Policy Analysis Research Articles

Forced displacement and the healthcare workforce crisis: Venezuelan healthcare workers in Peru

Abstract Background The migration of healthcare workforces tends to be economically based benefiting high income countries, while draining lower-income countries of workers and skills. However, national instability or civil conflict may also have the effect of forcing out health workers. Few articles focus on the experiences of these types of migrants. This study aims to close a gap in the migration debate by exploring the capacity of integrating displaced healthcare workers in middle-to-low resourced health systems, using Peru as a case study. Methods The study draws on a policy analysis, statistical data and expert information from Peru. Results Peru has become the second largest Latin American destination for Venezuelan forced displaced migrants, a number of which are healthcare workers. While the exact numbers of these workers is unknown, it is estimated that 4,000 and 3,000 physicians and about 2,500 nurses and health technicians from Venezuela reside in Peru. These workers find entry into the heath system difficult due to bureaucratic and costly registration and qualification validation procedures. However, during Covid-19 the conditions were relaxed, and a large number of these workers entered the healthcare workforce. They were primarily physicians and worked in urban medical facilities, though there was some distribution across the country’s departments. This avenue to the healthcare workforce allowed the mobilisation of dormant health skills and assisted to lift density numbers. Conclusions Peru’s experiences bring into focus the potential benefits of mobilising new resources through integrating displaced healthcare worker migrants. It is too early to assess the sustainability of these policies on the country’s healthcare workforce and its Universal Health Coverage goals, yet there seem to be some positive experiences. Speakers/Panelists Tomas Zapata WHO/Europe, Copenhagen, Denmark

The politics of universal health system reform in the context of COVID-19

Abstract Background Implementing universalism is more a political than a technical project. With this in mind, Ireland devised a ten-year plan through political consensus to deliver universal healthcare - Sláintecare. The COVID-19 pandemic occurred early in its implementation. Methods This is qualitative research drawing on international literature on universal health system reform in the context of COVID-19 as well as the politics of health reform. The overall research programme is co-produced with the Irish health system. A timeline and analysis of the reform journey is drawn from documentary analysis of key policy documents, parliamentary reports and key informant interviews. Results Despite a policy commitment since 2005, universal healthcare implementation only became government policy in Ireland 2018. While whole system reform and implementation progress has been slow, the COVID-19 health system response boosted aspects of universalism and reform. All COVID-related services during the pandemic were universal, free at the point of delivery, as are most new services introduced since 2021. Despite the political consensus holding through a change government and the pandemic, and significant additional investment in the public health system, there remain many obstacles to reform. These include different stakeholder understanding of implementing universalism in Ireland especially in the context of COVID-19, how best to implement universal healthcare and the politics of delivering reform. Conclusions Contrary to other countries’ experience during COVID, Ireland pursued its policy aim of delivering universalism and expanded services provided universally, free at the point of delivery, with a focus on enhanced community care. The universalism applied to COVID-related prevention and care, new women’s health and chronic disease management services. Despite progress, government has yet to legislate for a universal entitlement to care and obstacles to reform implementation remain.

2.I. Scientific session: Addressing vaccine hesitancy: from understanding determinants to implementing targeted strategies

