43 results
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2. Reconciling devolution with health financing and public financial management: challenges and policy options for the health sector.
- Author
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Ravishankar N, Mathauer I, Barroy H, Vîlcu I, Chaitkin M, Offosse MJ, Co PA, Nakyanzi A, Mbuthia B, Lourenço S, Mardani H, and Kutzin J
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- Humans, Africa, Asia, Budgets, Burkina Faso, Financial Management, Financing, Government, Indonesia, Kenya, Mozambique, Nigeria, Philippines, Uganda, Universal Health Insurance economics, Health Policy economics, Healthcare Financing
- Abstract
The interplay between devolution, health financing and public financial management processes in health-or the lack of coherence between them-can have profound implications for a country's progress towards universal health coverage. This paper explores this relationship in seven Asian and African countries (Burkina Faso, Kenya, Mozambique, Nigeria, Uganda, Indonesia and the Philippines), highlighting challenges and suggesting policy solutions. First, subnational governments rely heavily on transfers from central governments, and most are not required to allocate a minimum share of their budget to health. Central governments channelling more funds to subnational governments through conditional grants is a promising way to increase public financing for health. Second, devolution makes it difficult to pool funding across populations by fragmenting them geographically. Greater fiscal equalisation through improved revenue sharing arrangements and, where applicable, using budgetary funds to subsidise the poor in government-financed health insurance schemes could bridge the gap. Third, weak budget planning across levels could be improved by aligning budget structures, building subnational budgeting capacity and strengthening coordination across levels. Fourth, delays in central transfers and complicated procedures for approvals and disbursements stymie expenditure management at subnational levels. Simplifying processes and enhancing visibility over funding flows, including through digitalised information systems, promise to improve expenditure management and oversight in health. Fifth, subnational governments purchase services primarily through line-item budgets. Shifting to practices that link financial allocations with population health needs and facility performance, combined with reforms to grant commensurate autonomy to facilities, has the potential to enable more strategic purchasing., Competing Interests: Competing interests: None declared., (© World Health Organization 2024. Licensee BMJ.)
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- 2024
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3. Questioning global health in the times of COVID-19: Re-imagining primary health care through the lens of politics of knowledge.
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Priya, Ritu, Sarkar, Amitabha, Das, Sayan, Gaitonde, Rakhal, Ghodajkar, Prachinkumar, and Gandhi, Mohit P.
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PRIMARY health care ,WORLD health ,HEALTH policy ,COVID-19 ,CHILD health services - Abstract
The advent of the COVID-19 pandemic and the inequitable response to it has created a space for rethinking the knowledge translation that informs current health policy formulation and planning. Wide recognition of the failure of global health governance and national health systems has led to calls for reviving the Primary Health Care (PHC) agenda for post-COVID health systems development. Despite the joint international declaration on PHC made four decades ago, it has had limited application. This paper argues that the recent attempts to rethink PHC will prove inadequate without analysing and learning from the politics of knowledge (PoK) underlying global health policy and planning. Even with the growing relevance of the spirit of the Alma-Ata Declaration (1978) and its operationalisation as detailed in the report of conference proceedings, reassessment of reasons for its limited implementation continues to be located largely in the political economy of the medical establishment, the international economic order or in national governance flaws. Failure to address the dominant knowledge paradigm in the Alma Ata articulation of PHC has contributed to its limited application. This calls for expansion in the analysis from knowledge translation to generation and hierarchisation of knowledge. The paper discusses how the application of PoK as an analytical lens helps understand the power equations underlying the process of knowledge generation and its translation into policy and practice. Beneath the techno-centric and commodified health system is the dominant 'knowledge' system whose foundations and assumptions ought to be interrogated. By following a PoK approach, a reorientation of thinking about the relationship between various forms of knowledge and knowledge holders is anticipated. A new health service system design is outlined—translating the spirit of PHC of 1978 into a 'PHC Version 2.0'—that addresses the PoK gap in operational terms, with an approach to guide all levels of healthcare. It suggests how the world can be empowered to respond better by engaging with diverse ontologies and epistemologies to conceptualise knowledge and frame policies. Further, in the contexts of Asia, Africa and Latin America, it can contribute to the development of self-reliance to democratise general health policy and planning in the post-pandemic period. [ABSTRACT FROM AUTHOR]
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- 2023
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4. Coding practice in national and regional kidney biopsy registries.
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Dendooven, Amélie, Peetermans, Han, Helbert, Mark, Nguyen, Tri Q., Marcussen, Niels, Nagata, Michio, Gesualdo, Loreto, Perkowska-Ptasinska, Agnieszka, Capusa, Cristina, López-Gómez, Juan M., Geddes, Colin, Abdul-Hamid, Myrurgia A., Segelmark, Mårten, Yahya, Rosnawati, Garau, Mariela, Villanueva, Russell, Dorman, Anthony, Barbour, Sean, Cornet, Ronald, and Hopfer, Helmut
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RENAL biopsy ,MEDICAL registries ,KIDNEY diseases ,DIAGNOSIS ,HEALTH policy - Abstract
Background: Kidney biopsy registries all over the world benefit research, teaching and health policy. Comparison, aggregation and exchange of data is however greatly dependent on how registration and coding of kidney biopsy diagnoses are performed. This paper gives an overview over kidney biopsy registries, explores how these registries code kidney disease and identifies needs for improvement of coding practice.Methods: A literature search was undertaken to identify biopsy registries for medical kidney diseases. These data were supplemented with information from personal contacts and from registry websites. A questionnaire was sent to all identified registries, investigating age of registries, scope, method of coding, possible mapping to international terminologies as well as self-reported problems and suggestions for improvement.Results: Sixteen regional or national kidney biopsy registries were identified, of which 11 were older than 10 years. Most registries were located either in Europe (10/16) or in Asia (4/16). Registries most often use a proprietary coding system (12/16). Only a few of these coding systems were mapped to SNOMED CT (1), older SNOMED versions (2) or ERA-EDTA PRD (3). Lack of maintenance and updates of the coding system was the most commonly reported problem.Conclusions: There were large gaps in the global coverage of kidney biopsy registries. Limited use of international coding systems among existing registries hampers interoperability and exchange of data. The study underlines that the use of a common and uniform coding system is necessary to fully realize the potential of kidney biopsy registries. [ABSTRACT FROM AUTHOR]- Published
- 2021
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5. The research-policy-deliberation nexus: a case study approach.
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Brooy, Camille La, Kelaher, Margaret, and La Brooy, Camille
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PUBLIC health ,UNIVERSITIES & colleges ,DOCTORAL students ,INTERPERSONAL communication ,RESEARCH institutes ,HIGHER education ,EXECUTIVES ,MEDICAL care research ,HEALTH policy ,POLICY sciences ,GOVERNMENT policy ,RESEARCH personnel - Abstract
Background: Decision-makers tend to make connections with researchers far too late in the game of public policy, expecting to find a retail store in which researchers are busy filling shop-front shelves with a comprehensive set of all possible relevant studies that a decision-maker might some day drop by to purchase. This linear type of relation between research and policy needs to be replaced by a more interactive model that facilitates both researchers obtaining a better understanding of policy processes and policymakers being more aware and involved in the conceptualisation and conduct of research. This paper explores the role of governance in facilitating the research-policy nexus, testing a typology of research utilisation based on Murray's (Soc Policy Society 10(4):459-70, 2011) analysis that considers various degrees of researcher-policymaker deliberation in decision-making processes. The projects were all part of various evaluation efforts carried out by the researchers to explore the use of governance in health promotion activities.Methods: Three case studies were chosen to provide some specific examples that illustrate each level of Murray's typology. The examples involve intersectoral health promotion collaborations that combine evidence-based research in health policy initiatives with various levels of researcher involvement. For all three projects, interview data was collated in the same way, coded thematically and analysed to consider the relationship between researchers and policymakers.Results: Comparing the three models and their applicability to health promotion interventions, it could be observed that all programmes demonstrated successful examples of research translation. Strong governance imperatives structuring relationships led to more successful outcomes, whereby research was successfully translated into a public policy initiative that also led to improved health outcomes. The key idea across all of these models was that strong governance arrangements mitigated some of the barriers evidenced by the varying degrees of deliberation and researcher involvement in processes.Conclusions: The paper demonstrates that successful research utilisation is related to strong governance agendas and that early and ongoing involvement of relevant decision-makers and researchers in the governance processes, that is both the conceptualisation and conduct of a study, tend to be the best predictors of success. [ABSTRACT FROM AUTHOR]- Published
- 2017
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6. How the ARCH Project has Contributed to the Development of the ASEAN Regional Collaboration Mechanism on Disaster Health Management.
