Health Policy Open最新文献

{"title":"A critical Response to “How firearm legislation impacts firearm mortality”, A focused look at Canadian and Australian evidence","authors":"Caillin Langmann","doi":"10.1016/j.hpopen.2025.100137","DOIUrl":"10.1016/j.hpopen.2025.100137","url":null,"abstract":"<div><div>A recent review article in <em>Health Policy Open</em>, entitled “How firearm legislation impacts firearm mortality internationally: A scoping review” claims that Australian and Canadian firearms legislation is associated with reductions in homicide and suicide by firearms. Unfortunately, the review overexaggerates the effectiveness of firearms legislation in Australia and Canada, leaves out some important studies, and does not rigorously examine these articles.</div><div>Eight Australian studies are referenced that examine the association between gun control legislation, primarily the National Firearms Act (NFA), and firearm homicide. Seven studies find no association between gun control legislation and firearm homicide. Only one study finds a reduction in female homicide but this is contradicted by a study using methods controlling for confounding factors. Four studies examining suicide rates and the association with the NFA find no associated benefit, including the single study that controls for confounders. Two studies find an associated decline in firearm suicide rates with the NFA but there is a decline in non firearms homicide rates at the same time that makes it impossible to know if the decline is associated with the NFA or another variable.</div><div>The results of the Canadian studies on legislation and the association with firearms homicide points to no beneficial association when more methodologically sound methods and studies are reviewed. Canadian studies on the association with legislation and suicide by firearm demonstrate a reduction in suicide rates with a substitution for other methods and no overall reduction in suicide rates.</div><div>Overall, Australian and Canadian studies to not appear to demonstrate beneficial associations with gun control legislation.</div></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"8 ","pages":"Article 100137"},"PeriodicalIF":1.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143594082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The regulation on the use of supplements for weight control: Case studies from Australia, the United States of America, and the United Kingdom","authors":"Saiya Whitney Dawson ,&nbsp;Dai Quy Le ,&nbsp;Eng Joo Tan,&nbsp;Long Khanh-Dao Le","doi":"10.1016/j.hpopen.2025.100136","DOIUrl":"10.1016/j.hpopen.2025.100136","url":null,"abstract":"<div><h3>Background</h3><div>Overweight and obesity have become more prevalent worldwide which has led to an increase in the demand for non-prescribed weight loss supplements. Given that these products are loosely regulated, they are often misused by adolescents and young adults.</div></div><div><h3>Objective</h3><div>This study aims to review regulatory policies for weight loss supplements in Australia, the United States, and the United Kingdom to identify areas for improvement.</div></div><div><h3>Method</h3><div>Peer-reviewed literature was retrieved from EMBASE, OVID, and EBSCOhost databases. Grey literature was identified using Google Advanced Search with 32 targeted keywords and region-specific government domains (.gov.au, .gov, .gov.uk). A narrative synthesis was employed to analyze and compare regulatory policies.</div></div><div><h3>Results</h3><div>A total of 34 articles (7 peer-reviewed and 27 grey literature documents) were included. In Australia, weight loss supplements are classified as low-risk medicines and are not subject to pre-market regulation. In the United States, the Food and Drug Administration primarily enforces regulations post-market. In contrast, the United Kingdom has implemented proactive measures through collaborations between government organizations. These include restrictions on the sale and packaging of over-the-counter laxatives and mandatory pharmacist consultations to assess patient needs.</div></div><div><h3>Conclusions</h3><div>The findings highlight significant regulatory gaps in Australia and the US compared to the UK. Adopting similar policies to those implemented in the UK could help reduce the accessibility of weight loss supplements among at-risk populations like adolescents and young adults. This study also discusses the implications of these findings for developing effective policies and regulations for non-prescribed weight loss supplements.