatment In Brazil: Impacts And Challenges

PubMed Central

Nunn, Amy Stewart; Fonseca, Elize Massard da; Bastos, Francisco I.; Gruskin, Sofia

2009-01-01

Brazil has one of the developing world's largest, and arguably most successful, AIDS treatment programs. In this paper we review the treatment program, including controversial policies that Brazil has used to promote widespread local and global access to AIDS treatment. We also examine the lessons learned from this program and highlight the challenges Brazil faces, including the rising costs of AIDS treatment and changes in donors' funding priorities. Finally, we explore the relevance of Brazil's treatment program for other countries and its broad implications for global AIDS and health policy. PMID:19597210

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

PubMed

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

2014-09-01

One of the challenges for health reform in Asia is the diverse set of socio-economic and political structures, and the related variability in the direction and pace of health systems and policy reform. This paper aims to make comparative observations and analysis of health policy reform in the context of historical change, and considers the implications of these findings for the practice of health policy analysis. We adopt an ecological model for analysis of policy development, whereby health systems are considered as dynamic social constructs shaped by changing political and social conditions. Utilizing historical, social scientific and health literature, timelines of health and history for five countries (Cambodia, Myanmar, Mongolia, North Korea and Timor Leste) are mapped over a 30-50 year period. The case studies compare and contrast key turning points in political and health policy history, and examines the manner in which these turning points sets the scene for the acting out of longer term health policy formation, particularly with regard to the managerial domains of health policy making. Findings illustrate that the direction of health policy reform is shaped by the character of political reform, with countries in the region being at variable stages of transition from monolithic and centralized administrations, towards more complex management arrangements characterized by a diversity of health providers, constituency interest and financing sources. The pace of reform is driven by a country's institutional capability to withstand and manage transition shocks of post conflict rehabilitation and emergence of liberal economic reforms in an altered governance context. These findings demonstrate that health policy analysis needs to be informed by a deeper understanding and questioning of the historical trajectory and political stance that sets the stage for the acting out of health policy formation, in order that health systems function optimally along their own historical pathways. Copyright © 2014 Elsevier Ltd. All rights reserved.

Egalitarian policies and social determinants of health in Bolivarian Venezuela.

PubMed

Muntaner, Caries; Benach, Joan; Páez Victor, María; Ng, Edwin; Chung, Haejoo

2013-01-01

In 1999, newly-elected Venezuelan President Hugo Chávez initiated a far-reaching social movement as part of a political project known as the Bolivarian Revolution. Inspired by the democratic ideologies of Simón Bolívar, this movement was committed to reducing intractable inequalities that defined Venezuela's Fourth Republic (1958-1998). Given the ambitious scope of these reforms, Venezuela serves as an instructive example to understand the political context of social inequalities and population health. In this article, we provide a brief overview of the impact of egalitarian policies in Venezuela, stressing: (a) the socialist reforms and social class changes initiated by the Bolivarian Movement; (b) the impact of these reforms and changes on poverty and social determinants of health; (c) the sustainability of economic growth to continue pro-poor policies; and (d) the implications of egalitarian policies for other Latin American countries. The significance and implications of Chávez's achievements are now further underscored given his recent passing, leading one to ask whether political support for Bolivarianism will continue without its revolutionary leader.

New directions for migration policy in Europe.

PubMed Central

Laczko, Frank

2002-01-01

There is a growing debate about the future direction of migration policy in Europe. After nearly 30 years of pursuing restrictive immigration and asylum policies, many European Union (EU) governments are beginning to re-assess their migration policies and to call for a new approach. For the first time in many years, several EU governments have begun to talk again about the benefits of labour migration and, even more significantly, have even begun to take action to recruit more migrants, especially skilled workers. This paper looks at the background to current calls for a new approach to migration in Europe and public reaction to these new initiatives. It first describes recent trends in migration in Europe and then briefly considers the demographic case for more migration. This is followed by a brief outline of some of the measures being considered by European governments to promote selective labour migration. The remainder of the paper is devoted to a discussion of some of the implications of this change in policy, focusing on two main issues: the likely consequences for sending countries, and the implications for the fight against the smuggling and trafficking of people. PMID:12028795

Migrants, refugees and insecurity. Current threats to peace?

PubMed

Lohrmann, R

2000-01-01

Since the early 1980s, international migration has moved beyond humanitarian, economic development, labor market and societal integration concerns, raising complex interactive security implications for governments of migrant sending, receiving and transit countries, as well as for multilateral bodies. This article examines the effects of international migration on varied understandings and perceptions of international security. It discusses why international migration has come to be perceived as a security issue, both in industrialized and developing countries. Questions are raised on the migration-security nexus and the way in which the concepts "security" and "migration" are used. The real and perceived impacts of international migration upon national and regional security, both in industrialized and developing countries, are analyzed. The policies developed by governments and multilateral agencies since the mid-1980s to mitigate the destabilizing effects of certain kinds of international population movement and human displacement are examined. The conclusions stress the need for the establishment of a comprehensive framework of international cooperation among origin and receiving countries and international organizations to address the destabilizing implications of international migration.

Developing countries and trade in health services: which way is forward?

PubMed

Timmermans, Karin

2004-01-01

International trade in health services appears to be increasing It may receive a further boost when liberalized and bound under international trade agreements, such as the General Agreement on Trade in Services (GATS). Liberalization of trade in health services can create opportunities, but may also exacerbate preexisting problems. Moreover, once liberalization is locked in under international trade agreements, reversing policies becomes difficult, especially for developing countries. Making undue commitments to liberalize health services under GATS may therefore result in the loss of policy space. Yet the GATS agreement contains considerable flexibility to fine-tune commitments in accordance with national (health) objectives. But flexibility entails complexity, and for GATS the complexity is compounded by the fact that some of its rules are still being developed. Moreover, flexibility is meaningless unless used, and used well, which calls for a profound analysis of the alternatives and their implications. This article provides an overview of considerations related to (international) trade in health services and key features of GATS that are relevant to public health. It highlights that policymakers have something at stake in GATS negotiations; thus, they should take an interest in liberalization of trade in health services, analyze its implications, and give input and guidance to their country's trade negotiators. Moreover, to convey their concerns and aspirations effectively, they must learn the trade language, while staying focused on (public) health objectives.

Implications of an ageing population in the Asian context.

PubMed

Suyono, H

1999-12-01

Population aging is the increasing number and proportion of old persons aged 60 years and above in the developing countries and 65 years and above in the developed countries that exceeds 10% of the total population. In Asia, the last decade of the 20th century is marked by significant changes in the age structure due to the process of population aging. The implications of this aging population on the life of Asian countries has to be addressed since demographically the current situation is changing rapidly and there lie the future challenges that have to be answered. Due to the growing size of the elderly population, Asia will need better plans to prevent these elderly groups from turning into the socioeconomically vulnerable group of society. However, many governments are not prepared with effective policies, programs, and services that are particularly designed to care for the elderly. The provision of infrastructure and services, including education, employment, health and housing are necessary steps that need to be taken. Some of the suggested measures include: the Social Safety Net Programs; the implementation of the Association of Southeast Asian Nations Plan of Action on Rural Development and Poverty Eradication; and strengthen volunteerism and the role of private sector in human development. The role of the media in transmitting information concerning policies and programs intended to increase the welfare of the older persons is also very important.

Reviewing independent access to HIV testing, counselling and treatment for adolescents in HIV-specific laws in sub-Saharan Africa: implications for the HIV response

PubMed Central

Eba, Patrick M.; Lim, HyeYoung

2017-01-01

Abstract Introduction: AIDS is a leading cause of death among adolescents in sub-Saharan Africa. Yet, legal, policy and social barriers continue to restrict their access to HIV services. In recent years, access to independent HIV testing and treatment for adolescents has gained increased attention. The 2013 WHO Guidance on HIV testing and counselling and care for adolescents living with HIV (WHO Guidance) calls for reviewing legal and regulatory frameworks to facilitate adolescents’ access to comprehensive HIV services. As of 31 March 2017, some 28 countries in sub-Saharan Africa have adopted HIV-specific legislation. But there is limited understanding of the provisions of these laws on access to HIV services for adolescents and their implication on efforts to scale up HIV prevention, testing, treatment and care among this population. Methods: A desk review of 28 HIV-specific laws in sub-Saharan Africa complemented with the review of HIV testing policies in four countries using human rights norms and key public health recommendations from the 2013 WHO Guidance. These recommendations call on countries to (i) lower the age of consent to HIV testing and counselling and allow mature adolescents who have not reached the age of consent to independently access HIV testing, (ii) ensure access to HIV counselling for adolescents, (iii) protect the confidentiality of adolescents living with HIV and (iv) facilitate access to HIV treatment for adolescents living with HIV. Results: Most HIV-specific laws fail to take into account human rights principles and public health recommendations for facilitating adolescents’ access to HIV services. None of the countries with HIV-specific laws has adopted all four recommendations for access to HIV services for adolescents. Discrepancies exist between HIV laws and national policy documents. Inadequate and conflicting provisions in HIV laws are likely to hinder access to HIV testing, counselling and treatment for adolescents. Conclusions: Efforts to end legal barriers to access to HIV services for adolescents in sub-Saharan Africa should address HIV-specific laws. Restrictive provisions in these laws should be reformed, and their protective norms effectively implemented including by translating them into national policies and ensuring sensitization and training of healthcare workers and communities. This study reiterates the need for action in all countries across Africa and beyond to review their laws and policies to create an enabling environment to accelerate access to HIV prevention, testing and treatment services for adolescents. PMID:28799324

A cost of living longer: Projections of the effects of prospective mortality improvement on economic support ratios for 14 advanced economies.

PubMed

Parr, Nick; Li, Jackie; Tickle, Leonie

2016-07-01

The economic implications of increasing life expectancy are important concerns for governments in developed countries. The aims of this study were as follows: (i) to forecast mortality for 14 developed countries from 2010 to 2050, using the Poisson Common Factor Model; (ii) to project the effects of the forecast mortality patterns on support ratios; and (iii) to calculate labour force participation increases which could offset these effects. The forecast gains in life expectancy correlate negatively with current fertility. Pre-2050 support ratios are projected to fall most in Japan and east-central and southern Europe, and least in Sweden and Australia. A post-2050 recovery is projected for most east-central and southern European countries. The increases in labour force participation needed to counterbalance the effects of mortality improvement are greatest for Japan, Poland, and the Czech Republic, and least for the USA, Canada, Netherlands, and Sweden. The policy implications are discussed.

Does social policy moderate the impact of unemployment on health? A multilevel analysis of 23 welfare states.

PubMed

Vahid Shahidi, Faraz; Siddiqi, Arjumand; Muntaner, Carles

2016-12-01

The magnitude of observable health inequalities between the unemployed and their employed counterparts differs considerably across countries. Few attempts have been made to test theoretical explanations for this cross-national variation. Moreover, existing studies suffer from important theoretical and methodological limitations. This study addresses these limitations and investigates whether differences in the generosity of social protection policies and in public attitudes towards those policies explain why unemployment-related health inequalities are steeper in some societies than in others. Multilevel logistic modelling was used to link contextual-level variables on social protection policies and public attitudes in 23 European countries to individual-level data on self-rated health from the 2012 wave of the European Social Survey. The magnitude of inequalities in self-rated health between the unemployed and their employed counterparts varies significantly across countries as a function of cross-national differences in the level of social protection awarded to the unemployed and the level of public support for the welfare state. The results provide empirical support for the claim that governments can play a more active role in mitigating unemployment-related health inequalities by expanding the generosity and scope of social protection policies. Whether such an expansion of social protection will take place in the current climate of fiscal austerity is a political question whose implications merit the attention of population health scholars. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

The Implications of the Developmental Origins of Health and Disease on Public Health Policy and Health Promotion in South Africa

PubMed Central

Reddy, Sasiragha Priscilla; Mbewu, Anthony David

2016-01-01

The developmental origins of health and disease (DOHaD) hypothesis states that environmental influences in utero and in early life can determine health and disease in later life through the programming of genes and/or altered gene expression. The DOHaD is likely to have had an effect in South Africa during the fifty years of apartheid; and during the twenty years since the dawn of democracy in 1994. This has profound implications for public health and health promotion policies in South Africa, a country experiencing increased prevalence of noncommunicable diseases (NCDs) and risk factors and behaviours for NCDs due to rapid social and economic transition, and because of the DOHaD. Public health policy and health promotion interventions, such as those introduced by the South African Government over the past 20 years, were designed to improve the health of pregnant women (and their unborn children). They could in addition, through the DOHaD mechanism, reduce NCDs and their risk factors in their offspring in later life. The quality of public health data over the past 40 years in South Africa precludes the possibility of proving the DOHaD hypothesis in that context. Nevertheless, public health and health promotion policies need to be strengthened, if South Africa and other low and middle income countries (LMICs) are to avoid the very high prevalence of NCDs seen in Europe and North America in the 50 years following the Second World War, as a result of socio economic transition and the DOHaD. PMID:27834861

The Implications of the Developmental Origins of Health and Disease on Public Health Policy and Health Promotion in South Africa.

PubMed

Reddy, Sasiragha Priscilla; Mbewu, Anthony David

2016-11-09

The developmental origins of health and disease (DOHaD) hypothesis states that environmental influences in utero and in early life can determine health and disease in later life through the programming of genes and/or altered gene expression. The DOHaD is likely to have had an effect in South Africa during the fifty years of apartheid; and during the twenty years since the dawn of democracy in 1994. This has profound implications for public health and health promotion policies in South Africa, a country experiencing increased prevalence of noncommunicable diseases (NCDs) and risk factors and behaviours for NCDs due to rapid social and economic transition, and because of the DOHaD. Public health policy and health promotion interventions, such as those introduced by the South African Government over the past 20 years, were designed to improve the health of pregnant women (and their unborn children). They could in addition, through the DOHaD mechanism, reduce NCDs and their risk factors in their offspring in later life. The quality of public health data over the past 40 years in South Africa precludes the possibility of proving the DOHaD hypothesis in that context. Nevertheless, public health and health promotion policies need to be strengthened, if South Africa and other low and middle income countries (LMICs) are to avoid the very high prevalence of NCDs seen in Europe and North America in the 50 years following the Second World War, as a result of socio economic transition and the DOHaD.

From Policy to Practice: Supporting Students with Diverse Needs in Thailand: Critical Issues and Implications

ERIC Educational Resources Information Center

Opartkiattikul, Watinee; Arthur-Kelly, Michael; Dempsey, Ian

2014-01-01

A commitment to maximizing learning outcomes for all students is an axiom of most educational systems around the world. However this goal is sometimes compromised by factors that can be complex and difficult to address. Student behavior problems are one of the major issues challenging educators in many countries including Thailand. Recently, laws…

China-U.S. Relations: Current Issues and Implications for U.S. Policy

DTIC Science & Technology

2007-06-14

countries, the effectiveness of current U.S. food safety inspection regimes, and the vulnerability of the U.S. food supply to accidental contamination or...that allow it to purchase U.S. weapons offered for sale in 2001, and the periodic independence-leaning actions and rhetoric of its President and other... Food Contamination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Unfair Trade Subsidies

Trade in Services and Its Policy Implications: The Case of Cross-Border/Transnational Higher Education in Malaysia

ERIC Educational Resources Information Center

Morshidi, Sirat; Razak, Ahmad Abdul; Koo, Yew Lie

2011-01-01

The geography of trade in services is becoming increasingly important for a developing country such as Malaysia. But, present discussion on trade in education services, in particular, higher education and the General Agreement on Trade in Services (GATS) in Malaysia is rather limited and takes a short-term perspective. This is especially so with…

Teacher Education Policies, Practices, and Reform in Scotland: Implications in the Indian Context

ERIC Educational Resources Information Center

Misra, Pradeep Kumar

2015-01-01

India, a country of 1.27 billion, nowadays needs reforms, improvements, and new approaches in teacher education to cater to the demands of changing economy and society. This call to improve teacher education becomes more significant considering the fact that 50% of India's current population is below the age of 25 and over 65% below 35. There are…

Practice and education of nurse anaesthetists.

PubMed Central

Henry, B.; McAuliffe, M.

1999-01-01

A survey was conducted of the anaesthesia services provided by nurses and the education available to them in this field in 107 countries. Among the procedures carried out were general anaesthesia, spinal blocks and tracheal intubation. The implications of the findings for health planning and policy-making are discussed with particular reference to workforce structure and women's involvement in it. PMID:10212519

Report of an Investigation into the Possibilities for Educational Development in Rhodesia-Zimbabwe After a Political Settlement.

ERIC Educational Resources Information Center

1978

A group of senior faculty members of the University of Rhodesia initiated a study of attitudes to education among certain influential sections of opinion within the country and the implications for future educational planning. The study began with the interviewing of selected witnesses with interests in educational policy from among the political…

Integrated Emergy, Energy and Economic Evaluation of Rice and Vegetable Production Systems in Alluvial Paddy Fields: Implications for Agricultural Policy in China

EPA Science Inventory

China is the largest rice producing and consuming country in the world, but rice production has given way to the production of vegetables during the past twenty years. The government has been trying to stop this land-use conversion and increase the area in rice-vegetable rotation...

Infinite Rehearsal of Culture in St Catherine Jamaica: Heritage as Tourist Product, Implications for Caribbean Pedagogy

ERIC Educational Resources Information Center

Cross, Beth

2006-01-01

Over the last 20 years educational policies across the globe have become more closely aligned with industry interests. Jamaica is no exception. But what does this mean when the country's leading "industry" is tourism? It is no coincidence that in this decade the Ministry for Education became the Ministry for Education and Culture. When…

What Deters Students from Studying Abroad? Evidence from Four European Countries and Its Implications for Higher Education Policy

ERIC Educational Resources Information Center

Netz, Nicolai

2015-01-01

This study examines factors that deter students in Austria, Germany, Switzerland and the Netherlands from studying abroad. Using an adaptation of the Rubicon model of action phases, the path to gaining study abroad experience is conceptualised as a process involving two thresholds: the decision threshold and the realisation threshold. Theoretical…

Drug abuse in Vietnam: a critical review of the literature and implications for future research.

PubMed

Nguyen, Van T; Scannapieco, Maria

2008-04-01

To provide an overall picture of drug abuse in Vietnam, its prevalence, correlates and patterns. Studies addressing the drug abuse problem in Vietnam are reviewed. Attention is paid to studies conducted from 1993 onwards. The reviewed studies were collected from both refereed and non-refereed sources. Drug abuse is rising sharply in Vietnam: almost threefold over the past 10 years. From a predominantly rural-mountainous phenomenon, illicit drug abuse spread rapidly to urban areas. Meanwhile, the average age of drug users has declined and more women have been engaging in drug consumption. At the same time, heroin has replaced opium as the most preferred drug in the country's illicit drug market, especially among young users in urban areas. At the national level, the second main route of drug administration, injecting, has exceeded smoking and taken precedence in the country's drug abuse culture, especially among heroin users. Drug abuse in Vietnam has changed radically over the past decade, which has implications for the national and international community and requires further research to fill the knowledge gap and to inform intervention policy for better drug control policy.

Breast Cancer Epidemiology in Gulf Cooperation Council Countries: A Regional and International Comparison.

PubMed

Albeshan, Salman M; Mackey, Martin G; Hossain, Syeda Z; Alfuraih, Abdulrahman A; Brennan, Patrick C

2017-07-13

Breast cancer is the most frequently diagnosed noncutaneous malignancy in women living in Gulf Cooperation Council countries. The present report aimed to highlight the similarities and variations in breast cancer incidence, age at diagnosis, clinicopathologic features, molecular characteristics, and lifestyle factors that contribute to an increasing incidence of breast cancer compared with neighboring Arab and westernized countries. The data presented, although having important implications for policy makers, also highlights the need for further research. Such research would ensure that effective prevention and detection strategies are tailored to the specific needs of the Gulf women such that the management of breast cancer is optimized. Copyright © 2017 Elsevier Inc. All rights reserved.

Coastal and river flood risk analyses for guiding economically optimal flood adaptation policies: a country-scale study for Mexico

NASA Astrophysics Data System (ADS)

Haer, Toon; Botzen, W. J. Wouter; van Roomen, Vincent; Connor, Harry; Zavala-Hidalgo, Jorge; Eilander, Dirk M.; Ward, Philip J.

2018-06-01

Many countries around the world face increasing impacts from flooding due to socio-economic development in flood-prone areas, which may be enhanced in intensity and frequency as a result of climate change. With increasing flood risk, it is becoming more important to be able to assess the costs and benefits of adaptation strategies. To guide the design of such strategies, policy makers need tools to prioritize where adaptation is needed and how much adaptation funds are required. In this country-scale study, we show how flood risk analyses can be used in cost-benefit analyses to prioritize investments in flood adaptation strategies in Mexico under future climate scenarios. Moreover, given the often limited availability of detailed local data for such analyses, we show how state-of-the-art global data and flood risk assessment models can be applied for a detailed assessment of optimal flood-protection strategies. Our results show that especially states along the Gulf of Mexico have considerable economic benefits from investments in adaptation that limit risks from both river and coastal floods, and that increased flood-protection standards are economically beneficial for many Mexican states. We discuss the sensitivity of our results to modelling uncertainties, the transferability of our modelling approach and policy implications. This article is part of the theme issue `Advances in risk assessment for climate change adaptation policy'.

The impact of the International Monetary Fund's macroeconomic policies on the AIDS pandemic.

PubMed

Baker, Brook K

2010-01-01

Expansion of funding for HIV/AIDS, especially treatment, is under attack over concerns about cost effectiveness and financial constraints. The International Monetary Fund is deeply implicated in the history of the AIDS pandemic, the underlying weakness of health systems, and the ideology of constrained resources that underlies most attacks on AIDS funding. The IMF imposed structural violence on developing countries in the 1980s and 1990s through neoliberal and macroeconomic reforms that intensified individual and communal vulnerability to infection and dismantled already weak health systems. This same macroeconomic fundamentalism has recently been repackaged and renamed. IMF fundamentalist policies continue to prioritize low inflation, constricted government spending, robust foreign currency reserves, and prompt repayment of debt at the expense of investments in health and more expansionary, pro-growth and job-creation policies. Several recent surveys have concluded that the IMF reluctantly relaxed overly restrictive policy prescriptions in response to the global economic crisis, but this relaxation was temporary at best and only extended to countries previously acceding to IMF orthodoxy. AIDS activists are campaigning for billions of dollars to fulfill the promise of universal access. If IMF pressures persist, developing countries will continue to undermine the additionality of donor health financing by substituting donor for domestic financing, refusing to invest in recurrent costs for medicines and health workers, and neglecting needed investments in health infrastructure and health system strengthening.

Poverty in Eritrea: challenges and implications for development.

PubMed

Rena, Ravinder

2009-01-01

Poverty, one of the world's most serious problems, is particularly severe in Africa. Eritrea is a 16-year-old nation that gained its independence from Ethiopia in 1993. The country's economy was doing relatively well between 1993 and 1997. Eritrea was then exposed to numerous challenges such as drought, famines and recurrent war. As a result, poverty has become more rampant in a country where over 66 per cent of people live below the poverty line. Some families live on remittances. The government has taken some poverty alleviation measures. However, it has not mitigated poverty due to a lack of resources and a poorly implemented poverty alleviation programme. This article attempts to explore the incidence of poverty. It also provides details of poverty surveys that have been conducted since independence. It discusses various poverty challenges and provides some policy implications for development.

Media framing of complex issues: The case of endangered languages.

PubMed

Rivenburgh, Nancy K

2013-08-01

This study investigates how media frame a global trend that is complex in nature, emergent in terms of scientific understanding, and has public policy implications: the rapid disappearance of languages. It analyzes how English-language media from 15 western, industrialized countries frame the causes and implications of endangered languages over 35 years (1971-2006) - a time period notable for growing, interdisciplinary concerns over the potential negative impacts of losing the world's linguistic diversity. The results reveal a media discourse characterized by three complementary frames that are sympathetic to the plight of endangered languages, but that present the problem, its cause, and societal implications in a logical structure that would promote public complacency.

Social world of organ transplantation, trafficking, and policies.

PubMed

Yousaf, Farhan Navid; Purkayastha, Bandana

2016-05-01

Although success of organ transplants reflects advances in medical procedures, the success has generated debates about the ethical standards and policies that govern transplants, especially the acquisition of organs for transplants. We focus on laws, policies, and organ trafficking to highlight the interdisciplinary perspectives that can shape our understanding of transplantation as a social phenomenon. We discuss international policies and country-specific legislation from Pakistan to point to gaps and their implications for protecting vulnerable people who are exploited for organ removal. International collaboration and the legal framework need to be strengthened to fight the menace globally and to deal with the cases of organ trafficking within the legal ambit of human trafficking so that the rights of victims are upheld by states, justice systems, and ultimately medical establishments and practitioners.

Social cost of carbon pricing of power sector CO2: accounting for leakage and other social implications from subnational policies

NASA Astrophysics Data System (ADS)

Bistline, John E.; Rose, Steven K.

2018-01-01

In environments where climate policy has partial coverage or unequal participation, carbon dioxide (CO2) emissions or economic activity may shift to locations and sectors where emissions are unregulated. This is referred to as leakage. Leakage can offset or augment emissions reductions associated with a policy, which has important environmental and economic implications. Although leakage has been studied at national levels, analysis of leakage for subnational policies is limited. This is despite greater market integration and many existing state and regional environmental regulations in the US. This study explores leakage potential, net emissions changes, and other social implications in the US energy system with regionally differentiated pricing of power sector CO2 emissions. We undertake an economic analysis using EPRI’s US-REGEN model, where power sector CO2 emissions are priced in individual US regions with a range of social cost of carbon (SCC) values. SCC estimates are being considered by policy-makers for valuing potential societal damages from CO2 emissions. In this study, we evaluate the emissions implications within the SCC pricing region, within the power sector outside the SCC region, and outside the power sector (i.e. in the rest of the energy system). Results indicate that CO2 leakage is possible within and outside the electric sector, ranging from negative 70% to over 80% in our scenarios, with primarily positive leakage outcomes. Typically ignored in policy analysis, leakage would affect CO2 reduction benefits. We also observe other potential societal effects within and across regions, such as higher electricity prices, changes in power sector investments, and overall consumption losses. Efforts to reduce leakage, such as constraining power imports into the SCC pricing region likely reduce leakage, but could also result in lower net emissions reductions, as well as larger price increases. Thus, it is important to look beyond leakage and consider a broader set of environmental and economic metrics. Leakage rates, net emissions outcomes, electricity price changes, fuel market effects, and macroeconomic costs vary by region of the country, time, policy stringency, policy design (e.g. leakage mitigation provisions), policy environment in neighboring regions, and price responsiveness of demand.

HIV testing for pregnant women: a rights-based analysis of national policies.

PubMed

King, Elizabeth J; Maman, Suzanne; Wyckoff, Sarah C; Pierce, Matthew W; Groves, Allison K

2013-01-01

Ethical and human rights concerns have been expressed regarding the global shift in policies on HIV testing of pregnant women. The main purpose of this research was to conduct a policy analysis using a human rights-based approach of national policies for HIV testing of pregnant women. We collected HIV testing policies from 19 countries including: Cambodia, China, Guyana, Haiti, India, Jamaica, Kenya, Moldova, Papua New Guinea, Russian Federation, South Africa, Sudan, Swaziland, Tanzania, Ukraine, United States, Uzbekistan, Zambia and Zimbabwe. We analysed the HIV testing policies using a standardised framework that focused on government obligations to respect, protect and fulfil. Our results highlight the need for more attention to issues of pregnant women's autonomy in consenting to HIV testing, confidentiality in antenatal care settings and provision of counselling and care services. We conclude with a discussion about potential implications of the current testing policies and provide recommendations for ways that HIV testing policies can more effectively uphold the human rights of pregnant women.

Is Child Labor a Barrier to School Enrollment in Low- and Middle-Income Countries?

PubMed Central

Putnick, Diane L.; Bornstein, Marc H.

2015-01-01

Achieving universal primary education is one of the Millennium Development Goals. In low- and middle-income developing countries (LMIC), child labor may be a barrier. Few multi-country, controlled studies of the relations between different kinds of child labor and schooling are available. This study employs 186,795 families with 7- to 14-year-old children in 30 LMIC to explore relations of children’s work outside the home, family work, and household chores with school enrollment. Significant negative relations emerged between each form of child labor and school enrollment, but relations were more consistent for family work and household chores than work outside the home. All relations were moderated by country and sometimes by gender. These differentiated findings have nuanced policy implications. PMID:26034342

Effects of age and gender on elderly suicide rates in Catholic and Orthodox countries: an inadvertent neglect?

PubMed

Pritchard, C; Baldwin, D

2000-10-01

When compared to suicide rates in the general population, it may be expected that elderly suicide rates would be lower in Catholic and Orthodox societies than in non-Catholic or non-Orthodox countries because of religious affiliations and extended family traditions. National suicide rates in the general population were compared with rates in the sub-population of those aged over 75 years. Proportionately, there are significantly higher suicide rates in elderly men in Catholic and Orthodox countries, compared to rates in other countries, with a trend for similar findings among women. There may be important implications on health and social policy and clinical practice in the efforts to reduce suicide rates among elderly people. Copyright 2000 John Wiley & Sons, Ltd.

Effects of regulation on drug launch and pricing in interdependent markets.

PubMed

Danzon, Patricia M; Epstein, Andrew J

2012-01-01

This study examines the effect of price regulation and competition on launch timing and pricing of new drugs. Our data cover launch experience in 15 countries from 1992 to 2003 for drugs in 12 major therapeutic classes. We estimate a two-equation model of launch hazard and launch price of new drugs. We find that launch timing and prices of new drugs are related to a country's average prices of established products in a class. Thus to the extent that price regulation reduces price levels, such regulation directly contributes to launch delay in the regulating country. Regulation by external referencing, whereby high-price countries reference low-price countries, also has indirect or spillover effects, contributing to launch delay and higher launch prices in low-price referenced countries. Referencing policies adopted in high-price countries indirectly impose welfare loss on low-price countries. These findings have implications for US proposals to constrain pharmaceutical prices through external referencing and drug importation.

Meso level influences on long term condition self-management: stakeholder accounts of commonalities and differences across six European countries.

PubMed

Rogers, Anne; Vassilev, Ivaylo; Pumar, Maria J Jesús; Todorova, Elka; Portillo, Mari Carmen; Foss, Christina; Koetsenruijter, Jan; Ratsika, Nikoleta; Serrano, Manuel; Knutsen, Ingrid A Ruud; Wensing, Michel; Roukova, Poli; Patelarou, Evridiki; Kennedy, Anne; Lionis, Christos

2015-07-08

European countries are increasingly adopting systems of self -care support (SMS) for long term conditions which focus on enhancing individual, competencies, skills, behaviour and lifestyle changes. To date the focus of policy for engendering greater self- management in the population has been focused in the main on the actions and motivations of individuals. Less attention has been paid to how the broader influences relevant to SMS policy and practice such as those related to food production, distribution and consumption and the structural aspects and economics relating to physical exercise and governance of health care delivery systems might be implicated in the populations ability to self- manage. This study aimed to identify key informants operating with knowledge of both policy and practice related to SMS in order to explore how these influences are seen to impact on the self-management support environment for diabetes type 2. Ninety semi-structured interviews were conducted with key stakeholder informants in Bulgaria, Spain, Greece, Norway, Netherlands and UK. Interviews were transcribed and analysed using thematic and textual analysis. Stakeholders in the six countries identified a range of influences which shaped diabetes self-management (SM). The infrastructure and culture for supporting self- management practice is viewed as driven by political decision-makers, the socio-economic and policy environment, and the ethos and delivery of chronic illness management in formal health care systems. Three key themes emerged during the analysis of data. These were 1) social environmental influences on diabetes self-management 2) reluctance or inability of policy makers to regulate processes and environments related to chronic illness management 3) the focus of healthcare system governance and gaps in provision of self-management support (SMS). Nuances in the salience and content of these themes between partner countries related to the presence and articulation of dedicated prevention and self- management policies, behavioural interventions in primary care, drug company involvement and the impact of measures resulting from economic crises, and differences between countries with higher versus lower social welfare support and public spending on shaping illness management. The results suggest reasons for giving increasing prominence to meso level influences as a means of rebalancing and improving the effectiveness of implementing an agenda for SMS. There is a need to acknowledge the greater economic and policy challenging environment operating in some countries which act as a source of inequality between countries in addressing SMS for chronic illness management and impacts on people's capacity to undertake self-care activities.

Unravelling networks in local public health policymaking in three European countries - a systems analysis.

PubMed

Spitters, Hilde P E M; Lau, Cathrine J; Sandu, Petru; Quanjel, Marcel; Dulf, Diana; Glümer, Charlotte; van Oers, Hans A M; van de Goor, Ien A M

2017-02-03

Facilitating and enhancing interaction between stakeholders involved in the policymaking process to stimulate collaboration and use of evidence, is important to foster the development of effective Health Enhancing Physical Activity (HEPA) policies. Performing an analysis of real-world policymaking processes will help reveal the complexity of a network of stakeholders. Therefore, the main objectives were to unravel the stakeholder network in the policy process by conducting three systems analyses, and to increase insight into the similarities and differences in the policy processes of these European country cases. A systems analysis of the local HEPA policymaking process was performed in three European countries involved in the 'REsearch into POlicy to enhance Physical Activity' (REPOPA) project, resulting in three schematic models showing the main stakeholders and their relationships. The models were used to compare the systems, focusing on implications with respect to collaboration and use of evidence in local HEPA policymaking. Policy documents and relevant webpages were examined and main stakeholders were interviewed. The systems analysis in each country identified the main stakeholders involved and their position and relations in the policymaking process. The Netherlands and Denmark were the most similar and both differed most from Romania, especially at the level of accountability of the local public authorities for local HEPA policymaking. The categories of driving forces underlying the relations between stakeholders were formal relations, informal interaction and knowledge exchange. A systems analysis providing detailed descriptions of positions and relations in the stakeholder network in local level HEPA policymaking is rather unique in this area. The analyses are useful when a need arises for increased interaction, collaboration and use of knowledge between stakeholders in the local HEPA network, as they provide an overview of the stakeholders involved and their mutual relations. This information can be an important starting point to enhance the uptake of evidence and build more effective public health policies.

Moving the Agenda on Noncommunicable Diseases: Policy Implications of Mobile Phone Surveys in Low and Middle-Income Countries.

PubMed

Pariyo, George W; Wosu, Adaeze C; Gibson, Dustin G; Labrique, Alain B; Ali, Joseph; Hyder, Adnan A

2017-05-05

The growing burden of noncommunicable diseases (NCDs), for example, cardiovascular diseases and chronic respiratory diseases, in low- and middle-income countries (LMICs) presents special challenges for policy makers, due to resource constraints and lack of timely data for decision-making. Concurrently, the increasing ubiquity of mobile phones in LMICs presents possibilities for rapid collection of population-based data to inform the policy process. The objective of this paper is to highlight potential benefits of mobile phone surveys (MPS) for developing, implementing, and evaluating NCD prevention and control policies. To achieve this aim, we first provide a brief overview of major global commitments to NCD prevention and control, and subsequently explore how countries can translate these commitments into policy action at the national level. Using the policy cycle as our frame of reference, we highlight potential benefits of MPS which include (1) potential cost-effectiveness of using MPS to inform NCD policy actions compared with using traditional household surveys; (2) timeliness of assessments to feed into policy and planning cycles; (3) tracking progress of interventions, hence assessment of reach, coverage, and distribution; (4) better targeting of interventions, for example, to high-risk groups; (5) timely course correction for suboptimal or non-effective interventions; (6) assessing fairness in financial contribution and financial risk protection for those affected by NCDs in the spirit of universal health coverage (UHC); and (7) monitoring progress in reducing catastrophic medical expenditure due to chronic health conditions in general, and NCDs in particular. We conclude that MPS have potential to become a powerful data collection tool to inform policies that address public health challenges such as NCDs. Additional forthcoming assessments of MPS in LMICs will inform opportunities to maximize this technology. ©George W Pariyo, Adaeze C Wosu, Dustin G Gibson, Alain B Labrique, Joseph Ali, Adnan A Hyder. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 05.05.2017.

Through the back door: nurse migration to the UK from Malawi and Nepal, a policy critique.

PubMed

Adhikari, Radha; Grigulis, Astrida

2014-03-01

The UK National Health Service has a long history of recruiting overseas nurses to meet nursing shortages in the UK. However, recruitment patterns regularly fluctuate in response to political and economic changes. Typically, the UK government gives little consideration of how these unstable recruitment practices affect overseas nurses. In this article, we present findings from two independent research studies from Malawi and Nepal, which aimed to examine how overseas nurses encountered and overcame the challenges linked to recent recruitment and migration restrictions. We show how current UK immigration policy has had a negative impact on overseas nurses' lives. It has led them to explore alternative entry routes into the UK, affecting both the quality of their working lives and their future decisions about whether to stay or return to their home country. We conclude that the shifting forces of nursing workforce demand and supply, leading to abrupt policy changes, have significant implications on overseas nurses' lives, and can leave nurses 'trapped' in the UK. We make recommendations for UK policy-makers to work with key stakeholders in nurse-sending countries to minimize the negative consequences of unstable nurse recruitment, and we highlight the benefits of promoting circular migration.

Research in space commercialization, technology transfer and communications, vol. 2

NASA Technical Reports Server (NTRS)

Dunn, D. A.; Agnew, C. E.

1983-01-01

Spectrum management, models for evaluating communications systems, and implications of communications regulations for NASA are considered as major parts of communications policy. Marketing LANDSAT products in developing countries, a political systems analysis of LANDSAT, and private financing and operation of the space operations center (space station) are discussed. Investment requirements, risks, government support, and other primary business and management considerations are examined.

Reevaluating the Relationship between Education and Child Labour Using the Capabilities Approach: Policy and Implications for Inequality in Cambodia

ERIC Educational Resources Information Center

Kluttz, Jenalee

2015-01-01

Cambodia has experienced rapid economic growth in the last two decades, improving living standards and diminishing poverty. Unfortunately, it has failed to do so evenly. Growth within the country has widened the gap between rich and poor and exacerbated the rural/urban divide. This inequality is mirrored in the school system. Inequality within the…

1-1 in Education: Current Practice, International Comparative Research Evidence and Policy Implications. OECD Education Working Papers, No. 44,

ERIC Educational Resources Information Center

Valiente, Oscar

2010-01-01

Over the last decade, more and more public and private stakeholders, in developed and developing countries, have been supporting 1:1 initiatives in education (i.e. every child receives her/his own personal computing device). These 1:1 initiatives represent a qualitative move forward from previous educational experiences with ICT, inasmuch as every…

Policy and Practice Implications of the Program for International Student Assessment (PISA) 2000. Report of the International Reading Association PISA Task Force.

ERIC Educational Resources Information Center

Topping, Keith; Valtin, Renate; Roller, Cathy; Brozo, William; Dionisio, M. Lourdes

The Program for International Student Assessment (PISA) is a study of comparisons. Subjects, 15-year-old students from 32 participating countries, were compared in their abilities to "use literacy knowledge and skills to meet real-life challenges," as assessed on a two-hour, paper-and-pencil test. Students also responded to a…

A narrative synthesis of illustrative evidence on effects of capitation payment for primary care: lessons for Ghana and other low/middle-income countries.

PubMed

Andoh-Adjei, Francis-Xavier; Spaan, Ernst; Asante, Felix A; Mensah, Sylvester A; van der Velden, Koos

2016-12-01

To analyse and synthesize available international experiences and information on the motivation for, and effects of using capitation as provider payment method in country health systems and lessons and implications for low/middle-income countries. We did narrative review and synthesis of the literature on the effects of capitation payment on primary care. Eleven articles were reviewed. Capitation payment encourages efficiency: drives down cost, serves as critical source of income for providers, promotes adherence to guidelines and policies, encourages providers to work better and give health education to patients. It, however, induces reduction in the quantity and quality of care provided and encourages skimming on inputs, underserving of patients in bad state of health, "dumping" of high risk patients and negatively affect patient-provider relationship. The illustrative evidence adduced from the review demonstrates that capitation payment in primary care can create positive incentives but could also elicit un-intended effects. However, due to differences in country context, policy makers in Ghana and other low/middle-income countries may only be guided by the illustrative evidence in their design of a context-specific capitation payment for primary care. Netherlands Fellowship Programme (NFP), Fellowship number: NFP-PhD.12/352.

Do foreign direct investment and renewable energy consumption affect the CO2 emissions? New evidence from a panel ARDL approach to Kyoto Annex countries.

PubMed

Mert, Mehmet; Bölük, Gülden

2016-11-01

This study examines the impact of foreign direct investment (FDI) and the potential of renewable energy consumption on carbon dioxide (CO 2 ) emissions in 21 Kyoto countries using an unbalanced panel data. For this purpose, Environmental Kuznets Curve (EKC) hypothesis was tested using panel cointegration analysis. Panel causality tests show that there are significant long-run causalities from the variables to carbon emissions, renewable energy consumption, fossil fuel energy consumption and inflow foreign direct investments. The results of our model support the pollution haloes hypothesis which states that FDI brings in clean technology and improves the environmental standards. However, an inverted U-shaped relationship (EKC) was not supported by the estimated model for the 21 Kyoto countries. This means that economic growth cannot ensure environmental protection itself or environmental goals cannot await economic growth. Another important finding is that renewable energy consumption decreases carbon emissions. Based on the empirical results, some important policy implications emerge. Kyoto countries should stimulate the FDI inflows and usage of renewable energy consumption to mitigate the air pollution and meet the emission targets. This paper provides new insights into environment and energy policies through FDI inclusion.

Implications of Graphic Cigarette Warning Labels on Smoking Behavior: An International Perspective.

PubMed

Jung, Minsoo

2016-03-01

Graphic warning labels (GWLs) have been developed as a representative non-price policy to block such marketing. This study investigated the current state and effect of the global introduction of GWLs and examines the future tasks related to GWLs. We systematically reviewed literatures on GWL and a tobacco control strategy in the past fifteen years. The policy of enforcing GWLs has spread globally based on the Framework Convention on Tobacco Control. GWLs are more effective than text warnings and are implemented in over 70 countries. The policy has showed the impact of GWLs as a preventive effect on adolescents' smoking, inducement of smoking cessation, reduction in the amount of tobacco smoked, and reduction in smoking rates. The success of an anti-smoking policy can manifests itself as an effect of individual policies, the rise of tobacco prices, and the introduction of GWLs.

Health Systems Research in a Complex and Rapidly Changing Context: Ethical Implications of Major Health Systems Change at Scale.

PubMed

MacGregor, Hayley; Bloom, Gerald

2016-12-01

This paper discusses health policy and systems research in complex and rapidly changing contexts. It focuses on ethical issues at stake for researchers working with government policy makers to provide evidence to inform major health systems change at scale, particularly when the dynamic nature of the context and ongoing challenges to the health system can result in unpredictable outcomes. We focus on situations where 'country ownership' of HSR is relatively well established and where there is significant involvement of local researchers and close ties and relationships with policy makers are often present. We frame our discussion around two country case studies with which we are familiar, namely China and South Africa and discuss the implications for conducting 'embedded' research. We suggest that reflexivity is an important concept for health system researchers who need to think carefully about positionality and their normative stance and to use such reflection to ensure that they can negotiate to retain autonomy, whilst also contributing evidence for health system change. A research process informed by the notion of reflexive practice and iterative learning will require a longitudinal review at key points in the research timeline. Such review should include the convening of a deliberative process and should involve a range of stakeholders, including those most likely to be affected by the intended and unintended consequences of change. © 2016 The Authors Developing World Bioethics Published by John Wiley & Sons Ltd.

Air pollution management and control in Latin America and the Caribbean: implications for climate change.

PubMed

Riojas-Rodríguez, Horacio; da Silva, Agnes Soares; Texcalac-Sangrador, José Luis; Moreno-Banda, Grea Litai

2016-09-01

To assess the status of the legal framework for air quality control in all countries of Latin America and Caribbean (LAC); to determine the current distribution of air monitoring stations and mean levels of air pollutants in all capital and large cities (more than 100 000 inhabitants); and to discuss the implications for climate change and public policymaking. From January 2015-February 2016, searches were conducted of online databases for legislation, regulations, policies, and air pollution programs, as well as for the distribution of monitoring stations and the mean annual levels of air pollution in all LAC countries. Only 117 cities distributed among 17 of 33 LAC countries had official information on ground level air pollutants, covering approximately 146 million inhabitants. The annual mean of inhalable particles concentration in most of the cities were over the World Health Organization Air Quality Guidelines; notably, only Bolivia, Peru, and Guatemala have actually adopted the guidelines. Most of the cities did not have information on particulate matter of 2.5 microns or less, and only a few measured black carbon. The air quality regulatory framework should be updated to reflect current knowledge on health effects. Monitoring and control of ground level pollutants should be extended and strengthened to increase awareness and protect public health. Using the co-benefits of air pollution control for health and climate as a framework for policy and decision-making in LAC is recommended.

Perspectives of intellectual disability in Latin American countries: epidemiology, policy, and services for children and adults.

PubMed

Mercadante, Marcos T; Evans-Lacko, Sara; Paula, Cristiane S

2009-09-01

The prevalence of intellectual disability is an estimated 1-4% worldwide. Etiological factors such as malnutrition, lack of perinatal care, and exposure to toxic and infectious agents, which are more common in low-income and middle-income (LAMI) countries, may contribute to a higher prevalence of intellectual disability in Latin America. This review summarizes the data on intellectual disability coming from Latin America, which is published in scientific journals and is available from official websites and discusses potential health policy and services implications of these studies. Methodologically rigorous studies on intellectual disability in Latin America are lacking. This paucity of basic epidemiological information is a barrier to policy and services development and evaluation around intellectual disability. Only two studies, one from Chile and another from Jamaica, allow for adequate population estimates of intellectual disability. Interestingly, the countries with the highest scientific production in Latin America, Brazil and Mexico, did not produce the most informative research in epidemiology, policy or services related to intellectual disability. The main conclusion of this review is that a lack of scientific evidence makes it difficult to properly characterize the context of intellectual disability in Latin America. Insufficient data is also a barrier to policy and services development for governments in Latin America. Although recently there have been efforts to develop government programs to meet the needs of the intellectual disability population in Latin America, the effectiveness of these programs is questionable without proper evaluation. There is a need for studies that characterize the needs of people with intellectual disability specifically in Latin America, and future research in this area should emphasize how it can inform current and future policies and services for people with intellectual disability.

Stakeholder perceptions of job stress in an industrialized country: implications for policy and practice.

PubMed

Page, Kathryn M; LaMontagne, Anthony D; Louie, Amber M; Ostry, Aleck S; Shaw, Andrea; Shoveller, Jeannie A

2013-08-01

We used a secondary, qualitative analysis of stakeholder perceptions of work stress in Australia to characterize the context for policy and practice intervention. Themes included: Individual versus contextual descriptions of stress; perceived 'gender' differences in manifesting and reporting of stress; the work/home interface; and perceived sectoral and occupational differences in compensation claim rates. We found that people often still perceive stress as an individual rather than organizational problem and view work stress as a stereotypically feminine weakness that affects only certain people. Organizations downplay and overlook risks, increasing worker reluctance to report stressors, creating barriers to job stress interventions. Our study may be relevant to other industrial countries where researchers currently study job stress interventions to improve their effectiveness. Comprehensive approaches can increase knowledge and decrease stigma about job stress and mental illness, and target both work- and non-work-related influences on mental health.

