eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2018-05-01
7
5
369
373
10.15171/ijhpm.2017.143
3451
Shaping Policy Change in Population Health: Policy Entrepreneurs, Ideas, and Institutions
Daniel Béland
daniel.beland@usask.ca
1
Tarun R. Katapally
tarun.katapally@uregina.ca
2
Johnson Shoyama Graduate School of Public Policy, University of Saskatchewan, Saskatoon, SK, Canada
Johnson Shoyama Graduate School of Public Policy, University of Regina, Regina, SK, Canada
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
Population Health
Policy Change
Policy Entrepreneurs
Ideas
Institutions
Evidence
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2018-05-01
7
5
374
393
10.15171/ijhpm.2017.147
3454
Assessment of the Effects of Economic Sanctions on Iranians’ Right to Health by Using Human Rights Impact Assessment Tool: A Systematic Review
Fatemeh Kokabisaghi
mrs.kokabi@yahoo.com
1
Healthcare and Law Department, School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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
Economic Sanctions
Right to Medicine
Human Rights
Iran
HRIA Tool
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2018-05-01
7
5
394
401
10.15171/ijhpm.2017.102
3409
Unit Costing of Health Extension Worker Activities in Ethiopia: A Model for Managers at the District and Health Facility Level
Maureen E. Canavan
maureen.canavan@yale.edu
1
Erika Linnander
erika.linnander@yale.edu
2
Shirin Ahmed
shirin.ahmed@yale.edu
3
Halima Mohammed
halimaomer50@gmail.com
4
Elizabeth H. Bradley
ebradley@vassar.edu
5
Yale Global Health Leadership Institute, Yale University, New Haven, CT, USA
Yale Global Health Leadership Institute, Yale University, New Haven, CT, USA
Yale Global Health Leadership Institute, Yale University, New Haven, CT, USA
Yale Global Health Leadership Institute, Yale University, New Haven, CT, USA
Yale Global Health Leadership Institute, Yale University, New Haven, CT, USA
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
Health Extension Workers (HEWs)
Costing Tools
Health System Strengthening
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2018-05-01
7
5
402
411
10.15171/ijhpm.2017.104
3410
The Response to and Impact of the Ebola Epidemic: Towards an Agenda for Interdisciplinary Research
Michael Calnan
m.w.calnan@kent.ac.uk
1
Erica W. Gadsby
e.gadsby@kent.ac.uk
2
Mandy Kader Kondé
kaderkonde@gmail.com
3
Abdourahime Diallo
dialloabdourahime@hotmail.fr
4
Jeremy S. Rossman
j.s.rossman@kent.ac.uk
5
SSPSSR, University of Kent, Kent, UK
Centre for Health Services Studies, University of Kent, Kent, UK
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
FOSAD Health and Sustainable Development Foundation and CEFORPAG Center of Excellence for Training, Research on Malaria & Priority Diseases in Guinea, Conakry, Guinea
School of Biosciences, University of Kent, Kent, UK
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
Ebola
Guinea
Research Priorities
Survivors
Social Impact
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2018-05-01
7
5
412
420
10.15171/ijhpm.2017.105
3414
What Factors Do Allied Health Take Into Account When Making Resource Allocation Decisions?
Haylee Lane
haylee.lane@monash.edu
1
Tamica Sturgess
tamica.sturgess@monashhealth.org
2
Kathleen Philip
kathleen.philip@dhhs.vic.gov.au
3
Donna Markham
donna.markham@monashhealth.org
4
Jennifer Martin
jenny.martin@rmit.edu.au
5
Jill Walsh
jill.walsh@monashhealth.org
6
Wendy Hubbard
wendy.hubbard9@gmail.com
7
Terry Haines
terrence.haines@monash.edu
8
School of Primary & Allied Health Care, Monash University, Frankston, VIC, Australia
Workforce Innovation Strategy Education and Research Unit, Monash Health, Clayton, VIC, Australia
Department of Health and Human Services, Melbourne, VIC, Australia
Monash Health, Clayton, VIC, Australia
Centre of Applied Social Research, RMIT University, Melbourne, VIC, Australia
Monash Health, Clayton, VIC, Australia
State-Wide Equipment Program, Ballarat Health Services, Ballarat, VIC, Australia
School of Primary & Allied Health Care, Monash University, Frankston, VIC, Australia
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
Resource Allocation
Allied Health
Decision-Making
Priority Setting
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2018-05-01
7
5
421
432
10.15171/ijhpm.2017.106
3416
The Challenges of a Complex and Innovative Telehealth Project: A Qualitative Evaluation of the Eastern Quebec Telepathology Network
Hassane Alami
hassane.alami@umontreal.ca
1
Jean-Paul Fortin
jean-paul.fortin@fmed.ulaval.ca
2
Marie-Pierre Gagnon
marie-pierre.gagnon@fsi.ulaval.ca
3
Hugo Pollender
hugo.pollender.ciussscn@ssss.gouv.qc.ca
4
Bernard Têtu
bernard.tetu@fmed.ulaval.ca
5
France Tanguay
france.tanguay@ssss.gouv.qc.ca
6
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
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
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
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
University Hospital Center of Quebec-Laval University Research Center, Quebec City, QC, Canada
Integrated Health and Social Services Centre of Chaudière-Appalaches Hôtel-Dieu de Lévis, Lévis City, QC, Canada
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
Telepathology Network
Telehealth Implementation
Evaluation
Sustainability
Healthcare Services
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2018-05-01
7
5
433
442
10.15171/ijhpm.2017.112
3421
The Global Health Policies of the EU and its Member States: A Common Vision?
