International Journal of Health Policy and Management最新文献

{"title":"The Use of Evidence to Design an Essential Package of Health Services in Pakistan: A Review and Analysis of Prioritisation Decisions at Different Stages of the Appraisal Process.","authors":"Sergio Torres-Rueda, Anna Vassall, Raza Zaidi, Nichola Kitson, Muhammad Khalid, Wahaj Zulfiqar, Maarten Jansen, Wajeeha Raza, Maryam Huda, Frank Sandmann, Rob Baltussen, Sameen Siddiqi, Ala Alwan","doi":"10.34172/ijhpm.2024.8043","DOIUrl":"10.34172/ijhpm.2024.8043","url":null,"abstract":"<p><strong>Background: </strong>Pakistan embarked on a process of designing an essential package of health services (EPHS) as a pathway towards universal health coverage (UHC). The EPHS design followed an evidence-informed deliberative process; evidence on 170 interventions was introduced along multiple stages of appraisal engaging different stakeholders tasked with prioritising interventions for inclusion. We report on the composition of the package at different stages, analyse trends of prioritised and deprioritised interventions and reflect on the trade-offs made.</p><p><strong>Methods: </strong>Quantitative evidence on cost-effectiveness, budget impact, and avoidable burden of disease was presented to stakeholders in stages. We recorded which interventions were prioritised and deprioritised at each stage and carried out three analyses: (1) a review of total number of interventions prioritised at each stage, along with associated costs per capita and disability-adjusted life years (DALYs) averted, to understand changes in affordability and efficiency in the package, (2) an analysis of interventions broken down by decision criteria and intervention characteristics to analyse prioritisation trends across different stages, and (3) a description of the trajectory of interventions broken down by current coverage and cost-effectiveness.</p><p><strong>Results: </strong>Value for money generally increased throughout the process, although not uniformly. Stakeholders largely prioritised interventions with low budget impact and those preventing a high burden of disease. Highly cost-effective interventions were also prioritised, but less consistently throughout the stages of the process. Interventions with high current coverage were overwhelmingly prioritised for inclusion.</p><p><strong>Conclusion: </strong>Evidence-informed deliberative processes can produce actionable and affordable health benefit packages. While cost-effective interventions are generally preferred, other factors play a role and limit efficiency.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"8043"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889180","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":"Why Systems Thinking Is Needed to Center Trust in Health Policy and Systems Comment on \"Placing Trust at the Heart of Health Policy and Systems\".","authors":"Diane T Finegood, Chris Yakimov","doi":"10.34172/ijhpm.8706","DOIUrl":"10.34172/ijhpm.8706","url":null,"abstract":"<p><p>The editorial by McKee and colleagues is an important call to action to put a spotlight on trust and its role in the function of health systems. The authors make a good case for this focus considering how trust in health systems seems to have eroded in recent years, an erosion accelerated by the COVID-19 pandemic. They recognize that trust is complex given the many forms of trust, the importance of context, and its dynamic and unpredictable nature. However, the solutions they offer including learning how to measure trust and figuring out the causes and consequences of trust are just simple or complicated solutions to this complex challenge. Instead, we need to approach building trust in healthcare by embracing and harnessing complexity. This starts by understanding the difference between complicated and complex challenges and then by applying complex systems frameworks that offer insight into new ways forward.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"8706"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768845","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":"Training it Forward: The Role of Embedded Research Fellows in the Network of Scholars Program in Nova Scotia Comment on \"Early Career Outcomes of Embedded Research Fellows: An Analysis of the Health System Impact Fellowship Program\".","authors":"Gail Tomblin Murphy, Tara Sampalli, Mark Embrett, Logan Lawrence, Meaghan Sim, Julia Guk, Kaylee Murphy-Boyle, Marta MacInnis","doi":"10.34172/ijhpm.8653","DOIUrl":"https://doi.org/10.34172/ijhpm.8653","url":null,"abstract":"<p><p>Kasaai et al describe the career trajectories of embedded scientists trained through the Health System Impact Fellowship (HSIF), showing that 37% of 2017-2019 HSIF alumni continue as embedded researchers in health systems. These findings suggest that the HSIF program effectively supports career readiness in health services and policy research (HSPR). Similarly, the Network of Scholars (NoS) program, launched post-pandemic in Nova Scotia, mirrors these results, with alumni continuing in embedded roles and mentoring a new cohort of learners from undergraduate to postgraduate levels. NoS has incorporated competencies in quality, project management, and innovation to strengthen training for embedded scientists, aligning with the mandate of the Institute of Health Services Policy and Research. Since 2021, NoS has supported over 100 learners, contributing to over 300 rapid reviews and 100 rapid evaluations addressing top health system priorities while enhancing learner competencies and advancing Nova Scotia's Learning Health System (LHS) vision.