Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Modelling the Health Policy Process: One Size Fits All or Horses for Courses? 1 5 4349 10.34172/ijhpm.2022.7580 EN Martin Powell Health Services Management Centre, University of Birmingham, Birmingham, UK Russell Mannion Health Services Management Centre, University of Birmingham, Birmingham, UK Journal Article 2022 07 29 A range of conceptual models for understanding the policy process have been applied to the health policy process, largely in particular sub areas or policy domains such as public health. However, these contributions appear to offer different rationales and present different frameworks for understanding the policy process. This Editorial critically examines articles that explore the health policy process with models from wider public policy and from health policy. It can be seen that very few of the wider models have been applied in studies of the health policy process. Conversely, some models feature in studies of the health policy process, but not in the wider policy process literature, which suggests that literature on the health policy process is semi-detached from the wider policy process literature. There seem to be two very different future research directions: focusing on ‘home grown’ models, or taking greater account of the wider policy process literature. Does ‘one size fit all’ or is it ‘horses for courses’?

https://www.ijhpm.com/article_4349_84f9880fc466f713c4a03cf634c60064.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 International Journal of Health Policy and Management (IJHPM): A Decade of Advancing Knowledge and Influencing Global Health Policy (2013-2023) 1 12 4453 10.34172/ijhpm.2023.8124 EN Mina Moradzadeh Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Mohammad Karamouzian Centre On Drug Policy Evaluation, St. Michael’s Hospital, Toronto, ON, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV, Kerman University of Medical Sciences, Kerman, Iran Sahar Najafizadeh Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Vahid Yazdi-Feyzabadi Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Ali-Akbar Haghdoost Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Journal Article 2023 05 11

https://www.ijhpm.com/article_4453_50f644e6f0839faa0f2f54059a1d67ab.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Reducing the Risks of Nuclear War—The Role of Health Professionals 1 2 4484 10.34172/ijhpm.2023.8208 EN Kamran Abbasi Editor-in-Chief, British Medical Journal, London, UK Parveen Ali Health Sciences School, University of Sheffield, Sheffield, UK Doncaster and Bassetlaw Teaching Hospitals, Doncaster, UK Sheffield University Interpersonal Violence Research Group, Sheffield, UK Virginia Barbour Medical Journal of Australia, Brisbane, QLD, Australia Kirsten Bibbins-Domingo University of California, San Francisco, CA, USA Marcel GM Olde Rikkert Dutch Journal of Medicine, and Radboud University Medical Center, Nijmegen, The Netherlands Richard Horton The Lancet, London, UK Robert Mash Division of Family Medicine and Primary Care, Stellenbosch University, Stellenbosch, South Africa Editor-in-chief, African Journal of Primary Health Care and Family Medicine, Stellenbosch, South Africa Carlos Monteiro Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paolo, Brazil Elena N. Naumova Tufts University, Boston, MA, USA Eric J. Rubin Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Cambridge, MA, USA Peush Sahni MBBS (All India Institute of Medical Sciences [AIIMS]), New Delhi, India James Tumwine School of Medicine at Kabale University, Kampala, Uganda Paul Yonga CA Medlynks Medical Centre and Laboratory, East African Medical Journal, Nairobi, Kenya Chris Zielinski University of Winchester and Vice-President, World Association of Medical Editors, Winchester, UK Arun Mitra President Indian Doctors for Peace and Development, Ludhiana, India Tilman Ruff International Physicians for the Prevention of Nuclear War, University of Melbourne, Melbourne, VIC, Australia Andy Haines London School of Hygiene and Tropical Medicine, London, UK Ira Helfand International Physicians for the Prevention of Nuclear War, Springfield, IL, USA Journal Article 2023 07 19 Reducing the Risks of Nuclear War—The Role of Health Professionals

https://www.ijhpm.com/article_4484_9bf1a4a6781bf3717d8b776372414471.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Time to Treat the Climate and Nature Crisis as One Indivisible Global Health Emergency 1 3 4528 10.34172/ijhpm.2023.8307 EN Kamran Abbasi Editor-in-Chief, British Medical Journal, London, UK Parveen Ali Health Sciences School, University of Sheffield, Doncaster and Bassetlaw Teaching Hospitals, Sheffield, UK Sheffield University Interpersonal Violence Research Group, Sheffield, UK Virginia Barbour Medical Journal of Australia, Brisbane, QLD, Australia Thomas Benfield The Danish Medical Journal, Copenhagen, Denmark Kirsten Bibbins-Domingo University of California, San Francisco, CA, USA Stephen Hancocks British Dental Journal, London, UK Richard Horton The Lancet, London, UK Laurie Laybourn-Langton Chatham House, Exeter, UK Robert Mash Division of Family Medicine and Primary Care, Stellenbosch University, Stellenbosch, South Africa Editor-in-Chief, African Journal of Primary Health Care and Family Medicine, Stellenbosch, South Africa Peush Sahni MBBS (All India Institute of Medical Sciences [AIIMS], New Delhi), New Delhi, India Wadeia Mohammad Sharief Medical Education & Research Department, Dubai Health Authority, Dubai, UAE Emirates Family Medicine Society, Dubai, UAE Family Medicine Scientific Council, Arab Board of Health Specialization, Dubai, UAE Paul Yonga CA Medlynks Medical Centre and Laboratory, Nairobi, Kenya East African Medical Journal, Nairobi, Kenya Chris Zielinski University of Winchester and President-elect, World Association of Medical Editors, Winchester, UK Journal Article 2023 10 07 Time to Treat the Climate and Nature Crisis as One Indivisible Global Health Emergency

https://www.ijhpm.com/article_4528_9e9d63c49252ee561643cb7925d8bc56.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 An Overview of Stakeholders, Methods, Topics, and Challenges in Participatory Approaches Used in the Development of Medical Devices: A Scoping Review 1 8 4317 10.34172/ijhpm.2022.6839 EN Kas Woudstra Department of Health Evidence and Operation Rooms, Radboud University Medical Center, Nijmegen, The Netherlands Rob Reuzel Department of Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands Maroeska Rovers Department of Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands Marcia Tummers Department of Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands Journal Article 2021 10 06 Background There is a wide variety of participatory approaches to involve stakeholders in the development of medical devices, but there is no comprehensive overview of these approaches. We therefore studied what participatory approaches are used in the development of medical devices as well as the most important characteristics and challenges of these approaches. Methods We conducted a scoping review and searched PubMed, Embase and Web of Science for articles published between July 2014 and July 2019. Papers were included if they presented original research featuring any form of stakeholder participation in the development of medical devices. We used The Spectrum of Public Participation to categorise the approach of each paper. Subsequently, we described the characteristics of each approach: the stakeholders involved, data collection methods, and topics addressed. We also identified challenges of the approaches as reported by researchers. Results 277 papers were included, which could be categorised into three levels of participation: collaboration, involvement, and consultation. Patients and healthcare professionals are frequently engaged in all approaches. The most often used methods are workshops in the collaboration approach papers, and interviews in the involvement and consultation approach papers. Topics addressed in all approaches are: the problem, device requirements, design choices, testing, and procedural aspects of involvement. Reported challenges entail issues related to sampling, analysis, social dynamics, feasibility, and the limited number of topics that can be addressed. Conclusion Participatory approaches reported in literature can be categorised in three overarching approaches that have comparable methodological characteristics. This suggests that if researchers want to apply a participatory approach it is not necessary to adopt a pre-determined approach, such as ‘participatory action research’ (PAR). Instead, they can independently determine the degree of participation, stakeholders, methods, topics, and strategies to account for challenges, making sure the participatory approach fits their research question and context.

https://www.ijhpm.com/article_4317_33c05446d847ea452161c49ea1c566d1.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Re-evaluating Our Knowledge of Health System Resilience During COVID-19: Lessons From the First Two Years of the Pandemic 1 18 4345 10.34172/ijhpm.2022.6659 EN Dell D. Saulnier Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden Anna Duchenko Swiss Tropical and Public Health Institute, Basel, Switzerland Sierra Ottilie-Kovelman Swiss Tropical and Public Health Institute, Basel, Switzerland Fabrizio Tediosi Swiss Tropical and Public Health Institute, Basel, Switzerland University of Basel, Basel, Switzerland Karl Blanchet Geneva Centre of Humanitarian Studies, Faculty of Medicine, University of Geneva, Geneva, Switzerland Journal Article 2021 07 28 Background Health challenges like coronavirus disease 2019 (COVID-19) are becoming increasingly complex, transnational, and unpredictable. Studying health system responses to the COVID-19 pandemic is an opportunity to enhance our understanding of health system resilience and establish a clearer link between theoretical concepts and practical ideas on how to build resilience. Methods This narrative literature review aims to address four questions using a health system resilience framework: (i) What do we understand about the dimensions of resilience? (ii) What aspects of the resilience dimensions remain uncertain? (iii) What aspects of the resilience dimensions are missing from the COVID-19 discussions? and (iv) What has COVID-19 taught us about resilience that is missing from the framework? A scientific literature database search was conducted in December 2020 and in April 2022 to identify publications that discussed health system resilience in relation to COVID-19, excluding articles on psychological and other types of resilience. A total of 63 publications were included. Results There is good understanding around information sharing, flexibility and good leadership, learning, maintaining essential services, and the need for legitimate, interdependent systems. Decision-making, localized trust, influences on interdependence, and transformation remain uncertain. Vertical interdependence, monitoring risks beyond the health system, and consequences of changes on the system were not discussed. Teamwork, actor legitimacy, values, inclusivity, trans-sectoral resilience, and the role of the private sector are identified as lessons from COVID-19 that should be further explored for health system resilience. Conclusion Knowledge of health system resilience has continued to cohere following the pandemic. The eventual consequences of system changes and the resilience of subsystems are underexplored. Through governance, the concept of health system resilience can be linked to wider issues raised by the pandemic, like inclusivity. Our findings show the utility of resilience theory for strengthening health systems for crises and the benefit of continuing to refine existing resilience theory.

https://www.ijhpm.com/article_4345_810fa64adfb144476a0276401ad6f3d7.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 How International Health System Austerity Responses to the 2008 Financial Crisis Impacted Health System and Workforce Resilience – A Realist Review 1 15 4354 10.34172/ijhpm.2022.7420 EN Padraic Fleming Centre for Health Policy and Management, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland Louise Caffrey School of Social Work and Social Policy, Trinity College Dublin, The University of Dublin, College Green, Dublin 2, Ireland Sara Van Belle FWO, Institute of Tropical Medicine, Antwerp, Belgium Sarah Barry Centre for Health Policy and Management, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland Sara Burke Centre for Health Policy and Management, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland Jacki Conway Everlake, 5 Marine Terrace, Dun Laoghaire, Dublin, Ireland Rikke Siersbaek Centre for Health Policy and Management, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland David Mockler Library Reader Services, Trinity College Dublin, The University of Dublin, St James Hospital, Dublin 8, Ireland Steve Thomas Centre for Health Policy and Management, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland Journal Article 2022 05 27 Background The Great Recession, following the 2008 financial crisis, led many governments to adopt programmes of austerity. This had a lasting impact on health system functionality, resources, staff (numbers, motivation and morale) and patient outcomes. This study aimed to understand how health system resilience was impacted and how this affects readiness for subsequent shocks. Methods A realist review identified legacies associated with austerity (proximal outcomes) and how these impact the distal outcome of health system resilience. EMBASE, CINAHL, MEDLINE, EconLit and Web of Science were searched (2007–May 2021), resulting in 1081 articles. Further theory-driven searches resulted in an additional 60 studies. Descriptive, inductive, deductive and retroductive realist analysis (utilising excel and Nvivo) aided the development of context-mechanism-outcome configurations (CMOCs), alongside stakeholder engagement to confirm or refute emerging results. Causal pathways, and the interplay between context and mechanisms that led to proximal and distal outcomes, were revealed. The refined CMOCs and policy recommendations focused primarily on workforce resilience. Results Five CMOCs demonstrated how austerity-driven policy decisions can impact health systems when driven by the priorities of external agents. This created a real or perceived shift away from the values and interests of health professionals, a distrust in decision-making processes and resistance to change. Their values were at odds with the realities of implementing such policy decisions within sustained restrictive working conditions (rationing of staff, consumables, treatment options). A diminished view of the profession and an inability to provide high-quality, equitable, and needs-led care, alongside stagnant or degraded working conditions, led to moral distress. This can forge legacies that may adversely impact resilience when faced with future shocks. Conclusion This review reveals the importance of transparent, open communication, in addition to co-produced policies in order to avoid scenarios that can be detrimental to workforce and health system resilience.

https://www.ijhpm.com/article_4354_dbe5d3fe8be09467a5815b51166e18f4.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Barriers and Facilitators to Implementing Interventions for Reducing Avoidable Hospital Readmission: Systematic Review of Qualitative Studies 1 17 4384 10.34172/ijhpm.2023.7089 EN Becky Q Fu Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong Claire CW Zhong Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong 0000-0001-8079-3634 Charlene HL Wong Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong Fai Fai Ho School of Chinese Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Per Nilsen Department of Medicine, Health and Caring Sciences, Linköping University, Linköping, Sweden Chi Tim Hung Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong Eng Kiong Yeoh Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong Vincent CH Chung Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong School of Chinese Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Journal Article 2022 02 11 Background Avoidable hospital readmission is a major problem among health systems. Although there are effective peri-discharge interventions for reducing avoidable hospital readmission, successful implementation is challenging. This systematic review of qualitative studies aimed to identify barriers and facilitators to implementing peri-discharge interventions from providers’ and service users’ perspectives. Methods We searched four databases for potentially eligible qualitative studies from databases’ inception to March 2020, and updated literature search for studies published between January 2020 to October 2021. Barriers and facilitators to implementing peri-discharge interventions were identified and mapped onto the Consolidated Framework for Implementation Research (CFIR) constructs. Inductive analysis of the CFIR constructs was performed to yield thematic areas that illustrated the relationship between various facilitators and barriers, generating practical insights to key implementation issues. Results Thirteen qualitative studies were included in this systematic review. Key issues were clustered in the CFIR constructs of Design Quality and Complexity of the intervention, strength of Network and Communication, being responsive to Patient Needs with sufficient Resource support, and External Incentives. The three thematic areas were rationality of the interventions, readiness and effort of multidisciplinary implementation teams, and influence of external stakeholders. Common barriers included (i) limited resources, (ii) poor communication among team members, (iii) incompatibility between the new intervention and existing work routine, (iv) complicated implementation process, (v) low practicality of supporting instruments, and (vi) lack of understanding about the content and effectiveness of the new interventions. Common facilitators were (i) information sharing via regular meetings on implementation issues, (ii) organizational culture that values quality and accountability, (iii) financial penalties for hospitals with high avoidable readmissions rates, (iv) external support offered via quality improvement programs and community resources, and (v) senior leadership support. Conclusion This study synthesized commonly-presenting barriers and facilitators to implementing peri-discharge interventions among different healthcare organizations. Findings may inform development of implementation strategies in different health systems after appropriate tailoring, based on a consensus-based formative research process.

https://www.ijhpm.com/article_4384_65f0b980247ad9dad9c5cb8b14673a02.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Systems Thinking and Complexity Science Methods and the Policy Process in Non-communicable Disease Prevention: A Systematic Scoping Review 1 17 4389 10.34172/ijhpm.2023.6772 EN Chloe Clifford Astbury Global Food System & Policy Research, School of Global Health, York University, Toronto, ON, Canada Kirsten M. Lee Global Food System & Policy Research, School of Global Health, York University, Toronto, ON, Canada Elizabeth McGill Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK Janielle Clarke Global Food System & Policy Research, School of Global Health, York University, Toronto, ON, Canada Matt Egan Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK 0000-0002-4040-200X Afton Halloran World Health Organization European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark Regina Malykh World Health Organization European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation Holly Rippin World Health Organization European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation Kremlin Wickramasinghe World Health Organization European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation Tarra L. Penney Global Food System & Policy Research, School of Global Health, York University, Toronto, ON, Canada Journal Article 2021 09 10 Background Given the complex determinants of non-communicable diseases (NCDs), and the dynamic policy landscape, researchers and policy-makers are exploring the use of systems thinking and complexity science (STCS) in developing effective policies. The aim of this review is to systematically identify and analyse existing applications of STCS-informed methods in NCD prevention policy. Methods We searched academic databases (Medline, Scopus, Web of Science, EMBASE) for all publications indexed by October 13, 2020, screening titles, abstracts and full texts and extracting data according to published guidelines. We summarised key data from each study, mapping applications of methods informed by STCS to policy process domains. We conducted a thematic analysis to identify advantages, limitations, barriers and facilitators to using STCS. Results 4681 papers were screened and 112 papers were included in this review. The most common policy areas were tobacco control, obesity prevention and physical activity promotion. Methods applied included system dynamics modelling, agent-based modelling and concept mapping. Advantages included supporting evidence-informed decisionmaking; modelling complex systems and addressing multi-sectoral problems. Limitations included the abstraction of reality by STCS methods, despite aims of encompassing greater complexity. Challenges included resource-intensiveness; lack of stakeholder trust in models; and results that were too complex to be comprehensible to stakeholders. Ensuring stakeholder ownership and presenting findings in a user-friendly way facilitated STCS use. Conclusion This review maps the proliferating applications of STCS methods in NCD prevention policy. STCS methods have the potential to generate tailored and dynamic evidence, adding robustness to evidence-informed policy-making, but must be accessible to policy stakeholders and have strong stakeholder ownership to build consensus and change stakeholder perspectives. Evaluations of whether, and under what circumstances, STCS methods lead to more effective policies compared to conventional methods are lacking, and would enable more targeted and constructive use of these methods.

https://www.ijhpm.com/article_4389_fdaa33fd34c44efd03fa46ce78bd2432.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Towards A Framework for Implementing Remote Patient Monitoring From an Integrated Care Perspective: A Scoping Review 1 13 4400 10.34172/ijhpm.2023.7299 EN Rafael Miranda Centro de Estudos de Gestão do Instituto Superior Técnico (CEG-IST), Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal Enterprise Services, Siemens Healthineers Portugal, Lisboa, Portugal Mónica Duarte Oliveira Centro de Estudos de Gestão do Instituto Superior Técnico (CEG-IST), Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal iBB - Institute for Bioengineering and Biosciences and i4HB - Associate Laboratory Institute for Health and Bioeconomy, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal Paulo Nicola Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal Filipa Matos Baptista Enterprise Services, Siemens Healthineers Portugal, Lisboa, Portugal Isabel Albuquerque Comprehensive Health Research Center (CHRC), Universidade NOVA de Lisboa, Lisboa, Portugal Journal Article 2022 03 31 Background Remote patient monitoring (RPM) has been increasingly adopted over the last decade, with the COVID-19 pandemic fostering its rapid development. As RPM implementation is recognised as complex and highly demanding in terms of resources and processes, there are multiple challenges in providing RPM in an integrated logic. Methods To examine the structural elements that are relevant for implementing RPM integrated care, a scoping review was conducted in PubMed, Scopus, and Web of Science, leveraging a search strategy that combines terms relative to (1) conceptual models and real-life initiatives; (2) RPM; and (3) care integration. Results 28 articles were included, covering nine conceptual models and 19 real-life initiatives. Eighteen structural elements of RPM integrated care implementation were identified among conceptual models, defining a structure for assessing real-life initiatives. 78.9% of those initiatives referred to at least ten structural elements, with patient education and self-monitoring promotion, multidisciplinary core workforce, ICTs (information and communications technologies) and telemonitoring (TM) devices, and health indicators measurement being present in all studies, and therefore being core elements to the design of RPM initiatives. Conclusion RPM goes far beyond technology, with underlying processes and involved actors playing a central role in care provision. The structural elements identified can guide RPM implementation and promote maturity in adoption. Future research may focus on assessing design completeness, evaluating impacts, and analysing related financial arrangements.

https://www.ijhpm.com/article_4400_d9a4e2849ccf6bb656a949f245a8ad4d.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Model Choice for Quantitative Health Impact Assessment and Modelling: An Expert Consultation and Narrative Literature Review 1 13 4401 10.34172/ijhpm.2023.7103 EN Natalie Mueller ISGlobal, Barcelona, Spain Universitat Pompeu Fabra (UPF), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Rodrigo Anderle Institute of Collective Health (ISC), Federal University of Bahia (UFBA), Salvador, Brazil Nicolai Brachowicz ISGlobal, Barcelona, Spain Helton Graziadei School of Applied Mathematics, Getulio Vargas Foundation, Rio de Janeiro, Brazil Simon J. Lloyd ISGlobal, Barcelona, Spain Gabriel De Sampaio Morais Institute of Collective Health (ISC), Federal University of Bahia (UFBA), Salvador, Brazil Alberto Pietro Sironi Institute of Collective Health (ISC), Federal University of Bahia (UFBA), Salvador, Brazil Karina Gibert Intelligent Data Science and Artificial Intelligence Research Center, Universitat Politècnica de Catalunya (IDEAI-UPC), Barcelona, Spain Cathryn Tonne ISGlobal, Barcelona, Spain Universitat Pompeu Fabra (UPF), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Mark Nieuwenhuijsen ISGlobal, Barcelona, Spain Universitat Pompeu Fabra (UPF), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Davide Rasella ISGlobal, Barcelona, Spain Institute of Collective Health (ISC), Federal University of Bahia (UFBA), Salvador, Brazil Hospital Clínic—Universitat de Barcelona, Barcelona, Spain Journal Article 2022 01 19 Background Health impact assessment (HIA) is a widely used process that aims to identify the health impacts, positive or negative, of a policy or intervention that is not necessarily placed in the health sector. Most HIAs are done prospectively and aim to forecast expected health impacts under assumed policy implementation. HIAs may quantitatively and/or qualitatively assess health impacts, with this study focusing on the former. A variety of quantitative modelling methods exist that are used for forecasting health impacts, however, they differ in application area, data requirements, assumptions, risk modelling, complexities, limitations, strengths, and comprehensibility. We reviewed relevant models, so as to provide public health researchers with considerations for HIA model choice. Methods Based on an HIA expert consultation, combined with a narrative literature review, we identified the most relevant models that can be used for health impact forecasting. We narratively and comparatively reviewed the models, according to their fields of application, their configuration and purposes, counterfactual scenarios, underlying assumptions, health risk modelling, limitations and strengths. Results Seven relevant models for health impacts forecasting were identified, consisting of (i) comparative risk assessment (CRA), (ii) time series analysis (TSA), (iii) compartmental models (CMs), (iv) structural models (SMs), (v) agentbased models (ABMs), (vi) microsimulations (MS), and (vii) artificial intelligence (AI)/machine learning (ML). These models represent a variety in approaches and vary in the fields of HIA application, complexity and comprehensibility. We provide a set of criteria for HIA model choice. Researchers must consider that model input assumptions match the available data and parameter structures, the available resources, and that model outputs match the research question, meet expectations and are comprehensible to end-users. Conclusion The reviewed models have specific characteristics, related to available data and parameter structures, computational implementation, interpretation and comprehensibility, which the researcher should critically consider before HIA model choice.

https://www.ijhpm.com/article_4401_7c942a23ef6fba850d5216c452f94db5.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 National Public Health Surveillance of Corporations in Key Unhealthy Commodity Industries – A Scoping Review and Framework Synthesis 1 16 4385 10.34172/ijhpm.2023.6876 EN Elizabeth Bennett College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, VIC, Australia Stephanie M. Topp College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, VIC, Australia Alan Rob Moodie Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia Journal Article 2021 10 20 Background Corporations in unhealthy commodity industries (UCIs) have growing influence on the health of national populations through practices that lead to increased consumption of unhealthy products. The use of government-led public health surveillance is best practice to better understand any emerging public health threat. However, there is minimal systematic evidence, generated and monitored by national governments, regarding the scope of UCI corporate practices and their impacts. This study aims to synthesise current frameworks that exist to identify and monitor UCI influence on health to highlight the range of practices deployed by corporations and inform future surveillance efforts in key UCIs. Methods Seven biomedical, business and scientific databases were searched to identify literature focused on corporate practices that impact human health and frameworks for monitoring or assessment of the way UCIs impact health. Content analysis occurred in three phases, involving (1) the identification of framework documents in the literature and extraction of all corporate practices from the frameworks; (2) initial inductive grouping and synthesis followed by deductive synthesis using Lima and Galea’s ‘vehicles of power’ as a heuristic; and (3) scoping for potential indicators linked to each corporate practice and development of an integrated framework. Results Fourteen frameworks were identified with 37 individual corporate practices which were coded into five different themes according the Lima and Galea ‘Corporate Practices and Health’ framework. We proposed a summary framework to inform the public health surveillance of UCIs which outlines key actors, corporate practices and outcomes that should be considered. The proposed framework draws from the health policy triangle framework and synthesises key features of existing frameworks. Conclusion Systematic monitoring of the practices of UCIs is likely to enable governments to mitigate the negative health impacts of corporate practices. The proposed synthesised framework highlights the range of practices deployed by corporations for public health surveillance at a national government level. We argue there is significant precedent and great need for monitoring of these practices and the operationalisation of a UCI monitoring system should be the object of future research.

https://www.ijhpm.com/article_4385_bb90ae58c737c2f5279ce20d7852e6a3.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Employee-Driven Innovation in Health Organizations: Insights From a Scoping Review 1 14 4426 10.34172/ijhpm.2023.6734 EN Stephanie B.M. Cadeddu Health Hub: Politics, Organizations, and Law (H-POD), University of Montreal, Montreal, QC, Canada University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada Labante Outcha Dare School of Public Health, University of Montreal, Montreal, QC, Canada Jean-Louis Denis Health Hub: Politics, Organizations, and Law (H-POD), University of Montreal, Montreal, QC, Canada University of Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada Department of Health Management, Evaluation and Policy, School of Public Health, University of Montreal, Montreal, QC, Canada Journal Article 2021 08 28 Background Employee-driven innovation (EDI) occurs when frontline actors in health organizations use their firsthand experience to spur new ideas to transform care. Despite its increasing prevalence in health organizations, the organizational conditions under which EDI is operationalized have received little scholarly attention. Methods This scoping review identifies gaps and assembles existing knowledge on four questions: What is EDI in health organizations and which frontline actors are involved? What are the characteristics of the EDI process? What contextual factors enable or impede EDI? And what benefits does EDI bring to health organizations? We searched seven databases with keywords related to EDI in health organizations. After screening 1580 studies by title and abstract, we undertook full-text review of 453 articles, retaining 60 for analysis. We performed a descriptive and an inductive thematic analysis guided by the four questions. Results Findings reveal an heterogeneous literature. Most articles are descriptive (n = 41). Few studies are conceptual and empirical (n = 15) and four are conference papers. EDI was often described as a participatory, learning innovation process involving frontline clinical and non-clinical staff and managers. Majority EDI were top-down, often driven by the organization’s focus on participatory improvement and innovation and research-based initiatives. Five categories of methods is used in top-down EDI, two thirds of which includes a learning, a team and/or a digital component. Hybrid EDI often involves a team-based component. Bottom-up EDI emerged spontaneously from the work of frontline actors. Enablers, barriers, and benefits of EDI are seen at macro, organizational, team and individual levels; some benefits spread to other health organizations and health systems. Conclusion This scoping review provides a comprehensive understanding of the organizational conditions under which EDI is operationalized. It offers insights for researchers, health organizations, and policy-makers about how and why frontline actors’ involvement is crucial for the transformation of care.

https://www.ijhpm.com/article_4426_fb3c8beaf82a8d7f28b473f82a4fa7d5.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Reflections on Managing the Performance of Value-Based Healthcare: A Scoping Review 1 10 4436 10.34172/ijhpm.2023.7366 EN Hilco J. Van Elten Nyenrode Business Universiteit, Breukelen, The Netherlands Steven W. Howard Health Services Administration Department, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA Ivo De Loo Nyenrode Business Universiteit, Breukelen, The Netherlands Frans Schaepkens Nyenrode Business Universiteit, Breukelen, The Netherlands Journal Article 2022 05 25 Background Value-based healthcare (VBHC), which can be viewed as a strategy to organize and improve healthcare services, has far-reaching organizational and managerial consequences. It is common managerial practice to support the execution of a strategy by monitoring the ensuing activities. Such monitoring provides feedback and guidance on the execution of these activities to the management of an organization and helps to realize organizational strategies. Monitoring of activities is commonly done by performance management systems. Given the rising attention in the literature and in practice for VBHC, we ask to what extent VBHC is supported by performance management systems in practice, and how we can explain what we find to support further successful implementation of VBHC. Methods In our scoping review of financial and performance management at the organization or unit-level of healthcare organizations that apply value-based approaches, we identified 1267 unique papers in Embase, Medline, OVID, and Web of Science. After the (double-blinded) title and abstract screening, 398 full-text articles were assessed for further analysis. Results Our review reveals only eleven original papers discussing specifically the integration of VBHC and performance management systems. Almost all the featured applications in these papers focus on a specific project or medical specialty. Only one paper exemplifies how VBHC has been integrated with the performance management systems of a medical institution, and no paper provides a clear link with strategy execution. We ask why this is the case and propose several explanations by studying the extant performance management literature. We see these explanations as issues for further reflection for VBHC practitioners and researchers. Conclusion We conclude that one of the reasons for the absence of papers integrating VBHC and performance management systems is formed by the tensions that exist between striving for “the best care” or even for providing “all care that is viably possible” and pursuing greater (financial) efficiency. Implementing VBHC as an important organizational strategy and explicating this strategy in the performance management systems requires that these tensions need to be brought into the fore. When this is not done, we believe that VBHC adoptions that are fully integrated with performance management systems will remain limited in practice.

https://www.ijhpm.com/article_4436_27532c80f256fbf6ebd9eea9bedf39ea.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 A Review of the Applicability of Current Green Practices in Healthcare Facilities 1 15 4445 10.34172/ijhpm.2023.6947 EN Ana Luísa Soares Medical Physics Service, Portuguese Oncology Institute of Porto, Porto, Portugal Sandra C. Buttigieg Department of Health Systems Management and Leadership, Faculty of Health Sciences, University of Malta, Msida, Malta Bartosz Bak Radiotherapy Department II, Greater Poland Cancer Center, Poznan, Poland Department of Electroradiology, University of Medical Science, Poznan, Poland Sonya McFadden Faculty of Life and Health Sciences, Ulster University, Newtownabbey, UK Ciara Hughes Faculty of Life and Health Sciences, Ulster University, Newtownabbey, UK Patricia McClure Faculty of Life and Health Sciences, Ulster University, Newtownabbey, UK Jose Guilherme Couto Radiography Department, Faculty of Health Sciences, University of Malta, Msida, Malta Isabel Bravo Medical Physics and Radiobiology Group, Research Center (IPOP), Portuguese Oncology Institute of Porto, Porto, Portugal Journal Article 2021 11 16 Background Circular economy (CE) has raised great interest as a concept and as a development model worldwide. This concept aims to provide a substitute for the linear economic model, which was based on production and consumption, continuous growth, and resources depletion. CE allows a greener economy with sustainable development and promotes more balanced societies. The healthcare sector is a major contributor to the climate crisis, with a carbon footprint representing 4.4% of global net emissions. It is thus essential to rethink the applicability of CE in healthcare. Methods We conducted a scoping review guided by the Arksey and O’Malley methodological framework and utilised PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist. A systematic search from MEDLINE complete, SCOPUS, and Web of Science databases published between 1992 and 2022. Results Through database searching a total of 1018 records were identified and 475 duplicates were removed. From the total search, 543 articles were screened by title/abstract according to the inclusion and exclusion criteria. After screening, 38 full-text articles were selected and assessed for eligibility. Forty-seven additional records were also identified through other sources and screened for eligibility. Other sources included: 12 articles from snowballing of previous papers; 9 articles following peer-reviewers suggestions; 19 reports from relevant organisations in CE and healthcare; two webpage, and one book. Conclusion Specific areas were identified where hospitals could reduce their greenhouse gas (GHG) emissions and consequently their negative environmental impact, namely through waste management, energy, water, transportation/travel, hospital design, food optimisation, green procurement, and behaviour. Also, lack of staff awareness and knowledge of the environmental impact of healthcare, and hospitals sustainability were identified as major contributors.

https://www.ijhpm.com/article_4445_1adcc926fcb475094b99b890dfd11313.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Developing a Conceptual Framework for an Age-Friendly Health System: A Scoping Review 1 12 4447 10.34172/ijhpm.2023.7342 EN Badrye Karami Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Abbas Ostad-Taghizadeh Department of Disaster & Emergency Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Arash Rashidian Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Maryam Tajvar Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Journal Article 2022 04 20 Background Population aging is usually associated with increased health care needs. Developing an age-friendly health system with special features, structure, and functions to meet the special needs of older people and improving their health status and quality of life is essential. This study aimed to develop a conceptual framework for an age-friendly health system, which would offer a conceptual basis for providing the best possible care for older people in health system to let them experience a successful, healthy, and active aging. Methods A scoping review was used to design the conceptual framework based on Arksey and O’Malley’s model, including six stages, with the final stage of using expert’s opinions to improve and validate the initial framework. The health system model of Van Olmen, was selected as the baseline model for this framework. Then, by reviewing the available evidence, the characteristics of an age-friendly health system were extracted and incorporated in the baseline mode. Results Using the electronic searching, initially 12 316 documents were identified, of which 140 studies were selected and included in this review study. The relevant data were extracted from the 140 studies by two reviewers independently. Most studies were conducted in 2016-2020, and mostly were from United States (33.6%). To have an age-friendly health system, interventions and changes should be performed in functions, components and objectives of health systems. This system aims to provide evidence-based care through trained workforces and involves older people and their families in health policy-makings. Its consequences include better health acre for older people, with fewer healthcare-related harms, greater care satisfaction and increased use of cost-effective health services. Conclusion To meet the needs of older people, health systems should make interventions in their functions for better performance. In line with these changes, other parts of society should work in harmony and set the health of older people as a top priority to ensure they can have a successful aging.

https://www.ijhpm.com/article_4447_7d8d148225b85f20e0a67398354e1773.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Quality and Utility of European Cardiovascular and Orthopaedic Registries for the Regulatory Evaluation of Medical Device Safety and Performance Across the Implant Lifecycle: A Systematic Review 1 11 4470 10.34172/ijhpm.2023.7648 EN Lotje A. Hoogervorst Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands Department of Biomedical Data Sciences & Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands Timon H. Geurkink Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands Anne Lübbeke Division of Orthopaedic Surgery and Traumatology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK Sergio Buccheri Department of Cardiology, Uppsala University, Uppsala, Sweden Jan W. Schoones Directorate of Research Policy (Formerly: Walaeus Library), Leiden University Medical Center, Leiden, The Netherlands Marina Torre Scientific Secretariat of the Presidency, Istituto Superiore di Sanità, Rome, Italy Paola Laricchiuta Scientific Secretariat of the Presidency, Istituto Superiore di Sanità, Rome, Italy 0000-0001-6892-7185 Paul Piscoi Health Technology Unit B6, Directorate General for Health (DG SANTE), European Commission, Brussels, Belgium Alma B. Pedersen Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark Department of Clinical Medicine, Aarhus University, Aarhus, Denmark Chris P. Gale Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK Leeds Institute for Data analytics, University of Leeds, Leeds, UK Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK James A. Smith Botnar Research Centre and Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK National Institute for Health Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK Aldo P. Maggioni Centro Studi ANMCO, Via Alfonso la Marmora, Florence, Italy Stefan James Department of Cardiology, Uppsala University, Uppsala, Sweden Department of Medical Science, Uppsala University, Uppsala, Sweden Clinical Research Center, Uppsala University, Uppsala, Sweden Alan G. Fraser Department of Cardiology, University Hospital of Wales, Cardiff, UK Rob G.H.H. Nelissen Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands 0000-0003-1228-4162 Perla J. Marang-van De Mheen Department of Biomedical Data Sciences & Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands Journal Article 2022 08 24 Background The European Union Medical Device Regulation (MDR) requires manufacturers to undertake post-market clinical follow-up (PMCF) to assess the safety and performance of their devices following approval and Conformité Européenne (CE) marking. The quality and reliability of device registries for this Regulation have not been reported. As part of the Coordinating Research and Evidence for Medical Devices (CORE-MD) project, we identified and reviewed European cardiovascular and orthopaedic registries to assess their structures, methods, and suitability as data sources for regulatory purposes. Methods Regional, national and multi-country European cardiovascular (coronary stents and valve repair/replacement) and orthopaedic (hip/knee prostheses) registries were identified using a systematic literature search. Annual reports, peer-reviewed publications, and websites were reviewed to extract publicly available information for 33 items related to structure and methodology in six domains and also for reported outcomes. Results Of the 20 cardiovascular and 26 orthopaedic registries fulfilling eligibility criteria, a median of 33% (IQR: 14%-71%) items for cardiovascular and 60% (IQR: 28%-100%) items for orthopaedic registries were reported, with large variation across domains. For instance, no cardiovascular and 16 (62%) orthopaedic registries reported patient/procedure-level completeness. No cardiovascular and 5 (19%) orthopaedic registries reported outlier performances of devices, but each with a different outlier definition. There was large heterogeneity in reporting on items, outcomes, definitions of outcomes, and follow-up durations. Conclusion European cardiovascular and orthopaedic device registries could improve their potential as data sources for regulatory purposes by reaching consensus on standardised reporting of structural and methodological characteristics to judge the quality of the evidence as well as outcomes.

https://www.ijhpm.com/article_4470_400ef7af971ca7e30d4a75dd339226a3.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Human Resources for Health in Conflict Affected Settings: A Scoping Review of Primary Peer Reviewed Publications 2016–2022 1 16 4450 10.34172/ijhpm.2023.7306 EN Olivier Onvlee KIT Royal Tropical Institute, Amsterdam, The Netherlands Maryse Kok KIT Royal Tropical Institute, Amsterdam, The Netherlands James Buchan Faculty of Health, WHO Collaborating Centre, University of Technology, Sydney, NSW, Australia Marjolein Dieleman KIT Royal Tropical Institute, Amsterdam, The Netherlands Mariam Hamza World Bank, Washington, DC, USA Christopher Herbst World Bank, Washington, DC, USA Journal Article 2022 04 04 Background Conflict has devastating effects on health systems, especially on healthcare workers (HCWs) working in under-resourced and hostile environments. However, little evidence is available on how policy-makers, often together with development partners, can optimize the organization of the health workforce and support HCWs to deliver accessible and trustworthy health services in conflict-affected settings (CAS). Methods A scoping review was conducted to review recent evidence (2016-2022) on human resources for health (HRH) in CAS, and critically discuss HRH challenges in these settings. Thirty-six studies were included in the review and results were presented using an adapted version of the health labour market (HLM) framework. Results Evidence from CAS highlights that conflict causes specific constraints in both the education sector and in the HLM, and deepens any existing disconnect between those sectors. Parallel and inadequate education and performance management systems, attacks on health facilities, and increased workload and stress, amongst other factors, affect HCW motivation, performance, distribution, and attrition. Short-term, narrowly focused policy-making undermines the long-term sustainability and resilience of the health workforce in CAS, and also contributes to the limited and narrow available research base. Conclusion While HRH and workforce issues in CAS include those found in many other low- and middle-income countries (LMICs), an additional set of challenges for HCWs, governance dynamics and institutional constraints in CAS ‘multiply’ negative effects on the health workforce. HRH policies, programmes and interventions must be aligned with the political and broader societal context, including the stage, severity and other dynamics of conflict. During conflict, it is important to try to monitor in- and outflow of HCWs and provide HCWs the support they need at local level or through remote measures. The post-conflict situation may present opportunities for improvement in HRH, but a clear understanding of political economy dynamics is required to better act on any such a window of opportunity.

https://www.ijhpm.com/article_4450_bdc9b1a71a75c2becd9ee485a38e7928.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Economic Sanctions Affecting Household Food and Nutrition Security and Policies to Cope With Them: A Systematic Review 1 19 4477 10.34172/ijhpm.2023.7362 EN Fatemeh Mohammadi-Nasrabadi Research Department of Food and Nutrition Policy and Planning, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran Delaram Ghodsi Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran Arezoo Haghighian-Roudsari Department of Community Nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran Fatemeh Esfarjani Research Department of Food and Nutrition Policy and Planning, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohammad-Reza Khoshfetrat Research Department of Food and Nutrition Policy and Planning, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0002-7708-0024 Zeinab Houshialsadat School of Public Health, Physiotherapy and Sports Sciences, University College Dublin, Dublin, Ireland Maryam Mohammadi-Nasrabadi Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran Ghasem Fadavi Food, Halal and Agricultural Products Research Group, Research Center of Food Technology and Agricultural Products, Standard Research Institute, Karaj, Iran Reza Majdzadeh Interdisciplinary Research and Practice Division, School of Health and Social Care, University of Essex, Colchester, UK Journal Article 2022 05 02 Background This review was conducted to identify the impact of economic sanctions on household food and nutrition security and policies to cope with them in countries exposed to sanctions. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines 2020 were used to identify, select, appraise, and synthesize studies. Electronic databases in addition to Persian ones have been systematically searched for all related documents published until March 2022. Exclusion criteria were: lack of data related to food insecurity in countries subject to sanction and very low quality of the article. The quality of included studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal checklists. The results were presented as qualitative and quantitative syntheses. Results Of 1428 identified studies, 36 publications remained in the review, which belong to Iran (n = 8), Cuba (n = 8), Russia (n = 7), Iraq (n = 7), and Haiti (n = 6), respectively. Declining gross domestic product (GDP), devaluation of the national currency, and the quality of food, increase in inflation, unemployment, and consumer prices, infant and under 5 years mortality, energy, and protein deficiency, and the poverty rate were reported as sanction consequences. The most important strategies to improve food security were the humanitarian assistance provided by the international community (Haiti), equity and priority for vulnerable groups mainly by expanding the healthcare system (Cuba), adopting a food ration system in the oil-for-food program, and fixing the price of food baskets (Iraq), import substitution and self-sufficiency (Russia), support domestic production, direct and indirect support and compensation packages for vulnerable households (the approach of resistance economy in Iran). Conclusion Due to the heterogeneity of studies, meta-analysis was not possible. Since inadequate physical and economic food access caused by sanctions affects especially disadvantaged and vulnerable groups, planning to improve food security and providing support packages for these groups seems necessary.

https://www.ijhpm.com/article_4477_8b0834642727143e48da21cec59fd437.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Characteristics of Medical Deserts and Approaches to Mitigate Their Health Workforce Issues: A Scoping Review of Empirical Studies in Western Countries 1 16 4458 10.34172/ijhpm.2023.7454 EN Linda E. Flinterman Health Workforce and Organization Studies, Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands Ana I. González-González Avedis Donabedian Research Institute – UAB, Madrid, Spain Laura Seils Avedis Donabedian Research Institute – UAB, Madrid, Spain Julia Bes Health Workforce and Organization Studies, Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands Marta Ballester Avedis Donabedian Research Institute – UAB, Madrid, Spain Joaquim Bañeres Avedis Donabedian Research Institute – UAB, Madrid, Spain Sorin Dan Innovation and Entrepreneurship InnoLab, University of Vaasa, Vaasa, Finland Alicja Domagala Department of Health Policy and Management, Institute of Public Health, Jagiellonian University, Krakow, Poland Katarzyna Dubas-Jakóbczyk Department of Health Economics and Social Security, Institute of Public Health, Jagiellonian University, Krakow, Poland Robert Likic School of Medicine, University of Zagreb, Zagreb, Croatia Marieke Kroezen Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands Ronald Batenburg Health Workforce and Organization Studies, Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands Department of Sociology, Radboud University, Nijmegen, The Netherlands Journal Article 2022 06 10 Background Medical deserts are considered a problematic issue for many Western countries which try to employ multitude of policies and initiatives to achieve a better distribution of their health workforce (HWF). The aim of this study was to systematically map research and provide an overview of definitions, characteristics, contributing factors and approaches to mitigate medical deserts within the European Union (EU)-funded project “ROUTE-HWF” (a Roadmap OUT of mEdical deserts into supportive Health WorkForce initiatives and policies). Methods We performed a scoping review to identify knowledge clusters/research gaps in the field of medical deserts focusing on HWF issues. Six databases were searched till June 2021. Studies reporting primary research from Western countries on definitions, characteristics, contributing factors, and approaches were included. Two independent reviewers assessed studies for eligibility, extracted data and clustered studies according to the four defined outcomes. Results Two-hundred and forty studies were included (n = 116, 48% Australia/New Zealand; n = 105, 44% North America; n = 20, 8% Europe). All used observational designs except for five quasi-experimental studies. Studies provided definitions (n = 171, 71%), characteristics (n = 95, 40%), contributing factors (n = 112, 47%), and approaches to mitigate medical deserts (n = 87, 36%). Most medical deserts were defined by the density of the population in an area. Contributing factors to HWF issues in medical deserts consisted in work-related (n = 55, 23%) and lifestyle-related factors (n = 33, 14%) of the HWF as well as sociodemographic characteristics (n = 79, 33%). Approaches to mitigate them focused on training adapted to the scope of rural practice (n = 67, 28%), HWF distribution (n = 3, 1%), support/infrastructure (n = 8, 3%) and innovative models of care (n = 7, 3%). Conclusion Our study provides the first scoping review that presents and categorizes definitions, characteristics, contributing factors, and approaches to mitigate HWF issues in medical deserts. We identified gaps such as the scarcity of longitudinal studies to investigate the impact of factors contributing to medical deserts, and interventional studies to evaluate the effectiveness of approaches to mitigate HWF issues.

https://www.ijhpm.com/article_4458_c098f40b0db22c01c329de92d4c02cf0.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Interactions Between Nutrition Professionals and Industry: A Scoping Review 1 17 4483 10.34172/ijhpm.2023.7626 EN Virginie Hamel Department of Nutrition, Faculty of Medicine, University of Montreal, Montreal, QC, Canada Centre de recherche en Santé publique, Montreal, QC, Canada Marita Hennessy College of Medicine and Health, University College Cork, Cork, Ireland Mélissa Mialon Trinity Business School, Trinity College Dublin, Dublin, Ireland 0000-0002-9883-6441 Jean-Claude Moubarac Department of Nutrition, Faculty of Medicine, University of Montreal, Montreal, QC, Canada Centre de recherche en Santé publique, Montreal, QC, Canada Journal Article 2022 08 17 Background In recent years, interactions between nutrition professionals (NPs) and the food industry, such as sponsorship arrangements, have raised concerns, particularly as these may negatively impact the trustworthiness and credibility of the nutrition profession. This study aimed to map the literature and identify knowledge gaps regarding interactions between NPs and industry. We sought to examine the nature of such interactions and NPs perspectives about these, as well as the risks and solutions. Methods We conducted a scoping review according to a pre-registered protocol, searching eight electronic databases and grey literature sources in March 2021 to identify documents for inclusion. Two independent reviewers screened citations for inclusion and conducted data extraction. Quantitative and qualitative syntheses were conducted. Results We identified 115 documents for analysis, published between 1980 to 2021, with a majority from the United States (n = 59, 51%). Only 32% (n = 37) were empirical studies. The food industry was the most frequent industry type discussed (n = 91, 79%). We identified 32 types of interactions between NPs and industry, such as continuing education provided by industry and sponsorship of professional bodies and health and nutrition organizations. The financial survival of nutrition organizations and continuing education access for NPs were the most frequently cited advantages of industry-NPs interactions. On the other hand, undermining public trust, NPs credibility and public health nutrition recommendations were pointed out as risks of these interactions. Following a code of ethics, policies, or guidelines was the most frequently proposed solution for managing these interactions. Conclusion Despite the increasing attention given to this issue, few empirical papers have been published to date. There is a need for more research to better and systematically document industry interactions with NPs and the impacts associated with these, as well as more research on effective management strategies.

