Implementation Of Health Policies Research Articles

Implementation of national policies and interventions (WHO Best Buys) for non-communicable disease prevention and control in Ghana: a mixed methods analysis.

The World Health Organization (WHO) encourages all member states to adopt and implement a package of essential evidence-based interventions called the Best Buys to reduce the burden of non-communicable diseases (NCDs). To date, little is known about the implementation of national policies and interventions for NCD control in the WHO member states in sub-Saharan Africa. Our study aimed to evaluate the implementation of national policies and interventions (WHO Best Buys) for non-communicable disease prevention and control in Ghana. This was explanatory mixed methods research which started with a document review of Ghana's WHO Best Buys scores from the 2015, 2017, 2018, 2020 and 2022 WHO NCD Progress Monitor Reports. Thereafter, we conducted 25 key informant interviews and one focus group discussion (11 participants) with key policymakers and stakeholders in the NCD landscape in Ghana to understand the implementation of the NCD policies and interventions, and the policy implementation gaps and challenges faced. Data from the NCD Progress reports were presented using mean scores whilst the qualitative data was analysed thematically. Ghana has shown some advancements in the implementation of the WHO Best Buys measures. Ghana's implementation scores for 2015, 2017, 2020 and 2022 were 5.0, 9.0, 5.0 and 5.5 respectively, against the mean implementation scores of 7.6/19 for lower-middle-income countries and 9.5/19 for upper-middle-income countries. Efforts to decrease major risk factors such as excessive alcohol consumption and unhealthy diet have been progressing slowly. The most common challenges were related to a) the role of socio-cultural factors, b) stakeholder engagement, c) enforcement and implementation of public health policies, d) implementation guidelines, e) public awareness and education on NCDs, f) financing of NCD prevention and control, g) curative-centered health systems, and h) over-centralization of NCD care. Ghana has made progress in adopting the WHO Best Buys targeting risk factors of NCDs. However, the country faces contextual barriers to effective implementation. With the retrogression of some measures over time despite making progress in some earlier years, further investigation is needed to identify facilitators for sustained implementation of the WHO Best Buys interventions.

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.

Operational and organizational variation in determinants of policy implementation success: the case of policies that earmark taxes for behavioral health services

BackgroundResearch on determinants of health policy implementation is limited, and conceptualizations of evidence and implementation success are evolving in the field. This study aimed to identify determinants of perceived policy implementation success and assess whether these determinants vary according to: (1) how policy implementation success is operationally defined [i.e., broadly vs. narrowly related to evidence-based practice (EBP) reach] and (2) the role of a person’s organization in policy implementation. The study focuses on policies that earmark taxes for behavioral health services.MethodsWeb-based surveys of professionals involved with earmarked tax policy implementation were conducted between 2022 and 2023 (N = 272). The primary dependent variable was a 9-item score that broadly assessed perceptions of the tax policy positively impacting multiple dimensions of outcomes. The secondary dependent variable was a single item that narrowly assessed perceptions of the tax policy increasing EBP reach. Independent variables were scores mapped to determinants in the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework. Multiple linear regression estimated associations between measures of determinants and policy implementation success.ResultsPerceptions of tax attributes (innovation determinant), tax EBP implementation climate (inner-context determinant), and inter-agency collaboration in tax policy implementation (outer-context and bridging factor determinant) were significantly associated with perceptions of policy implementation success. However, the magnitude of associations varied according to how success was operationalized and by respondent organization type. For example, the magnitude of the association between tax attributes and implementation success was 42% smaller among respondents at direct service organizations than non-direct service organizations when implementation success was operationalized broadly in terms of generating positive impacts (β = 0.37 vs. β = 0.64), and 61% smaller when success was operationalized narrowly in terms of EBP reach (β = 0.23 vs. β = 0.59). Conversely, when success was operationalized narrowly as EBP reach, the magnitude of the association between EBP implementation climate and implementation success was large and significant among respondents at direct service organizations while it was not significant among respondents from non-direct service organizations (β = 0.48 vs. β=-0.06).ConclusionDeterminants of perceived policy implementation success may vary according to how policy implementation success is defined and the role of a person’s organization in policy implementation. This has implications for implementation science and selecting policy implementation strategies.

