This study examines how public health issues were communicated during the 2020 US presidential campaign, particularly those concerning the global COVID-19 pandemic. Using content analysis, we examined the available campaign speeches of the two major candidates, Donald Trump and Joseph R. Biden. We examined how the candidates discussed the COVID-19 pandemic and vital areas of public health in those speeches. Analysis of these speeches found little discussion on healthcare in general and little to no discussion on the vital areas of public health. We also found that COVID-19 statements were not as prevalent as we anticipated, given the unprecedented scope of the pandemic. Even during a pandemic, public health matters received very little attention during a Presidential campaign. Public health topics accounted for less than 1% of the content in candidates' official speeches. Given that elites help increase knowledge of public health concerns and influence policy, the lack of attention given to the pandemic in the 2020 general election cycle is surprising, if not alarming.
{"title":"COVID-19 and 2020 presidential election speeches: A content analysis of pandemic campaign rhetoric","authors":"William Hatcher, Martha H. Ginn","doi":"10.1002/wmh3.600","DOIUrl":"https://doi.org/10.1002/wmh3.600","url":null,"abstract":"This study examines how public health issues were communicated during the 2020 US presidential campaign, particularly those concerning the global COVID-19 pandemic. Using content analysis, we examined the available campaign speeches of the two major candidates, Donald Trump and Joseph R. Biden. We examined how the candidates discussed the COVID-19 pandemic and vital areas of public health in those speeches. Analysis of these speeches found little discussion on healthcare in general and little to no discussion on the vital areas of public health. We also found that COVID-19 statements were not as prevalent as we anticipated, given the unprecedented scope of the pandemic. Even during a pandemic, public health matters received very little attention during a Presidential campaign. Public health topics accounted for less than 1% of the content in candidates' official speeches. Given that elites help increase knowledge of public health concerns and influence policy, the lack of attention given to the pandemic in the 2020 general election cycle is surprising, if not alarming.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"25 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139495156","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}
Arrianna Marie Planey, Sharita R. Thomas, Jodi A. Lewis, Marah Maaita
In primary-care-centric models of care provision, specialist co-location with primary care physicians (PCPs) can potentially improve care coordination and continuity. This study asks whether the co-location of specialists with referring PCPs can reinforce racial, ethnic, and class inequities in spatial access to care. Given a US healthcare policy context wherein audiologist services are only reimbursed if they are medical practitioner-referred, audiologists are hypothesized to co-locate with PCPs. Using spatial cluster analysis and spatial regression approaches, this study quantifies the tendency for PCPs and audiologists to co-locate and analyzes the consequences for spatial access disparities in the Chicago, Illinois metropolitan region. Audiologists and PCPs co-cluster significantly across Chicagoland. The spatial lag model confirms racial, ethnic, and class disparities in network travel distance to audiology services in the core counties of the region. The results suggest that, for audiology services, health policies and the resultant interdependence across the hierarchy of care manifest spatially, possibly reinforcing service access disparities within segregated city regions.
