Science.gov

Sample records for health policy analysis

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

    PubMed

    Embrett, Mark G; Randall, G E

    2014-05-01

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

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

    PubMed

    Embrett, Mark G; Randall, G E

    2014-05-01

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

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

    PubMed Central

    2012-01-01

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

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

    PubMed

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

    2013-12-01

    Although until April 2012, all Spanish citizens regardless of their origin, residence status and work situation were entitled to health care, available evidence suggested inadequate access for immigrants. Following the Aday and Andersen model, we conducted an analysis of policy elements that affect immigrants' access to health care in Spain, based on documentary analysis of national policies and selected regional policies related to migrant health care. Selected documents were (a) laws and plans in force at the time containing migrant health policies and (b) evaluations. The analysis included policy principles, objectives, strategies and evaluations. Results show that the national and regional policies analyzed are based on the principle that health care is a right granted to immigrants by law. These policies include strategies to facilitate access to health care, reducing barriers for entry to the system, for example simplifying requirements and raising awareness, but mostly they address the necessary qualities for services to be able to attend to a more diverse population, such as the adaptation of resources and programs, or improved communication and training. However, limited planning was identified in terms of their implementation, necessary resources and evaluation. In conclusion, the policies address relevant barriers of access for migrants and signal improvements in the health system's responsiveness, but reinforcement is required in order for them to be effectively implemented. PMID:23850165

  5. 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

  6. Values in Health Policy – A Concept Analysis

    PubMed Central

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

    2016-01-01

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

  7. Public Participation in the Process of Local Public Health Policy, Using Policy Network Analysis

    PubMed Central

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

    2014-01-01

    Objectives: To assess the current public participation in-local health policy and its implications through the analysis of policy networks in health center programs. Methods: We examined the decision-making process in sub-health center installations and the implementation process in metabolic syndrome management program cases in two districts (‘gu’s) of Seoul. Participants of the policy network were selected by the snowballing method and completed self-administered questionnaires. Actors, the interactions among actors, and the characteristics of the network were analyzed by Netminer. Results: The results showed that the public is not yet actively participating in the local public health policy processes of decision-making and implementation. In the decision-making process, most of the network actors were in the public sector, while the private sector was a minor actor and participated in only a limited number of issues after the major decisions were made. In the implementation process, the program was led by the health center, while other actors participated passively. Conclusions: Public participation in Korean public health policy is not yet well activated. Preliminary discussions with various stakeholders, including civil society, are needed before making important local public health policy decisions. In addition, efforts to include local institutions and residents in the implementation process with the public officials are necessary to improve the situation. PMID:25475197

  8. [Access to health services: approaches, concepts, policies and analysis model].

    PubMed

    Assis, Marluce Maria Araújo; de Jesus, Washington Luiz Abreu

    2012-11-01

    Access to health services is a multifaceted and multidimensional issue involving political, economic, social, organizational, technical and symbolic aspects in establishing access to universal healthcare. This theoretical review paper intends to discuss the different approaches, analyze the context and policies for special groups on access, marking an analysis model delineated by the above aspects, from readings on the topic in question. This analysis reveals a diversity of approaches to access the formulation and implementation of public policies and their potential for changing the organization of the health system. We identified progress in reducing inequalities in health and increased access to the network of the Unified Health System (SUS), especially in primary care. There were also limitations related to accessibility, fragmentation, decentralization and regionalization of the service network, with inadequacies in the process of care and attention to specific groups, and regional disparities. Finally, the analysis model proposed seeks to develop a critical stance to reflect and intervene in health practices and services, with the objective goal being responsible, comprehensive, effective, equitable and quality healthcare.

  9. Strengthening the health workforce and rolling out universal health coverage: the need for policy analysis.

    PubMed

    Koon, Adam D; Mayhew, Susannah H

    2013-07-24

    This article opens a debate about how to think about moving forward with the emerging twin movements of human resources for health (HRH) and universal health coverage (UHC). There is sufficient evidence to warrant these movements, but actors and the policy process significantly affect which policies are adopted and how they are implemented. How exactly this occurs in low- and middle-income countries (LMICs) is not very well understood. Furthermore, it is not clear whether actors will mobilize for or against the emergent HRH and UHC agendas. Policy analysis should help illuminate potential strategies to account for multiple interests and divergent values in volatile stakeholder environments. We argue that not only should the movement for UHC be paired with current efforts to address the human resources crisis, but also, for both to succeed, we need to know more about how health policy works in LMICs.

  10. Strengthening the health workforce and rolling out universal health coverage: the need for policy analysis

    PubMed Central

    Koon, Adam D.; Mayhew, Susannah H.

    2013-01-01

    This article opens a debate about how to think about moving forward with the emerging twin movements of human resources for health (HRH) and universal health coverage (UHC). There is sufficient evidence to warrant these movements, but actors and the policy process significantly affect which policies are adopted and how they are implemented. How exactly this occurs in low- and middle-income countries (LMICs) is not very well understood. Furthermore, it is not clear whether actors will mobilize for or against the emergent HRH and UHC agendas. Policy analysis should help illuminate potential strategies to account for multiple interests and divergent values in volatile stakeholder environments. We argue that not only should the movement for UHC be paired with current efforts to address the human resources crisis, but also, for both to succeed, we need to know more about how health policy works in LMICs. PMID:23886375

  11. Analysis of maternal and child health policies in Malawi: The methodological perspective.

    PubMed

    Daire, J; Khalil, D

    2015-12-01

    The question of why most health policies do not achieve their intended results continues to receive a considerable attention in the literature. This is in the light of the recognized gap between policy as intent and policy as practice, which calls for substantial research work to understand the factors that improve policy implementation. Although there is substantial work that explains the reasons why policies achieve or fail to achieve their intended outcomes, there are limited case studies that illustrate how to analyze policies from the methodological perspective. In this article, we report and discuss how a mixed qualitative research method was applied for analyzing maternal and child health policies in Malawi. For the purposes of this article, we do not report research findings; instead we focus our dicussion on the methodology of the study and draw lessons for policy analysis research work. We base our disusssion on our experiences from a study in which we analyzed maternal and child health policies in Malawi over the period from 1964 to 2008. Noting the multifaceted nature of maternal and child health policies, we adopted a mixed qualitative research method, whereby a number of data collection methods were employed. This approach allowed for the capturing of different perspectives of maternal and child health policies in Malawi and for strengthening of the weaknesses of each method, especially in terms of data validity. This research suggested that the multidimensional nature of maternal and child health policies, like other health policies, calls for a combination of research designs as well as a variety of methods of data collection and analysis. In addition, we suggest that, as an emerging research field, health policy analysis will benefit more from case study designs because they provide rich experiences in the actual policy context. PMID:26955434

  12. Analysis of maternal and child health policies in Malawi: The methodological perspective.

    PubMed

    Daire, J; Khalil, D

    2015-12-01

    The question of why most health policies do not achieve their intended results continues to receive a considerable attention in the literature. This is in the light of the recognized gap between policy as intent and policy as practice, which calls for substantial research work to understand the factors that improve policy implementation. Although there is substantial work that explains the reasons why policies achieve or fail to achieve their intended outcomes, there are limited case studies that illustrate how to analyze policies from the methodological perspective. In this article, we report and discuss how a mixed qualitative research method was applied for analyzing maternal and child health policies in Malawi. For the purposes of this article, we do not report research findings; instead we focus our dicussion on the methodology of the study and draw lessons for policy analysis research work. We base our disusssion on our experiences from a study in which we analyzed maternal and child health policies in Malawi over the period from 1964 to 2008. Noting the multifaceted nature of maternal and child health policies, we adopted a mixed qualitative research method, whereby a number of data collection methods were employed. This approach allowed for the capturing of different perspectives of maternal and child health policies in Malawi and for strengthening of the weaknesses of each method, especially in terms of data validity. This research suggested that the multidimensional nature of maternal and child health policies, like other health policies, calls for a combination of research designs as well as a variety of methods of data collection and analysis. In addition, we suggest that, as an emerging research field, health policy analysis will benefit more from case study designs because they provide rich experiences in the actual policy context.

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

    PubMed Central

    2014-01-01

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

  14. Strengthening Cost-Effectiveness Analysis for Public Health Policy.

    PubMed

    Russell, Louise B; Sinha, Anushua

    2016-05-01

    Although the U.S. spends more on medical care than any country in the world, Americans live shorter lives than the citizens of other high-income countries. Many important opportunities to improve this record lie outside the health sector and involve improving the conditions in which Americans live and work: safe design and maintenance of roads, bridges, train tracks, and airports; control of environmental pollutants; occupational safety; healthy buildings; a safe and healthy food supply; safe manufacture of consumer products; a healthy social environment; and others. Faced with the overwhelming array of possibilities, U.S. decision makers need help identifying those that can contribute the most to health. Cost-effectiveness analysis is designed to serve that purpose, but has mainly been used to assess interventions within the health sector. This paper briefly reviews the objective of cost-effectiveness analysis and its methodologic evolution and discusses the issues that arise when it is used to evaluate interventions that fall outside the health sector under three headings: structuring the analysis, quantifying/measuring benefits and costs, and valuing benefits and costs.

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

    PubMed Central

    2013-01-01

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

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

    PubMed

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

    2013-03-07

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

  17. School Health Promotion Policies and Adolescent Risk Behaviors in Israel: A Multilevel Analysis

    ERIC Educational Resources Information Center

    Tesler, Riki; Harel-Fisch, Yossi; Baron-Epel, Orna

    2016-01-01

    Background: Health promotion policies targeting risk-taking behaviors are being implemented across schools in Israel. This study identified the most effective components of these policies influencing cigarette smoking and alcohol consumption among adolescents. Methods: Logistic hierarchical linear model (HLM) analysis of data for 5279 students in…

  18. Chronic disease prevention policy in British Columbia and Ontario in light of public health renewal: a comparative policy analysis

    PubMed Central

    2013-01-01

    Background Public health strategies that focus on legislative and policy change involving chronic disease risk factors such as unhealthy diet and physical inactivity have the potential to prevent chronic diseases and improve quality of life as a whole. However, many public health policies introduced as part of public health reform have not yet been analyzed, such as in British Columbia and Ontario. The purpose of this paper is to present the results of a descriptive, comparative analysis of public health policies related to the Healthy Living Core Program in British Columbia and Chronic Disease Prevention Standard in Ontario that are intended to prevent a range of chronic diseases by promoting healthy eating and physical activity, among other things. Methods Policy documents were found through Internet search engines and Ministry websites, at the guidance of policy experts. These included government documents as well as documents from non-governmental organizations that were implementing policies and programs at a provincial level. Documents (n = 31) were then analysed using thematic content analysis to classify, describe and compare policies in a systematic fashion, using the software NVivo. Results Three main categories emerged from the analysis of documents: 1) goals for chronic disease prevention in British Columbia and Ontario, 2) components of chronic disease prevention policies, and 3) expected outputs of chronic disease prevention interventions. Although there were many similarities between the two provinces, they differed somewhat in terms of their approach to issues such as evidence, equity, and policy components. Some expected outputs were adoption of healthy behaviours, use of information, healthy environments and increased public awareness. Conclusions The two provincial policies present different approaches to support the implementation of related programs. Differences may be related to contextual factors such as program delivery structures and

  19. AIDS, policy analysis, and the electorate: the role of schools of public health.

    PubMed

    Krieger, N; Lashof, J C

    1988-04-01

    Current debates concerning appropriate policy to combat the epidemic of acquired immunodeficiency syndrome (AIDS) have raised critical questions regarding the role that schools of public health and individual public health professionals should play, if any, in AIDS-related policy analysis and social advocacy. In the summer of 1986, the School of Public Health at the University of California at Berkeley initiated a telegram sent by the Deans of all 23 schools of public health to protest US Department of Justice AIDS policy and, in the subsequent fall, the school expanded its public educational role in an unprecedented manner by initiating and issuing, with California's other three schools of public health, a policy analysis of Proposition 64, the LaRouche AIDS Quarantine Initiative. That analysis exposed the proposition's fallacious claims regarding casual transmission of AIDS and served to educate the electorate on the likely public health impact of this deleterious legislation. Based on these experiences, and in light of ongoing national controversy regarding AIDS, we believe schools of public health have an important role to play in policy analysis, and individual public health professionals have a role to play in social advocacy.

  20. AIDS, policy analysis, and the electorate: the role of schools of public health.

    PubMed Central

    Krieger, N; Lashof, J C

    1988-01-01

    Current debates concerning appropriate policy to combat the epidemic of acquired immunodeficiency syndrome (AIDS) have raised critical questions regarding the role that schools of public health and individual public health professionals should play, if any, in AIDS-related policy analysis and social advocacy. In the summer of 1986, the School of Public Health at the University of California at Berkeley initiated a telegram sent by the Deans of all 23 schools of public health to protest US Department of Justice AIDS policy and, in the subsequent fall, the school expanded its public educational role in an unprecedented manner by initiating and issuing, with California's other three schools of public health, a policy analysis of Proposition 64, the LaRouche AIDS Quarantine Initiative. That analysis exposed the proposition's fallacious claims regarding casual transmission of AIDS and served to educate the electorate on the likely public health impact of this deleterious legislation. Based on these experiences, and in light of ongoing national controversy regarding AIDS, we believe schools of public health have an important role to play in policy analysis, and individual public health professionals have a role to play in social advocacy. PMID:3348472

  1. Using secondary analysis of qualitative data of patient experiences of health care to inform health services research and policy.

    PubMed

    Ziebland, Sue; Hunt, Kate

    2014-02-26

    Qualitative research is recognized as an important method for including patients' voices and experiences in health services research and policy-making, yet the considerable potential to analyse existing qualitative data to inform health policy and practice has been little realized. This failure may partly be explained by: a lack of awareness amongst health policy makers of the increasing wealth of qualitative data available; and around 15 years of internal debates among qualitative researchers on the strengths, limitations and validity of re-use of qualitative data. Whilst acknowledging the challenges of qualitative secondary data analysis, we argue that there is a growing imperative to be pragmatic and to undertake analysis of existing qualitative data collections where they have the potential to contribute to health policy formulation. Time pressures are inherent in the policy-making process and in many circumstances it is not possible to seek funding, conduct and analyse new qualitative studies of patients' experiences in time to inform a specific policy. The danger then is that the patient voice, and the experiences of relatives and carers, is either excluded or included in a way that is easily dismissed as 'unrepresentative'. We argue that secondary analysis of qualitative data collections may sometimes be an effective means to enable patient experiences to inform policy decision-making.

  2. Personalized health care and health information technology policy: an exploratory analysis.

    PubMed

    Wald, Jonathan S; Shapiro, Michael

    2013-01-01

    Personalized healthcare (PHC) is envisioned to enhance clinical practice decision-making using new genome-driven knowledge that tailors diagnosis, treatment, and prevention to the individual patient. In 2012, we conducted a focused environmental scan and informal interviews with fifteen experts to anticipate how PHC might impact health Information Technology (IT) policy in the United States. Findings indicatedthat PHC has a variable impact on current clinical practice, creates complex questions for providers, patients, and policy-makers, and will require a robust health IT infrastructure with advanced data architecture, clinical decision support, provider workflow tools, and re-use of clinical data for research. A number of health IT challenge areas were identified, along with five policy areas including: interoperable clinical decision support, standards for patient values and preferences, patient engagement, data transparency, and robust privacy and security.

  3. Developing the national community health assistant strategy in Zambia: a policy analysis

    PubMed Central

    2013-01-01

    Background In 2010, the Ministry of Health in Zambia developed the National Community Health Assistant strategy, aiming to integrate community health workers (CHWs) into national health plans by creating a new group of workers, called community health assistants (CHAs). The aim of the paper is to analyse the CHA policy development process and the factors that influenced its evolution and content. A policy analysis approach was used to analyse the policy reform process. Methodology Data were gathered through review of documents, participant observation and key informant interviews with CHA strategic team members in Lusaka district, and senior officials at the district level in Kapiri Mposhi district where some CHAs have been deployed. Results The strategy was developed in order to address the human resources for health shortage and the challenges facing the community-based health workforce in Zambia. However, some actors within the strategic team were more influential than others in informing the policy agenda, determining the process, and shaping the content. These actors negotiated with professional/statutory bodies and health unions on the need to develop the new cadre which resulted in compromises that enabled the policy process to move forward. International agencies also indirectly influenced the course as well as the content of the strategy. Some actors classified the process as both insufficiently consultative and rushed. Due to limited consultation, it was suggested that the policy content did not adequately address key policy content issues such as management of staff attrition, general professional development, and progression matters. Analysis of the process also showed that the strategy might create a new group of workers whose mandate is unclear to the existing group of health workers. Conclusions This paper highlights the complex nature of policy-making processes for integrating CHWs into the health system. It reiterates the need for recognising the

  4. Meanings in policy: a textual analysis of Canada's "Achieving Health For All" document.

    PubMed

    Iannantuono, A; Eyles, J

    1997-06-01

    This paper presents a textual analysis of a key Canadian health policy document--Achieving Health for All (AHFA). It begins by establishing the importance of policy language and an interpretive approach to reveal dominant meanings and assumptions. This approach points out the significance of language and its contexts (text and intertext) and of developing a formal analytic strategy, based on semiotics. The paper concludes with a detailed, illustrated analysis of AHFA, suggesting that the document's discourse, through appealing to all, with emphases on the nation, community and all Canadians, establishes a frame of individual responsibility and rights, health promotion and broad health determinants--a frame that resonates with the cost-constrained nature of health care delivery-as found in provincial reform documents in the 1980s and 1990s.

  5. Health Care Reform and Concurrent Curative Care for Terminally Ill Children: A Policy Analysis

    PubMed Central

    Lindley, Lisa C.

    2012-01-01

    Within the Patient Protection and Affordable Care Act of 2010 or health care reform, is a relatively small provision about concurrent curative care that significantly affects terminally ill children. Effective on March 23, 2010, terminally ill children, who are enrolled in a Medicaid or state Children’s Health Insurance Plans (CHIP) hospice benefit, may concurrently receive curative care related to their terminal health condition. The purpose of this article was to conduct a policy analysis of the concurrent curative care legislation by examining the intended goals of the policy to improve access to care and enhance quality of end of life care for terminally ill children. In addition, the policy analysis explored the political feasibility of implementing concurrent curative care at the state-level. Based on this policy analysis, the federal policy of concurrent curative care for children would generally achieve its intended goals. However, important policy omissions focus attention on the need for further federal end of life care legislation for children. These findings have implications nurses. PMID:22822304

  6. Health policy and mental health.

    PubMed

    Dekker, E

    1987-01-01

    Health policy can be described as policy directed at the determinants of health, i.e. biological and environmental factors, lifestyle and the health care system. This type of policy now has become a policy objective in an increasing number of countries. In this article mental health is placed in the broad context of this policy. The central question is: can the mental health field grasp the opportunity of a growing interest in prevention and health promotion in general, as major objectives of health policy? Or will it stay more or less isolated from the mainstream of current developments? Answering this question means looking at the conditions of health policy. For health policy it is required that a definition be given of health problems and "causing" conditions. There should further be available intervention possibilities of a preventive and intersectoral character and also preventive strategies. It is stated that there is enough standardized information on mental health problems and experience with community-based research to let mental health participate in drawing up a community diagnosis. It also appears possible to construct an ecological health status model for mental health. Research on the factors in this model shows a shift in focus from risk populations to risk situations, e.g. unemployment, industrial disability, divorce and isolation. Further it is recognized that the search for causal factors is substituted by that for precipitating factors. Social-demographic factors, taken alone, are not precipitating factors. What matters is the combination of an underdeveloped coping mechanism, little social support, and prolonged stressful conditions or sudden stressful events.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10287174

  7. Agriculture Policy Is Health Policy

    PubMed Central

    Jackson, Richard J.; Minjares, Ray; Naumoff, Kyra S.; Shrimali, Bina Patel; Martin, Lisa K.

    2009-01-01

    The Farm Bill is meant to supplement and secure farm incomes, ensure a stable food supply, and support the American farm economy. Over time, however, it has evolved into a system that creates substantial health impacts, both directly and indirectly. By generating more profit for food producers and less for family farmers; by effectively subsidizing the production of lower-cost fats, sugars, and oils that intensify the health-destroying obesity epidemic; by amplifying environmentally destructive agricultural practices that impact air, water, and other resources, the Farm Bill influences the health of Americans more than is immediately apparent. In this article, we outline three major public health issues influenced by American farm policy. These are (1) rising obesity; (2) food safety; and (3) environmental health impacts, especially exposure to toxic substances and pesticides. PMID:23144677

  8. Privacy policy analysis for health information networks and regional health information organizations.

    PubMed

    Noblin, Alice M

    2007-01-01

    Regional Health Information Organizations (RHIOs) are forming in response to President George W. Bush's 2004 mandate that medical information be made available electronically to facilitate continuity of care. Privacy concerns are a deterrent to widespread acceptance of RHIOs. The Health Information Portability and Accountability Act of 1996 provides some guidelines for privacy protection. However, most states have stricter guidelines, causing difficulty when RHIOs form across these jurisdictions. This article compares several RHIOs including their privacy policies where available. In addition, studies were reviewed considering privacy concerns of people in the United States and elsewhere. Surveys reveal that Americans are concerned about the privacy of their personal health information and ultimately feel it is the role of the government to provide protection. The purpose of this article is to look at the privacy issues and recommend a policy that may help to resolve some of the concerns of both providers and patients. Policy research and action are needed to move the National Health Information Network toward reality. Efforts to provide consistency in privacy laws are a necessary early step to facilitate the construction and maintenance of RHIOs and the National Health Information Network.

  9. Improving State Health Policy Assessment: An Agenda for Measurement and Analysis

    PubMed Central

    Silver, Diana

    2012-01-01

    We examine the scope of inquiry into the measurement and assessment of the state public health policy environment. We argue that there are gains to be made by looking systematically at policies both within and across health domains. We draw from the public health and public policy literature to develop the concepts of interdomain and intradomain policy comprehensiveness and illustrate how these concepts can be used to enhance surveillance of the current public health policy environment, improve understanding of the adoption of new policies, and enhance evaluations of the impact of such policies on health outcomes. PMID:22813417

  10. [Health policies and politicized health? An analysis of sexual and reproductive health policies in Peru from the perspective of medical ethics, quality of care, and human rights].

    PubMed

    Miranda, J Jaime; Yamin, Alicia Ely

    2008-01-01

    Health professionals view medical ethics as a discipline that provides the basis for more adequate patient care. In recent years the concepts of quality of care and human rights - with their attending discourses - have joined the concept of medical ethics among the paradigms to consider in care for humans both at the individual and health policy levels. The current study seeks to analyze such paradigms, based on a case study of sexual and reproductive health policies in Peru in the last 10 years.

  11. How Policy Improves Health.

    PubMed

    Fairfax, Colita Nichols; Feit, Marvin D

    2015-01-01

    A discussion of health equity should be intricately examined in policy and practice discourse about the healthcare industry. This article addresses health equity with strategies to institutionalize it through policy implementation. This discourse is relevant to social work because social workers are charged with elucidating conditions that are maniacal and disadvantageous to racial groups, undocumented workers, immigrants and women. Social workers engaged in policy practice should consider how these stakeholders are excluded from health equity, because of the lack of transformative policy implementation that addresses industry practices that encourage disparity and maintain equity. This article hopes to provide a helpful view of health equity.

  12. ‘Including health in systems responsible for urban planning’: a realist policy analysis research programme

    PubMed Central

    Harris, Patrick; Friel, Sharon; Wilson, Andrew

    2015-01-01

    Introduction Realist methods are increasingly being used to investigate complex public health problems. Despite the extensive evidence base clarifying the built environment as a determinant of health, there is limited knowledge about how and why land-use planning systems take on health concerns. Further, the body of research related to the wider determinants of health suffers from not using political science knowledge to understand how to influence health policy development and systems. This 4-year funded programme of research investigates how the land-use planning system in New South Wales, Australia, incorporates health and health equity at multiple levels. Methods and analysis The programme uses multiple qualitative methods to develop up to 15 case studies of different activities of the New South Wales land-use planning system. Comparison cases from other jurisdictions will be included where possible and useful. Data collection includes publicly available documentation and purposively sampled stakeholder interviews and focus groups of up to 100 participants across the cases. The units of analysis in each case are institutional structures (rules and mandates constraining and enabling actors), actors (the stakeholders, organisations and networks involved, including health-focused agencies), and ideas (policy content, information, and framing). Data analysis will focus on and develop propositions concerning the mechanisms and conditions within and across each case leading to inclusion or non-inclusion of health. Data will be refined using additional political science and sociological theory. Qualitative comparative analysis will compare cases to develop policy-relevant propositions about the necessary and sufficient conditions needed to include health issues. Ethics and dissemination Ethics has been approved by Sydney University Human Research Ethics Committee (2014/802 and 2015/178). Given the nature of this research we will incorporate stakeholders, often as

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

    PubMed

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

    2004-07-01

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

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

    PubMed Central

    2012-01-01

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

  15. Cost-effectiveness analysis and policy choices: investing in health systems.

    PubMed Central

    Murray, C. J.; Kreuser, J.; Whang, W.

    1994-01-01

    The role of health systems infrastructure in studies of cost-effectiveness analysis and health resource allocation is discussed, and previous health sector cost-effectiveness analyses are cited. Two substantial difficulties concerning the nature of health system costs and the policy choices are presented. First, the issue of health system infrastructure can be addressed by use of computer models such as the Health Resource Allocation Model (HRAM) developed at Harvard, which integrates cost-effectiveness and burden of disease data. It was found that a model which allows for expansion in health infrastructure yields nearly 40% more total DALYs for a hypothetical sub-Saharan African country than a model which neglects infrastructure expansion. Widespread use of cost-effectiveness databases for resource allocations in the health sector will require the cost-effectiveness analyses shift from reporting costs to reporting production functions. Second, three distinct policy questions can be treated using these tools, each necessitating its own inputs and constraints: allocations when given a fixed budget and health infrastructure, or when given resources for marginal expansion, or when given a politically constrained situation of expanding resources. Confusion concerning which question is being addressed must be avoided through development of a consistent and rigorous approach to using cost-effectiveness data for informing resource allocations. PMID:7923545

  16. Equity in public health standards: a qualitative document analysis of policies from two Canadian provinces

    PubMed Central

    2012-01-01

    Introduction Promoting health equity is a key goal of many public health systems. However, little is known about how equity is conceptualized in such systems, particularly as standards of public health practice are established. As part of a larger study examining the renewal of public health in two Canadian provinces, Ontario and British Columbia (BC), we undertook an analysis of relevant public health documents related to equity. The aim of this paper is to discuss how equity is considered within documents that outline standards for public health. Methods A research team consisting of policymakers and academics identified key documents related to the public health renewal process in each province. The documents were analyzed using constant comparative analysis to identify key themes related to the conceptualization and integration of health equity as part of public health renewal in Ontario and BC. Documents were coded inductively with higher levels of abstraction achieved through multiple readings. Sets of questions were developed to guide the analysis throughout the process. Results In both sets of provincial documents health inequities were defined in a similar fashion, as the consequence of unfair or unjust structural conditions. Reducing health inequities was an explicit goal of the public health renewal process. In Ontario, addressing “priority populations” was used as a proxy term for health equity and the focus was on existing programs. In BC, the incorporation of an equity lens enhanced the identification of health inequities, with a particular emphasis on the social determinants of health. In both, priority was given to reducing barriers to public health services and to forming partnerships with other sectors to reduce health inequities. Limits to the accountability of public health to reduce health inequities were identified in both provinces. Conclusion This study contributes to understanding how health equity is conceptualized and incorporated

  17. [Health policies and politicized health? An analysis of sexual and reproductive health policies in Peru from the perspective of medical ethics, quality of care, and human rights].

    PubMed

    Miranda, J Jaime; Yamin, Alicia Ely

    2008-01-01

    Health professionals view medical ethics as a discipline that provides the basis for more adequate patient care. In recent years the concepts of quality of care and human rights - with their attending discourses - have joined the concept of medical ethics among the paradigms to consider in care for humans both at the individual and health policy levels. The current study seeks to analyze such paradigms, based on a case study of sexual and reproductive health policies in Peru in the last 10 years. PMID:18209830

  18. Cervical cancer and the global health agenda: Insights from multiple policy-analysis frameworks

    PubMed Central

    Parkhurst, Justin O.; Vulimiri, Madhulika

    2013-01-01

    Cervical cancer is the second leading cause of cancer deaths for women globally, with an estimated 88% of deaths occurring in the developing world. Available technologies have dramatically reduced mortality in high-income settings, yet cervical cancer receives considerably little attention on the global health policy landscape. The authors applied four policy-analysis frameworks to literature on global cervical cancer to explore the question of why cervical cancer may not be receiving the international attention it may otherwise warrant. Each framework explores the process of agenda setting and discerns factors that either facilitate or hinder policy change in cases where there is both a clear problem and a potential effective solution. In combination, these frameworks highlight a number of crucial elements that may be needed to raise the profile of cervical cancer on global health agendas, including improving local (national or sub-national) information on the condition; increasing mobilisation of affected civil society groups; framing cervical cancer debates in ways that build upon its classification as a non-communicable disease (NCD) and an issue of women's rights; linking cervical cancer screening to well-funded services such as those for HIV treatment in some countries; and identifying key global policy windows of opportunity to promote the cervical cancer agenda, including emerging NCD global health discussions and post-2015 reviews of the Millennium Development Goals. PMID:24236409

  19. Federalism and health policy.

    PubMed

    Nathan, Richard P

    2005-01-01

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

  20. Health services financing and delivery: analysis of policy options for Dubai, United Arab Emirates

    PubMed Central

    Hamidi, Samer

    2015-01-01

    Introduction A national health account (NHA) provides a systematic approach to mapping the flow of health sector funds within a specified health system over a defined time period. This article attempts to present a profile of health system financing in Dubai, United Arab Emirates using data from NHAs, and to compare the functional structures of financing schemes in Dubai with schemes in Qatar and selected member countries of the Organization for Economic Cooperation and Development (OECD). Methods The author analyzed secondary data published in NHAs of Dubai and Qatar and data collected by the OECD countries and publicly available from Eurostat (Statistical Office of the European Union) of 25 OECD countries for comparative analysis. All health financing indicators used were as defined in the international System of Health Accounts (SHA). Results In Dubai, spending on inpatient care was the highest-costing component, with 30% of current health expenditures (CHE). Spending on outpatient care was the second highest-costing component and accounted for about 23% of the CHE. Household spending accounted for about 22% of CHE (equivalent to US$187 per capita), compared to an average of 20% of CHE of OECD countries. Dubai spent 0.02% of CHE on long-term care, compared to an average of 11% of CHE of OECD countries. Dubai spent about 6% of CHE on prevention and public health services, compared to an average of 3.2% of CHE of OECD countries. Conclusion The findings point to potential opportunities for growth and improvement in several health policy issues in Dubai, including increasing focus and funding of preventive services; shifting from inpatient care to day surgery, outpatient, and home-based services and strengthening long-term care; and introducing cost-containment measures for pharmaceuticals. More investment in the translation of NHA data into policy is suggested for future researchers. PMID:25750545

  1. Tobacco control policies and perinatal and child health: a systematic review and meta-analysis protocol

    PubMed Central

    Been, Jasper V; Mackenbach, Johan P; Millett, Christopher; Basu, Sanjay; Sheikh, Aziz

    2015-01-01

    Introduction Children experience considerable morbidity and mortality due to tobacco smoke exposure. Tobacco control policies may benefit child health by reducing this exposure. We aim to comprehensively assess the effects of the range of tobacco control policies advocated by the WHO on perinatal and child health. Methods and analysis We will systematically search 19 electronic literature databases (from inception) for published studies, and the WHO International Clinical Trials Registry Platform for unpublished studies. Additional work will be identified via handsearching references and citations, and through consulting an international panel of experts. No language restrictions will apply. Following Cochrane Effective Practice and Organisation of Care (EPOC) guidelines, randomised and clinical controlled trials, controlled before-and-after studies, and interrupted time series designs, are eligible. Studies of interest will assess the impact of any of the WHO-advocated tobacco control policies contained in the MPOWER acronym (except ‘Monitoring tobacco use’) on at least one outcome of interest among children aged 0–12 years. The primary outcomes are: perinatal mortality, preterm birth, asthma exacerbations requiring hospital attendance and respiratory infections requiring hospital attendance. Data will be extracted using customised forms and authors will be contacted to obtain missing information. Risk of bias will be assessed using EPOC criteria. Findings will be reported in narrative and tabular form. Between-study heterogeneity will be assessed clinically and statistically using I2. If appropriate and possible, random-effects meta-analysis will be conducted for each unique combination of intervention and outcome. Subgroup analyses will be performed to assess the influence of the comprehensiveness of each policy, and to explore the impact of each policy according to socioeconomic status. Ethics and dissemination No ethical assessment is necessary as we

  2. Power and Agenda-Setting in Tanzanian Health Policy: An Analysis of Stakeholder Perspectives

    PubMed Central

    Fischer, Sara Elisa; Strandberg-Larsen, Martin

    2016-01-01

    Background: Global health policy is created largely through a collaborative process between development agencies and aid-recipient governments, yet it remains unclear whether governments retain ownership over the creation of policy in their own countries. An assessment of the power structure in this relationship and its influence over agenda-setting is thus the first step towards understanding where progress is still needed in policy-making for development. Methods: This study employed qualitative policy analysis methodology to examine how health-related policy agendas are adopted in low-income countries, using Tanzania as a case study. Semi-structured, in-depth, key informant interviews with 11 policy-makers were conducted on perspectives of the agenda-setting process and its actors. Kingdon’s stream theory was chosen as the lens through which to interpret the data analysis. Results: This study demonstrates that while stakeholders each have ways of influencing the process, the power to do so can be assessed based on three major factors: financial incentives, technical expertise, and influential position. Since donors often have two or all of these elements simultaneously a natural power imbalance ensues, whereby donor interests tend to prevail over recipient government limitations in prioritization of agendas. One way to mediate these imbalances seems to be the initiation of meaningful policy dialogue. Conclusion: In Tanzania, the agenda-setting process operates within a complex network of factors that interact until a "policy window" opens and a decision is made. Power in this process often lies not with the Tanzanian government but with the donors, and the contrast between latent presence and deliberate use of this power seems to be based on the donor ideology behind giving aid (defined here by funding modality). Donors who used pooled funding (PF) modalities were less likely to exploit their inherent power, whereas those who preferred to maintain maximum

  3. [Men's health policy].

    PubMed

    Schwarz, Eduardo; Gomes, Romeu; Couto, Márcia Thereza; Moura, Erly Catarina de; Carvalho, Sarah de Araújo; Silva, Simione Fátima Cesar da

    2012-12-01

    The paper discusses the articulation among epidemiological information systems, scientific production and men's health policies. Three secondary sources were used: data from the Ministry of Health (Mortality and Hospital Information Systems, Surveillance of Protection and Risk Factors for Chronic Diseases through Telephone Survey), papers published in SciELO, and documents of the Ministry of Health regarding men's health. The results indicate that, in terms of morbidity and mortality, men are more exposed to risks than women. In the scientific production, studies focus predominantly on injuries and diseases that affect exclusively the male population, to the detriment of other health-related aspects. Legal documents highlight the epidemiological panorama of male morbidity and mortality and the policy-making methodology. Researchers need to expand the use of data from the epidemiological information systems of the Ministry of Health and to incorporate the gender relational perspective critically.

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

    PubMed Central

    2014-01-01

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

  5. Privacy and health in the information age: a content analysis of health web site privacy policy statements.

    PubMed

    Rains, Stephen A; Bosch, Leslie A

    2009-07-01

    This article reports a content analysis of the privacy policy statements (PPSs) from 97 general reference health Web sites that was conducted to examine the ways in which visitors' privacy is constructed by health organizations. PPSs are formal documents created by the Web site owner to describe how information regarding site visitors and their behavior is collected and used. The results show that over 80% of the PPSs in the sample indicated automatically collecting or requesting that visitors voluntarily provide information about themselves, and only 3% met all five of the Federal Trade Commission's Fair Information Practices guidelines. Additionally, the results suggest that the manner in which PPSs are framed and the use of justifications for collecting information are tropes used by health organizations to foster a secondary exchange of visitors' personal information for access to Web site content. PMID:19657826

  6. Public health and policy.

    PubMed

    Nunnery, Jennifer; Angulo, Frederick J; Tollefson, Linda

    2006-02-24

    Antimicrobial agent usage data are essential for focusing efforts to reduce misuse and overuse of antimicrobial agents in food producing animals because these practices may select for resistance in bacteria of animals. Transfer of resistant bacteria from animals to humans can lead to human infection caused by resistant pathogens. Resistant infections can lead to treatment failures, resulting in prolonged or more severe illness. Multiple World Health Organization (WHO) reports have concluded that both antimicrobial resistance and antimicrobial usage should be monitored on the national level. The system for collecting antimicrobial usage data should be clear and transparent to facilitate trend analysis and comparison within and among countries. Therapeutic, prophylactic and growth promotion use should be recorded, along with route of administration and animal species and/or production class treated. The usage data should be compared to resistance data, and the comparison should be made available in a timely manner. In the United States, surveillance of antimicrobial resistance in foodborne bacteria is performed by the National Antimicrobial Resistance Monitoring System (NARMS) for enteric bacteria, however, the United States still lacks a mechanism for collecting antimicrobial usage data. Combined with antimicrobial resistance information from NARMS, antimicrobial usage data will help to direct education efforts and policy decisions, minimizing the risk that people will develop antimicrobial resistant infections as a result of eating food of animal origin. Ultimately mitigation strategies guided by usage data will be more effective in maintaining antimicrobial drugs for appropriate veterinary use and in protecting human health. PMID:16269192

  7. Probabilistic uncertainty analysis of epidemiological modeling to guide public health intervention policy.

    PubMed

    Gilbert, Jennifer A; Meyers, Lauren Ancel; Galvani, Alison P; Townsend, Jeffrey P

    2014-03-01

    Mathematical modeling of disease transmission has provided quantitative predictions for health policy, facilitating the evaluation of epidemiological outcomes and the cost-effectiveness of interventions. However, typical sensitivity analyses of deterministic dynamic infectious disease models focus on model architecture and the relative importance of parameters but neglect parameter uncertainty when reporting model predictions. Consequently, model results that identify point estimates of intervention levels necessary to terminate transmission yield limited insight into the probability of success. We apply probabilistic uncertainty analysis to a dynamic model of influenza transmission and assess global uncertainty in outcome. We illustrate that when parameter uncertainty is not incorporated into outcome estimates, levels of vaccination and treatment predicted to prevent an influenza epidemic will only have an approximately 50% chance of terminating transmission and that sensitivity analysis alone is not sufficient to obtain this information. We demonstrate that accounting for parameter uncertainty yields probabilities of epidemiological outcomes based on the degree to which data support the range of model predictions. Unlike typical sensitivity analyses of dynamic models that only address variation in parameters, the probabilistic uncertainty analysis described here enables modelers to convey the robustness of their predictions to policy makers, extending the power of epidemiological modeling to improve public health. PMID:24593920

  8. The terrain of health policy analysis in low and middle income countries: a review of published literature 1994–2007

    PubMed Central

    Gilson, Lucy; Raphaely, Nika

    2008-01-01

    This article provides the first ever review of literature analysing the health policy processes of low and middle income countries (LMICs). Based on a systematic search of published literature using two leading international databases, the article maps the terrain of work published between 1994 and 2007, in terms of policy topics, lines of inquiry and geographical base, as well as critically evaluating its strengths and weaknesses. The overall objective of the review is to provide a platform for the further development of this field of work. From an initial set of several thousand articles, only 391 were identified as relevant to the focus of inquiry. Of these, 164 were selected for detailed review because they present empirical analyses of health policy change processes within LMIC settings. Examination of these articles clearly shows that LMIC health policy analysis is still in its infancy. There are only small numbers of such analyses, whilst the diversity of policy areas, topics and analytical issues that have been addressed across a large number of country settings results in a limited depth of coverage within this body of work. In addition, the majority of articles are largely descriptive in nature, limiting understanding of policy change processes within or across countries. Nonetheless, the broad features of experience that can be identified from these articles clearly confirm the importance of integrating concern for politics, process and power into the study of health policy. By generating understanding of the factors influencing the experience and results of policy change, such analysis can inform action to strengthen future policy development and implementation. This article, finally, outlines five key actions needed to strengthen the field of health policy analysis within LMICs, including capacity development and efforts to generate systematic and coherent bodies of work underpinned by both the intent to undertake rigorous analytical work and concern

  9. Policy for Promotion of Women's Mental Health: Insight from Analysis of Policy on Postnatal Depression in Mexico.

    PubMed

    Place, Jean Marie S; Billings, Deborah L; Frongillo, Edward A; Blake, Christine E; Mann, Joshua R; deCastro, Filipa

    2016-03-01

    This article critically examines federal, state and facility-level policies, as well as clinical practice guidelines regarding postnatal depression in Mexico. Thirteen documents including national health plans, national action plans, federal and state laws and regulations, clinical practice guidelines, and public-sector healthcare facility policies were collected and evaluated according to whether they included a statement of intent and/or actions related to the care of women at risk for or experiencing postnatal depression. While postnatal depression is included in several policies in Mexico, it is not addressed in ways that guide actions to manage postnatal depression. Specific direction on postnatal depression in policies would bridge a gap in maternal mental healthcare given that medication, treatment, and timing of interventions is unique in the postpartum context.

  10. Screening Mental Health Problems in Schools. A Center Policy Issues Analysis Brief

    ERIC Educational Resources Information Center

    Center for Mental Health in Schools at UCLA, 2007

    2007-01-01

    Long-standing policy controversies have heated up as a result of increasing proposals for using schools to screen for mental health problems (e.g., depression screening). This brief highlights the following issues: (1) How appropriate is large-scale screening for mental health problems? (2) Will the costs of large-scale mental health screening…

  11. A thematic review and a policy-analysis agenda of Electronic Health Records in the Greek National Health System.

    PubMed

    Emmanouilidou, Maria; Burke, Maria

    2013-01-01

    The increasing pressure to improve healthcare outcomes and reduce costs is driving the current agenda of governments at worldwide level and calls for a fundamental reform of the status quo of health systems. This is especially the case with the Greek NHS (National Health System), a system in continuous crisis, and with the recent ongoing financial turbulence under intensive scrutiny. Technological innovations and Electronic Health Records (EHR) in particular, are recognised as key enablers in mitigating the existing burdens of healthcare. As a result, EHR is considered a core component in technology-driven reform processes. Nonetheless, the successful implementation and adoption of EHR proves to be a challenging task due to a mixture of technological, organisational and political issues. Drawing upon experiences within the European Union (EU) healthcare setting and the Greek NHS the paper proposes a conceptual framework as a policy-analysis agenda for EHR interventions in Greece. While the context of discussion is Greece, the paper aims to also derive useful insights to healthcare policy-makers around the globe.

  12. Social-democratic government and health policy in Europe: a quantitative analysis.

    PubMed

    Mackenbach, Johan P; McKee, Martin

    2013-01-01

    Although health policy ultimately depends on political decision making, empirical evidence of the impact of politics on implementation of health policies and their population health outcomes is scarce. In this study, we assess the effects of social-democratic government participation on indicators of preventive health policy (tobacco, alcohol, food, mother and child health, infectious diseases, hypertension, cancer screening, road traffic safety, air pollution) in Europe. Cumulative years of social-democratic government differed widely between European countries, as did indicators of current health policy performance, but the latter are not associated with recent social-democratic government. However, there is a positive association with social-democratic government cumulated over five decades. Positive effects of social-democratic government are mainly seen on indicators of tobacco and alcohol control. We conclude that long-term social-democratic government participation may have had a positive impact on some areas of preventive health policy, perhaps through the creation of strong public health institutions or a strong public health workforce.

  13. Using Win-Win Strategies to Implement Health in All Policies: A Cross-Case Analysis

    PubMed Central

    Molnar, Agnes; Renahy, Emilie; O’Campo, Patricia; Muntaner, Carles; Freiler, Alix; Shankardass, Ketan

    2016-01-01

    Background In spite of increasing research into intersections of public policy and health, little evidence shows how policy processes impact the implementation of Health in All Policies (HiAP) initiatives. Our research sought to understand how and why strategies for engaging partners from diverse policy sectors in the implementation of HiAP succeed or fail in order to uncover the underlying social mechanisms contributing to sustainable implementation of HiAP. Methods In this explanatory multiple case study, we analyzed grey and peer-review literature and key informant interviews to identify mechanisms leading to implementation successes and failures in relation to different strategies for engagement across three case studies (Sweden, Quebec and South Australia), after accounting for the role of different contextual conditions. Findings Our results yielded no support for the use of awareness-raising or directive strategies as standalone approaches for engaging partners to implement HiAP. However, we found strong evidence that mechanisms related to “win-win” strategies facilitated implementation by increasing perceived acceptability (or buy-in) and feasibility of HiAP implementation across sectors. Win-win strategies were facilitated by mechanisms related to several activities, including: the development of a shared language to facilitate communication between actors from different sectors; integrating health into other policy agendas (eg., sustainability) and use of dual outcomes to appeal to the interests of diverse policy sectors; use of scientific evidence to demonstrate the effectiveness of HiAP; and using health impact assessment to make policy coordination for public health outcomes more feasible and to give credibility to policies being developed by diverse policy sectors. Conclusion Our findings enrich theoretical understanding in an under-unexplored area of intersectoral action. They also provide policy makers with examples of HiAP across wealthy

  14. Addressing preference heterogeneity in public health policy by combining Cluster Analysis and Multi-Criteria Decision Analysis: Proof of Method.

    PubMed

    Kaltoft, Mette Kjer; Turner, Robin; Cunich, Michelle; Salkeld, Glenn; Nielsen, Jesper Bo; Dowie, Jack

    2015-01-01

    The use of subgroups based on biological-clinical and socio-demographic variables to deal with population heterogeneity is well-established in public policy. The use of subgroups based on preferences is rare, except when religion based, and controversial. If it were decided to treat subgroup preferences as valid determinants of public policy, a transparent analytical procedure is needed. In this proof of method study we show how public preferences could be incorporated into policy decisions in a way that respects both the multi-criterial nature of those decisions, and the heterogeneity of the population in relation to the importance assigned to relevant criteria. It involves combining Cluster Analysis (CA), to generate the subgroup sets of preferences, with Multi-Criteria Decision Analysis (MCDA), to provide the policy framework into which the clustered preferences are entered. We employ three techniques of CA to demonstrate that not only do different techniques produce different clusters, but that choosing among techniques (as well as developing the MCDA structure) is an important task to be undertaken in implementing the approach outlined in any specific policy context. Data for the illustrative, not substantive, application are from a Randomized Controlled Trial of online decision aids for Australian men aged 40-69 years considering Prostate-specific Antigen testing for prostate cancer. We show that such analyses can provide policy-makers with insights into the criterion-specific needs of different subgroups. Implementing CA and MCDA in combination to assist in the development of policies on important health and community issues such as drug coverage, reimbursement, and screening programs, poses major challenges -conceptual, methodological, ethical-political, and practical - but most are exposed by the techniques, not created by them.

