Traditional and complementary medicine has always aided the global population in managing various ailments and its role has been acknowledged by World Health Organization. The G20 is the leading global platform for economic collaboration, influencing international policies across sectors such as agriculture, culture, the digital economy, education, employment, finance, and health to guide resilient global strategies. This study highlights conversations within the health working group of the Sherpa track, focusing in particular on traditional medicines and their diverse intersecting aspects. The information was collected from publications by G20 Indian presidency including G20 communications, think tanks (T20), press releases, speeches, and policy briefs. Throughout four health working group meetings, two side events organized by the Ministry of Ayush, and three joint health‐finance task force meetings, key topics discussed included digital health, Universal Health Coverage, Medical Value Travel through wellness tourism, a One‐Health approach, primary healthcare, Yoga, biodiversity, access and benefit sharing of natural resources, and scientific evidence—all of which were connected to traditional medicines. Unlike past G20 presidencies, the Indian G20 presidency recognize the importance of traditional medicines, marking renewed cooperation in this area. The “Gujrat Declaration 2023” must act as a guiding beacon for crafting robust policies concerning traditional medicines on a global scale. The Ministry of Ayush has excelled in advancing traditional medicine systems across all its sectors through well‐organized and intellectually enriching discussions. Upcoming G20 presidencies should build on the discussions about traditional medicine initiated by the Indian presidency and elevate them to new heights. Considering traditional medicine's unique logic, principals, validity, and largescale patient dependency, efforts should be made to form a dedicated sub‐working group within the health working group to delve deeper into the subject.
{"title":"Mapping out a direction: India's G20 presidency propels global promotion of traditional medicine","authors":"Preet Amol Singh, Neha Bajwa, Subhajit Hazra, Arun Chandan","doi":"10.1002/wmh3.634","DOIUrl":"https://doi.org/10.1002/wmh3.634","url":null,"abstract":"Traditional and complementary medicine has always aided the global population in managing various ailments and its role has been acknowledged by World Health Organization. The G20 is the leading global platform for economic collaboration, influencing international policies across sectors such as agriculture, culture, the digital economy, education, employment, finance, and health to guide resilient global strategies. This study highlights conversations within the health working group of the Sherpa track, focusing in particular on traditional medicines and their diverse intersecting aspects. The information was collected from publications by G20 Indian presidency including G20 communications, think tanks (T20), press releases, speeches, and policy briefs. Throughout four health working group meetings, two side events organized by the Ministry of Ayush, and three joint health‐finance task force meetings, key topics discussed included digital health, Universal Health Coverage, Medical Value Travel through wellness tourism, a One‐Health approach, primary healthcare, Yoga, biodiversity, access and benefit sharing of natural resources, and scientific evidence—all of which were connected to traditional medicines. Unlike past G20 presidencies, the Indian G20 presidency recognize the importance of traditional medicines, marking renewed cooperation in this area. The “Gujrat Declaration 2023” must act as a guiding beacon for crafting robust policies concerning traditional medicines on a global scale. The Ministry of Ayush has excelled in advancing traditional medicine systems across all its sectors through well‐organized and intellectually enriching discussions. Upcoming G20 presidencies should build on the discussions about traditional medicine initiated by the Indian presidency and elevate them to new heights. Considering traditional medicine's unique logic, principals, validity, and largescale patient dependency, efforts should be made to form a dedicated sub‐working group within the health working group to delve deeper into the subject.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"11 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142189774","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}
Farrukh Jamal, Abdullah Ali H. Ahmadini, Muhammad M. Hassan, Waqas Sami, Muhammad Ameeq, Areeba Naeem
BackgroundA consistent referral system and patient patronage are the primary connections between the three tiers in the healthcare delivery system. Patients were scheduled to visit primary care clinics for the first time. Subsequently, patients are moved to more distinguished healthcare facilities to receive additional care.ObjectivesThis study aims to investigate the reasons behind patients' transfer from primary and secondary care to tertiary care, as well as the critical factors that influence these referrals.MethodsThis study employs a mixed‐methods approach to explore factors determining referral service provision across primary, secondary, and tertiary healthcare levels. Along with conducting semi‐structured interviews with healthcare professionals, we systematically examined a wealth of retrospective data on 1331 referred patients from 130 health facilities, including patient records, demographics, referral status, and clinical presentation. All statistical analysis was processed in R, and Corel Draw 12 was also used for graphical illustration.ResultsHealthcare facilities referred most emergencies to several departments, including the cardiac care unit, medical, urology, intensive care unit/emergency, obstetrics and gynaecology, children's, orthopaedic, and psychiatry. The percentage of all cases referred is displayed ward‐by‐ward; the intensive care unit/emergency wards have a high referral ratio of 65.51%, while the obstetrics and gynaecology wards have an 18.40% referral ratio.ConclusionThere is a need for increased government investments to strengthen the capacity, human resources, and availability of equipment in primary, secondary, and tertiary public health facilities to deliver quality services in order to reduce the patient referral ratio.
