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Bedouin in Lebanon are estimated to represent two‐three per cent of the population. Most of them benefited from the 1994 Normalisation Law and are domiciled there. Being in rural areas and under‐privileged neighbourhoods, Bedouin continue to suffer from problems like social exclusion and poor health care provision. This paper assesses the awareness and knowledge of policy makers of the health policies and health status of the Bedouin community in Lebanon. In‐depth interviews were conducted with nine health policy makers from government, private and non‐government organisation sectors, and UN agencies (UNFPA, UNICEF) on topics of Bedouin status and livelihood, health policies and current health provision and use in reproductive and child health, and interventions to improve access to and quality of reproductive and child health and well‐being. Most of the policy makers interviewed had little or no knowledge of Bedouin population estimates, identity status and normalisation, geographical distribution in the rural peripheral areas of Lebanon, range of mobility, common health problems, or provision and use of health services. Policy makers said they had no current or future plans for health policies or procedures for the Bedouin community, but expressed willingness to contribute to any interventions to improve Bedouin health and well‐being. In Lebanon, where the public health sector is feeble and inequitable, mostly affecting marginalised and underprivileged communities including the Bedouin, policy makers hold unrealistic stereotypes about Bedouin and Bedouin health issues, and there are no comprehensive health policies that integrate Bedouin. It is essential that policy makers be more sensitised to and aware of the status of Bedouin in Lebanon, and advocacy and lobbying be initiated to include Bedouin health in government health and social policies.
In recent years there has been an increasing focus on improving the physical health of people with serious mental illness and many policies and guidelines are now tailored…
In recent years there has been an increasing focus on improving the physical health of people with serious mental illness and many policies and guidelines are now tailored to support professionals working in mental health services to meet these requirements. We found, however, that the physical health care policies produced by mental health trusts in England varied enormously. Policies were often cumbersome, vague and lacked clear guidance on what particular action should be taken, when it should be taken, and by whom. Physical health care policy documents of three mental health care trusts in the north sector of the East Midlands Strategic Health Authority (UK) were examined in detail. We found significant disparities between the policies in terms of size, readability, external references and reading cost. None could be read swiftly and all incorporated vague language into their directives. It would be beneficial for there to be more consideration given to forming local policies that are readable, succinct, and unambiguous. There is potential for considerable economy of effort with collaboration in production of these documents.
Mental health problems make a significant contribution to morbidity and mortality in adolescents worldwide. To address mental health in adolescents policy response should…
Mental health problems make a significant contribution to morbidity and mortality in adolescents worldwide. To address mental health in adolescents policy response should intertwine the life course approach and the ecological model that positions adolescents in the context of multifactorial influences. The purpose of this paper is to describe policy response at four levels: multisector policies and interventions, health systems policies and interventions, evidence-based clinical interventions and actions to monitor progress. It aims to analyse the implications for adolescent mental health of key recent global commitments including the sustainable development goals (SDGs) and the Global Strategy for Women’s, Children’s and Adolescents’ Health.
Multisector policies and interventions on determinants of adolescent mental health and well-being are drawn from the Global Strategy for Women’s, Children’s and Adolescents’ Health. Key health systems actions are derived from the Comprehensive Mental Health Action Plan (2013-2020). In both cases, policies and interventions are made specific for provisions relevant to adolescents. Examples of implementation of policies and interventions are drawn from a World Health Organization (WHO) review of national policy documents found in WHO MiNDbank. A list of indicators to monitor progress is being proposed based on Mental Health Atlas and WHO indicators for adolescent health.
With some notable exceptions, the mental health of adolescents is not adequately addressed by national health policies. There is a considerable body of evidence on the effectiveness of policies and interventions, and recent global commitments give new hope for promoting adolescent mental health through a multisectoral response, within which the health sector has an important role to play. Global reporting mechanisms, including the Mental Health Atlas, should be “adolescent-sensitive”, meaning that adolescent specific impact, outcomes, inputs and determinants should be measured, reported and acted upon.
This paper analyses the meaning specific to adolescents in the policies and interventions promoted in the SDGs, the Global Strategy for Women’s, Children’s and Adolescents’ Health and the Comprehensive Mental Health Action Plan (2013-2020). For the first time a four-levels policy response specific to adolescent mental health is put together: multisector policies and interventions, health systems policies and interventions, evidence-based clinical interventions and actions to monitor progress.
