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1.
Health Care Manage Rev ; 48(1): 2-13, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36413650

RESUMO

BACKGROUND: Determining the different features and potential impacts of community initiatives aimed at health-related outcomes poses challenges for both researchers and policy makers. PURPOSE: This article explores the nature of heterogeneous "community engagement initiatives" (CEIs) considering both their social and organizational features in order to understand the managerial and policy implications to maximize their potential local health and social care-related impacts. METHODOLOGY: A threefold qualitative analysis was conducted: (a) Three frameworks were developed to classify and analyze different CEIs features, building upon the current literature debate; (b) primary data were collected from Italian CEIs; and (c) a comparative cross-case analysis of a total of 79 CEIs in Italy and the United Kingdom was implemented. FINDINGS: The results show two types of strategic policy and management implications: (a) CEI portfolios are very broad and differentiated; (b) different social networks have diversified social constructs, internal cultures, and organizational features; and (c) there is a consequent need to contextualize relational and steering approaches in order to maximize their potential community added value. CONCLUSION: CEIs are fundamental pillars of contemporary welfare systems because of both the changing demography and epidemiology and the disruptive impact of platform economy models. This challenging scenario and the related CEIs involve a complex social mechanism, which requires a new awareness and strengthened competences for public administrations' steering. PRACTICE IMPLICATIONS: It is crucial for policy makers and managers to become familiar with all the different CEIs available in order to choose which solution to implement, depending on their potential impacts related to local public health and social care priorities. They also need to select the related effective steering logic.


Assuntos
Rede Social , Apoio Social , Humanos , Itália , Reino Unido , Pessoal Administrativo
2.
Eval Program Plann ; 95: 102176, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36356387

RESUMO

Government authorities are seeking new, cost-effective ways to stimulate growth and job creation by increasingly favoring the development of innovation ecosystems. Corporate-startup collaboration as a phenomenon has therefore progressively been supported by government authorities as a way of simultaneously helping startups to scale and providing opportunities for incumbents to renew themselves. However, evaluating the results of such collaborations is complex, which means that it can be a challenge for any government agency to evaluate its related interventions. This paper is explorative and based on empirical data from a study of the Swedish innovation agency, Vinnova. The purpose is to improve our understanding on how governments today evaluate government funded corporate-startup collaboration initiatives and how evaluations can be improved by utilizing methods based on theory-driven and realist approaches. An evaluation framework for policy makers based on a theory-driven and learning cycle approach is presented in this paper.


Assuntos
Ecossistema , Governo , Humanos , Avaliação de Programas e Projetos de Saúde , Órgãos Governamentais , Pessoal Administrativo
3.
JAMA Health Forum ; 3(11): e224115, 2022 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-36399351

RESUMO

Importance: The US Food and Drug Administration (FDA) has an accelerated approval program that has become the subject of scholarly attention and criticism, not only for the FDA's oversight of the program but also for its implications for payers. Observations: State Medicaid programs' legal obligations to provide reimbursement for accelerated approval products have created fiscal challenges for Medicaid that have been exacerbated by industry's changing use of the accelerated approval program over time. Although strategies for accelerated approval reforms have been proposed, most focus on reforming the FDA's accelerated approval pathway and product regulation without taking into account the implications of this pathway for state Medicaid programs. There is a need for policy reforms that balance the goal of speeding approval of important medicines with states' real concerns regarding spending on medications with little evidence of clinical benefits. Areas of potential reform include formulary exclusion, Medicaid rebates, value-based pricing, and consolidated purchasing or carve outs. Conclusions and Relevance: Policy makers may wish to consider options for reforming reimbursement for accelerated approval products in addition to reforms to the FDA's operation of the pathway. Policy reform proposals can provide a range of options to evaluate trade-offs of access and pricing.


Assuntos
Aprovação de Drogas , Medicaid , Estados Unidos , Humanos , Preparações Farmacêuticas , United States Food and Drug Administration , Pessoal Administrativo
5.
Front Public Health ; 10: 1045512, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36438272