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Silapunt, Phumin, Fernando, Ferdinal, Catampongan, Jim, Limpaporn, Sansana, Yuddhasaraprasiddhi, Kittima, Promkhum, Dangfun, Tianwibool, Parinya, Sairai, Phatsawan, Rungsansarit, Hathairat, Wuthisuthimethawee, Prasit, Keeratipongpaiboon, Kanin, Tantivesruangdet, Nopmanee, Chantaratin, Kanungnij, Tiyawat, Gawin, Takada, Yosuke, Kita, Taro, Kai, Soichiro, and Ikeda, Shuichi
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EMERGENCY management ,HEALTH policy ,PUBLIC health ,DOCUMENTATION ,ACTION research ,INTERPROFESSIONAL relations ,ELECTRONIC health records ,MEDICAL needs assessment - Abstract
Objective: This paper aims to clarify how the Project for Strengthening the ASEAN Regional Capacity on Disaster Health Management (ARCH Project) strengthened regional collaboration mechanisms on disaster health management (DHM) in ASEAN. Methods: The political process and the relevant documents of the ARCH Project were reviewed. Results: The ARCH Project established the Regional Coordination Committee as a coordination platform for providing strategic direction to the project and strengthening the regional coordination of DHM. Also, the Project Working Groups and Sub-Working Groups were set up as implementation bodies for the project activities with representatives of ASEAN Member States (AMS). With support from DHM experts of Japan and Thailand, a series of discussions were conducted for the development of a Standard Operating Procedure (SOP) for the Coordination of International Emergency Medical Teams (I-EMTs), regional tools, and collective measures supporting AMS to overcome challenges, and thereby meeting the minimum requirements set by the WHO EMT Initiative. The progress and outputs of the ARCH Project are subsequently elevated to the ASEAN Health Sector for endorsement, the updates are further shared to the Joint Task Force to Promote Synergy with Other Relevant ASEAN Bodies on Humanitarian Assistance and Disaster Relief (JTF-HADR) for the implementation of the ASEAN Declaration on One ASEAN One Response. The initiation of the ARCH Project in July 2016 has resulted in the development of the ASEAN regional collaboration framework, including the establishment of the Regional Coordination Committee on Disaster Health Management (RCCDHM), the SOP for ASEAN I-EMT coordination, and regional tools, such as forms for Medical Record for Emergency and Disaster and Health Needs Assessment. Moreover, further discussions on ASEAN Collective Measures that aim to support AMS to meet the WHO EMT minimum standards and strengthening I-EMT coordination capacity were also conducted. As adopted by the ASEAN Health Ministers Meeting (AHMM) in 2019, the RCCDHM was established as one of the mechanisms to operationalize the Plan of Action to implement the ASEAN Leaders' Declaration on DHM. Conclusion: The contribution of the ARCH Project to strengthen the ASEAN regional capacity in DHM has enhanced the regional coordination platform, with a formalization of RCCDHM as ASEAN's official regional mechanism, and of the on-going integration process of the SOP for EMT coordination into the ASEAN SASOP. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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7. Objectives, methods, and results in critical health systems and policy research: evaluating the healthcare market.
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Unger JP, Morales I, and De Paepe P
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- Africa, Asia, Humans, Netherlands, Switzerland, Health Care Sector, Health Policy
- Abstract
Background: Since the 1980s, markets have turned increasingly to intangible goods - healthcare, education, the arts, and justice. Over 40 years, the authors investigated healthcare commoditisation to produce policy knowledge relevant to patients, physicians, health professionals, and taxpayers. This paper revisits their objectives, methods, and results to enlighten healthcare policy design and research., Main Text: This paper meta-analyses the authors' research that evaluated the markets impact on healthcare and professional culture and investigated how they influenced patients' timely access to quality care and physicians' working conditions. Based on these findings, they explored the political economic of healthcare. In low-income countries the analysed research showed that, through loans and cooperation, multilateral agencies restricted the function of public services to disease control, with subsequent catastrophic reductions in access to care, health de-medicalisation, increased avoidable mortality, and failure to attain the narrow MDGs in Africa. The pro-market reforms enacted in middle-income countries entailed the purchaser-provider split, privatisation of healthcare pre-financing, and government contracting of health finance management to private insurance companies. To establish the materiality of a cause-and-effect relationship, the authors compared the efficiency of Latin American national health systems according to whether or not they were pro-market and complied with international policy standards. While pro-market health economists acknowledge that no market can offer equitable access to healthcare without effective regulation and control, the authors showed that both regulation and control were severely constrained in Asia by governance and medical secrecy issues. In high-income countries they questioned the interest for population health of healthcare insurance companies, whilst comparing access to care and health expenditures in the European Union vs. the U.S., the Netherlands, and Switzerland. They demonstrated that commoditising healthcare increases mortality and suffering amenable to care considerably and carries professional, cultural, and ethical risks for doctors and health professionals. Pro-market policies systems cause health systems inefficiency, inequity in access to care and strain professionals' ethics., Conclusion: Policy research methodologies benefit from being inductive, as health services and systems evaluations, and population health studies are prerequisites to challenge official discourse and to explore the historical, economic, sociocultural, and political determinants of public policies.
- Published
- 2020
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8. Investing in Tobacco Control: Twelve Years of MPOWER Measures and Progress in the Western Pacific Region.
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De Pinho Campos K, Kashiwabara M, Teakle A, De Guzman R, Lannan K, and Mercado S
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- Adolescent, Adult, Aged, Asia epidemiology, Child, Female, Global Health, Humans, Male, Middle Aged, Pacific Islands epidemiology, Smoking Cessation legislation & jurisprudence, World Health Organization, Young Adult, Health Plan Implementation, Health Policy, Smoking epidemiology, Smoking Cessation methods, Tobacco Industry standards, Tobacco Use prevention & control
- Abstract
Tobacco use has detrimental effects in the Western Pacific Region. The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) came into effect in 2005 to address the global tobacco epidemic, and WHO introduced the MPOWER measures to facilitate implementation of key demand-reduction measures of the WHO FCTC at the country level. This paper provides an overview of progress made by countries within the Region since the introduction of the MPOWER measures 12 years ago, and examines challenges and threats hindering their further implementation.
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- 2020
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9. Re-visioning evidence: Reflections on the recent controversy around gender selective abortion in the UK.
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Unnithan, Maya and Dubuc, Sylvie
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POLICY sciences ,AUTONOMY (Psychology) ,DEBATE ,ETHNIC groups ,HUMAN reproduction ,HUMAN rights ,HEALTH policy ,MEDICAL practice ,SEX distribution ,ABORTION ,ABORTION laws ,PSYCHOLOGY - Abstract
Reports in the British media over the last 4 years have highlighted the schisms and contestations that have accompanied the reports of gender selective abortions amongst British Asian families. The position that sex-selection may be within the terms of the 1967 Abortion Act has particularly sparked controversy amongst abortion campaigners and politicians but equally among medical practitioners and the British Pregnancy Advisory Service who have hitherto tended to stay clear of such debates. In what ways has the controversy around gender-based abortion led to new framings of the entitlement to service provision and new ways of thinking about evidence in the context of reproductive rights? We reflect on these issues drawing on critiques of what constitutes best evidence, contested notions of reproductive rights and reproductive governance, comparative work in India and China as well as our involvement with different groups of campaigners including British South Asian NGOs. The aim of the paper is to situate the medical and legal provision of abortion services in Britain within current discursive practices around gender equality, ethnicity, reproductive autonomy, probable and plausible evidence, and policies of health reform. [ABSTRACT FROM AUTHOR]
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- 2018
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10. Saving Lives and Livelihoods in the COVID-19 Pandemic: What Have We Learned, Particularly from Asia?
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Kok, Derek Qi Ren and Woo, Wing Thye
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COVID-19 pandemic ,HEALTH policy ,PUBLIC health ,RESPIRATORY protective devices ,SOCIAL distancing ,VIRAL transmission - Abstract
The key practices in successful government responses to the COVID-19 pandemic are (1) early border controls to contain the initial spread of the virus from abroad; (2) rapidly increasing the capacity of national health systems in terms of mobilizing staff, securing supplies (e.g., protective equipment and respiratory devices), and optimizing space (e.g., ensuring adequate numbers of acute and intensive care beds) to scale up testing-tracing-treating infrastructure; (3) promoting individual hygienic behavior such as social distancing and face mask use, which requires, respectively, active government enforcement of regulations against holding spreader events, and strong government intervention in the market to ensure adequate supplies; (4) fiscal measures to extend disaster relief to workers, businesses, and vulnerable populations; and (5) clear, concise, and consistent communications from leaders and authorities. International cooperation must have a key role in the fight against the pandemic. So far, a global response to the crisis has been glaringly absent. Although it is understandable that countries prioritize their own needs, it must be understood that no country is safe until every other country is also safe. Global access to future vaccines, supplies, tests, and treatments is the only way to ensure the virus is truly eradicated within a country. The richer countries should establish a global fund to provide the poor countries with the needed vaccine, and to enhance their efforts in testing, tracing, and treating COVID-19 cases. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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11. Priorities for primary health care policy implementation: recommendations from the combined experience of six countries in the Asia–Pacific.
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Kassai, Ryuki, van Weel, Chris, Flegg, Karen, Tong, Seng Fah, Han, Tin Myo, Noknoy, Sairat, Dashtseren, Myagmartseren, Le An, Pham, Ng, Chirk Jenn, Khoo, Ee Ming, Noh, Kamaliah Mohd, Lee, Meng-Chih, Howe, Amanda, and Goodyear-Smith, Felicity
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FAMILY medicine ,HEALTH care reform ,INTERPROFESSIONAL relations ,MEDICAL personnel ,HEALTH policy ,NATIONAL health insurance ,PRIMARY health care ,RURAL health - Abstract
Primary health care is essential for equitable, cost-effective and sustainable health care. It is the cornerstone to achieving universal health coverage against a backdrop of rising health expenditure and aging populations. Implementing strong primary health care requires grassroots understanding of health system performance. Comparing successes and barriers between countries may help identify mutual challenges and possible solutions. This paper compares and analyses primary health care policy in Australia, Malaysia, Mongolia, Myanmar, Thailand and Vietnam. Data were collected at the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA) Asia–Pacific regional conference in November 2017 using a predetermined framework. The six countries varied in maturity of their primary health care systems, including the extent to which family doctors contribute to care delivery. Challenges included an insufficient trained and competent workforce, particularly in rural and remote communities, and deficits in coordination within primary health care, as well as between primary and secondary care. Asia–Pacific regional policy needs to: (1) focus on better collaboration between public and private sectors; (2) take a structured approach to information sharing by bridging gaps in technology, health literacy and interprofessional working; (3) build systems that can evaluate and improve quality of care; and (4) promote community-based, high-quality training programs. Strengthening primary health care (PHC) leads to improved population health outcomes at lower cost. By analysing the PHC policy of six Asia–Pacific countries, we identified key areas for regional development and outline recommendations for future policy. Successful PHC policy in this region requires equitable public–private partnerships, structured approaches to information sharing, an improved multidisciplinary focus on health literacy, systematic improvement and evaluation of the quality of care provided and high-yield, high-quality community-based training programs for sustainable workforce development. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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12. Integrated health care systems in Asia: an urgent necessity.
