Globalization and Health最新文献

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Addressing global health equity through Global Collaborative Evidence Networks: a narrative literature review of governance models, power and participation. 通过全球协作证据网络解决全球卫生公平问题:关于治理模式、权力和参与的叙述性文献综述。
IF 6.1 2区 医学
Globalization and Health Pub Date : 2026-02-07 DOI: 10.1186/s12992-026-01192-1
Bianca Pilla, Kylie Porritt, Zoe Jordan
{"title":"Addressing global health equity through Global Collaborative Evidence Networks: a narrative literature review of governance models, power and participation.","authors":"Bianca Pilla, Kylie Porritt, Zoe Jordan","doi":"10.1186/s12992-026-01192-1","DOIUrl":"10.1186/s12992-026-01192-1","url":null,"abstract":"<p><strong>Background: </strong>Global Health Equity is increasingly threatened by interconnected global crises that expose systemic inequities in health systems, global health governance and evidence infrastructures. Global Collaborative Evidence Networks have emerged as mechanisms for mobilising knowledge, fostering interdisciplinary collaboration, and supporting decision-making across diverse contexts to address Global Health Equity. However, their potential is constrained by persistent challenges related to governance, inclusion, and power asymmetries. This review critically examines the conceptual, structural, and governance dimensions of Global Collaborative Evidence Networks to assess their potential and limitations in advancing Global Health Equity.</p><p><strong>Methods: </strong>A narrative literature review was conducted in July 2024, searching PubMed, Scopus, Web of Science, Embase, CINAHL, and grey literature sources. A thematic analysis of 162 included studies was conducted using Braun and Clarke's reflexive approach to identify themes and sub-themes.</p><p><strong>Results: </strong>The review found that while Global Health Equity has emerged as a key normative framework shaped by historical, political, and socio-economic structures, its operationalisation remains fragmented, particularly in global governance and research systems. Global Collaborative Evidence Networks, positioned as vehicles to advance Global Health Equity, demonstrate considerable potential yet often reproduce entrenched power asymmetries. Substantial gaps remain in how equity, diversity, and inclusion are conceptualised and operationalised within these networks. Although many promote shared purpose and trust-based collaboration, participation and influence often concentrated in high-income institutions, reinforcing systemic and resource asymmetries. Key tensions, such as between efficiency and inclusiveness, unity and diversity, and centralisation and decentralisation, shape governance dynamics and impact who benefits from network participation. Despite the proliferation of equity-focused frameworks in global health partnerships, none have been adapted for networks, and accountability mechanisms remain weak. Theoretical perspectives from network typologies and governance modes offer valuable perspectives but require integration with intersectional and decolonial approaches to address persistent power imbalances.</p><p><strong>Conclusion: </strong>Global Collaborative Evidence Networks are a powerful mechanism for supporting and strengthening evidence-based decision-making to address global health inequities. However, they risk replicating existing inequities without deliberate, equity-centred governance. This review calls for the development of empirically grounded, context-sensitive frameworks to guide the equitable, diverse and inclusive design, evaluation, and governance of Global Collaborative Evidence Networks.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12977543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
U.S. withdrawal from WHO and aid programs: implications and opportunities for Africa's global health security. 美国退出世卫组织及其援助项目:对非洲全球卫生安全的影响和机遇。
IF 6.1 2区 医学
Globalization and Health Pub Date : 2026-02-04 DOI: 10.1186/s12992-026-01189-w
Justin Onyebuchi Nwofe, Emmanuel Adewale Ojo, Femi Emmanuel Owolagba, Precious Ogechukwu Onyebuchi, Tajudeen Disu, Kingsley Chukwuemeka Onugwu, Michael Tomori, Daniel Chinenyeike Offie, Nneka Egbonrelu, Dickson Adetolu Adetoye, Amali Owoicho, John Ogaga, Babatope O Adebiyi
{"title":"U.S. withdrawal from WHO and aid programs: implications and opportunities for Africa's global health security.","authors":"Justin Onyebuchi Nwofe, Emmanuel Adewale Ojo, Femi Emmanuel Owolagba, Precious Ogechukwu Onyebuchi, Tajudeen Disu, Kingsley Chukwuemeka Onugwu, Michael Tomori, Daniel Chinenyeike Offie, Nneka Egbonrelu, Dickson Adetolu Adetoye, Amali Owoicho, John Ogaga, Babatope O Adebiyi","doi":"10.1186/s12992-026-01189-w","DOIUrl":"10.1186/s12992-026-01189-w","url":null,"abstract":"<p><p>The United States has long played a central role in global health through its engagement with the World Health Organization (WHO) and through major bilateral programs, including the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and the U.S. Agency for International Development (USAID). These investments have contributed to health infrastructure development, disease surveillance, and the expansion of treatment and prevention programs across