Addressing the needs of Ethiopia's street homeless women of reproductive age in the health and social protection policy: a qualitative study.

INTRODUCTION: Globally, homelessness is a growing concern, and homeless women of reproductive age are particularly vulnerable to adverse physical, mental, and reproductive health conditions, including violence. Although Ethiopia has many homeless individuals, the topic has received little attention in the policy arena. Therefore, we aimed to understand the reason for the lack of attention, with particular emphasis on women of reproductive age. METHODS: This is a qualitative study; 34 participants from governmental and non-governmental organisations responsible for addressing homeless individuals' needs participated in in-depth interviews. A deductive analysis of the interview materials was applied using Shiffman and Smith's political prioritisation framework. RESULTS: Several factors contributed to the underrepresentation of homeless women's health and well-being needs in the policy context. Although many governmental and non-governmental organisations contributed to the homeless-focused programme, there was little collaboration and no unifying leadership. Moreover, there was insufficient advocacy and mobilisation to pressure national leaders. Concerning ideas, there was no consensus regarding the definition of and solution to homeless women's health and social protection issues. Regarding political contexts and issue characteristics, a lack of a well-established structure, a paucity of information on the number of homeless women and the severity of their health situations relative to other problems, and the lack of clear indicators prevented this issue from gaining political priority. CONCLUSIONS: To prioritise the health and well-being of homeless women, the government should form a unifying collaboration and a governance structure that addresses the unmet needs of these women. It is imperative to divide responsibilities and explicitly include homeless people and services targeted for them in the national health and social protection implementation documents. Further, generating consensus on framing the problems and solutions and establishing indicators for assessing the situation is vital.

What semantic analysis can tell us about long term trends in the global STI policy agenda.

The scope, complexity and the "volume" of knowledge accumulated render producing an overview of the core themes of science, technology and innovation policies difficult. Reviews of this policy domain mostly either refer to general issues without deep immersion into details or focus on specific narrower aspects. The paper uses semantic analysis to identify major themes of science, technology and innovation policies over the last three decades and to trace their evolution towards current policy setting. We use semantic tools for processing and analysing documents produced by one of the major and highly reputable international expert bodies, the OECD Working Party on Technology and Innovation Policy. We show that selected themes remain in the mainstream even though being affected by regular policy adjustments and refinements and which disappear or appear with new challenges and expected solutions. Other themes appear niche or exotic themes which are under discussion for some time only.

Towards an explanatory framework for national level maternal health policy agenda item evolution in Ghana: an embedded case study.

BACKGROUND: Understanding decision-making processes that influence the fate of items on the health policy agenda at national level in low- and middle-income countries is important because of the implications for programmes and outcomes. This paper seeks to advance our understanding of these processes by asking how and why maternal health policy agenda items have fared in Ghana between 1963 and 2014. METHODS: The study design was a single case study of maternal health agenda evolution once on a decision pathway in Ghana, with three different agenda items as sub-units of analysis (fee exemptions for maternal health, free family planning and primary maternal health as part of a per capita provider payment system). Data analysis involved chronologically reconstructing how maternal health policy items evolved over time. RESULTS: The fate of national level maternal health policy items was heavily influenced by how stakeholders (bureaucrats, professional bodies, general public and developmental partners) exercised power to put forward and advocate for specific ideas through processes of issues framing within a changing political and socioeconomic context. The evolution and fate of an agenda item once on a decision pathway involved an iterative process of interacting drivers shaping decisions through cycles of 'active' and 'static' pathways. Items could move from 'active' to 'static' pathways, depending on changing context and actor positions. Items that pursued the 'static' pathway in a particular cycle fell into obscurity by a process that could be described as a form of 'no decision made' in that an explicit decision was not taken to drop the item, but neither was any policy content agreed. Low political interest was exhibited and attempts to bring the item back into active decision-making were made by actors mainly in the bureaucratic arena seeking and struggling (unsuccessfully) to obtain financial and institutional support. Policy items that pursued 'active' pathways showed opposite characteristics and generally moved beyond agenda into formulation and implementation. CONCLUSION: Policy change requires sustaining policy agenda items into formulation and implementation. To do this, change agents need to understand and work within the relevant context, stakeholder interests, power, ideas and framing of issues.

