Implementation Of Health Policies Research Articles

Preventing deviant behaviours in the formulation and implementation of environmental health policies in the era of self-media

National health could significantly impact political, economic and social spheres, having a critical role in national development, social stability and sustainable economic growth. The Chinese government is prioritizing health in all policies and promoting environmental health work. However, deviations in the implementation of China’s environmental health policy, such as excessive or incomplete execution, could hinder progress. Studies have identified the main factors that are inhibiting effective policy implementation; these include incomplete grassroots policy mechanisms, cognitive biases amongst policy executors, varying acceptance of policy execution objects and environmental complexity. To mitigate these issues, several actions have been recommended including improving government mechanisms, enhancing technical support, developing talents, increasing public scientific literacy and considering the needs of policy executors and environmental complexity. The Internet, especially self-media platforms, can enhance policy communication, reduce information bias and foster a favourable environment for policy implementation. By using self-media’s dissemination mechanism effectively, we can strengthen public consensus and improve public scientific literacy in environmental health. This contributes to eliminating policy formulation and implementation deviations, fully leveraging the guiding role of policies and promoting the construction of a Healthy China.

What Canadians search about asthma: A 10-year Google Trends study on asthma and related topics

BackgroundGoogle Trends (GTr) is now becoming an important tool in epidemiological studies to assess the trend of online searches by people of any geographical location. While previous studies assessed trends in searches for some allergic conditions, very few studies reported search patterns for asthma and asthma-related topics. MethodsWe took monthly Canadian GTr data for asthma-related keywords such as ‘asthma’, ‘shortness of breath’, ‘wheeze’, ‘asthma emergency’, ‘asthma hospital’, and ‘asthma medication’ between January 1, 2014, and December 31, 2023. We assessed the trend of yearly relative search volume (RSV) for the past 10 years. We also assessed the trend by influenza and wildfire seasons. ResultsWe observed a marginal increase in searches for some asthma-related topics such as ‘asthma’ ‘shortness of breath’, and ‘wheeze’ in Canada between 2014 and 2023 but not other topics such as ‘asthma emergency’, ‘asthma hospital’, and ‘asthma medication’. The pattern of searches for ‘asthma’, ‘shortness of breath’, and ‘wheeze’ did not change by influenza of wildfire seasons across the years. ConclusionOur study is the first to demonstrate searches for asthma and related topics by Canadians in the past 10 years and indicates GTr as an emerging tool in epidemiology that can be used in planning the implementation of public health policies.

Lessons From the Global SARS-CoV-2 Health Emergency for Potential Future Pandemics

Abstract The emergence of novel infectious agents with pandemic potential remains a critical global concern, as underscored by the COVID-19 pandemic. This study investigates the various factors contributing to the risk of new pandemics and proposes a framework for pandemic prevention and mitigation. We review the characteristics of several infectious agents, including influenza viruses, coronaviruses, filoviruses, paramyxoviruses, Lassa fever virus, Crimean-Congo hemorrhagic fever virus, and the yellow fever virus. These agents are discussed in terms of their transmission modes, reservoirs, potential for human-to-human spread, and historical outbreaks. We emphasize the importance of monitoring and early detection of these agents, especially those with localized outbreaks and zoonotic potential. Our analysis highlights the role of human activities in pandemic risk. Factors such as overuse of antibiotics, environmental changes (deforestation, wildlife habitat encroachment), climate change effects on disease vectors, and increasing global connectivity are examined as drivers of disease emergence. Furthermore, we propose a foursome of critical actions for pandemic prevention and response: early detection and rapid containment; restricting the transmission by social distancing, masking, quarantine, and elimination of vector, which are crucial even before the vaccine is available; global vaccine and treatment distribution; and robust health policy implementation. We emphasize the importance of international collaboration, information sharing, and preparedness to effectively combat pandemics. In conclusion, this commentary provides a comprehensive overview of infectious agents with pandemic potential and their associated risks. It calls for proactive measures to prevent and mitigate future pandemics, emphasizing the need for a global strategy that combines early detection, rapid response, and sustained public health infrastructure.

