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Open Access
Article
Publication date: 30 April 2024

Laura Curran and Jennifer Manuel

This study aims to examine the relationship between medication for opioid use disorder (MOUD) among pregnant individuals, referral source, mental health, political affiliation and…

Abstract

Purpose

This study aims to examine the relationship between medication for opioid use disorder (MOUD) among pregnant individuals, referral source, mental health, political affiliation and substance use policies in all 50 states in the USA.

Design/methodology/approach

This study describes MOUD receipt among pregnant people with an opioid use disorder (OUD) in 2018. The authors explored sociodemographic differences in MOUD receipt, referrals and co-occurring mental health disorders. The authors included a comparison of MOUD receipt among states that have varying substance use policies and examined the impact of these policies and the political affiliation on MOUD. The authors used multilevel binary logistic regression to examine effects of individual and state-level characteristics on MOUD.

Findings

Among 8,790 pregnant admissions with OUD, the majority who received MOUD occurred in the Northeast region (71.52%), and 14.99% were referred by the criminal justice system (n = 1,318). Of those who were self-referred, 66.39% received MOUD, while only 30.8% of referrals from the criminal justice system received MOUD. Those referred from the criminal justice system or who had a co-occurring mental health disorder were least likely to receive MOUD. The multilevel model showed that while policies were not a significant predictor, a state’s political affiliation was a significant predictor of MOUD.

Research limitations/implications

The study has some methodological limitations; a state-level analysis, even when considering the individual factors, may not provide sufficient description of community-level or other social factors that may influence MOUD receipt. This study adds to the growing literature on the ineffectiveness of prenatal substance use policies designed specifically to increase the use of MOUD. If such policies are consistently assessed as not contributing to substantial increase in MOUD among pregnant women over time, it is imperative to investigate potential mechanisms in these policies that may not facilitate MOUD access the way they are intended to.

Practical implications

Findings from this study aid in understanding the impact that a political affiliation may have on treatment access; states that leaned more Democratic were more likely to have higher rates of MOUD, and this finding can lead to research that focuses on how and why this contributes to greater treatment utilization. This study provides estimates of underutilization at a state level and the mechanisms that act as barriers, which is a stronger assessment of how state-specific policies and practices are performing in addressing prenatal substance use and a necessary step in implementing changes that can improve the links between pregnant women and MOUD.

Originality/value

To the best of the authors’ knowledge, this is the first study to explore individual-level factors that include mental health and referral sources to treatment that lead to MOUD use in the context of state-level policy and political environments. Most studies estimate national-level rates of treatment use only, which can be useful, but what is necessary is to understand what mechanisms are at work that vary by state. This study also found that while substance use policies were designed to increase MOUD for pregnant women, this was not as prominent a predictor as other factors, like mental health, being referred from the criminal justice system, and living in a state with more Democratic-leaning affiliations.

Details

Drugs, Habits and Social Policy, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2752-6739

Keywords

Open Access
Article
Publication date: 26 December 2023

Dorothy Ai-wan Yen, Benedetta Cappellini, Jane Denise Hendy and Ming-Yao Jen

The COVID-19 pandemic has caused severe challenges to ethnic minorities in the UK. While the experiences of migrants are both complex and varied depending on individuals' social…

Abstract

Purpose

The COVID-19 pandemic has caused severe challenges to ethnic minorities in the UK. While the experiences of migrants are both complex and varied depending on individuals' social class, race, cultural proximity to the host country and acculturation levels, more in-depth studies are necessary to fully understand how COVID-19 affects specific migrant groups and their health. Taiwanese migrants were selected because they are an understudied group. Also, there were widespread differences in pandemic management between the UK and Taiwan, making this group an ideal case for understanding how their acculturation journey can be disrupted by a crisis.

Design/methodology/approach

Qualitative data were collected at two different time points, at the start of the UK pandemic (March/April 2020) and six months on (October/November 2020), to explore migrant coping experiences over time. Theoretically, the authors apply acculturation theory through the lens of coping, while discussing health-consumption practices, as empirical evidence.

Findings

Before the outbreak of the pandemic, participants worked hard to achieve high levels of integration in the UK. The pandemic changed this; participants faced unexpected changes in the UK’s sociocultural structures. They were forced to exercise the layered and complex “coping with coping” in a hostile host environment that signalled their new marginalised status. They faced impossible choices, from catching a life-threatening disease to being seen as overly cautious. Such experience, over time, challenged their integration to the host country, resulting in a loss of faith in the UK’s health system, consequently increasing separation from the host culture and society.