Africa. The recent U.S. withdrawal from WHO and the freezing of USAID funding raise concerns for infectious disease control, healthcare delivery, and global health security, particularly in settings with high dependence on external financing. This commentary argues that the U.S. withdrawal, while disruptive, should not be understood solely as a setback, but as an opportunity for African governments to assume greater ownership of their health systems and exercise leadership through deliberate political and policy choices. These include increased domestic health financing, stronger institutional governance, and enhanced regional coordination. The paper outlines pathways for sustaining donor-built infrastructure, expanding local pharmaceutical and diagnostic manufacturing, and aligning public–private partnerships with national health priorities. By strengthening domestic capacity and regional cooperation, African governments can reduce vulnerability to external funding shocks, improve outbreak preparedness, and play a more active role in shaping global health security agendas.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"22 1","pages":"19"},"PeriodicalIF":6.1,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12874739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
From PHEIC to PHECs: reclaiming Africa's agency in global health security governance. 从国际关注的突发公共卫生事件到国际关注的突发公共卫生事件:重新树立非洲在全球卫生安全治理中的主体地位。
IF 6.1 2区 医学
Globalization and Health Pub Date : 2026-02-04 DOI: 10.1186/s12992-025-01177-6
Nelson Aghogho Evaborhene
{"title":"From PHEIC to PHECs: reclaiming Africa's agency in global health security governance.","authors":"Nelson Aghogho Evaborhene","doi":"10.1186/s12992-025-01177-6","DOIUrl":"10.1186/s12992-025-01177-6","url":null,"abstract":"<p><p>In the wake of COVID-19 pandemic, the African Union elevated the Africa Centres for Disease Control and Prevention (Africa CDC) to autonomous status, empowering it to declare Public Health Emergencies of Continental Concern (PHECs). This mechanism was first operationalized in 2024 in response to sustained mpox transmission across multiple African countries, despite the World Health Organization's (WHO) earlier lifting of the Public Health Emergency of International Concern (PHEIC). This article examines the PHECs as a decolonial intervention in global health governance. Applying the Critique, Reform, Withdrawal, and Transformation (CRWT) framework, I argue that the PHECs reflect both a strategic withdrawal from overreliance on the WHO PHEIC system and a transformative effort to embed African-led governance rooted in Pan-African solidarity. The article highlights mechanisms for sustaining Pandemic Prevention, Preparedness, and Response (PPPR), including tiered activation, cross-sectoral oversight, civil society engagement, and alignment with continental financial instruments. Invariably, the PHECs represent a critical reconfiguration of Africa's role in global health-from recipient of external interventions to architect of regional norms, practices, and accountability. Its promise lies not in rejecting multilateralism but in recalibrating it, embedding regional expertise, political leadership, and operational autonomy within broader global frameworks.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"22 1","pages":"18"},"PeriodicalIF":6.1,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12874699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Commercial determinants of health revisited: integrating business scholarship for greater public health impact. 重新审视健康的商业决定因素:整合商业学术以扩大公共健康影响。
IF 6.1 2区 医学
Globalization and Health Pub Date : 2026-01-30 DOI: 10.1186/s12992-026-01187-y
Junghoon Park, Bryan W Husted
{"title":"Commercial determinants of health revisited: integrating business scholarship for greater public health impact.","authors":"Junghoon Park, Bryan W Husted","doi":"10.1186/s12992-026-01187-y","DOIUrl":"10.1186/s12992-026-01187-y","url":null,"abstract":"<p><p>In her influential 2020 review in Globalization and Health, Mialon synthesizes the commercial determinants of health (CDOH) literature and underscores how commercial actors are connected to public health through the institutional environments in which they operate. Much of this research conceptualizes firms as institutionally embedded but relatively homogeneous actors, emphasizing external practices such as the production and promotion of harmful commodities, lobbying, and corporate social responsibility initiatives. While recent CDOH scholarship has begun to recognize the importance of organizational-level factors, few studies analyze the internal processes through which corporate conduct with public health consequences emerges. We argue that integrating insights from management scholarship can enrich CDOH research by opening the “black box” of the firm and clarifying how such conduct arises from interactions among institutional contexts, organizational arrangements, and individual-level dynamics. Drawing on management research, we conceptualize firms as multilevel systems in which institutional conditions inform conduct through organizational governance, resources, and practices, as well as through individual values, cognitions, sensemaking, and interaction among organizational members and stakeholders. These analytically distinct yet dynamically interconnected levels give rise to patterned forms of corporate conduct that affect public health. By foregrounding these multilevel connections, this paper advances a management-informed framework for CDOH research that moves beyond documenting harmful practices toward explaining how firms contribute to public health outcomes and identifying leverage points for intervention.