{"title":"The colocation of primary care physicians and audiologists in the Chicago metro region reinforces racial, ethnic, and class inequities in spatial access to care","authors":"Arrianna Marie Planey, Sharita R. Thomas, Jodi A. Lewis, Marah Maaita","doi":"10.1002/wmh3.598","DOIUrl":"https://doi.org/10.1002/wmh3.598","url":null,"abstract":"In primary-care-centric models of care provision, specialist co-location with primary care physicians (PCPs) can potentially improve care coordination and continuity. This study asks whether the co-location of specialists with referring PCPs can reinforce racial, ethnic, and class inequities in spatial access to care. Given a US healthcare policy context wherein audiologist services are only reimbursed if they are medical practitioner-referred, audiologists are hypothesized to co-locate with PCPs. Using spatial cluster analysis and spatial regression approaches, this study quantifies the tendency for PCPs and audiologists to co-locate and analyzes the consequences for spatial access disparities in the Chicago, Illinois metropolitan region. Audiologists and PCPs co-cluster significantly across Chicagoland. The spatial lag model confirms racial, ethnic, and class disparities in network travel distance to audiology services in the core counties of the region. The results suggest that, for audiology services, health policies and the resultant interdependence across the hierarchy of care manifest spatially, possibly reinforcing service access disparities within segregated city regions.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"51 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139423543","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}
Pritam Daniel Sundaresan, Estie Kruger, John Mc Geachie, Marc Tennant
The availability of hospital-based dental services across Australia varies with a number of hospitals disestablishing dental departments due to rising costs. However, the perceived costs are difficult to quantify as funding models used to capture activity are not uniform across health facilities. To investigate this the predicted funding generated using current models of activity-based funding in the provision of specialist dentistry in Australian public hospitals was examined. Using data from Fiona Stanley Hospital regarding the dental treatment for head and neck cancer patients as part of their work-up for cancer management, expected funding was estimated using the existing fee-for-service and capped-fee models currently in use. Funding estimates were based on the Department of Veterans' Affairs Fee Schedule of Dental Services and the Independent Hospital Pricing Authority's Australian Non-Admitted Care Classification. A total of 127 patients received dental treatment over 209 appointments including 17 patients who had all their remaining teeth removed. Analysis revealed the fee-for-service model generated more expected funding than the current capped-fee model, or an average of AUD$458 (USD$356) per patient. Differences in how activity was recorded resulted in 81.7% uncaptured funding between the two models. This study shows that fee-for-service models capture activity more accurately. However, this model is not used in public hospitals despite it being standard practice in stand-alone public dental clinics. As a result, hospital-based dental clinics appear to be unproductive. Further research can include developing a model that better captures both the activity undertaken as well as patient complexity.
{"title":"Inequalities in public funding: Are hospital-based dental services funding models in Australia logical?","authors":"Pritam Daniel Sundaresan, Estie Kruger, John Mc Geachie, Marc Tennant","doi":"10.1002/wmh3.595","DOIUrl":"https://doi.org/10.1002/wmh3.595","url":null,"abstract":"The availability of hospital-based dental services across Australia varies with a number of hospitals disestablishing dental departments due to rising costs. However, the perceived costs are difficult to quantify as funding models used to capture activity are not uniform across health facilities. To investigate this the predicted funding generated using current models of activity-based funding in the provision of specialist dentistry in Australian public hospitals was examined. Using data from Fiona Stanley Hospital regarding the dental treatment for head and neck cancer patients as part of their work-up for cancer management, expected funding was estimated using the existing fee-for-service and capped-fee models currently in use. Funding estimates were based on the Department of Veterans' Affairs Fee Schedule of Dental Services and the Independent Hospital Pricing Authority's Australian Non-Admitted Care Classification. A total of 127 patients received dental treatment over 209 appointments including 17 patients who had all their remaining teeth removed. Analysis revealed the fee-for-service model generated more expected funding than the current capped-fee model, or an average of AUD$458 (USD$356) per patient. Differences in how activity was recorded resulted in 81.7% uncaptured funding between the two models. This study shows that fee-for-service models capture activity more accurately. However, this model is not used in public hospitals despite it being standard practice in stand-alone public dental clinics. As a result, hospital-based dental clinics appear to be unproductive. Further research can include developing a model that better captures both the activity undertaken as well as patient complexity.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"102 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2024-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139413331","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}
Chúk Odenigbo, Sonia Wesche, Paul Mkandawire, Eric Crighton
Using a case study design, this research explores the Coronavirus 2019 disease (COVID-19) pandemic from the perspectives and worldviews of Malawians (Black/African knowledge) through the Bawaka Yolŋu ontology of co-becoming (Black/Indigenous knowledge). This study seeks to examine the ways in which COVID-19 has influenced perceptions of place and the places themselves, thereby contributing to the development of policies and strategies for effectively navigating and living with the ongoing COVID-19 pandemic. The study involved forty-one in-depth semi-structured interviews and two unstructured interviews, enabling a nuanced exploration of COVID-19's impact through the diverse perspectives of Malawian knowledge holders including religious leaders, health-care workers, farmers, and community leaders. The findings reveal a multifaceted transformation in the relationship of Malawians with nature, place, and one another. Nature, once a source of sustenance, has become a realm of danger due to its association with airborne transmission. Place, typically a communal space, has shifted towards individualized safety, necessitating changes in how homes are adapted and perceived. The communal fabric of Malawian society, deeply ingrained in communal practices, has been strained, altering traditional gatherings and societal interactions. This research adds depth to our understanding of COVID-19's complex impacts, emphasizing the importance of cultural and environmental contexts in shaping responses to the pandemic. The insights gained hold significance for tailored policy interventions and community-focused strategies to navigate and adapt to the evolving challenges presented by COVID-19.
