Health policy and planning最新文献

{"title":"Correction to: 'We stay silent and keep it in our hearts': a qualitative study of failure of complaints mechanisms in Malawi's health system.","authors":"","doi":"10.1093/heapol/czae057","DOIUrl":"https://doi.org/10.1093/heapol/czae057","url":null,"abstract":"","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141544770","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":"Understanding Kenyan policymakers' perspectives about the introduction of new maternal vaccines.","authors":"Rupali J Limaye, Berhaun Fesshaye, Prachi Singh, Rose Jalang'o, Rosemary Njura Njogu, Emily Miller, Jessica Schue, Molly Sauer, Clarice Lee, Ruth A Karron","doi":"10.1093/heapol/czae059","DOIUrl":"https://doi.org/10.1093/heapol/czae059","url":null,"abstract":"<p><p>New vaccine policy adoption is a complex process, especially in low-and-middle-income countries (LMICs), requiring country policymakers to navigate challenges such as competing priorities, human and financial resource constraints, and limited logistical capacity. Since the Expanded Programme on Immunization's (EPI) beginning, most new vaccine introductions under this structure have not been aimed at adult populations. The majority of adult vaccines offered under the EPI are not typically tested among and tailored for pregnant persons, except those that are specifically recommended for pregnancy. Given that new maternal vaccines, including RSV and GBS vaccines, are on the horizon, it is important to understand what barriers may arise during the policy development and vaccine introduction process. In this study, we sought to understand information needs among maternal immunization policymakers and decision-makers in Kenya for new vaccine maternal policy adoption through in-depth interviews with 20 participants in Nakuru and Mombasa counties in Kenya. Results were mapped to an adapted version of an established framework by Levine et al., (2010) focused on new vaccine introduction in LMICs. Participants reported that the policy process for new maternal vaccine introduction requires substantial evidence as well as coordination among diverse stakeholders. Importantly, our findings suggest that the process for new maternal vaccines does not end with the adoption of a new policy, as intended recipients and various actors can determine the success of a vaccine program. Previous shortcomings, in Kenya, and globally during HPV vaccine introduction show the need to allocate adequate resources in education of communities given the sensitive target group. With maternal vaccines targeting a sensitive group - pregnant persons- in the pipeline, we are at an opportune time to understand how to ensure successful vaccine introduction with optimal acceptance and uptake, while also addressing vaccine hesitancy to increase population benefit.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141491643","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 influence of crisis on policy formulation: The case of alcohol regulation in South Africa during COVID-19 (2020-2021).","authors":"Mumta Hargovan, Leslie London, Marsha Orgill","doi":"10.1093/heapol/czae055","DOIUrl":"https://doi.org/10.1093/heapol/czae055","url":null,"abstract":"<p><p>This study contributes to a neglected aspect of health policy analysis: policy formulation processes. Context is central to the policy cycle, yet the influence of crises on policy formulation is underrepresented in the health policy literature in Low-and-Middle Income countries (LMIC). This paper analyses a detailed case study of how the COVID-19 crisis influenced policy formulation processes for the regulation of alcohol in South Africa, as part of COVID-19 control measures, in 2020 and 2021. It provides a picture of the policy context, specifically considering the extent to which the crisis influenced the position and power of actors, and policy content. Qualitative data was collected from 9 key informant interviews and 127 documents. Data were analysed using thematic content analysis. The Berlan et al (2014) framework was applied as a lens to describe complex policy formulation processes. The study revealed that the perceived urgency of the pandemic prompted a heightened sense of awareness of alcohol-related trauma as a known, preventable threat to public health system capacity. This enabled a high degree of innovation among decision-makers in the generation of alternative alcohol policy content. Within the context of uncertainty, epistemic and experiential policy learning drove rapid, adaptive cycles of policy formulation, demonstrating the importance of historical and emerging public health evidence in crisis-driven decision-making. Within the context of centralisation and limited opportunities for stakeholder participation, non-state actors mobilized to influence policy through the public arena. The paper concludes that crisis-driven policy formulation processes are shaped by abrupt redistributions of power among policy actors and the dynamic interplay of evolving economic, political, and public health priorities. Understanding the complexity of the local policy context may allow actors to navigate opportunities for public health oriented alcohol policy reforms in South Africa and other LMICs.