Health Insecurity and Social Protection: Pathways, Gaps, and Their Implications on Health Outcomes and Poverty

PubMed Central

Gama, Elvis

2016-01-01

Health insecurity has emerged as a major concern among health policy-makers particularly in low- and middle-income countries (LMICs). It includes the inability to secure adequate healthcare today and the risk of being unable to do so in the future as well as impoverishing healthcare expenditure. The increasing health insecurity among 150 million of the world’s poor has moved social protection in health (SPH) to the top of the agenda among health policy-makers globally. This paper aims to provide a debate on the potential of social protection contribution to addressing health insecurity, poverty, and vulnerability brought by healthcare expenditure in low-income countries, to explore the gaps in current and proposed social protection measures in healthcare and provide suggestions on how social protection intervention aimed at addressing health insecurity, poverty, and vulnerability may be effectively implemented. PMID:26927589

Health Insecurity and Social Protection: Pathways, Gaps, and Their Implications on Health Outcomes and Poverty.

PubMed

Gama, Elvis

2015-11-27

Health insecurity has emerged as a major concern among health policy-makers particularly in low- and middle-income countries (LMICs). It includes the inability to secure adequate healthcare today and the risk of being unable to do so in the future as well as impoverishing healthcare expenditure. The increasing health insecurity among 150 million of the world's poor has moved social protection in health (SPH) to the top of the agenda among health policy-makers globally. This paper aims to provide a debate on the potential of social protection contribution to addressing health insecurity, poverty, and vulnerability brought by healthcare expenditure in low-income countries, to explore the gaps in current and proposed social protection measures in healthcare and provide suggestions on how social protection intervention aimed at addressing health insecurity, poverty, and vulnerability may be effectively implemented. © 2016 by Kerman University of Medical Sciences.

Forced Migration: Refugee Populations

PubMed Central

Boyle, Joyceen S.

2015-01-01

Undocumented migration is a global phenomenon that manifests in various contexts. This article describes the impact of the movement of large numbers of people in several African countries, producing a unique type of migrant—the refugee. We describe issues that refugee movements create on fragile health care systems, situations that precipitate refugee movements, certain human rights violations that are of particular concern such as gender based violence (GBV) and child soldiers, and lastly, implications for nursing practice and policy. We use examples from several countries in Sub-Saharan Africa, including the Democratic Republic of the Congo, Rwanda, Liberia, Sierra Leone, and Mozambique. Drawing on key documents from the United Nations High Commissioner for Refugees, current literature, as well as the international experience of the authors, this article presents an overview of forced migration and discusses opportunities for nurses to impact research, practice and policy related to refugee health. PMID:25645484

PEPFAR Funding and Reduction in HIV Infection Rates in 12 Focus Sub-Saharan African Countries: A Quantitative Analysis.

PubMed

Chin, Roger J; Sangmanee, Domrongphol; Piergallini, Lisa

2015-01-01

HIV and AIDS continue to have a calamitous effect on individuals living on the continent of Africa. U.S. President George W. Bush implemented the President's Emergency Plan for AIDS Relief (PEPFAR) with the objective of committing approximately $15 billion from 2004 through 2008 to assist with the reduction of the HIV pandemic worldwide. The majority of the PEPFAR policy and funding focused on 12 countries in sub-Saharan Africa: Botswana, Cote d'Ivoire, Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, and Zambia. The policy question this research paper seeks to analyze is whether the PEPFAR funding (as a % of Gross Domestic Product (GDP)) allocated to the 12 countries in Africa had any effect on the decrease of HIV infection rates of males and females between the ages of 15 and 49. A fixed-effects panel regression analysis was conducted to determine if this association exists. This study examined the 12 African countries that received PEPFAR funding over the years 2002 to 2010; even though PEPFAR was only active from 2004 through 2008, this research included two years prior and two years after this timeframe in order to better estimate the effect of PEPFAR funding on HIV reduction. The results illustrate that on average, ceteris paribus, for every 1 percentage point increase in PEPFAR funding per GDP a country received, the country's HIV infection rate decreased by 0.355 percentage points. While the empirical findings in this study suggested that the correlation between PEPFAR funding and HIV reduction is statistically significant, the practical significance is perhaps less obvious. Arguably, the reduction rate should be higher given the extent of funding targeted to this project. The conclusion of this research provides suggestions on future research and the policy implications of PEPFAR.

Human trafficking law and social structures.

PubMed

Wooditch, Alese

2012-08-01

Human trafficking has only recently emerged at the forefront of policy reform, even in developed nations. Yet, heightened awareness of the issue has not translated into effective policy as the majority of nations have ineffective antitrafficking practices; many countries have failed to criminalize human trafficking, whereas others do not actively enforce statutes in place. By applying Black's theory of law, this study offers a preliminary understanding into the variation of global prosecutorial efforts in human trafficking and adequacy of antitrafficking law. To isolate this relationship, the effects of trafficking markets are controlled. As with prior research, the study finds limited support for the theory. The article concludes with a discussion on the implications of the quantity of antitrafficking law and morphology association for policy development.

The global move toward Internet shopping and its influence on pollution: an empirical analysis.

PubMed

Al-Mulali, Usama; Sheau-Ting, Low; Ozturk, Ilhan

2015-07-01

This study investigates the influence of Internet retailing on carbon dioxide (CO2) emission in 77 countries categorized into developed and developing countries during the period of 2000-2013. To realize the aims of the study, a model that represents pollution is established utilizing the panel two-stage least square (TSLS) and the generalized method of moments (GMM). The results for both regressions similarly indicated that GDP growth, electricity consumption, urbanization, and trade openness are the main factors that increase CO2 emission in the investigated countries. Although the results show that Internet retailing reduces CO2 emission in general, a disaggregation occurs between developed and developing countries whereby Internet retailing has a significant negative effect on CO2 emission in the developed countries while it has no significant impact on CO2 emission in the developing countries. From the outcome of this study, a number of policy implications are provided for the investigated countries.

The nutrition policy process: the role of strategic capacity in advancing national nutrition agendas.

PubMed

Pelletier, David L; Menon, Purnima; Ngo, Tien; Frongillo, Edward A; Frongillo, Dominic

2011-06-01

Undernutrition is the single largest contributor to the burden of disease in developing countries and has documented effects on social and economic development, yet progress in reducing undernutrition remains slow. This paper identifies the range of factors that have influenced the nutrition agenda in developing countries, in order to inform the implementation of three major global initiatives related to undernutrition. Data sources include interviews with nutrition practitioners at the national and international level, written accounts from six African countries, and observations of the policy process in five countries. Data were thematically coded to identify recurrent factors that facilitated or inhibited progress in addressing undernutrition. The data reveal the following: First, societal conditions and catalytic events pose a variety of challenges and opportunities to enlarge and shape the nutrition agenda. Some countries have been successful in using such opportunities, while others have been less successful and there have been some unintended consequences. Second, disagreements over interventions and strategies are an almost universal feature of the nutrition policy process, occur primarily among mid-level actors rather than among politicians or senior administrators, and are primarily the product of structural factors such as organizational mandates, interests, and differences in professional perspectives. Third, many of these structural factors can be molded, aligned, and/or circumvented through strategic action on the part of the mid-level actors to strengthen movement on the nutrition agenda. This evidence that strategic action can redirect and/or overcome the effects of structural factors has important implications for future efforts to advance the nutrition agenda.

Child Development in Developing Countries: Introduction and Methods

PubMed Central

Bornstein, Marc H.; Britto, Pia Rebello; Nonoyama-Tarumi, Yuko; Ota, Yumiko; Petrovic, Oliver; Putnick, Diane L.

2011-01-01

The Multiple Indicator Cluster Survey (MICS) is a nationally representative, internationally comparable household survey implemented to examine protective and risk factors of child development in developing countries around the world. This Introduction describes the conceptual framework, nature of the MICS3, and general analytic plan of articles in this Special Section. The articles that follow describe the situations of children with successive foci on nutrition, parenting, discipline and violence, and the home environment addressing two common questions: How do developing and underresearched countries in the world vary with respect to these central indicators of children's development? and How do key indicators of national development relate to child development in each of these substantive areas? The Special Section concludes with policy implications from the international findings. PMID:22277004

World Health Organization's Mental Health Atlas 2005:implications for policy development

PubMed Central

SAXENA, SHEKHAR; SHARAN, PRATAP; GARRIDO, MARCO; SARACENO, BENEDETTO

2006-01-01

In 2005, the World Health Organization (WHO) launched the second edition of the Mental Health Atlas, consisting of revised and updated information on mental health from countries. The sources of information included the mental health focal points in the Ministries of Health, published literature and unpublished reports available to WHO. The results show that global mental health resources remain low and grossly inadequate to respond to the high level of need. In addition, the revised Atlas shows that the improvements over the period 2001 to 2004 are very small. Imbalances across income groups of countries remain largely the same. Enhancement in resources devoted to mental health is urgently needed, especially in low- and middle-income countries. PMID:17139355

Sex Trafficking: Policies, Programs, and Services.

PubMed

Orme, Julie; Ross-Sheriff, Fariyal

2015-10-01

Sex trafficking (ST), a contemporary form of female slavery, is a human rights issue of critical concern to social work. The global response to ST has been substantial, and 166 countries have adopted anti-ST legislation. Despite considerable efforts to combat ST, the magnitude is increasing. To date, the majority of anti-ST efforts have focused on criminalization policies that target traffickers or purchasers of sexual services, who are predominantly male; prevention programming and services for predominantly female victims have received less support. Therapeutic services to assist pornography addicts and purchasers of sexual services are also necessary. In this article, authors examine current anti-ST policies, programs, and services, both domestically and globally, and present an innovative paradigm that addresses social inequities and emphasizes prevention programming. They conclude with a discussion of the paradigm's implications for social work policies, practices, and services.

Exploring a shared leadership perspective for NHS doctors.

PubMed

Willcocks, Stephen George; Wibberley, Gemma

2015-01-01

The purpose of this paper is to explore involving doctors in shared leadership. It examines the policies that have led to the focus on shared leadership and the implications for practice. This is a conceptual paper, examining policy developments and key literature to understand the move towards shared leadership. It focuses on UK NHS, and in particular doctors, although the concepts will be relevant to other disciplines in healthcare, and healthcare systems in other countries. This paper suggests that the shared-leadership approach for doctors has potential given the nature of clinical practice, the inherently collaborative nature of healthcare and the demands of new healthcare organisations. Health policy reform, generally, will mean that all doctors need to be engaged with leadership, albeit, perhaps, at different levels, and with different degrees of formality. Leadership will remain an important precondition for the success of the reforms. This is likely to be the case for other countries involved in healthcare reform. To highlight the benefits and barriers to shared leadership for doctors. Offers an alternative to traditional approaches to leadership.

Equity and length of lifespan are not the same.

PubMed

Seligman, Benjamin; Greenberg, Gabi; Tuljapurkar, Shripad

2016-07-26

Efforts to understand the dramatic declines in mortality over the past century have focused on life expectancy. However, understanding changes in disparity in age of death is important to understanding mechanisms of mortality improvement and devising policy to promote health equity. We derive a novel decomposition of variance in age of death, a measure of inequality, and apply it to cause-specific contributions to the change in variance among the G7 countries (Canada, France, Germany, Italy, Japan, the United Kingdom, and the United States) from 1950 to 2010. We find that the causes of death that contributed most to declines in the variance are different from those that contributed most to increase in life expectancy; in particular, they affect mortality at younger ages. We also find that, for two leading causes of death [cancers and cardiovascular disease (CVD)], there are no consistent relationships between changes in life expectancy and variance either within countries over time or between countries. These results show that promoting health at younger ages is critical for health equity and that policies to control cancer and CVD may have differing implications for equity.

Militarism and globalization: Is there an empirical link?

PubMed

Irandoust, Manuchehr

2018-01-01

Despite the fact that previous studies have extensively investigated the causal nexus between military expenditure and economic growth in both developed and developing countries, those studies have not considered the role of globalization. The aim of this study is to examine the relationship between militarism and globalization for the top 15 military expenditure spenders over the period 1990-2012. The bootstrap panel Granger causality approach is utilized to detect the direction of causality. The results show that military expenditure and overall globalization are causally related in most of the countries under review. This implies that countries experiencing greater globalization have relatively large increases in militarization over the past 20 years. The policy implication of the findings is that greater military spending by a country increases the likelihood of military conflict in the future, the anticipation of which discourages globalization.

Smoke-free air policies: past, present and future.

PubMed

Hyland, Andrew; Barnoya, Joaquin; Corral, Juan E

2012-03-01

Smoke-free policies have been an important tobacco control intervention. As recently as 20 years ago, few communities required workplaces and hospitality venues to be smoke-free, but today approximately 11% of the world's population live in countries with laws that require these places to be smoke-free. This paper briefly summarises important milestones in the history of indoor smoke-free policies, the role of scientific research in facilitating their adoption, a framework for smoke-free policy evaluation and industry efforts to undermine regulations. At present, smoke-free policies centre on workplaces, restaurants and pubs. In addition, many jurisdictions are now beginning to implement policies in outdoor areas and in shared multiunit housing settings. The future of smoke-free policy development depends on credible scientific data that documents the health risks of secondhand smoke exposure. Over the next 20 years smoke-free policies will very likely extend to outdoor and private areas, and changes in the types of tobacco products that are consumed may also have implications for the nature and scope of the smoke-free policies of the future.

Coastal and river flood risk analyses for guiding economically optimal flood adaptation policies: a country-scale study for Mexico.

PubMed

Haer, Toon; Botzen, W J Wouter; van Roomen, Vincent; Connor, Harry; Zavala-Hidalgo, Jorge; Eilander, Dirk M; Ward, Philip J

2018-06-13

Many countries around the world face increasing impacts from flooding due to socio-economic development in flood-prone areas, which may be enhanced in intensity and frequency as a result of climate change. With increasing flood risk, it is becoming more important to be able to assess the costs and benefits of adaptation strategies. To guide the design of such strategies, policy makers need tools to prioritize where adaptation is needed and how much adaptation funds are required. In this country-scale study, we show how flood risk analyses can be used in cost-benefit analyses to prioritize investments in flood adaptation strategies in Mexico under future climate scenarios. Moreover, given the often limited availability of detailed local data for such analyses, we show how state-of-the-art global data and flood risk assessment models can be applied for a detailed assessment of optimal flood-protection strategies. Our results show that especially states along the Gulf of Mexico have considerable economic benefits from investments in adaptation that limit risks from both river and coastal floods, and that increased flood-protection standards are economically beneficial for many Mexican states. We discuss the sensitivity of our results to modelling uncertainties, the transferability of our modelling approach and policy implications.This article is part of the theme issue 'Advances in risk assessment for climate change adaptation policy'. © 2018 The Author(s).

International recruitment of nurses: policy and practice in the United Kingdom.

PubMed

Buchan, James

2007-06-01

To synthesize information about nurse migration into and out of the United Kingdom in the period to 2005, and to assess policy implications. There has been rapid growth in inflow of nurses to the United Kingdom from other countries. In recent years, 40-50 percent of new nurse registrants in the United Kingdom have come from other countries, principally the Philippines, Australia, India, and South Africa. Outflow has been at a lower level, mainly to other English-speaking developed countries--Australia, the United States, New Zealand, Ireland, and Canada. The United Kingdom is a net importer of nurses. The principal policy instrument in the United Kingdom, the Code of Practice on International Recruitment, has not ended the inflow of nurses to the United Kingdom from sub-Saharan Africa. Given the increasing globalization of labor markets, it is likely that the historically high levels of inflow of internationally recruited nurses to the United Kingdom will continue over the next few years; however the "peak" number reached in 2002/2003 may not be repeated, particularly as large-scale active international recruitment has now been ended, for the short term at least. New English language tests and other revised requirements for international applicants being introduced by the Nurses and Midwives Council from September 2005 may restrict successful applications from some countries and will also probably add to the "bottleneck" of international nurse applicants. Demographic-driven demand for health care, combined with a potential reduction in supply of U.K. nurses as many more reach potential retirement age means that international recruitment is likely to remain on the policy agenda in the longer term, even with further growth in the number of home-based nurses being trained.

The post-2015 development agenda for diabetes in sub-Saharan Africa: challenges and future directions

PubMed Central

Renzaho, Andre M. N.

2015-01-01

Background Diabetes is one of the non-communicable diseases (NCDs) which is rising significantly across sub-Saharan African (SSA) countries and posing a threat to the social, economic, and cultural fabric of the SSA population. The inclusion of NCDs into the post-2015 development agenda along with the global monitoring framework provides an opportunity to monitor progress of development programmes in developing countries. This paper examines challenges associated with dealing with diabetes within the development agenda in SSA and explores some policy options. Design This conceptual review draws from a range of works published in Medline and the grey literature to advance the understanding of the post-2015 development agenda and how it relates to NCDs. The paper begins with the burden of diabetes in sub-Sahara Africa and then moves on to examine challenges associated with diabetes prevention, treatment, and management in Africa. It finishes by exploring policy implications. Results With regards to development programmes on NCDs in the SSA sub-continent, several challenges exist: 1) poor documentation of risk factors, 2) demographic transitions (rapid urbanisation and ageing), 3) the complementary role of traditional healers, 4) tuberculosis and the treatment of the acquired immunodeficiency syndrome as risk factors for diabetes, 5) diabetes in complex emergencies, 6) diabetes as an international development priority and not a policy agenda for many SSA countries, and 7) poorly regulated food and beverage industry. Conclusion For the post-2015 development agenda for NCDs to have an impact, sufficient investments will be needed to address legislative, technical, human, and fiscal resource constraints through advocacy, accountability, political leadership, and effective public–private partnership. Striking the right balance between competing demands and priorities, policies, and implementation strategies hold the key to an effective response to diabetes in SSA countries. PMID:25994288

The post-2015 development agenda for diabetes in sub-Saharan Africa: challenges and future directions.

PubMed

Renzaho, Andre M N

2015-01-01

Diabetes is one of the non-communicable diseases (NCDs) which is rising significantly across sub-Saharan African (SSA) countries and posing a threat to the social, economic, and cultural fabric of the SSA population. The inclusion of NCDs into the post-2015 development agenda along with the global monitoring framework provides an opportunity to monitor progress of development programmes in developing countries. This paper examines challenges associated with dealing with diabetes within the development agenda in SSA and explores some policy options. This conceptual review draws from a range of works published in Medline and the grey literature to advance the understanding of the post-2015 development agenda and how it relates to NCDs. The paper begins with the burden of diabetes in sub-Sahara Africa and then moves on to examine challenges associated with diabetes prevention, treatment, and management in Africa. It finishes by exploring policy implications. With regards to development programmes on NCDs in the SSA sub-continent, several challenges exist: 1) poor documentation of risk factors, 2) demographic transitions (rapid urbanisation and ageing), 3) the complementary role of traditional healers, 4) tuberculosis and the treatment of the acquired immunodeficiency syndrome as risk factors for diabetes, 5) diabetes in complex emergencies, 6) diabetes as an international development priority and not a policy agenda for many SSA countries, and 7) poorly regulated food and beverage industry. For the post-2015 development agenda for NCDs to have an impact, sufficient investments will be needed to address legislative, technical, human, and fiscal resource constraints through advocacy, accountability, political leadership, and effective public-private partnership. Striking the right balance between competing demands and priorities, policies, and implementation strategies hold the key to an effective response to diabetes in SSA countries.

A Critical Analysis of the National Norms and Standards for School Funding Policy: Implications for Social Justice and Equity in South Africa

ERIC Educational Resources Information Center

Mestry, Raj

2014-01-01

Assessment of the legacy of apartheid at the end of the apartheid era in South Africa highlighted major inequalities between white and black, urban and rural areas, and several departments of education. Eighteen years into democracy, the country needs to distinguish between the initiatives taken by the government to address the apartheid legacy,…

Poverty and Hunger: Issues and Options for Food Security in Developing Countries. A World Bank Policy Study.

ERIC Educational Resources Information Center

Reutlinger, Shlomo; And Others

Food security means access by all people at all times to enough food for an active and healthy life. Available data suggest that more than 700 million people in the developing world lack the food necessary for such a life. No problem of underdevelopment may be more serious or have such important implications for the long-term growth of low-income…

Researching the Uses of the English Language in the Law Job Market in the Sultanate of Oman: Implications for Policy-Practice Improvement

ERIC Educational Resources Information Center

Al-Issa, Ali S. M.

2014-01-01

The Sultanate of Oman is a developing country that has accepted the English language as a significant tool for modernization. This was best interpreted in the opening of Sultan Qaboos University (SQU) in 1986, which has delivered its different academic programmes totally or partially through the English language. One of the colleges of SQU has…

Security Implications of US Arms Transfers to China

DTIC Science & Technology

1986-06-01

allied countries. 5. integrate arms transfers into a borader overall relationship. US freedom of action may be limited by the constraints discussed...administration’s arms transfer policy, it is first necessary to determine their relative validity. 1. Improve Balance Of Payments During the FY 86...favorable balance of payments, support growth of the Gross National Product (GNP), and generate tax revenues for the government.[Ref. 71] If the US wants

The Quality of Education and Economic Development. A World Bank Symposium. Papers prepared for the Conference of the World Bank Research Committee (Harpers Ferry, West Virginia, May 1983).

ERIC Educational Resources Information Center

Heyneman, Stephen P., Ed.; White, Daphne Siev, Ed.

Recent research findings on the economic implications of investments in the quality of education are examined in this report. "The Quality of Education and Economic Growth: A Review of Literature" (Lewis C. Solmon) reviews evidence on ways to develop educational policy that would stimulate economic growth in developing countries. "School Quality…

Essays on energy, equity, and the environment in developing countries

NASA Astrophysics Data System (ADS)

Israel, Debra Kim

1999-11-01

The essays in this dissertation explore different environmental and public policy issues relevant to developing countries. Essay I examines household-level survey responses to the question "How willing would you be to pay somewhat higher taxes to the government if you knew the money would be spent to protect the environment and prevent land, water and air pollution?" Specifically, for twelve developing and three developed countries included in the survey, the empirical relationships among willingness to pay for environmental quality, relative household income and national income are investigated. The results indicate that when the effects of household and national income are combined, households with below-average income in low-income countries are less willing to pay for environmental protection than those with above-average income in high-income countries. Furthermore, willingness to pay for environmental protection increases more significantly with relative household income than with national income. Essay II uses data from urban Bolivia to study the determinants of household fuel choice, an important link between deforestation and indoor air pollution in developing countries. In particular, the effects of fixed fuel costs, income growth, and female earned income on household fuel choice are examined. The results imply that reduction in firewood use in developing countries is not likely to occur simply as the result of income growth. The essay discusses possible policy implications based on the results that fixed fuel costs appear to be a deterrent to switching to a cleaner fuel and households with female earned income seem less likely to use firewood than other households. Essay III analyzes the equity implications of the elimination of fuel subsidies in the 1985 Bolivian economic reforms. An analysis of the direct static burden shows that while the elimination of gasoline subsidies was progressively distributed, the elimination of LPG and kerosene subsidies was regressive. Overall, the impact was close to proportional. However, including the indirect effect of urban transportation fare increases adds to the regressivity of the subsidy removal, while including the partial equilibrium effects implies a more progressive burden.

An Implication of Health Sector Reform for Disadvantaged Women's Struggle for Birth Control: A Case of Kurdish Rural-Urban Migrant Women in Van, Turkey.

PubMed

Him, Miki Suzuki; Hoşgör, Ayşe Gündüz

2015-09-01

In this article, we examine how socioeconomically disadvantaged women are affected by health sector reform and family planning policy changes in Turkey through a case study of Kurdish women's struggles for birth control. In Turkey, a family planning program became relatively marginalized in primary health care services as a result of health sector reform as well as a shift of population policy toward a moderately pronatal approach. We argue that an emerging health care system would leave disadvantaged women unable to benefit from contraceptives and would perpetuate reproductive health inequalities between women in the country.

Universal neonatal hearing screening: applications for a developing country in the Asia-Pacific region.

PubMed

Navarro-Locsin, C Gretchen

2003-01-01

Various centers around the world have implemented and evaluated universal hearing screening programs as a response to the US National Institute of Health policy statement on early identification of hearing loss. Several well conducted clinical trials have been devised to examine and evaluate various factors relevant to establishing a UNHS program. This paper aims to describe some of these factors and analyze their applications and implications for a UNHS program for a developing country in the Asia-Pacific Region. Specifically, three main issues will be discussed: hospital vs community based programs, choice of technology, and choice of screening protocol.

Relationships between population and environment in rural areas of developing countries.

PubMed

Rudel, T I

1991-01-01

Studies that have assessed the impact of population change on the environment in rural areas of selected developing countries are reviewed. The implications are that both developed and developing countries might focus on single aspects of a much larger global problem. Rural areas were selected because the bulk of the world's population lives in rural areas. Population environment interactions are 1st discussed at the global level. Studies on changing import patterns of developing countries are usless in accounting for agricultural policy shifts or other factors that may be unrelated to population growth but may be related to food imports. When the magnitude of food production and population growth is examined, there is a balance established between the two. However, analysis of the spatial distribution of desertification and soil degradation shows greater local level effects. Population/environment relationships are examined in critical ecological zones: tropical deforestation, desertification, land degradation in resource poor zones, and responses to population pressures and resource degradation. The conclusions reached are that better statistics on degradation are needed and that the trends in the human ecology of rural populations have clear implications for government policies on the environment. Agricultural development has been uneven and inequitable such that many peasant populations have suffered a decline in standards of living, particularly in Africa. There has also been an accelerated increase in rates of land degradation in resource poor areas, which are densely populated. The population response has been migration shifts out of resource poor areas to ecologically marginal areas, which has resulted in extensive desertification and deforestation. Expansion of the areas under cultivation has not just increased agricultural production but agriculture and population have invaded ecologically marginal zones in deserts and rain forests. Measurement of the magnitude and geographic distribution of deforestation is enhanced with the use of remote sensing techniques, such as those used in the 1982 UN Food and Agriculture baseline study. Soil degradation is not so easily measured. The implications are that regional development funds need to directed away from critical zones or areas adjacent to critical zones. Research is needed to understand rural to rural migration.

The Link Between Mental Illness and Firearm Violence: Implications for Social Policy and Clinical Practice

PubMed Central

Rozel, John S.; Mulvey, Edward P.

2018-01-01

The United States has substantially higher levels of firearm violence than most other developed countries. Firearm violence is a significant and preventable public health crisis. Mental illness is a weak risk factor for violence despite popular misconceptions reflected in the media and policy. That said, mental health professionals play a critical role in assessing their patients for violence risk, counseling about firearm safety, and guiding the creation of rational and evidence-based public policy that can be effective in mitigating violence risk without unnecessarily stigmatizing people with mental illness. This article summarizes existing evidence about the interplay among mental illness, violence, and firearms, with particular attention paid to the role of active symptoms, addiction, victimization, and psychosocial risk factors. The social and legal context of firearm ownership is discussed as a preface to exploring practical, evidence-driven, and behaviorally informed policy recommendations for mitigating firearm violence risk. PMID:28375722

The Link Between Mental Illness and Firearm Violence: Implications for Social Policy and Clinical Practice.

PubMed

Rozel, John S; Mulvey, Edward P

2017-05-08

The United States has substantially higher levels of firearm violence than most other developed countries. Firearm violence is a significant and preventable public health crisis. Mental illness is a weak risk factor for violence despite popular misconceptions reflected in the media and policy. That said, mental health professionals play a critical role in assessing their patients for violence risk, counseling about firearm safety, and guiding the creation of rational and evidence-based public policy that can be effective in mitigating violence risk without unnecessarily stigmatizing people with mental illness. This article summarizes existing evidence about the interplay among mental illness, violence, and firearms, with particular attention paid to the role of active symptoms, addiction, victimization, and psychosocial risk factors. The social and legal context of firearm ownership is discussed as a preface to exploring practical, evidence-driven, and behaviorally informed policy recommendations for mitigating firearm violence risk.

Trade policy and public health.

PubMed

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.

Strangers in strange lands: a metasynthesis of lived experiences of immigrant asian nurses working in Western countries.

PubMed

Xu, Yu

2007-01-01

Nurses from Asian countries make up the majority of immigrant nurses globally. Although there are a limited number of studies on the lived experiences of Asian nurses working in Western countries, the development of nursing science will be impeded if the rich understanding gleaned from these studies is not synthesized. Using Noblit and Hare's (Meta-ethnography: Synthesizing Qualitative Studies. Newbury Park, Calif: Sage; 1988) procedures, a metasynthesis was conducted on 14 studies that met preset selection criteria. Four overarching themes emerged: (a) communication as a daunting challenge; (b) differences in nursing practice; (c) marginalization, discrimination, and exploitation; and (d) cultural differences. Based on the metasynthesis, a large narrative and expanded interpretation was constructed and implications for nursing knowledge development, clinical practice, and policy making are elaborated.

In-house or outsourced public services? A social and economic analysis of the impact of spending policy on the private wage share in OECD countries.

PubMed

Pensiero, Nicola

2017-08-01

This article analyses the relationship between government spending and the distribution of private income between capital and labour. While most previous research assumes that government spending redistributes in favour of the less wealthy, I distinguish between types of expenditures that enhance the bargaining position of labour - that is, unemployment benefits, public sector employment and investment in new capital - and labour-saving and pro-business types of expenditures - that is, outsourcing to private firms. The results are derived from various panel regression techniques on a panel of 19 Organisation for Economic Co-operation and Development (OECD) countries in the period 1985-2010 and show that expenditures on public sector employment and, to a lesser extent, on new capital prevented the private wage share from declining further, even after controlling for labour market institutions, globalisation and technological change. Conversely, expenditures on outsourcing substantially contributed to reducing the private wage share. Unemployment benefits had a non-significant and negative effect on the private wage share because their increase was the consequence of higher levels of unemployment rather than policy. Implications for theory and policy are drawn, including the support for a public employment-led spending policy.

Encouraging the use of generic medicines: implications for transition economies.

PubMed

King, Derek R; Kanavos, Panos

2002-08-01

Generic drugs have a key role to play in the efficient allocation of financial resources for pharmaceutical medicines. Policies implemented in the countries with a high rate of generic drug use, such as Canada, Denmark, Germany, the Netherlands, the United Kingdom, and the United States, are reviewed, with consideration of the market structures that facilitate strong competition. Savings in these countries are realized through increases in the volume of generic drugs used and the frequently significant differences in the price between generic medicines and branded originator medicines. Their policy tools include the mix of supply-side measures and demand-side measures that are relevant for generic promotion and higher generic use. On the supply-side, key policy measures include generic drug marketing regulation that facilitates market entry soon after patent expiration, reference pricing, the pricing of branded originator products, and the degree of price competition in pharmaceutical markets. On the demand-side, measures typically encompass influencing prescribing and dispensing patterns as well as introducing a co-payment structure for consumers/patients that takes into consideration the difference in cost between branded and generic medicines. Quality of generic medicines is a pre-condition for all other measures discussed to take effect. The paper concludes by offering a list of policy options for decision-makers in Central and Eastern European economies in transition.

In-house or outsourced public services? A social and economic analysis of the impact of spending policy on the private wage share in OECD countries

PubMed Central

Pensiero, Nicola

2017-01-01

This article analyses the relationship between government spending and the distribution of private income between capital and labour. While most previous research assumes that government spending redistributes in favour of the less wealthy, I distinguish between types of expenditures that enhance the bargaining position of labour – that is, unemployment benefits, public sector employment and investment in new capital – and labour-saving and pro-business types of expenditures – that is, outsourcing to private firms. The results are derived from various panel regression techniques on a panel of 19 Organisation for Economic Co-operation and Development (OECD) countries in the period 1985–2010 and show that expenditures on public sector employment and, to a lesser extent, on new capital prevented the private wage share from declining further, even after controlling for labour market institutions, globalisation and technological change. Conversely, expenditures on outsourcing substantially contributed to reducing the private wage share. Unemployment benefits had a non-significant and negative effect on the private wage share because their increase was the consequence of higher levels of unemployment rather than policy. Implications for theory and policy are drawn, including the support for a public employment-led spending policy. PMID:28919641

Rotavirus vaccines

PubMed Central

Yen, Catherine; Tate, Jacqueline E; Hyde, Terri B; Cortese, Margaret M; Lopman, Benjamin A; Jiang, Baoming; Glass, Roger I; Parashar, Umesh D

2014-01-01

Rotavirus is the leading cause of severe diarrhea among children <5 years worldwide. Currently licensed rotavirus vaccines have been efficacious and effective, with many countries reporting substantial declines in diarrheal and rotavirus-specific morbidity and mortality. However, the full public health impact of these vaccines has not been realized. Most countries, including those with the highest disease burden, have not yet introduced rotavirus vaccines into their national immunization programs. Research activities that may help inform vaccine introduction decisions include (1) establishing effectiveness, impact, and safety for rotavirus vaccines in low-income settings; (2) identifying potential strategies to improve performance of oral rotavirus vaccines in developing countries, such as zinc supplementation; and (3) pursuing alternate approaches to oral vaccines, such as parenteral immunization. Policy- and program-level barriers, such as financial implications of new vaccine introductions, should be addressed to ensure that countries are able to make informed decisions regarding rotavirus vaccine introduction. PMID:24755452

Is the demand for alcoholic beverages in developing countries sensitive to price? Evidence from China.

PubMed

Tian, Guoqiang; Liu, Feng

2011-06-01

Economic literature in developed countries suggests that demand for alcoholic beverages is sensitive to price, with an estimated price elasticity ranging from -0.38 for beer and -0.7 for liquor. However, few studies have been conducted in developing countries. We employ a large individual-level dataset in China to estimate the effects of price on alcohol demand. Using the data from China Health and Nutrition Survey for the years 1993, 1997, 2000, 2004 and 2006, we estimate two-part models of alcohol demand. Results show the price elasticity is virtually zero for beer and only -0.12 for liquor, which is far smaller than those derived from developed countries. Separate regressions by gender reveals the results are mainly driven by men. The central implication of this study is, while alcohol tax increases can raise government revenue, it alone is not an effective policy to reduce alcohol related problems in China.

Epidemic predictions in an imperfect world: modelling disease spread with partial data

PubMed Central

Dawson, Peter M.; Werkman, Marleen; Brooks-Pollock, Ellen; Tildesley, Michael J.

2015-01-01

‘Big-data’ epidemic models are being increasingly used to influence government policy to help with control and eradication of infectious diseases. In the case of livestock, detailed movement records have been used to parametrize realistic transmission models. While livestock movement data are readily available in the UK and other countries in the EU, in many countries around the world, such detailed data are not available. By using a comprehensive database of the UK cattle trade network, we implement various sampling strategies to determine the quantity of network data required to give accurate epidemiological predictions. It is found that by targeting nodes with the highest number of movements, accurate predictions on the size and spatial spread of epidemics can be made. This work has implications for countries such as the USA, where access to data is limited, and developing countries that may lack the resources to collect a full dataset on livestock movements. PMID:25948687

Study findings on evaluation of integrated family planning programme performance.

PubMed

1980-01-01

In 1976 the United Nations's Economic and Social Commission for Asia and the Pacific launched a comparative study on integrated family planning programs in a number of countries in the region. In November 1979 the study directors from the participating countries meet in Bangkok to discuss the current status of the studies in their countries. The Korean and Malaysian studies were completed, the Bangladesh study was in the data collecting phase, and the Pakistani research design phase was completed. The meeting participants focused their attention on the findings and policy implications of the 2 completed studies and also discussed a number of theorectical and methodological issues which grew out of their research experience. The Malaysian study indicated that group structure, financial resources, and the frequency and quality of worker-client contact were the most significant variables determining program effectiveness. In the Korean Study, leadership, financial resources, and the frequency and quality of contact between agencies were the key variables in determining program effectiveness. In the Malaysian study there was a positive correlation between maternal and child health service performance measures and family planning service performance measures. This finding supported the contention that these 2 types of service provision are not in conflict with each other but instead serve to reinforce each other. Policy implications of the Korean study were 1) family planning should be an integral part of all community activities; 2) family planning workers should be adequately supported by financial and supply allocations; and 3) adequate record keeping and information exchange procedures should be incorporated in the programs.

Exploring Dutch surgeons' views on volume-based policies: a qualitative interview study.

PubMed

Mesman, Roos; Faber, Marjan J; Westert, Gert P; Berden, Bart

2018-01-01

Objective In many countries, the evidence for volume-outcome associations in surgery has been transferred into policy. Despite the large body of research that exists on the topic, qualitative studies aimed at surgeons' views on, and experiences with, these volume-based policies are lacking. We interviewed Dutch surgeons to gain more insight into the implications of volume-outcome policies for daily clinical practice, as input for effective surgical quality improvement. Methods Semi-structured interviews were conducted with 20 purposively selected surgeons from a stratified sample for hospital type and speciality. The interviews were recorded, transcribed verbatim and underwent inductive content analysis. Results Two overarching themes were inductively derived from the data: (1) minimum volume standards and (2) implications of volume-based policies. Although surgeons acknowledged the premise 'more is better', they were critical about the validity and underlying evidence for minimum volume standards. Patients often inquire about caseload, which is met with both understanding and discomfort. Surgeons offered many examples of controversies surrounding the process of determining thresholds as well as the ways in which health insurers use volume as a purchasing criterion. Furthermore, being held accountable for caseload may trigger undesired strategic behaviour, such as unwarranted operations. Volume-based policies also have implications for the survival of low-volume providers and affect patient travel times, although the latter is not necessarily problematic in the Dutch context. Conclusions Surgeons in this study acknowledged that more volume leads to better quality. However, validity issues, undesired strategic behaviour and the ways in which minimum volume standards are established and applied have made surgeons critical of current policy practice. These findings suggest that volume remains a controversial quality measure and causes polarization that is not conducive to a collective effort for quality improvement. We recommend enforcing thresholds that are based on the best achievable level of consensus and assessing additional criteria when passing judgement on quality of care.

Free Trade Agreements: Impact on U.S. Trade and Implications for U.S. Trade Policy

DTIC Science & Technology

2010-02-23

markets in which member countries go beyond a customs union by eliminating barriers to labor and capital flows across national borders within the... market ; and • economic unions where members merge their economies even further by establishing a common currency, and therefore a unified monetary... market over the lowest tariff wall. Most FTAs also include procedures on the settlement of disputes arising among members and rules on the

'One health' and development priorities in resource-constrained countries: policy lessons from avian and pandemic influenza preparedness in Zambia.

PubMed

Mwacalimba, Kennedy Kapala; Green, Judith

2015-03-01

'One World, One Health' has become a key rallying theme for the integration of public health and animal health priorities, particularly in the governance of pandemic-scale zoonotic infectious disease threats. However, the policy challenges of integrating public health and animal health priorities in the context of trade and development issues remain relatively unexamined, and few studies to date have explored the implications of global disease governance for resource-constrained countries outside the main centres of zoonotic outbreaks. This article draws on a policy study of national level avian and pandemic influenza preparedness between 2005 and 2009 across the sectors of trade, health and agriculture in Zambia. We highlight the challenges of integrating disease control interventions amidst trade and developmental realities in resource-poor environments. One Health prioritizes disease risk mitigation, sidelining those trade and development narratives which speak to broader public health concerns. We show how locally important trade and development imperatives were marginalized in Zambia, limiting the effectiveness of pandemic preparedness. Our findings are likely to be generalizable to other resource-constrained countries, and suggest that effective disease governance requires alignment with trade and development sectors, as well as integration of veterinary and public health sectors. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

Drivers for animal welfare policies in Africa.

PubMed

Molomo, M; Mumba, T

2014-04-01

Livestock in Africa represent on average 30% of the agricultural gross domestic product (GDP) and about 10% of the national GDP. Up to 300 million people depend on livestock for their income and livelihood. Accordingly, livestock are considered to be important for the African continent. Despite this, little or no provision for animal welfare is made in the laws and regulations of most African countries. However, the World Organisation for Animal Health (OIE) Performance of Veterinary Services (PVS) Tool includes animal welfare as a critical competency in Veterinary Services, and most African countries have now conducted PVS appraisals. The development of a Regional Animal Welfare Strategy in Africa is also important because it will provide opportunities for full engagement by all relevant parties. Key elements in this process should include collaboration and coordination in information dissemination to all stakeholders, who should include all those in the value chain. The roles played by the OIE Member Delegates and Focal Points, and non-governmental organisations (NGOs), in driving animal welfare policy in most African countries are notable. Without a level of understanding of animal welfare that is sufficient to support clear animal welfare policy development and implementation, problems may appear in the near future which could jeopardise the attainment of increased animal productivity and product quality. This may have negative implications for economic growth and for national and international trade.

E-Commerce and Security Governance in Developing Countries

NASA Astrophysics Data System (ADS)

Sanayei, Ali.; Rajabion, Lila

Security is very often mentioned as one of the preconditions for the faster growth of e-commerce. Without a secure and reliable internet, customer will continue to be reluctant to provide confidential information online, such as credit card number. Moreover, organizations of all types and sizes around the world rely heavily on technologies of electronic commerce (e-commerce) for conducting their day-to-day business transaction. Providing organizations with a secure e-commerce environment is a major issue and challenging one especially in Middle Eastern countries. Without secure e-commerce, it is almost impossible to take advantage of the opportunities offered by e-commerce technologies. E-commerce can create opportunities for small entrepreneurs in Middle Eastern countries. This requires removing infrastructure blockages in telecommunications and logistics alongside the governance of e-commerce with policies on consumer protection, security of transactions, privacy of records and intellectual property. In this paper, we will explore the legal implications of e-commerce security governance by establishing who is responsible for ensuring compliance with this discipline, demonstrating the value to be derived from information security governance, the methodology of applying information security governance, and liability for non-compliance with this discipline. Our main focus will be on analyzing the importance and implication of e-commerce security governance in developing countries.

Education and social inclusion of people with disabilities in five countries in West Africa: a literature review.

PubMed

Jolley, Emma; Lynch, Paul; Virendrakumar, Bhavisha; Rowe, Stacy; Schmidt, Elena

2017-07-14

An estimated 1 billion people worldwide live with some form of disability. With the adoption of the Sustainable Development Goals and the "Leave no one behind" agenda, there is a global momentum to ensure that disadvantaged groups, not least people with disabilities, are included and accounted for, in mainstream development efforts. However, in many low-income settings little is known about disability and the policies and programs in place to improve the lives of those affected. This literature review describes the extent and quality of published and unpublished literature on education and social inclusion of people with disabilities in five West African countries: Cameroon, Liberia, Mali, Sierra Leone and Senegal. Fifty-four unique documents met inclusion criteria of the review and described related policy and legislation; national and international stakeholders; intervention programs and primary research related to disability and inclusion. The majority of documents were from Sierra Leone (19); and four described more than one country. Primary research included mainly qualitative studies and cross-sectional surveys; 33 sources were critically appraised with the majority being attributed unclear risk of bias (20). The findings call for (i) standardized tools for monitoring the implementation of programs and policies at national level; (ii) improved stakeholder coordination mechanisms; (iii) development and adoption of coordinated approaches to measuring disability and social exclusion; (iv) rigorous evaluations of the effectiveness of disability programs and (v) disaggregation of routine data by disability. Implication for Rehabilitation There is a need for standardized tools for monitoring the implementation of programs and policies at national level. Countries that have not yet ratified the UNCRPD or the protocol should be supported to do so. Stakeholder coordination mechanisms need to be improved. Improved coordination between stakeholders involved in disability at the country level could help improve the quality of services delivered. Development and adoption of coordinated approaches is key to measuring disability and social exclusion. There are few, if any, rigorous evaluation of the effectiveness of disability-specific evaluations in the five countries. There is a need for disaggregation of routine data from development programs by disability to inform implementation.

Effect of the economic recession on pharmaceutical policy and medicine sales in eight European countries.

PubMed

Leopold, Christine; Mantel-Teeuwisse, Aukje K; Vogler, Sabine; Valkova, Silvia; de Joncheere, Kees; Leufkens, Hubert G M; Wagner, Anita K; Ross-Degnan, Dennis; Laing, Richard

2014-09-01

To identify pharmaceutical policy changes during the economic recession in eight European countries and to determine whether policy measures resulted in lower sales of, and less expenditure on, pharmaceuticals. Information on pharmaceutical policy changes between 2008 and 2011 in eight European countries was obtained from publications and pharmaceutical policy databases. Data on the volume and value of the quarterly sales of products between 2006 and 2011 in the 10 highest-selling therapeutic classes in each country were obtained from a pharmaceutical market research database. We compared these indicators in economically stable countries; Austria, Estonia and Finland, to those in economically less stable countries, Greece, Ireland, Portugal, Slovakia and Spain. Economically stable countries implemented two to seven policy changes each, whereas less stable countries implemented 10 to 22 each. Of the 88 policy changes identified, 33 occurred in 2010 and 40 in 2011. They involved changing out-of-pocket payments for patients in 16 cases, price mark-up schemes in 13 and price cuts in 11. Sales volumes increased moderately in all countries except Greece and Portugal, which experienced slight declines after 2009. Sales values decreased in both groups of countries, but fell more in less stable countries. Less economically stable countries implemented more pharmaceutical policy changes during the recession than economically stable countries. Unexpectedly, pharmaceutical sales volumes increased in almost all countries, whereas sales values declined, especially in less stable countries.

Mean reversion in the current account of forty-eight african countries: Evidence from the Panel SURADF test

NASA Astrophysics Data System (ADS)

Chu, Hsiao-Ping; Chang, Tsangyao; Chang, Hsu-Ling; Su, Chi-Wei; Yuan, Young

2007-10-01

Here, the Panel seemingly unrelated regressions augmented Dickey-Fuller test (SURADF) test, first introduced and advanced by Breuer et al. [Misleading inferences from panel unit-root tests with an illustration from purchasing power parity, Rev. Int. Econ. 9(3) (2001) 482-493], is used to investigate the mean-reverting behavior of the current account of 48 African countries during the 1980-2004 periods. The empirical results from numerous panel-based unit root tests, conducted earlier, indicated that the current account of each of these countries is stationary; however, when Breuer et al.'s (2001) Panel SURADF test is conducted, it is found that a unit root exists in the current account of 11 of the countries studied. These results have one extremely important policy implication for the 48 African countries studied: the current account deficit of most is sustainable, and thus signifying that those nations should have no incentive to default on their international debt.

Understanding the Research–Policy Divide for Oral Health Inequality

PubMed Central

Bell, Erica; Crocombe, Leonard; Campbell, Steven; Goldberg, Lynette R.; Seidel, Bastian M.

