Global Health Research and Policy最新文献

{"title":"Development of the China's list of ambulatory care sensitive conditions (ACSCs): a study protocol.","authors":"Jianjian Wang, Dong Roman Xu, Yan Zhang, Hongqiao Fu, Sijiu Wang, Ke Ju, Chu Chen, Lian Yang, Weiyan Jian, Lei Chen, Xiaoyang Liao, Yue Xiao, Ruixian Wu, Mihajlo Jakovljevic, Yaolong Chen, Jay Pan","doi":"10.1186/s41256-024-00350-5","DOIUrl":"10.1186/s41256-024-00350-5","url":null,"abstract":"<p><strong>Background: </strong>The hospitalization rate of ambulatory care sensitive conditions (ACSCs) has been recognized as an essential indicator reflective of the overall performance of healthcare system. At present, ACSCs has been widely used in practice and research to evaluate health service quality and efficiency worldwide. The definition of ACSCs varies across countries due to different challenges posed on healthcare systems. However, China does not have its own list of ACSCs. The study aims to develop a list to meet health system monitoring, reporting and evaluation needs in China.</p><p><strong>Methods: </strong>To develop the list, we will combine the best methodological evidence available with real-world evidence, adopt a systematic and rigorous process and absorb multidisciplinary expertise. Specific steps include: (1) establishment of working groups; (2) generations of the initial list (review of already published lists, semi-structured interviews, calculations of hospitalization rate); (3) optimization of the list (evidence evaluation, Delphi consensus survey); and (4) approval of a final version of China's ACSCs list. Within each step of the process, we will calculate frequencies and proportions, use descriptive analysis to summarize and draw conclusions, discuss the results, draft a report, and refine the list.</p><p><strong>Discussion: </strong>Once completed, China's list of ACSCs can be used to comprehensively evaluate the current situation and performance of health services, identify flaws and deficiencies embedded in the healthcare system to provide evidence-based implications to inform decision-makings towards the optimization of China's healthcare system. The experiences might be broadly applicable and serve the purpose of being a prime example for nations with similar conditions.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"9 1","pages":"11"},"PeriodicalIF":4.0,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10949688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Government responses to the COVID-19 pandemic of the Gulf Cooperation Council countries: good practices and lessons for future preparedness.","authors":"Shu Chen, Lei Guo, Yewei Xie, Di Dong, Rana Saber, Mohammed Alluhidan, Adwa Alamri, Abdulrahman Alfaisal, Nahar Alazemi, Yahya M Al-Farsi, Yazid A Al Ohaly, Yi Zhang, Severin Rakic, Mariam Hamza, Christopher H Herbst, Shenglan Tang","doi":"10.1186/s41256-024-00349-y","DOIUrl":"10.1186/s41256-024-00349-y","url":null,"abstract":"<p><p>The COVID-19 pandemic has dramatically threatened the Gulf Cooperation Council (GCC) countries which have a large proportion of foreign workers. The governments of GCC countries have proactively implemented a comprehensive set of policy measures, and up to our knowledge, a systematic analysis of qualitative and quantitative evidence on the government response is still lacking. We summarized the GCC countries' government response and quantitatively measured that response using four indexes-the Government Response Index, the Stringency Index, the Vaccine Index, and the Initial Response Index, to analyse their response for future pandemic preparedness. Overall, the government response of all the GCC countries to the COVID-19 pandemic has been comprehensive, stringent, and timely. Notably, the GCC countries have implemented comprehensive vaccine policies. In addition, they have worked actively to protect foreign workers to improve their access to health services and secure their essential living conditions, regardless of their immigrant status. All the GCC countries dynamically adjusted their response to the evolving COVID-19 epidemiological burden and started to relax the stringency of the control policies after the Omicron wave, though the governments had different response magnitudes as measured by the four indexes. These findings have provided several important lessons for future pandemic response and preparedness for countries with similar economic, demographic, and health contexts in (1) prompt actions of containment and closure policies with dynamic adjusting, (2) strengthening health system policies, (3) comprehensive vaccination policies with universal access, (4) equitable and free access to testing, diagnosis, and treatment for all, and (5) strengthening the resilience of health systems.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"9 1","pages":"10"},"PeriodicalIF":4.0,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10941437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of pre-migration socioeconomic status and post-migration mental health in Syrian refugees in Lebanon: a descriptive sex-stratified cross-sectional analysis.","authors":"Saskia Lange, Toivo Glatz, Andreas Halgreen Eiset","doi":"10.1186/s41256-024-00347-0","DOIUrl":"10.1186/s41256-024-00347-0","url":null,"abstract":"<p><strong>Background: </strong>Refugee populations present with high levels of psychological distress, which may vary among sociodemographic characteristics. Understanding the distribution across these characteristics is crucial to subsequently provide more tailored support to the most affected according to their specific healthcare needs. This study therefore seeks to investigate the association between pre-migration socioeconomic status (SES) and post-migration mental health separately for male and female Syrian refugees in Lebanon.