  15. A comparative analysis of early child health and development services and outcomes in countries with different redistributive policies

    PubMed Central

    2013-01-01

    Background The social environment is a fundamental determinant of early child development and, in turn, early child development is a determinant of health, well-being, and learning skills across the life course. Redistributive policies aimed at reducing social inequalities, such as a welfare state and labour market policies, have shown a positive association with selected health indicators. In this study, we investigated the influence of redistributive policies specifically on the social environment of early child development in five countries with different political traditions. The objective of this analysis was to highlight similarities and differences in social and health services between the countries and their associations with other health outcomes that can inform better global early child development policies and improve early child health and development. Methods Four social determinants of early child development were selected to provide a cross-section of key time periods in a child’s life from prenatal to kindergarten. They included: 1) prenatal care, 2) maternal leave, 3) child health care, and 4) child care and early childhood education. We searched international databases and reports (e.g. Organization for Economic Cooperation and Development, World Bank, and UNICEF) to obtain information about early child development policies, services and outcomes. Results Although a comparative analysis cannot claim causation, our analysis suggests that redistributive policies aimed at reducing social inequalities are associated with a positive influence on the social determinants of early child development. Generous redistributive policies are associated with a higher maternal leave allowance and pay and more preventive child healthcare visits. A decreasing trend in infant mortality, low birth weight rate, and under five mortality rate were observed with an increase in redistributive policies. No clear influence of redistributive policies was observed on

  16. Pandemic H1N1 in Canada and the use of evidence in developing public health policies--a policy analysis.

    PubMed

    Rosella, Laura C; Wilson, Kumanan; Crowcroft, Natasha S; Chu, Anna; Upshur, Ross; Willison, Donald; Deeks, Shelley L; Schwartz, Brian; Tustin, Jordan; Sider, Doug; Goel, Vivek

    2013-04-01

    When responding to a novel infectious disease outbreak, policies are set under time constraints and uncertainty which can limit the ability to control the outbreak and result in unintended consequences including lack of public confidence. The H1N1 pandemic highlighted challenges in public health decision-making during a public health emergency. Understanding this process to identify barriers and modifiable influences is important to improve the response to future emergencies. The purpose of this study is to examine the H1N1 pandemic decision-making process in Canada with an emphasis on the use of evidence for public health decisions. Using semi-structured key informant interviews conducted after the pandemic (July-November 2010) and a document analysis, we examined four highly debated pandemic policies: use of adjuvanted vaccine by pregnant women, vaccine priority groups and sequencing, school closures and personal protective equipment. Data were analysed for thematic content guided by Lomas' policy decision-making framework as well as indicative coding using iterative methods. We interviewed 40 public health officials and scientific advisors across Canada and reviewed 76 pandemic policy documents. Our analysis revealed that pandemic pre-planning resulted in strong beliefs, which defined the decision-making process. Existing ideological perspectives of evidence strongly influenced how information was used such that the same evidentiary sources were interpreted differently according to the ideological perspective. Participants recognized that current models for public health decision-making failed to make explicit the roles of scientific evidence in relation to contextual factors. Conflict avoidance theory explained policy decisions that went against the prevailing evidence. Clarification of roles and responsibilities within the public health system would reduce duplication and maintain credibility. A more transparent and iterative approach to incorporating evidence

  17. [Ethics in health policy and public health].

    PubMed

    Tichácek, B

    2000-11-01

    The author explains and illustrates by historical references terms such as health policy, public health, health. Next he deals with ethical principles of the health policy in the following sections: a) respecting people and their rights, b) maximalization of benefit and minimalization of damage, c) legal aspects.

  18. Integrating Information and Communication Technology for Health Information System Strengthening: A Policy Analysis.

    PubMed

    Marzuki, Nuraidah; Ismail, Saimy; Al-Sadat, Nabilla; Ehsan, Fauziah Z; Chan, Chee-Khoon; Ng, Chiu-Wan

    2015-11-01

    Despite the high costs involved and the lack of definitive evidence of sustained effectiveness, many low- and middle-income countries had begun to strengthen their health information system using information and communication technology in the past few decades. Following this international trend, the Malaysian Ministry of Health had been incorporating Telehealth (National Telehealth initiatives) into national health policies since the 1990s. Employing qualitative approaches, including key informant interviews and document review, this study examines the agenda-setting processes of the Telehealth policy using Kingdon's framework. The findings suggested that Telehealth policies emerged through actions of policy entrepreneurs within the Ministry of Health, who took advantage of several simultaneously occurring opportunities--official recognition of problems within the existing health information system, availability of information and communication technology to strengthen health information system and political interests surrounding the national Multimedia Super Corridor initiative being developed at the time. The last was achieved by the inclusion of Telehealth as a component of the Multimedia Super Corridor. PMID:26085477

  19. Integrating Information and Communication Technology for Health Information System Strengthening: A Policy Analysis.

    PubMed

    Marzuki, Nuraidah; Ismail, Saimy; Al-Sadat, Nabilla; Ehsan, Fauziah Z; Chan, Chee-Khoon; Ng, Chiu-Wan

    2015-11-01

    Despite the high costs involved and the lack of definitive evidence of sustained effectiveness, many low- and middle-income countries had begun to strengthen their health information system using information and communication technology in the past few decades. Following this international trend, the Malaysian Ministry of Health had been incorporating Telehealth (National Telehealth initiatives) into national health policies since the 1990s. Employing qualitative approaches, including key informant interviews and document review, this study examines the agenda-setting processes of the Telehealth policy using Kingdon's framework. The findings suggested that Telehealth policies emerged through actions of policy entrepreneurs within the Ministry of Health, who took advantage of several simultaneously occurring opportunities--official recognition of problems within the existing health information system, availability of information and communication technology to strengthen health information system and political interests surrounding the national Multimedia Super Corridor initiative being developed at the time. The last was achieved by the inclusion of Telehealth as a component of the Multimedia Super Corridor.

  20. Good practices and health policy analysis in European sports stadia: results from the 'Healthy Stadia' project.

    PubMed

    Drygas, Wojciech; Ruszkowska, Joanna; Philpott, Matthew; Björkström, Olav; Parker, Mike; Ireland, Robin; Roncarolo, Federico; Tenconi, Maria

    2013-06-01

    Sport plays an important role within society and sports stadia provide significant settings for public health strategies. In addition to being places of mass gathering, stadia are often located in less affluent areas and are traditionally attended by 'harder to reach' communities. Unfortunately sports stadia and the clubs they host are rarely perceived as places that promote healthy lifestyles. Fast food, alcohol and tobacco are commonly advertized, served and consumed during sports games giving the spectators and TV fans contradictory messages concerning healthy choices. As part of a wider programme of work part-funded by the European Union, a study was therefore designed to explore current 'good practice' relating to positive health interventions in sports stadia across a number of European countries. Using a specially designed questionnaire, information about health policies and good practices relating to food offerings in stadia, physical activity promotion among local communities, tobacco policy, positive mental health initiatives, environmental sustainability practices and social responsibility policies were collected in 10 European countries (England and Northern Ireland, Finland, Georgia, Greece, Ireland, Italy, Latvia, Poland, Spain and Sweden) involving 88 stadia. The audit results show that stadia health policies differ considerably between specific countries and sports. Based on the literature analysed, the examples of good practices collected through the study, and the subsequent instigation of a European Healthy Stadia Network, it shows that there is considerable potential for stadia to become health promoting settings.

  1. Towards universal coverage: a policy analysis of the development of the National Health Insurance Scheme in Nigeria.

    PubMed

    Onoka, Chima A; Hanson, Kara; Hanefeld, Johanna

    2015-11-01

    This article examines why and how a national health insurance (NHI) proposal targeting universal health coverage (UHC) in Nigeria developed over time. The study involved document reviews, in-depth interviews, a further review of preliminary analysis by relevant actors and use of a stakeholder analysis approach. The need for strategies to improve healthcare funding during the economic recession of the 1980s stimulated the proposal. The inclusion of Health Maintenance Organizations (HMOs) as financing organizations for national health insurance at the expense of sub-national (state) government mechanisms increased credibility of policy implementation but resulted in loss of support from states. The most successful period of the policy process occurred when a new minister of health (strongly supported by the president that displayed interest in UHC) provided leadership through the Federal Ministry of Health (FMOH), and effectively managed stakeholders' interests and galvanized their support to advance the policy. Later, the National Health Insurance Scheme (the federal government's implementing/regulatory agency) assumed this leadership role but has been unable to extend coverage in a significant way. Nigeria's experience shows that where political leaders are interested in a UHC-related proposal, the strong political leadership they provide considerably enhances the pace of the policy process. However, public officials should carefully guide policymaking processes that involve private sector actors, to ensure that strategies that compromise the chance of achieving UHC are not introduced. In contexts where authority is shared between federal and state governments, securing federal level commitment does not guarantee that a national health insurance proposal has become a 'national' proposal. States need to be provided with an active role in the process and governance structure. Finally, the article underscores the utility of retrospective stakeholder analysis in

  2. Towards universal coverage: a policy analysis of the development of the National Health Insurance Scheme in Nigeria.

    PubMed

    Onoka, Chima A; Hanson, Kara; Hanefeld, Johanna

    2015-11-01

    This article examines why and how a national health insurance (NHI) proposal targeting universal health coverage (UHC) in Nigeria developed over time. The study involved document reviews, in-depth interviews, a further review of preliminary analysis by relevant actors and use of a stakeholder analysis approach. The need for strategies to improve healthcare funding during the economic recession of the 1980s stimulated the proposal. The inclusion of Health Maintenance Organizations (HMOs) as financing organizations for national health insurance at the expense of sub-national (state) government mechanisms increased credibility of policy implementation but resulted in loss of support from states. The most successful period of the policy process occurred when a new minister of health (strongly supported by the president that displayed interest in UHC) provided leadership through the Federal Ministry of Health (FMOH), and effectively managed stakeholders' interests and galvanized their support to advance the policy. Later, the National Health Insurance Scheme (the federal government's implementing/regulatory agency) assumed this leadership role but has been unable to extend coverage in a significant way. Nigeria's experience shows that where political leaders are interested in a UHC-related proposal, the strong political leadership they provide considerably enhances the pace of the policy process. However, public officials should carefully guide policymaking processes that involve private sector actors, to ensure that strategies that compromise the chance of achieving UHC are not introduced. In contexts where authority is shared between federal and state governments, securing federal level commitment does not guarantee that a national health insurance proposal has become a 'national' proposal. States need to be provided with an active role in the process and governance structure. Finally, the article underscores the utility of retrospective stakeholder analysis in

  3. Australia's national mental health policy.

    PubMed

    Whiteford, H A

    1993-10-01

    In April 1992 the health ministers of all Australian states, territories, and the federal government endorsed Australia's first National Mental Health Policy. The major principles outlined in the policy include protecting consumers' rights, setting national service standards, mainstreaming mental health services with general health services, better integrating inpatient and community mental health services to ensure continuity of care, and linking mental health services and other social and disability services. A five-year National Mental Health Plan, accompanied by additional federal funding, has also been released, with time frames for implementing the policy in all states and territories and at the federal level. PMID:8225277

  4. Global Health and Foreign Policy

    PubMed Central

    Feldbaum, Harley; Lee, Kelley; Michaud, Joshua

    2010-01-01

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

  5. A Policy Analysis of the implementation of a Reproductive Health Vouchers Program in Kenya

    PubMed Central

    2012-01-01

    Background Innovative financing strategies such as those that integrate supply and demand elements like the output-based approach (OBA) have been implemented to reduce financial barriers to maternal health services. The Kenyan government with support from the German Development Bank (KfW) implemented an OBA voucher program to subsidize priority reproductive health services. Little evidence exists on the experience of implementing such programs in different settings. We describe the implementation process of the Kenyan OBA program and draw implications for scale up. Methods Policy analysis using document review and qualitative data from 10 in-depth interviews with facility in-charges and 18 with service providers from the contracted facilities, local administration, health and field managers in Kitui, Kiambu and Kisumu districts as well as Korogocho and Viwandani slums in Nairobi. Results The OBA implementation process was designed in phases providing an opportunity for learning and adapting the lessons to local settings; the design consisted of five components: a defined benefit package, contracting and quality assurance; marketing and distribution of vouchers and claims processing and reimbursement. Key implementation challenges included limited feedback to providers on the outcomes of quality assurance and accreditation and budgetary constraints that limited effective marketing leading to inadequate information to clients on the benefit package. Claims processing and reimbursement was sophisticated but required adherence to time consuming procedures and in some cases private providers complained of low reimbursement rates for services provided. Conclusions OBA voucher schemes can be implemented successfully in similar settings. For effective scale up, strong partnership will be required between the public and private entities. The government’s role is key and should include provision of adequate funding, stewardship and looking for opportunities to utilize

  6. A retrospective health policy analysis of the development and implementation of the voluntary health insurance system in Lebanon: learning from failure.

    PubMed

    El-Jardali, Fadi; Bou-Karroum, Lama; Ataya, Nour; El-Ghali, Hana Addam; Hammoud, Rawan

    2014-12-01

    Public policymaking is complex and suffers from limited uptake of research evidence, particularly in the Eastern Mediterranean Region (EMR). In-depth case studies examining health policymaking in the EMR are lacking. This retrospective policy analysis aims at generating insights about how policies are being made, identifying factors influencing policymaking and assessing to what extent evidence is used in this process by using the Lebanese Voluntary Health Insurance policy as a case study. The study examined the policymaking process through a policy tracing technique that covered a period of 12 years. The study employed a qualitative research design using a case study approach and was conducted in two phases over the course of two years. Data was collected using multiple sources including: 1) a comprehensive and chronological media review; 2) twenty-two key informant interviews with policymakers, stakeholders, and journalists; and 3) a document review of legislations, minutes of meetings, actuarial studies, and official documents. Data was analyzed and validated using thematic analysis. Findings showed that the voluntary health insurance policy was a political decision taken by the government to tackle an urgent political problem. Evidence was not used to guide policy development and implementation and policy implementers and other stakeholders were not involved in policy development. Factors influencing policymaking were political interests, sectarianism, urgency, and values of policymakers. Barriers to the use of evidence were lack of policy-relevant research evidence, political context, personal interests, and resource constraints. Findings suggest that policymakers should be made more aware of the important role of evidence in informing public policymaking and the need for building capacity to develop, implement and evaluate policies. Study findings are likely to matter in light of the changes that are unfolding in some Arab countries and the looming

  7. Documentary analysis of risk-assessment and safety-planning policies and tools in a mental health context.

    PubMed

    Higgins, Agnes; Doyle, Louise; Morrissey, Jean; Downes, Carmel; Gill, Ailish; Bailey, Sive

    2016-08-01

    Despite the articulated need for policies and processes to guide risk assessment and safety planning, limited guidance exists on the processes or procedures to be used to develop such policies, and there is no body of research that examines the quality or content of the risk-management policies developed. The aim of the present study was to analyse the policies of risk and safety management used to guide mental health nursing practice in Ireland. A documentary analysis was performed on 123 documents received from 22 of the 23 directors of nursing contacted. Findings from the analysis revealed a wide variation in how risk, risk assessment, and risk management were defined. Emphasis within the risk documentation submitted was on risk related to self and others, with minimal attention paid to other types of risks. In addition, there was limited evidence of recovery-focused approaches to positive risk taking that involved service users and their families within the risk-related documentation. Many of the risk-assessment tools had not been validated, and lacked consistency or guidance in relation to how they were to be used or applied. The tick-box approach and absence of space for commentary within documentation have the potential to impact severely on the quality of information collected and documented, and subsequent clinical decision-making. Managers, and those tasked with ensuring safety and quality, need to ensure that policies and processes are, where possible, informed by best evidence and are in line with national mental health policy on recovery.

  8. Health Policy for the Elderly.

    ERIC Educational Resources Information Center

    Wallace, Steven P.; Estes, Carroll L.

    1989-01-01

    Analyzes demographic and health trends during the Reagan years. Describes the current nature of health care, federal role, effects of the fiscal crisis on health policy, and repercussions of deregulation of the health-care industry. Presents issues that need to be addressed to prevent severe fragmentation of health care. (MW)

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

    PubMed Central

    2010-01-01

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

  10. The politics of public health policy.

    PubMed

    Oliver, Thomas R

    2006-01-01

    Politics, for better or worse, plays a critical role in health affairs. The purpose of this article is to articulate a role for political analysis of public health issues, ranging from injury and disease prevention to health care reform. It begins by examining how health problems make it onto the policy agenda. Perceptions regarding the severity of the problem, responsibility for the problem, and affected populations all influence governmental responses. Next, it considers how bounded rationality, fragmented political institutions, resistance from concentrated interests, and fiscal constraints usually lead political leaders to adopt incremental policy changes rather than comprehensive reforms even when faced with serious public health problems. It then identifies conditions under which larger-scale transformation of health policy can occur, focusing on critical junctures in policy development and the role of policy entrepreneurs in seizing opportunities for innovation. Finally, it reviews the challenges confronting officials and agencies who are responsible for implementing and administering health policies. Public health professionals who understand the political dimensions of health policy can conduct more realistic research and evaluation, better anticipate opportunities as well as constraints on governmental action, and design more effective policies and programs.

  11. Transitioning to a national health system in Cyprus: a stakeholder analysis of pharmaceutical policy reform

    PubMed Central

    Kanavos, Panos G

    2015-01-01

    Abstract Objective To review the pharmaceutical sector in Cyprus in terms of the availability and affordability of medicines and to explore pharmaceutical policy options for the national health system finance reform expected to be introduced in 2016. Methods We conducted semi-structured interviews in April 2014 with senior representatives from seven key national organizations involved in pharmaceutical care. The captured data were coded and analysed using the predetermined themes of pricing, reimbursement, prescribing, dispensing and cost sharing. We also examined secondary data provided by the Cypriot Ministry of Health; these data included the prices and volumes of prescription medicines in 2013. Findings We identified several key issues, including high medicine prices, underuse of generic medicines and high out-of-pocket drug spending. Most stakeholders recommended that the national government review existing pricing policies to ensure medicines within the forthcoming national health system are affordable and available, introduce a national reimbursement system and incentivize the prescribing and dispensing of generic medicines. There were disagreements over how to (i) allocate responsibilities to governmental agencies in the national health system, (ii) reconcile differences in opinion between stakeholders and (iii) raise awareness among patients, physicians and pharmacists about the benefits of greater generic drug use. Conclusion In Cyprus, if the national health system is going to provide universal health coverage in a sustainable fashion, then the national government must address the current issues in the pharmaceutical sector. Importantly, the country will need to increase the market share of generic medicines to contain drug spending. PMID:26478624

  12. Social determinants of health in Canada: Are healthy living initiatives there yet? A policy analysis

    PubMed Central

    2012-01-01

    Introduction Preventative strategies that focus on addressing the social determinants of health to improve healthy eating and physical activity have become an important strategy in British Columbia and Ontario for combating chronic diseases. What has not yet been examined is the extent to which healthy living initiatives implemented under these new policy frameworks successfully engage with and change the social determinants of health. Methods Initiatives active between January 1, 2006 and September 1, 2011 were found using provincial policy documents, web searches, health organization and government websites, and databases of initiatives that attempted to influence to nutrition and physical activity in order to prevent chronic diseases or improve overall health. Initiatives were reviewed, analyzed and grouped using the descriptive codes: lifestyle-based, environment-based or structure-based. Initiatives were also classified according to the mechanism by which they were administered: as direct programs (e.g. directly delivered), blueprints (or frameworks to tailor developed programs), and building blocks (resources to develop programs). Results 60 initiatives were identified in Ontario and 61 were identified in British Columbia. In British Columbia, 11.5% of initiatives were structure-based. In Ontario, of 60 provincial initiatives identified, 15% were structure-based. Ontario had a higher proportion of direct interventions than British Columbia for all intervention types. However, in both provinces, as the intervention became more upstream and attempted to target the social determinants of health more directly, the level of direct support for the intervention lessened. Conclusions The paucity of initiatives in British Columbia and Ontario that address healthy eating and active living through action on the social determinants of health is problematic. In the context of Canada's increasingly neoliberal political and economic policy, the public health sector may face

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

    PubMed Central

    2010-01-01

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

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

    PubMed

    Labonté, Ronald; Gagnon, Michelle L

    2010-01-01

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

  15. Model Child Care Health Policies.

    ERIC Educational Resources Information Center

    Aronson, Susan; Smith, Herberta

    Drawn from a review of policies at over 100 child care programs nationwide, the model health policies presented in this report are intended for adaptation and selective use by out-of-home child care facilities. Following an introduction, the report presents model policy forms with blanks for adding individualized information for the following…

  16. Food security and nutrition in the Russian Federation – a health policy analysis

    PubMed Central

    Lunze, Karsten; Yurasova, Elena; Idrisov, Bulat; Gnatienko, Natalia; Migliorini, Luigi

    2015-01-01

    Background In the Russian Federation (Russia), an elevated burden of premature mortality attributable to non-communicable diseases (NCDs) has been observed since the country's economic transition. NCDs are largely related to preventable risk factors such as unhealthy diets. Objective This health policy study's aim was to analyze past and current food production and nutritional trends in Russia and their policy implications for Russia's NCD burden. Design We examined food security and nutrition in Russia using an analytical framework of food availability, access to food, and consumption. Results Agricultural production declined during the period of economic transition, and nutritional habits changed from high-fat animal products to starches. However, per-capita energy consumption remained stable due to increased private expenditures on food and use of private land. Paradoxically, the prevalence of obesity still increased because of an excess consumption of unsaturated fat, sugar, and salt on one side, and insufficient intake of fruit and vegetables on the other. Conclusions Policy and economic reforms in Russia were not accompanied by a food security crisis or macronutrient deprivation of the population. Yet, unhealthy diets in contemporary Russia contribute to the burden of NCDs and related avoidable mortality. Food and nutrition policies in Russia need to specifically address nutritional shortcomings and food-insecure vulnerable populations. Appropriate, evidence-informed food and nutrition policies might help address Russia's burden of NCDs on a population level. PMID:26112143

  17. Health Policies and Black Americans.

    ERIC Educational Resources Information Center

    Willis, David P., Ed.

    This collection of essays focuses on the impact of health policy on black Americans by examining the relation between public policy and the distribution of health needs and effects. The book includes an introduction by David P. Willis and is divided into seven sections. Section I, "Who Are Black Americans?" includes the following chapters: (1)…

  18. A TRANSDISCIPLINARY APPROACH TO HEALTH POLICY RESEARCH AND EVALUATION

    PubMed Central

    Wan, Thomas T.H.

    2014-01-01

    An integrated perspective consists of macro- and micro-level approaches to health policy research and evaluation is presented. Analytical strategies are suggested for policy analysis, targeting on health disparities at individual and population levels. This systems approach enables investigators to view how scientific public policy analysis can be implemented to assess policy impacts. In this special issue, five papers are introduced. PMID:25419221

  19. Mitigating the effects of preferentially selected monitoring sites for environmental policy and health risk analysis.

    PubMed

    Shaddick, Gavin; Zidek, James V; Liu, Yi

    2016-08-01

    The potential effects of air pollution are a major concern both in terms of the environment and in relation to human health. In order to support both environmental and health policy there is a need for accurate estimates of the exposures that populations might experience. The information for this typically comes from environmental monitoring networks but often the locations of monitoring sites are preferentially located in order to detect high levels of pollution. Using the information from such networks has the potential to seriously affect the estimates of pollution that are obtained and that might be used in health risk analyses. In this context, we explore the topic of preferential sampling within a long-standing network in the UK that monitored black smoke due to concerns about its effect on public health, the extent of which came to prominence during the famous London fog of 1952. Abatement measures led to a decline in the levels of black smoke and a subsequent reduction in the number of monitoring locations that were thought necessary to provide the information required for policy support. There is evidence of selection bias during this process with sites being kept in the most polluted areas. We assess the potential for this to affect the estimates of risk associated air pollution and show how using Bayesian spatio-temporal exposure models may be used to attempt to mitigate the effects of preferential sampling in this case. PMID:27494959

  20. 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. PMID:25494052

  1. 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.

  2. An analysis of Liberia's 2007 national health policy: lessons for health systems strengthening and chronic disease care in poor, post-conflict countries

    PubMed Central

    2011-01-01

    Background Globally, chronic diseases are responsible for an enormous burden of deaths, disability, and economic loss, yet little is known about the optimal health sector response to chronic diseases in poor, post-conflict countries. Liberia's experience in strengthening health systems and health financing overall, and addressing HIV/AIDS and mental health in particular, provides a relevant case study for international stakeholders and policymakers in other poor, post-conflict countries seeking to understand and prioritize the global response to chronic diseases. Methods We conducted a historical review of Liberia's post-conflict policies and their impact on general economic and health indicators, as well as on health systems strengthening and chronic disease care and treatment. Key sources included primary documents from Liberia's Ministry of Health and Social Welfare, published and gray literature, and personal communications from key stakeholders engaged in Liberia's Health Sector Reform. In this case study, we examine the early reconstruction of Liberia's health care system from the end of conflict in 2003 to the present time, highlight challenges and lessons learned from this initial experience, and describe future directions for health systems strengthening and chronic disease care and treatment in Liberia. Results Six key lessons emerge from this analysis: (i) the 2007 National Health Policy's 'one size fits all' approach met aggregate planning targets but resulted in significant gaps and inefficiencies throughout the system; (ii) the innovative Health Sector Pool Fund proved to be an effective financing mechanism to recruit and align health actors with the 2007 National Health Policy; (iii) a substantial rural health delivery gap remains, but it could be bridged with a robust cadre of community health workers integrated into the primary health care system; (iv) effective strategies for HIV/AIDS care in other settings should be validated in Liberia and

  3. [Policies to reduce health inequalities].

    PubMed

    Borrell, Carme; Artazcoz, Lucía

    2008-01-01

    This paper reviews policies to reduce social inequalities in health and presents some examples. Previously it presents the model on social determinants of health inequalities. The model described on the determinants of health inequalities is used by the Commission on Social Determinants of Health of the World Health Organisation that contains three main elements: the socio-economic and political context, socioeconomic status and intermediary factors. It describes 10 principles to keep in mind to launch interventions aimed at reducing inequalities in health and describes various policies depending on different "entry points" considered in the conceptual model. Finally we present two examples: The Public Health Policy of Sweden and the programme "Barrio Adentro" in Venezuela.

  4. HEALTH INSURANCE INFORMATION-SEEKING BEHAVIORS AMONG INTERNET USERS: AN EXPLORATORY ANALYSIS TO INFORM POLICIES.

    PubMed

    Erlyana, Erlyana; Acosta-Deprez, Veronica; O'Lawrence, Henry; Sinay, Tony; Ramirez, Jeremy; Jacot, Emmanuel C; Shim, Kyuyoung

    2015-01-01

    The purpose of this study was to explore characteristics of Internet users who seek health insurance information online, as well as factors affecting their behaviors in seeking health insurance information. Secondary data analysis was conducted using data from the 2012 Pew Internet Health Tracking Survey. Of 2,305 Internet user adults, only 29% were seeking health insurance information online. Bivariate analyses were conducted to test differences in characteristics of those who seek health insurance information online and those who do not. A logistic regression model was used to determine significant predictors of health insurance information-seeking behavior online. Findings suggested that factors such as being a single parent, having a high school education or less, and being uninsured were significant and those individuals were less likely to seek health insurance information online. Being a family caregiver of an adult and those who bought private health insurance or were entitled to Medicare were more likely to seek health insurance information online than non-caregivers and the uninsured. The findings suggested the need to provide quality health insurance information online is critical for both the insured and uninsured population.

  5. Documentary analysis of risk-assessment and safety-planning policies and tools in a mental health context.

    PubMed

    Higgins, Agnes; Doyle, Louise; Morrissey, Jean; Downes, Carmel; Gill, Ailish; Bailey, Sive

    2016-08-01

    Despite the articulated need for policies and processes to guide risk assessment and safety planning, limited guidance exists on the processes or procedures to be used to develop such policies, and there is no body of research that examines the quality or content of the risk-management policies developed. The aim of the present study was to analyse the policies of risk and safety management used to guide mental health nursing practice in Ireland. A documentary analysis was performed on 123 documents received from 22 of the 23 directors of nursing contacted. Findings from the analysis revealed a wide variation in how risk, risk assessment, and risk management were defined. Emphasis within the risk documentation submitted was on risk related to self and others, with minimal attention paid to other types of risks. In addition, there was limited evidence of recovery-focused approaches to positive risk taking that involved service users and their families within the risk-related documentation. Many of the risk-assessment tools had not been validated, and lacked consistency or guidance in relation to how they were to be used or applied. The tick-box approach and absence of space for commentary within documentation have the potential to impact severely on the quality of information collected and documented, and subsequent clinical decision-making. Managers, and those tasked with ensuring safety and quality, need to ensure that policies and processes are, where possible, informed by best evidence and are in line with national mental health policy on recovery. PMID:26889653

  6. Analysis of health services use for respiratory illness in Indonesian children: implications for policy.

    PubMed

    Thind, Amardeep

    2005-03-01

    Respiratory illness continues to be a leading cause of paediatric morbidity and mortality in Indonesia. The Indonesian government is moving towards a more managed care-based approach as it reforms its health care system following the 1997 financial crisis. In order to better design contractual relationships between the payor and different providers, there needs to be a better understanding of the patterns and predictors of health services utilization for respiratory illness. This study uses the Indonesia Demographic and Health Survey to study the determinants of private, public and non-formal provider utilization for respiratory illness. Multinomial logistic regression models for predicting use were constructed using the Andersen Behavioural Model as the conceptual framework. The findings indicate that age, household size, maternal education, religion, the asset index, location and illness severity play a role in determining use of private, public or non-formal providers. The results indicate that from a policy perspective, the Indonesian government needs be inclusive rather than exclusive in the choice of providers that are contracted by the managed care plans, in order to safeguard the health of the under-five population.

  7. Dual choice health insurance policy: a proposal and a cost analysis.

    PubMed

    Cheng, Joseph; Ives, Jeffrey C

    2009-01-01

    The central issue in the current health care reform is cost. No health care reform can be successful without putting a rein on cost while maintaining a high quality of health care service. We believe one approach to solving the cost and quality issue is to allow patients the option to choose resources that are currently underutilized. Traditional health insurance plans offer consumers limited choice in that coverage is often denied when patients choose complementary and alternative medicine (CAM) treatments, even though the economic and social cost of treating certain conditions with alternative medicine may be more favorable than with conventional medicine. This article proposes a Dual Choice health insurance plan that would cover the cost of alternative medicines for certain medical conditions in the first stage. Should the alternative treatment turn out to be less effective, patients have the option to switch to conventional treatment in the second stage. Not only does this policy provide patients with more choices than in traditional plans, it will also likely provide significant cost savings while taking into account uncertainty regarding the effectiveness of CAM. By virtue of the wider choice offered to patients and lower cost, which is illustrated by a 2x2 effectiveness matrix, the authors think that insurance companies will be successful offering such an innovative insurance plan and will even out-compete companies offering only traditional plans. Furthermore, there will be substantial benefits that go beyond the cost savings. With both cost savings and patient welfare being central in the health care reform being proposed by the Obama administration, the dual choice plan offers considerable benefits.

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

    PubMed

    Puchalski, Krzysztof; Korzeniowska, Elzbieta

    2008-01-01

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

  9. Health services research and health policy.

    PubMed

    Banta, H D; Bauman, P

    1976-01-01

    Health services research (HSR) has the potential to influence the decision-making process in a health services system that is acutelearchers feel, with some truth, that their research has had only a limited effect on health policy. Some reasons for this are described, including the primacy of political, rather than technical, considerations in policy making, the lack of a comprehensive health policy, and the poor quality and irrelevance of much HSR. The role of funding for HSR by the Federal government is described; it is shown that the Federal effort is fragmented, despite the consolidation efforts made in 1968. Increased support for specific targeted, problem-solving health services research is proposed, and some possible methods to achieve this are described.

  10. Health and development: some concerns about South Africa's health policy.

    PubMed

    Head, J

    1996-09-01

    This critique of South Africa's health policy opens by noting that the World Health Organization's definition of health as "a state of complete physical mental and social well-being" recognizes that health is synonymous with development. Specific areas of concern are then identified as 1) the consequences for health and development of South Africa's emphasis on reducing the budget deficit, 2) the implications of maintaining a private health sector, and 3) the absence of health policy implementation planning. The analysis opens with a look at Mozambique's experience in setting up a health service after independence (between 1976 and 1980). Next, the unique features of South Africa's transition from apartheid to democracy are identified as the rapid migration of people to industrial centers for work, the continuing residence of the powerful European population, and an international context that limits opportunities to promote growth through social democratic policies. The implications of these factors to the health policy are that social inequalities will continue to exist because the health policy fails to delineate how health services will be provided to large urban areas and maintains a two-tier system. It is critical to nationalize the public sector and to involve health workers in the reform process.

  11. Health and Wellness Policy Ethics

    PubMed Central

    Cavico, Frank J.; Mujtaba, Bahaudin G.

    2013-01-01

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

  12. Assessment of health risks of policies

    SciTech Connect

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

    2014-09-15

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

  13. Health impact assessment of Roma housing policies in Central and Eastern Europe: A comparative analysis

    SciTech Connect

    Molnar, Agnes; Adam, Balazs; Antova, Temenujka; Bosak, Lubos; Dimitrov, Plamen; Mileva, Hristina; Pekarcikova, Jarmila; Zurlyte, Ingrida; Gulis, Gabriel; Adany, Roza; Kosa, Karolina

    2012-02-15

    Marginalised Roma communities in European countries live in substandard housing conditions the improvement of which has been one of the major issues of the Decade of Roma Inclusion, the ongoing intergovernmental European Roma programme. The paper presents EU-funded health impact assessments of national Roma housing policies and programmes in 3 Central and Eastern European countries in light of the evaluation of a completed local project in a fourth CEE country so as to compare predicted effects to observed ones. Housing was predicted to have beneficial health effects by improving indoor and outdoor conditions, access to services, and socioeconomic conditions. Negative impacts were predicted only in terms of maintenance expenses and housing tenure. However, observed impacts of the completed local project did not fully support predictions especially in terms of social networks, satisfaction with housing and neighbourhood, and inhabitant safety. In order to improve the predictive value of HIA, more evidence should be produced by the careful evaluation of locally implemented housing projects. In addition, current evidence is in favour of planning Roma housing projects at the local rather than at the national level in alignment with the principle of subsidiarity. - Highlights: Black-Right-Pointing-Pointer Predictive validity of HIA of national Roma housing policies - in light of current evidence - is low. Black-Right-Pointing-Pointer Implemented housing projects should be comprehensively evaluated to improve reliability of HIA. Black-Right-Pointing-Pointer Roma housing projects should be planned at the local rather than at the national level. Black-Right-Pointing-Pointer HIA should be used to plan Roma housing projects at the local level.

  14. Health policy and case management.

    PubMed

    Mark, D D

    2000-01-01

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

  15. The future of Indian Health Services for native Americans in the United States: an analysis of policy options and recommendations.

    PubMed

    Henley, Tiffany; Boshier, Maureen

    2016-10-01

    The passage of the Affordable Care Act in the United States has opened a policy window for the establishment of an independent Medicaid agency for the Navajo Nation. This article explores several policy options to improve health care services for Native Americans. Although there is a lack of scholarly research on the impact of healthcare reform and the effectiveness of current health care programs for American Indians, policymakers should utilize evidence-based research to inform policy decisions. PMID:27150047

  16. Health reform requires policy capacity

    PubMed Central

    Forest, Pierre-Gerlier; Denis, Jean-Louis; Brown, Lawrence D.; Helms, David

    2015-01-01

    Among the many reasons that may limit the adoption of promising reform ideas, policy capacity is the least recognized. The concept itself is not widely understood. Although policy capacity is concerned with the gathering of information and the formulation of options for public action in the initial phases of policy consultation and development, it also touches on all stages of the policy process, from the strategic identification of a problem to the actual development of the policy, its formal adoption, its implementation, and even further, its evaluation and continuation or modification. Expertise in the form of policy advice is already widely available in and to public administrations, to well-established professional organizations like medical societies and, of course, to large private-sector organizations with commercial or financial interests in the health sector. We need more health actors to join the fray and move from their traditional position of advocacy to a fuller commitment to the development of policy capacity, with all that it entails in terms of leadership and social responsibility. PMID:25905476

  17. Health reform requires policy capacity.

    PubMed

    Forest, Pierre-Gerlier; Denis, Jean-Louis; Brown, Lawrence D; Helms, David

    2015-04-17

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

  18. Estimating uncertainty in policy analysis: health effects from inhaled sulfur oxides

    SciTech Connect

    Amaral, D.A.L.

    1983-01-01

    This study presents methods for the incorporation of uncertainty into quanitative analysis of the problem of estimating health risks from coal-fired power plants. Probabilistic long-range models of sulfur material balance and sets of plume trajectories are combined to produce probabilistic estimates of population exposure to sulfur air pollution for the addition of a hypothetical coal-burning power plant in the Ohio River Valley. In another segment, the change in population exposure which might occur if ambient sulfate were to be reduced everywhere in the northeastern United States is calculated. A third case is made up of a set of hypothetical urban and rural scenarios representing typical northeastern situations. Models of health impacts obtained through the elicitation of subjective expert judgment are applied to each of these population exposure estimates. Seven leading experts in the field of sulfur air pollution and health participated, yielding five quantitative models for morbidity and/or mortality effects from human exposure to ambient sulfate. In each case analyzed, the predictions based on probability distributions provided by the experts spanned several orders of magnitude, including some predictions of zero effects and some of up to a few percent of the total morality. It is concluded that uncertainty about whether sulfate has adverse effects dominates the scientific uncertainty about the atmospheric processes which generate and transport this pollutant.

  19. In the shadow of a new smoke free policy: A discourse analysis of health care providers' engagement in tobacco control in community mental health

    PubMed Central

    2010-01-01

    Background The prevalence of tobacco use among individuals with mental illness remains a serious public health concern. Tobacco control has received little attention in community mental health despite the fact that many individuals with mental illness are heavy smokers and experience undue tobacco-related health consequences. Methods This qualitative study used methods of discourse analysis to examine the perceptions of health care providers, both professionals and paraprofessionals, in relation to their roles in tobacco control in the community mental health system. Tobacco control is best conceptualised as a suite of policies and practices directed at supporting smoke free premises, smoking cessation counselling and limiting access to tobacco products. The study took place following the establishment of a new policy that restricted tobacco smoking inside all mental health facilities and on their grounds. Ninety one health care providers participated in open-ended interviews in which they described their role in tobacco control. The interview data were analyzed discursively by asking questions such as: what assumptions underlie what is being said about tobacco? Results Five separate yet overlapping discursive frames were identified in which providers described their roles. Managing a smoke free environment emphasised the need to police and monitor the smoke free environment. Tobacco is therapeutic was a discourse that underscored the putative value of smoking for clients. Tobacco use is an individual choice located the decision to smoke with individual clients thereby negating a role in tobacco control for providers. It's someone else's role was a discourse that placed responsibility for tobacco control with others. Finally, the discourse of tobacco control as health promotion located tobacco control in a range of activities that are used to support the health of clients. Conclusions This study provides insights into the complex factors that shape tobacco control

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

    PubMed

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

    2016-10-01

    We describe a framework used to analyze health policy content in baccalaureate nursing program courses that combines the conceptual model for nursing and health policy and the Adams influence model to account for knowledge and skills needed for health policy work. Our analysis of health policy content in courses in one baccalaureate nursing program focused on what policies were emphasized and how educational content supported the development of personal influence. The analysis revealed course content focused on public sources of health policies and lack of overt course content about policies from organizational and professional sources. Additionally, we identified little course content about the development of personal influence skills except for communication and message articulation components. As the nursing profession continues to build influence in the policy arena, educators must continue to prepare future nurses for such work. PMID:27641285

  1. Promoting universal financial protection: a policy analysis of universal health coverage in Costa Rica (1940–2000)

    PubMed Central

    2013-01-01

    Background This paper explores the implementation and sustenance of universal health coverage (UHC) in Costa Rica, discussing the development of a social security scheme that covered 5% of the population in 1940, to one that finances and provides comprehensive healthcare to the whole population today. The scheme is financed by mandatory, tri-partite social insurance contributions complemented by tax funding to cover the poor. Methods The analysis takes a historical perspective and explores the policy process including the key actors and their relative influence in decision-making. Data were collected using qualitative research instruments, including a review of literature, institutional and other documents, and in-depth interviews with key informants. Results Key lessons to be learned are: i) population health was high on the political agenda in Costa Rica, in particular before the 1980s when UHC was enacted and the transfer of hospitals to the social security institution took place. Opposition to UHC could therefore be contained through negotiation and implemented incrementally despite the absence of real consensus among the policy elite; ii) since the 1960s, the social security institution has been responsible for UHC in Costa Rica. This institution enjoys financial and managerial autonomy relative to the general government, which has also facilitated the UHC policy implementation process; iii) UHC was simultaneously constructed on three pillars that reciprocally strengthened each other: increasing population coverage, increasing availability of financial resources based on solidarity financing mechanisms, and increasing service coverage, ultimately offering comprehensive health services and the same benefits to every resident in the country; iv) particularly before the 1980s, the fruits of economic growth were structurally invested in health and other universal social policies, in particular education and sanitation. The social security institution became a

  2. [Moving forward in health impact assessment: analysis of the non-health public policies of the Basque Government (Spain) as step prior to systematic screening].

    PubMed

    Aldasoro, Elena; Sanz, Elvira; Bacigalupe, Amaia; Esnaola, Santiago; Calderón, Carlos; Cambra, Koldo; Zuazagoitia, Juan

    2012-01-01

    Health not only depends on biologic or lifestyle factors but also on other economic, social, political, and environmental factors that shape the way people live and become ill. Thus, health policies are not the only policies affecting health, and consequently governments are increasingly interested in identifying the effect of other non-health policies on health. Health impact assessment is a prospective methodology that aims to predict the health impacts of policies before their implementation so that modifications can be suggested to maximize positive effects and avoid unexpected negative repercussions on health. The first stage in this process is screening, which can be used to select the interventions that could benefit from complete health impact assessment. Since resources are limited and not all government interventions can be assessed, tools that allow prioritization are essential. As a first stage in the validation of a systematic screening tool for health impact assessment in Spain, this article presents the process of compiling and classifying the non-health public policies of the eighth term of office of the Basque Government. Of the 97 policies analyzed, 76% were related to structural determinants of health inequalities, 79% were tactical or operational, 67% were aimed at specific population groups, and 66% were already implemented. The technical staff of other participating departments perceived the entire process of this initiative and its rationale positively. This initial experience allowed the planning of non-health policies in the Basque Country to be determined in detail as a means to move forward in incorporating impact on health in all policies. PMID:22000110

  3. [Moving forward in health impact assessment: analysis of the non-health public policies of the Basque Government (Spain) as step prior to systematic screening].

    PubMed

    Aldasoro, Elena; Sanz, Elvira; Bacigalupe, Amaia; Esnaola, Santiago; Calderón, Carlos; Cambra, Koldo; Zuazagoitia, Juan

    2012-01-01

    Health not only depends on biologic or lifestyle factors but also on other economic, social, political, and environmental factors that shape the way people live and become ill. Thus, health policies are not the only policies affecting health, and consequently governments are increasingly interested in identifying the effect of other non-health policies on health. Health impact assessment is a prospective methodology that aims to predict the health impacts of policies before their implementation so that modifications can be suggested to maximize positive effects and avoid unexpected negative repercussions on health. The first stage in this process is screening, which can be used to select the interventions that could benefit from complete health impact assessment. Since resources are limited and not all government interventions can be assessed, tools that allow prioritization are essential. As a first stage in the validation of a systematic screening tool for health impact assessment in Spain, this article presents the process of compiling and classifying the non-health public policies of the eighth term of office of the Basque Government. Of the 97 policies analyzed, 76% were related to structural determinants of health inequalities, 79% were tactical or operational, 67% were aimed at specific population groups, and 66% were already implemented. The technical staff of other participating departments perceived the entire process of this initiative and its rationale positively. This initial experience allowed the planning of non-health policies in the Basque Country to be determined in detail as a means to move forward in incorporating impact on health in all policies.

  4. Is it a policy crisis or it is a health crisis? The Egyptian context--analysis of the Egyptian health policy for the H1N1 flu pandemic control.

    PubMed

    Seef, Sameh; Jeppsson, Anders

    2013-01-01

    A new influenza virus that was first detected in people in April 2009, was initially referred to colloquially as "swine flu", since it contained genes from swine, avian and human influenza viruses. It can, however, not be transmitted by eating pork or dealing with pigs. In Egypt, several hundred thousand pigs were killed in May, in spite of advice from global health authorities that such an action was unnecessary. Pigs are raised and consumed mainly by the Christian minority, which constitute some 10% of the population. Health Ministry estimated there were between 300,000-350,000 pigs in Egypt. This paper will analyze the Egyptian health policy for controlling the pandemic H1N1 flu, exploring its context, content, process, and actors. The analysis is based on the Leichter Context, which refers to systemic factors-political, economic and social, both national and international-that may have an effect on health policy, and is based on data collected from literature review and policy documents. The International health officials said the swine flu virus that has caused worldwide fear is not transmitted by pigs, and that pig slaughters do nothing to stop its spread. The WHO stopped using the term "swine flu" to avoid confusion. In Egypt, even the editor of a pro-government newspaper criticized the order to slaughter: "Killing (pigs) is not a solution, otherwise, we should kill the people, because the virus spreads through them," wrote Abdullah Kamal of the daily Rose El-Youssef. The World Health organization also criticized the decision. The extinction of the Egyptian pigs is an example of how a health issue can be used to persecute a minority within a country. Although the current influenza has nothing whatsoever to do with pigs, the previous name of the epidemic was used as an argument to violate the rights of the Christian minority in Egypt.

  5. Is it a policy crisis or it is a health crisis? The Egyptian context--analysis of the Egyptian health policy for the H1N1 flu pandemic control.