2014-01-01

Background: No studies exist of the congruence of research in oral health to policy. This study aimed to examine the broad congruence of oral health research to policy, and implications for developing oral health research that is more policy relevant, particularly for the wider challenge of addressing unequal oral health outcomes, rather than specific policy translation issues. Methods: Bayesian-based software was used in a multi-layered method to compare the conceptual content of 127,193 oral health research abstracts published between 2000–2012 with eight current oral health policy documents from Organisation for Economic Co-operation and Development countries. Findings: Fifty-five concepts defined the research abstracts, of which only eight were policy-relevant, and six of which were minor research concepts. Conclusions The degree of disconnection between clinical concepts and healthcare system and workforce development concepts was striking. This study shows that, far from being “lost in translation,” oral health research and policy are so different as to raise doubts about the extent to which research is policy-relevant and policy is research-based. The notion of policy relevance encompasses the lack of willingness of policy makers to embrace research, and the need for researchers to develop research that is, and is seen to be, policy-relevant. PMID:25617516

Turning the tide: national policy approaches to increasing physical activity in seven European countries.

PubMed

Bull, Fiona; Milton, Karen; Kahlmeier, Sonja; Arlotti, Alberto; Juričan, Andrea Backović; Belander, Olov; Martin, Brian; Martin-Diener, Eva; Marques, Ana; Mota, Jorge; Vasankari, Tommi; Vlasveld, Anita

2015-06-01

Physical inactivity is one of the four leading behavioural risk factors for non-communicable disease (NCD). Like tobacco control, increasing levels of health-enhancing physical activity (HEPA) will require a national policy framework providing direction and a clear set of actions. Despite frequent calls, there has been insufficient progress on policy development in the majority of countries around the world. This study sought and summarised national HEPA policy in seven European countries (Finland, Italy, the Netherlands, Norway, Portugal, Slovenia and Switzerland). Data collection used a policy audit tool (PAT), a 27-item instrument structured into four sections. All countries reported some legislation or policy across the sectors of education, sport and health. Only some countries reported supportive policy in the transport and environment sectors. Five countries reported a stand-alone HEPA policy and six countries reported national recommendations. HEPA prevalence targets varied in magnitude and specificity and the presence of other relevant goals from different sectors highlighted the opportunity for joint action. Evaluation and the use of scientific evidence were endorsed but described as weak in practice. Only two countries reported a national multisector coordinating committee and most countries reported challenges with partnerships on different levels of policy implementation. Bringing together the key components for success within a national HEPA policy framework is not simple. This in-depth policy audit and country comparison highlighted similarities and differences and revealed new opportunities for consideration by other countries. These examples can inform countries within and beyond Europe and guide the development of national HEPA policy within the NCD prevention agenda. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Why do Americans have shorter life expectancy and worse health than people in other high-income countries?

PubMed Central

Avendano, Mauricio; Kawachi, Ichiro

2014-01-01

Americans lead shorter and less healthy lives than people in other high-income countries. We review the evidence and explanations for these variations in longevity and health. Our overview suggests that the US health disadvantage applies to multiple mortality and morbidity outcomes. The American health disadvantage begins at birth and extends across the life-course, and it is particularly marked for American women and for regions in the US South and Midwest. Proposed explanations include differences in health care, individual behaviors, socioeconomic inequalities, and the physical and built environment. While these factors may contribute to poorer health in America, a focus on proximal causes fails to adequately account for the ubiquity of the US health disadvantage across the life-course. We discuss the role of specific public policies and conclude that while multiple causes are implicated, crucial differences in social policy might underlie an important part of the US health disadvantage. PMID:24422560

Why do Americans have shorter life expectancy and worse health than do people in other high-income countries?

PubMed

Avendano, Mauricio; Kawachi, Ichiro

2014-01-01

Americans lead shorter and less healthy lives than do people in other high-income countries. We review the evidence and explanations for these variations in longevity and health. Our overview suggests that the US health disadvantage applies to multiple mortality and morbidity outcomes. The American health disadvantage begins at birth and extends across the life course, and it is particularly marked for American women and for regions in the US South and Midwest. Proposed explanations include differences in health care, individual behaviors, socioeconomic inequalities, and the built physical environment. Although these factors may contribute to poorer health in America, a focus on proximal causes fails to adequately account for the ubiquity of the US health disadvantage across the life course. We discuss the role of specific public policies and conclude that while multiple causes are implicated, crucial differences in social policy might underlie an important part of the US health disadvantage.

Wheeling and Banking Strategies for Optimal Renewable Energy Deployment. International Experiences

DOE Office of Scientific and Technical Information (OSTI.GOV)

Heeter, Jenny; Vora, Ravi; Mathur, Shivani

This paper defines the principles of wheeling (i.e., transmission) tariffs and renewable energy (RE) banking provisions and their role in RE deployment in countries with plans for large-scale RE. It reviews experiences to date in the United States, Mexico, and India and discusses key policy and regulatory considerations for devising more effective wheeling and/or banking provisions for countries with ambitious RE deployment targets. The paper addresses the challenges of competing needs of stakeholders, especially those of RE generators, distribution utilities, and transmission network owners and operators. The importance of wheeling and banking and their effectiveness for financial viability of REmore » deployment is also explored. This paper aims to benefit policymakers and regulators as well as key renewable energy stakeholders. Key lessons for regulators include: creating long-term wheeling and banking policy certainty, considering incentivizing RE through discounted transmission access, and assessing the cost implications of such discounts, as well as expanding access to renewable energy customers.« less

Health technology assessment in four countries: response from political science.

PubMed

Chinitz, David

2004-01-01

Four studies, each on health technology assessment (HTA) in a different country, are presented in this volume. Conveying differing levels of sensitivity to political aspects of HTA, their storylines are similar in terms of the importance of the institutional structures that produce HTA and mediate its influence on health policy decision making. Regarding the internal politics of HTA, the latter appears to have developed in a relatively depoliticized environment, supported by a dense and varied web of institutional sites for funding, production, and consumption of HTA, buffered from the capricious impacts of electoral politics. Regarding external politics, HTA in all the countries began with relatively politically innocuous studies of technologies recognized to be of major import to national health systems or researcher-initiated studies. However, with increased focus in health systems on explicit determination of health benefits baskets, the role of HTA has become more high profile. This means that political accountability for the entire HTA process will increase. The implication is that future management of HTA programs will require self-conscious attention to the building of institutions capable of handling the delicate process of integrating science and politics in health policy.

Measuring economic complexity of countries and products: which metric to use?

NASA Astrophysics Data System (ADS)

Mariani, Manuel Sebastian; Vidmer, Alexandre; Medo, Matsúš; Zhang, Yi-Cheng

2015-11-01

Evaluating the economies of countries and their relations with products in the global market is a central problem in economics, with far-reaching implications to our theoretical understanding of the international trade as well as to practical applications, such as policy making and financial investment planning. The recent Economic Complexity approach aims to quantify the competitiveness of countries and the quality of the exported products based on the empirical observation that the most competitive countries have diversified exports, whereas developing countries only export few low quality products - typically those exported by many other countries. Two different metrics, Fitness-Complexity and the Method of Reflections, have been proposed to measure country and product score in the Economic Complexity framework. We use international trade data and a recent ranking evaluation measure to quantitatively compare the ability of the two metrics to rank countries and products according to their importance in the network. The results show that the Fitness-Complexity metric outperforms the Method of Reflections in both the ranking of products and the ranking of countries. We also investigate a generalization of the Fitness-Complexity metric and show that it can produce improved rankings provided that the input data are reliable.

[International trade in health services and the medical industrial complex: implications for national health systems].

PubMed

Santos, Maria Angelica Borges dos; Passos, Sonia Regina Lambert

2010-08-01

Health services have increasingly proven to be an innovative sector, gaining prominence in the medical industrial complex through expansion to public and international markets. International trade can foster economic development and redirect the resources and infrastructure available for healthcare in different countries in favorable or unfavorable directions. Wherever private providers play a significant role in government-funded healthcare, GATS commitments may restrict health policy options in subscribing countries. Systematic information on the impacts of electronic health services, medical tourism, health workers' migration, and foreign direct investment is needed on a case-by-case basis to build evidence for informed decision-making, so as to maximize opportunities and minimize risks of GATS commitments.

Addressing Structural and Environmental Factors for Adolescent Sexual and Reproductive Health in Low- and Middle-Income Countries

PubMed Central

Mmari, Kristin

2015-01-01

A deeper understanding of how structure and environment shape the sexual and reproductive health vulnerabilities of youths across a range of outcomes has implications for the development of successful policies and programs. We have discussed some of the key structural and environmental factors that influence the sexual and reproductive health of adolescents, particularly in low- and middle-income countries, and the importance of engaging adolescents in identifying solutions. We have highlighted 2 case studies that describe structural or environmental approaches to improving adolescent sexual and reproductive health and made recommendations to more systematically incorporate attention to structure and environment to improve global adolescent health. PMID:26270290

Addressing Structural and Environmental Factors for Adolescent Sexual and Reproductive Health in Low- and Middle-Income Countries.

PubMed

Sommer, Marni; Mmari, Kristin

2015-10-01

A deeper understanding of how structure and environment shape the sexual and reproductive health vulnerabilities of youths across a range of outcomes has implications for the development of successful policies and programs. We have discussed some of the key structural and environmental factors that influence the sexual and reproductive health of adolescents, particularly in low- and middle-income countries, and the importance of engaging adolescents in identifying solutions. We have highlighted 2 case studies that describe structural or environmental approaches to improving adolescent sexual and reproductive health and made recommendations to more systematically incorporate attention to structure and environment to improve global adolescent health.

A review of biophysical and socio-economic effects of unconventional oil and gas extraction - Implications for South Africa.

PubMed

Esterhuyse, Surina; Avenant, Marinda; Redelinghuys, Nola; Kijko, Andrzej; Glazewski, Jan; Plit, Lisa; Kemp, Marthie; Smit, Ansie; Vos, A Tascha; Williamson, Richard

2016-12-15

The impacts associated with unconventional oil and gas (UOG) extraction will be cumulative in nature and will most likely occur on a regional scale, highlighting the importance of using strategic decision-making and management tools. Managing possible impacts responsibly is extremely important in a water scarce country such as South Africa, versus countries where more water may be available for UOG extraction activities. This review article explains the possible biophysical and socio-economic impacts associated with UOG extraction within the South African context and how these complex impacts interlink. Relevant policy and governance frameworks to manage these impacts are also highlighted. Copyright © 2016 Elsevier Ltd. All rights reserved.

Alcohol Control Policies in 46 African Countries: Opportunities for Improvement.

PubMed

Ferreira-Borges, Carina; Esser, Marissa B; Dias, Sónia; Babor, Thomas; Parry, Charles D H

2015-07-01

There is little information on the extent to which African countries are addressing alcohol consumption and alcohol-related harm, which suggests that evaluations of national alcohol policies are needed in this region. The aim of this article is to examine the strength of a mix of national alcohol control policies in African countries, as well as the relationship between alcohol policy restrictiveness scores and adult alcohol per capita consumption (APC) among drinkers at the national level. We examined national alcohol policies of 46 African countries, as of 2012, in four regulatory categories (price, availability, marketing and drink-driving), and analyzed the restrictiveness of national alcohol policies using an adapted Alcohol Policy Index (API). To assess the validity of the policy restrictiveness scores, we conducted correlational analyses between policy restrictiveness scores and APC among drinkers in 40 countries. Countries attained a mean score of 44.1 of 100 points possible, ranging from 9.1 (Sao Tomé and Principe) to 75.0 (Algeria), with low scores indicating low policy restrictiveness. Policy restrictiveness scores were negatively correlated with and APC among drinkers (rs = -0.353, P = 0.005). There is great variation in the strength of alcohol control policies in countries throughout the African region. Tools for comparing the restrictiveness of alcohol policies across countries are available and are an important instrument to monitor alcohol policy developments. The negative correlation between policy restrictiveness and alcohol consumption among drinkers suggests the need for stronger alcohol policies as well as increased training and capacity building at the country level. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Student Learning Assessment and the Curriculum: Issues and Implications for Policy, Design and Implementation. In-Progress Reflections No. 1 on "Current and Critical Issues in the Curriculum and Learning"

ERIC Educational Resources Information Center

Muskin, Joshua A.

2015-01-01

The role of assessment in education has grown greatly over the past few decades, a trend that has two major manifestations. One is the rapid increase in the number of countries and other jurisdictions either participating in international surveys (tests) of learning or initiating their own system-wide assessments; or both. The other is the…

The G-20 and International Economic Cooperation: Background and Implications for Congress

DTIC Science & Technology

2009-12-09

exports may decline should another country devalue its currency or restrict imports to attempt to reverse a trade deficit or protect domestic industries...International Monetary Fund ( IMF ), and more informal economic forums, like the Group of Seven, or G-7, and the Group of 20, or G-20. This report focuses on...international framework to monitor and coordinate economic policies, voting reform at the IMF and World Bank, increased funding of multilateral development banks

Chinese Engagement in Africa: Drivers, Reactions, and Implications for U.S. Policy

DTIC Science & Technology

2014-01-01

downstream oil sectors in countries such as Sudan, Angola, and Nigeria . Africa also presents a huge untapped market for Chinese goods. Africa’s collective... Nigeria , and it’s oil, oil, nothing but oil. But the Chinese come and they are interested in every sector of our economy.”30 The dearth of Western...mining, engineering, and construction sectors .49 The Lekki Free Trade Zone (LFTZ) in Nigeria , a joint venture between Lekki Worldwide Investment Limited

Chinese Policy in Africa: Stakes, Strategy and Implications

DTIC Science & Technology

2008-03-21

voracious demand for energy to feed its booming economy, its need to become less dependant on market dictated- pricing , and its fear of a global crisis...the world’s diamond and chromium. Vast bauxite , nickel, and lead deposits are also found in Africa.20 No other continent is blessed with such...textile products, and more and more "made-in-China” products of low prices are in great demand in remote African countries. Africa is actually

Effect of the economic recession on pharmaceutical policy and medicine sales in eight European countries

PubMed Central

Mantel-Teeuwisse, Aukje K; Vogler, Sabine; Valkova, Silvia; de Joncheere, Kees; Leufkens, Hubert GM; Wagner, Anita K; Ross-Degnan, Dennis; Laing, Richard

2014-01-01

Abstract Objective To identify pharmaceutical policy changes during the economic recession in eight European countries and to determine whether policy measures resulted in lower sales of, and less expenditure on, pharmaceuticals. Methods Information on pharmaceutical policy changes between 2008 and 2011 in eight European countries was obtained from publications and pharmaceutical policy databases. Data on the volume and value of the quarterly sales of products between 2006 and 2011 in the 10 highest-selling therapeutic classes in each country were obtained from a pharmaceutical market research database. We compared these indicators in economically stable countries; Austria, Estonia and Finland, to those in economically less stable countries, Greece, Ireland, Portugal, Slovakia and Spain. Findings Economically stable countries implemented two to seven policy changes each, whereas less stable countries implemented 10 to 22 each. Of the 88 policy changes identified, 33 occurred in 2010 and 40 in 2011. They involved changing out-of-pocket payments for patients in 16 cases, price mark-up schemes in 13 and price cuts in 11. Sales volumes increased moderately in all countries except Greece and Portugal, which experienced slight declines after 2009. Sales values decreased in both groups of countries, but fell more in less stable countries. Conclusion Less economically stable countries implemented more pharmaceutical policy changes during the recession than economically stable countries. Unexpectedly, pharmaceutical sales volumes increased in almost all countries, whereas sales values declined, especially in less stable countries. PMID:25378754

The Trans-Pacific Partnership and pharmaceutical innovation.

PubMed

Freeman, Robert A

2016-01-01

Trade agreements are an overlooked area of research and policy analysis that affect market access, pricing and reimbursement decisions by pharmaceutical manufacturers, and research and development decisions in the long term. The Trans-Pacific Partnership (TPP) is the most recent multi-national agreement under considerations that may have profound implications in developed and developing countries in the Pacific Rim. As in the case of other trade arrangements, the TPP negotiations are not transparent, but a major leak of the most recent draft has been published in WikiLeaks. The leaked document has raised a number of concerns about intellectual property rights (IPR) and regulatory data protection (RDP) that have implications for public health and economic policy throughout the region. In particular, IPR and RDP go beyond the minimum standards set under the World Trade Organization (WTO) and may affect drug access negatively by delaying generic drug and biosimilar product availability and by raising prices by removing national regulations dealing with drug pricing and reimbursement. Of particular concern is the establishment of a litigation process where multi-national companies can sue individual countries before a panel of private attorneys who are appointed by the World Bank or United Nations. This paper addresses these concerns along with a commentary on the likelihood of occurring and the need for future research. Copyright © 2015 Elsevier Inc. All rights reserved.

The consumer welfare implications of governmental policies and firm strategy in markets for medicines.

PubMed

Chatterjee, Chirantan; Kubo, Kensuke; Pingali, Viswanath

2015-12-01

This paper empirically examines the consumer welfare implications of changes in government policies related to patent protection and compulsory licensing in the Indian market for oral anti-diabetic (OAD) medicines. In contrast to previous studies on the impact of pharmaceutical patents in India, we observe, and estimate the welfare effects accruing from differential pricing and voluntary licensing strategies of patent-holding innovator firms. Three novel molecules belonging to the dipeptidyl peptidase-4 (DPP-4) inhibitor class of OADs have been launched in India by the patent holders, at lower prices than those prevailing in the developed countries. Using aggregate market transaction data, we structurally estimate demand and supply and use the parameter estimates in our model to simulate consumer welfare under various counterfactual scenarios. Our results suggest that the introduction of DPP-4 inhibitors generated a consumer surplus gain of around 7.6 cents per day for a typical DPP-4 inhibitor user under the existing differential pricing and voluntary licensing strategies. If the innovators decide to price at developed-country levels, this surplus is eliminated almost entirely. The issuance of compulsory licensing does not always improve consumer welfare because if innovators defer or delay the introduction of new drugs in response, the loss in consumer welfare could be substantial. Copyright © 2015 Elsevier B.V. All rights reserved.

Patient and provider perspectives on quality and health system effectiveness in a transition economy: evidence from Ukraine.

PubMed

Luck, J; Peabody, J W; DeMaria, L M; Alvarado, C S; Menon, R

2014-08-01

Facing a severe population health crisis due to noncommunicable diseases, Ukraine and other former Soviet republics and Eastern European countries have a pressing need for more effective health systems. Policies to enhance health system effectiveness should consider the perspectives of different stakeholder groups, including providers as well as patients. In addition, policies that directly target the quality of clinical care should be based on objective performance measures. In 2009 and 2010 we conducted a coordinated series of household and facility-level surveys to capture the perspectives of Ukrainian household members, outpatient clinic patients, and physicians regarding the country's health system overall, as well as the quality, access, and affordability of health care. We objectively measured the quality of care for heart failure and chronic obstructive pulmonary disease using CPV(®) vignettes. There was broad agreement among household respondents (79%) and physicians (95%) that Ukraine's health system should be reformed. CPV(®) results indicate that the quality of care for common noncommunicable diseases is poor in all regions of the country and in hospitals as well as polyclinics. However, perspectives about the quality of care differ, with household respondents seeing quality as a serious concern, clinic patients having more positive perceptions, and physicians not viewing quality as a reform priority. All stakeholder groups viewed affordability as a problem. These findings have several implications for policies to enhance health system effectiveness. The shared desire for health system reform among all stakeholder groups provides a basis for action in Ukraine. Improving quality, strengthening primary care, and enhancing affordability should be major goals of new health policies. Policies to improve quality directly, such as pay-for-performance, would be mutually reinforcing with purchasing reforms such as transparent payment mechanisms. Such policies would align the incentives of physicians with the desires of the population they serve. Copyright © 2014. Published by Elsevier Ltd.

Health and schooling: evidence and policy implications for developing countries.

PubMed

Gomes-neto, J B; Hanushek, E A; Leite, R H; Frota-bezzera, R C

1997-01-01

Health and education are typically viewed as distinct topics from both the research and policy perspectives. Accordingly, the direct interactions between health status and education have been neglected in both research and policy making. The authors use survey data collected from students during the 1980s in Piaui, Ceara, and Pernambuco states as part of an evaluation of a major educational intervention program, EDURURAL, to investigate the complementarities of health with school attainment and cognitive achievement. A series of anthropometric measures for individual students in rural northeast Brazil are used in educational performance models. The promotion models and value-added achievement models both demonstrate the importance of students' visual acuity. Poor vision systematically leads to higher drop-out rates, more grade repetition, and lower achievement. The achievement models also point to the role of good nutrition.

Comparative Study on Migration, Urbanization and Development in the ESCAP Region (RAS/P13/79). Rev. version.

PubMed

1982-01-01

Development of a study project by the UN Economic and Social Commission for Asia and the Pacific (ESCAP) on migration, urbanization, and development in the following countries is described: Indonesia, Malaysia, Pakistan, Philippines, Republic of Korea, Sri Lanka, and Thailand. The project's immediate goal is to assist decision makers in formulating population redistribution policies. It was recommended that ESCAP develop and test a migration questionnaire to assist member countries in undertaking surveys to study the interrelationships of migration and development. Upon completion of survey manuals to assist in the survey implementation, it was suggested that ESCAP run a series of in-country workshops to discuss the applications of survey results for policy formulation. A national migration survey will be taken in each country in the early 1980s in order to discern pattern and type of population mobility, factors that cause people to move or not to move, and the consequences of migration on places of origin and destination. A sample of 14,000 households in each country will be selected and 1 person of age 15-64 will be chosen as the respondent for each household. the following are some items which will be studied: 1) volume of migration streams within and between metropolitan areas and urban-rural areas; 2) decision making factors; 3) interactions between population movement and family structure, chages in fertility levels, employment, and education; 4) impact of agricultural systems on seasonal movements; 5) contributions of migrants to the cities; and 6) implications of international migration to and from the country. Leading family planning agencies will use these results to develop policy relating to population distribution, industry location, migration laws, regional economic planning, modern technology, and rural education. The management framework of the project is presented. After these results are published, government agencies can utilize them by incorporating direct questions on population movement into the national census, conducting demonstration projects to assess the impact of population movement programs, and training personnel.

Use of health systems evidence by policymakers in eastern mediterranean countries: views, practices, and contextual influences

PubMed Central

2012-01-01

Background Health systems evidence can enhance policymaking and strengthen national health systems. In the Middle East, limited research exists on the use of evidence in the policymaking process. This multi-country study explored policymakers’ views and practices regarding the use of health systems evidence in health policymaking in 10 eastern Mediterranean countries, including factors that influence health policymaking and barriers and facilitators to the use of evidence. Methods This study utilized a survey adapted and customized from a similar tool developed in Canada. Health policymakers from 10 countries (Algeria, Bahrain, Jordan, Lebanon Oman, Pakistan, Palestine, Sudan, Tunisia, and Yemen) were surveyed. Descriptive and bi-variate analyses were performed for quantitative questions and thematic analysis was done for qualitative questions. Results A total of 237 policymakers completed the survey (56.3% response rate). Governing parties, limited funding for the health sector and donor organizations exerted a strong influence on policymaking processes. Most (88.5%) policymakers reported requesting evidence and 43.1% reported collaborating with researchers. Overall, 40.1% reported that research evidence is not delivered at the right time. Lack of an explicit budget for evidence-informed health policymaking (55.3%), lack of an administrative structure for supporting evidence-informed health policymaking processes (52.6%), and limited value given to research (35.9%) all limited the use of research evidence. Barriers to the use of evidence included lack of research targeting health policy, lack of funding and investments, and political forces. Facilitators included availability of health research and research institutions, qualified researchers, research funding, and easy access to information. Conclusions Health policymakers in several countries recognize the importance of using health systems evidence. Study findings are important in light of changes unfolding in some Arab countries and can help undertake an analysis of underlying transformations and their respective health policy implications including the way evidence will be used in policy decisions. PMID:22799440

From forest landscape to agricultural landscape in the developing tropical country of Malaysia: pattern, process, and their significance on policy.

PubMed

Abdullah, Saiful Arif; Hezri, Adnan A

2008-11-01

Agricultural expansion and deforestation are spatial processes of land transformation that impact on landscape pattern. In peninsular Malaysia, the conversion of forested areas into two major cash crops--rubber and oil palm plantations--has been identified as driving significant environmental change. To date, there has been insufficient literature studying the link between changes in landscape patterns and land-related development policies. Therefore, this paper examines: (i) the links between development policies and changes in land use/land cover and landscape pattern and (ii) the significance and implications of these links for future development policies. The objective is to generate insights on the changing process of land use/land cover and landscape pattern as a functional response to development policies and their consequences for environmental conditions. Over the last century, the development of cash crops has changed the country from one dominated by natural landscapes to one dominated by agricultural landscapes. But the last decade of the century saw urbanization beginning to impact significantly. This process aligned with the establishment of various development policies, from land development for agriculture between the mid 1950s and the 1970s to an emphasis on manufacturing from the 1980s onward. Based on a case study in Selangor, peninsular Malaysia, a model of landscape pattern change is presented. It contains three stages according to the relative importance of rubber (first stage: 1900--1950s), oil palm (second stage: 1960s--1970s), and urban (third stage: 1980s--1990s) development that influenced landscape fragmentation and heterogeneity. The environmental consequences of this change have been depicted through loss of biodiversity, geohazard incidences, and the spread of vector-borne diseases. The spatial ecological information can be useful to development policy formulation, allowing diagnosis of the country's "health" and sustainability. The final section outlines the usefulness of landscape analysis in the policy-making process to prevent further fragmentation of the landscape and forest loss in Malaysia in the face of rapid economic development.

Priority setting for the prevention and control of cardiovascular diseases: multi-criteria decision analysis in four eastern Mediterranean countries.

PubMed

Ghandour, Rula; Shoaibi, Azza; Khatib, Rana; Abu Rmeileh, Niveen; Unal, Belgin; Sözmen, Kaan; Kılıç, Bülent; Fouad, Fouad; Al Ali, Radwan; Ben Romdhane, Habiba; Aissi, Wafa; Ahmad, Balsam; Capewell, Simon; Critchley, Julia; Husseini, Abdullatif

2015-01-01

To explore the feasibility of using a simple multi-criteria decision analysis method with policy makers/key stakeholders to prioritize cardiovascular disease (CVD) policies in four Mediterranean countries: Palestine, Syria, Tunisia and Turkey. A simple multi-criteria decision analysis (MCDA) method was piloted. A mixed methods study was used to identify a preliminary list of policy options in each country. These policies were rated by different policymakers/stakeholders against pre-identified criteria to generate a priority score for each policy and then rank the policies. Twenty-five different policies were rated in the four countries to create a country-specific list of CVD prevention and control policies. The response rate was 100% in each country. The top policies were mostly population level interventions and health systems' level policies. Successful collaboration between policy makers/stakeholders and researchers was established in this small pilot study. MCDA appeared to be feasible and effective. Future applications should aim to engage a larger, representative sample of policy makers, especially from outside the health sector. Weighting the selected criteria might also be assessed.

The Primary Care Physician Workforce: Ethical and Policy Implications

PubMed Central

Starfield, Barbara; Fryer, George E.

2007-01-01

PURPOSE We undertook a study to examine the characteristics of countries exporting physicians to the United States according to their relative contribution to the primary care supply in the United States. METHODS We used data from the World Health Organization and from the American Medical Association Physician Masterfile to gather sociodemographic, health system, and health characteristics of countries and the number of international medical graduates (IMGs) for the countries, according to the specialty of their practice in the United States. RESULTS Countries whose medical school graduates added a relatively greater percentage of the primary care physicians than the overall percentage of primary care physicians in the United States (31%) were poor countries with relatively extreme physician shortages, high infant mortality rates, lower life expectancies, and lower immunization rates than countries contributing relatively more specialists to the US physician workforce. CONCLUSION The United States disproportionately uses graduates of foreign medical schools from the poorest and most deprived countries to maintain its primary care physician supply. The ethical aspects of depending on foreign medical graduates is an important issue, especially when it deprives disadvantaged countries of their graduates to buttress a declining US primary care physician supply. PMID:18025485

Work stress and depressive symptoms in older employees: impact of national labour and social policies.

PubMed

Lunau, Thorsten; Wahrendorf, Morten; Dragano, Nico; Siegrist, Johannes

2013-11-21

Maintaining health and work ability among older employees is a primary target of national labour and social policies (NLSP) in Europe. Depression makes a significant contribution to early retirement, and chronic work-related stress is associated with elevated risks of depression. We test this latter association among older employees and explore to what extent indicators of distinct NLSP modify the association between work stress and depressive symptoms. We choose six indicators, classified in three categories: (1) investment in active labour market policies, (2) employment protection, (3) level of distributive justice. We use data from three longitudinal ageing studies (SHARE, HRS, ELSA) including 5650 men and women in 13 countries. Information on work stress (effort-reward imbalance, low work control) and depressive symptoms (CES-D, EURO-D) was obtained. Six NLSP indicators were selected from OECD databases. Associations of work stress (2004) with depressive symptoms (2006) and their modification by policy indicators were analysed using logistic multilevel models. Risk of depressive symptoms at follow-up is higher among those experiencing effort-reward imbalance (OR: 1.55 95% CI 1.27-1.89) and low control (OR: 1.46 95% CI 1.19-1.79) at work. Interaction terms indicate a modifying effect of a majority of protective NLSP indicators on the strength of associations of effort - reward imbalance with depressive symptoms. Work stress is associated with elevated risk of prospective depressive symptoms among older employees from 13 European countries. Protective labour and social policies modify the strength of these associations. If further supported findings may have important policy implications.

Work stress and depressive symptoms in older employees: impact of national labour and social policies

PubMed Central

2013-01-01

Background Maintaining health and work ability among older employees is a primary target of national labour and social policies (NLSP) in Europe. Depression makes a significant contribution to early retirement, and chronic work-related stress is associated with elevated risks of depression. We test this latter association among older employees and explore to what extent indicators of distinct NLSP modify the association between work stress and depressive symptoms. We choose six indicators, classified in three categories: (1) investment in active labour market policies, (2) employment protection, (3) level of distributive justice. Methods We use data from three longitudinal ageing studies (SHARE, HRS, ELSA) including 5650 men and women in 13 countries. Information on work stress (effort-reward imbalance, low work control) and depressive symptoms (CES-D, EURO-D) was obtained. Six NLSP indicators were selected from OECD databases. Associations of work stress (2004) with depressive symptoms (2006) and their modification by policy indicators were analysed using logistic multilevel models. Results Risk of depressive symptoms at follow-up is higher among those experiencing effort-reward imbalance (OR: 1.55 95% CI 1.27-1.89) and low control (OR: 1.46 95% CI 1.19-1.79) at work. Interaction terms indicate a modifying effect of a majority of protective NLSP indicators on the strength of associations of effort - reward imbalance with depressive symptoms. Conclusions Work stress is associated with elevated risk of prospective depressive symptoms among older employees from 13 European countries. Protective labour and social policies modify the strength of these associations. If further supported findings may have important policy implications. PMID:24256638

Private health insurance: implications for developing countries.

PubMed Central

Sekhri, Neelam; Savedoff, William

2005-01-01

Private health insurance is playing an increasing role in both high- and low-income countries, yet is poorly understood by researchers and policy-makers. This paper shows that the distinction between private and public health insurance is often exaggerated since well regulated private insurance markets share many features with public insurance systems. It notes that private health insurance preceded many modern social insurance systems in western Europe, allowing these countries to develop the mechanisms, institutions and capacities that subsequently made it possible to provide universal access to health care. We also review international experiences with private insurance, demonstrating that its role is not restricted to any particular region or level of national income. The seven countries that finance more than 20% of their health care via private health insurance are Brazil, Chile, Namibia, South Africa, the United States, Uruguay and Zimbabwe. In each case, private health insurance provides primary financial protection for workers and their families while public health-care funds are targeted to programmes covering poor and vulnerable populations. We make recommendations for policy in developing countries, arguing that private health insurance cannot be ignored. Instead, it can be harnessed to serve the public interest if governments implement effective regulations and focus public funds on programmes for those who are poor and vulnerable. It can also be used as a transitional form of health insurance to develop experience with insurance institutions while the public sector increases its own capacity to manage and finance health-care coverage. PMID:15744405

Private health insurance: implications for developing countries.

PubMed

Sekhri, Neelam; Savedoff, William

2005-02-01

Private health insurance is playing an increasing role in both high- and low-income countries, yet is poorly understood by researchers and policy-makers. This paper shows that the distinction between private and public health insurance is often exaggerated since well regulated private insurance markets share many features with public insurance systems. It notes that private health insurance preceded many modern social insurance systems in western Europe, allowing these countries to develop the mechanisms, institutions and capacities that subsequently made it possible to provide universal access to health care. We also review international experiences with private insurance, demonstrating that its role is not restricted to any particular region or level of national income. The seven countries that finance more than 20% of their health care via private health insurance are Brazil, Chile, Namibia, South Africa, the United States, Uruguay and Zimbabwe. In each case, private health insurance provides primary financial protection for workers and their families while public health-care funds are targeted to programmes covering poor and vulnerable populations. We make recommendations for policy in developing countries, arguing that private health insurance cannot be ignored. Instead, it can be harnessed to serve the public interest if governments implement effective regulations and focus public funds on programmes for those who are poor and vulnerable. It can also be used as a transitional form of health insurance to develop experience with insurance institutions while the public sector increases its own capacity to manage and finance health-care coverage.

Evaluating National Environmental Sustainability: Performance Measures and Influential Factors for OECD-Member Countries featuring Canadian Performance and Policy Implications

NASA Astrophysics Data System (ADS)

Calbick, Kenneth S.

This research reviews five studies that evaluate national environmental sustainability with composite indices; performs uncertainty and sensitivity analyses of techniques for building a composite index; completes principal components factor analysis to help build subindices measuring waste and pollution, sustainable energy, sustainable food, nature conservation, and sustainable cities (Due to its current importance, the greenhouse gases (GHG) indicator is included individually as another policy measure.); analyses factors that seem to influence performance: climate, population growth, population density, economic output, technological development, industrial structure, energy prices, environmental governance, pollution abatement and control expenditures, and environmental pricing; and explores Canadian policy implications of the results. The techniques to build composite indices include performance indicator selection, missing data treatment, normalisation technique, scale-effect adjustments, weights, and aggregation method. Scale-effect adjustments and normalisation method are significant sources of uncertainty inducing 68% of the observed variation in a country's final rank at the 95% level of confidence. Choice of indicators also introduces substantial variation as well. To compensate for this variation, the current study recommends that a composite index should always be analysed with other policy subindices and individual indicators. Moreover, the connection between population and consumption indicates that per capita scale-effect adjustments should be used for certain indicators. Rather than ranking normalisation, studies should use a method that retains information from the raw indicator values. Multiple regression and cluster analyses indicate economic output, environmental governance, and energy prices are major influential factors, with energy prices the most important. It is statistically significant for five out of seven performance measures at the 95% level of confidence: 37% variance explained on the environmental sustainability performance composite indicator out of 73%, 55% (of 55%) on the waste and pollution subindex, 20% (of 70%) on the sustainable energy subindex, 5% (of 100%) on the sustainable cities subindex, and 55% (of 81%) on the GHG indicator. Energy prices are relevant to Canadian policy; increasing prices could substantially improve Canada's performance. Policy makers should increase energy prices through a carbon pricing strategy that is congruent with the ecological fiscal reform advanced by the National Round Table on the Environment and the Economy. Keywords: sustainable development; composite indices; environmental policy; environmental governance; energy prices; Canada.

The impact of Nordic adult education ideas on the development of a democratic society in Lithuania

NASA Astrophysics Data System (ADS)

Teresevičienė, Margarita; Trepulė, Elena; Trečiokienė, Edita

2017-02-01

This article analyses the role of the cooperation with and the influence of the Nordic countries on the development of a democratic society in Lithuania through adult education since the reinstatement of its independence from Soviet regime in March 1990 to the present. The authors focus on three main areas: (1) the training of Lithuanian adult educators; (2) the establishment and development of NGOs; and (3) the implications for a Lithuanian policy of adult education. Within the framework of Nordic-Baltic cooperation established among five Nordic and three Baltic countries (NB8) in 1992, Lithuanian adult educators seized the opportunity to visit Scandinavian institutions and projects. Experiencing Nordic adult education ideas has resulted in a marked shift in Lithuanian adult educators' values, methodology and careers; and in the establishment of a series of very influential umbrella associations as well as hundreds of NGOs in Lithuania which work with adults and support functioning democratic values in society. This shift is related to the civic responsibility and active participation growing out of the bottom-up approaches of group work, cooperation, discussions and learning circles which are so inherent in the Nordic tradition of adult education. The internalisation of new democratic values was more complicated than expected for many Lithuanian politicians, adult educators and NGO leaders in terms of how political decisions were perceived and implemented. Furthermore, the influence of the Nordic-Baltic cooperation in adult education may also be traced in adult education policy implications in Lithuania. Some changes in the policies of contemporary Lithuania have not been successful and even failed to promote a democratic society.

Removing financial barriers to access reproductive, maternal and newborn health services: the challenges and policy implications for human resources for health

PubMed Central

2013-01-01

Background The last decade has seen widespread retreat from user fees with the intention to reduce financial constraints to users in accessing health care and in particular improving access to reproductive, maternal and newborn health services. This has had important benefits in reducing financial barriers to access in a number of settings. If the policies work as intended, service utilization rates increase. However this increases workloads for health staff and at the same time, the loss of user fee revenues can imply that health workers lose bonuses or allowances, or that it becomes more difficult to ensure uninterrupted supplies of health care inputs. This research aimed to assess how policies reducing demand-side barriers to access to health care have affected service delivery with a particular focus on human resources for health. Methods We undertook case studies in five countries (Ghana, Nepal, Sierra Leone, Zambia and Zimbabwe). In each we reviewed financing and HRH policies, considered the impact financing policy change had made on health service utilization rates, analysed the distribution of health staff and their actual and potential workloads, and compared remuneration terms in the public sectors. Results We question a number of common assumptions about the financing and human resource inter-relationships. The impact of fee removal on utilization levels is mostly not sustained or supported by all the evidence. Shortages of human resources for health at the national level are not universal; maldistribution within countries is the greater problem. Low salaries are not universal; most of the countries pay health workers well by national benchmarks. Conclusions The interconnectedness between user fee policy and HRH situations proves difficult to assess. Many policies have been changing over the relevant period, some clearly and others possibly in response to problems identified associated with financing policy change. Other relevant variables have also changed. However, as is now well-recognised in the user fee literature, co-ordination of health financing and human resource policies is essential. This appears less well recognised in the human resources literature. This coordination involves considering user charges, resource availability at health facility level, health worker pay, terms and conditions, and recruitment in tandem. All these policies need to be effectively monitored in their processes as well as outcomes, but sufficient data are not collected for this purpose. PMID:24053731

Removing financial barriers to access reproductive, maternal and newborn health services: the challenges and policy implications for human resources for health.

PubMed

McPake, Barbara; Witter, Sophie; Ensor, Tim; Fustukian, Suzanne; Newlands, David; Martineau, Tim; Chirwa, Yotamu

2013-09-22

The last decade has seen widespread retreat from user fees with the intention to reduce financial constraints to users in accessing health care and in particular improving access to reproductive, maternal and newborn health services. This has had important benefits in reducing financial barriers to access in a number of settings. If the policies work as intended, service utilization rates increase. However this increases workloads for health staff and at the same time, the loss of user fee revenues can imply that health workers lose bonuses or allowances, or that it becomes more difficult to ensure uninterrupted supplies of health care inputs.This research aimed to assess how policies reducing demand-side barriers to access to health care have affected service delivery with a particular focus on human resources for health. We undertook case studies in five countries (Ghana, Nepal, Sierra Leone, Zambia and Zimbabwe). In each we reviewed financing and HRH policies, considered the impact financing policy change had made on health service utilization rates, analysed the distribution of health staff and their actual and potential workloads, and compared remuneration terms in the public sectors. We question a number of common assumptions about the financing and human resource inter-relationships. The impact of fee removal on utilization levels is mostly not sustained or supported by all the evidence. Shortages of human resources for health at the national level are not universal; maldistribution within countries is the greater problem. Low salaries are not universal; most of the countries pay health workers well by national benchmarks. The interconnectedness between user fee policy and HRH situations proves difficult to assess. Many policies have been changing over the relevant period, some clearly and others possibly in response to problems identified associated with financing policy change. Other relevant variables have also changed.However, as is now well-recognised in the user fee literature, co-ordination of health financing and human resource policies is essential. This appears less well recognised in the human resources literature. This coordination involves considering user charges, resource availability at health facility level, health worker pay, terms and conditions, and recruitment in tandem. All these policies need to be effectively monitored in their processes as well as outcomes, but sufficient data are not collected for this purpose.

Evidence-based policy-making: the implications of globally-applicable research for context-specific problem-solving in developing countries.

PubMed

Behague, Dominique; Tawiah, Charlotte; Rosato, Mikey; Some, Télésphore; Morrison, Joanna

2009-11-01

In the past 15 or so years, the "evidence-based medicine" (EBM) framework has become increasingly institutionalized, facilitating its transfer across the globe. In the late 1990s, the basic principles of EBM began to have a marked influence in a number of non-clinical public policy arenas. Policy-makers working in these areas are now being urged to move away from developing policies according to political ideologies to a more legitimate approach based on "scientific fact," a process termed "evidence-based policy-making" (EBPM). The conceptual diffusion of EBM to non-clinical arenas has exposed epistemologically destabilizing views regarding the definition of "science," particularly as it relates to the demands of global versus national/sub-national policy-making. Using the maternal and neonatal subfield as an ethnographic case-study, this paper explores the effects of these divergences on EBPM in 5 developing countries (Bangladesh, Burkina Faso, Ghana, Malawi and Nepal). In doing so, our analysis aims to explain why EBPM has thus far had a limited impact in the area of context-specific programmatic policy-development and implementation at the national and sub-national levels. Results highlight that the political contexts in which EBPM is played out promote uniformity of methodological and policy approaches, despite the fact that disciplinary diversity is being called for repeatedly in the public health literature. Even in situations where national EBPM diverges from international priorities, national evidence-based policies are found to hold little weight in countering global policy interests, which some informants claim are themselves legitimated, rather than informed, by evidence. Informants also highlight the way interpretations of research findings are shaped by the broader political context within which donors set priorities and distribute limited resources - contexts that are driven by the need to provide generalisable research recommendations based on scientifically replicable methods. Added to this are clear rifts between senior and junior-level experts within countries that constrain national and sub-national research agendas from serving as tools for empowered knowledge production and problem-solving. We conclude by arguing for diverse forms of research that can more effectively address context-specific problems. While such diversity may render EBPM more conflict-ridden, debate is by no means an undesirable characteristic in any evolving system of knowledge, for it has the potential to foster critical insight and localized change.

Enabling Equal Access to Molecular Diagnostics: What Are the Implications for Policy and Health Technology Assessment?

PubMed

Plun-Favreau, Juliette; Immonen-Charalambous, Kaisa; Steuten, Lotte; Strootker, Anja; Rouzier, Roman; Horgan, Denis; Lawler, Mark

2016-01-01

Molecular diagnostics can offer important benefits to patients and are a key enabler of the integration of personalised medicine into health care systems. However, despite their promise, few molecular diagnostics are embedded into clinical practice (especially in Europe) and access to these technologies remains unequal across countries and sometimes even within individual countries. If research translation and the regulatory environments have proven to be more challenging than expected, reimbursement and value assessment remain the main barriers to providing patients with equal access to molecular diagnostics. Unclear or non-existent reimbursement pathways, together with the lack of clear evidence requirements, have led to significant delays in the assessment of molecular diagnostics technologies in certain countries. Additionally, the lack of dedicated diagnostics budgets and the siloed nature of resource allocation within certain health care systems have significantly delayed diagnostics commissioning. This article will consider the perspectives of different stakeholders (patients, health care payers, health care professionals, and manufacturers) on the provision of a research-enabled, patient-focused molecular diagnostics platform that supports optimal patient care. Through the discussion of specific case studies, and building on the experience from countries that have successfully integrated molecular diagnostics into clinical practice, this article will discuss the necessary evolutions in policy and health technology assessment to ensure that patients can have equal access to appropriate molecular diagnostics. © 2016 S. Karger AG, Basel.

The role of capital costs in decarbonizing the electricity sector

NASA Astrophysics Data System (ADS)

Hirth, Lion; Steckel, Jan Christoph

2016-11-01

Low-carbon electricity generation, i.e. renewable energy, nuclear power and carbon capture and storage, is more capital intensive than electricity generation through carbon emitting fossil fuel power stations. High capital costs, expressed as high weighted average cost of capital (WACC), thus tend to encourage the use of fossil fuels. To achieve the same degree of decarbonization, countries with high capital costs therefore need to impose a higher price on carbon emissions than countries with low capital costs. This is particularly relevant for developing and emerging economies, where capital costs tend to be higher than in rich countries. In this paper we quantitatively evaluate how high capital costs impact the transformation of the energy system under climate policy, applying a numerical techno-economic model of the power system. We find that high capital costs can significantly reduce the effectiveness of carbon prices: if carbon emissions are priced at USD 50 per ton and the WACC is 3%, the cost-optimal electricity mix comprises 40% renewable energy. At the same carbon price and a WACC of 15%, the cost-optimal mix comprises almost no renewable energy. At 15% WACC, there is no significant emission mitigation with carbon pricing up to USD 50 per ton, but at 3% WACC and the same carbon price, emissions are reduced by almost half. These results have implications for climate policy; carbon pricing might need to be combined with policies to reduce capital costs of low-carbon options in order to decarbonize power systems.

Reproductive tourism in Argentina: clinic accreditation and its implications for consumers, health professionals and policy makers.

PubMed

Smith, Elise; Behrmann, Jason; Martin, Carolina; Williams-Jones, Bryn

2010-08-01

A subcategory of medical tourism, reproductive tourism has been the subject of much public and policy debate in recent years. Specific concerns include: the exploitation of individuals and communities, access to needed health care services, fair allocation of limited resources, and the quality and safety of services provided by private clinics. To date, the focus of attention has been on the thriving medical and reproductive tourism sectors in Asia and Eastern Europe; there has been much less consideration given to more recent 'players' in Latin America, notably fertility clinics in Chile, Brazil, Mexico and Argentina. In this paper, we examine the context-specific ethical and policy implications of private Argentinean fertility clinics that market reproductive services via the internet. Whether or not one agrees that reproductive services should be made available as consumer goods, the fact is that they are provided as such by private clinics around the world. We argue that basic national regulatory mechanisms are required in countries such as Argentina that are marketing fertility services to local and international publics. Specifically, regular oversight of all fertility clinics is essential to ensure that consumer information is accurate and that marketed services are safe and effective. It is in the best interests of consumers, health professionals and policy makers that the reproductive tourism industry adopts safe and responsible medical practices.

Wages and Labour Mobility; A Report by a Group of Independent Experts on the Relation between Changes in Wage Differentials and the Pattern of Employment with a Foreword on the Implications of the Study for Income Policy.

ERIC Educational Resources Information Center

deWolff, Pieter; And Others

To determine the relationship between wage structure and employment patterns available evidence on changes in relative earnings and in relative numbers employed were surveyed for periods up to 15 years in 10 countries: Belgium, Canada, France, Germany, Italy, the Netherlands, Norway, Sweden, the United Kingdom, and the United States. Some findings…

Price restrictions and other restrictions on alcohol availability in Denmark and Sweden: a historical perspective with implications for the current debate.