</p><p><strong>Methods: </strong>In a cross-sectional study, a cluster randomized sample of 599 refugees from Syria were recruited between 2016 and 2019 within 12 months after they fled to Lebanon. Logistic regression was used to determine the association between self-reported pre-migration SES and levels of anxiety and depressive symptoms assessed on the Hopkins Symptoms Checklist-25 (HSCL-25) scale, both for the entire sample and stratified by sex. To assess the informative value of self-reported SES, its correlation with education variables was tested. All analyses were conducted in R version 4.3.</p><p><strong>Results: </strong>Using complete cases, 457 participants (322 female, 135 male) were included in the analyses. Females showed on average more symptoms of anxiety (Median: 2.5) and depression (Median: 2.4) than males (Median: 2.10 and 2.07, respectively). Below average SES was associated with significantly higher odds for mental illness compared to average SES (anxiety: OR 4.28, 95% CI [2.16, 9.49]; depression: OR 1.85, 95% CI [1.06, 3.36]). For anxiety, differences between SES strata were larger for males than females. The self-reported SES measure showed only a weak positive correlation with education.</p><p><strong>Conclusions: </strong>This study adds additional descriptive data highlighting mental health differences in Syrian refugees in Lebanon, whereby below average SES is associated with worse mental health outcomes compared to average SES. These findings demand further research into the underlying mechanisms. Improving our understanding of the observed differences will provide valuable insights that can contribute to the future development of targeted measures.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"9 1","pages":"9"},"PeriodicalIF":4.0,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10910804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access, interest and equity considerations for virtual global health activities during the COVID-19 pandemic: a cross-sectional study.","authors":"Lisa Umphrey, Alyssa Beck, Shuo Zhou, Enid Kawala Kagoya, George Paasi, Alexandra Coria, Jessica Evert, Marina Haque, Amy Rule, Molly M Lamb","doi":"10.1186/s41256-023-00333-y","DOIUrl":"10.1186/s41256-023-00333-y","url":null,"abstract":"<p><strong>Background: </strong>Global health activities (GHAs) reduce health disparities by promoting medical education, professional development, and resource sharing between high- and low- to middle-income countries (HICs and LMICs). Virtual global health activities facilitated continuity and bidirectionality in global health during the COVID-19 pandemic. While virtual engagement holds potential for promoting equity within partnerships, research on equitable access to and interest in virtual global health activities is limited.</p><p><strong>Methods: </strong>We conducted a cross-sectional, online, mixed-methods survey from January to February 2022 examining access to virtual activities before and during the pandemic across resource settings. Eligible participants were participants or facilitators of global health activities. Closed- and open-ended questions elicited participants' access to and interest in virtual global health engagement.</p><p><strong>Results: </strong>We analyzed 265 surveys from respondents in 45 countries (43.0% LMIC vs. HIC 57.0%). HIC respondents tended to report greater loss of in-person access due to the pandemic at their own institutions (16 of 17 queried GHAs), while LMIC respondents tended to report greater loss of in-person activities at another institution (9 of 17 queried GHAs). Respondents from LMICs were more likely to gain virtual access through another organization for all 17 queried VGHAs. HIC respondents had significantly more access to global health funding through their own organization (p < 0.01) and more flexibility for using funds. There were significant differences and trends between respondent groups in different resource environments in terms of accessibility to and interest in different virtual global health activities, both during and after the pandemic.</p><p><strong>Conclusions: </strong>Our results highlight the need to examine accessibility to virtual global health activities within partnerships between high- and low- to middle-income countries. While virtual activities may bridge existing gaps in global health education and partnerships, further study on priorities and agenda setting for such initiatives, with special attention to power dynamics and structural barriers, are necessary to ensure meaningful virtual global health engagement moving forward.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"9 1","pages":"8"},"PeriodicalIF":4.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10845763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development assistance, donor-recipient dynamic, and domestic policy: a case study of two health interventions supported by World Bank-UK and Global Fund in China.","authors":"Aidan Huang, Yingxi Zhao, Chunkai Cao, Mohan Lyu, Kun Tang","doi":"10.1186/s41256-024-00344-3","DOIUrl":"10.1186/s41256-024-00344-3","url":null,"abstract":"<p><strong>Background: </strong>This study views sustainability after the exit of development assistance for health (DAH) as a shared responsibility between donors and recipients and sees transitioning DAH-supported interventions into domestic health policy as a pathway to this sustainability. It aims to uncover and understand the reemergent aspects of the donor-recipient dynamic in DAH and how they contribute to formulating domestic health policy and post-DAH sustainability.