Health Policy And Planning[JOURNAL]
Sun
200 papers
Surgical indicators for obstetrics and family planning in routine health information systems: a landscape analysis.
Pepper M, Campbell OMR, Levin K … +15 more , Stafford R, Day LT, Tripathi V, Abacassamo F, Abdulazeez J, Kébé D, Kibungu J, Millimono S, Pal M, Rakotoarimanana F, Tounkara FK, Uwamariya J, Bijou S, Snell J, Khan F
Health Policy Plan · 2025 Oct · PMID 40795307 · Full text
Strengthening use of high-quality data for surgical obstetrics and family planning is important for improving maternal and perinatal health outcomes. Routine health information systems (RHIS) represent an important data...
Strengthening use of high-quality data for surgical obstetrics and family planning is important for improving maternal and perinatal health outcomes. Routine health information systems (RHIS) represent an important data source for indicator tracking. This landscape analysis aims to describe and compare surgical obstetric and family planning indicators put forth by global multi-stakeholder groups and those that are currently captured in RHIS in nine low- and middle-income countries. The analysis focused on five indicator topics: (i) caesarean delivery, (ii) peripartum hysterectomy, (iii) female genital fistula care, (iv) insertion/removal of long-acting reversible contraception and male/female sterilization, and (v) the general surgical context. We examined 12 indicator lists developed by multi-stakeholder groups and RHIS documentation from the Democratic Republic of the Congo, Guinea, India, Madagascar, Mali, Mozambique, Nigeria, Rwanda, and Senegal. 29 multi-stakeholder and 104 country indicators (119 unique indicators) met our inclusion criteria, typically capturing service provision or service readiness. Indicators on post-surgical outcomes or complications were rarer. The reviewed multi-stakeholder lists did not include indicators on peripartum hysterectomy. At the country level, not all RHIS included fistula care or peripartum hysterectomy indicators and there were marked differences with regard to what indicators were included and the relative distribution of indicators across the indicator topics. Only 14 (48%) of the multi-stakeholder indicators were included in countries' RHIS, with just two being tracked by all nine countries (caesarean deliveries and family planning users by modern method of contraception). There was a lack of standardized indicators for surgical obstetrics and family planning, and we noted typical RHIS challenges such as indicator profusion, duplication, vague indicator definitions, and measurement of composite or difficult-to-quantify concepts. Our findings suggest that there are opportunities to standardize and streamline prioritized measurement of surgical obstetric and family planning data for tracking with the ultimate aim of improving health services.
Building climate resilient healthcare systems: lessons from Thailand.
Robinson S, Tawatsupa B, Barnes M … +3 more , Hoetker G, Maijarernsri P, Bowen KJ
Health Policy Plan · 2025 Oct · PMID 40744653 · Full text
This innovation and practice report examines the achievements and challenges of the development and implementation of two policies guiding climate adaptation and mitigation action in Thailand's healthcare system, namely...
This innovation and practice report examines the achievements and challenges of the development and implementation of two policies guiding climate adaptation and mitigation action in Thailand's healthcare system, namely (i) The GREEN and CLEAN hospitals policy and (ii) The Health National Adaptation Plan. Based on key informant interviews and focus groups it was found that at the government level adaptation and mitigation planning was well developed. However, adaptation planning could be strengthened at the organizational level. Social values such as strong leadership and a sense of shared ownership significantly influenced initiative outcomes. Sub-district public health officials also served as crucial intermediaries between the government and local communities however, strengthening the coupling of environmental monitoring data with health impact analysis could further policy progression in the adaptation space. Participants also highlighted the need for increased funding, improved training, and greater knowledge sharing. Other healthcare systems could learn much from Thailand's approach to tackling climate change and health, particularly in the benefits of a detailed health-focused national mitigation and adaptation policy; establishment of local public health units; encouraging a sense of shared ownership; and, conceptualizing environmental sustainability as core to healthcare.
Beyond evidence: how actor dynamics and power shape knowledge translation for health policy in Kenya.
Guleid FH, Barasa E, Abiiro GA … +1 more , Nzinga J
Health Policy Plan · 2025 Sep · PMID 40744652 · Full text
Efforts to strengthen knowledge translation (KT) for policy-making often call for greater engagement with the policy process and its actors. Yet, existing KT approaches often focus on communication and dissemination of e...
