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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.)

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]

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]

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]

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]

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.

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.

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]

Purpose -- The purpose of this paper is to identify the key barriers to the delivery of school-based HIV and sexuality education in selected countries in Asia. Design/methodology/approach -- A review of published literature on barriers to school-based HIV and sexuality in countries in Asia was conducted, with a focus on research carried out after 1990. The paper also draws on recently undertaken national situation analyses of HIV and sexuality education conducted by the second author with support from UNESCO, as well as more general Asia-Pacific regional assessments undertaken by others. Findings -- Four key barriers to the delivery of good quality, school-based HIV and sexuality education are identified: cultural and contextual factors, policy factors, resource constraints and school-level factors. Originality/value -- The paper maps these four barriers as key areas in which action needs to occur in order to improve the delivery of school-based HIV and sexuality education. Potential levers for success are highlighted. [ABSTRACT FROM AUTHOR]

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]

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]

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.

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]

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]

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]

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]

The complex evidence-policy interface in low and middle income country settings is receiving increasing attention. Future Health Systems (FHS): Innovations for Equity, is a research consortium conducting health systems explorations in six Asian and African countries: Bangladesh, India, China, Afghanistan, Uganda, and Nigeria. The cross-country research consortium provides a unique opportunity to explore the research-policy interface. Three key activities were undertaken during the initial phase of this five-year project. First, key considerations in strengthening evidence-policy linkages in health system research were developed by FHS researchers through workshops and electronic communications. Four key considerations in strengthening evidence-policy linkages are postulated: development context; research characteristics; decision-making processes; and stakeholder engagement. Second, these four considerations were applied to research proposals in each of the six countries to highlight features in the research plans that potentially strengthen the research-policy interface and opportunities for improvement. Finally, the utility of the approach for setting research priorities in health policy and systems research was reflected upon. These three activities yielded interesting findings. First, developmental consideration with four dimensions -- poverty, vulnerabilities, capabilities, and health shocks -- provides an entry point in examining research-policy interfaces in the six settings. Second, research plans focused upon on the ground realities in specific countries strengthens the interface. Third, focusing on research prioritized by decision-makers, within a politicized health arena, enhances chances of research influencing action. Lastly, early and continued engagement of multiple stakeholders, from local to national levels, is conducive to enhanced communication at the interface. The approach described has four main utilities: first, systematic analyses of research proposals using key considerations ensure such issues are incorporated into research proposals; second, the exact meaning, significance, and inter-relatedness of these considerations can be explored within the research itself; third, cross-country learning can be enhanced; and finally, translation of evidence into action may be facilitated. Health systems research proposals in low and middle income countries should include reflection on transferring research findings into policy. Such deliberations may be informed by employing the four key considerations suggested in this paper in analyzing research proposals. [ABSTRACT FROM AUTHOR]

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.

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]

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.)

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.)

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]

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]

In China, alcohol consumption is increasing faster than anywhere else in the world. A steady increase in alcohol production has also been observed in the country, together with a rise in alcohol-related harm. Despite these trends, China's policies on the sale and consumption of alcoholic beverages are weak compared with those of other countries in Asia. Weakest of all are its policies on taxation, drink driving laws, alcohol sale to minors and marketing licenses. The authors of this descriptive paper draw attention to the urgent need for public health professionals and government officials in China to prioritize population surveillance, research and interventions designed to reduce alcohol use disorders. They describe China's current alcohol policies and recent trends in alcohol-related harm and highlight the need for health officials to conduct a thorough policy review from a public health perspective, using as a model the World Health Organization's global strategy to reduce the harmful use of alcohol.

This paper analyses the disparities in risks associated with biomedical technology focusing on the results of assisted reproductive technology (ART). ART among biomedical technologies transferred to Asia is a representative case that reveals in its clinical use and related scientific research the global politics of technology. This study notes the global politics at work in the recognition of and reaction to such risks. While many Asian countries aggressively pursue technological development, weak legislative and administrative regulations have created various problems and controversial cases. This study asserts that risks associated with technology are characterised as social facts not natural ones or mere 'side effects', since technological development and risk are closely intertwined.

