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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.

Health is a human right and a fundamental building block of sustainable development, economic prosperity and poverty reduction. To realize people’s right to health, evaluating the situation of the right and its determinants is necessary. This paper aims to analyze Iran’s conduct in realizing its population’s right to health.

A qualitative case study design involving a structured review of relevant laws, policy documents, reports and academic literature was undertaken. The data were collected from electronic databases and the official Web pages of the United Nations (UN) and Iran’s Government and analyzed by a framework suggested by the UN.

Iran’s law and policies intend to combat health inequalities and to provide an adequate standard of living for everyone, particularly disadvantaged groups and individuals. However, not all laws and policies protecting disadvantaged groups are adequately implemented. There are disparities in health status and access to health care among different socio-economic groups. International economic sanctions and government policies decreased people’s ability to access the necessities of life including health care. Moreover, social determinants of health, such as cultural beliefs regarding women’s rights have not been addressed sufficiently in the country’s laws.

This study includes a broad range of subjects and provides an overview of the health-care system of Iran. However, more detail is needed to describe every aspect of the right to health. It was not feasible to address them all in this paper and needs more research. In addition, as with the majority of qualitative studies, the design of the current study is subject to limitations. Firstly, the research quality of narrative reviews is dependent on the researcher’ skills and more easily can be influenced by his/her personal biases. Second, the rigor is more difficult to maintain, assess and demonstrate. Nevertheless, narrative studies often complement quantitative studies and are informative.

To fulfill the right to health, Iran should improve affordability and quality of care and the situation of the determinants of health. The gaps in people’s access to health care need to be identified, and all necessary means and scarce resources be allocated to remove access barriers and to improve the situation of disadvantaged people. The adoption of relatively low-cost targeted programs, the proper management of resources and the prevention of unnecessary costs are suggested.

This study aims to measure the level of satisfaction among women with childbirth services provided at public health facilities. Further, to analyse the impact of their socio-economic and obstetric characteristics on their level of satisfaction.

To accomplish these objectives a cross-sectional survey was conducted in two districts of an Indian state, Bihar. Structured questionnaire was developed based on the scale proposed by Okumu and Oyugi (2018) both for vaginal and caesarean birth patients. For empirical analysis multiple linear regression model was employed.

Results suggest that majority of mothers are satisfied with the care they received during childbirth, regardless of whether they chose a caesarean (55%) or vaginal delivery (53%). Women report the lowest levels of satisfaction with postpartum care and the privacy that was preserved by healthcare personnel at health facility. Further the study also confirms the association between patient’s socio-economic characteristics and their satisfaction level.

This is the first study of its kind to highlight the situation of public healthcare system in Bihar, which is the third most populated state in India with poor social and health indicators.

Young prisoners are one of the most vulnerable groups in society for mental health problems and ill-being. Therefore, there is a crucial need to understand their physical, psychological and social situations. This study aims to explore young Cambodian prisoners’ experiences and perceptions of mental health and well-being, their determinants and their coping strategies.

Six focus group discussions were carried out in three prisons with a total of 48 young prisoners between the ages of 15 and 24 years (50% women, 50% men). Semi-structured questions guided the discussions, and thematic analysis was applied to analyse the data.

Young prisoners reported multifaceted experiences of mental health and well-being. The majority described adverse mental health experiences, while some revealed better well-being, partly influenced by the socio-economic support from outside the prisons and previous involvement or not in drug abuse. The experience of physical overcrowding without emotional attachment among the fellow prisoners was perceived as the overarching determinant of loneliness and mental health problems, while socio-emotional support and rituals were described as the most important coping mechanisms.

This pioneering study from Cambodia gives young prisoners an opportunity to voice their experiences and perceptions of mental health and well-being in the prison setting. The findings in this study underline the importance of prison authorities tackling overcrowding to promote well-being and reduce mental health problems. Also, the coping mechanisms outlined by the participants should be considered when planning psychosocial interventions.

Peer support work is increasingly recognised as an adjunct support across various systems of health and social care, and is a core principle in trauma-informed care. Those accessing a wide range of human and social services may have experienced prior trauma. As such, trauma-informed care is a universal organisational model that seeks to realise, recognise and respond to trauma, while limiting possible re-traumatisation when individuals are engaging with systems of care. Peer support can play an integral role in supporting those who have experienced prior traumas. However, trauma does not exist in isolation and the wider environment influences, moderates and contributes to how an individual experiences and heals from trauma. Peers can play an important role helping to alleviate some of the environmental influences by helping to build the capacity of those that use health and social care services.

This study aims at evaluating the technical efficiency (TE) of healthcare systems in the Arab region and exploring the key factors that affect the efficiency performance.

The study applies a two-stage Data Envelopment Analysis (DEA) approach to a sample of 20 Arab countries. In the first stage, a DEA model is used to calculate the TE scores of the examined healthcare systems in 2019 and 2010, following both the output and input orientations of efficiency. In the second stage, a censored Tobit model is estimated to investigate the determinants of healthcare efficiency.

DEA results of 2019 indicate that achievable efficiency gains of the Arab countries range from 0.4% to 16% under the output and input orientations, respectively. Six countries are efficient under both orientations. Although the average efficiency scores of the Arab countries have deteriorated between 2010 and 2019, Djibouti and Sudan had the greatest efficiency improvements between the two years. Bahrain, Mauritania, Morocco and Qatar proved to be efficient in 2010 and 2019 under the two orientations of efficiency and according to the two DEA specifications followed. The Tobit model reveals that corruption and government health expenditure tend to have an adverse impact on healthcare efficiency.