https://www.ijhpm.com/article_4483_347c61ed97a8fa86924ef521fc5ddb43.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Taking on the Corporate Determinants of Ill-health and Health Inequity: A Scoping Review of Actions to Address Excessive Corporate Power to Protect and Promote the Public’s Health 1 17 4496 10.34172/ijhpm.2023.7304 EN Benjamin Wood Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, Australia Jennifer Lacy-Nichols Centre for Health Policy, The University of Melbourne School of Population and Global Health, Melbourne, VIC, Australia Gary Sacks Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, Australia Journal Article 2022 04 04 Background In many sectors of the economy, for-profit business corporations hold excessive power relative to some governments and civil society. These power imbalances have been recognised as important contributors to many pressing and complex societal challenges, including unhealthy diets, climate change, and widening socio-economic inequalities, and thus pose a major barrier to efforts to improve public health and health equity. In this paper, we reviewed potential actions for addressing excessive corporate power. Methods We conducted a scoping review of diverse literature (using Scopus, Web of Science, HeinOnline, and EBSCO databases), along with expanded searches, to identify state and collective actions with the potential to address excessive corporate power. Actions were thematically classified into overarching strategic objectives, guided by Meagher’s ‘3Ds’ heuristic, which classifies actions to curb corporate power into three groups: dispersion, democratisation, and dissolution. Based on the actions identified, we proposed two additional strategic objectives: reform and democratise the global governance of corporations, and strengthen countervailing power structures. Results We identified 178 documents that collectively cover a broad range of actions to address excessive corporate power. In total, 18 interrelated strategies were identified, along with several examples in which aspects of these strategies have been implemented. Conclusion The proposed framework sheds light on how a diverse set of strategies and actions that seek to address excessive corporate power can work synergistically to change the regulatory context in which corporations operate, so that broader societal goals, including health and equity, are given much greater prominence and consideration vis-à-vis powerful corporate interests.

https://www.ijhpm.com/article_4496_bf9c3766e91a6142f26043e7245b9cd2.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Benchmarking Drug Regulatory Systems for Capacity Building: An Integrative Review of Tools, Practice, and Recommendations 1 15 4515 10.34172/ijhpm.2023.8100 EN Junnan Shi State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China Xianwen Chen State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China Hao Hu State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China Centre for Pharmaceutical Regulatory Sciences, University of Macau, Macao, China Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao, China Carolina Oi Lam Ung State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, China Centre for Pharmaceutical Regulatory Sciences, University of Macau, Macao, China Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao, China Journal Article 2023 05 07 Background Benchmarking has been increasingly used on drug regulatory systems to achieve sustainable pharmaceutical system strengthening. This study aimed to identify the scope, tools and benefits of benchmarking regulatory capacities and the most recent development in such phenomenon. Methods This study employed an integrative and critical review of the literature and documents on benchmarking drug regulatory capacities identified from 6 databases and 5 websites of related organizations and government agencies in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Results Forty-three studies and 6 documents about regulatory benchmarking published between 2005 and 2022 were included in this review. Five benchmarking assessment tools or programmes recommended or adopted by international organizations or government agencies had been identified, which collectively covered 12 major regulatory functions (4 at system level and 8 at operational level) involving 9 indicator categories and 382 sub-indicators. Benchmarking drug regulatory systems was reportedly employed at national, regional and international levels for either internal assessment (mostly on regulatory system establishment, drug review process and post marketing surveillance) or external evaluation (mostly on regulatory standards, drug review process and pharmacovigilance systems) to assess current status, monitor performance, determine major challenges, and inform actions for capacity building. Priority of actions in areas such as regulatory process, resources allocation, cooperation and communication, and stakeholder engagement have been suggested for strengthening drug regulatory systems. Nevertheless, the evidence about benchmarking in optimizing regulatory capacities remained underreported. Conclusion This integrative review depicted a framework for decision-makers about why and how benchmarking drug regulatory systems should be undertaken. For effective benchmarking, well-informed decisions about the goals, the scope, the choice of reference points, and benchmarking tools are essential to guide the implementation strategies. Further studies about the positive effects of regulatory benchmarking are warranted to engage continuous commitment to the practice.

https://www.ijhpm.com/article_4515_52eb537e9aaec6fca614cafea4fd2889.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 The Experiences of Strategic Purchasing of Healthcare in Nine Middle-Income Countries: A Systematic Qualitative Review 1 21 4527 10.34172/ijhpm.2023.7352 EN Joshua Sumankuuro Centre for Health Policy, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa Department of Public Policy and Management, SD Dombo University of Business and Integrated Development Studies, Wa, Ghana School of Community Health, Charles Sturt University, Orange, NSW, Australia Frances Griffiths Centre for Health Policy, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa Warwick Medical School, University of Warwick, Coventry, UK Adam D. Koon Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA Witness Mapanga Centre for Health Policy, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa 0000-0001-8719-3084 Beryl Maritim Centre for Health Policy, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa Consortium for Advanced Research Training in Africa (CARTA), Nairobi, Kenya School of Public Health, University of the Witwatersrand, Johannesburg, South Africa 0000-0002-3754-0735 Atiya Mosam School of Public Health, University of the Witwatersrand, Johannesburg, South Africa Jane Goudge Centre for Health Policy, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa Journal Article 2022 04 26 Background Efforts to move towards universal health coverage (UHC) aim to rebalance health financing in ways that increase efficiency, equity, and quality. Resource constraints require a shift from passive to strategic purchasing (SP). In this paper, we report on the experiences of SP in public sector health insurance schemes in nine middle-income countries to understand what extent SP has been established, the challenges and facilitators, and how it is helping countries achieve their UHC goals. Methods We conducted a systematic search to identify papers on SP. Nine countries were selected for case study analysis. We extracted data from 129 articles. We used a common framework to compare the purchasing arrangements and key features in the different schemes. The evidence was synthesised qualitatively. Results Five countries had health technology assessment (HTA) units to research what services to buy. Most schemes had reimbursement mechanisms that enabled some degree of cost control. However, we found evidenced-based changes to the reimbursement mechanisms only in Thailand and China. All countries have some form of mechanism for accreditation of health facilities, although there was considerable variation in what is done. All countries had some strategy for monitoring claims, but they vary in complexity and the extent of implementation; three countries have implemented e-claim processing enabling a greater level of monitoring. Only four countries had independent governance structures to provide oversight. We found delayed reimbursement (six countries), failure to provide services in the benefits package (four countries), and high out-of-pocket (OOP) payments in all countries except Thailand and Indonesia, suggesting the schemes were failing their members. Conclusion We recommend investment in purchaser and research capacity and a focus on strong governance, including regular engagement between the purchaser, provider and citizens, to build trusting relationships to leverage the potential of SP more fully, and expand financial protection and progress towards UHC.

https://www.ijhpm.com/article_4527_aacfa281fe0869035961e90dd20cd7e1.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 What Are Healthy Societies? A Thematic Analysis of Relevant Conceptual Frameworks 1 12 4522 10.34172/ijhpm.2023.7450 EN Kent Buse The George Institute for Global Health, Imperial College London, London, UK Amy Bestman Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia Siddharth Srivastava The George Institute for Global Health, New Delhi, India Robert Marten The Alliance for Health Policy and Systems Research, World Health Organization (WHO), Geneva, Switzerland Sonam Yangchen The Alliance for Health Policy and Systems Research, World Health Organization (WHO), Geneva, Switzerland Devaki Nambiar The George Institute for Global Health, New Delhi, India Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India 0000-0001-5682-6109 Journal Article 2022 06 09 Background While support for the idea of fostering healthy societies is longstanding, there is a gap in the literature on what they are, how to beget them, and how experience might inform future efforts. This paper explores developments since Alma Ata (1978) to understand how a range of related concepts and fields inform approaches to healthy societies and to develop a model to help conceptualize future research and policy initiatives. Methods Drawing on 68 purposively selected documents, including political declarations, commission and agency reports, peer-reviewed papers and guidance notes, we undertook qualitative thematic analysis. Three independent researchers compiled and categorised themes describing the domains of a potential healthy societies approach. Results The literature provides numerous frameworks. Some of these frameworks promote alternative endpoints to development, eschewing short-term economic growth in favour of health, equity, well-being and sustainability. They also identify values, such as gender equality, collaboration, human rights and empowerment that provide the pathways to, or underpin, such endpoints. We categorize the literature into four “components”: people; places; products; and planet. People refers to social positions, interactions and networks creating well-being. Places are physical environments — built and natural — and the interests and policies shaping them. Products are commodities and commercial practices impacting population health. Planet places human health in the context of the ‘Anthropocene.’ These components interact in complex ways across global, regional, country and community levels as outlined in our heuristic. Conclusion The literature offers little critical reflection on why greater progress has not been made, or on the need to organise and resist the prevailing systems which perpetuate ill-health.

https://www.ijhpm.com/article_4522_47a70c3c15e554158d7200293254355d.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 How to Build Healthy Societies: A Thematic Analysis of Relevant Conceptual Frameworks 1 10 4523 10.34172/ijhpm.2023.7451 EN Devaki Nambiar The George Institute for Global Health, New Delhi, India Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India 0000-0001-5682-6109 Amy Bestman Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia Siddharth Srivastava The George Institute for Global Health, New Delhi, India Robert Marten The Alliance for Health Policy and Systems Research, World Health Organization (WHO), Geneva, Switzerland Sonam Yangchen The Alliance for Health Policy and Systems Research, World Health Organization (WHO), Geneva, Switzerland Kent Buse The George Institute for Global Health, Imperial College London, London, UK Journal Article 2022 06 09 Background As the Sustainable Development Goals deadline of 2030 draws near, greater attention is being given to health beyond the health sector, in other words, to the creation of healthy societies. However, action and reform in this area has not kept pace, in part due to a focus on narrower interventions and the lack of upstream action on health inequity. With an aim to guide action and political engagement for reform, we conducted a thematic analysis of concepts seeking to arrive at healthy societies. Methods This paper drew on a qualitative thematic analysis of a purposive sample of 68 documents including political declarations, reports, peer reviewed literature and guidance published since 1974. Three independent reviewers extracted data to identify, discuss and critique public policy levers and ‘enablers’ of healthy societies, the “how.” Results The first lever concerned regulatory and fiscal measures. The second was intersectoral action. The final lever a shift in the global consensus around what signifies societal transformation and outcomes. The three enablers covered political leadership and accountability, popular mobilization and the generation and use of knowledge. Conclusion Documents focused largely on technical rather than political solutions. Even as the importance of political leadership was recognized, analysis of power was limited. Rights-based approaches were generally neglected as was assessing what worked or did not work to pull the levers or invest in the enablers. Frameworks typically failed to acknowledge or challenge prevailing ideologies, and did not seek to identify ways to hold or governments or corporations accountable for failures. Finally, ideas and approaches seem to recur again over the decades, without adding further nuance or analysis. This suggests a need for more upstream, critical and radical approaches to achieve healthy societies.

https://www.ijhpm.com/article_4523_4050e2a0ceaec50e11b87dbde53869d7.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Measuring Accessibility to Healthcare Using Taxi Trajectories Data: A Case Study of Acute Myocardial Infarction Cases in Beijing 1 7 4309 10.34172/ijhpm.2022.6653 EN Yuwei Su School of Architecture, Tsinghua University, Beijing, China School of Urban Design, Wuhan University, Wuhan, China Zhengying Liu School of Architecture, Tsinghua University, Beijing, China Jie Chang Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China 0000-0002-2141-7791 Qiuju Deng Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China Yuyang Zhang School of Architecture, Tsinghua University, Beijing, China Jing Liu Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China Ying Long School of Architecture and Hang Lung Center for Real Estate, Key Laboratory of Eco Planning & Green Building, Ministry of Education, Tsinghua University, Beijing, China Journal Article 2021 08 20 Several methods have been applied to measure healthcare accessibility, ie, the Euclidean distance, the network distance, and the transport time based on speed limits. However, these methods generally produce less accurate estimates than actual measurements. This research proposed a method to estimate historical healthcare accessibility more accurately by using taxi Global Positioning System (GPS) traces. The proposed method’s advantages were evaluated vis a case study using acute myocardial infarction (AMI) cases in Beijing in 2008. Comparative analyses of the new measure and three conventionally used measures suggested that the median estimated transport time to the closest hospital with percutaneous coronary intervention (PCI) capability for AMI patients was 5.72 minutes by the taxi GPS trace-based measure, 2.42 minutes by the network distance-based measure, 2.28 minutes by the speed limit-based measure, 1.73 minutes by the Euclidean distance-based measure; and the estimated proportion of patients who lived within 5 minutes of a PCI-capable hospital was 38.17%, 89.20%, 92.52%, 95.05%, respectively. The three conventionally used measures underestimated the travel time cost and overestimated the percentage of patients with timely access to healthcare facilities. In addition, the new measure more accurately identifies the areas with low or high access to healthcare facilities. The taxi GPS trace-based accessibility measure provides a promising start for more accurately estimating accessibility to healthcare facilities, increasing the use of medical records in studying the effects of historical healthcare accessibility on health outcomes, and evaluating how accessibility to healthcare changes over time.

https://www.ijhpm.com/article_4309_57bf41fd73725b0af3e070ee12ebedc9.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Let’s Talk About it: The Utility of Formalized Support for Medical Residents 1 4 4476 10.34172/ijhpm.2023.7463 EN Rachel Gifford Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands Tiuri R. Van Rossum School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands Bram Fleuren Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands Daan Westra Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands Journal Article 2022 06 13 Medical residents are significantly impacted by burnout and depression. Recent events have only further increased the pressure and demands on the healthcare sector, intensifying the burden facing residents and posing a threat to residents’ well-being. As a result, significant efforts are being made to provide formalized support and well-being programs. Yet, emergent evidence indicates that residents do not sufficiently utilize this form of support. Considering the organizational investment and focus on formalized support programs, we conducted a mixed-method study to investigate residents’ utilization of formalized well-being support, and potential reasons for non-use. Our study was conducted during a period of increased work burden and stress for medical residents, where formalized support was specifically offered and targeted to medical staff. Our findings confirm earlier results of low support utilization and point to the importance of informal support mechanisms, in particular peer support. We conclude by discussing the role of managers and educational programs in facilitating a positive cultural shift to promote and support residents in seeking support.

https://www.ijhpm.com/article_4476_97191ce07adeef4626442f8c79f00ecc.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Population Size Estimation of People Who Use Illicit Drugs and Alcohol in Iran (2015-2016) 1 7 4303 10.34172/ijhpm.2022.6578 EN Azam Rastegari Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Mohammad Reza Baneshi Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Center for Longitudinal and Life Course Research, School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia Ahmad Hajebi Research Center for Addiction & Risky Behaviors (ReCARB), Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran Department of Psychiatry, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran Alireza Noroozi Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran Mohammad Karamouzian Centre On Drug Policy Evaluation, St. Michael’s Hospital, Toronto, ON, Canada HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV, Kerman University of Medical Sciences, Kerman, Iran Mostafa Shokoohi HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV, Kerman University of Medical Sciences, Kerman, Iran Ali Mirzazadeh HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV, Kerman University of Medical Sciences, Kerman, Iran Institute for Health Policy Studies, University of California, San Francisco, CA, USA 0000-0002-0478-3220 Toktam Khojasteh Bojnourdi Ministry of Health and Medical Education, Tehran, Iran Naser Nasiri HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV, Kerman University of Medical Sciences, Kerman, Iran Saiedeh Haji Maghsoudi Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Ali Akbar Haghdoost HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV, Kerman University of Medical Sciences, Kerman, Iran Hamid Sharifi HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV, Kerman University of Medical Sciences, Kerman, Iran Journal Article 2021 06 30 Background Estimating the number of people using illicit drugs and alcohol is necessary for informing health policy and programming. However, it is often challenging to reliably estimate the size of these marginalized populations through direct methods. In this study, we estimated the population size of these groups using the indirect Network Scale-Up (NSU) method in Iran from 2015 to 2016. Methods Using a self-administered questionnaire, we asked 15 124 individuals (54% men) about the number of people they know who used different types of drugs at least once in the past 12 months. Prevalence estimates were reported per 100 000 population. The uncertainty level (UL) was calculated using the bootstrap method. Results The average age of the respondents was 33 years old, and 35.1% of them were unmarried. The most common drugs and their prevalence were as follows: opium (2534 [95% UL: 2467-2598]), hashish (849 [95% UL: 811-886]), stimulants (methamphetamine, ecstasy pills, cocaine, and Ritalin) (842 [95% UL: 802-879]), heroin/crack (578 [95% UL: 550-607]), and drug injection (459 [95% UL: 438-484]). Additionally, we estimated the prevalence of alcohol use as 2797 (95% UL: 2731-2861). On average, substance use was 5.23 times more prevalent among men than women. Opium use was more prevalent among individuals aged >50 years old. Moreover, alcohol use was more prevalent among participants between 18 and 30 years old (5164 per 100 000 population). Conclusion Although opium continues to be the most prevalent illicit drug in Iran, the patterns of illicit drug use are heterogeneous among different age groups, genders, and provinces. Age-gender specific and culturally appropriate interventions are warranted to meet the needs of people in different subgroups.

https://www.ijhpm.com/article_4303_fd5eaf3afdad0d3893b12c3791d37e5b.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Impact of the COVID-19 Pandemic on Elective and Emergency Inpatient Procedure Volumes in Switzerland – A Retrospective Study Based on Insurance Claims Data 1 9 4306 10.34172/ijhpm.2022.6932 EN Yael Rachamin Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland 0000-0002-1484-6934 Matthias R. Meyer Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland Division of Cardiology, Cantonal Hospital Graubuenden, Chur, Switzerland Thomas Rosemann Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland Thomas Grischott Institute of Primary Care, University of Zurich and University Hospital Zurich, Zurich, Switzerland Journal Article 2021 11 10 Background The severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) pandemic forced hospitals to redistribute resources for the treatment of patients with coronavirus disease 2019 (COVID‑19), yet the impact on elective and emergency inpatient procedure volumes is unclear. Methods We analyzed anonymized data on 234 921 hospitalizations in 2017‑2020 (55.9% elective) from a big Swiss health insurer. We used linear regression models to predict, based on pre‑pandemic data, the expected weekly numbers of procedures in 2020 in the absence of a pandemic and compared these to the observed numbers in 2020. Compensation effects were investigated by discretely integrating the difference between the two numbers over time. Results During the first COVID‑19 wave in spring 2020, elective procedure numbers decreased by 52.9% (95% confidence interval ‑64.5% to ‑42.5%), with cardiovascular and orthopedic elective procedure numbers specifically decreasing by 45.5% and 72.4%. Elective procedure numbers normalized during summer with some compensation of postponed procedures, leaving a deficit of ‑9.9% (‑15.8% to ‑4.5%) for the whole year 2020. Emergency procedure numbers also decreased by 17.1% (‑23.7% to ‑9.8%) during the first wave, but over the whole year 2020, net emergency procedure volumes were similar to control years. Conclusion Inpatient procedure volumes in Switzerland decreased considerably in the beginning of the pandemic but recovered quickly after the first wave. Still, there was a net deficit in procedures at the end of the year. Health system leaders must work to ensure that adequate access to non‑COVID‑19 related care is maintained during future pandemic phases in order to prevent negative health consequences.

https://www.ijhpm.com/article_4306_b47a2fa706a511f87ff778ef00d3690d.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 The Hospital of Tomorrow Case Study: Multidisciplinarity, Inclusiveness and Holistic Approaches to Foster Innovation in Complex Organizations 1 12 4399 10.34172/ijhpm.2023.7330 EN Francesca Gorla World Health Organization, Headquarters, Geneva, Switzerland IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant’Orsola, Bologna, Italy Anja Borojevic World Health Organization, Regional Office for Europe, Copenhagen, Denmark James Lind Institute, Geneva, Switzerland Chiara Gibertoni IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant’Orsola, Bologna, Italy Lorena Landi IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant’Orsola, Bologna, Italy Marco Storchi IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant’Orsola, Bologna, Italy Luca Fontana World Health Organization, Headquarters, Geneva, Switzerland Jetri Regmi World Health Organization, Regional Office for Europe, Copenhagen, Denmark Barbara Burmen World Health Organization, Headquarters, Geneva, Switzerland Anna Silenzi World Health Organization, Headquarters, Geneva, Switzerland Journal Article 2022 04 12 Background This case study describes and analyses an action research initiative undertaken by management, staff and World Health Organization (WHO) at the IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant’Orsola, Italy. The initiative utilised staff engagement approaches developed during the COVID-19 pandemic to rethink and reshape future development plans. The initiative provides a ‘how-to’ case study for complex health facilities on ways to create similar multisectoral, inclusive and holistic processes in planning structural, functional and organizational solutions for their ‘hospitals of tomorrow.’ Methods The case study utilised an action research approach coordinated by a team of WHO facilitators in close collaboration with the Board of Hospital Directors. Heterogeneous and multidisciplinary working groups were created, with members from different levels of the hospital staff. In the context of facilitated group meetings held weekly over a one-year period, participants were asked to review topics of interest to future plans of the hospital and make recommendations on effective/innovative ways of addressing these in the short and long term. Working groups focused on different challenges. Results The initiative was successful in creating and sustaining broad staff engagement in the future planning processes. 80% groups maintained high staff participation throughout the entire project year. Participating staff reported enhanced communication and cooperation between departments represented in different groups. 87% of the proposed plans suggested by the working groups were approved by the Board for implementation. Conclusion Key factors contributing to the high approval rate of plans, strong engagement record of staff and enhanced cooperation between involved departments; included: multisectoral/cross hierarchal staff involvement, group attention to defining time-bound contextual goals, flexible implementation monitoring approaches, personnel skills and profiles of participants, direct and open communication at all levels and times, member commitment and clear exit strategy. The case study is presented as a model to stimulate similar actions in other complex healthcare facilities.

https://www.ijhpm.com/article_4399_bf521424b5b1a163c4943c99030e42ac.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 A Comparative Analysis on the Social Determinants of COVID-19 Vaccination Coverage in Fragile and Conflict Affected Settings and Non-fragile and Conflict Affected Settings 1 9 4308 10.34172/ijhpm.2022.6830 EN Sanjay Pattanshetty Department of Global Health Governance, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India Mantej Pardesi Department of Microeconomics and Public Economics, School of Business and Economics, Maastricht University, Maastricht, The Netherlands Nachiket Gudi Public Health Evidence South Asia, Department of Health Information, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India Journal Article 2021 10 02 Background The coronavirus disease 2019 (COVID-19) pandemic has coerced various resources of all the countries. While the high-income nations redirected financial and human resources to understand specific determinants of vaccination coverage, fragile and conflict-affected setting (FCS) nations were waiting for global bodies to cater to their ever-growing need for vaccines and other lifesaving drugs. This study aimed to determine various factors influencing vaccine coverage in the FCS context. Methods World Bank’s classification of FCS states was the primary source for country classification. The study utilized data from various other open sources. The study models cross-country inequities in COVID-19 vaccine coverage and we have employed multi-variate log-linear regressions to understand the relationship between COVID-19 vaccine coverage and cross-country macro-level determinants. The analysis was conducted on two samples, non-FCS Countries and the FCS countries. Results Socio-economic determinants such as gross domestic product (GDP) per capita, socioeconomic resilience; health system determinants such as density of human resources, government spending on health expenditure; and political determinants such as effective government, more power to regional governments, political stability and absence of violence play a pivotal role in vaccine coverage. We also found that FCS countries with a higher share of people strongly believing in the vaccine effectiveness have a positive association with COVID-19 vaccine coverage. Conclusion The study confirmed that political factors, government effectiveness and political stability are also important determinants of vaccine coverage. The result further draws attention to few policy implications such as promoting future research to explore the linkages between the perceived equality before the law and individual liberty and its effect on vaccination coverage in the FCS.

https://www.ijhpm.com/article_4308_a10b4b99271c551b00d3714455d3ee29.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Barriers Toward the National Program for Prevention and Control of Diabetes in Iran: A Qualitative Exploration 1 8 4316 10.34172/ijhpm.2022.6908 EN Sohila Sadeghi Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Endocrinology & Metabolism, Internal Medicine, School of Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Fatemeh Mahani Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Parisa Amiri Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Shahram Alamdari Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Davood Khalili Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Navid Saadat Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Seyed Alireza Ebadi Department of Endocrinology & Metabolism, Internal Medicine, School of Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Ali Reza Mahdavi Hazaveh Ministry of Health and Medical Education, Center for Non-communicable Disease Control, Tehran, Iran Mohammad Karim Shahrzad Internal Medicine and Endocrinology Shohada Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Fereidoun Azizi Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Journal Article 2021 11 02 Background Despite the achievements of the national program for the prevention and control of diabetes (NPPCD) over the past two decades, the available evidence indicates a high prevalence of this disease in Iran. This qualitative study aims to investigate barriers to the NPPCD by pursuing the perspectives of relevant policy-makers, planners, and healthcare workers. Methods A grounded theory approach was used to analyze participants’ perceptions and experiences. Semistructured interviews (n=23) and eight focus groups (n=109) were conducted with relevant policy-makers, planners, and healthcare workers in charge of Iran’s national diabetes management program. Of the 132 participants, ages ranged from 25 to 56 years, and 53% were female. Constant comparative analysis of the data was conducted manually, and open, axial, and selective coding was applied to the data. Results Two main themes emerged from data analysis: implementation barriers and inefficient policy-making/ planning. Insufficient financial resources, staff shortage and insufficient motivation, inadequate knowledge of some healthcare workers, and defects in the referral system were recognized as the NPPCD implementation barriers. Inappropriate program prioritizing, the lack of or poor intersectoral collaboration, and the lack of an effective evaluation system were the inefficient policy-making/planning problems. Conclusion Current results highlighted that inefficient policy-making and planning have led to several implementation problems. Moreover, the key strategies to promote this program are prioritizing the NPPCD, practical intersectoral collaboration, and utilizing a more efficient evaluation system to assess the program and staff performance.

https://www.ijhpm.com/article_4316_140832fc0de66023afdf95f06fe6c164.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Improving Insurance Protection for Rare Diseases: Economic Burden and Policy Effects — Simulation of People With Pompe Disease in China 1 13 4320 10.34172/ijhpm.2022.6282 EN Shanquan Chen School of Clinical Medicine, University of Cambridge, Cambridge, UK Dong Dong Jockey Club School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China Journal Article 2021 04 26 Background The economic burden of Pompe disease (PD) is under-researched. This study aimed to fill this gap and provide evidence-based suggestions for policy improvement based on policy simulation. Methods Data were derived from a nationally based cross-sectional survey on rare diseases in early 2018. Answers from 92 PD patients were used for data analysis and simulation. Catastrophic health expenditure (CHE) and impoverishment due to illness (IDI) were adopted to measure PD patients’ economic burden. Two typical reimbursement patterns, a dosage-based model and a cost-based model, in China were simulated. Results Twenty-four pediatric and 68 adult PD patients were investigated. Families with pediatric PD patients on average had lower annual household incomes than families with adult PD patients (RMB 37 890 vs. RMB 66 120). The direct medical expense and out-of-pocket expenses were almost double for pediatric patients compared with adult patients (RMB 120 050 vs. RMB 66 350; RMB 112 710 vs. RMB 57 940, respectively). The direct non-medical expense for patients was almost six times the expense of adult patients (RMB 73 790 vs. RMB 13 080, respectively). About 88.24% of families with pediatric PD patients and 67.21% of families with adult PD patients suffered from CHE. Around 84.21% of families with pediatric PD patients and 45.90% of families with adult PD patients were forced to live in poverty due to illness. The simulation indicated that, although the two current reimbursement schemes helped reduce CHE, they almost had no effect on reducing IDI; the dosage-based model was more sensitive to changes in policy parameters. Conclusion Our study highlighted the alarmingly high disease burden faced by PD patients with first-hand patientreported evidence. Our series of simulations could be a good reference for China and other countries to improve their reimbursement policy regarding PD.

https://www.ijhpm.com/article_4320_f64c1f099d1f6ff6d848328a27d62bfb.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Non-communicable Disease-Related Sustainable Development Goals for 66 Belt and Road Initiative Countries 1 13 4322 10.34172/ijhpm.2022.6172 EN Lin Chen Ningbo No. 2 Hospital, Ningbo, China Donghui Duan Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China Liyuan Han Ningbo No. 2 Hospital, Ningbo, China Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China 0000-0002-5958-1896 Lu Xu Ningbo No. 2 Hospital, Ningbo, China Sixuan Li Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China Yuwei Zhang Panjin Municipal Center for Disease Control and Prevention, Panjin City, China Wei Feng Fenghua District Center for Disease Control and Prevention, Ningbo, China Qinghai Gong Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China Angela E. Micah Department of Health Metrics Sciences/Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA Ruijie Zhang Ningbo No. 2 Hospital, Ningbo, China Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China Shiwei Liu Division of Chronic Disease and Aging Health management, Chinese Center for Disease Control and Prevention, Beijing, China Hui Li Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China Journal Article 2021 03 26 Background Since 2015, the Global Burden of Disease Study (GBD) has measured progress in achieving healthrelated Sustainable Development Goals (SDGs) annually worldwide. Little is known about the status and attainment of indicators of non-communicable diseases (NCDs) by 65 countries from the Belt and Road Initiative (BRI) proposed by China in 2013. Methods Data from GBDs were used to estimate 24 NCD-related SDG indicators in BRI countries from 1990 to 2017. Each indicator was scored from 0 to 100 to compare multiple indicators over the study period. The natural log of the annual change in each location and year and weighted annual rates of change were used to generate projections for 2030. National-level estimates were determined by socio-demographic index (SDI) quintiles in BRI countries with more than 1 million inhabitants. Results In 2017, the median overall score of NCD-related SDG index for the 66 BRI countries was 60 points, ranging from 29 points in Afghanistan to 84 points in Israel. More than 80% of countries achieved the SDG 2030 maternal mortality (MM) rate target in 2017, and the national skilled birth attendance rate was above 99% in more than 59% countries. However, none of the BRI countries achieved the goal for children’s overweight, modern methods of contraception, and universal health coverage. It was predicted that 80.4% of NCD-related SDG targets would be achieved in these countries by 2030. The overall score of NCD-related SDG index were positively associated with SDI quintiles. Conclusion For many indicators, the achieved progress in many countries is less than the annual rate necessary to meet SDG targets, indicating that substantial efforts need to be made in the coming years. Progress should be accelerated through collaborations between countries, implementation of NCD prevention and control strategies, and monitoring of inequalities in NCD-related SDGs within populations.

https://www.ijhpm.com/article_4322_439285a9fa910e26a6760bc08d1464af.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Explaining Variations in Long-term Care Use and Expenditures Under the Public Long-term Care Insurance Systems: A Case Study Comparison of Korea and Japan 1 11 4329 10.34172/ijhpm.2022.6640 EN Hongsoo Kim Graduate School of Public Health Department of Public Health Sciences, Institute of Health and Environment & Institute of Aging, Seoul National University, Seoul, Republic of Korea SOCIUM - Research Center on Inequality and Social Policy, University of Bremen, Bremen, Germany Nan-He Yoon Division of Social Welfare and Health Administration, Wonkwang University, Iksan, Republic of Korea Youjin Hahn School of Economics, Yonsei University, Seoul, Republic of Korea Hideki Hashimoto Department of Health and Social Behavior, The University of Tokyo School of Public Health, Tokyo, Japan Journal Article 2021 07 21 Background Establishing universal coverage of formal long-term care (LTC) services is an urgent policy need for aging populations that requires efficient management of quality and financing. Although current variation in LTC service use between and within countries suggests the potential for improvement by efficient management, this topic remains underexamined. We aimed to identify the sources of variance in LTC use and expenditures through a unique crosscountry comparison of Japan and South Korea, which have formal public LTC insurance (LTCI) schemes that are analogous but have unique operational and demographic structures. Methods Taking administrative regions as the unit of analysis, we assembled data on the LTC utilization rate of people aged ≥65 years, and expenditures per recipient from 2013 to 2015 as the outcome variables. Explanatory variables included demand-related factors, such as regional demographic and economic conditions, and supply characteristics derived from existing public databases. We conducted weighted least squares regression with fixed effects for the pooled data and used Blinder–Oaxaca decomposition to identify sources of outcome variance between the two countries. Results The average LTC utilization rate was 6.8% in Korea and 18.2% in Japan. Expenditures per recipient were approximately 1.4 times higher in Japan than in Korea. The difference in the utilization rate was mostly explained by between-country differences in supply- and demand-related factors, whereas the difference in expenditures per recipient was largely attributed to unobserved country-specific factors. Conclusion The current findings suggest that LTC utilization is determined largely by the demographic and functional characteristics of older people, whereas expenditures are more likely affected by institutional factors such as the insurance governance scheme and the policy choice of the target population segment and coverage. The results suggest that strategic choice of LTC institutional schemes is required to ensure financial sustainability to meet changing demands caused by population aging.

https://www.ijhpm.com/article_4329_8face42e4adc2d3d61375eecf78df7c7.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Re-aligning Incentives to Address Informal Payments in Tanzania Public Health Facilities: A Discrete Choice Experiment 1 13 4336 10.34172/ijhpm.2022.6877 EN Peter Binyaruka Department of Health System, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, Tanzania Antonio Andreoni Department of Economics, SOAS University of London, London, UK South African Research Chair in Industrial Development, University of Johannesburg, Johannesburg, South Africa 0000-0001-9389-0927 Dina Balabanova Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK Martin McKee Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK Eleanor Hutchinson Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK Blake Angell The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia Journal Article 2021 10 21 Background Informal payments for healthcare are typically regressive and limit access to quality healthcare while increasing risk of catastrophic health expenditure, especially in developing countries. Different responses have been proposed, but little is known about how they influence the incentives driving this behaviour. We therefore identified providers’ preferences for policy interventions to overcome informal payments in Tanzania. Methods We undertook a discrete choice experiment (DCE) to elicit preferences over various policy options with 432 health providers in 42 public health facilities in Pwani and Dar es Salaam region. DCE attributes were derived from a multi-stage process including a literature review, qualitative interviews with key informants, a workshop with health stakeholders, expert opinions, and a pilot test. Each respondent received 12 unlabelled choice sets describing two hypothetical job-settings that varied across 6-attributes: mode of payment, supervision at facility, opportunity for private practice, awareness and monitoring, measures against informal payments, and incentive payments to encourage noninfraction. Mixed multinomial logit (MMNL) models were used for estimation. Results All attributes, apart from supervision at facility, significantly influenced providers’ choices (P < .001). Health providers strongly and significantly preferred incentive payments for non-infraction and opportunities for private practice, but significantly disliked disciplinary measures at district level. Preferences varied across the sample, although all groups significantly preferred the opportunity to practice privately and cashless payment. Disciplinary measures at district level were significantly disliked by unit in-charges, those who never engaged in informal payments, and who were not absent from work for official trip. 10% salary top-up were preferred incentive by all, except those who engaged in informal payments and absent from work for official trip. Conclusion Better working conditions, with improved earnings and career paths, were strongly preferred by all, different respondents groups had distinct preferences according to their characteristics, suggesting the need for adoption of tailored packages of interventions.<br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;" />

https://www.ijhpm.com/article_4336_930261646ff55f065c9b65b86ad6cb5d.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 The Generative Mechanisms of Financial Strain and Financial Well-Being: A Critical Realist Analysis of Ideology and Difference 1 11 4327 10.34172/ijhpm.2022.6930 EN Nicole M. Glenn Centre for Healthy Communities, School of Public Health, University of Alberta, Edmonton, AB, Canada PolicyWise for Children & Families, Edmonton, AB, Canada Aryati Yashadhana Centre for Health Equity Training Research & Evaluation (CHETRE), University of New South Wales, Sydney, NSW, Australia Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia Ingham Institute for Applied Medical Research, Sydney, NSW, Australia School of Social Sciences, University of New South Wales, Sydney, NSW, Australia Karla Jaques Centre for Health Equity Training Research & Evaluation (CHETRE), University of New South Wales, Sydney, NSW, Australia Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia Ingham Institute for Applied Medical Research, Sydney, NSW, Australia Ana Belon Centre for Healthy Communities, School of Public Health, University of Alberta, Edmonton, AB, Canada Evelyne De Leeuw Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia Candace I. J. Nykiforuk Centre for Healthy Communities, School of Public Health, University of Alberta, Edmonton, AB, Canada Patrick Harris Centre for Health Equity Training Research & Evaluation (CHETRE), University of New South Wales, Sydney, NSW, Australia Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia Ingham Institute for Applied Medical Research, Sydney, NSW, Australia Journal Article 2021 11 09 Background Rapid, strategic action is required to mitigate the negative and unequal impact of the coronavirus disease 2019 (COVID-19) pandemic on the financial well-being (FWB) of global populations. Personal financial strain (FS) worsened most significantly among systematically excluded groups. Targeted government- and community-led initiatives are needed to address these inequities. The purpose of this applied research was to identify what works for whom, under what conditions, and why in relation to community and government initiatives that promote personal and household FWB and/or address FS in high income economies. Methods We employed a critical realist analysis to literature that reported on FWB/FS initiatives in high income countries. This included initiatives introduced in response to the pandemic as well as those that began prior to the pandemic. We included sources based on a rapid review. We coded academic, published literature (n = 39) and practicebased (n = 36) reports abductively to uncover generative mechanisms – ie, underlying, foundational factors related to community or government initiatives that either constrained and/or enabled FWB and FS. Results We identified two generative mechanisms: (1) neoliberal ideology; and (2) social equity ideology. A third mechanism, social location (eg, characteristics of identity, location of residence), cut across the two ideologies and demonstrated for whom the initiatives worked (or did not) in what circumstances. Neoliberal ideology (ie, individual responsibility) dominated initiative designs, which limited the positive impact on FS. This was particularly true for people who occupied systematically excluded social locations (eg, low-income young mothers). Social equity-based initiatives were less common within the literature, yet mostly had a positive impact on FWB and produced equitable outcomes. Conclusion Equity-centric initiatives are required to improve FWB and reduce FS among systemically excluded and marginalized groups. These findings are of relevance now as nations strive for financial recovery in the face of the ongoing global pandemic.

https://www.ijhpm.com/article_4327_5d7a171a1a8a7d995775645b78ffb7a3.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Energy as a Social and Commercial Determinant of Health: A Qualitative Study of Australian Policy 1 12 4343 10.34172/ijhpm.2022.7193 EN Fran Baum Stretton Institute, University of Adelaide, Adelaide, SA, Australia Michael P. McGreevy Department of Industrial Systems Engineering and Management, National University of Singapore, Singapore, Singapore Colin M. MacDougall College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia Mark Henley Uniting Care, Adelaide, SA, Australia Journal Article 2022 02 23 Background This paper considers energy as a social and commercial determinant of health. Stable access to clean and sustainable energy is integral for human wellbeing yet public health rarely considers its importance. Methods Using NVivo qualitative analysis software we analysed all Australian federal, state and territory strategic energy policies covering varying periods between 2016-2030. We defined strategic policy as including the goals, objectives and strategies of the department regarding a specific area of policy responsibility. This criterion excluded documents such as operational guidelines. 36 energy-related policies were analyzed. Results While the nature of energy supply is crucial to determining the impact of human and environmental health, our analysis showed that health and wellbeing are only rarely considered in policy. We developed a conceptual framework to guide our work linking energy policy with health. Australia’s continued reliance on fossil fuels evident in the policies poses health risks, especially as climate change threatens physical and mental health. Yet health considerations were mainly absent from the policies. However, some jurisdictions (South Australia and the Australian Capital Territory [ACT]) had policies encouraging a fast move to renewables. Energy pricing was a key focus in each jurisdiction and had become highly politicalized in the past decade. Little attention was paid to equity considerations in the policies. Conclusion Energy policy would be more health promoting if public health perspectives were considered during its development. On the basis of our policy analysis and literature review we conclude with recommendations for healthy energy policy.

https://www.ijhpm.com/article_4343_ebcad5b2acd96cc141a90d25a2d6abfc.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Understanding the Dynamics of More Restrictive Medicines Policy: A Case Study of Codeine Up-Scheduling in Australia 1 11 4352 10.34172/ijhpm.2022.6872 EN Kellia Chiu School of Pharmacy, Faculty of Medicine and Health & Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia Anne Marie Thow Menzies Centre for Health Policy, School of Public Health, Faculty of Medicine and Health & Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia 0000-0002-6460-5864 Lisa Bero Center for Bioethics and Humanities, University of Colorado Anschutz Medical Campus, Aurora, CO, USA Journal Article 2021 10 19 Background There has been increasing concern over opioid-related harms across the world. In Australia in 2018, codeine-containing products were up-scheduled from over-the-counter access at pharmacies, to requiring a prescription. The drug regulator’s decision to up-schedule was contentious and widely debated, due to the potentially large impact on consumers and healthcare professionals. This study aimed to analyse influences on the codeine up-scheduling policy. Methods This retrospective policy analysis used the Advocacy Coalition Framework (ACF) to understand how policy actors with shared beliefs formed adversarial coalitions to shape policy. Data were drawn from documents (regulator policy documents, public submissions, news reports, organisational media releases and position statements) and semistructured interviews with 15 key policy actors. Codes were generated relating to policy processes and actor beliefs; broad themes included the role of health professionals, perceptions of opioids, impact on consumers, and the role of government in healthcare. Results Two coalitions in this policy subsystem were identified: (1) supportive [with respect to the up-scheduling], and (2) opposing. The key evident beliefs of the supportive coalition were that the harms of codeine outweighed the benefits, and that government regulation was the best pathway for protecting consumers. The opposing coalition believed that the benefits of codeine accessible through pharmacists outweighed any harms, and consumers should manage their health without any more intervention than necessary. The policy decision reflected the influence of the supportive coalition, and this analysis highlighted the importance of their public health framing of the issue, the acceptability of their experts and supporting evidence, and the perceived legitimacy of the up-scheduling process. Conclusion Understanding these coalitions, their beliefs, and how they are translated through existing policy processes and institutions provides insight for those interested in influencing future health policy. Specific lessons include the importance of strategic frames and advocacy, and engagement with formal policy processes.

https://www.ijhpm.com/article_4352_87ca117dc4877d194aa615c18889cce3.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 To What Extent Do Free Healthcare Policies and Performance-Based Financing Reduce Out-of-Pocket Expenditures for Outpatient services? Evidence From a Quasi-experimental Study in Burkina Faso 1 11 4356 10.34172/ijhpm.2022.6767 EN Thit Thit Aye Heidelberg Institute of Global Health, Medical Faculty, University of Heidelberg, Heidelberg, Germany Hoa Thi Nguyen Heidelberg Institute of Global Health and Division of Tropical Medicine, Medical Faculty, University of Heidelberg, Heidelberg, Germany Stephan Brenner Heidelberg Institute of Global Health, Medical Faculty, University of Heidelberg, Heidelberg, Germany Paul Jacob Robyn Health, Nutrition and Population Global Practice, World Bank, Washington, DC, USA Ludovic Deo Gracias Tapsoba National Institute of Public Health, Ouagadougou, Burkina Faso Julia Lohmann Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK Heidelberg Institute of Global Health, Medical Faculty, University of Heidelberg, Heidelberg, Germany Manuela De Allegri Heidelberg Institute of Global Health, Medical Faculty, University of Heidelberg, Heidelberg, Germany Journal Article 2021 09 09 Background Burkina Faso has been implementing financing reforms towards universal health coverage (UHC) since 2006. Recently, the country introduced a performance-based financing (PBF) program as well as user fee removal (gratuité) policy for health services aimed at pregnant and lactating women and children under 5. We aim to assess the effect of gratuité and PBF policies on facility-based out-of-pocket expenditures (OOPEs) for outpatient services. Methods Our study is a controlled pre- and post-test design using healthcare facility data from the PBF program’s impact evaluation collected in 2014 and 2017. We compared OOPE related to primary healthcare use incurred by children under 5 and individuals above 5 to assess the effect of the gratuité policy on OOPE. We further compared OOPE incurred by individuals residing in PBF districts and non-PBF districts to estimate the effect of the PBF on OOPE. Effects were estimated using difference-in-differences models, distinguishing the estimation of the probability of incurring OOPE from the estimation of the magnitude of OOPE using a generalized linear model (GLM). Results The proportion of children under 5 incurring OOPE declined significantly from 90% in 2014 to 3% in 2017. Concurrently, mean OOPE also decreased. Differences in both the probability of incurring OOPE and mean OOPE between PBF and non-PBF facilities were small. Our difference in differences estimates indicated that gratuité produced an 84% (CI -86%, -81%) reduction in the probability of incurring OOPE and reduced total OOPE by 54% (CI 63%, 42%). We detected no significant effects of PBF, either in reducing the probability of incurring OOPE or in its magnitude. Conclusion User fee removal is an effective demand-side intervention for enhancing financial accessibility. As a supplyside intervention, PBF appears to have limited effects on reducing financial burden.

https://www.ijhpm.com/article_4356_a9d9f07f3e65373da38acab4228ef790.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Realistic Evaluation of the Integrated Electronic Diagnosis Approach (IeDA) for the Management of Childhood Illnesses at Primary Health Facilities in Burkina Faso 1 11 4353 10.34172/ijhpm.2022.6073 EN Karl Blanchet Geneva Centre of Humanitarian Studies, University of Geneva, Graduate Institute, Geneva, Switzerland London School of Hygiene and Tropical Medicine, London, UK Vincent-Paul Sanon Centre Muraz, Bobo Dioulasso, Burkina Faso Sophie Sarrassat London School of Hygiene and Tropical Medicine, London, UK Arsène Satouro Somé Centre Muraz, Bobo Dioulasso, Burkina Faso Journal Article 2021 04 13 Background In 2014, Terre des Hommes (Tdh) together with the Ministry of Health (MoH) launched the Integrated electronic Diagnosis Approach (IeDA) intervention in two regions of Burkina Faso consisting of supplying every health centre with a digital algorithm. A realistic evaluation was conducted to understand the implementation process, the mechanisms by which the IeDA intervention lead to change. Methods Data collection took place between January 2016 and October 2017. Direct observation in health centres were conducted. In-depth interviews were conducted with 154 individuals including 92 healthcare workers (HCW) from health centres, 16 officers from district health authorities, 6 members of health centre management committees. In addition, 5 focus groups were organised with carers. The initial coding was based on a preliminary list of codes inspired by the middle-range theory (MRT). Results Our results showed that the adoption of the electronic protocol depended on a multiplicity of management practices including role distribution, team work, problem solving approach, task monitoring, training, supervision, support and recognition. Such changes lead to reorganising the health team and redistributing roles before and during consultation, and positive atmosphere that included recognition of each team member, organisational commitment and sense of belonging. Conditions for such management changes to be effective included open dialog at all levels of the system, a minimum of resources to cover the support services and supervision and regular discussions focusing on solving problems faced by health centre teams. Conclusion This project reinforces the point that in a successful diffusion of IeDA, it is necessary to combine the introduction of technology with support and management mechanisms. It also important to highlight that managers’ attitude plays a great place in the success of the intervention: open dialog and respect are crucial dimensions. This is aligned with the findings from other studies.

