{"title":"Complaints about Violations of Voluntary and Pharmaceutical Industry-Run Medicine Promotion Codes in Canada.","authors":"Joel Lexchin","doi":"10.1177/27551938231165158","DOIUrl":"10.1177/27551938231165158","url":null,"abstract":"<p><p>Although regulation of pharmaceutical promotion in Canada is covered under the Food & Drugs Act and Regulations, in practice it is regulated by two codes, one a code administered by the Pharmaceutical Advertising Advisory Board and a second one controlled by Innovative Medicines Canada, the lobby organization for the large majority of the Canadian and foreign-owned pharmaceutical companies operating in Canada. This study examines complaints about code violations between 2012 and 2021 and puts those complaints and their outcomes into the context of the stringency of the codes, their governance, monitoring, penalties for violations, and compliance by companies. It combines the findings from this analysis with international experience with industry-run codes and concludes that overall, the Canadian codes are ineffective in controlling promotion. Finally, it offers recommendations for how regulation can be improved and how doctors' reliance on information from pharmaceutical companies can be reduced.</p>","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"518-527"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10631264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9139533","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 COVID-19 Pandemic and the Private Health Sector: Profiting without Socially Contributing.","authors":"Elias Kondilis, Alexis Benos","doi":"10.1177/27551938231201070","DOIUrl":"10.1177/27551938231201070","url":null,"abstract":"<p><p>The COVID-19 pandemic necessitated the mobilization of all available health care resources, including private, for-profit ones. The aim of this multiple methods study (combination of document and secondary data analysis) was to assess government regulations facilitating the private health sector's participation in the COVID-19 response in Greece. During the pandemic, the government made three successive increases in private providers' reimbursement fees, provided additional financial incentives to private providers, and allocated €280 million of emergency funding for the private sector's involvement in the national COVID-19 response. In response, private hospitals made available on average 2.2% of their total bed capacity per epidemic wave for the treatment of COVID-19 patients and 1.7% of their total bed capacity for the treatment of non-COVID-19 patients transferred from National Health System (NHS) hospitals. In 2020 the five largest health care corporate groups maintained their revenues, while in 2021 they increased them by 18.7%-a striking comparison with the 9% recession experienced by the Greek economy in 2020 and its 8.4% recovery in 2021. In a time of an acute public health crisis, private health care providers responded to society's pressing health care needs by insulating their facilities from COVID-19 patients and NHS patient transfers, minimizing their social contribution and safeguarding their revenues and profits.</p>","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"466-477"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10180100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Rethinking and Decolonizing Theories, Policies, and Practice of Health from the Global South.","authors":"Oscar Feo Istúriz, Gonzalo Basile, Neil Maizlish","doi":"10.1177/27551938231199325","DOIUrl":"10.1177/27551938231199325","url":null,"abstract":"<p><p>This article states the need to decolonize the theories, policies, and practices that dominate health, and reflects on the necessity for a new epistemology built from the Global South. This allows rethinking health with a new categorical framework, which incorporates socially determined health and life, with the optic of reaching the highest conceivable degree of living well/well-living. We put forth that the epistemic bases of epidemiology and the implementation of health systems tend to reproduce a coloniality of power and of established health knowledge. Health systems are viewed as an accumulation of reforms based on theories and policies of the Global North imposed on Latin America and the Caribbean. These systems have been built as bureaucratic, biomedicalized, treatment-oriented, and commercialized health systems that are perceived as external to societies and that reproduce mistreatment, violence, and racism. We make the argument to rethink, remake, and decolonize the theories and practices that govern both epidemiology and health systems, and, from the South, develop strategic processes for building health sovereignty as the vision for the reconstruction of hope and social justice.</p>","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"392-402"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10213942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Looking Beyond the Lamp Post: Health Inequality in the Times of COVID-19.","authors":"Vijay Kumar Yadavendu","doi":"10.1177/27551938231189203","DOIUrl":"10.1177/27551938231189203","url":null,"abstract":"<p><p>In times of a pandemic, the world lives in the throes of colossal economic and public health crises. The world seems unprepared and ill-equipped to cater to the catastrophic pandemic of COVID-19. The apocalyptic infectious diseases keep revisiting to expose the global widening economic and health inequalities. This review in its different sections argues that with the \"financialization of everything,\" a new consciousness comprising a more general heightened sense of awareness and interest in personal health and well-being pervades whereby citizens become customers. This effectively forefends the dynamics of interaction between the individual and her/his environment with its consequent impact on health and promotes an individuated risk and responsibility. Even in times of a pandemic, draconian state surveillance, lockdown, behavior modification, self-help, and self-care have emerged as guiding principles of public health. There is an urgent need for a radical reordering of the world order beyond the hegemonic, neoliberal, capitalistic ethos of rabid consumerism and unconstrained private profit.