Pub Date : 2020-12-01DOI: 10.1108/ijhg-12-2020-120
I. Ibragimova, H. Phagava
{"title":"Editorial","authors":"I. Ibragimova, H. Phagava","doi":"10.1108/ijhg-12-2020-120","DOIUrl":"https://doi.org/10.1108/ijhg-12-2020-120","url":null,"abstract":"","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44773126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-10-08DOI: 10.1108/ijhg-06-2020-0061
H. Marcus, L. Hanna
PurposeTo uncover the major government constraints to enactment and implementation of public health-targeted climate change adaptation (CCA) strategies in order to equip public health stakeholders and health advocates with the knowledge resources necessary to more effectively mobilize and support CCA for public health responses at the national level.Design/methodology/approachA mixed-methods online survey was distributed to the representatives of national public health associations and societies of 82 countries. The survey comprised 15 questions assessing national progress on CCA for public health and the effects of various institutional, economic/financial, technical and sociopolitical barriers on national adaptive capacity.FindingsSurvey responses from 11 countries indicated that national commitments to CCA for public health have increased markedly since prior assessments but significant shortcomings remain. The largest apparent barriers to progress in this domain were poor government coordination, lack of political will and inadequate adaptation finances.Originality/valueThis study is unique in relation to the prior literature on the topic in that it effectively captures an array of country-specific yet cross-cutting adaptation constraints across diverse national contexts. With a deepened understanding of the major determinants of national adaptive capacity, international actors can devise more effective, evidence-informed strategies to support national governments in responding to the health impacts of climate change.
{"title":"Understanding national barriers to climate change adaptation for public health: a mixed-methods survey of national public health representatives","authors":"H. Marcus, L. Hanna","doi":"10.1108/ijhg-06-2020-0061","DOIUrl":"https://doi.org/10.1108/ijhg-06-2020-0061","url":null,"abstract":"PurposeTo uncover the major government constraints to enactment and implementation of public health-targeted climate change adaptation (CCA) strategies in order to equip public health stakeholders and health advocates with the knowledge resources necessary to more effectively mobilize and support CCA for public health responses at the national level.Design/methodology/approachA mixed-methods online survey was distributed to the representatives of national public health associations and societies of 82 countries. The survey comprised 15 questions assessing national progress on CCA for public health and the effects of various institutional, economic/financial, technical and sociopolitical barriers on national adaptive capacity.FindingsSurvey responses from 11 countries indicated that national commitments to CCA for public health have increased markedly since prior assessments but significant shortcomings remain. The largest apparent barriers to progress in this domain were poor government coordination, lack of political will and inadequate adaptation finances.Originality/valueThis study is unique in relation to the prior literature on the topic in that it effectively captures an array of country-specific yet cross-cutting adaptation constraints across diverse national contexts. With a deepened understanding of the major determinants of national adaptive capacity, international actors can devise more effective, evidence-informed strategies to support national governments in responding to the health impacts of climate change.","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2020-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/ijhg-06-2020-0061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43814752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-17DOI: 10.1108/ijhg-01-2020-0006
A. Ahmadi, L. Doshmangir, V. S. Gordeev, B. Yazdizadeh, R. Majdzadeh
PurposeUnderreporting of new tuberculosis (TB) cases is one of the main problems in TB control, particularly in countries with high incidence and dominating role of a private sector in TB cases diagnosing. The purpose of this paper was to explore behavioral determinants of underreporting of new TB cases among private sector physicians in Iran.Design/methodology/approachThe authors conducted a population-based, cross-sectional study of physicians working in private clinics. The data collection tool was designed using the theory of planned behavior (TPB). The authors used structural equation models with maximum likelihood estimation to examine attitude toward the notification behavior.FindingsOf 519 physicians, 433 physicians completed the questionnaire. Attitude toward notification had the highest score (mean score = 87.65; sd = 6.79; range: 0–100). The effect of perceived behavioral controls on the notification behavior ((β^) = 0.13; CI: 0.01–0.25) was stronger than the total effect of attitude ((β^) = 0.06; CI: 0.00–0.12) and subjective norms ((β^) = 0.01; CI: −0.00–0.03) on the behavior. However, the attitude was the main predictor of intention and justified 46% of the intention variance. Intention had a significant effect on the behavior ((ß^) = 0.09; CI: 0.1–0.16).Practical implicationsConsidering stronger effect of perceived behavioral control on the behavior, interventions aiming at facilitating notification process would be more effective than those aiming at changing the attitude or enhancing intention among physicians.Originality/valueTo the best of our knowledge, no other study previously explored determinants of underreporting from the behavioral and cognitive perspective. Specifically, the authors explored the role of the TPB constructs in predicting intention to notify new TB cases.