https://www.ijhpm.com/article_4353_575b3d5304605be10f394c9d3737f655.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 From Local Action to Global Policy: A Comparative Policy Content Analysis of National Policies to Address Musculoskeletal Health to Inform Global Policy Development 1 20 4362 10.34172/ijhpm.2022.7031 EN Carmen Huckel Schneider Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia Sarika Parambath Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia James J. Young Center for Muscle and Joint Health, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark Department of Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada Swatee Jain Sydney Musculoskeletal, Bone & Joint Health Alliance, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia Helen Slater Curtin School of Allied Health, and Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia Saurab Sharma School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, NSW, Australia Deborah Kopansky-Giles Department of Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada Department of Family & Community Medicine, University of Toronto, Toronto, ON, Canada Lyn March Florance and Cope Professorial Department of Rheumatology, Royal North Shore Hospital and Kolling Institute, University of Sydney, Sydney, NSW, Australia Andrew M. Briggs Curtin School of Allied Health, and enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia Journal Article 2021 12 20 Background Global policy to guide action on musculoskeletal (MSK) health is in a nascent phase. Lagging behind other non-communicable diseases (NCDs) there is currently little global policy to assist governments to develop national approaches to MSK health. Considering the importance of comparison and learning for global policy development, we aimed to perform a comparative analysis of national MSK policies to identify areas of innovation and draw common themes and principles that could guide MSK health policy. Methods Multi-modal search strategy incorporating a systematic online search targeted at the 30 most populated nations; a call to networked experts; a specified question in a related eDelphi questionnaire; and snowballing methods. Extracted data were organised using an a priori framework adapted from the World Health Organization (WHO) Building Blocks and further inductive coding. Subsequently, texts were open coded and thematically analysed to derive specific sub-themes and principles underlying texts within each theme, serving as abstracted, transferable concepts for future global policy. Results The search yielded 165 documents with 41 retained after removal of duplicates and exclusions. Only three documents were comprehensive national strategies addressing MSK health. The most common conditions addressed in the documents were pain (non-cancer), low back pain, occupational health, inflammatory conditions, and osteoarthritis. Across eight categories, we derived 47 sub-themes with transferable principles that could guide global policy for: service delivery; workforce; medicines and technologies; financing; data and information systems; leadership and governance; citizens, consumers and communities; and research and innovation. Conclusion There are few examples of national strategic policy to address MSK health; however, many countries are moving towards this by documenting the burden of disease and developing policies for MSK services. This review found a breadth of principles that can add to this existing work and may be adopted to develop comprehensive system-wide MSK health approaches at national and global levels.

https://www.ijhpm.com/article_4362_2c2b339cac634e1589cce406b76745db.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Alignment in the Hospital-Physician Relationship: A Qualitative Multiple Case Study of Medical Specialist Enterprises in the Netherlands 1 13 4374 10.34172/ijhpm.2022.6917 EN Sander Ubels Radboud University Medical Centre, Nijmegen, The Netherlands Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, The Netherlands Erik M. Van Raaij Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, The Netherlands Rotterdam School of Management, Erasmus University, Rotterdam, The Netherlands Journal Article 2021 11 05 Background Policy-makers and hospital boards throughout the world have implemented different measures to create and sustain effective hospital-physician relationships. The ‘integrated funding’ policy reform in the Netherlands was aimed at increasing hospital-physician alignment and led to the unforeseen formation of medical specialist enterprises (MSEs): a fiscal entity representing all self-employed physicians in a hospital. It is unknown how hospitals and MSEs perceive their alignment and how they govern the relationship. This study explores the hospital-MSE relationship, and how governance styles influence perceived alignment in this relationship. Methods A multiple case study of five non-academic hospitals in the Netherlands was performed. Data was derived from two sources: (1) analysis of hospital-MSE contracts and (2) semi-structured interviews with hospital and MSE board members. Contracts were analysed using a predefined contract analysis template. Interview recordings were transcribed and subsequently coded using the sensitizing concepts approach. Results Contracts, relational characteristics, governance styles and perceived alignment differed substantially between cases. Two out of five contracts were prevention contracts, one was a mixed type, and two were promotion contracts. However, in all cases the contract played no role in the relationship. The use of incentives varied widely between the hospitals; most incentives were financial penalties. The governance style varied between contractual for two hospitals, mixed for one hospital and predominantly relational for two hospitals. Development of a shared business strategy was identified as an important driver of relational governance, which was perceived to boost alignment. Conclusion Large variation was observed regarding relational characteristics, governance and perceived alignment. MSE formation was perceived to have contributed to hospital-physician alignment by uniting physicians, boosting physicians’ managerial responsibilities, increasing financial alignment and developing shared business strategies. Relational governance was found to promote intensive collaboration between hospital and MSE, and thus may improve alignment in the hospital-physician relationship.

https://www.ijhpm.com/article_4374_fd2d36ac677a34849856de9b9b07bd58.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 What Makes People With Chronic Illnesses Discontinue Treatment? A Practice Theory Informed Analysis of Adherence to Treatment among Patients With Drug-Resistant Tuberculosis in Pakistan 1 11 4379 10.34172/ijhpm.2022.6576 EN Shazra Abbas Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia Michelle Kermode Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia Mohammad Dost Khan Deceased October 2020 Justin Denholm Department of Infectious Diseases, University of Melbourne, Melbourne, VIC, Australia Hamed Adetunji Faculty of Public Health & Health Informatics, Umm Al Qura University, Makkah Almukarramah, Saudi Arabia Sumit Kane Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia Journal Article 2021 06 30 Background Non-adherence to treatment is a frequently observed phenomenon amongst those on long-term treatment for chronic illnesses. This qualitative study draws upon the tenets of ‘practice theory’ to reveal what shapes patients’ ability to adhere to the demanding treatment for drug-resistant tuberculosis (DR-TB) at three treatment sites in KhyberPakhtunkhwa (KP) province of Pakistan. Methods This qualitative study involved observation of service provision over a period of nine months of stay at, and embedment within the three treatment sites and in-depth interviews with 13 service providers and 22 patients who became non-adherent to their treatment. Results Consistent with the extensive research based on the barriers and facilitator approach, both patients, and providers in our study also talked of patients’ doubts about diagnosis and treatment efficacy, side-effects of drugs, economic constraints, unreliable disbursements of monetary incentive, attitude of providers and co-morbidities as reasons for nonadherence to treatment. Applying a practice theory perspective yielded more contextualised insights; inadequate help with patients’ physical complaints, unempathetic responses to their queries, and failure to provide essential information, created conditions which hindered the establishment and maintenance of the ‘practice’ of adhering to treatment. These supply-side gaps created confusion, bred resentment, and exacerbated pre-existing distrust of public health services among patients, and ultimately drove them to disengage with the TB services and stop their treatment. Conclusion We argue that the lack of supply-side ‘responsiveness’ to patient needs beyond the provision of a few material inputs is what is lacking in the existing DR-TB program in Pakistan. We conclude that unless Pakistan’s TB program explicitly engages with these supply side, system level gaps, patients will continue to struggle to adhere to their treatments and the TB program will continue to lose patients. Conceptually, we make a case for reimagining the act of adherence (or not) to long-term treatment as a ‘Practice.’

https://www.ijhpm.com/article_4379_eba0f592c4dfff3922d7a183e05491d8.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Impact of COVID-19 Containment Measures on Unemployment: A Multi-country Analysis Using a Difference-in-Differences Framework 1 9 4369 10.34172/ijhpm.2022.7036 EN Walter Morris Institute for Global Health, University College, London, UK Ana Correa Institute for Global Health, University College, London, UK 0000-0002-0988-061X Rolando Leiva Institute for Global Health, University College, London, UK Journal Article 2021 12 25 Background At the start of the coronavirus disease 2019 (COVID-19) pandemic, in the absence of pharmaceutical interventions, countries resorted to containment measures to stem the spread of the disease. In this paper, we have conducted a global study using a sample of 46 countries to evaluate whether these containment measures resulted in unemployment. Methods We use a difference-in-differences (DID) specification with a heterogenous intervention to show the varying intensity effect of containment measures on unemployment, on a sample of 46 countries. We explain variations in unemployment from January-June 2020 using stringency of containment measures, controlling for gross domestic product (GDP) growth, inflation rate, exports, cases of COVID-19 per million, COVID-19-specific fiscal spending, time fixed effects, region fixed effects, and region trends. We conduct further subset analyses by COVID-cases quintiles and gross national income (GNI) per capita quintiles. Results The median level of containment stringency in our sample was 43.7. Our model found that increasing stringency to this level would result in unemployment increasing by 1.87 percentage points (or 1.67 pp, after controlling for confounding). For countries with below median COVID-19 cases and below median GNI per capita, this effect is larger. Conclusion Containment measures have a strong impact on unemployment. This effect is larger in poorer countries and countries with low COVID-19 cases. Given that unemployment has profound effects on mortality and morbidity, this consequence of containment measures may compound the adverse health effects of the pandemic for the most vulnerable groups. It is necessary for governments to consider this in future pandemic management, and to attempt to alleviate the impact of containment measures via effective fiscal spending.

https://www.ijhpm.com/article_4369_8c559f5e8852bb2aefa21e62ce89edb5.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 What Factors Explain Low Adoption of Digital Technologies for Health Financing in an Insurance Setting? Novel Evidence From a Quantitative Panel Study on IMIS in Tanzania 1 9 4381 10.34172/ijhpm.2023.6896 EN Leon Schuetze Heidelberg Institute of Global Health, Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany Siddharth Srivastava Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland University of Basel, Basel, Switzerland Naasegnibe Kuunibe Heidelberg Institute of Global Health, Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany Faculty of Integrated Development Studies, University for Development Studies, Wa, Ghana Elizeus Josephat Rwezaula Health Promotion and System Strengthening Project (HPSS), Dodoma, Tanzania Abdallah Missenye Kongwa District Council, Dodoma, Tanzania Manfred Stoermer Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland University of Basel, Basel, Switzerland Manuela De Allegri Heidelberg Institute of Global Health, Medical Faculty and University Hospital, University of Heidelberg, Heidelberg, Germany Journal Article 2021 10 28 Background Digital information management systems for health financing are implemented on the assumption that digitalization, among other things, enables strategic purchasing. However, little is known about the extent to which these systems are adopted as planned to achieve desired results. This study assesses the levels of, and the factors associated with the adoption of the Insurance Management Information System (IMIS) by healthcare providers in Tanzania. Methods Combining multiple data sources, we estimated IMIS adoption levels for 365 first-line health facilities in 2017 by comparing IMIS claim data (verified claims) with the number of expected claims. We defined adoption as a binary outcome capturing underreporting (verified<expected) vs. not-underreporting, using four different approaches. We used descriptive statistics and analysis of variance (ANOVA) to examine adoption levels across facilities, districts, regions, and months. We used logistic regression to identify facility-specific factors (ie, explanatory variables) associated with different adoption levels. Results We found a median (interquartile range [IQR]) difference of 77.8% (32.7-100) between expected and verified claims, showing a consistent pattern of underreporting across districts, regions, and months. Levels of underreporting varied across regions (ANOVA: F = 7.24, P < .001) and districts (ANOVA: F = 4.65, P < .001). Logistic regression results showed that higher service volume, share of people insured, and greater distance to district headquarter were associated with a higher probability of underreporting. Conclusion Our study shows that the adoption of IMIS in Tanzania may be sub-optimal and far from policy-makers’ expectations, limiting its capacity to provide the necessary information to enhance strategic purchasing in the health sector. Countries and agencies adopting digital interventions such as openIMIS to foster health financing reform are advised to closely track their implementation efforts to make sure the data they rely on is accurate. Further, our study suggests organizational and infrastructural barriers beyond the software itself hamper effective adoption.

https://www.ijhpm.com/article_4381_9fb98d9fce0b484a481ec69c2b8d1a1a.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 The Maritime SPOR SUPPORT Unit (MSSU) Bridge Process: An Integrated Knowledge Translation Approach to Address Priority Health Issues and Increase Collaborative Research in Nova Scotia, Canada 1 12 4382 10.34172/ijhpm.2023.6901 EN Julia Kontak Maritime SPOR SUPPORT Unit, Research and Innovation, Nova Scotia Health, Halifax, NS, Canada Amy Grant Maritime SPOR SUPPORT Unit, Research and Innovation, Nova Scotia Health, Halifax, NS, Canada Elizabeth Jeffers Maritime SPOR SUPPORT Unit, Research and Innovation, Nova Scotia Health, Halifax, NS, Canada Leah Boulos Maritime SPOR SUPPORT Unit, Research and Innovation, Nova Scotia Health, Halifax, NS, Canada Juanna Ricketts Maritime SPOR SUPPORT Unit, Research and Innovation, Nova Scotia Health, Halifax, NS, Canada Michael Davies Nova Scotia Department of Health and Wellness, Halifax, NS, Canada Marina Hamilton Maritime SPOR SUPPORT Unit, Research and Innovation, Nova Scotia Health, Halifax, NS, Canada Jill A. Hayden Department of Community Health & Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada Journal Article 2021 10 30 Background There is evidence of the benefits of integrated knowledge translation (IKT), yet there is limited research outlining the purpose of a knowledge broker (KB) within this approach. The Maritime SPOR SUPPORT Unit (MSSU) acts as a KB to support patient-oriented research across the Maritime provinces in Canada. The “Bridge Process” was developed by the Nova Scotia (NS) site as a strategy that involves work leading up to and following the Bridge Event. The process supports research addressing priority health topics discussed at the event by stakeholder groups. The objectives of this paper were to (1) describe the outputs/outcomes of this IKT approach; and (2) examine the role of the KB. Methods Quantitative data were collected from registration and evaluation surveys. Outputs are described with descriptive statistics. Qualitative data were collected through evaluation surveys and internal documents. Data related to KB tasks were categorized into three domains: (1) Knowledge Manager, (2) Linkage and Exchange Agent and (3) Capacity Developer. Results The Bridge Process was implemented four times. A total of 314 participants including government, health, patient/citizen, community, and research personnel attended the events. We identified 24 priority topics, with 7 led by teams receiving support to complete related projects. Participants reported improved understanding of the research gaps and policy needs and engaged with individuals they would not have otherwise. Although patients/citizens attended each Bridge Event, only 61% of participants who completed an evaluation survey indicated that they were ‘actively engaged in group discussion.’ The KB’s role was identified in all three domains including Knowledge Manager (eg, defining questions), Linkage and Exchange Agent (eg, engaging stakeholders), and Capacity Builder (eg, research interpretation). Conclusion The MSSU facilitated an IKT approach by acting as a KB throughout the Bridge Process. This deliberative and sequential process served as an effective strategy to increase collaborative health research in the province.

https://www.ijhpm.com/article_4382_486b7d5588a5184e62d301ee721aac5e.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Political Prioritisation for Performance-Based Financing at the County Level in Kenya: 2015 to 2018 1 13 4392 10.34172/ijhpm.2023.6909 EN Dennis Waithaka Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya Lucy Gilson Health Policy and Systems Division, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK Edwine Barasa Health Economics Research Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK Benjamin Tsofa Health Systems Research Group, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK Marsha Orgill Health Policy and Systems Division, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa Journal Article 2021 11 02 Background Performance-based financing (PBF) was introduced to Kilifi county in Kenya in 2015. This study investigates how and why political and bureaucratic actors at the local level in Kilifi county influenced the extent to which PBF was politically prioritised at the sub-national level. Methods The study employed a single-case study design. The Shiffman and Smith political priority setting framework with adaptations proposed by Walt and Gilson was applied. Data was collected through document review (n = 19) and in-depth interviews (n = 8). Framework analysis was used to analyse data and generate findings. Results In the period 2015-2018, the political prioritisation of PBF at the county level in Kilifi was influenced by contextual features including the devolution of power to sub-national actors and rigid public financial management (PFM) structures. It was further influenced by interpretations of the idea of ‘pay-for-performance,’ its framing as ‘additional funding,’ as well as contestation between actors at the sub national level about key PBF design features. Ultimately PBF ceased at the end of 2018 after donor funding stopped. Conclusion Health reformers must be cognisant of the power and interests of national and sub national actors in all phases of the policy process, including both bureaucratic and political actors in health and non-health sectors. This is particularly important in devolved public governance contexts where reforms require sustained attention and budgetary commitment at the sub national level. There is also need for early involvement of critical actors to develop shared understandings of the ideas on which interventions are premised, as well as problems and solutions.

https://www.ijhpm.com/article_4392_ef1817502c17ac01b35ea5189d4ff8f5.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Toward Universal Health Coverage: Regional Inequalities and Potential Solutions for Alleviating Catastrophic Health Expenditure in the Post-poverty Elimination Era of China 1 9 4383 10.34172/ijhpm.2023.7332 EN Yanan Luo Department of Global Health, School of Public Health, Peking University, Beijing, China Zhenyu Shi School of Public Health, Peking University, Beijing, China China Center for Health Development Studies, Peking University, Beijing, China Dan Guo School of Public Health, Peking University, Beijing, China China Center for Health Development Studies, Peking University, Beijing, China Ping He China Center for Health Development Studies, Peking University, Beijing, China 0000-0001-5040-5012 Journal Article 2022 04 28 Background This study took Beijing as an example to estimate the incidence and regional inequalities of catastrophic health expenditures (CHEs) in a megacity of China. Methods This study used data from the Health Services Survey Beijing (HSSB) 2018. Logistic regressions were used to investigate the risk factors for experiencing CHE, and concentration curves, the concentration index and its decomposition method based on probit models were used to estimate the inequalities in CHE. Results CHE occurred in 25.51% of the households of the outer suburb villages, 6.78% of the households of the innercity area communities, 17.10% of the households of the villages of the inner-city areas, and 11.91% of the households of the communities of the outer suburbs. In areas in the outer suburbs, households with private insurance coverage were associated with a lowered risk of CHE, and lower educational attainment and lower occupational class were related to an increasing risk of CHE. This study also discovered pro-rich financing disparities in CHE in Beijing, with the outer suburbs having the highest levels of CHE disparity. When it comes to the observed contributions of disparities in CHE, a significant portion of them is connected to the sorts of occupations, educational levels, and residential status. Conclusion The impoverishment brought on by medical expenses and CHE must still be taken into account in the postpoverty elimination era. The megacity of China was discovered to have significant regional differences in the incidence of pro-rich financing inequity in CHE. Disparities in socioeconomic status (SES), one of the controllable variables, may be a key area to address to lower the risk and minimize CHE inequality in megacities towards the path to universal health coverage (UHC). Additionally, it is important to consider the financial protection impact of inclusive supplementary medical insurance on lowering the likelihood of CHE in the periphery areas.

https://www.ijhpm.com/article_4383_7fb5511f6575196dcd6ed89817ddf720.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Early Career Outcomes of Embedded Research Fellows: An Analysis of the Health System Impact Fellowship Program 1 10 4386 10.34172/ijhpm.2023.7333 EN Bahar Kasaai CIHR Institute of Health Services and Policy Research, Toronto, ON, Canada 0000-0001-7264-7151 Erin Thompson CIHR Institute of Health Services and Policy Research, Toronto, ON, Canada Richard H. Glazier CIHR Institute of Health Services and Policy Research, Toronto, ON, Canada ICES (Institute for Clinical Evaluative Sciences), Toronto, ON, Canada MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada Meghan McMahon CIHR Institute of Health Services and Policy Research, Toronto, ON, Canada Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada Journal Article 2022 04 14 Background This descriptive study reports the early career outcomes of postdoctoral fellows who completed a novel embedded fellowship training program, the Canadian Institutes of Health Research (CIHR) Health System Impact (HSI) Fellowship. The program was designed to support impact-oriented career paths of doctoral graduates, build research capacity within health system organizations (HSOs), and help to advance learning health systems (LHSs) in Canada. Methods Employment of fellowship alumni upon completion of the program was tracked using internet searches of publicly accessible online sources and complemented with program survey data. Results Descriptive analyses show that all 87 eligible alumni included in the study are currently employed (100% of 87), with 92% employed in Canada. Their employment spans several sectors, including in academic (37%), public (29%), healthcare delivery (17%), and private (14%) sectors. Altogether, 32% of alumni hold hybrid roles with an affiliation in academia and another sector. The most common position types are senior scientist (42%), professorships (18%), and director, manager or administrator roles (12%). Program reporting data indicate that these employment outcomes are generally consistent with the group’s career aspirations reported at the start of the fellowship program, and that the program receives high ratings from fellows in the extent it is believed to support their career preparedness and readiness (4.49 out of 5). Conclusion This study finds that HSI Fellow alumni are employed mostly in research-related roles in a range of sectors including, but not limited to, academia, and that they positively perceive the program’s success in elevating their career readiness and potential to make an impact – suggesting that the program may help equip fellows with the skills, readiness and networks for contribution in a broad array of employment sectors and roles. The findings are a promising signal of the demand for research talent and the growing capacity for LHSs in Canada.

https://www.ijhpm.com/article_4386_70df3ef0a6c3f2a1c484eb1992204e8a.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Health Preparedness and Narrative Rationality: A Call for Narrative Preparedness 1 9 4409 10.34172/ijhpm.2023.7532 EN Eivind Engebretsen Centre for Sustainable Healthcare Education, Faculty of Medicine, University of Oslo, Oslo, Norway Mona Baker Centre for Sustainable Healthcare Education, Faculty of Medicine, University of Oslo, Oslo, Norway 0000-0001-5724-6229 Journal Article 2022 07 16 This conceptual paper argues the need for narrative preparedness, understood as the ability to engage and empathize with peoples’ stories and the values they encode, assess them based on the universe in which people live, and acknowledge the narrative rationality of each story – even when it conflicts with the rationality of science. Expanding ‘health preparedness’ to encompass ‘narrative preparedness’ complements the ideals of patient centeredness, which are sometimes betrayed when implemented into concrete decisions because the rationality of science that underpins medical practice fails to make sense of patients’ stories. We outline the central tenets of narrative preparedness and demonstrate its relevance by discussing various responses to mainstream discourses on COVID-19 as a case in point. We discuss and further develop Fisher’s narrative paradigm, which provides a model that complements traditional, scientific rationality with attention to narrative rationality and a radical democratic ground for health political critique. Applying the narrative paradigm to authentic examples of vaccine hesitancy and anti-vaccination demonstrates how closer attention to the way narratives are assessed by different constituencies might help us mitigate some of the sources of resistance and misunderstanding that continue to plague public communication about important medical issues such as pandemics. Health authorities must acknowledge and engage with the stories people believe in and their reasons for doing so. The crucial question for the success of health policy interventions is not only ‘what are the facts’ but ‘how do these facts make sense to people, and why.’ To be prepared for the next pandemic, health professionals must learn to engage with people’s stories and the processes by which they come to be understood and assessed differently by various constituencies.

https://www.ijhpm.com/article_4409_82f5df5e9605591ace09c78c60db03b0.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 What, Where, and How to Collect Real-World Data and Generate Real-World Evidence to Support Drug Reimbursement Decision-Making in Asia: A reflection Into the Past and A Way Forward 1 9 4398 10.34172/ijhpm.2023.6858 EN Sarin Kc Health Intervention and Technology Assessment Program (HITAP), Ministry of Health, Nonthaburi, Thailand Lydia Wenxin Lin Saw Swee Hock School of Public Health, National University of Singapore (NUS), Singapore, Singapore Diana Beatriz Samson Bayani Saw Swee Hock School of Public Health, National University of Singapore (NUS), Singapore, Singapore Yaroslava Zemlyanska Saw Swee Hock School of Public Health, National University of Singapore (NUS), Singapore, Singapore Amanda Adler The Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford, UK Jeonghoon Ahn Ewha Womans University, Seoul, South Korea Kelvin Chan Sunnybrook Odette Cancer Centre, Toronto, ON, Canada Sunnybrook Research Institute, Toronto, ON, Canada Canadian Centre for Applied Research in Cancer Control, Toronto, ON, Canada Dechen Choiphel Essential Medicine and Technology Division, Department of Medical Services, Ministry of Health, Thimphu, Bhutan Anne Julienne Genuino-Marfori Health Technology Assessment Unit, Department of Health, Quezon City, Philippines Brendon Kearney Faculty of Medicine, University of Adelaide, Adelaide, SA, Australia Health Policy Advisory Committee on Technology, Brisbane, QLD, Australia Yuehua Liu China Health Technology Assessment Centre, National Health Development Research Centre, Ministry of Health, Beijing, China Ryota Nakamura Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan Fiona Pearce Agency for Care Effectiveness, Ministry of Health, Singapore, Singapore Shankar Prinja Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India Raoh-Fang Pwu Taiwan National Hepatitis C Program Office, Ministry of Health and Welfare, Taipei, Taiwan Arsul Akmal Shafie Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia Binyan Sui China Health Technology Assessment Centre, National Health Development Research Centre, Ministry of Health, Beijing, China Auliya Suwantika Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, Indonesia 0000-0001-8671-2065 Sean Tunis Center for Medical Technology Policy (CMTP), Baltimore, MD, USA Hui-Min Wu Taiwan National Hepatitis C Program Office, Ministry of Health and Welfare, Taipei, Taiwan John Zalcberg Cancer Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia Department of Medical Oncology, Alfred Hospital, Melbourne, VIC, Australia Kun Zhao China Health Technology Assessment Centre, National Health Development Research Centre, Ministry of Health, Beijing, China Wanrudee Isaranuwatchai Health Intervention and Technology Assessment Program (HITAP), Ministry of Health, Nonthaburi, Thailand Centre for Excellence in Economic Analysis Research, St. Michael’s Hospital, Toronto, ON, Canada Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada Yot Teerawattananon Health Intervention and Technology Assessment Program (HITAP), Ministry of Health, Nonthaburi, Thailand Saw Swee Hock School of Public Health, National University of Singapore (NUS), Singapore, Singapore Hwee-Lin Wee Saw Swee Hock School of Public Health, National University of Singapore (NUS), Singapore, Singapore Department of Pharmacy, Faculty of Science, National University of Singapore (NUS), Singapore, Singapore Journal Article 2021 10 13 Background Globally, there is increasing interest in the use of real-world data (RWD) and real-world evidence (RWE) to inform health technology assessment (HTA) and reimbursement decision-making. Using current practices and case studies shared by eleven health systems in Asia, a non-binding guidance that seeks to align practices for generating and using RWD/RWE for decision-making in Asia was developed by the REAL World Data In ASia for HEalth Technology Assessment in Reimbursement (REALISE) Working Group, addressing a current gap and needs among HTA users and generators. Methods The guidance document was developed over two face-to-face workshops, in addition to an online survey, a face-to-face interview and pragmatic search of literature. The specific focus was on what, where and how to collect RWD/RWE. Results All 11 REALISE member jurisdictions participated in the online survey and the first in-person workshop, 10 participated in the second in-person workshop, and 8 participated in the in-depth face-to-face interviews. The guidance document was iteratively reviewed by all working group members and the International Advisory Panel. There was substantial variation in: (a) sources and types of RWD being used in HTA, and (b) the relative importance and prioritization of RWE being used for policy-making. A list of national-level databases and other sources of RWD available in each country was compiled. A list of useful guidance on data collection, quality assurance and study design were also compiled. Conclusion The REALISE guidance document serves to align the collection of better quality RWD and generation of reliable RWE to ultimately inform HTA in Asia.

https://www.ijhpm.com/article_4398_1a1cd356710299767cda74bafbba4c45.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Experiences and Implications of the First Wave of the COVID-19 Emergency in Italy: A Social Science Perspective 1 10 4414 10.34172/ijhpm.2023.6871 EN Serena Masino University of Westminster, London, UK Luisa Enria London School of Hygiene and Tropical Medicine, London, UK Journal Article 2021 10 18 Background Italy was among the first countries in the world to experience the devastating consequences of the COVID-19 emergency and suffered its consequences to a devastating scale. Understanding how the country got there in spite of a relatively well-resourced public and private health system in at least part of the country, is imperative to be able to operationalise any lessons learnt for future epidemics in Italy and beyond. Methods The paper reports the findings from a research scoping exercise conducted in Italy in 2020. We conducted extensive archival research and collected 29 testimonies either in writing or as semi-structured interviews. We sampled purposively with a stratification strategy in mind, specifically aiming to gain testimonies from different social groups, classes, ages, and nature of employment. Our sample also reflects the different experiences between the Northern and Southern regions, a divide that has long been economically and politically salient in the country. Results Evidence and considerations of epidemiological nature normally guide public health responses to crises. This study supports the idea that socio-economic, cultural and political factors also affect transmission outcomes. We highlight specifically the role that socio-economic and health inequalities play in this respect, through factors such as overcrowded dwellings, lack of alternatives to in-person work, informal work set-ups, pervasive organised crime presence, poorly planned social support and communication strategies. Conclusion A socio-economic and political lens is needed in addition to an epidemiological one to fully understand the social experiences and implications of public health crises such as the COVID-19 pandemic and to devise effective response measures that are locally relevant and acceptable. Thus insights provided by multi-disciplinary task forces can render policy-making and social support interventions as well as communication strategies more effective.

https://www.ijhpm.com/article_4414_307facc7ee6c12509b30d49ac4edc32f.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Sustaining a New Model of Acute Stroke Care: A Mixed-Method Process Evaluation of the Melbourne Mobile Stroke Unit 1 13 4411 10.34172/ijhpm.2023.7716 EN Kathleen L. Bagot Public Health and Health Services Research, Stroke, The Florey Institute Neuroscience and Mental Health, Heidelberg, University of Melbourne, Melbourne, VIC, Australia Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia Tara Purvis Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia Shaun Hancock Public Health and Health Services Research, Stroke, The Florey Institute Neuroscience and Mental Health, Heidelberg, University of Melbourne, Melbourne, VIC, Australia Henry Zhao Department of Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, Melbourne, VIC, Australia Department of Medicine, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia Austin Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia Ambulance Victoria, Melbourne, VIC, Australia Skye Coote Department of Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, Melbourne, VIC, Australia Department of Medicine, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia Damien Easton Department of Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, Melbourne, VIC, Australia Department of Medicine, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia Bruce CV Campbell Department of Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, Melbourne, VIC, Australia Department of Medicine, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia Ambulance Victoria, Melbourne, VIC, Australia Stroke Foundation, Melbourne, VIC, Australia Stephen M. Davis Department of Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, Melbourne, VIC, Australia Department of Medicine, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia Geoff A. Donnan Public Health and Health Services Research, Stroke, The Florey Institute Neuroscience and Mental Health, Heidelberg, University of Melbourne, Melbourne, VIC, Australia Department of Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, Melbourne, VIC, Australia Department of Medicine, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia Shane Foster Ambulance Victoria, Melbourne, VIC, Australia Francesca Langenberg Department of Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, Melbourne, VIC, Australia Ambulance Victoria, Melbourne, VIC, Australia Karen Smith Ambulance Victoria, Melbourne, VIC, Australia Department of Epidemiology and Preventive Medicine, Department of Paramedicine Monash University, Melbourne, Melbourne, VIC, Australia Discipline of Emergency Medicine, University of Western Australia, Perth, WA, Australia Michael Stephenson Ambulance Victoria, Melbourne, VIC, Australia Department of Epidemiology and Preventive Medicine, Department of Paramedicine Monash University, Melbourne, Melbourne, VIC, Australia Stephen Bernard Ambulance Victoria, Melbourne, VIC, Australia Department of Epidemiology and Preventive Medicine, Department of Paramedicine Monash University, Melbourne, Melbourne, VIC, Australia Sharon McGowan Stroke Foundation, Melbourne, VIC, Australia Bernard Yan Department of Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, Melbourne, VIC, Australia Peter Mitchell Department of Medicine, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia Sandy Middleton St Vincent’s Health Network Sydney, St Vincent’s Hospital Melbourne, Melbourne, VIC, Australia Nursing Research Institute, Australian Catholic University, Melbourne, VIC, Australia Dominique A. Cadilhac Public Health and Health Services Research, Stroke, The Florey Institute Neuroscience and Mental Health, Heidelberg, University of Melbourne, Melbourne, VIC, Australia Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia 0000-0001-8162-682X Journal Article 2022 09 30 Background Internationally, Mobile Stroke Unit (MSU) ambulances have changed pre-hospital acute stroke care delivery. MSU clinical and cost-effectiveness studies are emerging, but little is known about important factors for achieving sustainability of this innovative model of care. Methods Mixed-methods study from the Melbourne MSU (operational since November 2017) process evaluation. Participant purposive sampling included clinical, operational and executive/management representatives from Ambulance Victoria (AV) (emergency medical service provider), the MSU clinical team, and receiving hospitals. Sustainability was defined as ongoing MSU operations, including MSU workforce and future model considerations. Theoretically-based on-line survey with Unified Theory of Acceptance and Use of Technology (UTAUT), Self Determination Theory (SDT, Intrinsic Motivation), and open-text questions targeting barriers and benefits was administered (June-September 2019). Individual/group interviews were conducted, eliciting improvement suggestions and requirements for ongoing use. Descriptive and regression analyses (quantitative data) and directed content and thematic analysis (open text and interview data) were conducted. Results There were 135 surveys completed. Identifying that the MSU was beneficial to daily work (β = 0.61), not experiencing pressure/tension about working on the MSU (β = 0.17) and thinking they did well working within the team model (β = 0.17) were significantly associated with wanting to continue working within the MSU model [R2 = 0.76; F(15, 60) = 12.76, P < .001]. Experiences varied between those on the MSU team and those working with the MSU. Advantages were identified for patients (better, faster care) and clinicians (interdisciplinary learning). Disadvantages included challenges integrating into established systems, and establishing working relationships. Themes identified from 35 interviews were MSU team composition, MSU vehicle design and layout, personnel recruitment and rostering, communication improvements between organisations, telemedicine options, MSU operations and dispatch specificity. Conclusion Important factors affecting the sustainability of the MSU model of stroke care emerged. A cohesive team approach, with identifiable benefits and good communication between participating organisations is important for clinical and operational sustainability.

https://www.ijhpm.com/article_4411_9f74e06dbe7c4f3b7a36f248ba16f31c.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Institutional Variance in Mortality after Percutaneous Coronary Intervention for Acute Myocardial Infarction in Korea, Japan, and Taiwan 1 8 4415 10.34172/ijhpm.2023.6796 EN Hayato Yamana Data Science Center, Jichi Medical University, Shimotsuke, Japan Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan Seyune Lee Institute of Health and Environment, Seoul National University, Seoul, South Korea Yi-Chieh Lin Department of Healthcare Administration, College of Medicine, I-Shou University, Kaohsiung, Taiwan 0000-0002-5630-3540 Nan-He Yoon Division of Social Welfare and Health Administration, Wonkwang University, Iksan, South Korea Kiyohide Fushimi Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School, Tokyo, Japan Hideo Yasunaga Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan Shou-Hsia Cheng Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan Hongsoo Kim Institute of Health and Environment, Seoul National University, Seoul, South Korea Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea Institute of Aging, Seoul National University, Seoul, South Korea SOCIUM - Research Center on Inequality and Social Policy, University of Bremen, Bremen, Germany Journal Article 2021 09 19 Background Although there have been studies that compared outcomes of patients with acute myocardial infarction (AMI) across countries, little focus has been placed on institutional variance of outcomes. The aim of the present study was to compare institutional variance in mortality following percutaneous coronary intervention (PCI) for AMI and factors explaining this variance across different health systems. Methods Data on inpatients who underwent PCI for AMI in 2016 were obtained from the National Health Insurance Data Sharing Service in Korea, the Diagnosis Procedure Combination (DPC) Study Group Database in Japan, and the National Health Insurance Research Database (NHIRD) in Taiwan. Multilevel analyses with inpatient mortality as the outcome and the hierarchical structure of patients nested within hospitals were conducted, adjusting for common patient-level and hospital-level variables. We compared the intraclass correlation coefficient (ICC) and the proportion of variance explained by hospital-level characteristics across the three health systems. Results There were 17 351 patients from 160 Korean hospitals, 29 804 patients from 660 Japanese hospitals, and 10 863 patients from 104 Taiwanese hospitals included in the analysis. Inpatient mortality rates were 6.3%, 7.3%, and 6.0% in Korea, Japan, and Taiwan, respectively. After adjusting for patient and hospital characteristics, Taiwan had the lowest variation in mortality (ICC, 1.8%), followed by Korea (2.2%) and then Japan (4.5%). The measured hospital characteristics explained 38%, 19%, and 9% of the institutional variance in Korea, Taiwan, and Japan, respectively. Conclusion Korea, Japan, and Taiwan had similarly uniform outcomes across hospitals for patients undergoing PCI for AMI. However, Japan had a relatively large institutional variance in mortality and a lower proportion of variation explainable by hospital characteristics, compared with Korea and Taiwan.

https://www.ijhpm.com/article_4415_e9b4aacc6d0a5f679ea300746cfbbe3b.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Commercializing Personal Health Information: A Critical Qualitative Content Analysis of Documents Describing Proprietary Primary Care Databases in Canada 1 11 4430 10.34172/ijhpm.2023.6938 EN Sheryl Spithoff Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada Department of Family and Community Medicine, Women’s College Hospital, Toronto, ON, Canada Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada Quinn Grundy Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada Journal Article 2021 11 12 Background Commercial data brokers have amassed large collections of primary care patient data in proprietary databases. Our study objective was to critically analyze how entities involved in the collection and use of these records construct the value of these proprietary databases. We also discuss the implications of the collection and use of these databases. Methods We conducted a critical qualitative content analysis using publicly available documents describing the creation and use of proprietary databases containing Canadian primary care patient data. We identified relevant commercial data brokers, as well as entities involved in collecting data or in using data from these databases. We sampled documents associated with these entities that described any aspect of the collection, processing, and use of the proprietary databases. We extracted data from each document using a structured data tool. We conducted an interpretive thematic content analysis by inductively coding documents and the extracted data. Results We analyzed 25 documents produced between 2013 and 2021. These documents were largely directed at the pharmaceutical industry, as well as shareholders, academics, and governments. The documents constructed the value of the proprietary databases by describing extensive, intimate, detailed patient-level data holdings. They provided examples of how the databases could be used by pharmaceutical companies for regulatory approval, marketing and understanding physician behaviour. The documents constructed the value of these data more broadly by claiming to improve health for patients, while also addressing risks to privacy. Some documents referred to the trade-offs between patient privacy and data utility, which suggests these considerations may be in tension. Conclusion Documents in our analysis positioned the proprietary databases as socially legitimate and valuable, particularly to pharmaceutical companies. The databases, however, may pose risks to patient privacy and contribute to problematic drug promotion. Solutions include expanding public data repositories with appropriate governance and external regulatory oversight.

https://www.ijhpm.com/article_4430_7fc18ef1d598d62052e8ff052ddb1f2c.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Improving Performance in Complex Surroundings: A Mixed Methods Evaluation of Two Hospital Strategies in the Netherlands 1 12 4428 10.34172/ijhpm.2023.7243 EN Erik Wackers Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands Simone Van Dulmen Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands Bart Berden Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands Jan Kremer Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands 0000-0002-0495-0201 Niek Stadhouders Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands Patrick Jeurissen Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands Journal Article 2022 03 14 Background Hospital strategies aimed at increasing quality of care and simultaneously reducing costs show potential to improve healthcare, but knowledge on real-world effectiveness is limited. In 2014, two Dutch hospitals introduced such quality-driven strategies. Our aim was to evaluate contexts, mechanisms, and outcomes of both strategies using multiple perspectives. Methods We conducted a mixed methods evaluation. Four streams of data were collected and analysed: (1) semistructured interviewing of 62 stakeholders, such as medical doctors, nurses, managers, general practitioners (GPs), and consultants; (2) financial statements of both organisations and other hospitals in the Netherlands (counterfactual); (3) national database of quality indicators, and patient-reported experiences; and (4) existing material on strategy development and effects. Results Both strategies resulted in a relative decrease in volume of care within the hospital, while quality of care has not been affected negatively. One hospital failed to cut operating costs sufficiently, resulting in declining profit margins. We identified six main mechanisms that impacted these outcomes: (1) Quality-improvement projects spur change and commitment; (2) increased coordination between hospital and primary care leads to substitution of care; (3) insufficient use of data and support hinder quality improvement; (4) scaling down hospital facilities is required to convert volume reductions to cost savings; (5) shared savings through global budgets lead to shared efforts between payer and hospital; and (6) financial security for physicians facilitates shift towards quality-driven care. Conclusion This integrated analysis of mixed data sources demonstrated that the institution-wide nature of the strategies has induced a shift from a focus on production towards quality of care. Longer-term (financial) sustainability of hospital strategies aimed at decelerating production growth requires significant efforts in reducing fixed costs. This strategy poses financial risks for the hospital if operating costs are insufficiently reduced or if payer alignment is compromised.

https://www.ijhpm.com/article_4428_580bb95a8089c2effe4d19f0e61b3c4c.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 How Did Governments Address the Needs of People With Disabilities During the COVID-19 Pandemic? An Analysis of 14 Countries’ Policies Based on the UN Convention on the Rights of Persons With Disabilities 1 12 4402 10.34172/ijhpm.2023.7111 EN Keiko Shikako School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada Center for Interdisciplinaire Research in Rehabilitation of the Greater Montreal (CRIR), Montreal, QC, Canada Raphael Lencucha School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada Center for Interdisciplinaire Research in Rehabilitation of the Greater Montreal (CRIR), Montreal, QC, Canada Matthew Hunt School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada Center for Interdisciplinaire Research in Rehabilitation of the Greater Montreal (CRIR), Montreal, QC, Canada Sébastien Jodoin Faculty of Law, McGill University, Montreal, QC, Canada Mayada Elsabbagh Montreal Neurological Institute, McGill University, Montreal, QC, Canada Anne Hudon School of Rehabiltiation, University of Montreal, Montreal, QC, Canada Derrick Cogburn School of International Service and Kogod School of Business, American University, Washington, DC, USA Institute on Disability and Public Policy (IDPP), American University, Washington, DC, USA Ananya Chandra School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada Center for Interdisciplinaire Research in Rehabilitation of the Greater Montreal (CRIR), Montreal, QC, Canada Anna Gignac-Eddy Faculty of Law, McGill University, Montreal, QC, Canada Nilani Ananthamoorthy Faculty of Law, McGill University, Montreal, QC, Canada Rachel Martens Kids Brain Health Network, CanChild, Calgary, AB, Canada Journal Article 2022 01 21 Background People with disabilities have experienced heightened social risks in the context of the pandemic, resulting in higher rates of infection and mortality. They have also borne elevated burdens associated with public health measures. The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) obliges its 184 state parties to eliminate discrimination and ensure equality and inclusion for persons with disabilities, including protection and safety in situations of emergency. It remains unclear to what extent national COVID-19 policies have aligned with these commitments under the UNCRPD. Our objective in this exploratory study was to assess alignment between the UNCRPD indicators and COVID-19 policies from 14 countries with the goal of informing policy development that is inclusive of persons with disabilities and responsive to rights under the UNCRPD. Methods We identified COVID-19 policy documents from 14 purposively selected countries. Country selection considered diversity based on geographic regions and national income levels, with restriction to those countries that had ratified the UNCRPD and had English or French as an official language. We used a computational text mining approach and developed a complex multilevel dictionary or categorization model based on the UNCRPD Bridging the Gap indicators proposed by the Office of the High Commissioner on Human Rights (OHCHR). This dictionary was used to assess the extent to which indicators across the entirety of the UNCRPD were represented in the selected policies. We analyzed frequency of associations with UNCRPD, as well as conducting ‘key word in context’ analyses to identify themes. Results We identified 764 COVID-19 national policy documents from the period of January 2020 to June 2021. When analyzed in relation to the Articles of the UNCRPD, the most frequently identified were Articles 11 (risk and humanitarian emergencies), 23 (home and family), 24 (education), and 19 (community living). Six countries produced 27 policies that were specifically focused on disability. Common themes within these documents included continuation of services, intersectionality and equity, and disability considerations in regulations and public health measures. Conclusion Analyzing country policies in light of the UNCRPD offers important insights about how these policies do and do not align with states’ commitments. As new policies are developed and existing ones revised, more comprehensive approaches to addressing the rights of persons with disabilities are urgently needed.

https://www.ijhpm.com/article_4402_b681c61324300cc8805175adae1ee78d.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Biopharmaceutical Financialization and Public Funding of Medical Countermeasures (MCMs) in Canada During the COVID-19 Pandemic 1 16 4420 10.34172/ijhpm.2023.6936 EN Ipek Eren Vural Department of Political Science & Public Administration, Middle East Technical University, Ankara, Turkey Department of Political Science, Dalhousie University, Halifax, NS, Canada Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada Matthew Herder Health Law Institute, Dalhousie University, Halifax, NS, Canada Agnieszka Doll Department of Pharmacology, Dalhousie University, Halifax, NS, Canada Department of History and Sociology, University of British Columbia Okanagan, BC, Canada Janice E. Graham Department of Pediatrics, Dalhousie University, Halifax, NS, Canada Department of Sociology and Social Anthropology, Dalhousie University, Halifax, NS, Canada Journal Article 2021 11 11 Background Analysing the Canadian government’s efforts to support the development of COVID-19 “medical countermeasures” (MCMs), this article seeks insights into political economy as a driver of pandemic response. We explore whether Canadian public funding policy during the pandemic involved departures from established practices of financialisation in biopharmaceutical research and development (R&D), including the dominance of private sector involvement in an intellectual property (IP) intensive approach to innovation underscoring profit, and governance opacity. Methods We interrogate public funding for MCMs by analyzing how much the Government of Canada (GoC) spent, how those funds were allocated, on what terms, and to whom. We identify the funding institutions, and the funds awarded between February 10, 2020, and March 31, 2021, to support the research, development, and manufacturing of MCMs, including diagnostics, vaccines, therapeutics, and information about clinical management and virus transmission. To collect these data, we conducted searches on the Internet, public data repositories, and filed several requests under the Access to Information Act (1985). Subsequently, we carried out a document-based analysis of electronically accessible research contracts, proposals, grant calls, and policy announcements. Results The GoC announced CAD$ 1.4 billion for research, development and manufacturing of COVID-19 MCMs. Fully 68 (CAD$ 959 million) of the announced public funding was channelled to investment in private sector firms. Canadian public funding showed a consistent focus on early and late stage development of COVID-19 MCMs and the expansion of biopharmaceutical manufacturing capacity. Assessing whether Canada’s investments into developing COVID-19 MCMs safeguard affordable and transparent access to the products of publicly funded research, we found that access policies on IP management, sharing of clinical data, affordability and availability were not systematic, consistent, or transparent, and few, if any, mechanisms ensured long-term sustainability. Conclusion Beyond incremental change in policy goals, such as public investment in domestic biomanufacturing, the features of Canadian public policies endorsing financialization in the biopharmaceutical sector remained largely unchanged during the pandemic.

