ORIGINAL_ARTICLE
Shaping Policy Change in Population Health: Policy Entrepreneurs, Ideas, and Institutions
Political realities and institutional structures are often ignored when gathering evidence to influence population health policies. If these policies are to be successful, social science literature on policy change should be integrated into the population health approach. In this contribution, drawing on the work of John W. Kingdon and related scholarship, we set out to examine how key components of the policy change literature could contribute towards the effective development of population health policies. Shaping policy change would require a realignment of the existing school of thought, where the contribution of population health seems to end at knowledge translation. Through our critical analysis of selected literature, we extend recommendations to advance a burgeoning discussion in adopting new approaches to successfully implement evidence-informed population health policies.
https://www.ijhpm.com/article_3451_7848a531b7589a69e063ad4eeb13e598.pdf
2018-05-01
369
373
10.15171/ijhpm.2017.143
Population Health
Policy Change
Policy Entrepreneurs
Ideas
Institutions
Evidence
Daniel
Béland
daniel.beland@usask.ca
1
Johnson Shoyama Graduate School of Public Policy, University of Saskatchewan, Saskatoon, SK, Canada
LEAD_AUTHOR
Tarun R.
Katapally
tarun.katapally@uregina.ca
2
Johnson Shoyama Graduate School of Public Policy, University of Regina, Regina, SK, Canada
AUTHOR
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70
ORIGINAL_ARTICLE
Assessment of the Effects of Economic Sanctions on Iranians’ Right to Health by Using Human Rights Impact Assessment Tool: A Systematic Review
Background Over the years, economic sanctions have contributed to violation of right to health in target countries. Iran has been under comprehensive unilateral economic sanctions by groups of countries (not United Nations [UN]) in recent years. They have been intensified from 2012 because of international community’s uncertainty about peaceful purpose of Iran’s nuclear program and inadequacy of trust-building actions of this country. This review aimed to identify the humanitarian effects of the sanctions on the right of Iranians to health and the obligations of Iran and international community about it. Methods To assess economic sanction policies and identify violated rights and the obligations of states according to international human rights laws, in this study, Human Rights Impact Assessments (HRIA) tool is used. Applying this tool requires collection of evidences regarding the situation of rights. To provide such evidence, a systematic review of literature which involved 55 papers retrieved from the web-based databases and official webpages of Iran’s government and UN’ health and human rights committees and organizations was done. All articles about the consequences of economic sanctions related to nuclear activities of Iran on welfare and health of Iranians published from January 2012 till February 2017 in English and Persian languages were included. Search terms were economic sanctions, embargoes, Iran, welfare, health and medicine. Additional studies were identified by cross checking the reference lists of accessed articles. All selected papers were abstracted and entered into a matrix describing study design and findings, and categorized into a framework of themes reflecting the areas covered (health and its determinants). According to HRIA framework, related obligations of Iran and other states about adverse effects of the sanctions on Iranians’ right to health were extracted. Results The sanctions on Iran caused a fall of country’s revenues, devaluation of national currency, and increase of inflation and unemployment. These all resulted in deterioration of people’s overall welfare and lowering their ability to access the necessities of a standard life such as nutritious food, healthcare and medicine. Also, the sanctions on banking, financial system and shipment led to scarcity of quality lifesaving medicines. The impacts of sanctions were more immense on the lives of the poor, patients, women and children. Humanitarian exemptions did not protect Iranians from the adverse effects of sanctions. Conclusion Countries which imposed economic sanctions against Iran have violated Iranians’ right to health. International community should have predicted any probable humanitarian effects of sanctions and used any necessary means to prevent it. Furthermore, Iran should have used any essential means to protect people from the adverse effects of sanctions. Now, they should work on alleviation of the negative effects of sanctions. Even though, some of the effects such as disability and death cannot be compensated. In future, before imposition of sanctions, decisions makers should advice an international order to prevent such impacts on targeted countries’ populations
https://www.ijhpm.com/article_3454_413e7c40127a45913385d0def29682a6.pdf
2018-05-01
374
393
10.15171/ijhpm.2017.147
Economic Sanctions
Right to Medicine
Human Rights
Iran
HRIA Tool
Fatemeh
Kokabisaghi
mrs.kokabi@yahoo.com
1
Healthcare and Law Department, School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
LEAD_AUTHOR
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ORIGINAL_ARTICLE
Unit Costing of Health Extension Worker Activities in Ethiopia: A Model for Managers at the District and Health Facility Level
Background Over the last decade, Ethiopia has made impressive national improvements in health outcomes, including reductions in maternal, neonatal, infant, and child mortality attributed in large part to their Health Extension Program (HEP). As this program continues to evolve and improve, understanding the unit cost of health extension worker (HEW) services is fundamental to planning for future growth and ensuring adequate financial support to deliver effective primary care throughout the country. Methods We sought to examine and report the data needed to generate a HEW fee schedule that would allow for full cost recovery for HEW services. Using HEW activity data and estimates from national studies and local systems we were able to estimate salary costs and the average time spent by an HEW per patient/community encounter for each type of services associated with specific users. Using this information, we created separate fee schedules for activities in urban and rural settings with two estimates of non-salary multipliers to calculate the total cost for HEW services. Results In the urban areas, the HEW fees for full cost recovery of the provision of services (including salary, supplies, and overhead costs) ranged from 55.1 birr to 209.1 birr per encounter. The rural HEW fees ranged from 19.6 birr to 219.4 birr. Conclusion Efforts to support health system strengthening in low-income settings have often neglected to generate adequate, actionable data on the costs of primary care services. In this study, we have combined time-motion and available financial data to generate a fee schedule that allows for full cost recovery of the provision of services through billable health education and service encounters provided by Ethiopian HEWs. This may be useful in other country settings where managers seek to make evidence-informed planning and resource allocation decisions to address high burden of disease within the context of weak administrative data systems and severe financial constraints.
https://www.ijhpm.com/article_3409_6926d0924c3745d8c0bb9719cfe06b4c.pdf
2018-05-01
394
401
10.15171/ijhpm.2017.102
Health Extension Workers (HEWs)
Costing Tools
Health System Strengthening
Maureen E.
Canavan
maureen.canavan@yale.edu
1
Yale Global Health Leadership Institute, Yale University, New Haven, CT, USA
LEAD_AUTHOR
Erika
Linnander
erika.linnander@yale.edu
2
Yale Global Health Leadership Institute, Yale University, New Haven, CT, USA
AUTHOR
Shirin
Ahmed
shirin.ahmed@yale.edu
3
Yale Global Health Leadership Institute, Yale University, New Haven, CT, USA
AUTHOR
Halima
Mohammed
halimaomer50@gmail.com
4
Yale Global Health Leadership Institute, Yale University, New Haven, CT, USA
AUTHOR
Elizabeth H.
Bradley
ebradley@vassar.edu
5
Yale Global Health Leadership Institute, Yale University, New Haven, CT, USA
AUTHOR
Kassebaum NJ, Bertozzi-Villa A, Coggeshall MS, et al. Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9947):980-1004. doi:10.1016/s0140-6736(14)60696-6
1
Wang H, Liddell CA, Coates MM, et al. Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9947):957-979. doi:10.1016/s0140-6736(14)60497-9
2
Afework MF, Admassu K, Mekonnen A, Hagos S, Asegid M, Ahmed S. Effect of an innovative community based health program on maternal health service utilization in north and south central Ethiopia: a community based cross sectional study. Reprod Health. 2014;11:28. doi:10.1186/1742-4755-11-28
3
Gebrehiwot TG, San Sebastian M, Edin K, Goicolea I. The health extension program and its association with change in utilization of selected maternal health services in Tigray Region, Ethiopia: a segmented linear regression analysis. PLoS One. 2015;10(7):e0131195. doi: 10.1371/journal.pone.0131195
4
Karim AM, Admassu K, Schellenberg J, et al. Effect of ethiopia's health extension program on maternal and newborn health care practices in 101 rural districts: a dose-response study. PLoS One. 2013;8(6):e65160. doi: 10.1371/journal.pone.0065160
5
Medhanyie A, Spigt M, Kifle Y, et al. The role of health extension workers in improving utilization of maternal health services in rural areas in Ethiopia: a cross sectional study. BMC Health Serv Res. 2012;12:352. doi:10.1186/1472-6963-12-352
6
Yitayal M, Berhane Y, Worku A, Kebede Y. Health extension program factors, frequency of household visits and being model households, improved utilization of basic health services in Ethiopia. BMC Health Serv Res. 2014;14:156. doi:10.1186/1472-6963-14-156
7
Banteyerga H. Ethiopia's health extension program: improving health through community involvement. MEDICC Rev. 2011;13(3):46-49.
8
Ministry of Health. Quarterly Health Bulletin. Policy and Practice: Information for Action. Addis Ababa, Ethiopia: Federal Democratic Republic of Ethiopia; 2013.
