Health Policy Open最新文献_第3页

Catastrophic and impoverishing out-of-pocket payments for health care in Poland in 2013–2021 2013-2021年波兰灾难性和贫困的自付医疗保健费用

IF 1.7 Q3 HEALTH CARE SCIENCES & SERVICES

Health Policy Open

Pub Date : 2025-06-07 DOI: 10.1016/j.hpopen.2025.100143

Marzena Tambor , Jorge Alejandro García-Ramírez , Milena Pavlova

Protecting households from financial hardship when accessing health care is a universal policy objective across European countries. Previous analyses have shown that households in Poland relatively often experience financial strain due to out-of-pocket payments for health. This study aims to provide new evidence on financial protection in Poland, using indicators of catastrophic and impoverishing health spending. We used data from annual household budget surveys between 2013 and 2021. Catastrophic spending is defined as payments for health greater than 40% of the household’s capacity to pay, while impoverishing spending occurs when out-of-pocket payments are higher than the capacity to pay. We employed logistic regression to identify factors associated with catastrophic payments. The incidence of catastrophic spending was 9% in 2021 and remained relatively constant over the years analyzed, nearing 10% only in 2020. Further, 3.3% of households in 2021 were impoverished or further impoverished, down from 4.1% in 2013. Payments for medicines contribute the most to catastrophic spending, but the role of other services has been increasing. We found a significant association between catastrophic payments and gender, age, education, disability, residence place, number of children, main source of income, and consumption level. It is necessary to address existing coverage gaps and to evaluate implemented policies in order to develop more effective measures to reduce the burden of out-of-pocket payments in Poland.

保护家庭在获得保健服务时免于经济困难是欧洲各国的一项普遍政策目标。先前的分析表明，波兰家庭相对经常因自付医疗费而面临财务压力。本研究旨在利用灾难性和贫困化卫生支出指标，为波兰的财政保护提供新的证据。我们使用了2013年至2021年年度家庭预算调查的数据。灾难性支出被定义为卫生支出超过家庭支付能力的40%，而贫困支出发生在自付费用高于支付能力的情况下。我们采用逻辑回归来确定与灾难性支付相关的因素。2021年，灾难性支出的发生率为9%，在分析的几年中保持相对稳定，仅在2020年接近10%。此外，2021年3.3%的家庭处于贫困或进一步贫困状态，低于2013年的4.1%。药品支出在灾难性支出中所占比例最大，但其他服务的作用也在增加。我们发现灾难赔偿与性别、年龄、教育程度、残疾、居住地、子女数量、主要收入来源和消费水平之间存在显著关联。有必要解决现有的覆盖差距，并评估已执行的政策，以便制定更有效的措施，减少波兰自付费用的负担。

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引用次数: 0

What gets measured in palliative care? A review and synthesis of routine data collection in 16 countries 在姑息治疗中衡量的是什么？16个国家例行数据收集的审查和综合

IF 1.7 Q3 HEALTH CARE SCIENCES & SERVICES

Health Policy Open

Pub Date : 2025-04-19 DOI: 10.1016/j.hpopen.2025.100141

Eimir Hurley , Peter May , Soraya Matthews , Charles Normand , Bridget M. Johnston

Background

There is an increasing focus on strengthening palliative care data infrastructure to evaluate and improve the quality of care. We conducted an extensive review of policy documents to identify international best practice in the use of routine data in palliative care.

Methods

We identified 16 countries with well-established palliative care services before undertaking the review. We searched systematically for relevant documentation on each country in the academic, grey and governmental literature. For each country we then compiled a narrative synthesis utilising a standardised extraction template. Local experts verified country-level synopses. We combined the 16 country documents using thematic synthesis.

Results

There was significant heterogeneity in the data infrastructure of the countries examined. The majority of the databases and data sources focused on specialist palliative care services with a notable lack of data on palliative care delivered in primary and community care. Several countries have established bespoke palliative care databases; others harness existing data sources, and capitalise on the existence of unique patient identifiers. The gaps and limitations identified were commonly shared across all types of palliative and end of life care data infrastructure. Similarly, many of the factors deemed highly influential in implementing and sustaining existing databases are relevant across all data infrastructure.