Grave Reverberations: Inherited Colonial Logics during the COVID-19 Pandemic in the Philippines

Using the theory of reverberations, we track the dissonant transformation of sanitation regimes during the American colonial period in the Philippines, particularly during the cholera epidemic of 1902, to the mis/management of the COVID-19 pandemic in the present day. We argue that the formation, interpretation, and implementation of public health policies, especially with regards to the treatment of the dead, echo inherited colonial logics designed to exacerbate stigmas of virality and unruliness. In addition to past epidemics, responses to COVID-19 resonate with recurring episodes of terror formation, militarisation, and misinformation in the country. The enduring legacies of colonialism—rooted in themes of extraction, individualism, and hegemony, and masked under the guise of benevolence—live on in modern policies in ways that are not always readily apparent. Lastly, we see the notion of reverberations as one that allows analytical generosity in understanding the messiness of the postcolonial experience.

Perceptions of healthcare workers on men's sexual and reproductive health services utilization in Kwazulu-Natal.

Healthcare workers have crafted and implemented several health policies and programs to attract men, but men still struggle to access SRH services. This study explored healthcare workers' perceptions and views about the determinants of men's sexual and reproductive health service utilization. This qualitative study employed a purposive sampling technique to select healthcare workers in urology clinics and those managing men diagnosed with SRH conditions outside urology clinics. Data were analyzed thematically. HCWs highlighted men's lack of awareness due to inadequate community education and health campaigns, staff shortage, the unavailability of medicines and medical supplies, health system incapacity, personal factors, and cultural norms and beliefs as hindrances in using SRH services. Health policymakers and relevant stakeholders need to pay attention to the SRH needs of men. The ongoing awareness campaigns about the importance of SRH service utilization, including additional male nurses, can encourage men to engage more with such services.

The socioeconomic gradient in overweight and obesity among Colombian adult and pediatric populations: A scoping review.

Background: The imminent increase in overweight and obesity prevalence constitutes a pervasive concern for the adult and pediatric Colombian population. Nonetheless, the unequal distribution across distinct social groups limits the implementation of public health policies targeting these escalating rates. Aim: This study aimed to compile existing evidence regarding the prevalence of overweight and obesity in relation to the socioeconomic status (SES) of the Colombian population. Methods: A scoping review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews parameters in MEDLINE (PubMed), EMBASE, and LILACS databases for inclusion of investigations published up to January 2024. Results: Twenty-two cross-sectional studies were included. A higher prevalence of overweight and obesity was documented in adults with lower SES defined by social stratum and monetary income, while in particular for nonpregnant adult women, the prevalence of excess weight was higher in the medium-low socioeconomic stratum. In the pediatric population, higher SES defined by social stratum was directly related to an increased prevalence and risk of overweight and obesity. The ownership of household assets, however, was positively related to the risk of overweight in both adult and pediatric populations. Conclusion: The findings of this investigation disclose a socioeconomic gradient in overweight and obesity in Colombia that resembles the epidemiological distribution in high-income countries for adults, though similar to low-income countries for the pediatric population. Further intersectoral interventions aimed at the most vulnerable groups are imperative to mitigate the inequalities that condition their predisposition to overweight and obesity.

Mental Health Friendly Territories: Strategy for the implementation of the Mental Health Policy in Colombia

AbstractEvidence‐based practices in mental health have been proposed globally and have been adopted in Colombia. However, implementation problems often make it difficult for these initiatives to contribute to people's well‐being. The objective of the present study is to describe a strategy for implementing the components of global mental health in two complex Colombian territories: Chocó and La Guajira. These components are a primary health‐care approach, continuity of care, anti‐stigma, mental health as a human right, mental health in all policies, and a community model of recovery. A monitoring system was created for the reporting of these components by each territory. An appropriation of all the components by the health systems of both territories was found, as mobilization of existing technical resources in the territories and the strengthening of capacities at the administrative, clinical, and community levels, in addition to the articulation of all the strategies proposed at the level global for recovery. Innovation processes built in a participatory manner with communities can favor the implementation of evidence‐based practices and public policies in mental health in territories where social determinants make recovery a challenge.