What Are Strategies to Advance Policies Supporting Family Caregivers? Promising Approaches From a Statewide Task Force.

Family caregivers are the cornerstone of the long-term supports and services infrastructure in the United States, yet they often contend with many challenges related to this role. Public policy has been slow to change, leaving many caregivers vulnerable to health and economic consequences. Using models of policy making, we identify barriers to advancing policies that support family caregivers and overcome policy drift. We draw on discussions from the California Task Force on Family Caregiving as it prepares state policy recommendations. Identified strategies include identification of caregivers in health care and workplace settings to promote political consciousness raising, collecting and reporting on data that frame caregiving as a policy problem, borrowing policies and language from overlapping fields to emulate their policy successes, and presenting supportive caregiver policies as solutions to other policy problems. By presenting specific strategic approaches to advance caregiving policies, we provide tools to address the growing gap between caregiver needs and policy responses.

The changing role of health-oriented international organizations and nongovernmental organizations.

Apart from governments, there are many other actors active in the health policy arena, including a wide array of international organizations (IOs), public-private partnerships and non-governmental organizations (NGOs) that state as their main mission to improve the health of (low-income) populations of low-income countries. Despite the steady rise in numbers and prominence of NGOs, however, there is lack of empirical knowledge about their functioning in the international policy arena, and most studies focus on the larger organizations. This has also caused a somewhat narrow focus of theoretical studies. Some scholars applied the 'principal-agent' theory to study the origins of IOs, for example, other focus on changing power relations. Most of those studies implicitly assume that IOs, public-private partnerships and large NGOs act as unified and rational actors, ignoring internal fragmentation and external pressure to change directions. We assert that the classic analytical instruments for understanding the shaping and outcome of public policy: ideas, interests and institutions apply well to the study of IOs. As we will show, changing ideas about the proper role of state and non-state actors, changing positions and activities of major stakeholders in the (international) health policy arena, and shifts in political institutions that channel the voice of diverging interests resulted in (and reflected) the changing positions of the health-oriented organizations-and also affect their future outlook. Copyright © 2015 John Wiley & Sons, Ltd.

Multiple streams approach to tobacco control policymaking in the capital city of the world's largest tobacco consuming country.

The aim of this study was to analyse the policymaking process of Beijing tobacco control regulations based on a multiple streams framework to provide a reference for other cities, at the national level and for the international community to promote the development of tobacco control policy. Twenty-one documents related to tobacco control in Beijing were collected, nine informants were interviewed and the interview data were analysed by a thematic framework method. It was found that indicators, feedback and a focus event in the problem stream drew the attention of policymakers and the society for tobacco control. In 2011, Ying Songnian, a representative of the Beijing Municipal People's Congress, put forward tobacco control legislation, which was just in time for the legislative reform of the Congress. The proposal was studied by the Congress, and a strategy of 'social co-governance' was founded. In the political stream, the government actively promoted tobacco control and social organizations extensively participated in it. In 2013, the General Office of the Central Committee of the Chinese Communist Party and the General Office of the State Council issued a notice on matters related to leading cadres taking the lead in banning smoking in public places, which opened a policy window for decision-makers who were hesitatant. The issue of tobacco control was successfully put on the policy agenda and contributed to the introduction of the Beijing Municipal Regulations on Smoking Control. Development of the factors in problem stream, policy stream and political stream promoted the setting up of the tobacco control policy agenda in Beijing. It is suggested that more cities should learn from the experience of Beijing, seize the opportunity of the ideological change of the ruling party, actively identify the problems, mobilize and advocate for representatives and introduce the concept of 'social co-governance' to promote tobacco control legislation.

The Impact of Aging Policy on Societal Age Stereotypes and Ageism.