PubMed

Lindström, Martin

2005-01-01

Current political debate in Sweden is mainly centred on lowering taxes on alcohol in order to "harmonize" prices with those in neighbouring countries, although the evidence of a negative association between prices and alcohol consumption is more than convincing. Total per capita consumption figures for twentieth-century Denmark and Sweden are utilized to illustrate the astonishing effects on consumption patterns of active government policies to restrict availability.

China and the Splitting of Alliances: Historic Cases and Implications for North Korea

DTIC Science & Technology

2014-03-01

life. Stalin was exposed and condemned at the Congress for having had hundreds of thousands of people shot and for his abuse of power. Mao Tse -tung...countries, to put the Mongolian people under the influence of Mao Tse -tung’s ideas, and to compel Mongolia to pursue a pro-Maoist policy.185 Additionally...needed Soviet support to do so. In mid-1975, Hanoi took control of Laos and then began prosecuting a war against the Chinese-backed Khmer Rouge.295

The Third World Arms Market in the 1980’s: Implications for U. S. Policy.

DTIC Science & Technology

1981-06-02

transfer of modern armaments has gone beyond6 the bounds of ordinary laisse - faire economics. This study is best remembered for its early recognition of... styles , and 8 relationships" in arms transfers. As in the Adelphi study, arms transfers are tabulated numerically rather than in dollar terms. Country...or sells the services of DOD personnel such as training or management advice. 19 91. ILI ’a.UK E.B. Rex The Third World Arms Market 92. As written

Food labelling: Regulations and Public Health implications.

PubMed

Marcotrigiano, V; Lanzilotti, C; Rondinone, D; De Giglio, O; Caggiano, G; Diella, G; Orsi, G B; Montagna, M T; Napoli, C

2018-01-01

Legislators have implemented policies to improve food labelling to protect consumers and to make the presentation of ingredients and nutritional information more transparent. Proper food labelling allows consumers who may suffer from food allergies or intolerances to know exactly what ingredients a product contains, and it also helps them make more informed health and nutrition choices. This paper deals with the most current European and Italian legislation on food labelling, actions taken in non-EU countries to increase health choices, and the expected impact on Public Health.

Vietnam and the Soviet Union: Implications for Europe and American Foreign Policy Options.

DTIC Science & Technology

1983-03-01

Vietnamese daily newspaper, in May 1981. CEMA members were specifically congratulated for their part in constructing the trans -Vietnam railroad. [FBIS, 27 May...constructing the trans -Vietnam railroad. [FBIS, 27 May 1981:K7] As early as June 1978 the East European countries had provided significant aid to...reform fiasco of the fifties, the leadership placed at least part of the blame for Vietnam’s many internal problems on Party shortcomings. In Le Duc

A case study of polypharmacy management in nine European countries: Implications for change management and implementation.

PubMed

McIntosh, Jennifer; Alonso, Albert; MacLure, Katie; Stewart, Derek; Kempen, Thomas; Mair, Alpana; Castel-Branco, Margarida; Codina, Carles; Fernandez-Llimos, Fernando; Fleming, Glenda; Gennimata, Dimitra; Gillespie, Ulrika; Harrison, Cathy; Illario, Maddalena; Junius-Walker, Ulrike; Kampolis, Christos F; Kardas, Przemyslaw; Lewek, Pawel; Malva, João; Menditto, Enrica; Scullin, Claire; Wiese, Birgitt

2018-01-01

Multimorbidity and its associated polypharmacy contribute to an increase in adverse drug events, hospitalizations, and healthcare spending. This study aimed to address: what exists regarding polypharmacy management in the European Union (EU); why programs were, or were not, developed; and, how identified initiatives were developed, implemented, and sustained. Change management principles (Kotter) and normalization process theory (NPT) informed data collection and analysis. Nine case studies were conducted in eight EU countries: Germany (Lower Saxony), Greece, Italy (Campania), Poland, Portugal, Spain (Catalonia), Sweden (Uppsala), and the United Kingdom (Northern Ireland and Scotland). The workflow included a review of country/region specific polypharmacy policies, key informant interviews with stakeholders involved in policy development and implementation and, focus groups of clinicians and managers. Data were analyzed using thematic analysis of individual cases and framework analysis across cases. Polypharmacy initiatives were identified in five regions (Catalonia, Lower Saxony, Northern Ireland, Scotland, and Uppsala) and included all care settings. There was agreement, even in cases without initiatives, that polypharmacy is a significant issue to address. Common themes regarding the development and implementation of polypharmacy management initiatives were: locally adapted solutions, organizational culture supporting innovation and teamwork, adequate workforce training, multidisciplinary teams, changes in workflow, redefinition of roles and responsibilities of professionals, policies and legislation supporting the initiative, and data management and information and communication systems to assist development and implementation. Depending on the setting, these were considered either facilitators or barriers to implementation. Within the studied EU countries, polypharmacy management was not widely addressed. These results highlight the importance of change management and theory-based implementation strategies, and provide examples of polypharmacy management initiatives that can assist managers and policymakers in developing new programs or scaling up existing ones, particularly in places currently lacking such initiatives.

Improved harmonisation from policy dialogue? Realist perspectives from Guinea and Chad.

PubMed

Kwamie, Aku; Nabyonga-Orem, Juliet

2016-07-18

Harmonisation is a key principle of the Paris Declaration. The Universal Health Coverage (UHC) Partnership, an initiative of the European Union, the Government of Luxembourg and the World Health Organization, supported health policy dialogues between 2012 and 2015 in identified countries in the WHO African Region. The UHC Partnership has amongst its key objectives to strengthen national health policy development. In Guinea and Chad, policy dialogue focused on elaborating the national health plan and other key documents. This study is an analytical reflection inspired by realist evaluative approaches to understand whether policy dialogue led to improved harmonisation amongst health actors in Guinea and Chad, and if so, how and why. Interviews were conducted in Guinea and Chad with key informants at the national and sub-national government levels, civil society, and development partners. A review of relevant policy documents and reports was added to data collection to construct a full picture of the policy dialogue process. Context-mechanism-outcome configurations were used as the realist framework to guide the analysis on how participants' understanding of what policy dialogue was and the way the policy dialogue process unfolded led to improved harmonisation. Improved harmonisation as a result of policy dialogue was perceived to be stronger in Guinea than in Chad. While in both countries the participants held a shared view of what policy dialogue was and what it could achieve, and both policy dialogue processes were considered to be well implemented (i.e., well-facilitated, evidence-based, participatory, and consisted of recurring meetings and activities), certain contextual factors in Chad tempered the view of harmonisation as having improved. These were the pre-existence of dialogic policy processes that had exposed the actors to the potential that policy dialogue could have; a focus on elaborating provincial level strategies, which gave the sense that the process was more bottom-up; and the perception that there were acute resource constraints, which conditioned partners' interactions. Policy dialogue improves harmonisation in terms of fostering information exchange amongst partners; however, it does not appear to influence the operational procedures of the actors. This has implications for aid effectiveness.

[Healthcare: a growing role in international politics].

PubMed

Dixneuf, M; Rey, J L

2004-01-01

Since the end of the cold war the tone of international relations has clearly changed. Whereas relations were once defined strictly in terms of more or less armed confrontation, economic and social issues now play a growing role. Healthcare policies in Africa have long been influenced by the policies of countries sponsoring bilateral and even multilateral foreign aid programs. However the last ten years have witnessed an increasing interaction between international policy and healthcare policy. The two main reasons for this trend involve 1) access to drug treatment and the WTO and 2) the extension and impact of the AIDS epidemic. The problem of access to drug treatment for poor populations (fundamental right) has led to the emergence of an increasingly strong and effective civil society. Because of its social and economic effects as well as its geopolitical and security implications, AIDS has become a major factor in international relations. With regard to both these issues the place and role of the USA is demonstrative of the interaction between healthcare and international relations.

Access to Orphan Drugs: A Comprehensive Review of Legislations, Regulations and Policies in 35 Countries.

PubMed

Gammie, Todd; Lu, Christine Y; Babar, Zaheer Ud-Din

2015-01-01

To review existing regulations and policies utilised by countries to enable patient access to orphan drugs. A review of the literature (1998 to 2014) was performed to identify relevant, peer-reviewed articles. Using content analysis, we synthesised regulations and policies for access to orphan drugs by type and by country. Fifty seven articles and 35 countries were included in this review. Six broad categories of regulation and policy instruments were identified: national orphan drug policies, orphan drug designation, marketing authorization, incentives, marketing exclusivity, and pricing and reimbursement. The availability of orphan drugs depends on individual country's legislation and regulations including national orphan drug policies, orphan drug designation, marketing authorization, marketing exclusivity and incentives such as tax credits to ensure research, development and marketing. The majority of countries (27/35) had in place orphan drug legislation. Access to orphan drugs depends on individual country's pricing and reimbursement policies, which varied widely between countries. High prices and insufficient evidence often limit orphan drugs from meeting the traditional health technology assessment criteria, especially cost-effectiveness, which may influence access. Overall many countries have implemented a combination of legislations, regulations and policies for orphan drugs in the last two decades. While these may enable the availability and access to orphan drugs, there are critical differences between countries in terms of range and types of legislations, regulations and policies implemented. Importantly, China and India, two of the largest countries by population size, both lack national legislation for orphan medicines and rare diseases, which could have substantial negative impacts on their patient populations with rare diseases.

Is the Demand for Alcoholic Beverages in Developing Countries Sensitive to Price? Evidence from China

PubMed Central

Tian, Guoqiang; Liu, Feng

2011-01-01

Economic literature in developed countries suggests that demand for alcoholic beverages is sensitive to price, with an estimated price elasticity ranging from −0.38 for beer and −0.7 for liquor. However, few studies have been conducted in developing countries. We employ a large individual-level dataset in China to estimate the effects of price on alcohol demand. Using the data from China Health and Nutrition Survey for the years 1993, 1997, 2000, 2004 and 2006, we estimate two-part models of alcohol demand. Results show the price elasticity is virtually zero for beer and only −0.12 for liquor, which is far smaller than those derived from developed countries. Separate regressions by gender reveals the results are mainly driven by men. The central implication of this study is, while alcohol tax increases can raise government revenue, it alone is not an effective policy to reduce alcohol related problems in China. PMID:21776220

How Choice Changes the Education System: A Michigan Case Study

NASA Astrophysics Data System (ADS)

Plank, David; Sykes, Gary

1999-11-01

In countries around the world policy makers propose that parents should exercise more control over the choice of schools that their children attend. This paper considers the ways in which the introduction of new opportunities for school choice changes the education system. It argues that choice affects the education system as a whole by introducing new actors into the system, by changing the terms of relationships among existing actors, and by creating new pressures within the system that require new responses. The nature, magnitude, and consequences of these effects cannot be predicted in advance, as they depend on a number of factors including the social and economic context. The empirical basis for this paper derives from a case study of the implementation of choice policies in the state of Michigan in the US, but the conceptual issues raised have important implications for the study of school choice wherever such policies are adopted.

Health impact assessment: assessing opportunities and barriers to intersectoral health improvement in an expanded European Union

PubMed Central

Lock, K.; McKee, M.

2005-01-01

On 1 May 2004 the European Union (EU) underwent unprecedented enlargement, from 15 to 25 countries, increasing its population by 20% to over 450 million. Although EU law has limited specific competence in the area of health, its influence on other policy sectors such as agriculture, trade, and employment has wide ranging implications for health. Yet with the exception of provisions on communicable disease control and food safety, public health considerations have played little part in negotiations on EU accession. This paper argues for an intersectoral public health approach in the expanded EU. It reviews the legal basis for assessing the health impacts of policy in the EU and, using health impact assessment as a case study, it examines how well the new member states may be prepared to tackle intersectoral public health action within the constraints imposed by EU policy. PMID:15831682

"Our Only Child Has Died"-A Study of Bereaved Older Chinese Parents.

PubMed

Zheng, Yongqiang; Lawson, Thomas R; Anderson Head, Barbara

2017-03-01

Long and complicated grief is a relevant factor contributing to the deterioration of the older adults' later life quality. In China, the unintentional consequence of the one-child policy has emerged. There, the group of older adults who lost their only child is called shiduers. The current study compared 42 older adults who lost their only child to 33 older adults who have a child, in term of their physical and mental health, and social support. The results confirmed the general deteriorating trend in those aspects of the bereaved Chinese parents' life after their only child's death. The results also revealed the impairments on the shiduers' physical, mental, and social aspects were significant, compared to the clinical diagnosis cutoff points used in Western countries. Unique policy and cultural characteristics are the main factors contributing to the severe impairment of shiduers. Results have implications for policy advocacy and practice intervention in specific cultural environments.

The implications of UPE for teacher education

NASA Astrophysics Data System (ADS)

Thompson, A. R.; Greenland, J. J.

1983-06-01

The huge and sudden increase in the demand for qualified teachers which UPE has occasioned is obliging many countries to develop alternatives to conventional initial training, notably `distance' programmes and the use of headteachers as trainers of their staff. Universal primary, but not secondary, education also implies changing the content of the training curriculum. All these innovations should not be viewed as threatening constraints but as opportunities for progress towards a policy of lifelong professional development. Features of such a policy would include a review of the respective contributions of initial, induction and inservice training, school-based and school-focussed alternatives to `the course', a concern with the cost-effectiveness of different strategies, and the active involvement of teachers in their own training.

A half-baked solution: drivers of water crises in Mexico

NASA Astrophysics Data System (ADS)

Godinez Madrigal, Jonatan; van der Zaag, Pieter; van Cauwenbergh, Nora

2018-02-01

Mexico is considered a regional economic and political powerhouse because of the size of its economy, and a large population in constant growth. However, this same growth accompanied by management and governance failures are causing several water crises across the country. The paper aims at identifying and analyzing the drivers of water crises. Water authorities seem to focus solely on large infrastructural schemes to counter the looming water crises, but fail to structure a set of policies for the improvement of management and governance institutions. The paper concludes with the implications of a business-as-usual policy based on infrastructure for solving water problems, which include a non-compliance to the human right to water and sanitation, ecosystem collapses and water conflicts.

Children's Secondhand Smoke Exposure in Private Homes and Cars: An Ethical Analysis

PubMed Central

Jarvie, Jill A.

2008-01-01

Secondhand smoke (SHS) exposure is a known cause of disease among nonsmokers, contributing to lung cancer, heart disease, and sudden infant death syndrome, as well as other diseases. In response to the growing body of scientific literature linking SHS with serious diseases, many countries, states, and cities have established policies mandating smoke-free public spaces. Yet thousands of children remain unprotected from exposure to SHS in private homes and cars. New initiatives targeting SHS in these spaces have raised ethical questions about imposing constraints on private behavior. We reviewed legislation and court cases related to such initiatives and used a principlist approach to analyze the ethical implications of policies banning smoking in private cars and homes in which children are present. PMID:18923115

Globalisation and Governance: Educational Policy Instruments and Regulatory Arrangements

NASA Astrophysics Data System (ADS)

Mok, Ka-Ho

2005-07-01

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

Examining gender equity in health policies in a low- (Peru), middle- (Colombia), and high- (Canada) income country in the Americas.

PubMed

Stewart, Donna E; Dorado, Linda M; Diaz-Granados, Natalia; Rondon, Marta; Saavedra, Javier; Posada-Villa, Jose; Torres, Yolanda

2009-12-01

Gender inequities in health prevail in most countries despite ongoing attempts to eliminate them. Assessment of gender-sensitive health policies can be used to identify country specific progress as well as gaps and issues that need to be addressed to meet health equity goals. This study selected and measured the existence of gender-sensitive health policies in a low- (Peru), middle- (Colombia), and high (Canada)-income country in the Americas. Investigators selected 10 of 20 gender-sensitive health policy indicators and found eight to be feasible to measure in all three countries, although the wording and scope varied. The results from this study inform policy makers and program planners who aim to develop, improve, implement, and monitor national gender-sensitive health policies. Future studies should assess the implementation of policy indicators within countries and assess their performance in increasing gender equity.

The role of women in food provision and food choice decision-making in Singapore: a case study.

PubMed

Wang, May C; Naidoo, Nasheen; Ferzacca, Steve; Reddy, Geetha; Van Dam, Rob M

2014-01-01

As countries develop economically and increasing numbers of women enter the workforce, children are partly being cared for by someone other than their mother. Little is known about the impact of this shift in child-care provider on children's nutrition. This study presents findings from a case study of Singapore, a small country that has experienced phenomenal economic growth. Focus groups were conducted with 130 women of varying educational levels and ethnicities to learn about food decisions in their families. The findings showed that Singaporean working women cook infrequently, families eat out frequently, and children exert considerable influence on food choices. Implications for work-family policies and child health are discussed.

The Role of Women in Food Provision and Food Choice Decision-Making in Singapore: A Case Study

PubMed Central

WANG, MAY C.; NAIDOO, NASHEEN; FERZACCA, STEVE; REDDY, GEETHA; VAN DAM, ROB M.

2015-01-01

As countries develop economically and increasing numbers of women enter the workforce, children are partly being cared for by someone other than their mother. Little is known about the impact of this shift in child-care provider on children’s nutrition. This study presents findings from a case study of Singapore, a small country that has experienced phenomenal economic growth. Focus groups were conducted with 130 women of varying educational levels and ethnicities to learn about food decisions in their families. The findings showed that Singaporean working women cook infrequently, families eat out frequently, and children exert considerable influence on food choices. Implications for work–family policies and child health are discussed. PMID:25357270

Same-sex marriage: a new social phenomenon.

PubMed

Chamie, Joseph; Mirkin, Barry

2011-01-01

Same-sex marriage (SSM) is a new social phenomenon. In modern times SSM did not exist until the 21st century when an increasing number of countries began permitting same-sex couples to marry legally. This study presents statistical and related evidence concerning SSM worldwide, with special attention to the United States, where SSM has evolved into a major political and legal issue. In addition to examining data on levels and trends, differentials between men and women are investigated. The study also considers common arguments for and against SSM and likely changes in laws and policies that may occur. Although same-sex marriage now exists in a small number of countries and US states, its consequences and implications are being felt far beyond the borders of those countries and areas. In coming years same-sex marriage will remain a controversial and salient part of the legal, political, and cultural landscape, locally, nationally, and internationally.

Policies and Initiatives: Reforming Teacher Education in Nigeria

ERIC Educational Resources Information Center

Amadi, Martha Nkechinyere

2012-01-01

Much discussion surrounding educational policy currently is international in character. Governments, policy makers, stakeholders and many international organizations of both developed and developing countries have become concerned with how policies, practices, and outcomes in one country can be compared with those in other countries. Comparative…

Responsive Feeding: Implications for Policy and Program Implementation12

PubMed Central

Engle, Patrice L.; Pelto, Gretel H.

2011-01-01

In this article, we examine responsive feeding as a nutrition intervention, with an emphasis on the development and incorporation of responsive feeding into policies and programs over the last 2 decades and recommendations for increasing the effectiveness of responsive feeding interventions. A review of policy documents from international agencies and high-income countries reveals that responsive feeding has been incorporated into nutrition policies. Official guidelines from international agencies, nongovernmental organizations, and professional organizations often include best practice recommendations for responsive feeding. Four potential explanations are offered for the rapid development of policies related to responsive feeding that have occurred despite the relatively recent recognition that responsive feeding plays a critical role in child nutrition and growth and the paucity of effectiveness trials to determine strategies to promote responsive feeding. Looking to the future, 3 issues related to program implementation are highlighted: 1) improving intervention specificity relative to responsive feeding; 2) developing protocols that facilitate efficient adaptation of generic guidelines to national contexts and local conditions; and 3) development of program support materials, including training, monitoring, and operational evaluation. PMID:21270361

European Union research in support of environment and health: Building scientific evidence base for policy.

PubMed

Karjalainen, Tuomo; Hoeveler, Arnd; Draghia-Akli, Ruxandra

2017-06-01

Opinion polls show that the European Union citizens are increasingly concerned about the impact of environmental factors on their health. In order to respond and provide solid scientific evidence for the numerous policies related to the protection of human health and the environment managed at the Union level, the European Union made a substantial investment in research and innovation in the past two decades through its Framework Programmes for Research and Technological Development, including the current programme, Horizon 2020, which started in 2014. This policy review paper analysed the portfolio of forty collaborative projects relevant to environment and health, which received a total amount of around 228 million euros from the EU. It gives details on their contents and general scientific trends observed, the profiles of the participating countries and institutions, and the potential policy implications of the results obtained. The increasing knowledge base is needed to make informed policy decisions in Europe and beyond, and should be useful to many stakeholders including the scientific community and regulatory authorities. Copyright © 2017. Published by Elsevier Ltd.

Uneven dietary development: linking the policies and processes of globalization with the nutrition transition, obesity and diet-related chronic diseases

PubMed Central

Hawkes, Corinna

2006-01-01

In a "nutrition transition", the consumption of foods high in fats and sweeteners is increasing throughout the developing world. The transition, implicated in the rapid rise of obesity and diet-related chronic diseases worldwide, is rooted in the processes of globalization. Globalization affects the nature of agri-food systems, thereby altering the quantity, type, cost and desirability of foods available for consumption. Understanding the links between globalization and the nutrition transition is therefore necessary to help policy makers develop policies, including food policies, for addressing the global burden of chronic disease. While the subject has been much discussed, tracing the specific pathways between globalization and dietary change remains a challenge. To help address this challenge, this paper explores how one of the central mechanisms of globalization, the integration of the global marketplace, is affecting the specific diet patterns. Focusing on middle-income countries, it highlights the importance of three major processes of market integration: (I) production and trade of agricultural goods; (II) foreign direct investment in food processing and retailing; and (III) global food advertising and promotion. The paper reveals how specific policies implemented to advance the globalization agenda account in part for some recent trends in the global diet. Agricultural production and trade policies have enabled more vegetable oil consumption; policies on foreign direct investment have facilitated higher consumption of highly-processed foods, as has global food marketing. These dietary outcomes also reflect the socioeconomic and cultural context in which these policies are operating. An important finding is that the dynamic, competitive forces unleashed as a result of global market integration facilitates not only convergence in consumption habits (as is commonly assumed in the "Coca-Colonization" hypothesis), but adaptation to products targeted at different niche markets. This convergence-divergence duality raises the policy concern that globalization will exacerbate uneven dietary development between rich and poor. As high-income groups in developing countries accrue the benefits of a more dynamic marketplace, lower-income groups may well experience convergence towards poor quality obseogenic diets, as observed in western countries. Global economic polices concerning agriculture, trade, investment and marketing affect what the world eats. They are therefore also global food and health policies. Health policy makers should pay greater attention to these policies in order to address some of the structural causes of obesity and diet-related chronic diseases worldwide, especially among the groups of low socioeconomic status. PMID:16569239

Family policies in OECD countries: a comparative analysis.

PubMed

Thévenon, Olivier

2011-01-01

This article discusses the diversity of family policy models in 28 OECD countries in terms of the balance between their different objectives and the mix of instruments adopted to implement the policies. Cross-country policy differences are investigated by applying a principal component analysis to comprehensive country-level data from the OECD Family database covering variables such as parental leave conditions, childcare service provision, and financial support to families. The results find persistent differences in the family policy patterns embedded in different contexts of work-family "outcomes." Country classifications of family policy packages only partially corroborate categorizations in earlier studies, owing to considerable within-group heterogeneity and the presence of group outliers. The Nordic countries outdistance the others with comprehensive support to working parents with very young children. Anglo-Saxon countries provide much less support for working parents with very young children, and financial support is targeted on low-income and large families and focuses on preschool and early elementary education. Continental and Eastern European countries form a more heterogeneous group, while the support received by families in Southern Europe and in Asian countries is much lower in all its dimensions.

High Rates of Mycobacterium tuberculosis among Socially Marginalized Immigrants in Low-Incidence Area, 1991–2010, Italy

PubMed Central

Mercadante, Silvio; Pareek, Manish; Lalvani, Ajit; Bugiani, Massimiliano

2013-01-01

Migration from low- and middle-income countries to high-income countries increasingly determines the severity of tuberculosis (TB) cases in the adopted country. Socially marginalized groups, about whom little is known, may account for a reservoir of TB among the immigrant populations. We investigated the rates of and risk factors for Mycobacterium tuberculosis transmission, infection, and disease in a cohort of 27,358 socially marginalized immigrants who were systematically screened (1991–2010) in an area of Italy with low TB incidence. Overall TB and latent TB infection prevalence and annual tuberculin skin testing conversion rates (i.e., incidence of new infection) were 2.7%, 34.6%, and 1.7%, respectively. Prevalence of both TB and latent TB infection and incidence of infection increased as a function of the estimated TB incidence in the immigrants’ countries of origin. Annual infection incidence decreased with time elapsed since immigration. These findings have implications for control policy and immigrant screening in countries with a low prevalence of TB. PMID:23965807

Diffusion of innovations theory applied to global tobacco control treaty ratification.

PubMed

Valente, Thomas W; Dyal, Stephanie R; Chu, Kar-Hai; Wipfli, Heather; Fujimoto, Kayo

2015-11-01

This study applies diffusion of innovations theory to understand network influences on country ratification of an international health treaty, the Framework Convention for Tobacco Control (FCTC). From 2003 to 2014 approximately 90% of United Nations member countries ratified the FCTC. We hypothesized that communication between tobacco control advocates on GLOBALink, a 7000-member online communication forum in existence from 1992 to 2012, would be associated with the timing of treaty ratification. We further hypothesized dynamic network influences such that external influence decreased over time, internal influence increased over time, and the role of opinion leader countries varied over time. In addition we develop two concepts: Susceptibility and influence that uncover the micro-level dynamics of network influence. Statistical analyses lend support to the influence of co-subscriptions on GLOBALink providing a conduit for inter-country influences on treaty ratification and some support for the dynamic hypotheses. Analyses of susceptibility and infection indicated particularly influential countries. These results have implications for the study of policy diffusion as well as dynamic models of behavior change. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

The process of changing national malaria treatment policy: lessons from country-level studies.

PubMed

Williams, Holly Ann; Durrheim, David; Shretta, Rima

2004-11-01

Widespread resistance of Plasmodium falciparum parasites to commonly used antimalarials, such as chloroquine, has resulted in many endemic countries considering changing their malaria treatment policy. Identifying and understanding the key influences that affect decision-making, and factors that facilitate or undermine policy implementation, is critical for improving the policy process and guiding resource allocation during this process. A historical review of archival documents from Malaŵi and data obtained from in-depth policy studies in four countries (Tanzania, South Africa, Kenya and Peru) that have changed malaria treatment policy provides important lessons about decision-making, the policy cycle and complex policy environment, while specifically identifying strategies successfully employed to facilitate policy-making and implementation. Findings from these country-level studies indicate that the process of malaria drug policy review should be institutionalized in endemic countries and based on systematically collected data. Key stakeholders need to be identified early and engaged in the process, while improved communication is needed on all levels. Although malaria drug policy change is often perceived to be a daunting task, using these and other proven strategies should assist endemic countries to tackle this challenge in a systematic fashion that ensures the development and implementation of the rational malaria drug policy.

Costing the scaling-up of human resources for health: lessons from Mozambique and Guinea Bissau

PubMed Central

2010-01-01

Introduction In the context of the current human resources for health (HRH) crisis, the need for comprehensive Human Resources Development Plans (HRDP) is acute, especially in resource-scarce sub-Saharan African countries. However, the financial implications of such plans rarely receive due consideration, despite the availability of much advice and examples in the literature on how to conduct HRDP costing. Global initiatives have also been launched recently to standardise costing methodologies and respective tools. Methods This paper reports on two separate experiences of HRDP costing in Mozambique and Guinea Bissau, with the objective to provide an insight into the practice of costing exercises in information-poor settings, as well as to contribute to the existing debate on HRH costing methodologies. The study adopts a case-study approach to analyse the methodologies developed in the two countries, their contexts, policy processes and actors involved. Results From the analysis of the two cases, it emerged that the costing exercises represented an important driver of the HRDP elaboration, which lent credibility to the process, and provided a financial framework within which HRH policies could be discussed. In both cases, bottom-up and country-specific methods were designed to overcome the countries' lack of cost and financing data, as well as to interpret their financial systems. Such an approach also allowed the costing exercises to feed directly into the national planning and budgeting process. Conclusions The authors conclude that bottom-up and country-specific costing methodologies have the potential to serve adequately the multi-faceted purpose of the exercise. It is recognised that standardised tools and methodologies may help reduce local governments' dependency on foreign expertise to conduct the HRDP costing and facilitate regional and international comparisons. However, adopting pre-defined and insufficiently flexible tools may undermine the credibility of the costing exercise, and reduce the space for policy negotiation opportunities within the HRDP elaboration process. PMID:20579341

Costing the scaling-up of human resources for health: lessons from Mozambique and Guinea Bissau.

PubMed

Tyrrell, Amanda K; Russo, Giuliano; Dussault, Gilles; Ferrinho, Paulo

2010-06-25

In the context of the current human resources for health (HRH) crisis, the need for comprehensive Human Resources Development Plans (HRDP) is acute, especially in resource-scarce sub-Saharan African countries. However, the financial implications of such plans rarely receive due consideration, despite the availability of much advice and examples in the literature on how to conduct HRDP costing. Global initiatives have also been launched recently to standardise costing methodologies and respective tools. This paper reports on two separate experiences of HRDP costing in Mozambique and Guinea Bissau, with the objective to provide an insight into the practice of costing exercises in information-poor settings, as well as to contribute to the existing debate on HRH costing methodologies. The study adopts a case-study approach to analyse the methodologies developed in the two countries, their contexts, policy processes and actors involved. From the analysis of the two cases, it emerged that the costing exercises represented an important driver of the HRDP elaboration, which lent credibility to the process, and provided a financial framework within which HRH policies could be discussed. In both cases, bottom-up and country-specific methods were designed to overcome the countries' lack of cost and financing data, as well as to interpret their financial systems. Such an approach also allowed the costing exercises to feed directly into the national planning and budgeting process. The authors conclude that bottom-up and country-specific costing methodologies have the potential to serve adequately the multi-faceted purpose of the exercise. It is recognised that standardised tools and methodologies may help reduce local governments' dependency on foreign expertise to conduct the HRDP costing and facilitate regional and international comparisons. However, adopting pre-defined and insufficiently flexible tools may undermine the credibility of the costing exercise, and reduce the space for policy negotiation opportunities within the HRDP elaboration process.

[Strategies for reducing risks in smoking: opportunity or threat].

PubMed

Córdoba, Rodrigo; Nerín, Isabel

2009-12-01

The smoking control policies recommended by the World Health Organisation have achieved a slight decrease in smoking prevalence in the developed countries, although associated mortality is still very high. The use of tobacco products other than cigarettes and even medicinal nicotine (known as nicotine replacement therapy (NRT)) has been proposed as a risk reduction strategy. Among the tobacco products with less individual risk than cigarettes would be any type of tobacco without smoke (smokeless) with a low content in nitrosamines and modified cigarettes; both forms included under the PREP (Potentially Reduced Exposure Products) concept. The idea would be to promote these products among those who cannot quit smoking or wish to reduce their risk without giving up nicotine intake. The possible effects of risk reduction strategies, including PREP, on the decreased prevalence and morbidity and mortality are reviewed, and the possible implications that this measure could have in our country are analysed. Tobacco control measures in Spain are recent and still insufficient. Therefore, the current priority in Spain is the development of policies of control that have shown to more than effective. The marketing and advertising of new tobacco products, even with reduced potential risk, seems more a serious threat than an opportunity for the development of smoking control policies.

Temperature impacts on economic growth warrant stringent mitigation policy

NASA Astrophysics Data System (ADS)

Moore, Frances C.; Diaz, Delavane B.

2015-02-01

Integrated assessment models compare the costs of greenhouse gas mitigation with damages from climate change to evaluate the social welfare implications of climate policy proposals and inform optimal emissions reduction trajectories. However, these models have been criticized for lacking a strong empirical basis for their damage functions, which do little to alter assumptions of sustained gross domestic product (GDP) growth, even under extreme temperature scenarios. We implement empirical estimates of temperature effects on GDP growth rates in the DICE model through two pathways, total factor productivity growth and capital depreciation. This damage specification, even under optimistic adaptation assumptions, substantially slows GDP growth in poor regions but has more modest effects in rich countries. Optimal climate policy in this model stabilizes global temperature change below 2 °C by eliminating emissions in the near future and implies a social cost of carbon several times larger than previous estimates. A sensitivity analysis shows that the magnitude of climate change impacts on economic growth, the rate of adaptation, and the dynamic interaction between damages and GDP are three critical uncertainties requiring further research. In particular, optimal mitigation rates are much lower if countries become less sensitive to climate change impacts as they develop, making this a major source of uncertainty and an important subject for future research.

Multilingualism in South Africa with Particular Reference to the Role of African Languages in Education

NASA Astrophysics Data System (ADS)

Desai, Zubeida

2001-07-01

In this paper it is argued that language policy can play a central role in enabling citizens of a country to participate in the political, educational, social and economic life of that country. Or it can deny them that right. In discussions on the role of African languages, there is a tendency to confine the discussion to language in education. I argue that unless we locate the discussion in a broader context, we are not going to make much progress in extending the use of African languages beyond the home domain. The paper therefore consists of three sections. The first section looks broadly at the domains where language has an impact. The second section briefly outlines a process underway in South Africa to develop a framework for a national language policy, whilst the final section looks at the implications of this for education. Here I look at language in Education Policy in Practice. I give examples from a piece of primary research that I have conducted with Xhosa -speaking Grade 4 and Grade 7 learners who have been given pictures to describe first in Xhosa and then in English. The examples show the rich vocabulary children have when they express themselves in Xhosa and the poor vocabulary they have when they express themselves in English.

A systematic review of medical practice variation in OECD countries.

PubMed

Corallo, Ashley N; Croxford, Ruth; Goodman, David C; Bryan, Elisabeth L; Srivastava, Divya; Stukel, Therese A

2014-01-01

Major variations in medical practice have been documented internationally. Variations raise questions about the quality, equity, and efficiency of resource allocation and use, and have important implications for health care and health policy. To perform a systematic review of the peer-reviewed literature on medical practice variations in OECD countries. We searched MEDLINE to find publications on medical practice variations in OECD countries published between 2000 and 2011. We present an overview of the characteristics of published studies as well as the magnitude of variations for select high impact conditions. A total of 836 studies were included. Consistent with the gray literature, there were large variations across regions, hospitals and physician practices for almost every condition and procedure studied. Many studies focused on high-impact conditions, but very few looked at the causes or outcomes of medical practice variations. While there were an overwhelming number of publications on medical practice variations the coverage was broad and not often based on a theoretical construct. Future studies should focus on conditions and procedures that are clinically important, policy relevant, resource intensive, and have high levels of public awareness. Further study of the causes and consequences of variations is important. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Putting two and two together? Early childhood education, mothers’ employment and care service expansion in Chile and Mexico.

PubMed

Staab, Silke; Gerhard, Roberto

2011-01-01

In recent years, several middle-income countries, including Chile, Mexico and Uruguay, have increased the availability of early childhood education and care (ECEC) services. These developments have received little scholarly attention so far, resulting in the (surely unintended) impression that Latin American social policy is tied to a familialist track, when in reality national and regional trends are more varied and complex. This article looks at recent efforts to expand ECEC services in Chile and Mexico. In spite of similar concerns over low female labour force participation and child welfare, the approaches of the two countries to service expansion have differed significantly. While the Mexican programme aims to kick-start and subsidize home- and community-based care provision, with a training component for childminders, the Chilean programme emphasizes the expansion of professional ECEC services provided in public institutions. By comparing the two programmes, this article shows that differences in policy design have important implications in terms of the opportunities the programmes are able to create for women and children from low-income families, and in terms of the programmes’ impacts on gender and class inequalities. It also ventures some hypotheses about why the two countries may have chosen such different routes.

A review of national health policies and professional guidelines on maternal obesity and weight gain in pregnancy.

PubMed

Schumann, N L; Brinsden, H; Lobstein, T

2014-08-01

Maternal obesity creates an additional demand for health-care services, as the routine obstetric care pathway requires alterations to ensure the most optimal care for obese women of childbearing age. This review examines the extent to which relevant national health documents reflect and respond to the health implications of maternal obesity and excessive gestational weight gain. A targeted search of peer-reviewed publications and grey literature was conducted for each country to identify national health documents, which were subsequently content analyzed according to an adapted framework. A total of 37 documents were identified, including one policy, 10 strategies and 26 guidelines, published within the last 10 years. Out of the 31 countries investigated, only 13 countries address maternal obesity while none address excessive gestational weight gain. We found inconsistencies and gaps in the recommendations to health-care service providers for the management of maternal obesity and weight gain in pregnancy. The findings show that only limited guidance on maternal obesity and gestational weight gain exists. The authors recommend that international, evidence-based guidelines on the management of maternal obesity and excessive gestational weight gain should be developed to reduce the associated health-care and economic costs. © 2014 The Authors. Clinical Obesity © 2014 World Obesity.

Comparison of legislation, regulations and national health strategies for palliative care in seven European countries (Results from the Europall Research Group): a descriptive study.

PubMed

Van Beek, Karen; Woitha, Kathrin; Ahmed, Nisar; Menten, Johan; Jaspers, Birgit; Engels, Yvonne; Ahmedzai, Sam H; Vissers, Kris; Hasselaar, Jeroen

2013-07-17

According to EU policy, anyone in need of palliative care should be able to have access to it. It is therefore important to investigate which palliative care topics are subject to legislation and regulations in Europe and how these are implemented in (national) health care plans. This paper aims to deliver a structured overview of the legislation, existing regulations and the different health care policies regarding palliative care in seven European countries. In 2008 an inventory of the organisation of palliative care was developed by the researchers of the Europall project. Included were two open questions about legislation, regulations, and health policy in palliative care. This questionnaire was completed using palliative care experts selected from Belgium, England, France, Germany, the Netherlands, Poland and Spain. Additionally, (grey) literature on palliative care health policy and regulations from the participating countries was collected to complete the inventory. Comparative analysis of country specific information was performed afterwards. In all countries palliative care regulations and policies existed (either in laws, royal decrees, or national policies). An explicit right to palliative care was mentioned in the Belgium, French and German law. In addition, access to palliative care was mentioned by all countries, varying from explicit regulations to policy intentions in national plans. Also, all countries had a national policy on palliative care, although sometimes mainly related to national cancer plans. Differences existed in policy regarding palliative care leave, advance directives, national funding, palliative care training, research, opioids and the role of volunteers. Although all included European countries have policies on palliative care, countries largely differ in the presence of legislation and regulations on palliative care as well as the included topics. European healthcare policy recommendations should support palliative care access across Europe.

National policies on the management of latent tuberculosis infection: review of 98 countries

PubMed Central

Jagger, Ann; Reiter-karam, Silke; Getahun, Haileyesus

2018-01-01

Abstract Objective To review policies on management of latent tuberculosis infection in countries with low and high burdens of tuberculosis. Methods We divided countries reporting data to the World Health Organization (WHO) Global Tuberculosis Programme into low and high tuberculosis burden, based on WHO criteria. We identified national policy documents on management of latent tuberculosis through online searches, government websites, WHO country offices and personal communication with programme managers. We made a descriptive analysis with a focus on policy gaps and deviations from WHO policy recommendations. Findings We obtained documents from 68 of 113 low-burden countries and 30 of 35 countries with the highest burdens of tuberculosis or human immunodeficiency virus (HIV)-associated tuberculosis. Screening and treatment of latent tuberculosis infection in people living with HIV was recommended in guidelines of 29 (96.7%) high-burden and 54 (79.7%) low-burden countries. Screening for children aged < 5 years with household tuberculosis contact was the policy of 25 (83.3%) high- and 28 (41.2%) low-burden countries. In most high-burden countries the recommendation was symptom screening alone before treatment, whereas in all low-burden countries it was testing before treatment. Some low-burden countries’ policies did not comply with WHO recommendations: nine (13.2%) recommended tuberculosis preventive treatment for travellers to high-burden countries and 10 (14.7%) for patients undergoing abdominal surgery. Conclusion Lack of solid evidence on certain aspects of management of latent tuberculosis infection results in national policies which vary considerably. This highlights a need to advance research and develop clear, implementable and evidence-based WHO policies. PMID:29531416

Food Policy Approaches to Obesity Prevention: An International Perspective

PubMed Central

Zhang, Qi; Liu, Shiyong; Liu, Ruicui; Xue, Hong

2015-01-01

This paper provides a comprehensive overview of the recent obesity prevention–related food policies initiated in countries worldwide. We searched and reviewed relevant research papers and government documents, focusing on those related to dietary guidelines, food labeling, regulation of food marketing, and policies affecting food prices. We also commented on the effects and challenges of some of the related policy options. There are large variations regarding what, when, and how policies have been implemented across countries. Clearly, developed countries are leading the effort, and developing countries are starting to develop some related policies. The encouraging message is that many countries have been adopting policies that might help prevent obesity and that the support for more related initiatives is strong and continues to grow. Communicating information about these practices will help researchers, public health professionals, and policy makers around the world to take action to fight the growing epidemic of obesity and other nutrition-related diseases. PMID:25705571

The ethical and policy implications of research on income inequality and child well-being.

PubMed

Pickett, Kate E; Wilkinson, Richard G

2015-03-01

Child well-being is important for lifelong health and well-being. Although there is a robust evidence base linking social determinants of health (eg, relative poverty and income inequality) to child well-being, social and public health policy tends to focus on interventions to mitigate their effects, rather than remove the root causes. The goal of this study was to examine associations between child well-being and income inequality. We compared reported rates of childhood well-being in the 2007 and 2013 UNICEF reports on child well-being in wealthy countries. Twenty indicators of child well-being (excluding child poverty) were defined consistently in both the 2007 and 2013 reports. These variables were used to create an indicator of change in child well-being over the approximate decade 2000 to 2010. For our analyses of income inequality, we used the Organization for Economic Cooperation and Development Gini coefficient of income inequality for 2009 and change between 2000 and 2009, respectively. The overall index of child well-being in 2013 was closely and negatively correlated with income inequality (r = -0.60, P = .004) but not with average income (r = -0.3460, P = .12). Adjustment for income inequality, children in relative poverty, and the child poverty gap did not change the lack of association between average income and child well-being in 2013 in wealthy countries. Between 2000 and 2010, child well-being scores improved most in Italy, Norway, Portugal, the United Kingdom, and Germany. The biggest declines were seen in Sweden, Canada, Japan, Switzerland, and France. Countries that experienced the largest increases in income inequality had significantly greater declines in child well-being (r = -0.51, P = .02). Children born into socioeconomically disadvantaged families suffer worse child well-being and its lifelong implications, in all societies, worldwide. Our analyses show, however, that some wealthy societies are able to mitigate these inequalities; these societies have better child well-being, on average. This outcome has less to do with specific welfare policies or targeted interventions for poor children than to a societal commitment to greater equality. Copyright © 2015 by the American Academy of Pediatrics.

Some issues in Middle Eastern international migration.

PubMed

Sirageldin, I

1983-01-01

2 controversial issues related to the consequences of Middle Eastern international migration were examined: its effect on the development policies of the labor importing countries with a special reference to the case of Kuwait; and its effect on the growth potential of the labor exporting countries with special reference to recent development in Egypt's agricultural reproductivity. A preliminary note comments on the analytical nature of international labor migration in the Middle East and on the public view of emigrants as export commodities. The basic parameters of a desired population parity are interrelated. It is possible to influence the labor ratio (R2) as well as the nonKuwait crude labor participation rate (R3) through a migration policy. Thus, given a policy objective of some desired balance stated in trms of 1 or more of the identified parameters, it is possible to analyze the consequences of alternative migration strategies. It is important to consider the role of relative productivity (R6). An attempt to change R6 has implications for both the design of a migration policy and a national policy of human capital formation. Other factors may not be immediately related to a migration policy. The question then is whether these ratios are sensitive to policy intervention. In a simulation exercise it was assumed that the Kuwaiti crude labor force participation rate (R4) will increase by 13% during a period of 10 years. R4 increases if relatively more people work. Women are 1 segment of the labor force that is not adequately represented, partly because of traditions, lack of skills, and the presence of high fertility. None of these can change in the short run without an active policy of social reform. Yet, the assumption seems to be in the right direction. A policy that attempts to reduce R4 through increasing fertility in Kuwait is clearly against the tide. In sum, the labor importing countries faced with recent unfavorable demographic realities will actively develop population policies that are consistent with their socioeconomic plans. The flow of labor immigration is a tool that can be manipulated on relatively short notice, and the economic cost of such a policy is relatively simple to estimate. In examining labor exporting countries, the focus is narrowed to 1 sector (agriculture) and with 1 issue their emigration behavior are being blamed simultaneously for the decline of the agricultural sector. Some hypotheses are offered. Clearly, emigration in the case of Egyptian agriculture must be evaluated in terms of the gross benefit of remittances and in terms of their effect on local production in the short-and longterm. It seems that population and development policies must take care of the effect of emigration on agricultural productivity through 2 channels: the effect of remittances on expenditure and labor market behavior; and its effect on fertility behavior.

The Life Story Experience of "Migrant Dentists" in Australia: Potential Implications for Health Workforce Governance and International Cooperation

PubMed Central

Balasubramanian, Madhan; Spencer, A. John; Short, Stephanie D.; Watkins, Keith; Chrisopoulos, Sergio; Brennan, David S.