Abstract Supported by NextGenerationEU (no. PE00000007) and EU4Health (VAXaction), the workshop will present a pan-European perspective on vaccine hesitancy and the effectiveness of counteracting interventions, especially when facing potentially pandemic infectious threats. Analysing human responses to epidemics is crucial to improve mathematical disease modelling and develop strategies to monitor behaviours during outbreaks, including assessing levels of vaccine hesitancy. This session will explore the multifaceted issue of vaccine hesitancy, which remains a significant barrier to achieving optimal vaccination coverage and is identified as one of the top threats to global health. By integrating theoretical frameworks with practical applications, the workshop aims to present a comprehensive overview of strategies employed to mitigate hesitancy across various demographics and regions. The first presentation will cover a thorough overview of the strategies employed to counteract vaccine hesitancy, leveraging existing infrastructure, health promotion policies, and educational initiatives. It will also explore the role of digital health tools and regulatory measures, such as health passes and nudging techniques, in enhancing vaccination uptake. Furthermore, the session will cover a systematic review of immunisation information systems (IISs) and the proposal of an innovative unvaccinated registry. This part of the workshop will delve into technological advancements and the integration of behavioural insights, which are essential for enhancing vaccine coverage and informing public health strategies. Another significant aspect of the discussion will be the evolution of vaccine mandates, from their historical roots to their contemporary applications. This discussion will reflect on policy shifts necessitated by emerging public health challenges and the need for adaptable strategies that can respond effectively to fluctuating vaccine coverage and acceptance rates. Panel discussions will feature notable experts such as Prof. Carlo Signorelli, President of the Italian NITAG, and Prof. Maria Ganczak, Vice President of the EUPHA Infectious Diseases Control section. These discussions will provide a comparative analysis of vaccination policies across different European countries, highlighting diverse approaches to mandates and the implementation of public health interventions aimed at combating vaccine hesitancy. By providing a unified approach to understanding and combating vaccine hesitancy, we aim to facilitate a critical exchange of ideas and strategies among experts in the field. It will serve as a dynamic platform for discussing evidence-based interventions tailored to specific population needs, enhancing public health outcomes across Europe. This engaging session promises to offer valuable insights into the complexities of vaccine hesitancy and the collaborative efforts required to address this global health challenge effectively. Key messages • Enhanced data collection and analysis are essential to combat vaccine hesitancy, allowing for tailored interventions that address specific community needs and barriers to vaccination. • Effective strategies against vaccine hesitancy require historical understanding and flexibility to adapt to new challenges, ensuring public health policies are responsive and culturally sensitive.

About the need for a Swiss digital health ‘Sistine Chapel’ – lessons from 25 years of health policy

Abstract Background The Swiss government’s ‘DigiSanté’ program 2025-2034 aims to address Switzerland’s delay in digitising its healthcare system. Public and professionals’ trust is central for the implementation of digital health initiatives and partially based on past experiences with the digital health system. To inform DigiSanté, it is crucial to analyse the evolution of the socio-political discourse surrounding health data sharing in Switzerland in the past 25 years to identify the main obstacles encountered and lessons learned during this period. Methods We designed a multi-method study comprising a policy analysis of 65 Swiss policies on health data sharing from 1998 to 2023; scoping review of 250 editorials; sentiment analysis of 400 news articles from six major Swiss newspapers; and thematic analysis of transcripts from 11 online interviews with key stakeholders. Results We identified 32 key policy milestones in Swiss health data sharing, with the COVID-19 pandemic emerging as a trigger for present policymakers’ awareness of health data’s potential and the need for healthcare system digitization. The troubled implementation of the Electronic Patient Dossier (EPD) and its negative narrative are identified as more central in eroding long-term public trust than scandals. Primary obstacles to implementation of the EPD include misaligned stakeholders’ interests, slow policy processes, lack of professional support, low public awareness, and technical interoperability issues. Future strategies involve increasing actors’ involvement to establish a common vision and strategy and improving public communication. Conclusions The present socio-political discourse on health data sharing in Switzerland is shaped by past negative experiences with the EPD, compounded by additional scandals. To cultivate public trust, stakeholders should collaborate to align interests and ensure all parties work cooperatively toward common goals. Key messages • National and international scandals marginally affect public trust compared to the impact of the negative narrative surrounding the slow EPD implementation. • Misalignment of stakeholder interests is the main barrier to implementing health data sharing initiatives, causing delays and trust erosion.

An overview and comparison of approaches used for health policy analysis: What to use and when?

Abstract Background Public health challenges are complex and analyzing them requires advanced approaches such as, societal cost-benefit analysis (SCBA), health impact assessment (HIA), and strategic foresight. Analyzing health policy is a multifaceted process, and depends on, among others, the scope, approach, and policy goals. Given this complex and multifaceted nature, it is not always clear which approach to use, and how the approaches can complement each other. Therefore, health policy analysis could benefit from practical and explicit guidance regarding clear identification of cases and types of analysis. Hence in this paper we aim to develop a framework that can provide this guidance. Methods In this paper we describe the differences and similarities of three distinct health policy assessment approaches, SCBA (an economic evaluation approach that takes into account the impact on society as a whole), HIA (is a combination of tools that focus on evaluating the potential health effects of a given policy) and strategic foresight (a systematic and participatory approach used to anticipate and plan for future trends and uncertainties that may impact policy), their application, and how they can complement each other within the field of public health. A framework that can be used when deciding which health policy approach to use for a given case will be developed, based on existing literature, frameworks, and a case study. Discussion This paper contributes to knowledge on health policy analysis and towards efficiency and clarity in analyses conducted in this field. Key messages • There is little guidance regarding how to conduct health policy analysis. • Clear guidance on which approaches to use and how they complement each other will contribute towards efficiency and clarity in health policy analysis.