{"title":"Exploring critical factors in referral systems at different health‐care levels","authors":"Farrukh Jamal, Abdullah Ali H. Ahmadini, Muhammad M. Hassan, Waqas Sami, Muhammad Ameeq, Areeba Naeem","doi":"10.1002/wmh3.632","DOIUrl":"https://doi.org/10.1002/wmh3.632","url":null,"abstract":"BackgroundA consistent referral system and patient patronage are the primary connections between the three tiers in the healthcare delivery system. Patients were scheduled to visit primary care clinics for the first time. Subsequently, patients are moved to more distinguished healthcare facilities to receive additional care.ObjectivesThis study aims to investigate the reasons behind patients' transfer from primary and secondary care to tertiary care, as well as the critical factors that influence these referrals.MethodsThis study employs a mixed‐methods approach to explore factors determining referral service provision across primary, secondary, and tertiary healthcare levels. Along with conducting semi‐structured interviews with healthcare professionals, we systematically examined a wealth of retrospective data on 1331 referred patients from 130 health facilities, including patient records, demographics, referral status, and clinical presentation. All statistical analysis was processed in R, and Corel Draw 12 was also used for graphical illustration.ResultsHealthcare facilities referred most emergencies to several departments, including the cardiac care unit, medical, urology, intensive care unit/emergency, obstetrics and gynaecology, children's, orthopaedic, and psychiatry. The percentage of all cases referred is displayed ward‐by‐ward; the intensive care unit/emergency wards have a high referral ratio of 65.51%, while the obstetrics and gynaecology wards have an 18.40% referral ratio.ConclusionThere is a need for increased government investments to strengthen the capacity, human resources, and availability of equipment in primary, secondary, and tertiary public health facilities to deliver quality services in order to reduce the patient referral ratio.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"30 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142189773","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}
Mohammed Alkhaldi, Yara Asi, Marina AlBada, Wesam Mansour
The Middle East region has a long history of resistance, activism, and advocacy movements in health, most recently as part of the 2011 region‐wide Arab Spring. Despite this storied history, however, movements of resistance, activism, and advocacy in health in the region are rarely unpacked, examined, or documented. This historical and contextual analysis aims to examine the long‐standing confiscated health rights and subsequent experiences of resistance, activism, and advocacy in health in populations in Palestine, Lebanon, Egypt, and Iraq. Promoting a health equity and health rights‐based approach is key to achieving Universal Health Coverage and health‐related Sustainable Development Goals, particularly in contexts that experience fragile socioeconomic and humanitarian conditions and political instability such as many countries in the Middle East. Marginalized populations, including Palestinians living under Israeli occupation, Lebanese Lesbian, Gay, Bisexual, and Transgender+ (LGBT) communities, Egyptian women and girls affected by Female Genital Mutilation, and Iraqi refugees and Internally Displaced Persons, have been severely impacted by decades of oppression, conflict, and displacement. These populations have faced various forms of discrimination, neglect, and violence that have hindered their access to quality healthcare and basic health rights. Rather than relying on government efforts, local and international movements to advocate for and protect the health rights of these populations are key. Innovative approaches, strategic dialogue and collective actions are prerequisites for promoting resistance, activism, and advocacy in health in all country's systems structure. This analysis highlights the important of this social public health issue in the most turbulent region and provides evidence to guide all countries to realize equitable human rights for health for all populations.