{"title":"“We are adapting to it because it is within us”: The co-becoming of COVID-19 in Malawi","authors":"Chúk Odenigbo, Sonia Wesche, Paul Mkandawire, Eric Crighton","doi":"10.1002/wmh3.599","DOIUrl":"https://doi.org/10.1002/wmh3.599","url":null,"abstract":"Using a case study design, this research explores the Coronavirus 2019 disease (COVID-19) pandemic from the perspectives and worldviews of Malawians (Black/African knowledge) through the Bawaka Yolŋu ontology of co-becoming (Black/Indigenous knowledge). This study seeks to examine the ways in which COVID-19 has influenced perceptions of place and the places themselves, thereby contributing to the development of policies and strategies for effectively navigating and living with the ongoing COVID-19 pandemic. The study involved forty-one in-depth semi-structured interviews and two unstructured interviews, enabling a nuanced exploration of COVID-19's impact through the diverse perspectives of Malawian knowledge holders including religious leaders, health-care workers, farmers, and community leaders. The findings reveal a multifaceted transformation in the relationship of Malawians with nature, place, and one another. Nature, once a source of sustenance, has become a realm of danger due to its association with airborne transmission. Place, typically a communal space, has shifted towards individualized safety, necessitating changes in how homes are adapted and perceived. The communal fabric of Malawian society, deeply ingrained in communal practices, has been strained, altering traditional gatherings and societal interactions. This research adds depth to our understanding of COVID-19's complex impacts, emphasizing the importance of cultural and environmental contexts in shaping responses to the pandemic. The insights gained hold significance for tailored policy interventions and community-focused strategies to navigate and adapt to the evolving challenges presented by COVID-19.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"10 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138826395","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}
A. Alonso Aguirre, Lila C. Fleming, Alejandra G. Sandoval-Lugo, Renato Leal-Moreno, César P. Ley-Quiñónez, Alan A. Zavala-Norzagaray, Kathryn H. Jacobsen
Human consumption of sea turtles remains prevalent throughout Mexico even though laws restricting trade and take of threatened and endangered species have been in place for several decades. The illegal consumption of sea turtles represents a risk to animal conservation, and the pathogens in the meat can adversely affect human health. In 2017, we surveyed 201 adult residents of 22 coastal communities about their diets, health, and attitudes about the environment, and we collected hair samples that were tested for heavy metals. A large percentage of the samples had high levels of mercury (87%), arsenic (81%), lead (65%), aluminum (57%), and cadmium (31%). Odds ratios suggested that the 28% of participants who reported recent sea turtle consumption had an increased likelihood of high metal levels even after adjusting for sex, age, and consumption of fish that bioaccumulate heavy metals. Conservation efforts may be more successful when they appeal to people's self-interest rather than merely focusing on ecological benefits. Concerns about toxins in sharks, tuna, and other types of deep-sea fish have reduced human consumption of some species. Both sea turtle conservation and human health may benefit from awareness campaigns that emphasize the adverse outcomes associated with eating sea turtles while continuing to affirm the economic benefits of healthy ecosystems. Transdisciplinary research that draws on ecology, epidemiology, toxicology, law, and public policy provides a valuable foundation for solving complex health issues. Creative reframing of biodiversity concerns will be necessary for promoting planetary health in a time of accelerating environmental change.
