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BMJ Global Health Oct 2023Health taxes are effective policy instruments to save lives, raise government revenues and improve equity. Health taxes, however, directly conflict with commercial... (Review)
Review
Health taxes are effective policy instruments to save lives, raise government revenues and improve equity. Health taxes, however, directly conflict with commercial actors' interests. Both pro-tax health advocates and anti-tax industry representatives seek to frame health tax policy. Yet, little is known about which frames resonate in which settings and how framing can most effectively advance or limit policies. To fill this gap, we conducted qualitative research in 2022, including focus group discussions, in-depth interviews, document reviews and media analysis on the political economy of health taxes across eight low-income and middle-income countries. Studies captured multiple actors constructing context-specific frames, often tied to broader economic, health and administrative considerations. Findings suggest that no single frame dominates; in fact, a plurality of different frames exist and shape discourse and policymaking. There was no clear trade-off between health and economic framing of health tax policy proposals, nor a straightforward way to handle concerns around earmarking. Understanding how to best position health taxes can empower health policymakers with more persuasive framings for health taxes and can support them to develop broader coalitions to advance health taxes. These insights can improve efforts to advance health taxes by better appreciating political economy factors and constraining corporate power, ultimately leading to improved population-level health.
Topics: Humans; Developing Countries; Health Policy; Policy Making; Politics; Taxes
PubMed: 37832966
DOI: 10.1136/bmjgh-2023-012955 -
Frontiers in Public Health 2023The host-pathogen relationship is inherently dynamic and constantly evolving. Applying an implementation science lens to policy evaluation suggests that policy impacts... (Review)
Review
RATIONALE
The host-pathogen relationship is inherently dynamic and constantly evolving. Applying an implementation science lens to policy evaluation suggests that policy impacts are variable depending upon key implementation outcomes (feasibility, acceptability, appropriateness costs) and conditions and contexts.
COVID-19 CASE STUDY
Experiences with non-pharmaceutical interventions (NPIs) including masking, testing, and social distancing/business and school closures during the COVID-19 pandemic response highlight the importance of considering public health policy impacts through an implementation science lens of constantly evolving contexts, conditions, evidence, and public perceptions. As implementation outcomes (feasibility, acceptability) changed, the effectiveness of these interventions changed thereby altering public health policy impact. Sustainment of behavioral change may be a key factor determining the duration of effectiveness and ultimate impact of pandemic policy recommendations, particularly for interventions that require ongoing compliance at the level of the individual.
PRACTICAL FRAMEWORK FOR ASSESSING AND EVALUATING PANDEMIC POLICY
Updating public health policy recommendations as more data and alternative interventions become available is the evidence-based policy approach and grounded in principles of implementation science and dynamic sustainability. Achieving the ideal of real-time policy updates requires improvements in public health data collection and analysis infrastructure and a shift in public health messaging to incorporate uncertainty and the necessity of ongoing changes. In this review, the Dynamic Infectious Diseases Public Health Response Framework is presented as a model with a practical tool for iteratively incorporating implementation outcomes into public health policy design with the aim of sustaining benefits and identifying when policies are no longer functioning as intended and need to be adapted or de-implemented.
CONCLUSIONS AND IMPLICATIONS
Real-time decision making requires sensitivity to conditions on the ground and adaptation of interventions at all levels. When asking about the public health effectiveness and impact of non-pharmaceutical interventions, the focus should be on , and they can achieve public health impact. In the future, rather than focusing on models of public health intervention effectiveness that assume static impacts, policy impacts should be considered as dynamic with ongoing re-evaluation as conditions change to meet the ongoing needs of the ultimate end-user of the intervention: the public.
Topics: Humans; Implementation Science; Pandemics; COVID-19; Public Policy; Communicable Diseases; Health Policy
PubMed: 37663826
DOI: 10.3389/fpubh.2023.1207679 -
International Journal For Equity in... Dec 2023Cancer causes a major disease burden worldwide. This is increasingly being realised in low and middle-income countries, which account disproportionately for preventable... (Review)
Review
BACKGROUND
Cancer causes a major disease burden worldwide. This is increasingly being realised in low and middle-income countries, which account disproportionately for preventable cancer deaths. Despite the World Health Organization calling for governments to develop policies to address this and alleviate cancer inequality, numerous challenges in executing effective cancer policies remain, which require consideration of the country-specific context. As this has not yet been considered in Ghana, the aim of this review was to bring together and critique the social-environmental, health policy and system factors to identifying opportunities for future health policies to reduce cancer burden in the Ghanian context. A critical policy-focused review was conducted to bring together and critique the current health systems context relating to cancer in Ghana, considering the unmet policy need, health system and social factors contributing to the burden and policy advances related to cancer.