</div></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"8 ","pages":"Article 100136"},"PeriodicalIF":1.7,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The early market access vehicle – An innovative demand-driven model to catalyse introduction of new optimal health products in low- and middle-income countries","authors":"Ademola Osigbesan ,&nbsp;Ikechukwu Amamilo ,&nbsp;Aayush Solanki ,&nbsp;Robert Matiru ,&nbsp;James Conroy ,&nbsp;Alya Omar ,&nbsp;Karin Hatzold ,&nbsp;Carolyn Amole ,&nbsp;Kehinde Onasanya ,&nbsp;Janet Ginnard","doi":"10.1016/j.hpopen.2024.100135","DOIUrl":"10.1016/j.hpopen.2024.100135","url":null,"abstract":"<div><div>Low-and middle-income countries (LMICs) account for a significant proportion of the burden of disease for communicable illnesses globally; with malaria, tuberculosis (TB), and HIV/AIDS being the leading causes of death. Despite this disparity, LMICs often have limited or delayed access to newer optimal health products compared to high-income countries (HICs). This limitation in access, driven by a myriad of barriers, undermines the potential health benefits that could be gained in LMICs through the introduction of better health products. To improve this inequity, governments in HICs, non-governmental organizations, and pharmaceutical companies, often resort to establishing donation programs for LMICs, to circumvent some of the access barriers. While well-implemented donation programs have the potential to improve access to new products, poorly executed donation programmes are common. These often have negative effects such as: overreliance on donations by recipient countries, <em>dumping</em> of short-dated or unwanted products, costs of waste disposal where unsuitable or excess products are received, and a lack of focus on access sustainability planning. Unitaid’s early market access vehicle (EMAV) is an innovative demand-driven access model for introducing new optimal health commodities in LMICs. An EMAV entails a conditional purchase commitment to the manufacturer for a defined quantity of selected products in exchange for a set of access commitments, required to facilitate equitable access in the target markets. EMAVs are designed to link catalytic donations to pathways for sustainable access. Unitaid, in collaboration with its partners, has leveraged the EMAV to introduce two innovative health products in a number of LMICs. This article discusses the EMAV model and builds the case on why stakeholders working on new product access should consider this approach as an alternative to traditional donation programmes.</div></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"8 ","pages":"Article 100135"},"PeriodicalIF":1.7,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11750433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cost of the reemergence of monkeypox: An overview of health financing in Africa","authors":"Taiwo Oluwaseun Sokunbi,&nbsp;Elijah Orimisan Akinbi","doi":"10.1016/j.hpopen.2024.100132","DOIUrl":"10.1016/j.hpopen.2024.100132","url":null,"abstract":"","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"7 ","pages":"Article 100132"},"PeriodicalIF":1.7,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Closing the equity gap: A call for policy and programmatic reforms to ensure inclusive and effective HIV prevention, treatment and care for persons with disabilities in Eastern and Southern Africa","authors":"Tafadzwa Dzinamarira ,&nbsp;Christine Peta ,&nbsp;Enos Moyo ,&nbsp;Roda Madziva ,&nbsp;Rouzeh Eghtessadi ,&nbsp;Tatenda Makoni ,&nbsp;Godfrey Musuka","doi":"10.1016/j.hpopen.2024.100131","DOIUrl":"10.1016/j.hpopen.2024.100131","url":null,"abstract":"<div><div>In this paper, we explore the critical barriers that persons with disabilities face in accessing HIV services in the Eastern and Southern Africa (ESA) region, despite significant advancements in overall accessibility. We highlight the intersectional challenges experienced by individuals with disabilities, particularly women, and outline a comprehensive approach to bridge the existing gaps in policy and programmatic efforts. Specifically, we aim to address the exclusion of persons with disabilities from essential HIV prevention, treatment, and care services, a situation that has profound implications for their health, social inclusion, and economic productivity. In this discussion, we examine the current landscape, identify specific policy and programmatic hurdles, and propose targeted reforms, in an effort to contribute to the ongoing discourse on health equity and inclusivity.</div></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"7 ","pages":"Article 100131"},"PeriodicalIF":1.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient’s willingness to pay for improved community health insurance in Tanzania","authors":"Kassimu Tani ,&nbsp;Brianna Osetinsky ,&nbsp;Sally Mtenga ,&nbsp;Günther Fink ,&nbsp;Fabrizio Tediosi","doi":"10.1016/j.hpopen.2024.100130","DOIUrl":"10.1016/j.hpopen.2024.100130","url":null,"abstract":"<div><div>Globally, achieving universal health coverage remains significant challenge. Health insurance coverage in low- and middle-income countries is still low with only a few African countries managed to reach 50% coverage. This study aimed to investigate the factors influencing patients’ willingness to pay (WTP) for medication and various versions of the improved Community Health Insurance Fund (iCHF) in Tanzania. A facility-based cross-sectional study was conducted in all hospitals, health centres, and eight randomly sampled dispensaries, sampling participant from the queue, one out of every three patient based on their order of entry into consultation room, and interviewed 1,748 patients in Kilombero and Same districts in Tanzania. We used multi-stage Contingent Valuation Methods exploring data collected during client exit interviews. We employed a random utility model and estimated WTP through an ordered logit model. The independent variables were; patient’s gender, age, marital status, education, employment status, Non-Communicable