International Journal of Health Policy and Management最新文献

{"title":"Rethinking Human Resources for Health Planning in Labour Markets Disrupted by Conflict-Affected and Fragile Settings Comment on \"Human Resources for Health in Conflict Affected Settings: A Scoping Review of Primary Peer Reviewed Publications 2016-2022\".","authors":"Roomi Aziz","doi":"10.34172/ijhpm.9534","DOIUrl":"10.34172/ijhpm.9534","url":null,"abstract":"<p><p>In a world still grappling with exploring the underlying dynamics of challenges confronting human resources for health (HRH), how must the HRH research and planning ensue in conflict-affected settings (CAS)? Onvlee and colleagues undertake a scoping review to respond to this important question, using the World Health Organization's (WHO's) Health Labour Market (HLM) framework, to leverage upon available evidence. This commentary appraises the conceptual and methodological contributions of the review, while questioning the suitability of HLM to analyse HRH challenges in disrupted health systems. It argues that CAS-specific HRH planning exacts frameworks and approaches more attuned to political economy, contextual fragility, and structural inequalities, which shape healthcare workers' vulnerabilities and responses in CAS. The commentary identifies five gap questions for future scholarship, calling for intersectionality-driven, politically informed and context-specific research approaches for HRH evidence, transcending supply and demand framing of HRH, to inform HRH policies in conflict-affected and fragile settings.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"15 ","pages":"9534"},"PeriodicalIF":4.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Religion, Politics, and Vaccines: Elaborating the Integrative Public Policy Acceptance (IPAC) Framework Through HPV Vaccine Program Acceptance Among Religious Leaders in Bangladesh.","authors":"Md Towhidur Rahman, Sultan Mahmood, Katie Attwell","doi":"10.34172/ijhpm.9179","DOIUrl":"10.34172/ijhpm.9179","url":null,"abstract":"<p><strong>Background: </strong>In October 2023, Bangladesh introduced a free, single-dose human papillomavirus (HPV) vaccine for girls aged 9-14 through its national vaccination program to prevent cervical cancer, the second most common cancer among Bangladeshi females, caused by the HPV. Although vaccine hesitancy was not a significant issue before the COVID-19 pandemic, experiences from that pandemic and global literature suggest that the population's uptake of this vaccine may face barriers due to concerns related to reproductive health, fertility, and cultural and religious beliefs. This is particularly relevant in a country where Islam is the state religion, 91% of the population is Muslim, and religious leaders hold significant influence over public opinion.</p><p><strong>Methods: </strong>Building upon the recently developed Integrative Public Policy Acceptance (IPAC) framework, this qualitative study explores the factors shaping religious leaders' support for the HPV vaccine informing their potential role in promoting it. Semi-structured interviews with leaders from Bangladesh's five main Islamic traditions were thematically analysed using NVivo 14 with inductive and deductive coding.</p><p><strong>Results: </strong>Islamic religious leaders' varying support for HPV vaccinations in Bangladesh was influenced by their limited awareness of cervical cancer, as well as their religious and social concerns about ingredients, side effects and a fear of promoting promiscuity. Political ideologies also played a significant role, as leaders were less supportive of the program when they perceived the government as ideologically opposed to the beliefs or practices of their specific religious tradition.</p><p><strong>Conclusion: </strong>The study's contribution to the IPAC framework highlights the importance of political consensus in policy acceptance, explaining how partisanship and ideological differences impact public policy compliance. The findings underscore the need for health systems in Muslim majority countries to engage with religious authorities, build political inclusivity and consensus, and align health policies with religious and cultural values.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"15 ","pages":"9179"},"PeriodicalIF":4.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12980027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ageism and Health System Responsiveness to Older People: An Agenda for Action and Research.","authors":"Thi Vinh Nguyen, Sumit Kane","doi":"10.34172/ijhpm.9615","DOIUrl":"10.34172/ijhpm.9615","url":null,"abstract":"","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"15 ","pages":"9615"},"PeriodicalIF":4.