Politics-evidence conflict in national health policy making in Africa: a scoping review.

BACKGROUND: Generally, public health policy-making is hardly a linear process and is characterized by interactions among politicians, institutions, researchers, technocrats and practitioners from diverse fields, as well as brokers, interest groups, financiers and a gamut of other actors. Meanwhile, most public health policies and systems in Africa appear to be built loosely on technical and scientific evidence, but with high political systems and ideologies. While studies on national health policies in Africa are growing, there seems to be inadequate evidence mapping on common themes and concepts across existing literature. PURPOSE: The study seeks to explore the extent and type of evidence that exist on the conflict between politics and scientific evidence in the national health policy-making processes in Africa. METHODS: A thorough literature search was done in PubMed, Cochrane Library, ScienceDirect, Dimensions, Taylor and Francis, Chicago Journals, Emerald Insight, JSTOR and Google Scholar. In total, 43 peer-reviewed articles were eligible and used for this review. RESULT: We found that the conflicts to evidence usage in policy-making include competing interests and lack of commitment; global policy goals, interest/influence, power imbalance and funding, morals; and evidence-based approaches, self-sufficiency, collaboration among actors, policy priorities and existing structures. Barriers to the health policy process include fragmentation among actors, poor advocacy, lack of clarity on the agenda, inadequate evidence, inadequate consultation and corruption. The impact of the politics-evidence conflict includes policy agenda abrogation, suboptimal policy development success and policy implementation inadequacies. CONCLUSIONS: We report that political interests in most cases influence policy-makers and other stakeholders to prioritize financial gains over the use of research evidence to policy goals and targets. This situation has the tendency for inadequate health policies with poor implementation gaps. Addressing these issues requires incorporating relevant evidence into health policies, making strong leadership, effective governance and a commitment to public health.

[United in difference: on the vocation of Brazilian sociology at the Instituto Universitário de Pesquisas do Rio de Janeiro, 1973-1977]. / Unidos na diferença: sobre a vocação da sociologia brasileira no Instituto Universitário de Pesquisas do Rio de Janeiro, 1973-1977.

This article investigates the first generation (1973-1977) of researchers trained in the Graduate Program in Sociology at the Instituto Universitário de Pesquisas do Rio de Janeiro (IUPERJ). While IUPERJ is known as the birthplace of modern Brazilian political science, sociology there is less well known. Using documentary resources, interviews, and the secondary literature, we take a nuanced look at this generation, which has been described as both excessively heterogeneous and less original in comparison to political science at IUPERJ. For them, theoretical and methodological specialization was seen as central to a political sociology that sought responses to the demands of a society at the crossroads between modernization and redemocratization.

Este artigo busca compreender a vocação científica consagrada pela primeira geração (1973-1977) de pesquisadores do Programa de Pós-graduação em Sociologia do Instituto Universitário de Pesquisas do Rio de Janeiro (Iuperj). Embora o Iuperj seja visto como berço da moderna ciência política brasileira, pouco se sabe sobre sua sociologia. Para tal, baseamo-nos em documentos, entrevistas e bibliografia secundária. Queremos nuançar diagnósticos sobre essa geração, ora vista como excessivamente heterogênea, ora como pouco original se comparada à ciência política iuperjiana. Na vocação daquela geração, o elogio à especialização teórico-metodológica era parte central de uma sociologia política que buscava dar respostas às demandas de uma sociedade na encruzilhada entre modernização e redemocratização.

Who supports Bernie? Analyzing identity and ideological variation on Twitter during the 2020 democratic primaries.

Using a novel dataset of 590M messages by 21M users, we present the first large-scale examination of the behavior of likely Bernie supporters on Twitter during the 2020 U.S. Democratic primaries and presidential election. We use these data to dispel empirically the notion of a unified, stereotypical Bernie supporter (e.g., the "Bernie Bro"). Instead, our work uncovers significant variation in the identities and ideologies of Bernie supporters who were active on Twitter. Our work makes three contributions to the literature on social media and social movements. Methodologically, we present a novel mixed methods approach to surface identity and ideological variation within a movement via use of patterns in who retweets whom (i.e. who retweets which other users) and who retweets what (i.e. who retweets which specific tweets). Substantively, documentation of these variations challenges a trend in the social movement literature to assume actors within a particular movement are unified in their ideology, identity, and values.

The politics of disease.

