2024-03-28T19:42:16Z
https://www.ijhpm.com/?_action=export&rf=summon&issue=703
International Journal of Health Policy and Management
IJHPM
2021
10
9
Thinking Together, Working Apart: Leveraging a Community of Practice to Facilitate Productive and Meaningful Remote Collaboration
Mark
Embrett
Rebecca H.
Liu
Katie
Aubrecht
Andriy
Koval
Jonathan
Lai
Considering the coronavirus disease 2019 (COVID-19) pandemic, scholars were encouraged to cease collocated meetings. Many researchers have turned to remote collaboration to continue group-based projects. This paper focuses on the structure, processes, and outcomes that a group of physically distanced, embedded researchers used to collaborate across Canada to produce research outputs prior to the pandemic. The intent of this paper is to provide an overview of mechanisms that can facilitate meaningful and productive remote collaboration using online and digital technologies as a feasible and effective alternative mode of communication for research teams.
Remote Collaboration
Social Distancing
Community of Practice
Communication Technology
Training Modernization
2021
09
01
528
533
https://www.ijhpm.com/article_3854_2ba3fbb058f5246af85e6e45a07c936e.pdf
International Journal of Health Policy and Management
IJHPM
2021
10
9
Patient-Centred Care for Patients With Diabetes and HIV at a Public Tertiary Hospital in South Africa: An Ethnographic Study
Edna N.
Bosire
Emily
Mendenhall
Shane A.
Norris
Jane
Goudge
BackgroundHealthcare systems across the globe are adopting patient-centred care (PCC) approach to empower patients in taking charge of their illnesses and improve the quality of care. Although models of patient‐centredness vary, respecting the needs and preferences of individuals receiving care is important. South Africa has implemented an integrated chronic disease management (ICDM) which has PCC component. The ICDM aims to empower chronic care patients to play an active role in disease management process, whilst simultaneously intervening at a community/ population and health service level. However, chronic care is still fragmented due to systemic challenges that have hindered the practice of PCC. In this article, we explore provider perspectives on PCC for patients with comorbid type 2 diabetes and HIV at a public tertiary hospital in urban South Africa. MethodsThis study utilizes ethnographic methods, encompassing clinical observations, and qualitative interviews with healthcare providers (n = 30). Interview recordings were transcribed verbatim and data were analyzed inductively using a grounded theory approach. ResultsProviders reported various ways in which they conceptualized and practiced PCC. However, structural challenges such as staff shortages, lack of guidelines for comorbid care, and fragmented care, and patient barriers such as poverty, language, and missed appointments, impeded the possibility of practicing PCC. ConclusionHealth systems could be strengthened by: (i) ensuring appropriate multidisciplinary guidelines for managing comorbidities exist, are known, and available, (ii) strengthening primary healthcare (PHC) clinics by ensuring access to necessary resources that will facilitate successful integration and management of comorbid diabetes and HIV, (iii) training medical practitioners on PCC and structural competence, so as to better understand patients in their sociocultural contexts, and (iv) understanding patient challenges to effective care to improve attendance and adherence.
Diabetes
HIV/AIDS
Patient-Centred Care
South Africa
2021
09
01
534
545
https://www.ijhpm.com/article_3804_c5fd1da03845c5506bb596d24f22d3c1.pdf
International Journal of Health Policy and Management
IJHPM
2021
10
9
The Effectiveness of a Multi-Pronged Psycho-Social Intervention Among People With Mental Health and Epilepsy Problems - A Pre-Post Prospective Cohort Study Set in North India
Kaaren
Mathias
Dale
Corcoran
Pooja
Pillai
Smita
Deshpande
Miguel
San Sebastian
BackgroundIn low- and middle-income settings, many people with mental health problems cannot or do not access psychiatric services. Few studies of people with epilepsy and mental problems have evaluated the effectiveness of a predominantly psycho-social intervention, delivered by lay community workers. The aim of this study was to assess the effectiveness of a community-based complex mental health intervention within informal urban communities while simultaneously addressing social determinants of mental health among disadvantaged people with severe and common mental disorders (CMDs), and epilepsy. MethodsIn this observational, prospective cohort study set in Uttarakhand, India, the lay-worker led intervention included psychoeducation, behavioural activation, facilitation of access to care, and facilitated psycho-social support groups. Participants were categorised as having a severe or CMD or epilepsy and assessed 5 times over 24 months using primary outcome measures, including the Patient Health Questionnaire (PHQ9) (severity of depression), the World Health Organization Disability Assessment Schedule (WHODAS 2.0), the Recovery Star, and scoring of a bespoke Engagement Index. Analysis included descriptive statistics as well as hierarchical linear regression models to report fixed effects as regression coefficients. ResultsAmong the 297 (baseline) participants only 96 people (31%) regularly used psychotropic medication (at least 4 weeks) and over 60% could not or did not consult a psychiatrist at all in the study period. Nonetheless, people with CMDs showed a significant reduction in their depression severity (PHQ9: B = -6.94, 95% CI -7.37 to -6.51), while people with severe mental disorders (SMDs) showed a significant reduction in their disability score (WHODAS 2.0: B = -4.86, 95% CI - 7.14 to- 2.57). People with epilepsy also reduced their disability score (WHODAS 2.0: B = -5.22, 95% CI -7.29 to -3.15). ConclusionThis study shows significant improvements in mental health, depression, recovery, disability and social engagement for people with common and SMDs, and epilepsy, through a community-based intervention that was nonpharmaceutical. It provides preliminary evidence of the value of predominantly psycho-social interventions implemented by lay health workers among people with limited or no access to psychiatric services.
