International Journal of Health Planning and Management最新文献

{"title":"How Health Systems ‘Software’ Factors Affect Frontline Health Workers' Humanitarian Response Efforts During Infectious Disease Outbreaks in the Rohingya Refugee Camps, Cox's Bazar, Bangladesh","authors":"Georgia Venner,&nbsp;Jennifer Palmer,&nbsp;Tasmia Aksi,&nbsp;Mahima Das Mumu,&nbsp;Mohammed Mirza Nu,&nbsp;Gillian McKay,&nbsp;Mahbub Ur Rahman Ujjal,&nbsp;Bhargavi Rao,&nbsp;Ahmed Hossain,&nbsp;Susannah Mayhew","doi":"10.1002/hpm.70088","DOIUrl":"10.1002/hpm.70088","url":null,"abstract":"<p>Humanitarian settings face a growing healthcare workforce crisis marked by staff shortages, unsafe working conditions, and limited professional development. Despite being critical intermediaries in outbreak responses, demands on health workers come at a substantial cost to their health and wellbeing. Research on health workers responding to the Rohingya refugee crisis in Cox's Bazar, Bangladesh, is limited. Focussing on health systems “software” (relationships between people and structures), this study explores health workers' interactions with different levels of governance structures, including humanitarian response governance, the health sector coordination leadership team, and their affiliated NGO management structures when responding to disease outbreaks in the camps, particularly during COVID-19. Qualitative research consisted of 33 interviews and 4 data validation workshops with frontline health workers, and 13 key informant interviews with humanitarian stakeholders. Health workers' dependence on government camp authorities for their safety and public health enforcement produced complex relationships and sometimes compromised medical practices and professional support. Through the support of the health sector leadership team, infection prevention and control training was perceived as a key strength; however, health workers reported limited inclusion in decision-making and being professionally unprepared during outbreaks. These experiences compounded risks to their mental and physical health, and they reported receiving minimal organisational support. These relational and structural tensions undermined worker resilience and patient-provider trust. The findings underscore the need for outbreak preparedness and strategic reforms in humanitarian decision-making that prioritise health workers' safety, promote inclusiveness in decision-making, and embed sustained professional support in humanitarian health systems for future outbreaks.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"41 4","pages":"740-752"},"PeriodicalIF":2.5,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.70088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decentralisation of the Healthcare Systems and the Functioning of Public Health Programmes in Single-Party States: A Systematic Review","authors":"Phonevilay Viphonephom,&nbsp;Ho Van Hoa,&nbsp;Sengchanh Kounnavong,&nbsp;Daniel Reinharz","doi":"10.1002/hpm.70085","DOIUrl":"10.1002/hpm.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Decentralisation is the transfer of authority from central to local governments, involving shared responsibilities in planning, management, and decision-making. In public health, decentralisation might help improve service delivery by allowing local authorities to tailor interventions to the specific needs of diverse, geographically dispersed communities. However, no systematic review has been done on the state of knowledge regarding the capacity of local governments to influence the emergence and operation of national public health programmes in Marxist-Leninist single-party states.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Following the PRISMA protocol, 859 articles from the PubMed, EMBASE and Web of Science databases were examined. To be selected, studies had to be conducted in a Marxist-Leninist single-party country with a centralised economy and focused on the question of the condition of power sharing between government levels in the design and implementation of specific public health programmes. Only articles in English published between 2013 and 2023 were considered, resulting in 18 studies. Their quality was assessed using the MMAT 2018 and SANRA tools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Limited resources and the Party's fundamental ideology may constrain the extent of power sharing influencing local government empowerment. However, factors such as the Party's local unit engagement, collaboration with external organisations, and use of digital communication platforms enhance the capacity of local government to participate in public health programmes design and execution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite a politically centralising structure, one-party countries can, under certain circumstances, share responsibilities across government levels in order to increase the adequacy of programmes to meet the health needs of the population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"41 4","pages":"768-780"},"PeriodicalIF":2.5,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.70085","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-Stage