Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
5
6
2016
06
01
Global Health Governance Challenges 2016 – Are We Ready?
349
353
EN
Ilona
Kickbusch
Global Health Programme, Graduate Institute for International and Development Studies, Geneva, Switzerland
ilona.kickbusch@graduateinstitute.ch
10.15171/ijhpm.2016.27
The year 2016 could turn out to be a turning point for global health, new political realities and global insecurities will test governance and financing mechanisms in relation to both people and planet. But most importantly political factors such as the global power shift and “the rise of the rest” will define the future of global health. A new mix of health inequity and security challenges has emerged and the 2015 humanitarian and health crises have shown the limits of existing systems. The global health as well as the humanitarian system will have to prove their capacity to respond and reform. The challenge ahead is deeply political, especially for the rising political actors. They are confronted with the consequences of a model of development that has neglected sustainability and equity, and was built on their exploitation. Some direction has been given by the path breaking international conferences in 2015. Especially the agreement on the Sustainable Development Goals (SDGs) and the Paris agreement on climate change will shape action. Conceptually, we will need a different understanding of global health and its ultimate goals - the health of people can no longer be seen separate from the health of the planet and wealth measured by parameters of growth will no longer ensure health.
Global Health,Governance,Sustainable Development Goals (SDGs),Development,Power Shift,Sustainability,Humanitarian Crisis,Climate Change
https://www.ijhpm.com/article_3171.html
https://www.ijhpm.com/article_3171_4d1c28f177fa49b6089a399cce5d5eb0.pdf
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
5
6
2016
06
01
Power and Agenda-Setting in Tanzanian Health Policy: An Analysis of Stakeholder Perspectives
355
363
EN
Sara
Fischer
Department of Public Health, University of Copenhagen, Copenhagen, Denmark
sara.elisa.fischer@gmail.com
Martin
Strandberg-Larsen
Centre for Health Economics and Policy (CHEP), University of Copenhagen, Copenhagen, Denmark
masl@sund.ku.dk
10.15171/ijhpm.2016.09
Background <br />Global health policy is created largely through a collaborative process between development agencies and aid-recipient governments, yet it remains unclear whether governments retain ownership over the creation of policy in their own countries. An assessment of the power structure in this relationship and its influence over agenda-setting is thus the first step towards understanding where progress is still needed in policymaking for development. <br /> <br />Methods <br />This study employed qualitative policy analysis methodology to examine how health-related policy agendas are adopted in low-income countries, using Tanzania as a case study. Semi-structured, in-depth, key informant interviews with 11 policy-makers were conducted on perspectives of the agenda-setting process and its actors. Kingdon’s stream theory was chosen as the lens through which to interpret the data analysis. <br /> <br />Results <br />This study demonstrates that while stakeholders each have ways of influencing the process, the power to do so can be assessed based on three major factors: financial incentives, technical expertise, and influential position. Since donors often have two or all of these elements simultaneously a natural power imbalance ensues, whereby donor interests tend to prevail over recipient government limitations in prioritization of agendas. One way to mediate these imbalances seems to be the initiation of meaningful policy dialogue. <br /> <br />Conclusion <br />In Tanzania, the agenda-setting process operates within a complex network of factors that interact until a “policy window” opens and a decision is made. Power in this process often lies not with the Tanzanian government but with the donors, and the contrast between latent presence and deliberate use of this power seems to be based on the donor ideology behind giving aid (defined here by funding modality). Donors who used pooled funding (PF) modalities were less likely to exploit their inherent power, whereas those who preferred to maintain maximum control over the aid they provided (ie, non-pooled funders) more readily wielded their intrinsic power to push their own priorities.
