Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 10 2 2021 02 01 Universal Access to Healthcare: The Case of South Africa in the Comparative Global Context of the Late Anthropocene Era 49 54 3767 10.34172/ijhpm.2020.28 EN Solomon Benatar University of Cape Town, Cape Town, South Africa Dalla Lana School of Pubic Health, University of Toronto, Toronto, ON, Canada Stephen Gill Political Science, Communications and Culture, York University, Toronto, ON, Canada Journal Article 2019 11 20 Much current global debate – as well as a great deal of political rhetoric – about global health and healthcare is characterised by a renewed emphasis on the goal of universal access throughout the world. While this goal has been achieved to varying extents in the United Kingdom, Canada and many countries in Europe, even within those countries where national health systems have long been in place, the pervasive shift in emphasis from health as a social value to health as a commodity within a capitalist market civilization is eroding the commitment to equitable access to healthcare. Against this background the challenge is much greater in low- and middle-income countries that lag behind – especially if aspirations to universal access go beyond primary care. The challenges of achieving greater equity in access to health and in health outcomes, in a middle-income country like South Africa, illustrate the magnitude of the tensions and gaps that need to be traversed, given the vast differences between healthcare provided in the private and public sectors. Understandably the concept of National Health Insurance (NHI) in South Africa has widespread support. The strategies for how a successful and effective NHI could be implemented, over what time-frame and what it covers are, however, very controversial issues. What tends to be ignored is that sustainable improvement in health in South Africa, and elsewhere, is not determined merely by medical care but more especially by social structures intimately linked to deeply entrenched local and global social, economic and political forces and inequalities. While seldom openly addressed, some of these forces are explicated in this article to supplement views elsewhere, although most have elided emphasis on the pervasive effects of the global political economy on the provisioning and practising of health and healthcare everywhere on our planet.

https://www.ijhpm.com/article_3767_24e8de922071b7cfa417baf4f53f36ac.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 10 2 2021 02 01 Is a Decentralised Health Policy Associated With Better Self-rated Health and Health Services Evaluation? A Comparative Study of European Countries 55 66 3762 10.34172/ijhpm.2020.13 EN Pål E. Martinussen Department of Sociology and Political Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway Håvard T. Rydland Department of Sociology and Political Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway Journal Article 2019 07 05 Background While decentralisation has come to be a major policy strategy in many healthcare systems, there is still insufficient evidence about its impact. Most studies have been of developing countries, and they have provided mixed results. This study is the first to test the relevance of political decentralisation across European countries, thus meeting the demand for more studies of decentralisation in developed countries, and building on an indicator of decentralisation reflecting the allocation of authority for both health policy tasks and health policy areas. Methods As indicators of health system outcome, we employed 2 measures that have not previously been investigated in the context of decentralisation: self-rated health and satisfaction with healthcare system. Using multilevel modelling and controlling for individual-level demographic and socioeconomic variables, the paper utilised the 2014 (7th) and 2016 (8th) round of the European Social Survey (ESS), including more than 70 000 individuals from 20 countries. Results The results suggest that decentralisation has a positive and significant association with health system satisfaction, but not with self-rated health. Of the different operationalisations, decentralised healthcare provision had the strongest association with health system satisfaction. Conclusions Our study fails to provide clear support for decentralised health systems. There is a need for more research on the impact of such reforms in order to provide policy-makers with knowledge of desirable governance, organisational designs, management and incentives in healthcare.

