Health Policy Open最新文献

{"title":"The global landscape of country-level health technology assessment processes: A survey among 104 countries","authors":"Andrew J. Mirelman,&nbsp;Kratu Goel,&nbsp;Tessa Tan-Torres Edejer","doi":"10.1016/j.hpopen.2025.100138","DOIUrl":"10.1016/j.hpopen.2025.100138","url":null,"abstract":"<div><div>To make progress towards universal health coverage (UHC), countries need to be able to develop and implement evidence-informed<!--> <!-->and inclusive processes for decision-making to inform what services are provided and purchased.<!--> <!-->Health Technology Assessment (HTA) processes are an established mechanism to support evidence-informed decision-making in the health sector. To assess the practice of HTA in countries, WHO conducted a global survey that explores the status of HTA. The survey is the largest source of information in terms of number of countries<!--> <!-->for describing global<!--> <!-->HTA status. The final sample analysed in this paper is the 104 countries (82% or 104/127) that responded “yes” to the question of having a systematic, formal health decision-making process at the national level. The results show that while many countries have HTA bodies in place, these serve different functions. While there are more established processes in higher income country groups, even those show room for improvement in areas such as social participation and appeals. Lack of awareness of the importance of HTA and institutionalization were the top two barriers to HTA utilization. There is further progress that needs to be made in HTA globally. Countries need to build on available guidance to ensure the appropriate elements are in place for sustainable country decision-making processes and develop more understanding of how they vary across settings.</div></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"8 ","pages":"Article 100138"},"PeriodicalIF":1.7,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738099","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 effectiveness of the states’ crisis response policies: Survival analysis on the COVID-19 transmission suppression in the United States","authors":"Hanvit Kim,&nbsp;Kyungmin Lee,&nbsp;Jungwon Yeo","doi":"10.1016/j.hpopen.2025.100140","DOIUrl":"10.1016/j.hpopen.2025.100140","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to evaluate the effectiveness of various COVID-19 response policies in the United Sates that facilitated rapid virus transmission suppression and promoted quick return to normalcy during the first three years of the pandemic.</div></div><div><h3>Method</h3><div>We constructed comprehensive and unique time-to-event panel data that tracks the timeline of all policy implementations, and transmission waves, specifically measuring the duration from peak transmission to the desired suppression level, over 157 weeks. We then conducted a survival analysis to estimate the effectiveness of COVID-19 response policies in relation to the virus transmission dynamics. Our analysis focuses on the ten most populous U.S. states, representing diverse geographic, cultural, and political landscapes across the country. The survival analysis leverages the extensive time-to-event panel data collected from multiple sources.</div></div><div><h3>Results</h3><div>Our findings indicate that not all policies were equally effective in facilitating rapid transmission and promoting swift suppression return to normalcy. Containment or closure policies, such as school closures and stay-at-home orders, are associated with a shorter duration for returning to normalcy, highlighting their effectiveness in curbing COVID-19 transmission. In contrast, health system policies and vaccine policies showed mixed results.</div></div><div><h3>Conclusion</h3><div>The findings from our survival analysis of the novel data set provide practical insights for prioritizing policy measures among various options to effectively and timely suppress the transmission of highly contagious diseases. These insights can also enhance resource utilization and allocation within and across public health systems, while minimizing restrictions on people’s daily lives.</div></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"8 ","pages":"Article 100140"},"PeriodicalIF":1.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704157","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":"Public-Private partnership (PPP) and health service delivery in Malawi: The case of Christian Health Association of Malawi (CHAM) facilities in Mzimba district","authors":"Chisomo Salangwa ,&nbsp;Reston Munthali ,&nbsp;Lusungu Mfune ,&nbsp;Vegha Kaunga Nyirenda","doi":"10.1016/j.hpopen.2025.100139","DOIUrl":"10.1016/j.hpopen.2025.100139","url":null,"abstract":"<div><h3>Background</h3><div>PPPs are crucial in addressing healthcare challenges in Malawi, a low-income country. These partnerships, including those with CHAM, help improve access to health services by complementing the public sector, especially in areas with inadequate infrastructure and limited healthcare resources.</div></div><div><h3>Method</h3><div>This study employed qualitative methods, including interviews, focus groups, and document analysis, to investigate the impact of PPP on healthcare infrastructure and access. Purposive and snowball sampling selected 30 interviewees and 20 focus groups. Thematic analysis revealed insights into PPP dynamics, resource allocation, stakeholder interactions, and socio-economic factors in healthcare.</div></div><div><h3>Results</h3><div>Government officials recognise PPPs’ positive impact on healthcare access, especially in rural areas, but raise concerns about sustainability due to policy inconsistencies, financial instability, and service duplication. CHAM and district health professionals highlight delayed payments, cost management, and infrastructure issues. While PPPs increase healthcare utilisation, challenges like drug shortages, staff shortages, and financial strain threaten long-term sustainability without better coordination.</div></div><div><h3>Conclusion</h3><div>This study explores PPPs in Malawi’s health sector, focusing on healthcare quality, efficiency, equity, and access. It identifies challenges like mistrust, misaligned incentives, data inflation, contract renegotiations, staffing shortages, and infrastructure issues. The study emphasises improving transparency, aligning incentives, and addressing sustainability through better resource management and financing.</div></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"8 ","pages":"Article 100139"},"PeriodicalIF":1.7,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696788","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":"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}