Psychosocial
India
Mental Health
Intervention
Epilepsy
2021
09
01
546
553
https://www.ijhpm.com/article_3809_ae3a5bbcd9bd49937e88b0826ce1d780.pdf
International Journal of Health Policy and Management
IJHPM
2021
10
9
Financing Maternity and Early Childhood Healthcare in The Australian Healthcare System: Costs to Funders in Private and Public Hospitals Over the First 1000 Days
Emily
Callander
Antonia
Shand
David
Ellwood
Haylee
Fox
Natasha
Nassar
BackgroundMaternity care is a significant contributor to overall healthcare expenditure, and private care is seen as a mechanism to reduce the cost to public funders. However, public funders may still contribute to part of the cost of private care. The paper aims to quantify (1) the cost to different funders of maternal and early childhood healthcare over the first 1000 days for both women giving birth in private and public hospitals; (2) any variation in cost to different funders by birth type; and (3) the cost of excess caesarean sections in public and private hospitals in Australia. MethodsThis study utilised a whole of population linked administrative dataset, and classified costs by the funding source. The mean cost to different funders for private hospital births, and public hospital births in the Australian state, Queensland are presented by time period and by birth type. The World Health Organization’s (WHO’s) C-model was used to identify the optimal caesarean section rate based upon demographic and clinical factors, and counterfactual analysis was utilised to identify the cost to different funders if caesarean section had been utilised at this rate across Australia. ResultsWe found that for women who gave birth in a public hospital as a public patient, the mean cost was $22 474. For women who gave birth in a private hospital the mean cost was $24 731, and the largest contributor was private health insurers ($11 550), followed by Medicare ($7261) and individuals ($3312). Private hospital births cost government funders $10 050 on average; whereas public hospital public patient births cost government funders $21 723 on average and public hospital private patient births cost government funders $20 899 on average. If caesarean section deliveries were reduced, public hospital funders could save $974 million and private health insurers could save $216 million. ConclusionPrivate hospital births cost government funders less than public hospital births, but government funders still pay for around 40% of the cost of private hospital births. Caesarean sections, which are more frequently performed in private hospitals, are costly to all funders and reducing them could impart significant cost savings to all funders.
Perinatal Health
Maternal Health
Early Childhood Health
Universal Healthcare
Caesarean Section
Healthcare Costs
2021
09
01
554
563
https://www.ijhpm.com/article_3812_63e9efae3e6ed7f60f8d66800a902d96.pdf
International Journal of Health Policy and Management
IJHPM
2021
10
9
Cost of Utilising Maternal Health Services in Low- and Middle-Income Countries: A Systematic Review
Aduragbemi
Banke-Thomas
Francis Ifeanyi
Ayomoh
Ibukun-Oluwa Omolade
Abejirinde
Oluwasola
Banke-Thomas
Ejemai Amaize
Eboreime
Charles Anawo
Ameh
BackgroundCost is a major barrier to maternal health service utilisation for many women in low- and middle-income countries (LMICs). However, comparable evidence of the available cost data in these countries is limited. We conducted a systematic review and comparative analysis of costs of utilising maternal health services in these settings. MethodsWe searched peer-reviewed and grey literature databases for articles reporting cost of utilising maternal health services in LMICs published post-2000. All retrieved records were screened and articles meeting the inclusion criteria selected. Quality assessment was performed using the relevant cost-specific criteria of the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. To guarantee comparability, disaggregated costs data were inflated to 2019 US dollar equivalents. Total adjusted costs and cost drivers associated with utilising each service were systematically compared. Where heterogeneity in methods or non-disaggregated costs was observed, narrative synthesis was used to summarise findings. ResultsThirty-six studies met our inclusion criteria. Many of the studies costed multiple services. However, the most frequently costed services were utilisation of normal vaginal delivery (22 studies), caesarean delivery (13), and antenatal care (ANC) (10). The least costed services were post-natal care (PNC) and post-abortion care (PAC) (5 each). Studies used varied methods for data collection and analysis and their quality ranged from low to high