https://www.ijhpm.com/article_4420_960d355444178ca642c6b891b8f54744.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Power and Other Commercial Determinants of Health: An Empirical Study of the Australian Food, Alcohol, and Gambling Industries 1 14 4439 10.34172/ijhpm.2023.7723 EN Cassandra De Lacy-Vawdon Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia Brian Vandenberg School of Social Sciences, Monash University, Melbourne, VIC, Australia Charles Livingstone School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia 0000-0003-3946-2061 Journal Article 2022 10 03 Background Commercial determinants of health (CDoH) represent a critical frame for exploring undue corporate and commercial influence over health. Power lenses are integral to understanding CDoH. Impacts of food, alcohol, and gambling industries are observable CDoH outcomes. This study aims to inform understanding of the systems and institutions of commercial and/or corporate forces working within the Australian food, alcohol, and gambling industries that influence health and well-being, including broader discourses materialised via these systems and institutions. Methods Twenty semi-structured interviews were conducted with key-informants on Australian public policy processes. Interviewees were current and former politicians, political staff members, regulators and other public servants, industry representatives, lobbyists, journalists, and researchers with expertise and experience of the Australian food, alcohol, and/or gambling industries. Interviews sought participants’ perceptions of Australian food, alcohol, and gambling industries’ similarities and differences, power and influence, relationships, and intervention opportunities and needs. Results Strategies and tactics used by Australian food, alcohol and gambling industries are similar, and similar to those of the tobacco industry. They wield considerable soft (eg, persuasive, preference-shaping) and hard (eg, coercive, political, and legal/economic) power. Perceptions of this power differed considerably according to participants’ backgrounds. Participants framed their understanding of necessary interventions using orthodox neoliberal discourses, including limiting the role of government, emphasising education, consumer freedom, and personal choice. Conclusion Food, alcohol, and gambling industries exercise powerful influences in Australian public policy processes, affecting population health and well-being. Per Wood and colleagues’ framework, these manifest corporate, social, and ecological outcomes, and represent considerable instrumental, structural, and discursive power. We identify power as arising from discourse and material resources alike, along with relationships and complex industry networks. Addressing power is essential for reducing CDoH harms. Disrupting orthodox discourses and ideologies underpinning this should be a core focus of public health (PH) advocates and researchers alike.

https://www.ijhpm.com/article_4439_7e64b0977ebe597c27e6547e21ec8223.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Corporate Political Activity: Taxonomies and Model of Corporate Influence on Public Policy 1 22 4440 10.34172/ijhpm.2023.7292 EN Selda Ulucanlar Tobacco Control Research Group (TCRG), Department for Health, University of Bath, Bath, UK Kathrin Lauber School of Social and Political Science, University of Edinburgh, Edinburgh, UK Alice Fabbri Tobacco Control Research Group (TCRG), Department for Health, University of Bath, Bath, UK Ben Hawkins MRC Epidemiology Unit, University of Cambridge, Cambridge, UK Melissa Mialon Trinity Business School, Trinity College Dublin, Dublin, Ireland 0000-0002-9883-6441 Linda Hancock Alfred Deakin Institute, Deakin University, Melbourne, VIC, Australia 0000-0003-2953-2353 Viroj Tangcharoensathien International Health Policy Programme, Ministry of Public Health, Nonthaburi, Thailand Anna B. Gilmore Tobacco Control Research Group (TCRG), Department for Health, University of Bath, Bath, UK Journal Article 2022 03 29 Background Non-communicable diseases (NCDs) kill 41 million people a year. The products and services of unhealthy commodity industries (UCIs) such as tobacco, alcohol, ultra-processed foods and beverages and gambling are responsible for much of this health burden. While effective public health policies are available to address this, UCIs have consistently sought to stop governments and global organisations adopting such policies through what is known as corporate political activity (CPA). We aimed to contribute to the study of CPA and development of effective countermeasures by formulating a model and evidence-informed taxonomies of UCI political activity. Methods We used five complementary methods: critical interpretive synthesis of the conceptual CPA literature; brief interviews; expert co-author knowledge; stakeholder workshops; testing against the literature. Results We found 11 original conceptualisations of CPA; four had been used by other researchers and reported in 24 additional review papers. Combining an interpretive synthesis of all these papers and feedback from users, we developed two taxonomies – one on framing strategies and one on action strategies. The former identified three frames (policy actors, problem, and solutions) and the latter six strategies (access and influence policy-making, use the law, manufacture support for industry, shape evidence to manufacture doubt, displace, and usurp public health, manage reputations to industry’s advantage). We also offer an analysis of the strengths and weaknesses of UCI strategies and a model that situates industry CPA in the wider social, political, and economic context. Conclusion Our work confirms the similarity of CPA across UCIs and demonstrates its extensive and multi-faceted nature, the disproportionate power of corporations in policy spaces and the unacceptable conflicts of interest that characterise their engagement with policy-making. We suggest that industry CPA is recognised as a corruption of democracy, not an element of participatory democracy. Our taxonomies and model provide a starting point for developing effective solutions.

https://www.ijhpm.com/article_4440_9d32c5d7f36b2cf7e9d42bf84e22ae72.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 The Impact of Prescribing Monitoring Policy on Drug Use and Expenditures in China: A Multi-center Interrupted Time Series Study 1 10 4462 10.34172/ijhpm.2023.7343 EN Xiaoyan Nie Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA Ruilin Wang Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China Guangkai Liang Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China Xinyi Zhang Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China Ningjia Tang Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China Yuchun Cai Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China Congxiao Han Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China Yuxuan Zhao Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China Tong Jia Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China Fang Zhang Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA Sheng Han Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China Xiaodong Guan Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China Luwen Shi Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China 0000-0003-2683-6685 Christine Y. Lu Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA Journal Article 2022 04 20 Background A prescribing monitoring policy (PMP) was implemented in November 2015 in Anhui province, China, the first province to pilot this policy to manage the use and costs of select drugs based on their large prescription volumes and/or costs in hospitals. This study evaluated the impact of PMP on the use and expenditures of different drugs in three tertiary hospitals in Anhui. Methods We obtained monthly drug use and expenditures data from three tertiary hospitals in Anhui (November 2014 through September 2017). An interrupted time series (ITS) design was used to estimate changes in defined daily doses (DDDs per month) and drug expenditures (dollars per month) of policy-targeted and non-targeted drugs after PMP implementation. Drugs were grouped based on whether they were recommended (recommended drugs) by any clinical guidelines or not (non-recommended drugs), or if they were potentially over-used (proton pump inhibitors, PPIs). Results After PMP, DDDs and costs of the targeted PPIs (omeprazole) declined while use of non-targeted PPIs increased correspondingly with overall sustained declines in total PPIs. The policy impact on recommended drugs varied based on whether the targeted drugs have appropriate alternatives. The DDDs and costs of recommended drugs that have readily accessible appropriate alternatives (atorvastatin) declined, which offset increases in its alternative non-target drugs (rosuvastatin), while there was no significant change in those recommended drugs that did not have appropriate alternative drugs (clopidogrel and ticagrelor). Finally, the DDDs and costs of non-recommended drugs decreased significantly. Conclusion PMP policy impact was not the same across different drug groups. PMP did help contain the use and costs of potentially over-used drugs and non-recommended drugs. PMP did not seem to reduce the use of first-line therapeutic drugs recommended by clinical treatment guidelines, especially those lacking alternatives; such drugs are unlikely appropriate candidates for PMP.

https://www.ijhpm.com/article_4462_7fa026eea1dd9d4b7c38461896f18d52.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Factors Associated With In-Hospital Death Among Pneumonia Patients in US Hospitals From 2016~2019 1 7 4472 10.34172/ijhpm.2023.7390 EN Sun Jung Kim Department of Health Administration and Management, College of Medical Science, Soonchunhyang University, Asan, Republic of Korea Center for Healthcare Management Science, Soonchunhyang University, Asan, Republic of Korea Department of Software Convergence, Soonchunhyang University, Asan, Republic of Korea Mar Medina School of Pharmacy, University of Texas at El Paso, El Paso, TX, USA Lixian Zhong Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, College Station, TX, USA Jongwha Chang Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, College Station, TX, USA Journal Article 2022 05 13 Background Pneumonia is one of the leading causes of hospital admission in the United States with a global health burden of about 6.8 million hospitalizations and 1.1 million deaths in patients over 65 years old in 2015. This study aimed to identify possible patient and hospital-related risk factors for in-hospital pneumonia death across US hospitals. Methods The National Inpatient Sample (NIS) was used to identify nationwide pneumonia patients (n = 374 766, weighted n = 1 873 828) from 2016 to 2019. We examined the characteristics of the study sample and their association with in-hospital death. Multivariate survey logistic regression models were used to identify risk factors. Results During the study periods, in-hospital death rates continuously decreased (2.45% in 2016 to 2.19% in 2019). Descriptive statistics showed that patient and hospital factors had varied in-hospital death rates. Survey logistic regression results suggested that male, very low income, non-Medicare, government hospitals, rural hospitals, and specific hospital regions were associated with higher in-hospital death rates than their reference groups. Conclusion Socioeconomic factors, including income and insurance, are associated with pneumonia mortality. Census region, hospital ownership, and rural location are also related to in-hospital mortality. Such findings in underserved, impoverished, and rural areas to identify possible health disparities.

https://www.ijhpm.com/article_4472_0094143e281243898a1f2b594938de15.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Impact of Active Disinvestment on Decision-Making for Surgery in Patients With Subacromial Pain Syndrome: A Qualitative Semi-structured Interview Study Among Hospital Sales Managers and Orthopedic Surgeons 1 13 4482 10.34172/ijhpm.2023.7710 EN Timon H. Geurkink Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands Department of Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands Perla J. Marang-van De Mheen Department of Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands Jochem Nagels Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands Rudolf W. Poolman Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands Rob G.H.H. Nelissen Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands 0000-0003-1228-4162 Leti Van Bodegom-Vos Department of Biomedical Data Sciences, Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands Journal Article 2022 09 29 Background Withdrawal of reimbursement for low-value care through a policy change, ie, active disinvestment, is considered a potentially effective de-implementation strategy. However, previous studies have shown conflicting results and the mechanism through which active disinvestment may be effective is unclear. This study explored how the active disinvestment initiative regarding subacromial decompression (SAD) surgery for subacromial pain syndrome (SAPS) in the Netherlands influenced clinical decision-making around surgery, including the perspectives of orthopedic surgeons and hospital sales managers. Methods We performed 20 semi-structured interviews from November 2020 to October 2021 with ten hospital sales managers and ten orthopedic surgeons from twelve hospitals across the Netherlands as relevant stakeholders in the active disinvestment process. The interviews were video-recorded and transcribed verbatim. Inductive thematic analysis was used to analyse interview transcripts independently by two authors and discrepancies were resolved through discussion. Results Two overarching themes were identified that negatively influenced the effect of the active disinvestment initiative for SAPS. The first theme was that the active disinvestment represented a “Too small piece of the pie” indicating little financial consequences for the hospital as it was merely used in negotiations with healthcare insurers to reduce costs, required a disproportionate amount of effort from hospital staff given the small saving-potential, and was not clearly defined nor enforced in the overall healthcare insurer agreements. The second theme was “They [healthcare insurer] got it wrong,” as the evidence and guidelines had been incorrectly interpreted, the active disinvestment was at odds with clinician experiences and beliefs and was perceived as a reduction in their professional autonomy. Conclusion The two overarching themes and their underlying factors highlight the complexity for active disinvestment initiatives to be effective. Future de-implementation initiatives including active disinvestment should engage relevant stakeholders at an early stage to incorporate their different perspectives, gain support and increase the probability of success.

https://www.ijhpm.com/article_4482_ba79fc761049f89a05b9c0c40fe9c59c.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Global Stillbirth Policy Review – Outcomes And Implications Ahead of the 2030 Sustainable Development Goal Agenda 1 11 4486 10.34172/ijhpm.2023.7391 EN Nana A. Mensah Abrampah Faculty of Epidemiology and Population Health, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK 0000-0003-1749-5401 Yemisrach B. Okwaraji Maternal, Adolescent, Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK Danzhen You Division of Data, Analytics, Planning and Monitoring, UNICEF, New York City, NY, USA Lucia Hug Division of Data, Analytics, Planning and Monitoring, UNICEF, New York City, NY, USA Salome Maswime Global Surgery Division, Department of Surgery, University of Cape Town, Cape Town, South Africa Caroline Pule Global Surgery Division, Department of Surgery, University of Cape Town, Cape Town, South Africa Hannah Blencowe Maternal, Adolescent, Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK Debra Jackson Maternal, Adolescent, Reproductive & Child Health Centre, London School of Hygiene & Tropical Medicine, London, UK School of Public Health, University of the Western Cape, Cape Town, South Africa Journal Article 2022 05 15 Background Globally, data on stillbirth is limited. A call to action has been issued to governments to address the data gap by strengthening national policies and strategies to drive urgent action on stillbirth reduction. This study aims to understand the policy environment for stillbirths to advance stillbirth recording and reporting in data systems. Methods A systematic three-step process (survey tool examination, identifying relevant study questions, and reviewing country responses to the survey and national documents) was taken to review country responses to the global 2018-2019 World Health Organization (WHO) Reproductive, Maternal, Neonatal, Child and Adolescent Health (RMNCAH) Policy Survey. Policy Survey responses were reviewed to identify if and how stillbirths were included in national documents. This paper uses descriptive analyses to identify and describe the relationship between multiple variables. Results Responses from 155 countries to the survey were analysed, and over 800 national policy documents submitted by countries in English reviewed. Fewer than one-fifth of countries have an established stillbirth rate (SBR) target, with higher percentages reported for under-5 (71.0%) and neonatal mortality (68.5%). Two-thirds (65.8%) of countries reported a national maternal death review panel. Less than half (43.9%) of countries have a national policy that requires stillbirths to be reviewed. Two-thirds of countries have a national policy requiring review of neonatal deaths. WHO websites and national health statistics reports are the common data sources for stillbirth estimates. Countries that are signatories to global initiatives on stillbirth reduction have established national targets. Globally, nearly all countries (94.8%) have a national policy that requires every death to be registered. However, 45.5% of reviewed national policy documents made mention of registering stillbirths. Only 5 countries had national policy documents recommending training of health workers in filling out death certificates using the International Classification of Diseases (ICD)-10 for stillbirths. Conclusion The current policy environment in countries is not supportive for identifying stillbirths and recording causes of death. This is likely to contribute to slow progress in stillbirth reduction. The paper proposes policy recommendations to make every baby count.

https://www.ijhpm.com/article_4486_fbb277361d1842ef16b05ed0c891de94.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Characteristics and Distribution of Scholarship Donations From Pharmaceutical Companies to Japanese Healthcare Institutions in 2017: A Cross-sectional Analysis 1 8 4485 10.34172/ijhpm.2023.7621 EN Anju Murayama Tohoku University School of Medicine, Sendai, Japan Sae Kamamoto Medical Governance Research Institute, Tokyo, Japan Hiroaki Saito Department of Internal Medicine, Soma Central Hospital, Soma, Japan Erika Yamashita Medical Governance Research Institute, Tokyo, Japan Yosuke Suzuki Medical Governance Research Institute, Tokyo, Japan Tetsuya Tanimoto Department of Internal Medicine, Navitas Clinic Kawasaki, Kawasaki, Japan Medical Governance Research Institute, Tokyo, Japan Piotr Ozieranski Department of Social and Policy Sciences, University of Bath, Bath, UK Akihiko Ozaki Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Japan Journal Article 2022 08 16 Background Financial relationships between healthcare institutions and pharmaceutical companies can lead to conflicts of interest (COIs), potentially compromising patients’ care. In Japan, scholarship donations, unique type of payments made to healthcare institutions and their subunits by pharmaceutical industries without restricting their use including non-educational or research purpose, may often have implicit promotional purposes. However, detailed information about these payments remains scarce. Methods This study employed a cross-sectional design to analyse the extent and distribution of all scholarship donations made by all 73 pharmaceutical companies belonging to the Japan Pharmaceutical Manufacturers Association (JPMA) to healthcare institutions in 2017. Data were obtained from publicly available sources from the companies, and the total number of payments, their distributions across various institutions and specialties were analysed. Results A total of 27 007 payment contracts amounting to $178 703 721 in scholarship donations were made to 4839 specific departments and laboratories at 251 different institutions by 67 pharmaceutical companies. National universities received 50.8% of total payments. All universities setting medical school in Japan received one or more payments. Domestic pharmaceutical companies contributed to $137 797 302 (77.1%) in total. Clinical medicine departments received 89.6% ($160 113 147) with 6.2% ($11 011 946) and 2.0% ($3 600 456) allocated to basic medicine and social medicine specialties, respectively. Conclusion This study provided a comprehensive overview of scholarship donations from pharmaceutical companies to healthcare institutions in Japan, revealing significant financial support primarily directed to national universities and clinical medicine departments. Japanese policy-makers should consider implementing regulations that promote transparency and mitigate potential COIs arising from scholarship donations, which may be useful in other countries with similar schemes.

https://www.ijhpm.com/article_4485_5f1db279a889af62fa69b161820480e1.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Effects of the Long-term Care Insurance on Health Among Older Adults: A Panel Data From China 1 8 4495 10.34172/ijhpm.2023.7664 EN Xin Ye Institute for Global Public Policy, Fudan University, Shanghai, China LSE-Fudan Research Centre for Global Public Policy, Fudan University, Shanghai, China Mingzheng Hu School of Public Health, Peking University, Beijing, China China Center for Health Development Studies, Peking University, Beijing, China Hugo Lin CentraleSupélec, Paris-Saclay University, Paris, France Journal Article 2022 09 01 Background China’s long-term care insurance (LTCI) has been launched since 2016 to ensure that older disabled people obtain affordable care services. However, rigorous evaluations of the health effects of China’s LTCI pilots have been limited. This paper aimed to examine the effects of LTCI on health among older adults aged 60 years and above. Methods Drawing from panel data of the China Health and Retirement Longitudinal Study (CHARLS), we used a propensity score matching (PSM) and difference-in-difference (DID) approach to identify the health effects of the LTCI program and reduce the selection bias. Further, heterogeneity of the effects was examined by physical and intellectual function to evaluate whether the effects differed among subgroups of older population. Results The implementation of LTCI significantly improved self-rated health (β = 0.15, P < .05) and cognitive function (β = 0.59, P < .01) for older adults. The results were robust when keeping only those living in pilot cities (β = 0.31, P < .05 for self-rated health status; β = 0.98, P < .001 for cognitive function) or non-pilot cities (β = 0.14, P < .05 for self-rated health status; β = 0.60, P < .01 for cognitive function) as the control group. The effects of LTCI were especially manifested in older adults with physical disability (β = 0.13, P < .01 for self-rated health; β = 0.76, P < .001 for cognitive function) or intellectual disability (β = 0.16, P < .01 for self-rated health). Conclusion From a policy perspective, these findings suggested that LTCI in China could benefit the health outcomes of older adults, especially those with physical or cognitive disabilities. Policy-makers can target resources more effectively to improve health outcomes for the most vulnerable populations.

https://www.ijhpm.com/article_4495_c0c4b5a17713a694ce089b742331e70a.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Scaling-Up eConsult: Promising Strategies to Address Enabling Factors in Four Jurisdictions in Canada 1 13 4494 10.34172/ijhpm.2023.7203 EN Mylaine Breton Centre de recherche Charles-Le Moyne, Université de Sherbrooke, Longueuil, QC, Canada Catherine Lamoureux-Lamarche Centre de recherche Charles-Le Moyne, Université de Sherbrooke, Longueuil, QC, Canada Mélanie Ann Smithman Centre de recherche Charles-Le Moyne, Université de Sherbrooke, Longueuil, QC, Canada Erin Keely Department of Medicine, University of Ottawa, Division of Endocrinology/Metabolism, The Ottawa Hospital, Ottawa, ON, Canada Maxine Dumas Pilon Collège québécois des médecins de famille, Family Medicine Center, St-Mary’s Hospital, McGill University, Montréal, QC, Canada Alexander Singer Department of Family Medicine, University of Manitoba, Winnipeg, MN, Canada Gerard Farrell Department of Family Medicine, Memorial University, St. John, NL, Canada Paula Louise Bush Department of Family Medicine, McGill University, Montréal, QC, Canada Catherine Hudon Centre de recherche du CHUS, Université de Sherbrooke, Sherbrooke, QC, Canada Lynn Cooper Canadian Injured Workers Alliance, Thunder Bay, ON, Canada Véronique Nabelsi Département des sciences administratives, Université du Québec en Outaouais, Gatineau, QC, Canada Élizabeth Côté-Boileau Centre de recherche Charles-Le Moyne, Université de Sherbrooke, Longueuil, QC, Canada Justin Gagnon Department of Family Medicine, McGill University, Montréal, QC, Canada Isabelle Gaboury Centre de recherche Charles-Le Moyne, Université de Sherbrooke, Longueuil, QC, Canada Carolyn Steele Gray Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum, Research Institute, Sinai Health System, University of Toronto, Institute of Health Policy, Management and Evaluation, Toronto, ON, Canada Marie-Pierre Gagnon Faculté des sciences infirmières, Université Laval, Québec City, QC, Canada Regina Visca Department of Family Medicine, McGill University, Montréal, QC, Canada Clare Liddy Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada C.T. Lamont Primary Health Care Research Center, Bruyère Research Institute, Ottawa, ON, Canada Journal Article 2022 02 25 Background Effective healthcare innovations are often not scaled up beyond their initial local context. Lack of practical knowledge on how to move from local innovations to large-system improvement hinders innovation and learning capacity in health systems. Studying scale-up processes can lead to a better understanding of how to facilitate the scale-up of interventions. eConsult is a digital health innovation that aims to connect primary care professionals with specialists through an asynchronous electronic consultation. The recent implementation of eConsult in the public health systems of four Canadian jurisdictions provides a unique opportunity to identify different enabling strategies and related factors that promote the scaling up of eConsult across jurisdictions. Methods We conducted a narrative case study in four Canadian provinces, Quebec, Ontario, Manitoba, and Newfoundland & Labrador, over a 3-year period (2018–2021). We observed provincial eConsult committee meetings (n = 65) and national eConsult forums (n = 3), and we reviewed internal documents (n = 93). We conducted semistructured interviews with key actors in each jurisdiction (eg, researchers, primary care professionals, specialists, policy-makers, and patient partners) (n = 40). We conducted thematic analysis guided by the literature on factors and strategies used to scale up innovations. Results We identified a total of 31 strategies related to six key enabling factors to scaling up eConsult, including: (1) multi-actor engagement; (2) relative advantage; (3) knowledge transfer; (4) strong evidence base; (5) physician leadership; and (6) resource acquisition (eg, human, material, and financial resources). More commonly used strategies, such as leveraging research infrastructure and bringing together various actors, were used to address multiple enabling factors. Conclusion Actors used various strategies to scale up eConsult within their respective contexts, and these helped address six key factors that seemed to be essential to the scale-up of eConsult.

https://www.ijhpm.com/article_4494_32589f4ce4a6b738d34b3cd1b8c4a590.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Impact of COVID-19 on Utilisation of Funds by People With Disabilities: Lessons Drawn From the Australian National Disability Insurance Scheme 1 11 4491 10.34172/ijhpm.2023.7663 EN Yu Zhang School of Business, University of New South Wales, Canberra, ACT, Australia Satish Chand School of Business, University of New South Wales, Canberra, ACT, Australia Journal Article 2022 09 01 Background COVID-19 pandemic has affected everyone, especially people with disabilities (PwD). While there has been qualitative research on the impact of the pandemic on PwD in Australia, little quantitative evidence has been produced on the magnitude of this impact. Methods A range of descriptive analytic methods are employed on the data merged from the National Disability Insurance Scheme (NDIS) and COVID-19 data on national, state, and regional levels to compare the expenditure of the NDIS participants who are in pandemic-affected regions and time periods with those that are not. Regression analysis is also performed to estimate the participants’ utilisation of funds using explanatory variables drawn from the NDIS, COVID-19, and lockdown policy information. Results Our analysis reveals that: (1) the pandemic reduced expenditure of the NDIS participants by approximately A$ 31.2 million, equal to 8.85% of the total expenditure over five quarters for the state of Victoria (VIC) alone; (2) the contractions in expenditure lasted for up to two quarters during the pandemic; (3) the reductions in expenditure were largely associated with the limited mobility imposed via lockdowns compared to the impaired access to services; and (4) the spread of COVID-19 that led to restrictions on mobility of people had a bearing on utilisation of funds by NDIS participants in the subsequent quarter. Conclusion COVID-19 has affected the expenditure of the PwD in Australia. We overlaid the NDIS data on the COVID-19 outbreaks to estimate the impact of the pandemic on expenditure and utilisation rate of the funds allocated to the NDIS participants. Our findings point to potential policy interventions to mitigate some of the adverse consequences of similar nationwide emergencies.

https://www.ijhpm.com/article_4491_074182c3828030fbe54e7542c852ad80.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Women Consumers’ Views on Legislation to Restrict Prominent Placement and Multibuy Promotions of High Fat, Sugar, and Salt Products in England: A Qualitative Perspective 1 9 4492 10.34172/ijhpm.2023.7597 EN Preeti Dhuria Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK 0000-0003-2803-4424 Sarah Muir Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK Wendy Lawrence Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK Emma Roe School of Geography and Environmental Science, University of Southampton, Southampton, UK Sarah Crozier Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, Southampton, UK Cyrus Cooper Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK Janis Baird Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, Southampton, UK Christina Vogel Centre for Food Policy, City, University of London, London, UK Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, Southampton, UK 0000-0002-3897-3786 Journal Article 2022 08 05 Background As part of the childhood obesity strategy, the UK Government has introduced regulations to restrict the ways high fat salt and sugar (HFSS) products can be promoted in retail settings from October 2022. This study explored (i) consumers’ views on the likely impact of the UK legislation restricting the placement and promotion of HFSS products on their shopping behaviours and (ii) consumers’ beliefs about who is responsible for healthy eating. Methods Using a cross-sectional study design, qualitative semi-structured telephone interviews were conducted with a purposive sample of women who shopped at a discount supermarket. Thematic analysis was employed to identify key themes. Results Participants’ (n = 34) had a median age of 35 years and over half were in paid employment. Five themes were identified: (1) The legislation is acceptable, but people can still (and should be able to) buy HFSS items; (2) The legislation is likely to have more impact on shoppers who do not plan their shopping; (3) Affordability of healthy food is just as, or more, important than the legislation; (4) It’s up to the individual to eat healthily; and (5) Government and retailers can better support consumers to make healthy choices. Conclusion Most participants were optimistic about the incoming regulations and believed that it would support consumers to make healthier food choices. Many raised concerns, however, that the high price of healthy foods and continued availability of unhealthy foods within the stores could undermine the legislation’s benefits. Coupling the legislation with interventions to promote and reduce the costs of healthier products would go some way to ensure its success. Raising awareness about marketing strategies that play into consumer concerns for cost and autonomy could further increase acceptance of the policy.

https://www.ijhpm.com/article_4492_13e654bdeedac529d1473e9a0958927c.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Measuring Active Purchasing in Healthcare: Analysing Reallocations of Funds Between Providers to Evaluate Purchasing Systems Performance in the Netherlands 1 12 4500 10.34172/ijhpm.2023.7506 EN Niek Waltherus Stadhouders Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Medical Center, Nijmegen, The Netherlands Xander Koolman School of Business and Economics, Vrije Universiteit, Amsterdam, The Netherlands 0000-0003-4225-8854 Marit A.C. Tanke Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Medical Center, Nijmegen, The Netherlands Hans Maarse Department of Health Services Research, School for Public Health and Primary Care (Caphri), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands Patrick P.T. Jeurissen Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Medical Center, Nijmegen, The Netherlands Journal Article 2022 07 01 Background Purchasing systems aim to improve resource allocation in healthcare markets. The Netherlands is characterized by four different purchasing systems: managed competition in the hospital market, a non-competitive single payer system for long-term care (LTC), municipal procurement for home care and social services, and selfprocurement via personal budgets. We hypothesize that managed competition and competitive payer reforms boost reallocations of provider market share by means of active purchasing, ie, redistributing funds from high-quality providers to low-quality providers. Methods We define a Market Activity Index (MAI) as the sum of funds reallocated between providers annually. Provider expenditures are extracted from provider financial statements between 2006 and 2019. We compare MAI in six healthcare sectors under four different purchasing systems, adjusting for reforms, and market entry/exit. Next, we perform in-depth analyses on the hospital market. Using multivariate linear regressions, we relate reallocations to selective contracting, provider quality, and market characteristics. Results No difference was found between reallocations in the hospital care market under managed competition and the non-competitive single payer LTC (MAI between 2% and 3%), while MAI was markedly higher under procurement by municipalities and personal budget holders (between 5% and 15%). While competitive reforms temporarily increased MAI, no structural effects were found. Relatively low hospital MAI could not be explained by market characteristics. Furthermore, the extent of selective contracting or hospital quality differences had no significant effects on reallocations of funds. Conclusion Dutch managed competition and competitive purchaser reforms had no discernible effect on reallocations of funds between providers. This casts doubt on the mechanisms advocated by managed competition and active purchasing to improve allocative efficiency.

https://www.ijhpm.com/article_4500_92cb73cf33c4987b1902f0f0ebc752d7.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Using System Dynamics to Understand Transnational Corporate Power in Diet-Related Non-communicable Disease Prevention Policy-Making: A Case Study of South Africa 1 13 4501 10.34172/ijhpm.2023.7641 EN Penelope Milsom Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK Andrada Tomoaia-Cotisel RAND Corporation, Santa Monica, CA, USA Richard Smith College of Medicine and Health, University of Exeter, Exeter, UK 0000-0003-3837-6559 Simon Moeketsi Modisenyane Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK Helen Walls Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK Journal Article 2022 08 23 Background: Complex interactions between political economy factors and corporate power are increasingly recognized to prevent transformative policy action on non-communicable disease (NCD) prevention. System science offers promising methods for analysing such causal complexity. This study uses qualitative system dynamics methods to map the political economy of diet-related NCD (DR-NCD) prevention policy-making aiming to better understand the policy inertia observed in this area globally. Methods We interviewed 25 key policy actors. We analysed the interviews using purposive text analysis (PTA). We developed individual then combined casual loop diagrams to generate a shared model representing the DR-NCD prevention policy-making system. Key variables/linkages identified from the literature were also included in the model. We validated the model in several steps including through stakeholder validation interviews. Results We identified several inter-linked feedback processes related to political economy factors that may entrench different forms of corporate power (instrumental, structural, and discursive) in DR-NCD prevention policy-making in South Africa over time. We also identified a number of feedback processes that have the potential to limit corporate power in this setting. Conclusion Using complex system methods can be useful for more deeply understanding DR-NCD policy inertia. It is also useful for identifying potential leverage points within the system which may shift the existing power dynamics to facilitate greater political commitment for healthy, equitable, and sustainable food system transformation.

https://www.ijhpm.com/article_4501_609d07297dc91d0299b8d65bdfc0129d.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Impact of China’s National Volume-Based Procurement on Drug Procurement Price, Volume, and Expenditure: An Interrupted Time Series Analysis in Tianjin 1 10 4498 10.34172/ijhpm.2023.7724 EN Boya Zhao School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China Center for Social Science Survey and Data, Tianjin University, Tianjin, China Jing Wu School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China Center for Social Science Survey and Data, Tianjin University, Tianjin, China Journal Article 2022 10 03 Background National Volume-Based Procurement (NVBP) program has been carried out in China to lower drug prices and reduce patients’ medication burden. This study aims to evaluate its impact on drug purchasing in Tianjin city, one of the first 11 cities piloting NVBP in China. Methods Using monthly drug procurement data from Tianjin Medical Purchasing Center between 2018 and 2020, this study identified bid-winning drugs and their alternative drugs in the pilot NVBP, and evaluated the policy impacts on their procurement price (cost of defined daily dose, DDDc), volume (the number of defined daily dose, DDDs), and expenditure, during the first (initiated at April 1, 2019) and second (initiated at April 25, 2020) procurement cycles of pilot NVBP, applying interrupted time series (ITS) analysis. Included drugs were classified into 12 pharmacological subgroups for further analysis. Results Decrease in DDDc of NVBP-covered drugs (bid-winning and non-winning drugs) were observed in the first (level change: -CNY 3.878/DDD, P < .001; trend change: -CNY 0.068/DDD, P = .001; relative change: -61.55%) and second (level change: -CNY 0.356/DDD, P = .049) procurement cycles of pilot NVBP, while no significant change was observed for the DDDc of alternative drugs, except for the increase in antidiarrheic and anti-inflammatory/antirheumatic subgroups as more expensive drugs were purchased from new suppliers in the second procurement cycle. The DDDs of bid-winning drugs significantly increased, while decreased for the non-winning original and generic drugs. Procurement expenditure was saved for NVBP-covered drugs (level change: -CNY 7.29×107, P < .001; trend change: CNY 5.62×106, P < .001; relative change: -62.60%). However, during the second procurement cycle, procurement volume and expenditure of alternative drugs increased significantly in 7 out of 12 subgroups. Conclusion The pilot NVBP policy in China reduced procurement price, promoted generic substitution, and saved procurement expenditure. However, the increase in procurement price, volume and expenditure of alternative drugs may reveal the significance of regulating healthcare institutions’ drug purchasing behavior.

https://www.ijhpm.com/article_4498_1b2e3b33a5c6245f042aba5c9e499319.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 The Macroeconomic Impact of Increasing Investments in Malaria Control in 26 High Malaria Burden Countries: An Application of the Updated EPIC Model 1 8 4505 10.34172/ijhpm.2023.7132 EN Edith Patouillard Department of Health Financing and Economics, World Health Organization, Geneva, Switzerland Seoni Han Korea Institute for International Economic Policy, Sejong, Korea Jeremy Lauer Strathclyde Business School, University of Strathclyde, Glasgow, UK Mara Barschkett Federal Institute for Population Research and Department of Public Economics, German Institute of Economic Research (DIW Berlin), Berlin, Germany Jean-Louis Arcand Global Development Network, New Delhi, India Mohammed VI Polytechnic University, Rabat, Morocco Foundation for Studies and Research on International Development (FERDI), Clermont Ferrand, France Journal Article 2022 01 27 Background Malaria remains a major public health problem. While globally malaria mortality affects predominantly young children, clinical malaria affects all age groups throughout life. Malaria not only threatens health but also child education and adult productivity while burdening government budgets and economic development. Increased investments in malaria control can contribute to reduce this burden but have an opportunity cost for the economy. Quantifying the net economic value of investing in malaria can encourage political and financial commitment. Methods We adapted an existing macroeconomic model to simulate the effects of reducing malaria on the gross domestic product (GDP) of 26 high burden countries while accounting for the opportunity costs of increased investments in malaria. We compared two scenarios differing in their level of malaria investment and associated burden reduction: sustaining malaria control at 2015 intervention coverage levels, time at which coverage levels reached their historic peak and scaling-up coverage to reach the 2030 global burden reduction targets. We incorporated the effects that reduced malaria in children and young adolescents may have on the productivity of working adults and on the future size of the labour force augmented by educational returns, skills, and experience. We calibrated the model using estimates from linked epidemiologic and costing models on these same scenarios and from published country-specific macroeconomic data. Results Scaling-up malaria control could produce a dividend of US$ 152 billion in the modelled countries, equivalent to 0.17% of total GDP projected over the study period across the 26 countries. Assuming a larger share of malaria investments is paid out from domestic savings, the dividend would be smaller but still significant, ranging between 0.10% and 0.14% of total projected GDP. Annual GDP gains were estimated to increase over time. Lower income and higher burden countries would experience higher gains. Conclusion Intensified malaria control can produce a multiplied return despite the opportunity cost of greater investments.

https://www.ijhpm.com/article_4505_a9be338d6191c661315fc5fd3930dc04.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Examining the Long-term Spillover Effects of a Pay-forPerformance Program in a Healthcare System That Lacks Referral Arrangements 1 9 4499 10.34172/ijhpm.2023.7571 EN Chi-Chen Chen Department of Public Health, College of Medicine, Fu-Jen Catholic University, Taipei, Taiwan Kuo-Liong Chien Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan Department of Internal Medicine, National Taiwan University, Taipei, Taiwan Population Health Research Center, National Taiwan University, Taipei, Taiwan Shou-Hsia Cheng Population Health Research Center, National Taiwan University, Taipei, Taiwan Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan Journal Article 2022 07 26 Background Several studies have examined the intended effects of pay-for-performance (P4P) programs, yet little is known about the unintended spillover effects of such programs on intermediate clinical outcomes. This study examines the long-term spillover effects of a P4P program for diabetes care. Methods This study uses a nationwide population-based natural experimental design with a 3-year follow-up period under Taiwan’s universal coverage healthcare system. The intervention group consisted of 7688 patients who enrolled in the P4P program for diabetes care in 2017 and continuously participated in the program for three years. The comparison group was selected by propensity score matching (PSM) from patients seen by the same group of physicians. Each patient had four records: one pertaining to one year before the index date of the P4P program and the other three pertaining to follow-ups spanning over the next three years. Generalized estimating equations (GEEs) with difference-in-differences (DID) estimations were used to consider the correlation between repeated observations for the same patients and patients within the same matched pairs. Results Patients enrolled in the P4P program showed improvements in incentivized intermediate clinical outcomes that persisted over three years, including proper control of glycated hemoglobin (HbA1c) and low-density lipoprotein cholesterol (LDL-C). We found a slight positive spillover effect of the P4P program on the control of non-incentivized triglyceride [TG]). However, we found no such effects on the non-incentivized high-density lipoprotein cholesterol (HDL-C) control. Conclusion The P4P program has achieved its primary goal of improving the incentivized intermediate clinical outcomes. The commonality in production among a set of activities is crucial for generating the spillover effects of an incentive program.

https://www.ijhpm.com/article_4499_0b204aac8bd45f223b98360cdf8d9281.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 How the Stringency of the COVID-19 Restrictions Influences Motivation for Adherence and Well-Being: The Critical Role of Proportionality 1 13 4509 10.34172/ijhpm.2023.8021 EN Joachim Waterschoot Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium Sofie Morbée Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium Omer Van Den Bergh Health Psychology, Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium Vincent Yzerbyt Institute for Research in the Psychological Sciences, Université Catholique de Louvain, Louvain-la-Neuve, Belgium 0000-0003-1185-4733 Eveline Raemdonck Faculty of Psychological Sciences and Education, Université libre de Bruxelles, Bruxelles, Belgium Marie Brisbois Institute for Research in the Psychological Sciences, Université Catholique de Louvain, Louvain-la-Neuve, Belgium Mathias Schmitz Institute for Research in the Psychological Sciences, Université Catholique de Louvain, Louvain-la-Neuve, Belgium Olivier Klein Faculty of Psychological Sciences and Education, Université libre de Bruxelles, Bruxelles, Belgium Olivier Luminet Institute for Research in the Psychological Sciences, Université Catholique de Louvain, Louvain-la-Neuve, Belgium Fund for Scientific Research (FRS-FNRS), Brussels, Belgium Pascaline Van Oost Institute for Research in the Psychological Sciences, Université Catholique de Louvain, Louvain-la-Neuve, Belgium Maarten Vansteenkiste Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium Journal Article 2023 03 11 Background The stringency of the measures taken by governments to combat the COVID-19 pandemic varied considerably across countries and time. In the present study, we examined how the proportionality to the epidemiological situation is related to citizens’ behavior, motivation and mental health. Methods Across 421 days between March 2020 and March 2022, 273 722 Belgian participants (M age = 49.47; 63.9% female; 33% single) completed an online questionnaire. Multiple linear mixed regression modeling was used to examine the interaction between the epidemiological situation, as indicated by the actual hospitalization numbers, and the stringency index to predict day-to-day variation in the variables of interest. Results Systematic evidence emerged showing that disproportional situations, as opposed to proportional situations, were associated with a clear pattern of maladaptive outcomes. Specifically, when either strict or lenient measures were disproportional in relation to the epidemiological situation, people reported lower autonomous motivation, more controlled motivation and amotivation, less adherence to sanitary rules, higher perceived risk of infection, lower need satisfaction, and higher anxiety and depressive symptoms. Perceived risk severity especially covaried with the stringency of the measures. At the absolute level, citizens reported the highest need satisfaction and mental health during days with proportional lenient measures. Conclusion Stringent measures are not per se demotivating or compromising of people’s well-being, nor are lenient measures as such motivating or enhancing well-being. Only proportional measures, that is, measures with a level of stringency that is aligned with the actual epidemiological situation, are associated with the greatest motivational, behavioral, and mental health benefits.

https://www.ijhpm.com/article_4509_c2c5588922eddd9a208b82e03385694a.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Factors Associated With Emergency Department Visits Among Patients Receiving Publicly-Funded Homecare Services: A Retrospective Chart Review From Southern Taiwan Regional Hospital 1 8 4511 10.34172/ijhpm.2023.7377 EN Wen-Yi Chiu Department of Family Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan The Master Program of Long-Term Care in Aging, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan Ta-Chuan Yeh Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan Chia-Chi Yang The Master Program of Long-Term Care in Aging, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan Center for Long-Term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan Journal Article 2022 06 13 Background The public health strategy of increasing access to comprehensive home or community-based healthcare services and emergency home visits is intent on reducing the overcrowding of emergency departments (EDs). However, scientific evidence regarding the association between home-based healthcare services and ED uses is surprisingly insufficient and controversial so far. The present retrospective study identified the risk factors for ED visits among patients receiving publicly-funded homecare services. Methods The personal demographic and medical information, caregiver characteristics, and behaviours related to homecare services and ED visits from the medical records and structured questionnaires of 108 patients who were recipients of integrated homecare services in a regional hospital in southern Taiwan between January 1, 2020, and December 31, 2020, were collected. After screening the potential predictor variables using the preliminary univariate analyses, the multivariate logistic regression with best subset selection approach was conducted to identify best combination of determinants to predict unplanned ED utilizations. Results Best subset selection regression analysis showed Charlson Comorbidity Index (odds ratio [OR] = 1.33, 95% CI = 1.05 to 1.70), male caregiver (OR = 0.18, 95% CI = 0.05 to 0.66), duration of introducing homecare services (OR = 0.97, 95% CI = 0.95 to 1.00), working experience of dedicated nurses (OR = 0.89, 95% CI = 0.79 to 0.99) and number of ED utilizations within previous past year before enrollment (OR = 1.54, 95% CI = 1.14 to 2.10) as significant determinants for unplanned ED visits. Conclusion The present evidence may help government agencies propose supportive policies to improve access to integrated homecare resources and promote appropriate care recommendations to reduce unplanned or nonurgent ED visits among patients receiving homecare services.

https://www.ijhpm.com/article_4511_4e3ece59c01932b0f1d7e5d26d100999.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Implementation of Medicines Pricing Policies in Ghana: The Interplay of Policy Content, Actors’ Participation, and Context 1 12 4510 10.34172/ijhpm.2023.7994 EN Augustina Koduah Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, University of Ghana, Legon, Ghana Leonard Baatiema Department of Health Policy, Planning & Management, School of Public Health, University of Ghana, Legon, Ghana Irene A. Kretchy Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, University of Ghana, Legon, Ghana Irene Akua Agyepong Public Health Faculty, Ghana College of Physicians and Surgeons, Accra, Ghana Anthony Danso-Appiah Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon, Ghana 0000-0003-1747-0060 Anna Cronin De Chavez London School of Hygiene and Tropical Medicine, London, UK Timothy Ensor Nuffield Centre for International Health, University of Leeds, Leeds, UK Tolib Mirzoev Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK Journal Article 2023 02 27 Background Implementing medicines pricing policy effectively is important for ensuring equitable access to essential medicines and ultimately achieving universal health coverage. However, published analyses of policy implementations are scarce from low- and middle-income countries (LMICs). This paper contributes to bridging this knowledge gap by reporting analysis of implementation of two medicines pricing policies in Ghana: value-added tax (VAT) exemptions and framework contracting (FC) for selected medicines. We analysed implications of actor involvements, contexts, and contents on the implementation of these policies, and the interplay between these. This paper should be of interest, and relevance, to policy designers, implementers, the private sector and policy analysts. Methods Data were collected through document reviews (n = 18), in-depth interviews (IDIs) (n = 30), focus group discussions (FGDs) (n = 2) and consultative meetings (n = 6) with purposefully identified policy actors. Data were analysed thematically, guided by the four components of the health policy triangle framework. Results The nature and complexity of policy contents determined duration and degree of formality of implementation processes. For instance, in the FC policy, negotiating medicines prices and standardizing the tendering processes lengthened implementation. Highly varied stakeholder participation created avenues for decision-making and promoted inclusiveness, but also raised the need to manage different agendas and interests. Key contextual enablers and constraints to implementation included high political support and currency depreciation, respectively. The interrelatedness of policy content, actors, and context influenced the timeliness of policy implementations and achievement of intended outcomes, and suggest five attributes of effective policy implementation: (1) policy nature and complexity, (2) inclusiveness, (3) organizational feasibility, (4) economic feasibility, and (5) political will and leadership. Conclusion Varied contextual factors, active participation of stakeholders, nature, and complexity of policy content, and structures have all influenced the implementation of medicines pricing policies in Ghana.

https://www.ijhpm.com/article_4510_6386117791bed758a763232677fd3eb9.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Adaptive Mechanisms of Health Zones to Chronic Traumatic Events in Eastern DRC: A Multiple Case Study 1 10 4514 10.34172/ijhpm.2023.8001 EN Samuel Lwamushi Makali Ecole Régionale de Santé Publique, Faculté de Médecine, Université Catholique de Buka-vu, Bukavu, Democratic Republic of the Congo Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo 0000-0003-3538-1715 Hermès Karemere Ecole Régionale de Santé Publique, Faculté de Médecine, Université Catholique de Buka-vu, Bukavu, Democratic Republic of the Congo Robert Banywesize Division Provinciale de la santé du Sud-Kivu, Bukavu, Democratic Republic of the Congo Christian Molima Eboma Ecole Régionale de Santé Publique, Faculté de Médecine, Université Catholique de Buka-vu, Bukavu, Democratic Republic of the Congo Pacifique Mwene-Batu Ecole Régionale de Santé Publique, Faculté de Médecine, Université Catholique de Buka-vu, Bukavu, Democratic Republic of the Congo Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo Corneille Lembebu Ecole Régionale de Santé Publique, Faculté de Médecine, Université Catholique de Buka-vu, Bukavu, Democratic Republic of the Congo Giovanfrancesco Ferrari Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland Elisabeth Paul Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium Ghislain Bisimwa Balaluka Ecole Régionale de Santé Publique, Faculté de Médecine, Université Catholique de Buka-vu, Bukavu, Democratic Republic of the Congo Philippe Donnen Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium Journal Article 2023 03 02 Background The Eastern part of the Democratic Republic of Congo (DRC) has been affected by armed conflict for several years. Despite the growing interest in the impact of these conflicts on health service utilisation, few studies have addressed the coping mechanisms of the health system. The purpose of this study is to describe the traumatic events and coping mechanisms used by the health zones (HZs) in conflict settings to maintain good performance. Methods This multiple case study took place from July to October 2022 in four HZs in the South Kivu province of DRC. HZs were classified into “cases” according to their conflict profile: accessible and stable (Case 1), accessible but remote (Case 2), unstable (Case 3), and intermediate (Case 4). Eight performance indicators and the amount of funding provided to the HZs by non-governmental organisations (NGOs) were recorded. A graph was created to compare their evolution from 2013 to 2018. A thematic analysis of qualitative data from individual interviews with selected health workers was conducted. Results Both battle-related events (war and its effects) and non-battle-related events (epidemics, disasters, and strikes) were recorded according to the case conflict-profile. Although the cases (3 and 4) most affected by armed conflicts occasionally performed better than the stable ones (1 and 2), their operational action plan was poorly carried out. The coping mechanisms developed in cases 3 and 4 were the deployment of military nurses in preventive and supervisory activities, the solicitations of subsidies from NGOs, the relocation of healthcare facilities and the implementation of negotiation strategies with the belligerents. Conclusion Armed conflict results in traumatic events that disrupt the execution of the operational action plan of HZs. The HZs’ management team expertise, its strong leadership, and substantial financial support would enable this system to develop reliable and sustainable adaptive mechanisms.