{"title":"Behavioral barriers of tuberculosis notification in private health sector: policy implication and practice","authors":"A. Ahmadi, L. Doshmangir, V. S. Gordeev, B. Yazdizadeh, R. Majdzadeh","doi":"10.1108/ijhg-01-2020-0006","DOIUrl":"https://doi.org/10.1108/ijhg-01-2020-0006","url":null,"abstract":"PurposeUnderreporting of new tuberculosis (TB) cases is one of the main problems in TB control, particularly in countries with high incidence and dominating role of a private sector in TB cases diagnosing. The purpose of this paper was to explore behavioral determinants of underreporting of new TB cases among private sector physicians in Iran.Design/methodology/approachThe authors conducted a population-based, cross-sectional study of physicians working in private clinics. The data collection tool was designed using the theory of planned behavior (TPB). The authors used structural equation models with maximum likelihood estimation to examine attitude toward the notification behavior.FindingsOf 519 physicians, 433 physicians completed the questionnaire. Attitude toward notification had the highest score (mean score = 87.65; sd = 6.79; range: 0–100). The effect of perceived behavioral controls on the notification behavior ((β^) = 0.13; CI: 0.01–0.25) was stronger than the total effect of attitude ((β^) = 0.06; CI: 0.00–0.12) and subjective norms ((β^) = 0.01; CI: −0.00–0.03) on the behavior. However, the attitude was the main predictor of intention and justified 46% of the intention variance. Intention had a significant effect on the behavior ((ß^) = 0.09; CI: 0.1–0.16).Practical implicationsConsidering stronger effect of perceived behavioral control on the behavior, interventions aiming at facilitating notification process would be more effective than those aiming at changing the attitude or enhancing intention among physicians.Originality/valueTo the best of our knowledge, no other study previously explored determinants of underreporting from the behavioral and cognitive perspective. Specifically, the authors explored the role of the TPB constructs in predicting intention to notify new TB cases.","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2020-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/ijhg-01-2020-0006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49267703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-17DOI: 10.1108/ijhg-06-2020-0063
B. Taylor, Insa Osterhus, R. Stewart, S. Cunningham, Olive Macleod, M. McColgan
PurposeThis study explored the feasibility of developing scaled inspection tools for use during external inspection of health and social care facilities to give improved accuracy in identifying facilities “at risk”, a tool for risk-adjusted frequency of inspection, and greater consistency of judgements.Design/methodology/approachThis paper summarises the development through working groups and workshops involving 20 experienced inspectors (nurses and social workers) of the Regulation and Quality Improvement Authority who inspect the 206 nursing and 182 residential care homes in Northern Ireland. A brief evaluation survey, including response to a case vignette, gathered inspectors' views after using the tools for six months.FindingsEight two-dimensional Scaled Inspection Tools were created, each embodying a scale of performance (seriousness of risk issue) and a scale of the ability of the facility to manage that issue, each axis comprising four points. The Scaled Inspection Tools were used for on-site inspections during 2017–18. Evaluative comments were generally positive. The case vignette seemed to highlight greater risk aversion amongst newer inspectors.Research limitations/implicationsThe creation of scaled inspection tools adds credibility to the potential for developing risk-based governance in service regulation. Further testing of domains and their scope is required.Practical implicationsPrompts for each domain were found essential to guide inspectors. Despite the challenge of change, inspectors became enthusiastic about use for evaluating risks, and managers about improvements in consistency of inspection.Social implicationsKnowledge derived from statistical approaches needs to be incorporated into inspection and regulation, just as in other aspects of professional practice.Originality/valueScaled inspection tools, with two orthogonal axes corresponding to seriousness of risk and ability to manage the risk (inverse of likelihood of harm), proved acceptable and intuitive in use. The study gives credibility to the possibility of developing screening and surveillance approaches to risk-based governance in service regulation.
