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Journal of Psychiatric and Mental... Dec 2023WHAT IS KNOWN ON THE SUBJECT?: International guidelines for trans-and-gender-non-conforming (TGNC) exists in outpatient settings. Compared to cisgender and heterosexual... (Review)
Review
UNLABELLED
WHAT IS KNOWN ON THE SUBJECT?: International guidelines for trans-and-gender-non-conforming (TGNC) exists in outpatient settings. Compared to cisgender and heterosexual people, TGNC individuals are at a higher risk of mental health difficulties and have higher rates of inpatient mental health treatment. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: An international scoping review identifying the lack of guidelines existing for TGNC individuals in inpatient mental health settings. Compared to psychiatrists and psychologists, mental health nursing has the most contact with patients admitted for inpatient psychiatric treatment. The study identifies unaddressed needs in gender affirming policies and outlines preliminary policy recommendations to assist mental health staff in improving TGNC patient quality of care within the United States. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Reforming existing guidelines or creating new guidelines based on the identified themes and gaps to improve the well-being and treatment outcomes of TGNC individuals in inpatient psychiatric settings within the United States.
ABSTRACT
INTRODUCTION: Access to culturally sensitive care is critical for addressing known mental health disparities among trans-and gender-non-conforming (TGNC) individuals. Although there has been a proliferation of TGNC healthcare guidelines from accrediting bodies, policies have failed to address the needs of TGNC patients in inpatient psychiatric settings.
AIM
To identify unaddressed needs in policies and policy recommendations for the care of TGNC patients to inform recommendations for change.
METHOD
A scoping review protocol was developed following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 850 articles were reduced to seven relevant articles with six themes identified via thematic analysis.
RESULTS
Six themes were identified: lack of consistency in preferred and pronoun use, lack of communication among providers, lack of training in TGNC healthcare, personal bias, lack of formal policies, and housing segregation by sex rather than gender.
DISCUSSION
The creation of new guidelines or bolstering of existing guidelines to specifically address identified themes and gaps may improve the well-being and treatment outcomes of TGNC individuals in inpatient psychiatric settings.
IMPLICATIONS FOR PRACTICE
To provide a foundation for future studies to integrate these identified gaps and inform the future development of comprehensive formal policies that generalize TGNC care in inpatient settings.
Topics: Humans; Mental Health; Inpatients; Organizational Policy; Delivery of Health Care; Culturally Competent Care
PubMed: 37202857
DOI: 10.1111/jpm.12933 -
Health Research Policy and Systems Apr 2024Generally, public health policy-making is hardly a linear process and is characterized by interactions among politicians, institutions, researchers, technocrats and... (Review)
Review
BACKGROUND
Generally, public health policy-making is hardly a linear process and is characterized by interactions among politicians, institutions, researchers, technocrats and practitioners from diverse fields, as well as brokers, interest groups, financiers and a gamut of other actors. Meanwhile, most public health policies and systems in Africa appear to be built loosely on technical and scientific evidence, but with high political systems and ideologies. While studies on national health policies in Africa are growing, there seems to be inadequate evidence mapping on common themes and concepts across existing literature.
PURPOSE
The study seeks to explore the extent and type of evidence that exist on the conflict between politics and scientific evidence in the national health policy-making processes in Africa.
METHODS
A thorough literature search was done in PubMed, Cochrane Library, ScienceDirect, Dimensions, Taylor and Francis, Chicago Journals, Emerald Insight, JSTOR and Google Scholar. In total, 43 peer-reviewed articles were eligible and used for this review.
RESULT
We found that the conflicts to evidence usage in policy-making include competing interests and lack of commitment; global policy goals, interest/influence, power imbalance and funding, morals; and evidence-based approaches, self-sufficiency, collaboration among actors, policy priorities and existing structures. Barriers to the health policy process include fragmentation among actors, poor advocacy, lack of clarity on the agenda, inadequate evidence, inadequate consultation and corruption. The impact of the politics-evidence conflict includes policy agenda abrogation, suboptimal policy development success and policy implementation inadequacies.
