A Ghost in the Machine? Politics in Global Health Policy
Carlos
Bruen
Department of Epidemiology & Public Health Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
author
Ruairí
Brugha
Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
author
text
article
2014
eng
Members of the 67th World Health Assembly in 2014 were presented with a framework document to guide World Health Organization (WHO) engagement with non-state actors, a key part of WHO reform kick-started in 2011. According to this document, non-state actors include four distinct constituencies: i) nongovernmental organizations (NGOs), ii) private sector entities; iii) philanthropic foundations; iv) academic institutions (1).
International Journal of Health Policy and Management
Kerman University of Medical Sciences
2322-5939
3
v.
1
no.
2014
1
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https://www.ijhpm.com/article_2859_8d336c19f925a9eb8690a970110f9487.pdf
dx.doi.org/10.15171/ijhpm.2014.59
Core Attributes of Stewardship; Foundation of Sound Health System
Neelesh
Kapoor
Sub Regional Team Leader (NPSP-WHO), II Floor, Maternity Home, Peli Colony,
Aishbagh, Lucknow (Uttar Pradesh), India
author
Dewesh
Kumar
Department of Community Medicine
and Family Medicine, All India Institute of Medical Sciences, Basni-II, Jodhpur
(Rajasthan), India
author
Nivedita
Thakur
Apollo Hospital, Sector-26, Noida (Uttar Pradesh), India
author
text
article
2014
eng
Stewardship is not a new concept for public policy, but has not been used to its optimum by the health policy-makers. Although it is being practiced in most successful models of health system, but the onus to this function is still due till date. Lately, few experts in World Health Organization (WHO) have realized its importance and have been raising the issue at different platforms to pursue the most important function of the health system i.e. stewardship. These core attributes of stewardship need to be understood in totality for better understanding of the concept. The core attributes required for hassle free functioning of a health system include responsible manager, political will, normative dimension, balanced interventionist and proponents of good governance.
International Journal of Health Policy and Management
Kerman University of Medical Sciences
2322-5939
3
v.
1
no.
2014
5
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https://www.ijhpm.com/article_2848_652ef609551e287a9c451eddf98c6b76.pdf
dx.doi.org/10.15171/ijhpm.2014.52
Globalization and the Diffusion of Ideas: Why We Should Acknowledge the Roots of Mainstream Ideas in Global Health
Emilie
Robert
University of Montreal Hospital Centre-Research Centre (CR-CHUM), University
of Montréal, Montreal, Quebec, Canada
author
Mohammad
Hajizadeh
Institute for Health and Social Policy,
McGill University, Montreal, Quebec, Canada
author
Rowan
El-Bialy
Division of Community Health
and Humanities, Faculty of Medicine, Memorial University of Newfoundland,
St. John’s, Newfoundland and Labrador, Canada
author
Sayema
Bidisha
Department of Economics,
University of Dhaka, Dhaka, Bangladesh
author
text
article
2014
eng
Although globalization has created ample opportunities and spaces to share experiences and information, the diffusion of ideas, especially in global health, is primarily influenced by the unequal distribution of economic, political and scientific powers around the world. These ideas in global health are generally rooted in High-Income Countries (HICs), and then reach Low- and Middle-Income Countries (LMICs). We argue that acknowledging and addressing this invisible trend would contribute to a greater degree of open discussions in global health. This is expected to favor innovative, alternative, and culturally sound solutions for persistent health problems and reducing inequities.
International Journal of Health Policy and Management
Kerman University of Medical Sciences
2322-5939
3
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1
no.