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141467558","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":"A Comparison Between Different Models of Delivering Maternal Cash Transfers in Myanmar.","authors":"Elisa Maffioli, Nicholus Tint Zaw, Erica Field","doi":"10.1093/heapol/czae048","DOIUrl":"https://doi.org/10.1093/heapol/czae048","url":null,"abstract":"<p><p>As part of a randomized controlled trial conducted in Myanmar between 2016 and 2019, we explore the performance of a maternal cash transfer program across villages assigned to different models of delivery (by government health workers versus loan agents of a non-governmental organization) and identify key factors of success. Measures include enrollment inclusion and exclusion errors, failures in payment delivery to enrolled beneficiaries (whether beneficiaries received any transfer, fraction of benefits received, and whether there were delays and underpayment of benefit amounts), and whether beneficiaries remained in the program beyond eligibility. We find that women in villages where government health workers delivered cash transfers received on average two additional monthly transfers, were 19.7 percent more likely to receive payments on time and in-full and were 14.6 percent less likely to stay in the program beyond eligibility. With respect to the primary health objective of the program - child nutrition -, we find that children whose mother received cash by government health workers were less likely to be chronically malnourished compared to those whose mother received cash by loan agents. Overall, the delivery of cash transfers to mothers of young children by government health workers outperforms the delivery by loan agents in rural Myanmar. Qualitative evidence suggests two key factors of success: (i) trusted presence and past interactions with targeted beneficiaries and complementarities between government health workers' expertise and the program; and (ii) performance incentives based on specific health objectives along with top-down monitoring. We cannot exclude that other incentives or intrinsic motivation also played a role.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141467557","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 shifting roles of community health workers in the prevention and management of Noncommunicable disease during COVID-19 Pandemic: A scoping review.","authors":"Tilahun Haregu, Peter Delobelle, Abha Shrestha, Jeemon Panniyammakal, Kavumpurathu Raman Thankappan, Ganeshkumar Parasuraman, Darcelle Schouw, Archana Ramalingam, Ayuba Issaka, Yingting Cao, Naomi Levitt, Brian Oldenburg","doi":"10.1093/heapol/czae049","DOIUrl":"https://doi.org/10.1093/heapol/czae049","url":null,"abstract":"<p><p>Community Health Workers (CHWs) play a crucial role in the prevention and management of noncommunicable diseases (NCDs). The COVID-19 pandemic triggered the implementation of crisis-driven responses that involved shifts in the roles of CHWs in terms of delivering services for people with NCDs. Strategically aligning these shifts with health systems is crucial to improve NCD service delivery. The aim of this review was to identify and describe COVID-19-triggered shifting roles of CHWs that are promising in terms of NCD service delivery. We searched Ovid Medline, Embase, CINAHL, Web of Science, and CABI for Global Health for relevant articles published between Jan 1, 2020, and Feb 22, 2022. Studies that were conducted within a COVID-19 context and focused on the shifted roles of CHWs in NCD service delivery were included. We used PRISMA guidelines to report the findings. A total of 25 articles from 14 countries were included in this review. We identified 12 shifted roles of CHWs in NCD service delivery during COVID-19, which can be categorised in three dimensions: enhanced role of CHWs that include additional tasks such as medication delivery, extended roles such as the delivery of NCD services at household level and in remote communities; and enabled roles through the use of digital health technologies. Health and digital literacy of people with NCDs, access to internet connectivity for people with NCDs and the social and organizational context where CHWs work influenced the implementation of the shifted roles of CHWs. In conclusion, the roles of CHWs have shifted during COVID-19 pandemic to include the delivery additional NCD services at home and community levels, often supported by digital technologies. Given the importance of the shifting roles in the prevention and management of NCDs, adaptation and integration of these shifted roles into the routine activities of CHWs in the post-COVID period is recommended.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442492","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":"Editor-in-Chief changes at Health Policy and Planning.","authors":"Sandra Mounier-Jack, Virginia Wiseman, Lucy Gilson","doi":"10.1093/heapol/czae037","DOIUrl":"https://doi.org/10.1093/heapol/czae037","url":null,"abstract":"","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446016","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 social lives of point-of-care tests in low- and middle-income countries: A meta-ethnography.","authors":"Janet Perkins, Clare Chandler, Ann Kelly, Alice Street","doi":"10.1093/heapol/czae054","DOIUrl":"https://doi.org/10.1093/heapol/czae054","url":null,"abstract":"<p><p>Point-of-care tests (POCTs) have become technological solutions for many global health challenges. This meta-ethnography examines what in-depth qualitative research reveals about the \"social lives\" of POCTs from, highlighting key social considerations for policymakers, funders, developers and users in the design, development and deployment of POCTs. We screened qualitative research examining POCTs in low- and middle-income countries (LMICs) and selected 13 papers for synthesis. Findings illuminate five value-based logics-technological autonomy, care, scalability, rapidity and certainty-shaping global health innovation ecosystems and their entanglement with health systems. Our meta-ethnography suggests POCTs never achieve the technological autonomy often anticipated during design and development processes. Instead, they are both embedded in and constitutive of the dynamic relationships that make up health systems in practice. POCTs are often imagined as caring commodities; however, in use, notions of care inscribed in these devices are constantly negotiated and transformed in relation to