Disease (NCD) status, health insurance status, and the type of healthcare facility level. Our findings revealed that most patients exhibited a WTP of an amount equivalent to the current iCHF premiums and would also be willing to pay for an augmented iCHF premium inclusive of additional medication coverage. Upon adjusting for demographic characteristics, we observed that patients enrolled in an insurance program or benefiting from user fee waivers demonstrated a lower WTP for medication, while those with non-communicable diseases (NCDs) and seeking care in private facilities exhibited a higher WTP. Furthermore, patients with a secondary education level or above generally displayed higher WTP for premiums. Conversely, patients enrolled in private insurance and availing user fee waivers, along with those accessing care in public facilities, demonstrated a lowered WTP for iCHF premiums. These results highlight the need for targeted interventions to address systemic deficiencies and improve access to medicines. Our conclusions is that policies considering NCD status, education levels and income status are important when designing health insurance schemes for the informal sector in Tanzania, with the goal of increasing uptake of CHF.</div></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"7 ","pages":"Article 100130"},"PeriodicalIF":1.7,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142424008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving antibiotic prescribing – Recommendations for funding and pricing policies to enhance use of point-of-care tests","authors":"Sabine Vogler ,&nbsp;Caroline Steigenberger ,&nbsp;Friederike Windisch","doi":"10.1016/j.hpopen.2024.100129","DOIUrl":"10.1016/j.hpopen.2024.100129","url":null,"abstract":"<div><h3>Introduction</h3><div>Diagnostics can contribute to the improved quality of antibiotic prescribing. However, there is potential to enhance the use of point-of-care tests (POCTs) in general practice. This paper presents fit-for-purpose policy recommendations related to funding and pricing for POCTs applied for community-acquired acute respiratory tract infections (CA-ARTIs).</div></div><div><h3>Methods</h3><div>The development of the recommendations was informed by an analysis of the current status of funding and pricing policy frameworks for CA-ARTI POCTs in European countries, and an identification of barriers and facilitators for their uptake. Draft recommendations were developed and subsequently revised based on written and verbal feedback from meetings with experts.</div></div><div><h3>Results</h3><div>The proposal includes four recommendations for policy interventions related to funding and three recommendations regarding pricing policies. Two of the funding policy-related recommendations concern physicians’ remuneration, and two relate to product-specific reimbursement (public coverage) of the CA-ARTI POCTs. The pricing-related recommendations include a proposal to explore the introduction of price regulation, to pilot subscription-fee procurement models and to enhance more strategic approaches in public procurement of CA-ARTI POCTs.</div></div><div><h3>Conclusions</h3><div>Optimised pricing and funding policies could make a difference in enhancing uptake of CA-ARTI POCTs. It is crucial for the successful implementation of policies to consider country settings. Additionally, supportive policy action is recommended, including the systematic use of health technology assessment, stakeholder communication, and monitoring and evaluation.</div></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"7 ","pages":"Article 100129"},"PeriodicalIF":1.7,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142423999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From theory to practice: Harmonizing taxonomies of trustworthy AI","authors":"Christos A. Makridis ,&nbsp;Joshua Mueller ,&nbsp;Theo Tiffany ,&nbsp;Andrew A. Borkowski ,&nbsp;John Zachary ,&nbsp;Gil Alterovitz","doi":"10.1016/j.hpopen.2024.100128","DOIUrl":"10.1016/j.hpopen.2024.100128","url":null,"abstract":"<div><div>The increasing capabilities of AI pose new risks and vulnerabilities for organizations and decision makers. Several trustworthy AI frameworks have been created by U.S. federal agencies and international organizations to outline the principles to which AI systems must adhere for their use to be considered responsible. Different trustworthy AI frameworks reflect the priorities and perspectives of different stakeholders, and there is no consensus on a single framework yet. We evaluate the leading frameworks and provide a holistic perspective on trustworthy AI values, allowing federal agencies to create agency-specific trustworthy AI strategies that account for unique institutional needs and priorities. We apply this approach to the Department of Veterans Affairs, an entity with largest health care system in US. Further, we contextualize our framework from the perspective of the federal government on how to leverage existing trustworthy AI frameworks to develop a set of guiding principles that can provide the foundation for an agency to design, develop, acquire, and use AI systems in a manner that simultaneously fosters trust and confidence and meets the requirements of established laws and regulations.