RESUMO

Introduction: A balanced scorecard (BSC) is a comprehensive performance evaluation (PE) tool. A recent review summarized that a balanced consideration of PE from six perspectives in hospitals must be considered: financial, customer, internal, external, knowledge and growth, and managerial. However, patients were rarely engaged in BSC implementations. This research aims to engage Palestinian patients in BSC implementation to develop recommendations for policy makers. Methodology: In this cross-sectional study, the BSC-PATIENT survey was distributed between January and October 2021. We evaluated patients' experiences and their attitudes toward BSC dimensions (BSCP ATT). The differences in evaluations based on admission status were analyzed using the Mann-Whitney U test. Causal relationships between patients' experiences and attitudes were analyzed using multiple linear regression. We tested the multicollinearity of the model. Path analysis was performed to understand the BSC strategic maps based on the Palestinian patients' evaluations. Results: Out of 1,000 surveys, 740 were retrieved. The mean scores for Palestinian patient experiences evaluation showed that the services experience factor had the highest score (87.7 ± 17.7), and the patient care experience factor had the lowest score (57 ± 34.5). Patient experiences collectively predicted 56.4% of the variance in the BSCP ATT. The experience factors of information (ß = 0.400, t = 13.543, P < 0.001), patient care (ß = 0.241, t = 8.061, P < 0.001), services (ß = 0.176, t = 6.497, P < 0.001), and building (ß = 0.177, t = 6.308, P < 0.001) had the highest impact on BSCP ATT. The price had only a weak negative influence (ß = -0.051, t = -2.040, P = 0.042). Accessibility to hospitals did not have any impact on BSCP ATT. Significant differences between inpatient and outpatients' evaluations in regard to experiences related to patient care (P = 0.042), services (P < 0.001), accessibility (P < 0.001), and BSCP ATT (P = 0.003) were found. Conclusion: BSC-PATIENT successfully engaged patients in BSC PE at Palestinian hospitals. This research provides strong evidence for the impact of patients' information experience on their attitudes. Palestinian health policy makers must prioritize the design and delivery of patient education programs into their action plans and encourage a two-way information communication with patients. Strong evidence for patient care, services, and building experiences role in improving patients' attitudes was found. Managers should enhance patients' feedback and engagement culture in Palestinian hospitals.


Assuntos
Árabes , Hospitais , Humanos , Estudos Transversais , Política de Saúde , Pessoal Administrativo
6.
PLoS One ; 17(11): e0277152, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36441685

RESUMO

BACKGROUND: This study aimed to analyse the content of the Dental Benefits Act 2008 as a foundation for the Child Dental Benefits Schedule (CDBS) to determine how the Act encourages Australian families to seek and utilise oral health services. METHODS: This was a qualitative narrative document analysis conducted in 2022. Data was collected by searching formal websites for retrieving documents that reported the Australian Dental Benefits Act. The eligibility of the retrieved documents was assessed based on authenticity, credibility, representativeness, and meaningfulness of the data. A seven-steps procedure was applied for framework analysis. RESULTS: The content of the Dental Benefits Act 2008 provides directions on the three categories of operational, collective, and constitutional rules. Operational rules at the level of oral health providers and the population, as the service end users, can be demonstrated as rules in use in a mutual interaction with the collective and constitutional rules. The consequence of governing the rules at the community level can easily define how the oral health services are provided and utilised. The response is sent to the government level for better regulation of oral health service delivery and utilisation. Then, with interaction and advocacy with the diverse range of stakeholders and interdisciplinary partnerships, with community groups, non-government sectors and councils, the rules can be transformed, adopted, monitored, and enforced. Another mechanism of response has occurred at the providers' and users' level and to the operational rules to community groups and stakeholders via advertising and promoting the utilisation and provision of oral health services. CONCLUSION: This study integrates the perspective of politicians with those of policy makers to reconsider the role and significance of the rules based on the triple collaborations among oral health users and oral service providers, the community, and the stakeholders as well as the government. A comprehensive attention is still needed in future revisions of the Dental Benefits Act 2008 according to the contextual factors, socioeconomic and geographical attributes of the population for better implementation of de facto rules and more effective outcomes of the interventions. It is recommended that further research be undertaken utilising a mix-method approach for a holistic view prior to further revisions of the Act or proposal of probable upcoming schemes.