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Value Do Dutch Citizens Place on Health Interventions That Provide Greater Health Gains to Lower-Income Groups? A Discrete Choice Experiment.","authors":"Iris Meulman, Adrienne Rotteveel, Ellen Uiters, Mariëlle Cloin, Johan Polder, Niek Stadhouders","doi":"10.34172/ijhpm.9095","DOIUrl":"10.34172/ijhpm.9095","url":null,"abstract":"<p><strong>Background: </strong>Reimbursement decisions for new health interventions focus on maximizing health gains, with limited attention to who benefits from these gains or the impact on income related health inequalities. This study aimed to examine the preferences of Dutch citizens regarding the distribution of health gains of new interventions across income groups.</p><p><strong>Methods: </strong>A discrete choice experiment (DCE) was completed by 614 Dutch adults. Respondents were presented with 12 choice tasks. In each choice task, they were asked to choose between two health interventions that differed on the following attributes: total healthy life years gained, distribution of healthy life years gained across income groups, additional costs in terms of health insurance premium increases and whether the intervention was curative or preventive. Preferences were estimated using multinomial logit (MNL) models, relative attribute importance, willingness-to-pay, and willingness-to-trade total health gains. Preference heterogeneity was examined using latent class (LC) analyses.</p><p><strong>Results: </strong>Respondents found the distribution of health gains by income the most important attribute in their decision between health interventions (relative importance [RI] = 40.5%, 95% CI: 38.3%-42.7%). Overall, respondents preferred an equal distribution of healthy life years gained across income groups (β_{higher income groups} = -1.427, 95% CI: -1.547--1.307; β_{lower-income groups} = -0.315, 95% CI: -0.395--0.235). A health intervention should yield 14 283 (95% CI: 10 463-18, 102) additional healthy life years or reduce the yearly health insurance premium by €39.96 (95% CI: €29.03-€50.89) if it mainly favors lower-income groups. Preventive interventions were generally preferred over equally effective or more effective curative interventions (β_prevention = 0.270, 95% CI: 0.204-0.336). While preferences displayed a similar direction across LCs, the classes differed in the RI assigned to the attributes.</p><p><strong>Conclusion: </strong>Our findings suggest societal support for interventions that prioritize preventive programs over equally effective or more effective curative interventions and prioritize interventions that provide equal benefits across different income groups.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"15 ","pages":"9095"},"PeriodicalIF":4.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Ways of Working to Manage and Improve Quality in Integrated Care Systems in England.","authors":"Mirza Lalani, Michele Peters, Thavapriya Sugavanam, Helen Crocker, James Caiels, Harriet Hay, Sarah Gunn, Helen Hogan, Bethan Page, Ray Fitzpatrick","doi":"10.34172/ijhpm.8424","DOIUrl":"10.34172/ijhpm.8424","url":null,"abstract":"<p><strong>Background: </strong>Integrated care systems (ICSs) in England were formally established in July 2022 to coordinate the planning and delivery of health and care services. A key responsibility was to address the quality of these services. Our study aimed to examine how ICSs approach this responsibility and to identify opportunities and barriers experienced in their early establishment and development.</p><p><strong>Methods: </strong>A sample of four ICSs were recruited to participate. Interviews and meeting observations were undertaken in two phases (before and after the inception of ICSs) around 12 months apart. A total of 112 interviews were carried out with senior figures in the four ICSs supplemented by observation of relevant meetings and analysis of relevant documents.</p><p><strong>Results: </strong>Regarding quality, ICSs demonstrated several new ways of working. They set-up new structures for quality governance and created whole-system strategies for quality centred on major responsibilities regarding population health and health inequalities. These strategies required new and relevant metrics to assess quality and outcomes and a greater focus upon co-production in the development of services. They aimed to strike a fine balance between long-standing requirements for quality assurance and new responsibilities for quality improvement (QI). New approaches were underpinned by new collaborations between system partners extending beyond healthcare to include Local Authorities (responsible for social care and public health) and local communities.</p><p><strong>Conclusion: </strong>To address the many challenges of quality, ICSs have created new ways of working cultivating different kinds of collaborative relationships compared to established hierarchical, siloed and top-down ways of working prior to their formation. A focus on improving population health and reducing inequalities has required a shift from \"here and now\" urgent problem-solving to working with longer timelines. Such changes require patience in the context of political pressure to devote efforts to more salient problems such as waiting lists.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"8424"},"PeriodicalIF":4.