The COVID-19 pandemic highlights a long-known but often neglected aspect of international relations: the ability of disease to challenge and change all aspects of security, as well as the ability of public policies to change the course of disease progression. Diseases, especially mass epidemics like COVID-19, clearly affect political, economic, and social structures, but they can also be ameliorated or exacerbated by political policies, including public health policies. The threat of pandemic disease poses a widespread and increasing threat to international stability. Indeed, the political implications of pandemic disease have become increasingly evident as COVID-19 has precipitated death, economic collapse, and political instability around the globe. Any pandemic disease can precipitate catastrophes, from increasing health care costs to decreased productivity. This theoretical discussion highlights the intertwined interactions between social, political, and economic forces and the emergence and evolution of pandemic disease, with widespread implications for governance and international security.

Political factors, carbon emissions, and life expectancy in India: Implications for the Sustainable Development Goal 3.

This study examines the nexus among political factors, carbon emissions, and life expectancy between 1990 and 2020 in India. Data for this study was extracted from the World Bank Development indicators, after which it was subjected to econometrics analysis. The results showed that on averages, between 1990 and 2020, India experienced a life expectancy around 65 years. Fossil fuel energy consumption represents a small proportion of total energy consumption in India. However, carbon emissions and life expectancy have a positive and significant relationship. Fossil fuel usage and life expectancy possess a significantly positive relationship (FFEC = 0.044128, P-value = 0.0023) Moreover, government effectiveness and life expectancy have a significant direct relationship. Political stability and life expectancy have a significant negative relationship in the country. We conclude that policymakers in India should ensure that carbon emissions and fossil fuel usage in India do not pose a threat to life expectancy. Efforts should be put in place by policymakers in India to increase life expectancy , a strategic component of SDG 3- good health and well being for all at all ages, by ensuring stable political climate, good governance and efficient health enhanced public policies.

Cette étude examine le lien entre les facteurs politiques, les émissions de carbone et l'espérance de vie entre 1990 et 2020 en Inde. Les données de cette étude ont été extraites des indicateurs de développement de la Banque mondiale, après quoi elles ont été soumises à une analyse économétrique. Les résultats ont montré qu'en moyenne, entre 1990 et 2020, l'Inde a connu une espérance de vie d'environ 65 ans. La consommation d'énergie fossile représente une petite proportion de la consommation totale d'énergie en Inde. Cependant, les émissions de carbone et l'espérance de vie ont une relation positive et significative. L'utilisation de combustibles fossiles et l'espérance de vie possèdent une relation significativement positive (FFEC = 0,044128, valeur P = 0,0023). De plus, l'efficacité du gouvernement et l'espérance de vie ont une relation directe significative. La stabilité politique et l'espérance de vie ont une relation négative significative dans le pays. Nous concluons que les décideurs politiques indiens devraient veiller à ce que les émissions de carbone et l'utilisation de combustibles fossiles en Inde ne constituent pas une menace pour l'espérance de vie. Des efforts devraient être mis en place par les décideurs politiques indiens pour augmenter l'espérance de vie, une composante stratégique de l'ODD 3 - bonne santé et bien-être pour tous à tout âge, en garantissant un climat politique stable, une bonne gouvernance et des politiques publiques efficaces et améliorées en matière de santé.

Political participation among deaf youth in Great Britain.

Variations in political participation are linked to demographic factors, socioeconomic disparities, and cultural-ethnic diversity. Existing research has primarily explored reduced political involvement among individuals with disabilities, particularly in electoral politics. However, little research has attended the involvement of deaf people specifically. This is of interest because deaf youth are at an intersection of disability, language and cultural identity with their language affiliations and rejection or acceptance of disability evolving through childhood. This study draws from original data collected via an online survey, comprising 163 deaf young respondents aged 16-19 in Great Britain. We compare their levels of political participation with those of general population peers to explore how sociodemographic factors, alongside variations in self-identification as deaf, and meaningful interactions with other deaf people contribute to explain their political engagement. The results challenge conventional wisdom by demonstrating that deaf youth participate more actively in politics than their hearing peers in various forms of political involvement, including collective, contact, and institutional activism. We also recognize differences among deaf youth and propose that social aspects of identity formation, particularly embracing a deaf identity and having deaf friends, can boost certain forms of political engagement. In summary, this study underscores the importance of acknowledging the diversity of deaf youth in terms of affiliation with various forms of deaf identity, rendering their experience different from both disabled and hearing youth. By identifying the factors driving heightened political participation, policymakers and advocates can develop strategies to enhance political engagement among all young people, regardless of their hearing status.

Democratic quality and excess mortality during the COVID-19 pandemic.

The aim of this study is to analyse the relationship between democratic quality and excess mortality produced in the year 2020 before COVID-19 vaccinations were generalised. Using cross-sectional data from 80 countries on five continents, multiple linear regression models between excess mortality, the general democracy index and its disaggregation into five categories: electoral process and pluralism, government functioning, political participation, political culture and civil liberties were estimated. The analysis also considered, public health spending per capita, overweight inhabitants, the average temperature of the country, population over 65 years of age, The KOF Globalisation Index, and the Gross National Income per capita as control variables. It was possible to establish a strong inverse association between excess mortality per million inhabitants and the general democracy index and four of its five categories. There was a particularly strong relationship between excess mortality and the political culture dimension (-326.50, p < 0.001). The results suggest that the higher the democratic quality of the political institutions of a State and particularly of their political culture the more improved the response and management of the pandemic was in preventing deaths and protecting their citizens more effectively. Conversely, countries with lower democracy index values have higher excess mortality. Quality democratic political institutions provide more effective public health policies in the face of the COVID-19 pandemic.

Performing Platform Governance: Facebook and the Stage Management of Data Relations.

Controversies surrounding social media platforms have provided opportunities for institutional reflexivity amongst users and regulators on how to understand and govern platforms. Amidst contestation, platform companies have continued to enact projects that draw upon existing modes of privatized governance. We investigate how social media companies have attempted to achieve closure by continuing to set the terms around platform governance. We investigate two projects implemented by Facebook (Meta)-authenticity regulation and privacy controls-in response to the Russian Interference and Cambridge Analytica controversies surrounding the 2016 U.S. Presidential Election. Drawing on Goffman's metaphor of stage management, we analyze the techniques deployed by Facebook to reinforce a division between what is visible and invisible to the user experience. These platform governance projects propose to act upon front-stage data relations: information that users can see from other users-whether that is content that users can see from "bad actors", or information that other users can see about oneself. At the same time, these projects relegate back-stage data relations-information flows between users constituted by recommendation and targeted advertising systems-to invisibility and inaction. As such, Facebook renders the user experience actionable for governance, while foreclosing governance of back-stage data relations central to the economic value of the platform. As social media companies continue to perform platform governance projects following controversies, our paper invites reflection on the politics of these projects. By destabilizing the boundaries drawn by platform companies, we open space for continuous reflexivity on how platforms should be understood and governed.

Cuerpos desgener[iz]ados: rescatando las experiencias de personas intersex como usuarias del sistema de salud público Chileno / Corpos desgener[iz]ados: resgatando as experiências de pessoas intersexuais como usuárias do sistema público de saúde chileno / Desgener[iz]ated bodies: rescuing the experiences of intersex people as users of the Chilean public health system

Introducción: La intersexualidad comprende condicionesinfrecuentes donde una persona nace con una anatomíasexual diferente del binario hombre-mujer; esto suponehabitar un cuerpo fuera de lo inteligible y estigmatizado.Históricamente, desde la heteronorma, el modelo biomédicoha buscado normalizarles quirúrgicamente para asignarprecoz y arbitrariamente un sexo-género armónico con lagenitalidad. Desde los Derechos Humanos, estas prácticasson cuestionadas por colectivos Intersex.Materiales y método: Estudio de caso, entre años 2019 y2020; técnica de entrevista en profundidad a dos usuariosadultos de los Policlínicos de Urología y Endocrinología de unhospital público en Santiago, Chile; se utilizó la fenomenologíade Husserl para comprender la experiencia en el sistema desalud de las personas intersex. El análisis de la informaciónse basó en la propuesta de Colaizzi.Resultados: Se reconocieron unidades de significado principalese imbricadas, cuyas esencias permitieron describir el fenómenode: ser niño y habitar el espacio hospitalario, vivir con lacondición actualmente, y la experiencia de utilizar el sistemade salud siendo adulto.Conclusiones: Se identificaron diversas estrategias de agenciatanto en el espacio hospitalario como el cotidiano, medianteun proceso personal y silencioso de aprendizajes sobre lasimplicancias de ser intersexual.(AU)

Introduction: Intersexuality includes extremely rareconditions where a person is born with a sexual anatomydifferent from the male-female binary; this supposesinhabiting a body outside the intelligible, configuringa stigma. Historically and from the heteronorm, thebiomedical model has sought to surgically normalizethem in order to precociously and arbitrarily assigna gender in harmony with genitality. From HumanRights, these practices have been questioned byIntersex groups.Materials and method: During the years 2019 and2020, case studies were carried out through in-depthinterviews with two adult users of the Urology andEndocrinology Polyclinics of a public hospital atSantiago, Chile; Husserl's phenomenology was usedto visualize the phenomenon according to how it isexperienced by the subjects who carry it, using theprocedure described by Colaizzi as an informationanalysis plan.Results: Main and overlapping units of meaning wererecognized, whose essences allowed describing thephenomenon of: being a child and inhabiting thehospital space, currently living with the condition,and the experience of using the health system as anadult, with new and own meanings.Conclusions: Various agency strategies were identifiedboth in the hospital space and in everyday life, througha personal and silent process of learning about theimplications of being intersex.(AU)

Introdução: Intersexo compreende condições rarasem que uma pessoa nasce com uma anatomia sexualdiferente do binário masculino-feminino; Isso significahabitar um corpo fora do que é inteligível e estigmatizado.Historicamente, a partir da heteronormação, o modelobiomédico buscou normalizá-los cirurgicamente paraatribuir precoce e arbitrariamente um sexo-gêneroharmônico com a genitalidade. A partir dos DireitosHumanos, essas práticas são questionadas por gruposintersexuais.Materiais e método: Estudo de caso, entre os anos de2019 e 2020; técnica de entrevista em profundidadecom dois usuários adultos das Policlínicas de Urologiae Endocrinologia de um hospital público de Santiago,Chile; A fenomenologia de Husserl foi utilizada paracompreender a experiência de pessoas intersexuaisno sistema de saúde. A análise das informações foibaseada na proposta de Colaizzi.Resultados: Reconheceram-se unidades de significadoprincipais e sobrepostas, cujas essências permitiramdescrever o fenômeno de: ser criança e habitar oespaço hospitalar, viver atualmente com a condição e aexperiência de usar o sistema de saúde na fase adulta.Conclusões: Foram identificadas várias estratégiasde agenciamento tanto no hospital como na vidaquotidiana, através de um processo pessoal e silenciosode aprendizagem sobre as implicações de ser intersexo.(AU)

The FDA in the Crosshairs-Science, Politics, and Abortion.

In this Viewpoint, the Supreme Court case FDA v AHM is used to illustrate the tension the FDA faces between science and politics, and state authority over abortion vs federal authority over which drugs may be marketed nationwide.

Detection and impact estimation of social bots in the Chilean Twitter network.

The rise of bots that mimic human behavior represents one of the most pressing threats to healthy information environments on social media. Many bots are designed to increase the visibility of low-quality content, spread misinformation, and artificially boost the reach of brands and politicians. These bots can also disrupt civic action coordination, such as by flooding a hashtag with spam and undermining political mobilization. Social media platforms have recognized these malicious bots' risks and implemented strict policies and protocols to block automated accounts. However, effective bot detection methods for Spanish are still in their early stages. Many studies and tools used for Spanish are based on English-language models and lack performance evaluations in Spanish. In response to this need, we have developed a method for detecting bots in Spanish called Botcheck. Botcheck was trained on a collection of Spanish-language accounts annotated in Twibot-20, a large-scale dataset featuring thousands of accounts annotated by humans in various languages. We evaluated Botcheck's performance on a large set of labeled accounts and found that it outperforms other competitive methods, including deep learning-based methods. As a case study, we used Botcheck to analyze the 2021 Chilean Presidential elections and discovered evidence of bot account intervention during the electoral term. In addition, we conducted an external validation of the accounts detected by Botcheck in the case study and found our method to be highly effective. We have also observed differences in behavior among the bots that are following the social media accounts of official presidential candidates.

How COVID-19 affects voting for incumbents: Evidence from local elections in France.

How do voters react to an ongoing natural threat? Do voters sanction or reward incumbents even when incumbents cannot be held accountable because an unforeseeable natural disaster is unfolding? We address this question by investigating voters' reactions to the early spread of COVID-19 in the 2020 French municipal elections. Using a novel, fine-grained measure of the circulation of the virus based on excess-mortality data, we find that support for incumbents increased in areas that were particularly hard hit by the virus. Incumbents from both left and right gained votes in areas more strongly affected by COVID-19. We provide suggestive evidence for two mechanisms that can explain our findings: an emotional channel related to feelings of fear and anxiety, and a prospective-voting channel, related to the ability of incumbents to act more swiftly against the diffusion of the virus than challengers.

Evaluating the decentralisation of the Spanish healthcare system: a data envelopment analysis approach.

OBJECTIVES: The aim of the study was to answer whether the central government has been more efficient than the regional governments or vice versa. Likewise, through the analysis of the data, the aim was to shed light on whether decentralisation has had a positive impact on the efficiency of the hospital sector or not. DESIGN: In this paper, we have used data envelopment analysis to analyse the evolution of efficiency in the last 10 Autonomous Regions to receive healthcare competences at the end of 2001. PARTICIPANTS: For this study, we have taken into account the number of beds and full-time workers as inputs and the calculation of basic care units as outputs to measure the efficiency of the Spanish public sector, private sector and jointly in the years 2002, 2007, 2012 and 2017 for the last Autonomous Regions receiving healthcare competences. RESULTS: Of the Autonomous Regions that received the transfers at the end of 2001, the following stand out for their higher efficiency growth: the Balearic Islands (81.44% improvement), the Madrid Autonomous Region, which practically reached absolute efficiency levels (having increased by 63.77%), and La Rioja which, together with the Balearic Islands which started from very low values, improved notably (46.13%). CONCLUSION: In general, it can be observed that the transfer of responsibilities in the health sector has improved efficiency in the National Health Service. JEL CLASSIFICATION: C14; I18; H21.

From an election to an insurrection: Investigating differential engagement and sentiment in the #defundthepolice and #defendthepolice network on Twitter.

Social movements and their respective countermovements have evolved to use online social media platforms to recruit followers, share pertinent information, discuss relevant issues, and draw the attention of political figures. Movements' strategic use of Twitter has increasingly been studied, though there are relatively few studies that compare social movements and their corresponding countermovements simultaneously. We examine engagement in the #DefundthePolice social movement and #DefendthePolice countermovement in a Twitter network comprised of retweets using both hashtags from August 2020 to January 2021. Text and sentiment analysis as well as a content analysis of a random sample of retweets in the network's 20 largest subgroups reveal four key patterns. First, information commonly communicated in historical social movements is communicated in the online, Twitter network. Second, the use of movement and countermovement hashtags to criticize is common, suggesting Twitter engagement with the movement/countermovement is not a sufficient indicator of support for the movement. Third, social movements are inextricably embedded in politics, with political discourse present in all the 20 largest subgroups. Finally, though we do not include geo-tagged tweets in the analysis, physical geography is key theme in multiple subgroups. Broadly, our findings demonstrate the breadth of topics communicated within movement networks and highlight the importance of qualitatively examining Twitter data in the study of social movements.

Does the healthcare decentralization provide better public health security capacity and health services satisfaction? An analysis of OECD countries.

PURPOSE: Decentralization has profound implications for many health systems. This study investigates the effect of health system decentralization in Organization for Economic Co-operation and Development (OECD) countries on public health security capacity and health service satisfaction. DESIGN/METHODOLOGY/APPROACH: Multiple linear regression analyses were employed for variables related to the level of health security capacity and satisfaction with the healthcare system while controlling for all socio-demographic variables from the European Social Survey, including over 44,000 respondents from 25 OECD countries. The Health Systems in Transition series of countries were used for assessing the decentralization level. FINDINGS: The result of multiple linear regression analyses showed that the level of decentralization in health systems was significantly associated with higher health security capacity (ß-coefficient 3.722, 95% confidence interval (CI) [3.536 3.908]; p=<0.001) and health service satisfaction (ß-coefficient 1.463, 95% CI [1.389 1.536]; p=<0.001) in the study. Countries with a higher level of decentralization in health policy tasks and areas were significantly likely to have higher health services satisfaction, whereas this satisfaction had a significant negative relation with the lower level of decentralization status of secondary/tertiary care services in OECD countries (ß-coefficient -5.250, 95% CI [-5.757-4.743]; p = 0.001). ORIGINALITY/VALUE: This study contributes to a better understanding of the extent to which decentralization of health services affects public health safety capacity and satisfaction with health services, whereas the level of decentralization in OECD countries varies considerably. Overall, the findings highlight the importance of public health security and satisfaction with health care delivery in assessing the effects of decentralization in health services.