- Author
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Tham TY, Tran TL, Prueksaritanond S, Isidro JS, Setia S, and Welluppillai V
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- Asia, Demography, Electronic Health Records, Humans, Needs Assessment, Registries, Chronic Disease therapy, Delivery of Health Care, Integrated, Health Policy, Physician's Role, Primary Health Care
- Abstract
A rapidly aging population along with the increasing burden of patients with chronic conditions in Asia requires efficient health systems with integrated care. Although some efforts to integrate primary care and hospital care in Asia are underway, overall care delivery remains fragmented and diverse, eg, in terms of medical electronic record sharing and availability, patient registries, and empowerment of primary health care providers to handle chronic illnesses. The primary care sector requires more robust and effective initiatives targeted at specific diseases, particularly chronic conditions such as diabetes, hypertension, depression, and dementia. This can be achieved through integrated care - a health care model of collaborative care provision. For successful implementation of integrated care policy, key stakeholders need a thorough understanding of the high-risk patient population and relevant resources to tackle the imminent population demographic shift due to the extremely rapid rate of increase in the aging population in Asia., Competing Interests: Disclosure This paper was compiled based on discussions during an advisory board meeting on “Integrated Care Health Systems for Individualized Patient Care in Asia” held in Singapore on June 2, 2018, attended by the co-authors and sponsored by Pfizer. None of the authors received any honorarium for the preparation of the article. Dr Vicknesh Welluppillai is an employee of Pfizer. Dr Sajita Setia was an employee of Pfizer at the time the advisory board meeting took place. Ms Thuy Linh Tran underwent indirect patient care pharmacy training for 3 months at Pfizer, Singapore. This publication contains personal views and opinions of authors and no inference should be derived related to their current or previous employers. The authors report no other conflicts of interest in this work.
- Published
- 2018
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13. The politics of sanitization: Pandemic crisis, migration and development in Asia-Pacific.
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Chan, Yuk Wah and Lan, Pei-Chia
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MIGRANT labor ,BORDERLANDS ,PANDEMICS ,HEALTH policy ,MEDICAL language ,SOCIAL control - Abstract
COVID-19 has resulted in new anxieties about the risks and dangers involved in human mobility and forced governments to simultaneously re-engineer policies for temporary health control and longer-term border-crossing and migration policies; characterized by the sanitization of space and mobility. This special issue considers the policies, including health and non-health measures, that have impacts on migrant workers and migration. While COVID control measures are often phrased in medical language and policy discourses, they often serve multiple goals including political and social control. The papers in this issue cover different places in Asia and the Pacific. We propose the "politics of sanitization" as a conceptual framework to examine the multiple dimensions of state governance and the variegated impacts upon migrants, including: (1) sanitizing space and borders, (2) stigmatization and sanitizing migrants' bodies, (3) sanitizing ethnic borders and the national body, and (4) reorganizing the borders of sanitization and membership of society. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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14. South Asian Health. From Research to Practice and Policy: An Overview.
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Gany, Francesca, Palaniappan, Latha, Prasad, Lakshmi, Acharya, Sudha, and Leng, Jennifer
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TUMOR risk factors ,IMMIGRANTS ,HEALTH policy ,CARDIOVASCULAR diseases risk factors ,GENETICS ,HEALTH behavior ,HEALTH services accessibility ,HEALTH status indicators ,MENTAL health ,NEEDS assessment ,PSYCHOLOGICAL stress ,SOCIOECONOMIC factors ,LIFESTYLES ,PATIENT Protection & Affordable Care Act - Abstract
The US South Asian population has grown tremendously, and is now over 2.5 million. South Asians often face tremendous cultural, socioeconomic, linguistic and structural obstacles to good health, and face staggering cardiovascular disease (CVD) and cancer risk. Coupled with this is a paucity of detailed data on the population's unique CVD and cancer risk profiles, etiologic mechanisms, and effective interventions to address South Asian health disparities. This data gap compelled an initiative to develop more targeted research and evidence-based practice and policy approaches. The South Asian Health Initiative (SAHI), a community based participatory research partnership between the Immigrant Health and Cancer Disparities Center at Memorial Sloan Kettering Cancer and the South Asian Council for Social Services (SACSS), and the Palo Alto Medical Foundation Research Institute thus partnered to effect the first national South Asian translational research endeavor, South Asian Health: From Research to Practice and Policy, summarized in this paper. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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15. Why health policies should be transnational: A case for East Asia Pacific countries.
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Ambade, Preshit Nemdas, Katragadda, Chinmayee, Sun, Diana, Bootman, J. Lyle, and Abraham, Ivo
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CLUSTER analysis (Statistics) ,INTERNATIONAL relations ,MEDICAL care research ,HEALTH policy ,ONE-way analysis of variance - Abstract
This paper argues that health policies should transcend national boundaries yet should not reach the supranational level. Along with multinational global health efforts, such cross-national health policies are essential to leverage joint efforts by countries learning from their peers that experience similar health system challenges. In our analysis, we used World Bank Health, Nutrition, and Population (HNP) data from 1995 to 2014 for East Asia Pacific (EAP) countries to explore health system comparability across member nations. We applied a hierarchical cluster analysis using Ward's method and a squared Euclidean distance approach to classify 24 EAP countries into four relatively stable clusters based on their (dis)similarities over nine selected health expenditure and health system performance related indicators. One-way analysis of variance (ANOVA) was used to assess the discreteness of the formed clusters. Each cluster had unique characteristics based on the included indicators and health system performance of the member countries. We present transnational health policy recommendations for the EAP region based on both our use of robust methodology and the resulting comparative clusters. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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16. Progress toward universal health coverage in ASEAN.
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Hoang Van Minh, Lucero-Prisno III, Don Eliseo, Nawi Ng, Phaholyothin, Natalie, Alay Phonvisay, Kyaw Min Soe, Vanphanom Sychareun, Suyin Pocock, Nicola, Nathorn Chaiyakunapruk, Chhea Chhorvann, Ha Anh Duc, Piya Hanvoravongchai, and Lim, Jeremy
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AGING ,BUDGET ,COMMUNICABLE diseases ,EMIGRATION & immigration ,EPIDEMICS ,HEALTH status indicators ,HEALTH insurance ,INTERNATIONAL agencies ,LABOR demand ,MEDICAL care ,HEALTH policy ,WORLD health ,SYSTEMATIC reviews ,COST analysis - Abstract
Background: The Association of Southeast Asian Nations (ASEAN) is characterized by much diversity in terms of geography, society, economic development, and health outcomes. The health systems as well as healthcare structure and provisions vary considerably. Consequently, the progress toward Universal Health Coverage (UHC) in these countries also varies. This paper aims to describe the progress toward UHC in the ASEAN countries and discuss how regional integration could influence UHC. Design: Data reported in this paper were obtained from published literature, reports, and gray literature available in the ASEAN countries. We used both online and manual search methods to gather the information and 'snowball' further data. Results: We found that, in general, ASEAN countries have made good progress toward UHC, partly due to relatively sustained political commitments to endorse UHC in these countries. However, all the countries in ASEAN are facing several common barriers to achieving UHC, namely 1) financial constraints, including low levels of overall and government spending on health; 2) supply side constraints, including inadequate numbers and densities of health workers; and 3) the ongoing epidemiological transition at different stages characterized by increasing burdens of non-communicable diseases, persisting infectious diseases, and reemergence of potentially pandemic infectious diseases. The ASEAN Economic Community's (AEC) goal of regional economic integration and a single market by 2015 presents both opportunities and challenges for UHC. Healthcare services have become more available but health and healthcare inequities will likely worsen as better-off citizens of member states might receive more benefits from the liberalization of trade policy in health, either via regional outmigration of health workers or intra-country health worker movement toward private hospitals, which tend to be located in urban areas. For ASEAN countries, UHC should be explicitly considered to mitigate deleterious effects of economic integration. Political commitments to safeguard health budgets and increase health spending will be necessary given liberalization's risks to health equity as well as migration and population aging which will increase demand on health systems. There is potential to organize select health services regionally to improve further efficiency. Conclusions: We believe that ASEAN has significant potential to become a force for better health in the region. We hope that all ASEAN citizens can enjoy higher health and safety standards, comprehensive social protection, and improved health status. We believe economic and other integration efforts can further these aspirations. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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17. Health systems research for policy change: lessons from the implementation of rapid assessment protocols for diabetes in low- and middle-income settings.