CONCLUSIONS
We report that political interests in most cases influence policy-makers and other stakeholders to prioritize financial gains over the use of research evidence to policy goals and targets. This situation has the tendency for inadequate health policies with poor implementation gaps. Addressing these issues requires incorporating relevant evidence into health policies, making strong leadership, effective governance and a commitment to public health.
Topics: Humans; Health Policy; Policy Making; Public Policy; Politics; Africa
PubMed: 38622666
DOI: 10.1186/s12961-024-01129-3 -
BMJ Global Health Oct 2023Amidst high burden of infectious diseases, undernutrition and micronutrient deficiencies, non-communicable diseases (NCDs) are predicted to become the leading cause of...
Amidst high burden of infectious diseases, undernutrition and micronutrient deficiencies, non-communicable diseases (NCDs) are predicted to become the leading cause of death in Ghana by 2030. NCDs are driven, to a large extent, by unhealthy food environments. Concerned, the Ghana Ministry of Health (MOH) has since 2012 sought to garner the support of all to address this challenge. We aimed to support the MOH to address the challenge through public health policy measures, but would soon be reminded that longstanding challenges to policy development such as data poverty, and policy inertia needed to be addressed. To do this, the we generated the needed evidence, curated the evidence, and availed the evidence to Ghanaian policymakers, researchers and civil society actors. Thus, we addressed the problem of data poverty using context-relevant research, and policy inertia through advocacy and scholar activism. In this paper, we share how a public interest coalition used context-relevant research, evidence-informed advocacy and scholar activism to valorise and increase demand for healthy food policy (including food-related health taxes) in Ghana.
Topics: Humans; Ghana; Policy Making; Public Policy; Taxes
PubMed: 37813441
DOI: 10.1136/bmjgh-2023-012154 -
Global Health Action Dec 2023Advocacy is one of the core functions of public health and is a key tool for achieving Sustainable Development Goals. Public health associations play a key role in...
BACKGROUND
Advocacy is one of the core functions of public health and is a key tool for achieving Sustainable Development Goals. Public health associations play a key role in advocating for the development and implementation of strategies to prevent diseases and promote health and well-being.
OBJECTIVE
This study aims to map out the focus of public health advocacy carried out by selected national public health associations over 4 years, between 2018 and 2021, in order to identify gaps and strengths and support associations and professionals in their advocacy efforts.
METHODS
Twelve national public health associations participated in the study. Official policy documents produced between 2018 and 2021 were collected and analysed. The title and summary of the policy documents were examined line by line and coded into the main subject categories and themes. A qualitative thematic analysis was conducted. Policies were assessed from global and regional perspectives.
RESULTS
A total of 220 policy documents were analysed. Overall, the largest number of policy documents came from high-income countries and dealt with environmental health and communicable diseases, including COVID-19, with, however, important differences among regions. In the African region, public health advocacy focused mainly on strengthening health systems; Europe and South America were mostly concerned with communicable diseases and pandemic management; and North America and the Western Pacific regions focused primarily on climate change. Limited attention was paid to international health and health as a human right in all regions.
CONCLUSION
Our study showed that, especially in high-income countries, public health associations actively engage in advocacy; however, more effort needs to be devoted to implementing a more international and intersectoral approach at the global level, anchored in health as a human right and aligned with the Sustainable Development Goals.
Topics: Humans; Health Promotion; Public Health; COVID-19; Public Policy; Health Policy
PubMed: 36856722
DOI: 10.1080/16549716.2023.2183596 -
World Journal of Surgery Dec 2023National surgical policies have been increasingly adopted by African countries over the past decade. This report is intended to provide an overview of the current state...
BACKGROUND
National surgical policies have been increasingly adopted by African countries over the past decade. This report is intended to provide an overview of the current state of adoption of national surgical healthcare policies in Africa, and to draw a variety of lessons from representative surgical plans in order to support transnational learning.
METHODS
Through a desk review of available African national surgical healthcare plans and written contributions from a committee comprising six African surgical policy development experts, a few key lessons from five healthcare plans were outlined and iteratively reviewed.
