Abdallah M. Badahdah, Filip Viskupič, David L. Wiltse
The coronavirus disease 2019 (COVID‐19) pandemic ignited heated discussions on social media as well as in the medical, legal, and political communities, about whether health‐care providers should have the right to refuse to see unvaccinated patients. Another discussed idea during the pandemic, though it attracted less attention, was about patients' right to learn about the vaccination status of their health‐care providers. In this paper, we examined public attitudes toward these two rights using data from a cross‐sectional survey conducted in South Dakota in the summer of 2021. We utilized registration‐based sampling to recruit participants. The survey collected data on some of the most significant variables reported in the literature that shape people's attitudes toward COVID‐19 vaccines. Specifically, participants provided information on their age, gender, educational level, household income, COVID‐19 vaccination status, stress induced by the pandemic, and political partisan identification. The health‐care providers' rights as well as the patients' rights were gauged with one item each using a five‐point Likert scale. We analyzed data from 573 respondents (Mage = 56.6 years, SD = 16.48), which showed that older participants, those with higher levels of COVID‐19‐related stress, and vaccinated individuals expressed higher support, while Republicans expressed lower support for the two policies. Gender, education, and income did not influence participants' attitudes. Although the findings might have limited generalizability to populations outside South Dakota, they offer valuable insights for developing comprehensive ethical codes where vaccination status might be at the center stage for clinician‐patient relationships in future pandemic responses.
{"title":"Attitudes toward COVID‐19 vaccination status disclosure in the provider–patient relationship: Findings from a population survey","authors":"Abdallah M. Badahdah, Filip Viskupič, David L. Wiltse","doi":"10.1002/wmh3.613","DOIUrl":"https://doi.org/10.1002/wmh3.613","url":null,"abstract":"The coronavirus disease 2019 (COVID‐19) pandemic ignited heated discussions on social media as well as in the medical, legal, and political communities, about whether health‐care providers should have the right to refuse to see unvaccinated patients. Another discussed idea during the pandemic, though it attracted less attention, was about patients' right to learn about the vaccination status of their health‐care providers. In this paper, we examined public attitudes toward these two rights using data from a cross‐sectional survey conducted in South Dakota in the summer of 2021. We utilized registration‐based sampling to recruit participants. The survey collected data on some of the most significant variables reported in the literature that shape people's attitudes toward COVID‐19 vaccines. Specifically, participants provided information on their age, gender, educational level, household income, COVID‐19 vaccination status, stress induced by the pandemic, and political partisan identification. The health‐care providers' rights as well as the patients' rights were gauged with one item each using a five‐point Likert scale. We analyzed data from 573 respondents (<jats:italic>M</jats:italic><jats:sub>age</jats:sub> = 56.6 years, SD = 16.48), which showed that older participants, those with higher levels of COVID‐19‐related stress, and vaccinated individuals expressed higher support, while Republicans expressed lower support for the two policies. Gender, education, and income did not influence participants' attitudes. Although the findings might have limited generalizability to populations outside South Dakota, they offer valuable insights for developing comprehensive ethical codes where vaccination status might be at the center stage for clinician‐patient relationships in future pandemic responses.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"48 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140615717","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}
Felipe Agudelo-Hernández, Luz María Salazar Vieira, Laura Inés Plata-Casas
Evidence-based practices in mental health have been proposed globally and have been adopted in Colombia. However, implementation problems often make it difficult for these initiatives to contribute to people's well-being. The objective of the present study is to describe a strategy for implementing the components of global mental health in two complex Colombian territories: Chocó and La Guajira. These components are a primary health-care approach, continuity of care, anti-stigma, mental health as a human right, mental health in all policies, and a community model of recovery. A monitoring system was created for the reporting of these components by each territory. An appropriation of all the components by the health systems of both territories was found, as mobilization of existing technical resources in the territories and the strengthening of capacities at the administrative, clinical, and community levels, in addition to the articulation of all the strategies proposed at the level global for recovery. Innovation processes built in a participatory manner with communities can favor the implementation of evidence-based practices and public policies in mental health in territories where social determinants make recovery a challenge.