9
Dalaba MA, Akweongo P, Savadogo G, et al. Cost of maternal health services in selected primary care centres in Ghana: a step down allocation approach. BMC Health Serv Res. 2013;13:287. doi:10.1186/1472-6963-13-287
10
11. Costing of Health Services. MSH website. http://www.msh.org/our-work/health-systems/health-care-financing/costing-of-health-services. Published 2016.
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WHO. Costing Tools: Core Plus Management Sciences for Health. The Partnership for Maternal, Newborn & Child Health. http://www.who.int/pmnch/knowledge/publications/costing_tools/en/index6.html. Accessed January 31, 2016. Published 2016.
12
McCord GC, Liu A, Singh P. Deployment of community health workers across rural sub-Saharan Africa: financial considerations and operational assumptions. Bull World Health Organ. 2013;91(4):244-253b. doi:10.2471/blt.12.109660
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Vaughan K, Kok MC, Witter S, Dieleman M. Costs and cost-effectiveness of community health workers: evidence from a literature review. Hum Resour Health. 2015;13:71. doi:10.1186/s12960-015-0070-y
14
Ethiopian Federal Ministry of Health, Yale Global Health Leadership Institute, JSI Research & Training Institute, Inc. Health Extension Workers Time Motion Study Complemented by In-depth Interviews within Primary Health Care Units in Ethiopia. Addis Ababa, Ethiopia: Ethiopian Federal Ministry of Health; 2015.
15
Fetene N, Linnander E, Fekadu B, et al. The Ethiopian health extension program and variation in health systems performance: what matters? PLoS One. 2016;11(5):e0156438. doi:10.1371/journal.pone.0156438
16
Tilahun H, Fekadu B, Abdisa H, et al. Ethiopia's health extension workers use of work time on duty: time and motion study. Health Policy Plan. 2017;32(3):320-328. doi:10.1093/heapol/czw129
17
Mangham-Jefferies L, Mathewos B, Russell J, Bekele A. How do health extension workers in Ethiopia allocate their time? Hum Resour Health. 2014;12:61. doi:10.1186/1478-4491-12-61
18
Bryant M, Essomba RO. Measuring time utilization in rural health centres. Health Policy Plan. 1995;10(4):415-422.
19
Odendaal WA, Lewin S. The provision of TB and HIV/AIDS treatment support by lay health workers in South Africa: a time-and-motion study. Hum Resour Health. 2014;12:18. doi:10.1186/1478-4491-12-18
20
Krumwiede KR. The implementation stages of activity-based costing and the impact of contextual and organizational factors. Journal of Management Accounting Research. 1998;10:239-277.
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Pohlen TL, La Londe BJ. Implementing activity-based costing (ABC) in logistics. Journal of Business Logistics. 1994;15(2).
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Kaplan RS, Anderson SR. Time-driven activity-based costing. Harv Bus Rev. 2004;82(11):131-138.
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Kaplan RS, Porter ME. How to solve the cost crisis in health care. Harv Bus Rev. 2011;89(9):46-52.
24
Kaplan RS, Witkowski M, Abbott M, et al. Using time-driven activity-based costing to identify value improvement opportunities in healthcare. J Healthc Manag. 2014;59(6):399-412.
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Lapsley I, Arnaboldi M. Activity Based Costing in Healthcare: A UK Case Study. Res Healthc Financ Manag. 2005;10:59-73.
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Canby JBt. Applying activity-based costing to healthcare settings. Healthc Financ Manage. 1995;49(2):50-52.
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Lorella C, Maddalena I, Adelaide I, Cristina P. An activity-based costing approach for detecting inefficiencies of healthcare processes. Business Process Management Journal. 2015;21(1):55-79. doi:10.1108/BPMJ-11-2013-0144
28
Demeere N, Stouthuysen K, Roodhooft F. Time-driven activity-based costing in an outpatient clinic environment: development, relevance and managerial impact. Health Policy. 2009;92(2-3):296-304. doi:10.1016/j.healthpol.2009.05.003
29
OANDA. Currency Converter. https://www.oanda.com/currency/converter/. Accessed November 1, 2016. Published 2016.
30
Tanner M. Strengthening district health systems. Bull World Health Organ. 2005;83(6):403.
31
Group TWB. Ethiopia: Economic Overview. http://www.worldbank.org/en/country/ethiopia/overview#2. Published 2016.
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Berendes S, Heywood P, Oliver S, Garner P. Quality of private and public ambulatory health care in low and middle income countries: systematic review of comparative studies. PLoS Med. 2011;8(4):e1000433. doi:10.1371/journal.pmed.1000433
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Ozgediz D, Jamison D, Cherian M, McQueen K. The burden of surgical conditions and access to surgical care in low- and middle-income countries. Bull World Health Organ. 2008;86(8):646-647.
34
ORIGINAL_ARTICLE
The Response to and Impact of the Ebola Epidemic: Towards an Agenda for Interdisciplinary Research
Background The 2013-2016 Ebola virus disease (EVD) epidemic in West Africa was the largest in history and resulted in a huge public health burden and significant social and economic impact in those countries most affected. Its size, duration and geographical spread presents important opportunities for research than might help national and global health and social care systems to better prepare for and respond to future outbreaks. This paper examines research needs and research priorities from the perspective of those who directly experienced the EVD epidemic in Guinea. Methods The paper reports the findings from a research scoping exercise conducted in Guinea in 2017. This exercise explored the need for health and social care research, and identified research gaps, from the perspectives of different groups. Interviews were carried out with key stakeholders such as representatives of the Ministry of Health, non-governmental organizations (NGOs), academic and health service researchers and members of research ethics committees (N = 15); health practitioners (N = 12) and community representatives (N = 11). Discussion groups were conducted with male and female EVD survivors (N = 24) from two distinct communities. Results This research scoping exercise identified seven key questions for further research. An important research priority that emerged during this study was the need to carry out a comprehensive analysis of the wider social, economic and political impact of the epidemic on the country, communities and survivors. The social and cultural dynamics of the epidemic and the local, national and international response to it need to be better understood. Many survivors and their relatives continue to experience stigma and social isolation and have a number of complex unmet needs. It is important to understand what sort of support they need, and how that might best be provided. A better understanding of the virus and the long-term health and social implications for survivors and non-infected survivors is also needed. Conclusion This study identified a need and priority for interdisciplinary research focusing on the long-term sociocultural, economic and health impact of the EVD epidemic. Experiences of survivors and other non-infected members of the community still need to be explored but in this broader context.
https://www.ijhpm.com/article_3410_0e0e877110f1e603df04adebb313ff17.pdf
2018-05-01
402
411
10.15171/ijhpm.2017.104
Ebola
Guinea
Research Priorities
Survivors
Social Impact
Michael
Calnan
m.w.calnan@kent.ac.uk
1
SSPSSR, University of Kent, Kent, UK
LEAD_AUTHOR
Erica W.
Gadsby
e.gadsby@kent.ac.uk
2
Centre for Health Services Studies, University of Kent, Kent, UK
AUTHOR
Mandy Kader
Kondé
kaderkonde@gmail.com
3
Département Santé Publique, Université UGAN Conakry and FOSAD Health and Sustainable Development Foundation and CEFORPAG Center of Excellence for Training, Research on Malaria & Priority Diseases in Guinea, Conakry, Guinea
AUTHOR
Abdourahime
Diallo
dialloabdourahime@hotmail.fr
4
FOSAD Health and Sustainable Development Foundation and CEFORPAG Center of Excellence for Training, Research on Malaria & Priority Diseases in Guinea, Conakry, Guinea
AUTHOR
Jeremy S.
Rossman
j.s.rossman@kent.ac.uk
5
School of Biosciences, University of Kent, Kent, UK
AUTHOR
World Health Organisation (WHO). Ebola outbreak 2014 - present: How the outbreak and WHO's response unfolded. http://www.who.int/csr/disease/ebola/response/phases/en/. Updated 2016. Accessed March 16, 2017.
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Hugo M, Declerck H, Fitzpatrick G, et al. Post-traumatic stress reactions in Ebola virus disease survivors in Sierra Leone. Emergency Medicine: Open Access. 2015; 5:285. doi:10.4172/2165-7548.1000285
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Dhillon RS, Kelly JD. Community Trust and the Ebola Endgame. N Engl J Med. 2015;373(9):787-789. doi:10.1056/NEJMp1508413
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Anoko J. Communication with rebellious communities during an outbreak of EVD in guinea: an anthropological approach. http://www.ebola-anthropology.net/wp-content/uploads/2014/12/Communicationduring-an-outbreak-of-Ebola-Virus-Disease-with-rebellious-communities-in-Guinea.pdf. Accessed July 10, 2017. Published 2014.
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Calnan M, Rowe R. Trust matters for healthcare. Maidenhead: Open University Press. 2008.
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42
ORIGINAL_ARTICLE
What Factors Do Allied Health Take Into Account When Making Resource Allocation Decisions?
