Kerman University of Medical SciencesInternational Journal of Health Policy and Management2322-593951020161001Diabetes Dictating Policy: An Editorial Commemorating World Health Day 2016571573322310.15171/ijhpm.2016.79ENAmirhosseinTakianDepartment of Global Health and Public Policy, School of Public Health,
Tehran University of Medical Sciences, Tehran, IranDepartment of Health
Management and Economics, School of Public Health, Tehran University of
Medical Sciences, Tehran, IranCollege of Health and Life Sciences, Brunel
University London, Uxbridge, UKSaraKazempour-ArdebiliDiabetes Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences,
Tehran, IranJournal Article20160419The 21st century is an era of great challenge for humankind; we are combating terrorism, climate change, poverty, human rights issues and last but not least non-communicable diseases (NCDs). The burden of the latter has become so large that it is being recognized by world leaders globally as an area that it is in need of much greater attention. In light of this concern, the World Health Organization (WHO) dedicated this year’s World Health Day (held on April 7, 2016) to raising international awareness on diabetes, the fastest growing NCD in the world. This editorial is an account of the macro politics in place for fighting diabetes, both internationally and nationally.https://www.ijhpm.com/article_3223_91bfabbe0558eb1fc82d4ec694090915.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-593951020161001Health Departments’ Engagement in Emergency Preparedness Activities: The Influence of Health Informatics Capacity575582319310.15171/ijhpm.2016.48ENGulzar H.ShahJiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USABobbieNewellJiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USARuth E.WhitworthJiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USAJournal Article20150909Background <br />Local health departments (LHDs) operate in a complex and dynamic public health landscape, with changing demands on their emergency response capacities. Informatics capacities might play an instrumental role in aiding LHDs emergency preparedness. This study aimed to explore the extent to which LHDs’ informatics capacities are associated with their activity level in emergency preparedness and to identify which health informatics capacities are associated with improved emergency preparedness. <br /> <br />Methods <br />We used the 2013 National Profile of LHDs study to perform Poisson regression of emergency preparedness activities. <br /> <br />Results <br />Only 38.3% of LHDs participated in full-scale exercises or drills for an emergency in the 12 months period prior to the survey, but a much larger proportion provided emergency preparedness training to staff (84.3%), and/or participated in tabletop exercises (76.4%). Our multivariable analysis showed that after adjusting for several resource-related LHD characteristics, LHDs with more of the 6 information systems still tend to have slightly more preparedness activities. In addition, having a designated emergency preparedness coordinator, and having one or more emergency preparedness staff were among the most significant factors associated with LHDs performing more emergency preparedness activities. <br /> <br />Conclusion <br />LHDs might want to utilize better health information systems and information technology tools to improve their activity level in emergency preparedness, through improved information dissemination, and evidence collection.https://www.ijhpm.com/article_3193_ea2d9295ce5a0f066118c1b889227647.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-593951020161001Planning and Budgeting for Nutrition Programs in Tanzania: Lessons Learned From the National Vitamin A Supplementation Program583588319410.15171/ijhpm.2016.46ENMargaret BenjaminLyatuuHelen Keller International, Dar es Salaam, TanzaniaTeminaMkumbwaHelen Keller International, Dar es Salaam, TanzaniaRazStevensonUnited States Agency for
International Development (USAID), Dar es Salaam, TanzaniaMarissaIsidroHelen Keller International, Dar es Salaam, TanzaniaFrancisModahaTanzania Food
and Nutrition Centre, Dar es Salaam, TanzaniaHeatherKatcherHelen Keller International, Dar es Salaam, TanzaniaChristina NyhusDhillonHelen Keller International, Dar es Salaam, TanzaniaJournal Article20150911Background <br />Micronutrient deficiency in Tanzania is a significant public health problem, with vitamin A deficiency (VAD) affecting 34% of children aged 6 to 59 months. Since 2007, development partners have worked closely to advocate for the inclusion of twice-yearly vitamin A supplementation and deworming (VASD) activities with budgets at the subnational level, where funding and implementation occur. As part of the advocacy work, a VASD planning and budgeting tool (PBT) was developed and is used by district officials to justify allocation of funds. Helen Keller International (HKI) and the Tanzania Food and Nutrition Centre (TFNC) conduct reviews of VASD funds and health budgets annually in all districts to monitor the impact of advocacy efforts. This paper presents the findings of the fiscal year (FY) 2010 district budget annual review. The review was intended to answer the following questions regarding district-level funding: (1) how many funds were allocated to nutrition-specific activities in FY 2010? (2) how many funds were allocated specifically to twice-yearly VASD activities in FY 2010? and (3) how have VASD funding allocations changed over time? <br /> <br />Methods <br />Budgets from all 133 districts in Tanzania were accessed, reviewed and documented