Kerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59399620200601Achievements of the Cochrane Iran Associate Centre: Lessons Learned222228372010.15171/ijhpm.2019.122ENBitaMesgarpourCochrane Iran Associate Centre, National Institute for Medical research
Development (NIMAD), Tehran, Iran0000-0002-4461-1271SaraAghababaCochrane Iran Associate Centre, National Institute for Medical research
Development (NIMAD), Tehran, Iran0000-0002-7917-6943Hamid RezaBaradaranEndocrine Research Center, Institute of
Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran,
Iran0000-0002-5070-5864PayamKabiriDepartment of Epidemiology and Biostatistics, School of Public Health,
Tehran University of Medical Sciences, Tehran, Iran0000-0002-7634-370XAliKabirMinimally Invasive
Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran0000-0001-9496-4705AhmadSofi-MahmudiCochrane Iran Associate Centre, National Institute for Medical research
Development (NIMAD), Tehran, Iran0000-0001-6829-0823Ali AkbarHaghdoostSocial Determinants of Health Research Centre, Institute for Futures Studies in
Health, Kerman University of Medical Sciences, Kerman, Iran0000-0003-4628-4849Journal Article20190904<span class="fontstyle0">Healthcare decision-making is a process that mainly depends on evidence and involves increasing numbers of stakeholders, including the consumers. Cochrane evidence responds to this challenge by identifying, appraising, integrating and synthesizing high-quality evidence. Recently, a collaborative effort has been initiated in Iran with Cochrane to establish a representative local entity. A variety of multifaceted interventions were conducted according to Cochrane’s strategy to 2020, such as producing evidence, making Cochrane evidence accessible, advocating for evidence and building an effective and sustainable organization. In this report, the authors present the two and half year performance and achievements of Cochrane Iran based on a comprehensive and systematic approach. This case might be an example of health diplomacy, which is initiated by a successful international collaboration and proceed with recognizing the importance of adherence to the strategic action plans and goals.</span>https://www.ijhpm.com/article_3720_2fdfda6669c9a7b4470a08a9f9a41198.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59399620200601“Sell an Ox” - The Price of Cure for Hepatitis C in Two Countries229232372110.15171/ijhpm.2019.135ENOraPaltielSchool of Public Health, Hadassah-Hebrew University of Jerusalem, Jerusalem,
Israel0000-0001-8324-3873WorkagegnehuHailuDepartment of Internal Medicine, Gondar University Hospital, University
of Gondar, Gondar, EthiopiaZenahebezuAbayDepartment of Internal Medicine, Gondar University Hospital, University
of Gondar, Gondar, EthiopiaAvram MarkClarfieldMedical School for International Health, Ben
Gurion University, Beersheva, Israel0000-0002-0388-5663MartinMcKeeDepartment of Public Health & Policy,
London School of Hygiene and Tropical Medicine, London, UK0000-0002-0121-9683Journal Article20191012<span class="fontstyle0">Chronic hepatitis C virus (HCV) infection, associated with severe liver disease and cancer, affects 70 million people worldwide. New treatments with direct-acting-antivirals offer cure for about 95% of affected individuals; however, treatment costs may be prohibitive in both the poorest and richest nations. Opting for cure may require sacrificing essential household assets. We highlight the financial dilemmas involved, drawing parallels between Ethiopia and the United States, countries where universal health coverage does not yet exist. The World Health Organization (WHO) declaration for HCV eradication by 2030 will only become reality if universal access to efficacious and affordable treatment is guaranteed for everyone.</span>https://www.ijhpm.com/article_3721_729ac6da6ce8b1a9cc83367610e1cad9.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59399620200601How to Work Collaboratively Within the Health System: Workshop Summary and Facilitator Reflection233239371710.15171/ijhpm.2019.131ENChristine E.CassidySchool of Nursing, Faculty of Health, Dalhousie University, Halifax, NS,
Canada0000-0001-7770-5058SarahBowenApplied Research and Evaluation Consultant, Halifax, NS, Canada0000-0002-1341-5307GuillaumeFontaineFaculty of Nursing, University of Montreal, Montreal, QC, CanadaMontreal
Heart Institute Research Center, Montreal, QC, Canada0000-0002-7806-814XÉlizabethCôté-BoileauFaculty of Medicine
and Health Sciences Research, University of Sherbrooke, Sherbrooke, QC,
CanadaCharles-Le Moyne – Saguenay–Lac-Saint-Jean Research Center
on Health Innovations, Longueuil, QC, Canada0000-0002-7981-962XIngridBottingHealth Services Integration,
