Intersectoral Partnerships Between Local Governments and Health Organisations in High-Income Contexts: A Scoping Review.

BACKGROUND: Local governments are the closest level of government to the communities they serve. Traditionally providing roads, rates and garbage services, they are also responsible for policy and regulation, particularly land use planning and community facilities and services that have direct and indirect impacts on (equitable) health and well-being. Partnerships between health agencies and local government are therefore an attractive proposition to progress actions that positively impact community health and well-being. Yet, the factors underpinning these partnerships across different contexts are underdeveloped, as mechanisms to improve population health and well-being. METHODS: A scoping review was conducted to gain insight into the concepts, theories, sources, and knowledge gaps that shape partnerships between health and local governments. The search strategy followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines and was informed by a critical realist approach that identifies necessary, contingent and contextual factors in the literature. MEDLINE, Scopus, Web of Science, and ProQuest Central databases were searched for studies published between January 2005 and July 2021. RESULTS: The search yielded 3472 studies, after deleting duplicates and initial title and abstract screening, 188 papers underwent full text review. Twenty-nine papers were included in the review. Key themes shaping partnerships included funding and resources; partnership qualities; governance and policy; and evaluation and measures of success. The functional, organisational and individual aspects of these themes are explored and presented in a framework. CONCLUSION: Given that local government are the closest level of government to community, this paper provides a sophisticated roadmap that can underpin partnerships between local government and health agencies aiming to influence population health outcomes. By identifying key themes across contexts, we provide a framework that may assist in designing and evaluating evidence-informed health and local government partnerships.

Australian and Canadian financial wellbeing policy landscape during COVID-19: An equity-informed policy scan.

Background: This targeted and comprehensive policy scan examined how different levels of governments in Australia and Canada responded to the financial crisis brought on by the COVID-19 pandemic. We mapped the types of early policy responses addressing financial strain and promoting financial wellbeing. We also examined their equity considerations. Methods: Through a systematic search, snowballing, and manual search, we identified Canadian and Australian policies at all government levels related to financial strain or financial wellbeing enacted or amended in 2019-2020. Using a deductive-inductive approach, policies were categorized by jurisdiction level, focal areas, and target population groups. Results: In total, 213 and 97 policies in Canada and Australia, respectively, were included. Comparisons between Canadian and Australian policies indicated a more diversified and equity-targeted policy landscape in Canada. In both countries, most policies focused on individual and family finances, followed by housing and employment areas. Conclusions: The policy scan identified gaps and missed opportunities in the early policies related to financial strain and financial wellbeing. While fast, temporary actions addressed individuals' immediate needs, we recommend governments develop a longer-term action plan to tackle the root causes of financial strain and poor financial wellbeing for better health and non-health crisis preparedness. Statement on Ethics and Informed Consent: This research reported in this paper did not require ethical clearance or patient informed consent as the data sources were published policy documents. This study did not involve data collection with humans (or animals), nor any secondary datasets involving data provided by humans (or from animal studies).

Gaawaadhi Gadudha: understanding how cultural camps impact health, well-being and resilience among Aboriginal adults in New South Wales, Australia-a collaborative study protocol.

INTRODUCTION: The health and well-being of Aboriginal Australians is inextricably linked to culture and Country. Our study challenges deficit approaches to health inequities by seeking to examine how cultural connection, practice and resilience among Aboriginal peoples through participation in 'cultural camps' held on sites of cultural significance promotes health and well-being. METHODS AND ANALYSIS: The study will be undertaken in close collaboration and under the governance of traditional cultural knowledge holders from Yuwaalaraay, Gamilaraay and Yuin nation groups in New South Wales, Australia. Three cultural camps will be facilitated, where participants (n=105) will engage in activities that foster a connection to culture and cultural landscapes. A survey assessing connection to culture, access to cultural resources, resilience, self-rated health and quality of life will be administered to participants pre-camp and post-camp participation, and to a comparative group of Aboriginal adults who do not attend the camp (n=105). Twenty participants at each camp (n=60) will be invited to participate in a yarning circle to explore cultural health, well-being and resilience. Quantitative analysis will use independent samples' t-tests or χ2 analyses to compare camp and non-camp groups, and linear regression models to determine the impact of camp attendance. Qualitative analysis will apply inductive coding to data, which will be used to identify connections between coded concepts across the whole data set, and explore phenomenological aspects. Results will be used to collaboratively develop a 'Model of Cultural Health' that will be refined through a Delphi process with experts, stakeholders and policymakers. ETHICS AND DISSEMINATION: The study has ethics approval from the Aboriginal Health and Medical Research Council (#1851/21). Findings will be disseminated through a combination of peer-reviewed articles, media communication, policy briefs, presentations and summary documents to stakeholders.