Health Policy,Policy Analysis,Agenda-Setting,Power,Tanzania
https://www.ijhpm.com/article_3157.html
https://www.ijhpm.com/article_3157_af35f8fd0e8b79c65f1f0627f030343a.pdf
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
5
6
2016
06
01
Self-perceived Mental Health Status and Uptake of Fecal Occult Blood Test for Colorectal Cancer Screening in Canada: A Cross-Sectional Study
365
371
EN
Celestin
Hategekimana
School of Population and Public Health, University of British Columbia,
Vancouver, BC, Canada
celestin.hategeka@alumni.ubc.ca
Mohammad
Karamouzian
0000-0002-5631-4469
School of Population and Public Health, University of British Columbia,
Vancouver, BC, Canada
karamouzian.m@gmail.com
10.15171/ijhpm.2016.14
Background <br />While colorectal cancer (CRC) is one of the most preventable causes of cancer mortality, it is one of the leading causes of cancer death in Canada where CRC screening uptake is suboptimal. Given the increased rate of mortality and morbidity among mental health patients, their condition could be a potential barrier to CRC screening due to greater difficulties in adhering to behaviours related to long-term health goals. Using a population-based study among Canadians, we hypothesize that self-perceived mental health (SPMH) status and fecal occult blood test (FOBT) uptake for the screening of CRC are associated. <br /> <br />Methods <br />The current study is cross-sectional and utilised data from the Canadian Community Health Survey 2011-2012. Multinomial logistic regression analysis was undertaken to assess whether SPMH is independently associated with FOBT uptake among a representative sample of 11 386 respondents aged 50-74 years. <br /> <br />Results <br />Nearly half of the respondents reported having ever had FOBT for CRC screening, including 37.28% who have been screened within two years of the survey and 12.41% who had been screened more than two years preceding the survey. Respondents who reported excellent mental health were more likely to have ever been screened two years or more before the survey (adjusted odds ratio [AOR] = 2.08; 95% CI, 1.00-4.43) and to have been screened in the last two years preceding the survey (AOR = 1.53; 95% CI, 0.86-2.71) than those reported poor mental health status. <br /> <br />Conclusion <br />This study supports the association between SPMH status and FOBT uptake for CRC screening. While the efforts to maximize CRC screening uptake should be deployed to all eligible people, those with poor mental health may need more attention.
Screening,Colorectal Cancer (CRC),Fecal Occult Blood Test (FOBT),Self-perceived Mental,Health (SPMH) Status
https://www.ijhpm.com/article_3162.html
https://www.ijhpm.com/article_3162_a295fd3f43b1de56eeeecb194f63bf3a.pdf
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
5
6
2016
06
01
Norwegian Priority Setting in Practice – an Analysis of Waiting Time Patterns Across Medical Disciplines
373
378
EN
Jurgita
Januleviciute
Gangstøe
Department of Finance, Haukeland University Hospital, Bergen, Norway
jurgita.j.gangstoe@helse-bergen.no
Torhild
Heggestad
Department of Research and Development, Haukeland University Hospital,
Bergen, Norway
torhild.heggestad@helse-bergen.no
Ole
Frithjof
Norheim
0000-0002-5748-5956
Department of Research and Development, Haukeland University Hospital,
Bergen, Norway
ole.norheim@uib.no
10.15171/ijhpm.2016.23
Background <br />Different strategies for addressing the challenge of prioritizing elective patients efficiently and fairly have been introduced in Norway. In the time period studied, there were three possible outcomes for elective patients that had been through the process of priority setting: (i) high priority with assigned individual maximum waiting time; (ii) low priority without a maximum waiting time; and (iii) refusal (not in need for specialized services). We study variation in priority status and waiting time of the first two groups across different medical disciplines. <br /> <br />Methods <br />Data was extracted from the Norwegian Patient Register (NPR) and contains information on elective referrals to 41 hospitals in the Western Norway Regional Health Authority in 2010. The hospital practice across different specialties was measured by patient priority status and waiting times. The distributions of assigned maximum waiting times and the actual ones were analyzed using standard Kernel density estimation. The perspective of the planning process was studied by measuring the time interval between the actual start of healthcare and the maximum waiting time. <br /> <br />Results <br />Considerable variation was found across medical specialties concerning proportion of priority patients and their maximum waiting times. The degree of differentiation in terms of maximum waiting times also varied by medical discipline. We found that the actual waiting time was very close to the assigned maximum waiting time. Furthermore, there was no clear correspondence between the actual waiting time for patients and their priority <br />status. <br /> <br />Conclusion <br />Variations across medical disciplines are often interpreted as differences in clinical judgment and capacity. Alternatively they primarily reflect differences in patient characteristics, patient case-mix, as well as capacity. One hypothesis for further research is that the introduction of maximum waiting times may have contributed to push the actual waiting time towards the maximum. The finding that the actual waiting time was very close to the maximum waiting time supports this. The lack of clear correspondence between the actual waiting time for patients and their priority status may imply that urgency, described in the referral letter, and severity of illness, according to guidelines, are two separate entities.
