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Suicide is primarily conceptualised as an event with causes relating to individual lives. However, we argue that it is impor tant not to lose sight of the fact that not all causes of suicide are related simply to individual action and circumstances. Clear evidence exists for some risk factors for suicide being visable at the population level or related to membership of various social groups. Strategies to prevent suicide, therefore, ought to focus on such causes (eg. injustice, discrimination, mental illness in general), not just on causes relating to individuals. In turn, this means that suicide prevention should not merely focus on trying to reduce access to the means of suicide by individuals (eg. shotguns in rural areas, pesticides in India, means of strangulation in prisons etc) but should expand to include such things as socio‐economic determinants and other population influences on mental health. We argue that suicide ought to be thought of as being, in an impor tant sense, a public health problem, and that the resources of public health ethics are one impor tant element in seeking to address this impor tant issue.

The purpose of this paper is to describe progress in an across sectorial approach to primary health care at the district health service (DHS) level in Thailand in response to recent innovative national public policy directions which have been enshrined in constitutional doctrine and publicly endorsed by the Prime Minister. This paper describes one response to the Prime Minister’s challenge for Thailand to become the centre of learning in the sub-region in health management.

The authors utilised a descriptive case study approach utilising an analysis of the Naresuan University initiative of establishing the College of Health Systems Management (NUCHSM). Within that case study, there is a focus on challenges relevant to the socio-economic determinants of health (SOED) and an emphasis on utilising Sustainable Development Goals (SDGs) within the DHS structure.

The findings describe the establishment of the NUCHSM. A Master of Science (Health Systems Management) by research and a PhD degree have been created and supported by an international faculty. The Thailand International Cooperation Agency recognised NUCHSM by providing scholarships. International students are from Bangladesh, Bhutan, Kenya, Malawi and Timor Leste. Research consultancy projects include two in Lao People’s Democratic Republic; plus, a prototype DHS management system responsive to SDG attainment; and a project to establish a sustainable Ageing Society philosophy for a Thai municipality.

The case study on NUCHSM and its antecedents in its development have demonstrated originality in a long-standing international collaboration, and it has been recognised by the national government to provide scholarships to citizens of the countries in the sub-region to undertake postgraduate studies in health management. The concept of learning from each other and together, simultaneously as a group, through action research projects funded to enhance the evolution of DHSs is innovative.

The purpose of this study is to examine the socio-economic inequalities that exist in the use of unhygienic menstrual practices in India and its states, as well as to identify the contribution of various socio-economic factors that leads to these inequalities.

Data from the National Family Health Survey-5 (2019–21) for 240,285 menstruating women aged 15–24 years is used to examine the above objectives. The concentration index for unhygienic menstrual practices is calculated to measure the socio-economic inequalities, which are then decomposed into their determining factors.

The state of Punjab experiencing the highest level of economic inequality, followed by Telangana and Haryana. The results from decomposition analysis suggest that rural residence (13%), illiteracy (7%), poor economic status (53%), not reading newspaper (12%) and not watching TV (14%) contribute 99% to the total socio-economic inequality in using unhygienic menstrual practices in India. The contribution of economic status to total inequalities is more in all the states except for Kerala and Mizoram, where caste and residence play an important role.

This paper signifies the role of economic inequality in the use of unhygienic menstrual practices in India as well as the contribution of various socio-economic factors contributing towards these inequalities. The results from decomposition analysis suggest the need for unique health intervention strategies for different states following the evidence of major contributions to total inequalities in the use of unhygienic menstrual practices.

Unequal social conditions that provide people with unequal opportunities to live healthy lives are considered unjust and associated with “health inequity”. Governing power is impacting people's lives through laws, policies and professional decisions, and can be used intentionally to combat health inequity by addressing and changing people's living- and working conditions. Little attention is paid to how these ways of exercising governing power unintentionally can structure further conditions for health inequity. In this paper, the authors coin the term “governance determinants of health” (GDHs). The authors' discussion of GDHs potential impact on health inequity can help avoid the implementation of governing strategies with an adverse impact on health equality. This paper aims to discuss the aforementioned objective.

The authors identify Governance Determinants of Health, the GDHs. GDHs refer to governance strategies that structurally impact healthcare systems and health equality. The authors focus on the unintended, blind sides of GDHs that maintain or reinforce the effects of socioeconomic inequality on health.

The power to organize healthcare is manifested in distinct structural approaches such as juridification, politicalization, bureaucratization and medical standardization. The authors explore the links between different forms of governance and health inequalities.

The authors' discussion in this article is innovative as it seeks to develop a framework that targets power dynamics inherent in GHDs to help identify and avoid GDHs that may promote unequal access to healthcare and prompt health inequity. However, this framework has limitations as the real-world, blurred and intertwined aspects of governing instruments are simplified for analytical purposes. As such, it risks overestimating the boundaries between the separate instruments and reducing the complexity of how the GDHs work in practice. Consequently, this kind of theory-driven framework does not do justice to the myriad of peoples' complex empirical practices where GDHs may overlap and intertwine with each other. Nevertheless, this framework can still help assist governing authorities in imagining a direction for the impacts of GDHs on health equity, so they can take precautionary steps to avoid adverse impacts.

The authors develop and explore – and demonstrate – the relevance of a framework that can assist governing authorities in anticipating the impacts of GDHs on health inequity.

The development of any discussion paper presupposes that two initial requirements have already been satisfied: the first, that there is no ambiguity about the meaning of the terms of reference to be used in the subsequent discussion; the second, that the area under consideration is clearly identified, and that the limits or boundaries of study have been carefully delineated.