INTERSECTION BETWEEN PUBLIC POLICIES AND THE UNIFIED HEALTH SYSTEM (SUS): IMPLICATIONS FOR HEALTH MANAGEMENT AND THE PROVISION OF SERVICES TO THE POPULATION

The research aimed to analyze the intersection between public policies and the Unified Health System (SUS), assessing their implications for health management and the provision of services to the population. The methodology used included a literature review and the analysis of secondary data on the implementation of health policies in the context of the SUS. The results showed that, despite the principles of universality, comprehensiveness and equity of the SUS, management faces significant challenges, such as lack of resources, the need for an integrated approach and the importance of social participation. The analysis revealed that the articulation between public policies and the SUS is essential to promote equity in access to services and efficiency in the use of resources. It is concluded that strengthening the SUS and implementing public policies are essential to guarantee a health system that meets the needs of the population, requiring political and social commitment to overcome the obstacles faced.

Public and professional stakeholders' perceptions of alcohol advertising and availability policies: A qualitative study.

Reducing alcohol availability and restricting alcohol advertising are effective ways to reduce harm from alcohol. Implementation of public health policies involves collaboration between different stakeholders, and is influenced by public opinion. This paper explores public and professional stakeholders' perceptions of alcohol advertising and availability policies. It is the first to capture consensus and divergence in narratives of these stakeholders. We conducted semi-structured interviews with 14 stakeholders from third sector organisations, government, public health and alcohol licensing in Scotland. We conducted 11 online focus groups with 45 participants, living in neighbourhoods in Scotland characterised by varying levels of urbanity, deprivation and retail density change. We gave participants a list of policies and discussed their views on acceptability, feasibility and likely success. Despite general consensus that regulation of alcohol advertising is an important priority, public stakeholders were concerned about the feasibility of advertising interventions and potential unintended consequences. While professional stakeholders were in favour of regulating alcohol availability, public stakeholders had misgivings about feasibility and effectiveness. When prompted to discuss specific interventions, similar views about protecting children and achieving cultural change emerged. This study highlights the importance of policy makers and other stakeholders to consider public stakeholders' opinions on alcohol policy and understanding that their views may be influenced by competing framings of alcohol problems. Attempts to increase support for alcohol control policies need to consider people's concerns about the effectiveness and potential unintended consequences of these policies, and the wider social context of alcohol consumption.

The corporate political activity of Portugal’s food industry: enhancing public health transparency

Abstract Background This study in Portugal aims to monitor the Corporate Political Activity (CPA) in the food industry. Portugal provides a compelling case study due to its robust implementation of public health policies. Methods A systematic qualitative approach proposed by Mialon et al., a part of the INFORMAS Module 3, was employed. This method is based on the analysis of publicly available information. Key industry actors were selected through expert consultation and market analysis using EuroMonitor data. Information sources included industry, government, and academic materials accessed via websites and news. A thematic qualitative analysis was conducted involving iterative steps: identifying CPA practices based on predefined strategies - Taxonomy of Action Strategies: access and influence policymaking, use the law to obstruct policies, manufacture public support, shape evidence, displace and usurp public health, and manage reputations -, recording methods in a database, and saving evidence. Data collection spanned October 2023 to April 2024, covering materials from 2022 to 2023. Results Twenty-five key players were identified, including processed food and non-alcoholic beverage manufacturers, fast food companies, food retailers, and national trade associations. Food retailers, notably Jerónimo Martins, Lidl, Mercadona, and Sonae, showcased a higher prevalence of CPA. Nestlé and Sumol+Compal also emerged as prominent actors. The food industry in Portugal employs diverse strategies and tactics primarily focused on shaping evidence and managing reputations. While instances of displacing public health priorities and manufacturing public support were observed, they were relatively fewer. Only APED and FIPA showed engagement in policymaking influence. Conclusions Vigilant monitoring of CPA in the food industry in Portugal reveals dominant tactics of shaping evidence and managing reputations. Understanding these strategies is vital for policymaking to safeguard public health. Key messages • The food industry in Portugal employs diverse strategies, primarily shaping evidence and managing reputations, to influence public health policies. • Monitoring the Corporate Political Activity is key to preserving the integrity of public health policymaking in Portugal’s food industry.

