Search results
11 – 20 of over 123000Hussein Mohammed Al‐Borie and Muhammad Tanweer Abdullah
In recent years, effective leadership initiatives have been emphasized in the healthcare industry all over the world. This paper aims to examine contemporary healthcare…
Abstract
Purpose
In recent years, effective leadership initiatives have been emphasized in the healthcare industry all over the world. This paper aims to examine contemporary healthcare development in the Kingdom of Saudi Arabia (KSA) and prescribe four essential policy dimensions to its leadership, depicting the imperative needs for direction, integration, revision, and evidence – the “DIRE needs” approach.
Design/methodology/approach
The paper reviews literature on the contemporary KSA health system and provides guidelines for policy reforms vis‐à‐vis the emerging challenges.
Findings
First, the paper offers a conceptual model to examine the ongoing and future health policy development of the KSA. It identifies four key policy dimensions – direction, integration, revision, and evidence and links these to the scope of broader health sector reforms. Second, it characterizes these dimensions as key initiatives for health resource capacity and infrastructural development, essentially the primary health care, which need to be taken up by KSA mainstream health services leadership. Third, it underlines the importance of integrating institutional research and information systems for evidence‐based policy‐making and practicable implementation. Fourth, it offers a social science research perspective to the need for multi‐dimensional health policy reforms in the KSA.
Research limitations/implications
This paper opens up KSA health leadership initiatives that may be viewed as the DIRE needs, to be mainstreamed in the domains of policy and strategic planning, research and development, and healthcare management practices.
Originality/value
Social research in KSA health policy and planning is rare. This paper introduces a context‐specific multi‐dimensional model that provides critical insights into challenges and complexities that the Saudi health leadership must attend to. It defines a set of four essential benchmarking dimensions for guiding future policy reforms.
Details
Keywords
Duika Louise Burges Watson, Alizon Draper and Wendy Wills
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…
Abstract
Purpose
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.
Design/methodology/approach
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.
Findings
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.
Research limitations/implications
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.
Originality/value
This is the first comprehensive analysis of the discourse of choice in UK food policy.
Details
Keywords
Margaret Hodgins and Verna McKenna
Improving quality of life for older people calls for public policy initiatives that have a positive impact on the determinants of quality of life. This paper presents a review of…
Abstract
Improving quality of life for older people calls for public policy initiatives that have a positive impact on the determinants of quality of life. This paper presents a review of current social welfare, housing and health policy in the Republic of Ireland relevant to older people and policy areas that are of particular relevance to the determinants of quality of life identified in the literature. The state pension, on which older people are heavily reliant, constitutes the main focus of social welfare cash payments. However, a general practice of marginal increments that fail to take adequate account of inflation and costs of living can leave older people living on the margins of society. In relation to housing policy, there is a need for improved policy implementation regarding housing maintenance and facilitating home comfort in the older population. Overall, greater consideration for the housing needs of older people in general and social housing needs in particular are required. Since 1988 a preference for community over institutional care has persisted throughout Ireland's health policy documents, although gaps between policy aspiration and implementation measures continue to be highlighted. Future policy needs to focus on the creation of enabling environments for social participation and in the optimising of opportunities for physical, social and mental well‐being. The review underscored the absence of a rights‐based approach in policy‐making to date and the need for substantial capacity building to be undertaken among older people themselves.
Details
Keywords
Mark Fordjour Owusu, Arindam Basu and Pauline Barnett
The purpose of this paper is to assess policy and management of hypertension and diabetes in Ghana.
Abstract
Purpose
The purpose of this paper is to assess policy and management of hypertension and diabetes in Ghana.
Design/methodology/approach
The authors conducted 26 key informant interviews with policy makers, payers, providers and participants from advocacy groups associated with the management of hypertension and diabetes both at national and district levels in Ghana; conducted focus group discussions with a total of 18 hypertensive and diabetic patients; and analyzed documentation detailing activities that have been undertaken in response to the management of hypertension and diabetes in Ghana. The authors then conducted a content analysis after combining the three sources of information.
Findings
Using a stepwise policy process, the Ghanaian health sector has developed overarching policies and strategies on management of diabetes, hypertension, other non-communicable diseases, tobacco, alcohol and nutrition-related issues. Availability of funds and over-concentration on communicable diseases are the main barriers to the implementation of policies. Besides, response of the health sector to address the problems of hypertension and diabetes is focused more on clinical management than prevention; while the structures and processes to manage diabetes and hypertension is available at all levels of service delivery, more needs to be done on preventive aspects.