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"8653"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768842","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":"All Hands on Deck. Transforming the Health System Requires Innovation, Through Individual- and Diffusion Efforts Comment on \"Employee-Driven Innovation in Health Organizations: Insights From a Scoping Review\".","authors":"Willem H van Harten","doi":"10.34172/ijhpm.8506","DOIUrl":"10.34172/ijhpm.8506","url":null,"abstract":"<p><p>Employee driven innovation (EDI) is essential in transforming hospitals and other providers, but the challenge is also to have impact on health systems as a whole. Usually a mix from top down measures and bottom up initiatives leads to an innovative culture. An important aspect is the innate difference between types of providers related to initiating, facilitating and rewarding innovation. Second the rewarding system within organisations but also in science and scientific journals. Especially nursing and other non-medical professions can be emancipated in this regard. Further there is a growing interdependence with digitalisation in all its forms and awareness of the related team effort is needed to actually realise innovative projects within a standing organisation. Lastly change the paradigm related to the spread of innovations from \"not invented here\" to \"proudly copied from,\" create trust and organize collaboration between providers and spend sufficient attention to credible evidence on the effectiveness.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"8506"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889163","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":"Research Coproduction: How Can Coproduction Teams Increase Traffic on the Pathway to Impact? Comment on \"Research Coproduction: An Underused Pathway to Impact\".","authors":"Emily R Ramage, Erin Bicknell, Saran Chamberlain, Brooke Parsons, Catherine M Said, Elizabeth A Lynch","doi":"10.34172/ijhpm.8804","DOIUrl":"10.34172/ijhpm.8804","url":null,"abstract":"<p><p>The editorial by Rycroft-Malone and colleagues <i>Research Coproduction: An Underused Pathway to Impact</i>, explores the challenges and opportunities of coproduction to deliver research with impact. We, apply our experience as coproducers of research to present strategies that may accelerate uptake and increase traffic on the road to research impact. In doing so, we emphasise the importance of consistent terminology around coproduction, reporting impact metrics, diversity in research partnerships, and the careful consideration of researcher partners. Further, our commentary suggests practical strategies for teams to align their work with the principles of coproduction, and opportunities to support systems-level change to facilitate coproduction.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"8804"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768832","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":"Can a Well-Being Economy Save Us?","authors":"Ronald Labonté","doi":"10.34172/ijhpm.8507","DOIUrl":"10.34172/ijhpm.8507","url":null,"abstract":"<p><p>The COVID-19 pandemic led many countries to consider reforms to their economic policies, in part to better deal with global warming, mass population migration and displacements, and worsening global inequalities. Some health progressive changes have been made, but the world still confronts the contradiction between economic growth and the need to reduce aggregate global consumption. Well-being economies based on valuing human and planetary health have been proposed as a viable option, with more appeal than concepts such as degrowth or postgrowth economics. Some governments are moving in a \"well-being economy\" direction, but are they moving far and fast enough? What are the policy actions governments must take, and how will they overcome powerful interests opposed to any economic changes that might challenge their privileges? The idea of well-being economies resonates strongly with most cultures; and therein lies its civil society activist potential.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"8507"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889134","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":"Equity Lens on Canada's COVID-19 Response: Review of the Literature.","authors":"Muhammad Haaris Tiwana, Julia Smith, Megan Kirby, Simran Purewal","doi":"10.34172/ijhpm.2024.8132","DOIUrl":"10.34172/ijhpm.2024.8132","url":null,"abstract":"<p><strong>Background: </strong>A growing literature has documented how the secondary effects of the COVID-19 pandemic have compounded socioeconomic vulnerabilities already present in society, particularly across social categories such as gender, race, class, and socioeconomic status. Such effects demonstrate how pandemic response policies act as structural determinants of health to influence not only direct health outcomes but also intermediary outcomes, such as access to education or income.