Lies Steurs
lies.steurs@ugent.be
1
Remco Van de Pas
rvandepas@itg.be
2
Sarah Delputte
sarah.delputte@ugent.be
3
Jan Orbie
jan.orbie@ugent.be
4
Centre for EU Studies, Ghent University, Gent, Belgium
Institute of Tropical Medicine, Antwerp, Belgium
Centre for EU Studies, Ghent University, Gent, Belgium
Centre for EU Studies, Ghent University, Gent, Belgium
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
European Union (EU)
Global Health
Framing
Development Cooperation
Foreign Policy
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2018-05-01
7
5
443
454
10.15171/ijhpm.2017.117
3427
Factors That Influence Enrolment and Retention in Ghana’ National Health Insurance Scheme
Agnes Millicent Kotoh
amkotoh@ug.edu.gh
1
Genevieve Cecelia Aryeetey
okailey.aryeetey@gmail.com
2
Sjaak Van der Geest
s.vandergeest@uva.nl
3
School of Public Health, University of Ghana, Legon, Ghana
School of Public Health, University of Ghana, Legon, Ghana
Department of Sociology and Anthropology, University of Amsterdam, Amsterdam, The Netherlands
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
National Health Insurance (NHI)
Enrolment
Retention
Drugs
Ghana
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2018-05-01
7
5
455
458
10.15171/ijhpm.2017.111
3415
Knowledge Translation in Healthcare – Towards Understanding its True Complexities; Comment on “Using Complexity and Network Concepts to Inform Healthcare Knowledge Translation”
Joachim P. Sturmberg
jp.sturmberg@gmail.com
1
University of Newcastle, Callaghan, NSW, Australia
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
Complexity of Knowledge
Knowing in Medicine
Evidence
Complex Adaptive Organisation
Knowledge Transfer
Deviant Behaviour
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2018-05-01
7
5
459
462
10.15171/ijhpm.2017.107
3417
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?”
Florence Berteletti
florence.berteletti@smokefreepartnership.eu
1
Smoke Free Partnership, Brussels, Belgium
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
European Union (EU)
Multilateralism
Tobacco Taxation
Public Health Governance
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2018-05-01
7
5
463
466
10.15171/ijhpm.2017.113
3418
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”
Owen Adams
owen.adams@cma.ca
1
Canadian Medical Association, Ottawa, ON, Canada
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
Health Services
Policy
Research
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2018-05-01
7
5
467
469
10.15171/ijhpm.2017.109
3422
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?”
Lisa Forman
lisa.forman@utoronto.ca
1
Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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
Human Rights
International Law
Right to Health
Global Health
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2018-05-01
7
5
470
473
10.15171/ijhpm.2017.126
3428
Soda Taxes: The Importance of Analysing Policy Processes; Comment on “The Untapped Power of Soda Taxes: Incentivising Consumers, Generating Revenue, and Altering Corporate Behaviours”
Yann Le Bodo
yann.lebodo@ehesp.fr
1
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
Evaluation Platform on Obesity Prevention (EPOP), Quebec Heart and Lung University Institute Research Center – Laval University (Université Laval), Quebec City, QC, Canada
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
Soda Tax
Sugar
Food and Nutrition
Policy Process
Health Promotion
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2018-05-01
7
5
474
478
10.15171/ijhpm.2017.127
3431
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”
Phillip Baker
phillip.baker@sydney.edu.au
1
Alexandra Jones
ajones@georgeinstitute.org.au
2
Anne Marie Thow
annemarie.thow@sydney.edu.au
3
Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
Menzies Centre for Health Policy, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
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
Sugar-Sweetened Beverages
Taxes
Political Priority
Capacity
Framing
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2018-05-01
7
5
479
480
10.15171/ijhpm.2017.136
3441
Eating or Feeding Our Young: A Response to Recent Commentaries
Terrence Sullivan
tsulliva2@gmail.com
1
Vidhi Thakkar
vidhi.thakkar@mail.utoronto.ca
2
Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
https://www.ijhpm.com/article_3441_23299eec8ac3f3794eb33f5c95a225ad.pdf
Health Policy
Public Spending
Comparative Spending Health Services and Policy Research