Originality/value
This is the first study in Ghana to combine individual interviews, focus groups and document analysis to review policy development, implementation and response activities on the management of hypertension and diabetes. The authors believe that the evidence from this research will inform future policy initiatives on hypertension and diabetes management in Ghana.
Details
Keywords
Patrick Mapulanga, Jaya Raju and Thomas Matingwina
The purpose of this study is to examine levels of health research evidence in health policies in Malawi.
Abstract
Purpose
The purpose of this study is to examine levels of health research evidence in health policies in Malawi.
Design/methodology/approach
The study selected a typology of health policies in Malawi from 2002 to 2017. The study adopted the SPIRIT conceptual framework and assessed the levels of research evidence in health policy, systems and services research using the revised SAGE policy assessment tool. Documentary analysis was used to assess levels of health research evidence in health policies in Malawi.
Findings
In 29 (96.7 per cent) of the health policies, policy formulators including healthcare directors and managers used generic search engines such as Google or Google Scholar to look for heath research evidence. In 28 (93.3 per cent) of the health policies, they searched for grey literature and other government documents. In only 6 (20 per cent) of the heath policy documents, they used academic literature in a form of journal articles and randomised controlled trials. No systematic reviews or policy briefs were consulted. Overall, in 23 (76.7 per cent) of the health policy documents, health research evidence played a minimal role and had very little influence on the policy documents or decision-making.
Research limitations/implications
The empirical evidence in the health policy documents are limited because of insufficient research citation, low retrievability of health research evidence in the policy documents and biased selectivity of what constitutes health research evidence.
Practical implications
The study indicates that unfiltered information (data from policy evaluations and registries) constitutes majority of the research evidence in health policies both in health policy, systems and services research. The study seeks to advocate for the use of filtered information (peer reviewed, clinical trials and data from systematic reviews) in formulating health policies.
Originality/value
There is dearth of literature on the levels of health research evidence in health policy-making both in health policy, systems and services research. This study seeks to bridge the gap with empirical evidence from a developing country perspective.
Details
Keywords
Alvin Cheung, Charlotte Yu, Queenie Li and Helen So
The purpose of this paper is to review and compare the implementation of “arts inclusion” policies (AIPs) by 14 different public administrative systems around the world. It aims…
Abstract
Purpose
The purpose of this paper is to review and compare the implementation of “arts inclusion” policies (AIPs) by 14 different public administrative systems around the world. It aims to provide a consolidated source which informs further studies in this field, and to develop a framework to compare AIPs at a global level.
Design/methodology/approach
Using “arts inclusion policy” as the search term, academic journals from a wide spectrum of fields were reviewed. A data set was extracted from the Compendium of Cultural Policies and Trends’ online database which provided real-time information of national cultural policies. Another data set is from the United Nations’ Inequality-adjusted Human Development Index, as the geographic scope of the review – largely focussing on UK, US, Australian, Scandinavian and Asian contexts. Using existing policy-making literature as benchmark, the authors designed and applied a comparative framework dedicated to AIPs which focussed on “policy-making structures” as the main ground of comparison.
Findings
An important finding is that the policy development and implementation of AIPs often underscore inter-sectoral involvement in many public administrations in this study. With policy leadership and financial incentives pivotal to effective AIPs, central governments should take a more concerted leadership role to include AIPs in national inter-sectoral policies, encourage evidence-based research, expand funding and advocate the recognition of the impacts of arts inclusion. It is concluded that AIPs in western countries remain more developed in targeted scopes and programme diversity compared to those of Asian countries and regions. Continued studies in this field are encouraged.
Originality/value
This review is the first of its kind to include a number of Asian and western countries within its research scope, allowing it to offer a more holistic outlook on the development and implementation of AIPs in different countries and regions. A common critique with all relevant existing literature was usually their lack of concrete comparative grounds, and the present study’s all-encompassing review of literature from across different levels and sectors of respective public administrative systems contribute to a unique and comprehensive perspective in the arts and health discourse.