</p><p><strong>Methods: </strong>This review aims to scope research that analyzes pandemic response policies in Canada from an equity perspective, to identify common themes, recommendations, and gaps.</p><p><strong>Results: </strong>Fourteen studies were thematically analyzed, the majority being qualitative policy document analysis, applying critical frameworks and focused on effects on select priority populations. Analysis of economic and labour policies indicates a lack of consideration for the specific needs of priority populations, and those engaged in precarious, informal, and essential labour. Analysis of social policies illustrate the wide-ranging effects of school and service closures, particularly on women and children. Furthermore, these policies lacked consideration of populations marginalized during the pandemic, include older adults and their caregivers, as well as lack of consideration of the diversity of Indigenous communities. Recommendations proposed in this review call for developing policy responses that address persistent social and economic inequities, pandemic response policies tailored to the needs of priority populations and more meaningful consultation during policy development.</p><p><strong>Conclusion: </strong>The limited number of studies suggests there is still much scope for research recognizing policies as structural determinants of health inequities, including research which takes an intersectional approach.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"8132"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11270619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889139","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":"Generating Political Priority for the Health Needs of the 21st Century: A Qualitative Policy Analysis on the Prioritization of Rehabilitation Services in Uganda.","authors":"Rachel Neill, Elizeus Rutebemberwa, Raymond Tweheyo, Sam Tukei Ojulo, Gerald Okello, Abdulgafoor M Bachani, Yusra Ribhi Shawar","doi":"10.34172/ijhpm.8347","DOIUrl":"10.34172/ijhpm.8347","url":null,"abstract":"<p><strong>Background: </strong>Few low- or middle-income countries (LMICs) have prioritized the expansion of rehabilitation services. Existing scholarship has identified that problem definition, governance, and structural factors are influential in the prioritization of rehabilitation. The objective of this study was to identify the factors influencing the prioritization and implementation of rehabilitation services in Uganda.</p><p><strong>Methods: </strong>A case study design was utilized. The Prioritization of Rehabilitation in National Health Systems framework guided the study. Data sources included 33 key informant interviews (KIIs) with governmental and non-governmental stakeholders and peer-reviewed and grey literature on rehabilitation in Uganda. A thematic content analysis and concept map were conducted to analyze the data.</p><p><strong>Results: </strong>Rehabilitation is an unfunded priority in Uganda, garnering political attention but failing to receive adequate financial or human resource allocation. The national legacy of rehabilitation as a social program, instead of a health program, has influenced its present-day prioritization trajectory. These include a fragmented governance system, a weak advocacy coalition without a unified objective or champion, and a lack of integration into existing health systems structures that makes it challenging to scale-up service provision. Our findings highlight the interactive influences of structural, governance, and framing factors on prioritization and the importance of historical context in understanding both prioritization and implementation.</p><p><strong>Conclusion: </strong>Our findings demonstrate challenges in prioritizing emerging, multi-sectoral health areas like rehabilitation. Strategic considerations for elevating rehabilitation on Uganda's policy agenda include generating credible indicators to quantify the nature and extent of the population's need and uniting governmental and non-governmental actors around a common vision for rehabilitation's expansion. We present opportunities for strengthening rehabilitation, both in Uganda and in similar contexts grappling with many health sector priorities and limited resources.</p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"8347"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889142","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":"Moving Towards Effective and Efficient Implementation of Evidence-Informed Deliberative Processes for Health Benefit Package Design: A Response to Recent Commentaries.","authors":"Wija Oortwijn, Maarten Jansen, Leon Bijlmakers, Gavin Surgey, Rob Baltussen","doi":"10.34172/ijhpm.8647","DOIUrl":"10.34172/ijhpm.8647","url":null,"abstract":"","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"8647"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889167","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":"Praxis, Power, and Processes: Youth Participation in Health Policy - A Response to Recent Commentaries.","authors":"Tanya Jacobs, Asha George","doi":"10.34172/ijhpm.2024.8567","DOIUrl":"10.34172/ijhpm.2024.8567","url":null,"abstract":"","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"13 ","pages":"8567"},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11270606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889171","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}