Assuntos
Pessoal Administrativo , Publicidade , Criança , Humanos , Austrália , Altruísmo , Definição da Elegibilidade
7.
Sci Rep ; 12(1): 18784, 2022 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-36335237

RESUMO

Work alienation refers to mental self-separation from work, and it is an integral reflection of workers and their work. Few studies have explored the association between work area and work alienation among grassroots judicial administrators. A stratified sampling method was used to collect data from 288 grassroots judicial administrators in Guangzhou to measure the overall status quo and work alienation in this group. This study found that the current grassroots judicial administrative team has a reasonable structure, high professional quality, and rich grassroots work experience, but a high level of work intensity (Mean = .667) and a lack of autonomy (Mean = .757) are prominent. Work area (unstandardized regression coefficient, B = .917) is significantly related to work alienation when controlling for sociodemographic and work characteristic variables: the closer the work area is to the city centre areas, the higher the level of work alienation. In addition, education level also has a significant effect on work alienation: the lower the individual education level is, the stronger the work alienation. The discussion focuses on the knowledge needs in grassroots judicial administrative work and the importance of the external working environment, and further research implications are proposed.


Assuntos
Pessoal Administrativo , Local de Trabalho , Humanos , China , Alienação Social
9.
PLoS One ; 17(11): e0275523, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36417418

RESUMO

From the beginning of the COVID-19 pandemic, researchers advised policy makers to make informed decisions towards the adoption of mitigating interventions. Key easy-to-interpret metrics applied over time can measure the public health impact of epidemic outbreaks. We propose a novel method which quantifies the effect of hospitalizations or mortality when the number of COVID-19 cases doubles. Two analyses are used, a country-by-country analysis and a multi-country approach which considers all countries simultaneously. The new measure is applied to several European countries, where the presence of different variants, vaccination rates and intervention measures taken over time leads to a different risk. Based on our results, the vaccination campaign has a clear effect for all countries analyzed, reducing the risk over time. However, the constant emergence of new variants combined with distinct intervention measures impacts differently the risk per country.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Pandemias/prevenção & controle , Saúde Pública , Pessoal Administrativo , Europa (Continente)/epidemiologia
10.
Front Public Health ; 10: 1038726, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36419985

RESUMO

Background: School nutrition programs impact the intellectual, social, and emotional development of school children, as well as their future risk of developing Non-Communicable Diseases. While many stakeholders are involved in the development, implementation, and evaluation of school nutrition programs in Dubai, United Arab Emirates, little is known about the complementarity among those stakeholders, and the means to upscale school nutrition programs while ensuring effective, efficient, and equitable implementation. Accordingly, this study aims at exploring the perceptions of a diverse group of stakeholders, positioned at differing levels of the public health and education ecosystems in the United Arab Emirates, in relation to current guidelines and practices around the planning, implementation, and evaluation of school nutrition programs in Dubai, United Arab Emirates. Methods: The current study relied on a qualitative design, based on semi-structured key informant interviews. A total of 29 interviews were carried out. Those interviewees included leaders and directors from different institutions, decision- and policy- makers, nutritionists and dieticians, school nurses and nurse managers, and school principals and vice principals. All stakeholders were interviewed by the research team. Data was transcribed, and then thematically analyzed using the health systems' model as an analytic framework. Results: The thematic analysis of interview data identified five interrelated themes. The first theme relates to the limited coordination across regulatory local and federal entities, and the multiplicity of guidelines issued by the different stakeholders. The challenges around the human and financial resourcing of school nutrition programs constituted the second theme. The third theme was the weakly coordinated implementation efforts. The fourth theme was the need for better performance measurement, and the fifth theme flagged the need for improved inclusiveness for health needs and cultural preferences of the diverse student body in Dubai (given that there are citizens from more than 200 nationalities co-existing in Dubai). Conclusion: This study emphasizes that all the involved stakeholders need to better collaborate to upscale the school nutrition program in Dubai. This will require the formation of a unified governing body, which would identify and develop a single stream of resources, and sets in place a reliable, all encapsulating and equitable implementation plan along with an overarching monitoring and evaluation framework.


Assuntos
Ecossistema , Instituições Acadêmicas , Criança , Humanos , Estudantes , Escolaridade , Pessoal Administrativo
11.
BMC Public Health ; 22(1): 2234, 2022 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-36451170

