eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2017-06-01
6
6
301
304
10.15171/ijhpm.2017.35
3340
(Re) Making the Procrustean Bed? Standardization and Customization as Competing Logics in Healthcare
Russell Mannion
r.mannion@bham.ac.uk
1
Mark Exworthy
m.exworthy@bham.ac.uk
2
Health Services Management Centre, University of Birmingham, Birmingham, UK
Health Services Management Centre, University of Birmingham, Birmingham, UK
Recent years have witnessed a parallel and seemingly contradictory trend towards both the standardization and the customization of healthcare and medical treatment. Here, we explore what is meant by ‘standardization’ and ‘customization’ in healthcare settings and explore the implications of these changes for healthcare delivery. We frame the paradox of these divergent and opposing factors in terms of institutional logics – the socially constructed rules, practices and beliefs which perpetuate institutional behaviour. As the tension between standardization and customization is fast becoming a critical fault-line within many health systems, there remains an urgent need for more sustained work exploring how these competing logics are articulated, adapted, resisted and co-exist on the front line of care delivery.
https://www.ijhpm.com/article_3340_396bb56c098365d92a2a5af324cf6197.pdf
Standardization
Customization
Personalization
Competing Logics
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2017-06-01
6
6
305
308
10.15171/ijhpm.2017.05
3312
How Could Private Healthcare Better Contribute to Healthcare Coverage in Vietnam?
Mai Phuong Nguyen
maipn@brandeis.edu
1
Andrew Wilson
a.wilson@sydney.edu.au
2
Department of Medical Services Administration, Ministry of Health, Hanoi, Vietnam
The Menzies Centre for Health Policy, University of Sydney, Sydney, Australia
Private healthcare services in Vietnam are seen as a major part of the solution to the rapid increase in need and demand for healthcare services. Formally recognized over 20 years ago, the private health services coexist with public services and are available all over the country. However, the scale and size of private sector is still small compared to the public sector and public acceptance and reputation still limited. There are substantial concerns with the quality of services and the adequacy of regulation. Human resource for health is currently inadequate to support growth in both public and private sectors. The role of the private sector in achieving Vietnam’s population health objectives is not clear. In this emerging economy, there is significant potential for increased dependency on private healthcare to increase health access inequities. This paper discusses how private healthcare could better contribute to healthcare coverage in Vietnam.
https://www.ijhpm.com/article_3312_767453d36cb7b903dd56f32e9cd53e63.pdf
Health System
Public Sector
Private Healthcare
Health Coverage
Vietnam
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2017-06-01
6
6
309
316
10.15171/ijhpm.2016.132
3282
An Assessment of National Maternal and Child Health Policy-Makers’ Knowledge and Capacity for Evidence-Informed Policy-Making in Nigeria
Chigozie Jesse Uneke
unekecj@yahoo.com
1
Issiaka Sombie
isombie@wahooas.org
2
Namoudou Keita
nkeita@wahooas.org
3
Virgil Lokossou
vlokossou@wahooas.org
4
Ermel Johnson
jermel@wahooas.org
5
Pierre Ongolo-Zogo
pc.ongolo@gmail.com
6
Knowledge Translation Platform, African Institute for Health Policy and Health Systems Studies, Ebonyi State University, Abakaliki, Nigeria
Organisation Ouest Africaine de la Santé, Bobo-Dioulasso, Burkina Faso
Organisation Ouest Africaine de la Santé, Bobo-Dioulasso, Burkina Faso
Organisation Ouest Africaine de la Santé, Bobo-Dioulasso, Burkina Faso
Organisation Ouest Africaine de la Santé, Bobo-Dioulasso, Burkina Faso
Hopital Central Yaounde, Yaoundé, Cameroon
Background There is increasing interest globally in the use of more rigorous processes to ensure that maternal, newborn, and child health (MNCH) care recommendations are informed by the best available research evidence use. The purpose of this study was to engage Nigerian MNCH policy-makers and other stakeholders to consider issues around research to policy and practice interface and to assess their existing knowledge and capacity on the use of research evidence for policy-making and practice. Methods The study design is a cross-sectional evaluation of MNCH stakeholders’ knowledge as it pertains different dimensions of research to practice. This was undertaken during a national MNCH stakeholders’ engagement event