{"title":"Conservation and health policy implications linked to the human consumption of sea turtles in northwestern Mexico","authors":"A. Alonso Aguirre, Lila C. Fleming, Alejandra G. Sandoval-Lugo, Renato Leal-Moreno, César P. Ley-Quiñónez, Alan A. Zavala-Norzagaray, Kathryn H. Jacobsen","doi":"10.1002/wmh3.596","DOIUrl":"https://doi.org/10.1002/wmh3.596","url":null,"abstract":"Human consumption of sea turtles remains prevalent throughout Mexico even though laws restricting trade and take of threatened and endangered species have been in place for several decades. The illegal consumption of sea turtles represents a risk to animal conservation, and the pathogens in the meat can adversely affect human health. In 2017, we surveyed 201 adult residents of 22 coastal communities about their diets, health, and attitudes about the environment, and we collected hair samples that were tested for heavy metals. A large percentage of the samples had high levels of mercury (87%), arsenic (81%), lead (65%), aluminum (57%), and cadmium (31%). Odds ratios suggested that the 28% of participants who reported recent sea turtle consumption had an increased likelihood of high metal levels even after adjusting for sex, age, and consumption of fish that bioaccumulate heavy metals. Conservation efforts may be more successful when they appeal to people's self-interest rather than merely focusing on ecological benefits. Concerns about toxins in sharks, tuna, and other types of deep-sea fish have reduced human consumption of some species. Both sea turtle conservation and human health may benefit from awareness campaigns that emphasize the adverse outcomes associated with eating sea turtles while continuing to affirm the economic benefits of healthy ecosystems. Transdisciplinary research that draws on ecology, epidemiology, toxicology, law, and public policy provides a valuable foundation for solving complex health issues. Creative reframing of biodiversity concerns will be necessary for promoting planetary health in a time of accelerating environmental change.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"73 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138826397","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}
Existing literature suggests significant disparities in health expenditure incurred by households receiving health services. To determine fair contributions by beneficiaries, it is crucial to understand the existing inequalities in the context of financial protection measures and the factors influencing them. This exploratory study looks at how catastrophic health expenditures (CHE) are distributed across economic groups. The study also casts light on what drives the inequalities in the incidences of CHE. The study uses unit-level data from the 75th round of the National Sample Survey fielded periodically by the Government of India. It employs logistic regression to study factors affecting CHE. Furthermore, the concentration index and its regression-based decomposition are employed to have a sense of inequality and the factors driving it. The findings reveal socioeconomic inequality in CHE incidence and highlight the contribution of medical institutions (whether public or private) and consumption expenditure of households to the total inequality. The present study, while critically looking at the pre-existing inequalities, highlights the shortcomings of health financing in urban areas and calls for a reconsideration of extant policy designs. The study maintains that factors outside the control of the health system may be responsible for disparities in catastrophic medical spending. Therefore, to reduce the burden of catastrophic health spending and its inequalities, future policy measures must take into account both elements within the health system and those outside of it.
现有文献表明，接受医疗服务的家庭在医疗支出方面存在巨大差异。要确定受益人的公平缴费，关键是要了解财政保护措施背景下现有的不平等现象及其影响因素。这项探索性研究探讨了灾难性医疗支出（CHE）在不同经济群体中的分布情况。研究还揭示了导致灾难性医疗支出发生率不平等的原因。研究使用了印度政府定期开展的第 75 轮全国抽样调查中的单位层面数据。它采用逻辑回归法研究影响 CHE 的因素。此外，研究还采用了集中指数及其基于回归的分解方法，以了解不平等现象及其驱动因素。研究结果揭示了 CHE 发病率中的社会经济不平等现象，并强调了医疗机构（无论是公立还是私立）和家庭消费支出对总体不平等现象的贡献。本研究在批判性地审视原有的不平等现象的同时，强调了城市地区医疗融资的缺陷，并呼吁重新考虑现有的政策设计。本研究认为，卫生系统无法控制的因素可能是造成灾难性医疗支出差异的原因。因此，为了减轻灾难性医疗支出的负担及其不平等，未来的政策措施必须考虑到卫生系统内部和外部的因素。
{"title":"Disparities in catastrophic health expenditure for hospitalization in Urban Kerala, India: Evidence from 75th round of the National Sample Survey","authors":"Paul J. Philip, Gyana R. Panda","doi":"10.1002/wmh3.597","DOIUrl":"https://doi.org/10.1002/wmh3.597","url":null,"abstract":"Existing literature suggests significant disparities in health expenditure incurred by households receiving health services. To determine fair contributions by beneficiaries, it is crucial to understand the existing inequalities in the context of financial protection measures and the factors influencing them. This exploratory study looks at how catastrophic health expenditures (CHE) are distributed across economic groups. The study also casts light on what drives the inequalities in the incidences of CHE. The study uses unit-level data from the 75th round of the National Sample Survey fielded periodically by the Government of India. It employs logistic regression to study factors affecting CHE. Furthermore, the concentration index and its regression-based decomposition are employed to have a sense of inequality and the factors driving it. The findings reveal socioeconomic inequality in CHE incidence and highlight the contribution of medical institutions (whether public or private) and consumption expenditure of households to the total inequality. The present study, while critically looking at the pre-existing inequalities, highlights the shortcomings of health financing in urban areas and calls for a reconsideration of extant policy designs. The study maintains that factors outside the control of the health system may be responsible for disparities in catastrophic medical spending. Therefore, to reduce the burden of catastrophic health spending and its inequalities, future policy measures must take into account both elements within the health system and those outside of it.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"114 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138567225","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}