BACKGROUND AND OBJECTIVES: While studies have researched ageism in public policy, few investigated the impact of aging policy on ageism-typically, an unintended consequence. Ageism is linked to $63 billion in health care costs, so its antecedents are of interest. We test the association between Aging Policy Agenda Setting and Societal Age Stereotypes and hypothesize a mediating pathway via Medicalization of Aging, moderated by demographics. RESEARCH DESIGN AND METHODS: Scholars identified Singapore's Pioneer Generation Policy (PGP) as one of the largest policy implementations in recent years, where the agenda was set by the Prime Minister at an equivalent State of the Union address in 2013, and US$7 billion allocated to fund outpatient health care costs for aged 65 years or older. More than 400,000 older adults received a PGP card and home visits by trained volunteers who co-devised a personalized utilization plan. We leveraged a 10-billion-word data set with more than 30 million newspaper and magazine articles to dynamically track Societal Age Stereotype scores over 8 years from pre- to postpolicy implementation. RESULTS: Societal Age Stereotypes followed a quadratic trend: Prior to the Aging Policy Agenda Setting from 2010 to 2014, stereotypes were trending positive; after 2014, it trended downward to become more negative. Medicalization of Aging mediated the relationship between Aging Policy Agenda Setting and Societal Age Stereotypes. Furthermore, Old-age Support Ratio moderated the mediational model, suggesting that the impact of policy on medicalization is stronger when a society is more aged. DISCUSSION AND IMPLICATIONS: We provided a framework for policymakers to ameliorate the unintended consequences of aging policies on societal ageism-if unaddressed, it will exert an insidious toll on older adults, even if initial policies are well-intentioned.

Mapping co-benefits for carbon storage and biodiversity to inform conservation policy and action.

Integrated high-resolution maps of carbon stocks and biodiversity that identify areas of potential co-benefits for climate change mitigation and biodiversity conservation can help facilitate the implementation of global climate and biodiversity commitments at local levels. However, the multi-dimensional nature of biodiversity presents a major challenge for understanding, mapping and communicating where and how biodiversity benefits coincide with climate benefits. A new integrated approach to biodiversity is therefore needed. Here, we (a) present a new high-resolution map of global above- and below-ground carbon stored in biomass and soil, (b) quantify biodiversity values using two complementary indices (BIp and BIr) representing proactive and reactive approaches to conservation, and (c) examine patterns of carbon-biodiversity overlap by identifying 'hotspots' (20% highest values for both aspects). Our indices integrate local diversity and ecosystem intactness, as well as regional ecosystem intactness across the broader area supporting a similar natural assemblage of species to the location of interest. The western Amazon Basin, Central Africa and Southeast Asia capture the last strongholds of highest local biodiversity and ecosystem intactness worldwide, while the last refuges for unique biological communities whose habitats have been greatly reduced are mostly found in the tropical Andes and central Sundaland. There is 38 and 5% overlap in carbon and biodiversity hotspots, for proactive and reactive conservation, respectively. Alarmingly, only around 12 and 21% of these proactive and reactive hotspot areas, respectively, are formally protected. This highlights that a coupled approach is urgently needed to help achieve both climate and biodiversity global targets. This would involve (1) restoring and conserving unprotected, degraded ecosystems, particularly in the Neotropics and Indomalaya, and (2) retaining the remaining strongholds of intactness. This article is part of the theme issue 'Climate change and ecosystems: threats, opportunities and solutions'.

Agenda governamental brasileira: prioridades e mudanças na dinâmica da atenção sobre a distribuição orçamentária da União (2000-2021) / Agenda del gobierno brasileño: prioridades y cambios en la dinámica de atención a la distribución del presupuesto federal (2000-2021) / Brazilian policy agenda: priorities and changes in the dynamics of attention on the federal budget distribution (2000-2021)

Resumo Os estudos sobre agenda governamental têm adotado diversos indicadores para mensurar a atenção e as prioridades dos governos, a fim de analisar os processos de formulação e mudança de políticas públicas. Com base nas prerrogativas da teoria do equilíbrio pontuado sobre os padrões de mudanças na dinâmica das políticas, a distribuição do orçamento público tem se destacado como um dos instrumentos que melhor expressam os níveis de atenção e as prioridades dos governos em diferentes setores. Nesse contexto, alinhado a uma agenda internacional, este estudo busca investigar o padrão da atenção governamental acerca da distribuição orçamentária no Brasil. Assim, o objetivo deste trabalho é mapear a dinâmica da atenção governamental sobre a disposição do orçamento aprovado da União ao longo das últimas duas décadas (2000-2021), identificando os níveis percentuais de atenção aos diferentes setores de políticas públicas ao longo do tempo e os fatores conjunturais e institucionais que balizam os níveis de atenção governamental na classificação orçamentária. Para isso, foi formulado um banco de dados do orçamento aprovado de 2000 a 2021, no qual as 814 combinações de funções e subfunções de gastos foram codificadas em 21 setores, conforme metodologia do comparative agenda project (CAP). Os resultados indicam que a atenção governamental sobre essa distribuição opera sob um padrão majoritariamente incremental no decorrer do tempo, mas permeado por pontuações no equilíbrio em políticas setoriais específicas, comprovando a teoria do equilíbrio pontuado (punctuated equilibrium theory [PET]) no cenário nacional. De igual modo, apontam para a necessidade de mais estudos setoriais que expliquem as causas e os efeitos das pontuações na atenção governamental, suas relações com mudanças na agenda legislativa e os impactos de momentos de crises institucionais na definição de prioridades na distribuição orçamentária, apontados como agendas futuras a partir deste trabalho.

