Search

South Africa is signatory to international protocols that secure migrant rights to healthcare. Its national health policy prohibits discrimination. Pregnant women and children under six years ostensibly enjoy access to free healthcare, irrespective of migration status. What is clear “on paper,” however, becomes considerably more opaque when experienced by those who do not “have papers.” We explore this in Giyani, South Africa, an important migrant destination. Despite a progressive healthcare policy and immigrant rights regime, migrant women’s lack of proper documentation precludes them in practice from accessing state-provided reproductive healthcare. The result is twofold. Women who are entitled to public healthcare prefer to make use of private healthcare, despite the costs, and they make recourse to a range of extra-state relations for healthcare. We focus on one unexpected consequence: that the same healthcare providers who have formally refused access to state institutions may be available to migrants through personal networks, such as in churches. Here, medical care is seen as taking place in a religious register. The difference between what is “on paper” and “what papers migrants have” is critical but may be mediated by access to other realms of the social. [ABSTRACT FROM AUTHOR]

The book "Women and Whitlam: Revisiting the Revolution" edited by Michelle Arrow is a collection of essays that explores the agenda for women during the Whitlam government in Australia. The book is divided into five sections, each focusing on different aspects such as political influence, the law, health and social policy, media, arts, and education, and the legacies of the era. The essays provide historical knowledge, personal stories, and inspiration for readers. The collection aims to shape the future by examining the past and highlighting what was achieved and what still needs to be done for women's equality and justice. The book also emphasizes the importance of diverse perspectives and voices, including Indigenous contributors, in the fight for lasting and meaningful change. [Extracted from the article]

This special issue brings together five original research papers on chronic conditions in South Asian contexts with a view to rethink dominant discourses of risk, evidence and control surrounding the category of chronic conditions. Focusing on the multiple and contradictory (re)definitions of what counts as illness, specifically in the context of the rising burden of chronic illness, the papers in this issue deal with a range of health care practices from individual patients negotiating with 'healthy diet', to policy questions about the etiology of emerging disease burden and appropriateness of pharmaceutical interventions in 'traditional' sites of healing. While some of the chronic illnesses addressed in this special issue have received considerable attention from anthropologists (e.g. mental illness, diabetes), others, like leucorrhea have rarely been studied by anthropologists, despite the growing literature on 'chronic illnesses'. [ABSTRACT FROM AUTHOR]

The authors sought to explore the implications of the Patient Protection and Affordable Care Act's establishment of Accountable Care Organizations (ACO). Summit participants, who discussed best practices and issues to be addressed when designing and implementing ACOs. Healthcare leaders from across the country in charge of running, developing, and/or implementing ACOs for health systems. Participants were asked to consider the challenges, benefits, and strategies to ACO implementation. [ABSTRACT FROM AUTHOR]

This paper addresses the general subject of the representation of disabled people. The purpose is to show why disabled people need to speak for themselves, how they can work with other organisations, and how disabled people's organisations are, and can remain, truly representative. The paper discusses: (1) the representation of disabled people; (2) how do disability groups relate to able-bodied organisations, policy-makers, etc?; and (3) how can disabled people's groups remain truly representative? [ABSTRACT FROM AUTHOR]

The World Professional Association for Transgender Health (WPATH) has prepared a consensus statement to inform the Diagnostic and Statistical Manual (DSM) 5th Edition Work Group on Sexual and Gender Identity Disorder as it redefines the transgender experience. As part of that initiative, the authors of this article (a designated WPATH work group) looked at options for changing (or not changing) the DSM 5 diagnoses related to gender identity, taking into consideration how each of those options might affect access to care for transgender persons. Drawing on a thorough review of the literature, the WPATH work group undertook to describe the current and possible future states of access to health care; “access” defined according to established human rights measures, the “transgender experience” defined according to current DSM and International Classification of Diseases (ICD) codes. The role of various parties that influence access was considered, including transgender persons, care providers, policy writers, and decision makers in government and industry. A change to the DSM 5 that supports a normative transgender identity with distressed states is recommended in the context of a continuing dialogue between stakeholders. [ABSTRACT FROM AUTHOR]

An editorial is presented on maintaining the highest profile for European social work policy, practice, and education. Topics include popular special issues of the European Journal of Social Work being the issue on neoliberalism in social work; and important in the pursuit of social justice, human rights, collective responsibility, and respect for diversities.

We review medical economics literature presented at the 2023 annual AEA-ASSA convention, the largest gathering of economists worldwide. Pharmacoeconomic papers addressed a wide range of issues, including gender and racial gaps in clinical trials, hospital credit financing, drug rebates, covid-19 vaccine equality, and the opioid epidemic. Yet, they had some common identifiable themes. We examine them in the context of the "twin towers" of biopharmaceutical innovation: discovery and commercialization. Implementation outcomes and relative success of innovative solutions — whether in terms of products and services, structural design and arrangements, or policies — depend on how adequately they respond to questions and challenges that arise in drug discovery and commercialization, and who gains from them. That innovation's beneficiaries might not equally gain from its intended advantages is another unifying theme in the reviewed literature. Against this backdrop, biopharmaceutical innovation can breed new challenges and opportunities. And health policy can perform a critical, leveling function that reduces cost, increases access, and ensures quality of biopharmaceutical solutions. [ABSTRACT FROM AUTHOR]