2014
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9
https://www.ijhpm.com/article_2852_7e458e4277050ee6d0deece7151c71a7.pdf
dx.doi.org/10.15171/ijhpm.2014.55
Knowledge and Perception toward Colorectal Cancer Sreening in East of Iran
Farzad
Bidouei
Research and Education Department, Razavi Hospital, Mashhad, Iran
author
Saeid
Abdolhosseini
Research and Education Department, Razavi Hospital, Mashhad, Iran
author
Narges
Jafarzadeh
Research and Education Department, Razavi Hospital, Mashhad, Iran
author
Azra
Izanloo
Research and Education Department, Razavi Hospital, Mashhad, Iran
author
Kamran
Ghaffarzadehgan
Research and Education Department, Razavi Hospital, Mashhad, Iran
author
Ali
Abdolhosseini
Research and Education Department, Razavi Hospital, Mashhad, Iran
author
Fahimeh
Khoshroo
Research and Education Department, Razavi Hospital, Mashhad, Iran
author
Mitra
Vaziri
Research and Education Department, Razavi Hospital, Mashhad, Iran
author
Toktam
Tourdeh
Research and Education Department, Razavi Hospital, Mashhad, Iran
author
Hami
Ashraf
Research and Education Department, Razavi Hospital, Mashhad, Iran
author
text
article
2014
eng
Background Colorectal Cancer (CRC) is the third most common cancer in Iran and its early detection is necessary. This study is based on perception of people in the east of Iran toward CRC screening. Methods In a cross-sectional study, 1060 randomly selected individuals who referred to Razavi Hospital of Mashhad, Iran, between September the 1st, 2012 and February the 28th, 2013 as patients or their visitors involved in an interview to fill a questionnaire on CRC screening. Results The participants’ age ranged from 40 to 88 years (mean= 55). More than 90% had no knowledge of CRC and screening tests. The most cited reasons for not having screening tests were “did not have any problem” and “did not think it was needed”. Although, older people had more knowledge of CRC (P= 0.033), there was no relationship between gender, health insurance status, family history of individuals and their knowledge about CRC (P> 0.050). Employment, education and higher income had positive effect on the perception of people toward CRC screening (P< 0.050). Conclusion Lack of knowledge in people in lower socio-economical class with limited literacy is the most important barrier to CRC screening. As such, designing educational programs involving physicians and media is important to improve CRC screening rates.
International Journal of Health Policy and Management
Kerman University of Medical Sciences
2322-5939
3
v.
1
no.
2014
11
15
https://www.ijhpm.com/article_2846_69b836e96b08c2724bdea3d77e4dec1b.pdf
dx.doi.org/10.15171/ijhpm.2014.48
Investigating Underlying Principles to Guide Health Impact Assessment
Ali
Fakhri
Department of Health Service Management, School of Health Management
and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
author
Mohammadreza
Maleki
Department of Health Service Management, School of Health Management
and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
author
Mahmoodreza
Gohari
Department of Statistics and Mathematics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
author
Patrick
Harris
Centre for Health Equity Training, Research and Evaluation, Part of the
Centre for Primary Health Care and Equity, University of New South Wales,
Sydney, Australia
author
text
article
2014
eng
Background Many countries conduct Health Impact Assessment (HIA) of their projects and policies to predict their positive and negative health impacts. In recent years many guides have been developed to inform HIA practice, largely reflecting local developments in HIA. These guides have often been designed for specific contexts and specific need, making the choice between guides difficult. The objective of the current study is to identify underlying principles in order to guide HIA practice in Iran. Methods This study was conducted in three stages: 1) Studies comparing HIA guidelines were reviewed to identify criteria used for comparison seeking emphasized principles. 2) The HIA characteristics extracted from published papers were categorized in order to determine the principles that could guide HIA practice. 3) Finally, these principles were agreed by experts using nominal group technique. Results The review of the studies comparing HIA guides demonstrated there are no clear comparison criteria for reviewing HIA guides and no study mentioned HIA principles. Investigating the HIA principles from peer-reviewed papers, we found 14 issues. These were, considering of general features in planning and conducting HIAs such as HIA stream, level, timing and type, considering of the wider socio-political and economic context, considering of economic, technical and legal aspects of HIA and capacities for HIA, rationality and comprehensiveness, using appropriate evidence, elaborating on HIA relation to other forms of Impact Assessment, considering of equity, and encouraging intersectoral and interdisciplinary cooperation, involvement of stakeholders and transparency as underlying principles to guide HIA practice. The results emphasize how critical these technical as well as tactical considerations are in the early scoping step of an HIA which plans the conduct of the HIA in reponse to local contextual issues. Conclusion Determining the principles of HIA from peer-reviewed papers provides an opportunity for guiding HIA practice comprehensively. It seems to be feasible to develop a universal guide that covers all principles required.
International Journal of Health Policy and Management
Kerman University of Medical Sciences
2322-5939
3
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1
no.