CONCLUSION
The findings highlight the changing burden of cancer in Ghana and the contextual factors within the socio-ecosystem that contribute to this. Policies around expanding access to and coverage of services, as well as the harmonization with medical pluralism have potential to improve outcomes and increase equity but their implementation and robust data to monitor their impact pose significant barriers.
Topics: Humans; Ghana; Health Policy; Neoplasms; Public Policy
PubMed: 38066530
DOI: 10.1186/s12939-023-02067-2 -
Health Policy and Planning Nov 2023Due to constraints on institutional capacity and financial resources, the road to universal health coverage (UHC) involves difficult policy choices. To assist with these... (Review)
Review
Due to constraints on institutional capacity and financial resources, the road to universal health coverage (UHC) involves difficult policy choices. To assist with these choices, scholars and policy makers have done extensive work on criteria to assess the substantive fairness of health financing policies: their impact on the distribution of rights, duties, benefits and burdens on the path towards UHC. However, less attention has been paid to the procedural fairness of health financing decisions. The Accountability for Reasonableness Framework (A4R), which is widely applied to assess procedural fairness, has primarily been used in priority-setting for purchasing decisions, with revenue mobilization and pooling receiving limited attention. Furthermore, the sufficiency of the A4R framework's four criteria (publicity, relevance, revisions and appeals, and enforcement) has been questioned. Moreover, research in political theory and public administration (including deliberative democracy), public finance, environmental management, psychology, and health financing has examined the key features of procedural fairness, but these insights have not been synthesized into a comprehensive set of criteria for fair decision-making processes in health financing. A systematic study of how these criteria have been applied in decision-making situations related to health financing and in other areas is also lacking. This paper addresses these gaps through a scoping review. It argues that the literature across many disciplines can be synthesized into 10 core criteria with common philosophical foundations. These go beyond A4R and encompass equality, impartiality, consistency over time, reason-giving, transparency, accuracy of information, participation, inclusiveness, revisability and enforcement. These criteria can be used to evaluate and guide decision-making processes for financing UHC across different country income levels and health financing arrangements. The review also presents examples of how these criteria have been applied to decisions in health financing and other sectors.
Topics: Humans; Healthcare Financing; Health Priorities; Health Policy; Universal Health Insurance; Social Responsibility
PubMed: 37963078
DOI: 10.1093/heapol/czad066 -
Health Research Policy and Systems Sep 2023There is growing interest from health researchers in the governance of Health in All Policies (HiAP). Furthermore, the COVID-19 pandemic has re-ignited managers'... (Review)
Review
BACKGROUND
There is growing interest from health researchers in the governance of Health in All Policies (HiAP). Furthermore, the COVID-19 pandemic has re-ignited managers' interest in HiAP governance and in health prevention activities that involve actors from outside health ministries. Since the dynamics of these multi-actor, multi-sectoral policies are complex, the use of systems theory is a promising avenue toward understanding and improving HiAP governance. We focus on the concept of equilibrium within systems theory, especially as it points to the need to strike a balance between actors that goes beyond synergies or mimicry-a balance that is essential to HiAP governance.
METHOD
We mobilized two sources of data to understand how the concept of equilibrium applies to HiAP governance. First, we reviewed the literature on existing frameworks for collaborative governance, both in general and for HiAP specifically, in order to extract equilibrium-related elements. Second, we conducted an in-depth case study over three years of an HiAP implemented in Quebec, Canada.
RESULTS
In total, we identified 12 equilibrium-related elements relevant to HiAP governance and related to knowledge, actors, learning, mindsets, sustainability, principles, coordination, funding and roles. The equilibria were both operational and conceptual in nature.
CONCLUSIONS
We conclude that policy makers and policy implementers could benefit from mobilizing these 12 equilibrium-related elements to enhance HiAP governance. Evaluators of HiAP may also want to consider and integrate them into their governance assessments.
Topics: Humans; Pandemics; COVID-19; Health Policy; Administrative Personnel; Canada
PubMed: 37704970
DOI: 10.1186/s12961-023-01035-0 -
Journal of the Medical Library... Oct 2023With the arrival of ChatGPT, the academic community has expressed concerns about how generative artificial intelligence will be used by students and researchers alike....
With the arrival of ChatGPT, the academic community has expressed concerns about how generative artificial intelligence will be used by students and researchers alike. After consulting policies from other journals and discussing among the editorial team, we have created a policy on the use of AI on submissions to . This editorial provides a brief background on these concerns and introduces our policy.
Topics: Humans; Artificial Intelligence; Library Associations; Libraries, Medical; Policy; Research Personnel
PubMed: 37928115
DOI: 10.5195/jmla.2023.1826 -
PloS One 2023COVID-19 is a global pandemic. In response to this unprecedented crisis, Chinese government formulated a series of policies. This research is dedicated to exploring the...