{"title":"Rethinking and advancing the movement of resistance, activism, and advocacy in health in four central arenas of the Middle East Region","authors":"Mohammed Alkhaldi, Yara Asi, Marina AlBada, Wesam Mansour","doi":"10.1002/wmh3.633","DOIUrl":"https://doi.org/10.1002/wmh3.633","url":null,"abstract":"The Middle East region has a long history of resistance, activism, and advocacy movements in health, most recently as part of the 2011 region‐wide Arab Spring. Despite this storied history, however, movements of resistance, activism, and advocacy in health in the region are rarely unpacked, examined, or documented. This historical and contextual analysis aims to examine the long‐standing confiscated health rights and subsequent experiences of resistance, activism, and advocacy in health in populations in Palestine, Lebanon, Egypt, and Iraq. Promoting a health equity and health rights‐based approach is key to achieving Universal Health Coverage and health‐related Sustainable Development Goals, particularly in contexts that experience fragile socioeconomic and humanitarian conditions and political instability such as many countries in the Middle East. Marginalized populations, including Palestinians living under Israeli occupation, Lebanese Lesbian, Gay, Bisexual, and Transgender+ (LGBT) communities, Egyptian women and girls affected by Female Genital Mutilation, and Iraqi refugees and Internally Displaced Persons, have been severely impacted by decades of oppression, conflict, and displacement. These populations have faced various forms of discrimination, neglect, and violence that have hindered their access to quality healthcare and basic health rights. Rather than relying on government efforts, local and international movements to advocate for and protect the health rights of these populations are key. Innovative approaches, strategic dialogue and collective actions are prerequisites for promoting resistance, activism, and advocacy in health in all country's systems structure. This analysis highlights the important of this social public health issue in the most turbulent region and provides evidence to guide all countries to realize equitable human rights for health for all populations.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"10 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141942919","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}
Despite a greater percentage of women in the healthcare workforce, women are underrepresented in leadership positions. Researchers have examined the influence of gender on women involvement in policy‐making and leadership in male‐dominated professions. However, no research has explored nurses' perspectives about the role of gender in impacting their involvement in health policymaking in female‐dominant profession. This study explores nurse leaders' perspectives on how gender can influence their involvement in health policymaking in Pakistan. Eleven nurse leaders with at least 1 year of experience in policymaking participated in semi‐structured interviews. The data were analyzed using reflexive thematic analysis. Four themes emerged: Patriarchy Permeates Health Policymaking; Women's Social Status and Nurses' Involvement in Policymaking; Intentionally Disregarding Nurses' Insights on Policy Forums; Condescending Attitudes Towards Women Nurses on Policy Forums. The underrepresentation of nurses in health policymaking is influenced by gender and social biases and stereotypes against women and the negative social image of the nursing profession. Health‐care organizations must play an active role and develop policies to combat gender‐based discrimination and curb the underrepresentation of nurses in healthcare policymaking.
{"title":"“Patriarchy permeating health policymaking”: Influence of gender on involvement in health policymaking from nurse leaders' perspective","authors":"Shahzad Inayat, Ahtisham Younas, Parveen Ali","doi":"10.1002/wmh3.631","DOIUrl":"https://doi.org/10.1002/wmh3.631","url":null,"abstract":"Despite a greater percentage of women in the healthcare workforce, women are underrepresented in leadership positions. Researchers have examined the influence of gender on women involvement in policy‐making and leadership in male‐dominated professions. However, no research has explored nurses' perspectives about the role of gender in impacting their involvement in health policymaking in female‐dominant profession. This study explores nurse leaders' perspectives on how gender can influence their involvement in health policymaking in Pakistan. Eleven nurse leaders with at least 1 year of experience in policymaking participated in semi‐structured interviews. The data were analyzed using reflexive thematic analysis. Four themes emerged: Patriarchy Permeates Health Policymaking; Women's Social Status and Nurses' Involvement in Policymaking; Intentionally Disregarding Nurses' Insights on Policy Forums; Condescending Attitudes Towards Women Nurses on Policy Forums. The underrepresentation of nurses in health policymaking is influenced by gender and social biases and stereotypes against women and the negative social image of the nursing profession. Health‐care organizations must play an active role and develop policies to combat gender‐based discrimination and curb the underrepresentation of nurses in healthcare policymaking.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"14 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141881462","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}
Screening and early detection programs for breast cancer (BC) have significantly reduced mortality rates and enhanced survival rates globally. Breast cancer screening programs in low‐ and middle‐income countries like Iran need improvement. This study examines Iran's breast cancer screening and early detection (BCSED) policies, employing the Policy Triangle Model in two phases: a review of 27 documents including various related sources related of policies and strategies, followed by 20 semi‐structured interviews across four distinct levels: policy, regional, clinical, and community levels. Content analysis for documents and MAXQDA2020 software for the second phase were used, and findings integrated. In our analysis of 27 national documents and 20 interviews, we found 10 themes, 19 sub‐themes, and 42 specific codes across four dimensions of the mentioned framework. Main themes in the context dimension covered deficient interactions, deficiency in knowledge management, cultural challenges, and socioeconomic challenges. From the analysis of 27 national documents, we recognized service excellence schemes, personal health encouragement, and service levels. Policy formulation and monitoring and evaluation emerged as central themes for the process dimension, while stakeholder challenges were prominent in the actors' dimension. BCSED programs are multifactorial issues. Proposed strategies to address these issues include the dedicated funds for BC prevention programs, strengthening the Ministry of Health's stewardship role, elevating public awareness, and conducting systematic screening trials in select cities to provide valuable national evidence for future policymaking.