Winnipeg Regional Health Authority, Winnipeg, MB, Canada0000-0002-5141-5631Journal Article20191003<span class="fontstyle0">Effectiveness in health services research requires development of specific knowledge and skills for working in partnership with health system decision-makers. In an initial effort to frame capacity-building activities for researchers, we designed a workshop on working collaboratively within the health system. The workshop, based on recent research exploring health system experience and perspectives on research collaborations, was trialed at the annual Canadian Health Services and Policy Research (CAHSPR) conference in May 2019. Participants reported positive evaluations of the workshop. However, further efforts should target health services researchers that may not be as motivated to develop skills in collaborative research. Additional attention to equipping researchers with the skills needed to work in partnerships is recommended, including approaches and materials that avoid oversimplification of complex challenges.</span>https://www.ijhpm.com/article_3717_4c8fde54404b436ca9190f5845bf3fae.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59399620200601Health-Seeking Behaviors and its Determinants: A Facility-Based Cross-Sectional Study in the Turkish Republic of Northern Cyprus240249370110.15171/ijhpm.2019.106ENGulifeiyaAbuduxikeMedical Faculty, Near East University, Nicosia,TRNC, Turkey0000-0002-9798-7459ÖzenAşutMedical Faculty, Near East University, Nicosia,TRNC, Turkey0000-0002-9604-4037Songül AcarVaizoğluMedical Faculty, Near East University, Nicosia,TRNC, Turkey0000-0001-6962-4194SandaCaliMedical Faculty, Near East University, Nicosia,TRNC, Turkey0000-0001-9929-2637Journal Article20190523<span class="fontstyle0">Background</span><br /> <span class="fontstyle0">Understanding health-seeking behaviors and determining factors help governments to adequately allocate and manage existing health resources. The aim of the study was to examine the health-seeking behaviors of people in using public and private health facilities and to assess the factors that influence healthcare utilization in Northern Cyprus.<br /></span><br /> <br /> <span class="fontstyle0">Methods</span><br /> <span class="fontstyle0">A cross-sectional study was conducted in 2 polyclinics among 507 people using a structured intervieweradministered questionnaire. Health-seeking behaviors were measured using four indicators including routine medical check-ups, preferences of healthcare facilities, admission while having health problems, and refusal of health services while ill. Descriptive statistics and multivariable logistic regression analyses were done to explore factors influencing the use of health services.<br /></span><br /> <br /> <span class="fontstyle0">Results</span><br /> <span class="fontstyle0">About 77.3% of the participants reported to have visited health centers while they had any health problems. More than half (51.7%) of them had a routine medical check-up during the previous year, while 12.2% of them had refused to seek healthcare when they felt ill during the last five years. Of all, 39.1% of them reported preferring private health services. Current smokers (adjusted odds ratio [AOR] = 1.92, 95% CI: 1.17-3.14), having chronic diseases (AOR = 2.05, 95% CI: 1.95-2.16), having poor perceptions on health (AOR = 2.33; 95% CI: 1.563.48), and spending less on health during the last three months (AOR = 2.08, 95% CI: 1.43- 3.01) had about twice the odds of having routine checkups. Higher education (AOR = 1.87, 95% CI: 1.38-2.55) was shown to be a positive predictor for the health-seeking behaviors, whereas having self-care problems (AOR = 0.18, 95% CI: 0.08-0.40) and having a moderate-income (AOR = 0.68, 95% CI: 0.57-0.81) were inversely associated with seeking healthcare.<br /></span><br /> <br /> <span class="fontstyle0">Conclusion</span><br /> <span class="fontstyle0">The utilization of public and private health sectors revealed evident disparities in the socio-economic characteristics of participants. The health-seeking behaviors were determined by need factors including chronic disease status and having poor health perception and also by enabling factors such as education, income, insurance status and ability to pay by oneself. These findings highlight the need for further nationwide studies and provide evidence for specific strategies to reduce the socioeconomic inequalities in the use of healthcare services.</span>https://www.ijhpm.com/article_3701_311cd7f77849b289f7ca016efc1884c5.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59399620200601Designing an Optimum Fiscal Policy for Tobacco to Maximise the Tax Revenue, Social Savings and the Net Monetary Benefits in Sri Lanka250256370710.15171/ijhpm.2019.114ENSathira KasunPereraUniversity of New South Wales, Sydney, NSW, Australia0000-0002-7740-9037Bharat PhaniVaikuntamUniversity of New South Wales, Sydney, NSW, AustraliaUniversity of Sydney,
Sydney, NSW, Australia0000-0002-1060-4380DennyJohnCampbell Collaboration, New Delhi, IndiaNational
Institute of Medical Statistics, New Delhi, India0000-0002-4486-632XBuddhikaSenanayakeThe University of Queensland, Brisbane, QLD, Australia0000-0002-2278-2889Journal Article20180914<span class="fontstyle0">Background</span><br /> <span class="fontstyle0">Fiscal policy targeting tobacco control is identified as the most effective strategy for rapid control of tobacco use. An optimum fiscal policy to estimate the percentage taxation that will maximise the government tax revenue, social savings and the net monetary benefit has not been empirically designed before in Sri Lanka.