Efforts to strengthen knowledge translation (KT) for policy-making often call for greater engagement with the policy process and its actors. Yet, existing KT approaches often focus on communication and dissemination of evidence and undertheorise the role and influence of policy actors on KT. As such, this study examines how, why, and to what effect policy actors shape KT. Our findings address a critical gap in the KT literature regarding the relational dimensions of KT for policy-making in low-middle-income countries. We utilised purposive and snowball sampling to identify participants who are involved in health policy-making and KT in Kenya. This included policy-makers, academics/researchers, knowledge intermediaries, and external partners (development and implementation partners). Data were collected through in-depth interviews (n = 32), observations (n = 52 h), and document reviews (n = 34). Data analysis was informed by a theoretical framework that combined perspectives from actor-centred institutionalism, Gaventa's PowerCube, boundary work, and coproduction. Our findings reveal how actor influence in KT is shaped by institutional mandates and roles, which, in turn, shape how actors perceive their position and authority in KT processes. While some actors viewed themselves as constrained to the role of evidence provision, others acted as boundary spanners across policy spaces, enabled by their institutional flexibility and financial resources. In addition, actor interests shaped when and how they exercised power to support or resist KT. Furthermore, access to policy spaces determined whose evidence was visible and perceived as legitimate, reflecting deeper power structures. These dynamics frame KT as a relational process mediated by political and institutional structures. As such, this study highlights the need to reconceptualise KT to integrate relational and structural dimensions, moving beyond evidence dissemination to addressing actor and power dynamics. It contributes novel insights into the interplay between actors, context, and power in shaping KT outcomes.
Context and generalizability in health policy and systems research: a plea for an integrative praxis of theorizing.
Van Belle S, Marchal B
Health Policy Plan · 2025 Oct · PMID 40734515 · Full text
In this article, we address the conundrum of context in health policy and systems research, zooming in on research on implementation of programmes, policies, and interventions. We review how the field draws on non-linear...
In this article, we address the conundrum of context in health policy and systems research, zooming in on research on implementation of programmes, policies, and interventions. We review how the field draws on non-linear paradigms to better take into account 'context' in causal explanation, and we compare paradigms and the way in which they can inform more context-sensitive research, policies, and programmes. We propose a theorizing praxis that is based on the principles of realist inquiry and that allows researchers to draw lessons applicable to other settings by integrating a comprehensive analysis of context in their research.
Cervical cancer prevention and control in Nigeria: mapping and review of policies.
Okolie EA, Beek K, Patel B … +2 more , Ndikom CM, Joshi R
Health Policy Plan · 2025 Sep · PMID 40734514 · Full text
Cervical cancer is a significant public health issue in Nigeria and a major cause of cancer-related morbidity and mortality among women. Equitable implementation of cervical cancer control programs alongside relevant pol...
Cervical cancer is a significant public health issue in Nigeria and a major cause of cancer-related morbidity and mortality among women. Equitable implementation of cervical cancer control programs alongside relevant policies and strategic plans is vital to reducing the burden of cervical cancer and improving the quality of life. Considering the role of policies in guiding program implementation, we reviewed Nigeria's cervical cancer policy landscape to identify strengths, limitations, and opportunities for improvement. This policy appraisal involved a literature review to understand related policy review frameworks, developing a modified framework containing six domains, systematically searching key databases and websites to identify relevant policy documents, data extraction and analysis, and synthesizing findings from reviewed documents. A total of five documents were reviewed in this study-three integrated cancer control plans, a cervical cancer policy, and a strategic plan for cervical cancer prevention and control. Two of the reviewed documents are current (2023-7), one is outdated, and two are expired. Key strengths identified in these documents include (i) a clear articulation of goals, (ii) a collaborative development process, (iii) the adoption of a phased implementation approach for proposed interventions, (iv) detailed intervention plans, and (v) monitoring and evaluation plans with performance indicators. In contrast, key limitations include (i) poor participation of subnational level stakeholders, (ii) absence of costing and funding approach in some plans, (iii) lack of baseline data on unmet needs and outcomes of previous plans, and (iv) absence of health system resource mapping. Addressing identified limitations is critical to improving the quality of policy and policy-informing documents, strengthening implementation across all levels, lowering the cervical cancer burden, and improving women's health outcomes.
Willingness to pay for assisted reproductive technologies among individuals with infertility in China.
Li C, Cong H, Jan S … +3 more , Si L, Geng L, Li S
Health Policy Plan · 2025 Sep · PMID 40671365 · Full text
Infertility, a widely prevalent condition globally, incurs high economic burdens. Assisted reproductive technologies (ARTs) are effective treatments, but public health financing in low- and middle-income countries (LMICs...