Conclusions

This first-of-its-kind analysis details the characteristics of databases/data sources and highlights the significant heterogeneity which exists. The strengths and limitations of existing databases/data sources and the factors that influence how well these systems are sustained are examined, providing key learnings for those eager to improve the data infrastructure in their own jurisdictions.

背景：人们越来越关注加强姑息治疗数据基础设施，以评估和提高护理质量。我们对政策文件进行了广泛的审查，以确定在姑息治疗中使用常规数据的国际最佳做法。方法在进行评估之前，我们确定了16个拥有完善的姑息治疗服务的国家。我们系统地在学术文献、灰色文献和政府文献中检索了每个国家的相关文献。对于每个国家，我们利用标准化提取模板编制了一个叙事综合。当地专家核实了国家级的概要。我们采用专题综合的方法综合了16个国家的文件。结果被调查国家的数据基础设施存在显著的异质性。大多数数据库和数据来源侧重于专科姑息治疗服务，明显缺乏关于初级和社区护理提供的姑息治疗的数据。一些国家已经建立了定制的姑息治疗数据库；另一些则利用现有的数据源，并利用存在的唯一患者标识符。所确定的差距和局限性在所有类型的姑息治疗和临终关怀数据基础设施中普遍存在。同样，许多被认为对实现和维护现有数据库有很大影响的因素也与所有数据基础设施相关。这是同类分析中首次详细介绍了数据库/数据源的特征，并强调了存在的显著异质性。审查了现有数据库/数据源的优势和局限性以及影响这些系统维持情况的因素，为那些渴望改善本国管辖范围内数据基础设施的人提供了重要的经验教训。

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引用次数: 0

The global landscape of country-level health technology assessment processes: A survey among 104 countries 国家一级卫生技术评估进程的全球概况：对104个国家的调查

IF 1.7 Q3 HEALTH CARE SCIENCES & SERVICES

Health Policy Open

Pub Date : 2025-03-27 DOI: 10.1016/j.hpopen.2025.100138

Andrew J. Mirelman, Kratu Goel, Tessa Tan-Torres Edejer

To make progress towards universal health coverage (UHC), countries need to be able to develop and implement evidence-informed and inclusive processes for decision-making to inform what services are provided and purchased. Health Technology Assessment (HTA) processes are an established mechanism to support evidence-informed decision-making in the health sector. To assess the practice of HTA in countries, WHO conducted a global survey that explores the status of HTA. The survey is the largest source of information in terms of number of countries for describing global HTA status. The final sample analysed in this paper is the 104 countries (82% or 104/127) that responded “yes” to the question of having a systematic, formal health decision-making process at the national level. The results show that while many countries have HTA bodies in place, these serve different functions. While there are more established processes in higher income country groups, even those show room for improvement in areas such as social participation and appeals. Lack of awareness of the importance of HTA and institutionalization were the top two barriers to HTA utilization. There is further progress that needs to be made in HTA globally. Countries need to build on available guidance to ensure the appropriate elements are in place for sustainable country decision-making processes and develop more understanding of how they vary across settings.

为了在实现全民健康覆盖方面取得进展，各国需要能够制定和实施循证和包容性的决策进程，以便为提供和购买哪些服务提供信息。卫生技术评估（HTA）过程是支持卫生部门循证决策的既定机制。为了评估各国HTA的做法，世卫组织进行了一项全球调查，探讨了HTA的现状。就国家数量而言，该调查是描述全球卫生保健机构状况的最大信息来源。本文分析的最后一个样本是104个国家（82%或104/127），它们对在国家一级建立系统、正式的卫生决策过程的问题回答“是”。结果表明，虽然许多国家都设有卫生保健机构，但这些机构的职能各不相同。虽然在高收入国家群体中有更成熟的程序，但即使这些程序在社会参与和呼吁等领域也显示出改进的余地。缺乏对HTA重要性的认识和制度化是HTA利用的两大障碍。在全球范围内，HTA需要取得进一步进展。各国需要以现有的指导为基础，确保具备可持续国家决策进程的适当要素，并进一步了解这些要素在不同环境下的差异。