    PubMed

    Seef, Sameh; Jeppsson, Anders

    2013-01-01

    A new influenza virus that was first detected in people in April 2009, was initially referred to colloquially as "swine flu", since it contained genes from swine, avian and human influenza viruses. It can, however, not be transmitted by eating pork or dealing with pigs. In Egypt, several hundred thousand pigs were killed in May, in spite of advice from global health authorities that such an action was unnecessary. Pigs are raised and consumed mainly by the Christian minority, which constitute some 10% of the population. Health Ministry estimated there were between 300,000-350,000 pigs in Egypt. This paper will analyze the Egyptian health policy for controlling the pandemic H1N1 flu, exploring its context, content, process, and actors. The analysis is based on the Leichter Context, which refers to systemic factors-political, economic and social, both national and international-that may have an effect on health policy, and is based on data collected from literature review and policy documents. The International health officials said the swine flu virus that has caused worldwide fear is not transmitted by pigs, and that pig slaughters do nothing to stop its spread. The WHO stopped using the term "swine flu" to avoid confusion. In Egypt, even the editor of a pro-government newspaper criticized the order to slaughter: "Killing (pigs) is not a solution, otherwise, we should kill the people, because the virus spreads through them," wrote Abdullah Kamal of the daily Rose El-Youssef. The World Health organization also criticized the decision. The extinction of the Egyptian pigs is an example of how a health issue can be used to persecute a minority within a country. Although the current influenza has nothing whatsoever to do with pigs, the previous name of the epidemic was used as an argument to violate the rights of the Christian minority in Egypt. PMID:23565306

  6. Assessment of capacity for Health Policy and Systems Research and Analysis in seven African universities: results from the CHEPSAA project.

    PubMed

    Mirzoev, Tolib; Lê, Gillian; Green, Andrew; Orgill, Marsha; Komba, Adalgot; Esena, Reuben K; Nyapada, Linet; Uzochukwu, Benjamin; Amde, Woldekidan K; Nxumalo, Nonhlanhla; Gilson, Lucy

    2014-10-01

    The importance of health policy and systems research and analysis (HPSR+A) is widely recognized. Universities are central to strengthening and sustaining the HPSR+A capacity as they teach the next generation of decision-makers and health professionals. However, little is known about the capacity of universities, specifically, to develop the field. In this article, we report results of capacity self- assessments by seven universities within five African countries, conducted through the Consortium for Health Policy and Systems Analysis in Africa (CHEPSAA). The capacity assessments focused on both capacity 'assets' and 'needs', and covered the wider context, as well as organizational and individual capacity levels. Six thematic areas of capacity were examined: leadership and governance, organizations' resources, scope of HPSR+A teaching and research, communication, networking and getting research into policy and practice (GRIPP), demand for HPRS+A and resource environment. The self-assessments by each university used combinations of document reviews, semi-structured interviews and staff surveys, followed by comparative analysis. A framework approach, guided by the six thematic areas, was used to analyse data. We found that HPSR+A is an international priority, and an existing activity in Africa, though still neglected field with challenges including its reliance on unpredictable international funding. All universities have capacity assets, such as ongoing HPSR+A teaching and research. There are, however, varying levels of assets (such as differences in staff numbers, group sizes and amount of HPSR+A teaching and research), which, combined with different capacity needs at all three levels (such as individual training, improvement in systems for quality assurance and fostering demand for HPSR+A work), can shape a future agenda for HPSR+A capacity strengthening. Capacity assets and needs at different levels appear related. Possible integrated strategies for strengthening

  7. Assessment of capacity for Health Policy and Systems Research and Analysis in seven African universities: results from the CHEPSAA project

    PubMed Central

    Mirzoev, Tolib; Lê, Gillian; Green, Andrew; Orgill, Marsha; Komba, Adalgot; Esena, Reuben K; Nyapada, Linet; Uzochukwu, Benjamin; Amde, Woldekidan K; Nxumalo, Nonhlanhla; Gilson, Lucy

    2014-01-01

    The importance of health policy and systems research and analysis (HPSR+A) is widely recognized. Universities are central to strengthening and sustaining the HPSR+A capacity as they teach the next generation of decision-makers and health professionals. However, little is known about the capacity of universities, specifically, to develop the field. In this article, we report results of capacity self- assessments by seven universities within five African countries, conducted through the Consortium for Health Policy and Systems Analysis in Africa (CHEPSAA). The capacity assessments focused on both capacity ‘assets’ and ‘needs’, and covered the wider context, as well as organizational and individual capacity levels. Six thematic areas of capacity were examined: leadership and governance, organizations’ resources, scope of HPSR+A teaching and research, communication, networking and getting research into policy and practice (GRIPP), demand for HPRS+A and resource environment. The self-assessments by each university used combinations of document reviews, semi-structured interviews and staff surveys, followed by comparative analysis. A framework approach, guided by the six thematic areas, was used to analyse data. We found that HPSR+A is an international priority, and an existing activity in Africa, though still neglected field with challenges including its reliance on unpredictable international funding. All universities have capacity assets, such as ongoing HPSR+A teaching and research. There are, however, varying levels of assets (such as differences in staff numbers, group sizes and amount of HPSR+A teaching and research), which, combined with different capacity needs at all three levels (such as individual training, improvement in systems for quality assurance and fostering demand for HPSR+A work), can shape a future agenda for HPSR+A capacity strengthening. Capacity assets and needs at different levels appear related. Possible integrated strategies for

  8. Assessment of capacity for Health Policy and Systems Research and Analysis in seven African universities: results from the CHEPSAA project.

    PubMed

    Mirzoev, Tolib; Lê, Gillian; Green, Andrew; Orgill, Marsha; Komba, Adalgot; Esena, Reuben K; Nyapada, Linet; Uzochukwu, Benjamin; Amde, Woldekidan K; Nxumalo, Nonhlanhla; Gilson, Lucy

    2014-10-01

    The importance of health policy and systems research and analysis (HPSR+A) is widely recognized. Universities are central to strengthening and sustaining the HPSR+A capacity as they teach the next generation of decision-makers and health professionals. However, little is known about the capacity of universities, specifically, to develop the field. In this article, we report results of capacity self- assessments by seven universities within five African countries, conducted through the Consortium for Health Policy and Systems Analysis in Africa (CHEPSAA). The capacity assessments focused on both capacity 'assets' and 'needs', and covered the wider context, as well as organizational and individual capacity levels. Six thematic areas of capacity were examined: leadership and governance, organizations' resources, scope of HPSR+A teaching and research, communication, networking and getting research into policy and practice (GRIPP), demand for HPRS+A and resource environment. The self-assessments by each university used combinations of document reviews, semi-structured interviews and staff surveys, followed by comparative analysis. A framework approach, guided by the six thematic areas, was used to analyse data. We found that HPSR+A is an international priority, and an existing activity in Africa, though still neglected field with challenges including its reliance on unpredictable international funding. All universities have capacity assets, such as ongoing HPSR+A teaching and research. There are, however, varying levels of assets (such as differences in staff numbers, group sizes and amount of HPSR+A teaching and research), which, combined with different capacity needs at all three levels (such as individual training, improvement in systems for quality assurance and fostering demand for HPSR+A work), can shape a future agenda for HPSR+A capacity strengthening. Capacity assets and needs at different levels appear related. Possible integrated strategies for strengthening

  9. Sharpening the health policy analytical rapier Comment on "The politics and analytics of health policy"

    PubMed Central

    Powell, Martin

    2014-01-01

    This commentary on the Editorial ‘The politics and analytics of health policy’ by Professor Calum Paton focuses on two issues. First, it points to the unclear links between ideas, ideology, values, and discourse and policy, and warns that discourse is often a poor guide to enacted policy. Second, it suggests that realism, particularly ‘programme theory’ are useful tools for health policy analysis. ‘Market reform’ cannot be reduced to a simple ‘four legs good, two legs bad’ verdict, and programme theory might suggest that certain mechanisms may be good for one outcome in a particular context, but bad for another. PMID:24847488

  10. Economic analysis and pharmaceutical policy.

    PubMed

    Rovira, J

    1995-10-01

    Economic evaluation, a comparative analysis of alternative actions in terms of costs and consequences, allows rational decisions to be made concerning the deployment of resources (people, time, equipment, facilities and knowledge). Pharmaceutical policy reflects the various objectives of the many social groups, some of which are conflicting. While new methodologies for evaluation of health care programmes still need to gain wider acceptance, resource limitations for both care providers and decision makers make economic analysis an increasingly important tool.

  11. The Food and Health Policy Game.

    ERIC Educational Resources Information Center

    Jones, Lesley

    1984-01-01

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

  12. The emergence of the vertical birth in Ecuador: an analysis of agenda setting and policy windows for intercultural health.

    PubMed

    Llamas, Ana; Mayhew, Susannah

    2016-07-01

    Maternal mortality continues to claim the lives of thousands of women in Latin America despite the availability of effective treatments to avert maternal death. In the past, efforts to acknowledge cultural diversity in birth practices had not been clearly integrated into policy. However, in Otavalo (Ecuador) a local hospital pioneered the implementation of the 'Vertical Birth'-a practical manifestation of an intercultural health policy aimed at increasing indigenous women's access to maternity care. Drawing on agenda-setting theory, this qualitative research explores how the vertical birth practice made it onto the local policy agenda and the processes that allowed actors to seize a window of opportunity allowing the vertical birth practice to emerge. Our results show that the processes that brought about the vertical birth practice took place over a prolonged period of time and resulted from the interplay between various factors. Firstly, a maternal health policy community involving indigenous actors played a key role in identifying maternal mortality as a policy problem, defining its causes and framing it as an indigenous rights issue. Secondly, previous initiatives to address maternal mortality provided a wealth of experience that gave these actors the knowledge and experience to formulate a feasible policy solution and consolidate support from powerful actors. Thirdly, the election of a new government that had incorporated the demands of the indigenous movement opened up a window of opportunity to push intercultural health policies such as the vertical birth. We conclude that the socioeconomic and political changes at both national and local level allowed the meaningful participation of indigenous actors that made a critical contribution to the emergence of the vertical birth practice. These findings can help us advance our knowledge of strategies to set the agenda for intercultural maternal health policy and inform future policy in similar settings. Our

  13. The emergence of the vertical birth in Ecuador: an analysis of agenda setting and policy windows for intercultural health.

    PubMed

    Llamas, Ana; Mayhew, Susannah

    2016-07-01

    Maternal mortality continues to claim the lives of thousands of women in Latin America despite the availability of effective treatments to avert maternal death. In the past, efforts to acknowledge cultural diversity in birth practices had not been clearly integrated into policy. However, in Otavalo (Ecuador) a local hospital pioneered the implementation of the 'Vertical Birth'-a practical manifestation of an intercultural health policy aimed at increasing indigenous women's access to maternity care. Drawing on agenda-setting theory, this qualitative research explores how the vertical birth practice made it onto the local policy agenda and the processes that allowed actors to seize a window of opportunity allowing the vertical birth practice to emerge. Our results show that the processes that brought about the vertical birth practice took place over a prolonged period of time and resulted from the interplay between various factors. Firstly, a maternal health policy community involving indigenous actors played a key role in identifying maternal mortality as a policy problem, defining its causes and framing it as an indigenous rights issue. Secondly, previous initiatives to address maternal mortality provided a wealth of experience that gave these actors the knowledge and experience to formulate a feasible policy solution and consolidate support from powerful actors. Thirdly, the election of a new government that had incorporated the demands of the indigenous movement opened up a window of opportunity to push intercultural health policies such as the vertical birth. We conclude that the socioeconomic and political changes at both national and local level allowed the meaningful participation of indigenous actors that made a critical contribution to the emergence of the vertical birth practice. These findings can help us advance our knowledge of strategies to set the agenda for intercultural maternal health policy and inform future policy in similar settings. Our

  14. Policy Capacity Is Necessary but Not Sufficient Comment on "Health Reform Requires Policy Capacity".

    PubMed

    Gen, Sheldon; Wright, Amy Conley

    2015-01-01

    Policy capacity focuses on the managerial and organizational abilities to inform policy decisions with sound research and analysis, and facilitate policy implementation with operational efficiency. It stems from a view of the policy process that is rational and positivistic, in which optimal policy choices can be identified, selected, and implemented with objectivity. By itself, however, policy capacity neglects the political aspects of policy-making that can dominate the process, even in health policies. These technical capabilities are certainly needed to advance reforms in health policies, but they are not sufficient. Instead, they must be complemented with public engagement and policy advocacy to ensure support from the public that policies are meant to serve. PMID:26673469

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

    PubMed

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

    2014-09-01

    Amidst the growing literature on global health, much has been written recently about the Brazil, Russia, India, China, South Africa (BRICS) countries and their involvement and potential impact in global health, particularly in relation to development assistance. Rather less has been said about countries' motivations for involvement in global health negotiations, and there is a notable absence of evidence when their motivations are speculated on. This article uses an existing framework linking engagement in global health to foreign policy to explore differing levels of engagement by BRICS countries in the global health arena, with a particular focus on access to medicines. It concludes that countries' differing and complex motivations reinforce the need for realistic, pragmatic approaches to global health debates and their analysis. It also underlines that these analyses should be informed by analysis from other areas of foreign policy. PMID:24072881

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

    PubMed

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

    2014-09-01

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

  17. Costing for Policy Analysis.

    ERIC Educational Resources Information Center

    National Association of College and University Business Officers, Washington, DC.

    Cost behavior analysis, a costing process that can assist managers in estimating how certain institutional costs change in response to volume, policy, and environmental factors, is described. The five steps of this approach are examined, and the application of cost behavior analysis at four college-level settings is documented. The institutions…

  18. The Current Status of Mental Health in Schools: A Policy and Practice Analysis

    ERIC Educational Resources Information Center

    Center for Mental Health in Schools at UCLA, 2006

    2006-01-01

    Today's school and community stakeholders are attempting to address complex, multifaceted, and overlapping psychosocial and mental health concerns in diverse, fragmented and at-times marginalized ways. This has led to competition for sparse resources and inadequate results. Enhancing mental health in schools is not an easy task. The bottom line is…

  19. Health as foreign policy: harnessing globalization for health.

    PubMed

    Fidler, David P

    2006-12-01

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

  20. Prioritizing Sleep Health: Public Health Policy Recommendations.

    PubMed

    Barnes, Christopher M; Drake, Christopher L

    2015-11-01

    The schedules that Americans live by are not consistent with healthy sleep patterns. In addition, poor access to educational and treatment aids for sleep leaves people engaging in behavior that is harmful to sleep and forgoing treatment for sleep disorders. This has created a sleep crisis that is a public health issue with broad implications for cognitive outcomes, mental health, physical health, work performance, and safety. New public policies should be formulated to address these issues. We draw from the scientific literature to recommend the following: establishing national standards for middle and high school start times that are later in the day, stronger regulation of work hours and schedules, eliminating daylight saving time, educating the public regarding the impact of electronic media on sleep, and improving access to ambulatory in-home diagnostic testing for sleep disorders.

  1. Participation and coordination in Dutch health care policy-making. A network analysis of the system of intermediate organizations in Dutch health care.

    PubMed

    Lamping, Antonie J; Raab, Jörg; Kenis, Patrick

    2013-06-01

    This study explores the system of intermediate organizations in Dutch health care as the crucial system to understand health care policy-making in the Netherlands. We argue that the Dutch health care system can be understood as a system consisting of distinct but inter-related policy domains. In this study, we analyze four such policy domains: Finances, quality of care, manpower planning and pharmaceuticals. With the help of network analytic techniques, we describe how this highly differentiated system of >200 intermediate organizations is structured and coordinated and what (policy) consequences can be observed with regard to its particular structure and coordination mechanisms. We further analyze the extent to which this system of intermediate organizations enables participation of stakeholders in policy-making using network visualization tools. The results indicate that coordination between the different policy domains within the health care sector takes place not as one would expect through governmental agencies, but through representative organizations such as the representative organizations of the (general) hospitals, the health care consumers and the employers' association. We further conclude that the system allows as well as denies a large number of potential participants access to the policy-making process. As a consequence, the representation of interests is not necessarily balanced, which in turn affects health care policy. We find that the interests of the Dutch health care consumers are well accommodated with the national umbrella organization NPCF in the lead. However, this is no safeguard for the overall community values of good health care since, for example, the interests of the public health sector are likely to be marginalized.

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

    PubMed

    Blouin, Chantal

    2007-03-01

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

  3. Macropsychology, policy, and global health.

    PubMed

    MacLachlan, Malcolm

    2014-11-01

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

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

    PubMed

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

    2016-06-01

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

  5. Conflict and compromise in public health policy: analysis of changes made to five competitive food legislative proposals prior to adoption.

    PubMed

    Dinour, Lauren M

    2015-04-01

    Competitive foods in schools have historically been scrutinized for their ubiquity and poor nutritional quality, leading many states to enact legislation limiting the availability and accessibility of these items. Evaluations of these policy approaches show their promise in improving the healthfulness of school food environments, considered an important strategy for reducing childhood obesity. Yet little is known about the decision-making processes by which such legislation is formed and adopted. Using a comparative case study design, this study describes and analyzes the policy formation processes surrounding five state-level competitive food bills introduced in 2009-2010. Data for each case were drawn from multiple key informant interviews and document reviews. Case studies were conducted, analyzed, and written independently using a standard protocol and were subsequently compared for recurring and unique themes. Abbreviated case studies and summary tables are provided. Results indicate that bill cost is a major barrier to achieving strong, health-promoting policy change. Additionally, findings reveal that supporters of stronger competitive food policies often concede to changes that weaken a bill in order to neutralize opposition and achieve stakeholder buy-in. These challenges suggest that continued research on the development, implementation, and evaluation of public health policies can contribute to the advancement of new strategies for effective health promotion.

  6. Mental health policy developments in Latin America.

    PubMed Central

    Alarcón, R. D.; Aguilar-Gaxiola, S. A.

    2000-01-01

    New assessment guidelines for measuring the overall impact of mental health problems in Latin America have served as a catalyst for countries to review their mental health policies. Latin American countries have taken various steps to address long-standing problems such as structural difficulties, scarce financial and human resources, and social, political, and cultural obstacles in the implementation of mental health policies and legislation. These policy developments, however, have had uneven results. Policies must reflect the desire, determination, and commitment of policy-makers to take mental health seriously and look after people's mental health needs. This paper describes the development of mental health policies in Latin American countries, focusing on published data in peer-reviewed journals, and legislative change and its implementation. It presents a brief history of mental health policy developments, and analyzes the basis and practicalities of current practice. PMID:10885167

  7. A critical analysis of UK public health policies in relation to diet and nutrition in low-income households.

    PubMed

    Attree, Pamela

    2006-04-01

    Diet and nutrition, particularly among low-income groups, is a key public health concern in the UK. Low levels of fruit and vegetable consumption, and obesity, especially among children, have potentially severe consequences for the future health of the nation. From a public health perspective, the UK government's role is to help poorer families make informed choices within healthy frameworks for living. However, the question is - to what extent are such policies in accordance with lay experiences of managing diet and nutrition on a low-income? This paper critically examines contemporary public health policies aimed at improving diet and nutrition, identifying the underlying theories about the influences on healthy eating in poor families, and exploring the extent to which these assumptions are based on experiential accounts. It draws on two qualitative systematic reviews - one prioritizing low-income mothers' accounts of 'managing' in poverty; and the other focusing on children's perspectives. The paper finds some common ground between policies and lay experiences, but also key divergencies. Arguably, the emphasis of public health policy on individual behaviour, coupled with an ethos of empowered consumerism, underplays material limitations on 'healthy eating' for low-income mothers and children. Health policies fail to take into account the full impact of structural influences on food choices, or recognize the social and emotional factors that influence diet and nutrition. In conclusion, it is argued that while health promotion campaigns to improve low-income families' diets do have advantages, these are insufficient to outweigh the negative effects of poverty on nutrition.

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  9. Conflict and Compromise in Public Health Policy: Analysis of Changes Made to Five Competitive Food Legislative Proposals Prior to Adoption

    ERIC Educational Resources Information Center

    Dinour, Lauren M.

    2015-01-01

    Competitive foods in schools have historically been scrutinized for their ubiquity and poor nutritional quality, leading many states to enact legislation limiting the availability and accessibility of these items. Evaluations of these policy approaches show their promise in improving the healthfulness of school food environments, considered an…

  10. Science, politics and animal health policy: epidemiology in action.

    PubMed

    Hueston, W D

    2003-07-30

    Public policy decisions underlie society's response to current animal health issues ranging from emerging diseases and public health threats to food safety concerns and sustainable animal agriculture strategies. Despite strong calls for "science-based" decisions, animal health policy most commonly emerges at the interface of science and politics. Too often scientists' disdain for politics limits their involvement in formulating policy. By contrast, epidemiologists are ideally qualified to bring scientific skills to complex policy issues through analytical, macro-epidemiological approaches that consider the economic, legal, and cultural context of policy issues as well as the biological and medical aspects. Risk analysis provides a systematic approach to evaluating animal health issues and comparing policy options. Capturing these opportunities for applied epidemiology requires an understanding of the policy-making process as well as the basic principles of epidemiology. Furthermore, epidemiology training programs must incorporate communications skill building and experiential learning opportunities in a team environment.

  11. The emergence of the vertical birth in Ecuador: an analysis of agenda setting and policy windows for intercultural health

    PubMed Central

    Llamas, Ana; Mayhew, Susannah

    2016-01-01

    Maternal mortality continues to claim the lives of thousands of women in Latin America despite the availability of effective treatments to avert maternal death. In the past, efforts to acknowledge cultural diversity in birth practices had not been clearly integrated into policy. However, in Otavalo (Ecuador) a local hospital pioneered the implementation of the ‘Vertical Birth’—a practical manifestation of an intercultural health policy aimed at increasing indigenous women’s access to maternity care. Drawing on agenda-setting theory, this qualitative research explores how the vertical birth practice made it onto the local policy agenda and the processes that allowed actors to seize a window of opportunity allowing the vertical birth practice to emerge. Our results show that the processes that brought about the vertical birth practice took place over a prolonged period of time and resulted from the interplay between various factors. Firstly, a maternal health policy community involving indigenous actors played a key role in identifying maternal mortality as a policy problem, defining its causes and framing it as an indigenous rights issue. Secondly, previous initiatives to address maternal mortality provided a wealth of experience that gave these actors the knowledge and experience to formulate a feasible policy solution and consolidate support from powerful actors. Thirdly, the election of a new government that had incorporated the demands of the indigenous movement opened up a window of opportunity to push intercultural health policies such as the vertical birth. We conclude that the socioeconomic and political changes at both national and local level allowed the meaningful participation of indigenous actors that made a critical contribution to the emergence of the vertical birth practice. These findings can help us advance our knowledge of strategies to set the agenda for intercultural maternal health policy and inform future policy in similar settings

  12. Institutional analysis for energy policy

    SciTech Connect

    Morris, F.A.; Cole, R.J.

    1980-07-01

    This report summarizes principles, techniques, and other information for doing institutional analyses in the area of energy policy. The report was prepared to support DOE's Regional Issues Identification and Assessment (RIIA) program. RIIA identifies environmental, health, safety, socioeconomic, and institutional issues that could accompany hypothetical future scenarios for energy consumption and production on a regional basis. Chapter 1 provides some theoretical grounding in institutional analysis. Chapter 2 provides information on constructing institutional maps of the processes for bringing on line energy technologies and facilities contemplated in RIIA scenarios. Chapter 3 assesses the institutional constraints, opportunities, and impacts that affect whether these technologies and facilities would in fact be developed. Chapters 4 and 5 show how institutional analysis can support use of exercises such as RIIA in planning institutional change and making energy policy choices.

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

    PubMed

    Ney, Steven

    2012-04-01

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

  14. Evaluating health policy capacity: Learning from international and Australian experience

    PubMed Central

    Gleeson, Deborah H; Legge, David G; O'Neill, Deirdre

    2009-01-01

    Background The health sector in Australia faces major challenges that include an ageing population, spiralling health care costs, continuing poor Aboriginal health, and emerging threats to public health. At the same time, the environment for policy-making is becoming increasingly complex. In this context, strong policy capacity – broadly understood as the capacity of government to make "intelligent choices" between policy options – is essential if governments and societies are to address the continuing and emerging problems effectively. Results This paper explores the question: "What are the factors that contribute to policy capacity in the health sector?" In the absence of health sector-specific research on this topic, a review of Australian and international public sector policy capacity research was undertaken. Studies from the United Kingdom, Canada, New Zealand and Australia were analysed to identify common themes in the research findings. This paper discusses these policy capacity studies in relation to context, models and methods for policy capacity research, elements of policy capacity and recommendations for building capacity. Conclusion Based on this analysis, the paper discusses the organisational and individual factors that are likely to contribute to health policy capacity, highlights the need for further research in the health sector and points to some of the conceptual and methodological issues that need to be taken into consideration in such research. PMID:19245704

  15. Nurses’ policy influence: A concept analysis

    PubMed Central

    Arabi, Akram; Rafii, Forough; Cheraghi, Mohammad Ali; Ghiyasvandian, Shahrzad

    2014-01-01

    Background: Nurses’ influence on health policy protects the quality of care by access to required recourses and opportunities. This is a new and important concept for nursing; however, research studies on policy influence of nurses in health care sector are lacking a basic conceptual understanding of what this concept represents. The aim of this paper is to clarify the concept of nurses’ policy influence and to propose the definition of this concept, considering the context of Iran. Materials and Methods: The eight stages of Walker and Avant approach was used to guide this concept analysis. Various databases and internet engines were searched to find all related information about the concept. Textbooks were also searched manually. English language literature reports published between 1990 and 2012 were reviewed. Results: Based on the analysis undertaken, nurses’ policy influence is nurses’ ability in influencing decisions and affairs related to health through political knowledge, effective communication, and collaboration with other members of the health team, which results in the improvement of nurses’ job environment and increases patient outcomes. This is a dynamic process situated on a spectrum and is accompanied with nurses’ knowledge, competency, power, and advocacy, and also their ability to change. Conclusions: Nurses have individual views on health care issues and influence health care policies in different ways. With a common understanding of nurses’ policy influence as a concept, nurses will recognize the importance of policy making in the health sector and their influence on this process and also on patients’ outcomes. PMID:24949073

  16. Integrating health law and health policy: a European perspective.

    PubMed

    Legemaate, Johan

    2002-05-01

    Health law is intended to create an environment in which the promotion of health goes hand in hand with the protection of individual rights and the general principles of equality and justice. Over the years, the importance of health law has grown, both at national and international level. As health and human rights are closely interlinked, it is important to integrate health law and health policy. It is to be expected that, especially in Europe, the impact of health law on health policy-making will increase as a result of several developments, e.g. the internationalization of health care and health policy, the issue of consumer protection and the legalization of society. This requires a strategy to stimulate the fruitful relationship between health policy and health law. The most important components of this strategy are discussed.

  17. "Health 2020"--new framework for health policy. Part I.

    PubMed

    Opolski, Janusz T; Wysocki, Mirosław J

    2013-01-01

    The paper presents the new framework for health policy adopted in September 2012 during the 62nd session of World Health Organization (WHO) Regional Committee for Europe as the strategy "Health 2020". Four priority areas for policy action as well as prerequisites for achieving two interlinked strategic objectives; improving health for all and reducing health inequalities as well as improving leadership and participatory governance for health are presented and discussed.

  18. Model Child Care Health Policies. Fourth Edition.

    ERIC Educational Resources Information Center

    Aronson, Susan S.

    Drawn from a review of policies at over 100 child care programs nationwide, this document compiles model health policies intended for adaptation and selective use by out-of-home child care facilities. Following an introduction, the document presents model policy forms with blanks for adding individualized information for the following areas: (1)…

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

    PubMed

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

    2014-05-15

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

  20. Advanced Placement: Model Policy Components. Policy Analysis

    ERIC Educational Resources Information Center

    Zinth, Jennifer

    2016-01-01

    Advanced Placement (AP), launched in 1955 by the College Board as a program to offer gifted high school students the opportunity to complete entry-level college coursework, has since expanded to encourage a broader array of students to tackle challenging content. This Education Commission of the State's Policy Analysis identifies key components of…

  1. Green politics in Germany: what is Green health care policy?

    PubMed

    Wörz, M; Wismar, M

    2001-01-01

    For the first time ever, a Green party has governed in Germany. From September 1998 to January 2001 the German Green party, Bündnis 90/Die Grünen, held the Federal Ministry of Health. Little has been said so far about Bündnis 90/Die Grünen and its relation to health policy. This article is intended to fill that void. An analysis of the health policy program of the Greens reveals that it centers around moving the health sector toward more comprehensiveness and decentralization, strengthened patients' rights, increased use of preventive and alternative medicine, and a critique of the German cost-containment debate and policy. The current health policy program of the Greens is closest to that of the Party of Democratic Socialism, and to a lesser extent it has affinities to the program of the Social Democratic Party. The health policy program of Bündnis 90/Die Grünen is furthest from those of the Christian Democratic Union and the Free Democratic Party. The health care reforms passed in 1998 and 1999 were not a shift toward a "Green paradigm" of health care policy, because they included no fundamental changes. In addition, cost-containment is still a major political goal in German health care policy. PMID:11809012

  2. Mental health policy development in Africa.

    PubMed Central

    Gureje, O.; Alem, A.

    2000-01-01

    Mental health issues are usually given very low priority in health service policies. Although this is changing, African countries are still confronted with so many problems caused by communicable diseases and malnutrition that they have not waken up to the impact of mental disorders. Every country must formulate a mental health policy based on its own social and cultural realities. Such policies must take into account the scope of mental health problems, provide proven and affordable interventions, safeguard patients' rights, and ensure equity. PMID:10885166

  3. Financing and funding health care: Optimal policy and political implementability.

    PubMed

    Nuscheler, Robert; Roeder, Kerstin

    2015-07-01

    Health care financing and funding are usually analyzed in isolation. This paper combines the corresponding strands of the literature and thereby advances our understanding of the important interaction between them. We investigate the impact of three modes of health care financing, namely, optimal income taxation, proportional income taxation, and insurance premiums, on optimal provider payment and on the political implementability of optimal policies under majority voting. Considering a standard multi-task agency framework we show that optimal health care policies will generally differ across financing regimes when the health authority has redistributive concerns. We show that health care financing also has a bearing on the political implementability of optimal health care policies. Our results demonstrate that an isolated analysis of (optimal) provider payment rests on very strong assumptions regarding both the financing of health care and the redistributive preferences of the health authority.

  4. Associations between state minimum wage policy and health care access: a multi-level analysis of the 2004 Behavioral Risk Factor survey.

    PubMed

    McCarrier, Kelly P; Martin, Diane P; Ralston, James D; Zimmerman, Frederick J

    2010-05-01

    Minimum wage policies have been advanced as mechanisms to improve the economic conditions of the working poor. Both positive and negative effects of such policies on health care access have been hypothesized, but associations have yet to be thoroughly tested. To examine whether the presence of minimum wage policies in excess of the federal standard of $5.15 per hour was associated with health care access indicators among low-skilled adults of working age, a cross-sectional analysis of 2004 Behavioral Risk Factor Surveillance System data was conducted. Self-reported health insurance status and experience with cost-related barriers to needed medical care were adjusted in multi-level logistic regression models to control for potential confounding at the state, county, and individual levels. State-level wage policy was not found to be associated with insurance status or unmet medical need in the models, providing early evidence that increased minimum wage rates may neither strengthen nor weaken access to care as previously predicted.

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

    PubMed

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

    2011-04-01

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

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

    PubMed

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

    2013-01-01

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

  7. Policy analysis: palliative care in Ireland.

    PubMed

    May, Peter; Hynes, Geralyn; McCallion, Philip; Payne, Sheila; Larkin, Philip; McCarron, Mary

    2014-03-01

    Palliative care for patients with advanced illness is a subject of growing importance in health services, policy and research. In 2001 Ireland became one of the first nations to publish a dedicated national palliative care policy. This paper uses the 'policy analysis triangle' as a framework to examine what the policy entailed, where the key ideas originated, why the policy process was activated, who were the key actors, and what were the main consequences. Although palliative care provision expanded following publication, priorities that were unaddressed or not fully embraced on the national policy agenda are identified. The factors underlying areas of non-fulfilment of policy are then discussed. In particular, the analysis highlights that policy initiatives in a relatively new field of healthcare face a trade-off between ambition and feasibility. Key policy goals could not be realised given the large resource commitments required; the competition for resources from other, better-established healthcare sectors; and challenges in expanding workforce and capacity. Additionally, the inherently cross-sectoral nature of palliative care complicated the co-ordination of support for the policy. Policy initiatives in emerging fields such as palliative care should address carefully feasibility and support in their conception and implementation. PMID:23932413

  8. Policies for Improving Oral Health in Europe

    ERIC Educational Resources Information Center

    Blinkhorn, Anthony S.; Downer, Martin C.; Drugan, Caroline S.

    2005-01-01

    Background and Objective: The main purpose of this review was to rehearse the available evidence of good practice in dental public health in order to define policies that could improve oral health in the enlarged European Union and associated countries. Secondary objectives were to describe the basic principles of health service organisation and…

  9. Validation of indicators for health policy research.

    PubMed

    Panerai, R B

    1998-01-01

    The information used to determine the subjects of health policy research takes the form of indicators obtained by data manipulation. Validation is the process whereby the ability of health indicators to measure what they are supposed to measure is determined. The author discusses ways of overcoming various limitations affecting the development of health indicators.

  10. 78 FR 7784 - Health Information Technology Policy Committee Nomination Letters

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-04

    ... OFFICE Health Information Technology Policy Committee Nomination Letters AGENCY: Government... Recovery and Reinvestment Act of 2009 (ARRA) established the Health Information Technology Policy Committee (Health IT Policy Committee) and gave the Comptroller General responsibility for appointing 13 of its...

  11. 77 FR 27774 - Health Information Technology Policy Committee Vacancy

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-11

    ... OFFICE Health Information Technology Policy Committee Vacancy AGENCY: Government Accountability Office... Reinvestment Act of 2009 (ARRA) established the Health Information Technology Policy Committee (Health IT Policy Committee) and gave the Comptroller General responsibility for appointing 13 of its 20...

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

    PubMed

    Richman, Barak D

    2005-03-01

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

  13. 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

  14. International institutions and China's health policy.

    PubMed

    Huang, Yanzhong

    2015-02-01

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

  15. International institutions and China's health policy.

    PubMed

    Huang, Yanzhong

    2015-02-01

    This article examines the role of international institutional actors in China's health policy process. Particular attention is paid to three major international institutional actors: the World Bank, the World Health Organization, and the Global Fund to Fight AIDS, Tuberculosis and Malaria. Through process tracing and comparative case studies, the article looks at how international institutions contribute to policy change in China and seeks to explain different outcomes in the relationship between international institutions and China's health policies. It finds that despite the opaque and exclusive authoritarian structure in China, international institutions play a significant role in the country's domestic health governance. By investing their resources and capabilities selectively and strategically, international institutions can change the preferences of government policy makers, move latent public health issues to the government's agenda, and affect the timing of government action and the content of policy design. Furthermore, the study suggests that different outcomes in the relationship between China's health policies and global health governance can be explained through the seriousness of the externalities China faces. PMID:25480846

  16. Sociopolitical determinants of international health policy.

    PubMed

    De Vos, Pol; Van der Stuyft, Patrick

    2015-01-01

    For decades, two opposing logics have dominated the health policy debate: a comprehensive health care approach, with the 1978 Alma Ata Declaration as its cornerstone, and a private competition logic, emphasizing the role of the private sector. We present this debate and its influence on international health policies in the context of changing global economic and sociopolitical power relations in the second half of the last century. The neoliberal approach is illustrated with Chile's health sector reform in the 1980s and the Colombian reform since 1993. The comprehensive "public logic" is shown through the social insurance models in Costa Rica and in Brazil and through the national public health systems in Cuba since 1959 and in Nicaragua during the 1980s. These experiences emphasize that health care systems do not naturally gravitate toward greater fairness and efficiency, but require deliberate policy decisions. PMID:25813505

  17. Will embryonic stem cells change health policy?

    PubMed

    Sage, William M

    2010-01-01

    Embryonic stem cells are actively debated in political and public policy arenas. However, the connections between stem cell innovation and overall health care policy are seldom elucidated. As with many controversial aspects of medical care, the stem cell debate bridges to a variety of social conversations beyond abortion. Some issues, such as translational medicine, commercialization, patient and public safety, health care spending, physician practice, and access to insurance and health care services, are core health policy concerns. Other issues, such as economic development, technologic progress, fiscal politics, and tort reform, are only indirectly related to the health care system but are frequently seen through a health care lens. These connections will help determine whether the stem cell debate reaches a resolution, and what that resolution might be. PMID:20579256

  18. Will embryonic stem cells change health policy?

    PubMed

    Sage, William M

    2010-01-01

    Embryonic stem cells are actively debated in political and public policy arenas. However, the connections between stem cell innovation and overall health care policy are seldom elucidated. As with many controversial aspects of medical care, the stem cell debate bridges to a variety of social conversations beyond abortion. Some issues, such as translational medicine, commercialization, patient and public safety, health care spending, physician practice, and access to insurance and health care services, are core health policy concerns. Other issues, such as economic development, technologic progress, fiscal politics, and tort reform, are only indirectly related to the health care system but are frequently seen through a health care lens. These connections will help determine whether the stem cell debate reaches a resolution, and what that resolution might be.

  19. Sociopolitical determinants of international health policy.

    PubMed

    De Vos, Pol; Van der Stuyft, Patrick

    2015-01-01

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

  20. Health Planning. Health Policy--Paper #2.

    ERIC Educational Resources Information Center

    Stambler, Moses

    Health planning is a complex procedure in the American federal system of multi-authorities and multi-levels of responsibility. Because of its public nature, responsibility for the area of health planning is delegated to the health professional for its substantive dimension, but to the politician-bureaucrat and public-decision-maker for its policy…

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

    PubMed

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

    2016-07-01

    Framing research seeks to understand the forces that shape human behaviour in the policy process. It assumes that policy is a social construct and can be cast in a variety of ways to imply multiple legitimate value considerations. Frames provide the cognitive means of making sense of the social world, but discordance among them forms the basis of policy contestation. Framing, as both theory and method, has proven to generate considerable insight into the nature of policy debates in a variety of disciplines. Despite its salience for understanding health policy debates; however, little is known about the ways frames influence the health policy process. A scoping review using the Arksey and O'Malley framework was conducted. The literature on framing in the health sector was reviewed using nine health and social science databases. Articles were included that explicitly reported theory and methods used, data source(s), at least one frame, frame sponsor and evidence of a given frame's effect on the health policy process. A total of 52 articles, from 1996 to 2014, and representing 12 countries, were identified. Much of the research came from the policy studies/political science literature (n = 17) and used a constructivist epistemology. The term 'frame' was used as a label to describe a variety of ideas, packaged as values, social problems, metaphors or arguments. Frames were characterized at various levels of abstraction ranging from general ideological orientations to specific policy positions. Most articles presented multiple frames and showed how actors advocated for them in a highly contested political process. Framing is increasingly an important, yet overlooked aspect of the policy process. Further analysis on frames, framing processes and frame conflict can help researchers and policymakers to understand opaque and highly charged policy issues, which may facilitate the resolution of protracted policy controversies. PMID:26873903

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

    PubMed Central

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

    2016-01-01

    Framing research seeks to understand the forces that shape human behaviour in the policy process. It assumes that policy is a social construct and can be cast in a variety of ways to imply multiple legitimate value considerations. Frames provide the cognitive means of making sense of the social world, but discordance among them forms the basis of policy contestation. Framing, as both theory and method, has proven to generate considerable insight into the nature of policy debates in a variety of disciplines. Despite its salience for understanding health policy debates; however, little is known about the ways frames influence the health policy process. A scoping review using the Arksey and O’Malley framework was conducted. The literature on framing in the health sector was reviewed using nine health and social science databases. Articles were included that explicitly reported theory and methods used, data source(s), at least one frame, frame sponsor and evidence of a given frame’s effect on the health policy process. A total of 52 articles, from 1996 to 2014, and representing 12 countries, were identified. Much of the research came from the policy studies/political science literature (n = 17) and used a constructivist epistemology. The term ‘frame’ was used as a label to describe a variety of ideas, packaged as values, social problems, metaphors or arguments. Frames were characterized at various levels of abstraction ranging from general ideological orientations to specific policy positions. Most articles presented multiple frames and showed how actors advocated for them in a highly contested political process. Framing is increasingly an important, yet overlooked aspect of the policy process. Further analysis on frames, framing processes and frame conflict can help researchers and policymakers to understand opaque and highly charged policy issues, which may facilitate the resolution of protracted policy controversies. PMID:26873903

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

    PubMed

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

    2016-07-01

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

  4. Innovation in health policy: responding to the health society.

    PubMed

    Kickbusch, Ilona

    2007-01-01

    The 21st century health society is characterized by 2 major social processes: the expansion of the territory of health and the expansion of the reflexivity of health. The boundaries of what we call the <health system> are becoming increasingly fluid and health has become integral to how we live our everyday life. Health itself has become a major economic and social driving force in society. This shifts the pressure for policy innovation from a focus on the existing health system to a reorganization of how we approach health in 21st century societies. The dynamics of the health society challenge the way we conceptualize and locate health in the policy arena, the mechanisms through which we conduct health policy and they redefine who should be involved in the policy process. This concern is beginning to be addressed within government through joined up government approaches, beyond government through making health everybody's business and beyond nation states as a new interface between domestic and foreign policy. PMID:17663879

  5. The development of international health policies--accountability intact?

    PubMed

    Kickbusch, I

    2000-09-01

    International health governance as it exists today is facing major structural challenges in view of globalization, the increased transfer of international health risks and the mounting challenge of health inequalities worldwide. As a consequence the capacity of nation states to ensure population health and to address major health determinants has been weakened. This paper explores health as an exemplary field to illustrate that we have entered a new era of public policy which is defined by increasing overlaps between domestic and foreign policy, multilateral and bilateral strategies and national and international interest. Cross border spill overs and externalities of national actions need to move into the core of public policy at the national and global level within a new rules based system. A new perspective on global health governance is further necessitated through the increased number of players in the global health arena. The organizational form that is emerging is based on networks and is characterized by shifting alliances and blurred lines of responsibility. The paper explores the emerging paradox of state sovereignty and makes a set of proposals to pool state sovereignty on health and structure the myriad of networks. Particular attention is given to the role of the World Health Organization within this process of change and adjustment. In using a framework from international relations analysis the paper explores how nation states are socialized into accepting new norms, values and perceptions of interest with regard to national and international health and what challenges emerge for the WHO in "inventing" global health policy. PMID:10972440

  6. Need for Oral Health Policy in India

    PubMed Central

    Gambhir, RS; Gupta, T

    2016-01-01

    Dental diseases are a significant public health menace having a substantial impact on the quality of life which in turn affects the daily performance and general life satisfaction. There is a vast difference in health status including the oral health between urban and rural population of India and in other developing countries. The existing situation demands the formulation and implementation of National Oral Health Policy in India in order to expand the oral health care to make it more affordable, and reachable. An extensive literature search was conducted using various search engines in order to include relevant information in the review. Number of keywords and their combinations were used in order to extract appropriate data. Finally 24 out of 35 articles were selected upon detailed reading. The present paper focusses on some of the important subjects that can be considered while formulation of a National Oral Health Policy for the benefits of both the dental profession and community as a whole. There is a need of dental health planners and policy makers that have relevant qualifications and training in public health dentistry to understand the unique needs and resources for the development of an effective oral health policy. Professional dental organizations can also support government programs to provide basic oral health needs of extensive underserved population of this country. PMID:27144077

  7. Anchoring contextual analysis in health policy and systems research: A narrative review of contextual factors influencing health committees in low and middle income countries.

    PubMed

    George, Asha; Scott, Kerry; Garimella, Surekha; Mondal, Shinjini; Ved, Rajani; Sheikh, Kabir

    2015-05-01

    Health committees, councils or boards (HCs) mediate between communities and health services in many health systems. Despite their widespread prevalence, HC functions vary due to their diversity and complexity, not least because of their context specific nature. We undertook a narrative review to better understand the contextual features relevant to HCs, drawing from Scopus and the internet. We found 390 English language articles from journals and grey literature since 1996 on health committees, councils and boards. After screening with inclusion and exclusion criteria, we focused on 44 articles. Through an iterative process of exploring previous attempts at understanding context in health policy and systems research (HPSR) and the HC literature, we developed a conceptual framework that delineates these contextual factors into four overlapping spheres (community, health facilities, health administration, society) with cross-cutting issues (awareness, trust, benefits, resources, legal mandates, capacity-building, the role of political parties, non-governmental organizations, markets, media, social movements and inequalities). While many attempts at describing context in HPSR result in empty arenas, generic lists or amorphous detail, we suggest anchoring an understanding of context to a conceptual framework specific to the phenomena of interest. By doing so, our review distinguishes between contextual elements that are relatively well understood and those that are not. In addition, our review found that contextual elements are dynamic and porous in nature, influencing HCs but also being influenced by them due to the permeability of HCs. While reforms focus on tangible HC inputs and outputs (training, guidelines, number of meetings held), our review of contextual factors highlights the dynamic relationships and broader structural elements that facilitate and/or hinder the role of health committees in health systems. Such an understanding of context points to its

  8. Anchoring contextual analysis in health policy and systems research: A narrative review of contextual factors influencing health committees in low and middle income countries.

    PubMed

    George, Asha; Scott, Kerry; Garimella, Surekha; Mondal, Shinjini; Ved, Rajani; Sheikh, Kabir

    2015-05-01

    Health committees, councils or boards (HCs) mediate between communities and health services in many health systems. Despite their widespread prevalence, HC functions vary due to their diversity and complexity, not least because of their context specific nature. We undertook a narrative review to better understand the contextual features relevant to HCs, drawing from Scopus and the internet. We found 390 English language articles from journals and grey literature since 1996 on health committees, councils and boards. After screening with inclusion and exclusion criteria, we focused on 44 articles. Through an iterative process of exploring previous attempts at understanding context in health policy and systems research (HPSR) and the HC literature, we developed a conceptual framework that delineates these contextual factors into four overlapping spheres (community, health facilities, health administration, society) with cross-cutting issues (awareness, trust, benefits, resources, legal mandates, capacity-building, the role of political parties, non-governmental organizations, markets, media, social movements and inequalities). While many attempts at describing context in HPSR result in empty arenas, generic lists or amorphous detail, we suggest anchoring an understanding of context to a conceptual framework specific to the phenomena of interest. By doing so, our review distinguishes between contextual elements that are relatively well understood and those that are not. In addition, our review found that contextual elements are dynamic and porous in nature, influencing HCs but also being influenced by them due to the permeability of HCs. While reforms focus on tangible HC inputs and outputs (training, guidelines, number of meetings held), our review of contextual factors highlights the dynamic relationships and broader structural elements that facilitate and/or hinder the role of health committees in health systems. Such an understanding of context points to its

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

    PubMed

    Cumming, Jacqueline

    2015-06-01

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

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

    PubMed

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

    2012-02-01

    This Special Issue of Social Science & Medicine investigates the potential for positive inter-disciplinary interaction, a 'generative dance', between organization studies (OS), and two of the journal's traditional disciplinary foundations: health policy and medical sociology. This is both necessary and timely because of the extent to which organizations have become a neglected topic within medical sociology and health policy analysis. We argue there is need for further and more sustained theoretical and conceptual synergy between OS, medical sociology and health policy, which provides, on the one-hand a cutting-edge and thought-provoking basis for the analysis of contemporary health reforms, and on the other hand, enables the development and elaboration of theory. We emphasize that sociologists and policy analysts in healthcare have been leading contributors to our understanding of organizations in modern society, that OS enhances our understanding of medical settings, and that organizations remain one of the most influential actors of our time. As a starting point to discussion, we outline the genealogy of OS and its application to healthcare settings. We then consider how medical sociology and health policy converge or diverge with the concerns of OS in the study of healthcare settings. Following this, we focus upon the material environment, specifically the position of business schools, which frames the generative dance between OS, medical sociology and health policy. This sets the context for introducing the thirteen articles that constitute the Special Issue of Social Science & Medicine. PMID:22218227

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

    PubMed

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

    2012-02-01

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

  12. Applying Behavioral Economics to Public Health Policy

    PubMed Central

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

    2016-01-01

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

  13. Mental health law and public policy.

    PubMed

    Scallet, L J

    1980-09-01

    Litigation has been a successful strategy in securing rights for the mentally ill. After early victories, however, limits of litigation began to emerge; implementation of court orders raised many policy questions. The translation of broad rights into complex public policy has led directly to the legislative and administrative policy processes, as can be seen with the proposed Mental Health Systems Act. The author uses the evolution of Title 3, a rights and advocacy amendment of the proposed act, as a case study in the formation of public policy.