Infertility, a widely prevalent condition globally, incurs high economic burdens. Assisted reproductive technologies (ARTs) are effective treatments, but public health financing in low- and middle-income countries (LMICs) rarely covers ART services. In China, where birth rates are declining, willingness to pay (WTP) can inform insurance reimbursement policies by reducing out-of-pocket expenses. However, there is no consensus on WTP thresholds for assessing the cost-effectiveness of fertility treatments in LMICs. This study aimed to assess WTP for ART among individuals with infertility in China. Data were obtained from a cross-sectional survey conducted at five hospitals across different geographical and socioeconomic regions in China. Individuals with infertility were recruited using a quota sampling method. A contingent valuation method was employed, with three hypothetical WTP scenarios developed to present detailed information on the success rates, costs, and the treatment processes of in vitro fertilization (IVF), artificial insemination (AI), and preimplantation genetic testing (PGT). A total of 570 individuals with infertility participated in the survey [94.4% female; mean (standard deviation) age: 33.0 (4.7) years]. The sampled respondents were willing to pay renminbi (RMB) 30 163 [$4259, 95% confidence interval (CI): RMB 29 650-30 675] for IVF, RMB 6046 ($854, 95% CI: RMB 5987-6106) for AI, and RMB 47 234 ($6669, 95% CI: RMB 46 435-48 033) for PGT. These WTPs were equivalent to 0.34, 0.07, and 0.53 times the GDP per capita in China, respectively. Older age and male-factor or unexplained infertility were significantly associated with lower WTP (P < .05), while higher education and patient-physician communication about costs were positively associated with WTP (P < .05). These findings suggest that public health insurance schemes should establish appropriate cost-effectiveness thresholds and reimbursement ceilings for ART to improve affordability and access. Incorporating patient-physician communication about cost into clinical practice may facilitate shared decision-making and potentially increase patients' perceived value of ART.
Enhancing the well-being of the elderly: evidence from China on the role of health investment.
Zheng L, Fan W, Xiang H
Health Policy Plan · 2025 Sep · PMID 40660893 · Full text
Subjective well-being (SWB) is increasingly recognized as a critical indicator of healthy ageing. While prior studies highlight the importance of health behaviours, few examine how multidimensional health investments inf...
Subjective well-being (SWB) is increasingly recognized as a critical indicator of healthy ageing. While prior studies highlight the importance of health behaviours, few examine how multidimensional health investments influence SWB across different levels of well-being. This paper explores the relationship between health investment and SWB among older adults in China, using data from the 2018 Chinese Longitudinal Healthy Longevity Survey. Health investment is categorized into 4 domains: nutrition, healthcare access (insurance coverage and health product use), lifestyle behaviours (including exercise, smoking, and drinking), and living environment (access to clean drinking water). Quantile regression models are applied to assess heterogeneous effects across the SWB distribution, while mediation analysis investigates the role of self-rated health and functional health (activities of daily living) as potential pathways. Results show that the positive effects of nutrition and exercise are the most pronounced among individuals with lower SWB, while smoking and drinking exhibit stronger negative associations in this group. Mediation results suggest that perceived health plays a more consistent role than functional status in translating health investment into higher well-being. The impact of insurance is observed primarily through interaction effects, magnifying benefits from healthy behaviours and buffering risks from harmful ones. These findings point to the need for equity-sensitive ageing policies that target both health behaviours and social protection. Specifically, integrating social work and behavioural counselling into primary health outreach may help address substance-related risks and psychological vulnerabilities among the elderly. This evidence has wider relevance for ageing societies, particularly in low- and middle-income countries aiming to align health system goals with subjective well-being outcomes.
The effect of performance-based financing interventions on health worker motivation and job satisfaction: experimental evidence from six national pilots.
Lamba S, Friedman J, Kandpal E
Health Policy Plan · 2025 Sep · PMID 40644357 · Full text
A long-standing concern suggests that performance-based financing (PBF) may undermine the intrinsic motivation of health workers by heightening extrinsic motivation concerns via the novel introduction of financial incent...