Changing landscape of alcohol-associated liver disease in younger individuals, women, and ethnic minorities.

Alcohol use is the most important determinant of the development of alcohol-associated liver disease (ALD) and of predicting long-term outcomes in those with established liver disease. Worldwide, the amount, type, and pattern of use of alcohol vary. Alcohol use and consequent liver disease have been increasing in certain ethnic groups especially Hispanics and Native Americans, likely due to variations in genetics, cultural background, socio-economic status, and access to health care. Furthermore, the magnitude and burden of ALD have been increasing especially in the last few years among females and young adults who are at the prime of their productivity. It is critical to recognize the problem and care for these patients integrating cultural aspects in liver clinics. At the federal level, a societal approach is needed with the implementation of public health policies aiming to reduce alcohol consumption in the community. By addressing these challenges and promoting awareness, we can strive to reduce the burden of ALD, especially in high-risk demographic groups to improve their long-term health outcomes. Finally, we need studies and quality research examining these changing landscapes of demographics in ALD as a basis for developing therapeutic targets and interventions to reduce harmful drinking behaviours in these high-risk demographic groups.

Spectrum of prevalent cardiovascular diseases in urban Port-au-Prince, Haiti: a population-based cross-sectional study

Eighty percent of global cardiovascular disease (CVD) is projected to occur in low- and middle -income countries (LMICs), yet local epidemiological data are scarce. We provide the first population-based, adjudicated CVD prevalence estimates in Port-au-Prince, Haiti to describe the spectrum of heart disease and investigate associated risk factors. Demographic, medical history, clinical, imaging and laboratory data were collected among adults recruited using multistage random sampling from 2019 to 2021. Prevalent CVD (heart failure, stroke, ischemic disease) were adjudicated using epidemiological criteria similar to international cohorts. Multivariable Poisson regressions assessed relationships between risk factors and prevalent CVD. Among 3003 participants, median age was 40 years, 58.1% were female, 70.2% reported income <1 USD/day, and all identified as Black Haitian. CVD age-adjusted prevalence was 14.7% (95% CI 13.3%, 16.5%), including heart failure (11.9% [95% CI 10.5%, 13.5%]), stroke (2.4% [95% CI 1.9%, 3.3%]), angina (2.1% [95% CI 1.6%, 2.9%]), myocardial infarction (1.0% [95% CI 0.6%, 1.8%]), and transient ischemic attack (0.4% [95% CI 0.2%, 1.0%]). Among participants with heart failure, median age was 57 years and 68.5% of cases were among women. The most common subtype was heart failure with preserved ejection fraction (80.4%). Heart failure was associated with hypertension, obesity, chronic kidney disease, depression, and stress. Early-onset heart failure prevalence is alarmingly high in urban Haiti and challenge modelling assumptions that ischemic heart disease and stroke dominate CVDs in LMICs. These data underscore the importance of local population-based epidemiologic data within LMICs to expedite the selection and implementation of evidence-based cardiovascular health policies targeting each country's spectrum of heart disease. This study was funded by NIH grants R01HL143788, D43TW011972, and K24HL163393, clinicaltrials.govNCT03892265.

Use of mind genomics for public health and wellbeing: Lessons from COVID 19 pandemic

ABSTRACT Background: Machine learning (ML) tools can be used to analyze human mindsets and forecast behavioral patterns. ML can be used to understand the psychological processes and behavioral principles underlying public decision-making patterns. The aim of this study was to explore participants’ mindsets using ML and accordingly build messages for each mindset to enhance compliance with a public health policy, specifically physical distancing during the coronavirus disease 2019 (COVID-19) pandemic. Methods: An online questionnaire was administered using systematically varied combinations of elements and science of mind genomics. The questions focused on the perceived risk level of COVID-19, strategies to enhance physical distancing compliance, appropriate communicators of the policy, and different physical distancing practices. Snowball sampling was used to recruit participants until sample saturation was achieved among residents of the United Arab Emirates (UAE), aged 18– 80 years. Results: A total of 117 patients were included in this study. In the total panel, the strongest performing elements were those communicated by the government (P&lt;0.01) and clergy (P &lt; 0.05), with no differences between sex and age groups. Three mindset segments were identified: (1) followers of general strategies for physical distancing, (2) those interested in novel ways of practicing physical distancing, and (3) fascinating onlookers of the pandemic. Conclusion: Our results revealed that COVID-19 health-related messages are best communicated by the government and clergy in the UAE. These strategies may aid in the implementation and adoption of other public health policies.