Globally cannabis regulations are rapidly changing. In recent years social and political pressure, not science, has driven this change. Experience from jurisdictions that have implemented regulatory change, although relatively new, should be used to inform future policy development for other jurisdictions, assisting in addressing the wicked problem that cannabis regulations present. This review aimed to elicit underlying themes from a broad range of literature exploring the effects of regulatory change relating to cannabis. To achieve this a meta-narrative theoretical approach using inductive constant comparative analysis was used to synthesize data until thematic saturation was reached. Following a systematic literature search, 92 papers were analyzed before thematic saturation was complete. Five super-ordinate themes emerged that observed the societal and health effects following legislative and regulatory change: Normalization; Economics; Gatekeeping; Community and Health. These themes, empirically derived through a formal qualitative approach, were considered regarding cultural contexts, providing an understanding of how cannabis regulation is changing the social landscape. Consideration of the themes during future research may provide a focus point for the discussion of legislation and policy, not only relating to cannabis, but also other broad-ranging areas such as social policy, welfare, education and health. [ABSTRACT FROM AUTHOR]

This paper considers the ways that publicly funded developmental services for adults with developmental disabilities in southern Ontario are limited in how they support clients. This paper is informed by field research conducted in the summer of 2019, which was composed of semi-structured interviews, focus groups, and a policy review. Informed by parent advocates who are the main caregivers of their adult children labelled with intellectual and developmental disabilities, this paper claims that the administrative processes of the Ontario ministry that manages and funds adult disability services relate to broader exclusionary patterns among adults with developmental disabilities. I explore this claim by reviewing how common ableist assumptions of people with developmental disabilities are ingrained in the policies and administrative processes of these services. I contribute to ongoing discussions among Critical Disability Scholars of the ways that disability as a social category can be articulated outside of ableist assumptions. Informed by parent caregiver perspectives, this article outlines how the limitations of provincially funded disability services in Ontario, Canada cause significant challenge in the lives of those labelled with intellectual and developmental disabilities. One possible explanation for these limitations is that there is a disconnect between how the provincial government classifies who should receive immediate services and how many services, versus the actual need of those labelled with intellectual and developmental disabilities. The criteria for high supports, such as monthly funding, placement into a living facility, and the provincial assessment for determining a person's 'adaptive functioning' are rooted in problematic assumptions made of people labelled with intellectual and developmental disabilities. [ABSTRACT FROM AUTHOR]

There has been a major growth in global health networks in recent decades to address health issues including tobacco use, alcohol abuse, and maternal mortality. Most conditions that incur high costs have provoked networks of advocates working to mitigate the impact, increase investment in research, and establish campaigns. Global health networks often work simultaneously across policy, knowledge creation, and advocacy. Until recently there has been limited activity in global health networks and advocacy addressing hearing loss and deafness which has contributed to its relatively low visibility with policymakers compared to other health conditions. This discussion paper reports on a global consultation that explored the views of advocacy groups and individuals on advocacy for the management of hearing loss, and cochlear implantation (CI). It focussed on stakeholders' views of current advocacy endeavours, opportunities and barriers, and the possible development of a global advocacy network to improve access to cochlear implantation and the supporting services. The subsequent development of a global health network, the Cochlear Implant International Community of Action (CIICA) is discussed and the conditions necessary for the successful development of health networks are explored. This paper will be of interest to those wishing to understand the factors influencing the development of health networks and advocacy. [ABSTRACT FROM AUTHOR]

In emerging economies like India, the focus of public health policies is shifting toward the treating non-communicable diseases to preventing communicable diseases. The public welfare demands appropriate targeted healthcare subsidies for non-communicable diseases. In this paper, we investigate whether out-of-pocket expenditure toward mitigating non-communicable diseases for the poorer section of the population is catastrophic by nature. In a representative futuristic scenario for an emerging economy, we have collected the cancer patients' expenditure data from the patients and hospital management in a not-for-profit cancer hospital located in the state of Kerala. We have analyzed the variation of expenditure categorized as government subsidy toward treatment, private expenditure toward medical goods and services, and private expenditure toward non-medical goods and services against different socio-economic variables. The analysis of catastrophic health expenditure data reveals that relatively lower income lower-income households face more risk of catastrophic health expenditure and are in greater need of government subsidy. [ABSTRACT FROM AUTHOR]

There have been 188 rural hospital closures in the United States since 2010 with approximately 20% of these in Appalachia. Telehealth has become a way that nurses can reach rural patients who might not otherwise receive health care. The purpose of this paper is to (1) outline the federal policies enacted during COVID-19 for broadband expansion; and (2) suggest how advanced practice nursing care might be affected by broadband expansion and telehealth in the region. A search of PubMed was conducted in January 2023, using the search words, "policy", "telehealth", "broadband", and "Appalachia". New laws appropriated funds to expand broadband infrastructure that made it possible for telehealth to be used by nurses to deliver health care to rural patients. This discussion paper found that broadband legislation was instrumental in expanding telecommunications and telehealth by NPs. There is a great need for broadband to continue to expand and for trained nurses to provide care via telehealth. [ABSTRACT FROM AUTHOR]