{"title":"Mental Health Friendly Territories: Strategy for the implementation of the Mental Health Policy in Colombia","authors":"Felipe Agudelo-Hernández, Luz María Salazar Vieira, Laura Inés Plata-Casas","doi":"10.1002/wmh3.611","DOIUrl":"https://doi.org/10.1002/wmh3.611","url":null,"abstract":"Evidence-based practices in mental health have been proposed globally and have been adopted in Colombia. However, implementation problems often make it difficult for these initiatives to contribute to people's well-being. The objective of the present study is to describe a strategy for implementing the components of global mental health in two complex Colombian territories: Chocó and La Guajira. These components are a primary health-care approach, continuity of care, anti-stigma, mental health as a human right, mental health in all policies, and a community model of recovery. A monitoring system was created for the reporting of these components by each territory. An appropriation of all the components by the health systems of both territories was found, as mobilization of existing technical resources in the territories and the strengthening of capacities at the administrative, clinical, and community levels, in addition to the articulation of all the strategies proposed at the level global for recovery. Innovation processes built in a participatory manner with communities can favor the implementation of evidence-based practices and public policies in mental health in territories where social determinants make recovery a challenge.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"20 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140601910","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 preservation of the culturally important traditional herbal medicine practice in Ghana is threatened by the growth of allopathic medicine. It is argued that two main factors comprise this threat: significant safety concerns over many traditional herbal preparations, and a conflict in therapeutic frameworks which provides a substrate for the production of misinformation regarding allopathic medicine. Poorly enforced regulation of the commercial herbal market and a total lack of regulation of the traditional herbal market have led to prevalent contamination of herbal preparations with pathogenic bacteria and an unacceptable risk of pharmacological toxicity due to inconsistent production methods and understanding of the active components in these preparations. Simultaneously, misinformation spread by traditional herbal practitioners about allopathic medicine has caused significant morbidity and mortality in Ghana. Evidence from the literature and experience from clinical practice in a hospital in the Eastern region of Ghana are used to explore these factors and provide recommendations. First, thorough regulation of the herbal practice is needed to allay safety concerns. Second, the overall healthcare landscape will have to change to resolve the current tensions between practices. One solution would be the formation of a cooperative healthcare system which incorporates both the allopathic and herbal practices with well‐defined, nonoverlapping scopes of practice. However, such a novel landscape may be unrealistic, with the potential for traditional herbal practices being relegated to secondary role, mainly providing pharmacologically inert preparations while continuing to benefit patients through spiritual, cultural and pastoral interventions.
{"title":"Barriers to the safe preservation of the traditional herbal practice in Ghana","authors":"Benjamin Clay","doi":"10.1002/wmh3.612","DOIUrl":"https://doi.org/10.1002/wmh3.612","url":null,"abstract":"The preservation of the culturally important traditional herbal medicine practice in Ghana is threatened by the growth of allopathic medicine. It is argued that two main factors comprise this threat: significant safety concerns over many traditional herbal preparations, and a conflict in therapeutic frameworks which provides a substrate for the production of misinformation regarding allopathic medicine. Poorly enforced regulation of the commercial herbal market and a total lack of regulation of the traditional herbal market have led to prevalent contamination of herbal preparations with pathogenic bacteria and an unacceptable risk of pharmacological toxicity due to inconsistent production methods and understanding of the active components in these preparations. Simultaneously, misinformation spread by traditional herbal practitioners about allopathic medicine has caused significant morbidity and mortality in Ghana. Evidence from the literature and experience from clinical practice in a hospital in the Eastern region of Ghana are used to explore these factors and provide recommendations. First, thorough regulation of the herbal practice is needed to allay safety concerns. Second, the overall healthcare landscape will have to change to resolve the current tensions between practices. One solution would be the formation of a cooperative healthcare system which incorporates both the allopathic and herbal practices with well‐defined, nonoverlapping scopes of practice. However, such a novel landscape may be unrealistic, with the potential for traditional herbal practices being relegated to secondary role, mainly providing pharmacologically inert preparations while continuing to benefit patients through spiritual, cultural and pastoral interventions.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"20 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140601715","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 Affordable Care Act (ACA) continues to shape US politics at the elite level. We know less about whether this conflict still carries over to the broader public. Moreover, we know little about the degree to which the conflict reaches into its various policies and whether the policy threats to the ACA can affect public opinion. We fielded a large, and demographically diverse survey of US adults using Lucid (N = 6066) from July 8–21, 2020. The survey contained an experiment that introduced the topic to respondents as the 2010 health reform law, the ACA, or Obamacare and at times highlighted the potential undoing of the ACA by the US Supreme Court. Analyses were conducted using Ordinary Least Squares regression. Our findings indicate that perceptions of the ACA differ substantial based on partisanship and racial prejudice. Framing still matters in the minds of Americans and their perception of health reforms in general and its individual components by extending these differences. However, we find only very limited evidence for changes to public attitudes related to the policy threat of the Supreme Court ruling the ACA constitutional in California v. Texas. The ACA remains a political battleground in the minds of Americans. The politics of the ACA continue to be shaped by perceptions of race and partisanship.