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bottlenecks Analysis in the Intervention of Improving Maternal Health in Rural Areas of Tanzania: A Convergent Mixed-Method Approach.","authors":"Hyeyun Kim, Jiye Kim, Seohyeon Lee, Minkang Cho, Hyekyeong Kim","doi":"10.34172/ijhpm.8355","DOIUrl":"10.34172/ijhpm.8355","url":null,"abstract":"<p><strong>Background: </strong>Achieving universal health coverage for maternal health (MH) requires a health system that ensures the availability, accessibility, acceptability, and effective use of services. The study aimed to identify bottlenecks that hinder project outcomes of MH in the rural districts of Tanzania.</p><p><strong>Methods: </strong>This study employed a convergent mixed-method approach to conduct the bottleneck analysis. Quantitative data were collected to identify indicators of MH utilization, with source including Tanzanian health statistics, health facilities and the women in reproductive age (WRA) survey. In-depth interviews (IDIs) and focus group discussions (FGDs) were conducted with WRA, their families, community health workers (CHWs), and healthcare personnel (HP) to gain insight into factors influencing healthcare utilization from both a demand and an environmental perspective. Following the Tanahashi steps, the quantitative data were analyzed using descriptive statistics and the qualitative data were analyzed using a thematic approach. The findings from both were integrated to identify bottlenecks toward effective coverage and how bottlenecks affected the utilization of MH services.</p><p><strong>Results: </strong>Community awareness and acceptance were observed to be high, however only a limited number of individuals had received MH services. Utilization rates for antenatal care (ANC) and postnatal care (PNC) were 17.4% and 22.0%, respectively. This suggests that efforts to enhance awareness may be inadequate to change social norms and lead to health behaviors. Furthermore, even when women utilize the service, they may not do so in a timely or consistent manner due to low service quality or unsatisfactory experiences.</p><p><strong>Conclusion: </strong>To strengthen the logic model, contextual factors such as provider attitudes, service quality, supportive family, and community climate need to be considered to ensure that WRAs are satisfied with and continue to access services. With building supply-side infrastructure, ongoing efforts to change stakeholders' perceptions of MH services and utilization patterns will be needed to improve the coverage of MH services.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"8355"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Routes of Well-Being, Spiritual Harmony and Recovery in Mental Health: The Community as a Policy-Maker.","authors":"Felipe Agudelo-Hernández, Ana Belén Giraldo-Álvarez","doi":"10.34172/ijhpm.8390","DOIUrl":"10.34172/ijhpm.8390","url":null,"abstract":"<p><strong>Background: </strong>The participatory approach in policy construction is a historical debt to communities. An example of the above is the definition that Colombian Indigenous communities give to mental health or spiritual harmony. Spiritual harmonies are a collective good that implies being in harmony with the spirit and with thought, which is why it is related to the community context, with the territory, identity, autonomy, spirituality, worldview, diverse cultural uses, practices, and customs. The objective of this study was to analyze the process of building a mental health recovery path with multiple community representatives in a Colombian territory.</p><p><strong>Methods: </strong>Through a co-production method based on Participatory Action Research, focus groups were developed with representatives of children, youth, indigenous peoples, migrant populations, as well as government sectors such as health, education, and decision-makers in the territory. This study was carried out in 2023 in the District of Riohacha, Colombia, in the last quarter of 2023, within the framework of the construction of a mental health route, led by the District Mayor's Office. Fifty-nine people participated in the focus groups.</p><p><strong>Results: </strong>The necessity of living in safe and supportive environments was emphasized. The route built with the community was based on the definition of the necessary steps to generate a real approach to the context and their perceptions of well-being, mental health and spiritual harmonies. Three main themes were identified: (1) Mental health: a construct of well-being, care and identity, (2) Barriers to an integral approach and ideals of joint construction, and (3) The proposal for a comprehensive mental health route.</p><p><strong>Conclusion: </strong>Co-productive methodologies strengthen community autonomy and empowerment, and make the implementation of mental health programs more feasible. In public policies, it is increasingly necessary to have communities that are strengthened in the production of knowledge and in the proposals for implementation.