RESUMO

BACKGROUND: Prevention of road traffic injuries (RTIs) as a critical public health issue requires coordinated efforts. We aimed to model influential factors related to traffic safety. METHODS: In this cross-sectional study, the information from 384,614 observations recorded in Integrated Road Traffic Injury Registry System (IRTIRS) in a one-year period (March 2015-March 2016) was analyzed. All registered crashes from Tehran, Isfan, Fras, Razavi Khorasan, Khuzestan, and East Azerbaijan provinces, the six most populated provinces in Iran, were included in this study. The variables significantly associated with road traffic fatality in the uni-variate analysis were included in the multiple logistic regression. RESULTS: According to the multiple logistic regression, thirty-two out of seventy-one different variables were identified to be significantly associated with road traffic fatality. The results showed that the crash scene significantly related factors were passenger presence(OR = 4.95, 95%CI = (4.54-5.40)), pedestrians presence(OR = 2.60, 95%CI = (1.75-3.86)), night-time crashes (OR = 1.64, 95%CI = (1.52-1.76)), rainy weather (OR = 1.32, 95%CI = (1.06-1.64)), no intersection control (OR = 1.40, 95%CI = (1.29-1.51)), double solid line(OR = 2.21, 95%CI = (1.31-3.74)), asphalt roads(OR = 1.95, 95%CI = (1.39-2.73)), nonresidential areas(OR = 2.15, 95%CI = (1.93-2.40)), vulnerable-user presence(OR = 1.70, 95%CI = (1.50-1.92)), human factor (OR = 1.13, 95%CI = (1.03-1.23)), multiple first causes (OR = 2.81, 95%CI = (2.04-3.87)), fatigue as prior cause(OR = 1.48, 95%CI = (1.27-1.72)), irregulation as direct cause(OR = 1.35, 95%CI = (1.20-1.51)), head-on collision(OR = 3.35, 95%CI = (2.85-3.93)), tourist destination(OR = 1.95, 95%CI = (1.69-2.24)), suburban areas(OR = 3.26, 95%CI = (2.65-4.01)), expressway(OR = 1.84, 95%CI = (1.59-2.13)), unpaved shoulders(OR = 1.84, 95%CI = (1.63-2.07)), unseparated roads (OR = 1.40, 95%CI = (1.26-1.56)), multiple road defects(OR = 2.00, 95%CI = (1.67-2.39)). In addition, the vehicle-connected factors were heavy vehicle (OR = 1.40, 95%CI = (1.26-1.56)), dark color (OR = 1.26, 95%CI = (1.17-1.35)), old vehicle(OR = 1.46, 95%CI = (1.27-1.67)), not personal-regional plaques(OR = 2.73, 95%CI = (2.42-3.08)), illegal maneuver(OR = 3.84, 95%CI = (2.72-5.43)). And, driver related factors were non-academic education (OR = 1.58, 95%CI = (1.33-1.88)), low income(OR = 2.48, 95%CI = (1.95-3.15)), old age (OR = 1.67, 95%CI = (1.44-1.94)), unlicensed driving(OR = 3.93, 95%CI = (2.51-6.15)), not-wearing seat belt (OR = 1.55, 95%CI = (1.44-1.67)), unconsciousness (OR = 1.67, 95%CI = (1.44-1.94)), driver misconduct(OR = 2.51, 95%CI = (2.29-2.76)). CONCLUSION: This study reveals that driving behavior, infrastructure design, and geometric road factors must be considered to avoid fatal crashes. Our results found that the above-mentioned factors had higher odds of a deadly outcome than their counterparts. Generally, addressing risk factors and considering the odds ratios would be beneficial for policy makers and road safety stakeholders to provide support for compulsory interventions to reduce the severity of RTIs.


Assuntos
Pessoal Administrativo , Condução de Veículo , Humanos , Estudos Transversais , Irã (Geográfico)/epidemiologia , Azerbaijão
12.
BMC Health Serv Res ; 22(1): 1303, 2022 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-36309675

RESUMO

BACKGROUND: Process improvement in healthcare is informed by knowledge from the private sector. Skilled individuals may aid the adoption of this knowledge by frontline care delivery workers through knowledge brokering. However, the effectiveness of those who broker knowledge is limited when the context they work within proves unreceptive to their efforts. We therefore need greater insight into the contextual conditions that support individuals to broker process improvement knowledge to the frontline of care delivery, and how policy makers and organizations might generate such conditions. METHODS: Our research took place in a healthcare system within an Australian State. We undertook a qualitative, embedded single case study over the four year period of a process improvement intervention encompassing 57 semi-structured interviews (with knowledge brokers, policy makers, and executive sponsors), 12 focus groups, and 137 h of observation, which included the frontline implementation of actual process improvement initiatives, where knowledge brokering took place. RESULTS: We identified four phases of the process improvement intervention that moved towards a more mature collaboration within which knowledge brokering by improvement advisors began to emerge as effective. In the first phase knowledge brokering was not established. In the second phase, whilst knowledge brokering had been initiated, the knowledge being brokered lacked legitimacy amongst frontline practitioners, resulting in resistance. Only in the fourth and final phase of the intervention did the collective experience of policy makers result in reflections on how they might engender a more receptive context for knowledge brokering. CONCLUSION: We highlight a number of suggested actions that policy makers might consider, if they wish to engender contextual conditions that support knowledge brokering. Policy makers might consider: ensuring they respect local context and experience, by pulling good ideas upward, rather than imposing foreign knowledge from on high; facilitating the lateral diffusion of knowledge by building cultural linkages between people and organizations; strengthening collaboration, not competition, so that trans-organisational flow of ideas might be encouraged; being friend, not foe, to healthcare organizations on their knowledge integration journey. In sum, we suggest that top-down approaches to facilitating the diffusion and adoption of new ideas ought to be reconsidered.