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Beran D, Miranda JJ, Cardenas MK, and Bigdeli M
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- Administrative Personnel, Africa, Asia, Attitude, Cooperative Behavior, Decision Making, Humans, Income, Insulin therapeutic use, International Cooperation, Nicaragua, Surveys and Questionnaires, Trust, World Health Organization, Developing Countries, Diabetes Mellitus drug therapy, Health Policy, Health Services Accessibility, Health Services Research methods, Policy Making, Program Evaluation
- Abstract
Background: As many challenges exist for access to diabetes care in developing countries, the International Insulin Foundation developed a Rapid Assessment tool and implemented this approach to identify barriers to care and propose concrete recommendations for decision makers. The objective of this paper is to identify the factors that contributed to informing and influencing policymakers with regards to this work., Methods: A documentary review comprised Stage 1. Stage 2 used an online questionnaire to gain insight from users of the Rapid Assessment results. Based on Stages 1 and 2, Stage 3 comprised in-depth interviews with a total of nine individuals (one individual each from the six participating countries; two individuals from the World Health Organization; one "Global Diabetes Advocate"). Interviews were analyzed based on a list of themes developed from Stage 2., Results: Stage 1 led to the identification of various types of documents referring to the results. The online questionnaire had a response rate of 33%. Respondents directly involved in the assessment had a "Good" or "Very Good" appreciation of most aspects and scored these higher than those not directly involved. From the interviews, formalized methods and close collaboration between the international team and local partners were strengths. Trust and a relationship with local partners were also seen as assets. All stakeholders valued the results and the credibility of the data generated. Local partners felt that more could have been done for dissemination., Conclusion: This study shows the importance of specific results from the different assessments. In addressing complex issues having external experts involved was seen as an advantage. The uptake of results was due to the credibility of the research which was influenced by a mix of the people involved, past assessments, trusted local partners, and the use of the results by knowledge brokers, such as the World Health Organization. Through these brokers, others gained ownership of the data. The methods used and the fact that this data was grounded in a local context also reinforced its value. Despite limitations, this study offers a unique perspective where a similar research approach was taken in six countries.
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- 2015
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18. Shaping Norms for Health Governance in the Association of Southeast Asian Nations (ASEAN).
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Nodzenski, Marie, Kai Hong Phua, Yee Kuang Heng, and Tikki Pang
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HEALTH policy ,STAKEHOLDERS - Abstract
While global health governance mechanisms have been studied extensively, little research has been conducted on the factors that fundamentally shape and constrain international health policy-making or on the norms and values that influence or define global health politics. The political and economic emergence of several nations has been challenging the ways health policies and programs are designed and implemented, but also the fundamental values that underpin such policies.In light of unstructured Global Health Governance, increasing attention has been devoted to regions as health actors. In fast-developing Southeast Asia, the Association of Southeast Asian Nations (ASEAN) has become one of the most prominent actors in health and could potentially act as a platform for different stakeholders in health, fostering a convergence of interests, norms and values. This paper looks at the norms that shape and constrain health-policy making in Southeast Asia, with a particular focus on the growing role of the third sector in norm diffusion despite little political integration at regional level. Health issues provide a vantage point to analyse the changing nature of relations and governance frameworks as well as the emergence of new norms through civil society movements in Southeast Asia. [ABSTRACT FROM AUTHOR]
- Published
- 2016
19. Righting the mismatch between law, policy and the sexual and reproductive health needs of young people in the Asia-Pacific Region.
- Author
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Godwin J, Szabo G, Sass J, and Sauvarin J
- Subjects
- Abortion, Induced statistics & numerical data, Adolescent, Adult, Asia, Child, Decision Making, Female, Humans, Male, Marriage, New Zealand, Parental Consent legislation & jurisprudence, Young Adult, Health Policy, Health Services Accessibility legislation & jurisprudence, Reproductive Health, Reproductive Rights legislation & jurisprudence, Sexual Behavior
- Abstract
The context of sexual relations is changing in the Asia-Pacific. While the age of sexual debut remains the same, young people are generally marrying later and sex outside of marriage is increasing. The first systematic review of how laws and policies govern young people's access to sexual and reproductive health services was conducted in 2013. The study considered >400 national documents and held focus group discussions with >60 young people across three countries in the region. This paper examines the study findings in light of epidemiological data on young people's sexual behaviour and health, exposing a critical mismatch between the onset of sexual activity and laws and policies governing consent (to sex and medical treatment), and the restriction and orientation of services to married persons. An enabling legal and policy environment is an essential foundation for efforts to improve young people's sexual and reproductive health. This paper argues that international guidance and commitments (including the widely ratified Convention on the Rights of the Child) provide a framework for recognising young people's evolving capacity for independent decision-making, including in the realm of sexual and reproductive health. A number of countries in the region are using these frameworks to expand access to services, providing valuable examples for others to build on., (Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2014
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20. The inter-section of political history and health policy in Asia--the historical foundations for health policy analysis.
- Author
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Grundy J, Hoban E, Allender S, and Annear P
- Subjects
- Asia, Developing Countries, Health Policy economics, History, 20th Century, History, 21st Century, Health Care Reform history, Health Policy history, Policy Making, Politics
- Abstract
One of the challenges for health reform in Asia is the diverse set of socio-economic and political structures, and the related variability in the direction and pace of health systems and policy reform. This paper aims to make comparative observations and analysis of health policy reform in the context of historical change, and considers the implications of these findings for the practice of health policy analysis. We adopt an ecological model for analysis of policy development, whereby health systems are considered as dynamic social constructs shaped by changing political and social conditions. Utilizing historical, social scientific and health literature, timelines of health and history for five countries (Cambodia, Myanmar, Mongolia, North Korea and Timor Leste) are mapped over a 30-50 year period. The case studies compare and contrast key turning points in political and health policy history, and examines the manner in which these turning points sets the scene for the acting out of longer term health policy formation, particularly with regard to the managerial domains of health policy making. Findings illustrate that the direction of health policy reform is shaped by the character of political reform, with countries in the region being at variable stages of transition from monolithic and centralized administrations, towards more complex management arrangements characterized by a diversity of health providers, constituency interest and financing sources. The pace of reform is driven by a country's institutional capability to withstand and manage transition shocks of post conflict rehabilitation and emergence of liberal economic reforms in an altered governance context. These findings demonstrate that health policy analysis needs to be informed by a deeper understanding and questioning of the historical trajectory and political stance that sets the stage for the acting out of health policy formation, in order that health systems function optimally along their own historical pathways., (Copyright © 2014 Elsevier Ltd. All rights reserved.)
- Published
- 2014
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21. State of rare disease management in Southeast Asia.
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Shafie, Asrul Akmal, Chaiyakunapruk, Nathorn, Supian, Azuwana, Lim, Jeremy, Zafra, Matt, and Hassali, Mohamed Azmi Ahmad
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TREATMENT of rare diseases ,DISEASE prevalence ,ORPHAN drugs ,HEALTH policy ,DISEASE management ,SYMPTOMS - Abstract
Background: Rare diseases, also referred to as orphan diseases, are characterised by their low prevalence with majority of them are chronically debilitating and life threatening. Given the low prevalence and the widely dispersed but very small patient base for each disease, there may often be a disproportion in the availability of treatments and resources to manage patients, spur research and train experts. This is especially true in Southeast Asian countries that are currently in the process of implementing or revising their universal health coverage schemes. This paper aims to examine the status of rare disease management in Southeast Asian countries. It will serve as the basis for a more active discussion on how countries in the region can address an under-recognised rare disease burden and enhance national and regional capacities.Methods: The study consists of literature reviews and key stakeholders interviews in six focus countries, including the Philippines, Singapore, Malaysia, Indonesia, Vietnam, and Thailand and five countries as best practice, comprising of France, Canada, Australia, Taiwan, and South Korea. Rare disease management initiatives across each country were examined based on the World Health Organization's framework for action in strengthening health systems.Results: The results suggest rare disease management remains challenging across Southeast Asia, as many of the focus countries face fundamental issues from basic healthcare systems to funding. Nonetheless, there are substantial improvement opportunities, including leveraging best practices from around the world and organising a multi-stakeholder and regional approach and strategy.Conclusions: Southeast Asian countries have made significant progress in the management of rare disease, but there remain key areas for substantial development opportunities. [ABSTRACT FROM AUTHOR]- Published
- 2016
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- View/download PDF
22. Universal health coverage in 'One ASEAN': are migrants included?
- Author
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Guinto, Ramon Lorenzo Luis R., Curran, Ufara Zuwasti, Rapeepong Suphanchaimat, and Pocock, Nicola S.
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CITIZENSHIP ,HUMAN rights ,INSURANCE ,INTERNATIONAL agencies ,HEALTH policy ,NOMADS ,WORLD health - Abstract
Background: As the Association of South East Asian Nations (ASEAN) gears toward full regional integration by 2015, the cross-border mobility of workers and citizens at large is expected to further intensify in the coming years. While ASEAN member countries have already signed the Declaration on the Protection and Promotion of the Rights of Migrant Workers, the health rights of migrants still need to be addressed, especially with ongoing universal health coverage (UHC) reforms in most ASEAN countries. This paper seeks to examine the inclusion of migrants in the UHC systems of five ASEAN countries which exhibit diverse migration profiles and are currently undergoing varying stages of UHC development. Design: A scoping review of current migration trends and policies as well as ongoing UHC developments and migrant inclusion in UHC in Indonesia, Malaysia, Philippines, Singapore, and Thailand was conducted. Results: In general, all five countries, whether receiving or sending, have schemes that cover migrants to varying extents. Thailand even allows undocumented migrants to opt into its Compulsory Migrant Health Insurance scheme, while Malaysia and Singapore are still yet to consider including migrants in their government-run UHC systems. In terms of predominantly sending countries, the Philippines's social health insurance provides outbound migrants with portable insurance yet with limited benefits, while Indonesia still needs to strengthen the implementation of its compulsory migrant insurance which has a health insurance component. Overall, the five ASEAN countries continue to face implementation challenges, and will need to improve on their UHC design in order to ensure genuine inclusion of migrants, including undocumented migrants. However, such reforms will require strong political decisions from agencies outside the health sector that govern migration and labor policies. Furthermore, countries must engage in multilateral and bilateral dialogue as they redefine UHC beyond the basis of citizenship and reimagine UHC systems that transcend national borders. Conclusions: By enhancing migrant coverage, ASEAN countries can make UHC systems truly 'universal'. Migrant inclusion in UHC is a human rights imperative, and it is in ASEAN's best interest to protect the health of migrants as it pursues the path toward collective social progress and regional economic prosperity. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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23. Investigating factors affecting HIV/AIDS knowledge among women in low and middle-income countries in Asia.