A long-standing concern suggests that performance-based financing (PBF) may undermine the intrinsic motivation of health workers by heightening extrinsic motivation concerns via the novel introduction of financial incentives. However, the theoretical effect of PBF on worker motivation and job satisfaction is ambiguous as these programs may also improve working conditions, staff engagement, and other factors that determine health worker morale. We use data from six evaluations of national pilots to empirically assess the effect of PBF on worker motivation and job satisfaction. In these six pilots (in Cameroon, Kyrgyz Republic, Nigeria, Tajikistan, Zambia, and Zimbabwe), geographical units (or health facilities) were either randomized or quasi-experimentally assigned to receive PBF or the alternatives of direct facility financing (DFF), enhanced supervision (ES), or business-as-usual comparison arms. Baseline and endline health worker surveys were carried out in the context of these national pilots. The primary outcomes investigated here are health worker motivation and job satisfaction. Secondary outcomes include subconstructs of health worker motivation and job satisfaction extracted using exploratory factor analysis. For two countries out of six-Nigeria and Kyrgyz Republic-we find increases in overall worker motivation and null effects in the other four when contrasting PBF with the business-as-usual comparison. For five countries out of six (all but Cameroon), we find increases in job satisfaction. Further, PBF did not have any systematic motivating or demotivating effects when compared with the health system intervention alternatives of DFF and ES (each in a subset of countries), except in Nigeria where satisfaction in the PBF arm was lower when compared with DFF. All told, these results contain practically no evidence of an adverse effect of PBF on overall health worker motivation or job satisfaction and indeed suggest a beneficial impact in some country settings.
Health impact of alcohol regulatory interventions: a systematic review of policies in low- and middle-income countries.
Malawige AS, Aminde LN, Weeratunga GU … +2 more , Weerakoon K, Veerman JL
Health Policy Plan · 2025 Aug · PMID 40590311 · Full text
Alcohol consumption poses significant public health challenges globally, with low- and middle-income countries (LMICs) experiencing a substantial burden from alcohol-related harm. However, the effectiveness of interventi...
Alcohol consumption poses significant public health challenges globally, with low- and middle-income countries (LMICs) experiencing a substantial burden from alcohol-related harm. However, the effectiveness of interventions to control alcohol consumption in LMICs remains understudied. This paper aims to investigate the effectiveness of alcohol regulatory interventions adopted in LMICs. A systematic search of MEDLINE, EMBASE, CINAHL, PsycINFO, and Web of Science was conducted on 10 August 2024. The search strategy included terms related to regulatory interventions and their impact on alcohol consumption, health, and other related outcomes. Risk of bias was assessed using the National Institutes of Health, Cochrane Effective Practice and Organization of Care checklist, ISPOR-SDMD checklist, and CASP quality assessment tools, and a narrative synthesis was performed to summarize the review findings. Of the 169 full texts screened, 62 studies were included in this review. Most of the studies were conducted in upper-middle-income countries (n = 48, 77%), seven were from lower-middle-income countries, one from a low-income country, and others were combinations of the above. Sixty per cent of the included studies were of good quality. In terms of World Health Organization alcohol policy domains, 18 studies focused on restriction of physical availability, 11 on pricing, 1 on marketing, 21 on drink driving, and 11 on a combination of all policy domains. Alcohol consumption-related outcomes were reported in 26 studies, while health and other outcomes were reported in 25 and 14 studies, respectively. Restrictions on physical availability of alcohol were largely effective across all outcomes, while the pricing policy domain consistently demonstrated effectiveness in reducing alcohol consumption. The scarce evidence on marketing policy interventions was inconclusive; interventions targeting drink driving showed beneficial effects. The available evidence suggests that alcohol control policies are largely effective in LMICs. Further regular and statutory enforcement of these interventions is likely to improve their effectiveness.
New health taxes in Ghana: a qualitative study exploring potential public support.
Smith KE, Hellowell M, Logo DD … +2 more , Marten R, Singh A
Health Policy Plan · 2025 Sep · PMID 40583620 · Full text
In the context of a fiscal crisis and health pressures, Ghana's government has been exploring additional pro-health taxes. The World Health Organization and World Bank support health taxes as 'win-win' policies that can,...