Adverse Drug Reactions to β-Lactam Antibiotics: A Portuguese Pharmacovigilance Database Analysis

Abstract Background The β-lactam antibiotics are one of the most relevant drug classes globally. They accounted for the largest share of systemic antibiotics consumption in Portugal across both community and hospital settings. Due to their significance, continuous monitoring of adverse drug reactions (ADR) associated with β-lactams is fundamental. Aim To analyse and characterise cases related to β-lactam antibiotics received by the Portuguese National Pharmacovigilance System. Methods Retrospective analysis of cases containing at least one medicinal product classified as suspect under the Anatomical Therapeutic Chemical (ATC) code J01C or J01D, reported to the Portuguese Pharmacovigilance System between 2014 and 2023. Characterisation of cases considered patient demographics, reported suspected medicines, MedDRA Preferred Term (PT), seriousness and type of reporter. Results A total of 3557 cases were identified (54.0% females; median age = 42.0 years; interquartile range = 52.2), with 95.9% originating from spontaneous reporting and 93.5% being reported by healthcare professionals. The most frequently reported medicines were those belonging to ATC J01CR. Around 70% of cases were classified as serious, with 38.7% being related to situations of disability or other criteria of greater seriousness. Most frequently reported PTs were related to skin disorders. Anaphylactic reaction was the most reported Designated Medical Event term. The PTs “Drug ineffective” and “Off label use” were reported in 5.2% and 2.4% of the cases, respectively. Conclusions Despite the majority of cases are serious, most of the ADR identified are related to already known hypersensitivity reactions. To improve the knowledge regarding these medicines and to generate evidence to address emerging public health issues it is of paramount importance to strength the Portuguese Pharmacovigilance System. This can be achieved through enhancing spontaneous reporting and implementing active pharmacovigilance programs. Key messages • Monitoring the efficacy and safety profile of β-lactams in a real-world context is crucial to mitigate the impact in public health and associated economic burden. • Enhancing the surveillance systems improves data collection and evidence generation, supporting tailoring treatment approaches and implementation of public health policies.

Mental health support for healthcare workers: what is it about governance and policy implementation

Abstract Background We adopt a health system and governance perspective to address the mental health needs of healthcare workers, considering the nature of interventions and the levels and actors involved in governance. The aim is to move the debate forward by identifying governance gaps hampering the implementation of health workforce policies and exploring strategies to effectively increase mental health support. Methods A qualitative comparative methodology is applied based on a case study design utilising a multi-level intersectoral governance matrix. The assessment matrix comprises four key categories: health policy and data, social policy and psycho-social conditions, organisation of work, and job and professional conditions. We conducted a rapid assessment of healthcare workforce developments in the European context, drawing on secondary sources and country experts. The country sample comprises Germany, Portugal, Romania, Switzerland and the United Kingdom. Results Awareness of mental health threats among healthcare workers increased, but policy discourse is driven by service delivery and labour market demands. The attention to healthcare workers’ needs is stronger on the international level especially supported by WHO action, and weakest at national/regional levels. Although organisations and professions demonstrate varying degrees of activity, their efforts are scattered and lack sustainability. Similar challenges were identified across healthcare systems, including limited action, disconnected actors, missing coordination, and a lack of attention to governance gaps and system weaknesses. Conclusions There are similar problems across countries. Mental health policy is driven by labour market needs and ignores research evidence and the individual needs. Successful mental health policy implementation needs multi-level governance and coherent coordination mechanisms, and generally greater attention to the ‘human side’ of the healthcare workforce. Speakers/Panelists Sara Alidina Central Administration of the Health System, Lisbon, Portugal Tomas Zapata WHO/Europe, Copenhagen, Denmark

Ensuring the right to health care for detained adolescents: cross-sectoral strategies and policy innovations

