Health policy and planning最新文献

{"title":"Cervical Cancer Prevention and Control in Nigeria: Mapping and review of policies.","authors":"Elvis Anyaehiechukwu Okolie, Kristen Beek, Bindu Patel, Chizoma Millicent Ndikom, Rohina Joshi","doi":"10.1093/heapol/czaf049","DOIUrl":"https://doi.org/10.1093/heapol/czaf049","url":null,"abstract":"<p><p>Cervical cancer is a significant public health issue in Nigeria and a major cause of cancer-related morbidity and mortality among women. Equitable implementation of cervical cancer control programs alongside relevant policies and strategic plans is vital to reducing the burden of cervical cancer and improving quality of life. Considering the role of policies in guiding program implementation, we reviewed Nigeria's cervical cancer policy landscape to identify strengths, limitations, and opportunities for improvement. This policy appraisal involved a literature review to understand related policy review frameworks, developing a modified framework containing six domains, systematically searching key databases and websites to identify relevant policy documents, data extraction and analysis, and synthesizing findings from reviewed documents. A total of five documents were reviewed in this study - three integrated cancer control plans, a cervical cancer policy, and a strategic plan for cervical cancer prevention and control. Two of the reviewed documents are current (2023-2027), one is outdated, and two are expired. Key strengths identified in these documents include i) a clear articulation of goals, ii) a collaborative development process, iii) the adoption of a phased implementation approach for proposed interventions, iv) detailed intervention plans, and v) monitoring and evaluation plans with performance indicators. In contrast, key limitations include i) poor participation of subnational level stakeholders, ii) absence of costing and funding approach in some plans, iii) lack of baseline data on unmet needs and outcomes of previous plans, and iv) absence of health system resource mapping. Addressing identified limitations is critical to improving the quality of policy and policy-informing documents, strengthening implementation across all levels, lowering the cervical cancer burden, and improving women's health outcomes.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Context and generalisability in health policy and systems research: a plea for an integrative praxis of theorising.","authors":"Sara Van Belle, Bruno Marchal","doi":"10.1093/heapol/czaf048","DOIUrl":"https://doi.org/10.1093/heapol/czaf048","url":null,"abstract":"<p><p>In this article, we address the conundrum of context in health policy and systems research, zooming in on research on implementation of programmes, policies and interventions. We review how the field draws on non-linear paradigms to better take into account 'context' in causal explanation and we compare paradigms and the way in which they can inform more context-sensitive research, policies and programmes. We propose a theorizing praxis that is based on the principles of realist inquiry and that allows researchers to draw lessons applicable to other settings by integrating a comprehensive analysis of context in their research.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Willingness to pay for assisted reproductive technologies among individuals with infertility in China.","authors":"Chaofan Li, Hongbin Cong, Stephen Jan, Lei Si, Ling Geng, Shunping Li","doi":"10.1093/heapol/czaf045","DOIUrl":"https://doi.org/10.1093/heapol/czaf045","url":null,"abstract":"<p><p>Infertility, a widely prevalent condition globally, incurs high economic burdens. Assisted reproductive technologies (ARTs) are effective treatments, but public health financing in low- and middle-income countries (LMICs) rarely covers ART services. In China, where birth rates are declining, willingness to pay (WTP) can inform insurance reimbursement policies by reducing out-of-pocket expenses. However, there is no consensus on WTP thresholds for assessing the cost-effectiveness of fertility treatments in LMICs. This study aimed to assess WTP for ART among individuals with infertility in China. Data were obtained from a cross-sectional survey conducted at five hospitals across different geographical and socioeconomic regions in China. Individuals with infertility were recruited using a quota sampling method. A contingent valuation method was employed, with three hypothetical WTP scenarios developed to present detailed information on the success rates, costs, and the treatment processes of in-vitro fertilization (IVF), artificial insemination (AI), and preimplantation genetic testing (PGT). A total of 570 individuals with infertility participated in the survey (94.4% female; mean [SD] age: 33.0 [4.7] years). The sampled respondents