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"22 1","pages":"15"},"PeriodicalIF":6.1,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146092902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A rapid scoping review of antibiotic access and use barriers among refugee and migrant populations. 对难民和移民人群抗生素获取和使用障碍的快速范围审查。
IF 6.1 2区 医学
Globalization and Health Pub Date : 2026-01-29 DOI: 10.1186/s12992-026-01188-x
Suzanne Garkay Naro, Michèle Palkovits, Arne Ruckert, Andrea Morales Caceres, Ranjana Nagi, Cordelia Chik, Steven J Hoffman, Susan Rogers Van Katwyk
{"title":"A rapid scoping review of antibiotic access and use barriers among refugee and migrant populations.","authors":"Suzanne Garkay Naro, Michèle Palkovits, Arne Ruckert, Andrea Morales Caceres, Ranjana Nagi, Cordelia Chik, Steven J Hoffman, Susan Rogers Van Katwyk","doi":"10.1186/s12992-026-01188-x","DOIUrl":"10.1186/s12992-026-01188-x","url":null,"abstract":"<p><strong>Background: </strong>Antibiotic resistance (ABR) poses a significant global health and development threat from increasing globalization of travel, trade, and animal and human migration. ABR impacts refugees and migrants in unique ways due to increased exposure to infections and inequitable access to healthcare. The objective of this review is to synthesize the evidence on access to and appropriate use of antibiotics by migrants and refugees, identify the barriers they may experience in accessing and using antibiotics, and reflect on global policy entry points to modify such barriers considering the persistent globalization-related impacts on ABR.</p><p><strong>Methods: </strong>A global rapid scoping review was conducted to collect evidence on barriers to access and appropriate use of antibiotics among migrants and refugees. MEDLINE (Ovid), Scopus, Web of Science, CABI Global Health and the IGO Custom Search Engine were searched for academic and grey literature published in English, French, or Spanish from inception until September 22nd, 2025. A conceptual framework structured data extraction and thematic analysis of barriers to antibiotic use along the access pathway, including approachability, acceptability, availability, accommodation, affordability, and appropriateness.</p><p><strong>Results: </strong>This review included 125 studies from an array of geographic locations. Migrants and refugees experience barriers along the continuum of care from both the patient and health-system side, impacting access to, and appropriate use of antibiotics. Limited access to resources, prevalence of certain social norms and values, health literacy and beliefs, and autonomy, can impact healthcare seeking and utilization. Health system barriers, such as location and affordability of services or language barriers, can also limit access and appropriate use of quality-assured antibiotics.</p><p><strong>Conclusion: </strong>Migrants and refugees face structural, financial, and systemic barriers in accessing and using antibiotics. While globalization processes have shaped the barriers migrants and refugees experience when accessing health services, access pathways are heterogeneous and influenced by the health systems of the host countries, and other contextual, non-health policies and factors. Potential policy solutions to mitigate these barriers include initiatives to address country-of-origin norms and values and improving language accessibility. Improved global policy coordination can also address access challenges for migrants and refugees, as tackling ABR requires collective global action.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":" ","pages":"20"},"PeriodicalIF":6.1,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12874966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146085605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Selective empathy and the genocide in Gaza: the silence of health and academic associations. 选择性同情和加沙的种族灭绝:卫生和学术协会的沉默。
IF 6.1 2区 医学
Globalization and Health Pub Date : 2026-01-26 DOI: 10.1186/s12992-025-01168-7
Roberto De Vogli, Jonathan Montomoli, Richard Wilkinson, Kate Pickett