Abstract This presentation will draw attention to the health concerns of adolescents deprived of liberty, stressing that incarceration of minors should be a last resort. Notwithstanding, when governments allow for incarceration of minors, they must guarantee this does not translate into deprivation of basic human rights and that international treaties are respected, including access to high quality healthcare. This talk outlines the development of a policy brief based on data from the UN global study, which identifies essential health interventions for minors in various forms of detention-migration, youth detention, and adult detention where children reside with their parents. Using case studies from Greece, India, and the United States, shortcomings in existing health systems in detention contexts are stressed. A more recent policy brief focusing exclusively on children detained in the context of migration will be used to provide good practice case studies, where appropriate actions such as changes in legislation were put in place, namely in Canada, South Africa, Ukraine and Ireland. A key focus of the presentation will be the importance of cross-ministerial collaboration, as healthcare in the criminal justice system frequently falls under the jurisdiction of ministries other than health, complicating health policy implementation. The speaker will discuss integrated approaches that involve various sectors to ensure the health rights of detained youth are addressed. The presentation aims to illuminate the systemic changes needed to protect the health of detained adolescents, urging policymakers, healthcare providers, and advocates to adopt holistic and inter-sectoral strategies. The talk will also refer to policy actions and recommendations for Member States to support them in addressing challenges so they may achieve the principles of equivalent care and continuity of care that reflects the recommendations of the United Nations Global Study on Children Deprived of Liberty.

Trends in adult mortality rates in India, 1970 to 2018: age-period-cohort analysis.

High premature adult deaths in developing countries are gaining attention, as recent studies show their increasing impact on overall mortality rates. This paper has twofold objectives: firstly, it investigates the long-term trends and patterns of adult mortality between 1970 and 2018 in India. Secondly, it attempts to detect age, period, and cohort (APC) effects on adult mortality decline over time. Data on age-specific mortality rates and disease-adjusted life years for adult age groups (15-59 years) were collected from the Sample Registration System and the Global Burden of Disease study, respectively. The trends in age-standardized mortality rates were presented graphically, and critical change points were highlighted using a change-point analysis. The intrinsic estimator model was applied to estimate the independent effects of APC on adult mortality. The findings revealed that adult mortality declined between 1970 and 2018 with multiple critical change points. The APC effects showed a notable decline in adult mortality during 2005-2018 and for the recent birth cohorts, 1980-2004. However, the rate of mortality declined slowly over time. Results also indicated that mortality started increasing from mid-adult ages and peaked in older adult ages due to the age effects and provided evidence of a rise in adult life loss due to non-communicable diseases in recent years. Overall, the study underscores the importance of implementing health policies aimed at reducing life loss in the most economically active ages that can have long-term negative implications for the country's economic growth.

Mechanical ventilation, hospitalization time, deaths and disability according to the variants of Guillain-Barré syndrome: systematic review and meta-analysis.

Motivation for the study. It is unclear which variant of Guillain-Barré syndrome is mostly associated with adverse outcomes. Main findings. Variants had longer time in MV (7.42 days longer), and hospitalization (3.11 days longer). By subgroups, we found that children with the axonal variant had a greater use of MV; whereas, the demyelinating variant was more frequent among adults in MV. Implications. Our results could be used for the implementation of new public health policies, allowing health personnel to have a better knowledge of the prognosis of each variant and the necessary resources to face future outbreaks. To determine the requirement and time to mechanical ventilation and Intensive Care Unit (ICU), hospitalization and hospitalization time, death and disability of the axonal variants of Guillain-Barré Syndrome (GBS) in comparison with the acute demyelinating variant in patients of all the ages. The systematic review that included patients with GBS. The exposure variable was the axonal variants and the comparator was acute inflammatory demyelinating polyneuropathy (AIDP). The outcomes were the requirement and time on mechanical ventilation (MV), requirement and time in the ICU, hospitalization time, disability and death. The NewCasttle-Ottawa Scale (NOS) was used to assess risk of bias. A meta-analysis was conducted to calculate mean differences and relative risks (RR) with their 95% confidence intervals (CI) using inverse variances and random effects models. Of the 3116 articles found, 46 met the selection criteria. The time on MV was 7.42 days (95% CI: 0.36 to 1.48) and the hospitalization time was 3.11 (95% CI: 0.73 to 5.49) days for the axonal variants. The axonal variants had a RR of 0.47 (95% CI: 0.24 to 0.92) for the requirement of MV in adults, but it was 1.68 (95% CI: 1.25 to 2.25) in children. There was a high statistical heterogeneity. Axonal variants showed, on average, longer MV and hospitalization time, overall and by subgroups. A high MV requirement was found for axonal variants in children; it was lower for adults.