Background Allied health comprises multiple professional groups including dietetics, medical radiation practitioners, occupational therapists, optometrists and psychologists. Different to medical and nursing, Allied health are often organized in discipline specific departments and allocate budgets within these to provide services to a range of clinical areas. Little is known of how managers of allied health go about allocating these resources, the factors they consider when making these decisions, and the sources of information they rely upon. The purpose of this study was to identify the key factors that allied health consider when making resource allocation decisions and the sources of information they are based upon. Methods Four forums were conducted each consisting of case studies, a large group discussion and two hypothetical scenarios to elicit data. A thematic content analysis commenced during post-forum discussions of key factors by forum facilitators. These factors were then presented to an expert working party for further discussion and refinement. Transcripts were generated of all data recordings and a detailed thematic analysis was undertaken by one author to ensure coded data matched the initial thematic analysis. Results Twelve factors affecting the decision-making of allied health managers and clinicians were identified. One of these factors was disendorsed by the expert working party. The 11 remaining factors can be considered to be key decision-making principles that should be consistently applied to resource allocation. These principles were clustered into three overarching themes of readiness, impact and appropriateness. Conclusion Understanding these principles now means further research can be completed to more effectively integrate research evidence into health policy and service delivery, create partnerships among policy-makers, managers, service providers and researchers, and to provide support to answer difficult questions that policy-makers, managers and service providers face.
https://www.ijhpm.com/article_3414_5a3f1505feafb3127673ec5d07c20927.pdf
2018-05-01
412
420
10.15171/ijhpm.2017.105
Resource Allocation
Allied Health
Decision-Making
Priority Setting
Haylee
Lane
haylee.lane@monash.edu
1
School of Primary & Allied Health Care, Monash University, Frankston, VIC, Australia
LEAD_AUTHOR
Tamica
Sturgess
tamica.sturgess@monashhealth.org
2
Workforce Innovation Strategy Education and Research Unit, Monash Health, Clayton, VIC, Australia
AUTHOR
Kathleen
Philip
kathleen.philip@dhhs.vic.gov.au
3
Department of Health and Human Services, Melbourne, VIC, Australia
AUTHOR
Donna
Markham
donna.markham@monashhealth.org
4
Monash Health, Clayton, VIC, Australia
AUTHOR
Jennifer
Martin
jenny.martin@rmit.edu.au
5
Centre of Applied Social Research, RMIT University, Melbourne, VIC, Australia
AUTHOR
Jill
Walsh
jill.walsh@monashhealth.org
6
Monash Health, Clayton, VIC, Australia
AUTHOR
Wendy
Hubbard
wendy.hubbard9@gmail.com
7
State-Wide Equipment Program, Ballarat Health Services, Ballarat, VIC, Australia
AUTHOR
Terry
Haines
terrence.haines@monash.edu
8
School of Primary & Allied Health Care, Monash University, Frankston, VIC, Australia
AUTHOR
Klein R. Dimensions of rationing: who should do what? BMJ. 1993;307(6899):309-311.
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Baeroe K. Priority setting in health care: on the relation between reasonable choices on the micro-level and the macro-level. Theor Med Bioeth. 2008;29(2):87-102. doi:10.1007/s11017-008-9063-3
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Adams R, Jones A, Lefmann S, Sheppard L. Service Level Decision-making in Rural Physiotherapy: Development of Conceptual Models. Physiother Res Int. 2016;21(2):116-126. doi:10.1002/pri.1627
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Hoffmann TC, Legare F, Simmons MB, et al. Shared decision making: what do clinicians need to know and why should they bother? Med J Aust. 2014;201(1):35-39.
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Towle A, Godolphin W. Framework for teaching and learning informed shared decision making. BMJ. 1999;319(7212):766-771.
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Yancey AK, Cole BL, McCarthy WJ. A graphical, computer-based decision-support tool to help decision makers evaluate policy options relating to physical activity. Am J Prev Med. 2010;39(3):273-279. doi:10.1016/j.amepre.2010.05.013
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Angelis A, Kanavos P, Montibeller G. Resource allocation and priority setting in health care: a multi-criteria decision analysis problem of value? Global Policy. 2017;8:76-83. doi:10.1111/1758-5899.12387
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Sabik LM, Lie RK. Priority setting in health care: Lessons from the experiences of eight countries. Int J Equity Health. 2008;7:4. doi:10.1186/1475-9276-7-4
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Mainz J. Health care and Medical Priorities Commission. No Easy Choices. the Difficult Priorities of Health Care. Stockholm, Sweden: Swedish Government Official Reports, 1993; 93. 133 pages. Scand J Public Health. 1995;23(2):144-144. doi:10.1177/140349489502300212
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Arvidsson E, Andre M, Borgquist L, Andersson D, Carlsson P. Setting priorities in primary health care--on whose conditions? A questionnaire study. BMC Fam Pract. 2012;13:114. doi:10.1186/1471-2296-13-114
26
Imison C, Sonola L, Honeyman M, Ross S. The Reconfiguration of Clinical Services: What Is The Evidence? London. The King’s Fund; 2014.
27
Williams A. Thinking about equity in health care. J Nurs Manag. 2005;13(5):397-402. doi:10.1111/j.1365-2834.2005.00578.x
28
Mitton CR, Donaldson C. Setting priorities and allocating resources in health regions: lessons from a project evaluating program budgeting and marginal analysis (PBMA). Health Policy. 2003;64(3):335-348.
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Menon D, Stafinski T, Martin D. Priority-setting for healthcare: who, how, and is it fair? Health Policy. 2007;84(2-3):220-233. doi:10.1016/j.healthpol.2007.05.009
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31
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32
Heiwe S, Kajermo KN, Tyni-Lenne R, et al. Evidence-based practice: attitudes, knowledge and behaviour among allied health care professionals. Int J Qual Health Care. 2011;23(2):198-209. doi:10.1093/intqhc/mzq083
33
Philibert DB, Snyder P, Judd D, Windsor MM. Practitioners' reading patterns, attitudes, and use of research reported in occupational therapy journals. Am J Occup Ther. 2003;57(4):450-458.
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Salbach NM, Jaglal SB, Korner-Bitensky N, Rappolt S, Davis D. Practitioner and organizational barriers to evidence-based practice of physical therapists for people with stroke. Phys Ther. 2007;87(10):1284-1303. doi:10.2522/ptj.20070040
35
Robert G, Harlock J, Williams I. Disentangling rhetoric and reality: an international Delphi study of factors and processes that facilitate the successful implementation of decisions to decommission healthcare services. Implement Sci. 2014;9:123. doi:10.1186/s13012-014-0123-y
36
ORIGINAL_ARTICLE
The Challenges of a Complex and Innovative Telehealth Project: A Qualitative Evaluation of the Eastern Quebec Telepathology Network
Background The Eastern Quebec Telepathology Network (EQTN) has been implemented in the province of Quebec (Canada) to support pathology and surgery practices in hospitals that are lack of pathologists, especially in rural and remote areas. This network includes 22 hospitals and serves a population of 1.7 million inhabitants spread over a vast territory. An evaluation of this network was conducted in order to identify and analyze the factors and issues associated with its implementation and deployment, as well as those related to its sustainability and expansion. Methods Qualitative evaluative research based on a case study using: (1) historical analysis of the project documentation (newsletters, minutes of meetings, articles, ministerial documents, etc); (2) participation in meetings of the committee in charge of telehealth programs and the project; and (3) interviews, focus groups, and discussions with different stakeholders, including decision-makers, clinical and administrative project managers, clinicians (pathologists and surgeons), and technologists. Data from all these sources were cross-checked and synthesized through an integrativeand interpretative process. Results The evaluation revealed numerous socio-political, regulatory, organizational, governance, clinical, professional, economic, legal and technological challenges related to the emergence and implementation of the project. In addition to technical considerations, the development of this network was associated with major changes and transformations of production procedures, delivery and organization of services, clinical practices, working methods, and clinicaladministrative processes and cultures (professional/organizational). Conclusion The EQTN reflects the complex, structuring, and innovative projects that organizations and health systems are required to implement today. Future works should be more sensitive to the complexity associated with the emergence of telehealth networks and no longer reduce them to technological considerations.
https://www.ijhpm.com/article_3416_86a9bfa76bca74a75ac9ad3673db611e.pdf
2018-05-01
421
432
10.15171/ijhpm.2017.106
Telepathology Network
Telehealth Implementation
Evaluation
Sustainability
Healthcare Services
Hassane
Alami
hassane.alami@umontreal.ca
1
Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), CIUSSS-Capitale Nationale, Quebec City, QC, Canada
LEAD_AUTHOR
Jean-Paul
Fortin
jean-paul.fortin@fmed.ulaval.ca
2
Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), CIUSSS-Capitale Nationale, Quebec City, QC, Canada
AUTHOR
Marie-Pierre
Gagnon
marie-pierre.gagnon@fsi.ulaval.ca
3
Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), CIUSSS-Capitale Nationale, Quebec City, QC, Canada
AUTHOR
Hugo
Pollender
hugo.pollender.ciussscn@ssss.gouv.qc.ca
4
Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), CIUSSS-Capitale Nationale, Quebec City, QC, Canada
AUTHOR
Bernard
Têtu
bernard.tetu@fmed.ulaval.ca
5
University Hospital Center of Quebec-Laval University Research Center, Quebec City, QC, Canada
AUTHOR
France
Tanguay
france.tanguay@ssss.gouv.qc.ca
6
Integrated Health and Social Services Centre of Chaudière-Appalaches Hôtel-Dieu de Lévis, Lévis City, QC, Canada
AUTHOR
Flori F, Gilgenkrantz S. Démographie médicale. Med Sci (Paris). 2007;23(5):533-537.