As the country of Lebanon sinks deeper into economic turmoil and healthcare devastation, period poverty has been recorded to reach its all-time high, whereby it was estimated that 66% of adolescent Lebanese girls cannot afford menstrual products to manage their menstrual cycle. The following descriptive paper aims to discuss the overall situation of period poverty in Lebanon, particularly during the economic crisis that hit the country and that coincided with the start of the COVID-19 pandemic. It will then highlight nongovernmental organization initiatives and community-based partnerships that have been carried out with the goal of alleviating the significant physical, mental, and socioeconomic impact of period poverty on Lebanese girls and women. Finally, this paper will provide socioeconomic and policy recommendations to accomplish and sustain positive menstruation outcomes in Lebanon. This paper is necessary as it highlights the humanitarian impact of such an important women's rights issue in Lebanon. It helps fill a gap in the literature because limited data are available on the status of period poverty in the country to raise awareness and take action. [ABSTRACT FROM AUTHOR]

This paper argues that public addresses of heads of state are critical for public health policy during pandemics. Drawing insights from studies that investigate metaphors and frames in political and public health discourses, it explores how the Philippine government, especially President Rodrigo Duterte, framed COVID-19. In doing so, it hopes to broaden the understanding of how political rhetoric may be constitutive of public health policy. The analysis of the public addresses entailed three interrelated levels: (1) a description of broad historical, social, political, and cultural contexts of public addresses under investigation, (2) an explanation of the communicative situation including the production and consumption of these addresses—processes that mediate between the text and context, and (3) a textual analysis, which substantiates how the discursive patterns are realized through the president's rhetorical choices. Our analysis reveals that the president consistently deployed the rhetorical strategies of (1) enemization, (2) legitimization of the incumbent administration, and (3) dismissal of critics. The configuration of these strategies sustains a binaristic discourse structure that lays blame on a political other while the government asserts its legitimacy during a public health crisis. These rhetorical strategies organize support for public health policy by a populist administration to manage COVID-19. Implications of political rhetoric to public health and risk communication are discussed. [ABSTRACT FROM AUTHOR]

By analysing debates between member states of the World Health Organisation (WHO) over health inequities experienced by sexual and gender minorities (SGMs) from 2013 through to 2015 and 2016, this paper interrogates a WHO decision to 'do nothing', and the relationship between this decision and the production of ignorance and non-knowledge. This paper problematises state representatives' discursive practices regarding the lack of evidence on SGM health inequalities, drawing on the sociology of ignorance. Informed by the sociology of nothing, two analytical categories – non-recognition (omissive) and mis-recognition (commissive) of SGM communities – are proposed to critically understand the production of 'no-bodies' and the tolerance of the lack of evidence. The lack of evidence, rather than prompting WHO action, was used as a rationale for intentionally neglecting the health concerns of particular social groups due to their invisibility in health research. Therefore, the paper argues that the lack of evidence in itself is symptomatic of the existence of SGM health inequities, which require the WHO to take action such as formally expressing concerns about and endorsing research on the topic. [ABSTRACT FROM AUTHOR]

Historically, there is a documented lack of support for women leaving their communities to give birth. Due to an over-emphasis on risk discourse (no distinction between low- or high-risk pregnancies with options to birth at home, the large geographical distances to regional centres within circumpolar regions, remoteness of communities, lack of qualified staff, and limited resources), women are forced to travel great distances to give birth. In Canada until 2017, women travelled alone or bore the burden of paying out of pocket for someone to travel with them for support with the births of their babies. A recent policy change has allowed for one paid escort to accompany a pregnant woman. The purpose of this paper is to provide an outcome assessment of the perinatal transport and non-medical escort policy implemented by the federal government in Canada. The paper utilises a narrative literature review along with preliminary Indigenous photovoice results to illuminate the perspectives of Indigenous families. There are numerous challenges women face when travelling for birth including feelings of loneliness and fear, stress and separation from their children, lack of community connection, financial concerns, and a loss of self-determination. Women are given an opportunity in decision-making about who will travel with them as an escort. This does little to address the disparity of delivering their babies away from their families and communities, the burden of figuring out who cares for the children at home, and the impact their absences have on health of their families. Although, additional support has been provided for birthing women in northern Canada, there continues to be little effort to return to community birthing creating safety for Indigenous families through traditional practices, Indigenous midwifery, and community ceremonies and changing the disproportionate burden of poor outcomes experienced by Indigenous women. [ABSTRACT FROM AUTHOR]