Exploring the effects of COVID-19 outbreak control policies on services offered to people experiencing homelessness

BackgroundThe COVID-19 pandemic and subsequent implementation of public health policies exacerbated multiple intersecting systemic inequities, including homelessness. Housing is a key social determinant of health that played a significant part in the front-line defence against COVID-19, posing challenges for service providers working with people experiencing homelessness (PEH). Public health practitioners and not-for-profit organizations (NFPs) had to adapt existing COVID-19 policies and implement novel measures to prevent the spread of disease within congregate settings, including shelters. It is essential to share the perspectives of service providers working with PEH and their experiences implementing policies to prepare for future public health emergencies and prevent service disruptions.MethodsIn this qualitative case study, we explored how service providers in the non-profit sector interpreted, conceptualized, and implemented COVID-19 public health outbreak control policies in Nova Scotia. We interviewed 11 service providers between September and December 2020. Using thematic analysis, we identified patterns and generated themes. Local, provincial, and national policy documents were useful to situate our findings within the first year of the COVID-19 pandemic and contextualize participants’ experiences.ResultsImplementing policies in the context of homelessness was difficult for service providers, leading to creative temporary solutions, including pop-up shelters, a dedicated housing isolation phone line, comfort stations, and harm reduction initiatives, among others. There were distinct rural challenges to navigating the pandemic, which stemmed from technology limitations, lack of public transportation, and service closures. This case study illustrates the importance of flexible and context-specific policies required to support PEH and mitigate the personal and professional impact on service providers amid a public health emergency. Innovative services and public health collaboration also exemplified the ability to enhance housing services beyond the pandemic.ConclusionsThe results of this project may inform context-specific emergency preparedness and response plans for COVID-19, future public health emergencies, and ongoing housing crises.

Global, regional, and national impact of air pollution on stroke burden: changing landscape from 1990 to 2021

BackgroundExposure to air pollution contributes to cardiovascular disease-related deaths and morbidity, including stroke. However, few studies have examined the global stroke burden linked to air pollution. This study aimed to evaluate the global stroke morbidity and mortality associated with air pollution from 1990 to 2021.MethodWith the Global Burden of Disease Study (GBD) 2021, the numbers, and age-standardized rates (ASRs) of deaths and disability-adjusted life years (DALYs) for air pollution-related stroke were reported globally. Further subgroup analyses were conducted by age, sex, region and country, and stroke subtypes. A linear regression model explored global temporal trends and a cluster analysis examined temporal trends across GBD regions. To predict trends until 2040, the age-period-cohort (APC) model and the Bayesian age-period-cohort (BAPC) model were applied.ResultsIn 2021, there were 1,989,686 (95% uncertainty interval [95% UI], 1,530,479-2,493,238) deaths and 44,962,167 (95% UI, 35,020,339 − 55,467,024) DALYs due to air pollution-related stroke. The ASRs increased with age, peaking generally over 85 years. Males, the Central African region, and Guinea-Bissau showed higher stroke burdens Intracerebral hemorrhage was the most lethal subtype, with an ASR of 11.69 (95% UI 8.94–14.69) for deaths and 276.93 (95% UI 212.21-344.36) for DALYs. From 1990 to 2021, the crude number of deaths and DALYs increased by 13.4% and 6.3%, respectively, for the global stroke burden but showed a declining trend when age-standardized. Most GBD regions in Asia and Africa experienced an increasing stroke burden linked to air pollution, while Europe and America showed a decreasing trend. Predictions indicated a gradual reduction in ASRs, with higher rates in males from 2020 to 2040.ConclusionsThe global stroke burden associated with air pollution remained significant despite a decreasing trend until 2021. Although future predictions suggested a reduction, the crude counts for stroke burden remained substantial, with significant regional disparities. This warranted the implementation of public health policies and ongoing efforts.

Implementation Models and Examples of Health Policy in Indonesia

Indonesia's health policy continues to develop in line with changes in community needs and the global situation (Ministry of Health, 2020). However, the implementation of health policies often faces various challenges. Therefore, this research was conducted with the aim of analyzing examples of health policy implementation in Indonesia, including the problems. The research method used in this research is a qualitative descriptive method, namely collecting data from various secondary sources including journals, government reports and other official articles. The terms used in the literature review as a source for writing this journal are implementation, policy, and health. The results of this research show that the implementation of health policy in Indonesia faces various challenges, suchas limited resources, lack of coordination between stakeholders, and cultural barriers, as well as achieving optimal results varies. This also shows that improvements are needed in certain aspects.