{"title":"Stability and policy threats: US public opinion after a decade of the Affordable Care Act","authors":"Simon F. Haeder, Steven Sylvester","doi":"10.1002/wmh3.609","DOIUrl":"https://doi.org/10.1002/wmh3.609","url":null,"abstract":"The Affordable Care Act (ACA) continues to shape US politics at the elite level. We know less about whether this conflict still carries over to the broader public. Moreover, we know little about the degree to which the conflict reaches into its various policies and whether the policy threats to the ACA can affect public opinion. We fielded a large, and demographically diverse survey of US adults using Lucid (<jats:italic>N</jats:italic> = 6066) from July 8–21, 2020. The survey contained an experiment that introduced the topic to respondents as the 2010 health reform law, the ACA, or Obamacare and at times highlighted the potential undoing of the ACA by the US Supreme Court. Analyses were conducted using Ordinary Least Squares regression. Our findings indicate that perceptions of the ACA differ substantial based on partisanship and racial prejudice. Framing still matters in the minds of Americans and their perception of health reforms in general and its individual components by extending these differences. However, we find only very limited evidence for changes to public attitudes related to the policy threat of the Supreme Court ruling the ACA constitutional in California v. Texas. The ACA remains a political battleground in the minds of Americans. The politics of the ACA continue to be shaped by perceptions of race and partisanship.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"35 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140601798","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}
S. Scott Graham, Kimberlyn R. Harrison, Jade C. Shiva Edward, Zoltan P. Majdik, Joshua B. Barbour, Justin F. Rousseau
Considerable efforts have been devoted to addressing the problem of conflicts of interest (COI) in health research, policy, education, and practice. An overwhelming body of evidence demonstrates that conflicts associate with deleterious outcomes for the biomedical research enterprise. Nevertheless, little has changed for research, specifically, since the Institute of Medicine's landmark Conflicts of Interest in Medical Research, Practice, and Education was published over a decade ago. In this article, we draw on interdisciplinary research on manufactured controversies in science‐policy deliberation to argue that the development of meaningful COI policy has been stymied through argumentative “wedges” designed to delay consensus and policy formation. Argumentative wedges disrupt policy formation by mischaracterizing the evidence base, continuously redefining the terms of the debate and/or recommending overly narrow criteria for who should be allowed to participate in policy deliberation. In this article, we argue researchers and policymakers interested in better addressing the harmful effects of COI can improve their efforts through strategic efforts designed to disrupt the wedges of manufactured controversy. Additionally, we argue that efforts to address COI can be further enhanced through embracing a broader framework for COI inquiry. Specifically, we argue that aggregate approaches to COI can help to disrupt these wedges and provide a strong foundation for future policy.