Research limitations/implications

It is important to note that the Taiwanese sample recruited through Facebook community groups is biased and has a high level of homogeneity. These participants were well-integrated, middle-class migrants who were highly educated, relatively resourceful and active on social media. More studies are needed to fully understand the impact on well-being and acculturation of migrants from different cultural, contextual and social backgrounds. This being the case, the authors can speculate that migrants with less resource are likely to have found the pandemic experience even more challenging. More studies are needed to fully understand migrant experience from different backgrounds.

Practical implications

Public health policymakers are advised to dedicate more resources to understand migrants' experiences in the host country. In particular, this paper has shown how separation, especially if embraced temporarily, is not necessarily a negative outcome to be corrected with specific policies. It can be strategically adopted by migrants as a way of defending their health and well-being from an increasingly hostile environment. Migrants' home country experience provides vicarious learning opportunities to acquire good practices. Their voices should be encouraged rather than in favour of a surprising orthodox and rather singular approach in the discussion of public health management.

Social implications

The paper has clear public health policy implications. Firstly, public health policymakers are advised to dedicate more resources to understand migrants' experiences in the host country. Acknowledging migrants' voice is a critical first step to contribute to the development of a fair and inclusive society. Secondly, to retain skilful migrants and avoid a future brain-drain, policymakers are advised to advance existing infrastructure to provide more incentives to support and retain migrant talents in the post-pandemic recovery phase.

Originality/value

This paper reveals how a group of previously well-integrated migrants had to exercise “coping with coping” during the COVID crisis. This experience, over time, challenged their integration to the host country, resulting in a loss of faith in the UK’s health system, consequently increasing separation from the host culture and society. It contributes to the understanding of acculturation by showing how a such crisis can significantly disrupt migrants' acculturation journey, challenging them to re-acculturate and reconsider their identity stance. It shows how separation was indeed a good option for migrants for protecting their well-being from a newly hostile host environment.

Details

International Marketing Review, vol. 41 no. 7
Type: Research Article
ISSN: 0265-1335

Keywords

Book part
Publication date: 2 May 2024

Amanuel Elias

Anti-racism has been practiced in various ways, with varying degrees of effectiveness. This chapter engages with the body of scholarship that focuses on approaches aimed at…

Abstract

Anti-racism has been practiced in various ways, with varying degrees of effectiveness. This chapter engages with the body of scholarship that focuses on approaches aimed at promoting anti-racist actions, policies and social change. It discusses some of the main anti-racism strategies that have been deployed across different countries and examines anti-racism practices in interpersonal, intergroup and community settings. These approaches encompass civil rights campaigns, legislative and policy interventions, affirmative action, diversity and inclusion training, prejudice reduction, intergroup contact, organisational development and holistic anti-racism approaches. Some anti-racism practices and policies, such as awareness campaigns, social marketing and diversity training, also extend to digital platforms, with social media and multimedia networks deployed to broaden the reach and impact of anti-racist endeavours. This chapter specifically engages with local anti-racism movements and draws principles for broader implementation of anti-racism policy and practice. It concludes with a brief discussion of the effectiveness of contemporary anti-racism approaches.

Details

Racism and Anti-Racism Today
Type: Book
ISBN: 978-1-83753-512-5

Keywords

Open Access
Article
Publication date: 1 February 2024

Marta Postula, Krzysztof Kluza, Magdalena Zioło and Katarzyna Radecka-Moroz

Environmental degradation resulting from human activities may adversely affect human health in multiple ways. Until now, policies aimed at mitigating environmental problems such…

Abstract

Purpose

Environmental degradation resulting from human activities may adversely affect human health in multiple ways. Until now, policies aimed at mitigating environmental problems such as climate change, environmental pollution and damage to biodiversity have failed to clearly identify and drive the potential benefits of these policies on health. The conducted study assesses and demonstrates how specific environmental policies and instruments influence perceived human health in order to ensure input for a data-driven decision process.

Design/methodology/approach

The study was conducted for the 2004–2020 period in European Union (EU) countries with the use of dynamic panel data modeling. Verification of specific policies' impact on dependent variables allows to indicate this their effectiveness and importance. As a result of the computed dynamic panel data models, it has been confirmed that a number of significant and meaningful relationships between the self-perceived health index and environmental variables can be identified.