https://www.ijhpm.com/article_3762_aa43877092142762c2ede2519053490d.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 10 2 2021 02 01 Promoting Intersectoral Collaboration Through the Evaluations of Public Health Interventions: Insights From Key Informants in 6 European Countries 67 76 3765 10.34172/ijhpm.2020.19 EN Sabrina Kriegner Oslo Group on Global Health Policy, Department of Community Medicine and Global Health and Centre for Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway Trygve Ottersen Oslo Group on Global Health Policy, Department of Community Medicine and Global Health and Centre for Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway John-Arne Røttingen Research Council of Norway, Oslo, Norway Unni Gopinathan Oslo Group on Global Health Policy, Department of Community Medicine and Global Health and Centre for Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway Journal Article 2019 02 08 Background Intersectoral collaboration is critical to the successful implementation of many public health interventions (PHIs). Little attention has been paid to whether and how processes at the stage of evaluation can promote intersectoral collaboration. The objective of this study was to examine European experiences and views on whether and how the evaluation of PHIs promote intersectoral collaboration. Methods A qualitative study design was used. We conducted semi-structured interviews with 15 individuals centrally involved in the evaluation of PHIs in 6 European countries (Austria, Denmark, England, Germany, Norway, and Switzerland). Questions pertained to current processes for evaluating PHIs in the country and current and potential strategies for promoting intersectoral collaboration. Transcripts were analyzed using thematic analysis to identify key themes responding to our primary objective. Results Experiences with promoting intersectoral collaboration through the evaluation of PHIs could be summarized in 4 themes: (1) Early involvement of non-health sectors in the evaluative process and inclusion of non-health benefits can promote intersectoral collaboration, but should be combined with greater influence of these sectors in shaping PHIs; (2) Harmonization of methodological approaches may enable comparison of results and facilitate intersectoral collaboration, but should not be an overriding goal; (3) Involvement in health impact assessments (HIAs) can promote intersectoral collaboration, but needs to be incentivized and be conducted without putting overwhelming demands on non-health sectors; (4) A designated body for evaluating PHIs may promote intersectoral collaboration, but its design needs to take account of realities of policy-making. Conclusion The full potential for promoting intersectoral collaboration through the evaluation of PHIs appears currently unrealized in the settings we studied. To further promote intersectoral collaboration, evaluators and decisionmakers may consider the full range of strategies characterized in this study. This may be most effective if the strategies are deployed so that they reinforce each other, value outcomes beyond health, and are tailored to maximize political priority for PHIs across sectors.

https://www.ijhpm.com/article_3765_40a53106d4bc380cd64377ef2002ab5a.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 10 2 2021 02 01 How Do Nigerian Newspapers Report Corruption in the Health System? 77 85 3777 10.34172/ijhpm.2020.37 EN Mohammed Abba-Aji Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK Dina Balabanova Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK Eleanor Hutchinson Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK Martin McKee Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK Journal Article 2019 08 25 Background Nigeria has a huge burden of corruption, with the health system especially vulnerable. The media can play a role in tackling it, by shaping the narrative around it. However, its influence depends on the extent and framing of its reporting on corruption. This paper reviews, for the first time, coverage of corruption in the health system in the Nigerian print media. Methods The top 10, by circulation, newspapers in Nigeria were selected and searched using the LexisNexis database for articles covering corruption in the health sector over a 2-year period (2016–2018). Two newspapers are not included in the database and were searched manually. 135 articles were identified and subject to content and framing analyses. Results The Punch newspaper had the highest number of publications focussed on corruption in the health sector. The National Health Insurance Scheme (NHIS) was the organization attracting most coverage, followed by the Federal Ministry of Health. Corruption in the health sector was predominantly framed as a political issue. Most coverage was episodic, focused on the details of the particular case, with much less thematic, delving into underlying causes. Corruption was most often attributed to a lack of accountability while enforcement was the most frequent solution proffered. Conclusion This study highlights the potential role of media analyses in helping to understand how newspapers cover corruption in the health sector in Nigeria. It argues that the media has the potential to act as an agent of change for tackling corruption within the health sector.

