Kerman University of Medical SciencesInternational Journal of Health Policy and Management2322-593991020201001We Need Compassionate Leadership Management Based on Evidence to Defeat COVID-19413414380610.34172/ijhpm.2020.73ENAgnesBinagwahoUniversity of Global Health Equity, Kigali, Rwanda0000-0002-6779-3151Journal Article20200419<span class="fontstyle0">The current pandemic of coronavirus disease 2019 (COVID-19) has had unprecedented reach and shown the need for strong, compassionate and evidence-based decisions to effectively stop the spread of the disease and save lives. While aggressive in its response, Rwanda prioritized the lives of its people – a human right that some governments forget to focus on. The country took significant steps, before the first case and to limit the spread of the disease, rolled out a complete nationwide lockdown within one week of the first confirmed case, while also providing social support to vulnerable populations. This pandemic highlights the need for leaders to be educated on implementation science principles to be able to make evidence-based decisions through a multi-sectoral, integrated response, with consideration for contextual factors that affect implementation. This approach is critical in developing appropriate preparedness and response strategies and save lives during the current threat and those to come.</span>https://www.ijhpm.com/article_3806_4d40e26830dce7cb1041f7effa9724b2.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-593991020201001Sustainable COVID-19 Mitigation: Wuhan Lockdowns, Health Inequities, and Patient Evacuation415418379810.34172/ijhpm.2020.63ENLeeLiuSchool of Geoscience, Physics and Safety, College of Health, Science and Technology, University of Central Missouri, Warrensburg, MO, USASchool of Environment, Northeast Normal University, Changchun, Jilin, ChinaJournal Article20200409<span class="fontstyle0">The world is urgently looking for ways to flatten the coronavirus disease 2019 (COVID-19) curve, and many governments have resorted to implementing strict lockdowns, as researchers show the effectiveness of China’s approaches in containing the virus. However, this paper argues that the draconian lockdowns instituted in Wuhan, Hubei, China, may have actually contributed to intensifying patient surges and incapacitating local health systems. Medical aids were rushed to Hubei and new hospitals were rapidly built, however, the healthcare system was still unable to match the staggering increase of patients in the early stages of the lockdowns. The paper proposes using patient evacuation to enhance sustainable COVID-19 mitigation during lockdowns. It demonstrates that patients in Hubei could have been transported to other Chinese provinces where hospitals were under-utilized. This could have theoretically saved thousands of lives by reducing inequities between Hubei and the rest of China in healthcare capacity for treating COVID-19 patients.</span>https://www.ijhpm.com/article_3798_2ccdcec11fed10606c01babc930454f6.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-593991020201001COVID-19: A Window of Opportunity for Positive Healthcare Reforms419422380110.34172/ijhpm.2020.66ENStefanAuenerRadboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands0000-0002-8157-705XDanielleKroonRadboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands0000-0002-6602-5492ErikWackersRadboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands0002-0290-7103SimoneVan DulmenRadboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands0000-0003-4003-8540PatrickJeurissenRadboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands0000-0002-4198-2448Journal Article20200417<span class="fontstyle0">The current coronavirus disease 2019 (COVID-19) pandemic is testing healthcare systems like never before and all efforts are now being put into controlling the COVID-19 crisis. We witness increasing morbidity, delivery systems that sometimes are on the brink of collapse, and some shameless rent seeking. However, besides all the challenges, there are also possibilities that are opening up. In this perspective, we focus on lessons from COVID-19 to increase the sustainability of health systems. If we catch the opportunities, the crisis might very well be a policy window for positive reforms. We describe the positive opportunities that the COVID-19 crisis has opened to reduce the sources of waste for our health systems: failures of care delivery, failures of care coordination, overtreatment or low-value care, administrative complexity, pricing failures and fraud and abuse. We argue that current events can canalize some very needy reforms to make our systems more sustainable. As always, political policy windows are temporarily open, and so swift action is needed, otherwise the opportunity will pass and the vested interests will come back to pursue their own agendas. Professionals can play a key role in this as well.</span>https://www.ijhpm.com/article_3801_70f78b1bb80998e9cc7dfd97d0fc3cef.