were willing to pay RMB 30,163 ($4259, 95% CI: RMB 29,650-30,675) for IVF, RMB 6046 ($854, 95% CI: RMB 5987-6106) for AI, and RMB 47,234 ($6669, 95% CI: RMB 46,435-48,033) for PGT. These WTPs were equivalent to 0.34, 0.07, and 0.53 times the GDP per capita in China, respectively. Older age and male-factor or unexplained infertility were significantly associated with lower WTP (P<0.05), while higher education and patient-physician communication about costs were positively associated with WTP (P<0.05). These findings suggest that public health insurance schemes should establish appropriate cost-effectiveness thresholds and reimbursement ceilings for ART to improve affordability and access. Incorporating patient-physician communication about cost into clinical practice may facilitate shared decision-making and potentially increase patients' perceived value of ART.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing the Well-being of the Elderly: evidence from China on the role of Health Investment.","authors":"Lili Zheng, Wenxuan Fan, Hongli Xiang","doi":"10.1093/heapol/czaf044","DOIUrl":"https://doi.org/10.1093/heapol/czaf044","url":null,"abstract":"<p><p>Subjective well-being (SWB) is increasingly recognized as a critical indicator of healthy ageing. While prior studies highlight the importance of health behaviours, few examine how multidimensional health investments influence SWB across different levels of well-being. This paper explores the relationship between health investment and SWB among older adults in China, using data from the 2018 Chinese Longitudinal Healthy Longevity Survey. Health investment is categorized into four domains: nutrition, healthcare access (insurance coverage and health product use), lifestyle behaviours (including exercise, smoking, and drinking), and living environment (access to clean drinking water). Quantile regression models are applied to assess heterogeneous effects across the SWB distribution, while mediation analysis investigates the role of self-rated health and functional health (ADL) as potential pathways. Results show that the positive effects of nutrition and exercise are most pronounced among individuals with lower SWB, while smoking and drinking exhibit stronger negative associations in this group. Mediation results suggest that perceived health plays a more consistent role than functional status in translating health investment into higher well-being. The impact of insurance is observed primarily through interaction effects, magnifying benefits from healthy behaviours and buffering risks from harmful ones. These findings point to the need for equity-sensitive ageing policies that target both health behaviours and social protection. Specifically, integrating social work and behavioural counselling into primary health outreach may help address substance-related risks and psychological vulnerabilities among the elderly. This evidence has wider relevance for ageing societies, particularly in low- and middle-income countries aiming to align health system goals with subjective well-being outcomes.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of performance-based financing interventions on health worker motivation and job satisfaction: experimental evidence from six national pilots.","authors":"Sneha Lamba, Jed Friedman, Eeshani Kandpal","doi":"10.1093/heapol/czaf035","DOIUrl":"https://doi.org/10.1093/heapol/czaf035","url":null,"abstract":"<p><p>A long-standing concern suggests that performance-based financing (PBF) may undermine the intrinsic motivation of health workers by heightening extrinsic motivation concerns via the novel introduction of financial incentives. However, the theoretical effect of PBF on worker motivation and job satisfaction is ambiguous as these programs may also improve working conditions, staff engagement, and other factors that determine health worker morale. We use data from six evaluations of national pilots to empirically assess the effect of PBF on worker motivation and job satisfaction. In these six pilots (in Cameroon, Kyrgyz Republic, Nigeria, Tajikistan, Zambia, and Zimbabwe) geographical units (or health facilities) were either randomized or quasi-experimentally assigned to receive PBF or the alternatives of direct facility financing (DFF), enhanced supervision (ES), or business-as-usual comparison arms. Baseline and endline health worker surveys were carried out in the context of these national pilots. The primary outcomes investigated here are health worker motivation and job satisfaction. Secondary outcomes include sub-constructs of health worker motivation and job satisfaction extracted using exploratory factor analysis. For two countries out of six - Nigeria and Kyrgyz Republic - we find increases in overall worker motivation and null effects in the other four when contrasting with the business-as-usual comparison. For five countries out of six (all but Cameroon) we find increases in job satisfaction. Further, PBF did not have any systematic motivating or demotivating effects when compared to the health system intervention alternatives of DFF and ES (each in a subset of countries), except in Nigeria where satisfaction in the PBF arm was lower when compared with DFF. All told, these results contain practically no evidence of an adverse effect of PBF on overall health worker motivation or job satisfaction and indeed suggest a beneficial impact in some country settings.