- Author
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Dzadey, Dela, Biswas, Raaj Kishore, and Bhowmik, Jahar
- Subjects
AIDS prevention ,HIV prevention ,HEALTH education ,STATISTICS ,HEALTH policy ,MIDDLE-income countries ,REGRESSION analysis ,SURVEYS ,COMPARATIVE studies ,HUMAN services programs ,INTELLECT ,LOW-income countries ,INFECTIOUS disease transmission ,ACCESS to information ,WOMEN'S health - Abstract
Sustainable Development Goal 3 focuses on reducing HIV/AIDS spread, for which disseminating correct information on the disease is required. This study investigated factors associated with HIV/AIDS knowledge among women in several Asian LMICs. Global Multiple Indicator Cluster Survey-6 (MICS-6) for Bangladesh, Lao, Mongolia and Nepal were assessed. Bivariate analysis and generalised linear regression models were fitted. Overall, 60% of the respondents were aware or heard of the existence of HIV/AIDS, with 63.2% having transmission knowledge and 80.4% misconception knowledge. Results revealed that several demographic factors such as wealth index, education and access to information had a significant association with HIV/AIDS knowledge. Mongolia and Nepal have formal programmes in place that may provide policy and implementation advantages compared to Bangladesh and Lao. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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- View/download PDF
24. Alkohol: Kein gewöhnliches Konsumgut: Eine Zusammenfassung der dritten Auflage.
- Author
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Babor, Thomas F., Casswell, Sally, Graham, Kathryn, Huckle, Taisia, Livingston, Michael, Rehm, Jürgen, Room, Robin, Rossow, Ingeborg, and Sornpaisarn, Bundit
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HEALTH policy ,PUBLIC health ,EPIDEMIOLOGY ,LOW-income countries ,ALCOHOL ,GLOBAL burden of disease ,ALCOHOLISM ,MARKETING - Abstract
Copyright of Sucht is the property of Hogrefe AG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2023
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25. Health equity and migrants in the Greater Mekong Subregion.
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McMichael, Celia and Healy, Judith
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NOMADS ,HEALTH services accessibility ,HEALTH insurance ,MEDICAL quality control ,HEALTH policy ,MEDLINE ,ONLINE information services ,REFUGEES ,SYSTEMATIC reviews - Abstract
Background: Migrant health is receiving increasing international attention, reflecting recognition of the health inequities experienced among many migrant populations and the need for health systems to adapt to diverse migrant populations. In the Greater Mekong Subregion (GMS) there is increasing migration associated with uneven economic integration and growth, socio-economic vulnerabilities, and disparities between countries. There has been limited progress, however, in improving migrant access to health services in the Subregion. This paper examines the health needs, access barriers, and policy responses to cross-border migrants in five GMS countries. Methods: A review of published literature and research was conducted on migrant health and health service access in Cambodia, Lao People’s Democratic Republic, Myanmar, Thailand, and Viet Nam, as well as analysis of current migration trends and universal health coverage (UHC) indicators in the Subregion. The review included different migrant types: i.e. migrant workers, irregular migrants, victims of trafficking, refugees and asylum seekers, and casual cross-border migrants. Results: There is substantial diversity in the capacity of GMS health systems to address migrant populations. Thailand has sought to enhance migrant health coverage, including development of migrant health policies/programs, bilateral migrant worker agreements, and migrant health insurance schemes; Viet Nam provides health protection for emigrant workers. Overall, however, access to good quality health care remains weak for many citizens in GMS countries let alone migrants. Migrant workers – and irregular migrants in particular – face elevated health risks yet are not adequately covered and incur high out-of-pocket (OOP) payments for health services. Conclusions: UHC implies equity: UHC is only achieved wheneveryonehas the opportunity to access and use good-quality health care. Efforts to achieve UHC in the GMS require deliberate policy decisions to include migrants. The emergence of the UHC agenda, and the focus on migrant health among policy makers and partners, present an opportunity to tackle barriers to health service access, extend coverage, and strengthen partnerships in order to improve migrant health. This is an opportune time for GMS countries to develop migrant-inclusive health systems. [ABSTRACT FROM PUBLISHER]
- Published
- 2017
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26. The promotion of intrauterine contraception in low- and middle-income countries: a narrative review.
- Author
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Cleland, John, Ali, Moazzam, Benova, Lenka, and Daniele, Marina
- Subjects
- *
INTRAUTERINE contraceptives , *HEALTH policy , *FAMILY planning , *GOVERNMENT agencies , *MIDDLE-income countries , *LOW-income countries , *CONTRACEPTION , *CONTRACEPTIVE drugs , *HEALTH education , *MEDLINE , *POVERTY , *PUERPERIUM , *RESEARCH funding , *SYSTEMATIC reviews , *HIV seroconversion , *LEVONORGESTREL ,DEVELOPING countries - Abstract
Context: The contribution of copper-bearing intrauterine devices (IUDs) to overall contraceptive protection has declined in many countries, despite their well-known advantages. In response, initiatives to promote this method have been undertaken.Objective: To review and interpret the experience of interventions to promote use of IUDs in low- and middle-income countries in order to provide strategic guidance for policies and programs.Methods: We conducted a systematic search of Medline, Popline, Embase and Global Health electronic databases for relevant journal papers, reports and gray literature since 2010. Telephone interviews were held with two donors and six international family planning organizations.Results: We identified a total of 31 publications. Four reported the results of randomized control trials and three were derived from quasi-experiments. The majority were based on service statistics. Eight publications concerned interventions for HIV-positive women or couples, nine for postpartum or postabortion cases and 14 for general populations. Intervention approaches included vouchers, franchising of private practitioners, mobile outreach services, placement of dedicated staff in high-volume facilities and demand creation. Most publications adduced evidence of a positive impact and some reported impressively large numbers of IUD insertions. Results to date on the uptake of IUDs in postpartum interventions are modest. There is also almost no evidence of effects on IUD use at national levels. Implant uptake generally exceeded IUD uptake when both were offered.Conclusion: The evidence base is weak and offers few lessons on what strategies are most effective. The overall impression is that IUD use can be increased in a variety of ways but that progress is hampered by persistent adverse perceptions by both providers and potential clients. Provider enthusiasm is a key to success. The lack of a population impact stems in part from the fact that nearly all interventions are initiated by international organizations, with limited national reach except in small countries, rather than by government agencies. [ABSTRACT FROM AUTHOR]- Published
- 2017
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- View/download PDF
27. Developmental trajectories of health and long-term care systems: The transitions of solidarity in four Asian countries.
- Author
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Yeh, Ming-Jui
- Subjects
- *
HEALTH care industry , *HEALTH policy , *CAREGIVERS , *MEDICAL care costs , *MEDICAL care , *POLICY science research , *HEALTH care reform , *RESIDENTIAL care , *LONG-term health care - Abstract
• Provide a comprehensive overview of the solidarity in health and long-term care sectors. • The overall direction of reforms is developing toward universal coverage. • Reforms might be possible without overall consensus on solidarity. • The pay-as-you-go financial arrangements will require strong intergenerational solidarity. • The capacity of informal caregiving of family could be considered. Different from the development of health sector, there are significant variations in the underpinnings and formation timings of solidarity-based long-term care (LTC) systems. This paper compares the historical developmental trajectories and identifies factors of the transitions of the actual practices of solidarity - the scope of community, the scope of interdependence, and the costs of joint action - in the health and LTC sectors in four East Asian countries: Japan, South Korea, Taiwan, and Singapore. Comparative policy analysis. Healthcare tends to be considered a universal value such that its boundary should include all residents, while LTC is closer to an entitlement of citizens. The differing solidarity reflects path dependency as well as historical legacies and policy diffusion between the health and LTC sectors. In both health and LTC sectors, the costs involved in collective service provision are not distributed evenly between generations. Centralized governance is a prevailing feature of health and LTC sectors in East Asia, allowing solidarity-based institutional arrangements to be established without an overall sense of solidarity. The relationship between solidarity and health and LTC systems is complex and dynamic. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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- View/download PDF
28. Prevalence of Frailty among Community-Dwelling Older Adults in Asian Countries: A Systematic Review and Meta-Analysis.
- Author
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To, Thi-Lien, Doan, Thanh-Nhan, Ho, Wen-Chao, and Liao, Wen-Chun
- Subjects
FRAILTY ,FRAIL elderly ,BONE fractures ,OLDER people ,DATABASE searching ,HEALTH policy - Abstract
This study aimed to synthesize frailty prevalence among community-dwelling older adults in Asia and identify factors influencing prevalence estimates. Five electronic databases were searched by 29 April 2022, including representative samples of community-dwelling adults who were aged 60 years and older and lived in Asia. Cross-sectional or national longitudinal population-based cohort studies completed with validated instruments were selected. Twenty-one studies with 52,283 participants were included. The pooled prevalence rate of frailty was 20.5% (95% CI = 15.5% to 26.0%). The estimated frailty prevalence was 14.6% (95% CI = 10.9% to 18.8%) while assessed by the Fried frailty phenotype, 28.0% (95% CI = 21.3% to 35.3%) by the Cumulative Frailty Index, 36.4% (95% CI = 33.6% to 39.3%) by the Study of Osteoporotic Fractures (SOF) index, and 46.3% (95% CI = 40.1% to 52.4%) by the Clinical Frailty Scale (p < 0.01). Subgroup analysis in studies using the Fried's phenotype tool found that frailty prevalence was increased with older age (p = 0.01) and was higher in those who were single (21.5%) than in married participants (9.0%) (p = 0.02). The study results supported a better understanding of frailty prevalence in different geographical distributions and provide references for health policy decision-making regarding preventing frailty progression in older adults. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
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29. Integrating citizen engagement into evidence-informed health policy-making in eastern Europe and central Asia: scoping study and future research priorities.