This paper examines how Ebola survivors in Sierra Leone are enacting biological citizenship to effect responsive and accountable engagement with their government. Disaster survivors are often left without avenues to hold policymakers accountable, but, recently, injured or disabled people have taken legal action against their governments over issues such as negligence, delays, damaged property, and death. However, in Sierra Leone, members of the Ebola survivors' association have sued the government at the ECOWAS Community Court of Justice over a less conventional issue: corruption. After audit reports uncovered instances of financial impropriety that compromised the country's response to the 2013–2016 Ebola outbreak, two plaintiffs sued the government with the argument that corruption and the failure of the government to hold the culprits accountable constitute abuses of the rights to life and health of those affected by the disaster, and the entire population. Based on this case, the paper argues that the lawsuit is an attempt to redefine corruption as a health hazard and a human rights violation. This challenges authorities to give serious attention to how financial improprieties affect the ability of state agencies to guarantee equitable, dignified healthcare, and to take the post-disaster rehabilitation of survivors as a critical component of reconstruction programmes. Ultimately, the lawsuit might set a precedent for other disaster survivors to demand equitable and dignified access to health and proper rehabilitation. This paper draws on scholarly literature, official documents, and conversations with some of the survivors and their lawyer to make this argument. [ABSTRACT FROM AUTHOR]

An editorial is presented on the possible implications of personalization for adult care social workers. It outlines the considerable relevance for social work for the foreseeable future. An overview of the how similar personalization policy agendas in England and the Italian region of Lombardy are translated into practice is presented.

In this co-produced paper, we write about a collaboration that developed over more than a decade between a service user advisor and a social work educator within a higher education context. Starting with how we came to work together, the paper outlines early apprehensions about service user involvement, both as we experienced them and as expressed by colleagues, students, and managers. The paper discusses such themes as confidentiality, professional boundaries, and power imbalance. As authors w identify principles that have underpinned our relationship as well as obstacles faced and understandings reached. We emphasise possibilities discovered from this project which may have application for other courses and settings for the service user advisor role. As we write, we are confronting a new challenge as one of us continues in the work and one of us retires from it. [ABSTRACT FROM AUTHOR]

This paper problematizes the precision medicine approach embraced by the All of Us Research Program (US) and by Genomics England (UK) in terms of benefits distribution, by arguing that current "diversity and inclusion" efforts do not prevent exclusiveness, unless the framing and scope of the projects are revisited in public health terms. Grounded on document analysis and fieldwork interviews, this paper analyzes efforts to address potential patterns of exclusion upstream (from participating in precision medicine research) and downstream (from benefitting from precision medicine outputs). It argues that efforts for inclusion upstream are not corresponded downstream, and this unbalance jeopardizes the equitable capacities of the projects. It concludes that enhanced focus on socio-environmental determinants of health and aligned public health interventions as precision medicine outputs would be to the benefit of all and especially of those who are most at risk of (upstream as well as downstream) exclusion. [ABSTRACT FROM AUTHOR]

Alcohol use disorders (AUD) are associated with several mental health, family, and social consequences. This paper analyzes the few studies on BIs in primary care in Chile and Latin America through a culturally critical view. Future research should address the need of culturally appropriate BI for AUD, so that decisions on policies and programs are made based on evidence-based, culturally appropriated practices. The Chilean context presents a unique opportunity to implement BI, since primary care counts on resources and protocols already installed. Clinical social workers should play a key role in this challenge. [ABSTRACT FROM AUTHOR]

Policy studies have addressed many issues on the topic of policy change, generally following the ideas about policy composition set out by Hall and others. These typically view 'significant' policy change as related to alterations in the macro elements of policies, namely policy paradigms and governance preferences. These studies have also examined the roles of meso-level policy objectives and policy instrument preferences in these dynamics but see these as subsequent or subordinate to more macro-level changes. In contrast, the role of changes in policy specifications and tool calibrations at the micro-level of policies remain under-investigated and under-theorized despite growing recognition of their sometimes transformative role in policy dynamics. This paper re-examines foundational work on policy change in order to develop a clearer understanding of the content and significance of both calibrations and policy specifications. The significance of these insights is illustrated through a case study of recent healthcare policy reform efforts in South Korea after 1988 which highlights the role that micro-level policy changes played in shaping broader and deeper policy changes over the period. [ABSTRACT FROM AUTHOR]

Despite the increasing recognition of the importance of mental health promotion, its implementation in practice remains underdeveloped in most countries. Having a standalone strategy ensures commitment to delivering on mental health promotion within the political and policy system. This paper outlines the process of developing the first Mental Health Promotion Plan for the health service in Ireland. The process of developing the Plan, together with key reflections and learnings from the experience are outlined. The framework for the development of the Mental Health Promotion Plan, and the processes involved are outlined. The development process constituted three distinct phases over a two and a half year period: (i) planning; (ii) identifying core actions; (iii) stakeholder engagement. The steps involved in each of these phases are described. The Mental Health Promotion Plan takes a lifecourse and settings-based approach, including 27 actions for enhancing protective factors for mental health and minimising risk factors. A wide range of stakeholders from across sectors contributed to the development process. The development of this Plan marks a watershed in placing mental health promotion on the policy agenda at a national level, building on the existing health promotion policy and practice infrastructure in Ireland. [ABSTRACT FROM AUTHOR]