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-593991020201001For-Profit Hospitals Out of Business? Financial Sustainability During the COVID-19 Epidemic Emergency Response423428380210.34172/ijhpm.2020.67ENFlorien MargarethKruseIQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands0000-0003-3850-9331Patrick P.T.JeurissenIQ Healthcare, Radboud University Medical Center, Nijmegen, The NetherlandsMinistry of Health, Welfare and Sport, The Hague, The Netherlands0000-0002-4198-2448Journal Article20200405<span class="fontstyle0">This perspective argues that for-profit hospitals will be heavily affected by epidemic crises, including the current coronavirus disease 2019 (COVID-19) outbreak. Policy-makers should be aware that for-profit hospitals in particular are likely to face financial distress. The suspension of all non-urgent elective surgery and the relegation of market-based mechanisms that determines the allocation and compensation of care puts the financial state of these hospitals at serious risk. We identify three organisational factors that determine which hospitals might be most affected (ie, care-portfolio, size and whether it is private equity [PE]-owned). In addition, we analyse contextual factors that could explain the impact of financial distress among for-profit hospitals on the wider healthcare system.</span>https://www.ijhpm.com/article_3802_741334820f2021aef8ab8997ed04ca7a.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-593991020201001COVID-19 and Power in Global Health429431380510.34172/ijhpm.2020.72ENAmyPattersonDepartment of Politics, University of the South, Sewanee, TN, USA0000-0003-2891-3162Mary A.ClarkDepartment of Political Science, Tulane University, New Orleans, LA, USA0000-0002-3058-2916Journal Article20200408<span class="fontstyle0">Political scientists bring important tools to the analysis of the coronavirus disease 2019 (COVID-19) pandemic, particularly a focus on the crucial role of power in global health politics. We delineate different kinds of power at play during the COVID-19 crisis, showing how a dearth of compulsory, institutional, and epistemic power undermined global cooperation and fueled the pandemic, with its significant loss to human life and huge economic toll. Through the pandemic response, productive and structural power became apparent, as issue frames stressing security and then preserving livelihoods overwhelmed public health and human rights considerations. Structural power rooted in economic inequalities between and within countries conditioned responses and shaped vulnerabilities, as the crisis threatened to deepen power imbalances along multiple lines. Calls for global health security will surely take on a new urgency in the aftermath of the pandemic and the forms of power delineated here will shape their outcome.</span>https://www.ijhpm.com/article_3805_63f2ce22eda99be46b1d925bd8b1662e.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-593991020201001COVID-19 Control: Can Germany Learn From China?432435381710.34172/ijhpm.2020.78ENOlafMüllerInstitute of Global Health, Medical School, Ruprecht-Karls-University,
Heidelberg, Germany0000-0001-7852-3088GuangyuLuDepartment of Public Health, Medical College, Yangzhou University, Yangzhou, ChinaAlbrechtJahnInstitute of Global Health, Medical School, Ruprecht-Karls-University,
Heidelberg, GermanyOliverRazumDepartment of Epidemiology & International
Public Health, School of Public Health, Bielefeld University, Bielefeld, GermanyJournal Article20200509<span class="fontstyle0">The coronavirus disease 2019 (COVID-19) outbreak started in China in December 2019 and has developed into a pandemic. Using mandatory large-scale public health interventions including a lockdown with locally varying intensity and duration, China has been successful in controlling the epidemic at an early stage. The epicentre of the pandemic has since shifted to Europe and The Americas. In certain cities and regions, health systems became overwhelmed by high numbers of cases and deaths, whereas other regions continue to experience low incidence rates. Still, lockdowns were usually implemented country-wide, albeit with differing intensities between countries. Compared to its neighbours, Germany has managed to keep the epidemic relatively well under control, in spite of a lockdown that was only partial. In analogy to many countries at a similar stage, Germany is now under increasing pressure to further relax lockdown measures to limit economic and psychosocial costs. However, if this is done too rapidly, Germany risks facing tens of thousands more severe cases of COVID-19 and deaths in the coming months. Hence, it could again follow China’s example and relax measures according to local incidence, based on intensive testing.</span>https://www.ijhpm.com/article_3817_574a0c00d962f4fc1610e694f44216b5.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-593991020201001COVID-19 Pandemic: What Can the West Learn From the East?436438381910.34172/ijhpm.2020.85ENMostafaShokoohiDalla Lana School of Public Health, University of Toronto, Toronto, ON,