- Author
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Macaulay, Bobby, Reinap, Marge, Wilson, Michael G., and Kuchenmüller, Tanja
- Subjects
NEW democracies ,POLICY sciences ,GREY literature ,HEALTH policy ,REPORT writing ,SYSTEMATIC reviews ,EXECUTIVES ,RESEARCH funding ,LITERATURE reviews - Abstract
Background: The perspectives of citizens are an important and often overlooked source of evidence for informing health policy. Despite growing encouragement for its adoption, little is known regarding how citizen engagement may be integrated into evidence-informed health policy-making in low- and middle-income counties (LMICs) and newly democratic states (NDSs). We aimed to identify the factors and variables affecting the potential integration of citizen engagement into evidence-informed health policy-making in LMICs and NDSs and understand whether its implementation may require a different approach outside of high-income western democracies. Further, we assessed the context-specific considerations for the practical implementation of citizen engagement in one focus region-eastern Europe and central Asia.Methods: First, adopting a scoping review methodology, we conducted and updated searches of six electronic databases, as well as a comprehensive grey literature search, on citizen engagement in LMICs and NDSs, published before December 2019. We extracted insights about the approaches to citizen engagement, as well as implementation considerations (facilitators and barriers) and additional political factors, in developing an analysis framework. Second, we undertook exploratory methods to identify relevant literature on the socio-political environment of the focus region, before subjecting these sources to the same analysis framework.Results: Our searches identified 479 unique sources, of which 28 were adjudged to be relevant. The effective integration of citizen engagement within policy-making processes in LMICs and NDSs was found to be predominantly dependent upon the willingness and capacity of citizens and policy-makers. In the focus region, the implementation of citizen engagement within evidence-informed health policy-making is constrained by a lack of mutual trust between citizens and policy-makers. This is exacerbated by inadequate incentives and capacity for either side to engage.Conclusions: This research found no reason why citizen engagement could not adopt the same form in LMICs and NDSs as it does in high-income western democracies. However, it is recognized that certain political contexts may require additional support in developing and implementing citizen engagement, such as through trialling mechanisms at subnational scales. While specifically outlining the potential for citizen engagement, this study highlights the need for further research on its practical implementation. [ABSTRACT FROM AUTHOR]- Published
- 2022
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30. Temporal changes in diabetes prevalence and achievement of care goals in urban South Asia from 2010 to 2016 – The Center for Cardio‐metabolic Risk Reduction in South Asia Study.
- Author
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Anjana, Ranjit Mohan, Deepa, Mohan, Subashini, Radhakrishnan, Patel, Shivani A., Kondal, Dimple, Unnikrishnan, Ranjit, Tandon, Nikhil, Prabhakaran, Dorairaj, Venkat Narayan, K. M., Kadir, Muhammad M., Mohan, Viswanathan, and Ali, Mohammed K.
- Subjects
TREATMENT of diabetes ,CARDIOVASCULAR diseases risk factors ,CONFIDENCE intervals ,DIABETES ,GLYCOSYLATED hemoglobin ,GOAL (Psychology) ,MEDICAL care ,MEDICAL quality control ,HEALTH policy ,METROPOLITAN areas ,PATIENTS ,RISK management in business ,POPULATION health ,DISEASE prevalence ,CROSS-sectional method ,GLYCEMIC control - Abstract
Aim: Achievement of treatment targets among individuals with diabetes remains suboptimal in many parts of the globe. We aimed to assess changes in diabetes prevalence and achievement of diabetes care goals in South Asia using two consecutive cross‐sectional population‐based surveys. Methods: Two representative samples of South Asian adults were recruited using identical methods from Chennai, Delhi, and Karachi in 2010‐11 (n = 16,288; response rate–94.7%) and 2015‐16 (n = 14,587; response rate–94.0%) through the Center for Cardio‐metabolic Risk Reduction in South Asia (CARRS) Study. Quality of care goals were defined as HbA1c <53 mmol/mol (7.0%), blood pressure (BP) control: <140/90 mmHg, lipid control: LDL cholesterol <2.56 mmol/l (100 mg/dl), and self‐reported non‐smoking. Results: Weighted prevalence of self‐reported diabetes increased by 9.0% [13% (95%CI: 13–14) to 15% (14–15)] while that of newly diagnosed diabetes decreased by 16% [6.1% (5.7–6.6) to 5.1% (4.6–5.6)]. There were improvements in achieving glycaemic (25% to 30%, p = 0.002) and lipid (34% to 45%, p < 0.001) goals, but no notable improvements in BP control or smoking status. The proportion of individuals with self‐reported diabetes meeting more than one target also increased. Conclusions: Diabetes prevalence continues to grow among urban South Asians and large gaps still exist in the attainment of treatment targets. Concerted policy, systemic, clinical and individual efforts are needed to close these care gaps. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
31. Healthcare financing in South-East Asia: Does fiscal capacity matter?
- Author
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Behera, Deepak Kumar and Dash, Umakant
- Subjects
FISCAL capacity ,MIDDLE-income countries ,SYNDICATES (Finance) ,HEALTH policy ,PUBLIC finance - Abstract
Financing healthcare and achieve sustainable development goals by 2030 is the prime focus of many low-income and middle income countries. Improved public healthcare and reduce the burden of out-of-pocket health expenditure is the overarching public health policy objective across the Asia-Pacific region. This study examines the impact of fiscal capacity on health expenditure by controlling socio-economic factors in South-East Asia for the period of 1995–2013. We have employed a panel fixed effects regression model in order to capture country-level unobserved heterogeneity and macroeconomic policy changes in the health sector. Overall result shows that annual change in per capita government health expenditure (pooled financing) is influenced positively by the per capita income, fiscal capacity, ageing, and the prevalence of tuberculosis and rate of urbanization. The income elasticity of government health expenditure is less than one, which implies that the health expenditure is treated as a necessity for the public health providers. Overall empirical analysis concludes that pooled financing mechanism positively influenced by the size of fiscal capacity thereby the share of out-of-pocket health expenditure to total health expenditure declines over the period. The result suggests that the faster movement towards health financing transition would possible through the generation of fiscal capacity by improving public finance policies. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
32. The Refined Middle-Range Theory on Women's Leadership in Asian Culture.
- Author
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Im, Eun-Ok, Wang, Hsiu-Hung, Tsai, Hsiu-Min, Sakashita, Reiko, Oh, Eui Geum, Lin, Chia Chin, Kunaviktikul, Wipada, Inouye, Jillian, Huang, Lian-Hua, and Broome, Marion E.
- Subjects
CULTURE ,LEADERSHIP ,HEALTH policy ,NURSES ,PHILOSOPHY of nursing ,WOMEN ,SOCIOECONOMIC factors ,LEADERS ,WORK experience (Employment) - Abstract
Introduction: Because virtually no theories were available to explain unique characteristics of Asian women's leadership in nursing, a middle-range theory on women's leadership in Asian culture was previously published. To reflect recent political and social changes in different countries, there is a necessity to refine the theory. The purpose of this article is to present the refined middle-range theory on Asian women's leadership in nursing. Methodology: Using an integrative approach, the theory was further developed based on two major sources: literature reviews and exemplars/cases from six different countries. Results: The Refined Middle-Range Theory on Women's Leadership in Asian Culture has two main domains: (a) leadership frames and (b) leadership contexts. The domain of leadership contexts has been extended with two additional main concepts including demographic contexts and health workforce/system contexts. Discussion: The refined theory is expected to guide Asian women's leadership in nursing across the globe. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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33. A nursing informatics response to COVID‐19: Perspectives from five regions of the world.
- Author
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Atique, Suleman, Bautista, John R., Block, Lorraine J., Lee, Jung Jae, Lozada‐Perezmitre, Erika, Nibber, Raji, O'Connor, Siobhan, Peltonen, Laura‐Maria, Ronquillo, Charlene, Tayaben, Jude, Thilo, Friederike J. S., and Topaz, Maxim
- Subjects
HEALTH services accessibility ,HEALTH policy ,NURSES ,NURSING informatics ,WORLD health ,ONLINE education ,OCCUPATIONAL roles ,COVID-19 ,SOCIAL distancing ,STAY-at-home orders - Abstract
The article focuses on outbreak of epidemics and pandemics including Ebola, Severe Acute Respiratory Syndrome (SARS) and Coronavirus (COVID-19) and mentions implementation of lockdown of Hubei province. Topics discussed including nursing informatics community responding to crisis and lessons learned, reduction of impact of the disease on the country's healthcare system and e-learning technologies to ensure nursing students.