Findings

There is a strong positive impact of environmental taxation on the health index, and the strength of this relationship causes effects to be observed in the very short term, even the following year. In addition, the development of renewable energy sources (RES) and the elimination of fossil fuels from the energy mix exert positive, although milder, effects on health. The reduction of ammonia emissions from agriculture and reducing noise pollution are other health-supporting factors that have been shown to be statistically valid. Results allow to identify the most efficient policies in the analyzed area in order to introduce those with the best results or a mix of such measures.

Originality/value

The results of the authors' research clearly indicate the health benefits of measures primarily aimed at improving environmental factors, such as environmental taxes in general. The authors have also discovered an unexpected negative impact of an increase in the share of energy taxes in total taxes on the health index. The presented study opens several possibilities for further investigation, especially in the context of the rapidly changing geopolitical environment and global efforts to respond to environmental and health challenges. The authors believe that the outcome of the authors' study may provide new arguments to policymakers pursuing solutions that are not always easily acceptable by the public.

Details

Central European Management Journal, vol. 32 no. 1
Type: Research Article
ISSN: 2658-0845

Keywords

Open Access
Article
Publication date: 22 April 2024

Leman Isik, Christina Nilsson, Johan Magnusson and Dina Koutsikouri

While digital transformation holds immense promise, organizations often fail to realize its benefits. This study aims to address how policies for digital transformation benefits…

Abstract

Purpose

While digital transformation holds immense promise, organizations often fail to realize its benefits. This study aims to address how policies for digital transformation benefits realization are translated into practice.

Design/methodology/approach

The authors apply a qualitative, comparative case study of two large, public-sector health care organizations in Sweden. Through document and interview data, the authors analyze the process of translation.

Findings

The study finds that practice variation is primarily caused by two types of decoupling: policy-practice and means-ends. Contrary to previous studies, coercion in policy compliance is not found to decrease practice variation.

Research limitations/implications

The limitations primarily stem from the empirical selection of two large public health-care organizations in Sweden, affecting the study’s generalizability. Reducing practice variation is more effectively achieved through goal alignment than coercion, leading to implications for the design of governance and control.

Practical implications

Policymakers should, instead of focusing on control-related compliance, work to align organizational objectives and policies to decrease practice variation for successful benefits realization.

Social implications

The study contributes to better benefits realization of digital transformation initiatives in health care. As such, the authors contribute to a better functioning and more transformative health care in times of increased demand and decreased supply of health-care services.

Originality/value

The study challenges conventional wisdom by identifying that coercion is less effective than goal alignment in reducing practice variation, thereby enhancing the understanding of policy implementation dynamics in health-care settings.

Details

Transforming Government: People, Process and Policy, vol. 18 no. 2
Type: Research Article
ISSN: 1750-6166

Keywords

Article
Publication date: 2 May 2024

Aktieva Tri Tjitrawati and Mochamad Kevin Romadhona

This study aims to analyse in the health access of Indonesian illegal migrant workers in Malaysia, during which time they were not covered by Indonesia’s national social health…

Abstract

Purpose

This study aims to analyse in the health access of Indonesian illegal migrant workers in Malaysia, during which time they were not covered by Indonesia’s national social health insurance.

Design/methodology/approach

This study adopted a sociolegal approach, the research approach is conducted to understand the effect of a law, policy and regulation on access to health-care access among Indonesian migrant workers working illegally in Malaysia. This research involved 110 respondents who work illegally in Malaysia. The research explored the perceptions of respondents concerning to health access services of illegal migrant workers.

Findings

The study demonstrated the weakness of provisions intended to guarantee the health access to health care of migrant workers from Indonesia illegally working in Malaysia. A decline in health status was observed, but it was not significant. Bilateral cooperation between Indonesia and Malaysia is necessary to provide a framework for Indonesia providing health care to its citizens working in Malaysia, regardless of their legal status.

Originality/value

This paper concerns on the Indonesia illegal migrant workers experiencing illness and the access to the health service in Malaysia, and also the implementation of international regulation to protect Indonesian illegal migrant workers in Malaysia under ASEAN Consensus on the Protection and Promotion of the Rights of Migrant Workers.