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144612087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health impact of alcohol regulatory interventions: A systematic review of policies in low- and middle-income countries.","authors":"Amila Suranga Malawige, Leopold Ndemnge Aminde, Gayathri Udeshika Weeratunga, Kumudu Weerakoon, J Lennert Veerman","doi":"10.1093/heapol/czaf036","DOIUrl":"https://doi.org/10.1093/heapol/czaf036","url":null,"abstract":"<p><p>Alcohol consumption poses significant public health challenges globally, with low- and middle-income countries (LMICs) experiencing a substantial burden from alcohol-related harm. However, the effectiveness of interventions to control alcohol consumption in LMICs remains understudied. This paper aims to investigate the effectiveness of alcohol regulatory interventions adopted in LMICs. A systematic search of MEDLINE, EMBASE, CINAHL, PsycINFO and Web of Science was conducted on 10th August 2024. The search strategy included terms related to regulatory interventions and their impact on alcohol consumption, health, and other related outcomes. Risk of bias was assessed using the NIH, EPOC checklist, ISPOR-SDMD checklist and CASP quality assessment tools, and a narrative synthesis was performed to summarize the review findings. Of the 169 full texts screened, 62 studies were included in this review. Most of the studies were conducted in upper middle-income countries (n=48, 77%), seven were from lower middle-income countries, one from a low-income country and others were combinations of the above. Sixty percent of the included studies were of good quality. In terms of WHO alcohol policy domains, 18 studies focused on restriction of physical availability, 11 on pricing, one on marketing, 21 on drink driving, and 11 on a combination of all policy domains. Alcohol consumption-related outcomes were reported in 26 studies while health and other outcomes were reported in 25 and 14 studies respectively. Restrictions on physical availability of alcohol were largely effective across all outcomes while the pricing policy domain consistently demonstrated effectiveness in reducing alcohol consumption. The scarce evidence on marketing policy interventions was inconclusive; interventions targeting drink driving showed beneficial effects. The available evidence suggests that alcohol control policies are largely effective in LMICs. Further regular and statutory enforcement of these interventions is likely to improve their effectiveness.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New health taxes in Ghana: a qualitative study exploring potential public support.","authors":"Katherine E Smith, Mark Hellowell, Divine D Logo, Robert Marten, Arti Singh","doi":"10.1093/heapol/czaf042","DOIUrl":"https://doi.org/10.1093/heapol/czaf042","url":null,"abstract":"<p><p>In the context of a fiscal crisis and health pressures, Ghana's government have been exploring additional pro-health taxes. The World Health Organization and World Bank support health taxes as 'win-win' policies that can, if designed effectively, simultaneously improve health and raise revenue for health spending. However, international evidence shows that health taxes can meet political and public opposition. Yet, there is little research that empirically examines public views of health taxes. We compared policy stakeholders' perceptions of Ghanaian public support for health taxes with public views, seeking to understand the basis for potential public opposition, the extent to which evidence can shape public views, and whether tax framing and design influences public support. We undertook 28 semi-structured key informant interviews with stakeholders (from government, advocacy and business groups) and five focus groups with 38 members of the public (purposefully selected for diversity in gender, age, ethnicity, occupation and social background). We employed an innovative deliberative design for the focus groups, which enabled us to explore how public views responded to contrasting health tax 'frames'. Stakeholders generally believed public support for health taxes was low, especially for more widely consumed products. Yet most focus group participants expressed strong support