Waiting Lists,Prioritization,Healthcare Sector
https://www.ijhpm.com/article_3172.html
https://www.ijhpm.com/article_3172_b6c7e3fa8ce8ac4a497501ac1375192c.pdf
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
5
6
2016
06
01
We Need Action on Social Determinants of Health – but Do We Want It, too?; Comment on “Understanding the Role of Public Administration in Implementing Action on the Social Determinants of Health and Health Inequities”
379
382
EN
Evelyne
de Leeuw
0000-0003-3434-1439
Centre for Health Equity Training Research and Evaluation (CHETRE), University of New South Wales, Sydney, NSW, Australia
evelyne.de.leeuw@umontreal.ca
10.15171/ijhpm.2016.25
Recently a number of calls have been made to mobilise the arsenal of political science insights to investigate – and point to improvements in – the social determinants of health (SDH), and health equity. Recently, in this journal, such a rallying appeal was made for the field of public administration. This commentary argues that, although scholarly potential should justifiably be redirected to resolve these critical issues for humanity, a key ingredient in taking action may have been neglected. This factor is ‘community.’ Community health has been a standard element of the public health and health promotion, even political, repertoire for decades now. But this commentary claims that communities are insufficiently charged, equipped or appreciated to play the role that scholarship attributes (or occasionally avoids to identify) to them. Community is too important to not fully engage and understand. Rhetorical tools and inquiries can support their quintessential role.
Social Determinants,Community,Politics,Public Administration
https://www.ijhpm.com/article_3168.html
https://www.ijhpm.com/article_3168_9ec6a29f74ac082c80ee159beb17bca6.pdf
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
5
6
2016
06
01
A Sophisticated Architecture Is Indeed Necessary for the Implementation of Health in All Policies but not Enough; Comment on “Understanding the Role of Public Administration in Implementing Action on the Social Determinants of Health and Health Inequities”
383
385
EN
Eric
Breton
0000-0002-0132-4010
EHESP School of Public Health, Paris, France
eric.breton@ehesp.fr
10.15171/ijhpm.2016.28
In this commentary, I argue that beyond a sophisticated supportive architecture to facilitate implementation of actions on the social determinants of health (SDOH) and health inequities, the Health in All Policies (HiAP) project faces two main barriers: lack of awareness within policy networks on the social determinants of population health, and a tendency of health actors to neglect investing in other sectors’ complex problems.
Health in All Policies (HiAP),Social Determinants of Heath (SDOH),Health Equity,Public,Policy,Implementation
https://www.ijhpm.com/article_3170.html
https://www.ijhpm.com/article_3170_4884cd42fa89a521d37378c1b5d23173.pdf
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
5
6
2016
06
01
Human Rights Discourse in the Sustainable Development Agenda Avoids Obligations and Entitlements; Comment on “Rights Language in the Sustainable Development Agenda: Has Right to Health Discourse and Norms Shaped Health Goals?”
387
390
EN
Carmel
Williams
0000-0003-2765-3020
Francois-Xavier Bagnoud (FXB), Center for Health and Human Rights, Harvard
T.H. Chan, School of Public Health, Harvard University, Boston, MA, USA
carmel.williams@adelaide.edu.au
Alison
Blaiklock
Department of Public Health, University of Otago Wellington, Wellington, New
Zealand
mountains@ihug.co.nz
10.15171/ijhpm.2016.29
Our commentary on Forman et al paper explores their thesis that right to health language can frame global health policy responses. We examined human rights discourse in the outcome documents from three 2015 United Nations (UN) summits and found rights-related terms are used in all three. However, a deeper examination of the discourse finds the documents do not convey the obligations and entitlements of human rights and international human rights law. The documents contain little that can be used to empower the participation of those already left behind and to hold States and the private sector to account for their human rights duties. This is especially worrying in a neoliberal era.