Abstract This research focused on the Indonesian Government's global pandemic policy mapping from 2000 to 2023 ( n = 979). Indonesia has been affected by diseases such as H1N1, H5N1, SARS‐Cov‐1, and the current SARS‐CoV‐2 (COVID‐19). This research will focus on these outbreaks to see the readiness of Indonesian government policy mapping to emergencies. This research will measure Indonesian health policy mapping based on its capability to adapt to local contexts, construct a care delivery value chain, leverage shared delivery infrastructure, and improve health delivery and economic development. This study implemented feasibility analysis with a method scoring system for all the pillars above. Findings indicate that most health policies developed by the Indonesian Government are oriented toward responding to current conditions, not preparing for future health challenges. This research also provides patterns regarding the development of health policymaking to deal with emergency conditions.
{"title":"Mapping the extraordinary measure disease outbreak (EMDO): An analysis of health regulations in Indonesia 2000–2023","authors":"Adhi Cahya Fahadayna, Abdul Hair","doi":"10.1002/wmh3.593","DOIUrl":"https://doi.org/10.1002/wmh3.593","url":null,"abstract":"Abstract This research focused on the Indonesian Government's global pandemic policy mapping from 2000 to 2023 ( n = 979). Indonesia has been affected by diseases such as H1N1, H5N1, SARS‐Cov‐1, and the current SARS‐CoV‐2 (COVID‐19). This research will focus on these outbreaks to see the readiness of Indonesian government policy mapping to emergencies. This research will measure Indonesian health policy mapping based on its capability to adapt to local contexts, construct a care delivery value chain, leverage shared delivery infrastructure, and improve health delivery and economic development. This study implemented feasibility analysis with a method scoring system for all the pillars above. Findings indicate that most health policies developed by the Indonesian Government are oriented toward responding to current conditions, not preparing for future health challenges. This research also provides patterns regarding the development of health policymaking to deal with emergency conditions.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"81 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135342685","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}
Abstract In this editorial, the author argues that social and political values in a democratic United States of America have significant global impacts on the development of justice, human rights, and democracy. Abandoning these values in favor of national interests may result in the development of new undemocratic nations and facilitate the emergence of narcissistic sociopathic leaders.
{"title":"If democracy fails in the United States, it fails everywhere","authors":"Amir Khorram‐Manesh","doi":"10.1002/wmh3.594","DOIUrl":"https://doi.org/10.1002/wmh3.594","url":null,"abstract":"Abstract In this editorial, the author argues that social and political values in a democratic United States of America have significant global impacts on the development of justice, human rights, and democracy. Abandoning these values in favor of national interests may result in the development of new undemocratic nations and facilitate the emergence of narcissistic sociopathic leaders.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"84 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135342669","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}
Mochamad Iqbal Nurmansyah, Agus Samsudin, Ekorini Listiowati, Husnan Nurjuman, Yuanita Wulandari, Wa Ode Asmawati, Dirwan Suryo Soularto
Abstract This research aimed to explore the challenges of the COVID‐19 vaccination program from the perspective of multiple stakeholders in rural areas of eastern Indonesia. This qualitative participatory action research involved 115 participants selected from various groups in 20 subdistricts across five provinces, including Health Service workers, police staff monitoring the vaccination program, religious figures, and adult and youth community leaders. Furthermore, focus group discussion was conducted using semi‐structured interview guidelines based on the WHO Strategic Advisory Group of Experts (SAGE) for vaccine and immunization model. The manifest content approach was employed to analyze the visible contents within the text. Implementation of the vaccination program was complicated by contextual, individual, and group factors, as well as vaccine and vaccination‐specific factors. The contextual factors were socioeconomic, religious, and cultural conditions, changes in government policies, and geographical and climatic obstacles. Meanwhile, examples of group and individual factors were people's beliefs of COVID‐19 being harmless and their invulnerability to the disease, along with misinformation and disinformation about vaccination, and fatalistic attitudes. Factors related to the vaccine and vaccination process include limited vaccine supplies, inadequate supporting facilities, and insufficient administration of vaccines. Multiple and complex challenges of COVID‐19 vaccination in the rural areas of eastern Indonesia need attention from the local and national government, as well as other parties including the private sector, socio‐religious figures and organizations, and the media.