Model for Implementation of Occupational Health and Safety Management Policy for Enhanced Performance of Construction Workers

Model for Implementation of Occupational Health and Safety Management Policy for Enhanced Performance of Construction Workers

National public health institutes in the Eastern Mediterranean Region: Insights from experts in the field

National public health institutes (NPHIs) are crucial to the effectiveness of public health systems, including delivering essential public health functions and generating evidence for national health policies, strategies and plans....

Türkiye's Health Diplomacy Activities: A Qualitative Research

Health diplomacy is a field that facilitates the implementation and governance of global health policies. Assisting, such as transferring expertise, experience, and human and medical equipment to different countries, constitutes the content of health diplomacy. The main argument of this study is that Türkiye provides official development assistance abroad, establishes and operates health enterprises, and provides medical rescue and emergency health services in disasters and emergencies. For this reason, it has been tried to reveal Türkiye's perception of health diplomacy, how the health service process is carried out across the border, and the possible contributions of these services. A case study design was used to examine Türkiye's health diplomacy process. In this context, interviews were conducted with the public (n=1) and non-governmental organization personnel (n=8). The research findings were evaluated within the framework of four main themes: perception of health diplomacy, difficulties experienced in the health diplomacy process, solutions to the difficulties encountered in the health diplomacy process, and contributions of health diplomacy. The perception of health diplomacy is fieldwork, experience transfer, support, joint action, foreign policy, soft power, and health priority. In the process of health service delivery, it has been determined that there are difficulties in terms of medical equipment, service delivery, personnel, and politics, and these difficulties are tried to be solved through cooperation, communication, and other means. It has been concluded that health diplomacy contributes to the health of the recipient country or region and supports employment with newly opened health institutions. In addition, it was determined that Turkish health personnel gained experience, sympathy for Türkiye developed, and prejudices were broken.

Systems for rating bodies of evidence used in systematic reviews of air pollution exposure and reproductive and children’s health: a methodological survey

BackgroundTranslating findings from systematic reviews assessing associations between environmental exposures and reproductive and children’s health into policy recommendations requires valid and transparent evidence grading.MethodsWe aimed to evaluate systems for grading bodies of evidence used in systematic reviews of environmental exposures and reproductive/ children’s health outcomes, by conducting a methodological survey of air pollution research, comprising a comprehensive search for and assessment of all relevant systematic reviews. To evaluate the frameworks used for rating the internal validity of primary studies and for grading bodies of evidence (multiple studies), we considered whether and how specific criteria or domains were operationalized to address reproductive/children’s environmental health, e.g., whether the timing of exposure assessment was evaluated with regard to vulnerable developmental stages.ResultsEighteen out of 177 (9.8%) systematic reviews used formal systems for rating the body of evidence; 15 distinct internal validity assessment tools for primary studies, and nine different grading systems for bodies of evidence were used, with multiple modifications applied to the cited approaches. The Newcastle Ottawa Scale (NOS) and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework, neither developed specifically for this field, were the most commonly used approaches for rating individual studies and bodies of evidence, respectively. Overall, the identified approaches were highly heterogeneous in both their comprehensiveness and their applicability to reproductive/children’s environmental health research.ConclusionEstablishing the wider use of more appropriate evidence grading methods is instrumental both for strengthening systematic review methodologies, and for the effective development and implementation of environmental public health policies, particularly for protecting pregnant persons and children.

Knowledge, attitudes and practices of cervical cancer screening among female students enrolled in higher education institutions in Cabo Verde.