{"title":"Breast cancer screening and early detection programs in Iran: A health policy analysis and recommendations","authors":"Zeinab Dolatshahi, Pouran Raeissi Dehkordi, Hassan Abolghasem Gorji, Seyed Massoud Hashemi, Nahid Reisi, Toraj Harati Khalilabad","doi":"10.1002/wmh3.629","DOIUrl":"https://doi.org/10.1002/wmh3.629","url":null,"abstract":"Screening and early detection programs for breast cancer (BC) have significantly reduced mortality rates and enhanced survival rates globally. Breast cancer screening programs in low‐ and middle‐income countries like Iran need improvement. This study examines Iran's breast cancer screening and early detection (BCSED) policies, employing the Policy Triangle Model in two phases: a review of 27 documents including various related sources related of policies and strategies, followed by 20 semi‐structured interviews across four distinct levels: policy, regional, clinical, and community levels. Content analysis for documents and MAXQDA<jats:sub>2020</jats:sub> software for the second phase were used, and findings integrated. In our analysis of 27 national documents and 20 interviews, we found 10 themes, 19 sub‐themes, and 42 specific codes across four dimensions of the mentioned framework. Main themes in the context dimension covered deficient interactions, deficiency in knowledge management, cultural challenges, and socioeconomic challenges. From the analysis of 27 national documents, we recognized service excellence schemes, personal health encouragement, and service levels. Policy formulation and monitoring and evaluation emerged as central themes for the process dimension, while stakeholder challenges were prominent in the actors' dimension. BCSED programs are multifactorial issues. Proposed strategies to address these issues include the dedicated funds for BC prevention programs, strengthening the Ministry of Health's stewardship role, elevating public awareness, and conducting systematic screening trials in select cities to provide valuable national evidence for future policymaking.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"182 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141881529","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}
Heba I. Lashin, Mira M. Abu‐Elenin, Ahmed A. Elshora, Ahmed E. Elsharkawy, Mona M. Ghonem
The practice of defensive medicine is highly evident with the purpose of the legal self‐interest of physicians. It might be widely increased during the coronavirus disease 2019 (COVID‐19) pandemic to avoid lawsuits, especially in the absence of specific effective treatment. This study aimed to evaluate the practice of defensive medicine among the Egyptian physicians, and to identify the impact of the COVID‐19 pandemic on malpractice suits. An electronic survey link was sent to the sampled physicians working at Faculty of Medicine, Tanta University Hospitals. It included personal information, two questions measuring the physicians' perceptions about defensive medicine, Defensive Medicine Behavior Scale (DMBS) and eight questions evaluating physicians' concerns in terms of the COVID‐19 pandemic effects. The study enrolled 1074 physicians; 78.5% of them didn't possess sufficient knowledge about defensive medicine. About 73% of participants practiced defensive medicine more after the COVID‐19 pandemic, and 68.2% demonstrated increasing concerns about malpractice suits after the emergence of COVID‐19. DMBS was statistically significant high among surgical specialties physicians and those who spent less duration in the field of their expertise. There is a need to legislate a malpractice law to control the precedent increase of defensive medicine practice in Egypt. This will help to control the prevalence of defensive medicine practice, improve the quality of care, and reduce healthcare costs.