{"title":"Challenges of COVID‐19 vaccination program in rural areas of Eastern Indonesia: A qualitative study from a multistakeholder perspective","authors":"Mochamad Iqbal Nurmansyah, Agus Samsudin, Ekorini Listiowati, Husnan Nurjuman, Yuanita Wulandari, Wa Ode Asmawati, Dirwan Suryo Soularto","doi":"10.1002/wmh3.592","DOIUrl":"https://doi.org/10.1002/wmh3.592","url":null,"abstract":"Abstract This research aimed to explore the challenges of the COVID‐19 vaccination program from the perspective of multiple stakeholders in rural areas of eastern Indonesia. This qualitative participatory action research involved 115 participants selected from various groups in 20 subdistricts across five provinces, including Health Service workers, police staff monitoring the vaccination program, religious figures, and adult and youth community leaders. Furthermore, focus group discussion was conducted using semi‐structured interview guidelines based on the WHO Strategic Advisory Group of Experts (SAGE) for vaccine and immunization model. The manifest content approach was employed to analyze the visible contents within the text. Implementation of the vaccination program was complicated by contextual, individual, and group factors, as well as vaccine and vaccination‐specific factors. The contextual factors were socioeconomic, religious, and cultural conditions, changes in government policies, and geographical and climatic obstacles. Meanwhile, examples of group and individual factors were people's beliefs of COVID‐19 being harmless and their invulnerability to the disease, along with misinformation and disinformation about vaccination, and fatalistic attitudes. Factors related to the vaccine and vaccination process include limited vaccine supplies, inadequate supporting facilities, and insufficient administration of vaccines. Multiple and complex challenges of COVID‐19 vaccination in the rural areas of eastern Indonesia need attention from the local and national government, as well as other parties including the private sector, socio‐religious figures and organizations, and the media.","PeriodicalId":44943,"journal":{"name":"World Medical & Health Policy","volume":"77 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135928932","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}
Elaine Nguyen, Iris Buder, Karl Geisler, Elizabeth Fore
Abstract The impact of the coronavirus disease‐2019 (COVID‐19) pandemic has been felt worldwide. While the United States appears to be on path to recovery, the economic burden and rising medical care expenditures associated with the pandemic remains in the trillions of dollars. Utilizing data from the US Department of Health and Human Services and FAIR Health, this study estimates the economic burden of COVID‐19 for Idaho was estimated through assessment of direct medical costs and indirect costs for years 2020–2021. Total direct medical hospital costs associated with COVID‐19, among adults, were estimated as the sum of hospital costs associated with inpatient visits. The cost of testing was included in the direct cost assessment, with data from the Idaho Division of Public Health and Medicare Administrative Contractor payment rates. To determine indirect absenteeism costs, daily cases were multiplied by 7 to account for days of missed productivity; this number was then multiplied by an employment‐adjusted average daily wage to obtain a lost productivity dollar value. Lastly, premature mortality costs were estimated based on the lost value of future earnings. Results show that in 2020, the associated direct and indirect costs of COVID‐19 amounted to over $608 million and increased to over $1.3 billion in 2021 for the state of Idaho. As the pandemic lingers on with new variants and mutations, rising costs will continue to place a heavy burden on many Idahoans, who are already often face disparate health outcomes and access to health care.
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