RESUMO
BACKGROUND: During the COVID-19 pandemic, governments and health authorities faced tough decisions about infection prevention and control measures such as social distancing, face masks and travel. Judgements underlying those decisions require democratic input, as well as expert input. The aim of this review is to inform decisions about how best to achieve public participation in decisions about public health and social interventions in the context of a pandemic or other public health emergencies. OBJECTIVES: To systematically review examples of public participation in decisions by governments and health authorities about how to control the COVID-19 pandemic. DESIGN: We searched Participedia and relevant databases in August 2022. Two authors reviewed titles and abstracts and one author screened publications promoted to full text. One author extracted data from included reports using a standard data-extraction form. A second author checked 10% of the extraction forms. We conducted a structured synthesis using framework analysis. RESULTS: We included 24 reports (18 from Participedia). Most took place in high-income countries (n=23), involved 'consulting' the public (n=17) and involved public meetings (usually online). Two initiatives reported explicit support for critical thinking. 11 initiatives were formally evaluated (only three reported impacts). Many initiatives did not contribute to a decision, and 17 initiatives did not include any explicit decision-making criteria. CONCLUSIONS: Decisions about how to manage the COVID-19 pandemic affected nearly everyone. While public participation in those decisions had the potential to improve the quality of the judgements and decisions that were made, build trust, improve adherence and help ensure transparency and accountability, few examples of such initiatives have been reported and most of those have not been formally evaluated. Identified initiatives did point out potential good practices related to online engagement, crowdsourcing and addressing potential power imbalance. Future research should address improved reporting of initiatives, explicit decision-making criteria, support for critical thinking, engagement of marginalised groups and decision-makers and communication with the public. PROSPERO REGISTRATION NUMBER: 358991.
Assuntos
COVID-19 , Participação da Comunidade , Tomada de Decisões , SARS-CoV-2 , Humanos , COVID-19/prevenção & controle , Pandemias , Saúde PúblicaRESUMO
The effects of the COVID-19 pandemic are amplified among socially vulnerable groups, including international migrants, in terms of both disease transmission and outcomes and the consequences of mitigation measures. Migrants are overrepresented in COVID-19 laboratory-confirmed cases, hospital admissions, intensive care treatment and death statistics in all countries with available data. A syndemic approach has been suggested to understand the excess burden in vulnerable populations. However, this has not stopped the unequal burden of disease in Norway. Initially, the disease was mainly imported by Norwegians returning from skiing holidays in the Alps, and the prevalence of infection among migrants in Norway, defined as people born abroad to foreign parents, was low. Later, confirmed cases in migrants increased and have remained stable at 35-50% - more than twice the proportion of the migrant population (15%). To change this pattern, we need to understand the complex mechanisms underlying inequities in health and their relative and multiplying impacts on disease inequalities and to test the effect of counterfactual policies in order to reduce inequalities in disease burden. Yet, the current paradigm in the field of migration and health research, that is, the theories, research methods and explanatory models commonly applied, fail to fully understand the differences in health outcomes between international migrants and the host population. Here, we use the Norwegian situation as a case to explain the need for an innovative, system-level, interdisciplinary approach at a global level.
Assuntos
COVID-19 , Migrantes , Humanos , Noruega/epidemiologia , Pandemias , Saúde Pública , SARS-CoV-2RESUMO
Los trabajos reunidos en esta obra plantean un análisis exhaustivo de los litigios vinculados con los derechos de la salud, con el propósito de establecer hasta qué punto éstos son positivos y para quién. Para ello, desde una mirada comparada, se ciñen al examen de seis estudios de caso de países de la región, que complementan con un análisis transversal de la cuestión sobre sus diferentes aspectos.(AU)
Assuntos
Humanos , Direito à SaúdeRESUMO
Los trabajos reunidos en esta obra plantean un análisis exhaustivo de los litigios vinculados con los derechos de la salud, con el propósito de establecer hasta qué punto éstos son positivos y para quién. Para ello, desde una mirada comparada, se ciñen al examen de seis estudios de caso de países de la región, que complementan con un análisis transversal de la cuestión sobre sus diferentes aspectos.
Assuntos
Humanos , Direito à SaúdeRESUMO
This article offers a framework for exploring litigation as a strategy to advance the right to health by holding governments accountable to human rights norms. Since the 1990s, cases in which people go to court to claim their right to health have increased dramatically in resource-poor countries. With issues ranging from access to health services and medication, to discriminatory labor practices, to public health, to the basic determinants of health (such as food, water, shelter, and a healthy environment), these cases potentially have huge financial and social implications. Little is known, however, about the success of such attempts to hold governments accountable for their obligations with respect to the right to health--or about who benefits. Is litigation primarily used by marginalized persons to gain fair access to medical services, or is it more often a means by which those patients with more financial resources or creativity in seeking assistance pursue access to treatment that is not otherwise provided due to expense? To what extent does litigation affect health policy and service delivery? What little is known about these cases is fragmented and anecdotal The theoretical framework outlined here facilitates the systematic comparative and interdisciplinary studies needed to advance knowledge in this field, taking account of the entire litigation and implementation process.