convened under the auspices of the West African Health Organization (WAHO) and the Federal Ministry of Health (FMoH) in Abuja, Nigeria. A questionnaire was administered to participants, which was designed to assess participants’ knowledge, capacity and organizational process of generation, synthesis and utilization of research evidence in policy-making regarding MNCH. Results A total of 40 participants signed the informed consent form and completed the questionnaire. The mean ratings (MNRs) of participants’ knowledge of electronic databases and capacity to identify and obtain relevant research evidence from electronic databases ranged from 3.62-3.68 on the scale of 5. The MNRs of participants’ level of understanding of a policy brief, a policy dialogue and the role of researchers in policy-making ranged from 3.50-3.86. The MNRs of participants’ level of understanding of evidence in policy-making context, types and sources of evidence, capacity to identify, select, adapt, and transform relevant evidence into policy ranged from 3.63-4.08. The MNRs of the participants’ organization’s capacity to cover their geographical areas of operation were generally low ranging from 3.32-3.38 in terms of manpower, logistics, facilities, and external support. The lowest MNR of 2.66 was recorded in funding. Conclusion The outcomes of this study suggest that a stakeholders’ engagement event can serve as an important platform to assess policy-makers’ knowledge and capacity for evidence-informed policy-making and for the promotion of evidence use in the policy process.
https://www.ijhpm.com/article_3282_41c54626974d1a3d9d681dfd57c3ffe3.pdf
Maternal
Newborn
Child Health
Policy-Making
Evidence Use
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2017-06-01
6
6
317
326
10.15171/ijhpm.2016.135
3283
The Life Story Experience of “Migrant Dentists” in Australia: Potential Implications for Health Workforce Governance and International Cooperation
Madhan Balasubramanian
madhan.balasubramanian@adelaide.edu.au
1
A. John Spencer
john.spencer@adelaide.edu.au
2
Stephanie D. Short
stephanie.short@sydney.edu.au
3
Keith Watkins
watkinskj@ozemail.com.au
4
Sergio Chrisopoulos
sergio.chrisopoulos@adelaide.edu.au
5
David S. Brennan
david.brennan@adelaide.edu.au
6
Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
Discipline of Behavioural and Social Sciences in Health, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
Australian Dental Council, Melbourne, VIC, Australia
Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, SA, Australia
Background The migration of dentists is a major policy challenge facing both developing and developed countries. Dentists from over 120 countries migrate to Australia, and a large proportion are from developing countries. The aim of the study was to assess the life story experience (LSE) of migrant dentists in Australia, in order to address key policy challenges facing dentist migration. Methods A national survey of all migrant dentists resident in Australia was conducted in 2013. Migrant experiences were assessed through a suite of LSE scales, developed through a qualitative-quantitative study. Respondents rated experiences using a five-point Likert scale. Results A total of 1022 migrant dentists responded to the survey (response rate = 54.5%). LSE1 (health system and general lifestyle concerns in home country), LSE2 (appreciation towards Australian way of life) and LSE3 (settlement concerns in Australia) scales varied by migrant dentist groups, sex, and years since arrival to Australia (chi-square, P < .05). In a logistic regression model, migrants mainly from developing countries (ie, the examination pathway group) faced greater health system and general lifestyle concerns in their home countries (9.32; 3.51-24.72) and greater settlement challenges in Australia (5.39; 3.51-8.28), compared to migrants from well-developed countries, who obtained direct recognition of qualifications. Migrants also are more appreciative towards the Australian way of life if they had lived at least ten years in Australia (1.97; 1.27-3.05), compared to migrants who have lived for less than ten years. Conclusion Migrant dentists, mainly from developing countries, face challenges both in their home countries and in Australia. Our study offers evidence for multi-level health workforce governance and calls for greater consensus towards an international agenda to address dentist migration. Better integration of dentist migration with the mainstream health workforce governance is a viable and opportunistic way forward.