In the context of a fiscal crisis and health pressures, Ghana's government has been exploring additional pro-health taxes. The World Health Organization and World Bank support health taxes as 'win-win' policies that can, if designed effectively, simultaneously improve health and raise revenue for health spending. However, international evidence shows that health taxes can meet political and public opposition. Yet, there is little research that empirically examines public views of health taxes. We compared policy stakeholders' perceptions of Ghanaian public support for health taxes with public views, seeking to understand the basis for potential public opposition, the extent to which evidence can shape public views, and whether tax framing and design influences public support. We undertook 28 semi-structured key informant interviews with stakeholders (from government, advocacy, and business groups) and five focus groups with 38 members of the public (purposefully selected for diversity in gender, age, ethnicity, occupation, and social background). We employed an innovative deliberative design for the focus groups, which enabled us to explore how public views responded to contrasting health tax 'frames'. Stakeholders generally believed public support for health taxes was low, especially for more widely consumed products. Yet, most focus group participants expressed strong support for health taxes, especially those targeting (more widely-consumed) sugar-sweetened beverages. Support increased when health taxes were framed as measures to improve public health and/or create a fairer tax system, and when commitments were made to using resulting revenue for health spending (known as 'earmarking' or hypothecation). However, stakeholders and members of the public shared a concern that business influence in Ghanaian politics presents a key barrier to implementing effective health taxes sustainably. Overall, our findings suggest that health taxes with a clearly-framed health rationale could command strong Ghanaian public support but likely require effective advocacy to overcome political barriers.
Integrating eye health into a child health policy in Tanzania: global and national influences.
Malik ANJ, Spicer N, Mafwiri M … +2 more , Gilbert C, Schellenberg J
Health Policy Plan · 2025 Aug · PMID 40581094 · Full text
Global consensus has shifted to focus on how children can be supported to not only 'survive' but to 'thrive'. Blindness and visual loss in early childhood undermine a child's ability to thrive, affecting psychomotor, cog...
Global consensus has shifted to focus on how children can be supported to not only 'survive' but to 'thrive'. Blindness and visual loss in early childhood undermine a child's ability to thrive, affecting psychomotor, cognitive, and social development leading to life-long consequences for educational attainment, employment, economic and social status, and wellbeing. Despite this, eye health for children under the age of 5 years has been neglected, and not politically prioritized. In Tanzania, policy makers decided in 2019 to include eye conditions in the national Integrated Management of Newborn and Childhood Illness (IMNCI) programme, despite eye health not being part of the global World Health Organization/UNICEF IMNCI strategy. We conducted a qualitative policy analysis to explore enabling factors and barriers to this policy change. The interviews were semi-structured with key actors selected purposively and by snowball sampling, including those with a role in child and eye health at national and global levels. We used an adapted Shiffman and Smith framework (Generation of political priority for global health initiatives: a framework and case study of maternal mortality. Lancet 2007;370:1370-9) to guide the interviews and analysis, and the Consolidated Criteria for Reporting Qualitative Research for planning and reporting. This study shows how rapidly one country altered its overall child health policy to include eye health, driven by good quality collaborative research and collective action (cohesive policy community) which importantly included co-design with the decision makers (Ministry of Health actors). These developments coincided with the shift in the international agenda moving from 'survive to thrive' in child health which was leveraged to include eye care in the national strategy.
International price comparisons for national price-negotiated drugs in China: a cross-regional analysis.
Lyu L, Hu Q, Zou Y … +1 more , Ming J
Health Policy Plan · 2025 Aug · PMID 40578822 · Full text
China has long struggled with high medical costs and irrational drug pricing but has recently made significant progress by implementing drug negotiation strategies to effectively reduce the prices of targeted drugs. To a...
China has long struggled with high medical costs and irrational drug pricing but has recently made significant progress by implementing drug negotiation strategies to effectively reduce the prices of targeted drugs. To accurately depict drug prices on a global scale, a cross-sectional time-series analysis was conducted in China using Multinational Integrated Data Analysis System data from the first quarter of 2017 to the fourth quarter of 2022. This analysis compared the prices of 140 price-negotiated innovative drugs across 15 countries using five distinct price indices-Average Price Index, Laspeyres, Paasche, Fisher, and Chained Laspeyres-aiming to address gaps in understanding China's negotiated drug prices globally. The five drug price index (DPI) showed general consistency and revealed significant variations in drug prices across countries. China's drug pricing reforms have successfully reduced drug costs and alleviated the financial burden on patients, offering insights for other developing countries. Drug price indices serve as valuable tools for monitoring prices and promoting transparency, while using PPPs may better reflect actual affordability and provide a more reasonable assessment.
Health professionals' knowledge and understanding of inclusion health: a systematic literature review.
Flynn AV, Bermingham M, Caples M … +6 more , Curtin M, Dalton C, McLoughlin G, O'Mahony J, Vucen S, Saab MM
Health Policy Plan · 2026 Feb · PMID 40576084 · Full text
There is a growing need for healthcare professionals to ensure that their practices are inclusive and that they are considerate of the needs of marginalized communities. Inclusion health (IH) seeks to correct the imbalan...