1
Tetu B, Boulanger J, Houde C, et al. The Eastern Quebec telepathology network: a real collective project. Med Sci (Paris). 2012;28(11):993-999. doi:10.1051/medsci/20122811021
2
Tetu B, Perron E, Louahlia S, Pare G, Trudel MC, Meyer J. The Eastern Quebec Telepathology Network: a three-year experience of clinical diagnostic services. Diagn Pathol. 2014;9 Suppl 1:S1. doi:10.1186/1746-1596-9-s1-s1
3
Lowe J. Telepathology: Guidance from the Royal College of Pathologists. London, England: The Royal College of Pathologists; 2013.
4
Leinweber B, Massone C, Kodama K, et al. Teledermatopathology: a controlled study about diagnostic validity and technical requirements for digital transmission. Am J Dermatopathol. 2006;28(5):413-416. doi:10.1097/01.dad.0000211523.95552.86
5
Moqadem K, Pineau G: Télépathologie: lignes directrices et normes technologiques - Revue de la littérature. Québec: Agence d’évaluation des technologies et des modes d’intervention en santé (AETMIS); 2008.
6
Weinstein RS, López AM, Barker GP, et al. The innovative bundling of teleradiology, telepathology, and teleoncology services. IBM Systems Journal. 2007;46(1):69-84.
7
Collins BT. Telepathology in cytopathology: challenges and opportunities. Acta Cytol. 2013;57(3):221-232. doi:10.1159/000350718
8
Bernard C, Chandrakanth SA, Cornell IS, et al. Guidelines from the Canadian Association of Pathologists for establishing a telepathology service for anatomic pathology using whole-slide imaging. J Pathol Inform. 2014;5(1):15. doi:10.4103/2153-3539.129455
9
Ayad E. Virtual telepathology in Egypt, applications of WSI in Cairo University. Diagn Pathol. 2011;6 Suppl 1:S1. doi:10.1186/1746-1596-6-s1-s1
10
Pantanowitz L, Wiley CA, Demetris A, et al. Experience with multimodality telepathology at the University of Pittsburgh Medical Center. J Pathol Inform. 2012;3:45. doi:10.4103/2153-3539.104907
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Cornish TC, McClintock DS. Medicolegal and regulatory aspects of whole slide imaging-based telepathology. Diagn Histopathol (Oxf). 2014;20(12):475-481. doi:10.1016/j.mpdhp.2014.10.004
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Krupinski EA. Human Factors and Human-Computer Considerations in Teleradiology and Telepathology. Healthcare (Basel). 2014;2(1):94-114. doi:10.3390/healthcare2010094
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Ministère de la Santé et des Services sociaux du Québec. Loi modifiant l’organisation et la gouvernance du réseau de la santé et des services sociaux notamment par l’abolition des agences régionales (PL10), 2015. http://www2.publicationsduquebec.gouv.qc.ca/dynamicSearch/telecharge.php?type=5&file=2015C1F.PDF. Accessed Jun 27, 2016.
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Tetu B, Fortin JP, Gagnon MP, Louahlia S. The challenges of implementing a “patient-oriented” telepathology network; the Eastern Quebec telepathology project experience. Anal Cell Pathol (Amst). 2012;35(1):11-18. doi:10.3233/acp-2011-0023
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Perron E, Louahlia S, Nadeau L, et al. Telepathology for intraoperative consultations and expert opinions: the experience of the Eastern Quebec Telepathology Network. Arch Pathol Lab Med. 2014;138(9):1223-1228. doi:10.5858/arpa.2013-0466-OA
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Ministère de la santé et des services sociaux du Québec. Plans d’effectifs médicaux. http://www.msss.gouv.qc.ca/sujets/organisation/medecine-au-quebec/medecine-specialisee/prem/documents/toutes_specialites_2017-08-09.pdf. Accessed September 05, 2017.
19
Têtu B, Paré G, Trudel M-C, et al. Whole-slide imaging-based telepathology in geographically dispersed Healthcare Networks. The Eastern Québec Telepathology project. Diagn Histopathol (Oxf). 2014;20(12):462-469. doi:10.1016/j.mpdhp.2014.10.007
20
University Health Network. UHN Establishes First Telepathology System In Ontario. http://www.uhn.ca/corporate/News/PressReleases/Pages/UHN_first_telepathology_system.aspx. Accessed September 05, 2017. Published July 22, 2010.
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Alami H, Lamothe L, Fortin JP, Gagnon MP. L’implantation de la télésanté et la pérennité de son utilisation au Canada: quelques leçons à retenir (Telehealth implementation and the sustainability of its use in Canada: A few lessons to remember). European Research in Telemedicine/La Recherche Européenne en Télémédecine. 2016;5(4):105-117. doi:10.1016/j.eurtel.2016.10.001
52
ORIGINAL_ARTICLE
The Global Health Policies of the EU and its Member States: A Common Vision?
Background This article assesses the global health policies of the European Union (EU) and those of its individual member states. So far EU and public health scholars have paid little heed to this, despite the large budgets involved in this area. While the European Commission has attempted to define the ‘EU role in Global Health’ in 2010, member states are active in the domain of global health as well. Therefore, this article raises the question to what extent a common ‘EU’ vision on global health exists. Methods This is examined through a comparative framing analysis of the global health policy documents of the European Commission and five EU member states (France, Germany, the United Kingdom, Belgium, and Denmark). The analysis is informed by a two-layered typology, distinguishing global health from international health and four ‘global health frames,’ namely social justice, security, investment and charity. Results The findings show that the concept of ‘global health’ has not gained ground the same way within European policy documents. Consequently, there are also differences in how health is being framed. While the European Commission, Belgium, and Denmark clearly support a social justice frame, the global health strategies of the United Kingdom, Germany, and France put an additional focus on the security and investment frames. Conclusion There are different understandings of global/international health as well as different framings within relevant documents of the EU and its member states. Therefore, the existence of an ‘EU’ vision on global health is questionable. Further research is needed on how this impacts on policy implementation.
https://www.ijhpm.com/article_3421_e73ca7fecb48705838aec2fd3291cbea.pdf
2018-05-01
433
442
10.15171/ijhpm.2017.112
European Union (EU)
Global Health
Framing
Development Cooperation
Foreign Policy
Lies
Steurs
lies.steurs@ugent.be
1
Centre for EU Studies, Ghent University, Gent, Belgium
AUTHOR
Remco
Van de Pas
rvandepas@itg.be
2
Institute of Tropical Medicine, Antwerp, Belgium
LEAD_AUTHOR
Sarah
Delputte
sarah.delputte@ugent.be
3
Centre for EU Studies, Ghent University, Gent, Belgium
AUTHOR
Jan
Orbie
jan.orbie@ugent.be
4
Centre for EU Studies, Ghent University, Gent, Belgium
AUTHOR
Fidler DP. After the revolution: global health politics in a time of economic crisis and threatening future trends. Global Health Governance. 2009;2(2).
1
Feldbaum H, Lee K, Michaud J. Global health and foreign policy. Epidemiol Rev. 2010;32(1):82-92. doi:10.1093/epirev/mxq006
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Rollet V, Chang P. Is the European Union a Global Health Actor ? An Analysis of its Capacities , Involvement and Challenges. Eur Foreign Aff Rev. 2013;18(3):309-328.