Resumen Los estudios sobre la agenda gubernamental adoptaron varios indicadores para medir la atención y las prioridades de los gobiernos a los efectos de analizar los procesos de formulación y cambio de políticas públicas. Desde las prerrogativas de la teoría del equilibrio puntuado sobre los patrones de cambios en la dinámica de las políticas, la distribución del presupuesto público se ha destacado como uno de los instrumentos que mejor expresan los niveles de atención y las prioridades de los gobiernos de los diferentes sectores. En ese contexto, de acuerdo con una agenda internacional, este estudio busca investigar cuál es el patrón de atención gubernamental respecto a la distribución presupuestaria en Brasil. Así, el objetivo de este trabajo es mapear la dinámica de atención gubernamental sobre la distribución del presupuesto federal aprobado en las últimas dos décadas (2000-2021), identificando (i) cuáles son los niveles porcentuales de atención a los diferentes sectores de las políticas públicas a lo largo del tiempo y (ii) los factores coyunturales e institucionales que orientan los niveles de atención del gobierno en la clasificación presupuestaria federal. Para ello, se creó una base de datos del presupuesto aprobado de 2000 a 2021, en la que se codificaron las 814 combinaciones de funciones y subfunciones del gasto en 21 sectores, según la metodología del Proyecto de Agenda Comparada (CAP). Los resultados indican que la atención del gobierno sobre la distribución del presupuesto opera en un patrón mayoritariamente incremental en el tiempo, pero permeado por puntajes de equilibrio en políticas sectoriales específicas, demostrando así la teoría del equilibrio puntuado a nivel nacional. Asimismo, señalan la necesidad de mayores estudios sectoriales que expliquen las causas y efectos de los puntajes en la atención del gobierno, sus relaciones con los cambios en la agenda legislativa y los impactos de los momentos de crisis institucional en la definición de prioridades en la distribución presupuestaria, identificadas como futuras agendas a partir de este trabajo.

Abstract Studies on policy agenda have adopted several indicators to measure the attention and priorities of governments to analyze the processes of policy change and policy dynamics. Based on the Punctuated Equilibrium Theory (PET) applied on the patterns of policy change, the distribution of the public budget has stood out as one of the instruments that best express the levels of attention and priority for governments in different sectors. This study seeks to investigate the pattern of government attention on the federal budget distribution in Brazil. Thus, this work maps the dynamics of government attention on the distribution of the federal approved budget over the last two decades (2000-2021), identifying (i) what are the percentage levels of attention to the different sectors of public policies over time and (ii) the conjunctural and institutional factors that guide the levels of government attention in the budget distribution of the federal government in Brazil. A database of the federal approved budget from 2000 to 2021 was created, in which the 814 combinations of expenditure functions and subfunctions were coded into 21 sectors according to the methodology of the Comparative Agenda Project (CAP). The results indicate that government attention on the distribution of the Brazilian federal budget operates in a mostly incremental pattern over time, permeated by punctuations in specific sectoral policies, thus proving the Punctuated Equilibrium Theory at the national level. As for future research agenda, the study shows the need for further sectoral studies that explain the causes and effects of changes on government attention, their relationships with the legislative agenda, and the impacts of moments of institutional crisis in defining priorities in budget distribution.

Setting the global health agenda: The influence of advocates and ideas on political priority for maternal and newborn survival.

This study investigates a puzzle concerning global health priorities-why do comparable issues receive differential levels of attention and resources? It considers maternal and neonatal mortality, two high-burden issues that pertain to groups at risk at birth and whose lives could be saved with effective intrapartum care. Why did maternal survival gain status as a global health priority earlier and to a greater degree than newborn survival? Higher mortality and morbidity burdens among newborns and the cost-effectiveness of interventions would seem to predict that issue's earlier and higher prioritization. Yet maternal survival emerged as a priority two decades earlier and had attracted considerably more attention and resources by the close of the Millennium Development Goals era. This study uses replicative process-tracing case studies to examine the emergence and growth of political priority for these two issues, probing reasons for unexpected variance. The study finds that maternal survival's grounding as a social justice issue spurred growth of a strong and diverse advocacy network and aligned the issue with powerful international norms (e.g. expectations to advance women's rights and the Millennium Development Goals), drawing attention and resources to the issue over three decades. Newborn survival's disadvantage stems from its long status as an issue falling under the umbrellas of maternal and child survival but not fully adopted by these networks, and with limited appeal as a public health issue advanced by a small and technically focused network; network expansion and alignment with child survival norms have improved the issue's status in the past few years.

'The one with the purse makes policy': Power, problem definition, framing and maternal health policies and programmes evolution in national level institutionalised policy making processes in Ghana.

This paper seeks to advance our understanding of health policy agenda setting and formulation processes in a lower middle income country, Ghana, by exploring how and why maternal health policies and programmes appeared and evolved on the health sector programme of work agenda between 2002 and 2012. We theorized that the appearance of a policy or programme on the agenda and its fate within the programme of work is predominately influenced by how national level decision makers use their sources of power to define maternal health problems and frame their policy narratives. National level decision makers used their power sources as negotiation tools to frame maternal health issues and design maternal health policies and programmes within the framework of the national health sector programme of work. The power sources identified included legal and structural authority; access to authority by way of political influence; control over and access to resources (mainly financial); access to evidence in the form of health sector performance reviews and demographic health surveys; and knowledge of national plans such as Ghana Poverty Reduction Strategy. Understanding of power sources and their use as negotiation tools in policy development should not be ignored in the pursuit of transformative change and sustained improvement in health systems in low- and middle income countries (LMIC).

Policy agenda-setting studies: an overview of Brazilian research / Estudios sobre formación de la agenda de políticas públicas: un panorama de la investigación en Brasil / Estudos sobre formação da agenda de políticas públicas: um panorama das pesquisas no Brasil

Abstract This article aims to present a brief reflection on the studies in the field of the public policy agenda. To this end, the text presents the main theoretical and methodological developments on the subject found in the international literature, with an emphasis on three fundamental contributions: the studies developed by Cobb and Elder in the 1970s; John Kingdon's multiple streams model in the 1980s; and Baumgartner and Jones' propositions from the 1990s until the present. Next, we seek to understand how policy agenda-setting studies have been developed in Brazil. To do so, we conduct a mapping of the Brazilian academic production, considering theses, dissertations, and articles published in journals between 2000 and 2018. In conclusion, we note the growing expansion of agenda studies in Brazil, and we draw attention to some of the characteristics of these works, such as the preferred policy areas and the theoretical and methodological frameworks favored by researchers, among other aspects.

Resumen El artículo tiene como objetivo presentar em breve reflexión sobre los cielo n de agenda em el campo de las políticas públicas. Para ello, el texto presenta los principales desarrollos teóricos y metodológicos producidos em la literatura internacional sobre el tema, em énfasis em cie contribuciones fundamentales: los cielo n desarrollados por Cobb y Elder em la década de 1970, el modelo de flujos múltiples presentado por John Kingdon em la década de 1980; y las proposiciones de Baumgartner y Jones em la década de 1990 hasta el presente. Luego, buscamos cielo n er cie se han desarrollado estos cielo n em el contexto brasileño. Para ello, realizamos em relevamiento de la producción académica brasileña, considerando tesis, disertaciones y artículos publicados entre los años 2000 y 2018. Como conclusión, observamos la expansión de los cielo n sobre agenda y destacamos algunas de sus características, como las políticas sectoriales más estudiadas por los investigadores, modelos teóricos más populares, entre otros aspectos.