CanadaHIV/STI Surveillance Research Center, and WHO Collaborating
Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman
University of Medical Sciences, Kerman, Iran0000-0002-3810-752XMehdiOsooliCenter for Primary Health Care
Research, Lund University, Malmö, Sweden0000-0002-9862-3665SaverioStrangesDepartment of Epidemiology
and Biostatistics, Schulich School of Medicine & Dentistry, Western University,
London, ON, CanadaDepartment of Family Medicine, Western University,
London, ON, CanadaDepartment of Population Health, Luxembourg Institute
of Health, Strassen, Luxembourg0000-0001-5226-8373Journal Article20200516<span class="fontstyle0">Differences in public health approaches to control the coronavirus disease 2019 (COVID-19) pandemic could largely explain substantial variations in epidemiological indicators (such as incidence and mortality) between the West and the East. COVID-19 revealed vulnerabilities of most western countries’ healthcare systems in their response to the ongoing public health crisis. Hence, western countries can possibly learn from practices from several East Asian countries regarding infrastructures, epidemiological surveillance and control strategies to mitigate the public health impact of the pandemic. In this paper, we discuss that the lack of rapid and timely<em> </em></span><em><span class="fontstyle2">community-centered </span></em><span class="fontstyle0">approaches, and most importantly weak public health infrastructures, might have resulted in a high number of infected cases and fatalities in many western countries.</span>https://www.ijhpm.com/article_3819_76c7b6af66dc343137bd78b125de6c7a.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-593991020201001Comparing 3 Approaches for Making Vaccine Adoption Decisions in Thailand439447374010.15171/ijhpm.2020.01ENWaranyaRattanavipapongHealth Intervention and Technology Assessment Program (HITAP), Ministry of
Public Health, Nonthaburi, Thailandwaranya.r@hitap.netRitikaKapoorSaw Swee Hock School of Public Health,
National University of Singapore, Singapore, SingaporeYotTeerawattananonHealth Intervention and Technology Assessment Program (HITAP), Ministry of
Public Health, Nonthaburi, ThailandSaw Swee Hock School of Public Health,
National University of Singapore, Singapore, Singapore0000-0003-2217-2930JosLuttjeboerAsc Academics,
Groningen, The NetherlandsSiobhanBotwrightWorld Health Organization (WHO), Genève,
SwitzerlandRachel A.ArcherHealth Intervention and Technology Assessment Program (HITAP), Ministry of
Public Health, Nonthaburi, ThailandBirgitteGiersingWorld Health Organization (WHO), Genève,
SwitzerlandRaymond C. W.HutubessyWorld Health Organization (WHO), Genève,
SwitzerlandJournal Article20190510<span class="fontstyle0">Background</span><br /> <span class="fontstyle2">The World Health Organization (WHO) has developed the Total System Effectiveness (TSE) framework to assist national policy-makers in prioritizing vaccines. The pilot was launched in Thailand to explore the potential use of TSE in a country with established governance structures and accountable decision-making processes for immunization policy. While the existing literature informs vaccine adoption decisions in GAVI-eligible countries, this study attempts to address a gap in the literature by examining the policy process of a non-GAVI eligible country.<br /></span><br /> <br /> <span class="fontstyle0">Methods</span><br /> <span class="fontstyle2">A rotavirus vaccine (RVV) test case was used to compare the decision criteria made by the existing processes (Expanded Program on Immunization [EPI], and National List of Essential Medicines [NLEM]) for vaccine prioritization and the TSE-pilot model, using Thailand specific data.<br /></span><br /> <br /> <span class="fontstyle0">Results</span><br /> <span class="fontstyle2">The existing decision-making processes in Thailand and TSE were found to offer similar recommendations on the selection of a RVV product.<br /></span><br /> <br /> <span class="fontstyle0">Conclusion</span><br /> <span class="fontstyle2">The authors believe that TSE can provide a well-reasoned and step by step approach for countries, especially low- and middle-income countries (LMICs), to develop a systematic and transparent decision-making process for immunization policy.</span>https://www.ijhpm.com/article_3740_c169818f2463aeab146287f1ac8c643e.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-593991020201001Does the Narrative About the Use of Evidence in Priority Setting Vary Across Health Programs Within the Health Sector: A Case Study of 6 Programs in a Low-Income National Healthcare System448458374410.15171/ijhpm.2019.133ENLydiaKapiririDepartment of Health, Aging, and Society, McMaster University, Hamilton, ON, Canada0000-0002-1237-6369Journal Article20190425<span class="fontstyle0">Background</span><br /> <span class="fontstyle2">There is a growing body of literature on evidence-informed priority setting. However, the literature on the use of evidence when setting healthcare priorities in low-income countries (LICs), tends to treat the healthcare system (HCS) as a single unit, despite the existence of multiple programs within the HCS, some of which are donor supported.