https://www.ijhpm.com/article_3777_bb52828d7c6500080db22007fb79f76f.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 10 2 2021 02 01 Reimagining Researchers in Health Research; Comment on “Experience of Health Leadership in Partnering With University-Based Researchers in Canada: A Call to ‘Re-Imagine’ Research” 86 89 3742 10.15171/ijhpm.2020.05 EN Katrina M. Plamondon School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada Journal Article 2019 11 08 It is widely accepted that research evidence should inform policy and practice in health service organizations. Yet, amid increasingly complex and even wicked realities, where health inequities prevail and resource-strained health service organizations struggle to keep pace with demand, using research to inform practice and policy remains an elusive ideal. Bowen and colleagues’ study illuminates critical relational pathways for engagement in evidence-informed practice and decision-making and suggests beginning insights into what might contribute to the tenuousness of this aspirational ideal. But what kind of reimagination is needed to move toward more genuine engagement in research? This commentary argues for reimagining the relationship between researchers and health research, positioning researchers as responsive, guided by humility, and part of a greater collective effort to advance a public good. It challenges notions of objectivity and detached expertise, suggesting that researchers embrace an active practice of humility focused on approaching research in service and from a position of learning rather than knowing.

https://www.ijhpm.com/article_3742_819bfa77e249a691e1cb518da311f0f3.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 10 2 2021 02 01 What Can Health Services Researchers Offer Health Systems? Developing Meaningful Partnerships Between Academics and Health System Workers; Comment on “Experience of Health Leadership in Partnering with University-Based Researchers in Canada - A Call to ‘Re-imagine’ Research” 90 92 3745 10.15171/ijhpm.2020.07 EN Kate Churruca Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia Louise A. Ellis Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia Janet C. Long Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia Jeffrey Braithwaite Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia Journal Article 2019 11 14 As healthcare researchers, we know very well our own experiences on the challenges of partnering with those in the health system to do collaborative, internationally-regarded studies aiming for impact. Bowen and colleagues’ study in Canada empirically examines these issues from the other side, interviewing health system leaders about their perspectives of us researchers, research collaborations and the challenges and opportunities these pose. Based on their findings, they propose a need to re-imagine the contours of research. Inspired by that, in this commentary we examine the context for research partnerships and consider some of the emerging models for fostering more meaningful collaborations between researchers and those working in healthcare systems and organisations. Based on principles of embedded research and researchers, these models—including translational research networks (TRNs) and researcher-in-residence models—rely on a complex interplay of personal and interpersonal factors to be successful.

https://www.ijhpm.com/article_3745_e58f393d5e319a2ff8b2f368f8c9155c.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 10 2 2021 02 01 Building Research Capacity for Impact in Applied Health Services Research Partnerships; Comment on “Experience of Health Leadership in Partnering With University-Based Researchers in Canada – A Call to “Re-imagine” Research” 93 97 3751 10.15171/ijhpm.2020.11 EN Jo Cooke NIHR Collaboration and Leadership in Applied Health Research and Care for Yorkshire and Humber (CLAHRC YH), Sheffield, UK Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK Journal Article 2019 11 23 Bowen and colleagues ask us to re-imagine how to conduct research in academic-practice partnerships, and to develop capacity in the applied research and health workforce to do this. This commentary reinforces their messages, and describes a framework of research capacity development for impact (RCDi) which emphasizes active and continuous experiential learning within research partnerships. The RCDi framework includes the need to focus on multiple levels in the collaboration architecture, and describes principles of working that aims to increase impact on services, and learning opportunities for all partners.

https://www.ijhpm.com/article_3751_44d968155040a6b9b77e154d0ca58fdd.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 10 2 2021 02 01 The Potential for Early Health Economic Modelling in Health Technology Assessment and Reimbursement Decision-Making; Comment on “Problems and Promises of Health Technologies: The Role of Early Health Economic Modeling” 98 101 3753 10.15171/ijhpm.2020.17 EN Hansoo Kim School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia Stephen Goodall Centre for Health Economics Research and Evaluation, University of Technology Sydney, Ultimo, NSW, Australia Danny Liew School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia Journal Article 2019 10 28 Grutters et al recently investigated the role of early health economic modelling of health technologies by undertaking a secondary analysis of health economic modelling assessments performed by their group. Our commentary offers a broad perspective on the potential utility of early health economic modelling to inform health technology assessment (HTA) and decision-making around reimbursement of new health technologies. Further we provide several examples to compliment Grutters and colleagues’ observations.