Assuntos
Pessoal Administrativo , Conhecimento , Humanos , Austrália , Pesquisa Qualitativa , Atenção à Saúde
13.
Leadersh Health Serv (Bradf Engl) ; ahead-of-print(ahead-of-print)2022 10 11.
Artigo em Inglês | MEDLINE | ID: mdl-36205444

RESUMO

PURPOSE: The purpose of this study is to describe primary health-care managers' perceptions of management competencies at different management levels in digital health services using the management competency assessment program as a framework. DESIGN/METHODOLOGY/APPROACH: A secondary analysis study involving 21 semi-structured individual interviews was conducted among Finnish primary health-care managers at different management levels (frontline, middle and senior). The deductive framework method was used to analyze the data. FINDINGS: Similarities and differences were found in management competencies between different levels of management. Competencies related to the use of digitalization were highlighted by managers at all management levels. Managers at all management levels were involved in developing digital solutions and supporting employees in using digital solutions in their work. Frontline and middle managers emphasized more issues related to day-to-day management and communication with employees, whereas senior managers highlighted the management of large entities. RESEARCH LIMITATIONS/IMPLICATIONS: In the secondary analysis, data were used for purposes other than originally intended. Therefore, the data are subject to limitations of the methodology applied and should be transferred to other contexts with caution. PRACTICAL IMPLICATIONS: Identifying the management competencies needed to manage digital health services is important to target managers' training according to needs in the future. SOCIAL IMPLICATIONS: The results could be used to develop the management of digital health services, as well as improve digital health services and their deployment. ORIGINALITY/VALUE: Previous literature mostly examined managers' informatics competencies and paid little attention to other management competencies. This study discusses more broadly the management competencies that digital health services require from managers at different levels of management.


Assuntos
Pessoal Administrativo , Serviços de Saúde , Atenção Primária à Saúde , Competência Profissional , Pessoal Administrativo/normas , Finlândia , Humanos , Liderança , Atenção Primária à Saúde/organização & administração
14.
Soc Sci Med ; 314: 115430, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36279793

RESUMO

BACKGROUND: The COVID-19 outbreak early 2020 was followed by an unprecedented package of measures. The relative calmness of the pandemic early 2022 provides a momentum to prepare for various scenarios. OBJECTIVES: As acceptance of COVID-19 measures is key for public support we investigated citizens' preferences towards imposing measures in four scenarios: 1) spring/summer scenario with few hospitalizations; 2) autumn/winter scenario with many hospitalizations; 3) a new contagious variant, the impact on hospitalizations is unclear; 4) a new contagious variant, hospitalizations will substantially increase. METHODS: Study 1 comprised a Participatory Value Evaluation (PVE) in which 2011 respondents advised their government on which measures to impose in the four scenarios. Respondents received information regarding the impact of each measure on the risk that the health system would be overloaded. To triangulate the results, 2958 respondents in Study 2 evaluated the acceptability of the measures in each scenario. RESULTS: Measures were ranked similarly by respondents in Study 1 and 2: 1) the majority of respondents thought that hygiene measures should be upheld, even in the spring/summer; 2) the majority supported booster vaccination, working from home, encouraging self-testing, and mandatory face masks from scenario 2 onwards; 3) even in scenario 4, lockdown measures were not supported by the majority. Young respondents were willing to accept more risks for the health system than older respondents. CONCLUSION: The results suggest that policies that focus on prevention (through advising low-impact hygiene measures) and early response to moderate threats (by scaling up to moderately restrictive measures and boostering) can count on substantial support. There is low support for lockdown measures even under high-risk conditions, which further emphasizes the importance of prevention and a timely response to new threats. Our results imply that young citizens' concerns, in particular, should be addressed when restrictive COVID-19 measures are to be implemented.