The lived experiences of the welfare state of platform workers: The barriers to accessing social protection in Italy, Sweden and the United Kingdom

AbstractThe recent literature on platform work and the welfare state has stressed that, despite being affected by high‐income insecurity, platform workers cannot easily access social protection. However, it is unclear why platform workers encounter such barriers. This article offers an inductive and empirically based theoretical framework to investigate the obstacles faced by platform workers. It shows that the barriers experienced by platform workers depend on the eligibility criteria, the assessment criteria and the trade‐off between taxation and social protection. The article substantiates these claims by offering both a policy analysis of formal arrangements and a qualitative analysis of the lived experiences of welfare of 101 platform workers in Italy, Sweden and the UK during COVID‐19. The research found that, while many platform workers attempted to access social protection during COVID‐19, platform workers' access to social protection was affected by their positionality as outsiders, which clashes with the eligibility criteria (in Sweden and Italy); by the irregular nature of platform work, which contrasts with the rigidity of the assessment criteria (in the UK, Italy and Sweden); and by the implicit trade‐off experienced by platform workers between minimising taxation and accessing to social protection (in the UK and Italy).

Evaluation of Managerial Economics Applications Strategy using the SPSS Method

Managerial Economics is an economy branch is, this economic theory and size using methods solve real-world managerial problems. It helps businesses and organizations make informed decisions by using economic analysis. Here are some common applications of managerial economics: Demand Analysis and Forecasting: Businesses use managerial economics to understand consumer behavior and forecast future demand for their products or services. This involves studying factors that affect demand, such as price, income levels, and consumer preferences. Production and Cost Analysis: Managerial economics helps businesses optimize production processes and minimize costs. It involves analyzing production functions, cost structures, and economies of scale to determine the most efficient way to produce goods or services. Pricing Strategies: A product or the right price for the service It is up to a company to decide Crucial to profitability. Managerial economics helps businesses set prices by considering factors like production costs, competition, and consumer willingness to pay. Market Structure Analysis: Understanding the type of market, a company operates in (e.g., perfect competition, monopoly, oligopoly) is essential for making strategic decisions. Managerial economics helps analyses market structures and determine appropriate strategies for each. Risk and Uncertainty Analysis: Businesses often face uncertainty in various aspects, such as demand fluctuations, production costs, and market conditions. Managerial economics provides tools to assess and manage risks, including techniques like decision tree analysis and expected value calculations. Capital Budgeting and Investment Analysis: Managerial economics assists in evaluating investment opportunities and capital projects. It involves methods Payback period analysis of investments. Regulatory and Government Policy Analysis: Managerial economics helps businesses understand and navigate government regulations and policies that affect their operations. This can include areas like taxation, environmental regulations, and trade policies. Strategic Planning: Using economic analysis, businesses can develop long-term strategies for growth and sustainability. This may involve assessing market trends, competitive dynamics, and potential expansion opportunities. Game Theory and Competitive Strategy: Managerial economics incorporates game theory to analyze strategic interactions between competitors. It helps businesses formulate optimal strategies in competitive environments. Resource Allocation: Efficient allocation of resources, including labor, capital, and technology, is crucial for a company's success. Managerial economics provides tools to distribute funds in a manner that optimisesoverall productivity and profitability. Demand Analysis and Forecasting, Production and Cost Analysis, Pricing Strategies, Market Structure Analysis, Risk and Uncertainty Analysis, Capital Budgeting and Investment Analysis and Regulatory and Government Policy Analysis. The Cranach’s Alpha Reliability result. The overall Cranach’s Alpha value for the model is .744 which indicates 74% reliability. From the literature review, the above 50% Cranach’s Alpha value model can be considered for analysis.

