Global Health Policy Research Articles

Measuring influencing factors affecting mortality rates during the COVID-19 pandemic

ABSTRACT Background The COVID-19 pandemic has revealed clear deficiencies in global public health policies and healthcare systems when confronted with the emergence of a novel and deadly infectious disease. Objectives With 4 years elapsed since the onset of the pandemic, ample data now exist to analyse the associations between the implementation of diverse public health policies, sociodemographic factors and COVID-19 mortality rates. Methods This study utilised the dataset compiled by ‘Our World in Data’ spanning the period of the COVID-19 pandemic from 2020 to 2022. Stochastic frontier analysis was employed to assess the influencing factors and their relationship with mortality rates resulting from COVID-19 infections across 156 countries or regions. Results This study yielded several key findings: (1) There remains a 33% margin for improvement in the global mortality rate concerning the COVID-19 pandemic; (2) During the initial stage of the pandemic, when an effective vaccine was not yet available, implementing public health control policies could reduce both the infection and mortality rates; (3) Areas characterised by higher population densities, a greater proportion of individuals aged 65 and over, and elevated prevalence rates of diabetes demonstrated higher mortality rates; and (4) Increasing vaccination coverage emerged as an effective strategy for reducing mortality rates. Conclusions As our understanding of the COVID-19 virus improves, global economies and social interactions have gradually returned to normality. It is anticipated that the findings of this study can serve as a valuable reference in combating potential future pandemics caused by unknown viruses.

The Rise of Global Health Emergency Governance

AbstractIn this paper I shed new light on contemporary developments in global health governance, policymaking, and knowledge production. Specifically, by investigating the historical roots and emergence of global health emergency governance. Drawing on the Foucauldian notion of “problematisation” and on Science and Technology Studies of disaster, I trace, examine, and elucidate three main axes through which, I argue, health emergencies became a problem of global governance. I show, first, the formation of emergency management as a distinct professional field. Second, the migration of emergency management into global health governance and its proliferation within it. And third, the move from global health emergency management to the global governance of health emergencies. Overall, I suggest the rise of global health emergency governance provides crucial context for understanding social, political, and epistemic tensions and controversies in health emergencies such as COVID-19. Through the analysis, I identify a particular rationale that is rooted in emergency management and had become embedded in global health emergency governance. A rationale that involves “temporal compression” and “structural plasticity.” I discuss possible implications of this rationale for global health governance, policy, and knowledge.

Contradictions and possibilities for change: Exploring stakeholder perspectives of Canada's Feminist International Assistance Policy (FIAP) and their connection to a future for global health.

Increasing global inequities have led to ongoing critiques of both the historical roots and current practices in global health. From this literature, questions have emerged about the future of global health and Canada's role in this future. However, there is little research exploring the role of Canadian policy for global health funding and the experience of stakeholders that currently implement projects with Canadian funding. This study explores stakeholder perspectives of how Canada's Feminist International Assistance Policy (FIAP) influences adolescent sexual and reproductive health (ASRH) projects and how these perspectives align with calls for change in global health as proposed by Chidwick et al. in the conceptual framework for an imagined future for global health. This study was conducted from February to May 2023 through eight interviews with key informants who were working on ASRH projects, funded through Global Affairs Canada. The study approach included stakeholder analysis and qualitative description. Results highlight the role of Canadian organizations in ASRH projects, importance of partnerships, influence of the FIAP, operational and contextual tensions that arise from implementing FIAP values in ASRH projects outside of Canada, along with stakeholder views on moving forward in global health policy and practice. Findings indicate that the language of the FIAP is aligned with calls for change in global health although there is opportunity for further action towards operationalizing this change. Specifically, findings highlight opportunity to create more flexible funding processes, expand monitoring and evaluation approaches to better include feminist approaches, promote rights-based and dignity-based practices in ASRH, and increase timelines to facilitate greater consultation and partnership building with communities. In conclusion, the FIAP creates an impactful foundation for change towards equity and justice in ASRH projects, although Canadian funding structures and processes need to continue to re-imagine how they support organizations to action these changes.