COVID-19 is a global pandemic. In response to this unprecedented crisis, Chinese government formulated a series of policies. This research is dedicated to exploring the dynamic evolution of China's policy mix in response to COVID-19 in different crisis response stages from a network perspective. First, a three-dimensional analysis framework of "policy subject-policy target-policy instrument" was developed. Then, based on the data sets collected by textual analysis, the dynamic evolution of policy subject, policy target, policy instrument in China's policy mix in response to COVID-19 was discussed by using the method of SNA. This study concluded that the core policy subject, policy instrument, and policy target of China's response to COVID-19 changed with time. National Health Commission (NHC), Ministry of Finance (MOF), Ministry of Transport (MOT) and Ministry of Human Resources and Social Security (MHRSS) have important influences in the network of policy subjects. Other subjects are more at the edge of the network, and there are few joint issuances among policy subjects. The study also found that the core policy target was adjusted over time, with phased dynamic characteristics. At the initial stage of China's response to COVID-19, "reduce infection and mortality" and "steadily carry out economic and social work" were the core policy targets. With the COVID-19 under control, "enterprise development and work resumption" becomes a new core policy target. In addition, this study also revealed the dynamic evolution and unbalanced use of China's policy instruments in response to COVID-19 in different stages. The combination of policy instruments is mainly composed of "mandatory administration instruments" and "economic incentive instruments", and supplemented by "health promotion instruments" and "voluntary plan instruments". These findings may enrich the literature on COVID-19 policy to help researchers understand the dynamics of policy from a network perspective. Moreover, these findings may provide several valuable implications for policymakers and other countries to formulate more effective policies for epidemic response.
Topics: Humans; Developing Countries; COVID-19; China; Public Policy; Family Planning Policy
PubMed: 37768975
DOI: 10.1371/journal.pone.0291633 -
Health Policy (Amsterdam, Netherlands) Dec 2023A variety of methodologies have been developed to help health systems increase the 'value' created from their available resources. The urgency of creating value is... (Review)
Review
A variety of methodologies have been developed to help health systems increase the 'value' created from their available resources. The urgency of creating value is heightened by population ageing, growth in people with complex morbidities, technology advancements, and increased citizen expectations. This study develops a policy framework that seeks to reconcile the various approaches towards value-based policies in health systems. The distinctive contribution is that we focus on the value created by the health system as a whole, including health promotion, thus moving from value-based health care towards a value-based health system perspective. We define health system value to be the contribution of the health system to societal wellbeing. We adopt a framework of five dimensions of value, embracing health improvement, health care responsiveness, financial protection, efficiency and equity, which we map onto a society's aggregate wellbeing. Actors within the health system make different contributions to value, and we argue that their perspectives can be aligned with a unifying concept of health system value. We provide examples of policy levers and highlight key actors and how they can promote certain aspects of health system value. We discuss advantages of value-based approach based on the notion of wellbeing and some practical obstacles to its implementation.
Topics: Humans; Value-Based Health Care; Delivery of Health Care; Policy; Health Promotion
PubMed: 37797445
DOI: 10.1016/j.healthpol.2023.104918 -
BMC Research Notes Jul 2023This article introduces the Climate-related Financial Policies Database and provides statistics on its main indicators. The database records many aspects of green...
OBJECTIVES
This article introduces the Climate-related Financial Policies Database and provides statistics on its main indicators. The database records many aspects of green financial policymaking for 74 nations for the period 2000-2020 by financial (central banks, financial regulators, supervisors) and non-financial (ministries, banking organizations, governments, and others) entities. The database is crucial for identifying and evaluating present and future trends in green financial policies, as well as the role played by central banks and regulators in raising green financing and taming financial instability caused by climate change.
DATA DESCRIPTION
The database captures various aspects of financial (central banks and financial regulators and supervisors) and non-financial institutions' (ministries, banking associations, governments, and others) green financial policymaking in the period 2000-2020. Information is collected for the following variables: country/jurisdiction, economic development level (as defined by the World Bank Indicators), year of policy adoption, measure adopted and its bindingness, and authority/ies responsible for its implementation The database includes 74 countries, of which 39 are advanced economies, 20 are emerging, and 15 are developing economies. Open knowledge and data sharing encouraged by this article can support research in the developing field of financial policymaking related to climate change.
Topics: Policy Making; Policy
PubMed: 37415233
DOI: 10.1186/s13104-023-06418-8 -
CMAJ : Canadian Medical Association... Jun 2024
Topics: Humans; Social Support; Canada; Hospitals; Organizational Policy; Health Policy
PubMed: 38885977
DOI: 10.1503/cmaj.240577-f