https://www.ijhpm.com/article_3283_184d77f2dca0f236d8c6287a1359889f.pdf
Dentists
Workforce Governance
Health Policy
International Cooperation
Migration
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2017-06-01
6
6
327
338
10.15171/ijhpm.2016.137
3288
Evaluating Global Health Partnerships: A Case Study of a Gavi HPV Vaccine Application Process in Uganda
Carol Kamya
ckamya@idrc-uganda.org
1
Jessica Shearer
jshearer@path.org
2
Gilbert Asiimwe
asiimwegilbo@gmail.com
3
Emily Carnahan
ecarnahan@path.org
4
Nicole Salisbury
nsalisbury@path.org
5
Peter Waiswa
pwaiswa@musph.ac.ug
6
Jennifer Brinkerhoff
jbrink@gwu.edu
7
Dai Hozumi
dairiku@msn.com
8
Infectious Diseases Research Collaboration (IDRC), Kampala, Uganda
PATH Seattle, WA, USA
Infectious Diseases Research Collaboration (IDRC), Kampala, Uganda
PATH Seattle, WA, USA
PATH Seattle, WA, USA
Makerere University School of Public Health, Kampala, Uganda
George Washington University, Washington, DC, USA
Management Sciences for Health, Arlington, VA, USA
Background Global health partnerships have grown rapidly in number and scope, yet there has been less emphasis on their evaluation. Gavi, the Vaccine Alliance, is one such public-private partnership; in Gavi-eligible countries partnerships are dynamic networks of immunization actors who work together to support all stages and aspects of Gavi support. This paper describes a conceptual framework – the partnership framework – and analytic approach for evaluating the perceptions of partnerships’ added value as well as the results from an application to one case in Uganda. Methods We used a mixed-methods case study design embedded in the Gavi Full Country Evaluations (FCE) to test the partnership framework on Uganda’s human papillomavirus (HPV) vaccine application partnership. Data from document review, interviews, and social network surveys enabled the testing of the relationships between partnership framework domains (context, structure, practices, performance, and outcomes). Topic guides were based on the framework domains and network surveys identified working together relationships, professional trust, and perceptions of the effectiveness, efficiency, and legitimacy of the partnership’s role in this process. Results Data from seven in-depth interviews, 11 network surveys and document review were analyzed according to the partnership framework, confirming relationships between the framework domains. Trust was an important contributor to the perceived effectiveness of the process. The network was structured around the EPI program, who was considered the leader of this process. While the structure and composition of the network was largely viewed as supporting an effective and legitimate process, the absence of the Ministry of Education (MoE) may have had downstream consequences if this study’s results had not been shared with the Ministry of Health (MoH) and acted upon. The partnership was not perceived to have increased the efficiency of the process, perhaps as a result of unclear or absent guidelines around roles and responsibilities. Conclusion The health and functioning of global health partnerships can be evaluated using the framework and approach presented here. Network theory and methods added value to the conceptual and analytic processes and we recommend applying this approach to other global health partnerships to ensure that they are meeting the complex challenges they were designed to address.
https://www.ijhpm.com/article_3288_099e64aab766cea6b86d5daac3d7b748.pdf
Immunization
Social Network Analysis (SNA)
Partnership
Global Health
Uganda
GAVI
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2017-06-01
6
6
339
344
10.15171/ijhpm.2017.18
3325
A Policy Analysis on the Proactive Prevention of Chronic Disease: Learnings from the Initial Implementation of Integrated Measurement for Early Detection (MIDO)
Roberto Tapia-Conyer
rtapiac@fundacioncarlosslim.org
1
Rodrigo Saucedo-Martínez
rsaucedom@fundacioncarlosslim.org
2
Ricardo Mújica-Rosales
rmujica@fundacioncarlosslim.org
3
Héctor Gallardo-Rincón
hgallardo@fundacioncarlosslim.org
4
Evan Lee
lee_evan@lilly.com
5
Craig Waugh
waugh_craig@lilly.com
6
Lucía Guajardo
guajardo_gonzalez_lucia@lilly.com
7
Braulio Torres-Beltrán
btorres@c-230.com
8
Úrsula Quijano-González
uquijano@c-230.com
9
Mauricio López-Mendez
mlopezme@gmail.com
10
Elena Rose Atkinson
eatkinson@c-230.com
11
Fundación Carlos Slim, Mexico City, Mexico
Fundación Carlos Slim, Mexico City, Mexico
Fundación Carlos Slim, Mexico City, Mexico