Evolution of China's Breakthrough Therapy Drug Policy: AI-Driven Quantitative Evidence and Global Implications","authors":"Mingming Zhai,&nbsp;Aiquan Zhang,&nbsp;Xinyu Li,&nbsp;Xiaohui Liu,&nbsp;Ziyi Lu,&nbsp;Xinyuan Zhan,&nbsp;Zhe Huang","doi":"10.1002/hpm.70086","DOIUrl":"10.1002/hpm.70086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Many countries have accelerated the approval of innovative drugs through breakthrough therapy policies to meet public health needs. China needs to optimise its policy system to narrow the gap with international practices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To identify shortcomings in China's breakthrough therapy policies and formulate optimization strategies via quantitative analysis of their dynamic evolution and cross-jurisdictional comparisons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adopting a quantitative design, this study employs AI technologies (LDA topic modelling + time-series deduction), combined with cross-jurisdictional policy element matrix comparison and typical drug case analysis, to systematically analyse the evolutionary path and implementation effects of China's breakthrough therapy drug policies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Quantitative analysis of 59 policy texts (2020–2024) reveals that China's policies have undergone a three-stage evolution: ‘approval-driven (2020–2022)—collaborative transition (2023–2024)—ecological construction (exploratory scenario deduction after 2024)’. The core topics focus on ‘drug review’, ‘industrial innovation’, and ‘medical services’, among which ‘drug review’ and ‘industrial innovation’ form a dual-dominant pattern. However, the persistently low intensity of the ‘medical services’ topic reflects an ecological imbalance of ‘accelerated approval—industrial innovation—lagging accessibility’. Cross-jurisdictional comparisons show gaps in early innovation incentives, international collaboration, and medical support.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Based on the quantitative analysis of policy texts, this study proposes six optimization suggestions. These targeted strategies aim to address the imbalance of ‘fast approval but slow accessibility,’ support the ‘Healthy China 2030’ strategic goal, and provide references for developing countries in balancing resource allocation, accelerating research and development through the integration of artificial intelligence, and avoiding accessibility disparities via risk-sharing mechanisms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"41 4","pages":"753-767"},"PeriodicalIF":2.5,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging Community Drug Outlets for Vaccination Delivery in Tanzania: A Qualitative Study to Inform Future Implementation.","authors":"George Msema Bwire, Goodluck G Nyondo, Tusaligwe Mbilinyi, Renatus B Magati, Mathew Mganga, Arapha B Nshau","doi":"10.1002/hpm.70065","DOIUrl":"10.1002/hpm.70065","url":null,"abstract":"<p><strong>Objective: </strong>A prior pre-implementation survey in Tanzania identified moderate feasibility and low acceptability of integrating vaccination services into community drug outlets (CDOs). The qualitative review was conducted to gain deeper insight into the factors influencing the feasibility and acceptability of integrating vaccination services into CDOs, such as community pharmacies and Accredited Drug Dispensing Outlets (ADDOs).</p><p><strong>Methods: </strong>A descriptive qualitative design was employed as part of an explanatory sequential mixed-methods approach. Interviews were conducted with purposively sampled stakeholders, guided by findings from the prior survey. Interviews were audio-recorded and transcribed verbatim, then thematically analysed using implementation science frameworks, with coding supported by Nvivo software.</p><p><strong>Results: </strong>A total of 17 qualitative interviews were conducted with 46 participants across Dar es Salaam, Pwani, and Dodoma, including community members, health providers, regulators, and supply chain personnel. Six themes emerged: feasibility, acceptability, training, policy, infrastructure, and economics. Community pharmacies were viewed as more feasible and better equipped than ADDOs, which face more severe challenges related to limited space, inadequate cold chain capacity, and insufficient staffing. Acceptability was higher for pharmacies, though both settings (pharmacy and ADDO) require policy, training, and infrastructure improvements.</p><p><strong>Conclusion: </strong>Community pharmacies show greater readiness than ADDOs for vaccine delivery due to better infrastructure, professional staffing, and regulatory alignment. However, both face challenges requiring policy reform, training, and support systems. Future studies should assess operational readiness and develop national standards to guide safe, equitable, and sustainable pharmacy-based immunisation services.