There is a growing need for healthcare professionals to ensure that their practices are inclusive and that they are considerate of the needs of marginalized communities. Inclusion health (IH) seeks to correct the imbalances that result in health inequities and requires health practitioners to have an adequate understanding and knowledge of the needs of marginalized and vulnerable population groups. The aim of this systematic review was to synthesize and critically appraise evidence from studies that explored healthcare professionals' knowledge and/or awareness of IH. Academic Search Complete, CINAHL Plus with Full Text, MEDLINE, APA PsycArticles, APA PsycInfo, and SocINDEX were systematically searched without any year or language limits. The last search was conducted on 16 December 2024. A total of 4870 studies were identified, of which 37 were included (21 qualitative studies, 7 quantitative studies, 6 mixed-methods studies, 2 cross-sectional studies, and 1 quasi-experimental study). The methodological quality of the studies was appraised. Most studies were from the USA and Australia and focused on IH knowledge regarding members of the lesbian, gay, bisexual, trans, and queer community, people with disabilities, and culturally diverse populations. Studies examining healthcare professionals' knowledge and awareness were not homogenous in nature resulting in a wide variety of studies and types of data. Different minority groups require varied levels of insight and understanding from their healthcare professionals. There is therefore no one-size-fits-all solution. We recommend targeted interventions throughout the training and education of healthcare professionals, informed and designed by the participation of members of those marginalized communities.
Self-care and health seeking for diabetes and hypertension in Cambodia.
Wamsiedel M, Khuon D, Liu Y … +1 more , Saphonn V
Health Policy Plan · 2025 Sep · PMID 40570194 · Full text
Cambodia is experiencing a growing burden of non-communicable diseases (NCDs) as it undergoes an epidemiological transition. This qualitative study investigates the health-seeking behaviors of Cambodians in the context o...
Cambodia is experiencing a growing burden of non-communicable diseases (NCDs) as it undergoes an epidemiological transition. This qualitative study investigates the health-seeking behaviors of Cambodians in the context of hypertension and diabetes, focusing on the utilization of both formal healthcare and alternative medical practices. Data are from 20 in-depth interviews with participants without social health protection and 6 focus groups (n = 48), involving beneficiaries of the Health Equity Fund (HEF) and National Social Security Fund (NSSF). The research explores personal experiences with NCD management, perceptions of social health protection schemes, and perceived barriers to accessing healthcare. Data were collected in urban and rural settings in Cambodia, with thematic analysis facilitated by NVivo 14 software. Many participants delayed seeking biomedical advice due to economic constraints, cultural beliefs, and perceived inadequacies in the healthcare system. Traditional remedies and self-medication were commonly reported, often due to their accessibility and lower cost compared to biomedical healthcare services. Despite the availability of HEF and NSSF, structural challenges within the healthcare system, such as shortages of medications and trained staff at public health centers, emerged as significant barriers. Pharmacy workers and village healers are insufficiently utilized human resources. Formalizing their role in the secondary prevention of NCDs could contribute to the early detection of diabetes and hypertension. The findings suggest the need for an integrated health system that strengthens the capacity of primary care facilities to manage NCDs effectively and utilizes the semi-professional sector more systematically. Strengthening primary care, expanding service availability, and improving social health protection schemes are essential to reduce health disparities and improve access to quality care for NCDs in Cambodia.
'Honouring the storyteller': the potential of Playback Theatre in health policy and systems research.
Putturaj M, Jain R
Health Policy Plan · 2025 Aug · PMID 40556518 · Full text
Stories and storytelling stimulate inquiries in health policy, and initiate and become an integral part of policy dialogues. They can also be used as a health policy advocacy tool. Storytelling is a compelling way to eng...
Stories and storytelling stimulate inquiries in health policy, and initiate and become an integral part of policy dialogues. They can also be used as a health policy advocacy tool. Storytelling is a compelling way to engage with various actors in the health policy realm, co-creating knowledge and action in the social world of health systems. Playback Theatre (PT) is an improvisational form of theatre in which audience members share their life stories, which are then enacted on the spot by a group of citizen actors. Citizen actors are everyday people who are not necessarily professional performers but are trained in PT. PT's emphasis on emotional expression and representation allows individuals to deeply engage with the stories of others, leading to greater empathy and understanding across diverse social groups. If applied with a critical consciousness, we argue that PT methodology can illuminate health policy and systems research storytelling processes, given its ontological and epistemological alignment with social constructivism and its orientation towards values such as human dignity and social justice. In this article, we explore the possibilities and the limits of PT for storytelling in the field of Health Policy and Systems Research, as it emphasises stories as much as the storyteller.