RESULTS
The current state of national surgical healthcare policies across Africa was visually mapped, and lessons from a few compelling examples are highlighted. These include the power of initiative from Senegal; regional leadership from Zambia; contextualization, and renewal of commitment from Ethiopia; multidisciplinary focus and creation of multiple implementation entry points from Nigeria; partnerships and involvement of multiple stakeholders from Rwanda; and the challenge of surgical policy financing from Tanzania. The availability of global expertise, the power of global partnerships, and the critical role of health ministries and Ministers of Health in planning and implementation have also been highlighted.
CONCLUSIONS
Strategic planning for surgical healthcare improvement is at various stages across the continent, with potential for countries to learn from one another. Convenings of stakeholders and Ministers of Health from countries at various stages of strategic surgical plan development, execution, and evaluation can enhance African surgical policy development through the exchange of ideas, lessons, and experiences.
Topics: Humans; Health Policy; Policy Making; Rwanda; Tanzania; Delivery of Health Care
PubMed: 37550548
DOI: 10.1007/s00268-023-07131-0 -
Journal of Public Health Policy Dec 2023To support implementation of important public health policies, policymakers need information about implementation costs over time and across stakeholder groups. We...
To support implementation of important public health policies, policymakers need information about implementation costs over time and across stakeholder groups. We assessed implementation costs of two federal sugar-sweetened beverage (SSB) policies of current policy interest and with evidence to support their effects: excise taxes and health warning labels. Our analysis encompassed the entire policy life cycle using the Exploration, Preparation, Implementation, and Sustainment framework. We identified implementation actions using key informant interviews and developed quantitative estimates of implementation costs using published literature and government documents. Results show that implementation costs vary over time and among stakeholders. Explicitly integrating implementation science theory and using mixed methods improved the comprehensiveness of our results. Although this work is specific to federal SSB policies, the process can inform how we understand the costs of many public health policies, providing crucial information for public health policy making.
Topics: Humans; United States; Sugar-Sweetened Beverages; Public Policy; Taxes; Beverages
PubMed: 37714964
DOI: 10.1057/s41271-023-00435-4 -
The Proceedings of the Nutrition Society May 2024Globally, the prevalence of those living with obesity (≥30 kg/m) is rising, with this trend expected to continue if firm and decisive policy interventions are not... (Review)
Review
Globally, the prevalence of those living with obesity (≥30 kg/m) is rising, with this trend expected to continue if firm and decisive policy interventions are not introduced. Across Europe, despite many consecutive policies aiming to reverse rising trends in weight status over recent decades, no country is currently on track to halt and reverse current trends in the coming years. This is evident in Ireland too, whereby the reporting of nationally representative weight status data show that targets have not been achieved since reporting began. The aim of this review is to critically appraise recent evidence relating to the key determinants of obesity including weight status, diet quality and physical activity with an emphasis on socioeconomic inequalities. And to consider these in the context of respective policy measures and propose future-focused recommendations. Furthermore, as with the complex nature of obesity, multifaceted approaches that shift the focus from the individual and place responsibility at a societal level will be reviewed.
Topics: Humans; Ireland; Obesity; Exercise; Diet; Socioeconomic Factors; Health Policy; Prevalence; Nutrition Policy
PubMed: 38047397
DOI: 10.1017/S0029665123004780 -
Evaluation Review Jun 2024This chapter begins with an overview of recent developments that have encouraged and facilitated greater use of research syntheses, including Meta-Analysis, to guide...
This chapter begins with an overview of recent developments that have encouraged and facilitated greater use of research syntheses, including Meta-Analysis, to guide public policy and practice in education, workforce development, and social services. It discusses the role of Meta-Analysis for improving knowledge of the effectiveness of programs, policies, and practices and the applicability and generalizability of that knowledge to conditions other than those represented by the study samples and settings. The chapter concludes with recommendations for improving the potential of Meta-Analysis to accelerate knowledge development through changing how we design, conduct, and report findings of individual studies to maximize their usefulness in Meta-Analysis as well as how we produce and report Meta-Analysis findings. The paper includes references to resources supporting the recommendations.