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引用次数: 0

The effectiveness of the states’ crisis response policies: Survival analysis on the COVID-19 transmission suppression in the United States 各州危机应对政策的有效性：美国 COVID-19 传播抑制的生存分析

IF 1.7 Q3 HEALTH CARE SCIENCES & SERVICES

Health Policy Open

Pub Date : 2025-03-20 DOI: 10.1016/j.hpopen.2025.100140

Hanvit Kim, Kyungmin Lee, Jungwon Yeo

Objective

This study aims to evaluate the effectiveness of various COVID-19 response policies in the United Sates that facilitated rapid virus transmission suppression and promoted quick return to normalcy during the first three years of the pandemic.

Method

We constructed comprehensive and unique time-to-event panel data that tracks the timeline of all policy implementations, and transmission waves, specifically measuring the duration from peak transmission to the desired suppression level, over 157 weeks. We then conducted a survival analysis to estimate the effectiveness of COVID-19 response policies in relation to the virus transmission dynamics. Our analysis focuses on the ten most populous U.S. states, representing diverse geographic, cultural, and political landscapes across the country. The survival analysis leverages the extensive time-to-event panel data collected from multiple sources.

Results

Our findings indicate that not all policies were equally effective in facilitating rapid transmission and promoting swift suppression return to normalcy. Containment or closure policies, such as school closures and stay-at-home orders, are associated with a shorter duration for returning to normalcy, highlighting their effectiveness in curbing COVID-19 transmission. In contrast, health system policies and vaccine policies showed mixed results.

Conclusion

The findings from our survival analysis of the novel data set provide practical insights for prioritizing policy measures among various options to effectively and timely suppress the transmission of highly contagious diseases. These insights can also enhance resource utilization and allocation within and across public health systems, while minimizing restrictions on people’s daily lives.

目的本研究旨在评估美国各种COVID-19应对政策的有效性，这些政策有助于在大流行的前三年快速抑制病毒传播并促进迅速恢复正常。我们构建了全面而独特的事件时间面板数据，跟踪所有政策实施的时间表，以及传播波，特别是测量从峰值传播到期望抑制水平的持续时间，超过157周。然后，我们进行了生存分析，以评估COVID-19应对政策与病毒传播动态相关的有效性。我们的分析集中在美国人口最多的十个州，代表了全国不同的地理、文化和政治景观。生存分析利用从多个来源收集的大量事件时间面板数据。结果并非所有政策在促进快速传播和促进迅速抑制恢复正常方面都同样有效。封锁或关闭政策，如学校关闭和居家令，与恢复正常所需的时间较短有关，这突显了它们在遏制COVID-19传播方面的有效性。相比之下，卫生系统政策和疫苗政策的结果喜忧参半。结论我们对新数据集的生存分析结果为在各种选择中优先考虑政策措施以有效及时地抑制高传染性疾病的传播提供了实用的见解。这些见解还可以加强公共卫生系统内部和整个系统的资源利用和分配，同时最大限度地减少对人们日常生活的限制。

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引用次数: 0

Public-Private partnership (PPP) and health service delivery in Malawi: The case of Christian Health Association of Malawi (CHAM) facilities in Mzimba district 马拉维的公私伙伴关系和保健服务提供：马拉维基督教保健协会（CHAM）在姆辛巴地区的设施的案例

IF 1.7 Q3 HEALTH CARE SCIENCES & SERVICES

Health Policy Open

Pub Date : 2025-03-12 DOI: 10.1016/j.hpopen.2025.100139

Chisomo Salangwa , Reston Munthali , Lusungu Mfune , Vegha Kaunga Nyirenda

Background

PPPs are crucial in addressing healthcare challenges in Malawi, a low-income country. These partnerships, including those with CHAM, help improve access to health services by complementing the public sector, especially in areas with inadequate infrastructure and limited healthcare resources.

Method

This study employed qualitative methods, including interviews, focus groups, and document analysis, to investigate the impact of PPP on healthcare infrastructure and access. Purposive and snowball sampling selected 30 interviewees and 20 focus groups. Thematic analysis revealed insights into PPP dynamics, resource allocation, stakeholder interactions, and socio-economic factors in healthcare.