Health care systems around the globe are currently orienting themselves towards 'personalized medicine', a medical care regime aimed at individualizing prevention, diagnosis, and treatment of disease through proliferating amounts and sources of data, including genetic information. In Denmark, national health policies on personalized medicine focus on harnessing the potentials of genomic science and technology to bring knowledge about patient-specific genetic variation into clinical application. A major hope is to improve public health and prevent common diseases by integrating genomic information in health care, yet to act preventively, a temporal path has to be established defining what kind of knowledge to create and to act upon, and when. This paper explores the temporal orderings of medical knowledge in two different areas: health policy and clinical practice. Examining policy papers on personalized medicine issued by Danish governmental and research institutions, and, comparing them with contemporary practices of using genetic information in preventive cardiac health care, we demonstrate that genetic knowledge-making is ordered around two different conceptual views of time: namely the sequential order and the speed with which such knowledge is produced. We argue that the visions of knowledge-making and early intervention through genomic science and technology as conveyed in policy papers on personalized medicine, challenge preexisting practices and understandings of what constitutes timely prevention and actionable knowledge within clinical care. We close the article discussing how prevention through genomics amplifies the significance of the clinical space for public health as a site for sense-making and translation of controversial genetic knowledge. [ABSTRACT FROM AUTHOR]

The feelings and hopes of young people around the world are often neglected in policymaking and research, with consequences for both their wellbeing and the effectiveness of humanity's response to the climate crisis. Many of them are distressed by climate change's impacts, the inaction of political and corporate leaders, the ways other people respond to their feelings, and the lack of support they have to share their feelings or get involved in meaningful climate-related work. This paper is written by a group of twenty-three concerned young people from fifteen countries. It provides a first-hand account of our deepest feelings, how these feelings affect our daily lives, the support we want to help us cope, and our hopes for a radically more compassionate future. The results are particularly relevant to policymakers, mental health professionals, journalists, educators, and people working with young people more widely. [ABSTRACT FROM AUTHOR]

A recovery paradigm has been increasingly used recently to inform mental health and addiction policies with principles that promote autonomy, social capital, and inclusion. However, some policies such as coercive treatments conflict with recovery principles and social workers report challenges implementing recovery principles in practice. This scoping review explored the literature on recovery policies in mental health and addictions from a social work perspective (N = 29). Our results showed a need to strengthen training for social workers on recovery, increase the focus on policies for addiction recovery, reduce coercive treatment policies, support families, and reduce stigma and discrimination through equitable policies. [ABSTRACT FROM AUTHOR]

An editorial is presented to the article urban geographers and sociologists use ideas about "encounter" and "conviviality" to understand ways of engaging with difference in cities and ways of enabling people to step outside a fixed identity. Topics include urban geography literature on encounter has turned primarily to the front stage of this performance; and collection of papers brings together new directions of scholarship about the performance, purpose, and creation of encounter for people.

Trauma-informed care (TIC) is not a new concept. Despite TIC being at the forefront of international acute public mental health services policy, and researched since 2006, implementation has been hampered. This paper reports findings from a scoping study examining clinical and lived experience workers experience of TIC in Acute Adult Public Mental Health Services. In this scoping study five databases and grey literature were scanned in 2021 and updated in 2023, to address the question: What is known about TIC concerning the clinical and mental health lived experience workforce in the acute adult public mental health service? Forty-six papers met the inclusion criteria. Analysis revealed commitment in conceptualisation of TIC in mental health policy, requirements for incorporating TIC in acute adult mental health care, and barriers to implementation, including dissonance towards role expectations. The literature calls for investment in implementing TIC, which includes an increased workforce consisting of mental health lived experience workers, clinical staff with TIC knowledge and skills, and specialist TIC experts. Further research is needed to understand more fully the opportunities and barriers to implementing TIC in acute public mental health settings. [ABSTRACT FROM AUTHOR]

This paper sets out the Collaborative Service Design Playbook, to guide planning, design, and implementation of co-created health services. Successful health service development and implementation is best guided by theoretically informed approaches; however, organisations often lack design and implementation know-how and have difficulty applying it. This study seeks to improve health service design and potential for scale-up by proposing a tool to guide an end-to-end process, drawing together service design, co-design, and implementation science; and exploring the tool's feasibility to establish a sustainable service solution developed with participants and experts that is scalable and sustainable. The Collaborative Service Design Playbook phases include, (1) Define the opportunity and initiatives, (2) Design the concept and prototype, (3) Deliver to scale and evaluate; and (4) Optimise to transform and sustain. This paper has implications for health marketing through providing an end-to-end approach with phased guidance for health service development, implementation, and scale up. [ABSTRACT FROM AUTHOR]

The outbreak of coronavirus disease in 2019 has become a serious threat to human health. Whether meteorological conditions could influence the transmission and virulence of COVID-19 remains controversial. In this study, we systematically reviewed the impact of temperature and humidity on the replication, morbidity, and mortality of COVID-19. We also discussed the main factors underlying the inconsistency across studies. Pubmed, Web of Science, Embase, and Scopus were used to identify papers published up to 7 December 2020. We initially identified 3515 papers, and 28 articles met the inclusion criteria after screening. Most studies showed high temperature and high humidity can partly reduce the reproduction, morbidity, and mortality of COVID-19. But the rest papers failed to identify a significant association. The discrepant results may be related to the difference in the climate context, study design, exposure assessment, policy intervention, socioeconomic status, and public health service. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has disrupted societies globally. Public health institutions were tasked with responding to the pandemic in a dynamic and uncertain context. This paper sheds light on the experiences of COVID-19 response actors as they navigated multi-dimensional crises associated with the pandemic in general and vaccine hesitancy in particular. This research was conducted during the initial phase of the COVID-19 vaccine rollout in Flanders, Belgium. Participants included informants across all levels of the COVID-19 vaccination strategy including but not limited to those producing scientific knowledge, providing policy input, or implementing public health directives locally. 'Crisis' was identified as a recurring theme in interviews with informants. The paper highlights multi-dimensional crises experienced by informants such as the: (i) crisis of prioritization, (ii) crisis of communication, (iii) crisis of the changing image of science, (iv) crisis of epistemic agency and autonomy, and (v) crisis of trust. [ABSTRACT FROM AUTHOR]