</p><p><strong>Methods: </strong>We conducted a case study on two DAH-supported interventions: medical financial assistance in the Basic Health Services Project supported by the World Bank and UK (1998-2007) and civil society engagement in the HIV/AIDS Rolling Continuation Channel supported by the Global Fund (2010-2013) in China. From December 2021 to December 2022, we analyzed 129 documents and interviewed 46 key informants. Our data collection and coding were guided by a conceptual framework based on Walt and Gilson's health policy analysis model and the World Health Organization's health system building blocks. We used process tracing for analysis.</p><p><strong>Results: </strong>According to the collected data, our case study identified three reemergent, interrelated aspects of donor-recipient dynamics: different preferences and compromise, partnership dialogues, and responsiveness to the changing context. In the case of medical financial assistance, the dynamic was characterized by long-term commitment to addressing local needs, on-site mutual learning and understanding, and local expertise cultivation and knowledge generation, enabling proactive responses to the changing context. In contrast, the dynamic in the case of HIV/AIDS civil society engagement marginalized genuine civil society engagement, lacked sufficient dialogue, and exhibited a passive response to the context. These differences led to varying outcomes in transnational policy diffusion and sustainability of DAH-supported interventions between the cases.</p><p><strong>Conclusions: </strong>Given the similarities in potential alternative factors observed in the two cases, we emphasize the significance of the donor-recipient dynamic in transnational policy diffusion through DAH. The study implies that achieving post-DAH sustainability requires a balance between donor priorities and recipient ownership to address local needs, partnership dialogues for mutual understanding and learning, and collaborative international-domestic expert partnerships to identify and respond to contextual enablers and barriers.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"9 1","pages":"7"},"PeriodicalIF":4.0,"publicationDate":"2024-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10838425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139681927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of social networks on HIV risk behaviors among Vietnamese female sex workers: a qualitative study.","authors":"LongHui Zhou, Yi Liu, Dan Liu, ChenChang Xiao, JiaYu Li, MengXi Zhai, Xin Liu, Bin Yu, Hong Yan","doi":"10.1186/s41256-024-00346-1","DOIUrl":"10.1186/s41256-024-00346-1","url":null,"abstract":"<p><strong>Introduction: </strong>Female sex workers (FSWs) experience heightened vulnerability to HIV and other health harms, and cross-border FSWs face additional challenges due to language issues, higher mobility, and weaker negotiation skills. Given the critical role of social network factors in HIV transmission, it is imperative to explore the social network characteristics of Vietnamese cross-border FSWs in China to enhance AIDS prevention and control.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with 22 Vietnamese FSWs in Hekou County, Yunnan Province from May to July 2018. The samples were selected using a purposive sampling strategy and stopped when reached theoretical saturation. Data collection and analysis were conducted iteratively to identify themes within the data. Participants reported their social relationships and how these relationships affected their HIV risk behaviours. All the interviews were recorded, transcribed verbatim, and reviewed. Thematic analysis was used to analyse the data.</p><p><strong>Results: </strong>Among 22 Vietnamese FSWs, the median age was 23.5. Concerning social networks, interviews revealed that their social networks were composed of three components: Workplace networks (customer, boss, colleague), Hometown networks (spouse or boyfriend, family member, fellow villager), and Social institutions networks (Chinese social institutions network, Vietnamese social institutions network). None of these networks can simply support or hinder Vietnamese FSWs' preventive high-risk HIV behaviours, and the impact is achieved through each network's ways. Within the workplace network, the predominant influence is the ascendancy-submissiveness dynamic that exists among customers, bosses, and VFSWs. In the hometown network, familial responsibilities emerge as the principal factor impacting VFSWs. Meanwhile, within the social institution network, pivotal roles are played by the Chinese CDC and the Vietnamese government in the dissemination of HIV knowledge.</p><p><strong>Conclusions: </strong>The social networks of Vietnamese female sex workers exert a dual impact on high-risk HIV behaviors. Interventions should be designed and tailored to address the specific contextual factors and challenges associated with social networks among cross-border FSWs in China and other similar settings.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"9 1","pages":"6"},"PeriodicalIF":4.