Pub Date : 2023-12-11DOI: 10.34172/ijhpm.2023.7938
Yinkai Zhang, Yu-Chih Chen, Julia Shu-Huah Wang
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 self-rated 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.
{"title":"Long-term Care Insurance and Health and Perceived Satisfaction of Older Chinese: Comparisons Between Urban/Rural Areas, Chronic Conditions, and Their Intersectionality","authors":"Yinkai Zhang, Yu-Chih Chen, Julia Shu-Huah Wang","doi":"10.34172/ijhpm.2023.7938","DOIUrl":"https://doi.org/10.34172/ijhpm.2023.7938","url":null,"abstract":"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 self-rated 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.","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"8 2","pages":""},"PeriodicalIF":3.5,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139183953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-10DOI: 10.34172/ijhpm.2023.8007
Seremi Ibadin, Mary Brindle, Tracy Wasylak, Jill Robert, Stacey Litvinchuk, K. Sauro
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.
{"title":"Delivery and Prioritization of Surgical Care in Canada During COVID-19: An Environmental Scan","authors":"Seremi Ibadin, Mary Brindle, Tracy Wasylak, Jill Robert, Stacey Litvinchuk, K. Sauro","doi":"10.34172/ijhpm.2023.8007","DOIUrl":"https://doi.org/10.34172/ijhpm.2023.8007","url":null,"abstract":"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.","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"28 5","pages":""},"PeriodicalIF":3.5,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139184442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-06DOI: 10.34172/ijhpm.2023.8128
Lorna A. Stevenson, N. Maani, J. Olsen
{"title":"Introducing Critical Accounting for Governance as a Tool in Exploring the Commercial Determinants of Health","authors":"Lorna A. Stevenson, N. Maani, J. Olsen","doi":"10.34172/ijhpm.2023.8128","DOIUrl":"https://doi.org/10.34172/ijhpm.2023.8128","url":null,"abstract":"","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"16 4","pages":""},"PeriodicalIF":3.5,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139186253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-06DOI: 10.34172/ijhpm.2023.7906
Adeel Akmal, Nataliya Podgorodnichenko, Robin Gauld, Tim Stokes
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.
{"title":"New Zealand Pae Ora Healthcare Reforms 2022: Viable by Design? A Qualitative Study Using the Viable System Model","authors":"Adeel Akmal, Nataliya Podgorodnichenko, Robin Gauld, Tim Stokes","doi":"10.34172/ijhpm.2023.7906","DOIUrl":"https://doi.org/10.34172/ijhpm.2023.7906","url":null,"abstract":"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.","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"17 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139185980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-04DOI: 10.34172/ijhpm.2023.8223
Lucy Gilson, G. Walt
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.
{"title":"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\"","authors":"Lucy Gilson, G. Walt","doi":"10.34172/ijhpm.2023.8223","DOIUrl":"https://doi.org/10.34172/ijhpm.2023.8223","url":null,"abstract":"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.","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"98 7","pages":""},"PeriodicalIF":3.5,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139186759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-27DOI: 10.34172/ijhpm.2023.8006
Wajeeha Raza, Wahaj Zulfiqar, M. Shah, M. Huda, Syeda Shehirbano Akhtar, Urooj Aqeel, Saira Kanwal, Muhammad Khalid, Raza Zaidi, Maarten Jansen, N. Kitson, Leon Bijlmakers, S. Siddiqi, A. Alwan, Anna Vassall, S. Torres-Rueda
Background: The Federal Ministry of National Health Services, Regulations and Coordination (MNHSR&C) in Pakistan has committed to progress towards Universal Health Coverage (UHC) by 2030 by providing an essential package for health services (EPHS). Starting in 2019, the Disease Control Priorities 3 (DCP3) evidence framework was used to guide the development of Pakistan’s EPHS. In this paper, we describe the methods and results of a rapid costing approach used to inform the EPHS design process. Methods: A total of 167 unit costs were calculated through a context-specific, normative, ingredients-based, bottom-up economic costing approach. Costs were constructed by determining resource use from descriptions provided by MNHSR&C and validated by technical experts. Price data from publicly available sources were used. Deterministic univariate sensitivity analyses were carried out. Results: Unit costs ranged from 2019 US$ 0.27 to 2019 US$ 1,478. Interventions in the cancer package of services had the highest average cost (2019 US$ 837) while interventions in the environmental package of services had the lowest (2019 US$ 0.68). Cost drivers varied by platform; the two largest drivers were drug regimens and surgery-related costs. Sensitivity analyses suggest our results are not sensitive to changes in staff salary but are sensitive to changes in medicine pricing. Conclusion: We estimated a large number of context-specific unit costs, over a six-month period, demonstrating a rapid costing method suitable for EPHS design.