2017-01-01

Background: The migration of dentists is a major policy challenge facing both developing and developed countries. Dentists from over 120 countries migrate to Australia, and a large proportion are from developing countries. The aim of the study was to assess the life story experience (LSE) of migrant dentists in Australia, in order to address key policy challenges facing dentist migration. Methods: A national survey of all migrant dentists resident in Australia was conducted in 2013. Migrant experiences were assessed through a suite of LSE scales, developed through a qualitative-quantitative study. Respondents rated experiences using a five-point Likert scale. Results: A total of 1022 migrant dentists responded to the survey (response rate = 54.5%). LSE1 (health system and general lifestyle concerns in home country), LSE2 (appreciation towards Australian way of life) and LSE3 (settlement concerns in Australia) scales varied by migrant dentist groups, sex, and years since arrival to Australia (chi-square, P < .05). In a logistic regression model, migrants mainly from developing countries (ie, the examination pathway group) faced greater health system and general lifestyle concerns in their home countries (9.32; 3.51-24.72) and greater settlement challenges in Australia (5.39; 3.51-8.28), compared to migrants from well-developed countries, who obtained direct recognition of qualifications. Migrants also are more appreciative towards the Australian way of life if they had lived at least ten years in Australia (1.97; 1.27-3.05), compared to migrants who have lived for less than ten years. Conclusion: Migrant dentists, mainly from developing countries, face challenges both in their home countries and in Australia. Our study offers evidence for multi-level health workforce governance and calls for greater consensus towards an international agenda to address dentist migration. Better integration of dentist migration with the mainstream health workforce governance is a viable and opportunistic way forward. PMID:28812824

Evaluating the effectiveness of joint emission control policies on the reduction of ambient VOCs: Implications from observation during the 2014 APEC summit in suburban Beijing

NASA Astrophysics Data System (ADS)

Li, Kun; Li, Junling; Wang, Weigang; Tong, Shengrui; Liggio, John; Ge, Maofa

2017-09-01

Ambient volatile organic compounds (VOCs) at a suburban Beijing site were on-line detected using proton transfer reaction-mass spectrometry (PTR-MS) during autumn of 2014, near the location of the Asia-Pacific Economic Cooperation (APEC) summit. During the APEC summit, the Chinese government enacted strict emission control policies. It was found that VOC concentrations only slightly decreased during the first emission control period (EC I), when control policies were performed in Beijing and 5 cities along the Tai-hang Mountains. However, most of the VOCs (10 out of 12 non-biogenic species) significantly decreased (more than 40%) during the second emission control period (EC II), when control policies were carried out in 16 cities including Beijing, Tianjin, 8 cities of Hebei province and 6 cities of Shandong province. Also the ratio of toluene and benzene decreased during EC II, likely because the emission control policies changed the proportions of different anthropogenic sources. Using the positive matrix factorization (PMF) source apportionment method, five factors are analyzed: (1) vehicle + fuel, (2) solvent, (3) biomass burning, (4) secondary, and (5) background + long-lived. Among them, vehicle + fuel, solvent and biomass burning contribute most of the VOCs concentrations (60%-80%) during the polluted periods and are affected most by emission control policies. During EC II, the reductions of vehicle + fuel, solvent, biomass burning and secondary species were all no less than 50%. Overall, when emission control policies were carried out in many North China Plain (NCP) cities (i.e. EC II), the VOC concentrations of suburban Beijing markedly decreased. This indicates the cross-regional joint-control policies have a large influence on reductions of organic gas species. The findings of this study have vital implications for helping formulate effective emission control policies in China and other countries.

Examining land use change and cooking fuel-use in Uganda: implications and potential win-win scenarios for policy and carbon financing

NASA Astrophysics Data System (ADS)

Brunner, Nicole; Semmens, Darius; Hawbaker, Todd

2016-04-01

Uganda is one of the world's most biodiverse countries, yet also one of the poorest. Human dependence on natural resources, especially from forests, is most pronounced in developing countries such as Uganda, where many people live in poverty and rely on fuel wood for cooking. These demands often compete with conservation efforts aimed at protecting forests and biodiversity. An understanding of trends in forest condition and local community use of forests is necessary to explore the implications of changing environmental conditions on the sustainability of Uganda's forests and forest-related socioeconomic activities. A human-environment framework is applied to this research by comparing environmental layers derived from remotely sensed imagery with socioeconomic data acquired from household surveys. Statistical modeling was used to explain the relationship between household characteristics (e.g., fuel use) and environmental characteristics (e.g., land cover change) and to quantify the role of spatial arrangement or pattern in understanding human-environment relationships (e.g., access and distance). The findings show that distance from protected forests is related to changes in household fuel type. For example, increases in charcoal as the primary cooking fuel is observed in households a closer distance to protected forests. This change is likely due to access to forest resources. The results of this study could inform policies aimed at protecting forests as well as protecting the interests of people in proximity to protected forests.

Evaluating the effectiveness of impact assessment instruments: Theorising the nature and implications of their political constitution

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cashmore, Matthew, E-mail: m.cashmore@uea.ac.u; Richardson, Tim; Hilding-Ryedvik, Tuija

2010-11-15

The central role of impact assessment instruments globally in policy integration initiatives has been cemented in recent years. Associated with this trend, but also reflecting political emphasis on greater accountability in certain policy sectors and a renewed focus on economic competitiveness in Western countries, demand has increased for evidence that these instruments are effective (however defined). Resurgent interest in evaluation has not, however, been accompanied by the conceptual developments required to redress longstanding theoretical problems associated with such activities. In order to sharpen effectiveness evaluation theory for impact assessment instruments this article critically examines the neglected issue of their politicalmore » constitution. Analytical examples are used to concretely explore the nature and significance of the politicisation of impact assessment. It is argued that raising awareness about the political character of impact assessment instruments, in itself, is a vital step in advancing effectiveness evaluation theory. Broader theoretical lessons on the framing of evaluation research are also drawn from the political analysis. We conclude that, at least within the contemporary research context, learning derived from analysing the meaning and implications of plural interpretations of effectiveness represents the most constructive strategy for advancing impact assessment and policy integration theory.« less

From the Mahanadi Delta to Sendai via South America: Building bridges between research, practice and international policy for disaster resilience assessments

NASA Astrophysics Data System (ADS)

Fanchiotti, Margherita; Torres, Jair

2017-04-01

The concept of disaster resilience has gained momentum in recent decades and major international initiatives, such as the 2030 Agenda for Sustainable Development, the Sendai Framework for Disaster Risk Reduction 2015-2030 and the Paris Agreement, all recognise the importance of fostering community resilience to natural hazards to save lives and reduce losses. Despite significant advances in the policy settings for disaster resilience assessment, the interpretation of the concept itself and its implications for practice and policy remain clouded and more research is needed to gather evidence of what resilience means for governments and communities. This paper aims to bring together the research work the authors have conducted in the field of disaster resilience assessments at their respective institutions (University of Southampton, UK and the UME Graduate School at the Institute for Advanced Studies of Pavia, Italy) with the practical implementation projects and international policy consultations they have been involved in under UNESCO's umbrella. The main findings of a research study conducted as part of the 'Deltas, Vulnerability & Climate Change: Migration & Adaptation' (DECCMA) project to investigate the differential resilience of local communities in the Mahanadi Delta, India using a development approach will be presented. Statistical methods have been employed to identify development hotspots and have been combined with a qualitative analysis of community perceptions of development and the mutual implications of development for disaster resilience to build case studies of community resilience to inform theory, policy and practice. The authors will then discuss the practical implications of this research study for the implementation of UNESCO's 'Enhancing Natural HAzards resilience iN South America' (ENHANS) project, which seeks to train a critical mass of decision-makers, community leaders and experts on disaster risk and resilience assessments in four countries in South America (Ecuador, Chile, Peru and Uruguay), and the policy implications for their work as part of UNESCO's task force for developing UNISDR's New Ten Essentials for Making Cities Resilient, a checklist for building capacities for disaster resilience at the city level which aims to provide local authorities with tools, including scorecards and a handbook for local government leaders, to self-assess urban resilience and stimulate positive change, in line with the Sendai Framework.

Application of household production theory to selected natural-resource problems in less-developed countries

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mercer, D.E.

The objectives are threefold: (1) to perform an analytical survey of household production theory as it relates to natural-resource problems in less-developed countries, (2) to develop a household production model of fuelwood decision making, (3) to derive a theoretical framework for travel-cost demand studies of international nature tourism. The model of household fuelwood decision making provides a rich array of implications and predictions for empirical analysis. For example, it is shown that fuelwood and modern fuels may be either substitutes or complements depending on the interaction of the gross-substitution and income-expansion effects. Therefore, empirical analysis should precede adoption of anymore » inter-fuel substitution policies such as subsidizing kerosene. The fuelwood model also provides a framework for analyzing the conditions and factors determining entry and exit by households into the wood-burning subpopulation, a key for designing optimal household energy policies in the Third World. The international nature tourism travel cost model predicts that the demand for nature tourism is an aggregate of the demand for the individual activities undertaken during the trip.« less

Collective symbolic coping with new technology: Knowledge, images and public discourse.

PubMed

Wagner, Wolfgang; Kronberger, Nicole; Seifert, Franz

2002-09-01

Using data from policy analyses, media analyses and a European-wide survey about public perceptions of biotechnology conducted in 1996 and again in 1999, it is shown how a country's public develops an everyday understanding of a new technology (genetic modification) construed as potentially harmful by the media. To understand the reliance on images and related beliefs, we propose a theory of collective symbolic coping. It identifies four steps: first, the creation of awareness; second, production of divergent images; third, convergence upon a couple of dominant images in the public sphere; fourth, normalization. It is suggested that symbolic coping occurs in countries where a recent increase in policy activity and of media reporting has alerted the public; that this public show a high proportion of beliefs in menacing images; that these beliefs are relatively independent of pre-existing popular science knowledge; and that they are functionally equivalent to scientific knowledge in providing judgmental confidence and reducing self-ascribed ignorance. These propositions are shown to be true in Austria and Greece. Several implications of the theory are discussed, including social representation theory and public understanding of science.

Admission-Group Salary Differentials in the United States: The Significance of Labor Market Institutional Selection of High-Skilled Workers*

PubMed Central

Hao, Lingxin

2015-01-01

In 1990 a temporary-to-permanent pathway was established for highly skilled workers admitted to the United States under nonimmigrant programs. The paper argues that this policy shift has allowed employers to play a crucial role in the immigration of highly skilled workers, thereby creating labor-market institutional selection that gives a salary advantage to highly skilled temporary-admitted workers retained in the United States. Through analyses of the salary differentials among admission-category groups, the paper finds that the salary advantage is based on recruitment from Western countries, adjustment from temporary to permanent status after a second employer screening, working in the information technology sector and the private sector, holding a supervisory position, or having a skill-matched job, all of which are consequences of institutional selection rather than individual self-selection. Our results also reveal a difference between those admitted from abroad and those recruited from graduating foreign students in USA higher educational institutions, which suggests a distinction between overseas hiring and domestic hiring. Policy implications for the United States and other receiving countries are discussed. PMID:26269690

Policy and experiment in mother tongue literacy in Nigeria

NASA Astrophysics Data System (ADS)

Akinnaso, F. Niyi

1993-07-01

The advocacy for initial mother tongue literacy in elementary schools and in adult education has been intensified within the past three decades, reflecting new attitudes to cultural diversity, especially to multilingual and multicultural education. This paper assesses the efforts made in one country, Nigeria, to achieve mother tongue literacy for its citizens, through a comparative analysis of the national policy on mother tongue literacy and the Ife experimental project, whose major purpose was to test the effectiveness of the use of the mother tongue as a medium of instruction throughout the six years of primary education. Although, like the Ife project, many experimental projects on mother tongue literacy in other countries are shown to have succeeded in realizing their objectives, the findings highlight the mediating effects of several non-linguistic variables. The findings indicate that its use as the medium of instruction in schools cannot compensate for the deficiencies in the educational system, particularly poor quality instructional facilities, or the social barriers in the wider society which prevent certain groups of minority children from learning well in school. The implications of the findings are discussed.

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

PubMed Central

2013-01-01

Abstract 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. PMID:23940408

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

PubMed

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.

Trials and Tribulations: The ‘Use’ (and ‘Misuse’) of Evidence in Public Policy

PubMed Central

Deeming, Christopher

2013-01-01

Randomized controlled trials (RCTs) are increasingly playing a central role in shaping policy for development. By comparison, social experimentation has not driven the great transformation of welfare within the developed world. This introduces a range of issues for those interested in the nature of research evidence for making policy. In this article we will seek a greater understanding of why the RCT is increasingly seen as the ‘gold standard’ for policy experiments in low- and middle-income countries (LMICs), but not in the more advanced liberal democracies, and we will explore the implications of this. One objection to the use of RCTs, however can be cost, but implementing policies and programmes without good evidence or a good understanding of their effectiveness is unlikely to be a good use of resources either. Other issues arise. Trials are often complex to run and ethical concerns often arise in social ‘experiments’ with human subjects. However, rolling out untested policies may also be morally objectionable. This article sheds new light on the relationship between evidence and evaluation in public policy in both the global north and developing south. It also tackles emerging issues concerning the ‘use’ and ‘misuse’ of evidence and evaluation within public policy. PMID:23935229

[Social inequalities in adolescent smoking: A cross-national perspective of the role of individual and macro-structural factors].

PubMed

Pförtner, Timo-Kolja; Rathmann, Katharina; Moor, Irene; Kunst, Anton E; Richter, Matthias

2016-02-01

In an EU-funded project, we examined on the basis of international comparative analyses which factors were associated with and contributed to socioeconomic inequalities in adolescent smoking. This paper presents the results obtained and discusses their implications for policy and research. Analyses were based on the "Health Behaviour in School-aged Children (HBSC)" study in 2006 and included more than 50,000 adolescents from 37 countries. The focus was on the association between family affluence and weekly smoking (regularly, at least once a week) among adolescents. Explanatory variables at the individual level refer to psychosocial resources and burdens of school, family, and peers. At the country level, national income, various tobacco control policies, and an index of external differentiation of the educational system were used. The psychosocial factors of school and family explained many of the inequalities in the smoking behavior of adolescents. In an international comparison, socioeconomic inequalities in smoking were stronger in richer countries. Absolute smoking rates were lower and inequalities in smoking smaller for boys in countries with higher tobacco prices. On the other hand, educational systems with higher degrees of external differentiation showed lower inequalities in smoking beahviour by girls, and relatively higher rates of smoking (for boys and girls). Stronger inequalities in smoking behaviour were demonstrated in countries with a greater range of preventative measures for tobacco dependence (for boys) and with higher levels of government spending on tobacco control (for girls). Experiences in richer countries revealed that tobacco control needs to be strengthened for socially disadvantaged adolescents. The reduction of smoking prevalence and socioeconomic inequalities in smoking behavior should be based not only on a strengthening of psychosocial resources in the family and at school, but also on an increase in tobacco prices.

The state of world population and its implications for the US.

PubMed

Fornos, W

1987-07-01

Before the end of the century, annual world population growth is expected to exceed 90 million. Among the consequences of this rapid population growth--most of which will take place in developing countries-- are environmental degradation, urban deterioration, unemployment, hunger, resource depletion, and economic stagnation. Despite this alarming situation, the US Government has reduced appropriations for international population aid from US$290 million in 1985 to $200 million in 1988. In addition, the US has stopped funding the 2 organizations that have been most effective in providing family planning assistance to developing countries: the United Nations Fund for Population Activities and the International Planned Parenthood Federation. The US has adapted a policy that asserts that population is a neutral factor in development and promotes capitalism as a means of lowering fertility. However, experience in developing countries such as Thailand, China, and the Philippines that have undergone dramatic fertility declines attests that family planning efforts can result in economic growth. Over 80% of developing countries have established population control policies yet they will require substantial financial and technical aid from industrialized nations. It is ironic that the US has turned away from a commitment to helping poor countries to voluntarily reduce their high fertility rates at a time when such countries have accepted the necessity of such a goal. It is further ironic that the US expresses concern about the threat of revolution in areas such as Central America, yet fails to comprehend the social unrest and threats to global stability that will emerge as a result of continued population growth. At least a doubling--preferably a tripling--of US population assistance is needed.

Policy Guidelines for Effective Inclusion and Reintegration of People with Chronic Diseases in the Workplace: National and European Perspectives.

PubMed

Vlachou, Anastasia; Stavroussi, Panayiota; Roka, Olga; Vasilou, Evdokia; Papadimitriou, Dimitra; Scaratti, Chiara; Kadyrbaeva, Asel; Fheodoroff, Klemens; Brecelj, Valentina; Svestkova, Olga; Tobiasz-Adamczyk, Beata; Finnvold, Jon Erik; Gruber, Sonja; Leonardi, Matilde

2018-03-11

The increasing prevalence of chronic diseases among the European working age population, as well as the implications for the individual and societal level, underline the need for policy guidelines targeting the effective inclusion of persons with chronic diseases in the workplace. The aim of the present paper was to explore the perspectives of European and National-level stakeholders on existing strategies for work re-integration of persons with chronic diseases, and to provide policy guidelines. A highly-structured interview protocol was distributed to 58 National level stakeholders (policy makers, professionals and employers) from seven European countries. Additionally, 20 European organizations concerned with health-related issues and employment completed an online survey. The findings reveal that employment-related challenges remain largely unaddressed. Both national and European stakeholders considered the existing legislative frameworks inadequate and appraised the co-ordination for the implementation of employment re-integration policies as ineffective. Policies targeting at work re-integration of persons with chronic diseases at European and national level should focus on consistent cooperation among all key stakeholders, awareness raising to staff and management, dissemination of effective strategies, developing research and evaluation standards and establishing monitoring systems on inclusive labour markets.

Global influences on milk purchasing in New Zealand – implications for health and inequalities

PubMed Central

Smith, Moira B; Signal, Louise

2009-01-01

Background Economic changes and policy reforms, consistent with economic globalization, in New Zealand in the mid-1980s, combined with the recent global demand for dairy products, particularly from countries undergoing a 'nutrition transition', have created an environment where a proportion of the New Zealand population is now experiencing financial difficulty purchasing milk. This situation has the potential to adversely affect health. Discussion Similar to other developed nations, widening income disparities and health inequalities have resulted from economic globalization in New Zealand; with regard to nutrition, a proportion of the population now faces food poverty. Further, rates of overweight/obesity and chronic diseases have increased in recent decades, primarily affecting indigenous people and lower socio-economic groups. Economic globalization in New Zealand has changed the domestic milk supply with regard to the consumer and may shed light on the link between globalization, nutrition and health outcomes. This paper describes the economic changes in New Zealand, specifically in the dairy market and discusses how these changes have the potential to create inequalities and adverse health outcomes. The implications for the success of current policy addressing chronic health outcomes is discussed, alternative policy options such as subsidies, price controls or alteration of taxation of recommended foods relative to 'unhealthy' foods are presented and the need for further research is considered. Summary Changes in economic ideology in New Zealand have altered the focus of policy development, from social to commercial. To achieve equity in health and improve access to social determinants of health, such as healthy nutrition, policy-makers must give consideration to health outcomes when developing and implementing economic policy, both national and global. PMID:19152688

Ebola policies that hinder epidemic response by limiting scientific discourse.

PubMed

Asgary, Ramin; Pavlin, Julie A; Ripp, Jonathan A; Reithinger, Richard; Polyak, Christina S

2015-02-01

There is an unprecedented epidemic of Ebola virus disease (EVD) in west Africa. There has been a strong response from dedicated health professionals. However, there have also been irrational and fear-based responses that have contributed to misallocation of resources, stigma, and deincentivizing volunteers to combat Ebola at its source. Recently, the State of Louisiana Department of Health and Hospitals issued a ban on those coming from affected countries wishing to attend the annual meetings of American Society of Tropical Medicine and Hygiene and the American Public Health Association, both of which were held in New Orleans. We argue against such policies, question evidence and motivations, and discuss their practical and ethical implications in hampering effective responses to EVD by the scientific community. We aim to shed light on this issue and its implications for the future of public health interventions, reflect on the responsibility of health providers and professional societies as advocates for patients and the public health, and call for health professionals and societies to work to challenge inappropriate political responses to public health crises. © The American Society of Tropical Medicine and Hygiene.

How much can disaster and climate science contribute to loss and damage mechanisms in international climate policy?

NASA Astrophysics Data System (ADS)

Huggel, Christian; Allen, Simon; Eicken, Hajo; Hansen, Gerrit; Stone, Dáithí

2015-04-01

As the 5th Assessment Report of the Intergovernmental Panel on Climate Change (IPCC) recently has shown, there is increasing evidence of observed impacts of climate change on natural and human systems. Some of these impacts are negative and result in damage and loss of lives and assets. In international climate policy negotiations under the UNFCCC the discussions on loss and damage have gained significant traction during the past negotiation rounds. At COP 19 the Warsaw International Mechanism for Loss and Damage (WIM) was created as an institutional arrangement to address this issue. Thereby, loss and damage (L&D) are typically defined as the residual damage and loss that occur beyond mitigation and adaptation efforts. This implies that effective mitigation and adaptation policy can substantially reduce L&D. While there is wide agreement that knowledge and understanding needs to be strengthened on how L&D due to climate change affects countries, in particular highly vulnerable countries and populations, there is still substantial disagreement on several aspects. In fact, after COP20 in Lima a number of options are on the table, including whether L&D should be located under the adaptation framework or form a separate institutional arrangement, or whether a compensation regime should be established to support developing countries. Similarly, the scientific framework for a clear L&D concept, its application in real-world cases, and implications for international climate policy, in particular with respect to questions of responsibility, liability, compensation and financing, is still evolving. Earlier proposals, for instance, have included a threshold concept, with payments released upon crossing of certain thresholds of climate (related) parameters, similar to insurance procedures. The threshold would be defined as a departure of the parameter from baseline conditions, for instance a rainfall event that is more intense than a certain baseline based threshold. Further proposals for mechanisms of financing suggested a role of causation and thus attribution of L&D to (anthropogenic) climate change. Yet, causation mechanisms are particularly delicate in terms of climate justice, development and implications of legal liabilities. Here, we outline potential contributions of science to L&D mechanisms in greater specificity, in particular for (i) threshold based mechanisms, and (ii) causation related mechanisms. We draw on recent concepts of L&D attribution suggesting a more comprehensive attribution framework based on risk concepts. We present a first-order proof-of-concept for the above mechanisms (i) and (ii), using case studies of recent disasters (both related to extreme events and gradual climate change) in the Indian Himalayas, Colombia, Alaska and Australia. We analyze whether science is in a position to substantially contribute to the different L&D policy proposals, including the question whether currently available data and datasets on climate and hazards, exposure and vulnerability are in line with such support, in particular with regards to developing country contexts. We conclude with a perspective on critical research and data needs to further strengthen L&D science and policy.

Policies to Promote Non-Hydro Renewable Energy in the United States and Selected Countries

EIA Publications

2005-01-01

This article examines policies designed to encourage the development of non-hydro renewable energy in four countries - Germany, Denmark, the Netherlands, and Japan - and compares the policies enacted in each of these countries to policies that were used in the United States between 1970 and 2003.

The Policy Implications of College and Career Assessment Findings.

ERIC Educational Resources Information Center

Lenning, Oscar T.

This paper considers social policy and institutional practice policy implications of findings reported by Ernest Pascarella and Patrick Terenzini concerning student career choice and economic benefits of college. Sixteen social policy implications are identified. These include: beating the Japanese; overcoming the "pipeline mentality"; revising…

The World Report on Disability and its implications for rehabilitation psychology.

PubMed

MacLachlan, Malcolm; Mannan, Hasheem

2014-05-01

This study reviewed the World Report on Disability (World Health Organization & World Bank, 2011) and explored its implications for rehabilitation psychology. Key findings and recommendations were identified within the World Report and issues that are salient to the profession, practice and research within rehabilitation psychology were highlighted. The World Report has a particular emphasis on disability in low-income countries, where the majority of people with disabilities live. Despite the origins and development of rehabilitation psychology within high-income countries, the profession has much to contribute to addressing many of the challenges identified in the World Report. Specific targeted contributions might include addressing the human resources for health crisis in rehabilitation; developing prosocial and community-based interventions and programs; helping to identify and overcome difficulties to accessing health care; refining the measurement and classification of disability; and strengthening research, policy and advocacy for and with people with disabilities. The World Report on Disability presents exciting and challenging opportunities that exist for rehabilitation psychology practitioners and researchers, and for the profession itself. (c) 2014 APA, all rights reserved.

Policy challenges facing integrated community case management in Sub-Saharan Africa.

PubMed

Bennett, Sara; George, Asha; Rodriguez, Daniela; Shearer, Jessica; Diallo, Brahima; Konate, Mamadou; Dalglish, Sarah; Juma, Pamela; Namakhoma, Ireen; Banda, Hastings; Chilundo, Baltazar; Mariano, Alda; Cliff, Julie

2014-07-01

To report an in-depth analysis of policy change for integrated community case management of childhood illness (iCCM) in six sub-Saharan African countries. We analysed how iCCM policies developed and the barriers and facilitators to policy change. Qualitative retrospective case studies drawing from document reviews, semi-structured interviews and in-country validation workshops were conducted in Burkina Faso, Kenya, Malawi, Mali, Mozambique and Niger. These countries were selected to maximise variation in iCCM policy status, community health worker (CHW) models and different African regions. Country iCCM policies evolved in an ad hoc fashion, but were substantially influenced by the history of primary health care and the nature of CHW programmes. Technical officers within Ministries of Health led iCCM policy change with support from international donors, but neither communities nor political leadership was mobilised. Concerns about achieving the Millennium Development Goals, together with recognition of the shortcomings of existing child health programmes, led to the adoption of iCCM policies. Availability of external financing played a critical role in facilitating policy change. iCCM policy change has been promoted by international agencies, but national governments have struggled to align iCCM with country health systems. Greater investment is needed in tailoring global policy initiatives to match country needs. High-level, political ownership of iCCM policies could facilitate policy change, as could clearer strategies for ensuring the long-term sustainability of such policies. © 2014 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Policy challenges facing integrated community case management in Sub-Saharan Africa

PubMed Central

Bennett, Sara; George, Asha; Rodriguez, Daniela; Shearer, Jessica; Diallo, Brahima; Konate, Mamadou; Dalglish, Sarah; Juma, Pamela; Namakhoma, Ireen; Banda, Hastings; Chilundo, Baltazar; Mariano, Alda; Cliff, Julie

2014-01-01

Objective To report an in-depth analysis of policy change for integrated community case management of childhood illness (iCCM) in six sub-Saharan African countries. We analysed how iCCM policies developed and the barriers and facilitators to policy change. Methods Qualitative retrospective case studies drawing from document reviews, semi-structured interviews and in-country validation workshops were conducted in Burkina Faso, Kenya, Malawi, Mali, Mozambique and Niger. These countries were selected to maximise variation in iCCM policy status, community health worker (CHW) models and different African regions. Results Country iCCM policies evolved in an ad hoc fashion, but were substantially influenced by the history of primary health care and the nature of CHW programmes. Technical officers within Ministries of Health led iCCM policy change with support from international donors, but neither communities nor political leadership was mobilised. Concerns about achieving the Millennium Development Goals, together with recognition of the shortcomings of existing child health programmes, led to the adoption of iCCM policies. Availability of external financing played a critical role in facilitating policy change. Conclusions iCCM policy change has been promoted by international agencies, but national governments have struggled to align iCCM with country health systems. Greater investment is needed in tailoring global policy initiatives to match country needs. High-level, political ownership of iCCM policies could facilitate policy change, as could clearer strategies for ensuring the long-term sustainability of such policies. PMID:24750516

The crucial role of the private sector.

PubMed

Barberis, M; Paxman, J M

1986-12-01

Private support for the development of family planning programs continues to grow and now includes industries that provide family planning services, commercial outlets that distribute contraceptives, community groups that help to build demand, private medical practitioners who include contraception as a part of health care, organizations that provide technical and financial assistance to developing country programs, pharmaceutical firms, and foundations that underwrite contraceptive research. Although the mix of private and public programs differs from country to country, these 2 family planning programs complement each other and often work in close partnership. The private sector has the advantages of being able to pioneer innovative programs the public sector is unwilling or unable to pursue, to bring foreign financial and technical assistance to developing countries without political implications, and to achieve financially self-sustaining family planning efforts that are linked to other development efforts. In many countries, the private sector has been instrumental in developing a national family planning program and in eliminating barriers to family planning in countries with restrictive laws and policies. The private sector has been especially important in pioneering grassroots programs that improve the status of women through education, health care, training, and economic opportunity.

The impact of junk food marketing regulations on food sales: an ecological study.

PubMed

Kovic, Y; Noel, J K; Ungemack, J A; Burleson, J A

2018-06-01

To evaluate the impact of junk food broadcast marketing policies on nationwide junk food sales and identify policy characteristics effective in reducing sales. Country policy data (n = 79) were categorized in a thorough literature review and analysed using a repeated measures design against data on food sales per capita. Study conducted in United States, 2017. Countries with junk food broadcast marketing policies saw a decrease in junk food sales per capita after implementation, while those without said policies saw an increase (p = 0.013). Countries with statutory policies saw a decrease in sales per capita, while those with only self-regulation saw an increase (p = 0.004). Audience restrictions (p = 0.024) and standardized nutrition criteria (p = 0.008) were policy characteristics significantly associated with a decrease in sales per capita. Utilizing a novel approach to evaluate junk food broadcast marketing policies, the study demonstrated that countries with statutory policies saw a significant decrease in junk food sales per capita not seen in countries with no or only self-regulatory policies. To effectively reduce exposure to child-targeted junk food marketing, governments should establish strong, comprehensive statutory regulations. Additionally, countries that implement junk food marketing policies can use food sales data to track policy effectiveness. © 2018 World Obesity Federation.

Cost-effectiveness and resource implications of aggressive action on TB in China, India and South Africa: a combined analysis of nine models

PubMed Central

Menzies, Nicolas A; Gomez, Gabriela B; Bozzani, Fiammetta; Chatterjee, Susmita; Foster, Nicola; Baena, Ines Garcia; Laurence, Yoko V; Qiang, Sun; Siroka, Andrew; Sweeney, Sedona; Verguet, Stéphane; Arinaminpathy, Nimalan; Azman, Andrew S; Bendavid, Eran; Chang, Stewart T; Cohen, Ted; Denholm, Justin T; Dowdy, David W; Eckhoff, Philip A; Goldhaber-Fiebert, Jeremy D; Handel, Andreas; Huynh, Grace H; Lalli, Marek; Lin, Hsien-Ho; Mandal, Sandip; McBryde, Emma S; Pandey, Surabhi; Salomon, Joshua A; Suen, Sze-chuan; Sumner, Tom; Trauer, James M; Wagner, Bradley G; Whalen, Christopher C; Wu, Chieh-Yin; Boccia, Delia; Chadha, Vineet K; Charalambous, Salome; Chin, Daniel P; Churchyard, Gavin; Daniels, Colleen; Dewan, Puneet; Ditiu, Lucica; Eaton, Jeffrey W; Grant, Alison D; Hippner, Piotr; Hosseini, Mehran; Mametja, David; Pretorius, Carel; Pillay, Yogan; Rade, Kiran; Sahu, Suvanand; Wang, Lixia; Houben, Rein MGJ; Kimerling, Michael E; White, Richard G; Vassall, Anna

2017-01-01

BACKGROUND The End TB Strategy sets global goals of reducing TB incidence and mortality by 50% and 75% respectively by 2025. We assessed resource requirements and cost-effectiveness of strategies to achieve these targets in China, India, and South Africa. METHODS We examined intervention scenarios developed in consultation with country stakeholders, which scaled-up existing interventions to high but feasible coverage by 2025. Nine independent TB modelling groups collaborated to estimate policy outcomes, and we costed each scenario by synthesizing service utilization estimates, empirical cost data, and expert opinion on implementation strategies. We estimated health impact and resource implications for 2016–2035, including patient-incurred costs. To assess resource requirements and cost-effectiveness, we compared scenarios to a base case representing continued current practice. FINDINGS Incremental TB service costs differed by scenario and country, and in some cases more than doubled current funding needs. In general, expanding TB services substantially reduced patient-incurred costs; and in India and China this produced net cost-savings for most interventions under a societal perspective. In all countries, expanding TB care access produced substantial health gains. Compared to current practice, most intervention approaches appeared highly cost-effective when compared to conventional cost-effectiveness thresholds. INTERPRETATION Expanding TB services appears cost-effective for high-burden countries and could generate substantial health and economic benefits for patients, though funding needs challenge affordability. Further work is required to determine the optimal intervention mix for each country. PMID:27720689

Global approaches to regulating electronic cigarettes

PubMed Central

Kennedy, Ryan David; Awopegba, Ayodeji; De León, Elaine; Cohen, Joanna E

2017-01-01

Objectives Classify and describe the policy approaches used by countries to regulate e-cigarettes. Methods National policies regulating e-cigarettes were identified by (1) conducting web searches on Ministry of Health websites, and (2) broad web searches. The mechanisms used to regulate e-cigarettes were classified as new/amended laws, or existing laws. The policy domains identified include restrictions or prohibitions on product: sale, manufacturing, importation, distribution, use, product design including e-liquid ingredients, advertising/promotion/sponsorship, trademarks, and regulation requiring: taxation, health warning labels and child-safety standards. The classification of the policy was reviewed by a country expert. Results The search identified 68 countries that regulate e-cigarettes: 22 countries regulate e-cigarettes using existing regulations; 25 countries enacted new policies to regulate e-cigarettes; 7 countries made amendments to existing legislation; 14 countries use a combination of new/amended and existing regulation. Common policies include a minimum-age-of-purchase, indoor-use (vape-free public places) bans and marketing restrictions. Few countries are applying a tax to e-cigarettes. Conclusions A range of regulatory approaches are being applied to e-cigarettes globally; many countries regulate e-cigarettes using legislation not written for e-cigarettes. PMID:27903958

Healthy public policy in poor countries: tackling macro-economic policies.

PubMed

Mohindra, K S

2007-06-01

Large segments of the population in poor countries continue to suffer from a high level of unmet health needs, requiring macro-level, broad-based interventions. Healthy public policy, a key health promotion strategy, aims to put health on the agenda of policy makers across sectors and levels of government. Macro-economic policy in developing countries has thus far not adequately captured the attention of health promotion researchers. This paper argues that healthy public policy should not only be an objective in rich countries, but also in poor countries. This paper takes up this issue by reviewing the main macro-economic aid programs offered by international financial institutions as a response to economic crises and unmanageable debt burdens. Although health promotion researchers were largely absent during a key debate on structural adjustment programs and health during the 1980s and 1990s, the international macro-economic policy tool currently in play offers a new opportunity to participate in assessing these policies, ensuring new forms of macro-economic policy interventions do not simply reproduce patterns of (neoliberal) economics-dominated development policy.

Transcalar networks for policy transfer and implementation: the case of global health policies for malaria and HIV/AIDS in Cameroon.

PubMed

Ngoasong, Michael Zisuh

2011-01-01

This paper explores the nature and type of policy transfer promoted by global health partnerships to facilitate access to medication in Cameroon and the associated implementation challenges. Using concepts from policy transfer, multi-level governance and the politics of scale, the paper conceptualizes the social spaces (global-national-local linkages) through which global health policies are negotiated as transcalar networks. The framework is used to analyse policy documents, technical and media reports and journal articles focusing on two global health partnerships (GHPs)-Roll Back Malaria and the Accelerating Access Initiative-in Cameroon. Both GHPs helped to create the national Malaria and HIV/AIDS programmes in Cameroon, respectively. Global policies are negotiated through dialogue processes involving global, national and local partners who constitute the national HIV/AIDS and malaria committees. Successful policy transfer is evident from the consensual nature of decision-making. Analysis of policy implementation reveals that GHPs offer a 'technical fix' based on specific medical intervention programmes with a relatively limited focus on disease prevention. The GHP approach imposes new governance challenges due to policy resistance strategies (strategic interests of international agencies and country-specific challenges). Evidence of this is seen in the existence of several overlapping programmes and initiatives that distort accountability and governance mechanisms defined by the national committees. Finally, the implications of these challenges for achieving access to medication are discussed.

National-Level Wetland Policy Specificity and Goals Vary According to Political and Economic Indicators.

PubMed

Peimer, Alex W; Krzywicka, Adrianna E; Cohen, Dora B; Van den Bosch, Kyle; Buxton, Valerie L; Stevenson, Natalie A; Matthews, Jeffrey W

2017-01-01

Growing recognition of the importance of wetlands to human and ecosystem well-being has led countries worldwide to implement wetland protection policies. Different countries have taken different approaches to wetland protection by implementing various policies, including territorial exclusion, market-based offsetting, and incentive programs for land users. Our objective was to describe the relationship between components of national-level wetland protection policies and national characteristics, including natural resource, economic, social, and political factors. We compiled data on the wetland policies of all 193 countries recognized by the U.N. and described the relationships among wetland policy goals and wetland protection mechanisms using non-metric multidimensional scaling. The first non-metric multidimensional scaling axis strongly correlated with whether a country had a wetland-specific environmental policy in place. Adoption of a comprehensive, wetland-specific policy was positively associated with degree of democracy and a commitment to establishing protected areas. The second non-metric multidimensional scaling axis defined a continuum of policy goals and mechanisms by which wetlands are protected, with goals to protect wetland ecosystem services on one end of the spectrum and goals to protect biodiversity on the other. Goals for protecting ecosystem services were frequently cited in policy documents of countries with agriculture-based economies, whereas goals associated with wetland biodiversity tended to be associated with tourism-based economies. We argue that the components of a country's wetland policies reflect national-level resource and economic characteristics. Understanding the relationship between the type of wetland policy countries adopt and national-level characteristics is critical for international efforts to protect wetlands.

National-Level Wetland Policy Specificity and Goals Vary According to Political and Economic Indicators

NASA Astrophysics Data System (ADS)

Peimer, Alex W.; Krzywicka, Adrianna E.; Cohen, Dora B.; Van den Bosch, Kyle; Buxton, Valerie L.; Stevenson, Natalie A.; Matthews, Jeffrey W.

2017-01-01

Growing recognition of the importance of wetlands to human and ecosystem well-being has led countries worldwide to implement wetland protection policies. Different countries have taken different approaches to wetland protection by implementing various policies, including territorial exclusion, market-based offsetting, and incentive programs for land users. Our objective was to describe the relationship between components of national-level wetland protection policies and national characteristics, including natural resource, economic, social, and political factors. We compiled data on the wetland policies of all 193 countries recognized by the U.N. and described the relationships among wetland policy goals and wetland protection mechanisms using non-metric multidimensional scaling. The first non-metric multidimensional scaling axis strongly correlated with whether a country had a wetland-specific environmental policy in place. Adoption of a comprehensive, wetland-specific policy was positively associated with degree of democracy and a commitment to establishing protected areas. The second non-metric multidimensional scaling axis defined a continuum of policy goals and mechanisms by which wetlands are protected, with goals to protect wetland ecosystem services on one end of the spectrum and goals to protect biodiversity on the other. Goals for protecting ecosystem services were frequently cited in policy documents of countries with agriculture-based economies, whereas goals associated with wetland biodiversity tended to be associated with tourism-based economies. We argue that the components of a country's wetland policies reflect national-level resource and economic characteristics. Understanding the relationship between the type of wetland policy countries adopt and national-level characteristics is critical for international efforts to protect wetlands.

Policy implications of drug importation.

PubMed

Palumbo, Francis B; Mullins, C Daniel; Slagle, Ashley F; Rizer, Jessica

2007-12-01

Importation of prescription drugs into the United States has been a major health policy issue for some time. The original objective of personal importation was to allow patients to have access to drugs that were not available to them in the United States either for continuation of therapy begun in another country or when all US Food and Drug Administration (FDA)-approved drug options for their condition had been exhausted. An increasing proportion of personally imported drugs are currently marketed in the United States, but imported drugs are presumably available at a lower cost to the consumer. As US consumers opt for importation through Internet sites and other means of purchase from other countries, potential risks of exposure to counterfeit products have increased, presenting challenges to both the US regulatory system and pharmaceutical companies. This commentary summarizes the current state of importation of prescription drugs into the United States. Regulators and policymakers are under increasing pressure to address the high cost of branded drugs in the United States and the desires of many US patients to purchase less expensive formulations of these products through importation. In many cases, the historical policies surrounding personal importation of prescription drugs that are not sold in the United States have been blatantly ignored, leaving the FDA in a quandary. While current legislative proposals would allow for greater access to drugs directly to consumers from other countries, they do not address the fact that the FDA has no ability to monitor the safety and efficacy of imported products. As such, the possibility of the entry of counterfeit medications and the related potential harm remain concerns.

Direct foreign investment: a migration push-factor?

PubMed

Sassen-koob, S

1984-01-01

Policymakers and analysts now recognize that US military activities abroad contribute to the creation of refugee flows into the US. Previously, immigration into the US was viewed as a result of inept and failed domestic policies in the countries of origin. Results show that recent immigrants to the US come from countries with neither the poorest nor the largest population growth rate in the less developed world. However, the sending countries received US direct foreign investment (DFI) in the 1970s, particularly labor intensive investment in export manufacturing. Significant levels and concentrations of DFI promote emigration through: 1) the incorporation of new segments of the population into wage labor and the associated disruption of traditional work structures, 2) the feminization of the new industrial work force and its impact on the work opportunities of men, and 3) the consolidation of objective and ideological links with the highly industrialized countries where most foreign capital originates. The data suggest an examination of the causes of emigration on a much more specific level than that of underdevelopment, poverty, and population growth. These facts carry immediate policy implications for US immigration organizations: 1) if US firms in export processing zones recruited workers from the pool of unemployed--mostly prime-age males--rather than expanding the labor supply by recruiting young women, thereby disrupting unwaged work structures, and 2) if these firms would desist from having high turnover rates among workers, then the migration impact of this type of development would be minimized.

Global inequities between polluters and the polluted: climate change impacts on coral reefs.

PubMed

Wolff, Nicholas H; Donner, Simon D; Cao, Long; Iglesias-Prieto, Roberto; Sale, Peter F; Mumby, Peter J

2015-11-01

For many ecosystem services, it remains uncertain whether the impacts of climate change will be mostly negative or positive and how these changes will be geographically distributed. These unknowns hamper the identification of regional winners and losers, which can influence debate over climate policy. Here, we use coral reefs to explore the spatial variability of climate stress by modelling the ecological impacts of rising sea temperatures and ocean acidification, two important coral stressors associated with increasing greenhouse gas (GHG) emissions. We then combine these results with national per capita emissions to quantify inequities arising from the distribution of cause (CO2 emissions) and effect (stress upon reefs) among coral reef countries. We find pollution and coral stress are spatially decoupled, creating substantial inequity of impacts as a function of emissions. We then consider the implications of such inequity for international climate policy. Targets for GHG reductions are likely to be tied to a country's emissions. Yet within a given level of GHG emissions, our analysis reveals that some countries experience relatively high levels of impact and will likely experience greater financial cost in terms of lost ecosystem productivity and more extensive adaptation measures. We suggest countries so disadvantaged be given access to international adaptation funds proportionate with impacts to their ecosystem. We raise the idea that funds could be more equitably allocated by formally including a metric of equity within a vulnerability framework. © 2015 John Wiley & Sons Ltd.

Drivers and implications of change in global ocean health over the past five years

PubMed Central

Frazier, Melanie; Afflerbach, Jamie; O’Hara, Casey; Katona, Steven; Stewart Lowndes, Julia S.; Jiang, Ning; Pacheco, Erich; Scarborough, Courtney; Polsenberg, Johanna

2017-01-01

Growing international and national focus on quantitatively measuring and improving ocean health has increased the need for comprehensive, scientific, and repeated indicators to track progress towards achieving policy and societal goals. The Ocean Health Index (OHI) is one of the few indicators available for this purpose. Here we present results from five years of annual global assessment for 220 countries and territories, evaluating potential drivers and consequences of changes and presenting lessons learned about the challenges of using composite indicators to measure sustainability goals. Globally scores have shown little change, as would be expected. However, individual countries have seen notable increases or declines due in particular to improvements in the harvest and management of wild-caught fisheries, the creation of marine protected areas (MPAs), and decreases in natural product harvest. Rapid loss of sea ice and the consequent reduction of coastal protection from that sea ice was also responsible for declines in overall ocean health in many Arctic and sub-Arctic countries. The OHI performed reasonably well at predicting near-term future scores for many of the ten goals measured, but data gaps and limitations hindered these predictions for many other goals. Ultimately, all indicators face the substantial challenge of informing policy for progress toward broad goals and objectives with insufficient monitoring and assessment data. If countries and the global community hope to achieve and maintain healthy oceans, we will need to dedicate significant resources to measuring what we are trying to manage. PMID:28678881

Telecommunication Policies in Seventeen Countries: Propects for Future Competitive Access.

ERIC Educational Resources Information Center

Eward, Ronald S.

This document is a review and study of current and prospective telecommunication policies in 17 countries with regard to the competitive market access those policies foster or promise. It explores the policies of each country toward information flow that will also have an impact on international competition. The aim of the study is to identify the…

Financing healthcare in Gulf Cooperation Council countries: a focus on Saudi Arabia

PubMed Central

Alkhamis, Abdulwahab; Hassan, Amir; Cosgrove, Peter

2014-01-01

Background This paper presents an analysis of the main characteristics of the Gulf Cooperation Council’s (GCC) health financing systems and draws similarities and differences between GCC countries and other high-income and low-income countries, in order to provide recommendations for healthcare policy makers. The paper also illustrates some financial implications of the recent implementation of the Compulsory Employment-based Health Insurance (CEBHI) system in Saudi Arabia. Methods Employing a descriptive framework for the country-level analysis of healthcare financing arrangements, we compared expenditure data on healthcare from GCC and other developing and developed countries, mostly using secondary data from the World Health Organization health expenditure database. The analysis was supported by a review of related literature. Results There are three significant characteristics affecting healthcare financing in GCC countries: (i) large expatriate populations relative to the national population, which leads GCC countries to use different strategies to control expatriate healthcare expenditure; (ii) substantial government revenue, with correspondingly high government expenditure on healthcare services in GCC countries; and (iii) underdeveloped healthcare systems, with some GCC countries’ healthcare indicators falling below those of upper-middle-income countries. Conclusion Reforming the mode of health financing is vital to achieving equitable and efficient healthcare services. Such reform could assist GCC countries in improving their healthcare indicators and bring about a reduction in out-of-pocket payments for healthcare. PMID:23996348

How Well-Informed Are Pension Scheme Members on Their Future Pension Benefits? Evidence from Ireland.

PubMed

Barrett, Alan; Mosca, Irene; Whelan, Brendan

2015-01-01

One part of the policy response in many countries to increasing pension coverage will be greater private provision on the part of individuals. This requires that individuals are well informed about pensions. In this article, we assess levels of knowledge of pensions using a representative sample of older Irish adults. We find that two-thirds of individuals enrolled in pension schemes do not know what amount will be paid out on retirement and/or whether the payments will be in the form of lump sums, monthly payments, or both. One policy implication is the need for increased information to be directed at certain groups, in particular, women and less educated people. More fundamentally, the results suggest that the mandatory elements in pension systems should be extended.

Live to 70 Years and Older or Suffer in Silence: Understanding Health Insurance Status Among the Elderly Under the NHIS in Ghana.

PubMed

Fenny, Ama P

2017-01-01

Ghana has introduced a National Health Insurance Scheme (NHIS). Embedded in the NHIS is a policy to exempt poor and vulnerable groups from premiums and user fees. There has been some debate as to why the start-off age for exemption among the elderly is 70 years. Ghana has a shorter life expectancy than middle- and high-income countries and its current age of retirement is 60 years. This study explores the financial and social implications of continuing to charge premiums to people aged 60 to 69 years. Based on the analysis of data from a representative household survey, it is recommended that the exemption policy should be expanded to include all vulnerable elderly persons, regardless of age.

Tourism: world's biggest industry in the twenty-first century

DOE Office of Scientific and Technical Information (OSTI.GOV)

Papson, S.

If present growth rates continue, tourism, with its associated social, economic, and environmental impacts, could become the world's largest industry by the end of the century. These impacts may force many countries to reevaluate their tourist policies. Noticeable trends affecting tourism are an increase in leisure time, an expanding middle class, the diffusion of transportation and communication technology, a need to escape from the modern work environment, and a growth in travel marketing. The implications of these developments are examined in the context of world inflation and the scarcity of energy and materials.

Fertility transitions and schooling: from micro- to macro-level associations.