to identify line item funds allocated for VASD and other nutrition activities in FY 2010. Retrospective data from prior annual reviews for VASD were used to track trends in funding. The data were collected using specific data forms and then transcribed into an excel spreadsheet for analysis. <br /> <br />Results <br />The total funds allocated in Tanzania’s districts in FY 2010 amounted to US$1.4 million of which 92% were for VASD. Allocations for VASD increased from US$0.387 million to US$1.3 million between FY 2005 and FY 2010. Twelve different nutrition activities were identified in budgets across the 133 districts. Despite the increased trend, the percentage of districts allocating sufficient funds to implement VAS (as defined by cost per child) was just 21%. <br /> <br />Discussion <br />District-driven VAS funding in Tanzania continues to be allocated by districts consistently, although adequacy of funding is a concern. However, regular administrative data point to fairly high and consistent coverage rates for VAS across the country (over 80% over the last 10 years). Although this analysis may have omitted some nutrition-specific funding not identified in district budget data, it represents a reliable reflection of the nutrition funding landscape in FY 2010. For this year, total district nutrition allocations add up to only 2% of the amount needed to implement nutrition services at scale according to Tanzania’s National Nutrition Strategy Implementation Plan. <br /> <br />Conclusion <br />VASD advocacy and planning support at the district level has succeeded in ensuring district allocations for the program. To promote sustainable implementation of other nutrition interventions in Tanzania, more funds must be allocated and guidance must be accompanied by tools that enable planning and budgeting at the district level.https://www.ijhpm.com/article_3194_1ec62ad272e7efc0e085a103b65b58b5.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-593951020161001National Health Service Principles as Experienced by Vulnerable London Migrants in “Austerity Britain”: A Qualitative Study of Rights, Entitlements, and Civil-Society Advocacy589597319810.15171/ijhpm.2016.50ENElhamRafighiFaculty of Public Health and Policy, London School of Hygiene and Tropical
Medicine, London, UKShobaPoduvalFaculty of Public Health and Policy, London School of Hygiene and Tropical
Medicine, London, UKHelenaLegido-QuigleyFaculty of Public Health and Policy, London School of Hygiene and Tropical
Medicine, London, UKSaw Swee Hock School of Public Health, National
University of Singapore, Singapore, SingaporeNatashaHowardFaculty of Public Health and Policy, London School of Hygiene and Tropical
Medicine, London, UKJournal Article20151017Background <br />Recent British National Health Service (NHS) reforms, in response to austerity and alleged ‘health tourism,’ could impose additional barriers to healthcare access for non-European Economic Area (EEA) migrants. This study explores policy reform challenges and implications, using excerpts from the perspectives of non-EEA migrants and health advocates in London. <br /> <br />Methods <br />A qualitative study design was selected. Data were collected through document review and 22 indepth interviews with non-EEA migrants and civil-society organisation representatives. Data were analysed thematically using the NHS principles. <br /> <br />Results <br />The experiences of those ‘vulnerable migrants’ (ie, defined as adult non-EEA asylum-seekers, refugees, undocumented, low-skilled, and trafficked migrants susceptible to marginalised healthcare access) able to access health services were positive, with healthcare professionals generally demonstrating caring attitudes. However, general confusion existed about entitlements due to recent NHS changes, controversy over ‘health tourism,’ and challenges registering for health services or accessing secondary facilities. Factors requiring greater clarity or improvement included accessibility, communication, and clarity on general practitioner (GP) responsibilities and migrant entitlements. <br /> <br />Conclusion <br />Legislation to restrict access to healthcare based on immigration status could further compromise the health of vulnerable individuals in Britain. This study highlights current challenges in health services policy and practice and the role of non-governmental organizations (NGOs) in healthcare advocacy (eg, helping the voices of the most vulnerable reach policy-makers). Thus, it contributes to broadening national discussions and enabling more nuanced interpretation of ongoing global debates on immigration and health.https://www.ijhpm.com/article_3198_9dc50d2319eba324dfb9fc8104eb3d24.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-593951020161001Politics, Power, Poverty and Global Health: Systems and Frames599604324810.15171/ijhpm.2016.101ENSolomonBenatarUniversity of Cape Town, Cape Town, South AfricaDalla Lana School of Public Health, University of Toronto, Toronto, ON, CanadaJournal Article20160613Striking disparities in access to healthcare and in health outcomes are major characteristics of health across the globe. This inequitable state of global health and how it could be improved has become a highly popularized field of academic study. In a series of articles in this journal the roles of power and politics in global health have been addressed in considerable detail. Three points are added here to this debate. The first is consideration of how the use of definitions and common terms, for example ‘poverty eradication,’ can mask full exposure of the extent