{"title":"Selective empathy and the genocide in Gaza: the silence of health and academic associations.","authors":"Roberto De Vogli, Jonathan Montomoli, Richard Wilkinson, Kate Pickett","doi":"10.1186/s12992-025-01168-7","DOIUrl":"10.1186/s12992-025-01168-7","url":null,"abstract":"<p><p>BACKGROUND: Genocide is one of the most extreme forms of global health crisis. The ongoing mass atrocities in Gaza have resulted in a sharp decline in life expectancy, the systematic destruction of healthcare infrastructure and the highest number of medical personnel killed in any conflict ever recorded. While multiple human rights organisations have recognised these conditions as genocide, major health and academic associations have responded inconsistently. MAIN BODY: In response to widespread institutional inaction, an open letter was launched to urge academic and health associations to recognise the genocide in Gaza. This initiative gathered over 15,000 signatures from academics, health professionals and members of the public. It also prompted new statements of recognition from several major public health bodies, including the European Public Health Alliance, the European Public Health Association, and the World Federation of Public Health Associations. Endorsements from national societies and local healthcare authorities in Italy also demonstrated the effectiveness of public health advocacy in confronting moral silence. Nevertheless, many medical and public health societies, particularly in the United States, have either remained silent or issued neutral statements. There were stark differences in the language and moral framing of responses to Gaza compared to those to the Russian invasion of Ukraine, reflecting a phenomenon of “selective empathy”, whereby institutional solidarity varies according to national, ethnic, or geopolitical alignment. CONCLUSIONS: The silence or equivocation of many health and academic institutions in the face of genocide undermines public trust and the ethical foundations of global health. Addressing this requires global health organisations to move beyond neutrality and engage in principled advocacy to reaffirm their moral and scientific duty to defend human life and health without discrimination.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"22 1","pages":"12"},"PeriodicalIF":6.1,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12837125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146051684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
China's global health diplomacy through the World Health Organization: a qualitative study. 通过世界卫生组织进行的中国全球卫生外交:定性研究。
IF 6.1 2区 医学
Globalization and Health Pub Date : 2026-01-24 DOI: 10.1186/s12992-025-01165-w
Zhida Shang, Yanzhong Huang
{"title":"China's global health diplomacy through the World Health Organization: a qualitative study.","authors":"Zhida Shang, Yanzhong Huang","doi":"10.1186/s12992-025-01165-w","DOIUrl":"10.1186/s12992-025-01165-w","url":null,"abstract":"<p><p>BACKGROUND: Global health governance faces fragmentation following COVID-19 and the 2025 U.S. withdrawal from the World Health Organization (WHO), elevating China’s prominence within the organization. Existing literature has not yet comprehensively examined the China-WHO relationship in the post-COVID-19 period. This study addresses this gap by providing timely qualitative insights from high-level experts. RESULTS: Using a qualitative descriptive approach, in-depth semi-structured interviews were conducted with 10 high-level experts in global health governance with substantial WHO experience. Five key themes emerged: balancing sovereignty with multilateral cooperation, China’s evolving role within WHO, COVID-19 as a relationship downturn, Chinese contributions to the WHO’s mission, and U.S. withdrawal from the WHO as a cautious opportunity for China. The findings reveal China’s deliberate positioning within the WHO, emphasizing multilateralism rhetorically while engaging pragmatically through bilateral channels. While China remains reserved in making larger voluntary contributions, its strategic engagement through assessed contributions, technical expertise, personnel deployment, and bilateral health programs attest to its growing influence. Importantly, there is consensus that China does not seek explicit dominance within the WHO but aims to position itself more strategically within the evolving global health architecture. CONCLUSIONS: The study reveals that while the U.S. withdrawal creates a leadership vacuum, China does not seek to dominate the WHO but rather to enhance its strategic position through pragmatic engagement. Findings underscore the urgent need for WHO reforms in governance, representation, and financing, alongside enhanced transparency and mutual trust between China and the organization. This critical juncture offers an opportunity to recalibrate the China-WHO relationship in ways that strengthen global health preparedness, contingent on balancing sovereignty concerns with expectations for multilateral cooperation. CLINICAL TRIAL NUMBER: Not applicable.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":" ","pages":"25"},"PeriodicalIF":6.1,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12910900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Insecure employment and the social determinants of suicide: a narrative synthesis review. 不安全的就业和自杀的社会决定因素:一个叙事综合评论。
IF 6.1 2区 医学
Globalization and Health Pub Date : 2026-01-24 DOI: 10.1186/s12992-025-01185-6
Miriam van den Berg, Natalie Aboustate, Toby Freeman, Jon Jureidini, Fran Baum