{"title":"Costing Interventions for Developing an Essential Package of Health Services: Application of a Rapid Method and Results From Pakistan","authors":"Wajeeha Raza, Wahaj Zulfiqar, M. Shah, M. Huda, Syeda Shehirbano Akhtar, Urooj Aqeel, Saira Kanwal, Muhammad Khalid, Raza Zaidi, Maarten Jansen, N. Kitson, Leon Bijlmakers, S. Siddiqi, A. Alwan, Anna Vassall, S. Torres-Rueda","doi":"10.34172/ijhpm.2023.8006","DOIUrl":"https://doi.org/10.34172/ijhpm.2023.8006","url":null,"abstract":"Background: The Federal Ministry of National Health Services, Regulations and Coordination (MNHSR&C) in Pakistan has committed to progress towards Universal Health Coverage (UHC) by 2030 by providing an essential package for health services (EPHS). Starting in 2019, the Disease Control Priorities 3 (DCP3) evidence framework was used to guide the development of Pakistan’s EPHS. In this paper, we describe the methods and results of a rapid costing approach used to inform the EPHS design process. Methods: A total of 167 unit costs were calculated through a context-specific, normative, ingredients-based, bottom-up economic costing approach. Costs were constructed by determining resource use from descriptions provided by MNHSR&C and validated by technical experts. Price data from publicly available sources were used. Deterministic univariate sensitivity analyses were carried out. Results: Unit costs ranged from 2019 US$ 0.27 to 2019 US$ 1,478. Interventions in the cancer package of services had the highest average cost (2019 US$ 837) while interventions in the environmental package of services had the lowest (2019 US$ 0.68). Cost drivers varied by platform; the two largest drivers were drug regimens and surgery-related costs. Sensitivity analyses suggest our results are not sensitive to changes in staff salary but are sensitive to changes in medicine pricing. Conclusion: We estimated a large number of context-specific unit costs, over a six-month period, demonstrating a rapid costing method suitable for EPHS design.","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"32 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139229832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-13DOI: 10.34172/ijhpm.2023.8195
Jinmiao Lu, Xiaohua Ying, Zhiping Li
{"title":"Negotiating Medical Insurance Drug Prices: The Role in Reducing Costs of Orphan Drugs for Rare Diseases","authors":"Jinmiao Lu, Xiaohua Ying, Zhiping Li","doi":"10.34172/ijhpm.2023.8195","DOIUrl":"https://doi.org/10.34172/ijhpm.2023.8195","url":null,"abstract":"<jats:p> </jats:p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"9 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139278587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-12DOI: 10.34172/ijhpm.2023.8338
Ronald Labonté
{"title":"Transforming Capitalism, From Top Down to Bottom Up; A Response to the Recent Commentarie","authors":"Ronald Labonté","doi":"10.34172/ijhpm.2023.8338","DOIUrl":"https://doi.org/10.34172/ijhpm.2023.8338","url":null,"abstract":"<jats:p> </jats:p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"76 3","pages":""},"PeriodicalIF":3.5,"publicationDate":"2023-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139279403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-08DOI: 10.34172/ijhpm.2023.8326
Maria Guglielmin, K. Shankardass, Patricia O’Campo, Ahmed M Bayoumi, L. Kokkinen, Carles Muntaner
{"title":"Developing a Research Agenda for HiAP Implementation; A Response to the Recent Commentaries","authors":"Maria Guglielmin, K. Shankardass, Patricia O’Campo, Ahmed M Bayoumi, L. Kokkinen, Carles Muntaner","doi":"10.34172/ijhpm.2023.8326","DOIUrl":"https://doi.org/10.34172/ijhpm.2023.8326","url":null,"abstract":"<jats:p> </jats:p>","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"18 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139282546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-07DOI: 10.34172/ijhpm.2023.7451
Devaki Nambiar, Amy Bestman, Siddharth Srivastava, R. Marten, Sonam Yangchen, Kent Buse
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.
{"title":"How to Build Healthy Societies: A Thematic Analysis of Relevant Conceptual Frameworks","authors":"Devaki Nambiar, Amy Bestman, Siddharth Srivastava, R. Marten, Sonam Yangchen, Kent Buse","doi":"10.34172/ijhpm.2023.7451","DOIUrl":"https://doi.org/10.34172/ijhpm.2023.7451","url":null,"abstract":"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.","PeriodicalId":14135,"journal":{"name":"International Journal of Health Policy and Management","volume":"21 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139284215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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