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

    PubMed

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

    2010-06-01

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

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

    PubMed

    Chinitz, David P; Rodwin, Victor G

    2014-12-01

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

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

    PubMed Central

    Chinitz, David P; Rodwin, Victor G

    2014-01-01

    We argue that the field of Health Policy and Management (HPAM) ought to confront the gap between theory, policy, and practice. Although there are perennial efforts to reform healthcare systems, the conceptual barriers are considerable and reflect the theory-policy-practice gap. We highlight four dimensions of the gap: 1) the dominance of microeconomic thinking in health policy analysis and design; 2) the lack of learning from management theory and comparative case studies; 3) the separation of HPAM from the rank and file of healthcare; and 4) the failure to expose medical students to issues of HPAM. We conclude with suggestions for rethinking the field of HPAM by embracing broader perspectives, e.g. ethics, urban health, systems analysis and cross-national analyses of healthcare systems. PMID:25489592

  17. 78 FR 42945 - Health Information Technology Policy Committee Vacancy

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-18

    ... OFFICE Health Information Technology Policy Committee Vacancy AGENCY: Government Accountability Office... Reinvestment Act of 2009 (ARRA) established the Health Information Technology Policy Committee (Health IT.... ARRA requires that one member have expertise in health information privacy and security. Due to...

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

    PubMed

    Collin, Jeff

    2012-03-01

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

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

    PubMed

    Collin, Jeff

    2012-03-01

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

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

    PubMed Central

    Collin, Jeff

    2015-01-01

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

  1. Health Educators as Environmental Policy Advocates.

    ERIC Educational Resources Information Center

    Miner, Kimberly J.; Baker, Judith A.

    1993-01-01

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

  2. "Health 2020"--new framework for health policy. Part II.

    PubMed

    Opolski, Janusz T; Wysocki, Mirosław J

    2013-01-01

    The papers continues presentation of the new framework for health policy related to "Health 2020" strategy adopted in September 2012 unanimously by all member countries of EURO Region during the 62nd session of the World Health Organization Regional Committee for Europe. Four priority areas for action are presented.

  3. European Union health policy and its implications for national convergence.

    PubMed

    Cucic, S

    2000-06-01

    This paper explores the relevance for health care of European Union (EU) legislation, regulation and policies. Reports, communications and other materials of the European Commission and other relevant European bodies are screened for their implications for health care, primarily on the national health system level. The paper provides a brief overview of EU history and its main institutions, followed by an analysis of health (care)-related provisions in the EU's main legal documents--its treaties. The impact of the EU actions on health protection is considered with regard to both actions in the field of public health and health protection requirements in its policies. In the public health area, information systems that are now being developed are discussed, followed by an outline of health protection requirements in EU policies that can have an impact on health systems. These policies are then analysed using the political factions model. Finally an attempt is made to predict future developments, stressing the need for a far-reaching synchronization of national systems.

  4. The use of street-level bureaucracy theory in health policy analysis in low- and middle-income countries: a meta-ethnographic synthesis.

    PubMed

    Erasmus, Ermin

    2014-12-01

    This article presents a synthesis of studies that explicitly use the theory of street-level bureaucracy to illuminate health policy implementation in low- and middle-income countries. Street-level bureaucrats are frontline workers in bureaucracies, e.g. nurses, who regularly interact directly with citizens in discharging their policy implementation duties and who have some discretion over which services are offered, how services are offered and the benefits and sanctions allocated to citizens. This synthesis seeks to achieve the dual objectives of, first, reflecting on how street-level bureaucracy theory has been used in the literature and, second, providing an example of the application of the synthesis methodology of meta-ethnography to the health policy analysis literature. The article begins by outlining meta-ethnography and providing more information on the papers on which the synthesis is based. This is followed by a detailed account of how the synthesis was achieved and by an articulation of the synthesis. It then concludes with thoughts and questions on the value and relevance of the synthesis, the experience of conducting the synthesis and the partial way in which street-level bureaucracy theory has been used in the literature examined.

  5. Health inequalities: trends, progress, and policy.

    PubMed

    Bleich, Sara N; Jarlenski, Marian P; Bell, Caryn N; LaVeist, Thomas A

    2012-04-01

    Health inequalities, which have been well documented for decades, have more recently become policy targets in developed countries. This review describes time trends in health inequalities (by sex, race/ethnicity, and socioeconomic status), commitments to reduce health inequalities, and progress made to eliminate health inequalities in the United States, United Kingdom, and other OECD countries. Time-trend data in the United States indicate a narrowing of the gap between the best- and worst-off groups in some health indicators, such as life expectancy, but a widening of the gap in others, such as diabetes prevalence. Similarly, time-trend data in the United Kingdom indicate a narrowing of the gap between the best- and worst-off groups in some indicators, such as hypertension prevalence, whereas the gap between social classes has increased for life expectancy. More research and better methods are needed to measure precisely the relationships between stated policy goals and observed trends in health inequalities. PMID:22224876

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

    PubMed

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

    2014-01-01

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

  7. Allocation of authority in European health policy.

    PubMed

    Adolph, Christopher; Greer, Scott L; Massard da Fonseca, Elize

    2012-11-01

    Although many study the effects of different allocations of health policy authority, few ask why countries assign responsibility over different policies as they do. We test two broad theories: fiscal federalism, which predicts rational governments will concentrate information-intensive operations at lower levels, and redistributive and regulatory functions at higher levels; and "politicized federalism", which suggests a combination of systematic and historically idiosyncratic political variables interfere with efficient allocation of authority. Drawing on the WHO Health in Transition country profiles, we present new data on the allocation of responsibility for key health care policy tasks (implementation, provision, finance, regulation, and framework legislation) and policy areas (primary, secondary and tertiary care, public health and pharmaceuticals) in the 27 EU member states and Switzerland. We use a Bayesian multinomial mixed logit model to analyze how different countries arrive at different allocations of authority over each task and area of health policy, and find the allocation of powers broadly follows fiscal federalism. Responsibility for pharmaceuticals, framework legislation, and most finance lodges at the highest levels of government, acute and primary care in the regions, and provision at the local and regional levels. Where allocation does not follow fiscal federalism, it appears to reflect ethnic divisions, the population of states and regions, the presence of mountainous terrain, and the timing of region creation. PMID:22858423

  8. Corporate Philanthropy, Political Influence, and Health Policy

    PubMed Central

    Fooks, Gary J.; Gilmore, Anna B.

    2013-01-01

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

  9. Global health: governance and policy development.

    PubMed

    Kelley, Patrick W

    2011-06-01

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

  10. Education Policy Analysis Archives, 1996.

    ERIC Educational Resources Information Center

    Glass, Gene V., Ed.

    1997-01-01

    This document consists of the 19 articles published in the Electronic Journal "Education Policy Analysis Archives" for the year 1996: (1) "The Achievement Crisis Is Real: A Review of 'The Manufactured Crisis'" (Lawrence C. Stedman); (2) "Staff Development Policy: Fuzzy Choices in an Imperfect Market" (Robert T. Stout); (3) "Making Molehills out of…

  11. Education Policy Analysis Archives, 2000.

    ERIC Educational Resources Information Center

    Glass, Gene V., Ed.

    2000-01-01

    This document consists of the 2000 edition of the "Education Policy Analysis Archives." The papers include: (1) "Teacher Quality and Student Achievement: A Review of State Policy Evidence" (Linda Darling-Hammond); (2) "America Y2K: The Obsolescence of Educational Reforms" (Sherman Dorn); (3) "Forces for Change in Mathematics Education: The Case of…

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

    PubMed

    Palmer, G R

    2000-02-01

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

  13. Privacy policies for health social networking sites

    PubMed Central

    Li, Jingquan

    2013-01-01

    Health social networking sites (HSNS), virtual communities where users connect with each other around common problems and share relevant health data, have been increasingly adopted by medical professionals and patients. The growing use of HSNS like Sermo and PatientsLikeMe has prompted public concerns about the risks that such online data-sharing platforms pose to the privacy and security of personal health data. This paper articulates a set of privacy risks introduced by social networking in health care and presents a practical example that demonstrates how the risks might be intrinsic to some HSNS. The aim of this study is to identify and sketch the policy implications of using HSNS and how policy makers and stakeholders should elaborate upon them to protect the privacy of online health data. PMID:23599228

  14. Privacy policies for health social networking sites.

    PubMed

    Li, Jingquan

    2013-01-01

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

  15. Ethics in American Health 1: Ethical Approaches to Health Policy

    PubMed Central

    2008-01-01

    I trace the evolution of ethical approaches to health policy in the United States and examine a number of critical unresolved issues pertaining to the current set of frameworks. Several themes emerge. First, fair procedures claim more attention than substantive and procedural principles. Second, in the case of public deliberation, more focus has been placed on factors such as procedural mechanisms than on understanding how individuals and groups value different aspects of health and agree on health-related decisions. Third, the nation needs workable frameworks to guide collective choices about valuable social ends and their trade-offs; purely procedural strategies are limited in illuminating overarching health policy and ethics questions. There is a need to integrate consequential and procedural approaches to health ethics and policy. PMID:18703449

  16. Ethics in American health 1: ethical approaches to health policy.

    PubMed

    Ruger, Jennifer Prah

    2008-10-01

    I trace the evolution of ethical approaches to health policy in the United States and examine a number of critical unresolved issues pertaining to the current set of frameworks. Several themes emerge. First, fair procedures claim more attention than substantive and procedural principles. Second, in the case of public deliberation, more focus has been placed on factors such as procedural mechanisms than on understanding how individuals and groups value different aspects of health and agree on health-related decisions. Third, the nation needs workable frameworks to guide collective choices about valuable social ends and their trade-offs; purely procedural strategies are limited in illuminating overarching health policy and ethics questions. There is a need to integrate consequential and procedural approaches to health ethics and policy. PMID:18703449

  17. Mental health promotion policies in Europe.

    PubMed

    Ozamiz, Jose Agustin

    2011-04-01

    There is little evidence that systematic mental health promotion (MHP) policies exist in the countries of the European Union (EU). In order to explore this, a sample of public health stakeholders in ten European regions was selected. Each region was asked to complete a postal questionnaire about structural indicators of those environmental factors that might have an impact on mental health; stakeholders were also provided with information on MHP concepts and strategies. Subsequently the regions were visited, and stakeholders were interviewed on their MHP policies using an open-ended questionnaire. It was found that there were no existing procedures or plans that could support the hope that systematic MHP policies would be developed in the next years in the EU. Only three of the ten regions had started to develop such policies. An 8-item questionnaire on the framework and process of MHP policy development was developed and used in the present study. This questionnaire may be a useful instrument in future studies on structural indicators of mental health.

  18. 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.

  19. Health policy. Who's got the master card?

    PubMed

    Robinson, Ray

    2002-09-26

    The last decade has seen huge shifts away from the command and control model which dominated health policy since the foundation of the NHS. The current Labour government Initially favoured a system based on collaboration and partnership working but the incentives to achieve this were not sufficiently strong. Competition is now once again openly cited as a driver for improved performance. Political demands mean that command and control are likely to remain key features of government health policy. But this, in turn, is likely to place major limitations on the local autonomy pledged by the government.

  20. Media power and public mental health policy.

    PubMed

    Marcos, L R

    1989-09-01

    The author describes the functions of the news media and their influence on public mental health policy making. News media functions are divided into the categories of selecting the news, reporting information, serving as a channel of communication, presenting views and opinions, and legitimizing the issues. These functions are illustrated by focusing on a highly publicized New York City policy to involuntarily hospitalize mentally ill homeless people living in the streets. Strategies are suggested to mental health professionals on how to effectively interact with the news media. PMID:2764177

  1. Priorities of health policy: cost shifting or population health

    PubMed Central

    Richardson, Jeff RJ

    2005-01-01

    Background This paper is an edited version of an invited paper submitted to the Australian Health Care Summit on 17–19 August 2003. It comments upon the policies which have dominated recent debate and contrasts their importance with the importance of five issues which have received relatively little attention. Methods Policy is usually a response to identified problems and the paper examines the nature and size of the problems which heave led to recent policy initiatives. These are contrasted with the magnitude and potential cost effectiveness policies to address the problems in five areas of comparative neglect. Results It is argued that recent and proposed changes to the financing and delivery of health services in Australia have focused upon issues of relatively minor significance while failing to address adequately major inequities and system deficiencies. Conclusion There is a need for an independent review of the health system with the terms of reference focusing attention upon large system-wide failures. PMID:15679895

  2. Health care economics and policy.

    PubMed

    Lubeck, D P

    1991-04-01

    It is difficult to objectively and comprehensively measure the effects of the rheumatic diseases or their treatment. The concept of patient outcome measurement now encompasses many components: physical health, mental health, everyday functioning, general perceptions of well-being, treatment side effects, and cost-versus-benefit. Accordingly, a major research effort has been directed toward developing methods for the measurement of health status and patient outcome in arthritis and other rheumatologic diseases. The intent of this effort is to produce standard measures for evaluating disease impact, treatment impact, and costs of care. Numerous questionnaire-based instruments have appeared for clinical researchers to use, but they are couched in unfamiliar jargon and use terms such as "indirect costs," "lost productivity," and "quality-of-life." As these articles appear in the literature and clinical investigators include such measures in their studies or clinical trials, a review of the terms and an evaluation of these measures appears timely. This report describes the present state of the art, emerging problems, and future directions.

  3. 78 FR 24749 - Health Information Technology Policy Committee Appointment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-26

    ... OFFICE Health Information Technology Policy Committee Appointment AGENCY: Government Accountability... Act of 2009 (ARRA) established the Health Information Technology Policy Committee to make recommendations on the implementation of a nationwide health information technology infrastructure to the...

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

    PubMed

    Michaud, Josh; Kates, Jennifer

    2013-03-01

    Attention to global health diplomacy has been rising but the future holds challenges, including a difficult budgetary environment. Going forward, both global health and foreign policy practitioners would benefit from working more closely together to achieve greater mutual understanding and to advance respective mutual goals. PMID:25276514

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

    PubMed

    Michaud, Josh; Kates, Jennifer

    2013-03-01

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

  6. Health Policy and the Health of the Public.

    ERIC Educational Resources Information Center

    Lee, Philip R.

    1984-01-01

    Examines the evolution of health policies in the United States and their possible impact on public health. Reviews four periods of U.S. history (1776-1861, 1861-1931, 1931-1981, and 1981 to the present) with special emphasis on the significant increase in the federal role and the current attempts to reduce the federal role. (SK)

  7. Coherence between health policy and human resource strategy: lessons from maternal health in Vietnam, India and China.

    PubMed

    Martineau, Tim; Mirzoev, Tolib; Pearson, Stephen; Ha, Bui Thi Thu; Xu, Qian; Ramani, K V; Liu, Xiaoyun

    2015-02-01

    The failure to meet health goals such as the Millennium Development Goals (MDG) is partly due to the lack of appropriate resources for the effective implementation of health policies. The lack of coherence between the health policies and human resource (HR) strategy is one of the major causes. This article explores the relationship and the degree of coherence between health policy--in this case maternal health policy--processes and HR strategy in Vietnam, China and India in the period 2005-09. Four maternal health policy case studies were explored [skilled birth attendance (SBA), adolescent and sexual reproductive health, domestic violence and medical termination of pregnancy] across three countries through interviews with key respondents, document analysis and stakeholder meetings. Analysis for coherence between health policy and HR strategy was informed by a typology covering 'separation', 'fit' and 'dialogue'. Regarding coherence we found examples of complete separation between health policy and HR strategy, a good fit with the SBA policy though modified through 'dialogue' in Vietnam, and in one case a good fit between policy and strategy was developed through successive evaluations. Three key influences on coherence between health policy and HR strategy emerge from our findings: (1) health as the lead sector, (2) the nature of the policy instrument and (3) the presence of 'HR champions'. Finally, we present a simple algorithm to ensure that appropriate HR related actors are involved; HR is considered at the policy development stage with the option of modifying the policy if it cannot be adequately supported by the available health workforce; and ensuring that HR strategies are monitored to ensure continued coherence with the health policy. This approach will ensure that the health workforce contributes more effectively to meeting the MDGs and future health goals. PMID:24374717

  8. Health Policy Training: A Review of the Literature

    PubMed Central

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

    2015-01-01

    The context within which health care and public health systems operate is framed by health policies. There is growing consensus about the need for increased health policy leadership and a health professional workforce prepared to assume these leadership roles. At the same time, there is strong evidence supporting the need for a broader policy lens and the need to intentionally target health disparities. We reviewed the published literature between 1983 and 2013 regarding health policy training. From 5124 articles identified, 33 met inclusion criteria. Articles varied across common themes including target audience, goal(s), health policy definition, and core curricular content. The majority of articles were directed to medical or nursing audiences. Most articles framed health policy as health care policy and only a small number adopted a broader health in all policies definition. Few articles specifically addressed vulnerable populations or health disparities. The need for more rigorous research and evaluation to inform health policy training is compelling. Providing health professionals with the knowledge and skills to engage and take leadership roles in health policy will require training programs to move beyond their limited health care-oriented health policy framework to adopt a broader health and health equity in all policies approach. PMID:26703657

  9. Policy-as-Discourse and Schools in the Role of Health Promotion: The Application of Bernstein's Transmission Context in Policy Analysis

    ERIC Educational Resources Information Center

    Leow, Anthony Chee Siong

    2011-01-01

    As one of the most important sites in and through which state agendas are articulated and disseminated, schools and teachers play critical roles in the implementation of state-driven policies and initiatives targeted at children and young people. This is especially pertinent in the current educational landscape where schools and teachers are…

  10. [Women and the mental health policy].

    PubMed

    Guberman, N

    1990-05-01

    This article analyzes Québec mental health policy from a feminist point of view. The critique focuses on the decyphering of three tacit premises that the author describes as wanting. On the base of these premises, the author argues that the policy avoids differences in sex and in gender role and their impact on mental health/disorders, that it belongs to a "naturalist" trend that wants to benefit families through the social integration of psychiatrized patients, and that it offers a scuttled partnership with women's groups. The author concludes by pointing out the policy's limits and dangers for women and women's groups, and by raising the issue of the relationship feminist services maintain with the State.

  11. US Policy approaches for assessing soil health

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There is worldwide recognition for a more holistic vision of soil health and tools to guide soil conservation policy, management and restoration. To meet this need, U.S. conservation programs in the US Food, Conservation, and Energy Act of 2008 (the farm bill), including the Conservation Stewardship...

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

    PubMed

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

    2004-11-01

    This analysis focuses on public policies that affect primary HIV prevention and access to HIV care for Mexican migrants residing in California. Policy or structural level interventions, as opposed to behavioral or psychologic interventions, help to shape the environment in which people live. We use a conceptual model for policy analysis in public health to understand better the challenges faced by Mexican migrants. We assess potential policy level interventions that may serve as barriers to or facilitators of primary HIV prevention and care for Mexican migrants. Among potential barriers, we discuss restrictions on public health services based on legal immigration status, limits placed on affirmative action in education, and laws limiting travel and immigration. Under potential facilitators, we discuss community and migrant health centers, language access laws, and the use of community-based groups to provide prevention and treatment outreach. We also report on the limited research evaluating the implications of these public policies and ways to organize for more responsive public policies. PMID:15722867

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

    PubMed

    Green, A

    2000-01-01

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

  14. Understanding change in global health policy: ideas, discourse and networks.

    PubMed

    Harmer, Andrew

    2011-01-01

    How is radical change in global health policy possible? Material factors such as economics or human resources are important, but ideational factors such as ideas and discourse play an important role as well. In this paper, I apply a theoretical framework to show how discourse made it possible for public and private actors to fundamentally change their way of working together--to shift from international public and private interactions to global health partnerships (GHPs)--and in the process create a new institutional mechanism for governing global health. Drawing on insights from constructivist analysis, I demonstrate how discourse justified, legitimised, communicated and coordinated ideas about the practice of GHPs through a concentrated network of partnership pioneers. As attention from health policy analysts turns increasingly to ideational explanations for answers to global health problems, this paper contributes to the debate by showing how, precisely, discourse makes change possible.

  15. Understanding change in global health policy: ideas, discourse and networks.

    PubMed

    Harmer, Andrew

    2011-01-01

    How is radical change in global health policy possible? Material factors such as economics or human resources are important, but ideational factors such as ideas and discourse play an important role as well. In this paper, I apply a theoretical framework to show how discourse made it possible for public and private actors to fundamentally change their way of working together--to shift from international public and private interactions to global health partnerships (GHPs)--and in the process create a new institutional mechanism for governing global health. Drawing on insights from constructivist analysis, I demonstrate how discourse justified, legitimised, communicated and coordinated ideas about the practice of GHPs through a concentrated network of partnership pioneers. As attention from health policy analysts turns increasingly to ideational explanations for answers to global health problems, this paper contributes to the debate by showing how, precisely, discourse makes change possible. PMID:20924870

  16. Chronic conditions policies: oral health, a felt absence.

    PubMed

    Luis Schwab, Gerson; Tetu Moysés, Simone; Helena Sottile França, Beatriz; Iani Werneck, Renata; Frank, Erica; Jorge Moysés, Samuel

    2014-04-01

    The global health scenario shows an epidemic of non-communicable diseases that lead to long-term chronic conditions, some of which are incurable. Many infectious diseases, owing to their development and length, also generate chronic conditions. Similarly, non-morbid states, such as pregnancy, and some life cycles such as adolescence and ageing, follow the same logic. Among all these chronic conditions there is a significant interrelationship with oral health, both in parallel events and common risk factors. This article presents cross-sectional qualitative research into World Health Organisation recommended health policies to address chronic conditions. Several documents published by the organisation were analysed to verify the presence of references to oral health in relation to chronic conditions, particularly cardiovascular diseases and diabetes as these most frequently have oral manifestations. The analysis showed no significant references to oral health or its indicators within the published texts. The study recognises the value of the work developed by the World Health Organisation, as well as its worldwide leadership role in the development of health policies for chronic conditions. This article proposes a coalition of dentistry organisations that could, in a more forceful and collective way, advocate for a greater presence of oral health in drafting policies addressing chronic conditions.

  17. Gender, health and population policy.

    PubMed

    Postel, E

    1992-01-01

    Indonesia is an international showpiece of successful population control. The number of desired acceptors of family planning is fixed by a coordinating board in cooperation with international advisers including the World Bank. More than 95% of the actual acceptors or users of contraceptives are women rather than couples. Numerical targets are set for districts, subdistricts, villages and hamlets; and local administrators are charged with the execution of the program. Ambitious village or district leaders use a variety of incentives and disincentives to comply with these directives issued by superiors. "2 children is enough" is the slogan on ubiquitous posters in the archipelago. A woman who is pregnant for a 3rd time may face scorn in her village. Although family planning has succeeded in averting births, maternal mortality rates in Indonesia are among the highest in the world. 55% of Indonesian women suffer from anaemia, particularly pregnant or breast feeding women. In principle there is free choice of contraceptives, but effective means such as hormonal implants, IUDs, and sterilization are promoted instead of pills and barrier methods. Thus, a program originally designed to be sensitive to community concerns runs the risk of becoming an oppressive system. Under the rhetoric of human development the quality of family planning services should be improved, the status of women raised by better education and more employment opportunities, no discrimination, and better health services. The aim of United Nations Population Fund (UNFPA) is to extend modern family planning services to 567 million couples, 59% of all married women of reproductive age, by the age 2000. The contraceptive needs of unmarried women have been ignored again, while the plight of unmarried pregnant women has probably increased by increasing violence and wars.

  18. Gender, health and population policy.

    PubMed

    Postel, E

    1992-01-01

    Indonesia is an international showpiece of successful population control. The number of desired acceptors of family planning is fixed by a coordinating board in cooperation with international advisers including the World Bank. More than 95% of the actual acceptors or users of contraceptives are women rather than couples. Numerical targets are set for districts, subdistricts, villages and hamlets; and local administrators are charged with the execution of the program. Ambitious village or district leaders use a variety of incentives and disincentives to comply with these directives issued by superiors. "2 children is enough" is the slogan on ubiquitous posters in the archipelago. A woman who is pregnant for a 3rd time may face scorn in her village. Although family planning has succeeded in averting births, maternal mortality rates in Indonesia are among the highest in the world. 55% of Indonesian women suffer from anaemia, particularly pregnant or breast feeding women. In principle there is free choice of contraceptives, but effective means such as hormonal implants, IUDs, and sterilization are promoted instead of pills and barrier methods. Thus, a program originally designed to be sensitive to community concerns runs the risk of becoming an oppressive system. Under the rhetoric of human development the quality of family planning services should be improved, the status of women raised by better education and more employment opportunities, no discrimination, and better health services. The aim of United Nations Population Fund (UNFPA) is to extend modern family planning services to 567 million couples, 59% of all married women of reproductive age, by the age 2000. The contraceptive needs of unmarried women have been ignored again, while the plight of unmarried pregnant women has probably increased by increasing violence and wars. PMID:12285921

  19. Health policy, disparities, and the kidney.

    PubMed

    Williams, Amy W

    2015-01-01

    Kidney care and public policy have been linked for 40 years, with various consequences to outcomes. The 1972 Social Security Amendment, Section 2991, expanded Medicare coverage for all modalities of dialysis and transplant services and non-kidney-related care to those with end-stage renal disease (ESRD) regardless of age. This first and only disease-specific entitlement program was a step toward decreasing disparities in access to care. Despite this, disparities in kidney disease outcomes continue as they are based on many factors. Over the last 4 decades, policies have been enacted to understand and improve the delivery of ESRD care. More recent policies include novel shared-risk payment models to ensure quality and decrease costs. This article discusses the impact or potential impact of selected policies on health disparities in advanced chronic kidney disease and ESRD. Although it is too early to know the consequences of newer policies (Affordable Care Act, ESRD Prospective Payment System, Quality Incentive Program, Accountable Care Organizations), their goal of improving access to timely patient-centered appropriate affordable and quality care should lessen the disparity gap. The Nephrology community must leverage this dynamic state of care-delivery model redesign to decrease kidney-related health disparities. PMID:25573513

  20. Health policy, disparities, and the kidney.

    PubMed

    Williams, Amy W

    2015-01-01

    Kidney care and public policy have been linked for 40 years, with various consequences to outcomes. The 1972 Social Security Amendment, Section 2991, expanded Medicare coverage for all modalities of dialysis and transplant services and non-kidney-related care to those with end-stage renal disease (ESRD) regardless of age. This first and only disease-specific entitlement program was a step toward decreasing disparities in access to care. Despite this, disparities in kidney disease outcomes continue as they are based on many factors. Over the last 4 decades, policies have been enacted to understand and improve the delivery of ESRD care. More recent policies include novel shared-risk payment models to ensure quality and decrease costs. This article discusses the impact or potential impact of selected policies on health disparities in advanced chronic kidney disease and ESRD. Although it is too early to know the consequences of newer policies (Affordable Care Act, ESRD Prospective Payment System, Quality Incentive Program, Accountable Care Organizations), their goal of improving access to timely patient-centered appropriate affordable and quality care should lessen the disparity gap. The Nephrology community must leverage this dynamic state of care-delivery model redesign to decrease kidney-related health disparities.

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

    PubMed

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

    2015-03-01

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

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

    PubMed

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

    2015-03-01

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

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

    PubMed Central

    Dussault, Gilles; Dubois, Carl-Ardy

    2003-01-01

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

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

    PubMed

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

    2003-01-01

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

  5. [Public health policies in Chile: seeking to regain trust].

    PubMed

    Cuadrado, Cristóbal

    2016-09-07

    Healthcare represents a key area in the public agenda. In the case of Chile, this central part of citizen demands has emerged with an increasing criticism of the health system, its actors and institutions, while a major democratic and legitimacy crisis in Chilean society unfolds. The starting point of this analysis is the link between the critical and widespread societal dissatisfaction with the legitimacy crisis in the health sector. There is an interdependence and parallelism between these two different aspects of the crisis. The analysis is built around the dimensions of trust and legitimacy as a potential driver of the conflict, taking as an analytical framework the socio-political matrix. Conceptual elements around the ideas of trust and legitimacy in public policies are reviewed. This article focuses on recent situations surrounding the dynamics of the Chilean health system such as the rise of the Instituciones de Salud Previsional (ISAPRE) and the market-driven health system, the failed health care reform of the last decade, conflicts of interest in the formulation of public policies, loss of legitimacy of healthcare authorities, and the role of the health professionals in this process. Finally, a discussion arises seeking to regain public trust as a central issue for the future development and sustainability of health policies.

  6. [Public health policies in Chile: seeking to regain trust].

    PubMed

    Cuadrado, Cristóbal

    2016-01-01

    Healthcare represents a key area in the public agenda. In the case of Chile, this central part of citizen demands has emerged with an increasing criticism of the health system, its actors and institutions, while a major democratic and legitimacy crisis in Chilean society unfolds. The starting point of this analysis is the link between the critical and widespread societal dissatisfaction with the legitimacy crisis in the health sector. There is an interdependence and parallelism between these two different aspects of the crisis. The analysis is built around the dimensions of trust and legitimacy as a potential driver of the conflict, taking as an analytical framework the socio-political matrix. Conceptual elements around the ideas of trust and legitimacy in public policies are reviewed. This article focuses on recent situations surrounding the dynamics of the Chilean health system such as the rise of the Instituciones de Salud Previsional (ISAPRE) and the market-driven health system, the failed health care reform of the last decade, conflicts of interest in the formulation of public policies, loss of legitimacy of healthcare authorities, and the role of the health professionals in this process. Finally, a discussion arises seeking to regain public trust as a central issue for the future development and sustainability of health policies. PMID:27602919

  7. Pain management and health care policy.

    PubMed

    Naccache, Nicole; Abou Zeid, Hicham; Nasser Ayoub, Eliane; Antakly, Marie-Claire

    2008-01-01

    Opioid analgesics are essential for the management of moderate to severe pain. In spite of their documented effectiveness, opioids are often underutilized, a factor which has contributed significantly to the undertreatment of pain. Many countries have developed true national policies on cancer pain and palliative care, and in others only guidelines for care have been developed. Ideally, national policies facilitate and legislate not only a patient's right to care, but also the necessary components of education and drug availability which are so critical for the appropriate achievement of public health programs. PMID:19534079

  8. Do Social and Economic Policies Influence Health? A Review

    PubMed Central

    Joshi, Pamela; Geronimo, Kimberly; Acevedo-Garcia, Dolores

    2014-01-01

    Although social and economic policies are not considered part of health services infrastructure, such policies may influence health and disease by altering social determinants of health (SDH). We review social and economic policies in the US that have measured health outcomes among adults in four domains of SDH including housing and neighborhood, employment, family strengthening/marriage, and income supplementation. The majority of these policies target low-income populations. These social policies rarely consider health as their initial mission or outcomes. When measuring health, the programs document mental health and physical health benefits more than half the time, although some effects fade with time. We also find considerable segregation of program eligibility by gender and family composition. Policy makers should design future social policies to evaluate health outcomes using validated health measures; to target women more broadly across the socioeconomic spectrum; and to consider family caregiving responsibilities as ignoring them can have unintended health effects. PMID:25984439

  9. [Towards a comprehensive policy for health workers].

    PubMed

    Becerra, Carlos; Herrera, Tania

    2014-11-27

    Health workers are crucial to the performance of a health system. Their situation is critical and this has been recognized as a global problem. The main challenges are their number, distribution, skills and performance conditions. Addressing these issues must necessarily involve a multifactorial, intersectoral and international approach, where determinant factors are: educational policies, forms of recruitment, permanency and termination of contract, issues that arise throughout their working cycle. In Chile, the management of health workers does not follow a comprehensive outlook. The type, number and distribution of technicians and professionals do not respond to a nationwide planning strategy, and there is no coordination between health authorities and universities. The result is that the system is not responding to the health needs of the population, nor is fulfilling the promise of a public service career that encourages good performance, investing in its human resources.

  10. [Towards a comprehensive policy for health workers].

    PubMed

    Becerra, Carlos; Herrera, Tania

    2014-01-01

    Health workers are crucial to the performance of a health system. Their situation is critical and this has been recognized as a global problem. The main challenges are their number, distribution, skills and performance conditions. Addressing these issues must necessarily involve a multifactorial, intersectoral and international approach, where determinant factors are: educational policies, forms of recruitment, permanency and termination of contract, issues that arise throughout their working cycle. In Chile, the management of health workers does not follow a comprehensive outlook. The type, number and distribution of technicians and professionals do not respond to a nationwide planning strategy, and there is no coordination between health authorities and universities. The result is that the system is not responding to the health needs of the population, nor is fulfilling the promise of a public service career that encourages good performance, investing in its human resources. PMID:25489843

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

    PubMed

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

    2013-03-01

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

  12. India's draft National Health Policy, 2015: Improving policy to implementation effectiveness.

    PubMed

    Menabde, Nata; Lahariya, Chandrakant

    2015-01-01

    As the Government of India is working on drafting a new National Health Policy, developing national health accounts, and planning for a "health assurance mission," this opportunity has the potential to transform health status of millions of Indians and achieve universal health coverage. The draft of new National Health Policy of India was put in public domain for comments in early 2015. This editorial reviews the draft National Health Policy 2015 and proposes a few steps to improve implementation effectiveness.

  13. Climate policy decisions require policy-based lifecycle analysis.

    PubMed

    Bento, Antonio M; Klotz, Richard

    2014-05-20

    Lifecycle analysis (LCA) metrics of greenhouse gas emissions are increasingly being used to select technologies supported by climate policy. However, LCAs typically evaluate the emissions associated with a technology or product, not the impacts of policies. Here, we show that policies supporting the same technology can lead to dramatically different emissions impacts per unit of technology added, due to multimarket responses to the policy. Using a policy-based consequential LCA, we find that the lifecycle emissions impacts of four US biofuel policies range from a reduction of 16.1 gCO2e to an increase of 24.0 gCO2e per MJ corn ethanol added by the policy. The differences between these results and representative technology-based LCA measures, which do not account for the policy instrument driving the expansion in the technology, illustrate the need for policy-based LCA measures when informing policy decision making.

  14. Health Policy Roundtable Panel Discussion: Translating Health Insurance Studies into Policy Proposals

    PubMed Central

    Folz, Christina E

    2004-01-01

    Researchers often wonder whether and how their studies are translated into policy or practice. AcademyHealth convened a roundtable of experts at the organization's 2003 Annual Research Meeting in Nashville to discuss how research on health insurance enters the policy process. The participants drew on their experience at the state, federal, and local levels to suggest ways that policy researchers can maximize the likelihood that their work will be used by decision-makers. The following report is based on the transcript from this 90-minute discussion; it captures the panel's answers to a series of questions posed by session-chair, Sherry Glied. PMID:15149472

  15. Public health policy research: making the case for a political science approach.

    PubMed

    Bernier, Nicole F; Clavier, Carole

    2011-03-01

    The past few years have seen the emergence of claims that the political determinants of health do not get due consideration and a growing demand for better insights into public policy analysis in the health research field. Several public health and health promotion researchers are calling for better training and a stronger research culture in health policy. The development of these studies tends to be more advanced in health promotion than in other areas of public health research, but researchers are still commonly caught in a naïve, idealistic and narrow view of public policy. This article argues that the political science discipline has developed a specific approach to public policy analysis that can help to open up unexplored levers of influence for public health research and practice and that can contribute to a better understanding of public policy as a determinant of health. It describes and critiques the public health model of policy analysis, analyzes political science's specific approach to public policy analysis, and discusses how the politics of research provides opportunities and barriers to the integration of political science's distinctive contributions to policy analysis in health promotion.

  16. Social Relationships and Health: A Flashpoint for Health Policy

    PubMed Central

    Umberson, Debra; Montez, Jennifer Karas

    2011-01-01

    Social relationships—both quantity and quality—affect mental health, health behavior, physical health, and mortality risk. Sociologists have played a central role in establishing the link between social relationships and health outcomes, identifying explanations for this link, and discovering social variation (e.g., by gender and race) at the population level. Studies show that social relationships have short- and long-term effects on health, for better and for worse, and that these effects emerge in childhood and cascade throughout life to foster cumulative advantage or disadvantage in health. This article describes key research themes in the study of social relationships and health, and it highlights policy implications suggested by this research. PMID:20943583

  17. The Utility of Case-Control Methods for Health Policy and Planning Analysis: An Illustration from Kinshasa, Zaire.

    ERIC Educational Resources Information Center

    Mock, Nancy B.; And Others

    1993-01-01

    The use of case-control methodology as an applied policy/planning research tool in assessing the potential effectiveness of behavioral interventions is studied in connection with diarrhea control in Zaire. Results with 107 matched pairs of children demonstrate the importance of hygiene-related knowledge and the utility of the research approach.…

  18. Health Inequalities Policy in Korea: Current Status and Future Challenges

    PubMed Central

    Lee, Sang-il

    2012-01-01

    In recent years, health inequalities have become an important public health concern and the subject of both research and policy attention in Korea. Government reports, as well as many epidemiological studies, have provided evidence that a wide range of health outcomes and health-related behaviors are socioeconomically patterned, and that the magnitude of health inequalities is even increasing. However, except for the revised Health Plan 2010 targets for health equity, few government policies have explicitly addressed health inequalities. Although a number of economic and social policies may have had an impact on health inequalities, such impact has scarcely been evaluated. In this review, we describe the current status of research and policy on health inequalities in Korea. We also suggest future challenges of approaches and policies to reduce health inequalities and highlight the active and intensive engagement of many policy sectors and good evidence for interventions that will make meaningful reduction of health inequalities possible. PMID:22661869

  19. Policy incongruence and public health professionals' dissonance: the case of immigrants and welfare policy.

    PubMed

    Quill, B E; Aday, L A; Hacker, C S; Reagan, J K

    1999-01-01

    The steady increase in immigrants to the United States has fueled a critical analysis of the process of allocation of health and social benefits to these newcomers. The myriad of interests and values surrounding this issue precipitated the formulation and adoption of the Personal Responsibility and Work Opportunity (Welfare Reform) Act of 1996. This dramatic welfare reform impacts federal, state, and local agencies that are required to determine the eligibility of benefits and manage the attendant consequences to the public as well as members of this vulnerable group. Especially challenging are the decisions confronting public health professionals who struggle to reconcile the resulting policy, programmatic mandates, and compliance imperatives with prevailing public health principles and practice norms. This paper proposes a framework for understanding the incongruence between the provisions of the law as it pertains to legal and illegal immigrants and public health values. The impact of policy incongruence and professionals' dissonance on public health practice norms is explored with an explicit focus on public health outcomes and legal implications. The examination of tuberculosis as a health example reveals the policy conflicts and public health dilemmas. Finally, the paper elicits a range of options available to public professionals for responding to these legal mandates.

  20. [A history of primary health care policy in the Federal District, Brazil (1960-2007): an analysis based on the theoretical framework of historical neo-institutionalism].

    PubMed

    Göttems, Leila Bernardo Donato; Evangelista, Maria do Socorro Nantua; Pires, Maria Raquel Gomes Maia; Silva, Aline Ferreira Melgaço da; Silva, Priscila Avelino da

    2009-06-01

    This article analyzes the history of primary health care policy in the Federal District, Brazil, based on the theoretical framework of historical neo-institutionalism, identifying the predominant configurations and trends in the various administrations of the State Health Secretariat (SES-DF) from 1960 to 2007. The study indicates that the characteristics of the Federal District's health policy are dependent on the history of the original health system plans for setting priorities and goals, as well as for the health system's implementation. This influence, in addition to the centralization of decision-making processes and limited political participation, can contribute to making primary care ancillary to hospital care, thus jeopardizing its potential to produce change in the health care model.

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

    PubMed Central

    Ivanova, Olena; Dræbel, Tania; Tellier, Siri

    2015-01-01

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

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

    PubMed

    Ogden, Jessica; Morrison, Ken; Hardee, Karen

    2014-12-01

    This article recounts the development of a model for social capital building developed over the course of interventions focused on HIV-related stigma and discrimination, safe motherhood and reproductive health. Through further engagement with relevant literature, it explores the nature of social capital and suggests why undertaking such a process can enhance health policy and programmes, advocacy and governance for improved health systems strengthening (HSS) outcomes. The social capital process proposed facilitates the systematic and effective inclusion of community voices in the health policy process-strengthening programme effectiveness as well as health system accountability and governance. Because social capital building facilitates communication and the uptake of new ideas, norms and standards within and between professional communities of practice, it can provide an important mechanism for integration both within and between sectors-a process long considered a 'wicked problem' for health policy-makers. The article argues that the systematic application of social capital building, from bonding through bridging into linking social capital, can greatly enhance the ability of governments and their partners to achieve their HSS goals. PMID:24277736

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

    PubMed

    Ogden, Jessica; Morrison, Ken; Hardee, Karen

    2014-12-01

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

  4. Nurse Practitioners, Physician Assistants, and Certified Nurse-Midwives: A Policy Analysis. Health Technology Case Study 37.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Office of Technology Assessment.

    This case study was conducted to analyze the cost-effectiveness of nurse practitioners (NPs), physicians' assistants (PAs), and certified nurse midwives (CNMs) by examining (1) the contributions of each group in meeting health-care needs; (2) the effect of changing the method of payment for their services on the health-care delivery system; and…

  5. Policy initiation and political levers in health policy: lessons from Ghana’s health insurance

    PubMed Central

    2012-01-01

    Background Understanding the health policy formulation process over the years has focused on the content of policy to the neglect of context. This had led to several policy initiatives having a still birth or ineffective policy choices with sub-optimal outcomes when implemented. Sometimes, the difficulty has been finding congruence between different values and interests of the various stakeholders. How can policy initiators leverage the various subtle mechanisms that various players draw on to leverage their interests during policy formulation. This paper attempts to conceptualise these levers of policy formulation to enhance an understanding of this field of work based on lived experience. Methodology This is a qualitative participant observation case study based on retrospective recollection of the policy process and political levers involved in developing the Ghana National Health Insurance Scheme. The study uses a four-concept framework which is agenda setting, symbols manipulation, constituency preservation and coalition building to capture the various issues, negotiations and nuanced approaches used in arriving at desired outcomes. Results Technical experts, civil society, academicians and politicians all had significant influence on setting the health insurance agenda. Each of these various stakeholders carefully engaged in ways that preserved their constituency interests through explicit manoeuvres and subtle engagements. Where proposals lend themselves to various interpretations, stakeholders were quick to latch on the contentious issues to preserve their constituency and will manipulate the symbols that arise from the proposals to their advantage. Where interests are contested and the price of losing out will leave government worse off which will favour its political opponent, it will push for divergent interests outside parliamentary politics through intense negotiations to build coalitions so a particular policy may pass. Conclusions This paper has

  6. Analysis of human resources for health strategies and policies in 5 countries in Sub-Saharan Africa, in response to GFATM and PEPFAR-funded HIV-activities

    PubMed Central

    2013-01-01

    Background Global Health Initiatives (GHIs), aiming at reducing the impact of specific diseases such as Human Immunodeficiency Virus (HIV), have flourished since 2000. Amongst these, PEPFAR and GFATM have provided a substantial amount of funding to countries affected by HIV, predominantly for delivery of antiretroviral therapy (ARV) and prevention strategies. Since the need for additional human resources for health (HRH) was not initially considered by GHIs, countries, to allow ARV scale-up, implemented short-term HRH strategies, adapted to GHI-funding conditionality. Such strategies differed from one country to another and slowly evolved to long-term HRH policies. The processes and content of HRH policy shifts in 5 countries in Sub-Saharan Africa were examined. Methods A multi-country study was conducted from 2007 to 2011 in 5 countries (Angola, Burundi, Lesotho, Mozambique and South Africa), to assess the impact of GHIs on the health system, using a mixed methods design. This paper focuses on the impact of GFATM and PEPFAR on HRH policies. Qualitative data consisted of semi-structured interviews undertaken at national and sub-national levels and analysis of secondary data from national reports. Data were analysed in order to extract countries’ responses to HRH challenges posed by implementation of HIV-related activities. Common themes across the 5 countries were selected and compared in light of each country context. Results In all countries successful ARV roll-out was observed, despite HRH shortages. This was a result of mostly short-term emergency response by GHI-funded Non-Governmental Organizations (NGOs) and to a lesser extent by governments, consisting of using and increasing available HRH for HIV tasks. As challenges and limits of short-term HRH strategies were revealed and HIV became a chronic disease, the 5 countries slowly implemented mid to long-term HRH strategies, such as formalisation of pilot initiatives, increase in HRH production and mitigation

  7. Education Policy Analysis Archives, 1998.

    ERIC Educational Resources Information Center

    Glass, Gene V., Ed.