3
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4
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48
ORIGINAL_ARTICLE
Factors That Influence Enrolment and Retention in Ghana’ National Health Insurance Scheme
Background The government of Ghana introduced the National Health Insurance Scheme (NHIS) in 2004 with the goal of achieving universal coverage within 5 years. Evidence, however, shows that expanding NHIS coverage and especially retaining members have remained a challenge. A multilevel perspective was employed as a conceptual framework and methodological tool to examine why enrolment and retention in the NHIS remains low. Methods A household survey was conducted after 20 months educational and promotional activities aimed at improving enrolment and retention rates in 15 communities in the Central and Eastern Regions (ERs) of Ghana. Observation, indepth interviews and informal conversations were used to collect qualitative data. Forty key informants (community members, health providers and district health insurance schemes’ [DHISs] staff) purposely selected from two casestudy communities in the Central Region (CR) were interviewed. Several community members, health providers and DHISs’ staff were also engaged in informal conversations in the other five communities in the region. Also, four staff of the Ministry of Health (MoH), Ghana Health Service (GHS) and National Health Insurance Authority (NHIA) were engaged in in-depth interviews. Descriptive statistics was used to analyse quantitative data. Qualitative data was analysed using thematic content analysis. Results The results show that factors that influence enrolment and retention in the NHIS are multi-dimensional and cut across all stakeholders. People enrolled and renewed their membership because of NHIS’ benefits and health providers’ positive behaviour. Barriers to enrolment and retention included: poverty, traditional risk-sharing arrangements influence people to enrol or renew their membership only when they need healthcare, dissatisfaction about health providers’ behaviour and service delivery challenges. Conclusion Given the multi-dimensional nature of barriers to enrolment and retention, we suggest that the NHIA should engage DHISs, health providers and other stakeholders to develop and implement intervention activities to eliminate corruption, shortage of drugs in health facilities and enforce the compulsory enrolment stated in the NHIS policy to move the scheme towards universal coverage.
https://www.ijhpm.com/article_3427_6613ceb4bb98eabc6f6cb8435366bce9.pdf
2018-05-01
443
454
10.15171/ijhpm.2017.117
National Health Insurance (NHI)
Enrolment
Retention
Drugs
Ghana
Agnes Millicent
Kotoh
amkotoh@ug.edu.gh
1
School of Public Health, University of Ghana, Legon, Ghana
LEAD_AUTHOR
Genevieve Cecelia
Aryeetey
okailey.aryeetey@gmail.com
2
School of Public Health, University of Ghana, Legon, Ghana
AUTHOR
Sjaak
Van der Geest
s.vandergeest@uva.nl
3
Department of Sociology and Anthropology, University of Amsterdam, Amsterdam, The Netherlands
AUTHOR
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67
ORIGINAL_ARTICLE
Knowledge Translation in Healthcare – Towards Understanding its True Complexities; Comment on “Using Complexity and Network Concepts to Inform Healthcare Knowledge Translation”
This commentary argues that to fully appreciate the complexities of knowledge transfer one firstly has to distinguish between the notions of “data, information, knowledge and wisdom,” and that the latter two are highly context sensitive. In particular one has to understand knowledge as being personal rather than objective, and hence there is no form of knowledge that a-priori is more authoritative than another. Secondly, knowledge transfer in organisations can only be successful if the organisation is organised and managed as a “complex adaptive organisation” – its key characteristics arising from it’s a-priori defined common “purpose, goals and values.” Knowledge transfer, seen as “whole of system/organisation learning,” is highly context sensitive; while the principles may apply to many organisations, knowledge as such is not transferable from one context to another, it always will be a unique learning exercise at this particular point in time in this particular organisation.
https://www.ijhpm.com/article_3415_35eaf915f5e50de8c50b6e7ffbe49c65.pdf
2018-05-01
455
458
10.15171/ijhpm.2017.111
Complexity of Knowledge
Knowing in Medicine
Evidence
Complex Adaptive Organisation
Knowledge Transfer
Deviant Behaviour
Joachim P.
Sturmberg
jp.sturmberg@gmail.com
1
University of Newcastle, Callaghan, NSW, Australia
LEAD_AUTHOR
Kitson A, Brook A, Harvey G, et al. Using Complexity and Network Concepts to Inform Healthcare Knowledge Translation. Int J Health Policy Manag. 2017; forthcoming. doi:10.15171/ijhpm.2017.79
1
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21
ORIGINAL_ARTICLE
Reaching Outside the Comfort Zone: Realising the FCTC’s Potential for Public Health Governance and Regulation in the European Union; Comment on “The Legal Strength of International Health Instruments – What It Brings to Global Health Governance?”
In their paper, Nikogosian and Kickbusch show how the effects of the adoption by the World Health Organization (WHO) of the Framework Convention on Tobacco Control (WHO FCTC) and its first Protocol extend beyond tobacco control and contribute to public health governance more broadly, by revealing new processes, institutions and instruments. While there are certainly good reasons to be optimistic about the impact of these instruments in the public health sphere, the experience of the FCTC’s implementation in the context of the European Union (EU) shows that further efforts are still necessary for its full potential to be realised. Indeed, one of the main hurdles to the FCTC’s success so far has been the difficulty in developing and maintaining comprehensive multisectoral measures and involving sectors beyond the sphere of public health.
https://www.ijhpm.com/article_3417_386edbb2d3279a15f051349bfc262433.pdf
2018-05-01
459
462
10.15171/ijhpm.2017.107
European Union (EU)
Multilateralism
Tobacco Taxation
Public Health Governance
Florence
Berteletti
florence.berteletti@smokefreepartnership.eu
1
Smoke Free Partnership, Brussels, Belgium
LEAD_AUTHOR
WHO Framework Convention on Tobacco Control. WHO website. Geneva: World Health Organization; 2003. http://www.who.int/fctc/text_download/en/. Accessed July 12, 2017.
1
WHO Framework Convention on Tobacco Control. Protocol to Eliminate Illicit Trade in Tobacco Products. WHO website. Geneva: World Health Organization; 2013. http://www.who.int/fctc/protocol/en/. Accessed July 12, 2017.
2
Nikogosian H, Kickbusch I. The Legal Strength of International Health Instruments - What It Brings to Global Health Governance? Int J Health Policy Manag. 2016;5(12):683-685. doi:10.15171/ijhpm.2016.122
3
WHO. Which are the most effective and cost-effective interventions for tobacco control? http://www.euro.who.int/__data/assets/pdf_file/0004/74722/E82993.pdf. Accessed June 10, 2017. Published 2003.
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The World Bank. The Economics of Tobacco Use & Tobacco Control in the Developing World. http://ec.europa.eu/health/archive/ph_determinants/life_style/tobacco/documents/world_bank_en.pdf. Accessed June 10, 2017. Published 2003.
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Hopkins DP, Briss PA, Ricard CJ, et al. Reviews of evidence regarding interventions to reduce tobacco use and exposure to environmental tobacco smoke. Am J Prev Med. 2001;20(2 Suppl):16-66.
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Levy DT, Chaloupka F, Gitchell J. The effects of tobacco control policies on smoking rates: a tobacco control scorecard. J Public Health Manag Pract. 2004;10(4):338-353.
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Centre for Disease Control and Prevention (CDC). Preventing tobacco use among young people: a report of the Surgeon General. https://www.cdc.gov/mmwr/pdf/rr/rr4304.pdf. Accessed June 10, 2017. Published 1994.
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Ross H. Undermining Global Best Practice in Tobacco Taxation in the ASEAN Region -- Review of the ITIC’s ASEAN Excise Tax Reform: A Resource Manual. http://seatca.org/dmdocuments/Review_ITIC_Tax_Manual_Revised_Oct26.pdf. Accessed June 10, 2017. Published 2015.
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Doward J. Former UK Tax Chief Under Fire for Joining Smoking Lobbyists. The Guardian. May 16, 2015. https://www.theguardian.com/business/2015/may/16/uk-tax-chief-smoking-health-dave-hartnett-tobacco-hmrc. Accessed June 10, 2017
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Ross H. Undermining Global Best Practice in Tobacco Taxation in the ASEAN Region -- Review of the ITIC’s ASEAN Excise Tax Reform: A Resource Manual. Bangkok: Southeast Asia Tobacco Control Alliance (SEATCA); 2015.
13
Gilmore AB, Fooks G, Drope J, Bialous SA, Jackson RR. Exposing and addressing tobacco industry conduct in low-income and middle-income countries. Lancet. 2015;385(9972):1029-1043. doi:10.1016/s0140-6736(15)60312-9
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Tobacco taxation is one of the most cost-effective health interventions: government revenues increase while smoking rates fall. Tobacco Control Playbook website. https://tobaccoplaybook.net/en/006-taxation.html. Published September 13, 2016
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Castro JL. We won’t achieve sustainable development goals for NCDs or other targets without tobacco taxes. The Lancet Global Health Journal. August 30 2016. http://globalhealth.thelancet.com/2016/08/30/we-wont-achieve-sustainable-development-goals-ncds-or-other-targets-without-tobacco-taxes. Accessed July 12, 2017
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IARC handbooks of cancer prevention: tobacco control. Volume 14: effectiveness of tax and price policies for tobacco control. Lyon, France: International Agency for Research on Cancer; 2011. http://www.iarc.fr/en/publications/pdfs-online/prev/handbook14/handbook14.pdf. Accessed June 10, 2017.
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Chaloupka FJ, Straif K, Leon ME. Effectiveness of tax and price policies in tobacco control. Tob Control. 2011;20(3):235-238. doi:10.1136/tc.2010.039982
18
WHO report on the Global tobacco epidemic, 2015 Raising taxes on tobacco. WHO website. http://apps.who.int/iris/bitstream/10665/178574/1/9789240694606_eng.pdf. Accessed June 10, 2017. Published 2015.
19
Articles 26, 113 and 168 of the Treaty on the Functioning of the European Union.
20
Article 2 of Council Directive 2011/64/EU.