Bridging the Gap in Policy Implementation through a Health Equity Lens: Insights from a 2-Year Study on Measurement Development

Background: Policy implementation measurement lacks an equity focus, which limits understanding of how policies addressing health inequities, such as Universal School Meals (USM) can elicit intended outcomes. We report findings from an equity-focused measurement development study, which had two aims: (1) identify key constructs related to the equitable implementation of school health policies and (2) establish face and content validity of measures assessing key implementation determinants, processes, and outcomes. Methods: To address Aim 1, study participants (i.e., school health policy experts) completed a survey to rate the importance of constructs identified from implementation science and health equity by the research team. To accomplish Aim 2, the research team developed survey instruments to assess the key constructs identified from Aim 1 and conducted cognitive testing of these survey instruments among multiple user groups. The research team iteratively analyzed the data; feedback was categorized into “easy” or “moderate/difficult” to facilitate decision-making. Results: The Aim 1 survey had 122 responses from school health policy experts, including school staff (n = 76), researchers (n = 22), trainees (n = 3), leaders of non-profit organizations (n = 6), and others (n = 15). For Aim 2, cognitive testing feedback from 23 participants was predominantly classified as “easy” revisions (69%) versus “moderate/difficult” revisions (31%). Primary feedback themes comprised (1) comprehension and wording, (2) perceived lack of control over implementation, and (3) unclear descriptions of equity in questions. Conclusions: Through adaptation and careful dissemination, these tools can be shared with implementation researchers and practitioners so they may equitably assess policy implementation in their respective settings.

Popular Participation And Social Control As A Principle Of The Brazilian Unified Health System (SUS)

The following article addresses the importance of popular participation and social control in the Brazilian Unified Health System (SUS), as established by the Federal Constitution of 1988. These principles aim to ensure that health is a universal right and a state duty, and that the community plays an active role in the formulation, implementation, and oversight of health policies. Popular participation allows citizens to influence health decisions and ensures that their needs are reflected in public policies. This is achieved through meetings, consultations, and public hearings. Social control enables citizens to oversee the implementation of health policies, ensuring transparency and accountability among health managers. Health Councils, Health Conferences, and Health Ombudsman Offices are the main mechanisms for implementing these principles. Health Councils, operating at municipal, state, and federal levels, include representatives from the government, health professionals, and users, and are involved in the formulation, evaluation, and oversight of health policies. Health Conferences bring together a broad range of participants to discuss and propose improvements to the SUS, while Ombudsman Offices serve as channels for citizens to file complaints, suggestions, and reports of irregularities. However, the text also highlights challenges such as low community engagement, lack of resources and training, and issues of representativeness. These challenges impact the effectiveness of Health Councils and Conferences. To overcome these issues, it is necessary to promote greater awareness, improve infrastructure, and ensure diverse representation, ensuring that health policies adequately address the needs of the population.

ESTUDO DE EMERGÊNCIAS ONCOLÓGICAS EM PACIENTES PEDIÁTRICOS: REVISÃO OBSERVATÓRIA

Care activities in intensive care units and for cancer patients are guided by the humanization of care and contribute to hospital management, seen as a challenge to be faced in order to promote advances in the implementation of health policy in Brazil. In this way, it is feasible to analyze in this study a reflection on the humanization of care provided to critically ill patients, the strategies of humanization and care in the ICU and in patients under palliative care, in order to identify improvements in the care of critically ill patients in a humanized way. The aim of this study is to identify, through literature reviews, the interventions of nursing professionals in assisting patients in palliative care in the area of pediatric oncology. The methodology used is bibliographical research, based on articles available on the internet. In Brazil, a number of problems persist in health institutions on a daily basis, which are rooted in the system and make it difficult to achieve the principles of universality, comprehensiveness and equity, which are fundamental to the Unified Health System (SUS). To work in the Oncology Unit and provide palliative care. Thus, health professionals must have specialized and qualified training, including experience acquired throughout their careers, as well as personal and professional development.