Fundación Carlos Slim, Mexico City, Mexico
Eli Lilly and Company, Lilly Global Health, Geneva, Switzerland
Lilly NCD Partnership, Indianapolis, IN, USA
Lilly NCD Partnership, Mexico City, Mexico
C230 Consultores, Mexico City, Mexico
C230 Consultores, Mexico City, Mexico
C230 Consultores, Mexico City, Mexico
C230 Consultores, Mexico City, Mexico
Mexico, like many low- and middle-income countries (LMICs), faces an epidemic of chronic non-communicable diseases (NCDs), specifically diabetes, hypertension, obesity, and lipid disorders. Many people with these NCDs may not be aware that they have a disease, pointing to the need for broader screening programs. The traditional prevention policy in Mexico was based on screening with a paper-based risk factor questionnaire. However, this was used to screen patients already seeking healthcare services at facilities, and screening goals were set as a function of the number of questionnaires applied, not number of individuals screened. Due to this, Fundación Carlos Slim developed Medición Integrada para la Detección Oportuna (MIDOTM), or Integrated Measurement for Early Detection, an NCD screening and proactive prevention policy. This document is a policy analysis based on early learnings from the initial implementation of MIDO in eight primary healthcare centers in two central Mexican states. MIDO was found to expand screening programs beyond clinic walls, systematize community screening strategies, emphasize the detection of pre-disease phases, incorporate lifestyle counseling, and propose screening goals based on population targets. In collaboration with the Mexican Ministry of Health, MIDO has successfully screened over 500 000 individuals—about 40% of whom would not have been screened under previous policies. Of these more than 500 000 screened individuals, 13.4% had pre-diabetes (fasting glucose between 100 and 125 mg/dL), and 5.8% had undiagnosed diabetes (defined as fasting glucose above 126 mg/dL or random glucose above 200 mg/dL). However, there is still room for improvement in linking positive results from screening with disease confirmation and with patient incorporation into disease management. The experience of implementing MIDO in Mexico suggests that primary and secondary prevention programs in other parts of the world should consider the need for population-based screening targets, a greater focus on pre-disease stages, and the streamlining of the transition between screening, confirmation of diagnosis, and incorporation of patients into the healthcare system.
https://www.ijhpm.com/article_3325_5397e6d97536bed3d5a8023a9a44df1b.pdf
Early Diagnosis
Mass Screening
Policy
Mexico
Chronic Disease
Diabetes Mellitus
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2017-06-01
6
6
345
348
10.15171/ijhpm.2016.136
3284
“Seeing” the Difference: The Importance of Visibility and Action as a Mark of “Authenticity” in Co-production; Comment on “Collaboration and Co-production of Knowledge in Healthcare: Opportunities and Challenges”
Jo Cooke
j.m.cooke@sheffield.ac.uk
1
Joe Langley
j.langley@shu.ac.uk
2
Dan Wolstenholme
daniel.wolstenholme@sth.nhs.uk
3
Susan Hampshaw
susan.hampshaw@doncaster.gov.uk
4
NIHR Collaboration and Leadership in Applied Health Research and Care for Yorkshire and Humber (CLAHRC YH), Sheffield, UK
Lab4Living, Sheffield Hallam University, Sheffield, UK
Translating Knowledge Into Action, NIHR CLAHRC Yorkshire and Humber, Sheffield, UK
Doncaster Metropolitan Borough Council, Doncaster, UK
The Rycroft-Malone paper states that co-production relies on ‘authentic’ collaboration as a context for action. Our commentary supports and extends this assertion. We suggest that ‘authentic’ co-production involves processes where participants can ‘see’ the difference that they have made within the project and beyond. We provide examples including: the use of design in health projects which seek to address power issues and make contributions visible through iteration and prototyping; and the development of ‘actionable outputs’ from research that are the physical embodiment of coproduction. Finally, we highlight the elements of the Collaboration for Leadership in Applied Health Research and Care (CLAHRC) architecture that enables the inclusion of such collaborative techniques that demonstrate visible co-production. We reinforce the notion that maintaining collaboration requires time, flexible resources, blurring of knowledge produceruser boundaries, and leaders who promote epistemological tolerance and methodological exploration.
