Kerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59396920170901The Untapped Power of Soda Taxes: Incentivizing Consumers, Generating Revenue, and Altering Corporate Behavior489493337610.15171/ijhpm.2017.69ENSarah A.RoacheO’Neill Institute for National and Global Health Law, Law Center, Georgetown University, Washington, DC, USALawrence O.GostinO’Neill Institute for National and Global Health Law, Law Center, Georgetown University, Washington, DC, USAJournal Article20170426<span>Globally, soda taxes are gaining momentum as powerful interventions to discourage sugar consumption and <span>thereby reduce the growing burden of obesity and non-communicable diseases (NCDs). Evidence from early <span>adopters including Mexico and Berkeley, California, confirms that soda taxes can disincentivize consumption <span>through price increases and raise revenue to support government programs. The United Kingdom’s new <span>graduated levy on sweetened beverages is yielding yet another powerful impact: soda manufacturers are <span>reformulating their beverages to significantly reduce the sugar content. Product reformulation – whether <span>incentivized or mandatory – helps reduce overconsumption of sugars at the societal level, moving away from <span>the long-standing notion of individual responsibility in favor of collective strategies to promote health. But as <span>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 <span>disproportionately impacted by NCDs. As global momentum for sugar reduction increases, governments and <span>public health advocates should harness the power of soda taxes to tackle the economic, social, and informational <span>drivers of soda consumption, driving improvements in food environments and the public’s health.</span></span></span></span></span></span></span></span></span></span></span><br /></span>https://www.ijhpm.com/article_3376_cfa3e140fb10202332ce4e53fcbd5d63.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59396920170901Why and How Political Science Can Contribute to Public Health? Proposals for Collaborative Research Avenues495499334210.15171/ijhpm.2017.38ENFranceGagnonSchool of Administrative Sciences, TÉLUQ, Université du Québec, Quebec
City, QC, CanadaPierreBergeronDepartment of Social and Preventive Medicine, Université
Laval, Quebec City, QC, CanadaCaroleClavierDepartment of Political Science, Université
du Québec à Montréal, Montréal, QC, CanadaPatrickFafardSchool of Public and
International Affairs, University of Ottawa, Ottawa, ON, CanadaElisabethMartinFaculty of
Nursing, Université Laval, Quebec City, QC, CanadaChantalBlouinDepartment of Social and Preventive Medicine, Université
Laval, Quebec City, QC, CanadaJournal Article20161123Written 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.https://www.ijhpm.com/article_3342_2f40354f98413e512ac5c63607b7da08.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59396920170901Peruvian Mental Health Reform: A Framework for Scaling-up Mental Health Services501508331310.15171/ijhpm.2017.07ENMauricioToyamaCRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana
Cayetano Heredia, Lima, PeruHumbertoCastilloInstituto Nacional de Salud Mental “Honorio
Delgado - Hideyo Noguchi,” Lima, PeruJerome T.GaleaSocios en Salud, Lima, PeruDepartment of Global Health and Social Medicine, Harvard Medical School,
Boston, MA, USALena R.BrandtCRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana
Cayetano Heredia, Lima, PeruMaríaMendozaInstituto Nacional de Salud Mental “Honorio
Delgado - Hideyo Noguchi,” Lima, PeruVanessaHerreraInstituto Nacional de Salud Mental “Honorio
Delgado - Hideyo Noguchi,” Lima, PeruMarthaMitraniInstituto Nacional de Salud Mental “Honorio
Delgado - Hideyo Noguchi,” Lima, PeruYuriCutipéMinisterio de Salud, Lima, PeruVictoriaCaveroCRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana
Cayetano Heredia, Lima, PeruFranciscoDiez-CansecoCRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana
Cayetano Heredia, Lima, PeruJ. JaimeMirandaCRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana
Cayetano Heredia, Lima, PeruSchool of Medicine,
Universidad Peruana Cayetano Heredia, Lima, PeruJournal Article20160628Background <br />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. <br /> <br />Methods <br />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. <br /> <br />Results <br />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. <br /> <br />Conclusion <br />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.https://www.ijhpm.com/article_3313_27793e38fcd053d3aedb23b37e56d848.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59396920170901Providing Value to New Health Technology: The Early Contribution of Entrepreneurs, Investors, and Regulatory Agencies509518331410.15171/ijhpm.2017.11ENPascaleLehouxDepartment of Health Management, Evaluation and Policy, School of Public
Health, University of Montreal, Montréal, QC, CanadaInstitute of Public
Health Research of University of Montreal (IRSPUM), Montréal, QC, CanadaUniversity of Montreal Chair on Responsible Innovation in Health Montreal,
Montréal, QC, CanadaFiona A.MillerInstitute of Health Policy, Management and Evaluation,
University of Toronto, Toronto, ON, CanadaGenevièveDaudelinInstitute of Public