Asia Pacific is home to over 60% of the world's population and the fastest growing economies. Many of the leadership in the Asia Pacific region is becoming increasingly aware that improving the conditions for health would go a long way to sustaining economic prosperity in the region, as well as improving global and local health equity. There is no biological reason why males born in Cambodia can expect to live 23 years less than males born in Japan, or why females born in Tuvalu live 23 years shorter than females in New Zealand or why non-Indigenous Australian males live 12 years longer than Indigenous men. The nature and drivers of health inequities vary greatly among different social, cultural and geo-political contexts and effective solutions must take this into account. This paper utilizes the CSDH global recommendations as a basis for looking at the actions that are taking place to address the structural drivers and conditions of daily living that affect health inequities in the Asia Pacific context. While there are signs of action and hope, substantial challenges remain for health equity in Asia Pacific. The gains that have been made to date are not equally distributed and may be unsustainable as the world encounters new economic, social and environmental challenges. Tackling health inequities is a political imperative that requires leadership, political courage, social action, a sound evidence base and progressive public policy.

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]

Objectives: Future Health Systems: Innovations for Equity (FHS) is working in six partner countries in Asia and Africa, focusing on strengthening the research-policy interface in relation to specific health system research projects. These projects present an opportunity to study the influence of stakeholders on research and policy processes., Study Design: Qualitative stakeholder analysis., Methods: Stakeholder analysis was conducted in each FHS country using a structured approach. A cross-country evaluation was performed concentrating on six key areas: chosen research topic; type of intervention considered; inclusion/exclusion of stakeholder groups; general stakeholder considerations; power level, power type and agreement level of stakeholders; and classification of and approaches to identified stakeholders., Results: All six countries identified a range of stakeholders but each country had a different focus. Four of the six countries identified stakeholders in addition to the guidelines, while some of the stakeholder categories were not identified by countries. The mean power level of identified stakeholders was between 3.4 and 4.5 (1=very low; 5=very high). The percentage of classified stakeholders that were either drivers or supporters ranged from 60% to 91%., Conclusion: Three important common areas emerge when examining the execution of the FHS country stakeholder analyses: clarity on the purpose of the analyses; value of internal vs external analysts; and the role of primary vs secondary analyses. This paper adds to the global body of knowledge on the utilization of stakeholder analysis to strengthen the research-policy interface in the developing world., (Published by Elsevier Ltd.)

Public health research in New Zealand views Asian health - particularly, Asian women's sexual health issues - as a priority problem. In recent years, high rates of abortion and the growing incidence of unsafe sex among younger age Asian migrants have been publicized as a health concern. Public health research implicates migrant experiences and cultural factors as responsible for these trends. Loneliness and isolation among international students, inability to communicate effectively in English and lack of knowledge of available services are highlighted as reasons for the growing sexual ill-health in the Asian population in New Zealand. Extending from these, public health measures aim at improving culture-sensitive services, including targeted education. The present paper offers a critical commentary on these accepted public health perceptions that inform policy in New Zealand. It takes a Third World feminist approach to critique dominant public health discourses on Asian women's sexuality and questions the construction of knowledges about what are 'normal' and 'pathological' sexual practices. The paper revisits the data used to describe the 'problem' of Asian sexuality and argues that in order to understand sexual practices, it is important to query the cultural lenses that are used to describe and define them.

Face-to-face surveys of policy-makers and other influential leaders are a useful tool to identify, at an early stage, (a) major issues regarding the introduction of a new vaccine, (b) persons and groups in a country who play a major decision-making or influential role in the introduction of vaccines, (c) potential obstacles to the introduction of vaccines, and (d) data-needs of policy-makers to overcome these obstacles. By surveying the opinions and beliefs of those who will make or influence decisions on whether to introduce a new vaccine, these studies can help ensure that research activities respond to the needs of policy-makers in countries endemic for the target diseases. These surveys can also inform vaccine-introduction strategies by identifying financially and politically feasible means of distributing, targeting, and financing the vaccines. This paper describes the methodology used in conducting such surveys and discusses methodological issues. It also presents lessons learnt from two policy-maker surveys carried out in several Asian countries in regard to new-generation vaccines against cholera, typhoid fever, and shigellosis; and future vaccines against dengue fever/dengue haemorrhagic fever.