Gene-Based Targeting for Treatment of Hypercholesterolemia and Prevention of Atherosclerotic Cardiovascular Disease

Familial hypercholesterolemia, characterized by high levels of LDL cholesterol is a monogenic metabolic disorder linked to atherosclerotic cardiovascular disease. Several genetic mutations in genes such as LDLR and PSK9 are thought to cause familial hypercholesterolemia. This ultimately causes dysfunction of the LDLR pathway, increasing circulating LDL levels. Current treatment revolves around decreasing LDL cholesterol levels in the blood. Statins are the current gold standard while sterol absorption inhibitors (ezetimibe) and PCSK9 inhibitors (evolocumab) are either used as primary treatment in individuals with statin intolerance, or supplementary treatment otherwise. However, CRISPR-Cas9 offers an upstream therapeutic intervention, inducing mutations in pathogenic genes (such as LDLR) to upregulate or downregulate gene expression and subsequently reduce LDL cholesterol levels. This technology thus has great potential as a two-fold treatment option, offering an effective solution for familial hypercholesterolemia, while simultaneously diminishing the risk of atherosclerotic cardiovascular disease. A limitation to current research exists in the sole analysis of monogenic factors in genetic screening, thus polygenic, multifactorial analyses are required to assess more holistic treatment plans. Furthermore, there exist current limitations to CRISPR-Cas9 including ethical limitations and social considerations revolving around the perpetuation of social inequities through technology necessitating future research on global health policies.

World Health Organization Guidance on Health Practitioner Regulation: An Overview

ABSTRACT: The World Health Organization has released its first comprehensive Guidance document on health practitioner regulation, addressing a critical gap in global health policy. This Commentary provides an overview of the Guidance, which aims to support countries in strengthening their regulatory systems for health practitioners. The Guidance, developed through a rigorous process involving a literature review and expert consultation, covers a broad range of health practitioners and focuses on optimizing their utilization to meet population health needs. Key highlights include the description of the global regulatory landscape, identification of regulatory challenges in all societies, and policy considerations to realize dynamic, effective, and agile regulation. The COVID-19 pandemic is cited as an important example of a catalyst for regulatory reforms that enhanced workforce availability and access. This paper, co-authored by members of the World Health Organization Technical Expert Group, emphasizes the importance of aligning regulatory systems with broader health workforce and system priorities, adopting a risk-based approach, and addressing implementation gaps. It encourages policymakers, regulators, and researchers to use the Guidance to assess and update their regulatory systems and to generate more robust evidence on the impact of health practitioner regulation on health outcomes.

2.C. Round table: A Pandemic Treaty to deliver global health equity: negotiating under a ticking clock

Abstract Access to medical countermeasures (vaccines, therapeutics, diagnostics), fair resource allocation and a global health framework to counter future pandemics are to be provided for by the Pandemic Treaty, intensely debated in the Intergovernmental Negotiating Body (INB) over the past two years. The final negotiations round began under tremendous pressure (Apr 29, 2024), with dissonance on structural treaty elements and a ticking clock to finalise the text at the World Health Assembly (end of May 2024). At a time of shifting geopolitical powers, in a year of elections across the world, war in Europe and rising defence expenditure, countries are reluctant to commit; the draft postpones key decisions, proposing to establish two intergovernmental working groups for instruments on One Health and prevention, and on a Pathogen Access and Benefits (PABS), with technology transfer and capacity-building remain largely unaddressed, despite COVID-19 lessons. With EU and G7 countries holding to their positions on surveillance, financing, and intellectual property (IP), negotiations will continue. A more critical question remains: will the Treaty’s be adequate and timely enough to meet the challenges of inevitable future pandemics? Will it deliver the global framework of its foundational purpose of equity and justice? This RT aims to inform and involve the European public health community, continuing the series of activities embarked upon at the beginning of the pandemic, empowering its members for evidence-informed advocacy and concerted action. Following a brief presentation on the Treaty’s key provisions, each panel member will deliver a brief (2-3 min) intervention based on core expertise, with two rounds of panel questions/statements to follow, and with an interactive element to prioritise and submit questions. The first elaborating on the current provisions, linking them to the key expertise of panel members, i.e., international and EU law, public health law, One Health and infectious disease control, global health policies, technology transfer, fair pricing and access to countermeasures. The second examining what can be achieved via evidence-informed advocacy, and with a special focus on the role of the European public health community. Has it been well represented so far in negotiations? Should it be more involved? Is it well equipped to provide expert advice to Europe’s policymakers? Is there complementarity in relation to Europe’s Global Health Strategy (GHS) and national global health plans? Finally, the role of WHO will be briefly debated. How can sovereignty be safeguarded without compromising implementation? What is the role of transparency and sound governance to remain in line with national and EU laws and priorities? The last five minutes of this RT will be used to consolidate messages and share plans to inform future formal EUPHA positioning in negotiations. Key messages • Pandemic accord deliberation has have taken place under extreme urgency and geopolitical pressure. The European public health community must be informed and engaged for EU and country-level advocacy. • At a time of permacrisis, the adoption of a global framework for fair resouce allocation, access to medical countermeasures,and to strengthen health systems for future pandemics is urgently needed. Speakers/Panelists Sujitha Subramanian University of Liverpool, Liverpool, UK Dimitra Lingri European Healthcare Fraud and Corruption Network, Brussels, Belgium Debjani Muller HTAi, Edmonton, Canada Ricardo Mexia National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal Bettina Borisch WFPHA, Geneva, Switzerland