2014
17
22
https://www.ijhpm.com/article_2847_91093a6fd97686f62323bb9f9016d8c0.pdf
dx.doi.org/10.15171/ijhpm.2014.50
Qualitative Study of Nocebo Phenomenon (NP) Involved in Doctor-Patient Communication
Bushra
Ashraf
Department of Obstetrics & Gynecology, Mother and Child Health Centre,
Pakistan Institute of Medical Sciences, Shaheed Zulfiqar Ali Bhutto Medical
University, Islamabad, Pakistan
author
Muhammad
Saaiq
Department of Plastic Surgery and Burns, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
author
Khaleeq
Uz-Zaman
Departments of
Neurosurgery and Medical Education, Pakistan Institute of Medical Sciences,
Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
author
text
article
2014
eng
Background Doctor-patient communication has far reaching influences on the overall well-being of the patients. Words are powerful tools in the doctor’s armamentarium, having both healing as well as harming effects. Doctors need to be conscious about the choice of their words. This study aimed to determine the frequency and pattern of Nocebo Phenomenon (NP) un-intentionally induced by the communication of surgeons and anesthetists through the course of various interventional procedures such as surgery, anesthesia, and crucial communication encounters with their patients. Methods The study was carried out by the Department of Medical Education (DME), Pakistan Institute of Medical Sciences (PIMS), Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU), Islamabad over six months period. All residents and faculty members serving at our institute in various surgical and anesthesia departments constituted the study population. A questionnaire was employed as the data collection tool. Results Significant proportions of the doctor-patient communications under scrutiny entailed NP. It was more frequently observed in association with female gender of the involved professionals, residency status versus faculty position, and shorter professional experience (i.e. Conclusion NP existed in the clinical practice of the surgeons and anesthetists during their communication with patients. It was more frequently found among females, residents and professionals with less than five years of working experience. There is need to create awareness among these professionals about the subtle negative messages conveyed by such communication and alert them that the nocebo effects have negative repercussions on the clinical outcomes of their patients. The professionals should be formally educated to avoid nocebo words and phrases.
International Journal of Health Policy and Management
Kerman University of Medical Sciences
2322-5939
3
v.
1
no.
2014
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https://www.ijhpm.com/article_2851_ef7d42a16c09ba98d1f86094331b8207.pdf
dx.doi.org/10.15171/ijhpm.2014.54
The Dilemma of Physician Shortage and International Recruitment in Canada
Nazrul
Islam
School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
author
text
article
2014
eng
The perception of physician shortage in Canada is widespread. Absolute shortages and relative discrepancies, both specialty-wise and in urban-rural distribution, have been a daunting policy challenge. International Medical Graduates (IMGs) have been at the core of mitigating this problem, especially as long as shortage of physicians in rural areas is concerned. Considering such recruitment as historical reality is naïve annotation, but when it is recommended per se, then the indication of interest overweighs the intent of ethically justified solution. Such a recommendation has not only invited policy debate and disagreement, but has also raised serious ethical concerns. Canadian healthcare policy-makers were put into a series of twisting puzzles—recruiting IMGs in mitigating physician shortage was questioned by lack of vision for Canada’s self-sufficiency. In-migration of IMGs was largely attributed to Canada’s point-based physician-friendly immigration system without much emphasizing on IMGs’ home countries’ unfavorable factors and ignoring their basic human rights and choice of livelihood. While policy-makers’ excellence in integrating the already-migrated IMGs into the Canadian healthcare is cautiously appraised, its logical consequence in passively drawing more IMGs is loudly criticised. Even the passive recruitment of IMGs raised the ethical concern of source countries’ (which are often developing countries with already-compromised healthcare system) vulnerability. The current paper offers critical insights juxtaposing all these seemingly conflicting ideas and interests within the scope of national and transnational instruments.
International Journal of Health Policy and Management
Kerman University of Medical Sciences
2322-5939
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2014
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https://www.ijhpm.com/article_2850_278771f585f846f21fd3b26bfc9176e9.pdf
dx.doi.org/10.15171/ijhpm.2014.53
Libertarianism and Circumcision
Patrick
Testa
Joseph A. Butt, S.J. College of Business, Loyola University, New Orleans, USA
author
Walter
Block
Joseph A. Butt, S.J. College of Business, Loyola University, New Orleans, USA
author
text
article
2014
eng
Despite the millenniums-old tradition in Abrahamic circles of removing the foreskin of a penis at birth, the involuntary and aggressive practice of circumcision must not be made an exception to the natural, negative right to self-ownership—a birthright which should prevent a parent from physically harming a child from the moment of birth going forward. This paper will present a natural rights argument against the practice of male child circumcision, while also looking into some of the potential physical and psychological consequences of the practice. It will compare the practice with that of female circumcision, which is banned in developed nations but still practiced in the third world, as well as other forms of aggressive action, some once-prevalent, while disputing arguments made for parental ownership of the child, religious expression, cultural tradition, cleanliness, cosmetics, and conformity.