Climate change policing: Integrating environment-sensitive approaches in Nigerian security operations

Climate change has shifted from being solely a severe environmental challenge to becoming a critical threat to global security. Despite efforts to securitise climate change through speeches, policies, research, media and advocacy by various organisations, the specific roles of security agencies, especially in developing countries dealing with insurgencies, remain undefined. This study emphasises that an effective securitisation process must outline clear roles for security agencies, beginning with the creation of an environment friendly operational plan. In Nigeria, non-state violent groups use natural environments like forests and water bodies as hideouts, leading security forces to turn these areas into battlegrounds without environmental assessments or post-conflict remediation plans. This study investigates how eco-friendly practices are integrated into Nigerian security operations. Through 30 interviews and a critical analysis of climate-related policies, it was found that climate policies are not incorporated into security operations. This is evident in the criminalisation of forests, unsustainable disposal of crude oil and drugs, and correctional processes that ignore climate sensitivity. The study concludes that Nigerian security operations need a paradigm shift towards integrating climate-sensitive approaches, recommending that security agencies adopt practices that consider ecological impacts.

Guns better than education: political economy of defence, radical education policies, textbooks, and teachers’ outlook in Pakistan

ABSTRACT The proliferation of religious radicalism within Pakistani education has sparked increasing concern, with significant implications both locally and globally. Current scholarship has primarily focused on education policies and textbooks, often overlooking the complex entanglement between the political economy of defence, the influence of military and economic elites, and the particularisation of radical national and religious narratives. This article uses qualitative methods and purposive sampling to explore how these intertwined forces have radicalised education policies and school textbooks. The research reveals a deep historical nexus between the military apparatus, religious groups, and the state’s educational agenda, fuelling radical ideologies among public schools and madrassah (religious school) teachers. The article elucidates how these power structures have shaped educational discourse in Pakistan by examining this entanglement through the lens of Foucauldian governmentality. The findings underscore the critical societal implications of understanding these dynamics, particularly given teachers’ significant role in shaping students’ worldviews. This study offers valuable insights for international policy analysts, educators, and scholars concerned with the intersection of defence, politics, and education.

Comparative Educational Pluralism: A Framework for Comparative Policy Analysis

ABSTRACT In the face of ideologically driven inquiry and advocacy, debates about school choice and public-private-partnerships in education have produced more “light than heat.” Although scholars have recently emphasized the need for a greater focus on the particulars of policy design, limitations of existing frameworks have inhibited rigorous policy research capable of enhancing understanding of the effects of different policy designs, particularly when considering cross-national and comparative experiences. This article critically analyzes a set of prominent frameworks from the field before proposing a new Framework for Comparative Educational Pluralism that could inform a more design-sensitive and evidence-rooted approach to policy analysis and design pertaining to the role of non-state actors in education systems.

Analysis of contemporary climate adaptation policies in Ireland and their application to the coastal zone

Global climate change presents a range of impacts on Ireland's economy and society with particular challenges facing coastal areas. The need to adapt to these risks is considered both urgent and essential and the policy framework has evolved to meet these challenges with the adoption of climate action legislation and a National Adaptation Framework (NAF) to facilitate the transition to a climate-resilient economy and society by 2050. This paper briefly reviews the European and Irish government policy context for sectoral climate adaptation before reviewing and classifying the sectoral policy measures introduced to reduce vulnerabilities to climate change impacts. While the analysis reveals that progress has been made by adopting climate action legislation and by developing a suite of climate action focussed plans, it also demonstrates that the policy measures included in the Sectoral Adaptation Plans to reduce climate change vulnerabilities are limited in number and lacking in effectiveness. Furthermore, their application to cross-cutting themes, exemplified by the coast, is inadequate to deal with the practical climate change issues. These findings indicate that Ireland is at a preliminary stage when assessed according to the EU adaptation preparedness scorecard.