    1998-01-01

    This document consists of the 21 articles published in the electronic journal "Education Policy Analysis Archives" for the year 1996. The articles are: (1) "The Political Legacy of School Accountability Systems" (Sherman Dorn); (2) "Review of Stephen Arons's 'Short Route to Chaos'" (Charles L. Glenn); (3) "Planting Land Mines in Common Ground: A…

  8. Technology Assessment and Policy Analysis

    ERIC Educational Resources Information Center

    Majone, Giandomenico

    1977-01-01

    Argues that the application of policy analysis to technology assessment requires the abandonment of stereotyped approaches and a reformulation of analytical paradigms to include consideration of institutional constraints. Available from: Elsevier Scientific Publishing Company, Box 211, Amsterdam, the Netherlands, single copies available.…

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

    PubMed

    Adams, Owen

    2015-09-04

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

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

    PubMed

    Adams, Owen

    2016-01-01

    Forest and colleagues have persuasively made the case that policy capacity is a fundamental prerequisite to health reform. They offer a comprehensive life-cycle definition of policy capacity and stress that it involves much more than problem identification and option development. I would like to offer a Canadian perspective. If we define health reform as re-orienting the health system from acute care to prevention and chronic disease management the consensus is that Canada has been unsuccessful in achieving a major transformation of our 14 health systems (one for each province and territory plus the federal government). I argue that 3 additional things are essential to build health policy capacity in a healthcare federation such as Canada: (a) A means of "policy governance" that would promote an approach to cooperative federalism in the health arena; (b) The ability to overcome the "policy inertia" resulting from how Canadian Medicare was implemented and subsequently interpreted; and (c) The ability to entertain a long-range thinking and planning horizon. My assessment indicates that Canada falls short on each of these items, and the prospects for achieving them are not bright. However, hope springs eternal and it will be interesting to see if the July, 2015 report of the Advisory Panel on Healthcare Innovation manages to galvanize national attention and stimulate concerted action. PMID:26673650

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

    ERIC Educational Resources Information Center

    Centers for Disease Control and Prevention, 2007

    2007-01-01

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

  12. Scandals in health-care: their impact on health policy and nursing.

    PubMed

    Hutchison, Jacqueline S

    2016-03-01

    Through an analysis of several high-profile scandals in health-care in the UK, this article discusses the nature of scandal and its impact on policy reform. The nursing profession is compared to social work and medicine, which have also undergone considerable examination and change as a result of scandals. The author draws on reports from public inquiries from 1945 to 2013 to form the basis of the discussion about policy responses following scandals in health-care. In each case, the nature of the scandal, the public and government discourses generated by events and the policy response to those failings are explored. These scandals are compared to the recent scandal at Mid Staffordshire Hospital. Conclusions are drawn about the impact of these events on the future of the profession and on health policy directions. Recent events have raised public anxieties about caring practices in nursing. Health policy reform driven by scandal may obscure the effect of under resourcing in health services and poses a very real threat to the continued support for state-run services. Understanding the socially constructed nature of scandal enables the nurse to develop a greater critical awareness of policy contexts in order that they can influence health service reform.

  13. Evidence-Based Health Policy: A Preliminary Systematic Review

    ERIC Educational Resources Information Center

    Morgan, Gareth

    2010-01-01

    Objective: The development of evidence-based health policy is challenging. This study has attempted to identify some of the underpinning factors that promote the development of evidence based health policy. Methods: A preliminary systematic literature review of published reviews with "evidence based health policy" in their title was conducted…

  14. Universal financial protection through National Health Insurance: a stakeholder analysis of the proposed one-time premium payment policy in Ghana.

    PubMed

    Abiiro, Gilbert Abotisem; McIntyre, Di

    2013-05-01

    Extending coverage to the informal sector is a key challenge to achieving universal coverage through contributory health insurance schemes. Ghana introduced a mandatory National Health Insurance system in 2004 to provide financial protection for both the formal and informal sectors through a combination of taxes and annual premium payments. As part of its election promise in 2008, the current government (then in opposition) promised to make the payment of premiums 'one-time'. This has been a very controversial policy issue in Ghana. This study sought to contribute to assessing the feasibility of the proposed policy by exploring the understandings of various stakeholders on the policy, their interests or concerns, potential positions, power and influences on it, as well as the general prospects and challenges for its implementation. Data were gathered from a review of relevant documents in the public domain, 28 key informant interviews and six focus group discussions with key stakeholders in Accra and two other districts. The results show that there is a lot of confusion in stakeholders' understanding of the policy issue, and, because of the uncertainties surrounding it, most powerful stakeholders are yet to take clear positions on it. However, stakeholders raised concerns that revolved around issues such as: the meaning of a one-time premium within an insurance scheme context, the affordability of the one-time premium, financing sources and sustainability of the policy, as well as the likely impact of the policy on equity in access to health care. Policy-makers need to clearly explain the meaning of the one-time premium policy and how it will be funded, and critically consider the concerns raised by stakeholders before proceeding with further attempts to implement it. For other countries planning universal coverage reforms, it is important that the terminology of their reforms clearly reflects policy objectives.

  15. Learning from the best: the benefits of a structured health policy fellowship in developing nursing health policy leaders.

    PubMed

    Hofler, Linda D

    2006-05-01

    This article describes the experience of a nurse leader engaged in a state Health Policy Fellowship instituted in North Carolina by the North Carolina Center for Nursing (NCCN). This Health Policy Fellowship is designed to provide a focused practicum in major aspects of state-level health policy with emphasis on the role of the nurse leader. The program design includes exposure to experienced mentors with diverse areas of focus to learn from observation and interaction. This article describes the experience of a state Health Policy Fellow and includes discussion of understandings derived from interacting with key state stakeholders in the health policy arena and pearls of wisdom from the policy fellowship experience.

  16. School Policy and Environment: Results from the School Health Policies and Programs Study 2000.

    ERIC Educational Resources Information Center

    Small, Meg L.; Jones, Sherry Everett; Barrios, Lisa C.; Crossett, Linda S.; Dahlberg, Linda L.; Albuquerque, Melissa S.; Sleet, David A.; Greene, Brenda Z.; Schmidt, Ellen R.

    2001-01-01

    Uses data from the School Health Policies and Programs Study 2000 to describe state- and district-level policy support and coordination and state- and district-level policies regarding school environment, injury prevention, and substance use and violence prevention, noting school-level policies and practices in those areas, policies to inform…

  17. Exploring perceptions of community health policy in Kenya and identifying implications for policy change

    PubMed Central

    McCollum, Rosalind; Otiso, Lilian; Mireku, Maryline; Theobald, Sally; de Koning, Korrie; Hussein, Salim; Taegtmeyer, Miriam

    2016-01-01

    Background: Global interest and investment in close-to-community health services is increasing. Kenya is currently revising its community health strategy (CHS) alongside political devolution, which will result in revisioning of responsibility for local services. This article aims to explore drivers of policy change from key informant perspectives and to study perceptions of current community health services from community and sub-county levels, including perceptions of what is and what is not working well. It highlights implications for managing policy change. Methods: We conducted 40 in-depth interviews and 10 focus group discussions with a range of participants to capture plural perspectives, including those who will influence or be influenced by CHS policy change in Kenya (policymakers, sub-county health management teams, facility managers, community health extension worker (CHEW), community health workers (CHWs), clients and community members) in two purposively selected counties: Nairobi and Kitui. Qualitative data were digitally recorded, transcribed, translated and coded before framework analysis. Results: There is widespread community appreciation for the existing strategy. High attrition, lack of accountability for voluntary CHWs and lack of funds to pay CHW salaries, combined with high CHEW workload were seen as main drivers for strategy change. Areas for change identified include: lack of clear supervisory structure including provision of adequate travel resources, current uneven coverage and equity of community health services, limited community knowledge about the strategy revision and demand for home-based HIV testing and counselling. Conclusion: This in-depth analysis which captures multiple perspectives results in robust recommendations for strategy revision informed by the Five Wonders of Change Framework. These recommendations point towards a more people-centred health system for improved equity and effectiveness and indicate priority

  18. Pathways to the Use of Health Services Research in Policy

    PubMed Central

    Gold, Marsha

    2009-01-01

    Objective To apply social science theory so as to define more explicitly the pathways that influence policy makers' use of health services research. Methods The analysis builds on a literature review and the author's observations. It identifies important social science concepts relevant to use of research in policy and organizational decision making. It integrates and expands upon existing frameworks to differentiate and analyze 10 pathways that can lead to the use of health services research by policy makers. Principal Findings The process through which research is applied involves many factors, only some of which are amenable to influence by researchers. Within these constraints, multiple pathways can drive research use; no one of these is likely to perform better in all circumstances. Successful uptake is more likely when these pathways cause findings to be converted into messages meaningful to policy makers. Various intermediaries play an important role in creating effective pathways, while users also can influence them. Conclusions The pathways open up what too often is an unexplored “black box” that mediates between health services research and its use by policy makers. Such pathways can help stakeholders to bridge different perspectives in ways that strengthen the possibility that effective research will be supported and used. PMID:19490163

  19. Studying policy implementation using a macro, meso and micro frame analysis: the case of the Collaboration for Leadership in Applied Health Research & Care (CLAHRC) programme nationally and in North West London

    PubMed Central

    2012-01-01

    Background The publication of Best research for best health in 2006 and the “ring-fencing” of health research funding in England marked the start of a period of change for health research governance and the structure of research funding in England. One response to bridging the ‘second translational gap’ between research knowledge and clinical practice was the establishment of nine Collaborations for Leadership in Applied Health Research and Care (CLAHRCs). The goal of this paper is to assess how national-level understanding of the aims and objectives of the CLAHRCs translated into local implementation and practice in North West London. Methods This study uses a variation of Goffman’s frame analysis to trace the development of the initial national CLAHRC policy to its implementation at three levels. Data collection and analysis were qualitative through interviews, document analysis and embedded research. Results Analysis at the macro (national policy), meso (national programme) and micro (North West London) levels shows a significant common understanding of the aims and objectives of the policy and programme. Local level implementation in North West London was also consistent with these. Conclusions The macro-meso-micro frame analysis is a useful way of studying the transition of a policy from high-level idea to programme in action. It could be used to identify differences at a local (micro) level in the implementation of multi-site programmes that would help understand differences in programme effectiveness. PMID:23067208

  20. Communicating contentious health policy: lessons from Ireland's workplace smoking ban.

    PubMed

    Fahy, Declan; Trench, Brian; Clancy, Luke

    2012-05-01

    The Irish workplace smoking ban has been described as possibly a tipping point for public health worldwide. This article presents the first analysis of the newspaper coverage of the ban over the duration of the policy formation process. It adds to previous studies by analyzing how health communication strategists engaged, over time, with a newsworthy topic, viewed as being culturally controversial. It analyzes a sample of media content (n = 1,154) and firsthand accounts from pro-ban campaigners and journalists (n = 10). The analysis shows that the ban was covered not primarily as a health issue: Economic, political, social, democratic, and technical aspects also received significant attention. It shows how coverage followed controversy and examines how pro-ban campaigners countered effectively the anti-ban communication efforts of influential social actors in the economic and political spheres. The analysis demonstrates that medical-political sources successfully defined the ban's issues as centrally concerned with public health.

  1. Immigrant workers: health, law, and public policy.

    PubMed

    Guttmacher, S

    1984-01-01

    Immigrant workers are a large segment of the lower echelon of the U.S. labor force, and as many as 3.6 to 6 million of these workers and their families are living in the U.S. illegally. This paper examines who the recent immigrants are: explains why their current situation in the U.S. is an important public health matter; discusses the ethical and policy issues stemming from their health needs and from illegal status; and concludes with a brief look at some implications of the Simpson-Mazzoli Immigration and Reform Act, currently before Congress. The paper suggests that the illegal status of undocumented workers intensifies their health risks; that the immigrants' responsibility for budget short-falls in public services is not as clearcut as frequently assumed; and that legislation aimed at regulating the status of immigrant workers in the U.S. is unlikely to solve many of the central problems.

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

    PubMed

    Chávez-Alvarado, Susana

    2013-07-01

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

  3. 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

  4. Rhetorical Analysis in Critical Policy Research

    ERIC Educational Resources Information Center

    Winton, Sue

    2013-01-01

    Rhetorical analysis, an approach to critical discourse analysis, is presented as a useful method for critical policy analysis and its effort to understand the role policies play in perpetuating inequality. A rhetorical analysis of Character "Matters!", the character education policy of a school board in Ontario, Canada, provides an…

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

    PubMed

    Brindis, Claire D; Moore, Kristin

    2014-01-01

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

  6. Health Care Reform for Children with Public Coverage: How Can Policymakers Maximize Gains and Prevent Harm? Timely Analysis of Immediate Health Policy Issues

    ERIC Educational Resources Information Center

    Kenney, Genevieve M.; Dorn, Stan

    2009-01-01

    Moving toward universal coverage has the potential to increase access to care and improve the health and well-being of uninsured children and adults. The effects of health care reform on the more than 25 million children who currently have coverage under Medicaid or the Children's Health Insurance Program (CHIP) are less clear. Increased parental…

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

    PubMed

    Selway, Joel Sawat

    2011-01-01

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

  8. A Practical Method of Policy Analysis by Simulating Policy Options

    ERIC Educational Resources Information Center

    Phelps, James L.

    2011-01-01

    This article focuses on a method of policy analysis that has evolved from the previous articles in this issue. The first section, "Toward a Theory of Educational Production," identifies concepts from science and achievement production to be incorporated into this policy analysis method. Building on Kuhn's (1970) discussion regarding paradigms, the…

  9. The Role of Health Co-Benefits in the Development of Australian Climate Change Mitigation Policies

    PubMed Central

    Workman, Annabelle; Blashki, Grant; Karoly, David; Wiseman, John

    2016-01-01

    Reducing domestic carbon dioxide and other associated emissions can lead to short-term, localized health benefits. Quantifying and incorporating these health co-benefits into the development of national climate change mitigation policies may facilitate the adoption of stronger policies. There is, however, a dearth of research exploring the role of health co-benefits on the development of such policies. To address this knowledge gap, research was conducted in Australia involving the analysis of several data sources, including interviews carried out with Australian federal government employees directly involved in the development of mitigation policies. The resulting case study determined that, in Australia, health co-benefits play a minimal role in the development of climate change mitigation policies. Several factors influence the extent to which health co-benefits inform the development of mitigation policies. Understanding these factors may help to increase the political utility of future health co-benefits studies. PMID:27657098

  10. Humanization policy in primary health care: a systematic review

    PubMed Central

    Nora, Carlise Rigon Dalla; Junges, José Roque

    2013-01-01

    OBJECTIVE To analyze humanization practices in primary health care in the Brazilian Unified Health System according to the principles of the National Humanization Policy. METHODS A systematic review of the literature was carried out, followed by a meta-synthesis, using the following databases: BDENF (nursing database), BDTD (Brazilian digital library of theses and dissertations), CINAHL (Cumulative Index to nursing and allied health literature), LILACS (Latin American and Caribbean health care sciences literature), MedLine (International health care sciences literature), PAHO (Pan-American Health Care Organization Library) and SciELO (Scientific Electronic Library Online). The following descriptors were used: Humanization; Humanizing Health Care; Reception: Humanized care: Humanization in health care; Bonding; Family Health Care Program; Primary Care; Public Health and Sistema Único de Saúde (the Brazilian public health care system). Research articles, case studies, reports of experiences, dissertations, theses and chapters of books written in Portuguese, English or Spanish, published between 2003 and 2011, were included in the analysis. RESULTS Among the 4,127 publications found on the topic, 40 studies were evaluated and included in the analysis, producing three main categories: the first referring to the infrastructure and organization of the primary care service, made clear the dissatisfaction with the physical structure and equipment of the services and with the flow of attendance, which can facilitate or make difficult the access. The second, referring to the health work process, showed issues about the insufficient number of professionals, fragmentation of the work processes, the professional profile and responsibility. The third category, referring to the relational technologies, indicated the reception, bonding, listening, respect and dialog with the service users. CONCLUSIONS Although many practices were cited as humanizing they do not produce changes

  11. How Australia came to have a National Women's Health Policy.

    PubMed

    Gray, G

    1998-01-01

    A National Women's Health Policy was launched in Australia in 1989, and Australia became the only country to have a comprehensive policy on women's health. The policy is intended to provide a framework for decision-making in both mainstream and separate women's health services. The author examines the forces and factors that led to the formulation and adoption of the policy, then addresses the question of why Australia is alone in choosing a national policy as a focus for women's health action. A number of key influences, either absent or weaker in comparable countries, worked together to facilitate policy development. The activities of women working in a number of arenas coincided with the election of relatively supportive governments, creation of women's policy machinery in bureaucracies, employment of feminists in key positions, and opportunities for policy expansion afforded by federalism. These influences, within the Australian ideological context of strong support for social liberalism, account for the country's distinctive policy position.

  12. 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

  13. 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

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

    PubMed

    Goic, Alejando; Armas, Rodolfo

    2010-12-01

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

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

    PubMed

    Labonté, Ronald

    2014-06-01

    Health in All Policies (HiAP) approach is generally perceived as an intersectoral approach to national or sub-national public policy development, such that health outcomes are given full consideration by non-health sectors. Globalization, however, has created numerous 'inherently global health issues' with cross-border causes and consequences, requiring new forms of global governance for health. Although such governance often includes both state and non-state (private, civil society) actors in agenda setting and influence, different actors have differing degrees of power and authority and, ultimately, it is states that ratify intergovernmental covenants or normative declarations that directly or indirectly affect health. This requires public health and health promotion practitioners working within countries to give increased attention to the foreign policies of their national governments. These foreign policies include those governing national security, foreign aid, trade and investment as well as the traditional forms of diplomacy. A new term has been coined to describe how health is coming to be positioned in governments' foreign policies: global health diplomacy. To become adept at this nuanced diplomatic practice requires familiarity with the different policy frames by which health might be inserted into the foreign policy deliberations, and thence intergovernmental/global governance negotiations. This article discusses six such frames (security, trade, development, global public goods, human rights, ethical/moral reasoning) that have been analytically useful in assessing the potential for greater and more health-promoting foreign policy coherence: a 'Health in All (Foreign) Policies' approach. PMID:25217356

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

    PubMed

    Labonté, Ronald

    2014-06-01

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

  17. Towards Health in All Policies for Childhood Obesity Prevention

    PubMed Central

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

    2013-01-01

    The childhood obesity epidemic can be best tackled by means of an integrated approach, which is enabled by integrated public health policies, or Health in All Policies. Integrated policies are developed through intersectoral collaboration between local government policy makers from health and nonhealth sectors. Such intersectoral collaboration has been proved to be difficult. In this study, we investigated which resources influence intersectoral collaboration. The behavior change wheel framework was used to categorize motivation-, capability-, and opportunity-related resources for intersectoral collaboration. In-depth interviews were held with eight officials representing 10 non-health policy sectors within a local government. Results showed that health and non-health policy sectors did not share policy goals, which decreased motivation for intersectoral collaboration. Awareness of the linkage between health and nonhealth policy sectors was limited, and management was not involved in creating such awareness, which reduced the capability for intersectoral collaboration. Insufficient organizational resources and structures reduced opportunities for intersectoral collaboration. To stimulate intersectoral collaboration to prevent childhood obesity, we recommend that public health professionals should reframe health goals in the terminology of nonhealth policy sectors, that municipal department managers should increase awareness of public health in non-health policy sectors, and that flatter organizational structures should be established. PMID:24490059

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

    PubMed

    Tesler, Laura E; Malone, Ruth E

    2008-12-01

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

  19. The concept of stewardship in health policy.

    PubMed Central

    Saltman, R. B.; Ferroussier-Davis, O.

    2000-01-01

    There is widespread agreement that both the configuration and the application of state authority in the health sector should be realigned in the interest of achieving agreed policy objectives. The desired outcome is frequently characterized as a search for good governance serving the public interest. The present paper examines the proposal in The World Health Report 2000 that the concept of stewardship offers the appropriate basis for reconfiguration. We trace the development of stewardship from its initial religious formulation to more recent ecological and sociological permutations. Consideration is given to the potential of stewardship for encouraging state decision-making that is both normatively based and economically efficient. Various dilemmas that could impede or preclude such a shift in state behaviour are examined. We conclude that the concept of stewardship holds substantial promise if adequately developed and effectively implemented. PMID:10916910

  20. Corporate Philanthropy, Lobbying, and Public Health Policy

    PubMed Central

    Tesler, Laura E.

    2008-01-01

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

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

    PubMed Central

    Owen, John Wyn; Roberts, Olivia

    2005-01-01

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

  2. Advanced health biotechnologies in Thailand: redefining policy directions

    PubMed Central

    2013-01-01

    Background Thailand faces a significant burden in terms of treating and managing degenerative and chronic diseases. Moreover, incidences of rare diseases are rising. Many of these—such as diabetes, cancer, and inherited inborn metabolic diseases—have no definite treatments or cure. Meanwhile, advanced health biotechnology has been found, in principle, to be an effective solution for these health problems. Methods Qualitative approaches were employed to analyse the current situation and examine existing public policies related to advanced health biotechnologies in Thailand. The results of this analysis were then used to formulate policy recommendations. Results Our research revealed that the system in Thailand in relation to advanced health biotechnologies is fragmented, with multiple unaddressed gaps, underfunding of research and development (R&D), and a lack of incentives for the private sector. In addition, there are no clear definitions of advanced health biotechnologies, and coverage pathways are absent. Meanwhile, false advertising and misinformation are prevalent, with no responsible bodies to actively and effectively provide appropriate information and education (I&E). The establishment of a specialised institution to fill the gaps in this area is warranted. Conclusion The development and implementation of a comprehensive national strategic plan related to advanced health biotechnologies, greater investment in R&D and I&E for all stakeholders, collaboration among agencies, harmonisation of reimbursement across public health schemes, and provision of targeted I&E are specifically recommended. PMID:23281771

  3. Trends in public health policies addressing violence against women

    PubMed Central

    Loría, Kattia Rojas; Rosado, Teresa Gutiérrez; Espinosa, Leonor María Cantera; Marrochi, Leda María Marenco; Sánchez, Anna Fernández

    2014-01-01

    OBJECTIVE To analyze the content of policies and action plans within the public healthcare system that addresses the issue of violence against women. METHODS A descriptive and comparative study was conducted on the health policies and plans in Catalonia and Costa Rica from 2005 to 2011. It uses a qualitative methodology with documentary analysis. It is classified by topics that describe and interpret the contents. We considered dimensions, such as principles, strategies, concepts concerning violence against women, health trends, and evaluations. RESULTS Thirteen public policy documents were analyzed. In both countries’ contexts, we have provided an overview of violence against women as a problem whose roots are in gender inequality. The strategies of gender policies that address violence against women are cultural exchange and institutional action within the public healthcare system. The actions of the healthcare sector are expanded into specific plans. The priorities and specificity of actions in healthcare plans were the distinguishing features between the two countries. CONCLUSIONS The common features of the healthcare plans in both the counties include violence against women, use of protocols, detection tasks, care and recovery for women, and professional self-care. Catalonia does not consider healthcare actions with aggressors. Costa Rica has a lower specificity in conceptualization and protocol patterns, as well as a lack of updates concerning health standards in Catalonia. PMID:25210820

  4. Pay scheme preferences and health policy objectives.

    PubMed

    Abelsen, Birgit

    2011-04-01

    This paper studies the preferences among healthcare workers towards pay schemes involving different levels of risk. It identifies which pay scheme individuals would prefer for themselves, and which they think is best in furthering health policy objectives. The paper adds, methodologically, a way of defining pay schemes that include different levels of risk. A questionnaire was mailed to a random sample of 1111 dentists. Respondents provided information about their current and preferred pay schemes, and indicated which pay scheme, in their opinion, would best further overall health policy objectives. A total of 504 dentists (45%) returned the questionnaire, and there was no indication of systematic non-response bias. All public dentists had a current pay scheme based on a fixed salary and the majority of individuals preferred a pay scheme with more income risk. Their preferred pay schemes coincided with the ones believed to further stabilise healthcare personnel. The predominant current pay scheme among private dentists was based solely on individual output, and the majority of respondents preferred this pay scheme. In addition, their preferred pay schemes coincided with the ones believed to further efficiency objectives. Both public and private dentists believed that pay schemes, furthering efficiency objectives, had to include more performance-related pay than the ones believed to further stability and quality objectives. PMID:20565995

  5. Learning Relational Policies from Electronic Health Record Access Logs

    PubMed Central

    Malin, Bradley; Nyemba, Steve; Paulett, John

    2011-01-01

    Modern healthcare organizations (HCOs) are composed of complex dynamic teams to ensure clinical operations are executed in a quick and competent manner. At the same time, the fluid nature of such environments hinders administrators' efforts to define access control policies that appropriately balance patient privacy and healthcare functions. Manual efforts to define these policies are labor-intensive and error-prone, often resulting in systems that endow certain care providers with overly broad access to patients' medical records while restricting other providers from legitimate and timely use. In this work, we propose an alternative method to generate these policies by automatically mining usage patterns from electronic health record (EHR) systems. EHR systems are increasingly being integrated into clinical environments and our approach is designed to be generalizable across HCOs, thus assisting in the design and evaluation of local access control policies. Our technique, which is grounded in data mining and social network analysis theory, extracts a statistical model of the organization from the access logs of its EHRs. In doing so, our approach enables the review of predefined policies, as well as the discovery of unknown behaviors. We evaluate our approach with five months of access logs from the Vanderbilt University Medical Center and confirm the existence of stable social structures and intuitive business operations. Additionally, we demonstrate that there is significant turnover in the interactions between users in the HCO and that policies learned at the department level afford greater stability over time. PMID:21277996

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

    PubMed

    Yoder, Karen M; Edelstein, Burton L

    2012-12-01

    This article describes the planning, sequential improvements, and outcomes of Indiana University School of Dentistry's annual Oral Health Policy Forum. This one-day forum for fourth-year dental students was instituted in 2005 with the Indiana Dental Association and the Children's Dental Health Project to introduce students to the health policy process and to encourage their engagement in advocacy. Following a keynote by a visiting professor, small student groups develop arguments in favor and in opposition to five oral health policy scenarios and present their positions to a mock or authentic legislator. The "legislator" critiques these presentations, noting both effective and ineffective approaches, and the student deemed most effective by fellow students receives a gift award. During the afternoon, students tour the Indiana State House, observe deliberations, and meet with legislators. In 2009, 92 percent of students reported a positive impression of the forum, up from 60 percent in 2005. Half (49 percent) in 2009 indicated that they were more inclined to become involved with the political process following the forum, up from 21 percent in 2005. Dental students' feedback became increasingly positive as the program was refined and active learning opportunities were enhanced. This model for engaging students in policy issues important to their professional careers is readily replicable by other dental schools. PMID:23225676

  7. 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

  8. Methods: School Health Policies and Programs Study 2006

    ERIC Educational Resources Information Center

    Kyle, Tonja M.; Brener, Nancy D.; Kann, Laura; Ross, James G.; Roberts, Alice M.; Iachan, Ronaldo; Robb, William H.; McManus, Tim

    2007-01-01

    Background: The School Health Policies and Programs Study (SHPPS) 2006 examined 8 components of school health programs: health education, physical education and activity, health services, mental health and social services, nutrition services, healthy and safe school environment, faculty and staff health promotion, and family and community…

  9. Distributional impact of recent changes in private health insurance policies.

    PubMed

    Walker, Agnes; Percival, Richard; Thurecht, Linc; Pearse, James

    2005-05-01

    The impacts of changes to private health insurance (PHI) policies introduced since 1999 - in particular the 30% PHI rebate and the Lifetime Health Cover - have been much debated. We present historical analyses of the impacts in terms of the proportion of Australians having hospital insurance cover under different PHI policies, by age, gender and socioeconomic status, and project these to 2010 using a new Private Health Insurance coverage model. The combined effect of the 30% rebate and Lifetime Health Cover was to increase PHI membership from just over 30% in 1998 to just under 50% by the end of 2000, due mainly to more people taking out PHI cover from among the richest 20% of the population. Among the poorest 40% the impact was minimal. Model projections suggested that, had the new PHI policies not been introduced, then the proportion of Australians with PHI would have declined to around 20% by 2010, compared with 40% if the current arrangements remained in place. Also, analysis of 2001 survey data regarding choices to use a public or a private hospital indicated that higher income groups with or without PHI were the more likely to have used a private hospital than lower income groups. Among those with PHI, older people were more likely to have used a private hospital than younger ones.

  10. Do academic knowledge brokers exist? Using social network analysis to explore academic research-to-policy networks from six schools of public health in Kenya.

    PubMed

    Jessani, Nasreen S; Boulay, Marc G; Bennett, Sara C

    2016-06-01

    The potential for academic research institutions to facilitate knowledge exchange and influence evidence-informed decision-making has been gaining ground. Schools of public health (SPHs) may play a key knowledge brokering role-serving as agencies of and for development. Understanding academic-policymaker networks can facilitate the enhancement of links between policymakers and academic faculty at SPHs, as well as assist in identifying academic knowledge brokers (KBs). Using a census approach, we administered a sociometric survey to academic faculty across six SPHs in Kenya to construct academic-policymaker networks. We identified academic KBs using social network analysis (SNA) in a two-step approach: First, we ranked individuals based on (1) number of policymakers in their network; (2) number of academic peers who report seeking them out for advice on knowledge translation and (3) their network position as 'inter-group connectors'. Second, we triangulated the three scores and re-ranked individuals. Academic faculty scoring within the top decile across all three measures were classified as KBs. Results indicate that each SPH commands a variety of unique as well as overlapping relationships with national ministries in Kenya. Of 124 full-time faculty, we identified 7 KBs in 4 of the 6 SPHs. Those scoring high on the first measure were not necessarily the same individuals scoring high on the second. KBs were also situated in a wide range along the 'connector/betweenness' measure. We propose that a composite score rather than traditional 'betweenness centrality', provides an alternative means of identifying KBs within these networks. In conclusion, SNA is a valuable tool for identifying academic-policymaker networks in Kenya. More efforts to conduct similar network studies would permit SPH leadership to identify existing linkages between faculty and policymakers, shared linkages with other SPHs and gaps so as to contribute to evidence-informed health policies. PMID

  11. Do academic knowledge brokers exist? Using social network analysis to explore academic research-to-policy networks from six schools of public health in Kenya.

    PubMed

    Jessani, Nasreen S; Boulay, Marc G; Bennett, Sara C

    2016-06-01

    The potential for academic research institutions to facilitate knowledge exchange and influence evidence-informed decision-making has been gaining ground. Schools of public health (SPHs) may play a key knowledge brokering role-serving as agencies of and for development. Understanding academic-policymaker networks can facilitate the enhancement of links between policymakers and academic faculty at SPHs, as well as assist in identifying academic knowledge brokers (KBs). Using a census approach, we administered a sociometric survey to academic faculty across six SPHs in Kenya to construct academic-policymaker networks. We identified academic KBs using social network analysis (SNA) in a two-step approach: First, we ranked individuals based on (1) number of policymakers in their network; (2) number of academic peers who report seeking them out for advice on knowledge translation and (3) their network position as 'inter-group connectors'. Second, we triangulated the three scores and re-ranked individuals. Academic faculty scoring within the top decile across all three measures were classified as KBs. Results indicate that each SPH commands a variety of unique as well as overlapping relationships with national ministries in Kenya. Of 124 full-time faculty, we identified 7 KBs in 4 of the 6 SPHs. Those scoring high on the first measure were not necessarily the same individuals scoring high on the second. KBs were also situated in a wide range along the 'connector/betweenness' measure. We propose that a composite score rather than traditional 'betweenness centrality', provides an alternative means of identifying KBs within these networks. In conclusion, SNA is a valuable tool for identifying academic-policymaker networks in Kenya. More efforts to conduct similar network studies would permit SPH leadership to identify existing linkages between faculty and policymakers, shared linkages with other SPHs and gaps so as to contribute to evidence-informed health policies.

  12. Do academic knowledge brokers exist? Using social network analysis to explore academic research-to-policy networks from six schools of public health in Kenya

    PubMed Central

    Jessani, Nasreen S; Boulay, Marc G; Bennett, Sara C

    2016-01-01

    The potential for academic research institutions to facilitate knowledge exchange and influence evidence-informed decision-making has been gaining ground. Schools of public health (SPHs) may play a key knowledge brokering role—serving as agencies of and for development. Understanding academic-policymaker networks can facilitate the enhancement of links between policymakers and academic faculty at SPHs, as well as assist in identifying academic knowledge brokers (KBs). Using a census approach, we administered a sociometric survey to academic faculty across six SPHs in Kenya to construct academic-policymaker networks. We identified academic KBs using social network analysis (SNA) in a two-step approach: First, we ranked individuals based on (1) number of policymakers in their network; (2) number of academic peers who report seeking them out for advice on knowledge translation and (3) their network position as ‘inter-group connectors’. Second, we triangulated the three scores and re-ranked individuals. Academic faculty scoring within the top decile across all three measures were classified as KBs. Results indicate that each SPH commands a variety of unique as well as overlapping relationships with national ministries in Kenya. Of 124 full-time faculty, we identified 7 KBs in 4 of the 6 SPHs. Those scoring high on the first measure were not necessarily the same individuals scoring high on the second. KBs were also situated in a wide range along the ‘connector/betweenness’ measure. We propose that a composite score rather than traditional ‘betweenness centrality’, provides an alternative means of identifying KBs within these networks. In conclusion, SNA is a valuable tool for identifying academic-policymaker networks in Kenya. More efforts to conduct similar network studies would permit SPH leadership to identify existing linkages between faculty and policymakers, shared linkages with other SPHs and gaps so as to contribute to evidence-informed health

  13. An activist looks at nursing's role in health policy development.

    PubMed

    Ferguson, S L

    2001-01-01

    Health care delivery systems are evolving and transforming rapidly. Nurses will need new leadership and policy skills to meet the challenge of ensuring patient care safety and quality health care delivery. Nurses bring a unique perspective to health care policy development because of their educational training, professional values and ethics, advocacy skills, and experiential background. Significant progress has occurred over the years toward advancing nursing's presence, role, and influence in the development of health care policy. However, more nurses need to learn how to identify issues strategically; work with decision makers; understand who holds the power in the workplace, communities, state and federal level organizations; and understand who controls the resources for health care services. In health care policy development, nurses are essential in ensuring quality health care that is accessible and affordable for all women and their infants. More nurses need to actively work as leaders in the health policy arena. PMID:11572536

  14. Policy Recommendations for Health Professions Education. Item #7.

    ERIC Educational Resources Information Center

    Illinois State Board of Higher Education, Springfield.

    This report presents recommendations for Illinois' Board of Higher Education's approval in the areas of: (1) general policies for health professions education, (2) the adoption of immediate program priorities to implement the general policy directions in health education programs, and (3) specific recommendations for adjustments in Health Services…

  15. Availability, consistency and evidence-base of policies and guidelines on the use of mask and respirator to protect hospital health care workers: a global analysis

    PubMed Central

    2013-01-01

    Background Currently there is an ongoing debate and limited evidence on the use of masks and respirators for the prevention of respiratory infections in health care workers (HCWs). This study aimed to examine available policies and guidelines around the use of masks and respirators in HCWs and to describe areas of consistency between guidelines, as well as gaps in the recommendations, with reference to the WHO and the CDC guidelines. Methods Policies and guidelines related to mask and respirator use for the prevention of influenza, SARS and TB were examined. Guidelines from the World Health Organization (WHO), the Center for Disease Control and Prevention (CDC), three high-income countries and six low/middle-income countries were selected. Results Uniform recommendations are made by the WHO and the CDC in regards to protecting HCWs against seasonal influenza (a mask for low risk situations and a respirator for high risk situations) and TB (use of a respirator). However, for pandemic influenza and SARS, the WHO recommends mask use in low risk and respirators in high risk situations, whereas, the CDC recommends respirators in both low and high risk situations. Amongst the nine countries reviewed, there are variations in the recommendations for all three diseases. While, some countries align with the WHO recommendations, others align with those made by the CDC. The choice of respirator and the level of filtering ability vary amongst the guidelines and the different diseases. Lastly, none of the policies discuss reuse, extended use or the use of cloth masks. Conclusion Currently, there are significant variations in the policies and recommendations around mask and respirator use for protection against influenza, SARS and TB. These differences may reflect the scarcity of level-one evidence available to inform policy development. The lack of any guidelines on the use of cloth masks, despite widespread use in many low and middle-income countries, remains a policy gap

  16. The role of health education in public policy development.

    PubMed

    Steckler, A; Dawson, L

    1982-01-01

    Health educators should view policy development as a unit of professional practice analogous to the individual, the small group, the community, and the organization. The impact of policy on other units of practice and on people served by health educators is too great and the competition for scarce resources for health and human services is too keen to be disregarded. An increasingly active role in the policy process is, therefore, vital to the profession. Unfortunately, many health educators find an active role strange and lack guidelines for effective policy intervention. This paper attempts to mediate that situation. First a conceptual framework is offered. Operational definitions of important terms are given, including policy, public policy, social policy, health policy, and health education policy. A model of the policy development process is presented, detailing the purpose and dynamics of several steps: establishing problem awareness, setting goals and objectives, selecting a course of action, designing alternative courses of action, analyzing policy, assigning implementation responsibility, implementing, and evaluating. Then five categories of intervention strategies encompassing 16 individual suggested roles ranging from indirect influence to direct political involvement are presented. The categories are: acting as a source of policy information, providing technical assistance, organizing, influencing policymakers, and taking direct political action. PMID:7183668

  17. Influenza Vaccination for Immunocompromised Patients: Systematic Review and Meta-Analysis from a Public Health Policy Perspective

    PubMed Central

    Beck, Charles R.; McKenzie, Bruce C.; Hashim, Ahmed B.; Harris, Rebecca C.; Zanuzdana, Arina; Agboado, Gabriel; Orton, Elizabeth; Béchard-Evans, Laura; Morgan, Gemma; Stevenson, Charlotte; Weston, Rachel; Mukaigawara, Mitsuru; Enstone, Joanne; Augustine, Glenda; Butt, Mobasher; Kim, Sophie; Puleston, Richard; Dabke, Girija; Howard, Robert; O'Boyle, Julie; O'Brien, Mary; Ahyow, Lauren; Denness, Helene; Farmer, Siobhan; Figureroa, Jose; Fisher, Paul; Greaves, Felix; Haroon, Munib; Haroon, Sophie; Hird, Caroline; Isba, Rachel; Ishola, David A.; Kerac, Marko; Parish, Vivienne; Roberts, Jonathan; Rosser, Julia; Theaker, Sarah; Wallace, Dean; Wigglesworth, Neil; Lingard, Liz; Vinogradova, Yana; Horiuchi, Hiroshi; Peñalver, Javier; Nguyen-Van-Tam, Jonathan S.

    2011-01-01

    Background Immunocompromised patients are vulnerable to severe or complicated influenza infection. Vaccination is widely recommended for this group. This systematic review and meta-analysis assesses influenza vaccination for immunocompromised patients in terms of preventing influenza-like illness and laboratory confirmed influenza, serological response and adverse events. Methodology/Principal Findings Electronic databases and grey literature were searched and records were screened against eligibility criteria. Data extraction and risk of bias assessments were performed in duplicate. Results were synthesised narratively and meta-analyses were conducted where feasible. Heterogeneity was assessed using I2 and publication bias was assessed using Begg's funnel plot and Egger's regression test. Many of the 209 eligible studies included an unclear or high risk of bias. Meta-analyses showed a significant effect of preventing influenza-like illness (odds ratio [OR] = 0.23; 95% confidence interval [CI] = 0.16–0.34; p<0.001) and laboratory confirmed influenza infection (OR = 0.15; 95% CI = 0.03–0.63; p = 0.01) through vaccinating immunocompromised patie nts compared to placebo or unvaccinated controls. We found no difference in the odds of influenza-like illness compared to vaccinated immunocompetent controls. The pooled odds of seroconversion were lower in vaccinated patients compared to immunocompetent controls for seasonal influenza A(H1N1), A(H3N2) and B. A similar trend was identified for seroprotection. Meta-analyses of seroconversion showed higher odds in vaccinated patients compared to placebo or unvaccinated controls, although this reached significance for influenza B only. Publication bias was not detected and narrative synthesis supported our findings. No consistent evidence of safety concerns was identified. Conclusions/Significance Infection prevention and control strategies should recommend vaccinating immunocompromised patients

  18. Breastfeeding policy: a globally comparative analysis

    PubMed Central

    Raub, Amy; Earle, Alison

    2013-01-01

    Abstract Objective To explore the extent to which national policies guaranteeing breastfeeding breaks to working women may facilitate breastfeeding. Methods An analysis was conducted of the number of countries that guarantee breastfeeding breaks, the daily number of hours guaranteed, and the duration of guarantees. To obtain current, detailed information on national policies, original legislation as well as secondary sources on 182 of the 193 Member States of the United Nations were examined. Regression analyses were conducted to test the association between national policy and rates of exclusive breastfeeding while controlling for national income level, level of urbanization, female percentage of the labour force and female literacy rate. Findings Breastfeeding breaks with pay are guaranteed in 130 countries (71%) and unpaid breaks are guaranteed in seven (4%). No policy on breastfeeding breaks exists in 45 countries (25%). In multivariate models, the guarantee of paid breastfeeding breaks for at least 6 months was associated with an increase of 8.86 percentage points in the rate of exclusive breastfeeding (P < 0.05). Conclusion A greater percentage of women practise exclusive breastfeeding in countries where laws guarantee breastfeeding breaks at work. If these findings are confirmed in longitudinal studies, health outcomes could be improved by passing legislation on breastfeeding breaks in countries that do not yet ensure the right to breastfeed. PMID:24052676

  19. The paradox of health policy: revealing the true colours of this 'chameleon concept' Comment on "The politics and analytics of health policy".

    PubMed

    Exworthy, Mark

    2014-06-01

    Health policy has been termed a 'chameleon concept', referring to its ability to take on different forms of disciplinarity as well as different roles and functions. This paper extends Paton's analysis by exploring the paradox of health policy as a field of academic inquiry-sitting across many of the boundaries of social science but also marginalised by them. It situates contemporary approaches within disciplinary traditions, explaining its inter- and multi-disciplinary character. It also presents a 'way of seeing' health policy in terms of three axes: central/local, profession/management, and health/healthcare. The paper concludes with a call for a new research agenda which recognises health policy's pedigree but also one which carves a distinctive future of relevance and rigour.

  20. Policies for decentralization and development of health education.

    PubMed

    Green, L W

    1988-06-01

    This article reviews relevant US health education actions which are pertinent to understanding the possibilities for enhancing health education in Brazil, and discusses the interconnections between theory, policy, practice, and evaluation. One common assumption underlying most health education policy and practice is that participation of the population will increase involvement in programs. Economic theories of socialism and capitalism are implicit in short term policies, while long term policies imply understanding of cultural ideologies. The cycle: theory affects training and policy, policy affects training and practice, and practice affects evaluation which in turn affects theory and training. For instance, in the US the theory of life style's influence on health led to policy to change lifestyle. Ineffective health education led to more complex theories which changed health programs. Drunk drivers were penalized and smokers were restricted. Professional training programs increased to meet the demand. Policy had the most significant impact, and where it is absent, health education practice can become diffused and have an insignificant impact. The US cycle of underfunded policy for health education (professional poverty) began to change with the following initiatives: 1) improvement in research, 2) evaluation, 3) involvement of disciplines such as psychology and sociology in the study of health education problems, 4) significant policy analyses in the 1970's with the President's Committee on Health Education, and 5) new policy initiatives in the 1980's with the creation of the Office of Disease Prevention and Health Promotion in conjunction with the Center for Disease Control under the Public Health Service. Training in central in affecting practice and being affected by evaluation, theory, and policy. PMID:3232004

  1. Making Evidence on Health Policy Issues Accessible to the Media

    PubMed Central

    Roos, Noralou P.; O'Grady, Kathleen; Singer, Sharon Manson; Turczak, Shannon; Tapp, Camilla

    2012-01-01

    The media shape consumer expectations and interpretations of health interventions, influencing how people think about their need for care and the sustainability of the system. EvidenceNetwork.ca is a non-partisan, web-based project funded by the Canadian Institutes of Health Research and the Manitoba Health Research Council to make the latest evidence on controversial health policy issues available to the media. This website links journalists with health policy experts. We publish opinion pieces on current health policy issues in both French and English. We track who follows and uses the EvidenceNetwork.ca website and monitor the impact of our efforts. PMID:23968614

  2. Public policies and the problematic USA population health profile.

    PubMed

    Raphael, Dennis

    2007-11-01

    International interest in the social determinants of health and their public policy antecedents is increasing. Despite evidence that the USA presents one of the worst population health profiles and public policy environments in support of health among wealthy developed nations - a result of systemic inequities in income, influence, and power - the USA public health gaze is firmly - and narrowly - focused on issues of access to health care, racial and ethnic disparities in healthcare, and individual behavioral risk factors. Reasons for the USA's neglect of structural and public policy issues are explored and Ten Tips for American Public Health Researchers and Workers are presented.

  3. Making evidence on health policy issues accessible to the media.

    PubMed

    Roos, Noralou P; O'Grady, Kathleen; Singer, Sharon Manson; Turczak, Shannon; Tapp, Camilla

    2012-11-01

    The media shape consumer expectations and interpretations of health interventions, influencing how people think about their need for care and the sustainability of the system. EvidenceNetwork.ca is a non-partisan, web-based project funded by the Canadian Institutes of Health Research and the Manitoba Health Research Council to make the latest evidence on controversial health policy issues available to the media. This website links journalists with health policy experts. We publish opinion pieces on current health policy issues in both French and English. We track who follows and uses the EvidenceNetwork.ca website and monitor the impact of our efforts.

  4. E-health and the Universitas 21 organization: 3. Global policy.

    PubMed

    Scott, Richard E; Lee, Anna

    2005-01-01

    There is an urgent need to develop global e-health policy in order both to facilitate and to manage the potential of e-health. As part of the Universitas 21 (U21) project in e-health, an evaluation of the status of global e-health policy was performed using a SWOT analysis (strengths, weaknesses, opportunities and threats). The analysis showed that the greatest threat to global e-health policy is the autonomous nature of domestic health-care systems. The greatest opportunity may be the prospect for nations and individuals to work together in establishing mechanisms necessary to offer health-care access through global e-health--a new 'global public good'. Full integration of e-health into existing health-care systems could be achieved in both a practical and a policy sense through global e-health policy initiatives that facilitate integration across jurisdictions. There is a pressing need to resolve a range of e-health policy issues, and a concomitant need for research that will inform and support the process. A process that adopts a global approach is recommended.

  5. Food policies for physical and mental health.

    PubMed

    Jacka, Felice N; Sacks, Gary; Berk, Michael; Allender, Steven

    2014-01-01

    Noncommunicable diseases (NCDs) account for the largest burden of early mortality and are predicted to cost the global community more than US $30 trillion over the next 20 years. Unhealthy dietary habits, in large part driven by substantial changes to global food systems, are recognised as major contributors to many of the common NCDs, including cardiovascular disease, cancer and diabetes. Recent evidence now indicates that unhealthy diets are also risk factors for mental disorders, particularly depression and dementia. This affords substantial scope to leverage on the established and developing approaches to the nutrition-related NCDs to address the large global burden of these mental disorders and reinforces the imperative for governments take substantial actions in regards to improving the food environment and consequent population health via policy initiatives. PMID:24884515

  6. 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.

  7. 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.