Assuntos
COVID-19 , Controle de Doenças Transmissíveis , Humanos , Pessoal Administrativo , Controle de Doenças Transmissíveis/métodos , COVID-19/prevenção & controle , SARS-CoV-2
15.
Front Public Health ; 10: 1016156, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36238244

RESUMO

Introduction: The Nurturing Care Framework (NCF) describes "nurturing care" as the ability of nations and communities to support caregivers and provide an environment that ensures children's good health and nutrition, protects them from threats, and provides opportunities for early learning through responsive and emotionally supportive interaction. We assessed the extent to which Kenyan government policies address the components of the NCF and explored policy/decision makers' views on policy gaps and emerging issues. Methods: A search strategy was formulated to identify policy documents focusing on early childhood development (ECD), health and nutrition, responsive caregiving, opportunities for early learning and security and safety, which are key components of the NCF. We limited the search to policy documents published since 2010 when the Kenya constitution was promulgated and ECD functions devolved to county governments. Policy/decision-maker interviews were also conducted to clarify emerging gaps from policy data. Data was extracted, coded and analyzed based on the components of the NCF. Framework analysis was used for interview data with NCF being the main framework of analysis. The Jaccard's similarity coefficient was used to assess similarities between the themes being compared to further understand the challenges, successes and future plans of policy and implementation under each of the NCF domains. Results: 127 policy documents were retrieved from government e-repository and county websites. Of these, n = 91 were assessed against the inclusion criteria, and n = 66 were included in final analysis. The 66 documents included 47 County Integrated Development Plans (CIDPs) and 19 national policy documents. Twenty policy/decision-maker interviews were conducted. Analysis of both policy and interview data reveal that, while areas of health and nutrition have been considered in policies and county level plans (coefficients >0.5), the domains of early learning, responsive caregiving and safety and security face significant policy and implementation gaps (coefficients ≤ 0.5), particularly for the 0-3 year age group. Inconsistencies were noted between county level implementation plans and national policies in areas such as support for children with disabilities and allocation of budget to early learning and nutrition domains. Conclusion: Findings indicate a strong focus on nutrition and health with limited coverage of responsive caregiving and opportunities for early learning domains. Therefore, if nurturing care goals are to be achieved in Kenya, policies are needed to support current gaps identified with urgent need for policies of minimum standards that provide support for improvements across all Nurturing Care Framework domains.


Assuntos
Desenvolvimento Infantil , Políticas , Pessoal Administrativo , Criança , Pré-Escolar , Humanos , Quênia , Governo Local
16.
BMC Public Health ; 22(1): 1909, 2022 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-36229818

RESUMO

BACKGROUND: The COVID-19 pandemic is a multi-faceted phenomenon with many political, economic and social consequences. Success in managing and controlling this pandemic depends on the coordinated efforts of many organizations and institutions. Therefore, this study aimed to identify and analyze the actors and stakeholders related to managing and controlling this pandemic in Iran. METHODS: This mix-method stakeholder analysis was conducted in 2021 nationwide as retrospectively. The purposive sampling method was applied when inviting eligible participants to participate in the study. Our study was conducted in two phases. In the qualitative phase, data were collected using a semi-structured interview. An interview guide was developed based on the WHO stakeholder analysis framework. In the quantitative phase, we used a questionnaire developed based on the study framework. Each question was scored on a 5-point Likert scale, with a score greater than 4 was considered as high, 3-4 was considered as moderate, and 1-3 was considered as low. Data were analyzed using framework analysis, WHO stakeholders' analysis framework and MENDELOW matrix. MAXQDA qualitative data analysis software Version 11 and Policy Maker software (Version. 4) were used for data analysis. RESULTS: A total of 48 stakeholders were identified. Ministry of Health (MoH), National Headquarters for Coronavirus Control (NHCC) had the highest participation level, high supportive position, and knowledge of the subject. The Parliament of Iran (PoI), Islamic Revolutionary Guard Corps (IRGC), and Islamic Republic of Iran Broadcasting (IRIB) had the highest power/influence during the Covid-19 epidemic. Only two stakeholders (6.06%) had high participation, and 18.18% had moderate participation. All stakeholders except for the NHCC and the MoH lacked appropriate knowledge of the subject. Furthermore, only three stakeholders (9.09%) had high power/influence. CONCLUSION: Given the multidimensional nature of Covid-19, most institutions and organizations were involved in managing this pandemic. Stakeholders with high power/authority and resources had a low/moderate participation level and a moderate supportive position. Moreover, organizations with a high supportive position and participation had low power/authority and resources to cope with COVID-19.