with most assessed as average or high. Generally, across all included studies, cost of utilisation progressively increased from ANC and PNC to delivery and PAC, and from public to private providers. Medicines and diagnostics were main cost drivers for ANC and PNC while cost drivers were variable for delivery. Women experienced financial burden of utilising maternal health services and also had to pay some unofficial costs to access care, even where formal exemptions existed. ConclusionConsensus regarding approach for costing maternal health services will help to improve their relevance for supporting policy-making towards achieving universal health coverage. If indeed the post-2015 mission of the global community is to “leave no one behind,” then we need to ensure that women and their families are not facing unnecessary and unaffordable costs that could potentially tip them into poverty. Prospero Registration NumberCRD42019150058
Maternal Health
Utilisation
Cost
Economic Evaluation
Developing Countries
2021
09
01
564
577
https://www.ijhpm.com/article_3841_6e3606d8ce34f533825a2a0c3a1f7285.pdf
International Journal of Health Policy and Management
IJHPM
2021
10
9
Denial and Distraction: How the Populist Radical Right Responds to COVID-19; Comment on “A Scoping Review of PRR Parties’ Influence on Welfare Policy and its Implication for Population Health in Europe”
Michelle
Falkenbach
Scott L.
Greer
This commentary considers the impact of the coronavirus disease 2019 (COVID-19) pandemic on the study of populist radical right (PRR) politicians and their influence on public health and health policy. A systematic review of recent research on the influence of PRR politicians on the health and welfare policies shows that health is not a policy arena that these politicians have much experience in. In office, their effects can be destructive, primarily because they subordinate health to their other goals. Brazil, the US and the UK all show this pattern. PRR politicians in opposition such as the Freedom Party of Austria (FPÖ) in Austria or the Lega in Italy, said very little during the actual health crisis, but once the public no longer appeared afraid they lost no time in reactivating anti-European Union (EU) sentiments. Whether in government or in opposition, PRR politicians opted for distraction and denial. Their effects ranged from making the pandemic worse.
Populist Radical Right
COVID-19 Pandemic
Public Health
Health Policy
2021
09
01
578
580
https://www.ijhpm.com/article_3880_266821699c45dcdd148aa61f275fc3f3.pdf
International Journal of Health Policy and Management
IJHPM
2021
10
9
Welfare Chauvinism, Populist Radical Right Parties and Health Inequalities; Comment on “A Scoping Review of Populist Radical Right Parties’ Influence on Welfare Policy and its Implications for Population Health in Europe”
Clare
Bambra
Julia
Lynch
In this short commentary, we examine the implications of the welfare chauvinism of the populist radical right (PRR) for health inequalities by examining the international evidence about the impact of previous periods of welfare state contraction on population health and health inequalities. We argue that parties from various political traditions have in fact long engaged in stigmatisation of welfare recipients to justify welfare state retrenchment, a technique that the PRR have now ‘weaponised.’ We conclude by reflecting on implications of the rise of the PRR for the future of welfare states and health inequalities in the context of coronavirus disease 2019 (COVID-19).
Politics
COVID-19
Social Policy
Public Health
2021
09
01
581
584
https://www.ijhpm.com/article_3886_b370da5e584cb046821e447205a70d00.pdf
International Journal of Health Policy and Management
IJHPM
2021
10
9
Populism and Health Policy in Latin America; Comment on “A Scoping Review of Populist Radical Right Parties’ Influence on Welfare Policy and its Implications for Population Health in Europe”
Mary A.
Clark
Amy
Patterson
This commentary focuses on Latin America, a region known for its rich variety of populist politicians and some of the most extensive welfare states in the Global South. Contemporary Latin America offers examples of left-wing and right-wing populist leaders, none of whom demonstrate the same focus on excluding immigrants from welfare state benefits as that noted by Chiari Rinaldi and Marleen Bekker in the European context. We see this contrast not because immigrants’ access to health services is less important in Latin America, but because Latin American populists are more focused on internal “enemies.” The commentary concludes with observations regarding Latin American populist leaders’ handling of the Coronavirus disease 2019 (COVID-19) pandemic.