Results

Government officials recognise PPPs’ positive impact on healthcare access, especially in rural areas, but raise concerns about sustainability due to policy inconsistencies, financial instability, and service duplication. CHAM and district health professionals highlight delayed payments, cost management, and infrastructure issues. While PPPs increase healthcare utilisation, challenges like drug shortages, staff shortages, and financial strain threaten long-term sustainability without better coordination.

Conclusion

This study explores PPPs in Malawi’s health sector, focusing on healthcare quality, efficiency, equity, and access. It identifies challenges like mistrust, misaligned incentives, data inflation, contract renegotiations, staffing shortages, and infrastructure issues. The study emphasises improving transparency, aligning incentives, and addressing sustainability through better resource management and financing.

ppp在解决马拉维这个低收入国家的医疗保健挑战方面至关重要。这些伙伴关系，包括与中国商会的伙伴关系，通过补充公共部门，特别是在基础设施不足和保健资源有限的地区，帮助改善获得保健服务的机会。方法采用访谈、焦点小组和文献分析等定性研究方法，探讨PPP对医疗卫生基础设施和可及性的影响。目的和滚雪球抽样选择了30名受访者和20个焦点小组。专题分析揭示了PPP动态、资源分配、利益相关者互动和医疗保健中的社会经济因素。政府官员承认公私合作伙伴关系对医疗保健获取的积极影响，特别是在农村地区，但由于政策不一致、金融不稳定和服务重复，他们对可持续性提出了担忧。CHAM和地区卫生专业人员强调延迟付款、成本管理和基础设施问题。虽然公私伙伴关系提高了医疗保健的利用率，但如果没有更好的协调，药品短缺、人员短缺和财政紧张等挑战将威胁到长期可持续性。本研究探讨了马拉维卫生部门的公私合作伙伴关系，重点关注卫生保健质量、效率、公平和可及性。它指出了诸如不信任、不一致的激励机制、数据膨胀、合同重新谈判、人员短缺和基础设施问题等挑战。该研究强调提高透明度，调整激励措施，并通过更好的资源管理和融资来解决可持续性问题。

{"title":"Public-Private partnership (PPP) and health service delivery in Malawi: The case of Christian Health Association of Malawi (CHAM) facilities in Mzimba district","authors":"Chisomo Salangwa , Reston Munthali , Lusungu Mfune , Vegha Kaunga Nyirenda","doi":"10.1016/j.hpopen.2025.100139","DOIUrl":"10.1016/j.hpopen.2025.100139","url":null,"abstract":"<div><h3>Background</h3><div>PPPs are crucial in addressing healthcare challenges in Malawi, a low-income country. These partnerships, including those with CHAM, help improve access to health services by complementing the public sector, especially in areas with inadequate infrastructure and limited healthcare resources.</div></div><div><h3>Method</h3><div>This study employed qualitative methods, including interviews, focus groups, and document analysis, to investigate the impact of PPP on healthcare infrastructure and access. Purposive and snowball sampling selected 30 interviewees and 20 focus groups. Thematic analysis revealed insights into PPP dynamics, resource allocation, stakeholder interactions, and socio-economic factors in healthcare.</div></div><div><h3>Results</h3><div>Government officials recognise PPPs’ positive impact on healthcare access, especially in rural areas, but raise concerns about sustainability due to policy inconsistencies, financial instability, and service duplication. CHAM and district health professionals highlight delayed payments, cost management, and infrastructure issues. While PPPs increase healthcare utilisation, challenges like drug shortages, staff shortages, and financial strain threaten long-term sustainability without better coordination.</div></div><div><h3>Conclusion</h3><div>This study explores PPPs in Malawi’s health sector, focusing on healthcare quality, efficiency, equity, and access. It identifies challenges like mistrust, misaligned incentives, data inflation, contract renegotiations, staffing shortages, and infrastructure issues. The study emphasises improving transparency, aligning incentives, and addressing sustainability through better resource management and financing.</div></div>","PeriodicalId":34527,"journal":{"name":"Health Policy Open","volume":"8 ","pages":"Article 100139"},"PeriodicalIF":1.7,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A critical Response to “How firearm legislation impacts firearm mortality”, A focused look at Canadian and Australian evidence 对“枪支立法如何影响枪支死亡率”的关键回应，重点关注加拿大和澳大利亚的证据