Assessing the initial impact of the Russian invasion on Ukrainian agriculture: Challenges, policy responses, and future prospects

The war in Ukraine has caused significant losses to the Ukrainian agricultural sector and threatened global food security. This study aims to comprehensively analyse the impact of the Russian invasion on Ukrainian agriculture in its initial phase, examine the responses of Ukrainian agricultural policy and outline key elements for the post-war development of the Ukrainian agricultural sector. Using a systematic approach that includes thorough data collection and analysis from official sources, the Ukrainian press, relevant legislation and statistical data, our study focuses on the first five months of the conflict, from February 24, 2022 to July 24, 2022, to identify the main challenges during this period. The agricultural policy analysis shows that the Ukrainian government has adopted a reactive approach, including tax simplification, affordable credit, deregulation, financial support for the agricultural sector, reduced prices for inputs and resources to support farmers, and improvements in logistics. Critical factors identified for post-war development include repatriation and agricultural education, support for small and medium-sized farms, integration into global markets, emphasis on organic practices and sustainable development, and digitalization in agriculture. The integration of a systematic overview of the Ukrainian agricultural sector and an analysis of key elements of post-war development provides essential insights for policy-makers and researchers concerned with the impact of war on the agricultural sector and food security.

An ideology of deserving: A historical analysis of the United States' immigration policies governing forced migration and social welfare

AbstractLegislation governs both the admittance and treatment of forced migrants in the United States. Increasingly, many forced migrants are offered few welfare benefits, temporary protection, and no pathway to permanent residency. This paper explores forced migrants' legal categories and access to social welfare, focusing on five humanitarian protection statuses: Temporary Protected Status, Humanitarian Parole, Asylum Seeker, Refugee, and Asylee. Based on the concepts of welfare nationalism and the Protestant Work Ethic, our historical analysis examines the Welfare Reform Act of 1996 to see how this landmark legislation shaped access to welfare for noncitizens. We then focus on the emergence of humanitarian statuses since the 1950s and the legislation that constructed them. We conclude that immigration legislation governing forced migrants underlies an ideology of deserving, where some are treated as more meritorious than others. Thus, we call for welfare scholars to elevate immigration status as a key category in their research.

Organizational Strategies for Providing Foreign Language Education Services to Adults Over 45: International Practices and Approaches

Organizing educational services for people over the age of 45 is essential for their personal development, economic participation, social inclusion, and mental well-being. International and local legislation supports these initiatives, aiming to provide equitable and inclusive educational opportunities for all ages and to use the benefits of these people being fruitfully involved in the economic and social life of a country. The article aims to examine the strategies for providing educational services to adult learners (citizens over the age of 45) in different countries (European countries, the USA, Australia, China, Ukraine, Brazil, and Japan), with a focus on whether this process is integrated into social services and formal and informal education systems within the framework of the concept of lifelong learning. The methods included literature review on databases such as Google Scholar, JSTOR, and ERIC; comparative analysis of educational policy documents; case studies and reports from different nations; meta-analysis; field observations; and others typical to the field of comparative education and general education. They were utilized to provide a comprehensive and well-rounded analysis of how different countries organize and implement foreign language education services for adults over the age of 45. The findings reveal that the approaches to providing foreign language education for adults over 45 varies widely across different countries, reflecting each nation's unique historical traditions, cultural values, and current societal needs. This diversity in practice can be categorized into four main groups: services provided by social services; formal education systems; informal education systems; and self-organized services to present the prevailing approach to providing foreign language education for individuals over 45 in each country. The study concludes that the provision of foreign language learning services for individuals over 45 varies significantly across countries, reflecting diverse historical traditions, cultural attitudes, and current needs. Whether through social services, formal education systems, informal educational channels, or self-organization, each country’s approach highlights the importance of adapting educational services to meet the needs of an adult population seeking continued personal and professional growth.

Analysis Of The Role Of Local Governments In Sustainable Development In Urban Areas

This study aims to analyze the role of local governments in the implementation of sustainable development policies in urban areas. Using a qualitative approach through case study methods, data were collected via in-depth interviews with local government officials, focus group discussions with community members, and analysis of policy documents and local development reports. The findings indicate that local governments play a vital role in creating positive impacts on the environment and the quality of life for residents through various implemented programs, such as integrated waste management systems, the development of green open spaces, and sustainable transportation policies. Despite significant progress, this research also identifies challenges faced by local governments, including funding limitations, a lack of community education, and the need for improved inter-agency coordination. To enhance their effectiveness in achieving sustainable development goals, local governments must address these challenges through increased budget allocations, educational campaigns to raise community awareness, and strengthened collaboration among agencies. By taking these steps, local governments can be more effective in realizing sustainable development and ensuring a better quality of life for urban residents. This research provides important insights for policymakers and practitioners in their efforts to create sustainable and responsive urban communities.