为解决健康研究、政策、教育和实践中的利益冲突（COI）问题，人们付出了巨大的努力。大量证据表明，利益冲突会给生物医学研究事业带来有害结果。然而，自十多年前美国医学研究所发表具有里程碑意义的《医学研究、实践和教育中的利益冲突》一文以来，研究领域的具体情况几乎没有发生任何变化。在本文中，我们借鉴了关于科学政策审议中人为争议的跨学科研究，认为有意义的利益冲突政策的制定一直受阻于旨在延迟共识和政策形成的争论性 "楔子"。争论性楔子通过对证据基础的错误描述、不断重新定义辩论的条件和/或建议过于狭窄的标准来确定谁应被允许参与政策审议，从而扰乱了政策的形成。在本文中，我们认为有兴趣更好地应对 COI 有害影响的研究人员和决策者可以通过旨在打破人为争议楔子的战略努力来改进他们的工作。此外，我们还认为，通过采用更广泛的 COI 调查框架，可以进一步加强解决 COI 问题的努力。具体而言，我们认为，对 COI 采取综合方法有助于打破这些楔子，并为未来的政策奠定坚实的基础。
{"title":"Beyond bias: Aggregate approaches to conflicts of interest research and policy in biomedical research","authors":"S. Scott Graham, Kimberlyn R. Harrison, Jade C. Shiva Edward, Zoltan P. Majdik, Joshua B. Barbour, Justin F. Rousseau","doi":"10.1002/wmh3.608","DOIUrl":"https://doi.org/10.1002/wmh3.608","url":null,"abstract":"Considerable efforts have been devoted to addressing the problem of conflicts of interest (COI) in health research, policy, education, and practice. An overwhelming body of evidence demonstrates that conflicts associate with deleterious outcomes for the biomedical research enterprise. Nevertheless, little has changed for research, specifically, since the Institute of Medicine's landmark <jats:italic>Conflicts of Interest in Medical Research, Practice, and Education</jats:italic> was published over a decade ago. In this article, we draw on interdisciplinary research on manufactured controversies in science‐policy deliberation to argue that the development of meaningful COI policy has been stymied through argumentative “wedges” designed to delay consensus and policy formation. Argumentative wedges disrupt policy formation by mischaracterizing the evidence base, continuously redefining the terms of the debate and/or recommending overly narrow criteria for who should be allowed to participate in policy deliberation. In this article, we argue researchers and policymakers interested in better addressing the harmful effects of COI can improve their efforts through strategic efforts designed to disrupt the wedges of manufactured controversy. Additionally, we argue that efforts to address COI can be further enhanced through embracing a broader framework for COI inquiry. Specifically, we argue that aggregate approaches to COI can help to disrupt these wedges and provide a strong foundation for future policy.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"70 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140601707","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}
Fazladin T. Temurov, Aliya A. Musaeva, Shkurulla G. Masadikov, Sanjar A. Allabergenov, Shahrukh A. Abdukadirov
This paper is aimed at a comprehensive study of the incidence of dentists in the Turkestan region of the Republic of Kazakhstan using the screening study method. The study included 200 dentists from 12 outpatient clinics in Shymkent city, Turkestan region (South Kazakhstan). Data on visits to doctors in the period from 2015 to 2022 were used to investigate the incidence. The average long‐term value of morbidity coefficients among the studied medical workers was 995.9 ± 9.9 cases per 1000 people over 7 years. The analysis of the structure of diseases was carried out based on information obtained from sick leave records of the study group of dentists for the period from 2015 to 2022. The dental profession has its own characteristics; the unfavorable factors identified during the study can be divided into three groups: factors related to the treatment process; factors related to the organization of premises in dental clinics; factors related to insufficient ergonomics of dental equipment and instruments; and the quality of filling and dental materials. Six of the same classes of diseases play a leading role in the structure of diseases identified during medical examinations, but their significance is different: in the first place are diseases associated with increased psychological stress (circulatory disorders, psychoneuroses, diseases of the digestive system), diseases associated with forced working position (musculoskeletal diseases).