21
ORIGINAL_ARTICLE
Public Spending on Health Services and Policy Research in Canada: A Reflection on Thakkar and Sullivan; Comment on “Public Spending on Health Service and Policy Research in Canada, the United Kingdom, and the United States: A Modest Proposal”
Vidhi Thakkar and Terrence Sullivan have done a careful and thought-provoking job in trying to establish comparable estimates of public spending on health services and policy research (HSPR) in Canada, the United Kingdom and the United States. Their main recommendation is a call for an international collaboration to develop common terms and categories of HSPR. This paper raises two additional questions that have an international comparative dimension: There is little doubt that public spending on HSPR represents more than the “tip of the iceberg,” but how much more? And how do the countries fare on the uptake of HSPR by decision-makers? I have long speculated that probably as much or more is spent by provincial/territorial governments, regional health authorities, hospitals and other agencies on HSPR activities carried out by consultants in Canada than by the federal, provincial/territorial granting agencies. Support for this contention is provided in a paper by Penno and Gauld on spending on external consultancies by New Zealand’s District Health Boards (DHBs). Their estimate of the amount spent on consultancies in 2014/15 represents 80% of the amount spent on research by the Health Research Council of New Zealand in 2015. In terms of the uptake of research Jonathan Lomas pioneered the concept of linking researchers with decisionmakers when he became the founding Chief Executive Officer (CEO) of the Canadian Health Services Research Foundation (CHSRF) in 1997. An early assessment was promising, and it would be interesting to know if other countries have tried this. Most assessments of research uptake and impact are short-term in nature. It might be insightful to assess HSPR developments over the long term, such as prospective reimbursement through diagnosis related groups (DRGs) that has been evolving internationally for more 40+ years. In the short term the prospects for a major infusion of funding in HSPR in Canada are not promising, although there have been welcome investments in the Canadian Foundation for Healthcare Improvement (formerly CHSRF).
https://www.ijhpm.com/article_3418_920f128b2cb352f092eaccb8657befa5.pdf
2018-05-01
463
466
10.15171/ijhpm.2017.113
Health Services
Policy
Research
Owen
Adams
owen.adams@cma.ca
1
Canadian Medical Association, Ottawa, ON, Canada
LEAD_AUTHOR
Thakkar V, Sullivan T. Public spending on health service and policy research in Canada, the United Kingdon, and the United States: a modest proposal. Int J Health Policy Manag. 2017; forthcoming. doi:10.15171/ijhpm.2017.45
1
Health services research. Canadian Institutes of Health Research website. http://www.cihr-irsc.gc.ca/e/48809.html.
2
Penno E, Gauld R. The role, costs and value for money of external consultancies in the health sector: a study of New Zealand’s District Health Boards. Health Policy. 2017;121(4):458-467. doi:10.1016/j.healthpol.2017.02.005
3
Health Research Council of New Zealand. Annual report 2016. http://www.hrc.govt.nz/sites/default/files/annual_report_2016_0.pdf. Accessed July 21, 2017.
4
Hunter DJ, Frank J. Making research matter: Comment on “public spending on health service and policy research in Canada, The United Kingdom and the United States: a modest proposal.” Int J Health Policy Manag. 2017; forthcoming. doi:10.15171/ijhpm.2017.97
5
Millar K. Canadian Institute for Health Information. Accessed August 1, 2017.
6
Office of the Auditor General of Ontario. Consultant use in selected health organizations. http://www.auditor.on.ca/en/content/specialreports/specialreports/consultantuse_en.pdf. Accessed August 1, 2017.
7
Romanow R. Building on Values: the future of health care in Canada. http://publications.gc.ca/collections/Collection/CP32-85-2002E.pdf. Accessed August 1, 2017.
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Lomas J. Improving research dissemination and uptake in the health sector: beyond the sound of one hand clapping. McMaster University Centre for Health Economics and Policy Analysis Policy Commentary C97-1. Published November, 1997.
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Department of Finance Canada. Budget 1996. Budget plan. https://fin.gc.ca/budget96/bp/bp96e.pdf. Accessed August 1, 2017.
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Ross S, Lavis J, Rodriguez C, Woodside J, Denis JL. Partnership experiences: involving decision-makers in the research process. J Health Serv Res Policy. 2003;8 Suppl 2:26-34. doi:10.1258/135581903322405144
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About Academy Health. Academy Health website. http://www.academyhealth.org/about. Accessed September 11, 2017.
12
Health System Impact Fellowhips – host employer partner organizations. Canadian Institutes of Health Research website. http://www.cihr-irsc.gc.ca/e/50223.html. Accessed September 11, 2017.
13
Lewis S, Naylor CD, Battista R, et al. Canada needs an evidence-based decision-making trade show. Cmaj. 1998;158(2):210-212.
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Britnell M. In Search of the Perfect Health System. New York NY: Palgrave Macmillan. 2015.
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Tamblyn R, McMahon M, Girard N, Drake E, Nadigel J, Gaudreau K. Health services and policy research in the first decade at the Canadian Institutes of Health Research. CMAJ Open. 2016;4(2):E213-221. doi:10.9778/cmajo.20150045
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Canadian Institutes of Health Research. Funding overview. http://www.cihr-irsc.gc.ca/e/37788.html. Accessed August 3, 2017.
17
Fetter RB, Shin Y, Freeman JL, Averill RF, Thompson JD. Case mix definition by diagnosis-related groups. Med Care. 1980;18(2 Suppl):iii, 1-53.
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Congress of the U.S. Office of Technology Assessment. Diagnosis Related Groups (DRGs) and the Medicare Program: implications for medical technology. Washington, DC; 1983.
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Busse R, Geissler A, Quentin W, Wiley M. Diagnosis-related groups in Europe: moving towards transparency, efficiency and quality in hospitals. Berkshire, England: Open University Press; 2011.
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American Hospital Association. Medicare’s bundled payment initiatives: considerations for providers. http://www.aha.org/content/16/issbrief-bundledpmt.pdf. Accessed August 3, 2017.
21
Sutherland J, Crump RT, Repin N, Hellsten E. Paying for hospital services: a hard look at the options. https://www.cdhowe.org/sites/default/files/attachments/research_papers/mixed/Commentary_378_0.pdf. Accessed August 3, 2017.
22
Advisory Panel on Healthcare Innovation. Unleashing innovation: excellent healthcare for Canada. http://healthycanadians.gc.ca/publications/health-system-systeme-sante/report-healthcare-innovation-rapport-soins/alt/report-healthcare-innovation-rapport-soins-eng.pdf. Accessed August 3, 2017.
23
Department of Finance Canada. Building a strong middle class #Budget2017. http://www.budget.gc.ca/2017/docs/plan/budget-2017-en.pdf. Accessed August 3, 2017.
24
Canadian Foundation for Healthcare Improvement. Home is where the health is: scaling up INSPIRED approaches to COPD care. Prospectus. http://www.cfhi-fcass.ca/sf-docs/default-source/documents/inspired-scale/inspired-scale-prospectus-e.pdf?sfvrsn=8. Accessed Septemebr 11, 2017.
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26
Innovation, Science and Economic Development Canada. Statement from the Government of Canada on receiving the expert panel’s report on Canada’s Fundamental Science Review. https://www.canada.ca/en/innovation-science-economic-development/news/2017/04/statement_from_thegovernment ofcanadaonreceivingtheexpertpanelsre.html. Accessed August 3, 2017.
27
Schneider E, Sarnak D, Squires D, Shah A, Doty M. Mirror, mirror 2017: international comparison reflects flaws and opportunities for better U.S. health care. http://www.commonwealthfund.org/interactives/2017/july/mirror-mirror/. Accessed August 3, 2017.
28
ORIGINAL_ARTICLE
Human Rights Treaties Are an Important Part of the “International Health Instrumentariam”; Comment on “The Legal Strength of International Health Instruments - What It Brings to Global Health Governance?”
In their commentary, Haik Nikogosian and Ilona Kickbusch argue for the necessity of new binding international legal instruments for health to address complex health determinants and offer a cogent analysis of the implications of such treaties for future global health governance. Yet in doing so they pay no attention to the existing instrumentarium of international legally binding treaties relevant to health, in the form of human rights treaties. International human rights law has entrenched individual entitlements and state obligations in relation to individual and public health through iterative human rights treaties since 1946. These treaties offer normative specificity, institutional monitoring and the possibility of enforcement and accountability. If we are to build a new ‘international health instrumentariam’ we should not ignore existing and important tools that can assist in this endeavor.
https://www.ijhpm.com/article_3422_71b860a04763d07ddcc20a20e3674092.pdf
2018-05-01
467
469
10.15171/ijhpm.2017.109
Human Rights
International Law
Right to Health
Global Health
Lisa
Forman
lisa.forman@utoronto.ca
1
Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
LEAD_AUTHOR
Nikogosian H, Kickbusch I. The Legal Strength of International Health Instruments - What It Brings to Global Health Governance? Int J Health Policy Manag. 2016;5(12):683-685. doi:10.15171/ijhpm.2016.122
1
Constitution of the World Health Organization. Am J Public Health Nations Health. 1946;36(11):1315-1323.