{"title":"Developing scaled tools for residential and nursing home inspection: feasibility study","authors":"B. Taylor, Insa Osterhus, R. Stewart, S. Cunningham, Olive Macleod, M. McColgan","doi":"10.1108/ijhg-06-2020-0063","DOIUrl":"https://doi.org/10.1108/ijhg-06-2020-0063","url":null,"abstract":"PurposeThis study explored the feasibility of developing scaled inspection tools for use during external inspection of health and social care facilities to give improved accuracy in identifying facilities “at risk”, a tool for risk-adjusted frequency of inspection, and greater consistency of judgements.Design/methodology/approachThis paper summarises the development through working groups and workshops involving 20 experienced inspectors (nurses and social workers) of the Regulation and Quality Improvement Authority who inspect the 206 nursing and 182 residential care homes in Northern Ireland. A brief evaluation survey, including response to a case vignette, gathered inspectors' views after using the tools for six months.FindingsEight two-dimensional Scaled Inspection Tools were created, each embodying a scale of performance (seriousness of risk issue) and a scale of the ability of the facility to manage that issue, each axis comprising four points. The Scaled Inspection Tools were used for on-site inspections during 2017–18. Evaluative comments were generally positive. The case vignette seemed to highlight greater risk aversion amongst newer inspectors.Research limitations/implicationsThe creation of scaled inspection tools adds credibility to the potential for developing risk-based governance in service regulation. Further testing of domains and their scope is required.Practical implicationsPrompts for each domain were found essential to guide inspectors. Despite the challenge of change, inspectors became enthusiastic about use for evaluating risks, and managers about improvements in consistency of inspection.Social implicationsKnowledge derived from statistical approaches needs to be incorporated into inspection and regulation, just as in other aspects of professional practice.Originality/valueScaled inspection tools, with two orthogonal axes corresponding to seriousness of risk and ability to manage the risk (inverse of likelihood of harm), proved acceptable and intuitive in use. The study gives credibility to the possibility of developing screening and surveillance approaches to risk-based governance in service regulation.","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2020-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/ijhg-06-2020-0063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45392102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-06DOI: 10.1108/ijhg-12-2019-0081
C. Gadolin, Thomas Andersson, E. Eriksson, Andreas Hellström
PurposeThe purpose of this paper is to empirically explore and demonstrate the ability of healthcare professionals to attain professional fulfilment when providing healthcare inspired by “value shops”.Design/methodology/approachA qualitative case study incorporating interviews and observations was conducted.FindingsThe empirical data suggest that the professional fulfilment of both physicians and nurses is facilitated when care is organized through “value shops”. Both groups of professionals state that they are able to return to their “professional core”.Originality/valueThe beneficial outcomes of organizing healthcare inspired by the “value shop” have previously been explored in terms of efficiency and quality. However, the professional fulfilment of healthcare professionals when providing such care has not been explicitly addressed. Professional fulfilment is vital in order to safeguard high-quality care, as well as healthcare professionals' involvement and engagement in implementing quality improvements. This paper highlights the fact that care provision inspired by the “value shop” may facilitate professional fulfilment, which further strengthens the potential positive outcomes of the “value shop” when utilized in a healthcare setting.
{"title":"Providing healthcare through “value shops”: impact on professional fulfilment for physicians and nurses","authors":"C. Gadolin, Thomas Andersson, E. Eriksson, Andreas Hellström","doi":"10.1108/ijhg-12-2019-0081","DOIUrl":"https://doi.org/10.1108/ijhg-12-2019-0081","url":null,"abstract":"PurposeThe purpose of this paper is to empirically explore and demonstrate the ability of healthcare professionals to attain professional fulfilment when providing healthcare inspired by “value shops”.Design/methodology/approachA qualitative case study incorporating interviews and observations was conducted.FindingsThe empirical data suggest that the professional fulfilment of both physicians and nurses is facilitated when care is organized through “value shops”. Both groups of professionals state that they are able to return to their “professional core”.Originality/valueThe beneficial outcomes of organizing healthcare inspired by the “value shop” have previously been explored in terms of efficiency and quality. However, the professional fulfilment of healthcare professionals when providing such care has not been explicitly addressed. Professional fulfilment is vital in order to safeguard high-quality care, as well as healthcare professionals' involvement and engagement in implementing quality improvements. This paper highlights the fact that care provision inspired by the “value shop” may facilitate professional fulfilment, which further strengthens the potential positive outcomes of the “value shop” when utilized in a healthcare setting.","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2020-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/ijhg-12-2019-0081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44479810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PurposeThe control of particularly virulent communicable diseases such as COVID-19 can be considered a global public good. Unabated contagion, both within and across borders, can result in a global public bad. More effective control – such as by flattening the epidemiological curve – could prevent severe social and economic disruption by allowing domestic health and social protection systems to more adequately respond to the health crisis. This article elaborates on some of the main elements of counter COVID-19 responses, drawing on emerging international good practices. While a full evaluation of policy effectiveness is still forthcoming, it is critical to review and synthesize the emerging lessons and evidence even this early.Design/methodology/approachThis article reviews the international good practices in counter COVID-19 responses across countries.FindingsConcerted efforts across borders, such as by sharing data and collaborating in research and by coordinating international support for countercyclical economic and health responses at the national level, are some of the options for countering COVID-19 at the international level. Within countries, more inclusive social protection and health systems, combined with countercyclical economic policies, and concerted behavioral changes tend to produce more effective collective action against the spread of the disease.Research limitations/implicationsThis study is based on a review of emerging responses to the health crisis.Practical implicationsThe policies and practices reviewed in this paper could feed into better-informed crisis responses to COVID-19 and other types of health shocks.Originality/valueThis study is among the first general reviews of policy responses to the COVID-19 health crisis.