Protecting unaccompanied migrant youth in transit through Mexico: frontline perspectives on appropriate policy implementation.
Corona Maioli S, Burgess RA
Health Policy Plan · 2025 Aug · PMID 40468994 · Full text
Mexico is the world's largest global migration corridor and in the last decade there has been an increase in forced migration of families, women, and unaccompanied children and adolescents. The latter population requires...
Mexico is the world's largest global migration corridor and in the last decade there has been an increase in forced migration of families, women, and unaccompanied children and adolescents. The latter population requires specific policy and implementation frameworks due to increased vulnerability related to their age, gender, and unaccompanied status, which can seriously impact their long-term health and wellbeing. However, globally and in Mexico there are reports of lack of appropriate implementation of protection measures. Thus, this article aims to explore the perspectives of frontline workers who conduct daily work with unaccompanied migrant youth. Through 29 semi-structured interviews conducted with different migration workers, mostly based in Mexico, in summer 2021, we found that possibilities for advancing child rights exist even with a scarcity of resources. In fact, although workers highlighted a context of lack of resources, partly determined by a political vision that does not recognize humanity as a priority, specific skills and knowledge were identified for fostering migrant youth resilience. Knowledge such as clear best interests of the child guidelines, and skills such as empathy, adaptation, and recognition of agency of young people enabled some workers to provide appropriate safeguarding. However, we highlight how the contextual scarcity of services overruns individual worker capacities, leading to a lack of appropriate safeguarding overall. Based on worker perspectives, we provide recommendations for appropriate policy implementation. Results are reported according to Consolidated Criteria for Reporting Qualitative Research guidelines.
Crises and complexity: how can we make health interventions succeed?
Mkrtchyan Z, Moyo Y, Bozzani F … +8 more , Ingold H, Medley G, Torres-Rueda S, Terris-Prestholt F, Guinness L, Evaluation of Social and Population Health Interventions (ESPHI) Group , Foss AM, Ruiz F
Health Policy Plan · 2025 Aug · PMID 40464651 · Full text
The end of the COVID-19 global health emergency presents an opportunity to reflect on actions needed to enhance the effectiveness of responses to any future shocks. We highlight critical areas requiring attention from re...
The end of the COVID-19 global health emergency presents an opportunity to reflect on actions needed to enhance the effectiveness of responses to any future shocks. We highlight critical areas requiring attention from researchers and research commissioners to enhance the identification and adoption of 'good value' interventions, and we discuss the complexities of evidence-informed decision-making across multiple sectors, the evolving role of modeling, and the need for improved stakeholder engagement and institutional coordination to effectively address interconnected health and policy challenges. We conclude the commentary by making a set of related recommendations to support intervention identification and implementation. Researchers, policymakers, and other key stakeholders should: renew efforts to step out of silos and to develop methods and frameworks that link and synthesize evidence from multiple sources and perspectives, to support planetary health goals and the 'One Health' concept; support more research into understanding the constraints to adopting interventions regarded as good value for money, to enhance evaluation methods ex ante and to better inform systems and stakeholders of the implementation requirements; and maintain an ongoing commitment to equitable research partnerships to ensure that evidence use is relevant for the target settings.
Determinants of distress financing for healthcare service utilization: a convergent mixed-method study at a tertiary hospital in Malaysia.
Abd Gani SM, Thangiah N, Aiga H
Health Policy Plan · 2025 Aug · PMID 40446091 · Full text
Households with ill members often face financial hardship when seeking healthcare. Households mobilize their resources from various sources to pay for treatment costs. Financially, some households resort to borrowing mon...