Brazilian federalism was important in the political game of combating the pandemic for three reasons. First, Brazil's public health system depends heavily on…
Brazilian federalism was important in the political game of combating the pandemic for three reasons. First, Brazil's public health system depends heavily on intergovernmental relations between Union, states, and municipalities because there is a policy portfolio based on federative cooperation. Second, the subnational governments' autonomy to act against COVID-19 was constantly questioned by the Federal Government – the conflict between the President and governors was a key piece in all health policy. Finally, states and local governments were primarily responsible for policies to fight against pandemic, but the absence and/or wrong measures taken by the Federal Government (such as the delay in purchasing vaccines) generated intergovernmental incoordination, increased territorial inequality, and reduced the effectiveness of subnational public policies, especially those linked to social isolation. In this context, Brazilian federalism played a dual role in the pandemic. On the one hand, the federative structure partially succeeded in averting an even worse scenario, mitigating the impact of mistaken presidential decisions. The role of subnational governments, especially of the states, was critical as a counterweight to federal decisions. On the other hand, the President actively acted against governors and mayors and, above all, sought to weaken intergovernmental articulations within the Unified Health System (SUS), the federative model designed three decades ago. One could say that the federative actors, such as the Supreme Court (Supremo Tribunal Federal – STF) and subnational governments, were the main obstacles for the Bolsonarist antiscientific agenda. The success of this reaction to President Bolsonaro's negationist populism was partial, but the results of the fight against COVID-19 would have been much worse without these federalist barriers.
This article addresses the health problems of Puerto Rico by looking at them from the perspective of food and agriculture, underlining that there is a substantial policy…
This article addresses the health problems of Puerto Rico by looking at them from the perspective of food and agriculture, underlining that there is a substantial policy divide between agricultural policy and health. This reframing insists that we attend to the relationships between agriculture and food policy in order to offer new ways to think about the prevalence of so-called “lifestyle diseases” in Puerto Rico.
This study draws on a forensic research strategy that follows the framing of food and agriculture policies through a three-step diagnosis process using a mixed method approach. This three-dimensional analysis focuses on (1) history, (2) statistics, and (3) policies and legislations.
The disconnection between health and agriculture policies materializes (1) throughout 19-20th century agricultural developments, (2) across the current agriculture organization, and, (3) through legislations and policies. A dominant understanding of agriculture as a predominantly economic and trade-driven sector fuels this policy divide.
This article calls for a new policy imagination that will allow for a re-conceptualization of agriculture policies as health policies. In order to bring forward this policy imagination, this article suggests returning to ideas that precede the production and articulation of the policy divide through a re-appropriation of Latin American indigenous knowledge and ideas. As such, the Andean concept of Buen Vivir represents a particularly promising path explored in this article.
This paper presents a critical discourse analysis of “choice” as it appears in UK policy documents relating to food and public health. A dominant policy approach to…
This paper presents a critical discourse analysis of “choice” as it appears in UK policy documents relating to food and public health. A dominant policy approach to improving public health has been health promotion and health education with the intention to change behaviour and encourage healthier eating. Given the emphasis on evidence-based policy making within the UK, the continued abstraction of choice without definition or explanation provoked us to conduct this analysis, which focuses on 1976 to the present.
The technique of discourse analysis was used to analyse selected food policy documents and to trace any shifts in the discourses of choice across policy periods and their implications in terms of governance and the individualisation of responsibility.
We identified five dominant repertoires of choice in UK food policy over this period: as personal responsibility, as an instrument of change, as an editing tool, as a problem and freedom of choice. Underpinning these is a continued reliance on the rational actor model, which is consonant with neoliberal governance and its constructions of populations as body of self-governing individuals. The self-regulating, self-governing individual is obliged to choose as a condition of citizenship.
This analysis highlights the need for a more sophisticated approach to understanding “choice” in the context of public health and food policy in order to improve diet outcomes in the UK and perhaps elsewhere.
This is the first comprehensive analysis of the discourse of choice in UK food policy.
The aim of this study is to analyse the position and role of mental health in health promotion policy. Policy documents from Finland, Sweden, Denmark, the Netherlands…
The aim of this study is to analyse the position and role of mental health in health promotion policy. Policy documents from Finland, Sweden, Denmark, the Netherlands, England and Portugal indicate that, although mental health is considered a serious issue, it is problematic in policy terms. A range of arguments are put forward, making the case for the importance of mental health within the health promotion agenda, including the classification of mental illness as a public health problem, socio‐economic and individual costs of mental health problems and the view that mental well‐being is a crucial element of overall health. However problems of definition, measurement and a traditional focus on treatment and care continue to make mental health promotion problematic for policy makers.
The NHS has been the object of much international interest from its inception and through its periodic reforms. However, UK policy‐makers have expressed only limited and…
The NHS has been the object of much international interest from its inception and through its periodic reforms. However, UK policy‐makers have expressed only limited and selective concern for health sector reforms in other countries. This paper seeks to identify key elements of the present process and content of reforms to the UK NHS and examine the extent to which international learning would be important in developing these reforms. Particular emphasis is placed on learning from developing country experience. The paper therefore considers the policy process in the UK, the focus on primary care, the shift from competitive to collaborative strategies in addition to prioritising and planning. Each is considered in relation to developing country experience and the opportunities for learning. The paper concludes by setting out four areas leading to an international opening in NHS policy processes: developing political space in policy making, developing mechanisms for international exchanges, understanding policy context, and broadening international experience and changing values. The notion of a one‐way process in international policy learning is rejected: while the South can learn from the North, so too can the North from the South.