Health Research of University of Montreal (IRSPUM), Montréal, QC, CanadaJean-LouisDenisÉcole Nationale d’administration
publique (ENAP), Quebec City, QC, CanadaDepartment of Management,
Faculty of Social Science & Public Policy, King’s College, London, UKJournal Article20161020Background <br />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. <br /> <br />Methods <br />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. <br /> <br />Results <br />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. <br /> <br />Conclusion <br />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.https://www.ijhpm.com/article_3314_d55516fc36042b9d4d8e93b9053f3a4a.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59396920170901Factors Associated With Unhealthy Snacks Consumption Among Adolescents in Iran’s Schools519528331710.15171/ijhpm.2017.09ENVahidYazdi FeyzabadiDepartment of Health Management and Economics, School of Public Health,
Tehran University of Medical Sciences, Tehran, IranNastaranKeshavarz MohammadiSchool of Public Health,
Shahid Beheshti University of Medical Sciences, Tehran, IranNasrinOmidvarDepartment
of Community Nutrition, National Nutrition and Food Technology Research
Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti
University of Medical Sciences, Tehran, IranAkramKarimi-ShahanjariniSocial Determinants of Health
Research Center and Department of Public Health, School of Public Health,
Hamadan University of Medical Sciences, Hamadan, IranSaharnazNedjatEpidemiology
and Biostatistics Department, School of Public Health, Knowledge Utilization
Research Center, Tehran University of Medical Sciences, Tehran, IranArashRashidianDepartment of Health Management and Economics, School of Public Health,
Tehran University of Medical Sciences, Tehran, IranJournal Article20160703Background<br />Well-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.<br /> <br />Methods<br />In 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.<br /> <br />Results<br />Taste 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).<br /> <br />Conclusion<br />Unhealthy 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.https://www.ijhpm.com/article_3317_ffab6057aff866940e3452eac5fe8a59.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59396920170901How Should Global Fund Use Value-for-Money Information to Sustain its Investments in Graduating Countries?529533333010.15171/ijhpm.2017.25ENKittiKanpiromBureau of Health Administration, Ministry of Public Health, Nonthaburi,
ThailandAlia Cynthia G.LuzHITAP International Unit, Ministry of Public Health, Nonthaburi,
ThailandKalipsoChalkidouGlobal Health and Development Team, Imperial College London,
London, UKYotTeerawattananonHealth Intervention and Technology Assessment Program
(HITAP), Ministry of Public Health, Nonthaburi, ThailandJournal Article20161027It 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.https://www.ijhpm.com/article_3330_9ab002ee42f64ce1757b3d050fe69068.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59396920170901Thinking Out of the Box: A Green and Social Climate Fund; Comment on “Politics, Power, Poverty and Global Health: Systems and Frames”535538330210.15171/ijhpm.2016.154ENGorikOomsDepartment of Global Health and Development, London School of Hygiene
and Tropical Medicine, London, UKRemcoVan De PasDepartment of Public Health, Institute of
Tropical Medicine, Antwerp, BelgiumKristofDecosterDepartment of Public Health, Institute of
Tropical Medicine, Antwerp, BelgiumRachelHammondsLaw and Development Research Group,
Faculty of Law, University of Antwerp, Antwerp, BelgiumJournal Article20161029Solomon 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.https://www.ijhpm.com/article_3302_98bdeac264b9c0a05d658df5169852a0.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59396920170901Critical Global Health: Responding to Poverty, Inequality and Climate Change; Comment on “Politics, Power, Poverty and Global Health: Systems and Frames”539541330410.15171/ijhpm.2016.157ENDavidMcCoyCentre for Primary Care and Public Health, Queen Mary University, London, UKJournal Article20161121A 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.https://www.ijhpm.com/article_3304_5e714f2579676e430047c52bedcf071a.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59396920170901Don’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”543545330810.15171/ijhpm.2017.03ENWilliamHallCentre for Clinical Epidemiology & Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, CanadaJournal Article20161114As 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.https://www.ijhpm.com/article_3308_9d5fb8e62fccf52582e862d1d1d4cc80.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59396920170901Framing Political Change: Can a Left Populism Disrupt the Rise of the Reactionary Right?; Comment on “Politics, Power, Poverty and Global Health: Systems and Frames”547549331010.15171/ijhpm.2017.08ENRonaldLabontéCanada Research Chair, Globalization and Health Equity, Faculty of Medicine, School of Epidemiology, Public Health and Preventive Medicine,
University of Ottawa, Ottawa, ON, CanadaJournal Article20161113Solomon 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.https://www.ijhpm.com/article_3310_b31003a214bbfa0ec7b27d9acfa388e1.pdf