2024-03-29T12:19:31Z
https://www.ijhpm.com/?_action=export&rf=summon&issue=651
International Journal of Health Policy and Management
IJHPM
2017
6
9
The Untapped Power of Soda Taxes: Incentivizing Consumers, Generating Revenue, and Altering Corporate Behavior
Sarah A.
Roache
Lawrence O.
Gostin
Globally, soda taxes are gaining momentum as powerful interventions to discourage sugar consumption and thereby reduce the growing burden of obesity and non-communicable diseases (NCDs). Evidence from early adopters including Mexico and Berkeley, California, confirms that soda taxes can disincentivize consumption through price increases and raise revenue to support government programs. The United Kingdom’s new graduated levy on sweetened beverages is yielding yet another powerful impact: soda manufacturers are reformulating their beverages to significantly reduce the sugar content. Product reformulation – whether incentivized or mandatory – helps reduce overconsumption of sugars at the societal level, moving away from the long-standing notion of individual responsibility in favor of collective strategies to promote health. But as a matter of health equity, soda product reformulation should occur globally, especially in low- and middleincome countries (LMICs), which are increasingly targeted as emerging markets for soda and junk food and are disproportionately impacted by NCDs. As global momentum for sugar reduction increases, governments and public health advocates should harness the power of soda taxes to tackle the economic, social, and informational drivers of soda consumption, driving improvements in food environments and the public’s health.
Public Health Law
Soda Taxes
Product Reformulation
Diet and Nutrition
Sugars
2017
09
01
489
493
https://www.ijhpm.com/article_3376_cfa3e140fb10202332ce4e53fcbd5d63.pdf
International Journal of Health Policy and Management
IJHPM
2017
6
9
Why and How Political Science Can Contribute to Public Health? Proposals for Collaborative Research Avenues
France
Gagnon
Pierre
Bergeron
Carole
Clavier
Patrick
Fafard
Elisabeth
Martin
Chantal
Blouin
Written by a group of political science researchers, this commentary focuses on the contributions of political science to public health and proposes research avenues to increase those contributions. Despite progress, the links between researchers from these two fields develop only slowly. Divergences between the approach of political science to public policy and the expectations that public health can have about the role of political science, are often seen as an obstacle to collaboration between experts in these two areas. Thus, promising and practical research avenues are proposed along with strategies to strengthen and develop them. Considering the interdisciplinary and intersectoral nature of population health, it is important to create a critical mass of researchers interested in the health of populations and in healthy public policy that can thrive working at the junction of political science and public health.
Public Policy
Public Health
Research
Healthy Public Policies
Political Science
2017
09
01
495
499
https://www.ijhpm.com/article_3342_2f40354f98413e512ac5c63607b7da08.pdf
International Journal of Health Policy and Management
IJHPM
2017
6
9
Peruvian Mental Health Reform: A Framework for Scaling-up Mental Health Services
Mauricio
Toyama
Humberto
Castillo
Jerome T.
Galea
Lena R.
Brandt
María
Mendoza
Vanessa
Herrera
Martha
Mitrani
Yuri
Cutipé
Victoria
Cavero
Francisco
Diez-Canseco
J. Jaime
Miranda
Background Mental, neurological, and substance (MNS) use disorders are a leading cause of disability worldwide; specifically in Peru, MNS affect 1 in 5 persons. However, the great majority of people suffering from these disorders do not access care, thereby making necessary the improvement of existing conditions including a major rearranging of current health system structures beyond care delivery strategies. This paper reviews and examines recent developments in mental health policies in Peru, presenting an overview of the initiatives currently being introduced and the main implementation challenges they face. Methods Key documents issued by Peruvian governmental entities regarding mental health were reviewed to identify and describe the path that led to the beginning of the reform; how the ongoing reform is taking place; and, the plan and scope for scale-up. Results Since 2004, mental health has gained importance in policies and regulations, resulting in the promotion of a mental health reform within the national healthcare system. These efforts crystallized in 2012 with the passing of Law 29889 which introduced several changes to the delivery of mental healthcare, including a restructuring of mental health service delivery to occur at the primary and secondary care levels and the introduction of supporting services to aid in patient recovery and reintegration into society. In addition, a performance-based budget was approved to guarantee the implementation of these changes. Some of the main challenges faced by this reform are related to the diversity of the implementation settings, eg, isolated rural areas, and the limitations of the existing specialized mental health institutes to substantially grow in parallel to the scaling-up efforts in order to be able to provide training and clinical support to every region of Peru. Conclusion Although the true success of the mental healthcare reform will be determined in the coming years, thus far, Peru has achieved a number of legal, policy and fiscal milestones, thereby presenting a unique and fertile environment for the expansion of mental health services.