https://www.ijhpm.com/article_4514_5ab607bfb0477ff1b3b525a18f68698d.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Health System Considerations for Community-Based Implementation of Automated Respiratory Counters to Identify Childhood Pneumonia in 5 Regions of Ethiopia: A Qualitative Study 1 11 4512 10.34172/ijhpm.2023.7385 EN Angeli Rawat UNICEF Supply Division Innovation Unit, Copenhagen, Denmark School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada Agazi Ameha UNICEF Ethiopia Country Office, Addis Ababa, Ethiopia Jonas Karlström UNICEF Supply Division Innovation Unit, Copenhagen, Denmark Global Programmes and Research, SingHealth Duke-NUS Global Health Institute, Duke-NUS, Singapore, Singapore Lisanu Taddesse Federal Ministry of Health of Ethiopia, Addis Ababa, Ethiopia Elias Legesse Negeri Frontieri Consult, Addis Ababa, Ethiopia Anne Detjen Child and Community Health Unit, Health Programme Group, UNICEF, New York City, NY, USA Kristoffer Gandrup-Marino UNICEF Supply Division, Copenhagen, Denmark Noah Mataruse UNICEF Supply Division, Copenhagen, Denmark Karin Källander Digital Health and Health Information Systems Unit, Health Programme Group, UNICEF, New York City, NY, USA Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden Abraham Tariku Federal Ministry of Health of Ethiopia, Addis Ababa, Ethiopia Journal Article 2022 05 13 Background In Ethiopia, childhood pneumonia is diagnosed in primary healthcare settings by measuring respiratory rate (RR) along with the presence of cough, chest indrawing, difficulty breathing, and fast breathing. Our aim was to identify health system-level lessons from implementing two automated RR counters, Children’s Automated Respiration Monitor (ChARM) by Phillips® and Rad-G by Masimo®, to provide considerations for integrating such devices into child health programmes and health systems. This study was part of an initiative called the Acute Respiratory Infection Diagnostic Aids (ARIDA). Methods Key informant interviews (KIIs) were conducted with 57 participants (health workers in communities and facilities, trainers of health workers, district management, and key decision-makers) in five regions of Ethiopia. Data were analyzed in ATLAS.ti using thematic content analysis and themes were categorized using the Tanahashi bottleneck analysis. Results All participants recommended scaling up the ARIDA initiative nationally as part of Integrated Management of Newborn and Childhood Illness (IMNCI) in primary healthcare. Health workers perceived the devices as: time saving, acceptable by parents and children, and facilitating diagnosis and referrals. Health workers perceived an increased demand for services and reduced numbers of sick children not seeking care. Participants recommended increasing the number of devices distributed and health workers trained. Strengthening drug supply chains, improving oxygen gas availability, and strengthening referral networks would maximize perceived benefits. While training improved knowledge, more supportive supervision, integration with current guidelines and more guidance related to community engagement was recommended. Conclusion Automatic RR counters for the decentralized diagnosis of childhood pneumonia could have positive impact on improving the quality of diagnosis and management of pneumonia in children. However, the study has shown that a health system approach is required to ensure all steps along the pneumonia pathway are adequate, including drug and oxygen supply, community engagement, health worker training and support, and referral pathways.

https://www.ijhpm.com/article_4512_0e98d85bebd20fb5487078492b94f193.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Effects of DementiaNet’s Community Care Network Approach on Admission Rates and Healthcare Costs: A Longitudinal Cohort Analysis 1 9 4518 10.34172/ijhpm.2023.7700 EN Toine EP Remers Radboud university medical center, Scientific center for quality of healthcare (IQ healthcare), Nijmegen, The Netherlands Florien M. Kruse Radboud university medical center, Scientific center for quality of healthcare (IQ healthcare), Nijmegen, The Netherlands Simone A. Van Dulmen Radboud university medical center, Scientific center for quality of healthcare (IQ healthcare), Nijmegen, The Netherlands Dorien L. Oostra Radboud university medical center, Department of Geriatric Medicine, Nijmegen, The Netherlands Martijn FM Maessen Coöperatie Volksgezondheidszorg, Business intelligence services, Arnhem, The Netherlands Patrick PT Jeurissen Radboud university medical center, Scientific center for quality of healthcare (IQ healthcare), Nijmegen, The Netherlands Marcel GM Olde Rikkert Radboud university medical center, Department of Geriatric Medicine, Nijmegen, The Netherlands Radboud university medical center, Donders Institute for Brain, Cognition and Behaviour, Department of Geriatric Medicine, Radboud Alzheimer Centre, Nijmegen, The Netherlands Journal Article 2022 09 23 Background People with dementia are increasingly living at home, relying on primary care providers for most healthcare needs. Suboptimal collaboration and communication between providers could cause inefficiencies and worse patient outcomes. Innovative strategies are needed to address this growing disease burden and rising healthcare costs. The DementiaNet programme, a community care network approach targeted at patients with dementia in the Netherlands, has been shown to improve patient’s quality of care. However, very little is known about the impact of DementiaNet on admission risks and healthcare costs. This study addresses this knowledge gap. Methods A longitudinal cohort analysis was performed, using medical and long-term care claims data from 38 525 patients between 2015-2019. The primary outcomes were risk of hospital admission and annual total healthcare costs. Mixed-model regression analyses were used to identify changes in outcomes. Results Patients who received care from a DementiaNet community care network showed a general trend in lower risk of admission for all types of admissions studied (ie, hospital, emergency ward, intensive care, crisis, and nursing home). Also, the intervention group showed a significant reduction of 12% in nursing days (relative risk [RR] 0.88; 95% CI: 0.77–0.96). No significant differences were found for total healthcare costs. However, we found effects in two sub-elements of total healthcare costs, being a decrease of 19.7% (95% CI: 7.7%–30.2%) in annual hospital costs and an increase of 10.2% (95% CI: 2.3%–18.6%) in annual primary care costs. Conclusion Our study indicates that DementiaNet’s community care network approach may reduce admission risks for patients with dementia over a long-term period of five years. This is accompanied by a decrease in nursing days and savings in hospital care that exceed increased primary care costs. This improvement in integrated dementia care supports wider scale implementation and evaluation of these networks.

https://www.ijhpm.com/article_4518_f84879ea20d20e645778d812a26ab9c7.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Predictors of Mothers’ Care Seeking Behavior for Common Childhood Illnesses: Findings From the Afghanistan Health Survey 2015 1 9 4529 10.34172/ijhpm.2023.7598 EN Essa Tawfiq The Kirby Institute, University of New South Wales, Sydney, NSW, Australia Khwaja Mir Islam Saeed Global Health Development/Eastern Mediterranean Public Health Network (GHD/ EMPHNET), Amman, Jordan Afghanistan Field Epidemiology Training Program, Afghanistan National Public Health Institute, Kabul, Afghanistan Sayed Ali Shah Alawi Afghanistan Pediatric Association, Kabul, Afghanistan Jammalluddin Jawaid Agency for Assistance and Development of Afghanistan, Kabul, Afghanistan Syed Nasir Hashimi Jhpiego, Kabul, Afghanistan Journal Article 2022 08 05 Background Mothers’ care seeking behavior for childhood illness is a key factor of utilizing healthcare for children. We examined predictors of mothers’ care seeking for common childhood illnesses. Methods This was a cross-sectional study, using data from the Afghanistan Health Survey (AHS) 2015. Data were used from women who sought healthcare for their unwell children. The women were asked whether their children were sick with fever, cough, faster breathing, or diarrhea in the past 2 weeks. The outcome variable was defined as whether the mother sought healthcare for her unwell child from a public clinic, a private clinic, or from a pharmacy store. The Andersen’s healthcare seeking behavior model was used and multinomial regression analysis applied. Results There were 4979 women, aged 15-49 years, whose under-5 children were sick in the past 2 weeks. Thirty-nine percent of women sought healthcare for their children from a health provider. Mother’s age, child’s age, child’s sex, socioeconomic status, mothers’ perceived severity of childhood illness, and number of under-5 children were predictors of mothers’ care seeking behavior. The likelihood of healthcare seeking was lower for older children (Adjusted odds ratio [OR] [95% CI]: 0.51 [0.37-0.70] from public clinics; 0.33 [0.23-0.47] from private clinics; 0.36 [0.22-0.61] from pharmacy stores), and for girls (Adjusted OR [95% CI]: 0.74 [0.59-0.93] from private clinics). The likelihood of healthcare seeking was greater for children whose mothers knew symptoms of childhood illness (Adjusted OR [95% CI]: 2.97 [1.44-6.16] from public clinics; 7.20 [3.04-17.04] from pharmacy stores). The likelihood of healthcare seeking for children was greater in older mothers (Adjusted OR [95% CI]: 1.54 [1.11-2.12]). It was less likely for the mothers who have more children to seek healthcare for their children (Adjusted OR [95% CI]: 0.53 [0.43-0.65] from public clinics; 0.61 [0.48- 0.79] from private clinics; 0.51 [0.37-0.69] from pharmacy stores). Conclusion Health policy-makers may opt to use our findings, particularly mothers’ knowledge (perceived severity) of symptoms of childhood illness to develop interventions to enhance timely assessment and effective treatment of common preventable childhood illnesses.

https://www.ijhpm.com/article_4529_26ac94c3a01359f2fc5c6177b01dbce7.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Patients’ and Care Professionals’ Evaluation of the Effect of a Hospital Group on Integrated Care in Chinese Urban Health Systems: A Propensity Score Matching and Difference-in-Differences Regression Approach 1 9 4531 10.34172/ijhpm.2023.7897 EN Xin Wang School of Public Health, Sun Yat-Sen University, Guangzhou, China Caiyun Zheng School of Public Health, Sun Yat-Sen University, Guangzhou, China Yao Wang School of Public Health, Sun Yat-Sen University, Guangzhou, China Stephen Birch Centre for the Business and Economics of Health, University of Queensland, Brisbane, QLD, Australia Yixiang Huang School of Public Health, Sun Yat-Sen University, Guangzhou, China Pim Valentijn Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands Essenburgh Research & Consultancy, Essenburgh Group, Harderwijk, The Netherlands Journal Article 2022 12 19 Background A hospital group is an organizational integration strategy that has recently been widely implemented in Chinese urban health systems to promote integrated care. This study aims to evaluate the effect of hospital group on integrated care from the perspectives of both patients and care professionals. Methods Two cross-sectional surveys were conducted in Shenzhen city of China, in June 2018 and July 2021. All 30 community health stations (CHSs) in the hospital group were included in the intervention group, with 30 CHSs in the same district selected as the control group by simple random sampling. All care professionals within both the intervention and the control groups were invited to participate in the surveys. Twelve CHSs were selected from 30 CHSs in the intervention and the control groups by simple random sampling, and 20 patients with type 2 diabetes mellitus (T2DM) were selected from each of these selected CHSs to participate in the survey by systematic sampling. The Chinese version Rainbow Model of Integrated Care Measurement Tool (C-RMIC-MT) was used to assess integrated care. Propensity score matching and difference-in-differences regression (PSM-DID) were used to evaluate the effect of the hospital group on integrated care. Results After matching, 528 patients and 1896 care professionals were included in the DID analysis. Results from care professionals indicated that the hospital group significantly increased technical competence of the health system by 0.771 points, and cultural competence by 1.423 points. Results from patients indicated that the hospital group significantly decreased organizational integration of the health system by 0.649 points. Conclusion The results suggests that the effect of the hospital group on integrated care over and above routine strategies for integrated care is limited. Therefore, it is necessary to pay attention to implementing professional, clinical and other integration strategies beyond establishing hospital groups, in urban Chinese health systems.

https://www.ijhpm.com/article_4531_f40742951dc7eb9d61af744cfaa6b928.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 New Zealand Pae Ora Healthcare Reforms 2022: Viable by Design? A Qualitative Study Using the Viable System Model 1 13 4538 10.34172/ijhpm.2023.7906 EN Adeel Akmal Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand Department of Business Studies, University of Iceland, Reykjavik, Iceland Nataliya Podgorodnichenko DBA Programme, Otago Business School, University of Otago, Dunedin, New Zealand Robin Gauld Department of Management, Otago Business School, University of Otago, Dunedin, New Zealand Tim Stokes Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand Journal Article 2022 12 22 Background The New Zealand (NZ) Pae Ora (Healthy Futures) health reforms came into effect in July 2022 with the establishment of Health New Zealand (HNZ) (Te Whatu Ora) and the Māori Health Authority (MHA) (Te Aka Whai Ora) – the organisations charged for healthcare provision and delivery. Given these changes represent major health system reform, we aimed to conduct an early evaluation of the design of the reforms to determine if they can deliver a viable and sustainable NZ health system going forward. Methods The evaluation was informed by Beer’s viable system model (VSM). A qualitative exploratory design with semi-structured interviews and documents analysis using thematic analysis was used. We conducted 28 interviews with senior healthcare managers and reviewed over 300 official documents and news analyses. Results The VSM posits that for a system to be viable, all its five sub-systems (operations; co-ordination; operational control; development and governance) need to be strong. Our analysis suggests that the health reforms, despite their strengths, do not satisfy this requirement. The reforms do appreciate the complexity of the healthcare environment: multiple stakeholders, social inequalities, interdependencies. However, our analysis suggests a severe lack of detail regarding the implementation and operationalisation of the reforms. Furthermore, resourcing and coordination within the reformed system is also unclear. Conclusion The health system reforms may not lead to a viable future NZ health system. Poor communication of the reform implementation and operationalisation will likely result in system failure and inhibit the ability of frontline health organisations to deliver care.

https://www.ijhpm.com/article_4538_26addc75c11caf7dcfc6c288201319cd.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Delivery and Prioritization of Surgical Care in Canada During COVID-19: An Environmental Scan 1 13 4541 10.34172/ijhpm.2023.8007 EN Seremi Ibadin Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada Mary Brindle Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada Surgery Strategic Clinical Networks, Alberta Health Services, Calgary, AB, Canada Tracy Wasylak Surgery Strategic Clinical Networks, Alberta Health Services, Calgary, AB, Canada Jill Robert Surgery and Bone & Joint Health Strategic Clinical Networks, Alberta Health Services, Calgary, AB, Canada Stacey Litvinchuk Surgery Strategic Clinical Networks, Alberta Health Services, Calgary, AB, Canada Khara M. Sauro Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada Department of Oncology and Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada Journal Article 2023 03 03 Background During COVID-19 healthcare systems had to make concessions to make room for the surge of COVID-19 patients requiring hospital and intensive care. Postponing surgeries was a common strategy; however, it is unclear how surgical care was delivered during this time of constraint. The objective of this study was to understand how surgical care was delivered and prioritized during the COVID-19 pandemic response. Methods This was an environmental scan following the Canadian Agency for Drugs and Technologies in Health methodology. This study was conducted in Canada; a universal, publicly funded healthcare system. Evidence sources on policies pertaining to the provision of surgical care between January 2020 and October 2022 were obtained from ministries of health, health services agencies and publicly funded hospitals across all 10 provinces and three territories. We synthesized the evidence sources using framework analysis. Results We identified 205 evidence sources that described six themes about the provision of surgical care during the COVID-19 pandemic: the cycle of postponement and resumption; guidelines for triaging and prioritizing surgical cases; Infection Prevention and Control (IPAC), and safety measures for surgical care during COVID-19, patient-centred care, and looking forward (recovery planning, leadership, and decision-making). Conclusion This study provides a comprehensive understanding of how surgical care was disrupted and innovated during COVID-19 which can inform future strategies for providing effective and efficient surgical care during times of healthcare constraint.

https://www.ijhpm.com/article_4541_048f0af60d60b5fc8951e3e3106a6fea.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Long-term Care Insurance and Health and Perceived Satisfaction of Older Chinese: Comparisons Between Urban/Rural Areas, Chronic Conditions, and Their Intersectionality 1 13 4540 10.34172/ijhpm.2023.7938 EN Yinkai Zhang Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong SAR, China Yu-Chih Chen Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong SAR, China Social Policy Institute, Washington University in St. Louis, St. Louis, MO, USA Julia Shu-Huah Wang Department of Social Work, National Taiwan University, Taipei, Taiwan Journal Article 2023 01 17 Background Evidence of the impact of long-term care insurance (LTCI) on health and well-being has predominantly come from developed countries. China officially launched its city-level LTCI policy in 2016. Recent evidence in China has shown that having an LTCI program contributes to positive health. However, it is unclear whether such positive policy effects were attributed to policy announcement or implementation effects, and whether the policy effects vary by locality, chronic conditions, and their intersectionality. This study examines whether there are longitudinal health benefits for older Chinese who are participating in LTCI, particularly considering their city location (urban/rural), whether they have chronic conditions, and the intersectionality. Methods Following the Andersen Behavioral Model, health and satisfaction outcomes of 9253 adults aged 60+ years were extracted from the 2015 and 2018 waves of the China Health and Retirement Longitudinal Study (CHARLS). Individual data were linked to census socioeconomic data with city-level characteristics and LTCI policy variable. Multilevel lagged regression models investigated the impact of LTCI policy on health and satisfaction with health services, after controlling for baseline individual- and city-level covariates. Results Of 125 cities in the dataset, 21 (16.8%) had adopted LTCI. These city inhabitants had significantly better selfrated health and higher satisfaction relative to cities without LTCI policies when environmental- and personal-level characteristics were modeled. Health benefits of LTCI were stronger after policy announcement and were particularly observed among rural older adults and those with chronic conditions. Results also suggest that LTCI’s positive effects on satisfaction spill over to middle-aged adults. Conclusion Expanding coverage and eligibility to LTCI for all older Chinese could improve health and well-being.

https://www.ijhpm.com/article_4540_1b184855e0a4c88d45ff072f365cee02.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Overcoming Political Fragmentation: The Potential of Meso-Level Mechanisms; Comment on “Integration or Fragmentation of Health Care? Examining Policies and Politics in a Belgian Case Study” 1 3 4231 10.34172/ijhpm.2022.7075 EN Carolyn Steele Gray Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada Journal Article 2022 01 11 Martens and colleagues’ paper “Integration or Fragmentation of Health Care? Examining Policies and Politics in a Belgian Case Study,” offers an in-depth examination of integrated care policy efforts in Belgium. A key finding in this case study was that political fragmentation proved too great an obstacle for integration efforts. In this commentary, I draw on the organizational behaviour and integrated care literatures to suggest how meso-level mechanisms related to sensemaking, distributive leadership, and evaluation could help overcome policy (or macro) level challenges like those experienced in Belgium. The commentary also suggests we need to consider and address both the process and normative challenges in these transformation efforts.

https://www.ijhpm.com/article_4231_09979fc814fc443cfc24e5f6ea30992e.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Belgium’s Healthcare System: The Way Forward to Address the Challenges of the 21st Century; Comment on “Integration or Fragmentation of Health Care? Examining Policies and Politics in a Belgian Case Study” 1 4 4238 10.34172/ijhpm.2022.7070 EN Jan De Maeseneer WHO Collaborating Centre on Family medicine and PHC, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium Anna Galle WHO Collaborating Centre on Family medicine and PHC, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium Journal Article 2022 01 07 In this paper we have tried, starting from the results of an analysis of the functioning of integrated care in the Belgian Health System by Martens et al, to design a strategy that could contribute to better addressing the challenges of the 21st century in Belgium. We proposed health system changes at the macro-, meso- and micro-level. We focused on health policy development and organization of care, emphasizing the importance of a shift from a hospital-centric towards a primary care based approach. Special attention was paid to the need for institutional reforms, in order to facilitate the further development of interprofessional integrated care, that focuses on the achievement of the life-goals of a person.

https://www.ijhpm.com/article_4238_c0bba7e13f81b2d8a3194680c53c066d.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Beyond “Lack of Political Will”: Elaborating Political Economy Concepts to Advance “Thinking and Working Politically”; Comment on “Health Coverage and Financial Protection in Uganda: A Political Economy Perspective” 1 4 4264 10.34172/ijhpm.2022.7297 EN Aloysius Ssennyonjo Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium Institute of Development Policy (IOB), University of Antwerp, Antwerp, Belgium Journal Article 2022 03 31 Political economy analysis (PEA) has been advanced as critical to understanding the political dimensions of policy change processes. However, political economy (PE) is not a theory on its own but draws on several concepts. Nannini et al, in concert with other scholars, emphasise that politics is characterised by conflict, contestation and negotiation over interests, ideas and power as various agents attempt to influence their context. This commentary reflects how Nannini et al wrestled with these PEA concepts - summarised in their conceptual framework used for PEA of the Ugandan case study on financial risk protection reforms. The central premise is that a common understanding of the PEA concepts (mainly structure-agency interactions, ideas, interests, institutions and power) forms a basis for strategies to advance thinking and working politically. Consequently, I generate several insights into how we can promote politically informed approaches to designing, implementing and evaluating policy reforms and development efforts.

https://www.ijhpm.com/article_4264_9ef7fee3746e31eb8795edcb7ed08241.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 What Might Be Required for Inspections to Be Considered Fair?; Comment on “What Lies Behind Successful Regulation? A Qualitative Evaluation of Pilot Implementation of Kenya’s Health Facility Inspection Reforms” 1 3 4271 10.34172/ijhpm.2022.7296 EN Gunnar Husabø Department of Social Science, Western Norway University of Applied Sciences, Sogndal, Norway Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway Einar Hovlid Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway Journal Article 2022 03 31 Tama et al offer us an interesting analysis of a piloted regulatory reform that introduced a Joint Health Inspections (JHIs) system in three Kenyan counties. The study highlights key factors facilitating or hindering the implementation of the reform. In this commentary we reflect on the concept of fairness, which is one of the topics that is discussed in the study. We describe four important dimensions of fairness in the context of inspections: expectation clarity, consistency of assessment, consistency of enforcement, and fairness to patients. We argue that all four dimensions are important in the regulatory design, in order for the inspection to be perceived as fair.

https://www.ijhpm.com/article_4271_c61298bafd0565666ee86cfe4763d32a.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Policy by Pilot? Learning From Demonstration Projects for Integrated Care; Comment on “Integration or Fragmentation of Health Care? Examining Policies and Politics in a Belgian Case Study” 1 4 4267 10.34172/ijhpm.2022.7152 EN Radhika Gore Family Health Centers at NYU Langone, Brooklyn, NY, USA Journal Article 2022 02 04 Analysis of policy implementation for chronic disease in Belgium highlights the difficulties of launching experiments for integrated care in a health system with fragmented governance. It also entreats us to consider the inherent challenges of piloting integrated care for chronic disease. Sociomedical characteristics of chronic disease –political, social, and economic aspects of improving outcomes – pose distinct problems for pilot projects, particularly because addressing health inequity requires collaboration across health and social sectors and a long-term, life-course perspective on health. Drawing on recent US experience with demonstration projects for health service delivery reform and on chronic disease research, I discuss constraints of and lessons from pilot projects. The policy learning from pilots lies beyond their technical evaluative yield. Pilot projects can evince political and social challenges to achieving integrated chronic disease care, and can illuminate overlooked perspectives, such as those of community-based organizations (CBOs), thereby potentially extending the terms of policy debate.

https://www.ijhpm.com/article_4267_cdd72deeb17317f746fab2f327ba5c1e.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Impact of Regulatory Changes on Innovations in the Medical Device Industry; Comment on “Clinical Decision Support and New Regulatory Frameworks for Medical Devices: Are We Ready for It? - A Viewpoint Paper” 1 4 4278 10.34172/ijhpm.2022.7262 EN Petra Maresova Department of Economics, Faculty of Informatics and Management, University of Hradec Kralove, Hradec Kralove, Czech Republic Journal Article 2022 03 19 Economic regulation is an instrument of the state or other institutions to correct market failures, rectify the business environment, or protect consumers. Regulation can be a major driver of innovation, and it has proven to be so in the past. On the other hand, there are also documented cases of ineffective regulation due to information delays or shortcomings in government decision-making. The complexity of the impact of regulatory changes on innovation can currently be observed in the medical device market in Europe. Regulation (EU) 2017/745 whose main idea is to ensure greater safety and health protection for consumers, is a challenge for originator, manufacturer, mostly small and medium-sized enterprises. The regulation is associated with an increase in the cost of developing and maintaining the product on the market. We can now gradually begin to analyze whether it can be ranked among those that have become drivers of innovation.

https://www.ijhpm.com/article_4278_c9d94365eb14fb1e8e33ec6cb9127cce.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 How to Achieve Universal Health Coverage: A Case Study of Uganda Using the Political Process Model; Comment on “Health Coverage and Financial Protection in Uganda: A Political Economy Perspective” 1 3 4275 10.34172/ijhpm.2022.7307 EN Cidalia Eusebio Independent Researcher, London, UK Maria Bakola Research Unit for General Medicine and Primary Health Care, Faculty of Medicine, School of Health Science, University of Ioannina, Ioannina, Greece David Stuckler Dondena Centre for Research on Social and Population Dynamics, Milan, Italy Cergas Centre for Research on Health and Social Care Management, Milan, Italy Department of Social & Political Sciences, Bocconi University, Milan, Italy 0000-0002-1288-8401 Journal Article 2022 04 07 How can resource-deprived countries accelerate progress towards universal health coverage (UHC)? Here we extend the analysis of Nanini and colleagues to investigate a case-study of Uganda, where despite high-level commitments, health system priority and funding has shrunk over the past two decades. We draw on the Stuckler-McKee adapted Political Process model to evaluate three forces for effecting change: reframing the debate; acting on political windows of opportunity; and mobilising resources. Our analysis proposes a series of pragmatic steps from academics, nongovernmental organisations, and government officials that can help neutralise the forces that oppose UHC and overcome fragmentation of the pro-UHC movement.

https://www.ijhpm.com/article_4275_83a6cbb896109383cf6a3e67b521cb8e.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Health Financing Reforms in Uganda: Dispelling the Fears and Misconceptions Related to Introduction of a National Health Insurance Scheme; Comment on “Health Coverage and Financial Protection in Uganda: A Political Economy Perspective” 1 3 4281 10.34172/ijhpm.2022.7348 EN Robert K. Basaza School of Medicine, Uganda Christian University, Mukono, Uganda School of Public Health, Gudie University Project, Kampala, Uganda 0000-0003-3220-5548 Prossy K. Namyalo Institution of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada Faculty of Social Sciences, Ndejje University, Kampala, Uganda Boniface Mutatina College of Health Sciences, Makerere University, Kampala, Uganda Journal Article 2022 04 23 Uganda introduced health financing reforms that entailed abolition of user fees, and in due process planned to introduce a National Health Insurance Scheme (NHIS). This paper accentuates a contextual and political-economic analysis that dispels the fears and misconceptions related to introduction of the insurance scheme. The Grindle and Thomas model is used to depict how various factors affect decision making by policy elites concerning a particular policy at a particular time. Drawing lessons from the sub-Sahara region and in particular, Ghana and Rwanda’s experience, it is clear that the political will of the executive led by the president in many countries is a key determinant in bringing about health reforms. In this paper, we provide insights based on contextual and political-economic analysis to countries in similar setting that are interested in setting up NHISs.

https://www.ijhpm.com/article_4281_70bd2a907e68ce3cc3468a9ae41e63ff.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Integration of Healthcare in Belgium: Insufficient, but There Is Hope; Comment on “Integration or Fragmentation of Health Care? Examining Policies and Politics in a Belgian Case Study” 1 2 4289 10.34172/ijhpm.2022.7179 EN Jan De Lepeleire Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium Journal Article 2022 02 15 The maturity of integrated care in Belgium is rather low. The reasons are the country’s complex organization, a lack of leadership and finances, an abundance of pilot projects, very long implementation and change processes, a healthcare system driven by providers and different cultures of action. However, new projects and ongoing research can help overcome these barriers. The primary care zones in Flanders, the National Hospital Plan and the Federal Plan to support mental health in particular are luxating opportunities. Well planned research is urgently needed to confirm the hope these projects arouse.

https://www.ijhpm.com/article_4289_31cd5a7ed5d3daa56fc41943759db36d.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Reinforcing Science and Policy, With Suggestions for Future Research; Comment on “Evidence-Informed Deliberative Processes for Health Benefit Package Design – Part II: A Practical Guide” 1 4 4290 10.34172/ijhpm.2022.7398 EN Anthony J. Culyer Department of Economics and Related Studies and Centre for Health Economics, University of York, York, UK Journal Article 2022 05 18 Oortwijn et al continue their guide to good practice in the use of deliberative processes in health technology assessment (HTA) based on a survey of international practice. This is useful, and I applaud their care in maintaining objectivity, especially regarding the treatment of moral and politically controversial issues, in reporting how jurisdictions have handled such matters in designing HTA procedures and in their execution. To their suggestions for future research, I add: the historical development of deliberation in healthcare decision-making and in other fields of public choice, with comparisons of methods, successes and failures; development of guidance on the design and use of deliberative processes that enhance decision-making when there is no consensus amongst the decision-makers; ways of identifying and managing context-free and context-sensitive evidence; and a review of high-level capacity building to raise awareness of HTA and the use of knowledge translation and exchange (KTE) and deliberation amongst policy makers, especially in low and middle-income countries.

https://www.ijhpm.com/article_4290_1f434e0f2ec9debdee72ca7117f81159.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Integration of Chronic Care in a Fragmented Healthcare System; Comment on “Integration or Fragmentation of Health Care? Examining Policies and Politics in a Belgian Case Study” 1 3 4292 10.34172/ijhpm.2022.7143 EN Miek Smeets Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium Karolien Baldewijns Mobilab & Care, Thomas More University of Applied Sciences, Mechelen, Belgium Bert Vaes Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium Hilde Vandenhoudt LiCalab, Thomas More University of Applied Sciences, Mechelen, Belgium Journal Article 2022 02 01 The authors of “Integration or Fragmentation of Health Care? Examining Policies and Politics in a Belgian Case Study” present a fresh perspective on the inertia of integrated care (IC) implementation. They conclude that the decisive power in Belgium is fragmented and undermines efforts towards IC. As researchers in integrated heart failure (HF) care and active primary healthcare professionals, we comment on the three policy initiatives evaluated by Martens et al from a bottom-up perspective. A Learning Healthcare Network (LHCN) was established September 2019 to overcome fragmentation, the lack of evaluation and capacity loss each time a pilot project ends. This commentary wishes to illustrate that a LHCN can be a powerful meso-level mechanism to engage in alignment work and to overcome macro-level barriers that are often difficult to change and not supportive of IC

https://www.ijhpm.com/article_4292_5c34b91092f3f2fd72405e1912d666b1.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Linking Costs and Quality in Healthcare: Towards Sustainable Healthcare Systems; Comment on “Hospitals Bending the Cost Curve With Increased Quality: A Scoping Review Into Integrated Hospital Strategies” 1 3 4295 10.34172/ijhpm.2022.7461 EN Roland Bal Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands Iris Wallenburg Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands Journal Article 2022 06 13 Organisation-wide studies in cost and quality of care are rare, and Wackers et al make a valuable contribution in synthesizing the literature on this issue. Their paper provides a good overview of initiatives and a list of factors that help in furthering organisation-wide change. The eleven factors they distill from the literate however remain rather abstract and more work needs to be done to contextualize the factors and the work that is needed to accomplish them and to see how they are aligned. Challenges in healthcare quality and costs moreover increasingly cross organizational boundaries and we need new methods to study and evaluate these.

https://www.ijhpm.com/article_4295_d424e198076aaa3781f1f4fb40eac9f0.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Challenges and Opportunities for Deliberative Processes for Healthcare Decision-Making; Comment on “Evidence-Informed Deliberative Processes for Health Benefit Package Design – Part II: A Practical Guide” 1 4 4299 10.34172/ijhpm.2022.7458 EN Kenneth Bond Institute of Health Economics, Edmonton, AB, Canada Journal Article 2022 06 12 The second edition of the practical guide for evidence-informed deliberative processes (EDPs) is an important addition to the growing guidance on deliberative processes supporting priority setting in healthcare. While the practical guide draws on an extensive amount of information collected on established and developing processes within a range of countries, EDPs present health technology assessment (HTA) bodies with several challenges. (1) Basing recommendations on current processes that have not been well-evaluated and that have changed over time may lead to weaker legitimacy than desired. (2) The requirement for social learning among stakeholders may require increased resourcing and blur the boundary between moral deliberation and political negotiation. (3) Robust evaluation should be based on an explicit theory of change, and some process outcomes may be poor guides to overall improvement of EDPs. This comment clarifies and reinforces the recommendations provided in the practical guide.

https://www.ijhpm.com/article_4299_e18eb0ab41245477c79e3a9e461781e3.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Neurotrauma Registries in Low- and Middle-Income Countries for Building Organized Neurotrauma Care: The LATINO Registry Experience; Comment on “Neurotrauma Surveillance in National Registries of Low- and Middle-Income Countries: A Scoping Review and Comparative Analysis of Data Dictionaries” 1 3 4302 10.34172/ijhpm.2022.7505 EN Andrés M. Rubiano Universidad El Bosque, Bogotá, Colombia Angelica Clavijo Meditech Foundation, Cali, Colombia Journal Article 2022 07 01 Trauma registries play an important role in building capacity for trauma systems. Regularly, trauma registries exist in high-income countries (HICs) but not in low- and middle-income countries (LMICs). Neurotrauma includes common conditions, like traumatic brain injuries (TBIs) and spinal cord injuries. The development of organized neurotrauma care is crucial for improving the quality of care in less-resourced areas. The recent article published in International Journal of Health Policy and Management by Barthélemy et al entitled “Neurotrauma Surveillance in National Registries of Low- and Middle-Income Countries: A Scoping Review and Comparative Analysis of Data Dictionaries” adds an important body of literature to improve understanding of the importance of these types of efforts by promoting organized neurotrauma care systems in LMICs. Here, we provide a short commentary based on our experience with the Latin America and the Caribbean Neurotrauma Registry (LATINO-TBI) in the Latin America (LATAM) region.

https://www.ijhpm.com/article_4302_a09411f7a7056cf0db5a3daff16c6880.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Three Approaches to Improve a Practical Guide on Evidence-Informed Deliberative Processes for Health Benefit Package Design; Comment on “Evidence-Informed Deliberative Processes for Health Benefit Package Design – Part II: A Practical Guide” 1 3 4304 10.34172/ijhpm.2022.7502 EN Javier Guzman Center for Global Development, Washington, DC, USA Journal Article 2022 06 30 As countries around the world seek to deliver universal health coverage, they must prioritize which services to pay for with public funds, to whom, and at what cost. Countries are increasingly using health technology assessment (HTA) to identify which interventions provide the best value for money and merit inclusion in their health benefit packages (HBPs)—the explicit lists of health services provided using public funds. Oortwijn et al understand the importance of providing practical guidance on the foundation of HBP design, and their article, “Evidence-Informed Deliberative Processes for Health Benefit Package Design – Part II: A Practical Guide,” provides recommendations for HTA bodies to improve the legitimacy of their decision-making by incorporating four elements in their HBP procedures: stakeholder involvement, evidence-informed evaluation, transparency, and appeal. This article proposes three approaches to enhance the value of the guide: moving from structure to compliance and performance, prioritizing key issues of legitimacy within HBP processes, and acknowledging potential the costs and risks associated with the use of this framework.

https://www.ijhpm.com/article_4304_7a2d52522e92a8c0b08b749ae85aaa12.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 COVID-19 Aftermath: Direction Towards Universal Health Coverage in Low-Income Countries; Comment on “Health Coverage and Financial Protection in Uganda: A Political Economy Perspective” 1 4 4305 10.34172/ijhpm.2022.7519 EN Viroj Tangcharoensathien International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand Warisa Panichkriangkrai International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand Woranan Witthayapipopsakul International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand Walaiporn Patcharanarumol International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand Journal Article 2022 07 07 Progressive realization of universal health coverage (UHC) requires health systems capacity to provide quality service and financial risk protection which supports access to services without financial hardship. Government health spending in low-income countries (LICs) has been low and heavily relied on external donor resources and out-ofpocket payment. This has resulted in high prevalence of catastrophic health spending or foregone care by those who cannot afford. Under fiscal constraints posed by pandemic, reforms in LICs should focus on efficiency through health resource waste reduction. Targeting the poor even with low level of health spending can make a significant health gain. Investment in primary healthcare and health workforce is the foundation for realizing UHC which cannot be postponed. Innovative tax on health hazardous products, conditional debt relief can increase fiscal space for health; while international collaboration to accelerate coronavirus disease 2019 (COVID-19) vaccine coverage can bring LICs out of acute phase of pandemic.

https://www.ijhpm.com/article_4305_119c298957d9cb753daabb519e195516.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 The Challenges of Regulating Artificial Intelligence in Healthcare; Comment on “Clinical Decision Support and New Regulatory Frameworks for Medical Devices: Are We Ready for It? - A Viewpoint Paper” 1 4 4311 10.34172/ijhpm.2022.7261 EN Martin McKee Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK Olivier J. Wouters Department of Health Policy, London School of Economics, London, UK Journal Article 2022 03 18 Regulation of health technologies must be rigorous, instilling trust among both healthcare providers and patients. This is especially important for the control and supervision of the growing use of artificial intelligence in healthcare. In this commentary on the accompanying piece by Van Laere and colleagues, we set out the scope for applying artificial intelligence in the healthcare sector and outline five key challenges that regulators face in dealing with these modernday technologies. Addressing these challenges will not be easy. While artificial intelligence applications in healthcare have already made rapid progress and benefitted patients, these applications clearly hold even more potential for future developments. Yet it is vital that the regulatory environment keep up with this fast-evolving space of healthcare in order to anticipate and, to the extent possible, prevent the risks that may arise.

https://www.ijhpm.com/article_4311_584eddc3548d5e96f98db70a506cf809.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Systemic Reflections on Knowledge Transfer; Comment on “Sustaining Knowledge Translation Practices: A Critical Interpretive Synthesis” 1 3 4312 10.34172/ijhpm.2022.7559 EN Joachim P. Sturmberg College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia International Society for Systems and Complexity Sciences for Health (ISSCSH), Waitsfield, VT, USA Journal Article 2022 07 20 The systemic failure of organisational learning should not come as a surprise – after all every system delivers exactly what it is designed for. Knowledge management/transfer is a property of the organisational system rather than a particular technique. Hence, knowledge management/transfer is about the contextual framing in which learning focused on understanding can occur. Looking through a system lens any research field can be defined as a complex adaptive organisation, and its culture determines if and how learning and knowledge transfer (or shared learning) can occur. Creating and maintain a learning culture requires leadership that perpetuates continuous dialogues to achieve tacit and explicit knowledge exchange.<br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;" />

https://www.ijhpm.com/article_4312_0c477a6a660e6953a901a7ea527e2d11.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Health System Shock Frameworks Between Theory, Application, and Assessment; Comment on “The COVID-19 System Shock Framework: Capturing Health System Innovation During the COVID-19 Pandemic” 1 2 4313 10.34172/ijhpm.2022.7373 EN Ayman Fouda Center for Social & Health Innovation, MCI - The Entrepreneurial School, Innsbruck, Austria Naomi Moy School of Economics & Finance, Faculty of Business & Law, Queensland University of Technology, Brisbane, QLD, Australia Journal Article 2022 05 06 The COVID-19 System Shock Framework (CSSF) tested the resilience of service providers throughout the coronavirus disease 2019 (COVID-19) pandemic in Australia. In this commentary, we tackle the topic of the CSSF applicability in less mature health systems and propose elements or dimensions that could be added to provide comprehensive response to future shocks. We acknowledge the fact that information systems, telehealth, and standard operation procedures constitute important pillars of system shock frameworks. However, there are doubts on the applicability of such pillars in middle- and low-income countries where the infrastructure is weaker compared to high-income countries and the digital divide is wider. Moreover, while it provided a paramount solution to deliver health services during the pandemic, the negative impact of telehealth should be addressed. In addition, we propose that CSSF should consider focusing on the continuity of the other medical conditions, which may have been affected due to the mitigation policies. Finally, we propose adding a dimension on the evaluation of CSSF to provide quantifiable and comparable assessment with other providers or systems.

https://www.ijhpm.com/article_4313_745a72783517d93c81ee1a96be6222c3.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Ways to Improve Hospital Quality - A Health System Perspective; Comment on “Hospitals Bending the Cost Curve With Increased Quality: A Scoping Review Into Integrated Hospital Strategies” 1 3 4315 10.34172/ijhpm.2022.7422 EN Ansgar Wuebker RWI – Leibniz-Institute for Economic Research, Essen, Germany Leibniz Science Campus Ruhr, Essen, Germany Hochschule Harz, Wernigerode, Germany Journal Article 2022 05 30 Wackers and colleagues’ scoping review provides an informative and well-structured overview of hospital-based case studies focusing on integrated hospital strategies that seek to improve quality, while reducing or containing costs. Wackers et al take a hospital level perspective and evaluate facilitators and barriers to the successful implementation of those hospital strategies. I complement the hospital level perspective of Wackers et al with an analysis from a health system perspective. Regulations at the superordinate system level might influence decisions at the hospital level that are relevant for costs and quality of care. In this commentary, I discuss how interventions at the system level might affect hospital quality. The results suggest that especially competition between hospitals, pay for performance (PfP) initiatives in combination with publication of quality information, but also greater experience of hospital staff (as proxied by the volume outcome relationship) may provide impulses for improving quality of care.

https://www.ijhpm.com/article_4315_01adf9bb5e5fb98a729c2350b5bc35cf.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Health System Decentralization: Creating as Many Problems Than It Solves?; Comment on “The Effects of Health Sector Fiscal Decentralisation on Availability, Accessibility, and Utilisation of Healthcare Services: A Panel Data Analysis” 1 3 4321 10.34172/ijhpm.2022.7432 EN Dolores Jiménez-Rubio Department of Applied Economics, University of Granada, Granada, Spain Journal Article 2022 06 02 This comment draws on the study by Rotulo et al about the effects of fiscal decentralization on access, utilization and availability of healthcare resources across Italian regions. We start by discussing the recent trends in health system decentralization worldwide, and then reflect on the rationale and main benefits and the key complexities and challenges of this much debated reform. We address these issues with reference to the recent experience of Italy as well as that of other comparable highly decentralized countries, most notably Spain, paying particular attention to their similarities and contrasts. We conclude that decentralization of health services poses complex challenges and trade-offs which may require careful design of equalisation mechanisms, framework regulation and efficient coordination mechanisms by central and sub central governments.<br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;" />

https://www.ijhpm.com/article_4321_da237169509e3507e71330ffb822df84.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Vaccines, Politics and Mandates: Can We See the Forest for the Trees?; Comment on “Convergence on Coercion: Functional and Political Pressures as Drivers of Global Childhood Vaccine Mandates” 1 4 4318 10.34172/ijhpm.2022.7572 EN Noni E. MacDonald Department of Paediatrics, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada Ève Dubé Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, Québec, QC, Canada Jeannette Comeau Department of Paediatrics, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada Journal Article 2022 07 26 Under-vaccination is a complex problem that is not simple to address whether this is for routine childhood immunization or for coronavirus disease 2019 (COVID-19) vaccination. Vaccination mandates has been one policy instrument used to try to increase vaccine uptake. While the concept may appear straight forward there is no standard approach. The decision to shift to a more coercive mandated program may be influenced by both functional and/or political needs. With mandates there may be patient and/or public push back. Anti-mandate protests and increased public polarization has been seen with COVID-19 vaccine mandates. This may negatively impact on vaccine acceptance ie, be counterproductive, causing more harm than overall good in the longer term. We need a better understanding of the political and functional needs that drive policy change towards mandates as well as cases studies of the shorter- and longer-term outcomes of mandates in both routine and pandemic settings.

https://www.ijhpm.com/article_4318_99172e266288d706ced67bfebf6264d2.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Complexities of Simultaneously Improving Quality and Lowering Costs in Hospitals; Comment on “Hospitals Bending the Cost Curve With Increased Quality: A Scoping Review Into Integrated Hospital Strategies” 1 3 4323 10.34172/ijhpm.2022.7442 EN Dinesh R. Pai School of Business Administration, Penn State Harrisburg, Middletown, PA, USA Journal Article 2022 06 06 As health systems transition to value-based care delivery models, reducing costs and improving quality of care without sacrificing either remains a challenge for many healthcare organizations. There is extensive research on hospital costs, however, works addressing the complex relationship between hospital costs and the quality of care have been limited. In this commentary, I expound on the scoping review on integrated hospital strategies by Wackers et al that aim to improve quality while lowering costs. Specifically, I reiterate the complexity of the relationship between cost and quality and delve into major interdependent themes identified by the authors as relevant for the implementation of hospitals’ integrated strategy.<br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;" />

https://www.ijhpm.com/article_4323_23c410e4f98ff85a8c50b228c0579530.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Closing the Implementation Gap; Comment on “Insights Gained From a Re-analysis of Five Improvement Cases in Healthcare Integrating System Dynamics Into Action Research” 1 3 4325 10.34172/ijhpm.2022.7593 EN Sally Brailsford Southampton Business School, University of Southampton, Southampton, UK Journal Article 2022 08 01 Holmström et al provide an interesting and thought-provoking contribution to a perennial problem: why, despite a vast number of applications of simulation modelling in healthcare over the past 70 years, there is still remarkably little evidence of successful implementation of model results. Their paper is a retrospective analysis of five case studies, all undertaken as consultancy, that used a blend of system dynamics (SD) modelling and action research (AR). This commentary assesses the effectiveness of this approach in achieving implementation, based on the evidence presented, and discusses some of the issues raised. These issues include a comparison of Holmström’s approach with group model building (GMB) in SD, the differences between healthcare modelling projects undertaken by (a) business consultants and (b) academics, and the challenges of undertaking ‘systematic’ reviews of the grey literature.