Details
Keywords
Kinga Zdunek, Mitch Blair and Denise Alexander
The Models of Child Health Appraised (MOCHA) project recognises that child health policy is determined to a great extent by national culture; thus, exploring and understanding the…
Abstract
The Models of Child Health Appraised (MOCHA) project recognises that child health policy is determined to a great extent by national culture; thus, exploring and understanding the cultural influences on national policies are essential to fully appraise the models of primary care. Cultures are created by the population who adopt national rituals, beliefs and code systems and are unique to each country. To understand the effects of culture on public policy, and the resulting primary care services, we explored the socio-cultural background of four components of policy-making: content, actors, contexts and processes. Responses from the MOCHA Country Agents about recent key national concerns and debates about child health and policy were analysed to identify the key factors as determinants of policy. These included awareness, contextual change, freedom, history, lifestyle, religion, societal activation and tolerance. To understand the influence of these factors on policy, we identified important internal and external structural determinants, which we grouped into those identified within the structure of health care policy (internal), and those which are only indirectly correlated with the policy environment (external). An important child-focused cultural determinant of policy is the national attitude to child abuse. We focused on the role of primary care in preventing and identifying abuse of children and young people, and treating its consequences, which can last a lifetime.
Details
Keywords
This chapter argues that neoliberal governmentality in immunization relocates the Turkish state's position regarding vaccine and immunization policies. Neoliberalism is often…
Abstract
This chapter argues that neoliberal governmentality in immunization relocates the Turkish state's position regarding vaccine and immunization policies. Neoliberalism is often discussed in the context of privatization, performance, and effectiveness separately. However, more attention should be paid to the set of strategies that are employed in public policy processes to manage populations in terms of immunization, while intertwining power with knowledge. Following Foucault's concept of governmentality and taking it further within the context of biopolitics, this chapter focuses on different knowledge practices regarding vaccine and immunization policies in Turkey. In doing so, this case study applies a post-structural analysis to examine vaccine production, vaccine know-how, and immunization policies inscribed in policy documents as a form of knowledge practice. The analysis sheds light on the reflexive transformation of the concept of biopolitics, which is moving from state-oriented knowledge practices toward a neoliberal governmentality of immunization.
Details
Keywords
This chapter examines factors that maximize collaboration among various stakeholders with the purpose of health policy making in Turkey. The field research reveals that policy…
Abstract
This chapter examines factors that maximize collaboration among various stakeholders with the purpose of health policy making in Turkey. The field research reveals that policy networks have been formed in the sub-areas of public health, healthcare construction, and health tourism in the years between 2011 and 2015. Content analysis of 24 semi-structured interviews with policy and professional experts is conducted to assess Network Collaborative Capacity, built upon three dimensions, namely, structural, relational, and institutional. The findings reveal that networks differ in their capacity to collaborate as well as their impact on policy making resulting in three distinct models of network policy making. In the cases under investigation, network impact takes the form of (a) policy innovation through expertise sharing and evidence-based policy making associated with particularly high levels of relational capacity; (b) policy effectiveness through contract enforcement within a clear legal framework associated with particularly high levels of institutional capacity; and (c) policy coherence through organizational-knowledge-sharing and actor coordination. Findings also suggest that institutionalization in the form of network embeddedness in the surrounding political and economic environment is crucial for maintaining a collaborative momentum as well as achieving policy effectiveness at the stage of policy implementation. Based on these findings, further studies should focus on the institutionalization of policy networks, particularly in those middle-income countries such as Turkey that aim and often fail to address various policy challenges through short-lived practices of multi-stakeholder action. Finally, this study emphasizes the importance of incorporating neo-institutional approaches to network analysis.
Details
Keywords
Jared C. Carbone and Snorre Kverndokk
Empirical studies show that years of schooling are positively correlated with good health. The implication may go from education to health, from health to education, or from…
Abstract
Empirical studies show that years of schooling are positively correlated with good health. The implication may go from education to health, from health to education, or from factors that influence both variables. We formalize a model that determines an individual’s demand for knowledge and health based on the causal effects, and study the impacts on the individual’s decisions of policy instruments such as subsidies on medical care, subsidizing schooling, income tax reduction, lump-sum transfers, and improving health at young age. Our results indicate that income redistribution policies may be the best instrument to improve welfare, while a medical care subsidy is the best instrument for longevity. Subsidies to medical care or education would require large imperfections in these markets to be more welfare improving than distributional policies.
Details