Governments in many countries are increasingly interested in using community sport as a vehicle for improving public health through physical activity (PA) promotion. This has been associated with an increasing interdependence between the community sport and health policy sectors. However, there are no empirically grounded studies which have examined this directly and systematically in England. By examining Sport England's Get Healthy, Get Active (GHGA) initiative, this paper presents novel evidence derived from interviews held with strategic policy-makers from Sport England and a professional football charity (Everton in the Community), and 67 men who engaged in one of the GHGA funded programmes, Active Blues. The findings reveal how the increasing interdependence between community sport and health policy has been characterised by tightly contested and congested relations of power at local and national levels. Although Sport England was the lead organisation which coordinated and was accountable for community sport, it was nevertheless highly dependent on organisations outside of the sector, including health organisations, to deliver their community sport goals. This was indicative of the relatively vulnerable and marginal position which Sport England, and sport policy, occupied in the policy landscape and the associated generalisation of interests from sport to public health. The policy spillover from more powerful policy sectors such as health, to comparatively less powerful ones like community sport, raises questions about the degree to which government can realistically expect to achieve their formal community sport and health policy goals. [ABSTRACT FROM AUTHOR]

It is recognized worldwide that evidence on what effectively prevents abuse of at-risk adults (including older people) is lacking. The purpose of this paper is to make an explicit, contemporary proposal as to why front-line workers and policy-makers interested in preventing the abuse of at-risk adults should adopt an opportunity-focused, problem-oriented policing framework from criminology. This paper will first position the proposal within the current context of responses to the abuse of at-risk adults. Following this, the paper will outline how the problem-oriented policing framework can develop targeted, collaborative, sustainable, and measurable prevention strategies intended to remove the opportunity for specific examples of abuse of at-risk adults. [ABSTRACT FROM AUTHOR]

Laparoscopic tubal ligation is the most prevalent method of contraception amongst India's rural and urban poor. Drawing on 18 months of ethnographic fieldwork in rural Rajasthan in 2012–2013, this paper investigates how rural women's perceptions of a biomedical instrument—the laparoscope—influence their perceptions of sterilization, a procedure often entrenched in coercive, target- and incentive-driven population control programme. By investigating how a laparoscope is entangled in global exchanges, national policies, institutional arrangements, and local moral worlds, this paper demonstrates that while wider biomedical discourses perpetuate the narrative of safety and convenience, people's everyday lives inform their understandings of technology that is widely known but rarely seen. [ABSTRACT FROM AUTHOR]

Health policy and academic discourses on rare diseases and people with rare conditions frequently employ terms such as 'low prevalence' and 'unique' to characterize the smallness of the population under consideration and to justify targeted action toward these patient groups. This paper draws from recent anthropological scholarship on smallness and data, ethnographic research in Finland and Poland, as well as document and media analysis to examine how data is utilized in the context of isolated populations that are considered sites of rare diseases in these two countries. Specifically, this paper juxtaposes the notion of Finnish Disease Heritage (FDH) with that of a 'Kashubian gene' in Poland. The concept of FDH was developed by Finnish researchers in the 1970s; it encompasses almost forty rare hereditary diseases that are significantly more prevalent in Finland than elsewhere globally. On the other hand, the notion of the 'Kashubian gene' was first utilized by the media and some members of the Polish medical community around 2008. Based on 'unstable' data gathered during genetic research, the term referred to the high prevalence of a rare metabolic disorder (Long-Chain 3-Hydroxyacyl-CoA Dehydrogenase (LCHAD) deficiency) among Kashubians, an ethnic minority that resides in Northern Poland's Pomerania region. Whereas FDH facilitated the production and branding of 'a unique Finnish genetic identity' (Tupasela 2016b, 61), the notion of the 'Kashubian gene' has engendered health policy interventions targeting members of this ethnic minority and has contributed to stigmatizing practices carried out against Kashubians. [ABSTRACT FROM AUTHOR]

Personalized medicine has become a central focus of health and innovation policies in many countries. It is a complex policy field which, in the pursuit of both health and wealth, brings together technology, new data use, and medical care. The aim of this paper is to analyze how the notion of personalized medicine has evolved, and what publics are implied in the political mobilization of the concept. We answer these questions based on a document analysis of Danish strategy papers in the period 2014–2021 and expert interviews. We identify different strategy actors driving the process, shifts in topics during the strategy process, as well as different imaginaries of the public. We argue that each group of strategy actors act with a particular public in mind and that these influence how personalized medicine is envisioned. If the relationship between strategy development and the imagined publics remains unknown, it can pose a democratic problem. [ABSTRACT FROM AUTHOR]