- Published
- 2020
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34. The Surveillance for Enteric Fever in Asia Project (SEAP), Severe Typhoid Fever Surveillance in Africa (SETA), Surveillance of Enteric Fever in India (SEFI), and Strategic Typhoid Alliance Across Africa and Asia (STRATAA) Population-based Enteric Fever Studies: A Review of Methodological Similarities and Differences
- Author
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Carey, Megan E, MacWright, William R, Im, Justin, Meiring, James E, Gibani, Malick M, Park, Se Eun, Longley, Ashley, Jeon, Hyon Jin, Hemlock, Caitlin, Yu, Alexander T, Soura, Abdramane, Aiemjoy, Kristen, Owusu-Dabo, Ellis, Terferi, Mekonnen, Islam, Sahidul, Lunguya, Octavie, Jacobs, Jan, Gordon, Melita, Dolecek, Christiane, and Baker, Stephen
- Subjects
TYPHOID fever diagnosis ,DRUG resistance in microorganisms ,HEALTH services accessibility ,IMMUNIZATION ,HEALTH policy ,MEDICAL practice ,PHYSICIANS ,POPULATION density ,PUBLIC health surveillance ,SANITATION ,TYPHOID fever ,TYPHOID vaccines ,DECISION making in clinical medicine ,SYMPTOMS ,SEVERITY of illness index ,INFECTIOUS disease transmission - Abstract
Building on previous multicountry surveillance studies of typhoid and others salmonelloses such as the Diseases of the Most Impoverished program and the Typhoid Surveillance in Africa Project, several ongoing blood culture surveillance studies are generating important data about incidence, severity, transmission, and clinical features of invasive Salmonella infections in sub-Saharan Africa and South Asia. These studies are also characterizing drug resistance patterns in their respective study sites. Each study answers a different set of research questions and employs slightly different methodologies, and the geographies under surveillance differ in size, population density, physician practices, access to healthcare facilities, and access to microbiologically safe water and improved sanitation. These differences in part reflect the heterogeneity of the epidemiology of invasive salmonellosis globally, and thus enable generation of data that are useful to policymakers in decision-making for the introduction of typhoid conjugate vaccines (TCVs). Moreover, each study is evaluating the large-scale deployment of TCVs, and may ultimately be used to assess post-introduction vaccine impact. The data generated by these studies will also be used to refine global disease burden estimates. It is important to ensure that lessons learned from these studies not only inform vaccination policy, but also are incorporated into sustainable, low-cost, integrated vaccine-preventable disease surveillance systems. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
35. An Overview on Betel Quid and Areca Nut Practice and Control in Selected Asian and South East Asian Countries.
- Author
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Gunjal, Shilpa, Pateel, Deepak Gowda Sadashivappa, Yang, Yi-Hsin, Doss, Jennifer Geraldine, Bilal, Sobia, Maling, Thaddius Herman, Mehrotra, Ravi, Cheong, Sok Ching, and Zain, Rosnah Binti Mohd
- Subjects
SUBSTANCE abuse prevention ,BETEL palm ,CINAHL database ,HABIT ,HEALTH promotion ,MASTICATION ,HEALTH policy ,MEDLINE ,MOUTH tumors ,ONLINE information services ,SMOKELESS tobacco ,TERMS & phrases ,TOBACCO ,SYSTEMATIC reviews ,SEARCH engines ,DISEASE prevalence - Abstract
Background: Areca nut (AN) and betel quid (BQ) chewing are ancient practices followed by an extensive proportion of the world's population. These practices are endemic in larger parts of South and Southeast Asia and selected Western Pacific countries. The prevalence of these habits varies across regions, age, gender, cultural practice, and socioeconomic status groups. Considerable variations exist between countries with respect to prevention/intervention programs, and policy guidelines of BQ usage. Objectives: (1) To provide an overview of the BQ chewing prevalence, practices, preventive interventions and policies in selected Asian and Western Pacific countries. (2) To explore the different terminologies associated with BQ use. Method: A narrative review of the current literature related to BQ, AN, and oral cancer was conducted by searching PUBMED, CINAHL, and GOOGLE databases. Results: The literature review revealed that the prevalence of BQ was found to be highest in Papua New Guinea, followed by Bangladesh, India, Pakistan, Myanmar and Sri Lanka. While, Cambodia, Malaysia, Indonesia and Taiwan had comparatively lower prevalence. Smokeless tobacco, BQ with tobacco, BQ without tobacco, AN were some of the terminologies used for BQ in various studies. Conclusions: The prevalence, and the interventional policies related to BQ and AN chewing habits varies widely among the selected countries. With the increasing awareness and association of BQ with oral cancer, there is a need to have better awareness, prevention and interventional strategies in place. We also found considerable variation in the use of terminologies associated with BQ. [ABSTRACT FROM AUTHOR]
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- 2020
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36. Spatial and Temporal Patterns of Typhoid and Paratyphoid Fever Outbreaks: A Worldwide Review, 1990–2018.
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Kim, Samuel, Lee, Kang Sung, Pak, Gi Deok, Excler, Jean-Louis, Sahastrabuddhe, Sushant, Marks, Florian, Kim, Jerome H, and Mogasale, Vittal
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TYPHOID fever diagnosis ,BLOOD ,CELL culture ,DISEASE outbreaks ,HEALTH policy ,MULTIDRUG resistance ,PARATYPHOID fever ,POPULATION geography ,PUBLIC health ,TYPHOID fever ,SYSTEMATIC reviews ,DISEASE prevalence ,MIDDLE-income countries ,LOW-income countries ,DISEASE risk factors - Abstract
Background Analyses of the global spatial and temporal distribution of enteric fever outbreaks worldwide are important factors to consider in estimating the disease burden of enteric fever disease burden. Methods We conducted a global literature review of enteric fever outbreak data by systematically using multiple databases from 1 January 1990 to 31 December 2018 and classified them by time, place, diagnostic methods, and drug susceptibility, to illustrate outbreak characteristics including spatial and temporal patterns. Results There were 180 940 cases in 303 identified outbreaks caused by infection with Salmonella enterica serovar Typhi (S. Typhi) and Salmonella enterica serovar Paratyphi A or B (S. Paratyphi). The size of outbreak ranged from 1 to 42 564. Fifty-one percent of outbreaks occurred in Asia, 15% in Africa, 14% in Oceania, and the rest in other regions. Forty-six percent of outbreaks specified confirmation by blood culture, and 82 outbreaks reported drug susceptibility, of which 54% had multidrug-resistant pathogens. Paratyphoid outbreaks were less common compared to typhoid (22 vs 281) and more prevalent in Asia than Africa. Risk factors were multifactorial, with contaminated water being the main factor. Conclusions Enteric fever outbreak burden remains high in endemic low- and middle-income countries and, despite its limitations, outbreak data provide valuable contemporary evidence in prioritizing resources, public health policies, and actions. This review highlights geographical locations where urgent attention is needed for enteric fever control and calls for global action to prevent and contain outbreaks. [ABSTRACT FROM AUTHOR]
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- 2019
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37. Epidemiology of harmful use of alcohol in Nigeria: a systematic review and meta-analysis.
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Adeloye, Davies, Olawole-Isaac, Adebanke, Auta, Asa, Dewan, Mary T., Omoyele, Chiamaka, Ezeigwe, Nnenna, Jacobs, Wura, Mpazanje, Rex G., Harhay, Michael O., Alemu, Wondimagegnehu, and Adewole, Isaac F.
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ALCOHOL drinking ,META-analysis ,HEALTH policy ,EPIDEMIOLOGY - Abstract
Background: Nigeria, the most populous country in Africa, has reported relatively high levels of alcohol misuse, yet limited resources to guide effective population-wide response. There is a need to integrate existing empirical information in order to increase the power and precision of estimating epidemiological evidence necessary for informing policies and developing prevention programs. Objectives: We aimed to estimate nationwide and zonal prevalence of harmful use of alcohol in Nigeria to inform public health policy and planning. Methods: Epidemiologic reports on alcohol use in Nigeria from 1990 through 2018 were systematically searched and abstracted. We employed random-effects meta-analysis and meta-regression model to determine the number of harmful alcohol users. Results: 35 studies (n = 37,576 Nigerians) were identified. Pooled crude prevalence of harmful use of alcohol was 34.3% (95% CI: 28.6-40.1); twice as high among men (43.9%, 31.1-56.8) compared to women (23.9%, 16.4-31.4). Harmful alcohol use was higher in rural settings (40.1%, 24.2-56.1) compared to urban settings (31.2%, 22.9-39.6). The number of harmful alcohol users aged ≥15 years increased from 24 to 34 million from 1995 to 2015. However, actual age-adjusted prevalence of harmful use of alcohol in Nigeria decreased from 38.5% to 32.6% over the twenty-year period. Conclusions: While the prevalence of the total population that drinks harmfully appears to be dropping, absolute number of individuals that would be classified as harmful drinkers is increasing. This finding highlights the complexity of identifying and advocating for substance abuse policies in rapidly changing demographic settings common in Africa, Asia, and other developing countries. [ABSTRACT FROM AUTHOR]
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- 2019
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38. Introduction of Typhoid Conjugate Vaccines in Africa and Asia.
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CLIMATE change ,DECISION making ,DRUG resistance in microorganisms ,IMMUNIZATION ,HEALTH policy ,MEDICAL protocols ,TYPHOID fever ,TYPHOID vaccines ,FINANCIAL management ,HUMAN services programs - Abstract
Typhoid fever continues to be a major public health concern, particularly in many low- and middle-income countries. The current threats of increasing antimicrobial resistance, urbanization, and climate change elevate the urgency for better prevention and control efforts for typhoid fever. In 2017, the results of ground-breaking research on typhoid conjugate vaccines (TCVs), the World Health Organization prequalification of a TCV, and global policy and financing decisions have set the stage for the introduction of TCVs into routine immunization programs in endemic countries. Country-level decision-making and program planning are critical for local uptake and sustainability. [ABSTRACT FROM AUTHOR]
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- 2019
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39. Assessment of Global Kidney Health Care Status.