https://www.ijhpm.com/article_4325_d349a5dbe3af5310cdc1e3dd52cd58b2.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Additional Marketing Responses to a Tax on Sugar-Sweetened Beverages; Comment on “Understanding Marketing Responses to a Tax on Sugary Drinks: A Qualitative Interview Study in the United Kingdom, 2019” 1 4 4334 10.34172/ijhpm.2022.7638 EN Jasmina Ilicic Monash Business School, Monash University, Caulfield East, VIC, Australia Stacey Brennan The University of Sydney Business School, The University of Sydney, Sydney, NSW, Australia Katherine Cullerton School of Public Health, University of Queensland, Herston, QLD, Australia Journal Article 2022 08 22 Marketing responses to sugar-sweetened beverage (SSB) taxes are understudied in the literature. Previous research has been limited to examining price and advertising, in particular promotions responses. Forde et al advocate for a focus on exploring a range of marketing responses to a SSB tax, with an emphasis on the marketing mix (price, promotion, product, and place). Their qualitative findings from the United Kingdom focus mostly on possible product and price decisions, with limited discussion of place and promotions decisions. We argue that the proposed marketing mix decisions may be used to avoid or side-step a SSB tax and that their likelihood of adoption may be dependent upon additional factors besides brand strength, reputation, and portfolio size highlighted by Forde and colleagues, such as organizational capabilities, industry competition, and brand positioning. We recommend future research examine the importance of consumer behaviour in developing marketing programs and in response to the marketing mix levers pulled by industry.<br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;" />

https://www.ijhpm.com/article_4334_611b8faf67e1c192dbfd810d2c40a940.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 The Role of the Policy Process on Health Service Reconfigurations: Evidence, Path Dependency and Framing; Comment on “‘Attending to History’ in Major System Change in Healthcare in England: Specialist Cancer Surgery Service Reconfiguration” 1 3 4332 10.34172/ijhpm.2022.7642 EN Juan I. Baeza King’s College London, London, UK 0000-0003-2032-4507 Journal Article 2022 08 23 Historically healthcare services have largely developed on an incremental basis, with various piecemeal changes and some notable policy leaps that illustrate a punctuated equilibrium health policy process. More recently policy-makers have attempted, successfully and unsuccessfully, to reconfigure healthcare services to address perceived problems in the delivery of important services such as stroke, cancer, and trauma. Perry et al provide a welcome addition to research in this area by focusing on the importance of history in a reconfiguration of cancer services in Greater Manchester (GM). Perry et al analyse how and why this configuration was successful after several failed attempts in the past and in this commentary, I want to reflect on the explanatory role health policy analysis can contribute to studying the reconfiguration of healthcare services.

https://www.ijhpm.com/article_4332_d8fe2e37c1087093e657a56f5c5c731f.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Framing Marketing Responses to National Regulation: The Four Ps in Transnational Corporate Political Discourse; Comment on “Understanding Marketing Responses to a Tax on Sugary Drinks: A Qualitative Interview Study in the United Kingdom, 2019” 1 4 4337 10.34172/ijhpm.2022.7618 EN Kathrin Lauber Global Health Policy Unit, School of Social and Political Science, University of Edinburgh, Edinburgh, UK Journal Article 2022 08 16 A growing evidence base indicates that sugar-sweetened beverage (SSB) taxes are an effective tool to help reduce excess sugar intake. The effects of SSB taxes and the mechanisms which underlie them, however, are dependent on a number of interrelated factors such as policy design and responses of industry and consumers. Forde and colleagues contribute to unpacking these mechanisms by exploring the way in which the UK’s Soft Drinks Industry Levy (SDIL) shaped the four Ps of soft drinks marketing: product, price, placement, and promotion. This commentary builds on the authors’ insights by connecting them to existing knowledge on corporate political activity and the commercial determinants of health (CDOH) more broadly. Specifically, I discuss the risk that an industry framing of regulation-induced marketing changes as a voluntary step towards corporate responsibility undermines the need for government intervention to address obesity in other contexts and countries. I conclude by arguing that the public health community would benefit from considering marketing responses to regulation alongside industry narratives about these changes.

https://www.ijhpm.com/article_4337_0bca51129fa4ff02e1e7853e1bd02701.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Closing the Evidence Gap of Cash Transfer for Tuberculosis-Affected Households; Comment on “Does Direct Benefit Transfer Improve Outcomes Among People With Tuberculosis? – A Mixed-Methods Study on the Need for a Review of the Cash Transfer Policy in India” 1 3 4338 10.34172/ijhpm.2022.7658 EN Ahmad Fuady Department of Community Medicine, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia Primary Health Care Research and Innovation Center, Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia Journal Article 2022 08 31 Achieving the targets of eliminating tuberculosis (TB) requires a combination of biomedical, epidemiological, and social approaches. Having hitted by the coronavirus disease 2019 (COVID-19) pandemic which diminishes the financial capacity of TB-affected households, the importance of delivering socioeconomic support to TB-affected household emerges. However, the evidence of TB-related socioeconomic support is still scarce, and some questions are left unanswered. A sequential explanatory mixed-methods study by Dave and Rupani shows that the direct benefit transfer (DBT), a form of cash transfer, to TB-affected households improves TB treatment outcomes in India despite the challenges. Some critical issues remain to be discussed: trading-off between the amount of cash and its sustainability, choosing the most appropriate support packages, detecting, and reaching the target population, and arranging the most effective delivery strategy. Knowledge gap remains to be answered, and a global research agenda and political commitment are critical to encourage more evidence in delivering socioeconomic support for TB control.

https://www.ijhpm.com/article_4338_fbee71e291d0ca836cf11d21936e0eef.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 A Pragmatic and Systemic Approach to Advance Research in Health Policy and Management; Comment on “Insights Gained From a Re-analysis of Five Improvement Cases in Healthcare Integrating System Dynamics Into Action Research” 1 3 4339 10.34172/ijhpm.2022.7690 EN Guido Noto Department of Economics, University of Messina, Messina, Italy Journal Article 2022 09 18 “Healthcare is complex” - or similar sentences – is a statement that introduces a wide number of scientific articles dealing with health policy and management issues. We all agree that healthcare is complex, but most studies, although using this kind of sentence to introduce their background, do little to effectively deal with such complexity in their analyses. Holmström et al proposed a methodological approach to tackle healthcare complexity by integrating system dynamics (SD) into action research (AR). This commentary highlights three touch points that makes the combination of AR and SD feasible, namely the epistemological ground, the use of experimentation and the collaborative approach. The proposed approach addresses some of the key sources of the complexity characterizing healthcare settings.

https://www.ijhpm.com/article_4339_16756b6b734d2019e63ff6ecc8c394cb.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Modelling a System to Help Improve It; Comment on “Insights Gained From a Re-analysis of Five Improvement Cases in Healthcare Integrating System Dynamics Into Action Research” 1 3 4326 10.34172/ijhpm.2022.7556 EN John Øvretveit Karolinska Institute, Solna, Sweden Region Stockhom Healthcare, Stockhom, Sweden Journal Article 2022 07 19 The article that this commentary considers describes the use of systems modelling in an action research (AR) project that helped improvement teams to understand the dynamics of their service as a system. This commentary seeks to make the complex article easier to understand for those unfamiliar with the subjects. It describes the advantages, disadvantages and benefits, and suggests developments of this approach for research and practice using digital technologies. The conclusion of the commentary is that dynamic system modelling combined with AR is useful for certain purposes and can produce benefits in terms of a more sophisticated understanding of systems and feedback loops for practitioners. However, there are challenges for researchers unfamiliar with AR and dynamic system modelling as well workshop facilitation expertise.

https://www.ijhpm.com/article_4326_d651d186d980b0313025070667b0817c.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Companies’ Responses to a Tax on Sugar-Sweetened Beverages: Implications for Research; Comment on “Understanding Marketing Responses to a Tax on Sugary Drinks: A Qualitative Interview Study in the United Kingdom, 2019” 1 3 4347 10.34172/ijhpm.2022.7619 EN Judite Gonçalves School of Public Health, Imperial College London, London, UK Nova School of Business and Economics, Universidade Nova de Lisboa, Lisbon, Portugal Journal Article 2022 08 16 The paper by Forde et al, newly published in this journal, sheds light on how sugar-sweetened beverages (SSBs) companies may react to the introduction of a SSB tax. This commentary goes over the paper’s main findings and drafts implications for research on the impacts of SSB taxes. First and foremost, future research needs to assess the actual impacts of SSB taxes on companies’ actions, especially reformulation. Second, cross-country research, comparing large companies with similar beverage portfolios, could bring insights about the impacts of external factors, including different SSB taxes, on companies’ decisions. Third, SSB companies’ actions are potential confounders in empirical studies looking into the impacts of SSB taxes on prices, demand, or other outcomes. Researchers need to be aware of and discuss such aspects thoroughly in their studies, as the implications for the interpretation of results are evident.

https://www.ijhpm.com/article_4347_e21005f603002b66c86a00c8fe4a31db.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 “Attending to Collaboration” in Major System Change in Healthcare in England: A Response; Comment on “‘Attending to History’ in Major System Change in Healthcare in England: Specialist Cancer Surgery Service Reconfiguration” 1 3 4344 10.34172/ijhpm.2022.7661 EN Alec Fraser King’s Business School, King’s College London, London, UK Lorelei Jones School of Medical and Health Sciences, Bangor University, Bangor, UK Colin Lorne School of Social Sciences and Global Studies, Faculty of Arts and Social Sciences, The Open University, Milton Keynes, UK Ellen Stewart Department of Social Work and Social Policy, University of Strathclyde, Glasgow, UK Journal Article 2022 08 31 In this short article we comment upon the recent article by Perry et al “Attending to History” in Major System Change in Healthcare in England: Specialist Cancer Surgery Service Reconfiguration. We welcome the engagement with power, history and heuristics in the Perry et al paper. Our article discusses the importance of researcher positionality in Major System Change research, alongside managerial power and the centrality of politics to remaking health and care services. Additionally, we highlight the work of Ansell and Gash focused on ‘collaborative governance’ and its potential to offer insight in relation to Major System Change.

https://www.ijhpm.com/article_4344_a2913ea87e8a5d6322f4012bd6f70a9b.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Global Neurotrauma Surveillance: Are National Databases Overrated?; Comment on “Neurotrauma Surveillance in National Registries of Low- and Middle-Income Countries: A Scoping Review and Comparative Analysis of Data Dictionaries” 1 3 4346 10.34172/ijhpm.2022.7577 EN Marissa A. Boeck Department of Surgery, Zuckerberg San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA Hussein Ssenyonjo Faculty of Neurosurgery, College of Surgeons of East Central and Southern Africa, Mulago National Referral Hospital, Kampala, Uganda Olive C. Kobusingye Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda Journal Article 2022 07 28 Injuries are a public health crisis. Neurotrauma, a specific type of injury, is a leading cause of death and disability globally, with the largest burden in low- and middle-income countries (LMICs). However, there is a lack of quality neurotrauma-specific data in LMICs, especially at the national level. Without standard criteria for what constitutes a national registry, and significant challenges frequently preventing this level of data collection, we argue that singleinstitution or regional databases can provide significant value for context-appropriate solutions. Although granular data for larger populations and a universal minimum dataset to enable comparison remain the gold standard, we must put progress over perfection. It is critical to engage local experts to explore available data and build effective information systems to inform solutions and serve as the foundation for quality and process improvement initiatives. Other items to consider include adequate resource allocation and leveraging of technology as we work to address the persistent but largely preventable injury pandemic.

https://www.ijhpm.com/article_4346_49aeeaf0a5e8d6996b45ba694df32452.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Institutionalisation Is a Vital Element for Fairness of Priority Setting in the Package Design if the Target is Universal Health Coverage; Comment on “Evidence-Informed Deliberative Processes for Health Benefits Package Design – Part II: A Practical Guide” 1 4 4348 10.34172/ijhpm.2022.7544 EN Haniye Sadat Sajadi Knowledge Utilization Research Center, University Research and Development Center, Tehran University of Medical Sciences, Tehran, Iran 0000-0003-0897-4080 Mohamed Jama Ministry of Health, Federal Government of Somalia, Mogadishu, Somalia Reza Majdzadeh Interdisciplinary Research and Practice Division, School of Health and Social Care, University of Essex, Colchester, UK Journal Article 2022 07 16 The evidence-informed deliberative processes (EDPs) guide provides a practical framework for fair priority setting of the health benefits package (HBP) that countries can reasonably use. The steps presented in the EDPs are applicable for prioritising health services in designing HBP and are consistent with practical experience in countries. However, institutionalisation must be considered an element of fairness in the priority-setting process if the aim is to reach broader goals of a health system, such as universal health coverage (UHC). Otherwise, the EDPs for priority setting might not be integrated into the formal health system or impactful, resulting in a waste of time and resources, which is unfair. Institutionalisation means formalising the desired change as an embedded and integrated system so that the change lasts over time. For the institutionalisation of EPDs, four stages are suggested, which are (1) establishing a supportive legal framework, (2) designating governance and institutional structure, (3) stipulating the EDPs processes and (4) individual and institutional capacity building.

https://www.ijhpm.com/article_4348_9b831bda85d141de7fedc35b55d9960a.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 A New Perspective on Emerging Knowledge Translation Practices; Comment on “Sustaining Knowledge Translation Practices: A Critical Interpretive Synthesis” 1 3 4350 10.34172/ijhpm.2022.7545 EN Anita Kothari School of Health Studies, Western University, London, ON, Canada Jacqui Cameron School of Health and Society, University of Wollongong, Wollongong, NSW, Australia Department of Social Work, The University of Melbourne, Parkville, VIC, Australia Journal Article 2022 07 16 The critical interpretive synthesis by Borst and colleagues offered a new perspective on knowledge translation (KT) sustainability from the perspective of Science and Technology Studies. From our applied health services perspective, we found several interesting ideas to bring forward. First, the idea that KT sustainability includes the ongoing activation of networks led to several future research questions. Second, while not entirely a new concept, understanding how KT actors work strategically and continuously with institutional rules and regulations to sustain KT practice was noteworthy. We add to the discussion by emphasizing the importance of non-researcher voices (clinicians, administrators, policy-makers, patients, carers, public) in sustaining KT practice. We also remind readers that the health ecosystem is dynamic and interdependent, where one system level influences and is influenced by another, and that these constant adaptations suggest that understanding KT practices cannot be a one-off event but represent repeated moments for transformative learning.

https://www.ijhpm.com/article_4350_0cba0240b23d035c9fb614dfde683efb.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 The Geopolitics of Health Science Research; Comment on “The Roles of Regional Organisations in Strengthening Health Research Systems in Africa: Activities, Gaps, and Future Perspectives” 1 3 4363 10.34172/ijhpm.2022.7516 EN Pádraig Carmody Department of Geography, Trinity College Dublin, Dublin 2, Ireland School of Tourism and Hospitality, University of Johannesburg, Johannesburg, South Africa Journal Article 2022 07 06 African development is defined by a number of meta-trends, including climate disruption, digitalisation, informalisation, regionalisation and most recently the impacts of the coronavirus disease 2019 (COVID-19) pandemic. The paper under consideration here is informed primarily by two of these: regionalism and the COVID-19 pandemic. Africa, or at least parts of it, have been severely affected by pandemics in recent decades. At the same time deepening regionalisation allows for more coordinated and effective actions to mitigate their worst effects. However, to date, regional integration efforts have not generally delivered desired results, and in the area of Health Science Research (HSciR) specifically, which is the area of focus for this paper. This important paper considers the nature of current activities in relation to health research by regional organizations on the continent. It provides a baseline study and incipient manifesto for increased effectiveness and greater contribution in the area of HSciR on the continent.

https://www.ijhpm.com/article_4363_06bc9767f81242e3b28014e02bf59eed.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Austerity by Design; Comment on “Ensuring Global Health Equity in a Post-pandemic Economy” 1 4 4367 10.34172/ijhpm.2022.7754 EN Indra De Soysa Department of Sociology & Political Science (ISS), Norwegian University of Science & Technology (NTNU), Trondheim, Norway Journal Article 2022 10 15 Several scholars across many disciplines argue that neoliberal, free-market economic conditions drive inequalities, generating poverty and misery due to unfair austerity, ultimately affecting human health. Professor Labonté’s prescription is that we jettison these policies targeting economic growth and development for generating greater fairness for the world’s poor. This rejoinder argues contrarily that the criticism of neoliberal policies are misplaced, and that degrowth is really “self-imposed austerity,” which will not benefit the poor. This rejoinder scrutinizes some simple stylized fact and assesses the soundness of the broader arguments. The evidence suggests clearly that becoming wealthy and following prudent economic policies is the best path to improving population health, equity, and other progressive outcomes. Badly required growth for the poor comes from free markets and good governance, and equity for the sake of fairness neither results in better health outcomes, nor an improved environment.

https://www.ijhpm.com/article_4367_4841e85505740cc13f2ed543b332f85e.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Moral and Social Values in Evidence-Informed Deliberative Processes for Health Benefit Package Design; Comment on “Evidence-Informed Deliberative Processes for Health Benefit Package Design – Part II: A Practical Guide” 1 3 4364 10.34172/ijhpm.2022.7480 EN Michael J. DiStefano Department of Health Policy & Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA Journal Article 2022 06 18 An evidence-informed deliberative process (EDP) is defined as “a practical and stepwise approach for health technology assessment (HTA) bodies to enhance legitimate health benefit package design based on deliberation between stakeholders to identify, reflect and learn about the meaning and importance of values, informed by evidence on these values.” In this commentary, I discuss some considerations for EDPs that arise from acknowledging the difference between social and moral values. First, the best practices for implementing EDPs may differ depending on whether the approach is grounded in moral versus social values. Second, the goals of deliberation may differ when focused on moral versus social values. I conclude by offering some considerations for future research to support the use of EDPs in practice, including the need to assess how different approaches to appraisal (eg, more quantitative versus qualitative) impact perceptions of the value of deliberation itself.

https://www.ijhpm.com/article_4364_6b36eb5bc468efd6743b8d49726b1287.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Vaccine Mandates in the COVID-19 Era: Changing Paradigm or Public Health Opportunity?; Comment on “Convergence on Coercion: Functional and Political Pressures as Drivers of Global Childhood Vaccine Mandates” 1 4 4366 10.34172/ijhpm.2022.7616 EN Anna Odone Department of Public Health Experimental and Forensic Medicine, University of Pavia, Pavia, Italy 0000-0002-5657-9774 Giulia Dallagiacoma Department of Public Health Experimental and Forensic Medicine, University of Pavia, Pavia, Italy Giacomo Pietro Vigezzi Department of Public Health Experimental and Forensic Medicine, University of Pavia, Pavia, Italy Collegio Ca’ della Paglia, Fondazione Ghislieri, Pavia, Italy Journal Article 2022 08 14 The debate around vaccine mandates has flourished over the last decade, with several countries introducing or extending mandatory childhood vaccinations. In a recent study, Attwell and Hannah explore how functional and political pressures added to public health threats in selected countries, motivating governments to increase the coerciveness of their childhood vaccine regimes. In this commentary, we reflect on whether such model applies to the coronavirus disease 2019 (COVID-19) case and how the pandemic has re-shuffled the deck around vaccine mandates. We identify COVID-19 immunisation policies’ distinctive aspects as we make the case of countries implementing mass immunisation programmes while relying on digital COVID-19 certificates as an indirect form of mandate to increase vaccine uptake. We conclude by acknowledging that different forms of mandatory vaccination might serve as a shortcut to protect population health in times of emergency, underlining, however, that the ultimate public health goal is to promote voluntary, informed, and responsible adherence to preventive behaviours.

https://www.ijhpm.com/article_4366_9e8ac0ce3c8fc3a9f6c953d3921aaf94.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Making Sense of the Complexity of Decentralised Governance; Comment on “The Effects of Health Sector Fiscal Decentralisation on Availability, Accessibility, and Utilisation of Healthcare Services: A Panel Data Analysis” 1 3 4358 10.34172/ijhpm.2022.7449 EN Seye Abimbola School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia Journal Article 2022 06 09 The article by Rotulo and colleagues suggests that health sector fiscal decentralisation has been bad for Italy. But given the complexity of fiscal decentralisation, this interpretation is not necessarily so. Their analysis was based on assumptions about causality that are better suited for simple interventions. Assumptions of simplicity show up as misleading artefacts in the conclusion of evaluations of complex interventions. Complex interventions work by triggering mechanisms – eg, reasoning and learning processes – that manifest differently across the units of a decentralised system, contingent on context, evolving over time. Evaluation findings can only be partial and provisional; neither summarily good nor bad. The goal of evaluating a complex intervention – such as decentralised governance – should be to understand how, under what circumstances and for whom they are good or bad – at a point in time.

https://www.ijhpm.com/article_4358_1e1332b7514ff06ce5b5fffa8f933608.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 In Centralized Health Systems, Much Is Left Out When Analyses of Local HiAP Strategies Are Limited to Public Administration; Comment on “A Realist Explanatory Case Study Investigating How Common Goals, Leadership, and Committed Staff Facilitate Health in All Policies Implementation in the Municipality of Kuopio, Finland” 1 4 4357 10.34172/ijhpm.2022.7646 EN Eric Breton Department SHS and Arènes Research Unit (UMR CNRS 6051: team INSERM U1309), EHESP French National School of Public Health, Rennes, France Yann Le Bodo Department SHS and Arènes Research Unit (UMR CNRS 6051: team INSERM U1309), EHESP French National School of Public Health, Rennes, France Journal Article 2022 08 24 We argue that the lessons drawn by Guglielmin and colleagues, from the Health in All Policies (HiAP) approach in the municipality of Kuopio, are of limited use to centralised health systems. There is a need for research more attuned to the circumstances of local governments that have little power over the provision of health programmes; yet can address a range of determinants of population health. In these cases, adopting a state-centric perspective may fail to capture the role of other actors such as non-governmental organizations (NGOs) and local branches of state agencies. Evidence from France shows that centralised health systems can foster HiAP locally through political commitment and dedicated coordination staff whose role is to mobilise and support NGOs, inhabitants, and other local branches of regional and central governments. We highlight, as three important challenges, the issue of legitimacy, funding and positioning of the HiAP instrument in the local government structure.

https://www.ijhpm.com/article_4357_799fe768b39ab1d97a0dde574e8d7855.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Pandemic’s Experience Questioning Capitalistic Dominance; Comment on “Ensuring Global Health Equity in a Post-pandemic Economy” 1 2 4371 10.34172/ijhpm.2022.7764 EN Alexis Benos General Practice and Health Services Research, Department of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece Journal Article 2022 10 19 Reflecting on the up-to-date global experience of the coronavirus disease 2019 (COVID-19) pandemic is of crucial importance in order to draw conclusions needed for the design of policies aiming the prevention of new epidemics and the effective protection, preparedness and response of any new emerging. Ongoing environmental destruction, excess mortality by COVID-19 and non-COVID diseases reflecting the dismantlement and commodification of both public health services and healthcare services, deep economic crisis, increasing and deepening social inequalities are the main characteristics raised by the pandemic. The causes of the causes of all these are the dominant rules of the capitalistic system, driven mainly by the unlimited greed for profit on the expenses of the majority of the society. The effectiveness of any proposed correction of this system is discussed and the need for another society responding to the needs of the population is argued.

https://www.ijhpm.com/article_4371_556d544f7c6fc723f90041bfe865dff6.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Medical Dominance in Global Health Institutions as an Obstacle to Equity and Effectiveness; Comment on “Power Dynamics Among Health Professionals in Nigeria: A Case Study of the Global Fund Policy Process” 1 3 4372 10.34172/ijhpm.2022.7734 EN Sarah L. Dalglish Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA Institute for Global Health, University College London, London, UK Olutobi A. Sanuade Department of Population Health Sciences, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA 0000-0003-4972-1098 Stephanie M. Topp College of Public Health Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia Journal Article 2022 10 07 Medical professionals exercised structural and productive power in the Global Fund’s Country Coordinating Mechanism (CCM) in Nigeria, directly impacting the selection of approaches to HIV/AIDS care, as described in a case study by Lassa and colleagues. This research contributes to a robust scholarship on how biomedical power inhibits a holistic understanding of health and prevents the adoption of solutions that are socially grounded, multidisciplinary, and co-created with communities. We highlight Lassa and colleagues’ findings demonstrating the ‘long arm’ of global health institutions in country-level health policy choices, and reflect on how medical dominance within global institutions serves as a tool of control in ways that pervert incentives and undermine equity and effectiveness. We call for increased research and advocacy to surface these conduits of power and begin to loosen their hold in the global health policy agenda.

https://www.ijhpm.com/article_4372_5989f0ba55674b5d114529a056074c33.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Beyond Received Wisdom and Authorised Accounts: What Knowledge Is Needed to Avoid Repeating History?; Comment on “‘Attending to History’ in Major System Change in Healthcare in England: Specialist Cancer Surgery Service Reconfiguration” 1 3 4368 10.34172/ijhpm.2022.7647 EN Graham P. Martin University of Cambridge, Cambridge, UK Journal Article 2022 08 24 Perry and colleagues’ study of a programme to reconfigure cancer surgery provision in Greater Manchester highlights the importance of accounting for history in making successful change. In this short commentary, I expand on some of Perry and colleagues’ key findings. I note the way in which those leading change in Greater Manchester combined formal expertise in change management with sensitivity to local context, enhancing their approach to change through attention to details around relationships, events and assumptions that might otherwise have derailed the process. I identify lessons for others in how best to account for history in leading change, highlighting in particular the need to attempt to access and understand forms of history that may be suppressed, difficult-to-articulate, or otherwise marginalised.

https://www.ijhpm.com/article_4368_2826ea14781d8461ba41430f2b73cfba.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Things That Become Visible, for a While, Can Leave a Residue; Comment on “Ensuring Global Health Equity in a Post-pandemic Economy” 1 3 4375 10.34172/ijhpm.2022.7756 EN Nele Jensen Department of Global Health & Social Medicine, King’s College London, London, UK Journal Article 2022 10 28 Professor Labonté’s editorial is an important intervention that reiterates the stark socio-economic and health inequities that were exposed and perpetuated during the coronavirus disease 2019 (COVID-19) pandemic to call on the public health community to hold politicians to account for their promises of ‘building back better.’ The editorial makes present how quickly pandemic promises seem to have become dislodged by an ostensibly endless cycle of political and economic crises. But it also expresses a hope that lessons from the pandemic will eventually serve to challenge prevailing (economic) policy orthodoxy and feed a collective demand for more progressive social, economic and environmental justice-oriented politics.

https://www.ijhpm.com/article_4375_2c26cdb4ec14f0960f8b618fe52d1a5a.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Conditional Cash Transfer to Improve TB Outcomes: Necessary but Not Sufficient; Comment on “Does Direct Benefit Transfer Improve Outcomes Among People With Tuberculosis? – A Mixed-Methods Study on the Need for a Review of the Cash Transfer Policy in India” 1 3 4376 10.34172/ijhpm.2022.7643 EN Fernando Rubinstein Institute of Clinical Effectiveness and Health Policy, Buenos Aires, Argentina Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK Alejandro Blumenfeld Institute of Clinical Effectiveness and Health Policy, Buenos Aires, Argentina 0000-0002-6761-2584 Journal Article 2022 08 23 Tuberculosis (TB) still represents a major public health problem in many regions of the world. TB control can only be achieved through a comprehensive and inclusive response which takes into account both upstream and downstream coordinated interventions related to structural determinants such as poverty, nutrition, sanitation, housing and access to healthcare as well as timely diagnosis and support throughout the course of treatment. Several social and financial support strategies have been proposed to improve TB treatment adherence, including conditional cash transfers (CCTs). In this context, demonstrating that social protection directly improves a specific health outcome using routinely collected data, incomplete registries or surveillance reports brings about many methodological challenges. We briefly discuss this paper and some limitations, describe main findings from our own research in this area and make a call to expand social protection interventions to address structural conditions of those most affected.

https://www.ijhpm.com/article_4376_c1c8f900463e52816508d318bbbba102.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Retrospective Impact Evaluation Continuing to Prove Challenging Irrespective of Setting: A Study of Research Impact Enablers and Challenges Cloaked as an Impact Evaluation?; Comment on “‘We’re Not Providing the Best Care If We Are Not on the Cutting Edge of Research’: A Research Impact Evaluation at a Regional Australian Hospital and Health Service” 1 3 4377 10.34172/ijhpm.2022.7742 EN Shanthi Ramanathan Hunter Medical Research Institute, Newcastle, NSW, Australia College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, NSW, Australia Journal Article 2022 10 09 The original article provides a detailed and insightful presentation of enablers and detractors for research participation, translation, and impact, at a regional Australian hospital and health service. This information builds on existing knowledge, from the perspective of a non-metropolitan healthcare organisation. It stands to inform all healthcare organisations keen to embed research into their institutions. However, what the article fails to do is present the results of the research impact evaluation in a systematic and useful way for the reader to assess the benefits of research investment by a healthcare organisation including delivery of better quality care and improved patient outcomes. This commentary suggests why such information is critical to justify continued research investment by healthcare organisations and to showcase the potential benefits of the embedded research model. It also discusses the limitations of undertaking impact evaluation retrospectively and suggests that a prospective approach coupled with proper data collection systems and processes upfront could help future reporting of organisational research impact.

https://www.ijhpm.com/article_4377_8dd453013d1066ebaa3831f21ca3e142.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Towards Improved Organizational Governance of Neurotrauma Surveillance; Comment on “Neurotrauma Surveillance in National Registries of Low- and Middle-Income Countries: A Scoping Review and Comparative Analysis of Data Dictionaries” 1 4 4378 10.34172/ijhpm.2022.7554 EN Hanna E. Schenck School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands Halinder S. Mangat Department of Neurology and Neurocritical Care, Kansas University Medical Center, Kansas City, KS, USA Journal Article 2022 07 19 Neurotrauma surveillance data on burden and severity of disease serves as a tool to define legislations, guide highyield risk-specific prevention, and evaluate and monitor management strategies for adequate resource allocation. In this scoping review, Barthélemy and colleagues demonstrate the gap in neurotrauma surveillance in low- and middle-income countries (LMICs) and suggest strategies for governance in neurotrauma surveillance. We underline state accountability as well as the need for the close integration of academic and tertiary care clinical practitioners and policy-makers in addressing the public health crisis caused by neurotrauma. Additionally, multiple sources for surveillance must be included, especially in communities where victims may remain without access to formal healthcare. Finally, we offer insights into possible ways of increasing the visibility of neurotrauma on political agendas.

https://www.ijhpm.com/article_4378_11d8752db977b2f4a2dc799a16752d45.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Corporate Harm Minimisation: Promises and Perils; Comment on “Understanding Marketing Responses to a Tax on Sugary Drinks: A Qualitative Interview Study in the United Kingdom, 2019” 1 4 4373 10.34172/ijhpm.2022.7649 EN Jennifer Lacy-Nichols Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia Journal Article 2022 08 25 Taxes on sugary drinks are often used to encourage companies to reformulate their products to reduce the sugar content. This comment discusses how product reformulation can strengthen the market and political power of the food industry, and questions whether these political risks outweigh the public health benefits. It proposes the term ‘corporate harm minimisation’ to describe the strategic adaptation of a public health harm reduction strategy to align with company or industry goals. It concludes by reflecting on the other ways that corporations influence health beyond the production and marketing of ‘unhealthy commodities,’ and why public health actors must explore other strategies to challenge powerful corporations.

https://www.ijhpm.com/article_4373_8e911139a06bf874064540aa65821baf.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Evidence-Informed Deliberative Processes for UHC: Progress, Potential and Prudence; Comment on “Evidence-Informed Deliberative Processes for Health Benefit Package Design – Part II: A Practical Guide” 1 3 4380 10.34172/ijhpm.2023.7541 EN Unni Gopinathan Global Health Cluster, Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway Journal Article 2022 07 16 In their recent article on evidence-informed deliberative processes (EDPs) for health benefit package decisions, Oortwijn et al examine how the different steps of EDP play out in eight countries with relatively mature institutions for using health technology assessment (HTA). This commentary examines how EDP addresses stakeholder involvement in decision-making for equitable progress towards universal health coverage (UHC). It focuses on the value of inclusiveness, the need to pay attention to trade-offs between desirable features of EDP and the need to broaden the scope of processes examined beyond those specifically tied to producing and using HTAs . It concludes that EDPs have contributed to significant progress for health benefit design decisions worldwide and holds much potential in further application. At the same time, this commentary calls for prudence: investments in EDPs should be efficiently deployed to enhance the pre-existing legislative, institutional and political framework that exist to promote fair and legitimate healthcare decisions.

https://www.ijhpm.com/article_4380_23b6a9b4fcdee1a51d5786ecf91ba803.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Unpacking Contexting and Institutionalizing as Complex Sustaining Practices; Comment on “Sustaining Knowledge Translation Practices: A Critical Interpretive Synthesis” 1 3 4388 10.34172/ijhpm.2023.7523 EN Ninna Meier Department of Sociology and Social Work, Aalborg University, Aalborg, Denmark Journal Article 2022 07 10 This article discusses the work of Borst et al in which they suggest ‘sustaining work’ as a term that covers the efforts of actors to sustain the use of health research in policy and practice through three practices. I suggest that two of these, contexting and institutionalizing, need to be further unpacked to understand how and why they are important for sustaining work in knowledge translation (KT). To contribute here, I discuss KT as processes of organizational change that occurs within and across organizations, often involving actors with different views on and approaches to the use of health research in policy and practice. These actors will likely have very different understandings of what the context for using research is and they are likely be members of competing or conflicting institutions. Future research needs to take such elements into account to improve our understanding and practice of sustaining work.

https://www.ijhpm.com/article_4388_58e2e11f383481914964b91b08e33638.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 A Historical Legacy for Universal Health Coverage in the Republic of Korea: Moving Towards Health Coverage and Financial Protection in Uganda; Comment on “Health Coverage and Financial Protection in Uganda: A Political Economy Perspective” 1 6 4390 10.34172/ijhpm.2023.7434 EN Chun-Bae Kim Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea Hongcheon County Hypertension and Diabetes Registration and Education Center, Hongcheon, South Korea Journal Article 2022 06 03 Since 2001, when Uganda abolished user fees to improve the accessibility of healthcare, out-of-pocket costs still account for 42% of total health expenditure. Even if universal health coverage (UHC) is achieved on the demandside, government authorities face political and economic challenges due to soaring burden of diseases. Therefore, this study aimed to re-analyze the implementation process according to three pillars by World Health Organization (WHO) based on Korean UHC-related articles. In terms of breadth, the national health insurance (NHI) in Korea UHC was established from 1977 for employees to 1989 for self-employed. In terms of depth, benefit packages in Korea UHC have expanded from essential medical services to expensive care (ultrasono, computerized tomography, etc) including benefit period. Finally, in terms of height of coverage, the government has tried to relieve financial burden of households with catastrophes and enhance benefit plan for major diseases till now. This historical legacy for UHC in Korea can pose lessons to policy-makers in developing countries including Uganda and Ghana.

https://www.ijhpm.com/article_4390_23fb22537f3ed85ed3a8dd504adbd25e.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Health System Resilience as the Basis for Explanation Versus Evaluation; Comment on “The COVID-19 System Shock Framework: Capturing Health System Innovation During the COVID-19 Pandemic” 1 3 4395 10.34172/ijhpm.2023.7481 EN Stephanie M. Topp College of Public Health Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia Journal Article 2022 06 19 The onset and impacts of COVID-19 have prompted attention to national health system preparedness for, and capacity to adapt in response to, public health emergencies and other shocks. This preparedness and adaptive capacity are often framed as ‘health system resilience’ a concept previously associated more with assessments of health systems in conflict-affected and fragile states. Yet health system resilience remains a slippery concept, defined and applied in multiple ways. Reflecting on the Hodgins and colleagues’ study “the COVID-19 system shock framework: capturing health system innovation during the COVID-19 pandemic,” this article restates the limitations of health systems resilience as a concept capable of anchoring evaluative assessments of health system performance but stresses its value in the context of explanatory research investigating how and why health systems adapt, with due attention to the power of actors’ whose choices inform the nature and direction of change.

https://www.ijhpm.com/article_4395_175a5e9dc5419d273a9454d4840b7598.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Post-pandemic Economics and Health Equity; Comment on “Ensuring Global Health Equity in a Post-pandemic Economy” 1 4 4403 10.34172/ijhpm.2023.7695 EN Karime Chahuán-Jiménez Escuela de Auditoría, Centro de Investigación en Negocios y Gestión Empresarial, Universidad de Valparaíso, Valparaíso, Chile Journal Article 2022 09 21 This article aims to compare the foundations of the post-pandemic economy and its impact on health equity, according to Labonté with the economics theory. The methodology developed is based on bibliometrics analysis, the documents, and specifications for a cluster of concepts, allowing deepened exposure of Labonté, complementing with the latest publications on the post-pandemic economy. Finally, the results agreed with Labonté about to economic development for achieving an economy that allows health equity considering sustainable development and the possibility of achieving the livelihood of Green New Deal as a basis.

https://www.ijhpm.com/article_4403_f8ffb8ac04a6e8fb94e182cca1cdf2b2.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Policy vs Business: Well-Designed Health-Related Food Policy Should Not Let Industry Marketing Undermine its Intended Effects; Comment on “Understanding Marketing Responses to a Tax on Sugary Drinks: A Qualitative Interview Study in the United Kingdom, 2019” 1 3 4396 10.34172/ijhpm.2023.7640 EN Laura Cornelsen Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK Soledad Cuevas Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK Journal Article 2022 08 22 Health-related food policies, such as taxes on unhealthy food and drink, can act as catalysts for food industry to take action which may or may not align with the policy goal of improving population health. This commentary discusses the framework proposed by Forde et al in analysing the food industry marketing responses to the Soft Drink Industry Levy (SDIL), implemented in the United Kingdom in 2018. We suggest and discuss ways which may help broaden the use of the framework to other relevant policies. This includes widening the framework to cover strategies that may have not come up within the SDIL context but have been studied in other contexts. It would also be important to consider interactions between the strategies and with external factors influencing company decisions. Going forward, comprehensive evaluations of health-related policies should consider likely interactions with industry marketing strategies to fully understand potential impacts.

https://www.ijhpm.com/article_4396_92f8b1ff252ac781911c7397a3dd36af.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 The Role of Registries in Neurotrauma Research: Translating Data Into Health Policy That Enhances Patient Care; Comment on “Neurotrauma Surveillance in National Registries of Low- and Middle-Income Countries: A Scoping Review and Comparative Analysis of Data Dictionaries” 1 3 4394 10.34172/ijhpm.2023.7521 EN Nqobile Thango Division of Neurosurgery, Department of Surgery, University of Cape Town, Cape Town, South Africa Neuroscience Institute, University of Cape Town, Cape Town, South Africa Ronnie E. Baticulon Division of Neurosurgery, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines Laura Lippa Department of Neurosurgery, ASST Ospedale Maggiore Niguarda, Milano, Italy Journal Article 2022 07 08 The paucity of robust neurotrauma data is felt most in regions that experience a higher burden of traumatic brain injury (TBI). The scoping review done by Barthélemy et al provides insight into the current state of national registries in low- and middle-income countries (LMICs) while also exploring the tools required to standardize data collection. In this commentary, we reflect on the barriers to data collection (ie, creation and maintenance of a TBI registry) and explore how registries can aid both scientific output and preventative public awareness campaigns that may pave the way to improved health policy and social change that avert mortality and morbidity from TBI.

https://www.ijhpm.com/article_4394_4f861bcaaa1781da6c4ff2b3a6d1dd22.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Comparative Politics, Political Settlements, and the Political Economy of Health Financing Reform; Comment on “Health Coverage and Financial Protection in Uganda: A Political Economy Perspective” 1 3 4387 10.34172/ijhpm.2023.7630 EN Kevin Croke Harvard School of Public Health, Boston, MA, USA Journal Article 2022 08 20 Nannini et al analyze barriers to national health insurance reforms in Uganda using a political economy approach primarily rooted in stakeholder analysis. This approach is valuable, not only for its clear description of the interestbased politics at play, but also for its extension of stakeholder analysis to include consideration of the role of ideas and institutions in the policy process. However this analysis, and others like it, could be further strengthened by adding insights from two different sources. The first is the comparative politics literature on the Ugandan regime. The second is a related approach which analyzes public service delivery in the context of a country’s underlying “political settlement.” Stakeholder-based approaches to health financing reform emphasize interest group conflict about the contents of policy reforms. By contrast, these complementary approaches imply distinct barriers to successful implementation of national health insurance in Uganda, rooted in the regime’s de-industrialization and the personalization of politics and resource allocation. They also suggest possible leverage points or avenues for progress which differ from those suggested by stakeholder analysis.

https://www.ijhpm.com/article_4387_5f6e6203323896cbc393d8431a9b4c2b.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 The Evolution of External Healthcare Regulation in England; From Performance Oversight to Supporting Improvement; Comment on “The Special Measures for Quality and Challenged Provider Regimes in the English NHS: A Rapid Evaluation of a National Improvement Initiative for Failing Healthcare Organisations” 1 4 4397 10.34172/ijhpm.2023.7809 EN Mirza Lalani Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK Helen Hogan Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK Journal Article 2022 11 09 The Special Measures and Challenged Provider (SMCP) Regime introduced for struggling healthcare organisations in England represents a subtle shift to the scope of external regulation from performance oversight to include supporting internal service improvement. External regulation alone has a had a mixed impact on the quality of care and Vindrola-Padros and colleagues’ study highlights that externally driven improvement initiatives may also struggle to succeed in turning around performance. Principally, this is due to a failure in acknowledgment that poor performance results from a myriad of external and internal factors which coalesce to impede organisational performance. A struggling organisation may be indicative of wider issues in the local health and care system. Whole systems approaches to improvement with collaboration across providers and the effective use of data may support struggling organisations but their role maybe tempered with the increased centralisation of the delivery of improvement regimes such as SMCP.

https://www.ijhpm.com/article_4397_3410c10db4f02ac0e6d7928f2bd41a8f.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 The Instrumental Role of Strategic Communication to Counter Industry Marketing Responses to Sugary Drink Taxes; Comment on “Understanding Marketing Responses to a Tax on Sugary Drinks: A Qualitative Interview Study in the United Kingdom, 2019” 1 4 4408 10.34172/ijhpm.2023.7685 EN Nandita Murukutla Policy Advocacy and Communication Division, Vital Strategies, New York City, NY, USA Trish Cotter Policy Advocacy and Communication Division, Vital Strategies, New York City, NY, USA Alexey Kotov Policy Advocacy and Communication Division, Vital Strategies, New York City, NY, USA Journal Article 2022 09 15 Strong sugary drink taxes are effective at reducing sugary drinks consumption. In response, the sugary drinks industry employs various marketing strategies to undermine the taxes to protect and maintain its customer base. In their recent article in this journal, Forde et al present a framework for understanding how sugary drinks companies use marketing for this purpose. In this commentary, we reflect on this framework by drawing from recent experiences of sugary drinks industry marketing responses. Further, we review the global evidence on the instrumental role that strategic communication can play in protecting strong taxes from industry responses. We make a case for strategic communication as a vital tool in promoting and protecting sugary drinks tax proposals, both prior to and after their introduction.

https://www.ijhpm.com/article_4408_5d46153c1a4f21c939e9ffeefcefd2ea.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Regulatory Reforms for Health Facilities: Can These Suffice?; Comment on “What Lies Behind Successful Regulation? A Qualitative Evaluation of Pilot Implementation of Kenya’s Health Facility Inspection Reforms” 1 3 4405 10.34172/ijhpm.2023.7265 EN Arthur Bagonza Department of Community Health and Behavioral Sciences, School of Public Health, Makerere University, Kampala, Uganda David Musoke Department of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, Uganda Henry Wamani Department of Community Health and Behavioral Sciences, School of Public Health, Makerere University, Kampala, Uganda Journal Article 2022 03 20 In their study on how Joint Health Inspections (JHI) were implemented in practice with a need to identify key facilitators or barriers for regulatory policy and practice, Tama et al found that innovative regulatory reforms markedly improved inspection scores among intervention health facilities albeit with challenges. Their article makes an important contribution to the body of knowledge in as far as regulation of health facilities is concerned. In low- and middle-income countries (LMICs), private health facilities are poorly regulated and yet, they purge gaps where public health facilities are inadequate as was demonstrated during the COVID-19 pandemic. Therefore, while regulation of public health facilities is standardized, the research by Tama and colleagues provides a unique opportunity to continue dialogue on how private health facilities can be regulated through inspection and supervision. Regulation of public and private health facilities continues to be contentious since both experience unique contextual challenges.

https://www.ijhpm.com/article_4405_79826f577a88f2840e319c4fe576463b.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Evaluating Social Protection Policies With an Implementation Science Framework: India’s Direct Benefit Transfer for Tuberculosis; Comment on “Does Direct Benefit Transfer Improve Outcomes Among People With Tuberculosis? – A Mixed-Methods Study on the Need for a Review of the Cash Transfer Policy in India” 1 4 4404 10.34172/ijhpm.2023.7698 EN Ann M. Schraufnagel Division of Pulmonary and Critical Care Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, CA, USA Center for Tuberculosis, University of California-San Francisco, San Francisco, CA, USA Priya B. Shete Division of Pulmonary and Critical Care Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, CA, USA Center for Tuberculosis, University of California-San Francisco, San Francisco, CA, USA Journal Article 2022 09 22 Addressing the social and structural determinants of tuberculosis (TB) through social protection programs is a central feature of global public health policy and disease elimination strategies. However, how best to implement such programs remains unknown. India’s direct benefit transfer (DBT) program is the largest cash transfer program in the world dedicated to supporting individuals affected by TB. Despite several studies aimed at evaluating the impact of DBT, many questions remain about its implementation, mechanisms of action, and effectiveness. Dave and Rupani’s mixed-methods evaluation of this program previously published in this journal offers valuable insights into the strengths and limitations of the DBT program in improving TB treatment outcomes. Their results also provide an opportunity for demonstrating how systematically collected data may be further analyzed and presented using implementation science, a field of study using methods to promote the systematic uptake of evidence-based interventions to support sustainable program scale-up.

https://www.ijhpm.com/article_4404_023f2bb4826c5ce71ad5ffba3c82382f.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Contextual Factors That May Impact on the Development and Implementation of the Sugary Drinks Policy; Comment on “Understanding Marketing Responses to a Tax on Sugary Drinks: A Qualitative Interview Study in the United Kingdom, 2019” 1 3 4406 10.34172/ijhpm.2023.7713 EN Elisa Chilet-Rosell Department of Public Health, Faculty of Medicine, Universidad Miguel Hernández, Alicante, Spain CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Blanca Lumbreras Department of Public Health, Faculty of Medicine, Universidad Miguel Hernández, Alicante, Spain CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Journal Article 2022 09 29 Forde et al proposed an interesting framework to understand marketing response to a tax in sugary drinks based on stakeholder interviews. Sugary drinks regulation can lead to various strategies in the industry’s marketing activity. That is, it can either result in the industry introducing no changes or it can lead to changes, which can conflict or align with public health objectives. The importance of Forde and colleagues’ analysis lies in the potential for governments to anticipate the industry’s reaction to the legislation and the need of drivers to enable both big and small companies to follow the rules. Governments must not forget the importance of other contextual factors that will have an impact both on the development and implementation of this type of policies and on possible responses that could mitigate their impact such as public acceptance, the influence of mass media and corporate activities aimed at influencing policy.