International Journal of Health Policy and Management
Kerman University of Medical Sciences
2322-5939
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2014
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https://www.ijhpm.com/article_2849_e82a50040b519aedb554abd1ec5d35d2.pdf
dx.doi.org/10.15171/ijhpm.2014.51
The Paradox of Health Policy: Revealing the True Colours of This ‘Chameleon Concept’; Comment on “The Politics and Analytics of Health Policy”
Mark
Exworthy
Health Services Management Centre, University of Birmingham, Birmingham, UK
author
text
article
2014
eng
Health policy has been termed a ‘chameleon concept’, referring to its ability to take on different forms of disciplinarity as well as different roles and functions. This paper extends Paton’s analysis by exploring the paradox of health policy as a field of academic inquiry—sitting across many of the boundaries of social science but also marginalised by them. It situates contemporary approaches within disciplinary traditions, explaining its inter- and multi-disciplinary character. It also presents a ‘way of seeing’ health policy in terms of three axes: central/local, profession/management, and health/healthcare. The paper concludes with a call for a new research agenda which recognises health policy’s pedigree but also one which carves a distinctive future of relevance and rigour.
International Journal of Health Policy and Management
Kerman University of Medical Sciences
2322-5939
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https://www.ijhpm.com/article_2845_8efbfe9c7b0fa3b16bac545ff8ec5a91.pdf
dx.doi.org/10.15171/ijhpm.2014.49
Medical Tourism: A Fad or an Opportunity; Comment on “Patient Mobility in the Global Marketplace: A Multidisciplinary Perspective”
Nabil
Kronfol
Lebanese HealthCare Management Association, Center for Studies on Ageing, Beirut, Lebanon
author
text
article
2014
eng
This article is a commentary of an overview on “medical tourism” submitted by Lunt and Marrion, which describes a framework for the study of the issues related to medical tourism. The commentary attempts to differentiate between the current interest in medical tourism and the time-honored and well-established treatment abroad from countries with underdeveloped health systems. The commentary also calls for efforts to strengthen medical services and quality of care through the inflow of patients to countries that attract “medical tourists”.
International Journal of Health Policy and Management
Kerman University of Medical Sciences
2322-5939
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2014
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https://www.ijhpm.com/article_2855_824122c742dd3ad3454c9a920093d425.pdf
dx.doi.org/10.15171/ijhpm.2014.56
Globalization and Medical Tourism: The North American Experience; Comment on “Patient Mobility in the Global Marketplace: A Multidisciplinary Perspective”
Arturo Vargas
Bustamante
Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, USA
author
text
article
2014
eng
Neil Lunt and Russel Mannion provide an overview of the current state of the medical tourism literature and propose areas for future research in health policy and management. The authors also identify the main unanswered questions in this field ranging from the real size of the medical tourism market to the particular health profiles of transnational patients. In addition, they highlight unexplored areas of research from health economics, ethics, policy and management perspectives. To this very insightful editorial I would add the international trade perspective. While globalization has permeated labor and capital, services such as healthcare are still highly regulated by governments, constrained to regional or national borders and protected by organized interests. Heterogeneity of healthcare regulations and lack of cross-country reciprocity agreements act as barriers to the development of more widespread and dynamic medical tourism markets. To picture these barriers to transnational health services I use evidence from North America, identifying different “pull and push factors” for medical tourist in this region, discussing how economic integration and healthcare reform might shift the incentives to utilize healthcare abroad.
International Journal of Health Policy and Management
Kerman University of Medical Sciences
2322-5939
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2014
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https://www.ijhpm.com/article_2857_08afe95a810c684e575e412c5ef28b14.pdf
dx.doi.org/10.15171/ijhpm.2014.57
Magic Mountains and Multi-disciplines in International Medical Mobilities; Comment on “Patient Mobility in the Global Marketplace: A Multidisciplinary Perspective”
Tomas
Mainil
Centre for Health Region Development, HZ University of Applied Sciences,
Zeeland, The Netherlands
author
Herman
Meulemans
CELLO, Sociology of Health,
University of Antwerpen, Antwerp, Belgium
author
text
article
2014
eng
Medical mobilities offer both opportunities and challenges. This tension follows the same ratio as many other historic fora, but offers at the same time a sustainable equilibrium. Multi-disciplines are, therefore, the key to the medical lifeworld for the global health and well-being of transnational health users around the globe.
International Journal of Health Policy and Management
Kerman University of Medical Sciences
2322-5939
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2014
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https://www.ijhpm.com/article_2858_ecf9d2b6e62572881bedd60ac534d015.pdf
dx.doi.org/10.15171/ijhpm.2014.58