Policy Analysis
Mental Health Services
Low- and Middle-Income
Health Systems
Healthcare Reform
2017
09
01
501
508
https://www.ijhpm.com/article_3313_27793e38fcd053d3aedb23b37e56d848.pdf
International Journal of Health Policy and Management
IJHPM
2017
6
9
Providing Value to New Health Technology: The Early Contribution of Entrepreneurs, Investors, and Regulatory Agencies
Pascale
Lehoux
Fiona A.
Miller
Geneviève
Daudelin
Jean-Louis
Denis
Background New technologies constitute an important cost-driver in healthcare, but the dynamics that lead to their emergence remains poorly understood from a health policy standpoint. The goal of this paper is to clarify how entrepreneurs, investors, and regulatory agencies influence the value of emerging health technologies. Methods Our 5-year qualitative research program examined the processes through which new health technologies were envisioned, financed, developed and commercialized by entrepreneurial clinical teams operating in Quebec’s (Canada) publicly funded healthcare system. Results Entrepreneurs have a direct influence over a new technology’s value proposition, but investors actively transform this value. Investors support a technology that can find a market, no matter its intrinsic value for clinical practice or healthcare systems. Regulatory agencies reinforce the “double” value of a new technology —as a health intervention and as an economic commodity— and provide economic worth to the venture that is bringing the technology to market. Conclusion Policy-oriented initiatives such as early health technology assessment (HTA) and coverage with evidence may provide technology developers with useful input regarding the decisions they make at an early stage. But to foster technologies that bring more value to healthcare systems, policy-makers must actively support the consideration of health policy issues in innovation policy.
Innovation Policy
Health Policy
Health Technology Development (HTA)
Technology-Based Ventures
Early HTA
2017
09
01
509
518
https://www.ijhpm.com/article_3314_d55516fc36042b9d4d8e93b9053f3a4a.pdf
International Journal of Health Policy and Management
IJHPM
2017
6
9
Factors Associated With Unhealthy Snacks Consumption Among Adolescents in Iran’s Schools
Vahid
Yazdi Feyzabadi
Nastaran
Keshavarz Mohammadi
Nasrin
Omidvar
Akram
Karimi-Shahanjarini
Saharnaz
Nedjat
Arash
Rashidian
BackgroundWell-informed interventions are needed if school-based health promotion is to be effective. Amongother aims, the Iranian Health Promoting School (IHPS) program that was launched in 2011, has an important aimof promoting dietary behaviors of adolescents. The present study, therefore, aimed to investigate the factors affectingunhealthy snacking of adolescents and provide evidence for a more effective IHPS program. MethodsIn a cross-sectional study design, 1320 students from 40 schools in Kerman city were selected using aproportional stratified random sampling method. A modified qualitative Food Frequency Questionnaire (FFQ) wasused to gather data about unhealthy snacking behavior. Data about intrapersonal and environmental factors wereobtained using a validated and reliable questionnaire. A mixed-effects negative-binomial regression model was usedto analyze the data. ResultsTaste and sensory perception (prevalence rate ratio [PRR] = 1.18; 95% CI: 1.09-1.27), being a male (PRR = 1.20;95% CI: 1.05-1.38) and lower nutritional knowledge (PRR = 0.96; 95% CI: 0.91-0.99) were associated with higher weeklyunhealthy snaking. Perceived self-efficacy (PRR = 0.95; 95% CI: 0.91-1.00) negatively influenced the frequency ofunhealthy snaking, with this approaching significance (P< .06). In case of environmental factors, high socio-economicstatus (SES) level (PRR = 1.45; 95% CI: 1.26-1.67), single-parent family (PRR = 1.14; 95% CI: 1.01-1.30), more socialnorms pressure (PRR = 1.08; 95% CI: 1.01-1.17), pocket money allowance (PRR = 1.21; 95% CI: 1.09-1.34), easyaccessibility (PRR = 1.06; 95% CI:1.01-1.11), and less perceived parental control (PRR= 0.96; 95% CI: 0.92-0.99) all hada role in higher consumption of unhealthy snacks. Interestingly, larger school size was associated with less unhealthysnacking (PRR = 0.79; 95% CI: 0.68-0.92). ConclusionUnhealthy snacking behavior is influenced by individual, socio-cultural and physical-environmentalinfluences, namely by factors relating to poor parenting practices, high SES level, family characteristics, improper socialnorms pressure, and less knowledge and self-efficacy of students. This evidence can be used to inform a more evidencebased IHPS program through focusing on supportive strategies at the home, school, and local community levels.