https://www.ijhpm.com/article_4406_69195f6adb0e691516afd4ac697d3270.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 The Fentanyl System Shock – Are There Lessons to Learn From the COVID-19 System Shock Framework?; Comment on “The COVID-19 System Shock Framework: Capturing Health System Innovation During the COVID-19 Pandemic” 1 4 4410 10.34172/ijhpm.2023.7409 EN Maximilian Meyer University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland Jean N. Westenberg University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland 0000-0002-4720-8402 R. Michael Krausz Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada Journal Article 2022 05 24 The Sydney Children’s Hospitals Network (SCHN) addressed the challenges of the COVID-19 pandemic by implementing innovative changes which made their health system resilient and responsive. For other healthcare systems, there are important takeaways. In the United States and Canada, an urgent widespread response is needed to address the overdose crisis, driven by potent synthetic opioids (ie, fentanyl and its derivates). We project the COVID-19 System Shock Framework (CSSF) on to the North American healthcare systems and suggest a Fentanyl System Shock Framework, which provides a framework for necessary changes and innovations to address the overdose crisis. To become resilient to the fentanyl system shock, core components as well as overarching values, health policy, and online technologies need to be adapted to reduce the death count and meet the evolving needs of marginalised individuals who use opioid. Future research should focus on scientifically assessing such implementations to guide evidence-based decision making.

https://www.ijhpm.com/article_4410_428a78ba9803565d65a6cd26dd255bd7.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 A Gateway Framework to Guide Major Health System Changes; Comment on “‘Attending to History’ in Major System Change in Healthcare in England: Specialist Cancer Surgery Service Reconfiguration” 1 4 4417 10.34172/ijhpm.2023.7681 EN Kathy Eljiz University of New South Wales, Sydney, NSW, Australia 0000-0002-0970-1888 David Greenfield University of New South Wales, Sydney, NSW, Australia Alison Derrett Western Sydney Local Health District, Sydney, NSW, Australia Journal Article 2022 09 13 Recent events – on both a global scale and within individual countries – including the lockdowns associated with COVID-19 pandemic, inflation concerns, and political tensions, have increased pressure to reconfigure social services for ongoing sustainability. Healthcare services across the world are undergoing major system change (MSC). Given the complexity and different contextual drivers across healthcare systems, there is a need to use a variety of perspectives to improve our understanding of the processes for MSC. To expand the knowledge base and develop strategies for MSC requires analysing change projects from different perspectives to distil the elements that drove the success. We offer the Gateway Framework as a collaborative transformational system tool to assess and reorganise operations, services, and systems of healthcare organisations. This framework and guiding questions, accounts for past events whilst being proactive, future orientated, and derived from externally defined and a standardised requirements to promote safe, high-quality care.

https://www.ijhpm.com/article_4417_f713429bfc1043fe8c2e5dd1b68db625.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Knowledge Translation as Cultural and Epistemic Translation; Comment on “Sustaining Knowledge Translation Practices: A Critical Interpretative Synthesis” 1 4 4412 10.34172/ijhpm.2023.7873 EN John Ødemark Department of Culture Studies and Oriental Languages, University of Oslo, Oslo, Norway Journal Article 2022 12 08 This commentary examines the claim made by Borst et al that knowledge translation (KT) should look to Science and Technology Studies (STS), the sociology of translation, and constructionist views on knowledge, and begin to think of the sustainability of a certain practice as construction work in continuous progress, and not as states to be reached once and for all. While endorsing this claim, the present commentary also argues that what it calls the “epistemic reframing” behind the new construal of KT in Borst must be supplemented with approaches that goes beyond the sociology of translation. The commentary claims that this epistemic shift hinges upon a shift in the narrative framing of KT, and that we need to consider the broader narrative and historical ideology of knowledge dissemination behind KT, and that a failure to do so, leaves us with KT seen as a linear transmission of “true” knowledge to peoples and places lacking such knowledge.

https://www.ijhpm.com/article_4412_a26f1608d7eef132f7c5433fa34e1eca.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Routinizing the Use of Evidence in Policy – What is Needed?; Comment on “Sustaining Knowledge Translation Practices: A Critical Interpretive Synthesis” 1 4 4413 10.34172/ijhpm.2023.7604 EN Tanja Kuchenmüller Research for Health, Science Division, World Health Organization, Geneva, Switzerland Laura Dos Santos Boeira Instituto Veredas, São Paulo, Brazil Journal Article 2022 08 09 In their study of sustaining knowledge translation (KT) practices, Borst et al found that this process is an interplay of: (i) constructing and extending networks, (ii) creating contexts that support KT practices, and (iii) understanding how actors create, maintain, and disrupt institutions. Their article is an important contribution to the body of research promoting KT. In this commentary we reflect on the convergences and differences between the concepts of ‘sustaining’ and ‘institutionalizing’ KT, highlighting domains and processes related to the institutionalization, providing an analysis of KT landscape in Brazil and making a case for the need to increase countries’ routine use of evidence.

https://www.ijhpm.com/article_4413_180e5a01b13f917f59382fb164a39080.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Where Is Equity in HiAP?; Comment on “A Realist Explanatory Case Study Investigating How Common Goals, Leadership, and Committed Staff Facilitate Health in All Policies Implementation in the Municipality of Kuopio, Finland” 1 4 4422 10.34172/ijhpm.2023.7611 EN Michelle Amri Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA Jesse B. Bump Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA Bergen Centre for Ethics and Priority Setting, University of Bergen, Bergen, Norway Journal Article 2022 08 12 Health equity is no longer a central feature of Health in All Policies (HiAP) approaches despite its presence in select definitions of HiAP. In other words, HiAP is not just about considering health, but also health equity. But as HiAP has become more mainstream, its success around health equity has been muted and largely non-existent. Given the normative underpinning and centrality of equity in HiAP, equity should be better considered in HiAP and particularly when considering what ‘successful’ implementation may look like. Raising health on the radar of policy-makers is not mutually exclusive from considering equity. Taking an incremental approach to considering equity in HiAP can yield positive results. This article discusses these ideas and presents potential actions to restore HiAP’s once central equity objectives, which include: seeking synergies focused on health equity with those who hold different convictions, both in terms of goals and measures of success; considering the conditions that allow HiAP to be fostered, such as good governance; and drawing on research on HiAP and other multisectoral approaches.

https://www.ijhpm.com/article_4422_1bb03773c36d0c055757e4b0b0c684fc.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 The Key Role of Social Movements in Protecting the Health of People and the Planet; Comment on “Ensuring Global Health Equity in a Post-pandemic Economy” 1 3 4423 10.34172/ijhpm.2023.7757 EN Chiara Bodini Centre for International and Intercultural Health, University of Bologna, Bologna, Italy People’s Health Movement Journal Article 2022 10 15 In his recent article, titled “Ensuring Global Health Equity in a Post-pandemic Economy,” Ronald Labonté addresses a key challenge the world is facing, trying to ‘build back’ after the global crisis related to the COVID-19 pandemic. He explores and critically examines different policy options, from a more inclusive ‘stakeholder model’ of capitalism, to a greater role of states in shaping markets and investing in the protection of health and the environment, to more radical options that propose to reframe the capitalist mantra of growth and look at different ways to value and center our societies around what really matters most to protect life. Social movements are key players in such transformation, however the political space they move in is progressively shrinking.

https://www.ijhpm.com/article_4423_bd4c365691a47c09915117a15f30e191.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Enhancing Multiple Ways of Knowing; Comment on “Evaluating Public Participation in a Deliberative Dialogue: A Single Case Study” 1 2 4429 10.34172/ijhpm.2023.7776 EN Katherine M. Boydell Black Dog Institute, Sydney, NSW, Australia Department of Psychiatry and Mental Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada Journal Article 2022 10 24 This commentary reviews the Scurr and colleagues’ article published in International Journal of Health Policy and Management in February 2022 on “Evaluating Public Participation in a Deliberative Dialogue: A Single Case Study.” Schur adds to the current knowledge base by extending the stakeholder groups in deliberative dialogues (DD) to members of the affected community, a practice not commonly used in such DD strategies. Their study supports the inclusion of public participants in such dialogues, and offers practical guidelines for ways in which to accommodate these important participants. This commentary highlights the need to acknowledge diverse types of knowing into what is considered evidence and advocates for evidence to include a wide-ranging variety of sources including tacit knowledge via experience and ongoing learning.

https://www.ijhpm.com/article_4429_ccadc1ca174f5ca0455adfd8081fdec6.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Challenges and Strategic Solutions to Guarantee Last Mile Reach for an Indian TB Patient’s Nikshay Poshan Yojana; A Conditional Cash Transfer Scheme; Comment on “Does Direct Benefit Transfer Improve Outcomes Among People With Tuberculosis? – A Mixed-Methods Study on the Need for a Review of the Cash Transfer Policy in India” 1 4 4427 10.34172/ijhpm.2023.7668 EN Harsh Shah Department of Public Health Science, Indian Institute of Public Health - Gandhinagar, Gujarat, India Journal Article 2022 09 04 India has put efforts into the prevention and control of tuberculosis (TB) for more than 50 years. Nikshay Poshan Yojna (NPY) is one of the schemes of conditional cash transfers (CCTs) by the Government of India. The CCT schemes mostly address the demand side constraints. Governments could use this in developing nations as a tool to divert financial resources toward societal development. In India, NPY is more directed toward providing monetary support for a nutritional diet and reducing the catastrophic expenditure of TB patients. Several studies highlighted challenges in implementing cash transfer schemes and provided different operational models. A country like India should address the challenges with defined strategies to ensure its last-mile reach. A present commentary discussing challenges and possible solutions that policy-makers can adapt and set up a support structure to ensure that supportive actions are implemented in response to patient and system side issues.

https://www.ijhpm.com/article_4427_fe64b393ffa70f1bfda52a7fa8c07b57.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Interest Groups and Health Facility Regulation – Future Directions for Health Policy and Systems Research; Comment on “What Lies Behind Successful Regulation? A Qualitative Evaluation of Pilot Implementation of Kenya’s Health Facility Inspection Reforms” 1 4 4424 10.34172/ijhpm.2023.7826 EN Veena Sriram School of Population and Public Health, School of Public Policy and Global Affairs, University of British Columbia, Vancouver, BC, Canada Vikash R. Keshri The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia The George Institute for Global Health India, New Delhi, India Journal Article 2022 11 21 In their paper, Tama and colleagues observe that one key challenge in a pilot, multi-component intervention to strengthen health facility regulation was the reaction from health facility owners and providers to regulatory processes. In this commentary, we propose that future research and action on health facility regulation in low- and middleincome countries (LMICs) contexts adopt an explicit focus on addressing the role of interests and interest groups in health systems ‘hardware’ and ‘software.’ Research on policy processes in LMICs consist of fewer investigations into the political economy of national or sub-national interest groups, such as physician associations or associations of health facility owners. A growing body of literature explores supply-side and demand-side interest groups, power relations within and between these stakeholders, and their advocacy approaches within LMIC health sector policy processes. We posit that such analyses will also help identify facilitators and challenges to implementation and scaleup of similar reforms to health facility regulation. <br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;" />

https://www.ijhpm.com/article_4424_01401ea1af8c052255cc5d1a821f13a2.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Translating, Contexting, and Institutionalising Knowledge Translation Practices in Northern Australia: Some Reflections; Comment on “Sustaining Knowledge Translation Practices: A Critical Interpretive Synthesis” 1 4 4431 10.34172/ijhpm.2023.7587 EN Alexandra Edelman College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia Stephanie M. Topp College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia Journal Article 2022 08 01 In this commentary, we reflect on how the three processes of translating, contexting, and institutionalising knowledge translation (KT) practices, as introduced in a critical interpretive synthesis on sustaining KT, might be drawn on to improve KT sustainability in the northern Australian health system, and some likely challenges. The synthesis provides a useful reminder that health systems are social systems and offers an analytical framework against which to map approaches that aim to align knowledge production and utilisation. By positioning “places” of knowledge utilisation and actor roles and networks as key to KT sustainability, the framework also offers the potential to draw attention to non-clinical settings, actors, and relationships that are central to improving health, but that may be historically neglected in KT research and scholarship.

https://www.ijhpm.com/article_4431_850aac70971dc2292f9d829721a9b3a5.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 National Trauma Registries in LMICs: Long-Overdue Priority; Comment on “Neurotrauma Surveillance in National Registries of Low- and Middle-Income Countries: A Scoping Review and Comparative Analysis of Data Dictionaries” 1 3 4435 10.34172/ijhpm.2023.7504 EN Zerubabbel K. Asfaw Department of Neurosurgery, Icahn School of Medicine, New York City, NY, USA Journal Article 2022 06 30 The burden of trauma-related mortality is inversely related to income on an individual and national scale. Barthélemy et al highlight the significant variation of neurotrauma data included in national injury registries of low- and middle-income countries (LMICs) when compared to the World Health Organization (WHO) minimal dataset for injury (MDI). Moreover, the authors emphasize that the non-existence and underutilization of nationally standardized trauma registries hinder the data-driven identification of factors contributing to neurotrauma and subsequent attempts to improve neurotrauma care. Establishing a nationally standardized trauma registry should be prioritized by all stakeholders involved in curbing trauma-related mortality and building research capacity in LMICs. In this commentary, previous successful efforts to establish and maintain robust registries in LMICs through local and international partnerships are highlighted. The lessons and challenges chronicled in establishing such registries can inform future efforts to implement a nationally standardized trauma registry.

https://www.ijhpm.com/article_4435_4c2d6d00e32e8a1df1b33660859368cf.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Bibliometrics, the “Clinical Diagnostics” of Research Impact; Comment on “‘We’re Not Providing the Best Care If We Are Not on the Cutting Edge of Research’: A Research Impact Evaluation at a Regional Australian Hospital and Health Service” 1 4 4421 10.34172/ijhpm.2023.7703 EN Giovanni Abramo Laboratory for Studies in Research Evaluation, Institute for System Analysis and Computer Science, National Research Council of Italy, Rome, Italy Ciriaco Andrea D’Angelo Department of Engineering and Management, University of Rome “Tor Vergata,” Rome, Italy Laboratory for Studies in Research Evaluation, Institute for System Analysis and Computer Science, National Research Council of Italy, Rome, Italy 0000-0002-6977-6611 Journal Article 2022 09 26 Following the Townsville Hospital and Health Service (THHS) strategic revision as a “research-based” institution, Brown et al have investigated the impact of THHS research, and its key drivers, based on 15 stakeholder interviews and two quantitative indicators. This commentary argues that the quantitative analyses and findings would have benefitted from applying evaluative bibliometrics, hopefully, conducted by experienced bibliometricians. We present the potential of bibliometrics for assessing the scholarly impact of research, as well as a few examples of its application to the case of THHS, for informing research policies and strategies.

https://www.ijhpm.com/article_4421_cc0fb497c4c9f484bc7d5432fd5c352e.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 National Neurotrauma Registry Data in Low- and Middle-Income Countries – Current Status and Future Requirements; Comment on “Neurotrauma Surveillance in National Registries of Low- and Middle-Income Countries: A Scoping Review and Comparative Analysis of Data Dictionaries” 1 3 4433 10.34172/ijhpm.2023.7935 EN Fiona Lecky CURE, School of Health and Related Research, University of Sheffield, Sheffield, UK Journal Article 2023 01 11 Since 1990 National Trauma Registries, — taking the form of “not for profit” small and medium enterprises — have been integral to improvementsin major injury case fatality in high-income settings. This is laudable but unsatisfactory as globally most years of life lost to injury occur in low- and middle-income countries (LMICs). International Journal of Health Policy and Management, recently published a scoping review of neurotrauma registries in LMICs by Barthelemy et al; from this the commentary reflects on the state of the art and how these LMIC registries could be taken to “the next level” as meaningful tools for improving major injury patient care.

https://www.ijhpm.com/article_4433_843e2d928fb9a23be7fdcc6dd28916cf.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Coloniality, Elite Networks and Intersectionality: Key Concepts in Understanding Biomedical Power and Equity in Health Policy Processes; Comment on “Power Dynamics Among Health Professionals in Nigeria: A Case Study of the Global Fund Policy Process” 1 4 4425 10.34172/ijhpm.2023.7916 EN Rakesh Parashar Health Policy and Systems, Sambodhi Research and communications, Noida, India Veena Sriram School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada School of Public Policy and Global Affairs, University of British Columbia, Vancouver, BC, Canada Sharmishtha Nanda Independent Researcher, New Delhi, India Frayashti Shekhawat Global Studies Ambedkar University, Delhi, India Journal Article 2023 01 03 To understand the role of power in health policy processes in low- and middle-income country (LMIC) contexts, it is necessary to engage with global and local power structures and their historical contexts. In this commentary, we outline three dimensions that shape a dominant power in health policy processes — the biomedical power. We propose that understanding the linkages between medical power and colonialism; the close connection of public health, medicine and elite networks; and the intersectionalities that shape the powers of medical professionals can offer the means to examine the biomedical hegemony in health policy processes. Additionally we suggest that a more nuanced understanding of the interaction of local powers with global funding can offer some entry points to achieving more equitable and interdisciplinary health policy processes in LMICs.

https://www.ijhpm.com/article_4425_539624d00866f598342046c1812333f4.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 “Post”-pandemic Capitalism: Reform or Transform?; Comment on “Ensuring Global Health Equity in a Post-pandemic Economy” 1 4 4432 10.34172/ijhpm.2023.7936 EN Howard Waitzkin Health Sciences Center and Department of Sociology, University of New Mexico, Albuquerque, NM, USA Journal Article 2023 01 16 This commentary expresses appreciation for Professor Labonté’s work, along with some hopefully constructive suggestions. Professor Labonté’s editorial shows ambivalence about reforms within capitalism. Such reforms remain contradictory and unlikely to prevail. Transformation to post-capitalist political economies is an exciting focus of moving beyond the hurtful effects of capitalism. Can “the state … mitigate capitalism’s inherent inegalitarianism”? Problematically, government resides in the capitalist state, whose main purpose is to protect the capitalist economic system. The state’s contradictory characteristics manifest in inadequate measures to protect health, as during the COVID-19 pandemic. “Social determination,” referring to illness-generating structures of power and finance, is replacing “social determinants,” referring mainly to demographic variables. Problems warranting attention include: capitalist industrial agriculture causing pandemics through destruction of protective natural habitat, structural racism, sexism and social reproduction, social class structure linked to inequality, and expropriation of nature to accumulate capital. Transformation to post-capitalism involves creative construction of new solidarity economies, while creative destructions block smooth functioning of the capitalist system.

https://www.ijhpm.com/article_4432_6084fa2c833777c061197f01a59d53a9.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 The Dynamics of Power Flow From the Global Health Financing; Comment on “Power Dynamics Among Health Professionals in Nigeria: A Case Study of the Global Fund Policy Process” 1 4 4434 10.34172/ijhpm.2023.7806 EN Garrett Wallace Brown University of Leeds, Leeds, UK Natalie Rhodes School of Politics and International Studies (POLIS), University of Leeds, Leeds, UK Journal Article 2022 11 08 This article agrees with Lassa et al that biomedical paradigms and medical professionals are a dominating force within the policy dynamics of the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) and that there needs to be greater community involvement in how global health initiatives (GHIs) are adopted, designed, implemented and evaluated. However, we argue that many of the conditions identified are entrenched and perpetuated by how GHIs are financed and the financing modalities employed in Development Aid for Health (DAH), particularly in low resource settings. As a result, the dynamics of power not only flow from traditionally entrenched epistemic authorities but are disproportionally sustained by global health financing modalities that favour particular GHIs over others. As we argue, these DAH modalities can exert forms of power with problematic effects on policy-making.

https://www.ijhpm.com/article_4434_a067524faec86549e7ed50ccffd0242a.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 The Performance of Primary Healthcare in China: The Need for a Systematic Design for Improvement; Comment on “Quality and Performance Measurement in Primary Diabetes Care: A Qualitative Study in Urban China” 1 3 4437 10.34172/ijhpm.2023.7889 EN Weiyan Jian Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China Qiaosheng Li Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China Lanyue Zhang Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China Journal Article 2022 12 15 In the paper “Quality and Performance Measurement in Primary Diabetes Care: A Qualitative Study in Urban China,” Rasooly and colleagues provide an in-depth analysis of the ways in which Shanghai manages the quality and performance of the primary healthcare (PHC). The present commentary extends the analytical perspective offered in this paper from the city of Shanghai to the entire Chinese Mainland. In so doing, it points out certain systemic shortcomings in the capabilities of family doctors, the unreasonable competition between primary, secondary, and tertiary forms of healthcare, and the negative incentives in the salary system for PHC providers that must be overcome to improve performance. This commentary also proposes strategies and other recommendations for overcoming the bottlenecks identified in the paper as a means of systematically enhancing PHC performance across Mainland China.

https://www.ijhpm.com/article_4437_891b8c2295635b80468302999a5baac9.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 How to Account for Asymmetries in Deliberative Dialogues; Comment on “Evaluating Public Participation in a Deliberative Dialogue: A Single Case Study” 1 3 4416 10.34172/ijhpm.2023.7701 EN Jaime Jiménez-Pernett International Health Department, Andalusian School of Public Health, Granada, Spain Public Health Research Center of the University of Montreal (CReSP), University of Montreal, Montreal, QC, Canada Biosanitary Research Institute of Granada (ibs.GRANADA), Granada, Spain 0000-0002-9894-7133 Journal Article 2022 09 25 In health policy-making, various deliberative mechanisms can be used to engage the members of the public in exploring what might be a reasonable course of action. Scurr et al take power dynamics into consideration to analyse a deliberative dialogue involving stakeholders with diverse points of view. Given such asymmetries at play, the conclusions of deliberations could be biased. Scholars would benefit from guidance on designing and evaluating deliberative processes. This commentary aims to broadly reflect on the possible sources of power and information asymmetries in deliberative dialogues, and to bring the biographical resources approach to deal with such asymmetries.

https://www.ijhpm.com/article_4416_eca45647879b2826fcfd549e48405308.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Integrating System Dynamics and Action Research: Towards a Consideration of Normative Complexity; Comment on “Insights Gained From a Re-analysis of Five Improvement Cases in Healthcare Integrating System Dynamics Into Action Research” 1 3 4441 10.34172/ijhpm.2023.7582 EN Rik Wehrens Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, The Netherlands Lieke Oldenhof Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, The Netherlands Marjolijn Heerings Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, The Netherlands Violet Petit-Steeghs Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, The Netherlands Sander Van Haperen Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, The Netherlands Roland Bal Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, The Netherlands Trisha Greenhalgh University of Oxford, Oxford, UK Journal Article 2022 07 29 Holmström and co-authors argue for the value of integrating system dynamics into action research to deal with increasing complexity in healthcare. We argue that despite merits, the authors overlook the key aspect of normative complexity, which refers to the existence of multiple, often conflicting values that actors in healthcare systems have to pragmatically develop responses to in their daily practices. We argue that a better theoretical and empirical understanding of the multiplicity of values and how actors deal with value conflicts in daily practices can enrich discussions about complexity in healthcare. We introduce the alternative methodology of ‘value exnovation’ for action researchers to broaden the scope of system-based thinking and action research in healthcare.

https://www.ijhpm.com/article_4441_7ad8442cc36232e568e43295661221a4.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 For Sake of Youth and for Sake of Policies and Programmes. Why Youth Participation is a Right, a Requirement and a Value; Comment on “Between Rhetoric and Reality: Learnings From Youth Participation in the Adolescent and Youth Health Policy in South Africa” 1 3 4442 10.34172/ijhpm.2023.7890 EN Gabriele Prati Department of Psychology “Renzo Canestrari,” University of Bologna, Cesena (FC), Italy 0000-0002-0749-183X Cinzia Albanesi Department of Psychology “Renzo Canestrari,” University of Bologna, Cesena (FC), Italy Journal Article 2022 12 15 This commentary discusses an article by Jacobs and George which investigated how youth participation can be an important component of health policy-making by conducting a case study based on qualitative interviews. We appreciate the methodology and the main findings of the study, which contribute to advancing our understanding of the challenges and opportunities of youth participation in health policy-making. We note that this article raises several questions and issues that we must address to advance research and practice: (i) is there is a substantial gap between rhetoric and reality in terms of youth participation? (ii) do youth policies have a direct impact on youth participation? (iii) can we define and operationalise meaningful engagement? (iv) who is included and who is excluded in youth participation projects? and (v) is youth participation a right, a requirement and a value?

https://www.ijhpm.com/article_4442_0b881ab78403fee0f2015b4324958cf2.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Should We Worry About Spillover Effects of Sugar Sweetened Beverage Taxation Policies?; Comment on “Understanding Marketing Responses to a Tax on Sugary Drinks: A Qualitative Interview Study in the United Kingdom, 2019” 1 4 4391 10.34172/ijhpm.2023.7793 EN Peter Hangoma Department of Health Policy and Management, School of Public Health, University of Zambia, Lusaka, Zambia Chr. Michelsens Institute (CMI), Bergen, Norway Bergen Centre for Ethics and Priority Setting in Health (BCEPS), University of Bergen, Bergen, Norway Mwimba Chewe Department of Health Policy and Management, School of Public Health, University of Zambia, Lusaka, Zambia Journal Article 2022 11 01 Taxes on sugar sweetened beverages (SSBs) have been widely implemented and heralded as a panacea in reversing the growing burden of non-communicable diseases (NCDs). Using a qualitative research methodology, Forde et al explored how sugary drink companies respond to changes in taxation positing that relative effectiveness of sugar taxes will not only depend on how prices are affected, and how consumers respond, but also how producers respond by reformulating their products or engaging in counteractive marketing strategies. They argue that these responses may undermine the public health goal. We discuss some of the key issues that arise in their paper and conclude that company responses may not be sufficient in undermining the public health goal, and that consumption of sugary drinks fall after imposition of taxes, though demand is inelastic. We argue that inelasticity of demand for SSB may require a combination of interventions to sufficiently reduce excess consumption of sugar drinks.

https://www.ijhpm.com/article_4391_766f5d5c0a370547a7e9c5ddbfd17284.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Cutting Edge Research? Realistic Expectations of Priorities, Scope and Engagement; Comment on “‘We’re Not Providing the Best Care If We Are Not on the Cutting Edge of Research’: A Research Impact Evaluation at a Regional Australian Hospital and Health Service” 1 4 4446 10.34172/ijhpm.2023.7792 EN Siân Williams Healthcare consultant, London, UK Genevie Fernandes Usher Institute, University of Edinburgh, Edinburgh, UK Journal Article 2022 10 30 While research is linked with informed decision-making and improved healthcare delivery and patient outcomes, the process of generating and translating research evidence in practice and capturing its impact can often be challenging. Based on document and database reviews and interviews in a regional Australian health system, Brown et al discuss the challenges of assessing the impact of research investments over a ten-year period. This commentary explores three inter-related lessons from this article for developing and sustaining a research culture and supporting translation in a health system: (i) achieving a shared definition and expectation of research; (ii) the importance of stakeholder engagement particularly for research prioritisation; and (iii) enabling research across a system. In doing so, it highlights the role and value of engaging knowledge generators and end-users from clinical, management and community domains not only in research development but most importantly in research prioritisation.

https://www.ijhpm.com/article_4446_daa52c7dd7be694b15df0fbecd507a1a.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Coercion and Its Discontents: The Promise and Peril of Increasingly Restrictive of Vaccination Mandates; Comment on “Convergence on Coercion: Functional and Political Pressures as Drivers of Global Childhood Vaccine Mandates” 1 3 4454 10.34172/ijhpm.2023.7617 EN James Colgrove Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York City, NY, USA Journal Article 2022 08 15 Attwell and Hannah present a cogent analysis of why policy-makers in four jurisdictions chose to use coercive approaches to increase vaccination rates between 2015 and 2017. Their study calls attention to the challenging political calculations that are necessary when choosing between coercion and persuasion to increase vaccine uptake. Further research is needed on the consequences of making a mandatory vaccination policy more restrictive, in order to better understand the backlash and resistance such a strategy may provoke. Although one reason that policy-makers may choose a coercive approach is that it is cheaper and easier to implement than a persuasive one, sociopolitical trends and backlash related to the COVID-19 pandemic may make coercive policies more politically risky in the coming years.

https://www.ijhpm.com/article_4454_257ccb666e744700130d9f7d936cf249.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Is It Time to Explore the Health Policy Process Within Governance and Health Systems Frameworks?; Comment on “Modelling the Health Policy Process: One Size Fits All or Horses for Courses?” 1 3 4460 10.34172/ijhpm.2023.8047 EN Stephen Peckham Centre for Health Services Studies, University of Kent, Canterbury, UK Journal Article 2023 03 24 There is clearly a need to improve the use of more robust policy theory on health policy analysis. Powell and Mannion in an editorial on the relationship between health policy analysis and the wider field of public policy theory note, as others have done before, the limited application of policy theory in health policy analysis. However, they also highlight that within the health policy analysis arena new models have emerged which have wider use within policy analysis such as the health policy triangle. While Powell and Mannion suggest that health policy analysis can take one of two paths I argue that we should be developing more integrated frameworks of health policy processes, governance and systems which would involve the use of robust public policy theories and models.

https://www.ijhpm.com/article_4460_b666830abecfe94520f3325278af66aa.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 If Providing Best Care Means Being at the Cutting Edge of Research, Should It Be Implemented System-wide?; Comment on “‘We’re Not Providing the Best Care If We Are Not on the Cutting Edge of Research’: A Research Impact Evaluation at a Regional Australian Hospital and Health Service” 1 4 4464 10.34172/ijhpm.2023.7718 EN Stephen R. Hanney Health Economics Research Group, Department of Health Sciences, Brunel University London, London, UK Journal Article 2022 10 01 The COVID-19 pandemic intensified debates about the desirability of integrating health research systems into healthcare systems. An excellent evaluation undertaken prior to the pandemic examined a purposeful strategy to improve healthcare through an expansion in research capacity in the Townsville Hospital and Health Service (THHS), a regional service in northern Queensland. This comment puts that evaluation into a rapidly developing wider context, drawing on other work showing an association between research engagement in healthcare organisations and their improved healthcare. In most previous studies this impact arose as a by-product of the research activity. The Townsville scheme went further. But while the evaluation identified some progress and impacts, they were patchy, not system-wide. Recent pre-pandemic studies showed that going even further and integrating a health research system across a national healthcare system markedly improved healthcare, despite continuing challenges. The UK’s research experiences during COVID-19 are giving additional momentum to this approach globally.

https://www.ijhpm.com/article_4464_ec05e292270eb669f09d7123d79b29de.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Challenges in Assessment of Health Systems Decentralization: The Role of Path Dependence and Choice of Indicators; Comment on “The Effects of Health Sector Fiscal Decentralisation on Availability, Accessibility, and Utilisation of Healthcare Services: A Panel Data Analysis” 1 4 4466 10.34172/ijhpm.2023.74274 EN Flavia Mori Sarti School of Arts, Sciences and Humanities, University of Sao Paulo, Sao Paulo, Brazil Journal Article 2022 05 31 Optimal resource allocation within national health systems represents the ultimate challenge in diverse countries worldwide. Major part of the literature points that health systems decentralization potentially address the challenge. The present commentary focuses on the debate referring to effects of health systems decentralization, based on the evidence of the study of Arianna Rotulo and colleagues. Studies on the subject emphasize the role of path dependence and the influence of choice of indicators for measurement of effects in the assessment of health systems decentralization. Acknowledging the complexity of the phenomena, the results of the study of Rotulo et al on health system decentralization in Italy are highlighted through the analysis of recent evidence from the literature. The present commentary shows that there are diverse indicators adopted in the literature on the subject, pointing to mixed results, depending on country characteristics and selection of indicators in the analysis. The synthesis of indicators gathered in recent studies also indicate that health system indicators are sensitive to path dependence, thus, requiring additional attention to assumptions of studies on health systems decentralization. Thus, studies should consider the influence of path dependence on organizational practices and institutional structures involved in decentralization processes, in addition to acknowledging that assessments on decentralization vary substantially according to indicators adopted in the analysis, and their links with previous decisions within health systems.

https://www.ijhpm.com/article_4466_f33647e39753deda119a5afab5c77927.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Marketing Responses to the Taxation of Soft Drinks; Comment on “Understanding Marketing Responses to a Tax on Sugary Drinks: A Qualitative Interview Study in the United Kingdom, 2019” 1 3 4456 10.34172/ijhpm.2023.7612 EN Leigh Sparks Stirling Management School, University of Stirling, Stirling, UK Journal Article 2022 08 12 The paper by Forde et al provides a useful qualitative consideration of marketing responses to the implementation of the 2018 Soft Drinks Industry Levy (SDIL) in the United Kingdom. This commentary discusses that paper and its conclusions and seeks to place them in a broader context for marketing, fiscal measures and health and public policy. It suggests that modern conceptualisations of marketing and wider considerations of market and non-market strategies could provide a valuable lens to understand the ways in which companies and sectors respond to the threats they perceive and the constantly changing sectoral opportunities. It is important that fiscal measures introduced have the desired effects, and that not only positive behaviours (whether of companies or consumers) are incentivised, but that adverse behaviours are actively disincentivised.

https://www.ijhpm.com/article_4456_048e232c1968b28cb982f4066d903df9.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Using a Stages Model to Reveal the Politics in the Health Policy Process; Comment on “Modelling the Health Policy Process: One Size Fits All or Horses for Courses?” 1 3 4461 10.34172/ijhpm.2023.8066 EN Rod Sheaff Peninsula School of Medicine and Dentistry, University of Plymouth, ITTC Plymouth Science Park, Plymouth, UK Journal Article 2023 04 03 Models of the health policy process have largely developed in isolation from political studies more widely. Of the models which Powell and Mannion’s editorial considers, a stages model of the policy process offers a framework for combining these specifically health-focused models with empirical findings and more general explanatory models of the policy process drawn from other political studies. This commentary uses a stages model to assemble a bricolage which combines some of these components. That identifies a further research task and suggests ways of revealing in more life-like ways the politics involved in the health policy process: that is, how that process channels wider, often conflicting, non-health interests, actors, policies, conflicts, ideologies and sources of power from outside the health system into health policy formation, and introduces non-rationality.

https://www.ijhpm.com/article_4461_17b19da62c204711a1295fa7d7fb33dc.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 A Social, Not a Natural Science: Engaging With Broader Fields in Health Policy Analysis; Comment on “Modelling the Health Policy Process: One Size Fits All or Horses for Courses?” 1 3 4459 10.34172/ijhpm.2023.8101 EN Justin Parkhurst Department of Health Policy, London School of Economics and Political Science, London, UK Journal Article 2023 05 07 Powell and Mannion’s recent editorial discusses how different ‘models’ of the policy process have been applied within the health policy field. They present two ways forward for scholarship: more ‘home grown’ development of health-specific models, or deeper engagement with broader public policy scholarship. In this paper I argue for the latter approach for several reasons. First, health policy analysis is a social, not a natural science – and as such is not exceptional to other forms of policy scholarship. Second, many ‘health policy models’ are often grounded in conceptual work from elsewhere (or may not be health specific). Finally, there has been significant work to develop more nuanced understandings of theories, models, and frameworks available to particular analytical tasks and questions. As such, the growing body of global health policy scholarship may find it can benefit more from deeper engagement with existing conceptual work than constructing its own new models in most cases.

https://www.ijhpm.com/article_4459_1f8114d68de2d1f83f2237faeb83acb1.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 The Importance of Mapping Determinants, Attitudes and Beliefs of Vaccine Hesitancy in the Great Challenge of Compulsory Childhood Vaccination; Comment on “Convergence on Coercion: Functional and Political Pressures as Drivers of Global Childhood Vaccine Mandates” 1 4 4463 10.34172/ijhpm.2023.7614 EN Federica Guaraldi IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy Marco Montalti Unit of Hygiene, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, Bologna, Italy Davide Gori Unit of Hygiene, Department of Biomedical and Neuromotor Sciences, Public Health and Medical Statistics, University of Bologna, Bologna, Italy Journal Article 2022 08 13 Vaccine hesitancy (VH) has risen significantly during the COVID-19 pandemic, becoming a major global health concern. VH is characterized by the delay or refusal of vaccination despite its availability. Various frameworks have been developed to understand the complex factors influencing VH, with attitudes, beliefs, and external influences being the most significant. The surge in VH has reignited the debate on the best approach to address it: persuasive/educational or coercive. Attwell and Hannah studied the political and social reasons behind the adoption of mandatory vaccination in four jurisdictions (Italy, France, Australia, and California) due to declining vaccine coverage below the safety threshold. However, these methods may foster parental disbeliefs and opposition to vaccination campaigns. To combat VH, it is crucial to systematically assess its determinants within specific contexts and population groups. Increasing awareness about vaccination benefits, engaging with social media, and employing tailored strategies can foster spontaneous adherence to vaccination programs, eliminating the need for coercive measures.

https://www.ijhpm.com/article_4463_72517a4bede9715b1807ec7d51ae313a.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Why Is It So Hard to Evaluate Knowledge Exchange?; Comment on “Sustaining Knowledge Translation Practices: A Critical Interpretive Synthesis” 1 3 4465 10.34172/ijhpm.2023.7549 EN Kathryn Oliver Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK Journal Article 2022 07 18 Despite a growth in knowledge translation (KT) or exchange activities, and a smaller growth in their evaluations, it remains challenging to identify evidence of efficacy. This could be due to well-documented political and logistical difficulties involved in evaluating knowledge exchange interventions. By bringing in theory from science and technology studies (STS), Borst et al1 offer a new way of thinking about this problem. Most KT evaluations draw on health research traditions; centralising comparability, efficacy, and so on. Borst et al propose focusing on the work it takes to move knowledge over boundaries between these communities, seeing relationships as interactions, not just conduits for evidence. They show how ‘context’ can be understood as a mutual creation, not a static environment; and that institutions shape behaviours, rather than merely being sites or platforms for evidence mobilisation. Seeing KT as a creative, active practice opens new ways to design and evaluate KT mechanisms.

https://www.ijhpm.com/article_4465_dbe18302afc1e1840ce805a50e8b0c48.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Situating Biomedical and Professional Monopoly at the Intersections of Structural, Ideational and Agentic Power; Comment on “Power Dynamics Among Health Professionals in Nigeria: A Case Study of the Global Fund Policy Process” 1 4 4467 10.34172/ijhpm.2023.8019 EN Anuj Kapilashrami School of Health & Social Care, University of Essex, Colchester, UK Journal Article 2023 03 10 Lassa and colleagues’ study is a strong commentary on the biomedical hegemony and professional monopoly of medical doctors in the policy landscape of the Global Fund in Nigeria. Situating this critical dimension of professional power within wider scholarship of power and governance of global health initiatives (such as the Global Fund), in this comment, I put forth two core arguments. I call for a relational perspective of power in a dynamic policy space that the Fund characterises. I argue that a systems-view analysis of power requires a thorough examination of subsystems, how they interact, and the diverse forms of power — individual agentic, ideational, and structural — and the mechanisms through which power is wielded. The lens of governmentality allows linking individual (expertise and practices) with institutional regimes and social practices these enable; and in examining the interface of local/sub-national, national, and global within which policy formulation and implementation occurs.

https://www.ijhpm.com/article_4467_2bdc63a5dbdef1ee55d538c6cc5cf01e.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Impact of the Regulatory Framework on Medical Device Software Manufacturers: Are the Guidance Documents Supporting the Practical Implementation?; Comment on “Clinical Decision Support and New Regulatory Frameworks for Medical Devices: Are We Ready for It? – A Viewpoint Paper” 1 4 4468 10.34172/ijhpm.2023.7470 EN Ruth Beckers Qualix BV, Leuven, Belgium Pascale Van Hoydonck Qualix BV, Leuven, Belgium Journal Article 2022 06 15 The increasing use in clinical practice of software such as mobile apps and clinical decision support (CDS) software has only recently been taken up by regulators around the world. Specifically, the European Commission and the US Food and Drug Administration (FDA) have updated their regulatory framework in the last years. Van Laere et al have given an extensive overview of the European and US approaches to regulate CDS software. This commentary further discusses regulatory differences between the two geographies and their impact on manufacturers of medical device software. We discuss the practical implementation of the regulatory framework for medical device software (especially CDS software) with a reference to the available international guidance documents and their limitations. Given the direction of stricter regulatory oversight in Europe, additional European guidelines/examples are desirable to enable a pragmatic regulatory approach ensuring continued access to innovative medical device software for European patients.

https://www.ijhpm.com/article_4468_bd56259d9ff9ab6df24601c69d3091b3.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Health Science Research at a Regional Level: Insights From South America; Comment on “The Roles of Regional Organisations in Strengthening Health Research Systems in Africa: Activities, Gaps, and Future Perspectives” 1 4 4471 10.34172/ijhpm.2023.8076 EN María Belén Herrero Department of International Relations, Facultad Latinoamericana de Ciencias Sociales (FLACSO), Buenos Aires, Argentina Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina Beatriz Nascimento Lins De Oliveira Centre for Social Studies, Coimbra University (CES/UC), Coimbra, Portugal Journal Article 2023 04 15 The article seeks to shed light on the role of regional organizations in strengthening health research systems in Africa, how they operate and how they work, as well as debts and future challenges. As can be observed also in South America, the continued strengthening of health research requires strategic thinking about the roles, comparative advantages, and capacity of regional organizations to facilitate the flourishing of health research systems. Health research is a strategic field for the transformation of socio-health inequalities on the one hand and the reduction of regional asymmetries on the other. Thus, regional organizations represent key actors in strengthening health research systems and the regional research agenda reinforces its sovereign condition in the autonomous definition of relevant topics and financing. In this process, integration mechanisms face a great challenge, as shown by the recent pandemic, not only in Africa but also in South America.

https://www.ijhpm.com/article_4471_342be5b75e505001b72f6d1cb500e227.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Ensuring Global Health Equity in a Post-Pandemic Economy: Words Count!; Comment on “Ensuring Global Health Equity in a Post-pandemic Economy” 1 3 4473 10.34172/ijhpm.2023.7794 EN Mariska Meurs Wemos, Amsterdam, The Netherlands Myria Koutsoumpa Wemos, Amsterdam, The Netherlands Valeria Huisman Wemos, Amsterdam, The Netherlands Journal Article 2022 11 01 The authors wholeheartedly agree with Labonté: global health equity needs radical changes in economic thinking and policies, including degrowth and reducing consumption in parts of the world. But to mobilize sufficient people for radical change, reducing overconsumption and for degrowth, we may need to stop calling it that. Language is important and using the same frames and words as our opponents do can be counterproductive. Global health advocates need to be strategic about framing, use hope-based communication and develop attractive and convincing narratives. By doing so, hopefully we can bring these messages across to larger groups of people and increase the push for social change.

https://www.ijhpm.com/article_4473_f11c67774d9272b33e5eff92d2d96d6a.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Why Should Health Researchers Use Policy Theories?; Comment on “Modelling the Health Policy Process: One Size Fits All or Horses for Courses?” 1 3 4474 10.34172/ijhpm.2023.7977 EN Paul Cairney Division of History, Heritage, and Politics, University of Stirling, Stirling, UK Journal Article 2023 02 16 Powell and Mannion suggest that ‘health policy process’ research should draw more lessons from ‘the wider policy process literature.’ While health research could continue with sector specific models, the wider literature is ‘conceptually stronger.’ In that context, I clarify how and why health researchers should use policy theories. I describe a review of the use of policy theories in public health research to show that many researchers use them to not only understand policy-making but also influence policy and policy-making. Most policy theories are not designed for that purpose, but it is still possible to produce practical lessons. I outline the issues that arise when repurposing theory-informed insights, such as that policy change takes a long time, and the scale of policy-making is potentially overwhelming. I then highlight the valuable role of theories in raising dilemmas in relation to modes of governance and evidence production.

https://www.ijhpm.com/article_4474_d9ea95ba70ce77d4b8216071642ecdf8.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Integrated Care Policies and Politics in Belgium: Conceptual, Contextual and Governance Linkages for More Effective Integrated Care Policy Management; Comment on “Integration or Fragmentation of Health Care? Examining Policies and Politics in a Belgian Case Study” 1 3 4475 10.34172/ijhpm.2023.7009 EN Jean Macq Institute of Health and Society (IRSS), UCLouvain, Brussels, Belgium Journal Article 2021 12 14 The study on the management of integrated care (IC) policies in Belgium from Martens et al illustrates the complex process of the political and stakeholder game in a country whose governance is changing as a result of successive state reforms. We argue that the way forward for putting health back at the centre of IC policy design and management is to improve three types of connections. First, the conceptual connections should help to articulate the different IC policies into a coherent overall picture. Second, contextual connections should allow for the adaptation of policies to different country contexts. This requires a new form of governance, ie, a place-based and adaptive form of governance. This can be developed, provided that a third connection, between the different levels of governance, is fully revised.

https://www.ijhpm.com/article_4475_90b1a09c6bdcea99013c64ced0f0e409.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Embedded Research: Possibilities for Learning Health Systems; Comment on “‘We’re Not Providing the Best Care if We are Not on the Cutting Edge of Research’: A Research Impact Evaluation at a Regional Australian Hospital and Health Service” 1 4 4479 10.34172/ijhpm.2023.7694 EN Mandy M. Archibald College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada Journal Article 2022 09 20 Brown et al show that research investments in an organization with a research and translation mandate can make important gains for research impact across domains, including quality of care and patient outcomes. Their multistage mixed methods evaluation provides insight into research capacity development in rural health systems in Australia and draws attention towards persistent geographic inequities. In extension of this important contribution, here, a focus on the “what and the why” of embedded research is offered. Specific attention is paid to the sustainability potentials of systematized data capture systems, funding-operational mandate alignments, researcher-scientist career pathways, and networked approaches to mentorship.

https://www.ijhpm.com/article_4479_031d497abe177a7fc72d11ef91a0538e.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Health Policy Analysis Requires Attending to Institutions; Comment on “Modelling the Health Policy Process: One Size Fits All or Horses for Courses?” 1 3 4481 10.34172/ijhpm.2023.8085 EN Patrick Harris Centre for Health Equity, Training, Research & Evaluation (CHETRE), Part of the UNSW Sydney Research Centre for Primary Health Care & Equity, A Unit of Population Health, South Western Sydney Local Health District, NSW Health, Ingham Institute, Liverpool, NSW, Australia Journal Article 2023 04 24 Powell and Manion present an important review of reviews about health and policy research. They zero in on theories of the policy process as the most likely to unearth what is really going on in health policy. Here I contend that their analysis insufficiently attends to institutions. Powell and Manion situate ‘institutions’ (with ‘Ideas’ and ‘Interests’) as a ‘health policy process models’ that ‘tend to’ list factors rather than connect them. Rather, I show how there is a rich history of considering institutions in the political science literature that is under considered by Powell and Manion. By necessity for a Public Health audience I quickly pull back the covers on ‘rigour’ and ‘causation’ to demonstrate what is ‘fit for purpose’ in rigorous institution focussed policy analysis. I conclude by arguing how institutionally focussed public health policy analysis is vital for understanding and addressing heath inequities. That focus necessitates research that provides better, explicit, conceptualisations of power in health policy: especially drawing out the roles played by structure and agency. I offer some recent examples.