The purpose of this paper is to examine the barriers preventing women in prostitution from accessing co-ordinated health services in the Republic of Ireland. By examining the experiences of migrant women engaged in prostitution, the research contributes to knowledge pertaining to the psychosocial experiences of female sex workers’ access to healthcare.

The study interviewed migrant women across Ireland, using a biographical narrative approach and an adapted voice-centred relational model of analysis to determine the necessity for a health promotion strategy for this demographic.

The findings indicate migrant women work primarily indoors, hold precarious legal status and are in Ireland due to processes of globalisation, migration and economic necessity. The women discussed their entry into prostitution and their experiences within prostitution in the context of their psychosocial experiences.

While the findings are from a small qualitative sample confined to the Republic of Ireland, it is the first study to prioritise migrant sex workers’ psychosocial experiences in Ireland.

The research concludes education and service development that respects the various social determinants impacting women in prostitution is missing but remains necessary in Ireland. It finds a gendered reform of policies using an ecological framework for health that can address issues of poverty, migration and the global trends of the sex industry.

This means a national review of current services in health, social work and community development fields is timely.

This paper gives insight into the lives of migrant women involved in the sex industry and can make an important contribution to future research directions and practice in Irish and European prostitution contexts.

A public health approach for promoting mental health has become a major health policy agenda of many governments. Despite this worldwide attention on research addressing population mental health and general wellbeing, very little is heard on positive mental health from the low-and middle-income countries. This paper aims to present an attempt to develop a model of positive mental health among young people. This could be used for integrating the concept of positive mental health (PMH) into public health interventions.

The study was conducted in the state of Kerala, India. The paper administered the “Achutha Menon Centre Positive Mental health Scale” to a sample of 453 (230 men and 223 women) in the age group 18-24, along with an interview schedule exploring the relationship of PMH with many explanatory variables such as sex, beliefs, religion, education, employment and social capital. The paper developed an input path model through a series of multiple regressions explaining the levels of PMH in the community, which was then tested statistically (using AMOS version 7.0). The input model was created by identifying the determinants and correlates of PMH based on their predictive power on the outcome variable, the PMH score. The input diagram was used to test the model fit of the data.

The path model (Figure 1) clearly specified the determinants of PMH. Among them, the variables that have a direct determinant effect on PMH are: quality of home learning environment, employment status, education status, marital status, self-perception on possession of skills, happiness with life, membership in social organizations and socializing capability.

In this study, path model is used to confirm relationships among observed and latent variables. The path diagram assesses the comparative strength of the correlations between the variables and does not test the directionality. Or, the model itself cannot prove causation.

Determinants of PMH those are amenable to interventions as well as those which help in recognizing characteristic groups for intervention could help to plan future intervention programs.

Original paper based on primary data collected through a cross-sectional survey.

It can be said that the most important function of the health system is to provide health-care services. This directly affects society’s health and justice. To the best of the authors’ knowledge, this study is the first study that has meta-analyzed the percentage of health services utilization among Iranians to answer this question “How much is the percentage of health-care services utilization in Iran?”

This study is a systematic review and meta-analysis conducted in 2020. The literature review was done by searching the databases of Google Scholar, Scopus, PubMed, Web of Science, Science Direct, SID, Magiran and Irandoc from January 2010 to August 2020. Pooled utilization percentage (UP) was estimated by STATA 15 through random-effects meta-analysis with 95% confidence interval. The I² statistic was used to investigate the possibility of heterogeneity of articles (I² ≥ 50% indicate heterogeneity). A forest plot was applied to report the results. A funnel plot exploited due to publication bias assessment.

Approximately 22% of the reviewed articles have been done at the national level of Iran. Most studies have examined the utilization of outpatient and inpatient services. Based on the random effects method, the pooled value of UP was obtained at 47.82%, (95% CI: 39.33–56.31). Also, the pooled percentage of utilization was statistically significant (Test of UP = 0, Z = 456.44, p = 0.000).

Policymakers can improve the level of utilization from health services by expanding universal coverage, expanding insurance coverage and removing direct and indirect barriers.

To the best of the authors’ knowledge, this is the first systematic review and meta-analysis on health services utilization in Iran that completely considers the utilization rate in all health services and states the practical solutions to cope with utilization deficiencies and barriers.

The purpose of this paper is to investigate how “manias” in global health governance lead to health inequalities even before, during and in the aftermath of acute health crises such as the COVID-19 pandemic. “Manias” as used here refer to obsessive ir/rational behaviors, misguided policy/strategic choices and the exercise of power that benefit the major global health actors at the expense of stakeholders.

From post-colonial and historical perspectives, this study delineates how the major global health actors influence outcomes in global health governance and international business when they interact at the national–global level using an illustration from an emerging economy.

Power asymmetry in global health governance is constructed around the centralization of economic influence, medico-techno-scientific innovation and the geopolitical hegemony of a conglomerate of super-rich/powerful actors. They cluster these powers and resources in the core region (industrialized economies) and use them to influence the periphery (developing economies) through international NGOs, hybrid organizations, MNCs and multilateral/bilateral agreements. The power of actors to maintain manias lies in not only how they influence the periphery but also the consequences of the periphery’s “passivity” and “voluntary” renunciation of sovereignty in medical innovations and global health policies/politics.

As a quintessential feature of manias, power asymmetry makes it harder for weaker actors to actually change the institutional conditions that produce structural inequalities in global health.

This timely and multidisciplinary study calls for a novel architecture of global health governance. Thus, democratizing global health governance with sufficiently foresighted investments that prioritize equitable access by and the inclusiveness of vulnerable stakeholders will help dismantle institutionalized manias while decreasing health inequalities.