  8. Reviewing and reforming policy in health enterprise information security

    NASA Astrophysics Data System (ADS)

    Sostrom, Kristen; Collmann, Jeff R.

    2001-08-01

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

  9. [European integration and health policies: repercussions of the internal European Market on access to health services].

    PubMed

    Guimarães, Luisa; Giovanella, Lígia

    2006-09-01

    This article explores the health policy repercussions of countries' regional integration into the European Union. The aim is to review the regulation of access in other countries, with the conclusion of the single European market and the free circulation of persons, services, goods, and capital. The article begins by reviewing the various forms of integration and describes the expansion and institutionalization of Community agencies. The repercussions of European integration on health policies and regulation of access are analyzed. Market impacts on health result from Treaty directives and internal policy adjustments to free circulation. Health services access is gradually regulated and granted by rulings. Projects along borders illustrate the dynamics where differences are used to achieve comprehensive care. In the oldest integration experience, the market regulation has generated intentional and non-intentional impacts on the health policies of member states, regardless of the organizational model. Knowledge and analysis of this experience signals challenges for the Southern Cone Common Market (Mercosur) and adds to future debates and decisions.

  10. How energy policies affect public health.

    PubMed

    Romm, J J; Ervin, C A

    1996-01-01

    The connection between energy policy and increased levels of respiratory and cardiopulmonary disease has become clearer in the past few years. People living in cities with high levels of pollution have a higher risk of mortality than those living in less polluted cities. The pollutants most directly linked to increased morbidity and mortality include ozone, particulates, carbon monoxide, sulfur dioxide, volatile organic compounds, and oxides of nitrogen. Energy-related emissions generate the vast majority of these polluting chemicals. Technologies to prevent pollution in the transportation, manufacturing, building, and utility sectors can significantly reduce these emissions while reducing the energy bills of consumers and businesses. In short, clean energy technologies represent a very cost-effective investment in public health. Some 72% of the Federal government's investment in the research, development, and demonstration of pollution prevention technologies is made by the Department of Energy, with the largest share provided by the Office of Energy Efficiency and Renewable Energy. This article will examine the connections between air pollution and health problems and will discuss what the Department of Energy is doing to prevent air pollution now and in the future.

  11. How energy policies affect public health.

    PubMed Central

    Romm, J J; Ervin, C A

    1996-01-01

    The connection between energy policy and increased levels of respiratory and cardiopulmonary disease has become clearer in the past few years. People living in cities with high levels of pollution have a higher risk of mortality than those living in less polluted cities. The pollutants most directly linked to increased morbidity and mortality include ozone, particulates, carbon monoxide, sulfur dioxide, volatile organic compounds, and oxides of nitrogen. Energy-related emissions generate the vast majority of these polluting chemicals. Technologies to prevent pollution in the transportation, manufacturing, building, and utility sectors can significantly reduce these emissions while reducing the energy bills of consumers and businesses. In short, clean energy technologies represent a very cost-effective investment in public health. Some 72% of the Federal government's investment in the research, development, and demonstration of pollution prevention technologies is made by the Department of Energy, with the largest share provided by the Office of Energy Efficiency and Renewable Energy. This article will examine the connections between air pollution and health problems and will discuss what the Department of Energy is doing to prevent air pollution now and in the future. Images p390-a p391-a p392-a p393-a p394-a p395-a p396-a p397-a PMID:8837627

  12. Identifying and strengthening the structural roots of urban health in Canada: participatory policy research and the urban health agenda.

    PubMed

    Bryant, Toba; Raphael, Dennis; Travers, Robb

    2007-01-01

    An urban health research agenda for health promoters is presented. In Canada, urban issues are emerging as a major concern of policy makers. The voices raising these issues are from the non-health sectors, but many of these issues such as increasing income inequality and poverty, homelessness and housing insecurity, and social exclusion of youth, immigrants, and ethno-racial minorities have strong health implications as they are important social determinants of health. Emphasis on these and other social determinants of health and the policy decisions that strengthen or weaken them is timely as the quality of Canadian urban environments has become especially problematic. We argue for a participatory urban health research and action agenda with four components: (a) an emphasis on health promotion and the social determinants of health; (b) community-based participatory research; and (c) drawing on the lived experience of people to influence (d) policy analysis and policy change. Urban health researchers and promoters are urged to draw upon new developments in population health and community-based health promotion theory and research to identify and strengthen the roots of urban health through citizen action on public policy. PMID:17526318

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  14. Policy space for health and trade and investment agreements.

    PubMed

    Koivusalo, Meri

    2014-06-01

    New trade agreements affect how governments can regulate for health both within health systems and in addressing health protection, promotion and social determinants of health in other policies. It is essential that those responsible for health understand the impacts of these trade negotiations and agreements on policy space for health at a national and local level. While we know more about implications from negotiations concerning intellectual property rights and trade in goods, this paper provides a screening checklist for less-discussed areas of domestic regulation, services, investment and government procurement. As implications are likely to differ on the basis of the organization and structures of national health systems and policy priorities, the emphasis is on finding out key provisions as well as on how exemptions and exclusions can be used to ensure policy space for health. PMID:25217355

  15. THE NEED TO GET OVER THE COLONIAL HEALTH POLICY

    PubMed Central

    Shankar, Darshan

    1997-01-01

    India has a rich indigenuous medical heritage. However, even after fifty years of indepdendance it has not been given its due place in national health care delivery. This article argues strongly for evolving a nationalistic health policy. PMID:22556798

  16. Policy space for health and trade and investment agreements.

    PubMed

    Koivusalo, Meri

    2014-06-01

    New trade agreements affect how governments can regulate for health both within health systems and in addressing health protection, promotion and social determinants of health in other policies. It is essential that those responsible for health understand the impacts of these trade negotiations and agreements on policy space for health at a national and local level. While we know more about implications from negotiations concerning intellectual property rights and trade in goods, this paper provides a screening checklist for less-discussed areas of domestic regulation, services, investment and government procurement. As implications are likely to differ on the basis of the organization and structures of national health systems and policy priorities, the emphasis is on finding out key provisions as well as on how exemptions and exclusions can be used to ensure policy space for health.

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

    PubMed

    Ogden, Lydia L

    2012-01-01

    In the United States, fiscal and functional federalism strongly shape public health policy and programs. Federalism has implications for public health practice: it molds financing and disbursement options, including funding formulas, which affect allocations and program goals, and shapes how funding decisions are operationalized in a political context. This article explores how American federalism, both fiscal and functional, structures public health funding, policy, and program options, investigating the effects of intergovernmental transfers on public health finance and programs. PMID:22635185

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

    PubMed

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

    2016-06-01

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

  19. Understanding the social determinants of health among Indigenous Canadians: priorities for health promotion policies and actions

    PubMed Central

    Kolahdooz, Fariba; Nader, Forouz; Yi, Kyoung J.; Sharma, Sangita

    2015-01-01

    Background Indigenous Canadians have a life expectancy 12 years lower than the national average and experience higher rates of preventable chronic diseases compared with non-Indigenous Canadians. Transgenerational trauma from past assimilation policies have affected the health of Indigenous populations. Objective The purpose of this paper is to comprehensively examine the social determinants of health (SDH), in order to identify priorities for health promotion policies and actions. Design We undertook a series of systematic reviews focusing on four major SDH (i.e. income, education, employment, and housing) among Indigenous peoples in Alberta, following the protocol Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Equity. Results We found that the four SDH disproportionately affect the health of Indigenous peoples. Our systematic review highlighted 1) limited information regarding relationships and interactions among income, personal and social circumstances, and health outcomes; 2) limited knowledge of factors contributing to current housing status and its impacts on health outcomes; and 3) the limited number of studies involving the barriers to, and opportunities for, education. Conclusions These findings may help to inform efforts to promote health equity and improve health outcomes of Indigenous Canadians. However, there is still a great need for in-depth subgroup studies to understand SDH (e.g. age, Indigenous ethnicity, dwelling area, etc.) and intersectoral collaborations (e.g. community and various government departments) to reduce health disparities faced by Indigenous Canadians. PMID:26187697

  20. The Intellectual Landscape of Critical Policy Analysis

    ERIC Educational Resources Information Center

    Diem, Sarah; Young, Michelle D.; Welton, Anjalé D.; Mansfield, Katherine Cumings; Lee, Pei-Ling

    2014-01-01

    What counts as critical policy analysis in education? Over the past 30 years, a tightening of national educational policies can be seen in the USA and across the globe. Over this same period of time, a growing number of educational policy scholars, dissatisfied with traditional frameworks, have used critical frameworks in their analyses. Their…

  1. Wyoming Career and Technical Education Policy Analysis

    ERIC Educational Resources Information Center

    MPR Associates, Inc., 2009

    2009-01-01

    This policy analysis was produced for the Wyoming Department of Administration and Information by MPR Associates, Inc. Its purpose was to examine federal and state policy related to career and technical education (CTE) to determine whether existing policy (in the form of statutes, rules, regulations, and guidance) could either promote or impede…

  2. Promoting LGBT health and wellbeing through inclusive policy development

    PubMed Central

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

    2009-01-01

    In this paper we argue the importance of including gender and sexually diverse populations in policy development towards a more inclusive form of health promotion. We emphasize the need to address the broad health and wellbeing issues and needs of LGBT people, rather than exclusively using an illness-based focus such as HIV/AIDS. We critically examine the limitations of population health, the social determinants of health (SDOH), and public health goals, in light of the lack of recognition of gender and sexually diverse individuals and communities. By first acknowledging the unique health and social care needs of LGBT people, then employing anti-oppressive, critical and intersectional analyses we offer recommendations for how to make population health perspectives, public health goals, and the design of public health promotion policy more inclusive of gender and sexual diversity. In health promotion research and practice, representation matters. It matters which populations are being targeted for health promotion interventions and for what purposes, and it matters which populations are being overlooked. In Canada, current health promotion policy is informed by population health and social determinants of health (SDOH) perspectives, as demonstrated by Public Health Goals for Canada. With Canada's multicultural makeup comes the challenge of ensuring that diverse populations are equitably and effectively recognized in public health and health promotion policy. PMID:19442315

  3. A Study of Health Policies in Public School Administration.

    ERIC Educational Resources Information Center

    Lasch, Henry A.

    This study was undertaken to identify, classify, and interpret extant written school health policies. Furthermore, it was planned to ascertain whether schools were using standardized forms or systematic procedures to formulate school health policies. Administrators in school districts representing every geographical area of the U.S. were asked to…

  4. Policy Capacity in the Learning Healthcare System Comment on "Health Reform Requires Policy Capacity".

    PubMed

    Gardner, William

    2015-01-01

    Pierre-Gerlier Forest and his colleagues make a strong argument for the need to expand policy capacity among healthcare actors. In this commentary, I develop an additional argument in support of Forest et al view. Forest et al rightly point to the need to have embedded policy experts to successfully translate healthcare reform policy into healthcare change. Translation of externally generated innovation policy into local solutions is only one source of healthcare system change. We also need to build learning healthcare systems that can discover new health solutions at the frontline of care. Enhanced policy capacity staffing in those organizations will be key to building continuously learning health systems. PMID:26673470

  5. Health impact assessment of agriculture and food policies: lessons learnt from the Republic of Slovenia.

    PubMed Central

    Lock, Karen; Gabrijelcic-Blenkus, Mojca; Martuzzi, Marco; Otorepec, Peter; Wallace, Paul; Dora, Carlos; Robertson, Aileen; Zakotnic, Jozica Maucec

    2003-01-01

    The most important public health priority in agricultural policy-making is currently food safety, despite the relatively higher importance of food security, nutrition, and other agricultural-related health issues in terms of global burden of disease. There is limited experience worldwide of using health impact assessment (HIA) during the development of agriculture and food policies, which perhaps reflects the complex nature of this policy sector. This paper presents methods of HIA used in the Republic of Slovenia, which is conducting a HIA of proposed agricultural and food policies due to its accession to the European Union. It is the first time that any government has attempted to assess the health effects of agricultural policy at a national level. The HIA has basically followed a six-stage process: policy analysis; rapid appraisal workshops with stakeholders from a range of backgrounds; review of research evidence relevant to the agricultural policy; analysis of Slovenian data for key health-related indicators; a report on the findings to a key cross-government group; and evaluation. The experience in Slovenia shows that the HIA process has been a useful mechanism for raising broader public health issues on the agricultural policy agenda, and it has already had positive results for policy formation. HIA is one useful approach to more integrated policy-making across sectors, but clearly it is not the only mechanism to achieve this. A comparison of the approach used in Slovenia with HIA methods in other countries and policy contexts shows that there are still many limitations with HIA application at a government level. Lessons can be learnt from these case studies for future development and application of HIA that is more relevant to policy-makers, and assists them in making more healthy policy choices. PMID:12894321

  6. Resource allocation strategies in Southeastern European health policy.

    PubMed

    Jakovljevic, Mihajlo B

    2013-04-01

    The past 23 years of post-socialist restructuring of health system funding and management patterns has brought many changes to small Balkan markets, putting them under increasing pressure to keep pace with advancing globalization. Socioeconomic inequalities in healthcare access are still growing across the region. This uneven development is marked by the substantial difficulties encountered by local governments in delivering medical services to broad sectors of the population. This paper presents the results of a systematic review of the following evidence: published reports on health system reforms in the region commissioned by WHO, IMF, World Bank, OECD, European Commission; all available published evidence on health economics, funding, reimbursement in world/local languages since 1989 indexed at Medline, Excerpta Medica and Google Scholar; in depth analysis of official website data on medical care financing related legislation among key public institutions such as national Ministries of health, Health Insurance Funds, Professional Associations were applicable, in local languages; correspondence with key opinion leaders in the field in their respective communities. Contributors were asked to answer a particular set of questions related to the issue, thus enlightening fresh legislative developments and hidden patterns of policy maker's behavior. Cost awareness is slowly expanding in regional management, academic and industrial establishment. The study provides an exact and comprehensive description of its current extent and legislative framework. Western Balkans policy makers would profit substantially from health-economics-based decision-making to cope with increasing difficulties in funding and delivering medical care in emerging markets with a rapidly growing demand for health services.

  7. Accounting for health in climate change policies: a case study of Fiji

    PubMed Central

    Morrow, Georgina; Bowen, Kathryn

    2014-01-01

    Background Climate change is expected to affect the health of most populations in the coming decades, having the greatest impact on the poorest and most disadvantaged people in the world. The Pacific islands, including Fiji, are particularly vulnerable to the effects of climate change. Objective The three major health impacts of climate change in Fiji explored in this study were dengue fever, diarrhoeal disease, and malnutrition, as they each pose a significant threat to human health. The aim of this study was to investigate to what extent the Fiji National Climate Change Policy, and a selection of relevant sectoral policies, account for these human health effects of climate change. Design The study employed a three-pronged policy analysis to evaluate: 1) the content of the Fijian National Climate Change Policy and to what extent health was incorporated within this; 2) the context within which the policy was developed; 3) the relevant processes; and 4) the actors involved. A selection of relevant sectoral policies were also analysed to assess the extent to which these included climate change and health considerations. Results The policy analysis showed that these three health impacts of climate change were only considered to a minor extent, and often indirectly, in both the Fiji National Climate Change Policy and the corresponding National Climate Change Adaptation Strategy, as well as the Public Health Act. Furthermore, supporting documents in relevant sectors including water and agriculture made no mention of climate change and health impacts. Conclusions The projected health impacts of climate change should be considered as part of reviewing the Fiji National Climate Change Policy and National Climate Change Adaptation Strategy, and the Public Health Act. In the interest of public health, this should include strategies for combating dengue fever, malnutrition, and water-borne disease. Related sectoral policies in water and agriculture should also be revised to

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

    PubMed

    Troy, Lisa M; Kietzman, Kathryn G

    2016-06-01

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

  9. Policy analysis: a framework for nurse managers.

    PubMed

    Hewison, Alistair

    2007-10-01

    The lack of involvement of nurses in the policy process is an issue of concern which has resulted in calls for nurses to become more active in this area of activity. However, what is often less clear is precisely how this can be done. This paper presents a template for policy analysis which can be used by nurse managers. The nature of policy and policy analysis is explored to provide a broad context for the discussion and the need for managers and nurse managers in particular to be 'policy competent' is established, as a prerequisite for effective management. There is also an examination of policy analysis in nursing which demonstrates why a range of approaches to the analysis of policy is needed. Based on this, a particular framework for policy analysis which can be used by nurse managers is presented. The overall purpose of the paper is to encourage debate in this area and contribute to the development of a specific tool for policy analysis that may help ensure a nursing management perspective informs policy formation and implementation.

  10. Making Health System Performance Measurement Useful to Policy Makers: Aligning Strategies, Measurement and Local Health System Accountability in Ontario

    PubMed Central

    Veillard, Jeremy; Huynh, Tai; Ardal, Sten; Kadandale, Sowmya; Klazinga, Niek S.; Brown, Adalsteinn D.

    2010-01-01

    This study examined the experience of the Ontario Ministry of Health and Long-Term Care in enhancing its stewardship and performance management role by developing a health system strategy map and a strategy-based scorecard through a process of policy reviews and expert consultations, and linking them to accountability agreements. An evaluation of the implementation and of the effects of the policy intervention has been carried out through direct policy observation over three years, document analysis, interviews with decision-makers and systematic discussion of findings with other authors and external reviewers. Cascading strategies at health and local health system levels were identified, and a core set of health system and local health system performance indicators was selected and incorporated into accountability agreements with the Local Health Integration Networks. despite the persistence of such challenges as measurement limitations and lack of systematic linkage to decision-making processes, these activities helped to strengthen substantially the ministry's performance management function. PMID:21286268

  11. 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

  12. What Can Policy Analysis Add to Evaluation Research?: Predictive Modeling and Policy Optimization.

    ERIC Educational Resources Information Center

    Nagel, Stuart S.

    Policy analysis, or policy study, is defined as the study of the nature, causes, and effects of alternative public policies; sometimes policy analysis refers to specific methods used. Two new developments associated with policy analysis are discussed. One is the concern for deducing the effects of alternative policies before they are adopted, as…

  13. The engine or the caboose: health policy in developing countries.

    PubMed

    Goldsteen, R L; Pereira, J C; Goldsteen, K

    1990-12-01

    A discussion of health policy in developing countries is presented. It argues that developing countries must adopt a progressive approach to health policy which rejects the two-tiered system of public and private health care. However, it also points out that ideology is not sufficient to maintain support. A progressive health system must utilize administrative and social and behavioral sciences to achieve effectiveness and efficiency in health care delivery. It cannot ignore these goals any more than a private health care system can.

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

    PubMed

    Franco-Giraldo, Alvaro; Alvarez-Dardet, Carlos

    2008-01-01

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

  15. Health Services: Results from the School Health Policies and Programs Study 2000.

    ERIC Educational Resources Information Center

    Brener, Nancy D.; Burstein, Gale R.; DuShaw, Martha L.; Vernon, Mary E.; Wheeler, Lani; Robinson, Judy

    2001-01-01

    Describes School Health Policies and Programs Study 2000 findings about state- and district-level school health services policies and practices regarding: organization, staffing, and facilities; required services; school based health clinics and other sites; immunizations; screening; medication administration; HIV; student health records; special…

  16. Health services and policy research in the first decade at the Canadian Institutes of Health Research

    PubMed Central

    Tamblyn, Robyn; McMahon, Meghan; Girard, Nadyne; Drake, Elizabeth; Nadigel, Jessica; Gaudreau, Kim

    2016-01-01

    Background: Health services and policy research is the innovation engine of a health care system. In 2000, the Canadian Institutes of Health Research (CIHR) was formed to foster the growth of all sciences that could improve health care. We evaluated trends in health services and policy research funding, in addition to determinants of funding success. Methods: All applications submitted to CIHR strategic and open operating grant competitions between 2001 and 2011 were included in our analysis. Age, sex, size of research team, critical mass, season, year and research discipline were retrieved from application information. A cohort of 4725 applicants successfully funded between 2001 and 2005 were followed for 5 years to evaluate predictors of continuous funding. Multivariate generalized estimating equation logistic regression was used to estimate predictors of funding success and sustained funding. Results: Between 2001 and 2011, 80 163 applications were submitted to open and strategic grant competitions. Over time, grant applications increased from 327 to 1137 per year, and annual funding increased from $12.6 to $48.0 million. Grant applications from young male researchers were more likely to be funded than those from female researchers (odds ratio [OR] 1.40, 95% confidence interval [CI] 1.01-1.95), as were applications from larger research teams and institutions with a large critical mass. Only 24.0% of scientists whose first funded grant was in health services and policy research had sustained 5-year funding, compared with 52.8% of biomedical scientists (OR 0.34, 95% CI 0.24-0.49). Interpretation: The CIHR has successfully increased the amount of health services and policy research in Canada. To enhance conditions for success, researchers should be encouraged to work in teams, request longer duration grants, resubmit unsuccessful applications and affiliate themselves with institutions with a greater critical mass. PMID:27398366

  17. Agenda Setting and Evidence in Maternal Health: Connecting Research and Policy in Timor-Leste.

    PubMed

    Wild, Kayli; Kelly, Paul; Barclay, Lesley; Martins, Nelson

    2015-01-01

    The evidence-based policy (EBP) movement has received significant attention in the scientific literature; however, there is still very little empirical research to provide insight into how policy decisions are made and how evidence is used. The lack of research on this topic in low- and middle-income countries is of particular note. We examine the maternity waiting home policy in Timor-Leste to understand the role of context, policy characteristics, individual actors, and how evidence is used to influence the policy agenda. The research tracked the maternity waiting home policy from 2005 to 2009 and is based on in-depth interviews with 31 senior policy-makers, department managers, non-government organization representatives, and United Nations advisors. It is also informed by direct observation, attendance at meetings and workshops, and analysis of policy documents. The findings from this ethnographic case study demonstrate that although the post-conflict context opened up space for new policy ideas senior Ministry of Health officials rather than donors had the most power in setting the policy agenda. Maternity waiting homes were appealing because they were a visible, non-controversial, and logical solution to the problem of accessing maternal health services. Evidence was used in a variety of ways, from supporting pre-determined agendas to informing new policy directions. In the pursuit of EBP, we conclude that the power of research to inform policy lies in its timeliness and relevance, and is facilitated by the connection between researchers and policy-makers.

  18. Uncertainties of Federal Child Health Policies: Impact in Two States; NCHSR Research Digest Series.

    ERIC Educational Resources Information Center

    Foltz, Anne-Marie

    This report assesses the impact of federal child health policy under Titles V and XIX of the Social Security Act upon the states of Connecticut and Vermont for the years 1935 to 1975, and analyzes the reasons for the discrepancy between policy intent and state execution. Two simultaneous approaches are used for data analysis: a cross sectional…

  19. Can policy analysis theories predict and inform policy change? Reflections on the battle for legal abortion in Indonesia.

    PubMed

    Surjadjaja, Claudia; Mayhew, Susannah H

    2011-09-01

    The relevance and importance of research for understanding policy processes and influencing policies has been much debated, but studies on the effectiveness of policy theories for predicting and informing opportunities for policy change (i.e. prospective policy analysis) are rare. The case study presented in this paper is drawn from a policy analysis of a contemporary process of policy debate on legalization of abortion in Indonesia, which was in flux at the time of the research and provided a unique opportunity for prospective analysis. Applying a combination of policy analysis theories, this case study provides an analysis of processes, power and relationships between actors involved in the amendment of the Health Law in Indonesia. It uses a series of practical stakeholder mapping tools to identify power relations between key actors and what strategic approaches should be employed to manage these to enhance the possibility of policy change. The findings show how the moves to legalize abortion have been supported or constrained according to the balance of political and religious powers operating in a macro-political context defined increasingly by a polarized Islamic-authoritarian-Western-liberal agenda. The issue of reproductive health constituted a battlefield where these two ideologies met and the debate on the current health law amendment became a contest, which still continues, for the larger future of Indonesia. The findings confirm the utility of policy analysis theories and stakeholder mapping tools for predicting the likelihood of policy change and informing the strategic approaches for achieving such change. They also highlight opportunities and dilemmas in prospective policy analysis and raise questions about whether research on policy processes and actors can or should be used to inform, or even influence, policies in 'real-time'. PMID:21183461

  20. Can policy analysis theories predict and inform policy change? Reflections on the battle for legal abortion in Indonesia

    PubMed Central

    Surjadjaja, Claudia; Mayhew, Susannah H

    2011-01-01

    The relevance and importance of research for understanding policy processes and influencing policies has been much debated, but studies on the effectiveness of policy theories for predicting and informing opportunities for policy change (i.e. prospective policy analysis) are rare. The case study presented in this paper is drawn from a policy analysis of a contemporary process of policy debate on legalization of abortion in Indonesia, which was in flux at the time of the research and provided a unique opportunity for prospective analysis. Applying a combination of policy analysis theories, this case study provides an analysis of processes, power and relationships between actors involved in the amendment of the Health Law in Indonesia. It uses a series of practical stakeholder mapping tools to identify power relations between key actors and what strategic approaches should be employed to manage these to enhance the possibility of policy change. The findings show how the moves to legalize abortion have been supported or constrained according to the balance of political and religious powers operating in a macro-political context defined increasingly by a polarized Islamic-authoritarian—Western-liberal agenda. The issue of reproductive health constituted a battlefield where these two ideologies met and the debate on the current health law amendment became a contest, which still continues, for the larger future of Indonesia. The findings confirm the utility of policy analysis theories and stakeholder mapping tools for predicting the likelihood of policy change and informing the strategic approaches for achieving such change. They also highlight opportunities and dilemmas in prospective policy analysis and raise questions about whether research on policy processes and actors can or should be used to inform, or even influence, policies in ‘real-time’. PMID:21183461

  1. Health policy thoughtleaders' views of the health workforce in an era of health reform.

    PubMed

    Donelan, Karen; Buerhaus, Peter I; DesRoches, Catherine; Burke, Sheila P

    2010-01-01

    Although registered nurses rank similarly with physicians in the public's esteem, physicians are more visible than nurses in media coverage, public policy, and political spheres. Thus, nursing workforce issues are overshadowed by those of other health priorities, including Medicare and health reform. The purpose of this research was to understand the visibility and salience of the health workforce in general, gain an understanding about the effectiveness of messages concerning the nursing workforce in particular, and to understand why nursing workforce issues do not appear to have gained more traction in national health care policymaking. The National Survey of Thoughtleaders about the Health Workforce was administered via mail, telephone and online to health workforce and policy thoughtleaders from August 2009-October 2009. Of 301 thoughtleaders contacted, 123 completed questionnaires for a response rate of 41%. Thoughtleaders agree that nurses are critical to the quality and safety of our healthcare system, that there are current nursing shortages, and that nursing shortages will be intensified by health reform. Thoughtleaders reported that while they do hear about nursing issues frequently, they do not view most sources of information as proposing effective policy solutions. This study highlights a critical gap in effective policy advocacy and leadership to advance nurse workforce issues higher on the national health agenda. PMID:20637930

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

    PubMed

    Glied, Sherry A; Miller, Erin A

    2015-08-01

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

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

    PubMed

    Glied, Sherry A; Miller, Erin A

    2015-08-01

    Two prior studies, conducted in 1966 and in 1979, examined the role of economic research in health policy development. Both concluded that health economics had not been an important contributor to policy. Passage of the Affordable Care Act offers an opportunity to reassess this question. We find that the evolution of health economics research has given it an increasingly important role in policy. Research in the field has followed three related paths over the past century-institutionalist research that described problems; theoretical research, which proposed relationships that might extend beyond existing institutions; and empirical assessments of structural parameters identified in the theoretical research. These three strands operating in concert allowed economic research to be used to predict the fiscal and coverage consequences of alternative policy paths. This ability made economic research a powerful policy force. Key conclusions of health economics research are clearly evident in the Affordable Care Act. PMID:25854958

  4. Toward A Social Policy Analysis Curriculum.

    ERIC Educational Resources Information Center

    Stimson, John; Stimson, Ardyth

    An eight-course curriculum in social policy analysis which follows a policy analysis paradigm is proposed. The undergraduate curriculum concentrates on the ability to appreciate and operate under uncertainty; anticipation of interrelated, unexpected ramifications of new stimuli; understanding of the social construction of problems and their cures;…

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

    PubMed

    Soares, Catharina Leite Matos

    2012-01-01

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

  6. Education Policy Analysis Archives, 1997.

    ERIC Educational Resources Information Center

    Glass, Gene V., Ed.

    1997-01-01

    This electronic journal covers a variety of issues related to educational policy. The 22 articles (issues) of Volume 5 analyze aspects of policy in the United States and other countries for elementary, secondary, and higher education. Articles include: (1) "Markets and Myths: Autonomy in Public and Private schools" (Glass); (2) "Where Have All the…

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

    PubMed Central

    Nabyonga-Orem, Juliet; Mijumbi, Rhona

    2015-01-01

    Background: Although there is a general agreement on the benefits of evidence informed health policy development given resource constraints especially in Low-Income Countries (LICs), the definition of what evidence is, and what evidence is suitable to guide decision-making is still unclear. Our study is contributing to filling this knowledge gap. We aimed to explore health policy actors’ views regarding what evidence they deemed appropriate to guide health policy development. Methods: Using exploratory qualitative methods, we conducted interviews with 51 key informants using an in-depth interview guide. We interviewed a diverse group of stakeholders in health policy development and knowledge translation in the Uganda health sector. Data were analyzed using inductive content analysis techniques. Results: Different stakeholders lay emphasis on different kinds of evidence. While donors preferred international evidence and Ministry of Health (MoH) officials looked to local evidence, district health managers preferred local evidence, evidence from routine monitoring and evaluation, and reports from service providers. Service providers on the other hand preferred local evidence and routine monitoring and evaluation reports whilst researchers preferred systematic reviews and clinical trials. Stakeholders preferred evidence covering several aspects impacting on decision-making highlighting the fact that although policy actors look for factual information, they also require evidence on context and implementation feasibility of a policy decision. Conclusion: What LICs like Uganda categorize as evidence suitable for informing policy encompasses several types with no consensus on what is deemed as most appropriate. Evidence must be of high quality, applicable, acceptable to the users, and informing different aspects of decision-making. PMID:25905479

  8. Shifting from policy relevance to policy translation: do housing and neighborhoods affect children's mental health?

    PubMed

    Osypuk, Theresa L

    2015-02-01

    The impact of housing and neighborhood context on children's mental health, as addressed by Flouri et al. (Soc Psychiatry Psychiatr Epidemiol, 2014), is an important, understudied topic in social epidemiology. Although the vast majority of this body of research has been descriptive, generating translational research is essential. This article offers guidance on interpreting evidence from observational studies for translation into policy, related to three policy-relevant elements of housing: receipt of affordable housing subsidies, the target population to which results generalize, and operationalization and modeling of neighborhood context. Policy translation is imperative for understanding which levers outside the health sector can be manipulated to change fundamental causes of mental health related to housing and neighborhood. Shifting from policy relevance to policy translation may be challenging, especially for understanding social causation in observational studies, but it is a necessary shift for improving population health. PMID:25527210

  9. Shifting from policy relevance to policy translation: do housing and neighborhoods affect children's mental health?

    PubMed

    Osypuk, Theresa L

    2015-02-01

    The impact of housing and neighborhood context on children's mental health, as addressed by Flouri et al. (Soc Psychiatry Psychiatr Epidemiol, 2014), is an important, understudied topic in social epidemiology. Although the vast majority of this body of research has been descriptive, generating translational research is essential. This article offers guidance on interpreting evidence from observational studies for translation into policy, related to three policy-relevant elements of housing: receipt of affordable housing subsidies, the target population to which results generalize, and operationalization and modeling of neighborhood context. Policy translation is imperative for understanding which levers outside the health sector can be manipulated to change fundamental causes of mental health related to housing and neighborhood. Shifting from policy relevance to policy translation may be challenging, especially for understanding social causation in observational studies, but it is a necessary shift for improving population health.

  10. Health policy and systems research agendas in developing countries

    PubMed Central

    Gonzalez-Block, Miguel A

    2004-01-01

    Background Health policy and systems research (HPSR) is an international public good with potential to orient investments and performance at national level. Identifying research trends and priorities at international level is therefore important. This paper offers a conceptual framework and defines the HPSR portfolio as a set of research projects under implementation. The research portfolio is influenced by factors external to the research system as well as internal to it. These last include the capacity of research institutions, the momentum of research programs, funding opportunities and the influence of stakeholder priorities and public opinion. These dimensions can vary in their degree of coordination, leading to a complementary or a fragmented research portfolio. Objective The main objective is to identify the themes currently being pursued in the research portfolio and agendas within developing countries and to quantify their frequency in an effort to identify current research topics and their underlying influences. Methods HPSR topics being pursued by developing country producer institutions and their perceived priorities were identified through a survey between 2000 and 2002. The response to a call for letters of intent issued by the Alliance in 2000 for a broad range of topics was also analyzed. The institutions that were the universe of this study consisted of the 176 institutional partners of the Alliance for Health Policy and Systems Research producing research in low and middle income countries outside Europe. HPSR topics as well as the beneficiaries or issues and the health problems addressed were content analyzed. Topics were classified into 19 categories and their frequency analyzed across groups of countries with similar per capita income. Agendas were identified by analyzing the source of funding and of project initiation for projects under implementation. Results The highest ranking topic at the aggregate level is "Sector analysis", followed by

  11. Health policy and systems research agendas in developing countries.

    PubMed

    Gonzalez-Block, Miguel A

    2004-08-01

    BACKGROUND: Health policy and systems research (HPSR) is an international public good with potential to orient investments and performance at national level. Identifying research trends and priorities at international level is therefore important. This paper offers a conceptual framework and defines the HPSR portfolio as a set of research projects under implementation. The research portfolio is influenced by factors external to the research system as well as internal to it. These last include the capacity of research institutions, the momentum of research programs, funding opportunities and the influence of stakeholder priorities and public opinion. These dimensions can vary in their degree of coordination, leading to a complementary or a fragmented research portfolio. OBJECTIVE: The main objective is to identify the themes currently being pursued in the research portfolio and agendas within developing countries and to quantify their frequency in an effort to identify current research topics and their underlying influences. METHODS: HPSR topics being pursued by developing country producer institutions and their perceived priorities were identified through a survey between 2000 and 2002. The response to a call for letters of intent issued by the Alliance in 2000 for a broad range of topics was also analyzed. The institutions that were the universe of this study consisted of the 176 institutional partners of the Alliance for Health Policy and Systems Research producing research in low and middle income countries outside Europe. HPSR topics as well as the beneficiaries or issues and the health problems addressed were content analyzed. Topics were classified into 19 categories and their frequency analyzed across groups of countries with similar per capita income. Agendas were identified by analyzing the source of funding and of project initiation for projects under implementation. RESULTS: The highest ranking topic at the aggregate level is "Sector analysis", followed

  12. [Crisis and the independence of public health policies. SESPAS report 2014].

    PubMed

    Hernández Aguado, Ildefonso; Lumbreras Lacarra, Blanca

    2014-06-01

    Independence in the formulation of public health policies can be affected by various agents with objectives contrary to population health, such as large corporations. This lack of independence may be exacerbated by the economic crisis due to lower funding for health regulatory bodies or other measures designed to protect health. Large corporations have influenced the formulation of certain policies with an impact on health, such as those related to the tobacco industry, the chemical industry, nutrition, alcohol, pharmaceuticals, and health technology. The main areas in which these companies can influence policies are science, education, politics, and society in general. In this scenario, public health associations should take an active role in ensuring the independence of political decisions via actions such as the following: supporting strategies that guarantee the independence of public health policies and apply criteria of impartiality and transparency; rejecting those public-private partnerships launched to prevent health problems partly caused by these corporations; establishing partnerships to achieve independent training of health professionals and an institution with scientific authority in order to improve public health communication and counteract the lack of sound public health information; promoting a critical analysis of the definition of health problems and their solutions, and establishing related agendas (scientific, political and media) and alliances, so that continuing training for health professionals is independent.

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

    PubMed

    Fafard, Patrick

    2012-12-01

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

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

    PubMed

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

    2005-11-01

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

  15. Evironmental health policy in ukraine after the Chernobyl accident

    SciTech Connect

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

    1995-09-01

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

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

    PubMed

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

    2015-08-01

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

  17. "BE"ing a Certain Way: Seeking "Body Image" in Canadian Health and Physical Education Curriculum Policies

    ERIC Educational Resources Information Center

    Robertson, Lorayne; Thomson, Dianne

    2012-01-01

    Body image is an individual's emotional response to one's appearance including size and shape; this response may not be helpful in the pursuit of overall health and well-being. This policy analysis examines the treatment of body image in Canadian Health and Physical Education (HPE) curriculum policies using a body image analysis framework…

  18. Multisector Health Policy Networks in 15 Large US Cities

    PubMed Central

    Leider, J. P.; Carothers, Bobbi J.; Castrucci, Brian C.; Hearne, Shelley

    2016-01-01

    Context: Local health departments (LHDs) have historically not prioritized policy development, although it is one of the 3 core areas they address. One strategy that may influence policy in LHD jurisdictions is the formation of partnerships across sectors to work together on local public health policy. Design: We used a network approach to examine LHD local health policy partnerships across 15 large cities from the Big Cities Health Coalition. Setting/Participants: We surveyed the health departments and their partners about their working relationships in 5 policy areas: core local funding, tobacco control, obesity and chronic disease, violence and injury prevention, and infant mortality. Outcome Measures: Drawing on prior literature linking network structures with performance, we examined network density, transitivity, centralization and centrality, member diversity, and assortativity of ties. Results: Networks included an average of 21.8 organizations. Nonprofits and government agencies made up the largest proportions of the networks, with 28.8% and 21.7% of network members, whereas for-profits and foundations made up the smallest proportions in all of the networks, with just 1.2% and 2.4% on average. Mean values of density, transitivity, diversity, assortativity, centralization, and centrality showed similarity across policy areas and most LHDs. The tobacco control and obesity/chronic disease networks were densest and most diverse, whereas the infant mortality policy networks were the most centralized and had the highest assortativity. Core local funding policy networks had lower scores than other policy area networks by most network measures. Conclusion: Urban LHDs partner with organizations from diverse sectors to conduct local public health policy work. Network structures are similar across policy areas jurisdictions. Obesity and chronic disease, tobacco control, and infant mortality networks had structures consistent with higher performing networks, whereas

  19. Incorporating a health policy practicum in a graduate training program to prepare advanced practice nursing health services researchers.

    PubMed

    DiCenso, Alba; Housden, Laura; Heale, Roberta; Carter, Nancy; Canitz, Brenda; MacDonald-Rencz, Sandra; Buckley, Christine Rieck

    2012-11-01

    Health services research benefits from the active engagement of researchers and policy makers from generation through to application of research-based knowledge. One approach to help graduate students learn about the policy world is through participation in a policy practicum. This is an opportunity to work for a defined period of time in a setting where policy decisions are made. This article focuses on the integration of the policy practicum into graduate nursing education for advanced practice nurses. Ten graduate students and two postdoctoral fellows who had recently completed their practicums and three policy makers who had recently supervised students in provincial, federal, and international practicum projects were invited to submit a narrative about the experience. Based on qualitative analysis of the narratives, this article outlines objectives of the practicum, the policy practicum journey, student learning, and finally, the benefits and challenges of the experience.

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

    PubMed

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

    2011-12-01

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

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

    PubMed

    Wilson, C Ruth

    2013-01-01

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

  2. School-Based Health Care State Policy Survey. Executive Summary

    ERIC Educational Resources Information Center

    National Assembly on School-Based Health Care, 2012

    2012-01-01

    The National Assembly on School-Based Health Care (NASBHC) surveys state public health and Medicaid offices every three years to assess state-level public policies and activities that promote the growth and sustainability of school-based health services. The FY2011 survey found 18 states (see map below) reporting investments explicitly dedicated…

  3. Cross-national diffusion of mental health policy

    PubMed Central

    Shen, Gordon C

    2014-01-01

    Background: Following the tenets of world polity and innovation diffusion theories, I focus on the coercive and mimetic forces that influence the diffusion of mental health policy across nations. International organizations’ mandates influence government behavior. Dependency on external resources, namely foreign aid, also affects governments’ formulation of national policy. And finally, mounting adoption in a region alters the risk, benefits, and information associated with a given policy. Methods: I use post-war, discrete time data spanning 1950 to 2011 and describing 193 nations’ mental health systems to test these diffusion mechanisms. Results: I find that the adoption of mental health policy is highly clustered temporally and spatially. Results provide support that membership in the World Health Organization (WHO), interdependence with neighbors and peers in regional blocs, national income status, and migrant sub-population are responsible for isomorphism. Aid, however, is an insufficient determinant of mental health policy adoption. Conclusion: This study examines the extent to which mental, neurological, and substance use disorder are addressed in national and international contexts through the lens of policy diffusion theory. It also adds to policy dialogues about non-communicable diseases as nascent items on the global health agenda. PMID:25337601

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

    PubMed

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

    2015-05-01

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

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

    PubMed

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

    2015-05-01

    During the last 20 years Lao People's Democratic Republic has successfully developed and adopted some 30 health policies, strategies, decrees and laws in the field of health. Still, the implementation process remains arduous. This article aims at discussing challenges of health policy development and effective implementation by contextualizing the policy evolution over time and by focusing particularly on the National Drug Policy and the Health Care Law. Special attention is given to the role of research in policymaking. The analysis was guided by the conceptual framework of policy context, process, content and actors, combined with an institutional perspective, and showed that effective implementation of a health policy is highly dependent on both structures and agency of those involved in the policy process. The National Drug Policy was formulated and adopted in a short period of time in a resource-scarce setting, but with dedicated policy entrepreneurs and support of concerned international collaborators. Timely introduction of operational health systems research played a crucial role to support the implementation, as well as the subsequent revision of the policy. The development of the Health Care Law took several years and once adopted, the implementation was delayed by institutional legacies and issues concerning the choice of institutional design and financing, despite strong support of the law among the policymakers. Among many factors, timing of the implementation appeared to be of crucial importance, in combination with strong leadership. These two examples show that more research, that problematizes the complex policy environment in combination with improved communication between researchers and policymakers, is necessary to inform about measures for effective implementation. A way forward can be to strengthen the domestic research capacity and the international research collaboration regionally as well as globally. PMID:24740710

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

    PubMed Central

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

    2015-01-01

    During the last 20 years Lao People’s Democratic Republic has successfully developed and adopted some 30 health policies, strategies, decrees and laws in the field of health. Still, the implementation process remains arduous. This article aims at discussing challenges of health policy development and effective implementation by contextualizing the policy evolution over time and by focusing particularly on the National Drug Policy and the Health Care Law. Special attention is given to the role of research in policymaking. The analysis was guided by the conceptual framework of policy context, process, content and actors, combined with an institutional perspective, and showed that effective implementation of a health policy is highly dependent on both structures and agency of those involved in the policy process. The National Drug Policy was formulated and adopted in a short period of time in a resource-scarce setting, but with dedicated policy entrepreneurs and support of concerned international collaborators. Timely introduction of operational health systems research played a crucial role to support the implementation, as well as the subsequent revision of the policy. The development of the Health Care Law took several years and once adopted, the implementation was delayed by institutional legacies and issues concerning the choice of institutional design and financing, despite strong support of the law among the policymakers. Among many factors, timing of the implementation appeared to be of crucial importance, in combination with strong leadership. These two examples show that more research, that problematizes the complex policy environment in combination with improved communication between researchers and policymakers, is necessary to inform about measures for effective implementation. A way forward can be to strengthen the domestic research capacity and the international research collaboration regionally as well as globally. PMID:24740710

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

    ERIC Educational Resources Information Center

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

    2004-01-01

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

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

    PubMed

    Debrand, Thierry; Dourgnon, Paul

    2010-12-01

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

  9. Health Policy Formulation on a Federal Level, Process and Substance.

    ERIC Educational Resources Information Center

    Stambler, Moses

    Factors which influence the federal government's policy toward health care include cost, technology, social values, federalism, interest group politics, increased federal involvement, and the current utilitarian attitude toward research. The interaction of these factors results in a complex process of policy formation. For example, when the…

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

    ERIC Educational Resources Information Center

    Corn, Jacqueline Karnell

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

  11. Integrating Occupational Safety and Health into TAFE Courses: Policy Guidelines.

    ERIC Educational Resources Information Center

    Hill, Graham L.; Mageean, Pauline

    Intended to help administrators, curriculum developers, and teachers integrate occupational health and safety into Australian vocational courses on bricklaying, metal fabrication, and horticulture, this document suggests specific policies and provides further amplification concerning three general policies for that integration. The three general…

  12. "Emboldened Bodies": Social Class, School Health Policy and Obesity Discourse

    ERIC Educational Resources Information Center

    De Pian, Laura

    2012-01-01

    This paper examines the multiple ways in which health policy relating to obesity, diet and exercise is recontextualised and mediated by teachers and pupils in the context of social class in the UK. Drawing on a case study of a middle-class primary school in central England, the paper documents the complexity of the policy process, its uncertainty,…

  13. Nutrition, Population, and Health: Some Implications for Policy

    ERIC Educational Resources Information Center

    Winikoff, Beverly

    1978-01-01

    A discussion of the relationships, both biological and behavioral, among nutrition, population, and health in relation to government policy. Special emphasis is given to breast feeding and child survival. (BB)

  14. State legislative staff influence in health policy making.

    PubMed

    Weissert, C S; Weissert, W G

    2000-12-01

    State legislative staff may influence health policy by gathering intelligence, setting the agenda, and shaping the legislative proposals. But they may also be stymied in their roles by such institutional constraints as hiring practices and by turnover in committee leadership in the legislature. The intervening variable of trust between legislators and their support staff is also key to understanding influence and helps explain how staff-legislator relationships play an important role in designing state health policy. This study of legislative fiscal and health policy committee staff uses data from interviews with key actors in five states to model the factors important in explaining variation in the influence of committee staff on health policy.

  15. Canadian values, social policy and the health of our kids.

    PubMed

    Denburg, Avram

    2016-01-01

    What explains the widening disparities in child health and social circumstance in Canada? And why do we tolerate such inequality? In the present commentary, the author argues that to understand - and ultimately influence - the trajectory of child health and well-being in our country, we must attend to the impact of social policy on the life chances of Canadian children. This, in turn, demands that we probe the fundamental values that guide social policy in modern welfare states and locate Canada's place in this political spectrum. The author explores the controversial tax policy of income-splitting to contextualize this discussion of values, and argues that our polity increasingly privileges economic liberty above equality or solidarity. Until those best positioned to advocate for children - including paediatricians and child health care providers - begin to engage with social policy, the health and well-being of Canada's children will remain a tale of two increasingly different worlds.