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Universal Declaration of Human Rights. http://undocs.org/A/810. Published 1948.
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International Covenant on Economic, Social and Cultural Rights. http://www.ohchr.org/EN/ProfessionalInterest/Pages/CESCR.aspx. Published 1966.
4
International Convention on the Elimination of All Forms of Racial Discrimination. http://www.ohchr.org/EN/ProfessionalInterest/Pages/CERD.aspx. Published 1966.
5
Convention on the Elimination of All Forms of Discrimination Against Women. http://www.un.org/womenwatch/daw/cedaw/text/econvention.htm. Published 1979.
6
Convention on the Rights of the Child. http://undocs.org/A/44/49. Published 1989.
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Convention on the Rights of Persons with Disabilities. http://www.un.org/disabilities/documents/convention/convoptprot-e.pdf. Published 2006.
8
General Comment No. 14 (2000): The Right to the Highest Attainable Standard of Health (Article 12 of the International Covenant on Economic, Social and Cultural Rights). 2000. http://undocs.org/E/C.12/2000/4. Published 2000.
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11
Alyne Da Silva Pimentel Teixeira v. Brazil. http://www2.ohchr.org/english/law/docs/CEDAW-C-49-D-17-2008_en.pdf. Published 2011.
12
Ibañez XA, Dekanosidze T. The State’s obligation to regulate and monitor private health care facilities: the Alyne da Silva Pimentel and the Dzebniauri cases. Public Health Rev. 2017;38(1):17. doi:10.1186/s40985-017-0063-6
13
Press release: Brazil Takes Step to Implement Historic United Nations Ruling in Maternal Death Case. Center for Reproductive Rights website. https://www.reproductiverights.org/press-room/Brazil-Takes-Step-to-Implement-Historic-United-Nations-Ruling-in-Maternal-Death-Case%20. Accessed August 30, 2017. Published November 3, 2014.
14
Heymann J, Cassola A, Raub A, Mishra L. Constitutional rights to health, public health and medical care: the status of health protections in 191 countries. Glob Public Health. 2013;8(6):639-653. doi:10.1080/17441692.2013.810765
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Yamin AE, Gloppen S, eds. Can Courts Bring More Justice to Health? Cambridge: Harvard University Press; 2011.
16
Gross A, Flood C. The Right to Health in a Globalized World. Cambridge: Cambridge University Press; 2014.
17
WHO Framework Convention on Tobacco Control (FCTC). WHO website. http://www.who.int/fctc/text_download/en/. Published 2003.
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Cabrera OA, Gostin LO. Human rights and the Framework Convention on Tobacco Control: mutually reinforcing systems. Int J Law Context. 2011;7(3):285-303. doi:10.1017/S1744552311000139
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20
ORIGINAL_ARTICLE
Soda Taxes: The Importance of Analysing Policy Processes; Comment on “The Untapped Power of Soda Taxes: Incentivising Consumers, Generating Revenue, and Altering Corporate Behaviours”
Sarah A. Roache and Lawrence O. Gostin’s recent editorial comprehensively presents soda taxation rationales from a public health perspective. While we essentially agree that soda taxes are gaining momentum, this commentary expands upon the need for a better understanding of the policy processes underlying their development and implementation. Indeed, the umbrella concept of soda taxation actually covers a diversity of objectives and mechanisms, which may not only condition the feasibility and acceptability of a proposal, but also alter its impact. We briefly highlight some conditions that may have influenced soda tax policy processes and why further theory-driven case studies may be instructive.
https://www.ijhpm.com/article_3428_931790082e6ee53b3db9dfca88e42a40.pdf
2018-05-01
470
473
10.15171/ijhpm.2017.126
Soda Tax
Sugar
Food and Nutrition
Policy Process
Health Promotion
Yann
Le Bodo
yann.lebodo@ehesp.fr
1
Evaluation Platform on Obesity Prevention (EPOP), Quebec Heart and Lung University Institute Research Center – Laval University (Université Laval), Quebec City, QC, Canada
LEAD_AUTHOR
Philippe
De Wals
philippe.dewals@criucpq.ulaval.ca
2
Evaluation Platform on Obesity Prevention (EPOP), Quebec Heart and Lung University Institute Research Center – Laval University (Université Laval), Quebec City, QC, Canada
AUTHOR
Roache SA, Gostin LO. the untapped power of soda taxes: incentivizing consumers, generating revenue, and altering corporate behavior. Int J Health Policy Manag. 2017;6(9):489-493. doi:10.15171/ijhpm.2017.69
1
Le Bodo Y, Paquette MC, De Wals P. Taxing Soda for Public Health: A Canadian Perspective. 1st ed. Springer; 2016.
2
Colchero MA, Rivera-Dommarco J, Popkin BM, Ng SW. In Mexico, evidence of sustained consumer response two years after implementing a sugar-sweetened beverage tax. Health Aff (Millwood). 2017;36(3):564-571. doi:10.1377/hlthaff.2016.1231
3
Silver LD, Ng SW, Ryan-Ibarra S, et al. Changes in prices, sales, consumer spending, and beverage consumption one year after a tax on sugar-sweetened beverages in Berkeley, California, US: A before-and-after study. Langenberg C, ed. PLoS Med. 2017;14(4):e1002283. doi:10.1371/journal.pmed.1002283
4
Sarlio-Lähteenkorva S, Winkler JT. Could a sugar tax help combat obesity? BMJ. 2015;351:h4047. doi:10.1136/bmj.h4047
5
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6
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7
Actualícese.com. Impuesto a las bebidas azucaradas no tuvo eco en reforma tributaria. Actualícese. http://actualicese.com/actualidad/2017/01/20/impuesto-a-las-bebidas-azucaradas-no-tuvo-eco-en-reforma-tributaria/. Accessed October 4, 2017. Published January 20, 2017.
8
Gamboa R. The not-too-sweet side of sugar. The Philippine Star. August 31, 2017. http://www.philstar.com:8080/business/2017/08/31/1734257/not-too-sweet-side-sugar. Accessed October 4, 2017.
9
Hagenaars LL, Jeurissen PPT, Klazinga NS. The taxation of unhealthy energy-dense foods (EDFs) and sugar-sweetened beverages (SSBs): an overview of patterns observed in the policy content and policy context of 13 case studies. Health Policy. 2017;121(8):887-894. doi:10.1016/j.healthpol.2017.06.011
10
HM Treasury. Finance (No. 2) Bill 2017. Explanatory Notes. March 2017. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/600791/Finance_Bill_2017_Explanatory_Notes.pdf. Accessed August 21, 2017.
11
Pan American Health Organization (PAHO). Taxes on Sugar-Sweetened Beverages as a Public Health Strategy: The Experience of Mexico. Mexico DF; 2015.
12
WHO Regional Office for the Western Pacific. Technical Workshop on Taxing Sugar-Sweetened Beverages - Meeting Report. Manila, Philippines; 2017. http://iris.wpro.who.int/handle/10665.1/13549. Accessed June 28, 2017.
13
Thow AM, Quested C, Juventin L, Kun R, Khan AN, Swinburn B. Taxing soft drinks in the Pacific: implementation lessons for improving health. Health Promot Int. 2011;26(1):55-64. doi:10.1093/heapro/daq057
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Healthy Caribbean Coalition. A closer look - The Implementation of Taxation on Sugar-Sweetened Beverages by the Government of Barbados - A Civil society perspective. https://www.healthycaribbean.org/wp-content/uploads/2016/07/HCC-SSB-Brief-2016.pdf. Accessed June 28, 2017. Published July 2016.
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Mosier SL. Cookies, candy, and coke: examining state sugar-sweetened-beverage tax policy from a multiple streams approach. Int Rev Public Adm. 2013;18(1):93-120. doi:10.1080/12294659.2013.10805242
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Purtle J, Langellier B, Lê-Scherban F. A case study of the Philadelphia sugar-sweetened beverage tax policymaking process: implications for policy development and advocacy. J Public Health Manag Pract. March 2017. doi:10.1097/PHH.0000000000000563
17
Paarlberg R, Mozaffarian D, Micha R. Viewpoint: Can U.S. local soda taxes continue to spread? Food Policy. 2017;71:1-7. doi:10.1016/j.foodpol.2017.05.007
18
French Constitutional Council. Décision No2011-644DC. Article, Consolidation, Travaux Parlementaires; 2011. http://www.conseil-constitutionnel.fr/conseil-constitutionnel/francais/les-decisions/acces-par-date/decisions-depuis-1959/2011/2011-644-dc/decision-n-2011-644-dc-du-28-decembre-2011.104235.html. Accessed March 1, 2012.
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21
Nestle M. Soda Politics: Taking on Big Soda (and Winning). Oxford, UK: Oxford University Press; 2015.