The author evaluates healthcare efficiency and healthcare's efficiency determinants in the Arab countries. Regardless Arab countries' diversity, these countries are facing common health challenges, including diminishing role of governments in healthcare financing; increased out-of-pocket healthcare spending; poor healthcare outputs and prevalence of health inequities resulting from weak governance institutions. Comparing the efficiency of healthcare systems between 2010 and 2019 gives insights on the potential impact of the Arab spring uprisings on healthcare efficiency. Moreover, examining the determinants of healthcare efficiency allows for better understanding of how to improve the efficiency of healthcare systems in the region.

While the Olympic Games are always under the spotlight, the Paralympic Games are somehow ignored. This paper aims to invite the general public to think about the para-athletes and the differential treatments they received.

Among the participating countries, many of them were unable to win a single Olympic or Paralympic medal. When the dependent variable is left-censored, ordinary least squares regression is asymptotically biased downwards. In the literature, researchers typically employ the maximum likelihood Tobit model to take care of the censoring problem. However, some researchers argue that the Hurdle model has an advantage over the Tobit model in identifying the determinants of winning Olympic medals. Following their wisdom, this paper employs both the Tobit and Hurdle models in analysis.

The empirical evidence gathered in this paper suggests that population size, host status and average years of schooling are the big three socio-economic determinants when it comes to winning medals at the Paralympic Games and Olympic Games. The findings support the hypothesis that sports talent is randomly distributed and a large country has a higher chance to have talented athletes or para-athletes winning the Olympic medals. The strong host advantage also showed up in the following Paralympics but was not so strong at the next Olympics.

This paper not only examines the relationship between various social, economic and political factors in determining the success of a nation in the Paralympic Games but also attempts to identify possible non-traditional determinants.

Policies on integrated care have waxed and waned over time in the English health and care sectors, culminating in the creation of 42 integrated care systems (ICSs) which were confirmed in law in July 2022. One of the four fundamental purposes of ICSs is to tackle health inequalities. This paper reports on the content of the overarching ICS plans in order to explore how they focus on health inequalities and the strategies they intend to employ to make progress. It explores how the integrated approach of ICSs may help to facilitate progress on equity.

The analysis is based on a sample of 23 ICS strategic plans using a framework to extract relevant information on health inequalities.

The place-based nature of ICSs and the focus on working across traditional health and care boundaries with non-health partners gives the potential for them to tackle not only the inequalities in access to healthcare services, but also to address health behaviours and the wider social determinants of health inequalities. The plans reveal a commitment to addressing all three of these issues, although there is variation in their approach to tackling the wider social determinants of health and inequalities.

This study adds to our knowledge of the strategic importance assigned by the new ICSs to tackling health inequalities and illustrates the ways in which features of integrated care can facilitate progress in an area of prime importance to society.

Iron deficiency anemia (IDA) is the most common nutritional anemia in the world and a pervasive health problem, especially in developing countries. Children under two years of age are more prone to be affected by IDA. The best strategy to prevent and treat IDA is to use iron supplements. This study aims to examine the factors associated with noncompliance (such as non-utilization or inconsistent usage) of iron drop supplementation among infants between 6 and 24 months old.

Online databases (PubMed, Scopus and SID) were searched to retrieve relevant articles published from inception up to July 2023. Among the 2,177 articles detected, after removing duplicate and irrelevant titles, 21 cross-sectional studies that met the authors’ inclusion criteria were included. Screening for articles and data extraction were conducted separately by two researchers.

The findings suggest that some factors related to mothers, such as education, knowledge, attitude and performance; some factors associated with child such as child’s gastrointestinal and dental complications; taste and smell of iron drops; and birth order and gender are the main determinants of adherence to iron supplementation.

It can be proposed that the most significant factors affecting the feeding of iron drops to children under the age of two include: the level of mother’s awareness, socio-economic status of the household and the occurrence of digestive complications following the supplementation. Given these observations, adopting proper policies toward improving the nutritional awareness of mothers and producing iron supplements with minimal side effects seems crucial.

The measurement of women's economic welfare and exploring its underlying factors have been undervalued in the context of Khyber Pakhtunkhwa, Pakistan. This study addressed this gap by focusing on assessing women's subjective economic welfare and its socioeconomic and cultural determinants in the education and health sectors within Mardan, Northern Pakistan.

The study used stratified random sampling techniques for the selection of sample respondents and collected data through a well-structured questionnaire. To measure women’s economic welfare, the study utilizes Lorenz curves, the Gini index, the Sen Social Welfare function and an individual's gross monthly income. Furthermore, the ordinary least squares method was utilized to analyze the determinants of economic welfare.

The findings show greater income inequality and a lower welfare level for women in the education sector compared to the health sector. Likewise, the study identifies several key determinants, such as age, educational qualification, job experience, respect for working women, outside and work-place problems and the suffering of family members of working women for their economic well-being.

This study makes valuable contributions to the literature by focusing on the cultural perspective of Pakhtun women in Mardan and providing a context-specific understanding of subjective economic welfare. Additionally, the authors collected first-hand data, which gave an original outlook on working women's current economic welfare level. Furthermore, this study undertakes a comparative analysis of working women's welfare in the health and education sectors. This comparison offers a more accurate portrayal of the challenges and opportunities specific to these occupations.

The peer-review history for this article is available at: https://publons.com/publon/10.1108/IJSE-04-2023-0246