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Bello, Aminu K., Levin, Adeera, Tonelli, Marcello, Okpechi, Ikechi G., Feehally, John, Harris, David, Jindal, Kailash, Salako, Babatunde L., Rateb, Ahmed, Osman, Mohamed A., Qarni, Bilal, Saad, Syed, Lunney, Meaghan, Wiebe, Natasha, Feng Ye, Johnson, David W., and Ye, Feng
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KIDNEY disease treatments ,INTERNATIONAL cooperation on public health ,PREPAREDNESS ,HEMODIALYSIS facilities ,HEALTH planning ,NEPHROLOGY ,PERITONEAL dialysis ,KIDNEY transplantation ,SOCIETIES ,TREATMENT of chronic kidney failure ,ACUTE kidney failure ,CHRONIC kidney failure ,COMPARATIVE studies ,DEVELOPING countries ,HEMODIALYSIS ,INFORMATION storage & retrieval systems ,MEDICAL databases ,LEADERSHIP ,RESEARCH methodology ,MEDICAL care ,MEDICAL cooperation ,HEALTH policy ,ORGANIZATIONAL change ,POLICY sciences ,PRIMARY health care ,RESEARCH ,EVALUATION research ,PREVENTION - Abstract
Importance: Kidney disease is a substantial worldwide clinical and public health problem, but information about available care is limited.Objective: To collect information on the current state of readiness, capacity, and competence for the delivery of kidney care across countries and regions of the world.Design, Setting, and Participants: Questionnaire survey administered from May to September 2016 by the International Society of Nephrology (ISN) to 130 ISN-affiliated countries with sampling of key stakeholders (national nephrology society leadership, policy makers, and patient organization representatives) identified by the country and regional nephrology leadership through the ISN.Main Outcomes and Measures: Core areas of country capacity and response for kidney care.Results: Responses were received from 125 of 130 countries (96%), including 289 of 337 individuals (85.8%, with a median of 2 respondents [interquartile range, 1-3]), representing an estimated 93% (6.8 billion) of the world's population of 7.3 billion. There was wide variation in country readiness, capacity, and response in terms of service delivery, financing, workforce, information systems, and leadership and governance. Overall, 119 (95%), 95 (76%), and 94 (75%) countries had facilities for hemodialysis, peritoneal dialysis, and kidney transplantation, respectively. In contrast, 33 (94%), 16 (45%), and 12 (34%) countries in Africa had facilities for hemodialysis, peritoneal dialysis, and kidney transplantation, respectively. For chronic kidney disease (CKD) monitoring in primary care, serum creatinine with estimated glomerular filtration rate and proteinuria measurements were reported as always available in only 21 (18%) and 9 (8%) countries, respectively. Hemodialysis, peritoneal dialysis, and transplantation services were funded publicly and free at the point of care delivery in 50 (42%), 48 (51%), and 46 (49%) countries, respectively. The number of nephrologists was variable and was low (<10 per million population) in Africa, the Middle East, South Asia, and Oceania and South East Asia (OSEA) regions. Health information system (renal registry) availability was limited, particularly for acute kidney injury (8 countries [7%]) and nondialysis CKD (9 countries [8%]). International acute kidney injury and CKD guidelines were reportedly accessible in 52 (45%) and 62 (52%) countries, respectively. There was relatively low capacity for clinical studies in developing nations.Conclusions and Relevance: This survey demonstrated significant interregional and intraregional variability in the current capacity for kidney care across the world, including important gaps in services and workforce. Assuming the responses accurately reflect the status of kidney care in the respondent countries, the findings may be useful to inform efforts to improve the quality of kidney care worldwide. [ABSTRACT FROM AUTHOR]- Published
- 2017
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40. Trade, Labour Markets and Health.
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McNamara, Courtney and Labonté, Ronald
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ECONOMIC competition ,EMPLOYMENT ,HEALTH ,INTERNATIONAL relations ,LONGITUDINAL method ,HEALTH policy ,POLICY sciences ,PUBLIC health ,LABOR unions ,WORK ,GOVERNMENT policy ,RETROSPECTIVE studies ,DATA analysis software - Abstract
Previous analyses indicate that there are a number of potentially serious health risks associated with the Trans-Pacific Partnership (TPP). The objective of this work is to provide further insight into the potential health impacts of the TPP by investigating labour market pathways. The impact of the TPP on employment and working conditions is a major point of contention in broader public debates. In public health literature, these factors are considered fundamental determinants of health, yet they are rarely addressed in analyses of trade and investment agreements. We therefore undertake a prospective policy analysis of the TPP through a content analysis of the agreement’s Labour Chapter. Provisions of the Chapter are analyzed with reference to the health policy triangle and four main areas through which labour markets influence health: power relations, social policies, employment conditions and working conditions. Findings indicate that implementation of the TPP can have important impacts on health through labour market pathways. While the Labour Chapter is being presented by proponents of the agreement as a vehicle for improvement in labour standards, we find little evidence to support this view. Instead, we find several ways the TPP may weaken employment relations to the detriment of health. [ABSTRACT FROM AUTHOR]
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- 2017
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41. Recent trends in working with the private sector to improve basic healthcare: a review of evidence and interventions.
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Montagu, Dominic, Goodman, Catherine, Berman, Peter, Penn, Amy, and Visconti, Adam
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MEDICAL care ,PRIVATE sector ,HEALTH services accessibility ,MEDICAL care use ,DEVELOPING countries ,CONTRACTS & economics ,HEALTH policy ,SYSTEMATIC reviews ,HEALTH care industry ,ECONOMICS - Abstract
Copyright of Health Policy & Planning is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2016
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42. A global call for action to include gender in research impact assessment.
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Ovseiko, Pavel V., Greenhalgh, Trisha, Adam, Paula, Grant, Jonathan, Hinrichs-Krapels, Saba, Graham, Kathryn E., Valentine, Pamela A., Sued, Omar, Boukhris, Omar F., Al Olaqi, Nada M., Al Rahbi, Idrees S., Dowd, Anne-Maree, Bice, Sara, Heiden, Tamika L., Fischer, Michael D., Dopson, Sue, Norton, Robyn, Pollitt, Alexandra, Wooding, Steven, and Balling, Gert V.
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BIOLOGICAL research ,MEDICAL research ,INVESTMENTS & society ,GENDER ,RESEARCH & society ,GENDER identity ,HEALTH policy ,SCIENCE ,SEX distribution ,SEXISM - Abstract
Global investment in biomedical research has grown significantly over the last decades, reaching approximately a quarter of a trillion US dollars in 2010. However, not all of this investment is distributed evenly by gender. It follows, arguably, that scarce research resources may not be optimally invested (by either not supporting the best science or by failing to investigate topics that benefit women and men equitably). Women across the world tend to be significantly underrepresented in research both as researchers and research participants, receive less research funding, and appear less frequently than men as authors on research publications. There is also some evidence that women are relatively disadvantaged as the beneficiaries of research, in terms of its health, societal and economic impacts. Historical gender biases may have created a path dependency that means that the research system and the impacts of research are biased towards male researchers and male beneficiaries, making it inherently difficult (though not impossible) to eliminate gender bias. In this commentary, we - a group of scholars and practitioners from Africa, America, Asia and Europe - argue that gender-sensitive research impact assessment could become a force for good in moving science policy and practice towards gender equity. Research impact assessment is the multidisciplinary field of scientific inquiry that examines the research process to maximise scientific, societal and economic returns on investment in research. It encompasses many theoretical and methodological approaches that can be used to investigate gender bias and recommend actions for change to maximise research impact. We offer a set of recommendations to research funders, research institutions and research evaluators who conduct impact assessment on how to include and strengthen analysis of gender equity in research impact assessment and issue a global call for action. [ABSTRACT FROM AUTHOR]
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- 2016
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43. Perspectives and experiences of new migrants on health screening in Sweden.
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Faustine Kyungu Nkulu Kalengayi, Hurtig, Anna-Karin, Nordstrand, Annika, Ahlm, Clas, Ahlberg, Beth Maina, and Nkulu Kalengayi, Faustine Kyungu
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COMMUNICATION barriers ,MEDICAL screening ,MEDICAL care of immigrants ,CLINICAL trials ,MEDICAL care ,PSYCHOLOGY of caregivers ,COMMUNICABLE diseases ,PREVENTION of communicable diseases ,COOPERATIVENESS ,HEALTH attitudes ,LANGUAGE & languages ,PATIENT-professional relations ,HEALTH policy ,SENSORY perception ,NOMADS ,PSYCHOLOGY - Abstract
Background: In Sweden, migrants from countries considered to have a high burden of certain infectious diseases are offered health screening to prevent the spread of these diseases, but also identify their health needs. However, very little is known about their experiences and perceptions about the screening process. This study aimed at exploring these perceptions and experiences in order to inform policy and clinical practice.Method: Using an interpretive description framework, 26 new migrants were interviewed between April and June 2013 in four Swedish counties. Thematic analysis was used to analyze data.Results: The three themes developed include: new country, new practices; new requirements in the new country; and unmet needs and expectations. Participants described what it meant for them to come to a new country with a foreign language, new ways of communicating with caregivers/authorities and being offered health screening without clarification. Participants perceived health screening as a requirement from the authorities to be fulfilled by all newcomers but conceded that it benefits equally the host society and themselves. However, they also expressed concern over the involvement of the Migration Board staff and feared possible collaboration with health service to their detriment. They further stated that the screening program fell short of their expectations as it mainly focused on identifying infectious diseases and overlooked their actual health needs. Finally, they expressed frustration over delay in screening, poor living conditions in reception centers and the restrictive entitlement to care.Conclusions: Migrants are aware of their vulnerability and the need to undergo health screening though they view it as an official requirement. Thus, those who underwent the screening were more concerned about residency rather than the actual benefits of screening. The issues highlighted in this study may limit access to and uptake of the screening service, and compromise its effectiveness. To maximize the uptake: (1) linguistically and culturally adapted information is needed, (2) other screening approaches should be tried, (3) trained medical interpreters should be used, (4) a holistic and human right approach should be applied, (5) the involvement of migration staff should be reconsidered to avoid confusion and worries. Finally, to improve the effectiveness, (6) all migrants from targeted countries should be offered screening and efforts should be taken to improve the health literacy of migrants and the living conditions in reception centers. [ABSTRACT FROM AUTHOR]- Published
- 2016
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