PubMed

Eloundou-Enyegue, Parfait M; Giroux, Sarah C

2012-11-01

Research on the schooling implications of fertility transitions often faces an aggregation problem: despite policy interest in macro-level outcomes, empirical studies usually focus on the micro-level effects of sibsize on schooling. This article proposes an aggregation framework for moving from micro- to macro-level associations between fertility and schooling. The proposed framework is an improvement over previous aggregation methods in that it considers concurrent changes in the effects of sibsize, socioeconomic context, and family structure. The framework is illustrated with data from six sub-Saharan countries. Possible extensions are discussed.

ICT, openness and CO2 emissions in Africa.

PubMed

Asongu, Simplice A

2018-04-01

This study investigates how information and communication technology (ICT) complements globalisation in order to influence CO 2 emissions in 44 Sub-Saharan African countries over the period 2000-2012. ICT is measured with internet penetration and mobile phone penetration whereas globalisation is designated in terms of trade and financial openness. The empirical evidence is based on the generalised method of moments. The findings broadly show that ICT can be employed to dampen the potentially negative effect of globalisation on environmental degradation like CO 2 emissions. Practical, policy and theoretical implications are discussed.

Healthy and happy in Europe? On the association between happiness and life expectancy over time.

PubMed

Bjørnskov, Christian

2008-04-01

This paper revisits the standard finding in individual-level studies that happiness leads to longevity. It does so in a cross-country time-series analysis in which the use of a random effects estimator controls for most relevant time-invariant factors. The findings suggest that happiness is negatively associated with longevity at the national level, and suggests a potential indirect transmission channel, as national happiness is negatively associated with public health expenditures. The paper concludes by discussing the implications of the results for public policy and future research.

Sexual harassment and its consequences: a study within Turkish hospitals.

PubMed

Kisa, Adnan; Dziegielewski, Sophia F; Ates, Metin

2002-01-01

Sexual harassment remains a universal factor that can affect nursing performance and worker productivity in any type of health care facility. There are few studies in this area that have been conducted in developing countries. To measure the occurrence of sexual harassment, a questionnaire was given to 353 nurses in two different hospitals yielding a response rate of 61%. Overall, the majority of the respondents (n = 157 out of 251) reported that they had been subjected to sexual harassment in the workplace, and the harassment experience was strong enough to affect worker productivity. In addition, many nurses reported the belief that sexual harassment remains a disturbing problem in this developing country that should not be ignored. Based on these findings, implications for policy and further study are suggested.

The demand for health with uncertainty and insurance.

PubMed

Liljas, B

1998-04-01

This paper develops Michael Grossman's demand-for-health model by letting the depreciation rate depend upon the level of health, by letting the incidence and size of illness be uncertain and by investigating how the individual's demand for health would be affected by the introduction of insurance. Beside the more theoretical results, there are also some results with important policy implications. When formulating the hypothetical scenario in willingness to pay (WTP) studies it is important whether the individual believes that the level of health is uncertain or not. The existence of insurance could also affect the stated WTP amount. Taking this into account could therefore explain some of the differences in the WTP for seemingly identical health care programs in different countries or different areas in the same country.

Determinants of energy efficiency across countries

NASA Astrophysics Data System (ADS)

Yao, Guolin

With economic development, environmental concerns become more important. Economies cannot be developed without energy consumption, which is the major source of greenhouse gas emissions. Higher energy efficiency is one means of reducing emissions, but what determines energy efficiency? In this research we attempt to find answers to this question by using cross-sectional country data; that is, we examine a wide range of possible determinants of energy efficiency at the country level in an attempt to find the most important causal factors. All countries are divided into three income groups: high-income countries, middle-income countries, and low-income countries. Energy intensity is used as a measurement of energy efficiency. All independent variables belong to two categories: quantitative and qualitative. Quantitative variables are measures of the economic conditions, development indicators and energy usage situations. Qualitative variables mainly measure political, societal and economic strengths of a country. The three income groups have different economic and energy attributes. Each group has different sets of variables to explain energy efficiency. Energy prices and winter temperature are both important in high-income and middle-income countries. No qualitative variables appear in the model of high-income countries. Basic economic factors, such as institutions, political stability, urbanization level, population density, are important in low-income countries. Besides similar variables, such as macroeconomic stability and index of rule of law, the hydroelectricity share in total electric generation is also a driver of energy efficiency in middle-income countries. These variables have different policy implications for each group of countries.

Comparison of legislation, regulations and national health strategies for palliative care in seven European countries (Results from the Europall Research Group): a descriptive study

PubMed Central

2013-01-01

Background According to EU policy, anyone in need of palliative care should be able to have access to it. It is therefore important to investigate which palliative care topics are subject to legislation and regulations in Europe and how these are implemented in (national) health care plans. This paper aims to deliver a structured overview of the legislation, existing regulations and the different health care policies regarding palliative care in seven European countries. Methods In 2008 an inventory of the organisation of palliative care was developed by the researchers of the Europall project. Included were two open questions about legislation, regulations, and health policy in palliative care. This questionnaire was completed using palliative care experts selected from Belgium, England, France, Germany, the Netherlands, Poland and Spain. Additionally, (grey) literature on palliative care health policy and regulations from the participating countries was collected to complete the inventory. Comparative analysis of country specific information was performed afterwards. Results In all countries palliative care regulations and policies existed (either in laws, royal decrees, or national policies). An explicit right to palliative care was mentioned in the Belgium, French and German law. In addition, access to palliative care was mentioned by all countries, varying from explicit regulations to policy intentions in national plans. Also, all countries had a national policy on palliative care, although sometimes mainly related to national cancer plans. Differences existed in policy regarding palliative care leave, advance directives, national funding, palliative care training, research, opioids and the role of volunteers. Conclusions Although all included European countries have policies on palliative care, countries largely differ in the presence of legislation and regulations on palliative care as well as the included topics. European healthcare policy recommendations should support palliative care access across Europe. PMID:23866928

Access to Orphan Drugs: A Comprehensive Review of Legislations, Regulations and Policies in 35 Countries

PubMed Central

Gammie, Todd

2015-01-01

Objective To review existing regulations and policies utilised by countries to enable patient access to orphan drugs. Methods A review of the literature (1998 to 2014) was performed to identify relevant, peer-reviewed articles. Using content analysis, we synthesised regulations and policies for access to orphan drugs by type and by country. Results Fifty seven articles and 35 countries were included in this review. Six broad categories of regulation and policy instruments were identified: national orphan drug policies, orphan drug designation, marketing authorization, incentives, marketing exclusivity, and pricing and reimbursement. The availability of orphan drugs depends on individual country’s legislation and regulations including national orphan drug policies, orphan drug designation, marketing authorization, marketing exclusivity and incentives such as tax credits to ensure research, development and marketing. The majority of countries (27/35) had in place orphan drug legislation. Access to orphan drugs depends on individual country’s pricing and reimbursement policies, which varied widely between countries. High prices and insufficient evidence often limit orphan drugs from meeting the traditional health technology assessment criteria, especially cost-effectiveness, which may influence access. Conclusions Overall many countries have implemented a combination of legislations, regulations and policies for orphan drugs in the last two decades. While these may enable the availability and access to orphan drugs, there are critical differences between countries in terms of range and types of legislations, regulations and policies implemented. Importantly, China and India, two of the largest countries by population size, both lack national legislation for orphan medicines and rare diseases, which could have substantial negative impacts on their patient populations with rare diseases. PMID:26451948

Global approaches to regulating electronic cigarettes.

PubMed

Kennedy, Ryan David; Awopegba, Ayodeji; De León, Elaine; Cohen, Joanna E

2017-07-01

Classify and describe the policy approaches used by countries to regulate e-cigarettes. National policies regulating e-cigarettes were identified by (1) conducting web searches on Ministry of Health websites, and (2) broad web searches. The mechanisms used to regulate e-cigarettes were classified as new/amended laws, or existing laws. The policy domains identified include restrictions or prohibitions on product: sale, manufacturing, importation, distribution, use, product design including e-liquid ingredients, advertising/promotion/sponsorship, trademarks, and regulation requiring: taxation, health warning labels and child-safety standards. The classification of the policy was reviewed by a country expert. The search identified 68 countries that regulate e-cigarettes: 22 countries regulate e-cigarettes using existing regulations; 25 countries enacted new policies to regulate e-cigarettes; 7 countries made amendments to existing legislation; 14 countries use a combination of new/amended and existing regulation. Common policies include a minimum-age-of-purchase, indoor-use (vape-free public places) bans and marketing restrictions. Few countries are applying a tax to e-cigarettes. A range of regulatory approaches are being applied to e-cigarettes globally; many countries regulate e-cigarettes using legislation not written for e-cigarettes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Extent of alcohol prohibition in civil policy in Muslim majority countries: the impact of globalization.

PubMed

Al-Ansari, Basma; Thow, Anne-Marie; Day, Carolyn A; Conigrave, Katherine M

2016-10-01

Many policies have been introduced to reduce alcohol harm in different countries. However, Muslim majority countries (MMCs), where the major religion (Islam) prohibits alcohol consumption, have less well-developed civil alcohol policies. Overall, MMCs have low prevalence of alcohol consumption, although recently most MMCs have been undergoing transition, which has sometimes increased pressure for alcohol availability and impacted on social practices, alcohol policies and broader public health. Globalization, the influence of the global alcohol industry, recent governmental transition or political instability and the presence of immigrants from non-Muslim countries can all affect civil alcohol policy. In this context, consumption overall has increased compared with two decades ago. This paper presents an overview of current civil alcohol policy, with regard to the presence or absence of alcohol prohibition, and provides an insight into the legal availability of alcohol in MMCs and the challenges facing policymakers. English, Arabic and Persian language sources were examined, using PubMed, government websites for each country and the World Health Organization (WHO). Some of the challenges MMCs may face in developing alcohol policies are explored, including the need to interact with the global economy and the potential influence of the alcohol industry. Muslim majority countries have adopted a range of civil alcohol policies in recent decades. There is a pressing need for better data and to support Muslim majority countries in alcohol policy development. Lessons from Muslim majority countries can help to inform other parts of the world. © 2015 Society for the Study of Addiction.

The Impact of Tobacco Control Policies on Smoking Among Socioeconomic Groups in Nine European Countries, 1990-2007.

PubMed

Hu, Yannan; van Lenthe, Frank J; Platt, Stephen; Bosdriesz, Jizzo R; Lahelma, Eero; Menvielle, Gwenn; Regidor, Enrique; Santana, Paula; de Gelder, Rianne; Mackenbach, Johan P

2017-11-07

It is uncertain whether tobacco control policies have contributed to a narrowing or widening of socioeconomic inequalities in smoking in European countries during the past two decades. This paper aims to investigate the impact of price and non-price related population-wide tobacco control policies on smoking by socioeconomic group in nine European countries between 1990 and 2007. Individual-level education, occupation and smoking status were obtained from nationally representative surveys. Country-level price-related tobacco control policies were measured by the relative price of cheapest cigarettes and of cigarettes in the most popular price category. Country-level non-price policies were measured by a summary score covering four policy domains: smoking bans or restrictions in public places and workplaces, bans on advertising and promotion, health warning labels, and cessation services. The associations between policies and smoking were explored using logistic regressions, stratified by education and occupation, and adjusted for age, Gross Domestic Product, period and country fixed effects. The price of popular cigarettes and non-price policies were negatively associated with smoking among men. The price of the cheapest cigarettes was negatively associated with smoking among women. While these favorable effects were generally in the same direction for all socioeconomic groups, they were larger and statistically significant in lower socioeconomic groups only. Tobacco control policies as implemented in nine European countries, have probably helped to reduce the prevalence of smoking in the total population, particularly in lower socioeconomic groups. Widening inequalities in smoking may be explained by other factors. Policies with larger effects on lower socioeconomic groups are needed to reverse this trend. Socioeconomic inequalities in smoking widened between the 1990s and the 2000s in Europe. During the same period, there were intensified tobacco control policies in many European countries. It is uncertain whether tobacco control policies have contributed to a narrowing or widening of socioeconomic inequalities in smoking in European countries. This study shows that tobacco control policies as implemented in the available European countries have helped to reduce the prevalence of smoking in the total population, particularly in lower socioeconomic groups. Widening inequalities in smoking may be explained by other factors. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

WHO Essential Medicines Policies and Use in Developing and Transitional Countries: An Analysis of Reported Policy Implementation and Medicines Use Surveys

PubMed Central

Holloway, Kathleen Anne; Henry, David

2014-01-01

Background Suboptimal medicine use is a global public health problem. For 35 years the World Health Organization (WHO) has promoted essential medicines policies to improve quality use of medicines (QUM), but evidence of their effectiveness is lacking, and uptake by countries remains low. Our objective was to determine whether WHO essential medicines policies are associated with better QUM. Methods and Findings We compared results from independently conducted medicines use surveys in countries that did versus did not report implementation of WHO essential medicines policies. We extracted survey data on ten validated QUM indicators and 36 self-reported policy implementation variables from WHO databases for 2002–2008. We calculated the average difference (as percent) for the QUM indicators between countries reporting versus not reporting implementation of specific policies. Policies associated with positive effects were included in a regression of a composite QUM score on total numbers of implemented policies. Data were available for 56 countries. Twenty-seven policies were associated with better use of at least two percentage points. Eighteen policies were associated with significantly better use (unadjusted p<0.05), of which four were associated with positive differences of 10% or more: undergraduate training of doctors in standard treatment guidelines, undergraduate training of nurses in standard treatment guidelines, the ministry of health having a unit promoting rational use of medicines, and provision of essential medicines free at point of care to all patients. In regression analyses national wealth was positively associated with the composite QUM score and the number of policies reported as being implemented in that country. There was a positive correlation between the number of policies (out of the 27 policies with an effect size of 2% or more) that countries reported implementing and the composite QUM score (r = 0.39, 95% CI 0.14 to 0.59, p = 0.003). This correlation weakened but remained significant after inclusion of national wealth in multiple linear regression analyses. Multiple policies were more strongly associated with the QUM score in the 28 countries with gross national income per capita below the median value (US$2,333) (r = 0.43, 95% CI 0.06 to 0.69, p = 0.023) than in the 28 countries with values above the median (r = 0.22, 95% CI −0.15 to 0.56, p = 0.261). The main limitations of the study are the reliance on self-report of policy implementation and measures of medicine use from small surveys. While the data can be used to explore the association of essential medicines policies with medicine use, they cannot be used to compare or benchmark individual country performance. Conclusions WHO essential medicines policies are associated with improved QUM, particularly in low-income countries. Please see later in the article for the Editors' Summary PMID:25226527

WHO essential medicines policies and use in developing and transitional countries: an analysis of reported policy implementation and medicines use surveys.

PubMed

Holloway, Kathleen Anne; Henry, David

2014-09-01

Suboptimal medicine use is a global public health problem. For 35 years the World Health Organization (WHO) has promoted essential medicines policies to improve quality use of medicines (QUM), but evidence of their effectiveness is lacking, and uptake by countries remains low. Our objective was to determine whether WHO essential medicines policies are associated with better QUM. We compared results from independently conducted medicines use surveys in countries that did versus did not report implementation of WHO essential medicines policies. We extracted survey data on ten validated QUM indicators and 36 self-reported policy implementation variables from WHO databases for 2002-2008. We calculated the average difference (as percent) for the QUM indicators between countries reporting versus not reporting implementation of specific policies. Policies associated with positive effects were included in a regression of a composite QUM score on total numbers of implemented policies. Data were available for 56 countries. Twenty-seven policies were associated with better use of at least two percentage points. Eighteen policies were associated with significantly better use (unadjusted p<0.05), of which four were associated with positive differences of 10% or more: undergraduate training of doctors in standard treatment guidelines, undergraduate training of nurses in standard treatment guidelines, the ministry of health having a unit promoting rational use of medicines, and provision of essential medicines free at point of care to all patients. In regression analyses national wealth was positively associated with the composite QUM score and the number of policies reported as being implemented in that country. There was a positive correlation between the number of policies (out of the 27 policies with an effect size of 2% or more) that countries reported implementing and the composite QUM score (r=0.39, 95% CI 0.14 to 0.59, p=0.003). This correlation weakened but remained significant after inclusion of national wealth in multiple linear regression analyses. Multiple policies were more strongly associated with the QUM score in the 28 countries with gross national income per capita below the median value (US$2,333) (r=0.43, 95% CI 0.06 to 0.69, p=0.023) than in the 28 countries with values above the median (r=0.22, 95% CI -0.15 to 0.56, p=0.261). The main limitations of the study are the reliance on self-report of policy implementation and measures of medicine use from small surveys. While the data can be used to explore the association of essential medicines policies with medicine use, they cannot be used to compare or benchmark individual country performance. WHO essential medicines policies are associated with improved QUM, particularly in low-income countries. Please see later in the article for the Editors' Summary.

25 CFR 12.14 - Where can I find specific policies and standards for law enforcement functions in Indian country?

Code of Federal Regulations, 2013 CFR

2013-04-01

... THE INTERIOR LAW AND ORDER INDIAN COUNTRY LAW ENFORCEMENT Policies and Standards § 12.14 Where can I find specific policies and standards for law enforcement functions in Indian country? BIA will ensure... 25 Indians 1 2013-04-01 2013-04-01 false Where can I find specific policies and standards for law...

25 CFR 12.14 - Where can I find specific policies and standards for law enforcement functions in Indian country?

Code of Federal Regulations, 2012 CFR

2012-04-01

... THE INTERIOR LAW AND ORDER INDIAN COUNTRY LAW ENFORCEMENT Policies and Standards § 12.14 Where can I find specific policies and standards for law enforcement functions in Indian country? BIA will ensure... 25 Indians 1 2012-04-01 2011-04-01 true Where can I find specific policies and standards for law...

25 CFR 12.14 - Where can I find specific policies and standards for law enforcement functions in Indian country?

Code of Federal Regulations, 2011 CFR

2011-04-01

... THE INTERIOR LAW AND ORDER INDIAN COUNTRY LAW ENFORCEMENT Policies and Standards § 12.14 Where can I find specific policies and standards for law enforcement functions in Indian country? BIA will ensure... 25 Indians 1 2011-04-01 2011-04-01 false Where can I find specific policies and standards for law...

25 CFR 12.14 - Where can I find specific policies and standards for law enforcement functions in Indian country?

Code of Federal Regulations, 2014 CFR

2014-04-01

... THE INTERIOR LAW AND ORDER INDIAN COUNTRY LAW ENFORCEMENT Policies and Standards § 12.14 Where can I find specific policies and standards for law enforcement functions in Indian country? BIA will ensure... 25 Indians 1 2014-04-01 2014-04-01 false Where can I find specific policies and standards for law...

Political economy of tobacco control in low-income and middle-income countries: lessons from Thailand and Zimbabwe. Global Analysis Project Team.

PubMed Central

Chantornvong, S.; Collin, J.; Dodgson, R.; Lee, K.; McCargo, D.; Seddon, D.; Vaughan, P.; Woelk, G.

2000-01-01

Crucial to the success of the proposed Framework Convention on Tobacco Control will be an understanding of the political and economic context for tobacco control policies, particularly in low-income and middle-income countries. Policy studies in Thailand and Zimbabwe employed the analytical perspective of political economy and a research strategy that used political mapping, a technique for characterizing and evaluating the political environment surrounding a policy issue, and stakeholder analysis, which seeks to identify key actors and to determine their capacity to shape policy outcomes. These policy studies clearly revealed how tobacco control in low-income and middle-income countries is also being shaped by developments in the global and regional political economy. Hence efforts to strengthen national control policies need to be set within the context of globalization and the international context. Besides the transnational tobacco companies, international tobacco groups and foreign governments, international agencies and nongovernmental organizations are also playing influential roles. It cannot be assumed, therefore, that the tobacco control strategies being implemented in industrialized countries will be just as effective and appropriate when implemented in developing countries. There is an urgent need to expand the number of such tobacco policy studies, particularly in low-income and middle-income countries. Comprehensive guidelines for tobacco policy analysis and research are required to support this process, as is a broader international strategy to coordinate further tobacco policy research studies at country, regional and global levels. PMID:10994265

Tuberculosis in Asia and the pacific: the role of socioeconomic status and health system development.

PubMed

Wu, Jie; Dalal, Koustuv

2012-01-01

To identify the relationship between socioeconomic status, health system development and the incidence, prevalence and mortality of tuberculosis in Asia and the Pacific. Incidence, prevalence and mortality rates of tuberculosis and 20 variables of socioeconomic, health system and biological-behavioral issues were included in the study involving all 46 countries of the Asian Development Bank region (2007 data). Both univariate and multivariate linear regressions were used. The worst three tuberculosis affected countries were Cambodia, India and Indonesia, while the least affected was Australia. Tuberculosis incidence, prevalence and mortality rate were higher in countries with lower human development index, corruption perception index, gross domestic product (GDP) per capita and countries with more people under minimum food supplements. Among the health system variables, total health expenditure per capita, governmental health expenditure per capita, hospital beds, and access to improved water and sanitation were strongly associated with tuberculosis. Socioeconomic determinants and health system development have significant effect on the control of tuberculosis in Asia and the Pacific region. The study has some policy implications by means of lowering the corruption and improving the sanitation.

Reimbursement policies in the Asia-Pacific for chronic hepatitis B.

PubMed

Lim, Seng Gee; Amarapurkar, Deepak N; Chan, Henry Lik-Yuen; Crawford, Darrell H; Gane, Edward J; Han, Kwang-Hyub; Ahn, Sang Hoon; Jafri, Wasim; Jia, Jidong; Kao, Jia-Horng; Lesmana, Laurentius A; Lesmana, C Rinaldi A; Mohamed, Rosmawati; Phiet, Pham Hoang; Piratvisuth, Teerha; Sarin, Shiv K; Sollarno, Jose D; Eguchi, Yuichiro; Mahtab, Mamun-Al; Lee, Keat Hong

2015-01-01

There is considerable variation in reimbursement policies in Asian countries and this is likely to have an impact on treatment practice for chronic hepatitis B (CHB). Consequently a survey of leading hepatologists was performed to evaluate such policies and their impact on management of CHB in the Asia Pacific region. A questionnaire was sent to key hepatologists in Asia Pacific for information on CHB reimbursement policy-its nature, coverage, funding source, duration, review strategy and impact on Asia Pacific Association for the Study of the Liver (APASL) CHB guidelines. The results were analysed and described. Leading hepatologists from 16 Asia Pacific countries responded. Almost all of the countries have reimbursement policies but eligibility varied from only a limited group (e.g. civil servants only) to universal access. In most instances reimbursement was from the central government (except China, Pakistan and Hong Kong). Reimbursement policies were usually created by Ministry of Health committees, who received input from medical professionals, although they may not be aware of the APASL guidelines. Policies were limited by available resources, funds and prioritization. Where there was a regular review this occurred between 1 and 5 years. The quantum of reimbursement varied from 50% in Singapore to 100% in the majority of other countries. The criteria for treatment reimbursement were based on doctor's opinion alone (Bangladesh, India, Pakistan, Philippines, Singapore and Vietnam) or specific clinical/laboratory criteria in the rest of the countries. In general, most countries offered unlimited duration for reimbursement except Taiwan, Indonesia and Pakistan. Monitoring tests for treatment response were reimbursed in all countries other than Vietnam. Viral resistance was diagnosed by viral or biochemical breakthrough, and viral resistance testing was uncommon. The main rescue therapy was adefovir. Reimbursement policies differed from country to country, the quantum and the proportion of patients who received reimbursement also varied significantly. Asia Pacific countries were able to follow APASL guidelines with variable success based on their reimbursement policies.

Health in All Policies (HiAP) framework for country action.

PubMed

2014-06-01

This document serves as a 'starter's kit' for applying Health in All Policies (HiAP) in decision-making and implementation at national and subnational levels. It can be easily adapted for use in different country contexts and at the regional and global levels. WHAT IS HIAP?: HiAP is an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies and avoids harmful health impacts in order to improve population health and health equity. As a concept, it reflects the principles of: legitimacy, accountability, transparency and access to information, participation, sustainability and collaboration across sectors and levels of government. Health and health equity are values in their own right and are also important prerequisites for achieving many other societal goals. Many of the determinants of health and health inequities in populations have social, environmental and economic origins that extend beyond the direct influence of the health sector and health policies. Thus, public policies in all sectors and at different levels of governance can have a significant impact on population health and health equity. The Framework sets out six key components that should be addressed in order to put the HiAP approach into action: (1) establish the need and priorities for HiAP, (2) frame planned action, (3) identify supportive structures and processes, (4) facilitate assessment and engagement, (5) ensure monitoring, evaluation and reporting, (6) build capacity. These components are not fixed in order or priority. Rather, individual countries will adopt and adjust the components in ways that are most relevant for their specific governance, economic and social contexts. Although governments as a whole bear the ultimate responsibility for the health of their citizens, health authorities at all levels are key actors in promoting HiAP. They should therefore actively seek opportunities to collaborate with and influence other sectors. Intergovernmental organizations and structures (multi-lateral, bilateral, regional, etc.) can provide significant support to multi-sectoral action on health and development outcomes. Finally, having taken a lead role in multi-sectoral initiatives on issues such as marketing of breast-milk substitutes, tobacco control and the international recruitment of health personnel, the World Health Organization (WHO) has a special contribution to make to HiAP at both international and country levels. © World Health Organization 2013. Reprinted with permission of the publisher.

Health Policy 2016 – Implications for Geriatric Urology

PubMed Central

Suskind, Anne M.; Clemens, J. Quentin

2016-01-01

Purpose of Review The U.S. healthcare system is undergoing fundamental changes in an effort to improve access to care, curtail healthcare spending, and improve quality of care. These efforts largely focused on Medicare, and therefore will have a fundamental impact on the care of geriatric patients. This article reviews contemporary health policy issues, with a focus on how these issues may impact the care of geriatric urology patients. Recent Findings The Affordable Care Act (ACA) has broadened the scope of Medicare coverage. Future Medicare reimbursement will be increasingly tied to care coordination, quality reporting, and demonstration of appropriate outcomes. Additional research is needed to better define the comparative effectiveness of urologic therapies in geriatric patients. Workforce projections indicate that there is a shortage of urologists in many areas of the country, and that this shortage will worsen over time unless a new funding model is instituted for graduate medical education. Summary Medicare spending drives many health policy decisions. Therefore, few health policy topics are unique to geriatrics or geriatric urology. However, certain health policy topics (e.g., care coordination, risk-stratification) are particularly germaine to the elderly patients. Urologists with a particular interest in geriatric urology should be familiar with these issues. PMID:26765043

Health policy 2016: implications for geriatric urology.

PubMed

Suskind, Anne M; Clemens, J Quentin

2016-03-01

The US healthcare system is undergoing fundamental changes in an effort to improve access to care, curtail healthcare spending, and improve quality of care. These efforts largely focused on Medicare, and therefore, will have a fundamental impact on the care of geriatric patients. This article reviews contemporary health policy issues, with a focus on how these issues may impact the care of geriatric urology patients. The Affordable Care Act has broadened the scope of Medicare coverage. Future Medicare reimbursement will be increasingly tied to care coordination, quality reporting, and demonstration of appropriate outcomes. Additional research is needed to better define the comparative effectiveness of urologic therapies in geriatric patients. Workforce projections indicate that there is a shortage of urologists in many areas of the country, and that this shortage will worsen over time unless a new funding model is instituted for graduate medical education. Medicare spending drives many health policy decisions. Therefore, few health policy topics are unique to geriatrics or geriatric urology. However, certain health policy topics (e.g., care coordination and risk-stratification) are particularly germaine to the elderly patients. Urologists with a particular interest in geriatric urology should be familiar with these issues.

The Policies on Civic Education in Developing National Character in Indonesia

ERIC Educational Resources Information Center

Nurdin, Encep Syarief

2015-01-01

Each country has different policies on the implementation of Civic Education. As an independent country, Indonesia administers Civic Education separately through a special subject under the name "citizenship education", while other countries, such as Malaysia, integrate this form of education into other subjects. The policies on Civic…

Trend analysis of the pharmaceutical market in Iran; 1997–2010; policy implications for developing countries

PubMed Central

2013-01-01

Background So far, no detailed study of the Iranian pharmaceutical market has been conducted, and only a few studies have analyzed medicine consumption and expenditure in Iran. Pharmaceutical market trend analysis remains one of the most useful instruments to evaluate the pharmaceutical systems efficiency. An increase in imports of medicines, and a simultaneous decrease in domestic production prompted us to investigate the pharmaceutical expenditure structure. On the other hand, analyzing statistics provides a suitable method to assess the outcomes of national pharmaceutical policies and regulations. Methods This is a descriptive and cross-sectional study which investigates the Iranian pharmaceutical market over a 13-year period (1997–2010). This study used the Iranian pharmaceutical statistical datasheet published by the Iranian Ministry of Health. Systematic searches of the relevant Persian and English research literature were made. In addition, official government documents were analyzed as sources of both data and detailed statements of policy. Results Analysis of the Iranian pharmaceutical market in the 13-year period shows that medicine consumption sales value growth has been 28.38% annually. Determination of domestic production and import reveals that 9.3% and 42.3% annual growth, respectively, have been experienced. Conclusions The Iranian pharmaceutical market has undergone great growth in comparison with developing countries and the pharmerging group, and the market is expanding quickly while a major share goes to biotechnology drugs, which implies the need to commercialization activities in novel fields like pharmaceutical biotechnology. This market expansion has been in favor of imported medicine in sales terms, caused by the reinforcement of suspicious policies of policy makers that necessitates fundamental rearrangements. PMID:23805853

Policy impact of the Indonesian Central Bank certificate related on loan interest rate to the demand growth of property

NASA Astrophysics Data System (ADS)

Wirjodirdjo, B.; Asjari, H. Y.

2018-04-01

The Indonesian economic indicators shown a positive progress in the last three years, Foreign exchange reserves position of the end of March 2017 stood at US 121.8 billion higher than the position of the end of 2015 amounted to US 105.9 billion of the end of 2015. This reserve would ensure the resilience and maintaining sustainable Indonesian economic growth in the future. Although Indonesia’s foreign exchange is better, the structure of expenditure in the country is still less than ideal due the proportion of spending of consumer goods is far greater than the capital goods and tend to be unproductive spending. This needs to be regulated so that in the long term does not cause balance of payments deficit. Therefore, Indonesian Central Bank took a policy to raise interest rates for retail banks from 6% to 7.25% per annum gradually up to present. Policies relating to the interest rates on loans are intended to reduce the proportion of debt financing of consumer goods, however, these policies have implications to various economic sectors and one of those is property sector. A lot of research has been conducted related the impact of loan interest to the property sector but most of it is still in partial related to the ability the people to buy. However, this research has tried to see the implication of the macro Economic Policy of Indonesian Central Bank to the property sector as a systemic problem. This paper is going to present the study on the effects of these policies on the property sector, especially residence house. To obtain a comprehensive analysis and capture the relationship between interest rate policies and their impacts to the property sector, in this study the model developed and simulated using system dynamic methodology as an approach. Various scenarios are applied to the model to get an accurate information about how and when the effectiveness of the policy related to the property sector can be enforced. The result of this study can be delivered to the policy maker as feed-back to improving the policies related the interest rate.

Information and communication technology (ICT) and eHealth policy in Latin America and the Caribbean: a review of national policies and assessment of socioeconomic context.

PubMed

Jimenez-Marroquin, Maria Carolina; Deber, Raisa; Jadad, Alejandro R

2014-01-01

To examine the availability of national information and communication technology (ICT) or eHealth policies produced by countries in Latin America and the Caribbean (LAC), and to determine the influence of a country's socioeconomic context on the existence of these policies. Documents describing a national ICT or eHealth policy in any of the 33 countries belonging to the LAC region as listed by the United Nations were identified from three data sources: academic databases; the Google search engine; and government agencies and representatives. The relationship between the existence of a policy and national socioeconomic indicators was also investigated. There has been some progress in the establishment of ICT and eHealth policies in the LAC region. The most useful methods for identifying the policies were 1) use of the Google search engine and 2) contact with Pan American Health Organization (PAHO) country representatives. The countries that have developed a national ICT policy seem to be more likely to have a national eHealth policy in place. There was no statistical significant association between the existence of a policy and a country's socioeconomic context. Governments need to make stronger efforts to raise awareness about existing and planned ICT and eHealth policies, not only to facilitate ease of use and communication with their stakeholders, but also to promote collaborative international efforts. In addition, a better understanding of the effect of economic variables on the role that ICTs play in health sector reform efforts will help shape the vision of what can be achieved.

Energy technology and American democratic values

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thompson, G.M.

1988-01-01

Today, the benefits of liberal democracy have increasingly been cast into doubt. The debate over alternative energy policies illustrates the problems associated with liberal democracy. For many, it is the realization that energy choices and the selection of social and political values amount to much the same thing. Simply put, energy policy decisions, and the concomitant energy technologies, carry implications of an ethical, social and political nature. The argument of the social and political effects of energy technology flows from the more general thesis that all forms of technological practice condition social and political relations. That is, technological systems, beyondmore » performing the specific functions for which they were designed, act upon and influence social and political arrangements. Seen in this light, energy technologies are as important to the promotion and preservation of this country's political values as are its institutions and laws. Further, there is evidence to suggest that this country's cherished democratic value of freedom is slowly being eclipsed by the values attendant to corporate capitalism and its singular pursuit of growth. It is this dominance of economic values over political values which provides the environment within which the technological debate is waged. Ultimately, tracing the historic linkage between property and liberty, it is concluded that the preservation of our freedom require new thinking regarding the present configuration of ownership patterns. The questions surrounding energy policy serve to illuminate these concerns.« less

Accelerated Adoption of Smoke-Free Laws After Ratification of the World Health Organization Framework Convention on Tobacco Control

PubMed Central

Uang, Randy; Hiilamo, Heikki

2016-01-01

Objectives. We sought to evaluate the effect of ratifying the World Health Organization Framework Convention on Tobacco Control (FCTC) on countries enacting smoke-free laws covering indoor workplaces, restaurants, and bars. Methods. We compared adoption of smoke-free indoor workplace, restaurant, and bar laws in countries that did versus did not ratify the FCTC, accounting for years since the ratification of the FCTC and for countries’ World Bank income group. Results. Ratification of the FCTC significantly (P < .001) increased the probability of smoke-free laws. This effect faded with time, with a half-life of 3.1 years for indoor workplaces and 3.8 years for restaurants and bars. Compared with high-income countries, upper-middle–income countries had a significantly higher probability of smoke-free indoor workplace laws. Conclusions. The FCTC accelerated the adoption of smoke-free indoor workplace, restaurant, and bar laws, with the greatest effect in the years immediately following ratification. The policy implication is that health advocates must increase efforts to secure implementation of FCTC smoke-free provisions in countries that have not done so. PMID:26562125

Financing healthcare in Gulf Cooperation Council countries: a focus on Saudi Arabia.

PubMed

Alkhamis, Abdulwahab; Hassan, Amir; Cosgrove, Peter

2014-01-01

This paper presents an analysis of the main characteristics of the Gulf Cooperation Council's (GCC) health financing systems and draws similarities and differences between GCC countries and other high-income and low-income countries, in order to provide recommendations for healthcare policy makers. The paper also illustrates some financial implications of the recent implementation of the Compulsory Employment-based Health Insurance (CEBHI) system in Saudi Arabia. Employing a descriptive framework for the country-level analysis of healthcare financing arrangements, we compared expenditure data on healthcare from GCC and other developing and developed countries, mostly using secondary data from the World Health Organization health expenditure database. The analysis was supported by a review of related literature. There are three significant characteristics affecting healthcare financing in GCC countries: (i) large expatriate populations relative to the national population, which leads GCC countries to use different strategies to control expatriate healthcare expenditure; (ii) substantial government revenue, with correspondingly high government expenditure on healthcare services in GCC countries; and (iii) underdeveloped healthcare systems, with some GCC countries' healthcare indicators falling below those of upper-middle-income countries. Reforming the mode of health financing is vital to achieving equitable and efficient healthcare services. Such reform could assist GCC countries in improving their healthcare indicators and bring about a reduction in out-of-pocket payments for healthcare. © 2013 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd.

Frameworks for comparing emissions associated with production, consumption, and international trade.

PubMed

Kanemoto, Keiichiro; Lenzen, Manfred; Peters, Glen P; Moran, Daniel D; Geschke, Arne

2012-01-03

While the problem of climate change is being perceived as increasingly urgent, decision-makers struggle to agree on the distribution of responsibility across countries. In particular, representatives from countries hosting emissions-intensive exporting industries have argued that the importers of emissions-intensive goods should bear the responsibility, and ensuing penalties. Indeed, international trade and carbon leakage appear to play an increasingly important role in the carbon emissions debate. However, definitions of quantities describing the embodiment of carbon emissions in internationally traded products, and their measurement, have to be sufficiently robust before being able to underpin global policy. In this paper we critically examine a number of emissions accounting concepts, examine whether the ensuing carbon balances are compatible with monetary trade balances, discuss their different interpretations, and highlight implications for policy. In particular, we compare the emissions embodied in bilateral trade (EEBT) method which considers total trade flows with domestic emission intensities, with the multi-regional input-output (MRIO) method which considers trade only into final consumption with global emission intensities. If consumption-based emissions of different countries were to be compared, we would suggest an MRIO approach because of the global emissions coverage inherent in this method. If trade-adjusted emission inventories were to be compared, we would suggest an EEBT approach due to the consistency with a monetary trade balance.

Impacts of Climate Change on Vector Borne Diseases in the Mediterranean Basin - Implications for Preparedness and Adaptation Policy.

PubMed

Negev, Maya; Paz, Shlomit; Clermont, Alexandra; Pri-Or, Noemie Groag; Shalom, Uri; Yeger, Tamar; Green, Manfred S

2015-06-15

The Mediterranean region is vulnerable to climatic changes. A warming trend exists in the basin with changes in rainfall patterns. It is expected that vector-borne diseases (VBD) in the region will be influenced by climate change since weather conditions influence their emergence. For some diseases (i.e., West Nile virus) the linkage between emergence andclimate change was recently proved; for others (such as dengue) the risk for local transmission is real. Consequently, adaptation and preparation for changing patterns of VBD distribution is crucial in the Mediterranean basin. We analyzed six representative Mediterranean countries and found that they have started to prepare for this threat, but the preparation levels among them differ, and policy mechanisms are limited and basic. Furthermore, cross-border cooperation is not stable and depends on international frameworks. The Mediterranean countries should improve their adaptation plans, and develop more cross-sectoral, multidisciplinary and participatory approaches. In addition, based on experience from existing local networks in advancing national legislation and trans-border cooperation, we outline recommendations for a regional cooperation framework. We suggest that a stable and neutral framework is required, and that it should address the characteristics and needs of African, Asian and European countries around the Mediterranean in order to ensure participation. Such a regional framework is essential to reduce the risk of VBD transmission, since the vectors of infectious diseases know no political borders.

What Happens to Patterns of Food Consumption when Food Prices Change? Evidence from A Systematic Review and Meta-Analysis of Food Price Elasticities Globally.

PubMed

Cornelsen, Laura; Green, Rosemary; Turner, Rachel; Dangour, Alan D; Shankar, Bhavani; Mazzocchi, Mario; Smith, Richard D

2015-12-01

Recent years have seen considerable interest in examining the impact of food prices on food consumption and subsequent health consequences. Fiscal policies targeting the relative price of unhealthy foods are frequently put forward as ways to address the obesity epidemic. Conversely, various food subsidy interventions are used in attempts to reduce levels of under-nutrition. Information on price elasticities is essential for understanding how such changes in food prices affect food consumption. It is crucial to know not only own-price elasticities but also cross-price elasticities, as food substitution patterns may have significant implications for policy recommendations. While own-price elasticities are common in analyses of the impact of food price changes on health, cross-price effects, even though generally acknowledged, are much less frequently included in analyses, especially in the public health literature. This article systematically reviews the global evidence on cross-price elasticities and provides combined estimates for seven food groups in low-income, middle-income and high-income countries alongside previously estimated own-price elasticities. Changes in food prices had the largest own-price effects in low-income countries. Cross-price effects were more varied and depending on country income level were found to be reinforcing, undermining or alleviating own-price effects. Copyright © 2014 John Wiley & Sons, Ltd.

Migration and health: a study of effects of early life experiences and current socio-economic situation on mortality of immigrants in Sweden.

PubMed

Klinthäll, Martin; Lindström, Martin

2011-12-01

Previous research has demonstrated mortality differences between immigrants and natives living in Sweden. The aim of this study is to investigate the effects of early life conditions in the country of birth and current socio-economic conditions in adult life in Sweden on cardiovascular, cancer, all other cause and total mortality among immigrants and natives in Sweden. The cohort data concerning individual demographic characteristics and socio-economic conditions stems from the Swedish Longitudinal Immigrant Database (SLI), a register-based representative database, and consists of individuals from 11 countries of birth, born between 1921 and 1939, who were residents in Sweden between 1980 and 2001. The associations between current socio-economic conditions as well as infant mortality rates (IMR) and Gross Domestic Product (GDP) per capita in the year and country of birth, and total, cardiovascular, cancer and 'all other' mortality in 1980-2001 were calculated by survival analysis using Cox proportional hazards regression to calculate hazard rate ratios. The effects of current adult life socio-economic conditions in Sweden on mortality are both stronger and more straightforward than the effects of early life conditions in the sense that higher socio-economic status is significantly associated with lower mortality in all groups of diagnoses; however, we find associations between infant mortality rates (IMR) in the year and country of birth, and cancer mortality among men and women in the final model. Socioeconomic conditions in Sweden are more strongly associated with mortality than early life indicators IMR and GDP per capita in the year of birth in the country of origin. This finding has health policy and other policy implications.

Community mental health care in the Asia-Pacific region: using current best-practice models to inform future policy

PubMed Central

NG, CHEE; HERRMAN, HELEN; CHIU, EDMOND; SINGH, BRUCE

2009-01-01

The reporting of child sexual abuse (CSA) and physician-patient sexual relationships (PPSR) are currently the focus of professional, legal and media attention in several countries. This paper briefly reviews mental health policies on these issues and reports on a WPA survey of them. While the WPA Madrid Declaration permits breaching confidentiality for mandatory reporting of CSA and clearly prohibits PPSR, it is not known how or to what extent these policies are implemented in WPA Member Societies’ countries. It is also not known whether policies or laws exist on these topics nationally or to what extent psychiatrists and the public are aware of them. Representatives of WPA Member Societies were e-mailed a survey about issues pertaining to CSA and PPSR. Fifty-one percent of 109 countries replied. All reporting countries had laws or policies regarding the reporting of CSA, but this was often voluntary (63%) and without protection for reporting psychiatrists either by law (29%) or by Member Societies (27%). A substantial number of psychiatric leaders did not know the law (27%) or their Society’s policy (11%) on these matters. With respect to PPSR, some reporting countries lacked laws or policies about PPSR with current (17%) or past (56%) patients. Fewer than half of responding representatives believed that their Society’s members or the public were well informed about the laws and policies pertaining to CSA or PPSR. There is clearly a wide range of laws, policies and practices about CSA and PPSR in WPA Member Societies’ countries. There is a need in some countries for laws or supplemental policies to facilitate the protection of vulnerable child and adult patients through clear, mandatory reporting policies for CSA and PPSR. Mechanisms to protect and support reporting psychiatrists should also be developed where they do not already exist. There is also a need in some countries to develop strategies to improve the education of psychiatrists, trainees, and the public on these issues. PMID:19293961

Global Burden Of Disease Studies: Implications For Mental And Substance Use Disorders.

PubMed

Whiteford, Harvey; Ferrari, Alize; Degenhardt, Louisa

2016-06-01

Global Burden of Disease studies have highlighted mental and substance use disorders as the leading cause of disability globally. Using the studies' findings for policy and planning requires an understanding of how estimates are generated, the required epidemiological data are gathered, disability and premature mortality are defined and counted, and comparative risk assessment for risk-factor analysis is undertaken. The high burden of mental and substance use disorders has increased their priority on the global health agenda, but not enough to prompt concerted action by governments and international agencies. Using Global Burden of Disease estimates in health policy and planning requires combining them with other information such as evidence on the cost-effectiveness of interventions designed to reduce the disorders' burden. Concerted action is required by mental health advocates and policy makers to assemble this evidence, taking into account the health, social, and economic challenges facing each country. Project HOPE—The People-to-People Health Foundation, Inc.

Antismoking public policies as envisioned by bangladeshi smokers and non-smokers.

PubMed

Budden, M C; Hossain, N

1986-01-01

Tobacco use is growing quickly in the developing countries. International tobacco companies often escape the strict labeling laws of their national origins by operating in developing societies where such laws are lacking. Bangladesh is a prime example of a developing society where tobacco use and its subsequent social costs are increasing. A survey of Bangladeshis in the capital city of Dhaka shows that both smokers and non-smokers believe public programs aimed at educating the public on the dangers of tobacco use should be implemented. Schools were seen as a viable medium for educating the young. Government warnings concerning any dangers were mandated by both smokers and non-smokers. Limitations on where persons would be allowed to smoke was seen as a viable government policy by the respondents. A promising finding was that the more aware a person was of the dangers of tobacco consumption, the less likely the person was to use tobacco. Implications for government policy makers are discerned.

The International Database of Efficient Appliances (IDEA): A New Resource for Global Efficiency Policy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gerke, Brian F; McNeil, Michael A; Tu, Thomas

A major barrier to effective appliance efficiency program design and evaluation is a lack of data for determination of market baselines and cost-effective energy savings potential. The data gap is particularly acute in developing countries, which may have the greatest savings potential per unit GDP. To address this need, we are developing the International Database of Efficient Appliances (IDEA), which automatically compiles data from a wide variety of online sources to create a unified repository of information on efficiency, price, and features for a wide range of energy-consuming products across global markets. This paper summarizes the database framework and demonstratesmore » the power of IDEA as a resource for appliance efficiency research and policy development. Using IDEA data for refrigerators in China and India, we develop robust cost-effectiveness indicators that allow rapid determination of savings potential within each market, as well as comparison of that potential across markets and appliance types. We discuss implications for future energy efficiency policy development.« less

A Case for “Reverse One-Child” Policies in Japan and South Korea? Examining the Link between Education Costs and Lowest-Low Fertility

PubMed Central

Tan, Poh Lin; Morgan, S. Philip; Zagheni, Emilio

2018-01-01

Household spending on children’s pre-tertiary education is exceptionally high in Japan and South Korea, and has been cited as a cause of low fertility. Previous research attributes this high spending to a cultural emphasis on education in East Asian countries. In this paper, we argue that institutional factors, namely higher education and labor market systems, play an important role in reinforcing the pressure on parents to invest in their children’s education. We review evidence showing that graduating from a prestigious university has very high economic and social returns in Japan and South Korea, and examine the implications for fertility within the framework of quantity-quality models. Finally, we put forward ‘reverse one-child’ policies that directly address the unintended consequences of these institutional factors on fertility. These policies have the additional virtues of having very low fiscal requirements and reducing social inequality. PMID:29593367

The impact of donor policies in Europe: a steady increase, but not everywhere

PubMed Central

Coppen, Remco; Friele, Roland D; Gevers, Sjef KM; Blok, Geke A; van der Zee, Jouke

2008-01-01

Background Transplantable organs are scarce everywhere. Therefore, countries have developed policies to support the efficient use of potential donors. Nevertheless, the shortage of organs remains. Were these policies in vain? The aim of this study is to assess the impact of donor policies on donor procurement in 10 Western European countries from 1995 to 2005. Method To assess the impact of the donor policies we studied the conversion of potential donors into effectuated donors. 80% of the donors died from CVAs or a (traffic) accident. We considered these mortality rates to be a good proxy for potential donors. Here we call the conversion of potential donors into actual donors 'the donor efficiency rate by proxy'. Results The mortality rates for CVA and (traffic) accidents have decreased in the countries under study. At the same time, in most countries the donor efficiency rates have steadily increased. The variance in donor efficiency rates between countries has also increased from 1995 to 2005. Four countries introduced a new consent system or changed their existing system, without (visible) long-term effects. Conclusion The overall increase in donor efficiency means that the efforts to improve donor policies have paid off. However, substantial differences between countries were found. The success of donor policies in terms of the number of absolute donors is blurred by the success of policies on traffic safety and CVA treatment. It remains unclear which specific policy measures are responsible for the increase in donor efficiency rates. This increase is not related to having a presumed consent system. Furthermore, an analysis of countries that introduced a new consent system or changed their system showed no effect on donor efficiency. PMID:19014536

Measurement equivalence: a glossary for comparative population health research.