https://www.ijhpm.com/article_3753_8da4b9b34ddea7c70f241f380ec6fb4e.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 10 2 2021 02 01 Expanding the Role of Early Health Economic Modelling in Evaluation of Health Technologies; Comment on “Problems and Promises of Health Technologies: The Role of Early Health Economic Modeling” 102 105 3754 10.15171/ijhpm.2020.18 EN Carlo Federici Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Bocconi University, Milan, Italy University of Warwick, School of Engineering, Coventry, UK Aleksandra Torbica Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Bocconi University, Milan, Italy Journal Article 2019 11 10 In this commentary, we discuss early stage assessments of innovative medical technologies both in terms of methods applied as well as their use in healthcare decision-making. We argue that cost-effectiveness alone may be too reductive if taken as the only decision rule, and it would benefit from being used within a broader evaluation framework. We discuss innovative methods which may contribute to better estimate the potential costs and consequences of a technology in the absence of solid clinical data, as frequently the case in early assessments. Finally, we comment on the potential synergies which may take place should early economic models be used not only by technology developers alone but as a negotiating base during early dialogues with health technology assessment (HTA) bodies.

https://www.ijhpm.com/article_3754_332836c949ea3c863a4a475596838bd5.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 10 2 2021 02 01 Advancing Health Services Collaborative and Partnership Research; Comment on “Experience of Health Leadership in Partnering with University-Based Researchers in Canada – A Call to ‘Re-imagine’ Research” 106 110 3755 10.15171/ijhpm.2020.16 EN Monica E. Nyström Department of Learning, Informatics, Management and Ethics (LIME), Medical Management Centre, SOLIID, Karolinska Institutet, Stockholm, Sweden Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden Helena Strehlenert Department of Learning, Informatics, Management and Ethics (LIME), Medical Management Centre, SOLIID, Karolinska Institutet, Stockholm, Sweden Stockholm Gerontology Research Centre, Stockholm, Sweden Journal Article 2019 11 14 Bowen et al highlight the trend towards partnership research to address the complex challenges currently facing healthcare systems and organizations world-wide. They focus on important strategic actors in partner organizations and their experiences, views and advice for sustainable collaboration, within a Canadian context. The authors call for a multi-system change to provide better conditions for research partnerships. They highlight needs to re-imagine research, to move beyond an ‘acute care’ and clinical focus in research, to re-think research funding, and to improve the academic preparation for research partnerships. In this commentary we provide input to the discussion on practical guidance for those involved in research partnerships based on our partnership experiences from ten research projects conducted within the Swedish healthcare system since 2007. We also highlight areas that need attention in future research in order to learn from approaches used for collaborative and partnership research.

https://www.ijhpm.com/article_3755_7fc16706f3be94454ba1c77ba91dfeab.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 10 2 2021 02 01 Destination Impact! The Many Roads to Influencing Health System Change: A Response to Recent Commentaries 111 112 3816 10.34172/ijhpm.2020.77 EN Mark Embrett Health Program, Faculty of Arts and Science, St. Francis Xavier University, Antigonish, NS, Canada Nova Scotia Health Authority, Halifax, NS, Canada S Meaghan Sim Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada Nova Scotia Health Authority, Halifax, NS, Canada Katie Aubrecht Department of Sociology, St. Francis Xavier University, Antigonish, NS, Canada Ivy Cheng Division of Emergency Medicine (DOM), University of Toronto, Toronto, ON, Canada Sunnybrook Health Sciences Center, Toronto, ON, Canada Jonathan Lai Canadian Autism Spectrum Disorders Alliance (CASDA), Toronto, ON, Canada Rebecca Liu Women’s College Hospital Institute for Health Systems and Virtual Care, Toronto, ON, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada Samiratou Ouedraogo Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, QC, Canada Institut National de Santé Publique du Québec (INSPQ), Montréal, QC, Canada Margaret Saari SE Health, Markham, ON, Canada Journal Article 2020 05 16

https://www.ijhpm.com/article_3816_d230b37eacb27f99f7a144029ee68e44.pdf