for health taxes, especially those targeting (more widely-consumed) sugar-sweetened beverages (SSBs). Support increased when health taxes were framed as measures to improve public health and/or create a fairer tax system, and when commitments were made to using resulting revenue for health spending (known as 'earmarking' or hypothecation). However, stakeholders and members of the public shared a concern that business influence in Ghanaian politics presents a key barrier to implementing effective health taxes sustainably. Overall, our findings suggest that health taxes with a clearly-framed health rationale could command strong Ghanaian public support but likely require effective advocacy to overcome political barriers.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Price Comparisons for National Price-Negotiated Drugs in China: A Cross-Regional Analysis.","authors":"Lanting Lyu, Qiuru Hu, Yuanfang Zou, Jian Ming","doi":"10.1093/heapol/czaf040","DOIUrl":"https://doi.org/10.1093/heapol/czaf040","url":null,"abstract":"<p><p>China has long struggled with high medical costs and irrational drug pricing, but has recently made significant progress by implementing drug negotiation strategies to effectively reduce the prices of targeted drugs. To accurately depict drug prices on a global scale, a cross-sectional time-series analysis was conducted in China using Multinational Integrated Data Analysis System data from the first quarter of 2017 to the fourth quarter of 2022. This analysis compared the prices of 140 price-negotiated innovative drugs across 15 countries using five distinct price indices-Average Price Index, Laspeyres, Paasche, Fisher, and Chained Laspeyres-aiming to address gaps in understanding China's negotiated drug prices globally. The five drug price index (DPI) showed general consistency and revealed significant variations in drug prices across countries. China's drug pricing reforms have successfully reduced drug costs and alleviated the financial burden on patients, offering insights for other developing countries. Drug price indices serve as valuable tools for monitoring prices and promoting transparency, while using PPPs may better reflect actual affordability and provide a more reasonable assessment.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Professionals' Knowledge and Understanding of Inclusion Health: A systematic literature review.","authors":"Angela V Flynn, Margaret Bermingham, Maria Caples, Margaret Curtin, Caroline Dalton, Geraldine McLoughlin, James O'Mahony, Mohamad M Saab, Sonja Vucen","doi":"10.1093/heapol/czaf024","DOIUrl":"https://doi.org/10.1093/heapol/czaf024","url":null,"abstract":"<p><p>There is a growing need for healthcare professionals to ensure that their practices are inclusive and that they are considerate of the needs of marginalised communities. Inclusion health seeks to correct the imbalances that result in health inequities and requires health practitioners to have an adequate understanding and knowledge of the needs of marginalised and vulnerable population groups. The aim of this systematic review was to synthesise and critically appraise evidence from studies that explored healthcare professionals' knowledge and/or awareness of inclusion health. Academic Search Complete, CINAHL Plus with Full Text, MEDLINE, APA PsycArticles, APA PsycInfo, SocINDEX, were systematically searched without any year or language limits. The last search was conducted 16th of December 2024. A total of 4,870 studies were identified; of which, 37 were included (21 qualitative studies, 7 quantitative studies, 6 mixed-methods studies, 2 cross-sectional studies, and 1 quasi-experimental study). The methodological quality of the studies was appraised. Most studies were from the United States and Australia and focused on inclusion health knowledge regarding members of the Lesbian, Gay, Bisexual, Trans and Queer community, people with disabilities, and culturally diverse populations. Studies examining healthcare professionals' knowledge and awareness were not homogenous in nature resulting in a wide variety of studies and types of data. Different minority groups require varied levels of insights and understanding from their healthcare professionals. There is therefore no one-size-fits-all solution. We recommend targeted interventions throughout the training and education of healthcare professionals, informed and designed by the participation of members of those marginalised communities.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Honoring the storyteller\": the potential of Playback Theater in health policy and systems research.","authors":"Meena Putturaj, Radhika Jain","doi":"10.1093/heapol/czaf038","DOIUrl":"https://doi.org/10.1093/heapol/czaf038","url":null,"abstract":"","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}