</div></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"7 ","pages":"Article 100128"},"PeriodicalIF":1.7,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How firearm legislation impacts firearm mortality internationally: A scoping review","authors":"Brianna Greenberg ,&nbsp;Alexandria Bennett ,&nbsp;Asad Naveed ,&nbsp;Raluca Petrut ,&nbsp;Sabrina M. Wang ,&nbsp;Niyati Vyas ,&nbsp;Amir Bachari ,&nbsp;Shawn Khan ,&nbsp;Tea Christine Sue ,&nbsp;Nicole Dryburgh ,&nbsp;Faris Almoli ,&nbsp;Becky Skidmore ,&nbsp;Nicole Shaver ,&nbsp;Evan Chung Bui ,&nbsp;Melissa Brouwers ,&nbsp;David Moher ,&nbsp;Julian Little ,&nbsp;Julie Maggi ,&nbsp;Najma Ahmed","doi":"10.1016/j.hpopen.2024.100127","DOIUrl":"10.1016/j.hpopen.2024.100127","url":null,"abstract":"<div><h3>Background</h3><p>The literature on gun violence is broad and variable, describing multiple legislation types and outcomes in observational studies. Our objective was to document the extent and nature of evidence on the impact of firearm legislation on mortality from firearm violence.</p></div><div><h3>Methods</h3><p>A scoping review was conducted under PRISMA-ScR guidance. A comprehensive peer-reviewed search strategy was executed in several electronic databases from inception to March 2024. Grey literature was searched for unpublished sources. Data were extracted on study design, country, population, type of legislation, and overall study conclusions on legislation impact on mortality from suicide, homicide, femicide, and domestic violence. Critical appraisal for a sample of articles with the same study design (ecological studies) was conducted for quality assessment.</p></div><div><h3>Findings</h3><p>5057 titles and abstracts and 651 full-text articles were reviewed. Following full-text review and grey literature search, 202 articles satisfied our eligibility criteria. Federal legislation was identified from all included countries, while state-specific laws were only reported in studies from the U.S. Numerous legislative approaches were identified including preventative, prohibitive, and more tailored strategies focused on identifying high risk individuals. Law types had various effects on rates of firearm homicide, suicide, and femicide. Lack of robust design, uneven implementation, and poor evaluation of legislation may contribute to these differences.</p></div><div><h3>Interpretation</h3><p>We found that national, restrictive laws reduce population-level firearm mortality. These findings can inform policy makers, public health researchers, and governments when designing and implementing legislation to reduce injury and death from firearms.</p></div><div><h3>Funding</h3><p>Funding is provided by the Strategy for Patient-Oriented Research (SPOR) Evidence Alliance and in part by St. Michael’s Hospital, University of Toronto.</p></div><div><h3>Scoping review registration:</h3><p>Open Science Framework (OSF): <span><span>https://osf.io/sf38n</span><svg><path></path></svg></span>.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"7 ","pages":"Article 100127"},"PeriodicalIF":1.7,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590229624000121/pdfft?md5=966efb0375d3f282c3458a484d95fcac&pid=1-s2.0-S2590229624000121-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of the COVID-19 pandemic on conflict and health system–related violent events in Libya: An interrupted time series analysis","authors":"Tracy Kuo Lin ,&nbsp;Kalin Werner ,&nbsp;Mariam M. Hamza ,&nbsp;Christopher H. Herbst","doi":"10.1016/j.hpopen.2024.100126","DOIUrl":"10.1016/j.hpopen.2024.100126","url":null,"abstract":"<div><p>As a response to the COVID-19 pandemic, the United Nations Security Council passed resolution S/RES2532 (2020), requesting the cessation of hostilities. Despite ceasefire initiatives, evidence suggests that both conflict and violent events remained unabated—and, in some cases, escalated during the first months of the pandemic. This study uses interrupted time series analyses to examine the impact of the pandemic on violent and non-violent political events—including health system-related violence—in Libya, which has been experiencing a protracted conflict since 2014. We find a reduction of approximately 21 battles (<em>p</em> &lt; 0.001) only during the first month of the pandemic. However, overall, throughout the pandemic, there was an increase of roughly one battle per month (<em>p</em> &lt; 0.001). The violence that affected healthcare workers decreased during the first year of the pandemic (<em>p</em> &lt; 0.001); but by the second year the reduction in healthcare worker–related violence had dissipated. While the pandemic seems to have mitigated the level of violence experience by healthcare workers, the overall pattern of violence is a troubling one, particularly since they were observed while there is an international agreement for a ceasefire in place and a specific peace agreement occurring in Libya. The pattern suggests that policy to protect healthcare workers may need to be enhanced even more during crisis settings.</p></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"7 ","pages":"Article 100126"},"PeriodicalIF":1.7,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S259022962400011X/pdfft?md5=5fc25f12eec83da1ece2b29aeddabb38&pid=1-s2.0-S259022962400011X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}