22
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23
Hawkes N. Sugar tax will double funding for sport in primary schools, says chancellor. BMJ. 2016;352:i1602. doi:10.1136/bmj.i1602
24
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25
Sisnowski J, Street JM, Braunack-Mayer A. Targeting population nutrition through municipal health and food policy: implications of New York City's experiences in regulatory obesity prevention. Food Policy. 2016;58:24-34. doi:10.1016/j.foodpol.2015.10.007
26
Capazorio B. Parliament hears pros and cons of a sugar tax in SA. http://www.sowetanlive.co.za/news/2017/01/31/parliament-hears-pros-and-cons-of-a-sugar-tax-in-sa. Accessed June 28, 2017. Published January 31, 2017.
27
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Arthur R. UK sugar tax: Government encourages further reformulation as draft legislation published. Beverage Daily. October 5, 2017. https://www.beveragedaily.com/Article/2016/12/06/UK-sugar-tax-draft-legislation-published. Accessed October 5, 2017.
29
L’Essentiel. Finalement, il n’y aura pas de taxe sur les sodas. Lessentiel. September 18, 2017. http://www.lessentiel.lu/fr/luxembourg/story/Finalement-il-n-y-aura-pas-de-taxe-sur-les-sodas-29155744. Accessed October 5, 2017.
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Cullerton K, Donnet T, Lee A, Gallegos D. Playing the policy game: a review of the barriers to and enablers of nutrition policy change. Public Health Nutr. 2016;19(14):2643-2653. doi:10.1017/S1368980016000677.
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Clavier C, de Leeuw EJJ. Framing public policy in health promotion: ubiquitous, yet elusive. In: Health Promotion and the Policy Process. 1st ed. Oxford: Oxford University Press; 2013:1–22.
32
Gagnon F, Bergeron P, Clavier C, Fafard P, Martin E, Blouin C. Why and how political science can contribute to public health? Proposals for collaborative research avenues. Int J Health Policy Manag. 2017;6(9):495-499. doi:10.15171/ijhpm.2017.38
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Clarke B, Swinburn B, Sacks G. The application of theories of the policy process to obesity prevention: a systematic review and meta-synthesis. BMC Public Health. 2016;16(1):1084. doi:10.1186/s12889-016-3639-z
36
ORIGINAL_ARTICLE
Accelerating the Worldwide Adoption of Sugar-Sweetened Beverage Taxes: Strengthening Commitment and Capacity; Comment on “The Untapped Power of Soda Taxes: Incentivizing Consumers, Generating Revenue, and Altering Corporate Behavior”
In their recent article Roache and Gostin outline why governments and public health advocates should embrace soda taxes. The evidence is strong and continues to grow: such taxes can change consumer behavior, generate significant revenue and incentivize product reformulation. In essence, such taxes are an important and now well-established instrument of fiscal and public health policy. In this commentary we expand on their arguments by considering how the worldwide adoption of such taxes might be further accelerated. First, we identify where in the world taxes have been implemented to date and where the untapped potential remains greatest. Second, drawing upon recent case study research on country experiences we describe several conditions under which governments may be more likely to make taxation a political priority in the future. Third, we consider how to help strengthen the technical and legal capacities of governments to design and effectively administer taxes, with emphasis on low- and middle-income countries. We expect the findings to be most useful to public health advocates and policy-makers seeking to promote healthier diets and good nutrition.
https://www.ijhpm.com/article_3431_e907f46cc80d9d0205449cc5e81a6990.pdf
2018-05-01
474
478
10.15171/ijhpm.2017.127
Sugar-Sweetened Beverages
Taxes
Political Priority
Capacity
Framing
Phillip
Baker
phillip.baker@sydney.edu.au
1
Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
LEAD_AUTHOR
Alexandra
Jones
ajones@georgeinstitute.org.au
2
The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
AUTHOR
Anne Marie
Thow
annemarie.thow@sydney.edu.au
3
Menzies Centre for Health Policy, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
AUTHOR
Roache S, Gostin L. The untapped power of soda taxes: incentivizing consumers, generating revenue, and altering corporate behavior. Int J Health Policy Manag. 2017;6(9):489-493. doi:10.15171/ijhpm.2017.69
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3
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Baker P, Friel S. Processed foods and the nutrition transition: evidence from Asia. Obes Rev. 2014;15(7):564-577. doi:10.1111/obr.12174
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Baker P, Gill T, Friel S, Carey G, Kay A. Generating political priority for regulatory interventions targeting obesity prevention: an Australian case study. Soc Sci Med. 2017;177:141-149. doi:10.1016/j.socscimed.2017.01.047
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Magnusson RS, Patterson D. The role of law and governance reform in the global response to non-communicable diseases. Global Health. 2014;10:44. doi:10.1186/1744-8603-10-44
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Donaldson E. Advocating for sugar-sweetened beverage taxation: a case study of Mexico. John Hopkins Bloomberg School of Public Health; 2017.
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Wright A, Smith KE, Hellowell M. Policy lessons from health taxes: a systematic review of empirical studies. BMC Public Health. 2017;17(1):583. doi:10.1186/s12889-017-4497-z
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Thow AM, Quested C, Juventin L, Kun R, Khan AN, Swinburn B. Taxing soft drinks in the Pacific: implementation lessons for improving health. Health Promot Int. 2011;26(1):55-64. doi:10.1093/heapro/daq057
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Williams SN. 'Soda taxes' and 'fat taxes' can help tackle the twin problems of global obesity and under-nutrition. Perspect Public Health. 2016;136(1):21-22. doi:10.1177/1757913915616733
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Roh S, Schuldt JP. Where there's a will: can highlighting future youth-targeted marketing increase support for soda taxes? Health Psychol. 2014;33(12):1610-1613. doi:10.1037/hea0000021
19
George A. Not so sweet refrain: Sugar-sweetened beverages taxes, industry opposition and harnessing the lessons learned from tobacco control legal challenges. Melbourne: McCabe Centre for Law and Cancer; 2017.
20
World Health Organization Regional Office for Europe. Using pricing policies to promote healthy diets. Copenhagen: WHO; 2015.
21
Backholer K, Blake M, Vandevijvere S. Have we reached a tipping point for sugar-sweetened beverage taxes? Public Health Nutr. 2016;19(17):3057-3061. doi:10.1017/s1368980016003086
22
Thow AM, Jones A, Hawkes C, Ali I, Labonte R. Nutrition labelling is a trade policy issue: lessons from an analysis of specific trade concerns at the World Trade Organization. Health Promot Int. 2017. doi:10.1093/heapro/daw109
23
Magnusson RS. Framework legislation for non-communicable diseases: and for the Sustainable Development Goals? BMJ Glob Health. 2017;2(3). doi:10.1136/bmjgh-2017-000385
24
Gostin LO, Abou-Taleb H, Roache SA, Alwan A. Legal priorities for prevention of non-communicable diseases: innovations from WHO's Eastern Mediterranean region. Public Health. 2017;144:4-12. doi:10.1016/j.puhe.2016.11.001
25
ORIGINAL_ARTICLE
Eating or Feeding Our Young: A Response to Recent Commentaries
https://www.ijhpm.com/article_3441_23299eec8ac3f3794eb33f5c95a225ad.pdf
2018-05-01
479
480
10.15171/ijhpm.2017.136
Health Policy
Public Spending
Comparative Spending Health Services and Policy Research
Terrence
Sullivan
tsulliva2@gmail.com
1
Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
LEAD_AUTHOR
Vidhi
Thakkar
vidhi.thakkar@mail.utoronto.ca
2
Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
AUTHOR
Hunter DJ, Frank J. Making research matter: Comment on “Public spending on health service and policy research in Canada, the United Kingdom, and the United States: a modest proposal.” Int J Health Policy Manag. 2017; Forthcoming. doi:10.15171/ijhpm.2017.97
1
Barer ML, Bryan S. Health services research spending and healthcare system impact: Comment on “Public spending on health service and policy research in Canada, the United Kingdom, and the United States: a modest proposal.” Int J Health Policy Manag. 2017; Forthcoming. doi:10.15171/ijhpm.2017.92
2
Adams O. Public spending on health services and policy research in Canada: a reflection on Thakkar and Sullivan: Comment on “Public spending on health service and policy research in Canada, the United Kingdom, and the United States: a modest proposal.” Int J Health Policy Manag. 2017; Forthcoming.. doi:10.15171/ijhpm.2017.113
3
Thakkar V, Sullivan T. Public spending on health service and policy research in Canada, the United Kingdom, and the United States: a modest proposal. Int J Health Policy Manag. 2017;6(11):617-620. doi:10.15171/ijhpm.2017.45
4
Canadian Institute for Health Research. CIHR in Numbers 2016-2017. http://www.cihr-irsc.gc.ca/e/50218.html. Accessed November 3, 2017. Published August 2017.
5
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6
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Health Systems Impact Fellowships- Host Employer Partner Organization. http://www.cihr-irsc.gc.ca/e/50223.html. Accessed November 14, 2017. Published May 2017.
8
Canadian Association for Health Services and Policy Research. 2017. https://www.cahspr.ca/. Accessed November 14, 2017. Published 2017.
9