Global health

Abstract Global health emphasizes the importance of addressing health challenges that transcend national borders and require strong international collaboration and governance. This concept is grounded in collaborative transnational actions aimed at promoting health for all, reducing disparities, and protecting against threats. Strengthening health systems, public health infrastructure, improving health service delivery, and ensuring equal access to healthcare for all are key focus areas in global health. This plenary will address several major health challenges and critical issues, such as the rising burden of non-communicable diseases, re-emerging pandemics, environmental threats, and the suboptimal responses of national healthcare systems to manage these challenges. The need to focus on vulnerable and marginalized populations, particularly those affected by migration and ethnicity, will be highlighted. The discussion will also showcase the importance of including ethnic minority and Indigenous people’s perspectives in health policy and decision-making processes, as well as addressing the social determinants of health that disproportionately affect these communities. Central to the discussion on global health is the role of global health policy and diplomacy, focusing on how countries can collaborate to address health threats and challenges, shaping international strategies and frameworks. Innovation, including reverse innovation and the development of evidence-informed policies and effective public health strategies that can be implemented globally and is relevant also in resource-constrained contexts, is another critical aspect in addressing the intersection of health and development. Finally, strong public health leadership is needed to shape practices and policies, as well as fostering the next generation of global health leaders. The multifaceted nature of global health calls for a comprehensive approach to health—one that integrates policy, leadership, and equity into the core of public health strategies. The integration of health into all policies at the global level is vital for creating supportive environments, policies, services, and communications that promote better health for all. Moderators Iveta Nagyova President EUPHA Henrique Barros President ASPHER Speakers/Panellists Emma Rawson Te Patu President World Federation of Public Health Associations Charles Agyemang Professor of Global Migration, Ethnicity & Health, University of Amsterdam, Netherlands Agnès Buzyn Former Minister of Health and Social Affairs, France Moredreck Chibi Public Health Innovation Lead, WHO Regional Office for Europe

Eradicating Poverty and Unshackling from Illness Expense: The Impact of Targeted Poverty Alleviation Policy on Medical Burden

Health poverty alleviation is a crucial aspect of targeted poverty alleviation policy, with easing the medical burden being its primary goal. This study evaluates China's targeted poverty alleviation policy's impact on reducing the medical burden of impoverished households, using data from the China Health and Retirement Longitudinal Survey (CHARLS) for the years 2011, 2013, 2015, and 2018. Employing Difference-in-Differences (DID) methodology, this paper finds significant reductions in both the out-of-pocket to income ratio and catastrophic medical expenditure among targeted households. The policy's success is attributed to the "income effect", raising household income levels, and the "safety-net effect" increasing the reimbursement ratio for inpatient expenses. These results are valid across several robustness tests including propensity score matching (PSM-DID) and placebo test. The findings have implications for global health policy, suggesting that targeted poverty alleviation interventions can effectively alleviate medical burden and prevent poverty due to health expenses, offering a viable model for other developing countries facing similar challenges.