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":"440-449"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social and Health Services in the Platform: Developing a Concession Pricing Model for Eldercare Service Platforms.","authors":"Rui Liu, Zeyuan Huang, Jingfeng Yuan, Jianfeng Zhao, Yinhua Shen, Lingzhi Li","doi":"10.1002/hpm.70059","DOIUrl":"10.1002/hpm.70059","url":null,"abstract":"<p><p>As eldercare service platforms (ECSPs) are becoming increasingly popular due to the rapidly ageing population, using only a single pricing strategy has resulted in a mismatch between bilateral users (providers and consumers) in these platforms. To address these challenges, multiple innovative pricing strategies, considering the characteristics of the consumers, service providers, governments, and the private sector should be formulated by governments. Therefore, based on social welfare maximisation, this study develops a concession pricing model for ECSPs that combines different government subsidy methods, platforms' service quality, network externalities, and price elasticity. The results suggest that ECSPs should set a higher price for the group with more significant network externalities and a lower price for the group with more negligible network externalities. The optimal concession price decreases with service quality, while the size of bilateral users increases with service quality. It is further found out that governments should prioritise subsidising eldercare services with a low price elasticity of demand to improve subsidy efficiency, and that their subsidies can expand the size of bilateral users, decrease the concession prices, and improve social welfare. This study contributes to the body of knowledge of public services by proposing a concession pricing model for ECSPs, adding further evidence to the discussion about social and health services in platform. In practice, the findings would be of utmost interest to governments and the private sector that need to make more informed pricing decisions to improve the efficiency of eldercare services provision and maximise platform profit.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":"521-544"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Inequalities in Access to Sexual and Reproductive Healthcare Services for Indigenous Women in Three Latin American Countries.","authors":"Gustavo Nigenda, Clara Juárez-Ramírez, Daniel Maceira, Oswaldo Lazo","doi":"10.1002/hpm.70063","DOIUrl":"10.1002/hpm.70063","url":null,"abstract":"<p><strong>Introduction: </strong>In Latin America, indigenous populations' access to sexual and reproductive health services is burdened by ideological neocolonial practices.</p><p><strong>Methods: </strong>Qualitative information was collected in three Latin American countries regarding barriers to sexual and reproductive healthcare access for indigenous populations. Three types of informants were interviewed: pregnant women, health care providers, and key actors.</p><p><strong>Results: </strong>In the three countries studied, we found some similarities in the social and cultural context of indigenous communities that represent the greatest barriers to guarantee their access to sexual and reproductive healthcare. The similarities revolve around three main themes: roots of inequalities, access to health services, and interculturality.</p><p><strong>Discussion: </strong>The determinants of indigenous women's access to public sexual and reproductive healthcare services in the three countries are articulated in a complex set of factors. Traditional beliefs about pregnancy, delivery care practices, and newborn care differ significantly from the biomedical perspective of healthcare workers. The latter can be understood as a historical mechanism of colonization and allows understanding the conflictive relationship of indigenous groups towards institutional care practices.</p><p><strong>Conclusion: </strong>The knowledge and beliefs of indigenous cultures bolster their own ways of understanding and caring for sexual and reproductive health and need to be respected to provide them with appropriate healthcare suited to their needs.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":"477-489"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146097593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ireland's Future Health and Social Care Workforce Strategy: Technical Maturity, Unfinished Agenda.","authors":"Jim Campbell, Tiago Correia","doi":"10.1002/hpm.70064","DOIUrl":"10.1002/hpm.70064","url":null,"abstract":"","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":"423-425"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Local Responses to Limits on U.S. Public Health Authority During the COVID-19 Emergency.","authors":"Genevive R Meredith, Xue Zhang, Zachary M Batterman, Hannah M Morris, Zhiwei Chen, Mah Liqa, Mildred E Warner","doi":"10.1002/hpm.70062","DOIUrl":"10.1002/hpm.70062","url":null,"abstract":"<p><p>Public health has become politicized in the U.S. Though research shows that limiting public health authority during emergency response puts community wellbeing and health outcomes at risk, during the COVID-19 emergency (2020-2021), some U.S. state policymakers limited the disease-preventing