School Health Promotion
Health Behavior
Snack
Nutrition Policy
Adolescent
2017
09
01
519
528
https://www.ijhpm.com/article_3317_ffab6057aff866940e3452eac5fe8a59.pdf
International Journal of Health Policy and Management
IJHPM
2017
6
9
How Should Global Fund Use Value-for-Money Information to Sustain its Investments in Graduating Countries?
Kitti
Kanpirom
Alia Cynthia G.
Luz
Kalipso
Chalkidou
Yot
Teerawattananon
It has been debated whether the Global Fund (GF), which is supporting the implementation of programs on the prevention and control of HIV/AIDS, tuberculosis (TB) and malaria, should consider the value-for-money (VFM) for programs/interventions that they are supporting. In this paper, we critically analyze the uses of economic information for GF programs, not only to ensure accountability to their donors but also to support country governments in continuing investment in cost-effective interventions initiated by the GF despite the discontinuation of financial support after graduation. We demonstrate that VFM is not a static property of interventions and may depend on program start-up cost, economies of scales, the improvement of effectiveness and efficiency of providers once the program develops, and acceptance and adherence of the target population. Interventions that are cost-ineffective in the beginning may become cost-effective in later stages. We consider recent GF commitments towards value for money and recommend that the GF supports interventions with proven cost-effectiveness from program initiation as well as interventions that may be cost-effective afterwards. Thus, the GF and country governments should establish mechanisms to monitor cost-effectiveness of interventions invested over time.
Value-for-Money (VFM)
Global Fund (GF)
Vertical Programs
Priority Setting
Government Healthcare
Investments
2017
09
01
529
533
https://www.ijhpm.com/article_3330_9ab002ee42f64ce1757b3d050fe69068.pdf
International Journal of Health Policy and Management
IJHPM
2017
6
9
Thinking Out of the Box: A Green and Social Climate Fund; Comment on “Politics, Power, Poverty and Global Health: Systems and Frames”
Gorik
Ooms
Remco
van de Pas
Kristof
Decoster
Rachel
Hammonds
Solomon Benatar’s paper “Politics, Power, Poverty and Global Health: Systems and Frames” examines the inequitable state of global health challenging readers to extend the discourse on global health beyond conventional boundaries by addressing the interconnectedness of planetary life. Our response explores existing models of international cooperation, assessing how modifying them may achieve the twin goals of ensuring healthy people and planet. First, we address why the inequality reducing post World War II European welfare model, if implemented stateby-state, is unfit for reducing global inequality and respecting environmental boundaries. Second, we argue that to advance beyond the ‘Westphalian,’ human centric thinking integral to global inequality and climate change requires challenging the logic of global economic integration and exploring the politically infeasible. In conclusion, we propose social policy focused changes to the World Trade Organisation (WTO) and a Green and Social Climate Fund, financed by new global greenhouse gas charges, both of which could advance human and planetary health. Recent global political developments may offer a small window of opportunity for out of the box proposals that could be advanced by concerted and united advocacy by global health activists, environmental activists, human rights activists, and trade unions.