IF 1.7 Q3 HEALTH CARE SCIENCES & SERVICES

Health Policy Open

Pub Date : 2025-03-10 DOI: 10.1016/j.hpopen.2025.100137

Caillin Langmann

A recent review article in Health Policy Open, entitled “How firearm legislation impacts firearm mortality internationally: A scoping review” claims that Australian and Canadian firearms legislation is associated with reductions in homicide and suicide by firearms. Unfortunately, the review overexaggerates the effectiveness of firearms legislation in Australia and Canada, leaves out some important studies, and does not rigorously examine these articles.

Eight Australian studies are referenced that examine the association between gun control legislation, primarily the National Firearms Act (NFA), and firearm homicide. Seven studies find no association between gun control legislation and firearm homicide. Only one study finds a reduction in female homicide but this is contradicted by a study using methods controlling for confounding factors. Four studies examining suicide rates and the association with the NFA find no associated benefit, including the single study that controls for confounders. Two studies find an associated decline in firearm suicide rates with the NFA but there is a decline in non firearms homicide rates at the same time that makes it impossible to know if the decline is associated with the NFA or another variable.

The results of the Canadian studies on legislation and the association with firearms homicide points to no beneficial association when more methodologically sound methods and studies are reviewed. Canadian studies on the association with legislation and suicide by firearm demonstrate a reduction in suicide rates with a substitution for other methods and no overall reduction in suicide rates.

Overall, Australian and Canadian studies to not appear to demonstrate beneficial associations with gun control legislation.

《卫生政策开放》最近发表的一篇题为“枪支立法如何影响国际上的枪支死亡率：范围审查”的评论文章声称，澳大利亚和加拿大的枪支立法与枪支杀人和自杀的减少有关。不幸的是，该评论过分夸大了澳大利亚和加拿大枪支立法的有效性，遗漏了一些重要的研究，并且没有严格审查这些文章。本文引用了澳大利亚的八项研究，研究了枪支管制立法（主要是《国家枪支法》（NFA））与枪支杀人之间的关系。七项研究没有发现枪支管制立法和枪支杀人之间的联系。只有一项研究发现女性凶杀案减少了，但这与一项使用控制混杂因素的方法的研究相矛盾。四项研究调查了自杀率及其与NFA的关系，发现没有相关的好处，包括控制混杂因素的单一研究。两项研究发现，枪支自杀率的下降与NFA有关，但与此同时，非枪支杀人率也在下降，这使得我们无法知道这种下降是与NFA有关还是与其他变量有关。加拿大关于立法和与火器杀人的联系的研究结果表明，在审查方法上更合理的方法和研究时，没有任何有益的联系。加拿大关于立法和枪支自杀之间关系的研究表明，用其他方法替代自杀率可以降低自杀率，但总体上没有降低自杀率。总的来说，澳大利亚和加拿大的研究似乎没有显示出与枪支管制立法有益的联系。

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引用次数: 0

The regulation on the use of supplements for weight control: Case studies from Australia, the United States of America, and the United Kingdom 关于使用补充剂控制体重的规定：来自澳大利亚、美利坚合众国和联合王国的案例研究

IF 1.7 Q3 HEALTH CARE SCIENCES & SERVICES

Health Policy Open

Pub Date : 2025-02-16 DOI: 10.1016/j.hpopen.2025.100136

Saiya Whitney Dawson , Dai Quy Le , Eng Joo Tan, Long Khanh-Dao Le

Background

Overweight and obesity have become more prevalent worldwide which has led to an increase in the demand for non-prescribed weight loss supplements. Given that these products are loosely regulated, they are often misused by adolescents and young adults.

Objective

This study aims to review regulatory policies for weight loss supplements in Australia, the United States, and the United Kingdom to identify areas for improvement.

Method

Peer-reviewed literature was retrieved from EMBASE, OVID, and EBSCOhost databases. Grey literature was identified using Google Advanced Search with 32 targeted keywords and region-specific government domains (.gov.au, .gov, .gov.uk). A narrative synthesis was employed to analyze and compare regulatory policies.