Human Rights,Right to Health,Climate Change,Sustainable Development Goals (SDGs),International Human Rights Law,Discourse Analysis,Neoliberalism
https://www.ijhpm.com/article_3173.html
https://www.ijhpm.com/article_3173_9e8b81489449e8eebe66c5be15b60e34.pdf
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
5
6
2016
06
01
The Conundrum of Online Prescription Drug Promotion; Comment on “Trouble Spots in Online Direct-to-Consumer Prescription Drug Promotion: A Content Analysis of FDA Warning Letters”
391
392
EN
Isaac
Wanasika
Moffort College of Business, University of Northern Colorado, Greeley, CO, USA
isaac.wanasika@unco.edu
10.15171/ijhpm.2016.33
This commentary discusses pertinent issues from Hyosun Kim’s paper on online prescription drug promotion. The study is well-designed and the findings highlight some of the consequences of the Food and Drug Administration’s (FDA’s) decision to deregulate online advertising of prescription drugs. While Kim’s findings confirm some of the early concerns, they also provide a perspective of implementation challenges in the everchanging technological environment.
Prescription Drug,Online Promotion,Food and Drug Administration (FDA)
https://www.ijhpm.com/article_3177.html
https://www.ijhpm.com/article_3177_a5d0c79f343109a816d326d8b49c4f36.pdf
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
5
6
2016
06
01
Beyond the Black Box Approach to Ethics!; Comment on “Expanded HTA: Enhancing Fairness and Legitimacy”
393
394
EN
Lars
Sandman
0000-0003-0987-7653
National Centre for Priority Setting in Health-Care, Linköping University,
Linköping, Sweden
lars.sandman@liu.se
Erik
Gustavsson
Division of Arts and
Humanities, Department of Culture and Communication, Linköping University,
Linköping, Sweden
erik.gustavsson@liu.se
10.15171/ijhpm.2016.43
<span>In the editorial published in this journal, Daniels and colleagues argue that his and Sabin’s accountability for <span>reasonableness (A4R) framework should be used to handle ethical issues in the health technology assessment <span>(HTA)-process, especially concerning fairness. In contrast to this suggestion, it is argued that such an approach <span>risks suffering from the irrrelevance or insufficiency they warn against. This is for a number of reasons: lack of <span>comprehensiveness, lack of guidance for how to assess ethical issues within the “black box” of A4R as to issues <span>covered, competence and legitimate arguments and finally seemingly accepting consensus as the final verdict on <span>ethical issues. We argue that the HTA community is already in a position to move beyond this black box approach.</span></span></span></span></span></span><br /></span>
Health Technology Assessment (HTA),Accountability for Reasonableness (A4R),Ethics,Ethical,Competence,Ethical Analysis
https://www.ijhpm.com/article_3187.html
https://www.ijhpm.com/article_3187_b3e04cbeccbb5921197749b11850fdfd.pdf
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
5
6
2016
06
01
Whistleblowing in the Wind Towards a Socially Situated Research Agenda: A Response to Recent Commentaries
395
396
EN
Russell
Mannion
0000-0002-0680-8049
Health Services Management Center, University of Birmingham, Birmingham,
UK
r.mannion@bham.ac.uk
Huw T.O.
Davies
Social Dimensions of Health Institute, Universities of Dundee and St
Andrews, Fife, UK
hd@st-andrews.ac.uk
10.15171/ijhpm.2016.34
Whistleblowing,Healthcare Organizations,Cultures of Silence,Cultures of Voice,Safer Care
https://www.ijhpm.com/article_3178.html
https://www.ijhpm.com/article_3178_2ff135203348b85c663ca9242396e15a.pdf
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
5
6
2016
06
01
New 2016 MeSH Addressing Information Gap, Poverty, Violence and Danger of Medicine Set the Tone for Policy-Makers in Patient Care
397
398
EN
Marc
Jamoulle
Department of General Practice, University of Liège, Liège, Belgium
marc_jamoulle@runbox.com
10.15171/ijhpm.2016.40
Information Science,Medical Subject Heading,General Practice,Medical Overuse
https://www.ijhpm.com/article_3185.html
https://www.ijhpm.com/article_3185_6935325a4f5cca08e9a976409cd09293.pdf