A descriptive cross-sectional study, using a self-administered structured questionnaire, was conducted in six higher education institutions (HEI) in Cabo Verde between November and December 2020. A total of 618 female undergraduate students were recruited using a simple random sampling technique. Descriptive statistical data analysis was used to report the results. The response rate was 96.6% (n = 618). Most of the participants, 90.6% (549), were single, with average age of 21.79 years (SD =±4). Although most of the participants had already heard about CC (94.6%), most students showed a low knowledge about this disease (86.2%). Moreover, only 9.1% reported having been screened for CC. Most undergraduate female students enrolled in HEI in Cabo Verde have poor knowledge and unfavourable attitudes toward CC. The level of knowledge is quite unsatisfactory. Within this context, the implementation of health policies focused on human papillomavirus education, prevention strategies, and CC screening is crucial.

Barriers to and facilitators for the creation, dissemination, implementation, monitoring, and evaluation of oral health policies in the WHO Africa region: A scoping review protocol.

Evidence-informed oral health policies (OHP) can be instrumental in ending the neglect of oral health globally. When appropriately developed and implemented, OHP can improve the efficiency of healthcare systems and the quality of health outcomes. However, more than half of the countries in the World Health Organization (WHO) African region do not have an oral health policy or even the existence of a policy in need of additional and more national-specific OHP as part of non-communicable diseases and universal health coverage agendas. The objective of this protocol's study is to determine the barriers to and facilitators for the creation, dissemination, implementation, monitoring, and evaluation of OHP in the WHO Africa region. We will conduct a systematic search in Global Health, Embase, PubMed, PAIS, ABI/Inform, Web of Science, Academic Search Complete, Scopus, databases that index gray literature, and the WHO policy repositories. We will include qualitative, quantitative, or mixed-methods research studies and OHP documents published since January 1, 2002, which address stakeholders' perceptions and experiences regarding barriers to and facilitators for the creation, dissemination, implementation, monitoring, and evaluation of OHP in countries part of the WHO African region. We will produce descriptive statistics (frequencies and proportions) for quantitative data and conduct descriptive content analysis for qualitative data. To effectively establish evidence-based OHP in the WHO African region, it is crucial to recognize existing challenges and opportunities for progress. The findings of this review will be relevant for Chief Dental Officers at ministries of health, administrators of dental schools, or academic institutions in the WHO African region and will inform a stakeholder dialogue meeting in Kenya in November of 2023. Open Science Framework: https://doi.org/10.17605/OSF.IO/9KMWR.

Correlation of geopolitics, education, democracy with COVID-19 vaccination rate

IntroductionVaccine hesitancy is an ongoing problem and determining the factors that increase the vaccination rate in various countries of the world might be useful for further implementation of efficient public health policies and negating anti-vaccination campaigns.Materials and methodsHuman Development Index (HDI), Education Index (EI), Democracy Index (DI), COVID-19 vaccination rates, COVID-19 data were collected from public sources such as UNDP - Human Development Reports, UNESCO - Education Index, Economist Intelligence, WHO– COVID-19 Dashboard, Our World In Data, The Financial Times COVID-19 Dashboard. Statistical analysis such as Pearson correlation, and linear regression analyses were done to determine a relation between the above-mentioned indices and COVID-19 vaccination rates (1-dose, 2-dose, booster, and combined).ResultsHDI had the strongest positive correlation with the vaccination rates (1-dose– r (181) = 0.632, p < 0.001, 2-dose– r (181) = 0.671, p < 0.001, booster– r (181) = 0.718, p < 0.001, combined– 0.703, p < 0.001). EI (1-dose– r (177) = 0.560, p < 0.001, 2-dose– r (177) = 0.599, p < 0.001, booster– r (177) = 0.642, p < 0.001, combined– 0.626, p < 0.001), DI (1-dose– r (163) = 0.445, p < 0.001, 2-dose– r (163) = 0.479, p < 0.001, booster– r (163) = 0.534, p < 0.001, combined– 0.508, p < 0.001), as well as Geographic location (1-dose– η (Eta) = 0.610 p < 0.001, 2-dose– η (Eta) = 0.633 p < 0.001, booster– η (Eta) = 0.657, p < 0.001, combined– η (Eta) = 0.645, p < 0.001) had positive correlation with vaccination rates.ConclusionThere is a strong positive correlation of COVID-19 vaccination rates with HDI and EI.