Results

A total of 34 articles (7 peer-reviewed and 27 grey literature documents) were included. In Australia, weight loss supplements are classified as low-risk medicines and are not subject to pre-market regulation. In the United States, the Food and Drug Administration primarily enforces regulations post-market. In contrast, the United Kingdom has implemented proactive measures through collaborations between government organizations. These include restrictions on the sale and packaging of over-the-counter laxatives and mandatory pharmacist consultations to assess patient needs.

Conclusions

The findings highlight significant regulatory gaps in Australia and the US compared to the UK. Adopting similar policies to those implemented in the UK could help reduce the accessibility of weight loss supplements among at-risk populations like adolescents and young adults. This study also discusses the implications of these findings for developing effective policies and regulations for non-prescribed weight loss supplements.

超重和肥胖在世界范围内变得越来越普遍，这导致了对非处方减肥补充剂的需求增加。鉴于这些产品监管松散，它们经常被青少年和年轻人滥用。目的本研究旨在回顾澳大利亚、美国和英国对减肥补充剂的监管政策，以确定需要改进的地方。方法从EMBASE、OVID和EBSCOhost数据库中检索经同行评审的文献。灰色文献使用谷歌高级搜索，包含32个目标关键词和特定地区的政府域名（.gov.au, .gov, .gov.uk）。本文采用叙事综合的方法来分析和比较监管政策。结果共纳入34篇文献，其中同行评议文献7篇，灰色文献27篇。在澳大利亚，减肥补充剂被归类为低风险药物，不受上市前监管。在美国，食品和药物管理局主要执行上市后的法规。相比之下，联合王国通过政府组织之间的合作实施了积极主动的措施。这些措施包括限制非处方泻药的销售和包装，以及强制药剂师咨询以评估患者的需求。与英国相比，研究结果突出了澳大利亚和美国在监管方面的重大差距。采取与英国类似的政策有助于减少青少年和年轻人等高危人群获得减肥补充剂的机会。本研究还讨论了这些发现对制定有效的非处方减肥补充剂政策和法规的影响。

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引用次数: 0

The early market access vehicle – An innovative demand-driven model to catalyse introduction of new optimal health products in low- and middle-income countries 早期市场准入工具——一种创新的需求驱动模式，促进在低收入和中等收入国家引进新的最佳保健产品。

IF 1.7 Q3 HEALTH CARE SCIENCES & SERVICES

Health Policy Open

Pub Date : 2024-12-16 DOI: 10.1016/j.hpopen.2024.100135

Ademola Osigbesan , Ikechukwu Amamilo , Aayush Solanki , Robert Matiru , James Conroy , Alya Omar , Karin Hatzold , Carolyn Amole , Kehinde Onasanya , Janet Ginnard

Low-and middle-income countries (LMICs) account for a significant proportion of the burden of disease for communicable illnesses globally; with malaria, tuberculosis (TB), and HIV/AIDS being the leading causes of death. Despite this disparity, LMICs often have limited or delayed access to newer optimal health products compared to high-income countries (HICs). This limitation in access, driven by a myriad of barriers, undermines the potential health benefits that could be gained in LMICs through the introduction of better health products. To improve this inequity, governments in HICs, non-governmental organizations, and pharmaceutical companies, often resort to establishing donation programs for LMICs, to circumvent some of the access barriers. While well-implemented donation programs have the potential to improve access to new products, poorly executed donation programmes are common. These often have negative effects such as: overreliance on donations by recipient countries, dumping of short-dated or unwanted products, costs of waste disposal where unsuitable or excess products are received, and a lack of focus on access sustainability planning. Unitaid’s early market access vehicle (EMAV) is an innovative demand-driven access model for introducing new optimal health commodities in LMICs. An EMAV entails a conditional purchase commitment to the manufacturer for a defined quantity of selected products in exchange for a set of access commitments, required to facilitate equitable access in the target markets. EMAVs are designed to link catalytic donations to pathways for sustainable access. Unitaid, in collaboration with its partners, has leveraged the EMAV to introduce two innovative health products in a number of LMICs. This article discusses the EMAV model and builds the case on why stakeholders working on new product access should consider this approach as an alternative to traditional donation programmes.