actions local public health agencies could take. This conflicts with public health agencies' mandate to protect lives. Using COVID-19 as a case study, we explored how local public health agencies upheld their mandate when faced with limited public health authority. We conducted qualitative semi-structured focus groups (October 2023) with a purposive sample of U.S. public health officials (n = 14) from seven U.S. states which experienced four types of restrictions on local public health actions (limits on the emergency authority of governor, chief executive, state health officer, and local government health officers). Participants discussed barriers and challenges faced, adaptations made, actions taken, and perspectives for the future. Emergent themes suggest that while limited resources and restricted public health authority caused strain, public health efforts were upheld through cross agency collaboration at the local level which supported innovation. To achieve this, trust-building and communication were vital. Limitations on local public health authority may increase in the U.S. in the coming years. To mitigate risks amidst future public health emergencies, public health leaders must focus on building trust, clear and consistent communication, and bolstering collaborative networks at the local level. The politicization of health policy at the state and federal level also needs to be addressed, as local action can only go so far.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":"450-460"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146067617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges for the Implementation of Artificial Intelligence in Healthcare in Developing Countries: Structural, Ethical and Technological Barriers.","authors":"Adriana Kelly Santana Correa, Lucas Vinícius Souza Santos, Marina Dos Santos Barreto, Allec Yuri Santos Martins, Eloia Emanuelly Dias Silva, Deise Maria Rego Rodrigues Silva, Pedro Henrique Macedo Moura, Ronaldy Santana Santos, Lucas Alves da Mota Santana, Rajiv Gandhi Gopalsamy, Adriana Gibara Guimarães, Lysandro Pinto Borges","doi":"10.1002/hpm.70067","DOIUrl":"10.1002/hpm.70067","url":null,"abstract":"<p><p>Artificial intelligence (AI) has been widely used in the health sector for diagnostic, assistance and guidance purposes. However, its expansion has come up against applicability barriers in underdeveloped countries due to structural, financial and technological limitations encountered within a specific context. With this letter, we draw attention to the challenges of implementing AI in developing countries, suggesting strategies for scientific studies to optimise this.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":"554-556"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146195924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upholding the Principles of Development Effectiveness for Health System Strengthening in the Eastern Mediterranean Region (EMR)-Why It Is Important Now More than Ever.","authors":"John Grundy, Chaudhri Irtaza Ahmad, Arshad Altaf, Thomas S O'Connell, Awad Mataria","doi":"10.1002/hpm.70066","DOIUrl":"10.1002/hpm.70066","url":null,"abstract":"<p><p>The Eastern Mediterranean Region (EMR) of the World Health Organisation (WHO) consists of 22 countries and territories which are exposed to high levels of natural and man-made emergencies, and which have significant gaps in coverage of essential health services. Narrow fiscal space, economic distress, periodic shocks of conflicts, pandemics and natural disasters, and sharp declines in development assistance, are factors contributing to gaps in access to essential health services. The region receives development assistance from a range of development partnerships, which, although contributing to improved programme coverage and disease prevention, has been limited in developing and sustaining longer term health system capabilities. The increasing threats of conflict, pandemics and climate-related natural disasters, as well as the recent sharp downturns in development assistance, builds the case for more effective, efficient and equitable development assistance programming. Development assistance principles of alignment of health partnerships with sector priorities and building of country systems provide opportunities to sustainably address chronic health coverage and equity challenges, improve the capability of health systems to withstand periodic shocks, and sustain health programme improvements over longer time frames. In this paper, we describe how these principles are being applied in the region through country health compacts for universal health coverage, country and regional coordination models, and implementation of monitoring and evaluation of development effectiveness. Given the rapidly changing development landscape, application of development effectiveness principles provides opportunities to strengthen health systems, safeguard health security, and progress towards universal health coverage.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":"545-553"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}