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10804538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139543510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the impact of comorbid type 2 diabetes mellitus on the disease burden of chronic hepatitis B virus infection and its complications in China from 2006 to 2030: a modeling study.","authors":"Jinzhao Xie, Xu Wang, Xinran Wang, Jinghua Li, Yusheng Jie, Yuantao Hao, Jing Gu","doi":"10.1186/s41256-024-00345-2","DOIUrl":"10.1186/s41256-024-00345-2","url":null,"abstract":"<p><strong>Background: </strong>China bears a high burden of both hepatitis B virus (HBV) infection and type 2 diabetes mellitus (T2DM). T2DM accelerates the progression of liver disease among individuals infected with HBV. This study aims to assess the excess disease burden caused by comorbid T2DM among HBV-infected individuals in China.</p><p><strong>Methods: </strong>We estimated the disease burden of HBV and its complications in China from 2006 to 2030 using individual-based Markov models. The baseline population consisted of 93 million HBV-infected individuals derived from the 2006 National Serological Epidemiological Survey. We developed two models: one incorporated the impact of T2DM on the disease progression of HBV infection, while the other did not consider the impact of T2DM. By comparing the outcomes between these two models, we estimated the excess disease burden attributable to comorbid T2DM among HBV-infected individuals.</p><p><strong>Results: </strong>The incidence of severe HBV complications, including cirrhosis, hepatocellular carcinoma (HCC), and liver-related deaths, exhibited an increasing trend from 2006 to 2030 among the Chinese HBV-infected population. Comorbid T2DM increased the annual incidence and cumulative cases of severe HBV complications. From 2006 to 2022, comorbid T2DM caused 791,000 (11.41%), 244,000 (9.27%), 377,000 (8.78%), and 796,000 (12.19%) excess cases of compensated cirrhosis, decompensated cirrhosis, HCC, and liver-related deaths, respectively. From 2023 to 2030, comorbid T2DM is projected to result in an 8.69% excess in severe HBV complications and an 8.95% increase in liver-related deaths. Among individuals aged 60 and older at baseline, comorbid T2DM led to a 21.68% excess in severe HBV complications and a 28.70% increase in liver-related deaths from 2006 to 2022, with projections indicating a further 20.76% increase in severe HBV complications and an 18.31% rise in liver-related deaths over the next seven years.</p><p><strong>Conclusions: </strong>Comorbid T2DM imposes a substantial disease burden on individuals with HBV infection in China. Healthcare providers and health policymakers should develop and implement tailored strategies for the effective management and control of T2DM in individuals with HBV infection.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"9 1","pages":"5"},"PeriodicalIF":4.0,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10801935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139513918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping of health technology assessment in China: a comparative study between 2016 and 2021.","authors":"Shimeng Liu, Yu Xia, Yi Yang, Jian Ming, Hui Sun, Yan Wei, Yingyao Chen","doi":"10.1186/s41256-023-00339-6","DOIUrl":"10.1186/s41256-023-00339-6","url":null,"abstract":"<p><strong>Background: </strong>Health Technology Assessment (HTA) in China has recently expanded from purely academic research to include policy or decision-oriented practice, especially after HTA evidence was used to update the National Reimbursement Drug List for the first time in 2017. This study aims to identify the progress and challenges of HTA development from 2016 to 2021 and inform policies and decisions to promote further HTA development in China.</p><p><strong>Methods: </strong>We conducted a cross-sectional web-based survey with policy makers, researchers and industry-providers in China in 2016 and 2021 respectively. The 'Mapping of HTA Instrument', was utilized to assess the HTA development across eight domains: Institutionalization, Identification, Priority setting, Assessment, Appraisal, Reporting, Dissemination of findings and conclusions, and Implementation in policy and practice. To reduce the influence of confounders and compare the mapping outcomes between the 2016 and 2021 groups, we conducted 1:1 Propensity Score Matching (PSM). Univariate analysis was conducted to compare the differences between the two groups. The overall results were further compared with those of a mapping study that included ten countries.</p><p><strong>Results: </strong>In total, 212 and 255 respondents completed the survey in 2016 and 2021, respectively. The total score of the HTA development level in China in 2021 was higher than that in 2016 before PSM (89.38 versus 83.96). Following PSM, 183 respondents from the 2016 and 2021 groups were matched. Overall, the mean scores for most indicators in the Institutionalization domain and Dissemination domain in 2021 were higher than those in 2016 (P < 0.05). The Appraisal domain in 2021 was more explicit, transparent and replicable than that in 2016 (t = -3.279, P < 0.05). However, the mean scores of most indicators in the Assessment domain were higher in 2016 than those in 2021 (P < 0.05).