Households with ill members often face financial hardship when seeking healthcare. Households mobilize their resources from various sources to pay for treatment costs. Financially, some households resort to borrowing money and selling their assets. This type of financial coping strategy is called distress financing (DF). This study aims to estimate the prevalence and determinants of DF among households with hospitalized members at University Malaya Medical Centre, Malaysia. It further explores the dynamics of DF and its impact on households' welfare by employing a convergent mixed-method approach. Quantitative data were collected using a structured interview. Households having reported to either borrow money, sell their assets, and/or withdraw from an employee provident fund were categorized as those suffering DF. To explore how households coped with high medical expenses and the consequences of DF, seven households adopting more than one DF strategy were purposively selected for in-depth interview. Of 199 households, 22 (11.1%) reported undergoing DF. Psychological distress, medical indebtedness, and poverty were typical consequences of DF. During hardship, the social network played a principal role in alleviating the financial burden, further emphasizing the importance of kinship. Households undergoing catastrophic health expenditure, headed by Chinese ethnicity, living in states other than Selangor, and living in a rental house were 8.2, 4.6, 4.4, and 3.5 times more likely to undergo DF, respectively. Targeted assistance in removing financial barriers would assure the continuum of care among households possibly suffering DF, thereby improving their health outcomes.
How policy entrepreneurs solve local health problems in the global South: an exploratory study.
Mhazo AT, Maponga CC, Abimbola S
Health Policy Plan · 2025 Aug · PMID 40446089 · Full text
The presence, absence, or effectiveness of policy entrepreneurs is often invoked as an explanation for the state of health policy making, especially in the global South. However, much remains under-analyzed about their s...
The presence, absence, or effectiveness of policy entrepreneurs is often invoked as an explanation for the state of health policy making, especially in the global South. However, much remains under-analyzed about their structure and function. This qualitative study aims to understand how policy entrepreneurs influence policy change in the global South. We complemented a review of the literature (26 papers) with key informant interviews of seven policy entrepreneurs from Zimbabwe. We used an adapted framework with four elements of policy entrepreneurship to frame the analysis: displaying social acuity, defining problems, building teams, and leading by example. Our analysis showed that policy entrepreneurship exists amongst high-level elites and low-level actors. Local policy entrepreneurs tend to exhibit high levels of social acuity to define context-relevant problems and devise holistic solutions. They define situations as problems through comparison with desirable states of affairs, emphasizing the failure of current policies and interpreting data as crises. They achieve team building by constantly re-framing problems to expand policy portrayals and increase the number of people mobilized around the problem. Displaying social acuity stands out as highly consequential for policy entrepreneurship, as it helps in defining problems in a way that resonates with other actors and in mobilizing teams to take collective action. Local policy entrepreneurs lead by example as they implement and demonstrate the workability of their solutions, ultimately proving to be key actors in tackling pervasive and oft-marginalized health problems. That underscores the need to value local ideas as opposed to preference for those that are influenced by global movements. Systematic programmes-such as establishing policy institutes in the global South-should be set up to drive such processes and to, more broadly, support local policy entrepreneurship, including through the formal training of actors in policy sciences.
Can medical consortiums bridge the gap in health inequity in China? A propensity score matching analysis.
Feng C, Chen Y, Wang W … +1 more , Chen S
Health Policy Plan · 2025 Aug · PMID 40434033 · Full text
While health is a fundamental right, health inequities between urban and rural residents remain significant in China. Medical consortia aim to bridge this gap by providing equitable and affordable healthcare. However, th...
While health is a fundamental right, health inequities between urban and rural residents remain significant in China. Medical consortia aim to bridge this gap by providing equitable and affordable healthcare. However, their effectiveness in enhancing health equity remains underexplored. This study aims to explore whether medical consortia have mitigated health inequity between urban and rural residents. We employed propensity score matching to mitigate selection bias among 9918 electronic medical records. We focused on two key areas: the effectiveness of medical consortia in reducing healthcare burdens and their influence on health equity, as indicated by the disparities in medical expenses between urban and rural residents. To obtain more detailed insights, we segmented medical expenses into low, medium, and high categories for both urban and rural residents and examined how medical consortia differentially affect health equity across these segments. Moreover, we evaluated whether the differences in referral effects on medical expenses between urban and rural residents can be explained by their varying disease structures and age distributions. We found that medical consortia can significantly reduce the medical burden on populations, but have limitations in improving health equity. The findings highlight a substantial reduction in medical expenses for urban populations. However, no significant reduction was observed in rural populations, with the low-medical-expense group experiencing an increased healthcare burden following the implementation of medical consortia. These findings are robust across various matching methods. Despite reducing healthcare burdens, medical consortia have not equalized health outcomes between urban and rural residents. Significant differences in the disease and age structures exist between urban and rural residents, which may account for the differing causal effects observed between them. Policymakers must prioritize health equity in healthcare reform and consider targeted interventions to address the distinct healthcare challenges of different socioeconomic groups.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe