Policy Briefs Research Articles

Relations between Islamic Emirate of Afghanistan and India: Revisiting the Future

This article explains the history of relations between India- Afghanistan and the prospects for any future engagement with the Islamic Emirate of Afghanistan, considering the recent developments in Afghanistan. It investigates how the two countries can find common grounds for economic, political, and social cooperation and what role India could take in helping stabilize Afghanistan and ultimately the region. The paper also elaborates on potential security threats to India in Afghanistan after the U.S withdrawal; Afghanistan-India entanglements post 15th August 2021 and concludes with recommendations for future engagement between both countries underpinned by secondary sources which include books, research papers, policy briefs, and articles from renowned newspapers.

Accelerating progress towards the SDGs: Collaborative policymaking in sanitation for integrated benefits in Sub-Saharan Africa

In 2020, 54% of the world had access to safe sanitation, but access further reduces to 21% in sub-Saharan Africa . With only eight years left to meet the Sustainable Development Goals (SDGs), there is an urgent need to accelerate action in the sanitation sector. Previous academic research highlights sanitation as vital for supporting cross-cutting outcomes in health, economics, climate, gender equality, and the environment. However, there is a gap in knowledge outputs for policymakers to highlights how action in sanitation can leverage investment from agencies and ministries to achieve multiple SDGs. Our transdisciplinary team (academics, policymakers, and practitioners) co-developed actionable outputs for diverse audiences to fill this gap, building on an existing global evidence review identifying 130 synergies between sanitation and the SDGs.We identified priority focus areas influencing sanitation policies and financing in Sub-Saharan Africa to collaboratively develop visual aids, policy briefs, and this academic publication to engage cross-sectoral audiences. Our approach offers insights into the value of theoretical knowledge for policy outcomes in the sanitation sector. It is most likely that SDG6 Targets particularly related to sanitation will not be met by 2030 as the sector suffers from under investment. Co-creation between academia and the development sector is critical for consolidating knowledge/research and development practice to influence investment, progress and innovation.

Complexity challenges for transition policy: lessons from coastal shipping in Norway

This policy briefing discusses decarbonization policies of “hard-to-abate” sectors, emphasizing the implications of these sectors’ complexity. Specifically, we discuss two sources of complexity: (a) heterogeneity in the form of variation across and within technologies and user segments and (b) interdependencies between technologies (within and between their value chains) and between user segments and adopter groups. Based on research on coastal shipping in Norway, a global frontrunner in decarbonization of this sector, we suggest three guiding principles for developing policy mixes for decarbonizing hard-to-abate sectors: (1) employ technology-specific policies but aim at broad sectoral or general policies when suitable, (2) consider value chain interdependency and user segment heterogeneity when prioritizing technologies and user segments, and (3) translate (rather than transfer) successful policies to other settings (e.g. user segments).

A RoBERTa Approach for Automated Processing of Sustainability Reports

There is a strong need and demand from the United Nations, public institutions, and the private sector for classifying government publications, policy briefs, academic literature, and corporate social responsibility reports according to their relevance to the Sustainable Development Goals (SDGs). It is well understood that the SDGs play a major role in the strategic objectives of various entities. However, linking projects and activities to the SDGs has not always been straightforward or possible with existing methodologies. Natural language processing (NLP) techniques offer a new avenue to identify linkages for SDGs from text data. This research examines various machine learning approaches optimized for NLP-based text classification tasks for their success in classifying reports according to their relevance to the SDGs. Extensive experiments have been performed with the recently released Open Source SDG (OSDG) Community Dataset, which contains texts with their related SDG label as validated by community volunteers. Results demonstrate that especially fine-tuned RoBERTa achieves very high performance in the attempted task, which is promising for automated processing of large collections of sustainability reports for detection of relevance to SDGs.

Improving equity in access to early diagnosis of cancer in different healthcare systems of Latin America: protocol for the EquityCancer-LA implementation-effectiveness hybrid study

IntroductionHealthcare fragmentation, a main cause for delay in cancer diagnosis and treatment, contributes to high mortality in Latin America (LA), particularly among disadvantaged populations. This research focuses on integrated care...

Using participatory action research to reimagine community mental health services in Colombia: a mixed-method study protocol

IntroductionMental healthcare systems are challenged by how they hear and respond to what marginalised communities experience as drivers of mental distress. In Colombia, this challenge intersects with wider challenges facing...

Visitor valuation for natural tourism development in Simarjarunjung, North Sumatra, Indonesia

Ecotourism is a type of tourism that became popular around the 1990s. Indonesia has a variety of unique nature that is good for the development of ecotourism. Most foreign tourists come to Indonesia because of its natural beauty and uniqueness. The increase in the local and national economy is obtained from visits and expenses incurred by tourists, so it must continue to be improved and maintain satisfaction. This study aims to analyze the characteristics, level of visitor satisfaction, and the factors that influence the motivation to visit tourist attractions in the Simarjarunjung area. This study uses descriptive and explanatory methods with a quantitative approach. Score and categorization of satisfaction level in each aspect studied, namely natural scenery, access/affordability, security, facilities, cleanliness, comfort, toilet facilities, road infrastructure, and promotion. Scores for all aspects are also obtained as an overall picture of the level of visitor satisfaction for each category of push and pull factors. From the regression analysis obtained the factors that have a significant effect on the motivation of visitors along with the direction and coefficient value. Aspects of satisfaction and motivation as well as the factors that influence them become important policy briefs for stakeholders to develop nature tourism.

Integrating Patient-reported Experience (PRE) in a multistage approach to study access to health services for women with chronic illness and migration experience.

Patient-reported Experience (PRE) is an emerging concept integrating patient perspectives and amplifying voices often marginalized in discussions surrounding health systems. However, it remains a challenge to use and integrate PREs when studying patient agency and access to quality services, particularly with data from multiple sources. In this article, using study materials from the Swiss MIWOCA project, we present and reflect upon a multistage PRE approach to study healthcare access. The MIWOCA project, a study on healthcare access and quality among immigrant women with chronic illnesses living in Switzerland, provided data from multiple sources for the integration of PRE data. These sources included interviews with women (n = 48), two focus group discussions with women (n = 15), interviews with service providers (n = 12)and observations from stakeholder dialogues (n = 3). In addition, we utilized field notes, focus group illustration maps, patient vignettesand policy briefs to develop a multistage data linking model. PRE data served as starting themes and reference topics in each of the interlinked stages of knowledge production. Deploying PREs, we coherently linked the data from preceding stages and used them to inform subsequent stages. This, in turn, enabled us to identify, reflectand rectify factors limiting immigrant women's agency and access to quality services. Ultimately, the approach engaged patients as knowledge co-producers for system-level changes. This knowledge was transformed into a set of practice recommendations and a policy brief addressing ways to improve health systems to better serve immigrant women in Switzerland. Building on PREs to systematically combine multiple data sources and engage patients continuously can improve our understanding of barriers in health systems. Beyond individual patient-doctor encounters, a multistage PRE approach can identify structural problems and provide clues for resolving them at the systems level. The PREs approach presented may serve as an example and encourage more public health experts to consider PREs in future research and practice. Women with chronic illness and immigration experience contributed to interview-guideline development, provided PREs in interviews, identified priority areas for health-service changeand actively participated in the development of practice recommendations.

The role of public health scientists within the German political discourse on the COVID-19 pandemic

Abstract Background During the COVID-19 pandemic politics was in search of scientific evidence to underpin decision making like never before. It is remarkable that voices from public health were less noticeable than those of virologists or immunologists. The aim of our ongoing study is to explore how public health scientists perceive their role in the relationship of their discipline and politics. Methods We conducted 10 reflexive interviews with epidemiologists and public health scientists from Germany and collected documents (official statements and policy briefs of scientific societies). Data from both sources were analysed using situational analysis (Clarke, 2018), an approach used to map and analyse discourses in complex situations. To ensure data quality we used respondent validation. Results According to participants, (1) improving population health was the top priority. Politicians tended to focus on short-term goals rather than long-term consequences. (2) Recognition of public health was increased by the pandemic in Germany. (3) However, politicians favoured virology, biomedical and clinical perspectives. (4) The strong motivation of public health scientists to support politics at the beginning of the pandemic turned into disillusionment. (5) The composition of advisory boards was described as non-transparent. (6) Initiatives by the public health community were not sufficiently impactful. (7) Expectations of policymakers regarding future cooperation were not clear to participants. Conclusions The results present different facets of a delicate relationship between public health sciences and politics. The pandemic increased the visibility and impact of public health in Germany on the one hand but also demonstrated that the realms of public health (science) and politics were not well connected. Involving scientific expertise in politics requires more transparency and the normative assumptions underlying the logics of science and politics need to be made more explicit. Key messages • The potential of public health to address the covid-19 pandemic has not been sufficiently acknowledged by policymakers, and the involvement of its experts requires greater transparency. • Reflecting on the normative assumptions underlying the different logics of public health sciences and politics can support their cooperation in the future.

9.L. Workshop: A motivated, healthy and high-performing workforce: Innovation in health workforce research in Europe

Abstract Background Hospitals and their health care staff were severely impacted by the Covid-19 pandemic. Many health professionals faced high levels of stress and burn-out due to unfavorable work environments, limited staffing and highly pressured workloads. Yet, even prior to the pandemic, health professionals in many countries faced challenging work environments with often limited resources and support. At the same time, the roles of health professionals are changing across Europe, with new roles, task-shifting and sharing happening in teams, also driven by the Covid-19 pandemic. From a health system and management perspective, recruitment and retention is critical to ensure that there is a sufficient and well-educated health workforce capable to perform high-quality care. Multiple innovations have been implemented across Europe, these will be presented and discussed with a view towards evaluating complex interventions, sustaining innovations, ensuring the scalability and transferability of proven interventions for the benefit of health professionals and wider society. Objectives This workshop will address innovative strategies at the micro (team level), meso (healthcare setting) and macro level (policy) to ensure that health professionals are motivated, perform high-quality care in teams and are sufficiently supported by enabling work environments and recruitment and retention policies. Innovations to improve work environments, task-shifting as well as recruitment and retention will be discussed, based on the findings from four EU-funded research projects: Magnet4Europe, H-Work, TASHI and METEOR. The format is a ‘round table’ with 5 panel discussants. The Magnet4Europe project focuses on the reorganization of hospital work environments for nurses and physicians in hospitals in five European countries. Innovative elements include a system-, inter-professional, organization-wide change management, structural empowerment of clinical staff and one-on-one twinning of European hospitals with U.S. twinning partners. Innovations in the EU projects The H- WORK project aims to design, implement and validate psychosocial interventions to promote mental health and well-being in SMEs and the public sector. Innovative elements are the evaluation of interventions at multiple levels (individual, team, manager and organisational level) and the development of the H-Work innovation platform with toolkits, policy briefs and novel digital solutions. The TaSHI project provides a novel and up-to-date knowledge on task shifting and transferability of good practices in implementation. Through a cross-national and -sectoral perspective, the focus is on task shifting as an innovation towards more effective organisation of care and workforce, to improve efficient and sustainable systems. METEOR aims to enhance scientific knowledge on the predictors of job retention for healthcare workers and develops evidence-based policy recommendations through stakeholder engagement and co-creation workshops. Key messages • Innovations to improve work environments include system-wide, integrated approaches spanning individual, team, management and organisational levels. • Elements of effective implementation of innovations are effective leadership at highest level, empowerment, evidence-informed action and tailored strategies on recruitment and retention of staff. Speakers/Panellists Walter Sermeus KU Leuven, Leuven, Belgium Ronald Batenburg NIVEL, Utrecht, Netherlands Lode Godderis KULeuven - IDEWE, Leuven, Belgium Rudolf Kubik Qedgroup, Prague, Czechia Claudia Maier Department of Healthcare Management, Technische Universität Berlin, Berlin, Germany

Uptake and impact of COVID-19 preventive measures amongst migrant populations in the Netherlands

Abstract Uptake of preventive measures to reduce transmission of viruses such as SARS-CoV-2, is crucial in the control of pandemics. To ensure equitable uptake we explored contextual factors that shaped uptake of COVID-19 preventive measures amongst smaller, albeit substantial, migrant populations in the Netherlands. 39 persons of Eritrean, Ghanaian, Indonesian and Filipino origin, with diverse legal status and length of stay in the Netherlands, participated in five online focus group discussions. Thematic analysis of data was informed by concepts from the Precaution Adoption Process Model and Protection Motivation Theory. Awareness and knowledge of preventive measures was shaped by limited Dutch proficiency, access to understandable information and interference of misinformation. Engagement by preventive measures was subject to COVID-19 threat appraisal and the ease with which complex behavioural messages could be translated to individual situations. Perceived vulnerability of undocumented migrants in particular, motivated information-seeking. A strong social norm to keep with cultural and religious practices, and limited opportunity for preventive behaviour in work and home context hindered uptake of preventive behaviour. Preventive measures brought about job, food, and housing insecurity, and increased barriers in access to healthcare for undocumented migrants. Migration-related, sociocultural, and socioeconomic factors shape uptake of preventive measures. Preventive measures negatively impact work, housing and access to healthcare of undocumented migrants. Our results suggest importance of multilingual information tailored to literacy needs; education and modelling of behaviour; and, regulations to ensure continued access to financial and material resources to minimise negative spill-over effects. Results were incorporated in two policy briefs advising local and national government. Collaboration with municipal health services lead to multilingual public health information. Key messages • Migration-related, sociocultural, and socioeconomic factors shape uptake of preventive measures. • Preventive measures negatively impact work, housing and access to healthcare of undocumented migrants.

Youth health promotion in countries affected by forced migration: The role of mHealth technologies

Abstract Issue/problem Young refugees often face barriers in accessing youth-friendly health information and care. Differing cultural norms, languages, laws, financial difficulties, gender disparities, and stigma pose additional challenges for youth in forced migration settings. Description of the practice REACH is a regional initiative of Columbia University, which aims to bridge the gap in health literacy and health care access among refugee and disadvantaged youth in Turkey, Lebanon, and Jordan, which are heavily affected by the Syrian conflict. Supported by TaiwanICDF, Blue Chip Foundation, and Columbia University, the REACH Project uses a community-based participatory action research approach and aims to assess the impact of mHealth technologies on improving health literacy and health care access among youth in host countries. With a strong adult-youth partnership, the project includes stakeholder meetings, mixed-methods studies with youth, health service providers and policy makers, in addition to health advocacy, communication and dissemination activities such as photo exhibitions, panels, and production of policy briefs and scientific publications. REACH has been working with youth, software developers, health professionals, academia, and I/NGOs to develop the multilingual and freely available REACH4Health app to promote youth health. Results Findings from three countries show that mHealth technologies have the potential to provide innovative, youth-friendly and widely used solutions to address the health education, health communication, and health care needs of disadvantaged and marginalized youth. Lessons Youth-adult partnerships, working with mixed groups of refugee and local youth, using community-based participatory research, peer-to-peer methodologies, and co-design approaches, as well as using social media tools contribute to the overall success of mHealth and health promotion interventions for disadvantaged youth in countries affected by forced migration. Key messages • mHealth technologies have a strong potential to improve health literacy and health care access of refugee and disadvantaged youth in countries affected by forced migration. • Youth-adult partnerships, working with mixed groups of refugee and local youth, using participatory approaches and peer-to-peer methodologies significantly contribute to youth health interventions.

Evaluating Technical and Issue Bias in Teacher Evaluation Policy Briefs and State Handbooks

Recognizing the need for scientific fidelity and balanced representation in the evidence that informs public policy, this study investigates technical and issue bias in 43 policy briefs and state handbooks that provided information about the use of Student Learning Objectives to evaluate teachers’ performance. The author uses multiple qualitative methods to categorize the contributors to the focal documents, identify the evidence they drew upon, and determine how they represented the information to their targeted audiences. The study reinforces the findings of prior research by documenting the outsized impact of advocacy groups in a policy-related evidence base. The results make an important addition to the scholarly literature by cataloging an array of technical assistance providers that translated and disseminated evidence to decision makers and spotlighting the various ways biased information appeared in the publications. Throughout, the study reinforces how incentives and timing shape evidence production and use in policymaking.

What are the impacts of increasing cost-effectiveness Threshold? a protocol on an empirical study based on economic evaluations conducted in Thailand.

Economic evaluations have been widely used to inform and guide policy-making process in healthcare resources allocation as a part of an evidence package. An intervention is considered cost-effective if an ICER is less than a cost-effectiveness threshold (CET), where a CET represents the acceptable price for a unit of additional health gain which a decision-maker is willing to pay. There has been discussion to increase a CET in many settings such as the United Kingdom and Thailand. To the best of our knowledge, Thailand is the only country that has an explicit CET and has revised their CET, not once but twice. Hence, the situation in Thailand provides a unique opportunity for evaluating the impact of changing CET on healthcare expenditure and manufacturers' behaviours in the real-world setting. Before we decide whether a CET should be increased, information on what happened after the CET was increased in the past could be informative and helpful. This study protocol describes a proposed plan to investigate the impact of increased cost-effectiveness threshold using Thailand as a case study. Specifically, we will examine the impact of increasing CET on the drug prices submitted by pharmaceutical companies to the National List of Essential Medicine (NLEM), the decision to include or exclude medications in the NLEM, and the overall budget impact. Retrospective data analysis of the impact of increased CET on national drug committee decisions in Thailand (an upper middle-income country) will be conducted and included data from various sources such as literature, local organizations (e.g. Thai Food and Drug Administration), and inputs from stakeholder consultation meetings. The outcomes include: (1) drug price submitted by the manufacturers and final drug price included in the NLEM if available; (2) decisions about whether the drug was included in the NLEM for reimbursement; and (3) budget impact. The independent variables include a CET, the variable of interest, which can take values of THB100,000, THB120,000, or THB160,000, and potential confounders such as whether this drug was for a chronic disease, market size, and primary endpoint. We will conduct separate multivariable regression analysis for each outcome specified above. Understanding the impact of increasing the CET would be helpful in assisting the decision to use and develop an appropriate threshold for one's own setting. Due to the nature of the study design, the findings will be prone to confounding effect and biases; therefore, the analyses will be adjusted for potential confounders and statistical methods will be explored to minimize biases. Knowledge gained from the study will be conveyed to the public through various disseminations such as reports, policy briefs, academic journals, and presentations.

How to Lead Collaborative Governance for Climate Transformation: A Guide for City Leaders and Decision-makers

Based on extensive international research on city climate governance and co-creation, this policy briefing allows for a nuanced understanding of how contextual features provide distinct types of challenges and condition city leadership in situations of diverse actors and purposes. The complexity of the challenge requires design and employment of a mix of collaborative, regulative, and financial policy tools to pursue effective climate transformation. Such a hybrid form of governance enables cities to inspire and mobilize multiple actors, adapt infrastructures, and enhance their own space of manoeuvre across scales. The briefing suggests 10 essential lessons highlighting key policy tools that climate-ambitious cities may mix and draw upon. The findings build on a combination of (climate) governance and leadership theory and empirical examples from a variety of global cities, including the cities of Cape Town, Copenhagen, Gothenburg, and Oslo.

Preferences of people with mild cognitive impairment for physical activity interventions in China: protocol for a discrete choice experiment study

IntroductionExercise interventions are important non-pharmacological interventions for patients with mild cognitive impairment (MCI), but patients with MCI have poor compliance and there is no consistent strategy for exercise interventions. Understanding...

Editorial

Editorial

How relevant is climate change research for climate change policy? An empirical analysis based on Overton data.

Climate change is an ongoing topic in nearly all areas of society since many years. A discussion of climate change without referring to scientific results is not imaginable. This is especially the case for policies since action on the macro scale is required to avoid costly consequences for society. In this study, we deal with the question of how research on climate change and policy are connected. In 2019, the new Overton database of policy documents was released including links to research papers that are cited by policy documents. The use of results and recommendations from research on climate change might be reflected in citations of scientific papers in policy documents. Although we suspect a lot of uncertainty related to the coverage of policy documents in Overton, there seems to be an impact of international climate policy cycles on policy document publication. We observe local peaks in climate policy documents around major decisions in international climate diplomacy. Our results point out that IGOs and think tanks–with a focus on climate change–have published more climate change policy documents than expected. We found that climate change papers that are cited in climate change policy documents received significantly more citations on average than climate change papers that are not cited in these documents. Both areas of society (science and policy) focus on similar climate change research fields: biology, earth sciences, engineering, and disease sciences. Based on these and other empirical results in this study, we propose a simple model of policy impact considering a chain of different document types: The chain starts with scientific assessment reports (systematic reviews) that lead via science communication documents (policy briefs, policy reports or plain language summaries) and government reports to legislative documents.

A realist review protocol on communications for community engagement in maternal and newborn health programmes in low- and middle-income countries

BackgroundCommunity engagement (CE) has been increasingly implemented across health interventions, including for maternal and newborn health (MNH). This may take various forms, from participatory women’s groups and community health committees to public advocacy days. While research suggests a positive influence of CE on MNH outcomes, such as mortality or care-seeking behaviour, there is a need for further evidence on the processes of CE in different settings in order to inform the future development and implementation of CE across programmes. Communication is an integral component of CE serving as a link between the programme and community. The aim of the realist review described in this protocol is to understand how, why, to what extent, and for whom CE contributes to intended and unintended outcomes in MNH programming, focusing on the communication components of CE.MethodsRealist review methodology will be used to provide a causal understanding of what communication for CE interventions in MNH programming work, for whom, to what extent, why, and how. This will be done by developing and refining programme theories on communications for CE in MNH through a systematic review of the literature and engaging key experts for input and feedback. By extrapolating context-mechanism-outcome configurations, this review seeks to understand how certain contexts trigger or inhibit specific mechanisms and what outcomes this interaction generates when communication in CE interventions is used in MNH programming.DiscussionA realist philosophy is well-suited to address the aims of this study because of the complex nature of CE. The review findings will be used to inform a realist evaluation case study of CE for an MNH programme in order to ascertain transferable findings that can inform and guide engagement activities in various settings. Findings will also be shared with stakeholders and experts involved in the consultative processes of the review (through workshops or policy briefs) in order to ensure the relevance of these findings to policy and practice.Systematic review registrationPROSPERO CRD42022293564

A Review of Immigrant Experiences during Trump Administration and COVID-19: Differences by Race

ABSTRACT Purpose Immigrants comprise about 14% of the existing population of the United States. The period under Trump administration and COVID-19 in particular have been challenging for immigrants. The goal of this review was to present a landscape of immigrants in the US and their experiences during the exclusionary environment under Trump administration and the pandemic. Method The study presents descriptive findings and chi-square results utilizing data collected from a survey. Our sample (N = 490) was collected during the early 2021. Results Findings indicate differences in COVID experiences, stress impact as a result of travel bans, and resiliency by race. Minority communities compared to those who were White were disproportionately impacted. Discussion and Conclusion By drawing on the literature, research and policy briefs and the study data, we discuss mental health implications and increased discrimination against immigrants. We propose ways in which researchers, practitioners and policy advocates can enhance support for immigrants.