RESUMO O artigo tem como objetivo apresentar uma breve reflexão sobre os estudos de agenda no campo das políticas públicas. Para isso, o texto apresenta os principais desenvolvimentos teóricos e metodológicos produzidos na literatura internacional sobre o tema, com ênfase em três contribuições fundamentais: os estudos desenvolvidos por Cobb and Elder nos anos 1970, o Modelo de Múltiplos Fluxos apresentado por John Kingdon nos anos 1980; e as proposições de Baumgartner e Jones nos anos 1990 até o presente. Na sequência, buscamos compreender como esses estudos têm sido desenvolvidos no contexto brasileiro. Para isso, realizamos um levantamento da produção acadêmica brasileira, considerando teses, dissertações e artigos publicados entre 200º e 2018. Como conclusão, observamos a expansão dos estudos sobre agenda e destacamos algumas de suas características, como as políticas setoriais mais estudadas pelos pesquisadores, os modelos teóricos mais populares, entre outros aspectos.

A dinâmica da atenção governamental sobre as políticas de saúde no Brasil: equilíbrio e pontuações nas primeiras décadas pós-redemocratização (1986-2003) / The dynamics of government attention on health policies in Brazil: balance and punctuation in the first decades after re-democratization (1986-2003)

Resumo Este trabalho tem o objetivo central de mapear e analisar a atenção de alguns atores e instituições sobre as políticas de saúde no Brasil entre 1986 e 2003. Esse modelo de pesquisa sobre agenda governamental é conhecido sob o termo "dinâmica de políticas" (policy dynamics) e analisa o processo de mudança de políticas públicas por meio da entrada e saída de temas nas prioridades dos policymakers. Mais de 10 mil dados, advindos de cinco fontes distintas (mensagens ao Congresso, produção legislativa, orçamento anual aprovado, Constituição Federal de 1988 e atas das conferências nacionais de saúde), foram selecionados e analisados de forma a identificar a atenção desses atores a temas específicos sobre a política de saúde. As análises de frequência, em perspectiva longitudinal e transversal, são feitas a partir de um grande conjunto de dados que refletem a atenção governamental ao longo das primeiras décadas pós-redemocratização do Brasil e permitem observar manutenções e mudanças nas políticas de saúde. Como resultado, foi possível identificar permanência da atenção governamental sobre as políticas de saúde ao longo de todo o período analisado, mostrando permanente e constante grau de atenção a essa política setorial. Do ponto de vista da dinâmica, foram identificadas manutenções, ajustes discretos e incrementais na política de saúde na maior parte do tempo, mas também foram pontuados momentos de grandes transformações ao longo do período.

Abstract This paper aims to map and analyze the attention of some actors and institutions on health policies in Brazil between 1986 and 2003. This model of research on the government agenda is known under the term of policy dynamics and analyzes the process of changing public policies by the entering and exiting of topics in the priorities of policymakers. More than 10,000 data from five different sources (messages to the Congress, legislative output, approved annual budget, Federal Constitution of 1988 and minutes of national health conferences) were selected and analyzed in order to identify the attention of these actors to specific topics on health policy. The frequency analyses, both on longitudinal and cross-sectional perspective, are based on a large set of data that reflect the government's attention during the first decades after the re-democratization in Brazil and allow for the observation and maintenance of changes in health policies. As a result, it was possible to identify permanence in the government attention on health policies throughout the analyzed period, showing a permanent and constant degree of attention to this sectoral policy. From the dynamics point of view, maintenance, discrete and incremental adjustments in health policy were identified most of the time, but also moments of great transformations were punctuated during the period.

Including the poor: the fiscal impacts of Medicaid expansion.

This article presents the fiscal impacts of the comprehensive reform of the Medicaid program put forth by the Health Policy Agenda for the American People. Proposed reforms include establishment of improved uniform eligibility standards, improvement in the scope and depth of coverage in state Medicaid programs, and increased provider payment rates. We estimate that expanding Medicaid coverage to all currently uninsured nonelderly persons below the federal poverty line would cost approximately $9 billion. A substantial portion of these costs would offset current spending elsewhere in the health care system. Improvement of state packages and increased provider payment could result in sharp increases in costs. We provide a range of estimates considering both the set of benefits provided and the behavior of the private insurance market.