  16. Canadian values, social policy and the health of our kids.

    PubMed

    Denburg, Avram

    2016-01-01

    What explains the widening disparities in child health and social circumstance in Canada? And why do we tolerate such inequality? In the present commentary, the author argues that to understand - and ultimately influence - the trajectory of child health and well-being in our country, we must attend to the impact of social policy on the life chances of Canadian children. This, in turn, demands that we probe the fundamental values that guide social policy in modern welfare states and locate Canada's place in this political spectrum. The author explores the controversial tax policy of income-splitting to contextualize this discussion of values, and argues that our polity increasingly privileges economic liberty above equality or solidarity. Until those best positioned to advocate for children - including paediatricians and child health care providers - begin to engage with social policy, the health and well-being of Canada's children will remain a tale of two increasingly different worlds. PMID:27441015

  17. National health policy for traditional medicine in India.

    PubMed

    Srinivasan, P

    1995-01-01

    External pressures have combined to erode the practice of India's traditional medical systems to such an extent that they are in danger of becoming extinct. A better balanced national health policy could go a long way towards reversing this trend.

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

    PubMed

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

    2015-04-01

    Mobile health (mHealth) customers shopping for applications (apps) should be aware of app privacy practices so they can make informed decisions about purchase and use. We sought to assess the availability, scope, and transparency of mHealth app privacy policies on iOS and Android. Over 35,000 mHealth apps are available for iOS and Android. Of the 600 most commonly used apps, only 183 (30.5%) had privacy policies. Average policy length was 1755 (SD 1301) words with a reading grade level of 16 (SD 2.9). Two thirds (66.1%) of privacy policies did not specifically address the app itself. Our findings show that currently mHealth developers often fail to provide app privacy policies. The privacy policies that are available do not make information privacy practices transparent to users, require college-level literacy, and are often not focused on the app itself. Further research is warranted to address why privacy policies are often absent, opaque, or irrelevant, and to find a remedy. PMID:25147247

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

    PubMed

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

    2015-04-01

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

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

    PubMed Central

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

    2014-01-01

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

  1. Teacher Policy: A Framework for Comparative Analysis

    ERIC Educational Resources Information Center

    Tatto, Maria Teresa

    2008-01-01

    This article outlines a framework for analysis of teacher focused policy studies within an international and comparative perspective. Using the notion of the professional life cycle of teachers, the article examines examples of key empirical studies that illustrate the impact of policy on addressing such issues as teacher recruitment, education,…

  2. Communities and health policy: a pathway for change.

    PubMed

    Bell, Judith; Standish, Marion

    2005-01-01

    Improving the health system can reduce the effects of health disparities, but it can do little to eliminate them. An upsurge in new research is documenting the impact of physical, social, and economic environmental factors: air quality, housing conditions, racism, relationship to community institutions, and neighborhood economic conditions, all of which affect health status over time. A combined focus on community and the policies that affect communities' environments presents opportunities for altering and ameliorating the underlying forces at the heart of the determinants of health. This Perspective presents examples of successful community involvement and policy change.

  3. Australia's primary health care workforce--research informing policy.

    PubMed

    Douglas, Kirsty A; Rayner, Frith K; Yen, Laurann E; Wells, Robert W; Glasgow, Nicholas J; Humphreys, John S

    2009-07-20

    In 2008, the Australian Primary Health Care Research Institute (APHCRI) held a Primary Health Care Workforce Roundtable with practising clinicians, policymakers and researchers, which drew on Australian evidence in health care policy, systematic reviews, and expertise and experience of participants. Key recommendations for an adequate, sustainable and effective primary health care workforce that arose from the meeting included: simplifying the Medicare Benefits Schedule, which is unnecessarily complex and inflexible; effectively funding undergraduate and prevocational medical and nursing education and training in primary health care; developing career structure and training pathways for general practitioners and primary health care nurses; developing of functional primary health care teams; and using a blended funding model, comprising fee-for-service as well as capitation for patients with chronic or complex needs. A report from the meeting, detailing these policy options, was submitted to the National Health and Hospitals Reform Commission for inclusion in their deliberations. PMID:19619091

  4. A Societal Outcomes Map for Health Research and Policy

    PubMed Central

    Garfinkel, Michele S.; Sarewitz, Daniel; Porter, Alan L.

    2006-01-01

    The linkages between decisions about health research and policy and actual health outcomes may be extraordinarily difficult to specify. We performed a pilot application of a “road mapping” and technology assessment technique to perinatal health to illustrate how this technique can clarify the relations between available options and improved health outcomes. We used a combination of data-mining techniques and qualitative analyses to set up the underlying structure of a societal health outcomes road map. Societal health outcomes road mapping may be a useful tool for enhancing the ability of the public health community, policymakers, and other stakeholders, such as research administrators, to understand health research and policy options. PMID:16449589

  5. Pew Memorial Trust policy synthesis: 2. Postretirement health benefits.

    PubMed Central

    Dopkeen, J C

    1987-01-01

    One-fourth of all those over 65 have some form of employer-provided retirement medical benefits. For these retirees and dependents, having this medical coverage may mean the difference between retirement security and ruin; but for employers, providing it could mean serious financial strain or even a threat to survival. The unfunded liability for retirement medical coverage has been variously projected from +100 billion to nearly +2 trillion. Continuing corporate concerns over the costs of health care, and recent changes in federal policies regarding Medicare and the taxation of employee benefit funds, threaten to alter the system of postretirement health benefits substantially and perhaps irrevocably for many. Employers are being forced to reassess their retiree commitments. Some corporations have undertaken to modify and even eliminate postretirement medical coverage for those over 65. These changes will affect not only the corporations involved and their retirees, but also the national and state governments to whom retirees may turn for additional assistance in meeting their health care needs. The purpose of this synthesis is to explain the issue of postretirement health benefits (PRHBs) for both public and private sector policymakers who will be most involved with this issue over the next five years. The analysis identifies the issues involved, considers the dimensions of the problem, and attempts to assess the implications for the future. PMID:3106266

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  9. Extent of East-african nurse leaders' participation in health policy development.

    PubMed

    Shariff, N; Potgieter, E

    2012-01-01

    This paper reports part of a bigger study whose aim was to develop an empowerment model that could be used to enhance nurse leaders' participation in health policy development. A Delphi survey was applied which included the following criteria: expert panelists, iterative rounds, statistical analysis, and consensus building. The expert panelists were purposively selected and included national nurse leaders in leadership positions at the nursing professional associations, nursing regulatory bodies, ministries of health, and universities in East Africa. The study was conducted in three iterative rounds. The results reported here were gathered as part of the first round of the study and that examined the extent of nurse leaders' participation in health policy development. Seventy-eight (78) expert panelists were invited to participate in the study, and the response rate was 47%. Data collection was done with the use of a self-report questionnaire. Data analysis was done by use of SPSS and descriptive statistics were examined. The findings indicated that nurse leaders participate in health policy development though participation is limited and not consistent across all the stages of health policy development. The recommendations from the findings are that health policy development process needs to be pluralistic and inclusive of all nurse leaders practicing in positions related to policy development and the process must be open to their ideas and suggestions.

  10. Health and social policies in the new South Africa.

    PubMed

    Pillay, Y G; Bond, P

    1995-01-01

    South Africa's first democratic government is today confronted with the challenge of recasting apartheid social and health policies, transforming a moribund bureaucracy's mode of governance, and restructuring a variety of public and private institutions, including the national Department of Health. In the attempt to redress racial, gender, and class inequities, enormous barriers confront health policy analysts and planners, progressive politicians, and activists within civil society who work in the field of health. This article sets the broad social policy context for the emerging strategies, documents some of the continuing inequities in the health sector, and recounts some recent experiences in one of the nine provinces (KwaZulu-Natal). to illustrate the difficulties and potentials that change of this magnitude presents under the prevailing conditions of neoliberal politics and economics.

  11. Health Policy and Management: in praise of political science

    PubMed Central

    Hunter, David J

    2015-01-01

    Health systems have entered a third era embracing whole systems thinking and posing complex policy and management challenges. Understanding how such systems work and agreeing what needs to be put in place to enable them to undergo effective and sustainable change are more pressing issues than ever for policy-makers. The theory-policy-practice-gap and its four dimensions, as articulated by Chinitz and Rodwin, is acknowledged. It is suggested that insights derived from political science can both enrich our understanding of the gap and suggest what changes are needed to tackle the complex challenges facing health systems. PMID:26029899

  12. Analysis of Academic Staffing Policies.

    ERIC Educational Resources Information Center

    Bloomfield, Stefan D.

    1980-01-01

    Large-scale Markov chain models and Monte Carlo simulation, two types of models useful for academic managers to analyze academic staffing policies, are described. Their relative advantages and disadvantages regarding technical requirements and performance, as well as managerial usefulness at different levels of the university, are discussed.…

  13. What passes and fails as health policy and management.

    PubMed

    Chinitz, David; Rodwin, Victor G

    2014-10-01

    The field of health policy and management (HPAM) faces a gap between theory, policy, and practice. Despite decades of efforts at reforming health policy and health care systems, prominent analysts state that the health system is "stuck" and that models for change remain "aspirational." We discuss four reasons for the failure of current ideas and models for redesigning health care: (1) the dominance of microeconomic thinking; (2) the lack of comparative studies of health care organizations and the limits of health management theory in recognizing the importance of local contexts; (3) the separation of HPAM from the rank and file of health care, particularly physicians; and (4) the failure to expose medical students to issues of HPAM. We conclude with suggestions for rethinking how the field of HPAM might generate more-promising policies for health care providers and managers by abandoning the illusion of context-free theories and, instead, seeking to facilitate the processes by which organizations can learn to improve their own performance. PMID:25037829

  14. Including health in transport policy agendas: the role of health impact assessment analyses and procedures in the European experience.

    PubMed Central

    Dora, Carlos; Racioppi, Francesca

    2003-01-01

    From the mid-1990s, research began to highlight the importance of a wide range of health impacts of transport policy decisions. The Third Ministerial Conference on Environment and Health adopted a Charter on Transport, Environment and Health based on four main components: bringing awareness of the nature, magnitude and costs of the health impacts of transport into intergovernmental processes; strengthening the arguments for integration of health into transport policies by developing in-depth analysis of the evidence; developing national case studies; and engaging ministries of environment, health and transport as well as intergovernmental and nongovernmental organizations. Negotiation of the Charter was based on two converging processes: the political process involved the interaction of stakeholders in transport, health and environment in Europe, which helped to frame the issues and the approaches to respond to them; the scientific process involved an international group of experts who produced state-of- the-art reviews of the health impacts resulting from transportation activities, identifying gaps in existing knowledge and methodological tools, specifying the policy implications of their findings, and suggesting possible targets for health improvements. Health arguments were used to strengthen environmental ones, clarify costs and benefits, and raise issues of health equity. The European experience shows that HIA can fulfil the need for simple procedures to be systematically applied to decisions regarding transport strategies at national, regional and local levels. Gaps were identified concerning models for quantifying health impacts and capacity building on how to use such tools. PMID:12894322

  15. Children and U.S. federal policy on health and health care: seen but not heard.

    PubMed

    Flores, Glenn; Lesley, Bruce

    2014-12-01

    Children account for 73.5 million Americans (24%), but 8% of federal expenditures. Data on health and health care indicate that child well-being in the United States has been in decline since the most recent recession. Childhood poverty has reached its highest level in 20 years, 1 in 4 children lives in a food-insecure household, 7 million children lack health insurance, a child is abused or neglected every 47 seconds, and 1 in 3 children is overweight or obese. Five children are killed daily by firearms, 1 in 5 experiences a mental disorder, racial/ethnic disparities continue to be extensive and pervasive, and major sequester cuts and underfunding of pediatric research have damaged our global leadership in biomedical research and hobbled economic growth. In this analysis, we identify 10 urgent priorities for the health and health care of US children, including poverty, food insufficiency, lack of health insurance, child abuse and neglect, overweight and obesity, firearm deaths and injuries, mental health, racial/ethnic disparities, immigration, and research. Overwhelming, bipartisan support by voters exists for enhancing our nation's investments in children's health and well-being. Federal policy action steps are proposed to successfully address these priorities and ensure a healthy, productive future for US children and the nation.

  16. Integrating ethics, health policy and health systems in low- and middle-income countries: case studies from Malaysia and Pakistan.

    PubMed

    Hyder, Adnan A; Merritt, Maria; Ali, Joseph; Tran, Nhan T; Subramaniam, Kulanthayan; Akhtar, Tasleem

    2008-08-01

    Scientific progress is a significant basis for change in public-health policy and practice, but the field also invests in value-laden concepts and responds daily to sociopolitical, cultural and evaluative concerns. The concepts that drive much of public-health practice are shaped by the collective and individual mores that define social systems. This paper seeks to describe the ethics processes in play when public-health mechanisms are established in low- and middle-income countries, by focusing on two cases where ethics played a crucial role in producing positive institutional change in public-health policy. First, we introduce an overview of the relationship between ethics and public health; second, we provide a conceptual framework for the ethical analysis of health system events, noting how this approach might enhance the power of existing frameworks; and third, we demonstrate the interplay of these frameworks through the analysis of a programme to enhance road safety in Malaysia and an initiative to establish a national ethics committee in Pakistan. We conclude that, while ethics are gradually being integrated into public-health policy decisions in many developing health systems, ethical analysis is often implicit and undervalued. This paper highlights the need to analyse public-health decision-making from an ethical perspective.

  17. Federalism and health policy: the intergovernmental committees in Brazil

    PubMed Central

    Machado, Cristiani Vieira; de Lima, Luciana Dias; Viana, Ana Luiza d'Ávila; de Oliveira, Roberta Gondim; Iozzi, Fabíola Lana; de Albuquerque, Mariana Vercesi; Scatena, João Henrique Gurtler; Mello, Guilherme Arantes; Pereira, Adelyne Maria Mendes; Coelho, Ana Paula Santana

    2014-01-01

    OBJECTIVE To analyze the dynamics of operation of the Bipartite Committees in health care in the Brazilian states. METHODS The research included visits to 24 states, direct observation, document analysis, and performance of semi-structured interviews with state and local leaders. The characterization of each committee was performed between 2007 and 2010, and four dimensions were considered: (i) level of institutionality, classified as advanced, intermediate, or incipient; (ii) agenda of intergovernmental negotiations, classified as diversified/restricted, adapted/not adapted to the reality of each state, and shared/unshared between the state and municipalities; (iii) political processes, considering the character and scope of intergovernmental relations; and (iv) capacity of operation, assessed as high, moderate, or low. RESULTS Ten committees had advanced level of institutionality. The agenda of the negotiations was diversified in all states, and most of them were adapted to the state reality. However, one-third of the committees showed power inequalities between the government levels. Cooperative and interactive intergovernmental relations predominated in 54.0% of the states. The level of institutionality, scope of negotiations, and political processes influenced Bipartite Committees’ ability to formulate policies and coordinate health care at the federal level. Bipartite Committees with a high capacity of operation predominated in the South and Southeast regions, while those with a low capacity of operations predominated in the North and Northeast. CONCLUSIONS The regional differences in operation among Bipartite Interagency Committees suggest the influence of historical-structural variables (socioeconomic development, geographic barriers, characteristics of the health care system) in their capacity of intergovernmental health care management. However, structural problems can be overcome in some states through institutional and political changes. The creation

  18. Am I My Brother's Keeper? African American Men's Health Within the Context of Equity and Policy.

    PubMed

    Enyia, Okechuku Kelechi; Watkins, Yashika J; Williams, Quintin

    2016-01-01

    African American men's health has at times been regarded as irrelevant to the health and well-being of the communities where they are born, grow, live, work, and age. The uniqueness of being male and of African descent calls for a critical examination and deeper understanding of the psycho-socio-historical context in which African American men have lived. There is a critical need for scholarship that better contextualizes African American Male Theory and cultural humility in terms of public health. Furthermore, the focus of much of the social determinants of health and health equity policy literature has been on advocacy, but few researchers have examined why health-related public policies have not been adopted and implemented from a political and theoretical policy analysis perspective. The purpose of this article will be to examine African American men's health within the context of social determinants of health status, health behavior, and health inequalities-elucidating policy implications for system change and providing recommendations from the vantage point of health equity. PMID:25424505

  19. Am I My Brother's Keeper? African American Men's Health Within the Context of Equity and Policy.

    PubMed

    Enyia, Okechuku Kelechi; Watkins, Yashika J; Williams, Quintin

    2016-01-01

    African American men's health has at times been regarded as irrelevant to the health and well-being of the communities where they are born, grow, live, work, and age. The uniqueness of being male and of African descent calls for a critical examination and deeper understanding of the psycho-socio-historical context in which African American men have lived. There is a critical need for scholarship that better contextualizes African American Male Theory and cultural humility in terms of public health. Furthermore, the focus of much of the social determinants of health and health equity policy literature has been on advocacy, but few researchers have examined why health-related public policies have not been adopted and implemented from a political and theoretical policy analysis perspective. The purpose of this article will be to examine African American men's health within the context of social determinants of health status, health behavior, and health inequalities-elucidating policy implications for system change and providing recommendations from the vantage point of health equity.

  20. [Health policy and practice towards equity].

    PubMed

    de Souza, Renilson Rehem

    2007-12-01

    The article discusses the concepts of equality and equity in the health area in Brazilian scenario, which means under the Unified Health System (UHS). The author shows the principles of UHS, emphasizing the principles of Universality and Integrality. Also reviews briefly the history of UHS and its construction process. It shows singularity of present issues such as technological advances and its consequences to the quality of health attention, both reflecting to the costs of the health care. It analyses some advances that were possible in Brazilian health attention and especially in São Paulo State. In conclusion, he explains a brief analyze about UHS news challenges: the increasing of accessibility to the health services, increasing of needs and the limited resources. PMID:20608374

  1. Assessment of the Status of National Oral Health Policy in India

    PubMed Central

    Kothia, Nandita Rani; Bommireddy, Vikram Simha; Devaki, Talluri; Vinnakota, Narayana Rao; Ravoori, Srinivas; Sanikommu, Suresh; Pachava, Srinivas

    2015-01-01

    Background: National oral health policy was conscripted by the Indian Dental Association (IDA) in 1986 and was accepted as an integral part of National Health Policy (NHP) by the Central Council of Health and Family Welfare in one of its conferences in the year 1995. Objectives of this paper were to find out the efforts made or going on towards its execution, its current status and recent oral health-related affairs or programs, if any. Methods: Literature search was done using the institutional library, web-based search engines like ‘Google’ and ‘PubMed’ and also by cross referencing. It yielded 108 articles, of which 50 were excluded as they were not pertinent to the topic. Twenty-four were of global perspective rather than Indian and hence were not taken into account and finally 34 articles were considered for analyses. Documents related to central and state governments of India were also considered. Results: All the articles considered for analysis were published within the past 10 years with gradual increase in number which depicts the researchers’ increasing focus towards oral health policy. Criticisms, suggestions and recommendations regarding national oral health programs, dental manpower issues, geriatric dentistry, public health dentistry, dental insurance, oral health inequality, and public-private partnerships have taken major occupancies in the articles. Proposals like "model for infant and child oral health promotion" and "oral health policy phase 1 for Karnataka" were among the initiatives towards national oral health policy. Conclusion: The need for implementation of the drafted oral health policy with modification that suits the rapidly changing oral health system of this country is inevitable. PMID:26340486

  2. A rollercoaster of policy shifts: Global trends and reproductive health policy in The Gambia

    PubMed Central

    Sundby, Johanne

    2014-01-01

    Global trends influence strategies for health-care delivery in low- and middle-income countries. A drive towards uniformity in the design and delivery of healthcare interventions, rather than solid local adaptations, has come to dominate global health policies. This study is a participatory longitudinal study of how one country in West Africa, The Gambia, has responded to global health policy trends in maternal and reproductive health, based on the authors’ experience working as a public health researcher within The Gambia over two decades. The paper demonstrates that though the health system is built largely upon the principles of a decentralised and governed primary care system, as delineated in the Alma-Ata Declaration, the more recent policies of The Global Fund to Fight HIV/AIDS, Tuberculosis, and Malaria and the GAVI Alliance have had a major influence on local policies. Vertically designed health programmes have not been easily integrated with the existing system, and priorities have been shifted according to shifting donor streams. Local absorptive capacity has been undermined and inequalities exacerbated within the system. This paper problematises national actors’ lack of ability to manoeuvre within this policy context. The authors’ observations of the consequences in the field over time evoke many questions that warrant discussion, especially regarding the tension between local state autonomy and the donor-driven trend towards uniformity and top–down priority setting. PMID:25203251

  3. A rollercoaster of policy shifts: global trends and reproductive health policy in The Gambia.

    PubMed

    Sundby, Johanne

    2014-01-01

    Global trends influence strategies for health-care delivery in low- and middle-income countries. A drive towards uniformity in the design and delivery of healthcare interventions, rather than solid local adaptations, has come to dominate global health policies. This study is a participatory longitudinal study of how one country in West Africa, The Gambia, has responded to global health policy trends in maternal and reproductive health, based on the authors' experience working as a public health researcher within The Gambia over two decades. The paper demonstrates that though the health system is built largely upon the principles of a decentralised and governed primary care system, as delineated in the Alma-Ata Declaration, the more recent policies of The Global Fund to Fight HIV/AIDS, Tuberculosis, and Malaria and the GAVI Alliance have had a major influence on local policies. Vertically designed health programmes have not been easily integrated with the existing system, and priorities have been shifted according to shifting donor streams. Local absorptive capacity has been undermined and inequalities exacerbated within the system. This paper problematises national actors' lack of ability to manoeuvre within this policy context. The authors' observations of the consequences in the field over time evoke many questions that warrant discussion, especially regarding the tension between local state autonomy and the donor-driven trend towards uniformity and top-down priority setting.

  4. Professional development through policy advocacy: communicating and advocating for health and health equity.

    PubMed

    Garcia, Lydia Berenice; Hernandez, Kristen Eileen; Mata, Holly

    2015-03-01

    Communicating and advocating for evidence-based public health policy is a key component of health promotion practice, but public health professionals often lack experience in policy advocacy. This article provides perspectives from public health professionals who participated in successful public health policy advocacy efforts in their community. Their experiences using evidence-based research to advocate for policies that promote health equity contributed significantly to their career development, and also contributed to community capacity to reduce tobacco-related disparities. This article builds on previous work emphasizing the value of career development opportunities that enhance and diversify the public health workforce, and provides practical tips and "lessons learned" that are relevant to a wide range of public health professionals. PMID:25416310

  5. [The trajectory of the national policy for the reorientation of professional training in health in the Unified Health System (SUS)].

    PubMed

    Dias, Henrique Sant'anna; Lima, Luciana Dias de; Teixeira, Márcia

    2013-06-01

    This paper examines the national policy and its antecedents for reorientation of professional health training implemented after 2003. It highlights landmarks and transformations in the course of policies between 1980 and 2010, elements of continuity and change and the connections between past and current policy initiatives. The study involved a review of the literature on the subject and document analysis supported by theoretical analysis of public policies, particularly historical institutionalism. The results point to four different moments during the trajectory of the policy, marked by changes in the initiatives of reorientation of higher education in health: antecedents; initial experiences; university protagonism; broadening and enhancement. As an element of continuity, there is the permanence of objects in the guiding principles advocated in the policies. The evidence of implementation expresses prospects of enhancement, with diversification of mobilized actors and organizations, and more projects implemented. The accumulated experience suggests structural maturity of the structural bases of action and the main changes relate to the enhancement of decision-making bodies of the SUS and the approximation to the process of decentralization and regionalization of national health policy. PMID:23752528

  6. [The trajectory of the national policy for the reorientation of professional training in health in the Unified Health System (SUS)].

    PubMed

    Dias, Henrique Sant'anna; Lima, Luciana Dias de; Teixeira, Márcia

    2013-06-01

    This paper examines the national policy and its antecedents for reorientation of professional health training implemented after 2003. It highlights landmarks and transformations in the course of policies between 1980 and 2010, elements of continuity and change and the connections between past and current policy initiatives. The study involved a review of the literature on the subject and document analysis supported by theoretical analysis of public policies, particularly historical institutionalism. The results point to four different moments during the trajectory of the policy, marked by changes in the initiatives of reorientation of higher education in health: antecedents; initial experiences; university protagonism; broadening and enhancement. As an element of continuity, there is the permanence of objects in the guiding principles advocated in the policies. The evidence of implementation expresses prospects of enhancement, with diversification of mobilized actors and organizations, and more projects implemented. The accumulated experience suggests structural maturity of the structural bases of action and the main changes relate to the enhancement of decision-making bodies of the SUS and the approximation to the process of decentralization and regionalization of national health policy.

  7. Effects of Targeted Subsidies Policy on Health Behavior in Iranian Households: A Qualitative Study

    PubMed Central

    DOSHMANGIR, Leila; DOSHMANGIR, Parinaz; ABOLHASSANI, Nazanin; MOSHIRI, Esmaeil; JAFARI, Mehdi

    2015-01-01

    Background: This study aimed to explore the effects of national targeted subsidies policy on health behavior of Iranian households. Methods: In this qualitative study, data were collected between January 2012 and December 2013 through face-to-face interviews (23 experts in national and provincial levels of health system and 18 household heads) and through a comprehensive and purposive document analysis. The data was analyzed using a thematic analysis method (inductive-deductive) and assisted by Atlas-ti software. Results: Rising health care costs, removing some food subsidies and the increase in price of most goods and services due to the implementation of economic policy of targeted subsidies have led to significant changes in the demand for health services, changes in the consumption trends of goods and services affecting health as well as changes in the health habits of households. Conclusion: Targeted subsidies and the cash subsidy policy have some negative effects on population health behavior especially among poor people. Hence, maintaining or increasing the cash subsidy is not an efficient allocation of resources toward health care system. So, it is necessary to identify appropriate strategies and policies and apply interventions in order to moderate negative effects and enhance positive effects resulted from implementing this economic reform on population health behavior. PMID:26056676

  8. Health Needs: Policy Plan and School Practice in Greece

    ERIC Educational Resources Information Center

    Soultatou, Pelagia; Duncan, Peter; Athanasiou, Kyriacos; Papadopoulos, Irena

    2011-01-01

    Purpose: The purpose of this paper is to explore the concept of health-related needs on a policy design and curriculum enactment basis in terms of the national school health education curriculum in Greek secondary education. Design/methodology/approach: A single case study, using an ethnographic approach, was conducted in Greece, seeking to…

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

    ERIC Educational Resources Information Center

    Johnson, Norine G.

    2003-01-01

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

  10. Taking power, politics, and policy problems seriously: the limits of knowledge translation for urban health research.

    PubMed

    Murphy, Kelly; Fafard, Patrick

    2012-08-01

    Knowledge translation (KT) is a growing movement in clinical and health services research, aimed to help make research more relevant and to move research into practice and policy. This paper examines the conventional model of policy change presented in KT and assesses its applicability for increasing the impact of urban health research on urban health policy. In general, KT conceptualizes research utilization in terms of the technical implementation of scientific findings, on the part of individual decision-makers who can be "targeted" for a KT intervention, in a context that is absent of political interests. However, complex urban health problems and interventions infrequently resemble this single decision, single decision-maker model posited by KT. In order to clarify the conditions under which urban health research is more likely or not to have an influence on public policy development, we propose to supplement the conventional model with three concepts drawn from the social science: policy stages, policy networks, and a discourse analysis approach for theorizing power in policy-making.

  11. Taking power, politics, and policy problems seriously: the limits of knowledge translation for urban health research.

    PubMed

    Murphy, Kelly; Fafard, Patrick

    2012-08-01

    Knowledge translation (KT) is a growing movement in clinical and health services research, aimed to help make research more relevant and to move research into practice and policy. This paper examines the conventional model of policy change presented in KT and assesses its applicability for increasing the impact of urban health research on urban health policy. In general, KT conceptualizes research utilization in terms of the technical implementation of scientific findings, on the part of individual decision-makers who can be "targeted" for a KT intervention, in a context that is absent of political interests. However, complex urban health problems and interventions infrequently resemble this single decision, single decision-maker model posited by KT. In order to clarify the conditions under which urban health research is more likely or not to have an influence on public policy development, we propose to supplement the conventional model with three concepts drawn from the social science: policy stages, policy networks, and a discourse analysis approach for theorizing power in policy-making. PMID:22678649

  12. NUDGING FOR HEALTH: ON PUBLIC POLICY AND DESIGNING CHOICE ARCHITECTURE

    PubMed Central

    Quigley, Muireann

    2013-01-01

    There have been recent policy moves aimed at encouraging individuals to lead healthier lives. The Cabinet Office has set up a ‘nudge unit’ with health as one of its priorities and behavioural approaches have started to be integrated into health-related domestic policy in a number of areas. Behavioural research has shown that that the way the environment is constructed can shape a person's choices within it. Thus, it is hoped that, by using insights from such research, people can be nudged towards making decisions which are better for their health. This article outlines how nudges can be conceived of as part of an expanding arsenal of health-affecting regulatory tools being used by the Government and addresses some concerns which have been expressed regarding behavioural research-driven regulation and policy. In particular, it makes the case that, regardless of new regulatory and policy strategies, we cannot escape the myriad of influences which surround us. As such, we can view our health-affecting decisions as already being in some sense shaped and constructed. Further, it argues we may in fact have reason to prefer sets of health-affecting options which have been intentionally designed by the state, rather than those that stem from other sources or result from random processes. Even so, in closing, this article draws attention to the largely unanswered questions about how behavioural research translates into policy and regulatory initiatives. PMID:24081425

  13. Policy Capacity for Health Reform: Necessary but Insufficient

    PubMed Central

    Adams, Owen

    2016-01-01

    Forest and colleagues have persuasively made the case that policy capacity is a fundamental prerequisite to health reform. They offer a comprehensive life-cycle definition of policy capacity and stress that it involves much more than problem identification and option development. I would like to offer a Canadian perspective. If we define health reform as re-orienting the health system from acute care to prevention and chronic disease management the consensus is that Canada has been unsuccessful in achieving a major transformation of our 14 health systems (one for each province and territory plus the federal government). I argue that 3 additional things are essential to build health policy capacity in a healthcare federation such as Canada: (a) A means of "policy governance" that would promote an approach to cooperative federalism in the health arena; (b) The ability to overcome the "policy inertia" resulting from how Canadian Medicare was implemented and subsequently interpreted; and (c) The ability to entertain a long-range thinking and planning horizon. My assessment indicates that Canada falls short on each of these items, and the prospects for achieving them are not bright. However, hope springs eternal and it will be interesting to see if the July, 2015 report of the Advisory Panel on Healthcare Innovation manages to galvanize national attention and stimulate concerted action. PMID:26673650

  14. Advancing health policy in nursing education through service learning.

    PubMed

    Cohen, S S; Milone-Nuzzo, P

    2001-03-01

    Knowledge of health policy is an increasingly important aspect of nursing practice and education, especially as nurses strive to improve the rapidly changing health care delivery system. At the same time, many educators, researchers, foundations, and government officials are touting the benefits of service learning. In particular, service learning offers ways to enhance partnerships between academia and community agencies and to extend learning beyond the traditional classroom. We present a model for educating nurses as advanced practice nurses in health policy that links service learning with a framework for the political development of nurses. Under the rubric of service learning, the curriculum is based on the overlap among health policy, the role of the nurse as consultant, and community-based care. After discussing the importance of health policy for graduate nursing education and reviewing the essentials of service learning, we describe a three-semester graduate sequence in health policy service learning. The focus is on the clinical and classroom components of both individual and group practica and their relationship to stages of nursing's political development. The article concludes with evaluation considerations and the implications of our work for nursing theory, research, practice, and education.

  15. Global health impacts of policies: lessons from the UK

    PubMed Central

    2014-01-01

    Background The UK government committed to undertaking impact assessments of its policies on the health of populations in low and middle-income countries in its cross-government strategy “Health is Global”. To facilitate this process, the Department of Health, in collaboration with the National Heart Forum, initiated a project to pilot the use of a global health impact assessment guidance framework and toolkit for policy-makers. This paper aims to stimulate debate about the desirability and feasibility of global health impact assessments by describing and drawing lessons from the first stage of the project. Discussion Despite the attraction of being able to assess and address potential global health impacts of policies, there is a dearth of existing information and experience. A literature review was followed by discussions with policy-makers and an online survey about potential barriers, preferred support mechanisms and potential policies on which to pilot the toolkit. Although policy-makers were willing to engage in hypothetical discussions about the methodology, difficulties in identifying potential pilots suggest a wider problem in encouraging take up without legislative imperatives. This is reinforced by the findings of the survey that barriers to uptake included lack of time, resources and expertise. We identified three lessons for future efforts to mainstream global health impact assessments: 1) Identify a lead government department and champion – to some extent, this role was fulfilled by the Department of Health, however, it lacked a high-level cross-government mechanism to support implementation. 2) Ensure adequate resources and consider embedding the goals and principles of global health impact assessments into existing processes to maximise those resources. 3) Develop an effective delivery mechanism involving both state actors, and non-state actors who can ensure a “voice” for constituencies who are affected by government policies and also

  16. The Brazilian health informatics and information policy: building the consensus.

    PubMed

    Leão, Beatriz F; Costa, Cláudio G; Facchini, Luiz Augusto; Bandarra, Ernani B; Gonçalves, Sibele F; Bretas Jr, Nilo; Ferla, Alcindo

    2004-01-01

    This paper describes the construction of the Brazilian Health Information Policy. The Introduction gives an overview of the health informatics scenario in the country and the motivation for the definition of a national policy for the area. The process adopted and the strategies to reach consensus among the different players of the healthcare arena are discussed. The interface with the national health card project and the standards already established are also depicted. The current document and the strategies so far proposed are presented with their respective time table and goals. At the end, a comparison with other national initiatives is drawn. PMID:15361004

  17. Abortion policy and women's health in developing countries.

    PubMed

    Dixon-Mueller, R

    1990-01-01

    The World Health Organization estimates that almost half a million women in developing countries die in pregnancy and childbirth every year. Unsafe induced abortion is responsible for perhaps one-quarter of these deaths. In this article, the author reviews the legal, medical, and social contexts in which women in developing countries resort to clandestine abortion. Despite intensified international concern with reducing high rates of maternal mortality and morbidity, national policy makers and participants at international conferences on maternal health--with a few important exceptions--have not recommended that safe, legal services for terminating unwanted pregnancies be offered as an essential element of basic reproductive health care. United States international policy on funding abortion-related activities in maternal health and family planning programs is especially restrictive. A new policy approach is clearly needed if unacceptably high rates of maternal morbidity and mortality in many countries are to be reduced.

  18. [Processes in the construction of the Brazilian National Health Promotion Policy].

    PubMed

    Ferreira Neto, João Leite; Kind, Luciana; Resende, Maria Carolina Costa; Colen, Natália Silva

    2013-10-01

    We investigated the processes involved in the construction of the Brazilian National Health Promotion Policy (PNPS) through the analysis of three documents produced by the Ministry of Health from 2002 to 2005 and the final text of the National Health Promotion Policy, approved in 2006. We interviewed five subjects who participated in drafting the PNPS, three of whom were Ministry of Health administrators, plus two researchers. The documents were explored with discourse analysis. The article contributes to the debate on the development of the PNPS. Health promotion showed various points of disagreement, which led to the delay in the document's final approval. International induction via funding proved to be a crucial element for defining the final wording of the PNPS, reestablishing the emphasis (subject to criticism) on lifestyle changes in its "Actions". The article highlights the negotiated consensus that led to the creation of the PNPS Management Committee, with participation by various sub-sectors, an innovative structure within the Ministry of Health.

  19. Understanding Policy: Why Health Education Policy Is Important and Why It Does Not Appear to Work

    ERIC Educational Resources Information Center

    Evans, John; Davies, Brian; Rich, Emma; DePian, Laura

    2013-01-01

    Drawing on research investigating the impact of health imperatives around obesity, diet and exercise on the actions of teachers and pupils in schools, this paper offers a reflexive account of the relationships between the "noise" of obesity discourse in the public domain, policies forged to tackle health issues and the realities of teaching in…

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

    PubMed

    Machado, Cristiani Vieira; Lima, Luciana Dias de; Andrade, Carla Lourenço Tavares de

    2014-01-01

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

  1. Health system research in Vietnam: Generating policy-relevant knowledge

    PubMed Central

    Van Minh, Hoang; Giang, Le Minh; Cashin, Cheryl; Hinh, Nguyen Duc

    2015-01-01

    Vietnam’s health system continues to make great progress in improving its capacities and performance. However, despite the many significant achievements that have been made, this paper summaries 11 health system research papers from different perspectives with the aim of providing scientific evidence for policy actions in Vietnam. Health system research is ultimately concerned with improving the health of people and communities, by enhancing the efficiency and effectiveness of the health system as an integral part of the overall process of socioeconomic development, with full involvement of all actors. We hope the findings from this cluster of papers provide some insights into issues of importance for the continued advancement and strengthening of the health system in Vietnam and can be considered a valid and reliable resource to inform planning, management and policy-making decisions. PMID:25622126

  2. Recent health policy initiatives in Nordic countries

    PubMed Central

    Saltman, Richard B.

    1992-01-01

    Health care systems in Sweden, Finland, and Denmark are in the midst of substantial organizational reconfiguration. Although retaining their tax-based single source financing arrangements, they have begun experiments that introduce a limited measure of competitive behavior in the delivery of health services. The emphasis has been on restructuring public operated hospitals and health centers into various forms of public firms, rather than on the privatization of ownership of institutions. If successful, the reforms will enable these Nordic countries to combine their existing macroeconomic controls with enhanced microeconomic efficiency, effectiveness, and responsiveness to patients. PMID:10122003

  3. Analysis of State Bullying Laws and Policies

    ERIC Educational Resources Information Center

    Stuart-Cassel, Victoria; Bell, Ariana; Springer, J. Fred

    2011-01-01

    Bullying in schools has become widely viewed as an urgent social, health, and education concern that has moved to the forefront of public debate on school legislation and policy. The Columbine High School shooting in 1999 was the first of many high-profile incidents of violent behavior that appeared to implicate bullying as an underlying cause…

  4. Policy processes underpinning universal health insurance in Vietnam

    PubMed Central

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

    2014-01-01

    Background In almost 30 years since economic reforms or ‘renovation’ (Doimoi) were launched, Vietnam has achieved remarkably good health results, in many cases matching those in much higher income countries. This study explores the contribution made by Universal Health Insurance (UHI) policies, focusing on the past 15 years. We conducted a mixed method study to describe and assess the policy process relating to health insurance, from agenda setting through implementation and evaluation. Design The qualitative research methods implemented in this study were 30 in-depth interviews, 4 focus group discussions, expert consultancy, and 420 secondary data review. The data were analyzed by NVivo 7.0. Results Health insurance in Vietnam was introduced in 1992 and has been elaborated over a 20-year time frame. These processes relate to moving from a contingent to a gradually expanded target population, expanding the scope of the benefit package, and reducing the financial contribution from the insured. The target groups expanded to include 66.8% of the population by 2012. We characterized the policy process relating to UHI as incremental with a learning-by-doing approach, with an emphasis on increasing coverage rather than ensuring a basic service package and financial protection. There was limited involvement of civil society organizations and users in all policy processes. Intertwined political economy factors influenced the policy processes. Conclusions Incremental policy processes, characterized by a learning-by-doing approach, is appropriate for countries attempting to introduce new health institutions, such as health insurance in Vietnam. Vietnam should continue to mobilize resources in sustainable and viable ways to support the target groups. The country should also adopt a multi-pronged approach to achieving universal access to health services, beyond health insurance. PMID:25262793

  5. US health journal editors' opinions and policies on research in race, ethnicity, and health.

    PubMed

    Bennett, T; Bhopal, R

    1998-07-01

    Health research on race and ethnicity has been criticized for lacking rigor in conceptualization, terminology, and analysis. Scientific journals' editorial processes help determine research quality. This survey assessed editors' awareness of current debates, attitudes toward recent recommendations, and involvement in developing editorial policies. Twenty-nine editors of health journals with impact factors of > or = 1 (based on citation ratings) were sent a questionnaire including four key problems identified in research literature and recommendations from federal agencies; 23 (79%) responded. Seven editors relevant policies. Two had read the federal directive on racial and ethnic classification; one was aware of its current review. Most perceived the four key problems as uncommon. The majority agreed with Public Health Service recommendations on race and ethnicity research, except for analyzing effects of racism. Approximately 20% had discussed issues with co-editors, editorial boards, or reviewers. About 40% saw further discussion as beneficial; four planned to draft guidelines. Editors' potential for helping resolve problems in race/ethnicity research is not being realized. Greater participation would be beneficial to public health research and practice.

  6. US health journal editors' opinions and policies on research in race, ethnicity, and health.

    PubMed Central

    Bennett, T.; Bhopal, R.

    1998-01-01

    Health research on race and ethnicity has been criticized for lacking rigor in conceptualization, terminology, and analysis. Scientific journals' editorial processes help determine research quality. This survey assessed editors' awareness of current debates, attitudes toward recent recommendations, and involvement in developing editorial policies. Twenty-nine editors of health journals with impact factors of > or = 1 (based on citation ratings) were sent a questionnaire including four key problems identified in research literature and recommendations from federal agencies; 23 (79%) responded. Seven editors relevant policies. Two had read the federal directive on racial and ethnic classification; one was aware of its current review. Most perceived the four key problems as uncommon. The majority agreed with Public Health Service recommendations on race and ethnicity research, except for analyzing effects of racism. Approximately 20% had discussed issues with co-editors, editorial boards, or reviewers. About 40% saw further discussion as beneficial; four planned to draft guidelines. Editors' potential for helping resolve problems in race/ethnicity research is not being realized. Greater participation would be beneficial to public health research and practice. PMID:9685775

  7. Developing effective policy and practice for health promotion in Scotland.

    PubMed

    Wimbush, Erica; Young, Ian; Robertson, Graham

    2007-01-01

    Scotland has recently embarked on a new phase of policy and infrastructure development for improving population health and reducing health inequalities that broadly conforms to the Ottawa Charter and WHO's strategic framework for the prevention and control of non-communicable diseases. The new phase is characterised by an integrated, cross-government approach to improving health with strengthened political and Scottish Executive leadership and investment since devolution. A comprehensive policy framework for improving young people's health and reducing inequalities has been developed across education, health, environment and social justice. It builds on an earlier phase of relative stability and continuity in the health promotion infrastructure with policy focused on CVD and cancer prevention and tackling the behavioural risk factors (smoking, alcohol, diet, physical activity) as well as sexual health and mental health and wellbeing. These national strategies are currently being implemented across Scotland. They combine promotion, prevention, treatment and protection goals and target both population-level and high-risk groups. Crosscutting government objectives and headline targets for addressing poverty, disadvantage and health inequalities now supplement the NHS health improvement targets on smoking, alcohol, physical activity, teenage pregnancy and child immunization. Within the health service, prevention efforts are largely concerned with primary care development (anticipatory care) and health system reform to maximize their impact on reducing health inequalities. Efforts to tackle the social determinants of health and reduce inequalities in health outcomes are beginning to be connected and mainstreamed across local government with Community Planning Partnerships as the main vehicle. National level mechanisms for integrated funding, planning and performance reporting to deliver shared priority outcomes have yet to be developed. The development of health

  8. Political contexts and maternal health policy: insights from a comparison of south Indian states.

    PubMed

    Smith, Stephanie L

    2014-01-01

    Nearly 300,000 women die from pregnancy-related complications each year. One-fifth of these deaths occur in India. Maternal survival rose on India's national policy agenda in the mid-2000s, but responsibility for health policy and implementation in the federal system is largely devolved to the state level where priority for the issue and maternal health outcomes vary. This study investigates sources of variation in maternal health policy and implementation sub-nationally in India. The study is guided by four analytical categories drawn from policy process literature: constitutional, governing and social structures; political contexts; actors and ideas. The experiences of two south Indian states-Tamil Nadu a leader and Karnataka a relatively slow mover-are examined. Process-tracing, a case study methodology that helps to identify roles of complex historical events in causal processes, was employed to investigate the research question in each state. The study is informed by interviews with public health policy experts and service delivery professionals, observation of implementation sites and archival document analysis. Historical legacies-Tamil Nadu's non-Brahmin social movement and Karnataka's developmental disparities combined with decentralization-shape the states' political contexts, affecting variation in maternal health policy and implementation. Competition to advance consistent political priorities across regimes in Tamil Nadu offers fertile ground for policy entrepreneurship and strong public health system administration facilitates progress. Inconsistent political priorities and relatively weak public health system administration frustrate progress in Karnataka. These variations offer insights to the ways in which sub-national political and administrative contexts shape health policy and implementation. PMID:24444838

  9. Political contexts and maternal health policy: insights from a comparison of south Indian states.

    PubMed

    Smith, Stephanie L

    2014-01-01

    Nearly 300,000 women die from pregnancy-related complications each year. One-fifth of these deaths occur in India. Maternal survival rose on India's national policy agenda in the mid-2000s, but responsibility for health policy and implementation in the federal system is largely devolved to the state level where priority for the issue and maternal health outcomes vary. This study investigates sources of variation in maternal health policy and implementation sub-nationally in India. The study is guided by four analytical categories drawn from policy process literature: constitutional, governing and social structures; political contexts; actors and ideas. The experiences of two south Indian states-Tamil Nadu a leader and Karnataka a relatively slow mover-are examined. Process-tracing, a case study methodology that helps to identify roles of complex historical events in causal processes, was employed to investigate the research question in each state. The study is informed by interviews with public health policy experts and service delivery professionals, observation of implementation sites and archival document analysis. Historical legacies-Tamil Nadu's non-Brahmin social movement and Karnataka's developmental disparities combined with decentralization-shape the states' political contexts, affecting variation in maternal health policy and implementation. Competition to advance consistent political priorities across regimes in Tamil Nadu offers fertile ground for policy entrepreneurship and strong public health system administration facilitates progress. Inconsistent political priorities and relatively weak public health system administration frustrate progress in Karnataka. These variations offer insights to the ways in which sub-national political and administrative contexts shape health policy and implementation.

  10. Purchasing power: business and health policy change in Massachusetts.

    PubMed

    Bergthold, L A

    1988-01-01

    As in many states around the country, health care costs in Massachusetts had risen to an unprecedented proportion of the state budget by the early 1980s. State health policymakers realized that dramatic changes were needed in the political process to break provider control over health policy decisions. This paper presents a case study of policy change in Massachusetts between 1982 and 1988. State officials formulated a strategy to mobilize corporate interests, which were already awakening to the problems of high health care costs, as a countervailing power to the political monopoly of provider interests. Once mobilized, business interests became organized politically and even became dominant at times, controlling both the policy agenda and its process. Ultimately, business came to be viewed as a permanent part of the coalitions and commissions that helped formulate state health policy. Although initially allied with provider interests, business eventually forged a stronger alliance with the state, an alliance that has the potential to force structural change in health care politics in Massachusetts for years to come. The paper raises questions about the consequences of such alliances between public and private power for both the content and the process of health policymaking at the state level.