{"title":"Social cohesion vs COVID-19","authors":"M. Dayrit, R. Mendoza","doi":"10.2139/ssrn.3555152","DOIUrl":"https://doi.org/10.2139/ssrn.3555152","url":null,"abstract":"PurposeThe control of particularly virulent communicable diseases such as COVID-19 can be considered a global public good. Unabated contagion, both within and across borders, can result in a global public bad. More effective control – such as by flattening the epidemiological curve – could prevent severe social and economic disruption by allowing domestic health and social protection systems to more adequately respond to the health crisis. This article elaborates on some of the main elements of counter COVID-19 responses, drawing on emerging international good practices. While a full evaluation of policy effectiveness is still forthcoming, it is critical to review and synthesize the emerging lessons and evidence even this early.Design/methodology/approachThis article reviews the international good practices in counter COVID-19 responses across countries.FindingsConcerted efforts across borders, such as by sharing data and collaborating in research and by coordinating international support for countercyclical economic and health responses at the national level, are some of the options for countering COVID-19 at the international level. Within countries, more inclusive social protection and health systems, combined with countercyclical economic policies, and concerted behavioral changes tend to produce more effective collective action against the spread of the disease.Research limitations/implicationsThis study is based on a review of emerging responses to the health crisis.Practical implicationsThe policies and practices reviewed in this paper could feed into better-informed crisis responses to COVID-19 and other types of health shocks.Originality/valueThis study is among the first general reviews of policy responses to the COVID-19 health crisis.","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":"1 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2020-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41338972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-01DOI: 10.1108/ijhg-03-2020-081
D. Birnbaum, Michael Decker
{"title":"Editorial","authors":"D. Birnbaum, Michael Decker","doi":"10.1108/ijhg-03-2020-081","DOIUrl":"https://doi.org/10.1108/ijhg-03-2020-081","url":null,"abstract":"","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/ijhg-03-2020-081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41650254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-21DOI: 10.1108/ijhg-06-2019-0045
F. Shroff, J. Minhas, Chris Laugen
Purpose Many low- and middle-income countries (LMICs) are struggling to reduce maternal mortality rates, despite increased efforts by the United Nations through the implementation of their Millennium Development Goals program. Industrialized nations, such as Canada, have a collaborative role to play in raising the global maternal health standards. The purpose of this paper is to propose policy approaches for Canadians and other Organization of Economic Cooperation and Development (OECD) nations who wish to assist in reducing maternal mortality rates. Design/methodology/approach Ten Canadian health experts with experience in global maternal health were interviewed. Using qualitative analytical methods, the authors coded and themed their responses and paired them with peer-reviewed literature in this area to establish a model for improving global maternal health and survival rates. Findings Findings from this study indicated that maternal health may be improved by establishing a collaborative approach between interdisciplinary teams of health professionals (e.g. midwives, family physicians, OB/GYNs and nurses), literacy teachers, agriculturalists and community development professionals (e.g. humanitarians with diverse linguistic and cultural backgrounds). From this, a conceptual approach was devised for elevating the standard of maternal health. This approach includes specifications by which maternal health may be improved, such as gender justice, women’s literacy, freedom from violence against women, food and water security and healthcare accessibility. This model is based on community health center (CHC) models that integrate upstream changes with downstream services may be utilized by Canada and other OECD nations in efforts to enhance maternal health at home and abroad. Research limitations/implications Maternal mortality may be reduced by the adoption of a CHC model, an approach well suited for all nations regardless of economic status. Establishing such a model in LMICs would ideally establish long-term relationships between countries, such as Canada and the LMICs, where teams from supporting nations would collaborate with local Ministries of Health, non-government organizations as well as traditional birth attendants and healthcare professionals to reduce maternal mortality. Practical implications All OECD Nations ought to donate 0.7 percent of their GDP toward international community development. These funds should break the tradition of “tied aid”, thereby removing profit motives, and genuinely contribute to the wellbeing of people in LMICs, particularly women, children and others who are vulnerable. The power of partnerships between people whose aims are genuinely focused on caring is truly transformative. Social implications Canada is not a driver of global maternal mortality reduction work but has a responsibility to work in partnership with countries or regions in a humble and supportive role. Applying a comprehensive and in