</p>","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"478-487"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10372503/pdf/10.1177_27551938231189203.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10240491","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":"Mental Health Services in Colombia: A National Implementation Study.","authors":"Felipe Agudelo-Hernández, Rodrigo Rojas-Andrade","doi":"10.1177/27551938231156023","DOIUrl":"10.1177/27551938231156023","url":null,"abstract":"<p><p>Laws in Latin American countries are based on scientific evidence that calls for mental health services to move to the community. These care modalities have implementation problems. The objective of this article is to describe the implementation of the services proposed in Law 1616 of 2013 of Colombia (Mental Health Law): emergencies, hospitalization, community-based rehabilitation, pre-hospital care, day hospital for children and adults, Drug Addiction Care Center, groups support and mutual aid, telemedicine, and home and outpatient care. We used a mixed study, with a cross-sectional descriptive quantitative component, where an instrument was used to determine the level of implementation of these services, consisting of a scale that established the availability and use of these services, in addition to the climate of implementation of the services and community mental health strategies, in addition to a qualitative determination of barriers and facilitators of implementation. We found a low availability of all services in departments such as Amazonas, Vaupés, Putumayo, and Meta and an implementation of services in Bogotá and Caldas. The least implemented services are the community ones, and those with the greatest presence at the territorial level are emergencies and hospitalization. We conclude that low- and middle-income countries have few community models and invest a large part of their technical and economic effort in emergencies and hospitalization. There are difficulties in the implementation of most of the services proposed by Colombian legislation related to mental health.</p>","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"424-433"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9101292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Healthcare Financing in Nigeria: A Policy Review.","authors":"Alpha Chiemezie Madu, Katy Osborne","doi":"10.1177/27551938231173611","DOIUrl":"10.1177/27551938231173611","url":null,"abstract":"<p><p>A good health financing system is crucial for the effective performance of a country's health system. Many health systems around the world, especially in lower- and middle-income countries such as Nigeria, grapple with perennial challenges such as chronic underfunding, wastefulness, and lack of accountability rendering these systems inefficient. Nigeria's health system faces additional extraneous challenges such as a huge and rapidly growing population, a stagnant economy, and worsening insecurity of lives and property. Furthermore, recent disease outbreaks such as the Ebola epidemic and the COVID-19 pandemic and an evolving disease demography evidenced by an increasing prevalence of chronic, noncommunicable diseases asphyxiate an already floundering health system. To address these challenges and to bolster its efforts in attaining universal health coverage (UHC) and meeting the targets of the Sustainable Development Goals, the Nigerian government launched a new health policy in 2017. A review of the health financing section of this policy shows a focus on improving funding for health care by all levels of government and guaranteeing affordable and equitable access to health services by all Nigerians, albeit with insufficient clarity on how these will be achieved. A more critical review of the country's health financing system also reveals deep-seated systemic issues. Its out-of-pocket payments for funding health care are among the highest in the world, with abysmally low government contributions to health. Successive governments seem to lack the political will to address these shortfalls. Critical gaps exist in the country's health laws, making it difficult to implement the strategies proposed in the new policy. Nigeria must strengthen its health laws to, among other things, mandate health insurance and provide adequate funding for the health system by the government. It should also formulate a dedicated, more precise health financing policy with specific, measurable aims targeting identified problems to enable it to attain universal health coverage.