PubMed

Morris, Katherine Ann

2018-03-06

Comparative population health studies are becoming more common and are advancing solutions to crucial public health problems, but decades-old measurement equivalence issues remain without a common vocabulary to identify and address the biases that contribute to non-equivalence. This glossary defines sources of measurement non-equivalence. While drawing examples from both within-country and between-country studies, this glossary also defines methods of harmonisation and elucidates the unique opportunities in addition to the unique challenges of particular harmonisation methods. Its primary objective is to enable population health researchers to more clearly articulate their measurement assumptions and the implications of their findings for policy. It is also intended to provide scholars and policymakers across multiple areas of inquiry with tools to evaluate comparative research and thus contribute to urgent debates on how to ameliorate growing health disparities within and between countries. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Use of artemether-lumefantrine to treat malaria during pregnancy: what do we know and need to know?

PubMed

Mutabingwa, Theonest K; Adam, Ishag

2013-02-01

Artemether-lumefantrine is a fixed-dose combination containing 20 mg artemether/120 mg lumefantrine per tablet, used for treating uncomplicated malaria in patients weighing ≥5 kg. It is the first artemisinin-based combination registered in some European countries and in the USA. It is marketed in Europe as Riamet(®) (Novartis, Basel, Switzerland) and in malaria-endemic countries as Coartem(®) (Novartis). Safety concerns prevent early pregnancy usage, while limited postmarketing surveillance has delayed safety assessment and policy development. Large clinical studies, postmarketing surveillance and pharmacovigillance ongoing in some countries may soon bridge safety issues. Fatty diet requirements for optimal absorption, pregnancy-induced changes in pharmacokinetics, pregnancy-related anorexia and food taboos, and emerging reduced parasite sensitivity to artemisinin, challenges optimal artemether-lumefantrine dosing and efficacy during pregnancy. This evaluation addresses drug usage, safety concerns following early exposure, implications for changed pharmacokinetics and reduced parasite susceptibility. Clinical-use updates and strategies to address some knowledge gaps including key operational research are discussed.

The implications of megatrends in information and communication technology and transportation for changes in global physical activity.

PubMed

Pratt, Michael; Sarmiento, Olga L; Montes, Felipe; Ogilvie, David; Marcus, Bess H; Perez, Lilian G; Brownson, Ross C

2012-07-21

Physical inactivity accounts for more than 3 million deaths per year, most from non-communicable diseases in low-income and middle-income countries. We used reviews of physical activity interventions and a simulation model to examine how megatrends in information and communication technology and transportation directly and indirectly affect levels of physical activity across countries of low, middle, and high income. The model suggested that the direct and potentiating eff ects of information and communication technology, especially mobile phones, are nearly equal in magnitude to the mean eff ects of planned physical activity interventions. The greatest potential to increase population physical activity might thus be in creation of synergistic policies in sectors outside health including communication and transportation. However, there remains a glaring mismatch between where studies on physical activity interventions are undertaken and where the potential lies in low-income and middle-income countries for population-level effects that will truly affect global health.

The implications of megatrends in information and communication technology and transportation for changes in global physical activity

PubMed Central

Pratt, Michael; Sarmiento, Olga L; Montes, Felipe; Ogilvie, David; Marcus, Bess H; Perez, Lilian G; Brownson, Ross C

2016-01-01

Physical inactivity accounts for more than 3 million deaths per year, most from non-communicable diseases in low-income and middle-income countries. We used reviews of physical activity interventions and a simulation model to examine how megatrends in information and communication technology and transportation directly and indirectly affect levels of physical activity across countries of low, middle, and high income. The model suggested that the direct and potentiating effects of information and communication technology, especially mobile phones, are nearly equal in magnitude to the mean effects of planned physical activity interventions. The greatest potential to increase population physical activity might thus be in creation of synergistic policies in sectors outside health including communication and transportation. However, there remains a glaring mismatch between where studies on physical activity interventions are undertaken and where the potential lies in low-income and middle-income countries for population-level effects that will truly affect global health. PMID:22818940

Urban Environments and Obesity in Southeast Asia: A Systematic Review, Meta-Analysis and Meta-Regression

PubMed Central

Angkurawaranon, Chaisiri; Jiraporncharoen, Wichuda; Chenthanakij, Boriboon; Doyle, Pat; Nitsch, Dorothea

2014-01-01

Many environmental factors contribute to the rise in prevalence of obesity in populations but one key driver is urbanization. Countries in Southeast (SE) Asia have undergone rapid changes in urbanization in recent decades. The aim of this study is to provide a systematic review of studies exploring the relationship between living in an urban or rural environment (urbanicity) and obesity in Southeast Asia. In particular, the review will investigate whether the associations are uniform across countries and ages, and by sex. The literature search was conducted up to June 2014 using five databases: EMBASE, PubMed, GlobalHealth, DigitalJournal and Open Grey. Forty-five articles representing eight of the eleven countries in SE Asia were included in the review. The review found a consistent positive association between urbanicity and obesity in countries of Southeast Asia, in all age groups and both genders. Regional differences between the associations are partly explained by gross national income (GNI). In countries with lower GNI per capita, the association between urbanicity and obesity was greater. Such findings have implications for policy makers. They imply that population level interventions need to be country or region specific, tailored to suit the current stage of economic development. In addition, less developed countries might be more vulnerable to the negative health impact of urbanization than more developed countries. PMID:25426942

Integrating Renewable Generation into Grid Operations: Four International Experiences

DOE Office of Scientific and Technical Information (OSTI.GOV)

Weimar, Mark R.; Mylrea, Michael E.; Levin, Todd

International experiences with power sector restructuring and the resultant impacts on bulk power grid operations and planning may provide insight into policy questions for the evolving United States power grid as resource mixes are changing in response to fuel prices, an aging generation fleet and to meet climate goals. Australia, Germany, Japan and the UK were selected to represent a range in the level and attributes of electricity industry liberalization in order to draw comparisons across a variety of regions in the United States such as California, ERCOT, the Southwest Power Pool and the Southeast Reliability Region. The study drawsmore » conclusions through a literature review of the four case study countries with regards to the changing resource mix and the electricity industry sector structure and their impact on grid operations and planning. This paper derives lessons learned and synthesizes implications for the United States based on answers to the above questions and the challenges faced by the four selected countries. Each country was examined to determine the challenges to their bulk power sector based on their changing resource mix, market structure, policies driving the changing resource mix, and policies driving restructuring. Each countries’ approach to solving those changes was examined, as well as how each country’s market structure either exacerbated or mitigated the approaches to solving the challenges to their bulk power grid operations and planning. All countries’ policies encourage renewable energy generation. One significant finding included the low- to zero-marginal cost of intermittent renewables and its potential negative impact on long-term resource adequacy. No dominant solution has emerged although a capacity market was introduced in the UK and is being contemplated in Japan. Germany has proposed the Energy Market 2.0 to encourage flexible generation investment. The grid operator in Australia proposed several approaches to maintaining synchronous generation. Interconnections to other regions provides added opportunities for balancing that would not be available otherwise, and at this point, has allowed for integration of renewables.« less

Who Lives Where and Does It Matter? Changes in the Health Profiles of Older People Living in Long Term Care and the Community over Two Decades in a High Income Country.

PubMed

Matthews, Fiona E; Bennett, Holly; Wittenberg, Raphael; Jagger, Carol; Dening, Tom; Brayne, Carol

2016-01-01

There have been fundamental shifts in the attitude towards, access to and nature of long term care in high income countries. The proportion and profile of the older population living in such settings varies according to social, cultural, and economic characteristics as well as governmental policies. Changes in the profiles of people in different settings are important for policy makers and care providers. Although details will differ, how change occurs across time is important to all, including lower and middle income countries developing policies themselves. Here change is examined across two decades in England. Using the two Cognitive Function and Ageing Studies (CFAS I: 77% response, CFAS II: 56% response), two population based studies of older people carried out in the same areas conducted two decades apart, the study diagnosis of dementia using the Automated Geriatric Examination for Computer Assisted Taxonomy, health and wellbeing were examined, focusing on long term care. The proportion of individuals with three or more health conditions increased for everyone living in long term care between CFAS I (47.6%, 95% CI: 42.3-53.1) and CFAS II (62.7%, 95% CI: 54.8-70.0) and was consistently higher in those without dementia compared to those with dementia in both studies. Functional impairment measured by activities of daily living increased in assisted living facilities from 48% (95% CI: 44%-52%) to 67% (95% CI: 62%-71%). Health profiles of residents in long term care have changed dramatically over time. Dementia prevalence and reporting multiple health conditions have increased. Receiving care in the community puts pressure on unpaid carers and formal services; these results have implications for policies about supporting people at home as well as for service provision within long term care including quality of care, health management, cost, and the development of a skilled, caring, and informed workforce.

Global policy for improvement of oral health in the 21st century--implications to oral health research of World Health Assembly 2007, World Health Organization.

PubMed

Petersen, Poul Erik

2009-02-01

The World Health Organization (WHO) Global Oral Health Programme has worked hard over the past 5 years to increase the awareness of oral health worldwide as oral health is important component of general health and quality of life. Meanwhile, oral disease is still a major public health problem in high income countries and the burden of oral disease is growing in many low- and middle income countries. In the World Oral Health Report 2003, the WHO Global Oral Health Programme formulated the policies and necessary actions to the continuous improvement of oral health. The strategy is that oral disease prevention and the promotion of oral health needs to be integrated with chronic disease prevention and general health promotion as the risks to health are linked. The World Health Assembly (WHA) and the Executive Board (EB) are supreme governance bodies of WHO and for the first time in 25 years oral health was subject to discussion by those bodies in 2007. At the EB120 and WHA60, the Member States agreed on an action plan for oral health and integrated disease prevention, thereby confirming the approach of the Oral Health Programme. The policy forms the basis for future development or adjustment of oral health programmes at national level. Clinical and public health research has shown that a number of individual, professional and community preventive measures are effective in preventing most oral diseases. However, advances in oral health science have not yet benefited the poor and disadvantaged populations worldwide. The major challenges of the future will be to translate knowledge and experiences in oral disease prevention and health promotion into action programmes. The WHO Global Oral Health Programme invites the international oral health research community to engage further in research capacity building in developing countries, and in strengthening the work so that research is recognized as the foundation of oral heath policy at global level.

Access to age-appropriate essential medicines: a retrospective survey of compounding of medicines for children in hospitals in Nigeria and implications for policy development.

PubMed

Orubu, Ebiowei Samuel F; Okwelogu, Chinyere; Opanuga, Olabisi; Nunn, Tony; Tuleu, Catherine

2017-03-01

Policies to improve access to medicines for children in Nigeria do not include compounding as a source of medicines. Compounding is often applied as a last resort in health institutions to provide age-appropriate formulations usually for oral use in young children; but it bears some risk. Some countries have adopted policies aimed at reducing the risk based on available data. There is not much data for Nigeria. This retrospective study examined compounding records from January to December 2011 in a sample of seven hospitals to describe what medicines for oral use were commonly compounded in Nigeria. It then determined if these medicines were commercially available in forms suitable for use in children in selected countries—the United Kingdom, United States and India. The study found that out of 2845 items compounded, over 65% were medicines for cardiovascular conditions, diarrhoea or tuberculosis. The main reason (96%, n = 2399) for compounding was the unavailability of age-appropriate formulations. Medicines were almost all compounded using simple syrup, vitamin C or vitamin B syrups as suspending vehicles. Final products were all oral liquids. Comprehensive stability testing was not reported for the products. Almost all of the commonly compounded medicines were found to be commercially available in dosage forms suitable for use in children in the selected countries. These medicines were all listed in the World Health Organization Essential Medicines List for children as well as in the current edition of the Essential Medicines List of Nigeria. The fact that they were compounded highlights the need for improved access to age-appropriate dosage forms for children in Nigeria. The study recommends policy expansion through a three-pronged approach to improving access: increased supply through facilitated importation/accelerated product registration, or in-country manufacturing; rational drug use including therapeutic substitution, and establishment of a national formulary for compounding.

Cost-effectiveness and resource implications of aggressive action on tuberculosis in China, India, and South Africa: a combined analysis of nine models.

PubMed

Menzies, Nicolas A; Gomez, Gabriela B; Bozzani, Fiammetta; Chatterjee, Susmita; Foster, Nicola; Baena, Ines Garcia; Laurence, Yoko V; Qiang, Sun; Siroka, Andrew; Sweeney, Sedona; Verguet, Stéphane; Arinaminpathy, Nimalan; Azman, Andrew S; Bendavid, Eran; Chang, Stewart T; Cohen, Ted; Denholm, Justin T; Dowdy, David W; Eckhoff, Philip A; Goldhaber-Fiebert, Jeremy D; Handel, Andreas; Huynh, Grace H; Lalli, Marek; Lin, Hsien-Ho; Mandal, Sandip; McBryde, Emma S; Pandey, Surabhi; Salomon, Joshua A; Suen, Sze-Chuan; Sumner, Tom; Trauer, James M; Wagner, Bradley G; Whalen, Christopher C; Wu, Chieh-Yin; Boccia, Delia; Chadha, Vineet K; Charalambous, Salome; Chin, Daniel P; Churchyard, Gavin; Daniels, Colleen; Dewan, Puneet; Ditiu, Lucica; Eaton, Jeffrey W; Grant, Alison D; Hippner, Piotr; Hosseini, Mehran; Mametja, David; Pretorius, Carel; Pillay, Yogan; Rade, Kiran; Sahu, Suvanand; Wang, Lixia; Houben, Rein M G J; Kimerling, Michael E; White, Richard G; Vassall, Anna

2016-11-01

The post-2015 End TB Strategy sets global targets of reducing tuberculosis incidence by 50% and mortality by 75% by 2025. We aimed to assess resource requirements and cost-effectiveness of strategies to achieve these targets in China, India, and South Africa. We examined intervention scenarios developed in consultation with country stakeholders, which scaled up existing interventions to high but feasible coverage by 2025. Nine independent modelling groups collaborated to estimate policy outcomes, and we estimated the cost of each scenario by synthesising service use estimates, empirical cost data, and expert opinion on implementation strategies. We estimated health effects (ie, disability-adjusted life-years averted) and resource implications for 2016-35, including patient-incurred costs. To assess resource requirements and cost-effectiveness, we compared scenarios with a base case representing continued current practice. Incremental tuberculosis service costs differed by scenario and country, and in some cases they more than doubled existing funding needs. In general, expansion of tuberculosis services substantially reduced patient-incurred costs and, in India and China, produced net cost savings for most interventions under a societal perspective. In all three countries, expansion of access to care produced substantial health gains. Compared with current practice and conventional cost-effectiveness thresholds, most intervention approaches seemed highly cost-effective. Expansion of tuberculosis services seems cost-effective for high-burden countries and could generate substantial health and economic benefits for patients, although substantial new funding would be required. Further work to determine the optimal intervention mix for each country is necessary. Bill & Melinda Gates Foundation. Copyright © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

"Safe Foods" or "Fear Foods": the implications of food avoidance in college students from low- and middle-income countries.

PubMed

James, C; Harrison, A; Seixas, A; Powell, M; Pengpid, S; Peltzer, K

2017-09-01

The primary objective of this study was to explore if self-reported food avoidance (fats, carbohydrates and protein) exists among college students in low- and middle-income countries (LMICs) and its relationship with body mass index (BMI), dieting, mood/anxiety symptoms, physical activities and general health knowledge. This study is a subset (N = 6096) of a larger 26 LMICs cross-sectional survey, which consisted of 21,007 college students. We ascertained socio-demographic information, food avoidance, physical activities, dieting behaviours, depressive and PTSD symptoms, and recorded anthropometric measurements. Chi-square analyses assessed the relationship between predictor variables and food categories eliminated from participants' diet. Multiple logistic regression assessed if food avoidance predicts outcome variables such as binge drinking, high physical activity, being underweight, exhibiting significant depressive and PTSD symptoms. Food avoidance exists in as many as one-third of college students in low- and middle-income countries, with this being more likely in persons who are trying to lose weight whether by dieting or otherwise. Food avoidance was associated with higher BMI, depressive symptoms, and high intensity exercises, as well as the level of health knowledge influencing the types of food avoided. A significant difference was noted between lower middle-income and upper middle-income countries with respect to the foods they avoided. Despite being knowledgeable about health-related behaviours, we found that college students in our sample were not that different from those in developed countries and may be influenced by a similar advice given by non-experts about macronutrients. These results hold implications for intervention programmes and policy makers. Level V, descriptive cross-sectional survey.

Toxicants in folk remedies: Implications of elevated blood lead in an American-born infant due to imported diaper powder

USGS Publications Warehouse

Karwowski, Mateusz P.; Morman, Suzette A.; Plumlee, Geoffrey S.; Law, Terence; Kellogg, Mark; Woolf, Alan D.

2016-01-01

Though most childhood lead exposure in the USA results from ingestion of lead-based paint dust, non-paint sources are increasingly implicated. We present interdisciplinary findings from and policy implications of a case of elevated blood lead (13–18 mcg/dL, reference level <5 mcg/dL) in a 9-month-old infant, linked to a non-commercial Malaysian folk diaper powder. Analyses showed the powder contains 62 % lead by weight (primarily lead oxide) and elevated antimony [1000 parts per million (ppm)], arsenic (55 ppm), bismuth (110 ppm), and thallium (31 ppm). These metals are highly bioaccessible in simulated gastric fluids, but only slightly bioaccessible in simulated lung fluids and simulated urine, suggesting that the primary lead exposure routes were ingestion via hand-mouth transmission and ingestion of inhaled dusts cleared from the respiratory tract. Four weeks after discontinuing use of the powder, the infant’s venous blood lead level was 8 mcg/dL. Unregulated, imported folk remedies can be a source of toxicant exposure. Additional research on import policy, product regulation, public health surveillance, and culturally sensitive risk communication is needed to develop efficacious risk reduction strategies in the USA. The more widespread use of contaminated folk remedies in the countries from which they originate is a substantial concern.

Toxicants in folk remedies: implications of elevated blood lead in an American-born infant due to imported diaper powder.

PubMed

Karwowski, Mateusz P; Morman, Suzette A; Plumlee, Geoffrey S; Law, Terence; Kellogg, Mark; Woolf, Alan D

2017-10-01

Though most childhood lead exposure in the USA results from ingestion of lead-based paint dust, non-paint sources are increasingly implicated. We present interdisciplinary findings from and policy implications of a case of elevated blood lead (13-18 mcg/dL, reference level <5 mcg/dL) in a 9-month-old infant, linked to a non-commercial Malaysian folk diaper powder. Analyses showed the powder contains 62 % lead by weight (primarily lead oxide) and elevated antimony [1000 parts per million (ppm)], arsenic (55 ppm), bismuth (110 ppm), and thallium (31 ppm). These metals are highly bioaccessible in simulated gastric fluids, but only slightly bioaccessible in simulated lung fluids and simulated urine, suggesting that the primary lead exposure routes were ingestion via hand-mouth transmission and ingestion of inhaled dusts cleared from the respiratory tract. Four weeks after discontinuing use of the powder, the infant's venous blood lead level was 8 mcg/dL. Unregulated, imported folk remedies can be a source of toxicant exposure. Additional research on import policy, product regulation, public health surveillance, and culturally sensitive risk communication is needed to develop efficacious risk reduction strategies in the USA. The more widespread use of contaminated folk remedies in the countries from which they originate is a substantial concern.

Sustainable diet policy development: implications of multi-criteria and other approaches, 2008-2017.

PubMed

Lang, Tim; Mason, Pamela

2017-12-04

The objective of the present paper is to draw lessons from policy development on sustainable diets. It considers the emergence of sustainable diets as a policy issue and reviews the environmental challenge to nutrition science as to what a 'good' diet is for contemporary policy. It explores the variations in how sustainable diets have been approached by policy-makers. The paper considers how international United Nations and European Union (EU) policy engagement now centres on the 2015 Sustainable Development Goals and Paris Climate Change Accord, which require changes across food systems. The paper outlines national sustainable diet policy in various countries: Australia, Brazil, France, the Netherlands, Qatar, Sweden, UK and USA. While no overarching common framework for sustainable diets has appeared, a policy typology of lessons for sustainable diets is proposed, differentiating (a) orientation and focus, (b) engagement styles and (c) modes of leadership. The paper considers the particularly tortuous rise and fall of UK governmental interest in sustainable diet advice. Initial engagement in the 2000s turned to disengagement in the 2010s, yet some advice has emerged. The 2016 referendum to leave the EU has created a new period of policy uncertainty for the UK food system. This might marginalise attempts to generate sustainable diet advice, but could also be an opportunity for sustainable diets to be a goal for a sustainable UK food system. The role of nutritionists and other food science professions will be significant in this period of policy flux.

A case study of polypharmacy management in nine European countries: Implications for change management and implementation

PubMed Central

MacLure, Katie; Stewart, Derek; Kempen, Thomas; Mair, Alpana; Castel-Branco, Margarida; Codina, Carles; Fernandez-Llimos, Fernando; Fleming, Glenda; Gennimata, Dimitra; Gillespie, Ulrika; Harrison, Cathy; Illario, Maddalena; Junius-Walker, Ulrike; Kampolis, Christos F.; Kardas, Przemyslaw; Lewek, Pawel; Malva, João; Menditto, Enrica; Scullin, Claire; Wiese, Birgitt

2018-01-01

Background Multimorbidity and its associated polypharmacy contribute to an increase in adverse drug events, hospitalizations, and healthcare spending. This study aimed to address: what exists regarding polypharmacy management in the European Union (EU); why programs were, or were not, developed; and, how identified initiatives were developed, implemented, and sustained. Methods Change management principles (Kotter) and normalization process theory (NPT) informed data collection and analysis. Nine case studies were conducted in eight EU countries: Germany (Lower Saxony), Greece, Italy (Campania), Poland, Portugal, Spain (Catalonia), Sweden (Uppsala), and the United Kingdom (Northern Ireland and Scotland). The workflow included a review of country/region specific polypharmacy policies, key informant interviews with stakeholders involved in policy development and implementation and, focus groups of clinicians and managers. Data were analyzed using thematic analysis of individual cases and framework analysis across cases. Results Polypharmacy initiatives were identified in five regions (Catalonia, Lower Saxony, Northern Ireland, Scotland, and Uppsala) and included all care settings. There was agreement, even in cases without initiatives, that polypharmacy is a significant issue to address. Common themes regarding the development and implementation of polypharmacy management initiatives were: locally adapted solutions, organizational culture supporting innovation and teamwork, adequate workforce training, multidisciplinary teams, changes in workflow, redefinition of roles and responsibilities of professionals, policies and legislation supporting the initiative, and data management and information and communication systems to assist development and implementation. Depending on the setting, these were considered either facilitators or barriers to implementation. Conclusion Within the studied EU countries, polypharmacy management was not widely addressed. These results highlight the importance of change management and theory-based implementation strategies, and provide examples of polypharmacy management initiatives that can assist managers and policymakers in developing new programs or scaling up existing ones, particularly in places currently lacking such initiatives. PMID:29668763

Comparison and Evaluation of Global Scale Studies of Vulnerability and Risks to Climate Change

NASA Astrophysics Data System (ADS)

Muccione, Veruska; Allen, Simon K.; Huggel, Christian; Birkmann, Joern

2015-04-01

Understanding the present and future distribution of different climate change impacts and vulnerability to climate change is a central subject in the context of climate justice and international climate policy. Commonly, it is claimed that poor countries that contributed little to anthropogenic climate change are those most affected and most vulnerable to climate change. Such statements are backed by a number of global-scale vulnerability studies, which identified poor countries as most vulnerable. However, some studies have challenged this view, likewise highlighting the high vulnerability of richer countries. Overall, no consensus has been reached so far about which concept of vulnerability should be applied and what type of indicators should be considered. Furthermore, there is little agreement which specific countries are most vulnerable. This is a major concern in view of the need to inform international climate policy, all the more if such assessments should contribute to allocate climate adaptation funds as was invoked at some instances. We argue that next to the analysis of who is most vulnerable, it is also important to better understand and compare different vulnerability profiles assessed in present global studies. We perform a systematic literature review of global vulnerability assessments with the scope to highlight vulnerability distribution patterns. We then compare these distributions with global risk distributions in line with revised and adopted concepts by most recent IPCC reports. It emerges that improved differentiation of key drivers of risk and the understanding of different vulnerability profiles are important contributions, which can inform future adaptation policies at the regional and national level. This can change the perspective on, and basis for distributional issues in view of climate burden share, and therefore can have implications for UNFCCC financing instruments (e.g. Green Climate Fund). However, in order to better compare traditional vulnerability distributions with more recent conceptualisation of risks, more research should be devoted to global assessments of climate change risk distributions.

Macroeconomic implications of population ageing and selected policy responses.

PubMed

Bloom, David E; Chatterji, Somnath; Kowal, Paul; Lloyd-Sherlock, Peter; McKee, Martin; Rechel, Bernd; Rosenberg, Larry; Smith, James P

2015-02-14

Between now and 2030, every country will experience population ageing-a trend that is both pronounced and historically unprecedented. Over the past six decades, countries of the world had experienced only a slight increase in the share of people aged 60 years and older, from 8% to 10%. But in the next four decades, this group is expected to rise to 22% of the total population-a jump from 800 million to 2 billion people. Evidence suggests that cohorts entering older age now are healthier than previous ones. However, progress has been very uneven, as indicated by the wide gaps in population health (measured by life expectancy) between the worst (Sierra Leone) and best (Japan) performing countries, now standing at a difference of 36 years for life expectancy at birth and 15 years for life expectancy at age 60 years. Population ageing poses challenges for countries' economies, and the health of older populations is of concern. Older people have greater health and long-term care needs than younger people, leading to increased expenditure. They are also less likely to work if they are unhealthy, and could impose an economic burden on families and society. Like everyone else, older people need both physical and economic security, but the burden of providing these securities will be falling on a smaller portion of the population. Pension systems will be stressed and will need reassessment along with retirement policies. Health systems, which have not in the past been oriented toward the myriad health problems and long-term care needs of older people and have not sufficiently emphasised disease prevention, can respond in different ways to the new demographic reality and the associated changes in population health. Along with behavioural adaptations by individuals and businesses, the nature of such policy responses will establish whether population ageing will lead to major macroeconomic difficulties. Copyright © 2015 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved. Published by Elsevier Ltd. All rights reserved.

Policy Guidelines for Effective Inclusion and Reintegration of People with Chronic Diseases in the Workplace: National and European Perspectives

PubMed Central

Vlachou, Anastasia; Stavroussi, Panayiota; Roka, Olga; Vasilou, Evdokia; Papadimitriou, Dimitra; Scaratti, Chiara; Kadyrbaeva, Asel; Brecelj, Valentina; Svestkova, Olga; Tobiasz-Adamczyk, Beata; Finnvold, Jon Erik; Gruber, Sonja

2018-01-01

The increasing prevalence of chronic diseases among the European working age population, as well as the implications for the individual and societal level, underline the need for policy guidelines targeting the effective inclusion of persons with chronic diseases in the workplace. The aim of the present paper was to explore the perspectives of European and National-level stakeholders on existing strategies for work re-integration of persons with chronic diseases, and to provide policy guidelines. A highly-structured interview protocol was distributed to 58 National level stakeholders (policy makers, professionals and employers) from seven European countries. Additionally, 20 European organizations concerned with health-related issues and employment completed an online survey. The findings reveal that employment-related challenges remain largely unaddressed. Both national and European stakeholders considered the existing legislative frameworks inadequate and appraised the co-ordination for the implementation of employment re-integration policies as ineffective. Policies targeting at work re-integration of persons with chronic diseases at European and national level should focus on consistent cooperation among all key stakeholders, awareness raising to staff and management, dissemination of effective strategies, developing research and evaluation standards and establishing monitoring systems on inclusive labour markets. PMID:29534484

Comprehensive taxonomy and worldwide trends in pharmaceutical policies in relation to country income status.

PubMed

Maniadakis, N; Kourlaba, G; Shen, J; Holtorf, A

2017-05-25

Rapidly evolving socioeconomic and technological trends make it challenging to improve access, effectiveness and efficiency in the use of pharmaceuticals. This paper identifies and systematically classifies the prevailing pharmaceutical policies worldwide in relation to a country's income status. A literature search was undertaken to identify and taxonomize prevailing policies worldwide. Countries that apply those policies and those that do not were then grouped by income status. Pharmaceutical policies are linked to a country's socioeconomics. Developed countries have universal coverage and control pharmaceuticals with external and internal price referencing systems, and indirect price-cost controls; they carry out health technology assessments and demand utilization controls. Price-volume and risk-sharing agreements are also evolving. Developing countries are underperforming in terms of coverage and they rely mostly on restrictive state controls to regulate prices and expenditure. There are significant disparities worldwide in the access to pharmaceuticals, their use, and the reimbursement of costs. The challenge in high-income countries is to maintain access to care whilst dealing with trends in technology and aging. Essential drugs should be available to all; however, many low- and middle-income countries still provide most of their population with only poor access to medicines. As economies grow, there should be greater investment in pharmaceutical care, looking to the policies of high-income countries to increase efficiency. Pharmaceutical companies could also develop special access schemes with low prices to facilitate coverage in low-income countries.

A systematic approach to injury policy assessment: introducing the assessment of child injury prevention policies (A-CHIPP).

PubMed

Alonge, Olakunle; Agrawal, Priyanka; Meddings, David; Hyder, Adnan A

2017-11-03

This study presents a systematic approach-assessment of child injury prevention policies (A-CHIPP)-to assess and track policies on effective child injury interventions at the national level. Results from an initial pilot test of the approach in selected countries are presented. A literature review was conducted to identify conceptual models for injury policy assessment, and domains and indicators were proposed for assessing national injury policies for children aged 1-9 years. The indicators focused on current evidence-supported interventions targeting the leading external causes of child injury mortality globally, and were organised into a self-administered A-CHIPP questionnaire comprising 22 questions. The questionnaire was modified based on reviews by experts in child injury prevention. For an initial test of the approach, 13 countries from all six WHO regions were selected to examine the accuracy, usefulness and ease of understanding of the A-CHIPP questionnaire. Data on the A-CHIPP questionnaire were received from nine countries. Drowning and road traffic injuries were reported as the leading causes of child injury deaths in seven of these countries. Most of the countries lacked national policies on interventions that address child injuries; supportive factors such as finance and leadership for injury prevention were also lacking. All countries rated the questionnaire highly on its relevance for assessment of injury prevention policies. The A-CHIPP questionnaire is useful for national assessment of child injury policies, and such an assessment could draw attention of stakeholders to policy gaps and progress in child injury prevention in all countries. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Generic drug prices and policy in Australia: room for improvement? a comparative analysis with England.

PubMed

Mansfield, Sarah J

2014-02-01

To assess the degree to which reimbursement prices in Australia and England differ for a range of generic drugs, and to analyse the supply- and demand-side factors that may contribute to these differences. Australian and English reimbursement prices were compared for a range of generic drugs using pricing information obtained from government websites. Next, a literature review was conducted to identify supply- and demand-side factors that could affect generic prices in Australia and England. Various search topics were identified addressing potential supply-side (e.g. market approval, intellectual property protection of patented drugs, generic pricing policy, market size, generic supply chain and discounting practices) and demand-side (consumers, prescribers and pharmacists) factors. Related terms were searched in academic databases, official government websites, national statistical databases and internet search engines. Analysis of drug reimbursement prices for 15 generic molecules (representing 45 different drug presentations) demonstrated that Australian prices were on average over 7-fold higher than in England. Significant supply-side differences included aspects of pricing policy, the relative size of the generics markets and the use of clawback policies. Major differences in demand-side policies related to generic prescribing, pharmacist substitution and consumer incentives. Despite recent reforms, the Australian Government continues to pay higher prices than its English counterpart for many generic medications. The results suggest that particular policy areas may benefit from review in Australia, including the length of the price-setting process, the frequency of subsequent price adjustments, the extent of price competition between originators and generics, medical professionals' knowledge about generic medicines and incentives for generic prescribing. WHAT IS KNOWN ABOUT THE TOPIC? Prices of generic drugs have been the subject of much scrutiny over recent years. From 2005 to 2010 the Australian Government responded to observations that Pharmaceutical Benefits Scheme prices for many generics were higher than in numerous comparable countries by instituting several reforms aimed at reducing the prices of generics. Despite this, several studies have demonstrated that prices for generic statins (one class of cholesterol-lowering drug) are higher in Australia compared with England and many other developed countries, and prices of numerous other generics remain higher than in the USA and New Zealand. Recently there has been increasing interest in why these differences exist. WHAT DOES THIS PAPER ADD? By including a much larger range of commonly used and costly generic drugs, this paper builds significantly on the limited previous investigations of generic drug prices in Australia and England. Additionally, this is the first comprehensive investigation of multiple supply- and, in particular, demand-side factors that may explain any price differences between these countries. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? Practitioners may contribute to the higher prices of generic medications in Australia compared with England through relatively low rates of generic prescribing. There are also significant implications for health policy makers, as this paper demonstrates that if Australia achieved the same prices as England for many generic drugs there could be substantial savings for the Pharmaceutical Benefits Scheme.

Compulsory licensing in Canada and Thailand: comparing regimes to ensure legitimate use of the WTO rules.

PubMed

Lybecker, Kristina M; Fowler, Elisabeth

2009-01-01

This paper examines two recent examples of compulsory licensing legislation: one globally embraced regime and one internationally controversial regime operating under the same WTO rules. In particular, we consider Canadian legislation and the use of compulsory licensing for HIV/AIDS drugs destined for a developing country. This is then contrasted with the conditions under which Thai authorities are pursuing compulsory licenses, the outcomes of their compulsory licenses, as well as the likely impact of the Thai policy. Finally, we construct a rubric to evaluate characteristics of a successful regime. This is used to analyze the Canadian and Thai regimes and frame the expected implications of each national policy. It is hoped that the assessment will guide changes to compulsory licensing design to ensure that legitimate regimes are embraced while illegitimate ones are disallowed.

Tobacco control in the 21st century: a critical issue for the nursing profession.

PubMed

Sarna, Linda; Bialous, Stella

2005-01-01

Tobacco control is central to reducing death and disability and improving quality of life worldwide and nursing action is imperative. This article addresses tobacco as a global health issue with implications for nursing practice, education, research, and policy development. The lack of knowledge and skills, lack of expectation for clinical intervention, limited research, an absence of professional policies, and minimal nursing leadership have diminished the critical role that nurses can play in confronting this epidemic. Swift action is needed to ensure that all nurses are prepared to effectively engage in activities to prevent tobacco use, provide evidence-based cessation interventions, and support efforts to prevent exposure to secondhand smoke. Increased opportunities are needed to support creative nursing research efforts that test interventions and strategies to reduce barriers to tobacco control within different cultures, subcultures, and countries.

Children's knowledge of packaged and fast food brands and their BMI. Why the relationship matters for policy makers.

PubMed

Cornwell, T Bettina; McAlister, Anna R; Polmear-Swendris, Nancy

2014-10-01

Studies regarding the advancing challenges of obesity in many countries are beginning to converge on the importance of early food exposure and consumption patterns. Across two studies (Study 1, 34 boys, 35 girls; Study 2, 40 boys, 35 girls, ages 3-6), child knowledge of brands offering products high in sugar, salt and fat was shown to be a significant predictor of child BMI, even after controlling for their age and gender and when also considering the extent of their TV viewing. Additionally, two different collage measures of brand knowledge (utilized across the two studies) performed similarly, suggesting that this measure may be serving as a surrogate indicator of an overall pattern of product exposure and consumption. Policy implications are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

External costs of risky health behaviors associated with leading actual causes of death in the U.S.: a review of the evidence and implications for future research.

PubMed

Zohrabian, Armineh; Philipson, Tomas J

2010-06-01

This paper reviews the evidence on external costs of risky behaviors in the U.S. and provides a framework for estimating them. External costs arise when a person does not bear all the costs of his or her behavior. They provide one of the strongest rationales for government interventions. Although the earlier estimates of external costs no longer have policy relevance, they demonstrated that the existence of external costs was an empirical question. We recommend that the estimates of external costs be updated as insurance structures, environments, and knowledge about these behaviors change. The general aspects of external costs may apply to countries other than the U.S. after taking into account differences in institutional, policy and epidemiological characteristics.

Importing food damages domestic environment: Evidence from global soybean trade.

PubMed

Sun, Jing; Mooney, Harold; Wu, Wenbin; Tang, Huajun; Tong, Yuxin; Xu, Zhenci; Huang, Baorong; Cheng, Yeqing; Yang, Xinjun; Wei, Dan; Zhang, Fusuo; Liu, Jianguo

2018-05-22

Protecting the environment and enhancing food security are among the world's Sustainable Development Goals and greatest challenges. International food trade is an important mechanism to enhance food security worldwide. Nonetheless, it is widely concluded that in international food trade importing countries gain environmental benefits, while exporting countries suffer environmental problems by using land and other resources to produce food for exports. Our study shows that international food trade can also lead to environmental pollution in importing countries. At the global level, our metaanalysis indicates that there was increased nitrogen (N) pollution after much farmland for domestically cultivated N-fixing soybeans in importing countries was converted to grow high N-demanding crops (wheat, corn, rice, and vegetables). The findings were further verified by an intensive study at the regional level in China, the largest soybean-importing country, where the conversion of soybean lands to corn fields and rice paddies has also led to N pollution. Our study provides a sharp contrast to the conventional wisdom that only exports contribute substantially to environmental woes. Our results suggest the need to evaluate environmental consequences of international trade of all other major goods and products in all importing countries, which have significant implications for fundamental rethinking in global policy-making and debates on environmental responsibilities among consumers, producers, and traders across the world.

25 CFR 12.14 - Where can I find specific policies and standards for law enforcement functions in Indian country?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Where can I find specific policies and standards for law enforcement functions in Indian country? 12.14 Section 12.14 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER INDIAN COUNTRY LAW ENFORCEMENT Policies and Standards § 12.14 Where can I find specific policies and standards fo...

China’s Currency: Economic Issues and Options for U.S. Trade Policy

DTIC Science & Technology

2007-07-15

a policy that is practiced by a variety of developing countries . Chinese officials have expressed concern that abandoning the current currency...has been proven to be unreliable in reality: prices are consistently lower in developing countries than industrialized countries . Some economists have...not caused by the exchange rate policy of one country , but rather the shortfall between U.S. saving and investment. That being said, there are a

Manpower Policies and the Disadvantaged; A Summary Report on Labor Market Information Systems and the Disadvantaged, with Emphasis on Policy Implications.

ERIC Educational Resources Information Center

Myers, Charles A.

The report highlights policy implications of research conducted on formal and informal labor market information systems and the disadvantaged. Policy implications are developed at the end of each of eight sections reviewing studies in the areas of: insurance, an inner-city training program, newspaper ads, the Job Bank system, immigrant labor,…

The use of home brew in Pacific Islands countries and territories.

PubMed

Nosa, Vili; Duffy, Shavonne; Singh, Debbie; Lavelio, Save; Amber, Uma; Homasi-Paelate, Avanoa; Alfred, Julia

2018-01-01

This review examines what is known about the production and use of home brew in the Pacific Islands countries and territories. Data collection involved interviews of 78 men and women from the Marshall Islands, Papua New Guinea, Toga, and Tuvalu. The interviews were conducted in 2013 by local interviewers. The questions fell into four key areas: people's history of home-brew consumption, the reasons for home-brew use, the effects of home brew, and people's perceptions about home brew. An open ethnographic approach revealed that males are the main consumers of home brew, that home brew is consumed in private venues by those with low socioeconomic status, and that there are positive and negative outcomes associated with the use of home brew. Finally, policy implications of the findings are included in this article.

Universal patterns or the tale of two systems? Mathematics achievement and educational expectations in post-socialist Europe

PubMed Central

Bodovski, Katerina; Kotok, Stephen; Henck, Adrienne

2014-01-01

Although communist ideology claimed to destroy former class stratification based on labor market capitalist relationships, de facto during socialism one social class hierarchy was substituted for another that was equally unequal. The economic transition during the 1990s increased stratification by wealth, which affected educational inequality. This study examines the relationships among parental education, gender, educational expectations, and mathematics achievement of youths in five post-socialist Eastern European countries, comparing them with three Western countries. We employed the 8th-grade data from the Trends in International Mathematics and Science Study (TIMSS) 1995 and 2007. The findings point to the universal associations between parental education and student outcomes, whereas gender comparisons present interesting East-West differences. The theoretical and policy implications of these findings are discussed. PMID:25346564

Family Policy: Government and Families in Fourteen Countries.

ERIC Educational Resources Information Center

Kamerman, Sheila B., Ed.; Kahn, Alfred J., Ed.

This collection of articles by scholars and policy makers from 14 countries presents multidisciplinary perspectives on the formation of national policy on families. Central topics common to many of the articles include: (1) the differences between policies aimed at affecting the family and policies which have other aims but which do influence the…

Inequalities by immigrant status in depressive symptoms in Europe: the role of integration policy regimes.

PubMed

Malmusi, Davide; Palència, Laia; Ikram, Umar Z; Kunst, Anton E; Borrell, Carme

2017-04-01

We aimed to study whether country integration policy models were related to inequalities by immigrant status in depressive symptoms in Europe. This is a cross-sectional study using data from 17 countries in the sixth wave of the European Social Survey (2012), comparing subjects born either in the country of residence (non-immigrants, N = 28,333) or in a country not classified as "advanced economy" by the IMF (immigrants, N = 2041). Depressive symptoms were assessed with the eight-item version of the Center for Epidemiologic Studies Depression scale. Countries were grouped into three integration policy regimes (inclusive, assimilationist, and exclusionist). Linear regressions were fitted adjusting first by age, sex, and education level, then sequentially by citizenship, perceived discrimination, and socio-economic variables. In all integration regimes, immigrants report significantly more depressive symptoms than non-immigrants. The gap is the largest in exclusionist countries (immigrants score 1.16, 95% CI 0.65-1.68, points higher than non-immigrants in the depression scale), followed by assimilationist countries (0.85 and 0.57-1.13) and inclusive countries (0.60 and 0.36-0.84). Financial strain explains all the associations in inclusive countries, most of it in assimilationist countries, but only a small part in exclusionist countries. Across most European countries, immigrants seem to experience more depressive symptoms than the population born in the country, mostly reflecting their poorer socio-economic situation. Inequalities are larger in countries with more restrictive policies. Despite some limitations, this study adds new evidence to suggest that immigrants' health is shaped by integration policies in their host country.

Preliminary Country Reports on Feasibility Survey: Policy Research and Education Institutions for Developing Countries.

ERIC Educational Resources Information Center

Mitchell, James M.; Luikart, F. W.

The feasibility of creating independent research and education centers that deal with public policy issues in developing countries is assessed. Countries that were surveyed include Brazil, Colombia, Bolivia, Costa Rica, Guatemala, South Korea, Philippines, Pakistan, and Nepal. For each country, a report describes the social and political climate…

The SAZA study: implementing health financing reform in South Africa and Zambia.

PubMed

Gilson, Lucy; Doherty, Jane; Lake, Sally; McIntyre, Di; Mwikisa, Chris; Thomas, Stephen

2003-03-01

This paper explores the policy-making process in the 1990s in two countries, South Africa and Zambia, in relation to health care financing reforms. While much of the analysis of health reform programmes has looked at design issues, assuming that a technically sound design is the primary requirement of effective policy change, this paper explores the political and bureaucratic realities shaping the pattern of policy change and its impacts. Through a case study approach, it provides a picture of the policy environment and processes in the two countries, specifically considering the extent to which technical analysts and technical knowledge were able to shape policy change. The two countries' experiences indicate the strong influence of political factors and actors over which health care financing policies were implemented, and which not, as well as over the details of policy design. Moments of political transition in both countries provided political leaders, specifically Ministers of Health, with windows of opportunity in which to introduce new policies. However, these transitions, and the changes in administrative structures introduced with them, also created environments that constrained the processes of reform design and implementation and limited the equity and sustainability gains achieved by the policies. Technical analysts, working either inside or outside government, had varying and often limited influence. In part, this reflected the limits of their own capacity as well as weaknesses in the way they were used in policy development. In addition, the analysts were constrained by the fact that their preferred policies often received only weak political support. Focusing almost exclusively on designing policy reforms, these analysts gave little attention to generating adequate support for the policy options they proposed. Finally, the country experiences showed that front-line health workers, middle level managers and the public had important influences over policy implementation and its impacts. The limited attention given to communicating policy changes to, or consulting with, these actors only heightened the potential for reforms to result in unanticipated and unwanted impacts. The strength of the paper lies in its 'thick description' of the policy process in each country, an empirical case study approach to policy that is under-represented in the literature. While such an approach allows only a cautious drawing of general conclusions, it suggests a number of ways in which to strengthen the implementation of financing policies in each country.

Global health initiatives in Africa - governance, priorities, harmonisation and alignment.

PubMed

Mwisongo, Aziza; Nabyonga-Orem, Juliet

2016-07-18

The advent of global health initiatives (GHIs) has changed the landscape and architecture of health financing in low and middle income countries, particularly in Africa. Over the last decade, the African Region has realised improvements in health outcomes as a result of interventions implemented by both governments and development partners. However, alignment and harmonisation of partnerships and GHIs are still difficult in the African countries with inadequate capacity for their effective coordination. Both published and grey literature was reviewed to understand the governance, priorities, harmonisation and alignment of GHIs in the African Region; to synthesise the knowledge and highlight the persistent challenges; and to identify gaps for future research. GHI governance structures are often separate from those of the countries in which they operate. Their divergent funding channels and modalities may have contributed to the failure of governments to track their resources. There is also evidence that basically, earmarking and donor conditions drive funding allocations regardless of countries' priorities. Although studies cite the lack of harmonisation of GHI priorities with national strategies, evidence shows improvements in that area over time. GHIs have used several strategies and mechanisms to involve the private sector. These have widened the pool of health service policy-makers and providers to include groups such as civil society organisations (CSOs), with both positive and negative implications. GHI strategies such as co-financing by countries as a condition for support have been positive in achieving sustainability of interventions. GHI approaches have not changed substantially over the years but there has been evolution in terms of donor funding and conditions. GHIs still largely operate in a vertical manner, bypassing country systems; they compete for the limited human resources; they influence country policies; and they are not always harmonised with other donors. To maximise returns on GHI support, there is need to ensure that their approaches are more comprehensive as opposed to being selective; to improve GHI country level governance and alignment with countries' changing epidemiologic profiles; and to strengthen their involvement of CSOs.