  11. Purchasing power: business and health policy change in Massachusetts.

    PubMed

    Bergthold, L A

    1988-01-01

    As in many states around the country, health care costs in Massachusetts had risen to an unprecedented proportion of the state budget by the early 1980s. State health policymakers realized that dramatic changes were needed in the political process to break provider control over health policy decisions. This paper presents a case study of policy change in Massachusetts between 1982 and 1988. State officials formulated a strategy to mobilize corporate interests, which were already awakening to the problems of high health care costs, as a countervailing power to the political monopoly of provider interests. Once mobilized, business interests became organized politically and even became dominant at times, controlling both the policy agenda and its process. Ultimately, business came to be viewed as a permanent part of the coalitions and commissions that helped formulate state health policy. Although initially allied with provider interests, business eventually forged a stronger alliance with the state, an alliance that has the potential to force structural change in health care politics in Massachusetts for years to come. The paper raises questions about the consequences of such alliances between public and private power for both the content and the process of health policymaking at the state level. PMID:3171112

  12. What makes an academic paper useful for health policy?

    PubMed

    Whitty, Christopher J M

    2015-12-17

    Evidence-based policy ensures that the best interventions are effectively implemented. Integrating rigorous, relevant science into policy is therefore essential. Barriers include the evidence not being there; lack of demand by policymakers; academics not producing rigorous, relevant papers within the timeframe of the policy cycle. This piece addresses the last problem. Academics underestimate the speed of the policy process, and publish excellent papers after a policy decision rather than good ones before it. To be useful in policy, papers must be at least as rigorous about reporting their methods as for other academic uses. Papers which are as simple as possible (but no simpler) are most likely to be taken up in policy. Most policy questions have many scientific questions, from different disciplines, within them. The accurate synthesis of existing information is the most important single offering by academics to the policy process. Since policymakers are making economic decisions, economic analysis is central, as are the qualitative social sciences. Models should, wherever possible, allow policymakers to vary assumptions. Objective, rigorous, original studies from multiple disciplines relevant to a policy question need to be synthesized before being incorporated into policy.

  13. Factors that act as facilitators and barriers to nurse leaders’ participation in health policy development

    PubMed Central

    2014-01-01

    Background Health policies impact on nursing profession and health care. Nurses' involvement in health policy development ensures that health care is safe, of a high quality, accessible and affordable. Numerous factors influence nurse leaders' ability to be politically active in influencing health policy development. These factors can be facilitators or barriers to their participation. There is scant research evidence from Eastern African region that draws attention to this topic. This paper reports part of the larger study. The objectives reported in this paper were those aimed to: build consensus on factors that act as facilitators and barriers to nurse leaders' participation in health policy development in Kenya, Uganda and Tanzania. Methods A Delphi survey was applied which included: expert panelists, iterative rounds, statistical analysis, and consensus building. The expert panelists were purposively selected and included national nurse leaders in leadership positions in East Africa. Data collection was done, in three iterative rounds, and utilized a questionnaire with open and closed ended questions. 78 expert panelists were invited to participate in the study; the response rate was 47% of these 64.8% participated in the second round and of those 100% participated in the third round. Data analysis was done by examining the data for the most commonly occurring categories for the open ended questions and descriptive statistics for structured questions. Results The findings of the study indicate that both facilitators and barriers exist. The former include: being involved in health policy development, having knowledge and skills, enhancing the image of nursing and enabling structures and processes. The latter include: lack of involvement, negative image of nursing and structures and processes which exclude them. Conclusion There is a window of opportunity to enhance national nurse leaders' participation in health policy development. Nurse leaders have a key role

  14. Economic rationalisation of health behaviours: the dangers of attempting policy discussions in a vacuum.

    PubMed

    Reilly, Rachel; Rowley, Kevin; Luke, Joanne; Doyle, Joyce; Ritte, Rebecca; O'Shea, Rebekah; Brown, Alex

    2014-08-01

    When analysing the health behaviours of any group of people, understanding the constraints and possibilities for individual agency as shaped by the broader societal context is critical. In recent decades, our understanding of the ways in which physical and social environments influence health and health behaviours has expanded greatly. The authors of a recent analysis of Australian Aboriginal health data using an economic 'rational choice model,' published in this journal, claim to make a useful contribution to policy discussions relating to Aboriginal health, but neglect context. By doing so, they neglect the very factors that determine the success or failure of policy change. Notwithstanding the technical sophistication of the analyses, by ignoring most relevant determinants of health, the conclusions misrepresent the lives of Aboriginal and Torres Strait Islander people and therefore risk perpetuating harm, rather than improving health.

  15. Economic rationalisation of health behaviours: the dangers of attempting policy discussions in a vacuum.

    PubMed

    Reilly, Rachel; Rowley, Kevin; Luke, Joanne; Doyle, Joyce; Ritte, Rebecca; O'Shea, Rebekah; Brown, Alex

    2014-08-01

    When analysing the health behaviours of any group of people, understanding the constraints and possibilities for individual agency as shaped by the broader societal context is critical. In recent decades, our understanding of the ways in which physical and social environments influence health and health behaviours has expanded greatly. The authors of a recent analysis of Australian Aboriginal health data using an economic 'rational choice model,' published in this journal, claim to make a useful contribution to policy discussions relating to Aboriginal health, but neglect context. By doing so, they neglect the very factors that determine the success or failure of policy change. Notwithstanding the technical sophistication of the analyses, by ignoring most relevant determinants of health, the conclusions misrepresent the lives of Aboriginal and Torres Strait Islander people and therefore risk perpetuating harm, rather than improving health. PMID:24825820

  16. Financial sustainability versus access and quality in a challenged health system: an examination of the capitation policy debate in Ghana.

    PubMed

    Atuoye, Kilian Nasung; Vercillo, Siera; Antabe, Roger; Galaa, Sylvester Zackaria; Luginaah, Isaac

    2016-11-01

    Policy makers in low and middle-income countries are frequently confronted with challenges of increasing health access for poor populations in a sustainable manner. After several years of trying out different health financing mechanisms, health insurance has recently emerged as a pro-poor health financing policy. Capitation, a fixed fee periodically paid to health service providers for anticipated services, is one of the payment policies in health insurance. This article examines claims and counter-claims made by coalitions and individual stakeholders in a capitation payment policy debate within Ghana's National Health Insurance Scheme. Using content analysis of public and parliamentary proceedings, we situate the debate within policy making and health insurance literature. We found that the ongoing capitation payment debate stems from challenges in implementation of earlier health insurance claims payment systems, which reflect broader systemic challenges facing the health insurance scheme in Ghana. The study illustrates the extent to which various sub-systems in the policy debate advance arguments to legitimize their claims about the contested capitation payment system. In addition, we found that the health of poor communities, women and children are being used as surrogates for political and individual arguments in the policy debate. The article recommends a more holistic and participatory approach through persuasion and negotiation to join interests and core evidence together in the capitation policy making in Ghana and elsewhere with similar contexts. PMID:27178747

  17. Financial sustainability versus access and quality in a challenged health system: an examination of the capitation policy debate in Ghana.

    PubMed

    Atuoye, Kilian Nasung; Vercillo, Siera; Antabe, Roger; Galaa, Sylvester Zackaria; Luginaah, Isaac

    2016-11-01

    Policy makers in low and middle-income countries are frequently confronted with challenges of increasing health access for poor populations in a sustainable manner. After several years of trying out different health financing mechanisms, health insurance has recently emerged as a pro-poor health financing policy. Capitation, a fixed fee periodically paid to health service providers for anticipated services, is one of the payment policies in health insurance. This article examines claims and counter-claims made by coalitions and individual stakeholders in a capitation payment policy debate within Ghana's National Health Insurance Scheme. Using content analysis of public and parliamentary proceedings, we situate the debate within policy making and health insurance literature. We found that the ongoing capitation payment debate stems from challenges in implementation of earlier health insurance claims payment systems, which reflect broader systemic challenges facing the health insurance scheme in Ghana. The study illustrates the extent to which various sub-systems in the policy debate advance arguments to legitimize their claims about the contested capitation payment system. In addition, we found that the health of poor communities, women and children are being used as surrogates for political and individual arguments in the policy debate. The article recommends a more holistic and participatory approach through persuasion and negotiation to join interests and core evidence together in the capitation policy making in Ghana and elsewhere with similar contexts.

  18. Analysis of policy towards improvement of perinatal mortality in the Netherlands (2004-2011).

    PubMed

    Vos, Amber A; van Voorst, Sabine F; Steegers, Eric A P; Denktaş, Semiha

    2016-05-01

    Relatively high perinatal mortality and morbidity rates(2) in the Netherlands resulted in a process which induced policy changes regarding the Dutch perinatal healthcare system. Aims of this policy analysis are (1) to identify actors, context and process factors that promoted or impeded agenda setting and formulation of policy regarding perinatal health care reform and (2) to present an overview of the renewed perinatal health policy. The policy triangle framework for policy analysis by Walt and Gilson was applied(3). Contents of policy, actors, context factors and process factors were identified by triangulation of data from three sources: a document analysis, stakeholder analysis and semi-structured interviews with key stakeholders. Analysis enabled us to chronologically reconstruct the policy process in response to the perinatal mortality rates. The quantification of the perinatal mortality problem, the openness of the debate and the nature of the topic were important process factors. Main theme of policy was that change was required in the entire spectrum of perinatal healthcare. This ranged from care in the preconception phase through to the puerperium. Furthermore emphasis was placed on the importance of preventive measures and socio-environmental determinants of health. This required involvement of the preventive setting, including municipalities. The Dutch tiered perinatal healthcare system and divergent views amongst curative perinatal health care providers were important context factors. This study provides lessons which are applicable to health care professionals and policy makers in perinatal care or other multidisciplinary fields.

  19. The women's health movement: making policy, 1970-1995.

    PubMed

    Munch, Shari

    2006-01-01

    With the advent of second-wave feminism during the 1970s, a significant body of literature emerged describing sexist practices in women's health care. Gender-bias and gender disparities found in women's health care became concerns that garnered considerable attention in the United States because of the increased health risks posed for women. This article describes key historical challenges and accomplishments made in U.S. women's health care policy during the quarter century spanning 1970-1995 that influence contemporary health care social work practice and social work education.

  20. The need to include animal protection in public health policies

    PubMed Central

    Akhtar, Aysha

    2013-01-01

    Many critical public health issues require non-traditional approaches. Although many novel strategies are used, one approach not widely applied involves improving the treatment of animals. Emerging infectious diseases are pressing public health challenges that could benefit from improving the treatment of animals. Other human health issues, that overlap with animal treatment issues, and that warrant further exploration, are medical research and domestic violence. The diverse nature of these health issues and their connection with animal treatment suggest that there may be other similar intersections. Public health would benefit by including the treatment of animals as a topic of study and policy development. PMID:23803712

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

    ERIC Educational Resources Information Center

    Peckover, Sue

    2013-01-01

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

  2. Health Policy Roundtable—Policy by Numbers: The Role of Budget Estimates and Scoring in Health Care Reform

    PubMed Central

    Folz, Christina E

    2005-01-01

    The purpose of this roundtable is to explore the imperfect art of estimating the budget costs of health insurance proposals—called scoring when done by government agencies. The panel addresses the complexities involved in generating these estimates, which usually depend on many untested and untestable assumptions. For example, the Medicare prescription drug “donut hole” was invented so that policymakers could achieve budget targets. These budget scores play a critical role in the design of health policies, as well as in the reform proposals put forth by candidates in an election. The roundtable discusses how policymakers can and do use health policy estimates and budget scores. PMID:15762895

  3. Best of enemies: Using social network analysis to explore a policy network in European smoke-free policy.

    PubMed

    Weishaar, Heide; Amos, Amanda; Collin, Jeff

    2015-05-01

    Networks and coalitions of stakeholders play a crucial role in the development and implementation of policies, with previous research highlighting that networks in tobacco control are characterised by an antagonism between supporters and opponents of comprehensive tobacco control policies. This UK-based study used quantitative and qualitative network analysis (drawing on 176 policy submissions and 32 interviews) to systematically map and analyse a network of actors involved in the development of European Union (EU) smoke-free policy. Policy debates were dominated by two coalitions of stakeholders with starkly opposing positions on the issue. One coalition, consisting primarily of health-related organisations, supported comprehensive EU smoke-free policy, whereas the other, led by tobacco manufacturers' organisations, opposed the policy initiative. The data suggest that, aided by strong political commitment of EU decision makers to develop smoke-free policy, advocates supporting comprehensive EU policy were able to frame policy debates in ways which challenged the tobacco industry's legitimacy. They then benefited from the stark polarisation between the two coalitions. The paper provides empirical evidence of the division between two distinct coalitions in tobacco policy debates and draws attention to the complex processes of consensus-seeking, alliance-building and strategic action which are integral to the development of EU policy. Highlighting network polarisation and industry isolation as factors which seemed to increase tobacco control success, the study demonstrates the potential significance and value of FCTC article 5.3 for tobacco control policy-making. PMID:25863723

  4. Best of enemies: Using social network analysis to explore a policy network in European smoke-free policy.

    PubMed

    Weishaar, Heide; Amos, Amanda; Collin, Jeff

    2015-05-01

    Networks and coalitions of stakeholders play a crucial role in the development and implementation of policies, with previous research highlighting that networks in tobacco control are characterised by an antagonism between supporters and opponents of comprehensive tobacco control policies. This UK-based study used quantitative and qualitative network analysis (drawing on 176 policy submissions and 32 interviews) to systematically map and analyse a network of actors involved in the development of European Union (EU) smoke-free policy. Policy debates were dominated by two coalitions of stakeholders with starkly opposing positions on the issue. One coalition, consisting primarily of health-related organisations, supported comprehensive EU smoke-free policy, whereas the other, led by tobacco manufacturers' organisations, opposed the policy initiative. The data suggest that, aided by strong political commitment of EU decision makers to develop smoke-free policy, advocates supporting comprehensive EU policy were able to frame policy debates in ways which challenged the tobacco industry's legitimacy. They then benefited from the stark polarisation between the two coalitions. The paper provides empirical evidence of the division between two distinct coalitions in tobacco policy debates and draws attention to the complex processes of consensus-seeking, alliance-building and strategic action which are integral to the development of EU policy. Highlighting network polarisation and industry isolation as factors which seemed to increase tobacco control success, the study demonstrates the potential significance and value of FCTC article 5.3 for tobacco control policy-making.

  5. Exclusionary health policy: responding to the risk of poor health among sexual minority youth in Canada.

    PubMed

    Ylioja, Thomas; Craig, Shelley L

    2014-01-01

    Measuring indicators of health status and demographics are essential in the population health approach. In Canada, sexual minority youth face increased risk for poor health outcomes in behavioral and mental health indicators, yet the health policy response has been severely lacking. The current population health approach exacerbates the social exclusion of a vulnerable, at-risk population. The authors examine health status through the social determinants of health to highlight the need for including sexual identity, attraction, and behavior in youth population health surveys. Additional interventions that address the social determinants of health are needed.

  6. Community Health Workers: Social Justice and Policy Advocates for Community Health and Well-Being

    PubMed Central

    Pérez, Leda M.; Martinez, Jacqueline

    2008-01-01

    Community health workers are resources to their communities and to the advocacy and policy world on several levels. Community health workers can connect people to health care and collect information relevant to policy. They are natural researchers who, as a result of direct interaction with the populations they serve, can recount the realities of exclusion and propose remedies for it. As natural researchers, they contribute to best practices while informing public policy with the information they can share. In this light, community health workers may also be advocates for social justice. PMID:18048789

  7. Health and foreign policy: an American view.

    PubMed

    Cahill, K M

    1997-10-01

    Health and humanitarian complications of conflicts and disasters are, increasingly, the bases for international intervention. Concerns about widespread starvation, the spread of epidemic diseases, and a whole range of human-rights violations are now central factors in foreign affairs. Emphasising health issues can offer an innovative approach to the resolution of apparently intractable problems. Identifying the common concerns, of even the most bitter enemies, can provide an initial basis for dialogue and lead to diplomatic initiatives. Further, the methodology of public health and the metaphors of medicine provide a needed structure for a new era in post-Cold-War international relations; this would include an emphasis on preventive diplomacy that, the author argues, is as essential for the United States as it is for the United Nations.

  8. Health and foreign policy: an American view.

    PubMed

    Cahill, K M

    1997-10-01

    Health and humanitarian complications of conflicts and disasters are, increasingly, the bases for international intervention. Concerns about widespread starvation, the spread of epidemic diseases, and a whole range of human-rights violations are now central factors in foreign affairs. Emphasising health issues can offer an innovative approach to the resolution of apparently intractable problems. Identifying the common concerns, of even the most bitter enemies, can provide an initial basis for dialogue and lead to diplomatic initiatives. Further, the methodology of public health and the metaphors of medicine provide a needed structure for a new era in post-Cold-War international relations; this would include an emphasis on preventive diplomacy that, the author argues, is as essential for the United States as it is for the United Nations. PMID:9625928

  9. Evaluating diabetes health policies using natural experiments: the natural experiments for translation in diabetes study.

    PubMed

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

    2015-06-01

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

  10. Policy revision in health enterprise information security: P3WG final report

    NASA Astrophysics Data System (ADS)

    Sostrom, Kristen; Collmann, Jeff R.

    2003-05-01

    Health information management policies usually address the use of paper records with little or no mention of electronic health records. Information Technology (IT) policies often ignore the health care business needs and operational use of the information stored in its systems. Representatives from the Telemedicine & Advanced Technology Research Center (TATRC), TRICARE and Offices of the Surgeon General of each Military Service, collectively referred to as the Policies, Procedures and Practices Work Group (P3WG) examined military policies and regulations relating to computer-based information systems and medical records management. Using an interdisciplinary and interservice QA approach they compared existing military policies with the Health Insurance Portability and Accountability Act (HIPAA) Security Rule to identify gaps and discrepancies. The final report, including a plain English explanation of the individual standards and relevance to the Department of Defense (DoD), a comparative analysis and recommendations, will feed in to the security management process and HIPAA implementation efforts at multiple levels within the DoD. In light of High Reliability Theory, this process models how large enterprises may coordinate policy revision and reform across broad organizational and work domains, building consensus on key policy reforms among military stakeholders across different disciplines, levels of command hierarchy and services.

  11. Social Determinants and Disparities in Health: Their Crucifixion, Resurrection, and Ultimate Triumph(?) in Health Policy.

    PubMed

    House, James S

    2016-08-01

    David Mechanic has been a principal founder of modern sociological and social science approaches to health, especially in relation to health policy. These approaches have since the 1950s and 1960s resurrected ideas that had currency in the mid-nineteenth century but seemed crucified, dead, and buried by the rise of modern biomedicine from the mid-nineteenth century through the mid-twentieth century. Problems and lacunae in purely biomedical approaches to health in the later twentieth century, along with developments of new biopsychosocial approaches to health, have spawned a return toward ideas of Rudolf Virchow and mid-nineteenth-century social medicine that social determinants and disparities are major drivers of population health. Since individual health and population health constitute the major determinants of health care utilization and expenditures, social determinants and disparities in health are arguably the foundation of a new "demand-side" health policy that can resolve America's paradoxical health policy crisis of spending increasingly more than any nation on health care and insurance yet achieving increasingly worsening health outcomes relative to virtually all developed countries and some developing ones as well, something that current "supply-side" health policy, including Obamacare, cannot do, important as it is for expanding access to health insurance and care.

  12. Social Determinants and Disparities in Health: Their Crucifixion, Resurrection, and Ultimate Triumph(?) in Health Policy.

    PubMed

    House, James S

    2016-08-01

    David Mechanic has been a principal founder of modern sociological and social science approaches to health, especially in relation to health policy. These approaches have since the 1950s and 1960s resurrected ideas that had currency in the mid-nineteenth century but seemed crucified, dead, and buried by the rise of modern biomedicine from the mid-nineteenth century through the mid-twentieth century. Problems and lacunae in purely biomedical approaches to health in the later twentieth century, along with developments of new biopsychosocial approaches to health, have spawned a return toward ideas of Rudolf Virchow and mid-nineteenth-century social medicine that social determinants and disparities are major drivers of population health. Since individual health and population health constitute the major determinants of health care utilization and expenditures, social determinants and disparities in health are arguably the foundation of a new "demand-side" health policy that can resolve America's paradoxical health policy crisis of spending increasingly more than any nation on health care and insurance yet achieving increasingly worsening health outcomes relative to virtually all developed countries and some developing ones as well, something that current "supply-side" health policy, including Obamacare, cannot do, important as it is for expanding access to health insurance and care. PMID:27127266

  13. Health policy considerations for our sexual minority patients.

    PubMed

    O'Hanlan, Katherine A

    2006-03-01

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

  14. Linking research and policy to ensure children's environmental health.

    PubMed

    Goldman, L R

    1998-06-01

    The U.S. Environmental Protection Agency (U.S. EPA) has made protecting children's environmental health its highest priority. Data on how and when children may be at risk are vital for accomplishing this goal. Recent examples of the link between research and policy include U.S. EPA actions to carry out the recommendations of the National Academy of Sciences on pesticides in children's food, reduce and prevent childhood lead poisoning, and revise national ambient air quality standards for ozone and particulate matter. Today, the Food Quality Protection Act (FQPA), which makes protecting children from pesticide residues in food a national priority, is contributing to the growing need for data for decision making. Further impetus comes from provisions in the FQPA and 1996 Safe Drinking Water Act Amendments for establishing a screening and testing program for potential risks from endocrine disruptors. Another factor is the analysis that will be required under President William J. Clinton's executive order directing all federal agencies, for the first time, to reduce environmental health and safety risks to children. Success of the U.S. international commitment to protect children is directly tied to the strength and availability of environmental data. To meet such challenges, the U.S. EPA is revising key science policies, expanding research opportunities, and adding to the public's right-to-know tools. In this dynamic climate, there are growing opportunities for the research community to play a greater role in helping ensure the well-being of children living today and in generations to come. PMID:9646049

  15. Linking research and policy to ensure children's environmental health.

    PubMed Central

    Goldman, L R

    1998-01-01

    The U.S. Environmental Protection Agency (U.S. EPA) has made protecting children's environmental health its highest priority. Data on how and when children may be at risk are vital for accomplishing this goal. Recent examples of the link between research and policy include U.S. EPA actions to carry out the recommendations of the National Academy of Sciences on pesticides in children's food, reduce and prevent childhood lead poisoning, and revise national ambient air quality standards for ozone and particulate matter. Today, the Food Quality Protection Act (FQPA), which makes protecting children from pesticide residues in food a national priority, is contributing to the growing need for data for decision making. Further impetus comes from provisions in the FQPA and 1996 Safe Drinking Water Act Amendments for establishing a screening and testing program for potential risks from endocrine disruptors. Another factor is the analysis that will be required under President William J. Clinton's executive order directing all federal agencies, for the first time, to reduce environmental health and safety risks to children. Success of the U.S. international commitment to protect children is directly tied to the strength and availability of environmental data. To meet such challenges, the U.S. EPA is revising key science policies, expanding research opportunities, and adding to the public's right-to-know tools. In this dynamic climate, there are growing opportunities for the research community to play a greater role in helping ensure the well-being of children living today and in generations to come. PMID:9646049

  16. The Evolution of Health Care Advance Planning Law and Policy

    PubMed Central

    Sabatino, Charles P

    2010-01-01

    Context: The legal tools of health care advance planning have substantially changed since their emergence in the mid-1970s. Thirty years of policy development, primarily at the state legislative level addressing surrogate decision making and advance directives, have resulted in a disjointed policy landscape, yet with important points of convergence evolving over time. An understanding of the evolution of advance care planning policy has important implications for policy at both the state and federal levels. Methods: This article is a longitudinal statutory and literature review of health care advance planning from its origins to the present. Findings: While considerable variability across the states still remains, changes in law and policy over time suggest a gradual paradigm shift from what is described as a “legal transactional approach” to a “communications approach,” the most recent extension of which is the emergence of Physician Orders for Life-Sustaining Treatment, or POLST. The communications approach helps translate patients’ goals into visible and portable medical orders. Conclusions: States are likely to continue gradually moving away from a legal transactional mode of advance planning toward a communications model, albeit with challenges to authentic and reliable communication that accurately translates patients’ wishes into the care they receive. In the meantime, the states and their health care institutions will continue to serve as the primary laboratory for advance care planning policy and practice. PMID:20579283

  17. Advancing Public Health Obesity Policy Through State Attorneys General

    PubMed Central

    Brownell, Kelly D.

    2011-01-01

    Obesity in the United States exacts a heavy health and financial toll, requiring new approaches to address this public health crisis. State attorneys general have been underutilized in efforts to formulate and implement food and obesity policy solutions. Their authority lies at the intersection of law and public policy, creating unique opportunities unavailable to other officials and government entities. Attorneys general have a broad range of authority over matters specifically relevant to obesity and nutrition policy, including parens patriae (parent of the country) authority, protecting consumer interests, enacting and supporting rules and regulations, working together across states, engaging in consumer education, and drafting opinions and amicus briefs. Significant room exists for greater attorney general involvement in formulating and championing solutions to public health problems such as obesity. PMID:21233428

  18. Post-conflict health reconstruction: search for a policy.

    PubMed

    Rubenstein, Leonard S

    2011-10-01

    Despite increasing experience in health reconstruction in societies emerging from conflict, the policy basis for investing in the development of equitable and effective health systems in the wake of war remains unsettled. Consideration of post-conflict health reconstruction is almost entirely absent in donor policies on global health. Practically by default, health programmes are seen increasingly as an element of stabilisation and security interventions in the aftermath of armed conflict. That perspective, however, lacks an evidence base and can skew health programmes towards short-term security and stabilisation goals that have a marginal impact and violate the principles of equity, non-discrimination, and quality, which are central to sound health systems and public acceptance of them. A better approach is to ground policy in legitimacy, viewing health both as a core social institution and one that, if developed according to human rights principles, including equity, non-discrimination, participation and accountability, can advance the effectiveness and the quality of governance in the emerging state.

  19. Epidemiology, Policy, and Racial/Ethnic Minority Health Disparities

    PubMed Central

    Carter-Pokras, Olivia; Offutt-Powell, Tabatha; Kaufman, Jay S.; Giles, Wayne; Mays, Vickie

    2013-01-01

    Purpose Epidemiologists have long contributed to policy efforts to address health disparities. Three examples illustrate how epidemiologists have addressed health disparities in the U.S. and abroad through a “social determinants of health” lens. Methods To identify examples of how epidemiologic research has been applied to reduce health disparities, we queried epidemiologists engaged in disparities research in the U.S., Canada, and New Zealand, and drew upon the scientific literature. Results Resulting examples covered a wide range of topic areas. Three areas selected for their contributions to policy were: 1) epidemiology's role in definition and measurement, 2) the study of housing and asthma, and 3) the study of food policy strategies to reduce health disparities. While epidemiologic research has done much to define and quantify health inequalities, it has generally been less successful at producing evidence that would identify targets for health equity intervention. Epidemiologists have a role to play in measurement and basic surveillance, etiologic research, intervention research, and evaluation research. However, our training and funding sources generally place greatest emphasis on surveillance and etiologic research. Conclusions: The complexity of health disparities requires better training for epidemiologists to effectively work in multidisciplinary teams. Together we can evaluate contextual and multilevel contributions to disease and study intervention programs in order to gain better insights into evidenced-based health equity strategies. PMID:22626003

  20. Agenda Setting and Evidence in Maternal Health: Connecting Research and Policy in Timor-Leste

    PubMed Central

    Wild, Kayli; Kelly, Paul; Barclay, Lesley; Martins, Nelson

    2015-01-01

    The evidence-based policy (EBP) movement has received significant attention in the scientific literature; however, there is still very little empirical research to provide insight into how policy decisions are made and how evidence is used. The lack of research on this topic in low- and middle-income countries is of particular note. We examine the maternity waiting home policy in Timor-Leste to understand the role of context, policy characteristics, individual actors, and how evidence is used to influence the policy agenda. The research tracked the maternity waiting home policy from 2005 to 2009 and is based on in-depth interviews with 31 senior policy-makers, department managers, non-government organization representatives, and United Nations advisors. It is also informed by direct observation, attendance at meetings and workshops, and analysis of policy documents. The findings from this ethnographic case study demonstrate that although the post-conflict context opened up space for new policy ideas senior Ministry of Health officials rather than donors had the most power in setting the policy agenda. Maternity waiting homes were appealing because they were a visible, non-controversial, and logical solution to the problem of accessing maternal health services. Evidence was used in a variety of ways, from supporting pre-determined agendas to informing new policy directions. In the pursuit of EBP, we conclude that the power of research to inform policy lies in its timeliness and relevance, and is facilitated by the connection between researchers and policy-makers. PMID:26442239

  1. Agenda Setting and Evidence in Maternal Health: Connecting Research and Policy in Timor-Leste.

    PubMed

    Wild, Kayli; Kelly, Paul; Barclay, Lesley; Martins, Nelson

    2015-01-01

    The evidence-based policy (EBP) movement has received significant attention in the scientific literature; however, there is still very little empirical research to provide insight into how policy decisions are made and how evidence is used. The lack of research on this topic in low- and middle-income countries is of particular note. We examine the maternity waiting home policy in Timor-Leste to understand the role of context, policy characteristics, individual actors, and how evidence is used to influence the policy agenda. The research tracked the maternity waiting home policy from 2005 to 2009 and is based on in-depth interviews with 31 senior policy-makers, department managers, non-government organization representatives, and United Nations advisors. It is also informed by direct observation, attendance at meetings and workshops, and analysis of policy documents. The findings from this ethnographic case study demonstrate that although the post-conflict context opened up space for new policy ideas senior Ministry of Health officials rather than donors had the most power in setting the policy agenda. Maternity waiting homes were appealing because they were a visible, non-controversial, and logical solution to the problem of accessing maternal health services. Evidence was used in a variety of ways, from supporting pre-determined agendas to informing new policy directions. In the pursuit of EBP, we conclude that the power of research to inform policy lies in its timeliness and relevance, and is facilitated by the connection between researchers and policy-makers. PMID:26442239

  2. Costa Rica: Achievements of a Heterodox Health Policy

    PubMed Central

    Unger, Jean-Pierre; De Paepe, Pierre; Buitrón, René; Soors, Werner

    2008-01-01

    Costa Rica is a middle-income country with a strong governmental emphasis on human development. For more than half a century, its health policies have applied the principles of equity and solidarity to strengthen access to care through public services and universal social health insurance. Costa Rica’s population measures of health service coverage, health service use, and health status are excellent, and in the Americas, life expectancy in Costa Rica is second only to that in Canada. Many of these outcomes can be linked to the performance of the public health care system. However, the current emphasis of international aid organizations on privatization of health services threatens the accomplishments and universality of the Costa Rican health care system. PMID:17901439

  3. Space Life Sciences at NASA: Spaceflight Health Policy and Standards

    NASA Technical Reports Server (NTRS)

    Davis, Jeffrey R.; House, Nancy G.

    2006-01-01

    In January 2005, the President proposed a new initiative, the Vision for Space Exploration. To accomplish the goals within the vision for space exploration, physicians and researchers at Johnson Space Center are establishing spaceflight health standards. These standards include fitness for duty criteria (FFD), permissible exposure limits (PELs), and permissible outcome limits (POLs). POLs delineate an acceptable maximum decrement or change in a physiological or behavioral parameter, as the result of exposure to the space environment. For example cardiovascular fitness for duty standards might be a measurable clinical parameter minimum that allows successful performance of all required duties. An example of a permissible exposure limit for radiation might be the quantifiable limit of exposure over a given length of time (e.g. life time radiation exposure). An example of a permissible outcome limit might be the length of microgravity exposure that would minimize bone loss. The purpose of spaceflight health standards is to promote operational and vehicle design requirements, aid in medical decision making during space missions, and guide the development of countermeasures. Standards will be based on scientific and clinical evidence including research findings, lessons learned from previous space missions, studies conducted in space analog environments, current standards of medical practices, risk management data, and expert recommendations. To focus the research community on the needs for exploration missions, NASA has developed the Bioastronautics Roadmap. The Bioastronautics Roadmap, NASA's approach to identification of risks to human space flight, revised baseline was released in February 2005. This document was reviewed by the Institute of Medicine in November 2004 and the final report was received in October 2005. The roadmap defines the most important research and operational needs that will be used to set policy, standards (define acceptable risk), and

  4. Using participatory methods to examine policy and women prisoners' health.

    PubMed

    Hatton, Diane C; Fisher, Anastasia A

    2011-05-01

    This article describes how community-based participatory research (CBPR) led to the discovery of the unintended consequences of jail and prison copayment policy on women prisoners' health. The article addresses (a) a working definition of participatory research; (b) the importance of research with women prisoners; (c) the origins and development of our work and its grounding in CBPR; (d) issues related to research with prisoners; and (e) recommendations for using participatory methods to bring women prisoners into the discourse about the practices and policies that impact their lives. These methods have the potential to minimize the invisibility of prisoners and their health disparities. PMID:21903718

  5. Pitfalls in Health Communication: Healthcare Policy, Institution, Structure, & Process

    PubMed Central

    Calderón, José L; Beltrán, Robert A

    2004-01-01

    The state of health communication for a given population is a function of several tiers of structure and process: government policy, healthcare directives, healthcare structure and process, and the ethnosocial realities of a multicultural society. Common yet specific to these tiers of health communication is the interpersonal and intergroup use of language in all its forms. Language is the most common behavior exhibited by humankind. Its use at all tiers determines quality of healthcare and quality of life for healthcare consumers: patients and their families. Of note, at the consumer end, mounting evidence demonstrates that barriers to health communication contribute to poorer access to care, quality of care, and health outcomes. The lack of comprehensible and usable written and spoken language is a major barrier to health communication targeting primary and secondary disease prevention and is a major contributor to the misuse of healthcare, patient noncompliance, rising healthcare costs. In this paper, we cursorily examine the relationship among government policy, institutional directives, and healthcare structure and process and its influence on the public health, especially vulnerable populations. We conclude that limited health communication in the context of changing healthcare environments and diverse populations is an important underpinning of rising healthcare costs and sustained health disparities. More research is needed to improve communication about health at all tiers and to develop health communication interventions that are usable by all population groups. PMID:15208522

  6. Barriers to knowledge production, knowledge translation, and urban health policy change: ideological, economic, and political considerations.

    PubMed

    Muntaner, Carles; Chung, Haejoo; Murphy, Kelly; Ng, Edwin

    2012-12-01

    In this paper, we consider social forces that affect the processes of both knowledge production and knowledge translation in relation to urban health research. First, we briefly review our conceptual model, derived from a social-conflict framework, to outline how unequal power relations and health inequalities are causally linked. Second, we critically discuss ideological, political, and economic barriers that exist within academia that affect knowledge production related to urban health and health inequalities. Third, we broaden the scope of our analysis to examine how the ideological, political, and economic environment beyond the academy creates barriers to health equity policy making. We conclude with some key questions about the role that knowledge translation can possibly play in light of these constraints on research and policy for urban health.

  7. [The health policy of the Paul Verlaine University-Metz].

    PubMed

    Vaillant, Sylvie

    2010-01-01

    Students represent a population group that is for the most part in good health. However, students also face specific stresses and constraints that are likely to make it difficult for them to adapt to student life, and these adjustments can lead to unhealthy behaviours. Within Universities, the implementation of a coherent health policy must aim to positively impact on the development of both the professional and daily lives of young adults. The University of Paul Verlaine in Metz (France) has taken this perspective on board, and under the leadership of its social health department, the whole University has adopted a comprehensive policy for student well-being under the five action areas of the Ottawa Charter. This approach to well-being as a public policy strategy, through the Healthy Life policy, is central to all decisions taken at the Metz University and throughout the Regional Centre for Scholars and University Students (CROUS) in Lorraine. A number of facilities dedicated to students' health and well-being have been created in this supporting environment, and the engagement of students in the Healthy Life policy (some students 'relay' the information, others are 'peer educators') show that they are involved in the community life of the University. The introduction of teaching modules by the University's health department has given access to training to increase students' awareness of the concept of a holistic approach to health. Finally students have had improved access to healthcare services thanks to an increase in the number of activities provided by the student health department focusing on common problems experienced by university students.

  8. Using collective intelligence to fine-tune public health policy.

    PubMed

    Marsh, Andy; Carroll, Denis; Foggie, Richard

    2010-01-01

    The European Union Future Internet Assembly, the roadmap for the Web heading towards semantic interoperability and building on the UK's adoption of the Internet and social media are accelerating the development of Web 3.0. A number of health portals are opening, some with facilities for the capture of Patient Based Records. Collective Intelligence will be generated that, applied to health, has potential to support Public Health policy. By using the Internet, millions of people in the course of their daily activities contribute to uncertified data stores, some explicitly collaborating to create collective knowledge bases, some contributing implicitly through the patterns of their choices and actions. An application of soft computing, called Collective Health Intelligence, that reasons uncertified and certified data could enhance the social pool of existing health knowledge available to the public health agencies. Collective Health Intelligence could be used to complement national programmes by employing innovative sampling techniques, cost-effectively generating anonymous data trends that would quantify policy, indicate epidemiological effects and supply metrics to test policy efficacy. PMID:20543334

  9. Geographical classifications to guide rural health policy in Australia.

    PubMed

    McGrail, Matthew R; Humphreys, John S

    2009-01-01

    The Australian Government's recent decision to replace the Rural Remote and Metropolitan Area (RRMA) classification with the Australian Standard Geographical Classification - Remoteness Areas (ASGC-RA) system highlights the ongoing significance of geographical classifications for rural health policy, particularly in relation to improving the rural health workforce supply. None of the existing classifications, including the government's preferred choice, were designed specifically to guide health resource allocation, and all exhibit strong weaknesses when applied as such. Continuing reliance on these classifications as policy tools will continue to result in inappropriate health program resource distribution. Purely 'geographical' classifications alone cannot capture all relevant aspects of rural health service provision within a single measure. Moreover, because many subjective decisions (such as the choice of algorithm and breakdown of groupings) influence a classification's impact and acceptance from its users, policy-makers need to specify explicitly the purpose and role of their different programs as the basis for developing and implementing appropriate decision tools such as 'rural-urban' classifications. Failure to do so will continue to limit the effectiveness that current rural health support and incentive programs can have in achieving their objective of improving the provision of health care services to rural populations though affirmative action programs. PMID:19995449

  10. Potential Effects of Health Care Policy Decisions on Physician Availability

    NASA Technical Reports Server (NTRS)

    Garcia, Christopher; Goodrich, Michael

    2011-01-01

    Many regions in America are experiencing downward trends in the number of practicing physicians and the number of available physician hours, resulting in a worrisome decrease in the availability of health care services. Recent changes in American health care legislation may induce a rapid change in the demand for health care services, which in turn will result in a new supply-demand equilibrium . In this paper we develop a system dynamics model linking physician availability to health care demand and profitability. We use this model to explore scenarios based on different initial conditions and describe possible outcomes for a range of different policy decisions.

  11. [Sexual and reproductive rights: challenges for health policies].

    PubMed

    Avila, Maria Betânia

    2003-01-01

    This article discusses sexual and reproductive rights in the sense of a stance that assumes a perspective of transformations in social relations, the struggle against prejudices, the guarantee of well-being, and finally the relationship between sexuality, reproduction, and citizenship. The article then proceeds to reflect on health policy challenges in these fields, emphasizing such issues as: guaranteed resources, quality and quantity of health services in response to demands by the population, and cultural changes that produce a new view of the relationship between health professionals and health system clients, based on the principles of citizenship: recognition others as entitled to freedom and equality.

  12. Health policy and cost containment laws: lessons for public health education in social and behavioral change.

    PubMed

    Garcia, J J

    1986-01-01

    As an extension of a contribution by Health Policy and Law to Public Health Education in areas of mutual concern, a descriptive model of cost containment policy in health care delivery is developed. The model starts from the basis of a typology of key Congressional enactments promoting economically motivated policymaking in the Medicare and Medicaid programs. These policies and laws are, in turn, related to the resulting multilevel adaptive behavior in health care services delivery and acquisition. From this descriptive model the thesis is developed that although government has improved its effectiveness in attaining economic and budgetary goals, this type of policy is also creating displacements and generally leading to the retrenchment of national commitment to equity-promoting social welfare policy and the possibility of abandoning longstanding historical commitments on strictly economic and budgetary grounds. The article concludes by placing emphasis on the need for public health disciplines to collaborate in order to strengthen national policy, to create a new health policy synthesis, and to strengthen the ability of individuals to qualitatively improve their situation and more effectively assert their health and social welfare rights.

  13. Global health diplomacy: barriers to inserting health into Canadian foreign policy.

    PubMed

    Runnels, Vivien; Labonté, Ronald; Ruckert, Arne

    2014-01-01

    Health opportunities and risks have become increasingly global in both cause and consequence. Governments have been slow to recognise the global dimensions of health, although this is beginning to change. A new concept - global health diplomacy (GHD) - has evolved to describe how health is now being positioned within national foreign policies and entering into regional or multilateral negotiations. Traditionally, health negotiations have been seen as 'low politics' in international affairs: however, attention is now being given to understanding better how health can increase its prominence in foreign policy priorities and multilateral forums. We sought to identify how these efforts were manifested in Canada, with a focus on current barriers to inserting health in foreign policy. We conducted individual interviews with Canadian informants who were well placed through their diplomatic experience and knowledge to address this issue. Barriers identified by the respondents included a lack of content expertise (scientific and technical understanding of health and its practice), insufficient diplomatic expertise (the practice and art of diplomacy, including legal and technical expertise), the limited ways in which health has become framed as a foreign policy issue, funding limitations and cuts for global health, and lack of cross-sectoral policy coordination and coherence, given the important role that non-health foreign policy interests (notably in trade and investment liberalisation) can play in shaping global health outcomes. We conclude with some reflections on how regime change and domestic government ideology can also function as a barrier to GHD, and what this implies for retaining or expanding the placement of health in foreign policy. PMID:25005028

  14. Global health diplomacy: barriers to inserting health into Canadian foreign policy.

    PubMed

    Runnels, Vivien; Labonté, Ronald; Ruckert, Arne

    2014-01-01

    Health opportunities and risks have become increasingly global in both cause and consequence. Governments have been slow to recognise the global dimensions of health, although this is beginning to change. A new concept - global health diplomacy (GHD) - has evolved to describe how health is now being positioned within national foreign policies and entering into regional or multilateral negotiations. Traditionally, health negotiations have been seen as 'low politics' in international affairs: however, attention is now being given to understanding better how health can increase its prominence in foreign policy priorities and multilateral forums. We sought to identify how these efforts were manifested in Canada, with a focus on current barriers to inserting health in foreign policy. We conducted individual interviews with Canadian informants who were well placed through their diplomatic experience and knowledge to address this issue. Barriers identified by the respondents included a lack of content expertise (scientific and technical understanding of health and its practice), insufficient diplomatic expertise (the practice and art of diplomacy, including legal and technical expertise), the limited ways in which health has become framed as a foreign policy issue, funding limitations and cuts for global health, and lack of cross-sectoral policy coordination and coherence, given the important role that non-health foreign policy interests (notably in trade and investment liberalisation) can play in shaping global health outcomes. We conclude with some reflections on how regime change and domestic government ideology can also function as a barrier to GHD, and what this implies for retaining or expanding the placement of health in foreign policy.

  15. [Health in all policies and intersectoriality in health promotion: the Public Health Interdepartmental Plan of Catalonia].

    PubMed

    Mateu i Serra, Antoni

    2015-11-01

    In February 2014, the autonomous government in Catalonia, the Generalitat de Catalunya, approved the Catalan Public Health System Interdepartmental Plan (PINSAP, as per the Catalan acronym), responsible for the strategy in Catalonia for Health in All Policies, as recommended by the WHO and other international institutions. The PINSAP, as outlined under the Catalan Public Health Law, is binding for the government. The Plan was drawn up by the Interdepartmental Health Commission (CIS, as per the Catalan acronym) and is a collaboration between all Departments of the Generalitat. The Plan also receives contributions from 42 local, social and scientific bodies. Apart from the specific initiatives performed by each department which have a greater impact on health, the Plan proposes 30 initiatives, which are defined by their collaboration between public sectors, targeting determining health factors and paying special attention to combating inequalities and measuring the impact on health. The PINSAP encourages interdepartmental initiatives and collaboration between public sectors regarding determinants of health. Although it is only in its first year of implementation, many of their initiatives are already up and running and involving many healthcare professionals in Catalonia.

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

    PubMed

    Hunter, David J

    2015-06-01

    Health systems have entered a third era embracing whole systems thinking and posing complex policy and management challenges. Understanding how such systems work and agreeing what needs to be put in place to enable them to undergo effective and sustainable change are more pressing issues than ever for policy-makers. The theory-policy-practice-gap and its four dimensions, as articulated by Chinitz and Rodwin, is acknowledged. It is suggested that insights derived from political science can both enrich our understanding of the gap and suggest what changes are needed to tackle the complex challenges facing health systems. PMID:26029899

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

    PubMed

    Hunter, David J

    2015-03-12

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

  18. Obesity, Health at Every Size, and Public Health Policy

    PubMed Central

    2014-01-01

    Obesity is associated with chronic diseases that may negatively affect individuals’ health and the sustainability of the health care system. Despite increasing emphasis on obesity as a major health care issue, little progress has been made in its treatment or prevention. Individual approaches to obesity treatment, largely composed of weight-loss dieting, have not proven effective. Little direct evidence supports the notion of reforms to the “obesogenic environment.” Both these individualistic and environmental approaches to obesity have important limitations and ethical implications. The low levels of success associated with these approaches may necessitate a new non–weight-centric public health strategy. Evidence is accumulating that a weight-neutral, nutrition- and physical activity–based, Health at Every Size (HAES) approach may be a promising chronic disease-prevention strategy. PMID:24328657

  19. Levels of health development: a new tool for comparative research and policy formulation.

    PubMed

    Hunter, S S

    1990-01-01

    Levels of health development are formed by mathematically clustering countries using six health status indicators: crude birth, crude death, infant mortality and child death rates, and male and female life expectancy. Stratifying two international samples of 128 and 163 countries into levels of health development--groups with similar health status profiles--improves the results of regression analyses used to identify economic, political, social, educational, health and other health determinants. For this reason, health development levels are a systematic framework for delineation of health determinants. Earlier large scale statistical studies have been limited in their success in part because they did not partition their data sets prior to analysis, or used inappropriate criteria that blurred rather than heightened developmental differences in underlying social systems. These developmental differences regulate the way in which health status inputs are converted into health status outputs, defining the relative importance of health determinants at various developmental levels. At lowest health development levels (countries with poorer health status), the under-development of economic, health and educational infrastructures creates a vacuum which allows international intervention (aid, investment, export/import activities) to play a