Àgô Sankofa: an overview of the progression of sickle cell disease in Brazil in the past two decades.

Sickle cell disease (SCD) is an emblematic case of historical health neglect in Brazil and reflects how institutional racism produces health inequalities. This article engaged in a historical journey of this disease, showing the delayed implementation of health policies for people with sickle cell disease, often concealed in Public Power's (in)actions and omissions. The lack of commitment to implement the recommendations of the Brazilian Ministry of Health, such as neonatal screening, and the difficulty in incorporating technologies for health care result from this modus operandi. The advances and setbacks in programmatic actions and the constant pressure on several governmental entities have characterized the reported saga in the last twenty years. The present text discusses the policies for people with SCD, appropriating the Sankofa symbol, meaning that building the present is only possible by remembering past mistakes. Thus, we recognize this trajectory and this historical moment in which there is a concrete possibility of moving forward and achieving the longed-for comprehensive care for people with SCD. There is an invitation to glance at a new perspective, one in which hope is the trigger for the movements needed to guarantee the rights of people with SCD.

Non-pharmaceutical interventions to reduce COVID-19 transmission in the UK: a rapid mapping review and interactive evidence gap map.

Non-pharmaceutical interventions (NPIs) were crucial in the response to the COVID-19 pandemic, although uncertainties about their effectiveness remain. This work aimed to better understand the evidence generated during the pandemic on the effectiveness of NPIs implemented in the UK. We conducted a rapid mapping review (search date: 1 March 2023) to identify primary studies reporting on the effectiveness of NPIs to reduce COVID-19 transmission. Included studies were displayed in an interactive evidence gap map. After removal of duplicates, 11752 records were screened. Of these, 151 were included, including 100 modelling studies but only 2 randomized controlled trials and 10 longitudinal observational studies.Most studies reported on NPIs to identify and isolate those who are or may become infectious, and on NPIs to reduce the number of contacts. There was an evidence gap for hand and respiratory hygiene, ventilation and cleaning. Our findings show that despite the large number of studies published, there is still a lack of robust evaluations of the NPIs implemented in the UK. There is a need to build evaluation into the design and implementation of public health interventions and policies from the start of any future pandemic or other public health emergency.

The rehabilitation workforce in Brazil

BackgroundThe surge in individuals facing functional impairments has heightened the demand for rehabilitation services. Understanding the distribution of the rehabilitation workforce is pivotal for effective health system planning to address the population’s health needs.ObjectiveTo investigate the spatial and temporal dispersion of physical therapists, speech therapists, psychologists and occupational therapists across various tiers of care within Brazil’s Unified Health System and its regions.MethodThis is an ecological time series study on the supply of rehabilitation professionals. Data were obtained from the National Register of Health Establishments from 2007 to 2020. The density of professionals was calculated per 10,000 inhabitants annually for Brazil and its five regions. The Joinpoint regression model was used to analyze the temporal trends of the density of professionals, considering a 95% confidence interval.ResultsIn 2020, the most notable concentrations of psychologists, speech therapists, and occupational therapists in Brazil were observed in the domain of Specialized Health Care, with densities of 0.60, 0.20, and 0.16 professionals per 10,000 inhabitants, respectively. Conversely, the highest density of physical therapists was found within Hospital Health Care, with a density of 1.19 professionals per 10,000 inhabitants. Notably, variations in professional dispersion across different regions were apparent. Primary Health Care exhibited the highest density of professionals in the Northeast region, while the Southern region accounted for the highest densities in all professional categories within Specialized Health Care. The southeast region exhibited the largest workforce within Hospital Health Care. A marked upsurge in professional availability was noted across all categories, notably in the occupational therapy sector within hospital care (AAPC: 30.8), despite its initial low density.ConclusionThe implementation of public health policies played a significant role in the expansion of the rehabilitation workforce at all three levels of care in Brazil and its various regions from 2007 to 2020. Consequently, regional disparities and densities of professionals have emerged, mirroring patterns observed in low-income countries.