{"title":"Nosological approaches in studying the incidence rate among dental healthcare workers","authors":"Fazladin T. Temurov, Aliya A. Musaeva, Shkurulla G. Masadikov, Sanjar A. Allabergenov, Shahrukh A. Abdukadirov","doi":"10.1002/wmh3.610","DOIUrl":"https://doi.org/10.1002/wmh3.610","url":null,"abstract":"This paper is aimed at a comprehensive study of the incidence of dentists in the Turkestan region of the Republic of Kazakhstan using the screening study method. The study included 200 dentists from 12 outpatient clinics in Shymkent city, Turkestan region (South Kazakhstan). Data on visits to doctors in the period from 2015 to 2022 were used to investigate the incidence. The average long‐term value of morbidity coefficients among the studied medical workers was 995.9 ± 9.9 cases per 1000 people over 7 years. The analysis of the structure of diseases was carried out based on information obtained from sick leave records of the study group of dentists for the period from 2015 to 2022. The dental profession has its own characteristics; the unfavorable factors identified during the study can be divided into three groups: factors related to the treatment process; factors related to the organization of premises in dental clinics; factors related to insufficient ergonomics of dental equipment and instruments; and the quality of filling and dental materials. Six of the same classes of diseases play a leading role in the structure of diseases identified during medical examinations, but their significance is different: in the first place are diseases associated with increased psychological stress (circulatory disorders, psychoneuroses, diseases of the digestive system), diseases associated with forced working position (musculoskeletal diseases).","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"105 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140601784","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}
Can patients find physical therapists in their networks, and can they access physical therapy when they need to? To answer these questions, we analyzed provider directory accuracy and timely access for physical therapists for all managed care plans available in California in 2018 and 2019 using secondary data obtained from the California Department of Managed Health Care for a total of 119,084 physical therapy listings (60,967 for 2018 and 58,117 for 2019). Overall, 19% of listed providers in 2018 and 8% of listed providers in 2019 showed inaccuracies. However, we found substantial differences across markets, with a low of 54% accuracy for Medicaid listings in 2018. Commercial plans were consistently most accurate. In terms of adequacy, we found that more than 90% of listed providers were accessible within 15 days and 97% within 30 days, with Medicaid providing the highest rates of timely access. Overall, barriers to consumer access with regard to physical therapy appear to be primarily in the form of provider directory inaccuracies. High rates of inaccuracies raise concerns for patients as well as regulators. Ultimately, California is one of the most regulated states when it comes to network adequacy and access.
{"title":"Provider directory inaccuracy and timely access to physical therapy","authors":"Thomas Elton, Wendy Y. Xu, Simon F. Haeder","doi":"10.1002/wmh3.607","DOIUrl":"https://doi.org/10.1002/wmh3.607","url":null,"abstract":"Can patients find physical therapists in their networks, and can they access physical therapy when they need to? To answer these questions, we analyzed provider directory accuracy and timely access for physical therapists for all managed care plans available in California in 2018 and 2019 using secondary data obtained from the California Department of Managed Health Care for a total of 119,084 physical therapy listings (60,967 for 2018 and 58,117 for 2019). Overall, 19% of listed providers in 2018 and 8% of listed providers in 2019 showed inaccuracies. However, we found substantial differences across markets, with a low of 54% accuracy for Medicaid listings in 2018. Commercial plans were consistently most accurate. In terms of adequacy, we found that more than 90% of listed providers were accessible within 15 days and 97% within 30 days, with Medicaid providing the highest rates of timely access. Overall, barriers to consumer access with regard to physical therapy appear to be primarily in the form of provider directory inaccuracies. High rates of inaccuracies raise concerns for patients as well as regulators. Ultimately, California is one of the most regulated states when it comes to network adequacy and access.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"69 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140601781","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}
With the next pandemic likely not far off, the debate over the suitability of a broad, general vaccination mandate (GVM) goes on. This essay proposes a novel argument in favor of GVM—one based on the reality that left to its own devices, executive power, from governments to the local administration and even corporations, tends anyway to impose on the nonvaccinated restrictions of such harshness that vaccination becomes de facto mandatory. The most coercive measure was banning the nonvaccinated from the workplace, which was done—despite the fundamental importance of the right to work to the human being—without any genuine examination of the elements of balancing (necessity, proportionality) required whenever a right is limited by the authorities. Mandating vaccination de jure, by parliaments, before the next pandemic strikes would have the merits of avoiding legal hypocrisy and would be achieved following national public debate and a thorough process of balancing the rights at stake.