Spatial variations in health service utilization among migrant population: a perspective on health equity.

As health equity becomes a prioritized goal in global health policy, extensive research has revealed that socio-economic and geographical factors jointly exacerbate barriers to medical service access for both internal and international migrant populations, further accelerating existing health disparities. This study explores healthcare service utilization disparities among internal migrants in China, a population profoundly affected by the country's economic reforms and urbanization since the late 1970s. These transformations have led to significant migratory movements and subsequent healthcare challenges for these populations. Leveraging data from the 2017 China Migrant Dynamic Survey, comprising 169,989 samples across 28 provinces, we introduce a novel metric-the "No Treatment ratio" (NT-ratio). This ratio quantifies the proportion of migrants who, after falling ill, choose not to seek treatment relative to the total migrant population in a given province or region, serving as a critical measure of health risk. Building upon Anderson's Behavioral Model of Health Services Use, we adapted the model to better reflect the unique circumstances of migrant populations. The study employs spatial autocorrelation, hotspot analysis, and geodetector techniques to dissect the multifaceted factors influencing healthcare disparities. Our Findings reveal that the NT-ratio is significantly higher in eastern and northeastern China. Key factors influencing the NT-ratio include age, left-behind experiences, health education, and per capita medical resources. In response to these disparities, we recommend optimizing the distribution of medical resource, strengthening tiered diagnosis and treatment systems, and integrating health, education, and social security resources. These measures aim to improve healthcare utilization among migrant populations and reduce health inequities, aligning with global health objectives.

“It became a cycle I was not able to break” towards menstrual justice: addressing human rights violation at Indian workplaces

Purpose This paper aims to advance the concept of “menstrual justice” by building on the comprehensive framework developed by Margaret E. Johnson (2019), which integrates legal rights, social justice and intersectional analysis. By applying Johnson’s insights and human rights frameworks to menstrual health management, the study advocates for state interventions to safeguard women labourers from exploitative practices that endanger their reproductive health and to uphold their menstrual rights. Design/methodology/approach A case study methodology is used to scrutinize menstrual injustices experienced by women labourers in precarious employment conditions. Specifically, it examines two cases, the mass hysterectomies in Beed, Maharashtra and the administration of unidentified pharmaceuticals to women in Tamil Nadu factories to mitigate menstrual pain and maximize productivity. Findings The findings reveal severe violations pertaining to menstrual justice, with practices deeply rooted in socioeconomic deprivation and systemic neglect. These issues subject female workers to various forms of gender-based violence that goes beyond physical abuse, raising critical concerns about menstrual justice and human rights violations. Research limitations/implications The study’s findings have limited generalizability due to the specific contexts of the case study. Furthermore, the absence of insights from managers/supervisors, and factory owners limits a comprehensive understanding of the policies and factors leading to neglect of menstrual management practices. Practical implications The findings of the study will prompt the medical industry to initiate research into medications that can effectively alleviate period pain while minimizing harmful side effects. Current treatments often come with significant drawbacks, highlighting the need for safer and more effective alternatives. Addressing this research gap is vital for achieving menstrual equity, as it ensures that individuals suffering from menstrual pain have access to relief that does not jeopardize their overall health. Advancing research in this area will not only enhance the quality of life for menstruators but also contribute to a more equitable and inclusive approach to menstrual health care. Social implications The findings support reframing menstrual friendly labour policies including comprehensive sexual and reproductive health information to everyone, regardless of gender, to reduce misinformation and stigma associated with menstruation at workplaces. Additionally, the study proposes the introduction of reusable menstrual products like menstrual cups to overcome period poverty. Thus, ensuring access to these resources is crucial for enabling informed decision-making, promoting gender equality, addressing health disparities and fostering the development of menstrual-friendly workplace policies. Originality/value This study, by using a case study-based approach, has thoroughly examined the issues and challenges faced by female labourers in fields and factories. It uniquely identifies the inadequacies in menstrual management provisions for female workers in India and advocates for a human rights-based approach to ensure that menstruators can manage their menstrual health safely. Unlike most existing studies, which primarily focus on product usage and the stigma or myths surrounding menstruation, this study advances menstrual justice by calling for labour policy reforms and medical research to lessen menstrual pain without compromising menstruators’ health. These reforms aim to provide working women with adequate rest and necessary provisions during menstruation. Addressing these gaps is essential and has been largely overlooked in global health policies.