multiple understandings of care. POCTs promise to standardize care across scale, yet our analysis indicates non-standard processes, diagnoses and treatment pathways as essential to \"fluid technologies\" rather than dangerous aberrations. The rapidity of POCTs is constructed and negotiated within multiple distinct temporal registers and POCTs operate as temporal objects that can either speed up or slow down experiences of diagnosis and innovation. Finally, while often valued as epistemic tools that can dispel diagnostic uncertainty, these papers demonstrate that POCTs contribute to new forms of uncertainty. Together, these papers point to knowledge practices as multiple, and POCTs as contributing to, rather than reducing, multiplicity. The values embedded in POCTs are fluid and contested, with important implications for the kind of care these tools can deliver. These findings can contribute to more reflexive approaches to global health innovation, which take into account limitations of established global health logics, and recognise the socio-technical complexity of health systems.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141440429","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":"Factors associated with financial risk due to health spending in Argentina.","authors":"Juan Marcelo Virdis, María Eugenia Elorza, Fernando Delbianco","doi":"10.1093/heapol/czae051","DOIUrl":"https://doi.org/10.1093/heapol/czae051","url":null,"abstract":"<p><p>This article aims to assess the association between household demographic and socioeconomic characteristics and catastrophic health expenditure (CHE) in Argentina during 2017-2018. CHE was estimated as the proportion of household consumption capacity (using both income and total consumption in separate estimations) allocated for Out-of-Pocket Health Expenditure (OOP). For assessing the determinants, we estimated a generalized ordered logit model using different intensities of CHE (10%, 15%, 20% and 25%) as the ordinal dependent variable, and socioeconomic, demographic, and geographical variables as explanatory factors. We found that having members older than 65 years and with long-term difficulties increased the likelihood of incurring CHE. Additionally, having an economically inactive household head was identified as a factor that increases this probability. However, the research did not yield consistent results regarding the relationship between public and private health insurance and consumption capacity. Our results, along with the robustness checks, suggest that the magnitude of the coefficients for the household head characteristics could be exaggerated in studies that overlook the attributes of other household members. In addition, these results emphasize the significance of accounting for long-term difficulties and indicate that omitting this factor could overestimate the impact of members aged over 65.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141491725","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":"What explains the provision of health insurance by Indonesian employers? A Trend Analysis of the National Labour Force Survey 2018-2022.","authors":"Levina Chandra Khoe, Muchtaruddin Mansyur, Virginia Wiseman, Augustine Asante","doi":"10.1093/heapol/czae053","DOIUrl":"https://doi.org/10.1093/heapol/czae053","url":null,"abstract":"<p><p>Indonesian laws mandate that every employer should provide health insurance and work accident insurance to their employees. Nevertheless, there is a significant gap in the coverage of employer-sponsored insurance among Indonesian workers. This study examines the coverage of employer-sponsored insurance and work accident insurance and analyses the characteristics of the uninsured working population in Indonesia. We analysed nationally representative cross-sectional data from the National Labour Force Survey (NLFS) conducted between 2018-2022. The primary dependent variable was the provision of health insurance and work accident insurance by employers. The independent variables included having any physical disabilities, number of working hours, duration of employment, labour union membership, earning at least the provincial minimum wage, having a written contract, and working in high risk jobs. Logistic regression was employed using the R statistical software. The findings indicate that coverage of employer-sponsored health insurance is low in Indonesia - ranging from 36.1% in 2018 to 38.4% in 2022. Workers with a written contract, earning at least the provincial minimum wage, were members of a labour union, employed for at least 5 years, and working more than 40 hours a week were more likely to be insured. By contrast, workers who had physical disabilities or were employed in high risk jobs were less likely to be insured. Our study concludes that having a written employment contract is the single most influential factor that explains the provision of employer-sponsored health insurance in Indonesia. The country's labour laws should therefore formalise the provision of written employment contracts for all workers regardless of the type and nature of work. The existing laws on health insurance and work accident insurance should be enforced to ensure that employers meet their constitutionally mandated obligation of providing these types of insurance to their workers, particularly those engaged in high risk jobs.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141476512","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":"Sustaining progress towards universal health coverage amidst a full-scale war: learning from Ukraine.","authors":"Jarno Habicht, Mark Hellowell, M A Joe Kutzin","doi":"10.1093/heapol/czae041","DOIUrl":"https://doi.org/10.1093/heapol/czae041","url":null,"abstract":"","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293344","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}