{"title":"Insecure employment and the social determinants of suicide: a narrative synthesis review.","authors":"Miriam van den Berg, Natalie Aboustate, Toby Freeman, Jon Jureidini, Fran Baum","doi":"10.1186/s12992-025-01185-6","DOIUrl":"10.1186/s12992-025-01185-6","url":null,"abstract":"<p><p>BACKGROUND: Employment-related suicide is a global public health problem, which is becoming more urgent as the world’s workforce is increasingly employed under insecure conditions. Workers who lack secure employment—including those who are unemployed and in various forms of precarious employment—experience poorer health. Suicide is hidden in the literature on worker health, often subsumed by the focus on mental illness. This article presents a review of research on the relationship between insecure employment and suicide and what is known about the pathways underlying this relationship. This systematic review takes a narrative synthesis approach. The review is grounded in a social determinants of health paradigm and findings are synthesised into a socioecological model. Eighty-three articles are included. RESULTS: Suicide for people without secure employment is determined by factors that may be grouped into socio-structural factors, law and policy, employment and working conditions, place and community, and individuals. Reviewed studies identified the inter-relationships between determinants of suicide affecting people without secure employment at multiple levels of the socioecological model. CONCLUSIONS: When a socioecological lens is applied to the relationship between insecure employment and suicide, it is evident that those without secure employment are exposed to a multitude of pathways by which the risk of suicide may be increased. Reviewed articles provided important insights into the role of context-specific structural mechanisms in shaping the employment landscape and the social meaning attributed to employment status. Good quality employment is a priority for leveling the social gradient in suicide.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":" ","pages":"26"},"PeriodicalIF":6.1,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12915026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146043972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
From ground realities to policy: a framework for assessing multipolar health system governance in conflict-affected and high-risk areas. 从现实到政策:一个评估受冲突影响和高风险地区多极卫生系统治理的框架。
IF 6.1 2区 医学
Globalization and Health Pub Date : 2026-01-24 DOI: 10.1186/s12992-025-01183-8
Munzer Alkhalil, Zedoun Alzoubi, Salah Safadi, Aula Abbara, Abdulkarim Ekzayez, Alvaro Alonso Garbayo, Karl Blanchet, Paul Spiegel, Sameen Siddiqi
{"title":"From ground realities to policy: a framework for assessing multipolar health system governance in conflict-affected and high-risk areas.","authors":"Munzer Alkhalil, Zedoun Alzoubi, Salah Safadi, Aula Abbara, Abdulkarim Ekzayez, Alvaro Alonso Garbayo, Karl Blanchet, Paul Spiegel, Sameen Siddiqi","doi":"10.1186/s12992-025-01183-8","DOIUrl":"10.1186/s12992-025-01183-8","url":null,"abstract":"<p><strong>Introduction: </strong>Understanding and evaluating health system governance is essential for resilient health systems. This study develops a framework to analyse health system governance in conflict-affected and high-risk areas, including fragmented systems.</p><p><strong>Methods: </strong>The methodology adopts a qualitative multi-faceted approach, encompassing five methods: consultations with experts, thematic analysis of existing health system governance frameworks, focus group discussions, interviews with key informants, and reflections from primary authors during fieldwork. The discussion centred on examples primarily drawn from northwest Syria throughout the conflict (2011-2024).</p><p><strong>Findings: </strong>Existing health system governance frameworks are less relevant in conflict-affected and high-risk areas. The authors developed a new institutional framework by adding more dimensions to well-known principle-based frameworks, such as Siddiqi et al., to address the complexities imposed by conflicts. The framework has a descriptive part that includes power dynamics (types and dimensions) and stakeholders' traditional and non-traditional roles and responsibilities. Additionally, it has an evaluative part that includes eleven principles: strategic vision; participation and consensus orientation; rule of law and ethics; intelligence and conflict-sensitive transparency; responsiveness; equity and inclusiveness; effectiveness and efficiency; complex accountability; complementarity; localisation; and legitimacy.</p><p><strong>Conclusion: </strong>The proposed framework can deal with fragmented health systems characterised by multipolar health systems. It is typically applicable in conflict-affected and high-risk areas. It provides policymakers with a structured approach to describing and evaluating health system governance.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":" ","pages":"23"},"PeriodicalIF":6.1,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12903228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146043950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rethinking revolving door research: a scoping review of methods and datasets used by non-academics to examine the revolving door. 重新思考旋转门研究:对非学术界用于检查旋转门的方法和数据集的范围审查。
IF 6.1 2区 医学
Globalization and Health Pub Date : 2026-01-16 DOI: 10.1186/s12992-025-01184-7
Saskia Jaenecke, Jennifer Lacy-Nichols
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