Contested quantification for planetary health – A sociotechnical analysis of Bangladesh's water salinity monitoring infrastructure

In climate change and planetary health, the datafication of natural processes and their effects on human health is gaining importance, not least due to data's role in international funding mechanisms. In Bangladesh, water salinity has become the focus of much research and could emerge as an asset to access climate funding. Taking Bangladesh's water salinity monitoring infrastructure as a case study, this paper problematizes the “neutrality” of water salinity data. Adopting the methodological approach of an “infrastructural inversion”, we foreground the relational nature of data production. The study draws on ethnographic fieldwork in Bangladesh along the data production chain. We highlight how the involvement of a large variety of actors gave rise to vastly different data infrastructures and explicate the influence of actors' “problematization”. We further illustrate the importance of pre-existing materiality for the implementation of data collection systems on the ground and their power to influence whose reality is represented and whose is left out. Discussing these findings in the context of the international development sector reveals the complex interplay between the dual function of data as a mediator of knowledge and proof of legitimacy. Attention is paid to the tendencies of perpetuating patterns of exclusion and inclusion through data in a setting of project-based funding. We thereby provide global health researchers, policy makers and development practitioners with a detailed case study whilst stimulating reflection on the hegemony of datafication.

Analysis of Public Health Care Safeguard Measures in India

Public health is a branch of science that focuses on preventing disease and injuries in large populations by doing research, educating the public, and creating policies that promote health in all communities. Each person may define public health in a different way. In order to address global health issues, address community-wide health issues, and influence global health policies at both local and global levels, public health is a field of study that encompasses a variety of academic fields, including basic science, commerce, the arts, education, technology, engineering, computer science, pharmacy, and bioscience. Excluding the effects of non-intellectual property barriers like distribution, infrastructure, quality, and medical facilities, the goal of this study is to examine the public health barriers to intellectual property that affect medical access. This study aims to investigate how patent law protects drug accessibility while taking drug prices into consideration.

Health worker protests and the COVID-19 pandemic: an interrupted time-series analysis.

To assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on protests by health workers. We conducted an interrupted time series analysis of data from 159 countries for 2years before and after the World Health Organization classified COVID-19 as a pandemic in March 2020, thus between 2018 and 2022. We produced models examining two main outcomes: (i)the total weekly number of health worker protests globally; and (ii)the number of countries with one or more health worker protests in a given week. In total, there were 18 322 health worker protests in 133 countries between 2018 and 2022. The number of weekly health worker protests globally increased by 47% (30.1/63.5), an increase of 30.1 protests per week (95% confidence interval, CI: 11.7-48.6) at the onset of the COVID-19 pandemic. Furthermore, the number of countries experiencing such protests in a given week increased by 24% (5.7/24.1) following the declaration of the pandemic (an increase of 5.7 countries; 95% CI: 3.5-7.8). The pandemic increased the overall level of health worker protests globally as well as the number of countries experiencing such protests. These protests highlight discontent in the health workforce. Given the ongoing global health workforce crisis, understanding and addressing the drivers of health worker discontent is important for global health policy and security.

Assessment of demographic factors and mental health status: initiating a healthy campus program

Mental health issues have been essential in formulating global health policies for 30 years. The campus community is inseparable from the problem of mental health disorders, which can affect the work either students, lecturers, or staff. This research aimed to describe mental health conditions among the campus community based on demographic factors as an opportunity to initiate a healthy campus program. This study used a quantitative method with a cross-sectional design. The population was an academic community at a private campus in Yogyakarta, Indonesia. There are 347 samples taken by accidental sampling. The mental health instrument used the self-reporting questionnaire. There, 60.81% of respondents experienced psychological disorders, and 73.49% of respondents needed to be referred to a mental health professional regarding addiction, psychotic disorders, and post-traumatic stress disorder (PTSD). There was a significant relationship between demographic factors consisting of gender, age, type of work, employment status, education level, faculty, and emotional disorders with a p-value of <0.005. Moreover, age, gender, education level, type of work, and employment status related to mental disorders due to addiction, psychosis, and PTSD with a p-value<0.005. It is concluded that a large proportion of responders need a referral to a mental health expert. To promote a healthy campus, university officials should follow up with health promotion initiatives such as partnering with the local health office and public health center for additional treatment and improving policy support.