of rectification required, with consequent failure to understand what poverty eradication should mean, how this could be achieved and that a new definition is called for. Secondly, a criticism is offered of how the term ‘global health’ is used in a restricted manner to describe activities that focus on an anthropocentric and biomedical conception of health across the world. It is proposed that the discourse on ‘global health’ should be extended beyond conventional boundaries towards an ecocentric conception of global/planetary health in an increasingly interdependent planet characterised by a multitude of interlinked crises. Finally, it is noted that the paucity of workable strategies towards achieving greater equity in sustainable global health is not so much due to lack of understanding of, or insight into, the invisible dimensions of power, but is rather the outcome of seeking solutions from within belief systems and cognitive biases that cannot offer solutions. Hence the need for a new framing perspective for global health that could reshape our thinking and actions.https://www.ijhpm.com/article_3248_7cd4a615547cef734e873400545332a3.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-593951020161001The Evolving Role of Physicians - Don’t Forget the Generalist Primary Care Providers; Comment on “Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians”605606321910.15171/ijhpm.2016.77ENVincent KalumireCubakaAarhus University, Aarhus, DenmarkUniversity of Rwanda, Kigali, RwandaMichaelSchriverAarhus University, Aarhus, DenmarkMaaikeFlinkenflögelUniversity of Rwanda, Kigali, RwandaPhilipCottonUniversity of Rwanda, Kigali, RwandaJournal Article20160315The editorial <em>“Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians”</em> by Eyal et al describes non-physician clinicians’ (NPC) need for mentorship and support from physicians. We emphasise the same need of support for front line generalist primary healthcare providers who carry out complex tasks yet may have an inadequate skill mix.https://www.ijhpm.com/article_3219_9071fc6d18cb94564d1f73a6f31e1a89.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-593951020161001Decentralisation, Decision Space and Directions for Future Research; Comment on “Decentralisation of Health Services in Fiji: A Decision Space Analysis”607608322410.15171/ijhpm.2016.76ENMaryamZahmatkeshKingston University, London, UKMarkExworthyHealth Services Management Centre,
University of Birmingham, Birmingham, UKJournal Article20160419Decentralisation continues to re-appear in health system reform across the world. Evaluation of these reforms reveals how research on decentralisation continues to evolve. In this paper, we examine the theoretical foundations and empirical references which underpin current approaches to studying decentralisation in health systems.https://www.ijhpm.com/article_3224_6c517687aca9ae3ca95b909f1cfee1d1.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-593951020161001Implementing Health in All Policies – Time and Ideas Matter Too!; Comment on “Understanding the Role of Public Administration in Implementing Action on the Social Determinants of Health and Health Inequities”609610322810.15171/ijhpm.2016.81ENCaroleClavierDepartement of Political Science, Universite du Quebec a Montreal, Montréal, QC, Canada0000-0001-7327-1571Journal Article20160219Carey and Friel suggest that we turn to knowledge developed in the field of public administration, especially new public governance, to better understand the process of implementing health in all policies (HiAP). In this commentary, I claim that theories from the policy studies bring a broader view of the policy process, complementary to that of new public governance. Drawing on the policy studies, I argue that time and ideas matter to HiAP implementation, alongside with interests and institutions. Implementing HiAP is a complex process considering that it requires the involvement and coordination of several policy sectors, each with their own interests, institutions and ideas about the policy. Understanding who are the actors involved from the various policy sectors concerned, what context they evolve in, but also how they own and frame the policy problem (ideas), and how this has changed over time, is crucial for those involved in HiAP implementation so that they can relate to and work together with actors from other policy sectors.https://www.ijhpm.com/article_3228_eb8d9ba9bb7eca9bb4e31aa1d6e31587.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-593951020161001Looking Beyond FDA Warning Letters to Explore Unforeseen Trouble Spots in eDTCA: A Response to Recent Commentaries611612324010.15171/ijhpm.2016.92ENHyosunKimDivision of Communication, University of Wisconsin-Stevens Point, Stevens Point, WI, USAJournal Article20160620https://www.ijhpm.com/article_3240_dfc6a347eb61efd6874ed456b0a841ea.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-593951020161001Without Explicit Targets, Does France Meet Minimum Volume Thresholds for Hip and Knee Replacement and Bariatric Surgeries?613614324910.15171/ijhpm.2016.105ENWilliam B.WeeksThe Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth
College, Hanover, NH, USAThe Geisel School of Medicine, Hanover, NH,
USAAix-Marseille School of Economics (CNRS & EHESS), Aix-Marseille
University, Marseille, FranceBrunoVentelouAix-Marseille School of Economics (CNRS & EHESS), Aix-Marseille
University, Marseille, FranceZeynepOrInstitut de recherché et documentation en
économie de la santé, Paris, FranceJournal Article20160706https://www.ijhpm.com/article_3249_31da161a9cda932ed4eeaede7c4204d5.pdf