<br /></span><br /> <br /> <span class="fontstyle0">Objectives</span><br /> <span class="fontstyle2">(i) To examine how Ugandan health policy-makers define and attribute value to the different types of evidence; (ii) Based on 6 health programs (HIV, maternal, newborn and child health [MNCH], vaccines, emergencies, health systems, and non- communicable diseases [NCDs]) to discuss the policy-makers’ reported access to and use of evidence in priority setting across the 6 health programs in Uganda; and (iii) To identify the challenges related to the access to and use of evidence.<br /></span><br /> <br /> <span class="fontstyle0">Methods</span><br /> <span class="fontstyle2">This was a qualitative study based on in-depth key informant interviews with 60 national level (working in 6 different health programs) and 27 sub-national (district) level policy-makers. Data were analysed used a modified thematic approach.<br /></span><br /> <br /> <span class="fontstyle0">Results</span><br /> <span class="fontstyle2">While all respondents recognized and endeavored to use evidence when setting healthcare priorities across the 6 programs and in the districts; more national level respondents tended to value quantitative evidence, while more district level respondents tended to value qualitative evidence from the community. Challenges to the use of evidence included access, quality, and competing values. Respondents from highly politicized and donor supported programs such as vaccines, HIV and maternal neonatal and child health were more likely to report that they had access to, and consistently used evidence in priority setting.<br /></span><br /> <br /> <span class="fontstyle0">Conclusion</span><br /> <span class="fontstyle2">This study highlighted differences in the perceptions, access to, and use of evidence in priority setting in the different programs within a single HCS. The strong infrastructure in place to support for the access to and use of evidence in the politicized and donor supported programs should be leveraged to support the availability and use of evidence in the relatively under-resourced programs. Further research could explore the impact of unequal availability of evidence on priority setting between health programs within the HCS.</span>https://www.ijhpm.com/article_3744_be360aad5d8529785444ba1793d3f855.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-593991020201001Re-organising Junior Doctors During the COVID-19 Outbreak: A Single Centre Experience in the United Kingdom459460381110.34172/ijhpm.2020.74ENAnokha OommanJosephDepartment of General Surgery, North Middlesex Hospital, London, UK0000-0002-4647-9171Janso PadickakudiJosephDepartment of General Surgery, Broomfield Hospital, Essex, UK0000-0001-9659-5800JasdeepGahirDepartment of General Surgery, North Middlesex Hospital, London, UKBernadettePereiraDepartment of General Surgery, North Middlesex Hospital, London, UKJournal Article20200504https://www.ijhpm.com/article_3811_5d593034f9378eeadb9b679323e5b398.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-593991020201001Nosocomial SARS-CoV-2 Infections in Japan: A Cross-sectional Newspaper Database Survey461463381510.34172/ijhpm.2020.75ENYutaTaniMedical Governance Research Institute, Tokyo, Japan0000-0002-0169-9381ToyoakiSawanoDepartment of Surgery,
Sendai City Medical Center, Sendai, Japan0000-0002-1482-6618AyumuKawamotoFaculty of Medicine, University of
Szeged, Szeged, HungaryAkihikoOzakiDepartment of Breast Surgery, Jyoban Hospital of
Tokiwa Foundation, Fukushima, Japan0000-0003-4415-9657TetsuyaTanimotoMedical Governance Research Institute, Tokyo, Japan0000-0002-9818-8587Journal Article20200415https://www.ijhpm.com/article_3815_fb789e04a3fc7f7adc2f75f14d47e7d8.pdfKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-593991020201001Student-Led Initiatives’ Potential in the COVID-19 Response in Iran464465381810.34172/ijhpm.2020.82ENMohammadVahidiFaculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran,
Iran0000-0001-8670-5113LayaJalilian KhaveFaculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran,
Iran0000-0002-7163-7776GhazalSanadgolFaculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran,
Iran0000-0001-7965-1436DorsaShiriniFaculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran,
Iran0000-0002-9814-0620MohammadKaramouzianSchool of Population and Public Health, University of British Columbia,
Vancouver, BC, CanadaPierre Elliott Trudeau Foundation Scholar (2018) and
Member of the COVID-19 Impact CommitteeHIV/STI Surveillance Research
Centre, and WHO Collaborating Centre for HIV Surveillance, Institute for
Futures Studies in Health, Kerman University of Medical Sciences, Kerman,
Iran0000-0002-5631-4469Journal Article20200513https://www.ijhpm.com/article_3818_05d07b06225f6c0e977af613186f57a5.pdf