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"8390"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Achieving Diagnostic Excellence in Prenatal Diagnosis Through Patient-Reported Measures Comment on \"Achieving Diagnostic Excellence: Roadmaps to Develop and Use Patient-Reported Measures With an Equity Lens\".","authors":"An Chen, Oona Tchitcherin, Kirsi Väyrynen, Paulus Torkki, Seppo Heinonen, Aydin Tekay","doi":"10.34172/ijhpm.8921","DOIUrl":"10.34172/ijhpm.8921","url":null,"abstract":"<p><p>McDonald and colleagues' work \"Achieving Diagnostic Excellence: Roadmaps to Develop and Use Patient-Reported Measures With an Equity Lens\" emphasizes the critical role of patient-reported measures (PRMs) in achieving diagnostic excellence, with a focus on equity. PRMs capture patients' experiences, symptoms, and concerns throughout the diagnostic process, enhancing accuracy and addressing uncertainties. In contexts like maternity care, PRMs have been applied to reveal and reduce communication gaps and alleviate anxiety, offering crucial support for improving diagnostic experiences and outcomes. This commentary explores the application of McDonald and colleagues' visions and roadmaps to prenatal diagnosis, specifically focusing \"prenatal screening and testing\" (PreST), a complex process where diverse patient populations face challenges in understanding and responding to sequential test results. Tailored diagnosis-related PRMs can provide healthcare providers with tools to enhance shared decision-making, equitable communication, and patient satisfaction, leading to more inclusive and personalized diagnostic pathways.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"8921"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Applications of System Dynamics in Critical Food Systems Research Comment on \"Using System Dynamics to Understand Transnational Corporate Power in Diet-Related Non-communicable Disease Prevention Policy-Making: A Case Study of South Africa\".","authors":"Andrew D Brown, Simone Sherriff, Benjamin Wood, Steven Allender, Fiona Mitchell, Yin Paradies, Jennifer Browne","doi":"10.34172/ijhpm.9128","DOIUrl":"10.34172/ijhpm.9128","url":null,"abstract":"<p><p>This commentary commends Milsom et al for their critical and rigorous application of qualitative system dynamics to unpack corporate power in food policy-making. Their use of Critical Realism, best practice qualitative methods, and feedback loops exemplifies the maturation of system dynamics applications in public health research. We reflect on how their work aligns with broader debates about power and social theory in system dynamics and how it offers a blueprint for trustworthiness and reflexivity in qualitative modelling. Drawing on our team's work with Aboriginal communities in Australia, we highlight the value of culturally grounded, participatory modelling in amplifying the voices of communities experiencing historical and ongoing oppression. We support the authors' call to advance toward simulation modelling and stress the importance of engaging with both system dynamics and community-based knowledge to realise the transformative potential of systems-informed, community-led research in reshaping food policy and practice.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"9128"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Choosing to Implement Value-Based Healthcare Initiatives: A Strategic Decision for Achieving Better Performance in Improving Population Health Comment on \"Reflections on Managing the Performance of Value-Based Healthcare: A Scoping Review\".","authors":"Ana Paula Beck da Silva Etges","doi":"10.34172/ijhpm.9050","DOIUrl":"10.34172/ijhpm.9050","url":null,"abstract":"<p><p>Operational effectiveness is about improving what is being done, reducing errors and harms, and improving efficiency, while strategy involves making decisions and choices. Implementing value-based healthcare (VBHC) also means matching previous strategies and performance literature to guide building sustainable organizations in healthcare businesses. This commentary paper explores answers for: What does it mean to have a high-performance, sustainable, and impactful health organization? By describing frameworks about leadership and social capital, this piece argues that the healthcare system's sustainability involves making choices that set as a strategy implementing VBHC principles, cause implications on regulatory, organizational, and individual levels, and result in structuring systems that contribute to achieving high performance on improving population health. The argumentation suggests that achieving a high-performance, sustainable, and impactful health organization can be translated into positively impacting population health with financial accountability, and systems internal processes may serve as roads to achieve that impact on society.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"14 ","pages":"9050"},"PeriodicalIF":5.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}