Assuntos
COVID-19 , Pessoal Administrativo , COVID-19/epidemiologia , Humanos , Irã (Geográfico)/epidemiologia , Pandemias/prevenção & controle , Estudos Retrospectivos
17.
Health Res Policy Syst ; 20(1): 107, 2022 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-36209122

RESUMO

The COVID-19 pandemic has brought the combined disciplines of public health, infectious disease and policy modelling squarely into the spotlight. Never before have decisions regarding public health measures and their impacts been such a topic of international deliberation, from the level of individuals and communities through to global leaders. Nor have models-developed at rapid pace and often in the absence of complete information-ever been so central to the decision-making process. However, after nearly 3 years of experience with modelling, policy-makers need to be more confident about which models will be most helpful to support them when taking public health decisions, and modellers need to better understand the factors that will lead to successful model adoption and utilization. We present a three-stage framework for achieving these ends.


Assuntos
COVID-19 , Saúde Pública , Pessoal Administrativo , Humanos , Pandemias , Políticas
18.
Soc Sci Med ; 310: 115130, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36070634

RESUMO

Evidence-based practice (EBP) has become a dominant paradigm in North American behavioral health and social service provision. Once a model of expert decision-making that asked practitioners to search through the "best available evidence" to inform their clinical decisions and select interventions, EBP is now better understood as a complex system of legitimation that designates particular methods and-by extension-their practitioners as "evidence-based." While critics worry that EBP forecloses professional discretion by imposing particular epistemic virtues of intervention science, this ethnographic case demonstrates that 1) EBP legitimates professional actors, methods, and organizations at least as much as it hampers them and 2) a wide range of "extra-scientific" actors are involved in producing and legitimating the evidence of evidence-based practice, including policy makers, public and private insurers, state agencies, charitable foundations, registries and clearinghouses, health and human service organizations, and helping professionals themselves. Once we recognize the range of actors and institutions involved in basing and legitimating evidence, and the rhetorical work of tethering scientific terms to resonant political and economic discourses, we learn that there is nothing self-evident about evidence-based practice. Drawing on the social scientific study of expertise and focusing empirically on how one behavioral intervention earns and retains its status as an EBP, this study traces the trans-institutional life of evidence and the continual need to legitimate it as a base for behavioral health practice.


Assuntos
Pessoal Administrativo , Prática Clínica Baseada em Evidências , Humanos , Organizações , Serviço Social
19.
Glob Health Sci Pract ; 10(Suppl 1)2022 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-36109065

RESUMO

Health policy and systems research (HPSR) is generating an increasing amount of evidence in Mozambique, where implementation of a wide range of public health policies and interventions, and innovative technologies and solutions, is underway. We used qualitative methods to explore the relationship between HPSR and policy development and implementation in Mozambique. We conducted a literature review and in-depth interviews with researchers, experts, and policy makers. Through our analysis, we assessed barriers to the use of research evidence in the development and implementation of national health policies and identified potential opportunities to improve evidence use in this context.We found an increasing number of research institutions producing solid scientific evidence in the country, with activities in health in general and health systems specifically. There is also a growing trend for decision makers and policy makers to use the results of research during the design, formulation, and implementation of health policies. Most HPSR conducted in Mozambique is funded by international donors and focused on research questions of international interest. Therefore, research generated in Mozambique does not always address questions that are relevant to the local health system development agenda.While Mozambique has a lot of "gray literature" outlets, few of its publications support the translation of research evidence into policy. Much of the evidence generated in country is disseminated through project reports and briefings, not peer-reviewed literature. Furthermore, when the research evidence generated is not locally relevant, results may be published only in English and in scientific articles, instead of in formats useful to Mozambican policy makers-to the detriment of national-level understanding and use. We recommend that research institutions and policy makers in Mozambique collaborate on developing a platform that consolidates HPSR, making it more accessible and useful to policy makers.