People's Health in People's Hands: Dr. Abhay Bang and Dr. Rani Bang's Pioneering Approach to Rural Healthcare in India.

Dr. Abhay Bang and Dr. Rani Bang, a husband-and-wife team, have dedicated their lives to reforming healthcare in rural India. Their pioneering work in Gadchiroli, Maharashtra, through the Society for Education, Action, and Research in Community Health (SEARCH), has led to revolutionary interventions such as the Home-Based Newborn Care (HBNC) model, significantly reducing infant mortality rates. Their emphasis on women's health and community empowerment has revolutionized conventional healthcare practices and influenced global health policies. This review article sheds light on the historical context and lasting impact of their contributions to community-based healthcare and public health research.

Navigating the Nexus of Bioethics and Geopolitics: Implications for Global Health Security and Scientific Collaboration.

Bioethics plays a pivotal role in guiding ethical decision-making within the realm of medical research and healthcare. However, the influence of geopolitics on bioethical considerations, particularly regarding bioweapons research, remains an underexplored area. This study delves into the uncharted territory of how international political interests can intersect with bioethical principles, potentially shaping collaborative efforts and global health policies related to bioweapons research. Through a hypothetical scenario involving a hypothetical pathogen, a collaborative effort between unspecified countries, we examine the implications of such cooperation on global health governance, with a specific focus on bioweapons research. Ethical dilemmas surrounding responsible research, potential risks and benefits, equitable distribution of findings, and biosafety measures are explored. This analysis underscores the importance of transparent and responsible practices in bioweapons research amidst geopolitical tensions. By striking a balance between national interests and international solidarity, we advocate for robust bioethical frameworks to navigate such collaborations for the collective well-being of humanity and to mitigate potential risks associated with bioweapons research.

Malnutrition drives infection susceptibility and dysregulated myelopoiesis that persists after refeeding intervention.

Undernutrition is one of the largest persistent global health crises, with nearly 1 billion people facing severe food insecurity. Infectious disease represents the main underlying cause of morbidity and mortality for malnourished individuals, with infection during malnutrition representing the leading cause of childhood mortality worldwide. In the face of this complex challenge, simple refeeding protocols have remained the primary treatment strategy. Although an association between undernutrition and infection susceptibility has been appreciated for over a century, the underlying mechanisms remain poorly understood and the extent to which refeeding intervention is sufficient to reverse nutritionally acquired immunodeficiency is unclear. Here we investigate how malnutrition leads to immune dysfunction and the ability of refeeding to repair it. We find that chronic malnutrition severely impairs the ability of animals to control a sub-lethal bacterial infection. Malnourished animals exhibit blunted immune cell expansion, impaired immune function, and accelerated contraction prior to pathogen clearance. While this defect is global, we find that myelopoiesis is uniquely impacted, resulting in in reduced neutrophil and monocyte numbers prior to and post-infection. Upon refeeding, we observe that animals recover body mass, size, cellularity across all major immune organs, the capacity to undergo normal immune cell expansion in response to infection, and a restoration in T cell responses. Despite this broad improvement, refed animals remain susceptible to bacterial infection, uncoupling global lymphoid atrophy from immunodeficiency. Mechanistically, we find peripheral neutrophil and monocyte numbers fail to fully recover and refed animals are unable to undergo normal emergency myelopoiesis. Altogether, this work identifies a novel cellular link between prior nutritional state and immunocompetency, highlighting dysregulated myelopoiesis as a major driver. We believe these findings illustrate how exposure to food scarcity is an immunologic variable, even post-recovery, which should be accounted for in patient medical history and current global public health policy.

Identifying patterns and profiles of vaccination hesitancy among nurses for tailoring healthcare policies in the UK: A cross-sectional study.