</p>","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"434-443"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9470123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Optimizing Physician Payment for a Single-Payer Healthcare System.","authors":"Stephen B Kemble, James G Kahn","doi":"10.1177/27551938231176358","DOIUrl":"10.1177/27551938231176358","url":null,"abstract":"<p><p>Current forms of payment of independent physicians in U.S. health care may incentivize more care (fee-for-service) or less care (capitation), be inequitable across specialties (resource-based relative value scale [RBRVS]), and distract from clinical care (value-based payments [VBP]). Alternative systems should be considered as part of health care financing reform. We propose a \"Fee-for-Time\" approach that would pay independent physicians using an hourly rate based on years of necessary training applied to time for service delivery and documentation. RBRVS overvalues procedures and undervalues cognitive services. VBP shifts insurance risk onto physicians, introducing incentives to game performance metrics and to avoid potentially expensive patients. The administrative requirements of current payment methods introduce large administrative costs and undermine physician motivation and morale. We describe a Fee-for-Time payment scenario. A combination of single-payer financing and payment of independent physicians using the Fee-for-Time proposal would be simpler, more objective, incentive-neutral, fairer, less easily gamed, and less expensive to administer than any system with physician payment based on fee-for-service using RBRVS and VBP.</p>","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"543-547"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9517714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ijeoma C Uzoho, Kesha Baptiste-Roberts, Adeola Animasahun, Yvonne Bronner
{"title":"The Impact of COVID-19 Pandemic on Intimate Partner Violence (IPV) Against Women.","authors":"Ijeoma C Uzoho, Kesha Baptiste-Roberts, Adeola Animasahun, Yvonne Bronner","doi":"10.1177/27551938231185968","DOIUrl":"10.1177/27551938231185968","url":null,"abstract":"<p><p>Intimate partner violence (IPV) is a global public health crisis associated with adverse physical, psychological, economic, and social consequences. Studies on the impact of COVID-19 on IPV against women are scarce. This study aimed to understand the impact of COVID-19 on IPV against women. Google Scholar, PubMed, and the Cochrane Library were searched using the MeSH terms intimate partner violence, COVID-19, and women. Exclusion criteria were male-partner, elder, and child abuse and studies that targeted specific groups such as cancer, HIV, and substance abuse. Two independent reviewers completed the title, abstract screening, and review of selected articles. Thirteen out of 647 articles met the inclusion criteria. IPV against women increased in nine countries (Spain, United States, Nigeria, Ethiopia, Turkey, Peru, Bangladesh, Czech Republic, and the Democratic Republic of Congo); one country showed no change in gender-based violence among adolescent girls and young women (Kenya); and one study reported a decrease in IPV reporting by victims (United States). Policies made to mitigate the pandemic created unintended consequences that exacerbated risk factors for IPV against women. Lessons learned from COVID-19 must be used to develop policy-level support and response services to mitigate IPV against women amid a pandemic and other human crises.</p>","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"494-507"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10631266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10082470","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":"Medicines for the People, not the Financial Markets.","authors":"Beat Ringger","doi":"10.1177/27551938231189358","DOIUrl":"10.1177/27551938231189358","url":null,"abstract":"<p><p>Drug company marketing scandals have often made headlines. However, in recent years, a raft of new pharmaceutical industry transgressions has created crises for health care systems of high-income countries as well as poorer nations. Prices of life-saving drugs are soaring; supply shortfalls of essential medications have become common; development of new antibiotics against resistant organisms is lagging; and inequalities in access to medicines are widening. Policymakers must find new solutions to protect health systems and health.</p>","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"539-542"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9914196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Examining the Effectiveness of Financial Protection Schemes in Reducing Health Inequality.","authors":"Shakeel Ahmed, Sandhya R Mahapatro","doi":"10.1177/27551938231179046","DOIUrl":"10.1177/27551938231179046","url":null,"abstract":"<p><p>Health protection schemes such as health insurance and financial assistance provide immense help and support to access health care services, especially to the poor and marginalized section of society. India is witness to low health-related expenditure, and the society's socioeconomic and demographic structure further drops health care access to the new bottom. Consequently, inequality in health care access is highly observed across many socioeconomic attributes. The condition of Bihar, the poorest state of India, is more alarming. The analysis suggests that financial support in terms of universal health insurance coverage considerably reduces out-of-pocket expenditure and thus health inequality. Further, the low health insurance coverage is not solely due to a lack of institutional commitment and implementation process; the cognitive behavior and attitude of people are equally responsible for low health care access. An intensive awareness program to show the benefit of the health insurance scheme and sensitization of people against the social stigma is important to provide better health care access and reduce health inequality.</p>","PeriodicalId":73479,"journal":{"name":"International journal of social determinants of health and health services","volume":" ","pages":"444-454"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9929538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}