Assuntos
Política de Saúde , Formulação de Políticas , Pessoal Administrativo , Programas Governamentais , Humanos , Moçambique
20.
Cad Saude Publica ; 38(9): e00028922, 2022.
Artigo em Português | MEDLINE | ID: mdl-36169512

RESUMO

Analysis of the implementation, management, operation and sustainability of the Interfederative Health Consortia and the Regional Specialty Polyclinics, in the State of Bahia, Brazil. This is a single case study of a qualitative nature, with interviews with managers, social control, regulation, legislative, and mayors of municipalities in the member. The results indicate that capital expenditures and permanent cofinancing by the state manager are factors that encourage the participation of vertical consortia. The support of small municipalities, social participation bodies, and municipal councils stood out. We observed the strengthening of the cooperative relationship among public administrators from formal decision-making spaces and by the need for daily management of specialized care (SC). The offer of SC via consortia mitigated the dependence on buying SC from private services. The fear of losing autonomy, centralizing care in state equipment, and ignoring municipal financing were challenges in the process of restructuring regional specialty services. The support and sustainability of the initiative was based on the evaluation of a situation in which the accessibility to SC was more favorable after implementation of the Polyclinic and of user satisfaction with the quality of services. Strategies to communicate with the population and to bring together instances of social control need to be undertaken. We consider that the case represents a format, within public management, for the provision of more viable and timelier SC, gaining in dimension and quality, especially in territories with a significant number of small municipalities.


Neste artigo, analisa-se a implantação, gestão, funcionamento e sustentabilidade dos Consórcios Interfederativos de Saúde e das Policlínicas Regionais de Especialidades na Bahia, Brasil. Trata-se de estudo de caso único e de natureza qualitativa, em que foram realizadas entrevistas com gestores; repersentantes de controle social, regulação e legislativo; e prefeitos de municípios consorciados. Os resultados apontam que gastos de capital e cofinanciamento permanente de custeio pelo gestor estadual são fatores que incentivam a adesão aos consórcios verticais. Destacou-se o apoio dos municípios de pequeno porte, de instâncias de participação social e das câmaras municipais. Observou-se o fortalecimento da relação cooperativa entre os gestores a partir dos espaços decisórios formais e pela necessidade de gestão cotidiana da atenção especializada (AE). A oferta de AE via consórcios mitigou a dependência de compra de serviços privados. O receio de perda de autonomia, da centralização dos atendimentos em equipamentos estaduais e do não reconhecimento do financiamento municipal foram desafios no processo de reestruturação dos serviços regionais de especialidades. O apoio e a sustentabilidade da iniciativa se baseavam na avaliação de uma situação mais favorável de acesso à AE após implantação da Policlínica e da satisfação dos usuários com a qualidade dos serviços. São necessárias estratégias de comunicação com a população e de aproximação com as instâncias de controle social. Considera-se que o caso representa um formato, ao interior da gestão pública, para a prestação de AE mais viável, oportuna e com ganhos de escala e qualidade, sobretudo em territórios com expressivo número de municípios de pequeno porte.


Se analiza la implementación, la gestión, el funcionamiento y la sostenibilidad de los Consorcios Interfederativos de Salud y de las Policlínicas Regionales de Especialidades en Bahía, Brasil. Se trata de un estudio de caso único, de carácter cualitativo, con entrevistas a gestores, control social, regulación, legislatura y alcaldes de municipios consorciados. Los resultados indican que los gastos de capital y la cofinanciación permanente del costeo por parte del gestor estatal son factores que incentivan la adhesión a los consorcios verticales. Se destacó el apoyo de los pequeños municipios, de instancias de participación social y de los consejos municipales. Se observó el fortalecimiento de la relación cooperativa entre los gestores con base en los espacios formales de decisión y en la necesidad de la gestión cotidiana de la atención especializada (AE). La oferta de AE mediante consorcios mitigó la dependencia de compra de AE en servicios privados. El temor a la pérdida de autonomía, a la centralización de la atención en establecimientos estatales y al no reconocimiento de la financiación municipal fueron desafíos en el proceso de reestructuración de los servicios regionales de especialidades. El apoyo y la sostenibilidad de la iniciativa se sustentaban en la evaluación de una situación más favorable de acceso a la AE tras la implementación de la Policlínica y de la satisfacción de los usuarios con la calidad de los servicios. Es necesario emprender estrategias de comunicación con la población y un acercamiento a las instancias de control social. Se considera que el caso representa un formato, al interior de la gestión pública, para la prestación de AE más viable, oportuna, con ganancias en escala y calidad, sobre todo en territorios con un número expresivo de municipios pequeños.


Assuntos
Programas Governamentais , Política de Saúde , Pessoal Administrativo , Brasil , Humanos , Organizações
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