To profile the characteristics of nurses with varying levels of vaccine hesitancy toward the COVID-19 and influenza vaccines. In many countries across the world, healthcare workers, and nurses in particular, display significant reluctance toward COVID-19 and influenza vaccines due to concerns about safety, distrust in healthcare policies, and media influences. To address this, a proposed approach involves profiling nurses to tailor vaccination campaigns and to improve acceptance rates and public health outcomes. This cross-sectional study adopted the Vaccination Attitudes Examination scale to assess hesitancy toward COVID-19 and influenza vaccines among 294 registered nurses in the UK between March and July 2023. A K-means cluster analysis was performed. The Strengthening the Reporting of Observational Studies in Epidemiology guidelines were adopted. Three profiles were identified. Profile A showed low vaccination hesitancy, profile B showed average hesitancy, and profile C showed high hesitancy toward vaccines. The highest concern for all profiles was related to unforeseen future effects of vaccination. Profile C had more nurses in early career roles, whereas nurses in profiles A and B were in more senior roles. Profile A showed higher educational attainment. Nurses in profile C used Snapchat more, whereas nurses in profile A used Twitter more frequently. This study identified specific characteristics associated with higher levels of vaccination hesitancy in nursing. Unforeseen future effects of vaccination are a core aspect to consider in promoting vaccination. Policies and vaccination campaigns should be targeted on early career nurses and should deliver tailored messages to dispel misinformation about unforeseen future effects of vaccination through specific social media platforms. Senior nurses should be involved as role models in promoting vaccination. These results are key for enhancing an evidence-based approach to implementing global health policies in healthcare.

Global public health policy analysis: During the COVID-19 pandemic

The emergence of Covid 19 at the start of 2020 set the alarm for a new pandemic around the world following the turning century. Global efforts to fight against infectious diseases focus on protecting citizens from the virus, preventing the spread of the virus within and through a country, and promoting the idea of the dangers of the virus and ways of self-preservation. On a neurophysiological scale, ideal and effective strategies such as initiating quarantine around the world, in which a limit to the outside world is set, gradually stagnate the spread of the virus and maintain the optimum environment for the sick to recover. The mandatory policy and consensus around the world of wearing a mask and maintaining a six-foot distance substantially curbed the spread of the virus in public. On a microbiological scale, the technological advancement the world experienced in recent years resulted in the rapid development of public preventative treatment, such as vaccines, marking the turning point regarding the gradual decrease in the spread and, subsequently, the rate of death throughout the world. The methods of preventing the spread of disease, as well as protecting the citizens from further damage, have led to an exponential decay of cases regarding the coronavirus.

Nationwide mortality trends from 2001 to 2020 in Greece: health policy implications under the scope of aging societies

ObjectiveThis nationwide study aims to analyze mortality trends for all individual causes in Greece from 2001 to 2020, with a specific focus on 2020, a year influenced by the COVID-19 pandemic. As Greece is the fastest-aging country in Europe, the study’s findings can be generalized to other aging societies, guiding the reevaluation of global health policies. MethodsData on the population and the number of deaths were retrieved from the Hellenic Statistical Authority. We calculated age-standardized mortality rates (ASMR) and cause-specific mortality rates by sex in three age groups (0–64, 65–79, and 80+ years) from 2001 to 2020. Proportional mortality rates for 2020 were determined. Statistical analysis used generalized linear models with Python Programming Language. ResultsFrom 2001 to 2020, the ASMR of cardiovascular diseases (CVD) decreased by 42.7% (p < 0.0001), with declines in most sub-causes, except for hypertensive diseases, which increased by 2.8-fold (p < 0.0001). In 2020, the proportional mortality rates of the three leading causes were 34.9% for CVD, 23.5% for neoplasms, and 9.6% for respiratory diseases (RD). In 2020, CVD were the leading cause of death among individuals aged 80+ years (39.3%), while neoplasms were the leading cause among those aged 0–79 years (37.7%). Among cardiovascular sub-causes, cerebrovascular diseases were predominant in the 80+ year age group (30.3%), while ischemic heart diseases were most prevalent among those aged 0–79 years (up to 60.0%). ConclusionsThe global phenomenon of population aging necessitates a reframing of health policies in our aging societies, focusing on diseases with either a high mortality burden, such as CVD, neoplasms, and RD, or those experiencing increasing trends, such as hypertensive diseases.