Copyright of Urban Policy & Research is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Innovative interventions are needed to address the growing burden of breast cancer globally, especially among vulnerable patient populations. Given the success of Community Health Workers (CHWs) in addressing communicable diseases and non-communicable diseases, this scoping review will investigate the roles and impacts of CHWs in breast cancer screening programs. This paper also seeks to determine the effectiveness and feasibility of these programs, with particular attention paid to differences between CHW-led interventions in low- and middle-income countries (LMICs) and high-income countries (HICs).Methods: A scoping review was performed using six databases with dates ranging from 1978 to 2019. Comprehensive definitions and search terms were established for 'Community Health Workers' and 'breast cancer screening', and studies were extracted using the World Bank definition of LMIC. Screening and data extraction were protocolized using multiple independent reviewers. Chi-square test of independence was used for statistical analysis of the incidence of themes in HICs and LMICs.Results: Of the 1,551 papers screened, 33 were included based on inclusion and exclusion criteria. Study locations included the United States (n=27), Bangladesh (n=1), Peru (n=1), Malawi (n=2), Rwanda (n=1), and South Africa (n=1). Three primary roles for CHWs in breast cancer screening were identified: education (n=30), direct assistance or performance of breast cancer screening (n=7), and navigational services (n=6). In these roles, CHWs improved rates of breast cancer screening (n=23) and overall community member knowledge (n=21). Two studies performed cost-analyses of CHW-led interventions.Conclusion: This review extends our understanding of CHW effectiveness to breast cancer screening. It illustrates how CHW involvement in screening programs can have a significant impact in LMICs and HICs, and highlights the three CHW roles of education, direct performance of screening, and navigational services that emerge as useful pillars around which governments and NGOs can design effective programs in this area. [ABSTRACT FROM AUTHOR]

Surveillance of injuries in production agriculture is necessary to inform stakeholders about workplace hazards and risks in order to improve and advance injury prevention policies and practices for this dangerous industry. The most comprehensive fatal injury surveillance effort currently in the United States is the Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries (CFOI), which covers occupational fatalities in all U.S. industries, including production agriculture. However, this surveillance does not include many categories of fatalities that occur during agricultural work or on production agriculture worksites. To better capture the human cost of production agriculture, the authors of this paper call for the collection of additional data with a broader scope that supplements, not replaces, the current CFOI. This paper describes challenges in surveillance, highlights key procedural gaps, and offers recommendations for advancing national surveillance of fatal traumatic injuries associated with production agriculture. [ABSTRACT FROM AUTHOR]

In Burkina Faso, Burundi and Niger, the policy to remove user fees for primary care was carried out through significant adjustments in public financial management (PFM). The paper analyzes the PFM adjustments by stage of the budget cycle and describes their importance for health financing. The three countries shifted from input-based to program-based allocation for primary care facility compensation, allowed service providers autonomy to access and manage the funds, and established budget performance monitoring frameworks related to outputs. These PFM changes, in turn, enabled key improvements in health financing, namely, more direct funding of primary care facilities from general budget revenue, and payments to those service providers based on outputs and drawn from noncontributory entitlements. The paper draws on these experiences to provide key lessons on the PFM enabling conditions needed to expand health coverage through public financing mechanisms. [ABSTRACT FROM AUTHOR]

Understanding people's concepts of illness and health is key to crafting policies and communications campaigns to address a particular medical concern. This paper gathers cultural knowledge on infectious disease causation, prevention, and treatment the Philippines that are particularly relevant for the COVID-19 pandemic, and analyzes their implications for public health. This paper draws from ethnographic work (e.g. participant observation, interviews, conversations, virtual ethnography) carried out individually by each of the two authors from February to September 2020. The data was analyzed in relation to the anthropological literature on local health knowledge in the Philippines. We find that notions of hawa (contagion) and resistensiya (immunity) inform people's views of illness causation as well as their preventive practices - including the use of face masks and 'vitamins' and other pharmaceuticals, as well as the ways in which they negotiate prescriptions of face mask use and physical distancing. These perceptions and practices go beyond biomedical knowledge and are continuously being shaped by people's everyday experiences and circulations of knowledge in traditional and social media. Our study reveals that people's novel practices reflect recurrent, familiar, and long-held concepts - such as the moral undertones of hawa and experimentation inherent in resistensiya. Policies and communications efforts should acknowledge and anticipate how these notions may serve as either barriers or facilitators to participatory care and improved health outcomes. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to share insights from an ongoing project that seeks to promote physical activity to disabled people. Narrative commentary. An overlooked yet important group of messengers for promoting physical activity is first highlighted. These are social workers. Second, the process of developing guidelines for these messengers is described and the guide signposted. Third, an infographic to communicate physical activity is highlighted and insights offered on some of the messages co-produced in it. These messages include a focus on pleasure, amounts of physical activity, strength, sedentariness, visual images, language, and different impairments. The paper contributes to knowledge by offering new insights into how to promote physical activity to disabled people. A new group of messengers – social workers – for promoting physical activity to people with disabilities is highlighted. A guide for social workers to promote physical activity is described and offered. Insights for health promotion is offered on the co-production of physical activity messages. [ABSTRACT FROM AUTHOR]