Topics: Public Policy; Meta-Analysis as Topic
PubMed: 38308503
DOI: 10.1177/0193841X241229885 -
Archives of Disease in Childhood Jul 2023Interventions to tackle the social determinants of health can improve outcomes during pregnancy and early childhood, leading to better health across the life course.... (Review)
Review
OBJECTIVE
Interventions to tackle the social determinants of health can improve outcomes during pregnancy and early childhood, leading to better health across the life course. Variation in content, timing and implementation of policies across the 4 UK nations allows for evaluation. We conducted a policy-mapping review (1981-2021) to identify relevant UK early years policies across the social determinants of health framework, and determine suitable candidates for evaluation using administrative data.
METHODS
We used open keyword and category searches of UK and devolved Government websites, and hand searched policy reviews. Policies were rated and included using five criteria: (1) Potential for policy to affect maternal and child health outcomes; (2) Implementation variation across the UK; (3) Population reach and expected effect size; (4) Ability to identify exposed/eligible group in administrative data; (5) Potential to affect health inequalities. An expert consensus workshop determined a final shortlist.
RESULTS
336 policies and 306 strategy documents were identified. Policies were mainly excluded due to criteria 2-4, leaving 88. The consensus workshop identified three policy areas as suitable candidates for natural experiment evaluation using administrative data: pregnancy grants, early years education and childcare, and Universal Credit.
CONCLUSION
Our comprehensive policy review identifies valuable opportunities to evaluate sociostructural impacts on mother and child outcomes. However, many potentially impactful policies were excluded. This may lead to the inverse evidence law, where there is least evidence for policies believed to be most effective. This could be ameliorated by better access to administrative data, staged implementation of future policies or alternative evaluation methods.
Topics: Child, Preschool; Female; Humans; Child Care; Maternal Health; Policy; United Kingdom; Pregnancy
PubMed: 37001969
DOI: 10.1136/archdischild-2022-325219 -
Disability and Rehabilitation.... Nov 2023The aim was to develop targeted and complete policy structure of China's assistive products, and to provide recommendations for boosting the matching rate of assistive...
PURPOSE
The aim was to develop targeted and complete policy structure of China's assistive products, and to provide recommendations for boosting the matching rate of assistive products and driving the benign development of China's assistive product market.
METHODS
This paper establishes a theoretical framework of the development logic of assistive product policies. Then it adopts the text quantification method to review 81 relevant documents on these policies issued from 1988 to 2019 systematically.
RESULTS
We found that environmental policy tools account for the largest proportion with regard to policy tool, and can provide a good policy environment; the role of demand-based policy tools in creating market activity and stimulating industrial development needs to be elevated. The policies concerning assistive products industry in China show a rising trend. This paper is centred on the relatively stable theme of policy issuing. Coordination with various ministries can maximize the benefits. In the early period, the targeted policy objectives are put forward for assistive products industry; in the later period, the focus is on the combination with the policies concerning the elderly. Division of labour and proper coordination are required to coordinate type of policies.
CONCLUSION
The key to the industrial development lies in promoting the change of consumption concepts, and the difficulty lies in how to coordinate the contradiction interests between product suppliers and demanders through policy intervention.
IMPLICATIONS FOR REHABILITATION
The relatively disadvantaged position of users of assistive products determines certain public goods attributes of the products, which mean that the operation of the market cannot rely entirely on the price mechanism. That is, non-market mechanisms (especially the administrative mechanism) need to play their roles in the case of a market failure.After more than 30 years of development, assistive product policies in China covered various policy tools such as supply-based, demand-based and environment-based ones, and the assistive product industry has developed significantly. However, the recipients of assistive products are mainly among disadvantaged groups such as persons with disabilities and the elderly. The products have social welfare attributes. The policies involve profound changes in economic conditions, industrial models and institutional mechanisms. The key to the industrial development lies in promoting the change of consumption concepts, and the difficulty lies in how to coordinate the contradiction in interests between product suppliers and demanders through policy intervention at this stage.This paper systematically analyzes the development logic and practice of China's industry policies of assistive products and put forward suggestions that more attention of policies can be paid to the demand side and develop a demand-pull model, the consumption of universal products can be encouraged and guided by policies, and attempts in policies can be made to guide the consumption concept of assistive products.
Topics: Aged; Humans; China; Disabled Persons; Industry; Policy
PubMed: 36368072
DOI: 10.1080/17483107.2022.2143582