{"title":"The precedent of defensive medicine practice among physicians with a glance at the impact of the COVID‐19 pandemic","authors":"Heba I. Lashin, Mira M. Abu‐Elenin, Ahmed A. Elshora, Ahmed E. Elsharkawy, Mona M. Ghonem","doi":"10.1002/wmh3.628","DOIUrl":"https://doi.org/10.1002/wmh3.628","url":null,"abstract":"The practice of defensive medicine is highly evident with the purpose of the legal self‐interest of physicians. It might be widely increased during the coronavirus disease 2019 (COVID‐19) pandemic to avoid lawsuits, especially in the absence of specific effective treatment. This study aimed to evaluate the practice of defensive medicine among the Egyptian physicians, and to identify the impact of the COVID‐19 pandemic on malpractice suits. An electronic survey link was sent to the sampled physicians working at Faculty of Medicine, Tanta University Hospitals. It included personal information, two questions measuring the physicians' perceptions about defensive medicine, Defensive Medicine Behavior Scale (DMBS) and eight questions evaluating physicians' concerns in terms of the COVID‐19 pandemic effects. The study enrolled 1074 physicians; 78.5% of them didn't possess sufficient knowledge about defensive medicine. About 73% of participants practiced defensive medicine more after the COVID‐19 pandemic, and 68.2% demonstrated increasing concerns about malpractice suits after the emergence of COVID‐19. DMBS was statistically significant high among surgical specialties physicians and those who spent less duration in the field of their expertise. There is a need to legislate a malpractice law to control the precedent increase of defensive medicine practice in Egypt. This will help to control the prevalence of defensive medicine practice, improve the quality of care, and reduce healthcare costs.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"20 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141772472","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}
Michael K. Gusmano, Daniel Weisz, Swati Palghat, Victor G. Rodwin
The use of revascularization (coronary artery bypass surgery [CABG] and percutaneous coronary intervention [PCI]) in the United States is declining, but they remain important procedures for the treatment of patients with coronary artery disease. There are large and long‐standing disparities in the use of revascularization among patients hospitalized with heart disease. In this article, we investigate whether the implementation of the Patient Protection and Affordable Care Act (ACA) is associated with a reduction in disparities in the use of revascularization. We use data from the Agency for Healthcare Research and Quality (AHRQ)'s National Inpatient Sample (NIP) of the Healthcare Cost and Utilization Project (HCUP) project to compare the use of revascularization among patients 45 years and older in the United States in 2012 and 2018. For both years, we conducted multiple logistic regression analysis to assess the factors associated with coronary revascularization among patients hospitalized with heart disease. Hospitalizations for heart disease and the use of revascularization both fell between 2012 and 2018 at a rate that was greater than the reduction in heart disease deaths in the country. These findings are consistent with the clinical literature on the growth of medical management of heart disease. Disparities in the use of revascularization, by gender, insurance status, neighborhood, and race/ethnicity, were just as large after the implementation of the ACA in 2014. The expansion of insurance by the ACA, alone, was insufficient to reduce disparities in the use of revascularization in patients with diagnosed coronary heart disease in the United States.
{"title":"Enduring inequalities: Revascularization before and after the ACA","authors":"Michael K. Gusmano, Daniel Weisz, Swati Palghat, Victor G. Rodwin","doi":"10.1002/wmh3.627","DOIUrl":"https://doi.org/10.1002/wmh3.627","url":null,"abstract":"The use of revascularization (coronary artery bypass surgery [CABG] and percutaneous coronary intervention [PCI]) in the United States is declining, but they remain important procedures for the treatment of patients with coronary artery disease. There are large and long‐standing disparities in the use of revascularization among patients hospitalized with heart disease. In this article, we investigate whether the implementation of the Patient Protection and Affordable Care Act (ACA) is associated with a reduction in disparities in the use of revascularization. We use data from the Agency for Healthcare Research and Quality (AHRQ)'s National Inpatient Sample (NIP) of the Healthcare Cost and Utilization Project (HCUP) project to compare the use of revascularization among patients 45 years and older in the United States in 2012 and 2018. For both years, we conducted multiple logistic regression analysis to assess the factors associated with coronary revascularization among patients hospitalized with heart disease. Hospitalizations for heart disease and the use of revascularization both fell between 2012 and 2018 at a rate that was greater than the reduction in heart disease deaths in the country. These findings are consistent with the clinical literature on the growth of medical management of heart disease. Disparities in the use of revascularization, by gender, insurance status, neighborhood, and race/ethnicity, were just as large after the implementation of the ACA in 2014. The expansion of insurance by the ACA, alone, was insufficient to reduce disparities in the use of revascularization in patients with diagnosed coronary heart disease in the United States.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"67 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141772473","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}
There has been longstanding international fascination with the British National Health Service since it was established in 1948. The British population itself has offered enduring support for the principles and institutions of public provision. However, coverage of the NHS has typically been uneven in academic and policy debates. There is limited understanding of some darker corners of NHS provision resulting in a partial picture of public service provision. Public dentistry has been a Cinderella service in broader debates about the NHS and a check‐up is overdue. We offer a long‐term view of dentistry that assesses the current state of dental health policy, including its gradual decay. We examine the purpose of dentistry and the challenge of injecting fundamental National Health Service values (weighted capitation and a focus on need) into services and which necessitates redistribution and tackling shibboleths of NHS provision. Alongside political values and public attitudes, we examine the interests of professional stakeholders and how the combination of values, attitudes, and interests does not currently cohere into a sustainable policy. We explore how dentistry might recover purpose and respond to need. Discussion is prescient considering an acknowledged crisis in British dental care, including widespread public and media coverage, and with 2024 being a general election year with NHS provision a familiar battleground.