The privatization of health services is an emerging trend in Asia. China and Vietnam are no exceptions, with their reforms to promote private hospitals gradually developed in early 1990s. As newcomers to the health-care system, private hospitals must achieve legitimacy in a state-dominated system in order to survive and develop. This paper describes the strategies of the quest to gain legitimacy from the state through “public-lization” and from the public through a campaign to associate private hospitals with professionalism, a caring environment, and customer orientation. It argues that, in a transitional economy, when the state is allocating power to other sectors but maintaining a central position, private hospitals must be careful to seek legitimacy from the state and, equally importantly, their customers. Improvements to the institutional environment to ensure better regulation are recommended, as well as professional self-scrutiny and consumer participation. [ABSTRACT FROM AUTHOR]

Abstract: Since health research has become increasingly acknowledged as an important tool for development, many approaches have been undertaken to understand national health research from a systems perspective. This paper reviews 28 case studies that describe or analyse health research systems in 26 low- and middle-income countries. These case studies were sponsored either by the Council on Health Research for Development or the South-East Asia Regional Office of the World Health Organization. In reviewing these case studies, we identify several common challenges facing national health research systems. These challenges include the lack of coordination in research activities; the inadequate participation of stakeholders in research, policy and implementation processes; the lack of demand for research and the low accessibility of research findings. These obstacles are compounded by some fundamental systems constraints, such as the lack of financial resources, human capacities, infrastructure and data. By identifying from these case studies the common challenges of health research systems as well as approaches to overcome these, this paper highlights the potential for case studies to inform policies and strategies for strengthening health research systems, and presents recommendations for future case studies to increase this potential. [Copyright &y& Elsevier]

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Abstract: The tobacco industry has lobbied successfully to obtain the support of the United States government for opening Asian Markets to American tobacco products. This paper comments on two issues arising from these efforts: the development of an atmosphere of invasion and resistance to invasion in Asia; and the change in the image of the United States in Asian nations from that of a leader in health to that of an exporter of death. The threat of sanctions and the effects of the open market and United States tobacco company advertising in Japan, Taiwan, and South Korea are noted. Parallels are drawn between the opium wars a century and a half ago in China and the current threat of trade sanctions. Reacting to American policy, an Asia-Pacific Association for Control of Tobacco has been formed and linked with the US Coalition Against Smoking. (Am J Public Health 1990;80:659-662.) [ABSTRACT FROM AUTHOR]

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]

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]

• 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]

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]

Background & Aims: The World Health Organisation (WHO) Prevention & Control of Viral Hepatitis Infection: Framework for Global Action offers a global vision for the prevention and control of viral hepatitis. In October 2012, the Coalition to Eradicate Viral Hepatitis in Asia Pacific (CEVHAP) organised the North Asia Workshop on Viral Hepatitis in Taipei to discuss how to implement the WHO Framework in the North Asia region. This paper presents outcomes from this workshop. Methods: Twenty-eight representatives from local liver associations, patient organisations, and centres of excellence in Hong Kong, Japan, Korea, and Taiwan participated in the workshop. Findings: Priority areas for action were described along the four axes of the WHO Framework: (1) awareness, advocacy and resources; (2) evidence and data; (3) prevention of transmission; and (4) screening and treatment. Priorities included: axis 1: greater public and professional awareness, particularly among primary care physicians and local advocacy networks. Axis 2: better economic data and identifying barriers to screening and treatment uptake. Axis 3: monitoring of vaccination outcomes and targeted harm reduction strategies. Axis 4: strengthening links between hospitals and primary care providers, and secure funding of screening and treatment, including for hepatocellular carcinoma. Conclusions: The WHO Framework provides an opportunity to develop comprehensive and cohesive policies in North Asia and the broader region. A partnership between clinical specialists, primary care physicians, policy makers, and people with or at risk of viral hepatitis is essential in shaping future policies. [Copyright &y& Elsevier]

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]

The article focuses on general practice research and the relevance of regional journals. It says that the Asia-Pacific Wonca meeting which was conducted in Bangkok, Thailand discussed the concept of professional commonalities and the importance of research in order to have better understanding on patient's needs and to encourage better directed health care and policy initiatives in Asia. It states that the journal is specifically seeking papers on topics such as avian influenza pandemic planning and mental health.

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]

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]

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]

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.

The article focuses on a workshop on emerging pandemic infections research in Europe organized by the European Public Health Association section of Infectious Disease Control. One study focused on the differences in risk perception of infectious diseases in Europe and Asia. Another paper discussed the efforts of the international community to control the severe acute respiratory syndrome (SARS), presenting an inventory of European health policies for the control of pandemic infections.

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]