</p><p><strong>Conclusions: </strong>Our study suggest that the level of HTA development in China progressed significantly from 2016 to 2021. However, before engaging in HTA activities, further efforts are required to enhance the assessment process. For instance, it is important to establish a clear goal and scope for HTA; adapt standardized methodologies for evaluating the performance of systematic reviews or meta-analyses; and provide comprehensive descriptions of the safety, clinical effectiveness, cost, and cost-effectiveness of the assessed technologies, thus improving the development of HTA in China.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"9 1","pages":"4"},"PeriodicalIF":4.0,"publicationDate":"2024-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10790493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139478764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reimagining gendered community interventions: the case of family planning programs in rural Bangladesh.","authors":"Bhanu Bhatia, Sarah Hossain, Upasona Ghosh, Fanny Salignac","doi":"10.1186/s41256-023-00337-8","DOIUrl":"10.1186/s41256-023-00337-8","url":null,"abstract":"<p><p>Family planning programs in Bangladesh have been successfully operating for over half a century, achieving phenomenal reductions in fertility rates. Acknowledging restrictions on women's freedoms, much of the initial program design was concentrated on giving household supplies for women priority. However, one unfortunate impact of these outreach services is that, by bypassing the opportunity to challenge patriarchal attitudes directly, they inadvertently reinforce the power relationships of the status quo. Hence, we problematise the decision-making structures within Bangladesh's family planning programs. We argue that the fundamental flaw with Bangladesh's family planning program is the lack of conscious effort to understand women's health choices and decision-making as a complex contextual process of relational, structural, and institutional forces. Additionally, avoiding men in these programs often creates new dependencies for women, as this approach does not directly seek to build relational bridges based on equality between genders. As a result, many women still depend on permission from their husbands and family for reproductive health services and face constrained family planning choices and access to care. We recommend that family planning programs adopt a broader vision to create new and more sustainable possibilities in an ever-evolving social relations landscape where gender is constantly negotiated. Such strategies are even more pressing in the post-Covid world, as national systems are exposed to uncertainty and ambiguity.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"9 1","pages":"3"},"PeriodicalIF":4.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10788984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139473075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building a resilient health system for universal health coverage and health security: a systematic review.","authors":"Ayal Debie, Adane Nigusie, Dereje Gedle, Resham B Khatri, Yibeltal Assefa","doi":"10.1186/s41256-023-00340-z","DOIUrl":"10.1186/s41256-023-00340-z","url":null,"abstract":"<p><strong>Background: </strong>Resilient health system (RHS) is crucial to achieving universal health coverage (UHC) and health security. However, little is known about strategies towards RHS to improve UHC and health security. This systematic review aims to synthesise the literature to understand approaches to build RHS toward UHC and health security.</p><p><strong>Methods: </strong>A systematic search was conducted including studies published from 01 January 2000 to 31 December 2021. Studies were searched in three databases (PubMed, Embase, and Scopus) using search terms under four domains: resilience, health system, universal health coverage, and health security. We critically appraised articles using Rees and colleagues' quality appraisal checklist to assess the quality of papers. A systematic narrative synthesis was conducted to analyse and synthesise the data using the World Health Organization's health systems building block framework.</p><p><strong>Results: </strong>A total of 57 articles were included in the final review. Context-based redistribution of health workers, task-shifting policy, and results-based health financing policy helped to build RHS. High political commitment, community-based response planning, and multi-sectorial collaboration were critical to realising UHC and health security. On the contrary, lack of access, non-responsive, inequitable healthcare services, poor surveillance, weak leadership, and income inequalities were the constraints to achieving UHC and health security. In addition, the lack of basic healthcare infrastructures, inadequately skilled health workforces, absence of clear government policy, lack of clarity of stakeholder roles, and uneven distribution of health facilities and health workers were the challenges to achieving UHC and health security.</p><p><strong>Conclusions: </strong>Advanced healthcare infrastructures and adequate number of healthcare workers are essential to achieving UHC and health security. However, they are not alone adequate to protect the health system from potential failure. Context-specific redistribution of health workers, task-shifting, result-based health financing policies, and integrated and multi-sectoral approaches, based on the principles of primary health care, are necessary for building RHS toward UHC and health security.</p>","PeriodicalId":52405,"journal":{"name":"Global Health Research and Policy","volume":"9 1","pages":"2"},"PeriodicalIF":4.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139089304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}