Comparative policy analysis in airport security through the lenses of the multiple-streams framework

Comparative policy analysis in airport security through the lenses of the multiple-streams framework

Uncertainty in dynamic econometric input-output models: a Norwegian case study

Input-output models used for macroeconomic impact and policy analysis are often characterised by large data sets and resource-heavy computing. However, the types of results they provide are sensitive to uncertainty in their core assumptions. Various approaches have been proposed to account for the uncertainty in one or more parts of the analysis assumptions. Although it is standard practice to include varied cases in policy analysis, the notion of stochasticity of parameters across periods of time is less widespread. Costly numerical computing and difficulty in interpreting the results complicate this approach. In this work, we adapt an environmentally-extended dynamic econometric input-output model to account for uncertainty of various kinds. We demonstrate the methodology in the case of building renovation. The results provide insight into situations where explicitly considering uncertainty as part of the analysis is useful, as well as others in which no additional information was gained from such treatment.

Representing children and youth in global migration governance: mobilization, corporatist representation and partnerships

ABSTRACT While children and youth undeniably have a stake in and are affected by global migration governance, they have only recently gained recognition as a constituency in global multi-stakeholder dialogues around migration. In this article, we examine the ways in which the mobilization of young people has created new pathways for child and youth representation in the global governance of migration. Based on the analysis of policy documents, interviews and participant observations from the 13th Global Forum on Migration and Development (GFMD) in 2021, we demonstrate how children and youth as a stakeholder group have established new processes to identify policy priorities, select representatives and build partnerships to offer solutions to pressing migration challenges. Although institutional trajectories limit the kinds of representation that become possible, the mobilization of young people has resulted in a tangible strengthening of their access, space and strategic position to represent themselves in global migration governance.

Public-private partnerships in the agricultural sector

The levels of management in the field of agriculture were systematized, a comparative ana­lysis of the international experience of management in the agrarian sphere was carried out (on the example of Germany and Italy). The current trends in digitalization of agricultural management in the world, as well as tasks and challenges of digitalization in Ukraine were described. The hypothesis of the research is that the implementation of digital solutions in the Ukrainian agricultural sector will increase the efficiency of management, especially in the condi­tions of military challenges. Methodo­logically, the research is based on the analysis of policies, strategic plans, scientific works and other sources related to management in the field of agriculture, taking into account the impact of digital techno­logies. The centralized manage­ment model in the development of the agricul­tural sector still dominates in European coun­tries. However, the EU current policy in the field of regional development provides for the transfer of as many management functions as possible to the region­nal level. This approach is also characteristic of the national model of agricultural development policy. The most important and effective tool for the modernization of any of the known management systems in the modern world is their digitali­zation. Digitization of management in the agricu­ltural industry at all levels, from the state to small agribusiness entities, is no exception. The further digital transformation of manage­ment in national agriculture represents a higher level of digital integration, which affects the most complex organi­zational changes in the structures of state admi­nistration and agribusi­ness. The results of the implementation of these tasks can significantly affect the growth of profits in the agricultural business and the competitiveness of products, which will allow the agricultural industry to reach modern global technological boundaries

Policies and practices impacting the implementation of nature-based solutions: a comparative study of ponds and pondscapes in eight countries

Nature-based solutions (NBS) are increasingly suggested to address biodiversity decline and climate change. However, many ecosystems are hardly used as NBS, including ponds and pondscapes. We therefore examine how policies and practices affect their implementation as NBS. Using a content analysis of policy documents and stakeholder inputs, we assess the policy context in eight countries but also zoom in on policies and practices in seventeen pondscapes. We derive three key insights: first, a protective status for a pond or pondscape interlinks with other enabling factors for NBS implementation, and protection and conservation should therefore be considered more often as NBS. Second, there is a shortage of, especially long-term, financing. Third, local leadership should be nurtured to overcome a lack of institutional cooperation and stakeholder awareness as well as fragmented land ownership. Beyond that, we show that implementation barriers interlink and interventions should therefore address several barriers simultaneously.