A comprehensive statistical analysis of Malaria dynamics in the Adamawa region of Cameroon, from 2018 to 2022

Malaria remains a prominent public health concern in Cameroon, with the potential for epidemic outbreaks, necessitating a robust understanding of its dynamics. This paper uses routinely collected surveillance data from health facilities in the Adamawa Region since January 2018. By applying statistical analysis, this study aims to enhance comprehension, enable data predictions, and facilitate informed decision-making for public health policy implementation. Focusing on weekly health districts data spanning from 2018 to 2022, our analysis employs key statistical metrics for central tendency, data spread, distribution shape, and variable dependence. The study reveals distinctive trends, highlighting peak malaria transmission periods consistently occurring between August and November each year. The highest weekly recorded case count in any health district reached 1,294. The data exhibits leptokurtic distributions, skewed to the left of the median. And in 2022, 11% of the population was reported to have contracted malaria. Despite an overall region-wide average growth rate of -1.21% over the past five years, maintaining vigilant attention to this critical health issue is imperative. Auto dependence analysis indicates that observations are weekly correlated, assuming the time series as stationary. The stationarity has been confirmed by ADF and KPSS tests that we performed. This comprehensive data analysis helps our understanding of the malaria landscape in the Adamawa Region of Cameroon. The paper also recommends the inclusion of additional variables in data collection for a more holistic perspective. These findings provide a basis for the formulation and implementation of targeted interventions by relevant stakeholders, aiding in the prediction of future cases and ultimately contributing to the effective management of malaria in the region.

Inclusion of people with disabilities in Chilean health policy: a policy analysis

BackgroundAround 18% of the population in Chile has disabilities. Evidence shows that this population has greater healthcare needs, yet they face barriers to accessing healthcare due to health system failures. This paper aims to assess the inclusion of people with disabilities in health policy documents and to explore the perceptions of key national stakeholders regarding the policy context, policy processes, and actors involved.MethodsA policy content analysis was conducted of 12 health policy documents using the EquiFrame framework, adapted to assess disability inclusion. Documents were reviewed and rated on their quality of commitment against 21 core concepts of human rights in the framework. Key national stakeholders (n = 15) were interviewed, and data were thematically analysed under the Walt and Gilson Policy Analysis Triangle, using NVivo R1.ResultsCore human rights concepts of disability were mentioned at least once in nearly all health policy documents (92%). However, 50% had poor policy commitments for disability. Across policies, Prevention of health conditions was the main human rights concept reflected, while Privacy of information was the least referenced concept. Participants described a fragmented disability movement and health policy, related to a dominant biomedical model of disability. It appeared that disability was not prioritized in the health policy agenda, due to ineffective mainstreaming of disability by the Government and the limited influence and engagement of civil society in policy processes. Moreover, the limited existing policy framework on disability inclusion is not being implemented effectively. This implementation gap was attributed to lack of financing, leadership, and human resources, coupled with low monitoring of disability inclusion.ConclusionsImprovements are needed in both the development and implementation of disability-inclusive health policies in Chile, to support the achievement of the right to healthcare for people with disabilities and ensuring that the health system truly “leaves no one behind”.

Indicators of scientific production on Health Policy

Introduction: health and its maintenance constitute one of the main assets of man at any stage of his history. The implementation of health policies is aimed at solving global health problems that affect the population.Objective: characterize the scientific production on Health Policy in SCOPUSMethod: an observational, descriptive, bibliometric study was developed. A total of 229,339 articles were worked on. The SCOPUS database was used to collect the information; especially the SciVal tool for the analysis of information and the study of indicators. Descriptive statistics were applied to analyze the information.Results: a total of 229,339 articles were analyzed; equivalent to 2,471,305 appointments in the study period. I highlight the year 2023 with the highest number of articles published (31,982; 13.94%). The United States stood out with the highest number of articles published with 79,708 investigations (34.75%). The articles published in the journal BMC Health Services Research stood out with 10,425 investigations (23%). The largest number of articles were located in the health and health services categoryConclusions: scientific production related to Health Policy showed heterogeneous but constant growth, in contrast to the number of citations. The publications were related to the largest centers of scientific production. The research topics were directed with greater interest towards the quality of health services and assistance according to age groups