{"title":"Ante‐factum legislative general vaccination mandates as a solution to legal hypocrisy in pandemics","authors":"Ciprian N. Radavoi","doi":"10.1002/wmh3.606","DOIUrl":"https://doi.org/10.1002/wmh3.606","url":null,"abstract":"With the next pandemic likely not far off, the debate over the suitability of a broad, general vaccination mandate (GVM) goes on. This essay proposes a novel argument in favor of GVM—one based on the reality that left to its own devices, executive power, from governments to the local administration and even corporations, tends anyway to impose on the nonvaccinated restrictions of such harshness that vaccination becomes <jats:italic>de facto</jats:italic> mandatory. The most coercive measure was banning the nonvaccinated from the workplace, which was done—despite the fundamental importance of the right to work to the human being—without any genuine examination of the elements of balancing (necessity, proportionality) required whenever a right is limited by the authorities. Mandating vaccination <jats:italic>de jure</jats:italic>, by parliaments, before the next pandemic strikes would have the merits of avoiding legal hypocrisy and would be achieved following national public debate and a thorough process of balancing the rights at stake.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"25 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140601865","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}
Hiep N. Le, Ernesta Sofija, Neil Harris, Thu Nguyen, Hai Phung
Slow-onset disasters, a neglected climatic event, affect the agricultural sector in Southeast Asia and threaten regional food security. Improving food security in slow-onset disasters requires policy development by both regional and national governments. Despite this articulated need, very little research on the national and regional food security policies in slow-onset disaster events has been undertaken. Focusing on Southeast Asia, this paper aims to (i) review existing policies to support food security in slow-onset disasters; (ii) identify strengths, weaknesses, and gaps in the existing policies; (iii) explain the policy window on food security in slow-onset disasters. An analytical framework of eight components of food security was adopted for the content analysis of 39 related policy documents collected from 11 countries in Southeast Asia and the Association of Southeast Asian Nations. The study found that none of the 39 policies directly targeted improving food security in slow-onset disasters. Existing policies to support food security in slow-onset disasters were incorporated in the context of climate change or national target programs on green development, agricultural development, nutrition, and famine. Our analysis also revealed that existing policies primarily focus on the first two pillars of the food security framework: food availability and access, with a predominant emphasis on availability. However, the third pillar, food utilization, is often overlooked. This study recommends developing a comprehensive policy to address protracted food insecurity, particularly among vulnerable populations in areas impacted by slow-onset disasters.
{"title":"Food security in slow-onset disasters: A policy review in Southeast Asian regions","authors":"Hiep N. Le, Ernesta Sofija, Neil Harris, Thu Nguyen, Hai Phung","doi":"10.1002/wmh3.604","DOIUrl":"https://doi.org/10.1002/wmh3.604","url":null,"abstract":"Slow-onset disasters, a neglected climatic event, affect the agricultural sector in Southeast Asia and threaten regional food security. Improving food security in slow-onset disasters requires policy development by both regional and national governments. Despite this articulated need, very little research on the national and regional food security policies in slow-onset disaster events has been undertaken. Focusing on Southeast Asia, this paper aims to (i) review existing policies to support food security in slow-onset disasters; (ii) identify strengths, weaknesses, and gaps in the existing policies; (iii) explain the policy window on food security in slow-onset disasters. An analytical framework of eight components of food security was adopted for the content analysis of 39 related policy documents collected from 11 countries in Southeast Asia and the Association of Southeast Asian Nations. The study found that none of the 39 policies directly targeted improving food security in slow-onset disasters. Existing policies to support food security in slow-onset disasters were incorporated in the context of climate change or national target programs on green development, agricultural development, nutrition, and famine. Our analysis also revealed that existing policies primarily focus on the first two pillars of the food security framework: food availability and access, with a predominant emphasis on availability. However, the third pillar, food utilization, is often overlooked. This study recommends developing a comprehensive policy to address protracted food insecurity, particularly among vulnerable populations in areas impacted by slow-onset disasters.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"222 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139678469","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}
This study examines the impact of Saudi Arabia's updated Unified Health Insurance Policy, implemented in 2018, over a 4-year period. The objective is to assess its effects on key indicators in the health insurance sector, including gross written premiums (GWPs), insurance penetration, gross claims paid by health insurance, and insurance density. Quantitative data from official sources, including the Saudi Central Bank and the Council of Health Insurance (CHI), were analyzed. A two-sample t-test was employed to compare pre implementation (2014–2017) and post implementation (2019–2022) periods for selected indicators. The study found a significant increase in GWPs, suggesting heightened revenue generation for insurers, likely due to increased demand, adjusted pricing strategies, and expanded coverage. Insurance penetration notably widened, indicating improved accessibility, driven by awareness campaigns and subsidies. Gross claims paid by health insurance increased significantly, showing insurers disbursing more funds to cover healthcare costs. However, there was no significant impact on insurance density, highlighting the need for additional strategies to extend coverage. Saudi Arabia's updated Unified Health Insurance Policy has yielded transformative effects, enhancing accessibility and affordability. It has increased revenue generation, improved insurance penetration, and raised the amount paid by insurers to cover healthcare costs. The policy's impact on insurance density is limited, necessitating further efforts to extend coverage. These findings have significant policy implications, urging policymakers to refine healthcare policies and insurers to adapt to new revenue prospects, promising better overall health outcomes for the population. Further comprehensive research is essential to validate these conclusions and explore broader policy impacts.