Access to school-based eye health programs: a qualitative case study, Bogotá, Colombia

[ABSTRACT]. Objectives. To identify barriers and enablers to accessing school-based eye health programs in Bogotá, Colombia. Methods. We undertook a qualitative case study that explored how structural factors, and social and cultural norms influence access to school-based eye health programs. We conducted focus groups discussions and interviews with a purposive sample of 37 participants: government stakeholders (n = 4), representatives from nongovernmental organizations (n = 3), and an eye-care practitioner, as well as teachers (n = 7), a school nurse, parents (n = 7), and children (n = 14) from private and public schools. Data were analyzed using a priori themes from the availability, accessibility, acceptability and quality framework. Results. Routine vision screening in schools is not currently provided nor is there a budget to support it. Lack of collaboration between the health and education ministries and the absence of national planning affected the delivery of eye care in schools. Factors related to acceptability of school-based eye health programs included: poor acceptance of training teachers as vision screeners; stigma related to wearing spectacles; and distrust of health services. The cost of spectacles and poor access to eye health information were identified as barriers to positive child eye health outcomes by socioeconomically disadvantaged parents and children. Conclusion. Our findings suggest the need for a national school eye health plan and improved cooperation between health and education ministries. Interventions to improve trust in health services, tackle the lack of human resources while respecting professional qualifications, and raise awareness of the importance of eye health are recommended.

[RESUMEN]. Objetivo. Determinar los obstáculos y los elementos facilitadores para acceder a los programas de salud ocular en las escuelas en Bogotá (Colombia). Métodos. Se llevó a cabo un estudio cualitativo de casos que exploró cómo influyen los factores estructurales y las normas sociales y culturales en el acceso a la atención oftalmológica. Se realizaron entrevistas y grupos de opinión con una muestra intencionada de 37 participantes: interesados directos gubernamentales (n = 4), representantes de organizaciones no gubernamentales (n = 3) y un profesional de atención oftalmológica, así como docentes (n = 7), una enfermera escolar, padres (n = 7) y niños (n = 14) de escuelas privadas y públicas. Se analizaron los datos empleando temas determinados a priori sobre la disponibilidad, la accesibilidad, la aceptabilidad y el marco de calidad. Resultados. Actualmente, no se proporciona un tamizaje sistemático de la visión en las escuelas, ni se dispone de presupuesto para respaldarlo. La falta de colaboración entre los ministerios de salud y de educación, y la falta de planificación a nivel nacional tuvo repercusiones sobre la prestación de atención oftalmológica en las escuelas. Entre los factores relacionados con la aceptabilidad de los programas de salud ocular en las escuelas se encuentran una escasa aceptación de la posibilidad de capacitar a los docentes para que examinen la visión; el estigma relacionado con el uso de anteojos y la desconfianza de los servicios de salud. Los padres y los niños en una situación socioeconómica desfavorable indicaron que el costo de las gafas y el acceso limitado a la información sobre la salud ocular eran obstáculos para obtener resultados positivos de salud ocular en los niños. Conclusiones. Los resultados indican la necesidad de un plan nacional de salud ocular en las escuelas y una mejor cooperación entre los ministerios de salud y de educación. Se recomiendan intervenciones para mejorar la confianza en los servicios de salud, abordar la falta de recursos humanos al tiempo que se respetan las cualificaciones profesionales y concientizar sobre la importancia de la salud ocular.

[RESUMO]. Objetivos. Identificar barreiras e facilitadores para o acesso a programas escolares de saúde ocular em Bogotá, Colômbia. Métodos. Estudo de caso qualitativo que explorou como fatores estruturais e normas socioculturais influenciam o acesso aos cuidados com a visão. Realizamos discussões em grupos focais e entrevistas com uma amostra intencional de 37 participantes: partes interessadas do governo (n = 4), representantes de organizações não governamentais (n = 3) e um oftalmologista, bem como professores (n = 7), uma enfermeira escolar, pais de alunos (n = 7) e alunos (n = 14) de escolas públicas e particulares. Os dados foram analisados de acordo com temas escolhidos a priori, a partir do marco de disponibilidade, acessibilidade, aceitabilidade e qualidade. Resultados. O exame de visão de rotina não é realizado atualmente nas escolas, nem há espaço orçamentário para fazê-lo. A falta de colaboração entre os Ministérios da Saúde e da Educação e a ausência de planejamento em escala nacional afetaram a prestação de cuidados oftalmológicos nas escolas. Fatores relacionados à aceitabilidade dos programas escolares de saúde ocular incluíram baixa aceitação do treinamento de professores para realizar triagem de problemas visuais, estigma relacionado ao uso de óculos e desconfiança nos serviços de saúde. O custo dos óculos e o acesso limitado a informações sobre saúde ocular foram identificados como barreiras para desfechos positivos de saúde ocular infantil em pais e crianças em situação de desvantagem socioeconômica. Conclusão. Os resultados sugerem a necessidade de um plano nacional de saúde ocular nas escolas e de uma melhor cooperação entre os Ministérios da Saúde e da Educação. Recomendam-se intervenções para aumentar a confiança nos serviços de saúde, combater a falta de recursos humanos (respeitando as qualificações profissionais) e aumentar a conscientização sobre a importância da saúde ocular.