{"title":"NHS dentistry in Britain: A long overdue check‐up","authors":"Neil Lunt, Mark Exworthy","doi":"10.1002/wmh3.626","DOIUrl":"https://doi.org/10.1002/wmh3.626","url":null,"abstract":"There has been longstanding international fascination with the British National Health Service since it was established in 1948. The British population itself has offered enduring support for the principles and institutions of public provision. However, coverage of the NHS has typically been uneven in academic and policy debates. There is limited understanding of some darker corners of NHS provision resulting in a partial picture of public service provision. Public dentistry has been a Cinderella service in broader debates about the NHS and a check‐up is overdue. We offer a long‐term view of dentistry that assesses the current state of dental health policy, including its gradual decay. We examine the purpose of dentistry and the challenge of injecting fundamental National Health Service values (weighted capitation and a focus on need) into services and which necessitates redistribution and tackling shibboleths of NHS provision. Alongside political values and public attitudes, we examine the interests of professional stakeholders and how the combination of values, attitudes, and interests does not currently cohere into a sustainable policy. We explore how dentistry might recover purpose and respond to need. Discussion is prescient considering an acknowledged crisis in British dental care, including widespread public and media coverage, and with 2024 being a general election year with NHS provision a familiar battleground.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"38 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141608855","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}
Shivaughn Hem‐Lee‐Forsyth, N'Diera Viechweg, Eden Estevez, Terrisha Walcott‐Pierre, Lauren Wong
Human trafficking poses a global humanitarian and public health concern, particularly affecting women and migrants in many countries. This article assessed existing policies and laws addressing human trafficking and the sexual exploitation of women in the Caribbean nations of the Dominican Republic and Trinidad and Tobago. It identified the legislative frameworks and procedures for anti‐trafficking efforts in the Dominican Republic and Trinidad and Tobago through a comprehensive review of academic literature and policy documents. The analysis focused on evaluating the successes and challenges in implementing these policies. Findings revealed that while both countries had established anti‐trafficking laws, several structural, economic, social, and political barriers prevented effective interventions catering to the needs of vulnerable populations. Based on the analysis, recommendations were made to mitigate country and regional human trafficking, with a focus on the protection of women. Key recommendations include enhancing economic opportunities, strengthening social protections, and improving the criminal justice system's capacity to combat trafficking. A reduction in trafficking and sexual exploitation in the Dominican Republic and Trinidad and Tobago requires comprehensive policy implementation strategies aimed at protecting and supporting at‐risk native and migrant populations, providing sound economic opportunities and social protection, and strengthening effective legal responses to combat trafficking.