<br /></span><br /> <br /> <span class="fontstyle0">Methods</span><br /> <span class="fontstyle0">A model was developed using Microsoft Excel 2016, utilizing up-to-date published evidence on the cigarette sales, current fiscal policy, social cost of tobacco use, consumer response and the price elasticity of cigarettes. Univariate estimates on the expected revenue from tobacco tax, average annual social savings and the net monetary benefit were predicted for different levels of tobacco taxation. A deterministic sensitivity analysis was performed covering all possibilities. The percentage taxation maximizing the government tax revenue and the net monetary benefit were identified.<br /></span><br /> <br /> <span class="fontstyle0">Results</span><br /> <span class="fontstyle0">It was estimated that a further 30% tax increase from the 2019 baseline will generate approximately LKR 3544 million per year of additional tax revenue for the government while saving LKR 28 069 million per annum as social savings. A fiscal elevation of 50% will produce identical annual tax revenue to that of 2018, while securing a social saving of more than LKR 47 600 million per annum. The maximum net monetary benefit is achievable at an overnight tax increase of 90% from the baseline, however with a short-term compromise in tax revenue.<br /></span><br /> <br /> <span class="fontstyle0">Conclusion</span><br /> <span class="fontstyle0">The well-defined thresholds take tobacco taxation advocacy in Sri Lanka a step forward and will assist the government in taking an informed decision on its fiscal policy for cigarettes.</span>https://www.ijhpm.com/article_3707_66e316d8a1061e719af14892d79ccdf4.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59399620200601Changing the Conversation, Why We Need to Reframe Corruption as a Public Health Issue; Comment on “We Need to Talk About Corruption in Health Systems”257259370510.15171/ijhpm.2019.124ENDavidClarkeWorld Health Organization (WHO), Geneva, Switzerland0000-0002-5583-0779Journal Article20190903<span class="fontstyle0">There has been slow progress with finding practical solutions to health systems corruption, a topic that has long languished in policy-makers “too difficult tray.” Efforts to achieve universal health coverage (UHC) provide a new imperative for addressing the long-standing problem of corruption in health systems making fighting corruption at all levels and in all its forms a priority. In response, health system corruption should be classified as a risk to public health and addressed by adopting a public health approach. Taking a public health approach to health systems corruption could promote a new paradigm for working on health system anti-corruption efforts. A public health approach could increase the space for policy dialogue about corruption, focus work to address corruption on prevention, help generate and disseminate evidence about effective interventions strategies, and because of its focus on multisectoral action would provide new opportunities for promoting cooperation on anti-corruption work across multiple agencies and sectors. Using a public health approach to tackle health system corruption could help address the current inertia around the topic and create a new positive mindset among policy-makers who would come to see corruption as a manageable public health problem rather than an intractable one.</span>https://www.ijhpm.com/article_3705_64d0209e26b2064620333849ff525948.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59399620200601Modeling in Early Stages of Technology Development: Is an Iterative Approach Needed?; Comment on “Problems and Promises of Health Technologies: The Role of Early Health Economic Modeling”260262370910.15171/ijhpm.2019.118ENMichael F.DrummondUniversity of York, York, UK0000-0002-6126-0944Journal Article20190926<span class="fontstyle0">A recent paper by Grutters et al makes the case for early health economic modeling in the development of health technologies. A number of examples of the value of early modeling are given, with analyses being performed at different stages in the development of several non-drug health technologies. This commentary acknowledges the contribution of the paper by Grutters et al and argues for an iterative and integrated approach to early modeling, assessing the cost-effectiveness of the technology, the value of future research and the interaction with the manufacturer’s pricing and revenue expectations.</span>https://www.ijhpm.com/article_3709_b084a2a80bc10707eef39f0731ecd738.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59399620200601Use of Evidence-Informed Deliberative Processes – Learning by Doing; Comment on “Use of Evidence-informed Deliberative Processes by Health Technology Assessment Agencies Around the Globe”263265371010.15171/ijhpm.2019.116ENAnthony J.CulyerCentre for Health Economics and Department of Economics & Related Studies, University of York, York, UK0000-0002-8896-8491Journal Article20191009<span class="fontstyle0">The article by Oortwijn, Jansen, and Baltussen (OJB) is much more important than it appears because, in the absence of any good general theory of “evidence-informed deliberative processes” (EDP) and limited evidence of how they might be shaped and work in institutionalising health technology assessment (HTA), the best approach seems to be to accumulate the experience of a variety of countries, preferably systematically, from which some general principles might subsequently be inferred. This comment reinforces their arguments and provides a further example.</span>https://www.ijhpm.com/article_3710_af2df3c26a8ff318274ac190ea9749d3.pdf