{"title":"Power of partnerships","authors":"F. Shroff, J. Minhas, Chris Laugen","doi":"10.1108/ijhg-06-2019-0045","DOIUrl":"https://doi.org/10.1108/ijhg-06-2019-0045","url":null,"abstract":"\u0000Purpose\u0000Many low- and middle-income countries (LMICs) are struggling to reduce maternal mortality rates, despite increased efforts by the United Nations through the implementation of their Millennium Development Goals program. Industrialized nations, such as Canada, have a collaborative role to play in raising the global maternal health standards. The purpose of this paper is to propose policy approaches for Canadians and other Organization of Economic Cooperation and Development (OECD) nations who wish to assist in reducing maternal mortality rates.\u0000\u0000\u0000Design/methodology/approach\u0000Ten Canadian health experts with experience in global maternal health were interviewed. Using qualitative analytical methods, the authors coded and themed their responses and paired them with peer-reviewed literature in this area to establish a model for improving global maternal health and survival rates.\u0000\u0000\u0000Findings\u0000Findings from this study indicated that maternal health may be improved by establishing a collaborative approach between interdisciplinary teams of health professionals (e.g. midwives, family physicians, OB/GYNs and nurses), literacy teachers, agriculturalists and community development professionals (e.g. humanitarians with diverse linguistic and cultural backgrounds). From this, a conceptual approach was devised for elevating the standard of maternal health. This approach includes specifications by which maternal health may be improved, such as gender justice, women’s literacy, freedom from violence against women, food and water security and healthcare accessibility. This model is based on community health center (CHC) models that integrate upstream changes with downstream services may be utilized by Canada and other OECD nations in efforts to enhance maternal health at home and abroad.\u0000\u0000\u0000Research limitations/implications\u0000Maternal mortality may be reduced by the adoption of a CHC model, an approach well suited for all nations regardless of economic status. Establishing such a model in LMICs would ideally establish long-term relationships between countries, such as Canada and the LMICs, where teams from supporting nations would collaborate with local Ministries of Health, non-government organizations as well as traditional birth attendants and healthcare professionals to reduce maternal mortality.\u0000\u0000\u0000Practical implications\u0000All OECD Nations ought to donate 0.7 percent of their GDP toward international community development. These funds should break the tradition of “tied aid”, thereby removing profit motives, and genuinely contribute to the wellbeing of people in LMICs, particularly women, children and others who are vulnerable. The power of partnerships between people whose aims are genuinely focused on caring is truly transformative.\u0000\u0000\u0000Social implications\u0000Canada is not a driver of global maternal mortality reduction work but has a responsibility to work in partnership with countries or regions in a humble and supportive role. Applying a comprehensive and in","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2019-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/ijhg-06-2019-0045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48855525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-21DOI: 10.1108/IJHG-12-2018-0079
S. Shawer, Shirley Rowbotham, A. Heazell, T. Kelly, S. Vause
Purpose Many organisations, including the Royal College of Obstetricians and Gynaecologists, have recommended increasing the number of hours of consultant obstetric presence in UK National Health Service maternity units to improve patient care. St Mary’s Hospital, Manchester implemented 24-7 consultant presence in September 2014. The paper aims to discuss these issues. Design/methodology/approach To assess the impact of 24-7 consultant presence upon women and babies, a retrospective review of all serious clinical intrapartum incidents occurring between September 2011 and September 2017 was carried out by two independent reviewers; disagreements in classification were reviewed by a senior Obstetrician. The impact of consultant presence was classified in a structure agreed a priori. Findings A total of 72 incidents were reviewed. Consultants were directly involved in the care of 75.6 per cent of cases before 24-7 consultant presence compared to 96.8 per cent afterwards. Negative impact due to a lack of consultant presence fell from 22 per cent of the incidents before 24-7 consultant presence to 9.7 per cent after implementation. In contrast, positive impact of consultant presence increased from 14.6 to 32.3 per cent following the introduction of 24-7 consultant presence. Practical implications Introduction of 24-7 consultant presence reduced the negative impact caused by a lack of, or delay in, consultant presence as identified by serious untoward incident (SUI) reviews. Consultant presence was more likely to have a positive influence on care delivery. Originality/value This is the first assessment of the impact of 24-7 consultant presence on the SUIs in obstetrics.