How Socio-Economic Conditions Influence Forest Policy Development in Central and South-East Europe

NASA Astrophysics Data System (ADS)

Vuletić, Dijana; Potočić, Nenad; Krajter, Silvija; Seletković, Ivan; Fürst, Christine; Makeschin, Franz; Galić, Zoran; Lorz, Carsten; Matijašič, Dragan; Zupanič, Matjaž; Simončič, Primož; Vacik, Harald

2010-12-01

In this article, several findings on socio-economic conditions derived from national reports and a web-based questionnaire are discussed and related to the changing role of forestry and the future forest policy development. A number of Central and South-eastern European countries taking part in a SEE-ERA-NET project ReForMan project ( www.reforman.de ) participated in data acquisition: Austria, Bosnia and Herzegovina, Croatia, Germany, Serbia and Slovenia. The aim of the research was to illustrate the present structure of forestry sector, as well as investigate newly emerging topics in forestry of Central and South-eastern Europe. The results indicated certain patterns in attitudes and perceptions among stakeholders that can be related to socio-economic conditions defined for each country. Clear differences between member and non-member countries exist only in level of implementation of EU legislation. Results showed consensus on main threats to the forests among all countries, but also some country specifics in perceptions of factors influencing forestry, their importance and professional competencies. These results could be additionally explained by influence of historical conditions which shaped development of forest sector in SEE region especially in its organizational dimension as well as in perceived role of forestry expressed through recognition of main forest functions. The influence of European forest policy processes in the region is evident through adaptation of EU legislation and perceived implications of international processes on national levels. Based on this observation, two possible options for future development of the forestry sector can be foreseen: (i) focusing on the productive function of forests and fostering its' sustainable use; or (ii) putting an emphasis on environmental and social issues. In both cases supporting public participation in decision-making processes is recommendable. Another conclusion based on perceived medium to low professional competencies to cope with new topics, that there is lack of confidence and need for professional support in decisionmaking processes.

Innovative grassland management systems for environmental and livelihood benefits.

PubMed

Kemp, David R; Guodong, Han; Xiangyang, Hou; Michalk, David L; Fujiang, Hou; Jianping, Wu; Yingjun, Zhang

2013-05-21

Grasslands occupy 40% of the world's land surface (excluding Antarctica and Greenland) and support diverse groups, from traditional extensive nomadic to intense livestock-production systems. Population pressures mean that many of these grasslands are in a degraded state, particularly in less-productive areas of developing countries, affecting not only productivity but also vital environmental services such as hydrology, biodiversity, and carbon cycles; livestock condition is often poor and household incomes are at or below poverty levels. The challenge is to optimize management practices that result in "win-win" outcomes for grasslands, the environment, and households. A case study is discussed from northwestern China, where it has been possible to reduce animal numbers considerably by using an energy-balance/market-based approach while improving household incomes, providing conditions within which grassland recovery is possible. This bottom-up approach was supported by informing and working with the six layers of government in China to build appropriate policies. Further policy implications are considered. Additional gains in grassland rehabilitation could be fostered through targeted environmental payment schemes. Other aspects of the livestock production system that can be modified are discussed. This work built a strategy that has implications for many other grassland areas around the world where common problems apply.

Reducing inequalities in health: political and organisational implications for the British National Health Service.

PubMed

Hunter, D J

1983-12-01

Tackling health inequalities with any hope of success requires an understanding and appreciation of a number of issues concerning the nature and operation of services. Focussing on the British experience, the paper considers notions of need and demand insofar as these have a bearing on health inequalities. Need and demand are not finite, absolute states but are relative notions which are affected by users' attitudes and knowledge and by providers' preferences and interests. Drawing upon recent work, the paper argues that the existence of the National Health Service (NHS) has not fundamentally altered the nature of health inequalities in Britain. Those living in the North of the country generally enjoy poorer health than those living in the South. Inequalities between socio-economic groups are also much in evidence. The paper considers possible policy implications and comes out in favour of process change rather than major structural change of the kind witnessed in recent years in Britain where the NHS has undergone two major upheavals within a decade. This disruption has had the effect of diverting attention away from important policy issues at all levels of service planning and provision.(ABSTRACT TRUNCATED AT 250 WORDS)

Population ageing in Lebanon: current status, future prospects and implications for policy.

PubMed Central

Sibai, Abla Mehio; Sen, Kasturi; Baydoun, May; Saxena, Prem

2004-01-01

During the past three decades, fast declines in fertility and mortality in Lebanon have created a compressed demographic transition, a growing trend towards survival into later life, and a larger proportion of elderly people in the population. Projections show that people aged 65 years and over are expected to constitute 10.2% of the population by 2025. Nevertheless, changes to the structure and composition of the population remain unmatched by any corresponding increase in support measures either through formal channels such as pension plans or through health or socioeconomic security measures such as the provision of subsidies for health care, home help or any form of nursing care. This means that an older person is forced to be dependent upon family support if it exists. We examine demographic trends of population ageing in Lebanon between 1970 and 1995 and provide projections until 2025. Variations in population ageing within the country are also considered. We also assess health care and social policy implications of demographic changes in the context of health and economic sector reforms initiated recently by the state, and explore their impact upon the expanding population of elderly people. PMID:15112011

School Choice Policy: Seeking to Balance Educational Efficiency and Equity. A Comparative Analysis of 20 European Countries

ERIC Educational Resources Information Center

Lauri, Triin; Põder, Kaire

2013-01-01

In recent years, the degree of choice in education systems has increased in most countries. Still, the variation of choice policies across countries is substantial. The authors ask under what combinations of conditions (i.e. institutional features of education systems) choice policy succeeds in balancing educational efficiency and equity. Using…

Implementing Health Financing Reforms in Africa: Perspectives of Health System Stewards.

PubMed

Achoki, Tom; Lesego, Abaleng

A majority of health systems in the sub-Saharan Africa region are faced with multiple competing priorities amid pressing resource constraints. Health financing reforms, characterized by expansion of health insurance coverage, have been proposed as promising in the quest to improve health sustainably. However, in many countries where these measures are being attempted, their broader implications have not been fully appreciated. This study was based on perspectives of 37 health system stewards from Botswana who were interviewed in order to understand opportunities and challenges that would result in the quest to expand health insurance coverage in the country. Thematic synthesis of their perspectives, focusing on the key aspects of the health systems, was done in order to draw informative lessons that could be applicable to a broader set of low- and middle-income countries. Health systems attempting to expand health insurance coverage would be faced with various opportunities and challenges that have implications on performance. By increasing the pool of resources available to spend on health, health insurance would afford health systems the opportunity to increase population access to and use of health services. However, if unchecked, this could also translate to uncontrolled demand for expensive medicines and other health technologies, leading to cost escalation and inefficiencies within the system. Therefore, the success of any health financing reform is dependent on embracing sound policies, regulations, and accountability measures. Health financing reforms have broader implications to health system performance that should be fully appreciated and anticipated before implementation. Therefore, health system leaders who are keen to improve health must view any health financing reforms through the broader framework of the health system framework in order to make progress. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Mapping of nutrition and sectoral policies addressing malnutrition in Latin America.

PubMed

Tirado, María Cristina; Galicia, Luis; Husby, Hannah M; Lopez, Jaime; Olamendi, Stephania; Pia Chaparro, Maria; González, María A; Grajeda, Rubén

2016-08-01

To map existing policies addressing malnutrition in all its forms in Latin America and identify gaps in enabling environments supporting the five priority lines of action outlined in the World Health Organization Comprehensive Implementation Plan on Maternal, Infant and Young Child Nutrition (CIP) approved in 2014. This descriptive study consisted of a systematic Internet search for and mapping of publicly available nutrition-related and sectoral policies already in place to address malnutrition in all its forms in 18 Latin American countries (Argentina, Belize, Bolivia, Brazil, Chile, Colombia, Costa Rica, Dominican Republic, Ecuador, El Salvador, Guatemala, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru, and Uruguay). The policies were described in documents retrieved from the websites of ministries of health, education, agriculture, labor, and development; the national congress; and other government agencies. All 18 countries had relevant policies to address malnutrition, especially undernutrition and micronutrient deficiencies, but only a few had policies to address overweight and obesity. Nutrition actions were incorporated in food and nutrition security and social protection policies in all 18 countries, and were part of education, environment, agricultural, development, and/or employment policies in some countries. Information on human and financial resources assigned to nutrition was not available through the search strategies used in the study. All 18 countries included in this review had established enabling environments to support CIP implementation. However, each of the 18 countries needs to develop integrated policies for the promotion of nutrition and prevention of noncommunicable diseases through cross-sector involvement and multi-stakeholder collaboration.

Policy-relevant behaviours predict heavier drinking and mediate the relationship with age, gender and education status: Analysis from the International Alcohol Control study.

PubMed

Casswell, Sally; Huckle, Taisia; Wall, Martin; Parker, Karl; Chaiyasong, Surasak; Parry, Charles D H; Viet Cuong, Pham; Gray-Phillip, Gaile; Piazza, Marina

2018-02-21

To investigate behaviours related to four alcohol policy variables (policy-relevant behaviours) and demographic variables in relation to typical quantities of alcohol consumed on-premise in six International Alcohol Control study countries. General population surveys with drinkers using a comparable survey instrument and data analysed using path analysis in an overall model and for each country. typical quantities per occasion consumed on-premise; gender, age; years of education, prices paid, time of purchase, time to access alcohol and liking for alcohol advertisements. In the overall model younger people, males and those with fewer years of education consumed larger typical quantities. Overall lower prices paid, later time of purchase and liking for alcohol ads predicted consuming larger typical quantities; this was found in the high-income countries, less consistently in the high-middle-income countries and not in the low middle-income country. Three policy-relevant behaviours (prices paid, time of purchase, liking for alcohol ads) mediated the relationships between age, gender, education and consumption in high-income countries. International Alcohol Control survey data showed a relationship between policy-relevant behaviours and typical quantities consumed and support the likely effect of policy change (trading hours, price and restrictions on marketing) on heavier drinking. The path analysis also revealed policy-relevant behaviours were significant mediating variables between the effect of age, gender and educational status on consumption. However, this relationship is clearest in high-income countries. Further research is required to understand better how circumstances in low-middle-income countries impact effects of policies. © 2018 The Authors Drug and Alcohol Review published by John Wiley & Sons Australia, Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.

Drug prescribing in rural health facilities in China: implications for service quality and cost.

PubMed

Zhan, S K; Tang, S L; Guo, Y D; Bloom, G

1998-01-01

Overuse of drugs in rural areas of China has led to a growing concern regarding service quality and cost. The study found evidence of high levels of drug use in some rural health facilities in comparison with a number of other developing countries. Such a result was significantly associated with the government policy of financing health care, regulation and monitoring of health services, and users' attitudes and behaviour. It underlines the need for measures to be taken in China to improve drug use in order to allow its population access to effective care at reasonable cost.

Waiting time care guarantees: necessity or nemesis?

PubMed

Joshi, N P; Noseworthy, F T; Noseworthy, T W

2006-01-01

One of the priorities of governments in Canada is to reduce long waiting times for health services. This has raised the prospect of introducing waiting time care guarantees. Such guarantees affirm the healthcare system's social contract with the public and provide an entitlement to Canadians to receive timely care. There are clinical, legal and political implications, which must be considered and well managed before introduction. Other countries have ventured down this path. They teach us that waiting time care guarantees are good policy and make good sense. Correspondingly, they remind us not to make a promise we are not ready to keep.

State of mental healthcare systems in Eastern Europe: do we really understand what is going on?

PubMed Central

Winkler, Petr

2016-01-01

The article examines the current state of mental healthcare systems in countries of Eastern Europe and derives implications for future research and service development. Analysis of available statistics from the World Health Organization’s Mental Health Atlas suggests the need for better-quality data collection. Nonetheless, there appear to be insufficient resources allocated to mental health, lack of involvement of service users in policy-making and, to a large extent, systems continue to rely on mental hospitals. Based on the data presented, a set of directions for future reforms was drafted. PMID:29093919

China’s Currency: Economic Issues and Options for U.S. Trade Policy

DTIC Science & Technology

2008-01-09

order to foster economic stability and investor confidence, a policy that is practiced by a variety of developing countries . Chinese officials have...powerful in theory, it has been proven to be unreliable in reality: prices are consistently lower in developing countries than industrialized countries ...total U.S. bilateral trade deficits in 2006, indicating that the overall U.S. trade deficit is not caused by the exchange rate policy of one country

Worldwide Surveillance, Policy, and Research on Physical Activity and Health: The Global Observatory for Physical Activity.

PubMed

Varela, Andrea Ramirez; Pratt, Michael; Powell, Kenneth; Lee, I-Min; Bauman, Adrian; Heath, Gregory; Martins, Rafaela Costa; Kohl, Harold; Hallal, Pedro C

2017-09-01

The Global Observatory for Physical Activity (GoPA!) was launched in response to the physical inactivity pandemic. The aim of this article is to present current information about surveillance, policy, and research on physical activity (PA) and health worldwide. Information was collected for 217 countries. For 139 of these nations we identified a contact who confirmed information's accuracy and completeness. Associations were calculated among surveillance, policy and research categories. Of the 139 countries, 90.6% reported having completed 1 or more PA survey, but less than one-third had 3 or more. 106 included PA on a national plan, but only one-quarter of these were PA-specific. At least 1 peer reviewed publication was identified for 63.3% of the countries. Positive associations (P < .001) were found between research and policy (ρ = 0.35), research and surveillance (ρ = 0.41), and surveillance and policy (ρ = 0.31). Countries with a standalone plan were more likely to have surveillance. Countries with more research were more likely to have a standalone plan and surveillance. Surveillance, policy, and research indicators were positively correlated, suggesting that action at multiple levels tends to stimulate progress in other areas. Efforts to expand PA-related surveillance, policy, and research in lower income countries are needed.

m-Health Policy Readiness and Enabling Factors: Comparisons of Sub-Saharan Africa and Organization for Economic Cooperation and Development Countries.

PubMed

Lee, Seohyun; Begley, Charles E; Morgan, Robert; Chan, Wenyaw; Kim, Sun-Young

2018-02-12

As an innovative solution to poor access to care in low- and middle-income countries (LMICs), m-health has gained wide attention in the past decade. Despite enthusiasm from the global health community, LMICs have not demonstrated high uptake of m-health promoting policies or public investment. To benchmark the current status, this study compared m-health policy readiness scores between sub-Saharan Africa and high-income Organization for Economic Cooperation and Development (OECD) countries using an independent two-sample t test. In addition, the enabling factors associated with m-health policy readiness were investigated using an ordinal logistic regression model. The study was based on the m-health policy readiness scores of 112 countries obtained from the World Health Organization Third Global Survey on e-Health. The mean m-health policy readiness score for sub-Saharan Africa was statistically significantly lower than that for OECD countries (p = 0.02). The enabling factors significantly associated with m-health policy readiness included information and communication technology development index (odds ratio [OR] 1.57; 95% confidence interval [CI] 1.12-2.2), e-health education for health professionals (OR 4.43; 95% CI 1.60-12.27), and the location in sub-Saharan Africa (OR 3.47; 95% CI 1.06-11.34). The findings of our study suggest dual policy goals for m-health in sub-Saharan Africa. First, enhance technological and educational support for m-health. Second, pursue global collaboration for building m-health capacity led by sub-Saharan African countries with hands-on experience and knowledge. Globally, countries should take a systematic and collaborative approach in pursuing m-health policy with the focus on technological and educational support.

Influencing policy change: the experience of health think tanks in low- and middle-income countries

PubMed Central

Bennett, Sara; Corluka, Adrijana; Doherty, Jane; Tangcharoensathien, Viroj; Patcharanarumol, Walaiporn; Jesani, Amar; Kyabaggu, Joseph; Namaganda, Grace; Hussain, A M Zakir; de-Graft Aikins, Ama

2012-01-01

In recent years there has been a growth in the number of independent health policy analysis institutes in low- and middle-income countries which has occurred in response to the limitation of government analytical capacity and pressures associated with democratization. This study aimed to: (i) investigate the contribution made by health policy analysis institutes in low- and middle-income countries to health policy agenda setting, formulation, implementation and monitoring and evaluation; and (ii) assess which factors, including organizational form and structure, support the role of health policy analysis institutes in low- and middle-income countries in terms of positively contributing to health policy. Six case studies of health policy analysis institutes in Bangladesh, Ghana, India, South Africa, Uganda and Vietnam were conducted including two NGOs, two university and two government-owned policy analysis institutes. Case studies drew on document review, analysis of financial information, semi-structured interviews with staff and other stakeholders, and iterative feedback of draft findings. Some of the institutes had made major contributions to policy development in their respective countries. All of the institutes were actively engaged in providing policy advice and most undertook policy-relevant research. Relatively few were engaged in conducting policy dialogues, or systematic reviews, or commissioning research. Much of the work undertaken by institutes was driven by requests from government or donors, and the primary outputs for most institutes were research reports, frequently combined with verbal briefings. Several factors were critical in supporting effective policy engagement. These included a supportive policy environment, some degree of independence in governance and financing, and strong links to policy makers that facilitate trust and influence. While the formal relationship of the institute to government was not found to be critical, units within government faced considerable difficulties. PMID:21558320

Influencing policy change: the experience of health think tanks in low- and middle-income countries.

PubMed

Bennett, Sara; Corluka, Adrijana; Doherty, Jane; Tangcharoensathien, Viroj; Patcharanarumol, Walaiporn; Jesani, Amar; Kyabaggu, Joseph; Namaganda, Grace; Hussain, A M Zakir; de-Graft Aikins, Ama

2012-05-01

In recent years there has been a growth in the number of independent health policy analysis institutes in low- and middle-income countries which has occurred in response to the limitation of government analytical capacity and pressures associated with democratization. This study aimed to: (i) investigate the contribution made by health policy analysis institutes in low- and middle-income countries to health policy agenda setting, formulation, implementation and monitoring and evaluation; and (ii) assess which factors, including organizational form and structure, support the role of health policy analysis institutes in low- and middle-income countries in terms of positively contributing to health policy. Six case studies of health policy analysis institutes in Bangladesh, Ghana, India, South Africa, Uganda and Vietnam were conducted including two NGOs, two university and two government-owned policy analysis institutes. Case studies drew on document review, analysis of financial information, semi-structured interviews with staff and other stakeholders, and iterative feedback of draft findings. Some of the institutes had made major contributions to policy development in their respective countries. All of the institutes were actively engaged in providing policy advice and most undertook policy-relevant research. Relatively few were engaged in conducting policy dialogues, or systematic reviews, or commissioning research. Much of the work undertaken by institutes was driven by requests from government or donors, and the primary outputs for most institutes were research reports, frequently combined with verbal briefings. Several factors were critical in supporting effective policy engagement. These included a supportive policy environment, some degree of independence in governance and financing, and strong links to policy makers that facilitate trust and influence. While the formal relationship of the institute to government was not found to be critical, units within government faced considerable difficulties.

Compulsive Buying among College Students: An Investigation of Its Antecedents, Consequences, and Implications for Public Policy.

ERIC Educational Resources Information Center

Roberts, James A.

1998-01-01

This study investigated the incidence, antecedents, consequences, and policy implications of compulsive buying among college students (n=300). Details contributing factors and discusses the relationship between credit card use and compulsive buying. Discusses the implications for consumer policy and suggestions for further research. (JOW)

Variations of Fathering: Implications for Social Policy. Single Fathers with Custody: Implications for Social Policy.

ERIC Educational Resources Information Center

Hanson, Shirley May Harmon

This document summarizes current knowledge about single custodial fathers, and draws implications for social policy. Through a review of the literature, the following characteristics of single fathers are described: socioeconomic status, race, custody status, religion, age, employment, parental history, homemaking skills, motivation for custody,…

Early Childhood Care and Education and Other Family Policies and Programs in South-East Asia. Early Childhood and Family Policy Series.

ERIC Educational Resources Information Center

Kamerman, Sheila B.

This report describes early childhood care and education (ECCE) and other family support policies and programs in seven southeast Asian countries: Thailand, Malaysia, Philippines, Indonesia, Vietnam, Laos, and Cambodia. The report draws primarily on background country reports prepared by officials in these countries to focus on the context in…

Pharmaceutical policies in European countries.

PubMed

Barros, Pedro Pita

2010-01-01

Pharmaceutical expenditures have an important role in Europe. The attempts to control expenditure have used a wide range of policy measures. We reviewed the main measures adopted by the European Union countries, especially in countries where governments are the largest third-party payers. To complement a literature review on the topic, data was gathered from national reviews of health systems and direct inquiries to several government bodies. Almost all countries regulate prices of pharmaceutical products. Popular policy measures include international referencing to set prices (using as benchmark countries that have set lower prices), internal reference pricing systems to promote price competition in domestic markets, and positive lists for reimbursement to promote consumption of generics (including in some cases substitution by pharmacists of drugs prescribed by physicians). Despite the wide range of policy measures, it is not possible to identify a "silver bullet" to control pharmaceutical expenditures. We also identified two main policy challenges: policy coordination among countries within the European Union to maintain incentives for R&D at the global level, and the development of new relationships with the pharmaceutical industry; namely, the so-called risk-sharing agreements between the pharmaceutical industry and governments/regulators (or large third-party payers).

The Pedagogy of Education Policy Formulation: Working from Policy Assets

ERIC Educational Resources Information Center

Sack, Richard; Marope, Mmantsetsa

2007-01-01

This article explores a "pedagogical" approach to education policy formulation in developing countries. This constitutes a process that shows promise in promoting the "ownership" necessary for sustainable policies and programs, especially when they rely on external financing. Based on case studies from 26 countries focused on "what works," the…

Pharmacological treatment of severe psychiatric disorders in the developing world : lessons from India.

PubMed

Patel, Vikram; Andrade, Chittaranjan

2003-01-01

Severe psychiatric disorders (schizophrenia, bipolar disorder and major depressive disorder) cause much morbidity and disability in developing countries. Most of the evidence on the efficacy and effectiveness of drug treatments for these disorders is based on trials conducted in Western countries. Cultural, biological and health system factors may profoundly influence the applicability of such evidence in developing countries. Attitudes towards, and concepts about, psychiatric disorders vary across cultures, and these may influence the acceptability of drug treatments. Genetic and environmental factors may lead to variations in the pharmacodynamics and pharmacokinetics of psychotropic drugs across ethnic groups. This may explain why lower doses of psychotropic drugs tend to be used for non-Caucasian patients. There is a dearth of mental health professionals and care facilities in developing countries, especially in rural areas. Epidemiological studies show that, despite this lack of services, the outcome of schizophrenia is favourable in developing countries. This suggests that cultural, genetic or environmental factors may play as much of a role in influencing outcome as access to antipsychotic treatment. Regional drug policies may influence the availability and cost of psychotropic drugs. In particular, the Indian experience, where drugs are manufactured by several local pharmaceutical firms, thus bringing their cost down, may represent a unique deregulated drug industry. However, the impending impact of the Trade-Related Aspects of Intellectual Property Rights (TRIPS) agreement, with the strict enforcement of patent laws, will almost certainly lead to a rise in drug costs in the coming years. This may influence the choice and cost effectiveness of various drugs. The implications of these cross-cultural variations for policy and practice are the need to ensure a reliable supply of affordable psychotropic drugs in developing countries, trained healthcare professionals to use these drugs rationally, a concerted advocacy campaign to exclude drugs for severe psychiatric disorders from patent protection, and the development of psychosocial programmes to improve global outcomes.

Producing alcohol and other drugs as a policy 'problem': A critical analysis of South Africa's 'National Drug Master Plan' (2013-2017).

PubMed

Pienaar, Kiran; Savic, Michael

2016-04-01

The strong symbolic value of illicit drug use makes it a contested issue, which attracts mixed public opinion, intense media attention and close political scrutiny. This means that the formulation of plausible, authoritative policies governing illicit drugs must navigate fraught political terrain. In a country like South Africa with its long unique history of institutionalised oppression of the black majority, the issues confronting drug policy are particularly complex and the need for carefully formulated policy responses especially urgent. Yet despite this, the area of drug policy development in South Africa has received little scholarly attention to date. This paper explores the complexities of policymaking in the South African context by drawing on feminist scholar Carol Bacchi's poststructuralist approach to policy analysis, which focuses on how policy helps to produce the problems it purports to solve. Taking as its empirical focus, South Africa's current drug policy, the third National Drug Master Plan (NDMP), 2013-2017, the paper analyses how the policy constitutes the 'problem of alcohol and other drugs' (AODs). We identify three central policy proposals through which specific problematisations emerge: (1) the proposal that drug use is a global issue requiring a coordinated policy response, (2) appeals to evidence-based policy proposals and (3) the proposal that AOD 'use' and 'abuse' be treated interchangeably. We suggest that these proposals reveal a tendency towards inflating the 'problem of AODs' and thus work to justify punitive policy measures. In an effort to explore the implications of particular problematisations for effecting social change, we clarify the ways in which the policy may work to undermine the interests of those it seeks to aid by reinforcing stigma and marginalisation. Copyright © 2015 Elsevier B.V. All rights reserved.

Evidence-Informed Health Policies in Eastern Mediterranean Countries: Comparing Views of Policy Makers and Researchers

ERIC Educational Resources Information Center

El-Jardali, Fadi; Lavis, John N.; Jamal, Diana; Ataya, Nour; Dimassi, Hani

2014-01-01

The objective of this paper is to conduct comparative analysis about the views and practices of policy makers and researchers on the use of health systems evidence in policy making in selected Eastern Mediterranean countries. We analysed data from two self-reported surveys, one targeted at policy makers and the other at researchers. Results show a…

From Forest Landscape to Agricultural Landscape in the Developing Tropical Country of Malaysia: Pattern, Process, and Their Significance on Policy

NASA Astrophysics Data System (ADS)

Abdullah, Saiful Arif; Hezri, Adnan A.

2008-11-01

Agricultural expansion and deforestation are spatial processes of land transformation that impact on landscape pattern. In peninsular Malaysia, the conversion of forested areas into two major cash crops—rubber and oil palm plantations—has been identified as driving significant environmental change. To date, there has been insufficient literature studying the link between changes in landscape patterns and land-related development policies. Therefore, this paper examines: (i) the links between development policies and changes in land use/land cover and landscape pattern and (ii) the significance and implications of these links for future development policies. The objective is to generate insights on the changing process of land use/land cover and landscape pattern as a functional response to development policies and their consequences for environmental conditions. Over the last century, the development of cash crops has changed the country from one dominated by natural landscapes to one dominated by agricultural landscapes. But the last decade of the century saw urbanization beginning to impact significantly. This process aligned with the establishment of various development policies, from land development for agriculture between the mid 1950s and the 1970s to an emphasis on manufacturing from the 1980s onward. Based on a case study in Selangor, peninsular Malaysia, a model of landscape pattern change is presented. It contains three stages according to the relative importance of rubber (first stage: 1900-1950s), oil palm (second stage: 1960s-1970s), and urban (third stage: 1980s-1990s) development that influenced landscape fragmentation and heterogeneity. The environmental consequences of this change have been depicted through loss of biodiversity, geohazard incidences, and the spread of vector-borne diseases. The spatial ecological information can be useful to development policy formulation, allowing diagnosis of the country’s “health” and sustainability. The final section outlines the usefulness of landscape analysis in the policy-making process to prevent further fragmentation of the landscape and forest loss in Malaysia in the face of rapid economic development.

Promoting equitable global health research: a policy analysis of the Canadian funding landscape.

PubMed

Plamondon, Katrina; Walters, Dylan; Campbell, Sandy; Hatfield, Jennifer

2017-08-29

Recognising radical shifts in the global health research (GHR) environment, participants in a 2013 deliberative dialogue called for careful consideration of equity-centred principles that should inform Canadian funding polices. This study examined the existing funding structures and policies of Canadian and international funders to inform the future design of a responsive GHR funding landscape. We used a three-pronged analytical framework to review the ideas, interests and institutions implicated in publically accessible documents relevant to GHR funding. These data included published literature and organisational documents (e.g. strategic plans, progress reports, granting policies) from Canadian and other comparator funders. We then used a deliberative approach to develop recommendations with the research team, advisors, industry informants and low- and middle-income country (LMIC) partners. In Canada, major GHR funders invest an estimated CA$90 M per annum; however, the post-2008 re-organization of funding structures and policies resulted in an uncoordinated and inefficient Canadian strategy. Australia, Denmark, the European Union, Norway, Sweden, the United Kingdom and the United States of America invest proportionately more in GHR than Canada. Each of these countries has a national strategic plan for global health, some of which have dedicated benchmarks for GHR funding and policy to allow funds to be held by partners outside of Canada. Key constraints to equitable GHR funding included (1) funding policies that restrict financial and cost burden aspects of partnering for GHR in LMICs; and (2) challenges associated with the development of effective governance mechanisms. There were, however, some Canadian innovations in funding research that demonstrated both unconventional and equitable approaches to supporting GHR in Canada and abroad. Among the most promising were found in the International Development Research Centre and the (no longer active) Global Health Research Initiative. Promoting equitable GHR funding policies and practices in Canada requires cooperation and actions by multiple stakeholders, including government, funding agencies, academic institutions and researchers. Greater cooperation and collaboration among these stakeholders in the context of recent political shifts present important opportunities for advancing funding policies that enable and encourage more equitable investments in GHR.

WHO policy development processes for a new vaccine: case study of malaria vaccines.

PubMed

Milstien, Julie; Cárdenas, Vicky; Cheyne, James; Brooks, Alan

2010-06-24

Recommendations from the World Health Organization (WHO) are crucial to inform developing country decisions to use, or not, a new intervention. This article analysed the WHO policy development process to predict its course for a malaria vaccine. The decision-making processes for one malaria intervention and four vaccines were classified through (1) consultations with staff and expert advisors to WHO's Global Malaria Programme (GMP) and Immunization, Vaccines and Biologicals Department (IVB); (2) analysis of the procedures and recommendations of the major policy-making bodies of these groups; (3) interviews with staff of partnerships working toward new vaccine availability; and (4) review and analyses of evidence informing key policy decisions. WHO policy formulation related to use of intermittent preventive treatment in infancy (IPTi) and the following vaccine interventions: Haemophilus influenzae type b conjugate vaccine (Hib), pneumococcal conjugate vaccine (PCV), rotavirus vaccine (RV), and human papillomavirus vaccine (HPV), five interventions which had relatively recently been through systematic WHO policy development processes as currently constituted, was analysed. Required information was categorized in three areas defined by a recent WHO publication on development of guidelines: safety and efficacy in relevant populations, implications for costs and population health, and localization of data to specific epidemiological situations. Data needs for a malaria vaccine include safety; the demonstration of efficacy in a range of epidemiological settings in the context of other malaria prevention interventions; and information on potential rebound in which disease increases subsequent to the intervention. In addition, a malaria vaccine would require attention to additional factors, such as costs and cost-effectiveness, supply and demand, impact of use on other interventions, and distribution issues. Although policy issues may be more complex for future vaccines, the lead-time between the date of product regulatory approval and a recommendation for its use in developing countries is decreasing. This study presents approaches to define in advance core data needs to support evidence-based decisions, to further decrease this lead-time, accelerating the availability of a malaria vaccine. Specific policy areas for which information should be collected are defined, including studying its use within the context of other malaria interventions.

Applying an equity lens to tobacco-control policies and their uptake in six Western-European countries.

PubMed

Giskes, K; Kunst, A E; Ariza, C; Benach, J; Borrell, C; Helmert, U; Judge, K; Lahelma, E; Moussa, K; Ostergren, P O; Patja, K; Platt, S; Prättälä, R; Willemsen, M C; Mackenbach, J P

2007-07-01

We identified policies that may be effective in reducing smoking among socioeconomically disadvantaged groups, and examined trends in their level of application between 1985 and 2000 in six western-European countries (Sweden, Finland, the United Kingdom, the Netherlands, Germany, and Spain). We located studies from literature searches in major databases, and acquired policy data from international data banks and questionnaires distributed to tobacco policy organisations/researchers. Advertising bans, smoking bans in workplaces, removing barriers to smoking cessation therapies, and increasing the cost of cigarettes have the potential to reduce socioeconomic inequalities in smoking. Between 1985 and 2000, tobacco control policies in most countries have become more targeted to decrease the smoking behaviour of low-socioeconomic groups. Despite this, many national tobacco-control strategies in western-European countries still fall short of a comprehensive policy approach to addressing smoking inequalities.

Monitoring HIV and AIDS Related Policy Reforms: A Road Map to Strengthen Policy Monitoring and Implementation in PEPFAR Partner Countries

PubMed Central

2016-01-01

Achieving an AIDS-free generation will require the adoption and implementation of critical health policy reforms. However, countries with high HIV burden often have low policy development, advocacy, and monitoring capacity. This lack of capacity may be a significant barrier to achieving the AIDS-free generation goals. This manuscript describes the increased focus on policy development and implementation by the United States President’s Emergency Plan for AIDS Relief (PEPFAR). It evaluates the curriculum and learning modalities used for two regional policy capacity building workshops organized around the PEPFAR Partnership Framework agreements and the Road Map for Monitoring and Implementing Policy Reforms. A total of 64 participants representing the U.S. Government, partner country governments, and civil society organizations attended the workshops. On average, participants responded that their policy monitoring skills improved and that they felt they were better prepared to monitor policy reforms three months after the workshop. When followed-up regarding utilization of the Road Map action plan, responses were mixed. Reasons cited for not making progress included an inability to meet or a lack of time, personnel, or governmental support. This lack of progress may point to a need for building policy monitoring systems in high HIV burden countries. Because the success of policy reforms cannot be measured by the mere adoption of written policy documents, monitoring the implementation of policy reforms and evaluating their public health impact is essential. In many high HIV burden countries, policy development and monitoring capacity remains weak. This lack of capacity could hinder efforts to achieve the ambitious AIDS-free generation treatment, care and prevention goals. The Road Map appears to be a useful tool for strengthening these critical capacities. PMID:26914708

Disintegrated care: the Achilles heel of international health policies in low and middle-income countries

PubMed Central

Unger, Jean-Pierre; De Paepe, Pierre; Ghilbert, Patricia; Soors, Werner; Green, Andrew

2006-01-01

Abstract Purpose To review the evidence basis of international aid and health policy. Context of case Current international aid policy is largely neoliberal in its promotion of commoditization and privatisation. We review this policy's responsibility for the lack of effectiveness in disease control and poor access to care in low and middle-income countries. Data sources National policies, international programmes and pilot experiments are examined in both scientific and grey literature. Conclusions and discussion We document how health care privatisation has led to the pool of patients being cut off from public disease control interventions—causing health care disintegration—which in turn resulted in substandard performance of disease control. Privatisation of health care also resulted in poor access. Our analysis consists of three steps. Pilot local contracting-out experiments are scrutinized; national health care records of Colombia and Chile, two countries having adopted contracting-out as a basis for health care delivery, are critically examined against Costa Rica; and specific failure mechanisms of the policy in low and middle-income countries are explored. We conclude by arguing that the negative impact of neoliberal health policy on disease control and health care in low and middle-income countries justifies an alternative aid policy to improve both disease control and health care. PMID:17006553

Supply-side and demand-side policies for biosimilars: an overview in 10 European member states.

PubMed

Rémuzat, Cécile; Kapuśniak, Anna; Caban, Aleksandra; Ionescu, Dan; Radière, Guerric; Mendoza, Cyril; Toumi, Mondher

2017-01-01

This study aimed to provide an overview of biosimilar policies in 10 EU MSs. Methods : Ten EU MS pharmaceutical markets (Belgium, France, Germany, Greece, Hungary, Italy, Poland, Spain, Sweden, and the UK) were selected. A comprehensive literature review was performed to identify supply-side and demand-side policies in place in the selected countries. Results : Supply-side policies for biosimilars commonly include price linkage, price re-evaluation, and tendering; the use of internal or external reference pricing varies between countries; health technology assessment is conducted in six countries. Regarding demand-side policies, pharmaceutical prescription budgets or quotas and monitoring of prescriptions (with potential financial incentives or penalties) are in place in eight and in seven countries respectively. Switching is generally allowed, but is solely the physician's responsibility. Automatic substitution is not recommended, or even forbidden, in most EU MSs. Prescription conditions or guidelines that apply to biosimilars are established in nearly all surveyed EU MSs. Conclusions : Important heterogeneity in policies on biosimilars was seen between (and even within) selected countries, which may partly explain variations in biosimilar uptake. Supply-side policies targeting price have been reported to limit biosimilar penetration in the long term, despite short-term savings, while demand-side policies are considered to positively impact uptake.

Supply-side and demand-side policies for biosimilars: an overview in 10 European member states

PubMed Central

Rémuzat, Cécile; Kapuśniak, Anna; Caban, Aleksandra; Ionescu, Dan; Radière, Guerric; Mendoza, Cyril; Toumi, Mondher

2017-01-01

ABSTRACT Objective: This study aimed to provide an overview of biosimilar policies in 10 EU MSs. Methods: Ten EU MS pharmaceutical markets (Belgium, France, Germany, Greece, Hungary, Italy, Poland, Spain, Sweden, and the UK) were selected. A comprehensive literature review was performed to identify supply-side and demand-side policies in place in the selected countries. Results: Supply-side policies for biosimilars commonly include price linkage, price re-evaluation, and tendering; the use of internal or external reference pricing varies between countries; health technology assessment is conducted in six countries. Regarding demand-side policies, pharmaceutical prescription budgets or quotas and monitoring of prescriptions (with potential financial incentives or penalties) are in place in eight and in seven countries respectively. Switching is generally allowed, but is solely the physician’s responsibility. Automatic substitution is not recommended, or even forbidden, in most EU MSs. Prescription conditions or guidelines that apply to biosimilars are established in nearly all surveyed EU MSs. Conclusions: Important heterogeneity in policies on biosimilars was seen between (and even within) selected countries, which may partly explain variations in biosimilar uptake. Supply-side policies targeting price have been reported to limit biosimilar penetration in the long term, despite short-term savings, while demand-side policies are considered to positively impact uptake. PMID:28740617

Tuberculosis and latent tuberculous infection screening of migrants in Europe: comparative analysis of policies, surveillance systems and results.

PubMed

Kunst, H; Burman, M; Arnesen, T M; Fiebig, L; Hergens, M-P; Kalkouni, O; Klinkenberg, E; Orcau, À; Soini, H; Sotgiu, G; Zenner, D; de Vries, G

2017-08-01

Migration patterns into and within Europe have changed over the last decade. In 2015, European Union (EU) countries received over 1.2 million asylum requests, more than double the number registered in the previous year. This review compares the published literature on policies for tuberculosis (TB) and latent tuberculous infection (LTBI) screening in EU and European Free Trade Association (EFTA) countries with the existing TB/LTBI screening programmes for migrants in 11 EU/EFTA countries based on a survey of policy and surveillance systems. In addition, we provide a systematic review of the literature on the yield of screening migrants for active TB and LTBI in Europe. Published studies provide limited information about screening coverage and the yield of screening evaluations in EU/EFTA countries. Furthermore, countries use different screening strategies and settings, and different definitions for coverage and yield of screening for active TB and LTBI. We recommend harmonising case definitions, reporting standards and policies for TB/LTBI screening. To achieve TB elimination targets, a European platform for multi-country data collection and analysis, sharing of countries' policies and practices, and harmonisation of migrant screening strategies is needed.

Controlling water pollution in developing and transition countries--lessons from three successful cases.

PubMed

Kathuria, Vinish

2006-03-01

The policy prescription for solving environmental problems of developing countries and countries-in-transition (CIT) is slowly getting polarized into two viewpoints. One group of researchers and policy advocates including multilateral organizations upholds extensive use of market based instruments (MBIs) in these countries. The other group argues that institutions need to be built first or the policy makers should select the incremental or tiered approach taking into account the existing capabilities. The group also insists that the financial, institutional and political constraints make environmental regulation in these countries more problematic than in industrialized countries. In the short-run, the immediate needs of the developing countries can be addressed effectively by learning lessons from the difficulties encountered by a few successful cases and accordingly evolving an appropriate policy instrument. In this paper an attempt has been made to highlight three such cases from three different parts of the world--Malaysia (Asia-pacific), Poland (Eastern Europe) and Colombia (Latin America). The paper looks into what policy instruments led to a fall in water pollution levels in these countries and what role did MBIs play in this pollution mitigation? The case studies suggest that it is a combination of instruments--license fee, standards, charge and subsidies--reinforced by active enforcement that led to an overall improvement in environment compliance.

The future of health technology assessment in healthcare decision making in Asia.

PubMed

Yang, Bong-Min

2009-01-01

Most countries have healthcare resource constraints and it is easy to identify new health technologies as an area in need of resource management, particularly given that new health technologies usually increase rather than save costs. Resource constraints are even more noticeable in Asia than in other regions, with a comparatively greater speed of population aging and the development of health security systems. The healthcare industry and policy makers in Asia generally understand that rationing in healthcare delivery is inevitable and have come to accept health technology assessment (HTA) as a policy option. The HTA policy framework is slowly penetrating Asia; South Korea was the first country to regulate the use of pharmacoeconomic evidence in drug reimbursement decision making. The South Korean HTA policy was initially a surprise in Asia in that the policy was suddenly introduced with a short period of preparation, but industry, researchers and policy makers both in- and outside of South Korea have come to accept it as necessary and logical. Thailand and Taiwan have also taken steps towards using pharmacoeconomic evidence in HTA, while other Asian countries are planning to implement such policies. However, it could be some time before a legitimate pharmacoeconomic-based HTA policy is actually implemented in each country, and the course of action will vary depending on the policy culture, healthcare system and public trust in bureaucracy of each country.

Internationally Educated Health Professionals in Canada: Navigating Three Policy Subsystems Along the Pathway to Practice.

PubMed

Paul, Robert; Martimianakis, Maria Athina Tina; Johnstone, Julie; McNaughton, Nancy; Austin, Zubin

2017-05-01

The integration of internationally educated health professionals (IEHPs) into the health workforces of their adopted countries is an issue that has challenged policy makers and policy scholars for decades. In this article, the authors explore the implications of the ideological underpinnings of the policy subsystems that IEHPs must navigate in seeking employment in Canada, with a focus on Ontario.Using a policy subsystem approach, in 2015 the authors analyzed a large preexisting data set composed of articles, governmental reports, Web sites, and transcripts of interviews and focus groups conducted in Ontario with IEHPs, health care executives, human resource managers, and job counselors to IEHPs. Through this analysis, they identified three policy subsystems-the immigration system, the educational and licensure/regulatory system, and the health human resources system-that conflict ideologically and, as a result, create barriers to IEHP integration.To make substantive progress on IEHP integration in Canada, four questions should be considered. First, how can researchers bring new research methods to bear to explore why no jurisdiction has been able to create an integrated pathway to practice for IEHPs? Second, how and to what end are the institutions within the three policy subsystems regulating the IEHP pathway to practice? Third, how might the educational and licensure/regulatory policy subsystem create alternative health care employment options for IEHPs? Finally, how might health professions educators pursue a leadership role in the creation of an overarching institution to manage the pathway to practice for IEHPs?

Research Ethics in the Context of Transition: Gaps in Policies and Programs on the Protection of Research Participants in the Selected Countries of Central and Eastern Europe.

PubMed

Famenka, Andrei

2016-12-01

This paper examines the ability of countries in Central and Eastern Europe (CEE) to ensure appropriate protection of research participants in the field of increasingly globalizing biomedical research. By applying an analytical framework for identifying gaps in policies and programs for human subjects protection to four countries of CEE-Belarus, Latvia, Lithuania, and Poland, substantial gaps in the scope and content of relevant policies and major impediments to program performance have been revealed. In these countries, public policies on the protection of research participants lack consistency and reliable mechanisms for their implementation. Impediments to program performance most often relate to inadequacies in the national research ethics systems with regard to organizational structure, budgetary support, supervision, and training. The level of research ethics capacity varies from country to country and depends on socio-economic and political factors of post-communist transition. The breadth and depth of the problems identified suggest that the current level of protection for research participants in CEE might be inadequate to the challenges posed by the globalization of biomedical research. In CEE countries, there is a need for strengthening research ethics capacity through modification of relevant policies and improvement of program management. The differences among the countries call for further research on identifying the best approaches for filling the gaps in the policies and programs aimed at ensuring effective protection of research participants.

Research ethics in the context of transition: gaps in policies and programs on the protection of research participants in the selected countries of Central and Eastern Europe

PubMed Central

Famenka, Andrei

2015-01-01

This paper examines the ability of countries in Central and Eastern Europe (CEE) to ensure appropriate protection of research participants in the field of increasingly globalizing biomedical research. By applying an analytical framework for identifying gaps in policies and programs for human subjects protection to four countries of CEE – Belarus, Latvia, Lithuania, and Poland, substantial gaps in the scope and content of relevant policies and major impediments to program performance have been revealed. In these countries, public policies on the protection of research participants lack consistency and reliable mechanisms for their implementation. Impediments to program performance most often relate to inadequacies in the national research ethics systems with regard to organizational structure, budgetary support, supervision, and training. The level of research ethics capacity varies from country to country and depends on socio-economic and political factors of post-communist transition. The breadth and depth of the problems identified suggest that the current level of protection for research participants in CEE might be inadequate to the challenges posed by the globalization of biomedical research. In CEE countries, there is a need for strengthening research ethics capacity through modification of relevant policies and improvement of program management. The differences among the countries call for further research on identifying the best approaches for filling the gaps in the policies and programs aimed at ensuring effective protection of research participants. PMID:26548313

Economic policy uncertainty, equity premium and dependence between their quantiles: Evidence from quantile-on-quantile approach

NASA Astrophysics Data System (ADS)

Raza, Syed Ali; Zaighum, Isma; Shah, Nida

2018-02-01

This paper examines the relationship between economic policy uncertainty and equity premium in G7 countries over a period of the monthly data from January 1989 to December 2015 using a novel technique namely QQ regression proposed by Sim and Zhou (2015). Based on QQ approach, we estimate how the quantiles of the economic policy uncertainty affect the quantiles of the equity premium. Thus, it provides a comprehensive insight into the overall dependence structure between the equity premium and economic policy uncertainty as compared to traditional techniques like OLS or quantile regression. Overall, our empirical evidence suggests the existence of a negative association between equity premium and EPU predominately in all G7 countries, especially in the extreme low and extreme high tails. However, differences exist among countries and across different quantiles of EPU and the equity premium within each country. The existence of this heterogeneity among countries is due to the differences in terms of dependency on economic policy, other stock markets, and the linkages with other country's equity market.