Populism
Latin America
Health Policy
2021
09
01
585
587
https://www.ijhpm.com/article_3888_cc4462fb9399eec2c972fcf3fa6db4a2.pdf
International Journal of Health Policy and Management
IJHPM
2021
10
9
The Multifaceted Pathways Linking Populism to Ethnic Minority Health; Comment on “A Scoping Review of Populist Radical Right Parties’ Influence on Welfare Policy and its Implications for Population Health in Europe”
Karien
Stronks
Charles
Agyemang
Based on a scoping review of empirical studies accompanied by interviews with experts, Rinaldi and Bekker studied the impact of populist radical right (PRR) parties on access to welfare provisions – the latter standing proxy for population health and for health inequalities in particular. We argue that populism can impact on migrant and ethnic minority health in multiple ways, in addition to the welfare mechanism specified in that review. These include institutionalised discrimination affecting individuals’ positions in the social hierarchy, experiences of discrimination in interpersonal relationships, and a weakened legitimacy of health policies. Interdisciplinary teams that include public health scholars and political scientists should take up the challenge of understanding migrant and ethnic minority health from a systems perspective.
Migrant Health
Ethnic Minority Health
Populism
Discrimination
Systems Thinking
2021
09
01
588
590
https://www.ijhpm.com/article_3891_bcc5fd9b0e123273a663f30326c7b5c8.pdf
International Journal of Health Policy and Management
IJHPM
2021
10
9
Issue Competition and the Social Construction of Target Populations: Alternative Suggestions for the Study of the Influence of Populist Radical Right Parties on Health Policy and Health Outcomes; Comment on “A Scoping Review of Populist Radical Right Parties’ Influence on Welfare Policy and its Implications for Population Health in Europe”
Carole
Clavier
Elisabeth
Martin
France
Gagnon
Rinaldi and Bekker ask whether populist radical right (PRR) parties have an influence on population health and health equity. The assumption is that this influence is negative, but mediated by political system characteristics. Starting from the authors’ premise that the positions of PRR parties on welfare policies are a good proxy for health outcomes, we build on political science literature to suggest further avenues for research. The equivocal relationship between political parties and the ownership of specific healthcare, health insurance and public health issues invites studies that break down party positions relating to different health policy issues. As policy-makers use social representations of target populations to make policy decisions and anticipate the feedback these decisions might generate, it is worth studying how PRR parties influence societal, institutional and partisan perceptions of deserving and undeserving populations, even when they are not in government.
Political Parties
Issue Competition
Target Populations
Policy Feedback
Health Effects
2021
09
01
591
593
https://www.ijhpm.com/article_3897_3b7210d6948a54dce5cc4dd93fe90b4a.pdf
International Journal of Health Policy and Management
IJHPM
2021
10
9
Who Deserves Welfare and Who Does Not?; Comment on “A Scoping Review of Populist Radical Right Parties’ Influence on Welfare Policy and its Implications for Population Health in Europe”
Jasper
Muis
To what extent has the rise of populist radical right (PRR) parties in Europe affected welfare policies? Based on a scoping review of studies that address the relationship between PRR parties and welfare policy, Chiara Rinaldi and Marleen Bekker conclude that, due to their welfare chauvinistic positions, the participation of PRR parties in government coalitions is likely to have negative effects on the access to welfare provisions and health of vulnerable population groups. This short commentary reflects on this review article and critically examines its conclusion. It suggests some conceptual clarifications, raises some reservations about the review’s main claim, and provides some follow-up questions.
Populist Radical Right
Welfare Policy
Welfare Chauvinism
Public Health
2021
09
01
594
597
https://www.ijhpm.com/article_3911_34b0c6c06367cb2fc5e20b6ea209ad6c.pdf
International Journal of Health Policy and Management
IJHPM
2021
10
9
Taking the Relationship Between Populism and Healthcare Seriously: A Call for Empirical Analysis Rather Than Moral Condemnation; Comment on “A Scoping Review of Populist Radical Right Parties’ Influence on Welfare Policy and its Implications for Population Health in Europe”
Martijn
Felder
Iris
Wallenburg
Syb
Kuijper
Roland
Bal
In this commentary, we reflect on Rinaldi and Bekker’s scoping review of the literature on populist radical right (PRR) parties and welfare policies. We argue that their review provides political scientists and healthcare scholars with a firm basis to further explore the relationships between populism and welfare policies in different political systems. In line with the authors, we furthermore (re)emphasize the need for additional empirical inquiries into the relationship between populism and healthcare. But instead of expanding the research agenda suggested – for instance by adding categories or niches in which this relationship can be observed – we would like to challenge some of the premises of the studies conducted and reviewed thus far. We do so by identifying two concerns and by illustrating these concerns with two examples from the Netherlands.
Populism
Healthcare
Welfare States
2021
09
01
598
601
https://www.ijhpm.com/article_3915_f50e258a92780678ea947b365a620476.pdf