{"title":"Impact of consultant obstetric presence on serious incidents","authors":"S. Shawer, Shirley Rowbotham, A. Heazell, T. Kelly, S. Vause","doi":"10.1108/IJHG-12-2018-0079","DOIUrl":"https://doi.org/10.1108/IJHG-12-2018-0079","url":null,"abstract":"\u0000Purpose\u0000Many organisations, including the Royal College of Obstetricians and Gynaecologists, have recommended increasing the number of hours of consultant obstetric presence in UK National Health Service maternity units to improve patient care. St Mary’s Hospital, Manchester implemented 24-7 consultant presence in September 2014. The paper aims to discuss these issues.\u0000\u0000\u0000Design/methodology/approach\u0000To assess the impact of 24-7 consultant presence upon women and babies, a retrospective review of all serious clinical intrapartum incidents occurring between September 2011 and September 2017 was carried out by two independent reviewers; disagreements in classification were reviewed by a senior Obstetrician. The impact of consultant presence was classified in a structure agreed a priori.\u0000\u0000\u0000Findings\u0000A total of 72 incidents were reviewed. Consultants were directly involved in the care of 75.6 per cent of cases before 24-7 consultant presence compared to 96.8 per cent afterwards. Negative impact due to a lack of consultant presence fell from 22 per cent of the incidents before 24-7 consultant presence to 9.7 per cent after implementation. In contrast, positive impact of consultant presence increased from 14.6 to 32.3 per cent following the introduction of 24-7 consultant presence.\u0000\u0000\u0000Practical implications\u0000Introduction of 24-7 consultant presence reduced the negative impact caused by a lack of, or delay in, consultant presence as identified by serious untoward incident (SUI) reviews. Consultant presence was more likely to have a positive influence on care delivery.\u0000\u0000\u0000Originality/value\u0000This is the first assessment of the impact of 24-7 consultant presence on the SUIs in obstetrics.\u0000","PeriodicalId":42859,"journal":{"name":"International Journal of Health Governance","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2019-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1108/IJHG-12-2018-0079","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46805380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-21DOI: 10.1108/ijhg-12-2018-0074
S. Short, Nikhil P Hawal, N. Albusaidi, F. Purwaningrum
PurposeThe purpose of this paper is to identify the elements of effective policies and processes to inform future health professional regulation reforms and practice in the Emirates.Design/methodology/approachThis study is based on qualitative exploratory methodology. Methods of data collection and analysis included document analysis of the relevant literature, newspapers (as featured on their online websites), policy documents and official statistics. In-depth semi-structured interviews were conducted with key stakeholders, including employers in the health and higher education sectors in Ras Al Khaimah, human resources managers, regulators and public health professionals and scholars.FindingsThis paper brings to light the issues of maldistribution of the medical workforce, Emiritisation and examines implications for more effective medical workforce governance in the United Arab Emirates (UAE).Originality/valueFirst, the study provides policy recommendations for medical workforce governance in the context of UAE. Next, empirical studies on health workforce governance in the Middle East’s Gulf Cooperation Council are lacking and primarily focus on the international mobility of expatriates. The study addresses the lack of empirical studies on this topic in the UAE. Third, the UAE is a fertile ground for research on medical workforce governance and, more broadly, the mobility of health professionals due to its economic diversification strategy and thriving medical tourism industry.
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