https://www.ijhpm.com/article_4481_c8fd437f56c6e4a1ff168335fc97de77.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Advancing Youth Participation to Inform Equitable Health Policy; Comment on “Between Rhetoric and Reality: Learnings From Youth Participation in the Adolescent and Youth Health Policy in South Africa” 1 4 4480 10.34172/ijhpm.2023.7974 EN Janet Njelesani Department of Occupational Therapy, New York University (NYU), New York City, NY, USA Jean Hunleth Division of Public Health Sciences, Washington University in St. Louis, St. Louis, MO, USA Journal Article 2023 02 14 In their published study, Jacobs and George examine how youth participation was enabled to advance the Adolescent and Youth Health Policy (AYHP) in South Africa. Using an expanded and adapted conceptual framework of youth participation to inform their work, their findings center on the complexities of youth participation including enablers and the challenges experienced in the South African context. Building upon their foundational work, in this commentary we suggest further insights for consideration to advance youth participation to inform equitable health policies, including the inclusion of youth with intersecting identities and critical reflection to further advance the adapted conceptual framework.

https://www.ijhpm.com/article_4480_91e3cc1d34ab0e79bd1217b63d5bb4a7.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Rethinking Performance Measurement of Primary Care in China; Comment on “Quality and Performance Measurement in Primary Diabetes Care: A Qualitative Study in Urban China” 1 3 4469 10.34172/ijhpm.2023.7825 EN Jin Xu China Center for Health Development Studies, Peking University, Beijing, China Journal Article 2022 11 21 Increased political commitment and financial input to primary care have led to a growing role of performance measurement. Rasooly et al studied the implementation of performance measurement for primary care for people with diabetes in China. This is an important topic that has received little attention from previous literature. In light of the findings from the article, this paper argues for rethinking the current use of performance measurement. It also suggests potential ways to improve primary care performance measurement, in order to avoid some of the pitfalls of top-down performance measurement and to create an enabling environment for primary care strengthening.

https://www.ijhpm.com/article_4469_97993810b535d78d0fd846fc2c4e2c5d.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 The Values of the Care Economy; Comment on “Ensuring Global Health Equity in a Post-pandemic Economy” 1 3 4487 10.34172/ijhpm.2023.7762 EN Jennifer Cohen Department of Global and Intercultural Studies, Miami University, Oxford, OH, USA Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa Journal Article 2022 10 19 Labonté proposes that health equity and environmental sustainability may be best obtained through a care economy. Because a care economy plays a key role in Labonté’s formulation, its position in the capitalist political economy, the work it entails, and the workers who do it all merit further reflection. I aim to complement Labonté’s editorial by elaborating on care economies and the work of social reproduction. The existing care economy is a structural part of capitalism that largely generates and sustains inequities, reinforcing Labonté’s argument that transformation is needed. Transformation could, and should, change the perceived value, status, and material rewards of work in the care economy. I then touch on the policy tools Labonté describes, highlighting how they connect to my broader point: that the care economy is currently an integral, but devalued part of capitalism. For a transformation to take place, raising perceived value, status, and material rewards of caring work and the people who do it must be an explicit policy goal.

https://www.ijhpm.com/article_4487_6c33f51dbbbb56bdfb06e9b6e6ff0710.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Health in All Policies at the Local Level: What Facilitates Success?; Comment on “A Realist Explanatory Case Study Investigating How Common Goals, Leadership, and Committed Staff Facilitate Health in All Policies Implementation in the Municipality of Kuopio, Finland” 1 3 4489 10.34172/ijhpm.2023.7975 EN Carmel Williams Centre of the Health in All Policies Research Translation, School of Public Health, University of Adelaide, Adelaide, SA, Australia Health Translation SA, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia WHO Collaborating Centre on Advancing Health in All Policies Implementation, Adelaide, SA, Australia 0000-0003-2765-3020 Nicole Valentine Social Determinants of Health, World Health Organization (WHO), Geneva, Switzerland Journal Article 2023 02 15 The paper by Guglielmin and colleagues1 examines the implementation of Health in All Policies (HiAP) in a local government context in Kuopio Finland. The authors use a realist explanatory case study design to explore what has supported HiAP implementation with a focus on two specific hypotheses on what leads to success: common goals and committed leadership and staff. The paper is well argued using appropriate methodology and their findings support the importance of the success factors tested by their two hypotheses. However, the narrowed focus on just two hypotheses underrepresents the complexity of implementing HiAP at any level of government, including local government. Given its local government focus, the paper would have been strengthened by referencing the lessons gained from the Healthy Cities movement. Local government is a critical setting for action to address health and health equity and there is great potential to continue research that adds to the knowledge base on how to successful implement HiAP. Finally, it is important to acknowledge that Finland has a unique HiAP history. It is recognised as a global leader in the field, and the role of local government in Finland differs from many other countries. These factors may impact on the transferability of the case study findings.

https://www.ijhpm.com/article_4489_431e665b22a547a526781c2851b0a8ef.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 The Pervasiveness of Power: Dilemmas for Researchers of Major System Change in Healthcare; Comment on “‘Attending to History’ in Major System Change in Healthcare in England: Specialist Cancer Surgery Service Reconfiguration” 1 3 4488 10.34172/ijhpm.2023.7639 EN Chris Q Smith School of Social Policy, University of Birmingham, Birmingham, UK Iestyn Williams School of Social Policy, University of Birmingham, Birmingham, UK Journal Article 2022 08 22 To study major system change (MSC) in healthcare, it is crucial to consider the influence of power. Despite this, dominant perspectives on MSC in healthcare present these as relatively neutral processes, where reconfigurations are logical solutions to clearly defined problems. Perry and colleagues’ paper adds to a growing body of research which challenges the presentation of MSC as neutral, managerial processes, instead identifying how power dynamics lie at the heart of why service change happens, how it unfolds, and its outcomes. However, the introduction of power considerations raises several overlapping methodological and ethical dilemmas for researchers, and questions regarding research design and dissemination. In this commentary, we use the insights generated by Perry et al to further explore these issues.

https://www.ijhpm.com/article_4488_e1ef01e0f0290869dbaef0ee07b89440.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Advancing Empirics and Theory for a Deeper Political Economy Analysis; Comment on “Health Coverage and Financial Protection in Uganda: A Political Economy Perspective” 1 4 4490 10.34172/ijhpm.2023.7537 EN Ashley M. Fox Rockefeller College of Public Affairs and Policy, University at Albany, SUNY, Albany, NY, USA Journal Article 2022 07 15 At its core, political economy analysis involves examination of the relationship between the state and the market. A number of country case studies have emerged in recent years that aim to identify political economy factors facilitating or impeding health sector reforms towards universal coverage. In this commentary, we expand Nannini and colleagues’ analysis to elaborate on how political economy analyses can better inform policy design towards more successful reforms in low- and middle-income countries (LMICs) by drawing more heavily on improved research design and theory. We suggest three ways that political economy studies could make deeper claims by historicizing analyses, going comparative and/or by grounding findings more deeply in theory.

https://www.ijhpm.com/article_4490_09b1818dcd0d382d398692fe68645d13.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Policy Makes Politics; Comment on “Modelling the Health Policy Process: One Size Fits All or Horses for Courses?” 1 3 4493 10.34172/ijhpm.2023.8073 EN Scott L. Greer Health Management and Policy, Global Public Health, and Political Science, University of Michigan-Ann Arbor, Ann Arbor, MI, USA European Observatory on Health Systems and Policies, Brussels, Belgium Journal Article 2023 04 13 Powell and Mannion’s review of reviews maps the landscape of health policy research, showing a number of problematic and longstanding features. This commentary focuses on the extent to which health parochialism is good for the scientific development of the literature, the extent to which a “tournament of theories” actually develops our understanding of health policy process, and, finally, whether circumscribed theories of the policy process might be missing some of the most important and useful findings of broader comparative politics, which focus on the ways policies create politics over time. It concludes that health parochialism and focus on a circumscribed policy process is not likely to be helpful because it distracts attention from the ways in which coalitions and institutions over time shape politics and policy, a finding explored by scholars of many sectors whose findings should influence health policy research.

https://www.ijhpm.com/article_4493_fc60fb6a7f8cef728c1c83c71313736c.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Beyond Policy: Strengthening District Level Access to Surgery Is Critical to Achieving Surgical Equity in Universal Health Coverage; Comment on “Improving Access to Surgery Through Surgical Team Mentoring – Policy Lessons From Group Model Building With Local Stakeholders in Malawi” 1 3 4506 10.34172/ijhpm.2023.7594 EN Jaymie A. Henry The Global Alliance for Surgical, Obstetric, Trauma, and Anesthesia Care (G4 Alliance), Chicago, IL, USA Division of Cardiothoracic Surgery, Baylor College of Medicine, Houston, TX, USA Journal Article 2022 08 02 District level access to surgical care has been identified as the rate limiting step to increasing access to the bottom billion and relies on a complex interplay of patient-related and system-based factors that underlie the provision of quality surgical care at point of care. Surgical mentoring via visiting teams, use of current proprietary technologies to enhance communication, establishment of a national surgical coordinator and multi-stakeholder engagement with creative cost-sharing have all demonstrated promising results. Regardless of strategic implementation frameworks, system-based thinking coupled with implementation science with practical solutions will be necessary to inform stakeholders on the best way forward in their respective geographic field of work charting a path towards surgical equity in universal health coverage (UHC).

https://www.ijhpm.com/article_4506_39af77c708c1b54e4ee3d8f6d22e3b38.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Quality Measurement as a Path to High Quality Care; Comment on “Quality and Performance Measurement in Primary Diabetes Care: A Qualitative Study in Urban China” 1 6 4502 10.34172/ijhpm.2023.7884 EN John C. Matulis III Division of Community Internal Medicine, Geriatrics and Palliative Care, Department of Medicine, Mayo Clinic, Rochester, MN, USA Rozalina G. McCoy Division of Community Internal Medicine, Geriatrics and Palliative Care, Department of Medicine, Mayo Clinic, Rochester, MN, USA Division of Endocrinology, Diabetes & Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA University of Maryland Institute for Health Computing, Bethesda, MD, USA Journal Article 2022 12 13 A rigorous evaluation of the implementation of a diabetes quality measure implementation program across community healthcare clinics in Shanghai, China, where both quality measurement and primary care delivery are relatively recent but centrally supported, identified important concerns about the meaningfulness, feasibility, and accuracy of quality measures that are relevant to all quality measurement programs. These include the importance of stakeholder involvement in measure development and implementation, the need to select measures that accurately and reliably reflect care quality, the link between incentives for improved performance and data manipulation, the necessity for scientific credibility and practical feasibility of the measure, and the assurance that measure performance can be impacted by those being evaluated. In addition to elaborating on these aspects of quality measurement, we also discuss the need for quality measures that are balanced across established domains of quality, are not burdensome to participants, and are transparent, parsimonious, nimble, and oriented around continuous evaluation and improvement.

https://www.ijhpm.com/article_4502_6149dfa37fdf19eba7ac86b829228335.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Widening the Lens: Reflecting on the Mixing of System Dynamics With Action Research Alongside Work Within the Problem Structuring Methods Field; Comment on “Insights Gained From a Re-analysis of Five Improvement Cases in Healthcare Integrating System Dynamics Into Action Research” 1 3 4508 10.34172/ijhpm.2023.7620 EN Fran Ackermann School of Management and Marketing, Faculty of Business and Law, Curtin University, Perth, WA, Australia Journal Article 2022 08 16 This commentary reflects upon the insights for improvement cases reported by Holmström et al where they consider the integration of action research (AR) — a research methodology — and system dynamics (SD) — a modelling technique — to manage the complexity of patient care pathways. Whilst this combination can be effective, recognising that SD is a simulation model whereas AR is a research approach is important for both practical and conceptual reasons. In addition, some of the benefits noted can also be achieved through taking a wider examination of modelling techniques, particularly problem structuring methods (PSMs) as SD has been considered a PSM and PSMs are designed to effectively engage multi-disciplinary group members in the search for solutions as this will provide further avenues for both engagement and learning.

https://www.ijhpm.com/article_4508_c532d07d74e1ec138a0a1d0c5e02def6.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Frustrations of a Longtime Global Issues Activist; Comment on “Ensuring Global Health Equity in a Post-pandemic Economy” 1 4 4521 10.34172/ijhpm.2023.8242 EN Claudio Schuftan People’s Health Movement, Ho Chi Minh City, Vietnam Journal Article 2023 08 13 Labonté’s first commentary1 concluded with what I wholeheartedly agree, namely that “we need an activist public health movement to ensure there is sufficient political will to adopt them.” In their follow-up commentary, Moers and colleagues2 looked at things from a slightly different angle saying that to achieve equity will need radical changes in economic thinking and policies; they added that advocates needed to be strategic about framing and use hope-based communication and develop attractive and convincing narratives: “By doing so, hopefully we can bring these messages across to larger groups of people.” Well, I think that, together with many others, I have been strategic and radical, but only to accumulate a large bag of disappointments and broken hopes in trying to ‘bring the message across.’ But I come back to memories of so many defeats that I, with others, have lived through. Here, I describe my frustrations but explain why I do not give up hope.

https://www.ijhpm.com/article_4521_fa9400695d4009329a0bbff6be689193.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Harnessing Country Experiences for Health Benefit Package Design: Evidence-Informed Deliberative Processes and Experiences From the Joint Learning Network; Comment on “Evidence-Informed Deliberative Processes for Health Benefit Package Design – Part II: A Practical Guide” 1 3 4516 10.34172/ijhpm.2023.7856 EN Somil Nagpal The World Bank, Jakarta, Indonesia Naina Ahluwalia The World Bank, Washington, DC, USA Lauren Oliveira Hashiguchi The World Bank, Washington, DC, USA Kathleen McGee The World Bank, Washington, DC, USA Martin Lutalo The World Bank, Washington, DC, USA Journal Article 2022 12 02 Amidst competing priorities for allocating finite health resources, using evidence-informed priority setting is a valuable tool for achieving population-level health goals. The paper by Baltussen et al comprehensively reports on the development of practical guidance for evidence-informed deliberative processes (EDPs) which will help with sustainability of programs aimed at universal health coverage (UHC). The authors’ experience with the Joint Learning Network for UHC’s (JLN) peer-to-peer learning platform on evidence-informed priority setting offers insights on the practical challenges faced by countries in health benefits package (HBP) design, especially to draw in actors to advocate for the priorities and values across the health system. Lessons harvested from JLN countries that have established such advisory committees can provide practical insights for countries in earlier stages of establishing a systematic process for HBP design. Peer-to-peer learning modalities among countries offer viable and effective approaches to institutionalizing EDPs and systematic priority setting.

https://www.ijhpm.com/article_4516_df4de9ea430bae7c5a9de7ac51879c89.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Integrating System Dynamics Into Action Research: Drivers and Challenges in a Synergetic Complementarity; Comment on “Insights Gained From a Re-analysis of Five Improvement Cases in Healthcare Integrating System Dynamics Into Action Research” 1 3 4524 10.34172/ijhpm.2023.7585 EN Mohammadreza Zolfagharian Decision Sciences and Complex Systems Group, Faculty of Islamic Studies and Management, Imam Sadiq University, Tehran, Iran Journal Article 2022 07 31 This commentary discusses the paper by Holmström et al that explored how system dynamics (SD) may contribute effectively to an action research (AR) process to improve five health case studies. Accordingly, we reviewed some of the methodological aspects of the proposed integration of SD into AR using ongoing debates on multi-methodology and mixed methods research. In a systemic evaluation of the proposed design, we concentrated on some of the common distinct features of SD and AR, and the challenges as well as the expected outcomes of this integration. Finally, we tried to position the suggested framework within the multi-methodology efforts and to pave the way for developing it in future research and practice.

https://www.ijhpm.com/article_4524_2a163fd3d48bb793d8464c0d8ffad14e.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Supporting Youth Participation in Health and Climate Justice Through Advocacy Training; Comment on “Between Rhetoric and Reality: Learnings From Youth Participation in the Adolescent and Youth Health Policy in South Africa” 1 3 4530 10.34172/ijhpm.2023.7898 EN L. Katie O’Connell Georgia Institute of Technology, School of City and Regional Planning, Atlanta, GA, USA Nisha Botchwey Humphrey School of Public Affairs, University of Minnesota, Minneapolis, MN, USA Journal Article 2022 12 19 This paper responds to lessons from the Adolescent and Youth Health Policy (AYHP) process in South Africa by drawing comparisons with youth participation within the climate justice movement. Relationship building is essential to successful youth participation in health policy and climate change as it creates intergenerational learning and cross-cultural engagement. At the same time, both sets of youth also deal with compounding challenges due to contemporary and historical legacies of colonialism and inequality. Yet, tokenism challenges the participatory process as adults profess to value youth perspectives, yet recommendations by youth often do not get incorporated into policies or plans. For organizations and agencies trying to build youth’s capacity, organizations and agencies should look to programs that train youth in advocacy. These programs help build youth’s confidence, increase their optimism for change, and give youth a sense of ownership.

https://www.ijhpm.com/article_4530_630fa77dde2e6cdf726577b9c589dddb.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Doing Health Policy Analysis: The Enduring Relevance of Simple Models; Comment on “Modelling the Health Policy Process: One Size Fits All or Horses for Courses” 1 3 4537 10.34172/ijhpm.2023.8223 EN Lucy Gilson Health Policy and Systems Division, School of Public Health, University of Cape Town, Cape Town, South Africa Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK Gill Walt Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK Journal Article 2023 08 01 The analysis of health policy processes in low- and middle-income countries (LMICs) emerged as a research area in the early 1990s. In their recent editorial Powell and Mannion argue that such research can be deepened by applying public policy theory. In response, we raise three questions to consider: are public policy models fit for purpose in today’s world in LMICs (and what other theory can be used)? Is using theory the most important factor in deepening such research? Why do we, as researchers, do this work? Ultimately, we argue that the value of simple models, such as those already used in health policy analysis, lies in their enduring relevance and widespread use. They are supporting the development of the shared understandings that can, in turn, provide the basis for collective action addressing inequities in health and well-being.

https://www.ijhpm.com/article_4537_68865a97fbc0e06b98ef4da2a1c653d3.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Stakeholders’ Perceived Barriers and Successes of Quality Improvement Programs for Patients With Diabetes; Comment on “Quality and Performance Measurement in Primary Diabetes Care: A Qualitative Study in Urban China” 1 3 4543 10.34172/ijhpm.2023.7831 EN Ana Neumann Department of General Practice and Dental Public Health, School of Dentistry, The University of Texas Health Science Center at Houston, Houston, TX, USA Journal Article 2022 11 22 Rasooly et al performed a qualitative evaluation to characterize the experiences of 26 stakeholders with the implementation of diabetes-related quality and performance measures delivered in primary healthcare to patients with diabetes in metropolitan China. Results from this cross-sectional investigation identified relevant gaps in primary care delivery for people with diabetes from one major center in China. As diabetes is a prevalent condition worldwide, lessons learned from this research can be useful to guide, refine, and improve quality measurement evaluations in primary care in China and other countries. In this commentary, we comment on the strengths and weaknesses of the study, suggest future directions, and discuss how lessons learned from this research can be helpful to guide, refine, and improve the quality measurement of diabetes care in other countries.

https://www.ijhpm.com/article_4543_8d0d6def7b32b8c6c772856d033bf01a.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Investigating Resilience in Healthcare: Easier Said Than Done? A Response to the Recent Commentaries 1 3 4319 10.34172/ijhpm.2022.7682 EN Andrew Smaggus Queen’s University, Kingston, ON, Canada Janet C. Long Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia Louise A. Ellis Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia Robyn Clay-Williams Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia 0000-0002-6107-7445 Jeffrey Braithwaite Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia Journal Article 2022 09 16 Investigating Resilience in Healthcare: Easier Said Than Done? A Response to the Recent Commentaries

https://www.ijhpm.com/article_4319_7513cada9105d8ae56fbee50c92ea15e.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Evidence-Informed Policy-Making: Will It Ever Be Enough? A Response to the Recent Commentary 1 2 4324 10.34172/ijhpm.2022.7722 EN Sultana Al Sabahi Directorate General of Planning and Studies, Ministry of Health, Muscat, Oman Journal Article 2022 09 23 Evidence-Informed Policy-Making: Will It Ever Be Enough? A Response to the Recent Commentary

https://www.ijhpm.com/article_4324_6a68b68cd17aecb6a5940a9cb15437a1.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Dual Agency: A Fresh Perspective to Identify Dilemma Mitigation Strategies – A Response to the Recent Commentaries 1 3 4335 10.34172/ijhpm.2022.7758 EN Ruth Waitzberg Department of Health Care Management, Faculty of Economics & Management, Technical University Berlin, Berlin, Germany The Smokler Center for Health Policy Research, Myers-JDC-Brookdale Institute, Jerusalem, Israel Wilm Quentin Department of Health Care Management, Faculty of Economics & Management, Technical University Berlin, Berlin, Germany European Observatory on Health Systems and Policies, Brussels, Belgium Reinhard Busse Department of Health Care Management, Faculty of Economics & Management, Technical University Berlin, Berlin, Germany European Observatory on Health Systems and Policies, Brussels, Belgium Dan Greenberg Department of Health Systems Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel Journal Article 2022 10 12 Dual Agency: A Fresh Perspective to Identify Dilemma Mitigation Strategies – A Response to the Recent Commentaries

https://www.ijhpm.com/article_4335_af0a3cb9544ccb7eccd9be80159363ac.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 The Tale of Nine Belgian Health Ministers and a Multi-level Fragmented Governance System: Six Guiding Principles to Improve Integrated Care, Responsiveness, Resilience and Equity; A Response to the Recent Commentaries 1 2 4365 10.34172/ijhpm.2022.7848 EN Sara Van Belle Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium Joris Michielsen Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium Tom Cornu Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium Monika Martens Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium Department of Family Medicine and Population Health (FAMPOP), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium 0000-0002-1432-0684 Bruno Marchal Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium Journal Article 2022 11 19 The Tale of Nine Belgian Health Ministers and a Multi-level Fragmented Governance System: Six Guiding Principles to Improve Integrated Care, Responsiveness, Resilience and Equity; A Response to the Recent Commentaries

https://www.ijhpm.com/article_4365_0108ac4e7cb11339b4e3e6fb4f9076d4.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Attributes and Features of Context Relevant to Knowledge Translation in Health Settings: A Response to Recent Commentaries 1 4 4393 10.34172/ijhpm.2023.7908 EN Janet E. Squires Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, ON, Canada Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada Wilmer J. Santos Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada Ian D. Graham Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, ON, Canada Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada Jamie Brehaut Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada Janet A. Curran Faculty of Health, School of Nursing, Dalhousie University, Halifax, NS, Canada IWK Health Centre, Halifax, NS, Canada Jill J. Francis Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada School of Health Sciences, University of Melbourne, Melbourne, VIC, Australia Jeremy M. Grimshaw Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada Michael Hillmer Ontario Ministry of Health and LongTerm Care, Toronto, ON, Canada Noah Ivers Dalla Lana School of Public Health, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada Women’s College Research Institute, Toronto, ON, Canada John Lavis Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada Susan Michie University College London, London, UK Thomas Noseworthy Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada Alison M. Hutchinson School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia Barwon Health, Geelong, VIC, Australia Journal Article 2023 01 17 Attributes and Features of Context Relevant to Knowledge Translation in Health Settings: A Response to Recent Commentaries

https://www.ijhpm.com/article_4393_32b90f5d065817b1dedc49a03edc8ccb.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Challenges and Opportunities for Reducing Low-Value Care; A Response to Recent Commentaries 1 3 4407 10.34172/ijhpm.2023.7954 EN Simone A. Van Dulmen Radboud Institute for Health Sciences, IQ healthcare, Radboud University Medical Center, Nijmegen, The Netherlands Eva W. Verkerk Radboud Institute for Health Sciences, IQ healthcare, Radboud University Medical Center, Nijmegen, The Netherlands Karen Born Institute for Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, Canada Reshma Gupta University of California Health, Los Angeles, CA, USA Gert P. Westert Radboud Institute for Health Sciences, IQ healthcare, Radboud University Medical Center, Nijmegen, The Netherlands Rudolf B. Kool Radboud Institute for Health Sciences, IQ healthcare, Radboud University Medical Center, Nijmegen, The Netherlands Journal Article 2023 01 30 Challenges and Opportunities for Reducing Low-Value Care; A Response to Recent Commentaries

https://www.ijhpm.com/article_4407_691c58befe6747ba0a4b1ea7fbc94f5a.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Universal and Targeted Policy for Health Equity in the Neoliberal Era; A Response to the Recent Commentaries 1 2 4419 10.34172/ijhpm.2023.7998 EN Matthew Fisher Stretton Health Equity, University of Adelaide, Adelaide, SA, Australia Patrick Harris Centre for Health Equity Training, Research and Evaluation, University of New South Wales, Sydney, NSW, Australia Toby Freeman Stretton Health Equity, University of Adelaide, Adelaide, SA, Australia Emma George School of Allied Health Science and Practice, University of Adelaide, Adelaide, SA, Australia Fran Baum Stretton Health Equity, University of Adelaide, Adelaide, SA, Australia Journal Article 2023 02 19 Universal and Targeted Policy for Health Equity in the Neoliberal Era; A Response to the Recent Commentaries

https://www.ijhpm.com/article_4419_0a3a5d72eabf7d29ce73b90d5e59ed10.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Political Economy and Research Silos: A Response to the Recent Commentaries 1 4 4418 10.34172/ijhpm.2023.7995 EN Jennifer Lacy-Nichols Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia Owain Williams School of Politics and International Studies, University of Leeds, Leeds, UK Journal Article 2023 02 19 Political Economy and Research Silos: A Response to the Recent Commentaries

https://www.ijhpm.com/article_4418_363bc62c80ad0cffb0b533e1b46233a9.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Advancing Social Protection and Tuberculosis Elimination in India – Beyond Cash Transfers and Towards Addressing Social and Structural Determinants for a Healthier Future; A Response to the Recent Commentaries 1 2 4455 10.34172/ijhpm.2023.8130 EN Jigna D. Dave Department of Respiratory Medicine, Government Medical College Bhavnagar, Maharaja Krishnakumarsinhji Bhavnagar University, Bhavnagar, India Mihir P. Rupani Department of Community Medicine, Government Medical College Bhavnagar, Maharaja Krishnakumarsinhji Bhavnagar University, Bhavnagar, India Department of Clinical Epidemiology, Division of Health Sciences, ICMR-National Institute of Occupational Health (NIOH), Indian Council of Medical Research (ICMR), Ahmedabad, India Journal Article 2023 05 15 Advancing Social Protection and Tuberculosis Elimination in India – Beyond Cash Transfers and Towards Addressing Social and Structural Determinants for a Healthier Future; A Response to the Recent Commentaries

https://www.ijhpm.com/article_4455_687ca6bcb2c3938ade4411281ddd53ea.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Bridging Borders for Health: The Vital Role of Regional Cooperation in Infectious Disease Control and Mitigation of Health Emergencies; A Response to the Recent Commentaries 1 2 4478 10.34172/ijhpm.2023.8200 EN Anna Durrance-Bagale Department of Global Health & Development, London School of Hygiene & Tropical Medicine, London, UK Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore Li Yang Hsu Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore Natasha Howard Department of Global Health & Development, London School of Hygiene & Tropical Medicine, London, UK Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore Journal Article 2023 07 17 Bridging Borders for Health: The Vital Role of Regional Cooperation in Infectious Disease Control and Mitigation of Health Emergencies; A Response to the Recent Commentaries

https://www.ijhpm.com/article_4478_5ba10a0c33e2a93ac8570e282ab67f2d.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 The Dangers of Fiscal Decentralisation in Healthcare: A Response to the Recent Commentaries 1 2 4504 10.34172/ijhpm.2023.8266 EN Arianna Rotulo Department of Sustainable Health, Campus Fryslân, University of Groningen, Leeuwarden, The Netherlands Christina Paraskevopoulou School of Social Sciences, Panteion University of Social and Political Sciences, Attika, Greece Elias Kondilis Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece 0000-0001-9592-2830 Journal Article 2023 08 23 The Dangers of Fiscal Decentralisation in Healthcare: A Response to the Recent Commentaries

https://www.ijhpm.com/article_4504_b168b4b84ccb11e6e13d046c22f982f2.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Evolving Power Dynamics in Global Health: From Biomedical Hegemony to Market Dynamics in Global Health Financing; A Response to the Recent Commentaries 1 2 4503 10.34172/ijhpm.2023.8264 EN Samuel Lassa School of Health and Health Related Research, University of Sheffield, Sheffield, UK Division of Population Health, University of Sheffield, Sheffield, UK The Department of Community Medicine, University of Jos, Jos, Nigeria Muhammed Saddiq School of Health and Health Related Research, University of Sheffield, Sheffield, UK Jenny Owen School of Health and Health Related Research, University of Sheffield, Sheffield, UK Christopher Burton Division of Population Health, University of Sheffield, Sheffield, UK Julie Balen School of Health and Health Related Research, University of Sheffield, Sheffield, UK Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine, Faraja, The Gambia School of Allied and Public Health Professions, Canterbury Christ Church University, Canterbury, UK Journal Article 2023 08 23 Evolving Power Dynamics in Global Health: From Biomedical Hegemony to Market Dynamics in Global Health Financing; A Response to the Recent Commentaries

https://www.ijhpm.com/article_4503_8df4bc9e510405b1d7253af439820760.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 The Knowledge Translation Pizza-Dilemma: A Response to Recent Commentaries 1 2 4513 10.34172/ijhpm.2023.8296 EN Robert A.J. Borst Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands Rik Wehrens Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands Roland Bal Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands Journal Article 2023 09 26 The Knowledge Translation Pizza-Dilemma: A Response to Recent Commentaries

https://www.ijhpm.com/article_4513_29f32e6a9f0752dd2f929460e8ed6b0c.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Advancing Global Neurotrauma Surveillance Through National Registries: A Response to Recent Commentaries 1 3 4507 10.34172/ijhpm.2023.8288 EN Ernest J. Barthélemy Global Neurosurgery Laboratory, Division of Neurosurgery, SUNY Downstate Health Sciences University, Brooklyn, NY, USA Jacob Lepard Emory Children’s Center, Children’s Healthcare of Atlanta, Atlanta, GA, USA Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA Anna E. C. Hackenberg Technical University of Munich, Munich, Germany 5Department of Anaesthesiology, LMU University Hospital, Ludwig-Maximilian-University of Munich, Munich, Germany Joanna Ashby School of Medicine, University of Glasgow, Glasgow, UK Rebecca B. Baron Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York City, NY, USA Ella Cohen Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York City, NY, USA Jacquelyn Corley Samaritan Medical Group Brain & Spine Center, Corvallis, OR, USA Kee B. Park Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA Journal Article 2023 09 07 Advancing Global Neurotrauma Surveillance Through National Registries: A Response to Recent Commentaries

https://www.ijhpm.com/article_4507_60335d763e52311e57fdb06511d503e0.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Developing a Research Agenda for HiAP Implementation: A Response to the Recent Commentaries 1 3 4535 10.34172/ijhpm.2023.8326 EN Maria Guglielmin Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada Ketan Shankardass Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Toronto, ON, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada Patricia O'Campo MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Toronto, ON, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada Ahmed M. Bayoumi MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Toronto, ON, Canada Division of General Internal Medicine, St. Michael’s Hospital, Toronto, ON, Canada Department of Medicine, University of Toronto, Toronto, ON, Canada Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada Lauri Kokkinen Faculty of Social Sciences, Tampere University, Tampere, Finland Carles Muntaner MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Toronto, ON, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada Bloomberg School of Nursing University of Toronto, Toronto, ON, Canada Journal Article 2023 10 07 Developing a Research Agenda for HiAP Implementation: A Response to the Recent Commentaries

https://www.ijhpm.com/article_4535_3bc02b95fdb27c06e8f7a8f2c14b6373.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Transforming Capitalism, From Top Down to Bottom Up; A Response to the Recent Commentaries 1 4 4536 10.34172/ijhpm.2023.8338 EN Ronald Labonté Globalization and Health Equity, Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada Journal Article 2023 11 08 Transforming Capitalism, From Top Down to Bottom Up; A Response to the Recent Commentaries

https://www.ijhpm.com/article_4536_ffee4f7a1f99486ecee7c0aa8538da24.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Measuring Research Impact in a Health Service Is a Worthy but Complex Goal; A Response to Recent Commentaries 1 2 4534 10.34172/ijhpm.2023.8334 EN Amy Brown Townsville Hospital and Health Service, Townsville, QLD, Australia James Cook University, Townsville, QLD, Australia Tilley Pain Townsville Hospital and Health Service, Townsville, QLD, Australia James Cook University, Townsville, QLD, Australia Alexandra Edelman Menzies School of Health Research, Charles Darwin University, Alice Springs, NT, Australia James Cook University, Townsville, QLD, Australia Sarah Larkins James Cook University, Townsville, QLD, Australia Gillian Harvey Flinders University, Adelaide, SA, Australia Journal Article 2023 10 10 Measuring Research Impact in a Health Service Is a Worthy but Complex Goal; A Response to Recent Commentaries

https://www.ijhpm.com/article_4534_e07f0ab5d98eeeff215b6b547565d1c4.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 How to Design Integrated Strategies to Improve Healthcare Quality Whilst Containing Healthcare Costs? A Response to the Recent Commentaries 1 2 4532 10.34172/ijhpm.2022.8325 EN Erik Wackers Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands Niek Stadhouders Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands Anthony Heil Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands Simone Van Dulmen Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands Patrick Jeurissen Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands Ministry of Health, Welfare, and Sport, The Hague, The Netherlands Journal Article 2023 10 20 How to Design Integrated Strategies to Improve Healthcare Quality Whilst Containing Healthcare Costs? A Response to the Recent Commentaries

https://www.ijhpm.com/article_4532_66e4567ddab62346b9e9d058e77597ba.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Is Reformulation Still a Suitable Goal for Sugary Beverage Taxes? A Response to Recent Commentaries 1 3 4544 10.34172/ijhpm.2023.8366 EN Hannah Forde Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK Tarra L. Penney School of Global Health, York University, Toronto, ON, Canada Martin White MRC Epidemiology Unit, University of Cambridge, Cambridge, UK Jean Adams MRC Epidemiology Unit, University of Cambridge, Cambridge, UK Journal Article 2023 11 22 Is Reformulation Still a Suitable Goal for Sugary Beverage Taxes? A Response to Recent Commentaries

https://www.ijhpm.com/article_4544_82da807af08e3161bcc1cbad9ab8343e.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Comparative Insights to Advance Political Economy Analysis: A Response to Recent Commentaries 1 3 4545 10.34172/ijhpm.2023.8367 EN Maria Nannini ARCO (Action Research for CO-development), PIN Educational and Scientific Services for the University of Florence, Prato, Italy Department of Economics and Management, University of Florence, Florence, Italy Mario Biggeri ARCO (Action Research for CO-development), PIN Educational and Scientific Services for the University of Florence, Prato, Italy Department of Economics and Management, University of Florence, Florence, Italy Giovanni Putoto Doctors with Africa CUAMM, Padova, Italy Journal Article 2023 11 23 Comparative Insights to Advance Political Economy Analysis: A Response to Recent Commentaries

https://www.ijhpm.com/article_4545_9914f994eaaa00a30ac3f4480ce13d61.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Zero-Covid Strategy: What’s Next? 1 7 4189 10.34172/ijhpm.2022.6757 EN Zhiqing Zhan Department of Allergy and Clinical Immunology, Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China Department of Clinical Medicine, The Third Clinical School, Guangzhou Medical University, Guangzhou, China Jie Li Department of Clinical Medicine, The Third Clinical School, Guangzhou Medical University, Guangzhou, China Zhangkai J. Cheng Department of Allergy and Clinical Immunology, Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China Journal Article 2021 09 06

https://www.ijhpm.com/article_4189_0180cf0c235492bfbbdb3a7725f820b6.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 The Social Media Industry as a Commercial Determinant of Health 1 4 4248 10.34172/ijhpm.2022.6840 EN Marco Zenone Faculty of Public Health & Policy, London School of Hygiene and Tropical Medicine, London, UK Nora Kenworthy School of Nursing and Health Studies, University of Washington Bothell, Bothell, WA, USA Nason Maani Faculty of Public Health & Policy, London School of Hygiene and Tropical Medicine, London, UK Journal Article 2021 10 07

https://www.ijhpm.com/article_4248_0357b3eafff74f9eec69cd6d310cd803.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Development of Policy Recommendations to Support a National Autism Strategy: Case of a Virtual and Inclusive Stakeholder Engagement Process 1 4 4310 10.34172/ijhpm.2022.7182 EN Vanessa Tomas Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, ON, Canada Brittany Finlay School of Public Policy, University of Calgary, Calgary, AB, Canada Stephen J. Gentles Department of Community Health, Faculty of Human and Social Sciences, Wilfred Laurier University, Waterloo, ON, Canada Madison Campbell Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada Daljit Gill-Badesha Faculty of Education, University of British Columbia, Vancouver, BC, Canada Carolyn Abel Autism Alliance of Canada, Toronto, ON, Canada New York University, New York City, NY, USA Jennifer D. Zwicker School of Public Policy and Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada 0000-0002-0722-5929 Jonathan Lai Autism Alliance of Canada, Ottawa, ON, Canada Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada Journal Article 2022 02 16

https://www.ijhpm.com/article_4310_15edd2e7e638b28a8b02acda261be5a8.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Towards Legally Mandated Public Health Benchmarks 1 3 4328 10.34172/ijhpm.2022.7123 EN Jochen O. Mierau Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands Lifelines Cohort Study and Biobank, Roden, The Netherlands University Medical Center Groningen, Groningen, The Netherlands Brigit C.A. Toebes Aletta Jacobs School of Public Health, University of Groningen, Groningen, The Netherlands Faculty of Law, University of Groningen, Groningen, The Netherlands Journal Article 2022 01 25

https://www.ijhpm.com/article_4328_b4af18647d0302ff3571ec4b2a92c19c.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Ultra-Processed Food: The Tragedy of the Biological Commons 1 4 4359 10.34172/ijhpm.2022.7557 EN Norah Campbell Trinity Business School, Trinity College Dublin, Dublin 2, Ireland Sarah Browne Trinity Business School, Trinity College Dublin, Dublin 2, Ireland Marius Claudy School of Business, University College Dublin, Dublin, Ireland Kathryn Reilly Irish Heart Foundation, Dublin, Ireland Francis M. Finucane School of Medicine, CMNHS, University of Galway, Galway, Ireland Saolta University Health Care Group, Galway University Hospital, Galway, Ireland Journal Article 2022 08 22

https://www.ijhpm.com/article_4359_a9c64de3de81f9cb50ee600cdc3db5f5.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Implications of COVID-19 for Public Health Theory and Praxis From a Complex Systems Perspective 1 4 4351 10.34172/ijhpm.2022.7349 EN Vahid Yazdi-Feyzabadi Health Services Management Research Centre, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran Esmaeil Khedmati Morasae Centre for Circular Economy, Exeter University Business School, University of Exeter, Exeter, UK Sajad Delavari Health Human Resources Research Centre, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Journal Article 2022 04 24

https://www.ijhpm.com/article_4351_5cbf54fc921accb7b3c4818338a82378.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Exploring the Establishment of Hospice Service System Integrating Medical Care and Funeral Services 1 4 4370 10.34172/ijhpm.2022.7606 EN Yunling Wang Department of Medical Psychology and Ethics, School of Basic Medical Sciences, Shandong University, Jinan, China School of Marxism, Shandong First Medical University (Shandong Academy of Medical Sciences), Tai’an, China Weijia Tan Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada Yifang Wang The School of Health Humanities, Peking University, Beijing, China 0000-0003-1980-1126 Journal Article 2022 08 10

https://www.ijhpm.com/article_4370_5c9e53d2c2d52c735bf2b147860cd8cf.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Why Reducing Low-Value Care Fails to Bend the Cost Curve, and Why We Should Do it Anyway 1 3 4438 10.34172/ijhpm.2023.7803 EN Daniëlle Kroon Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands Niek W. Stadhouders Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands Simone A. Van Dulmen Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands Rudolf B. Kool Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands Patrick P.T. Jeurissen Radboud University Medical Center, Radboud Institute for Health Sciences, IQ healthcare, Nijmegen, The Netherlands Journal Article 2022 11 04

https://www.ijhpm.com/article_4438_153046d8c1e0c791d092463470e4a1ff.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Nurse Practitioner Integration: Insights Into the Next Generation of Policy and Research 1 4 4449 10.34172/ijhpm.2023.7411 EN Joshua Porat-Dahlerbruch Department of Acute and Tertiary Care, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA Department of Health Policy and Management, Guilford Glazer Faculty of Business & Faculty of Health Sciences, Ben-Gurion University of the Negev, Be’er Sheva, Israel Israel Implementation Science and Policy Engagement Centre, Ben-Gurion University of the Negev, Be’er Sheva, Israel Lusine Poghosyan Center for Healthcare Delivery Research and Innovations, School of Nursing, Columbia University, New York City, NY, USA Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York City, NY, USA Moriah Ellen Department of Health Policy and Management, Guilford Glazer Faculty of Business & Faculty of Health Sciences, Ben-Gurion University of the Negev, Be’er Sheva, Israel Israel Implementation Science and Policy Engagement Centre, Ben-Gurion University of the Negev, Be’er Sheva, Israel Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada Journal Article 2022 05 24

https://www.ijhpm.com/article_4449_82f7687603f6f99c93179dbf9b5eb846.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Understanding the Wide-Reaching Impact of Healthcare Merger and Acquisition Activity 1 4 4520 10.34172/ijhpm.2023.8049 EN David B. Burmeister Department of Emergency and Hospital Medicine, Lehigh Valley Health Network, University of South Florida Morsani College of Medicine (USF), Allentown PA, USA Journal Article 2023 03 27

https://www.ijhpm.com/article_4520_2b6484591bcb70c476321db81ee4bab3.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Do ChatGPT and Other Artificial Intelligence Bots Have Applications in Health Policy-Making? Opportunities and Threats 1 5 4526 10.34172/ijhpm.2023.8131 EN Plinio Morita School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada Department of Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada Research Institute for Aging, University of Waterloo, Waterloo, ON, Canada Centre for Digital Therapeutics, Techna Institute, University Health Network, Toronto, ON, Canada Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada Shahabeddin Abhari School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada Jasleen Kaur School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada Journal Article 2023 05 25

https://www.ijhpm.com/article_4526_aec2c16a90ba59e21e7c1d2c8f2d30be.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Introducing Critical Accounting for Governance as a Tool in Exploring the Commercial Determinants of Health 1 4 4539 10.34172/ijhpm.2023.8128 EN Lorna A. Stevenson Department of Management, University of St Andrews, St Andrews, UK Nason Maani School of Social and Political Science, University of Edinburgh, Edinburgh, UK Jonathan R. Olsen MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK Journal Article 2023 05 24

https://www.ijhpm.com/article_4539_d44d2d021619fb1f0d7cca7e2a4018a9.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Intersectoral Collaboration: What Works and What Doesn’t 1 2 4443 10.34172/ijhpm.2023.8090 EN Elizabeth H. Bradley Vassar College, Poughkeepsie, NY, USA Journal Article 2023 04 16

https://www.ijhpm.com/article_4443_1299623711b32d82aa09147d69fe8a0e.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Health and Care Workers in Pandemic Recovery: Major Challenges and Solutions 1 2 4444 10.34172/ijhpm.2023.8081 EN Viroj Tangcharoensathien International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand Ibadat Dhillon World Health Organization, South-East Asia Regional Office, New Delhi, India Journal Article 2023 04 14

https://www.ijhpm.com/article_4444_4a5ed59f78c67112c5e6921582b08ee1.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Using Financial Incentives and Market Mechanisms to Improve Hospitals’ Performance; A Double-edged Sword 1 2 4448 10.34172/ijhpm.2023.8088 EN Aidin Aryankhesal School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK Journal Article 2023 04 26

https://www.ijhpm.com/article_4448_5b91aa0548041804fc038d8a6db84056.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Enhancing Priority-Setting Decision-Making Process Through Use of Intersectionality for Public Participation 1 2 4452 10.34172/ijhpm.2023.8095 EN Anuj Kapilashrami School of Health and Social Care, University of Essex, Colchester, UK Donya Razavi Department of Health, Aging and Society, McMaster University, Hamilton, ON, Canada Reza Majdzadeh School of Health and Social Care, University of Essex, Colchester, UK Journal Article 2023 04 23

https://www.ijhpm.com/article_4452_90cf3395dea8f1c51c779b68a9aad5b5.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Constructing Equitable Health Resilience: A Call for a Systems Approach to Intersectionality 1 2 4451 10.34172/ijhpm.2023.8099 EN AbouAli Vedadhir Faculty of Social Sciences, University of Tehran, Tehran, Iran Department of Population Health Sciences, University of Bristol, Bristol, UK Peter Bloom School of Business, University of Essex, Colchester, UK Reza Majdzadeh School of Health and Social Care, University of Essex, Colchester, UK Journal Article 2023 05 06

https://www.ijhpm.com/article_4451_471afa3539563550ff5294f03cf8daeb.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Pricing New Drugs for COVID-19 in the Pharmaceutical Industry: Insights From the Chinese Medical Insurance 1 2 4457 10.34172/ijhpm.2023.7972 EN Jinmiao Lu Department of Clinical Pharmacy, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China Xiaohua Ying NHC Key Laboratory of Health Technology Assessment, Department of Health Economics, School of Public Health, Fudan University, Shanghai, China Zhiping Li Department of Clinical Pharmacy, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China Journal Article 2023 02 13

https://www.ijhpm.com/article_4457_84b3df3da29fd01f38da2b5a0fd7993f.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Value-Based Generic Drug Evaluation Focus on Chinese Real-World Evidence 1 2 4497 10.34172/ijhpm.2023.7970 EN Jinmiao Lu Department of Clinical Pharmacy, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China Xiaohua Ying NHC Key Laboratory of Health Technology Assessment, Department of Health Economics, School of Public Health, Fudan University, Shanghai, China Zhiping Li Department of Clinical Pharmacy, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China Journal Article 2023 02 13

https://www.ijhpm.com/article_4497_ed77255561bfca263e16dab816687ea7.pdf

Kerman University of Medical Sciences International Journal of Health Policy and Management 2322-5939 12 Issue 1 2023 12 01 Negotiating Medical Insurance Drug Prices: The Role in Reducing Costs of Orphan Drugs for Rare Diseases 1 2 4525 10.34172/ijhpm.2023.8195 EN Jinmiao Lu Department of Clinical Pharmacy, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China Xiaohua Ying NHC Key Laboratory of Health Technology Assessment, Department of Health Economics, School of Public Health, Fudan University, Shanghai, China Zhiping Li Department of Clinical Pharmacy, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China Journal Article 2023 07 13

https://www.ijhpm.com/article_4525_b6ea8bfd0060b08d79e4aaafbb0854e5.pdf