https://www.ijhpm.com/article_3284_05f48f9afe0d75caba74ec9742829620.pdf
Co-production
Knowledge Mobilisation
Design Approaches in Healthcare
Research Impact
Actionable Tools
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2017-06-01
6
6
349
351
10.15171/ijhpm.2016.139
3285
How the Spectre of Societal Homogeneity Undermines Equitable Healthcare for Refugees; Comment on “Defining and Acting on Global Health: The Case of Japan and the Refugee Crisis”
Oliver Razum
oliver.razum@uni-bielefeld.de
1
Judith Wenner
judith.wenner@uni-bielefeld.de
2
Kayvan Bozorgmehr
kayvan.bozorgmehr@med.uni-heidelberg.de
3
Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
Recourse to a purported ideal of societal homogeneity has become common in the context of the refugee reception crisis – not only in Japan, as Leppold et al report, but also throughout Europe. Calls for societal homogeneity in Europe originate from populist movements as well as from some governments. Often, they go along with reduced social support for refugees and asylum seekers, for example in healthcare provision. The fundamental right to health is then reduced to a citizens’ right, granted fully only to nationals. Germany, in spite of welcoming many refugees in 2015, is a case in point: entitlement and access to healthcare for asylum seekers are restricted during the first 15 months of their stay. We show that arguments brought forward to defend such restrictions do not hold, particularly not those which relate to maintaining societal homogeneity. European societies are not homogeneous, irrespective of migration. But as migration will continue, societies need to invest in what we call “globalization within.” Removing entitlement restrictions and access barriers to healthcare for refugees and asylum seekers is one important element thereof.
https://www.ijhpm.com/article_3285_f6b30f2e27c609195cfccdfdc74be8fe.pdf
Germany
Refugee
Access to Healthcare
Homogeneity
Equity
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2017-06-01
6
6
353
355
10.15171/ijhpm.2016.140
3287
The Trans-Pacific Partnership: Should We “Fear the Fear”?; Comment on “The Trans-Pacific Partnership: Is It Everything We Feared for Health?”
Helen L. Walls
helen.walls@lshtm.ac.uk
1
Johanna Hanefeld
johanna.hanefeld@lshtm.ac.uk
2
Richard D. Smith
richard.smith@lshtm.ac.uk
3
Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
RLabonté et al entitle their paper in this issue of the International Journal of Health Policy and Management “The Trans-Pacific Partnership: Is It Everything We Feared for Health?” Tantalisingly, they do not directly answer the question they pose, and in this commentary, we suggest that it is the wrong question; we should not ‘fear’ the Trans-Pacific Partnership (TPP) at all, rather we should ask how we are to respond. The public health community is right to be concerned with the potential implications of trade and investment agreements (TIAs) for health, particularly with shifts from multilateral to regional/bilateral agreements including provisions with greater risk to public health. But it is critical to understand also the potential health benefits, and especially the mitigating policy and governance mechanisms to respond to adverse TIA implications. Given entrenched and divergent sectoral worldviews and perspectives between trade and health communities on these issues, achieving the requisite understanding will also likely require characterisation of these perspectives and identification of areas of common understanding and agreed solutions
https://www.ijhpm.com/article_3287_ff8b90cffaffca734ff6b49b35ae7f42.pdf
International Trade
Public Health
Research
Policy
Governance
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2017-06-01
6
6
357
358
10.15171/ijhpm.2017.23
3326
The Global Health Crisis of Solidarity: A Response to Recent Commentaries
Claire Leppold
cleppold@ed.ac.uk
1
Akihiko Ozaki
ozakiakihiko@gmail.com
2
Yuki Shimada
smd.yuki@gmail.com
3
Tomohiro Morita
t.morita526@gmail.com
4
Tetsuya Tanimoto
tetanimot@yahoo.co.jp
5
Global Public Health Unit, School of Social and Political Science, University of Edinburgh, Edinburgh, UK
Minamisoma Municipal General Hospital, Fukushima, Japan
Minamisoma Municipal General Hospital, Fukushima, Japan
Soma Central Hospital, Fukushima, Japan
Jyoban Hospital, Tokiwa Foundation, Fukushima, Japan
https://www.ijhpm.com/article_3326_8a6df5a5fbe9915fb0a155f495f47f18.pdf
Japan
Global Health
Refugees
Displacement