低收入和中等收入国家（LMICs）在全球传染病疾病负担中占很大比例；疟疾、结核病和艾滋病毒/艾滋病是导致死亡的主要原因。尽管存在这种差异，与高收入国家相比，中低收入国家获得更新的最佳保健产品的机会往往有限或延迟。这种由无数障碍造成的获取方面的限制，破坏了中低收入国家通过引进更好的保健产品可能获得的潜在健康效益。为了改善这种不平等现象，高收入国家的政府、非政府组织和制药公司往往采取为中低收入国家建立捐赠计划的办法，以规避一些获取障碍。虽然执行良好的捐赠计划有可能改善获得新产品的机会，但执行不良的捐赠计划很常见。这些往往会产生负面影响，例如：过度依赖受援国的捐赠，倾销短期或不需要的产品，在接收不合适或过量产品时处理废物的成本，以及缺乏对可持续性规划的关注。国际药品采购机制的早期市场准入工具（EMAV）是一种创新的需求驱动的准入模式，用于在中低收入国家引进新的最佳卫生商品。EMAV要求制造商有条件地购买一定数量的选定产品，以换取一套准入承诺，这是促进目标市场公平准入所必需的。emav旨在将催化捐赠与可持续获取途径联系起来。Unitaid与其合作伙伴合作，利用EMAV在一些中低收入国家引进了两种创新保健产品。本文讨论了EMAV模型，并构建了为什么致力于新产品获取的利益相关者应该考虑将这种方法作为传统捐赠计划的替代方案的案例。

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引用次数: 0

The cost of the reemergence of monkeypox: An overview of health financing in Africa 猴痘重现的代价：非洲卫生筹资概览

IF 1.7 Q3 HEALTH CARE SCIENCES & SERVICES

Health Policy Open

Pub Date : 2024-11-24 DOI: 10.1016/j.hpopen.2024.100132

Taiwo Oluwaseun Sokunbi, Elijah Orimisan Akinbi

引用次数: 0

Closing the equity gap: A call for policy and programmatic reforms to ensure inclusive and effective HIV prevention, treatment and care for persons with disabilities in Eastern and Southern Africa 缩小公平差距：呼吁进行政策和方案改革，以确保东部和南部非洲对残疾人进行包容和有效的艾滋病毒预防、治疗和护理

IF 1.7 Q3 HEALTH CARE SCIENCES & SERVICES

Health Policy Open

Pub Date : 2024-10-16 DOI: 10.1016/j.hpopen.2024.100131

Tafadzwa Dzinamarira , Christine Peta , Enos Moyo , Roda Madziva , Rouzeh Eghtessadi , Tatenda Makoni , Godfrey Musuka

In this paper, we explore the critical barriers that persons with disabilities face in accessing HIV services in the Eastern and Southern Africa (ESA) region, despite significant advancements in overall accessibility. We highlight the intersectional challenges experienced by individuals with disabilities, particularly women, and outline a comprehensive approach to bridge the existing gaps in policy and programmatic efforts. Specifically, we aim to address the exclusion of persons with disabilities from essential HIV prevention, treatment, and care services, a situation that has profound implications for their health, social inclusion, and economic productivity. In this discussion, we examine the current landscape, identify specific policy and programmatic hurdles, and propose targeted reforms, in an effort to contribute to the ongoing discourse on health equity and inclusivity.

在本文中，我们探讨了东部和南部非洲（ESA）地区的残疾人在获得艾滋病服务方面所面临的关键障碍，尽管在整体无障碍环境方面取得了重大进展。我们强调了残疾人（尤其是女性）所经历的交叉挑战，并概述了弥合政策和计划工作中现有差距的综合方法。具体而言，我们旨在解决残疾人被排除在基本的艾滋病预防、治疗和护理服务之外的问题，这种情况对他们的健康、社会包容和经济生产力有着深远的影响。在本次讨论中，我们将审视当前的状况，找出具体的政策和项目障碍，并提出有针对性的改革建议，努力为当前有关健康公平性和包容性的讨论做出贡献。

引用次数: 0