{"title":"Sex trafficking in the Caribbean: A comparative analysis of policy responses in the Dominican Republic and Trinidad and Tobago","authors":"Shivaughn Hem‐Lee‐Forsyth, N'Diera Viechweg, Eden Estevez, Terrisha Walcott‐Pierre, Lauren Wong","doi":"10.1002/wmh3.623","DOIUrl":"https://doi.org/10.1002/wmh3.623","url":null,"abstract":"Human trafficking poses a global humanitarian and public health concern, particularly affecting women and migrants in many countries. This article assessed existing policies and laws addressing human trafficking and the sexual exploitation of women in the Caribbean nations of the Dominican Republic and Trinidad and Tobago. It identified the legislative frameworks and procedures for anti‐trafficking efforts in the Dominican Republic and Trinidad and Tobago through a comprehensive review of academic literature and policy documents. The analysis focused on evaluating the successes and challenges in implementing these policies. Findings revealed that while both countries had established anti‐trafficking laws, several structural, economic, social, and political barriers prevented effective interventions catering to the needs of vulnerable populations. Based on the analysis, recommendations were made to mitigate country and regional human trafficking, with a focus on the protection of women. Key recommendations include enhancing economic opportunities, strengthening social protections, and improving the criminal justice system's capacity to combat trafficking. A reduction in trafficking and sexual exploitation in the Dominican Republic and Trinidad and Tobago requires comprehensive policy implementation strategies aimed at protecting and supporting at‐risk native and migrant populations, providing sound economic opportunities and social protection, and strengthening effective legal responses to combat trafficking.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"53 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141503032","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}
The role of nutrition in promoting health and reducing the prevalence of noncommunicable diseases (NCDs) is vital, yet both inadequate and excessive food consumption can be detrimental. Moreover, excessive smoking and alcohol consumption contribute to higher mortality rates. Countries have implemented policies, strategies, and awareness campaigns to combat NCD‐related deaths. Within this context, the study aims to assess the relative efficiency of Organisation for Economic Co‐operation and Development (OECD) countries in preventing chronic NCDs by considering nutritional supply and smoking and alcohol consumption as inputs. It also seeks to identify countries' best policies and strategies to reduce regular NCD‐related death rates, emphasizing the importance of selecting and implementing adaptive strategies locally. This study employs slack‐based measurement (SBM) data envelopment analysis (SBM‐DEA). The mean efficiency score across the countries is 0.95, with a standard deviation of 0.09, indicating a generally high‐efficiency level. Twenty‐nine countries with an efficiency score of 1 are deemed relatively efficient. Austria, Belgium, Germany, Greece, Ireland, Korea, Luxembourg, the United Kingdom, and the United States did not achieve relative efficiency in NCD management. The findings highlight the importance of considering the unique context of each country when designing and implementing NCD prevention and management strategies. The study emphasizes the need for regular evaluation and appropriate measurement methods to assess the achievement of targets and address implementation challenges. Furthermore, it highlights the significance of adopting a comprehensive, coordinated approach to ensure the effectiveness of NCD policies and underscores the need for flexibility and adaptability in addressing NCDs.
{"title":"Optimising nutrition and consumption for better health: An analysis of noncommunicable disease strategies in the organisation for economic co‐operation and development nations","authors":"K. R. Sinimole","doi":"10.1002/wmh3.614","DOIUrl":"https://doi.org/10.1002/wmh3.614","url":null,"abstract":"The role of nutrition in promoting health and reducing the prevalence of noncommunicable diseases (NCDs) is vital, yet both inadequate and excessive food consumption can be detrimental. Moreover, excessive smoking and alcohol consumption contribute to higher mortality rates. Countries have implemented policies, strategies, and awareness campaigns to combat NCD‐related deaths. Within this context, the study aims to assess the relative efficiency of Organisation for Economic Co‐operation and Development (OECD) countries in preventing chronic NCDs by considering nutritional supply and smoking and alcohol consumption as inputs. It also seeks to identify countries' best policies and strategies to reduce regular NCD‐related death rates, emphasizing the importance of selecting and implementing adaptive strategies locally. This study employs slack‐based measurement (SBM) data envelopment analysis (SBM‐DEA). The mean efficiency score across the countries is 0.95, with a standard deviation of 0.09, indicating a generally high‐efficiency level. Twenty‐nine countries with an efficiency score of 1 are deemed relatively efficient. Austria, Belgium, Germany, Greece, Ireland, Korea, Luxembourg, the United Kingdom, and the United States did not achieve relative efficiency in NCD management. The findings highlight the importance of considering the unique context of each country when designing and implementing NCD prevention and management strategies. The study emphasizes the need for regular evaluation and appropriate measurement methods to assess the achievement of targets and address implementation challenges. Furthermore, it highlights the significance of adopting a comprehensive, coordinated approach to ensure the effectiveness of NCD policies and underscores the need for flexibility and adaptability in addressing NCDs.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"97 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140623240","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：