This article describes the development and dissemination of an evidence-based Policy Statement and Background Papers by the Australian Rehabilitation and Assistive Technology Association (ARATA). An experienced project team was engaged to conduct literature reviews and member consultations, develop resources and implement a targeted advocacy strategy that included a policy launch and meetings with government officials. The Policy Statement and Background Papers have enabled ARATA to represent the views of Assistive Technology (AT) Practitioners in consultations around the National Disability Insurance Scheme and other AT-related inquiries. In ARATA's experience, developing a policy statement and disseminating it through a targeted advocacy strategy is an effective way for a not-for-profit professional organisation to influence government policy. [ABSTRACT FROM AUTHOR]

The Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ+) community accounts for one of the major minority communities globally. Their major concerns entail traumatic experiences and the subsequent loss, which are essentially misconceived or overlooked. They experience persistent barriers for voicing their needs and the struggle amplifies especially in the realm of accessing mental healthcare. This population further strives to be seen and heard which is not very well received by the society. While many countries have progressed in designing favorable policies, there exists a wide gap in identifying the challenges faced by them in accessing the existing mental health services. The present paper focuses on the discrimination faced by the gender minority population caused due to the unfavorable attitudes, and stigma persisting at the interpersonal and community level. The paper further proposes commending suggestions for tailoring the policies created in accordance with the needs and requirements of this population. [ABSTRACT FROM AUTHOR]

Primary health care (PHC) improvement is often undermined by implementation gaps in low- and middle-income countries (LMICs). The influence that actor networks might have on the implementation has received little attention up to this point. This study sought to offer insights about actor networks and how they support PHC implementation in LMICs. We reviewed primary studies that utilised social network analysis (SNA) to determine actor networks and their influence on aspects of PHC in LMICs following the five-stage scoping review methodological framework by Arksey and O'Malley. Narrative synthesis was applied to describe the included studies and the results. Thirteen primary studies were found eligible for this review. Ten network types were identified from the included papers across different contexts and actors: professional advice networks, peer networks, support/supervisory networks, friendship networks, referral networks, community health committee (CHC) networks, inter-sectoral collaboration networks, partnership networks, communications networks, and inter-organisational network. The networks were found to support PHC implementation at patient/household or community-level, health facility-level and multi-partner networks that work across levels. The study demonstrates that: (1) patient/household or community-level networks promote early health-seeking, continuity of care and inclusiveness by enabling network members (actors) the support that ensures access to PHC services, (2) health facility-level networks enable collaboration among PHC staff and also ensure the building of social capital that enhances accountability and access to community health services, and (3) multi-partner networks that work across levels promote implementation by facilitating information and resource sharing, high professional trust and effective communication among actors. This body of literature reviewed suggests that, actor networks exist across different levels and that they make a difference in PHC implementation. Social Network Analysis may be a useful approach to health policy analysis (HPA) on implementation. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has created an unprecedented natural experiment in drug policy, treatment delivery, and harm reduction strategies by exposing wide variation in public health infrastructures and social safety nets around the world. Using qualitative data including ethnographic methods, questionnaires, and semi-structured interviews with people who use drugs (PWUD) and Delphi-method with experts from field sites spanning 13 different countries, this paper compares national responses to substance use during the first wave of the COVID-19 pandemic. Field data was collected by the Substance Use x COVID-19 (SU x COVID) Data Collaborative, an international network of social scientists, public health scientists, and community health practitioners convened to identify and contextualise health service delivery models and social protections that influence the health and wellbeing of PWUD during COVID-19. Findings suggest that countries with stronger social welfare systems pre-COVID introduced durable interventions targeting structural drivers of health. Countries with fragmented social service infrastructures implemented temporary initiatives for PWUD led by non-governmental organisations. The paper summarises the most successful early pandemic responses seen across countries and ends by calling for greater systemic investments in social protections for PWUD, diversion away from criminal-legal systems toward health interventions, and integrated harm reduction, treatment and recovery supports for PWUD. [ABSTRACT FROM AUTHOR]

Anthropologists have critically examined a range of reforms from education and land to finance and health. Yet the predominant way of looking at reforms has been through a lens focused on neoliberal governance. For example, prior studies of health reforms focus on insurance, financing, and access to care. Yet, seeing reform in this way fails to attend to other types of cultural work at play when calling a policy or law a reform. In this paper, we draw on ethnographic research on health policy reforms in Israel and Bolivia to examine the concept of reform and the work it does within national movements. We argue that while the language of reform often signals change or novelty, reforms also carry forward historical continuities and reifications of the past. By delving into the past and its relationship with ongoing health reforms, we attend to how reforms can reinforce and maintain health inequities in some cases, while creating a national language for new possibilities in others. Reform, as we will discuss in this paper, is not only about political ideology, neoliberal governance, or on-the-ground policy implementation, but centrally it is about representations of aspirations, and about crafting relationships between past, present, and future. [ABSTRACT FROM AUTHOR]