Global/Planetary Health
Inequality
Politics
Greenhouse Gas
2017
09
01
535
538
https://www.ijhpm.com/article_3302_98bdeac264b9c0a05d658df5169852a0.pdf
International Journal of Health Policy and Management
IJHPM
2017
6
9
Critical Global Health: Responding to Poverty, Inequality and Climate Change; Comment on “Politics, Power, Poverty and Global Health: Systems and Frames”
David
McCoy
A recent article by Sol Benatar calls on the global health community to reassess its approach to twin crises of global poverty and climate change. I build on his article by challenging mainstream narratives that claim satisfactory progress in efforts to reduce poverty and improve health for all, and arguing that any eradication of poverty that is consistent with environmental sustainability will require a more explicit emphasis on the redistribution of power and wealth. I suggest that the global health community has been largely socialised into accepting that progress and future solutions can be attained through more neoliberal development, technological advancement and philanthropic endeavour and that a more critical global health is required. I propose three steps that the global health community should take: first, create more space for the social, political and political sciences within global health; second, be more prepared to act politically and challenge power; and third, do more to bridge the global-local divide in recognition of the fact that progressive change requires mobilisation from the bottom-up in conjunction with top-down policy and legislative change.
Politics
Power
Poverty
Global Health
2017
09
01
539
541
https://www.ijhpm.com/article_3304_5e714f2579676e430047c52bedcf071a.pdf
International Journal of Health Policy and Management
IJHPM
2017
6
9
Don’t Discount Societal Value in Cost-Effectiveness; Comment on “Priority Setting for Universal Health Coverage: We Need Evidence-Informed Deliberative Processes, Not Just More Evidence on Cost-Effectiveness”
William
Hall
As healthcare resources become increasingly scarce due to growing demand and stagnating budgets, the need for effective priority setting and resource allocation will become ever more critical to providing sustainable care to patients. While societal values should certainly play a part in guiding these processes, the methodology used to capture these values need not necessarily be limited to multi-criterion decision analysis (MCDA)-based processes including ‘evidence-informed deliberative processes.’ However, if decision-makers intend to not only incorporates the values of the public they serve into decisions but have the decisions enacted as well, consideration should be given to more direct involvement of stakeholders. Based on the examples provided by Baltussen et al, MCDA-based processes like ‘evidence-informed deliberative processes’ could be one way of achieving this laudable goal.
Cost-Effectiveness
Priority Setting
Resource Allocation
Multi-Criterion Decision Analysis (MCDA)
Deliberative Processes
2017
09
01
543
545
https://www.ijhpm.com/article_3308_9d5fb8e62fccf52582e862d1d1d4cc80.pdf
International Journal of Health Policy and Management
IJHPM
2017
6
9
Framing Political Change: Can a Left Populism Disrupt the Rise of the Reactionary Right?; Comment on “Politics, Power, Poverty and Global Health: Systems and Frames”
Ronald
Labonté
Solomon Benatar offers an important critique of the limited frame that sets the boundaries of much of what is referred to as ‘global health.’ In placing his comments within a criticism of increasing poverty (or certainly income and wealth inequalities) and the decline in our environmental commons, he locates our health inequities within the pathology of our present global economy. In that respect it is a companion piece to an editorial I published around the same time. Both Benatar’s and my paralleling arguments take on a new urgency in the wake of the US presidential election. Although not a uniquely American event (the xenophobic right has been making inroads in many parts of the world), the degree of vitriol expressed by the President-elect of the world’s (still) most powerful and militarized country is being used to further legitimate the policies of right-extremist parties in Europe while providing additional justification for the increasingly autocratic politics of leaders (elected or otherwise) in many other of the world’s nations. To challenge right-populism’s rejection of the predatory inequalities that 4 years of (neo)-liberal globalization have created demands strong and sustained left populism built, in part, on the ecocentric frame advocated by Benatar.
Global Health Frames
Neoliberal Globalization
Political Populism
2017
09
01
547
549
https://www.ijhpm.com/article_3310_b31003a214bbfa0ec7b27d9acfa388e1.pdf