本研究探讨了沙特阿拉伯于 2018 年实施的更新版统一医疗保险政策在 4 年内的影响。目的是评估该政策对医疗保险部门关键指标的影响，包括总承保保费（GWPs）、保险渗透率、医疗保险支付的总赔付额和保险密度。我们分析了来自沙特中央银行和医疗保险委员会（CHI）等官方来源的定量数据。采用双样本 t 检验对选定指标的实施前（2014-2017 年）和实施后（2019-2022 年）进行比较。研究发现，GWPs 大幅增加，表明保险公司的创收能力增强，这可能是由于需求增加、定价策略调整和覆盖范围扩大。保险渗透率明显提高，表明在宣传活动和补贴的推动下，可获得性得到改善。医疗保险支付的总赔款大幅增加，表明保险公司支付了更多资金来支付医疗费用。然而，这对保险密度没有产生重大影响，突出表明需要采取更多战略来扩大覆盖范围。沙特阿拉伯更新后的统一医疗保险政策产生了变革性影响，提高了可及性和可负担性。该政策增加了创收，提高了保险渗透率，并增加了保险公司支付医疗费用的金额。该政策对保险密度的影响有限，需要进一步努力扩大覆盖范围。这些发现具有重要的政策意义，敦促政策制定者完善医疗保健政策，敦促保险公司适应新的创收前景，从而有望改善人口的总体健康状况。进一步的综合研究对于验证这些结论和探索更广泛的政策影响至关重要。
{"title":"Effect of Saudi's updated health insurance policy: 4-Year comparative study pre and post implementation","authors":"Abdulmajeed Saad AlHadlaq","doi":"10.1002/wmh3.603","DOIUrl":"https://doi.org/10.1002/wmh3.603","url":null,"abstract":"This study examines the impact of Saudi Arabia's updated Unified Health Insurance Policy, implemented in 2018, over a 4-year period. The objective is to assess its effects on key indicators in the health insurance sector, including gross written premiums (GWPs), insurance penetration, gross claims paid by health insurance, and insurance density. Quantitative data from official sources, including the Saudi Central Bank and the Council of Health Insurance (CHI), were analyzed. A two-sample <i>t</i>-test was employed to compare pre implementation (2014–2017) and post implementation (2019–2022) periods for selected indicators. The study found a significant increase in GWPs, suggesting heightened revenue generation for insurers, likely due to increased demand, adjusted pricing strategies, and expanded coverage. Insurance penetration notably widened, indicating improved accessibility, driven by awareness campaigns and subsidies. Gross claims paid by health insurance increased significantly, showing insurers disbursing more funds to cover healthcare costs. However, there was no significant impact on insurance density, highlighting the need for additional strategies to extend coverage. Saudi Arabia's updated Unified Health Insurance Policy has yielded transformative effects, enhancing accessibility and affordability. It has increased revenue generation, improved insurance penetration, and raised the amount paid by insurers to cover healthcare costs. The policy's impact on insurance density is limited, necessitating further efforts to extend coverage. These findings have significant policy implications, urging policymakers to refine healthcare policies and insurers to adapt to new revenue prospects, promising better overall health outcomes for the population. Further comprehensive research is essential to validate these conclusions and explore broader policy impacts.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"18 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139678466","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}
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