KIE: The fiscal impacts of the comprehensive reform of the Medicaid program put forth by the Health Policy Agenda for the American People are analyzed. The establishment of improved uniform eligibility standards, improvements in the scope and depth of coverage in state Medicaid programs, and increased provider payment rates would cost $9 billion for all currently uninsured nonelderly persons below the federal poverty line. A range of estimates of cost increases are provided which consider both the set of benefits provided and the behavior of the private insurance market.

Health policy agenda for the American people.

KIE: Published here is the summary report of a five-year project called the Health Policy Agenda for the American People. Initiated in 1982, The Agenda involved representatives from 172 health-related, business, government, and consumer groups meeting to examine the immediate and future concerns of the health care sector in the United States. Its goal was to develop a comprehensive and cohesive long-range policy to guide the direction of health care in times of rapid technological change with its economic and ethical repercussions. This report summarizes the structure, process, principles, and implementation of the Health Policy Agenda project and lists its 195 recommendations on issues ranging from educating health professionals to improving communication among researchers, the media, and the public.^ieng

A saúde na agenda da política externa brasileira nos governos dos presidentes Fernando Henrique Cardoso (1995 - 2002) e Luiz Inácio Lula da Silva (2003 - 2010) / Health in Brazil's foreign policy agenda in the administrations of Presidents Fernando Henrique Cardoso (1995 - 2002) and Luiz Inácio Lula da Silva (2003 - 2010)

O presente trabalho tem por objetivo realizar o diálogo entre os temas de saúde e política externa a partir do caso brasileiro durante os governos dos presidentes Fernando Henrique Cardoso (1995-2002) e Luiz Inácio Lula da Silva (2003-2010). Por meio da análise das diretrizes da política externa brasileira entre 1995 e 2010, busca-se identificar o porquê do processo de institucionalização do tema da saúde na agenda da política externa do país, considerando-se a hipótese de que a saúde era um tema de importância estratégica para o objetivo maior da diplomacia brasileira, qual seja a participação influente na política internacional. Para tanto, discute-se os conceitos de saúde global e diplomacia em saúde, as formas de interação entre a saúde e outras dimensões da política externa e o papel das ideias na formulação dessa política de acordo com a abordagem construtivista da Teoria de Relações Internacionais. Além disso, as mudanças político-administrativas nas estruturas do Ministério da Saúde e do Ministério das Relações Exteriores e as referências à saúde nos discursos políticos das autoridades brasileiras, especialmente dos presidentes da República, foram utilizadas para a ilustração do referido processo de institucionalização. A articulação significativa entre essas pastas ministeriais e a proeminência do Ministério da Saúde nas políticas internacionais em saúde também são analisadas na evolução da diplomacia em saúde do Brasil e sua projeção como uma referência global em saúde. Nota-se o fortalecimento do tema da saúde na agenda da diplomacia brasileira, apesar das diferenças nos estilos de política externa dos presidentes mencionados...

This study explores the dialogue between health and foreign policy under theadministrations of Presidents Fernando Henrique Cardoso (1995-2002) and Luiz InácioLula da Silva (2003-2010). Through an analysis of the contours and priorities ofBrazilian foreign policy between 1995 and 2010, it aims to identify the reasons of theprocess through which health issues were institutionalized as part of the Braziliandiplomatic agenda. Specifically, it sets out the hypothesis that health is a topic ofstrategic importance to the primary goal of Brazilian foreign policy, which is influentialparticipation in international politics. To this end, the research discusses the concepts ofglobal health and health diplomacy, interaction between health and other dimensions offoreign policy, and the role of ideas in the formulation of this policy in accordance withthe constructivist approach of International Relations Theory. Moreover, the politicaland administrative changes in the structures of the Ministries of Health and ForeignAffairs, as well as references to health in Brazilian political discourse, especially that ofthe presidents of the Republic, were employed to illustrate the process ofinstitutionalization. The significant link between these Ministries and the prominence ofthe Ministry of Health in international health policies are also analyzed in the evolutionof Brazil’s health diplomacy and the country’s projection as a global health leader.Despite the differences in styles of foreign policy between Fernando Henrique Cardosoand Lula da Silva, the importance of health as a part of Brazil’s foreign policy agendawas significant over the period examined...