Details

International Journal of Migration, Health and Social Care, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1747-9894

Keywords

Article
Publication date: 28 November 2023

Nirma Swaris, Rangika Umesh Halwatura and Dilanthi Amaratunga

Policy coherence is a complex and tough task for many developing nations because their capacity to examine and deliver evidence-based inputs to policymaking is limited, and policy…

Abstract

Purpose

Policy coherence is a complex and tough task for many developing nations because their capacity to examine and deliver evidence-based inputs to policymaking is limited, and policy dialogue platforms need to be effectively used. Resolving these difficulties is a critical requirement for policy consistency. As a result, the study focuses on the level of policy coherence for climate change adaptation (CCA), disaster risk reduction (DRR) and sustainable development goals (SDG) in Sri Lanka and suggests routes for policy coherence for Resilience. This study aims to investigate the coherent approach of CCA, DRR and SDG; to identify concerns in policy documents addressing the coherence of CCA, DRR and SDG in local context; and to propose policy coherence suggestions for resilience in Sri Lanka.

Design/methodology/approach

Methodology comprises a review and content analysis of 17 policy and legal documents in Sri Lanka and a qualitative study. The qualitative approach consists of semistructured interviews that obtained deep and broad expertise knowledge with ten government representatives and stakeholders. Both content analysis and interview data were analyzed by using NVivo.

Findings

It was discovered that there are several issues with the coherence of policies in Sri Lanka, including the fragmented approach, lack of integration, inadequate coordination, limited resources and lack of monitoring and evaluation. The policies are inspired by international frameworks, and local implementations are not focused, leading to inadequate implementation of policies. The lack of development cooperation for the use of innovative approaches, such as climate-resilient infrastructure and environmentally friendly solutions for CCA and DRR, further aggravates the situation. Another concern is the lack of land use management and responsibility for the development of physical infrastructure for DRR integration with CCA. It is found that there is a limited community involvement which is vital for the implementation of policies. Local implementations are encouraged to fill the gaps in existing policies/acts. The analytical framework of the study is based on a preliminary examination of policy documents, a review of the literature and discussions with practitioners. The framework reflects the current situation of policy integration which addresses strategic, conceptual, institutional, operational and financial coherence. The research suggests pathways for achieving policy coherence in CCA, DRR and SDG in Sri Lanka, such as enhancing the strategic coherence by improving goals to increase the coherence within CCA, DRR and SDG; improving the credibility of the unified approach for developing DRR and CCA risk assessments; intensifying institutional cooperation and stakeholder management; improving the common monitoring and evaluation; establishing implementation strategies; and increasing the community involvement.

Research limitations/implications

The study on policy coherence in Sri Lanka recommends increasing community and professional involvement, conducting more research, developing a national strategy, increasing capacity building, strengthening international collaboration and fostering multisectoral collaboration. These recommendations can help improve policy coherence between CCA, DRR and SDGs, align policies with national goals and priorities and improve implementation effectiveness. By implementing these recommendations, Sri Lanka can address the challenges of climate change and natural disasters and achieve SDGs.

Practical implications

The study on policy coherence for resilience in Sri Lanka has practical implications, including improved coordination and resource allocation, increased capacity building, improved reputation and sustainability. By integrating CCA, DRR and SDGs, this study can help Sri Lanka become more resilient to climate change and natural disasters, achieve SDGs and become a responsible actor in the international community. These implications can contribute to a more sustainable future and ensure that development goals are achieved in a way that is resilient to climate change and natural disasters.

Social implications

Increased community participation: the study emphasizes the importance of community involvement in the policy development process. This can help build trust between communities and government agencies, improve transparency and ensure that policies are developed in a way that is responsive to local needs and priorities.

Originality/value

Based on the identified existing loopholes in the policies and pathways to policy coherence, the issues in policymaking could be overcome. It could be used to establish strong linkages between policies based on CCA, DRR and SDGs to achieve long-term resilience.

Details

International Journal of Disaster Resilience in the Built Environment, vol. 15 no. 3
Type: Research Article
ISSN: 1759-5908

Keywords

Open Access
Article
Publication date: 19 January 2024

Roosa Amanda Lambin and Milla Nyyssölä

Mainland Tanzania has seen two decades of significant social policy reforms and transformations in its social and economic structures, whilst the country continues to grapple with…

426

Abstract

Purpose

Mainland Tanzania has seen two decades of significant social policy reforms and transformations in its social and economic structures, whilst the country continues to grapple with persisting gender inequalities. This article examines Tanzania's social policy developments from a gender perspective. The authors analyse the level, reach and quality of social policy delivery to working-age women across the areas of health policy, social protection and employment policy during 2000–2021.

Design/methodology/approach

The article draws on qualitative research deploying the scoping review method. The data consist of diverse secondary materials, including academic publications, government policy documents, relevant statistics and other types of “grey” literature.

Findings

Tanzania has made significant advancements in the legal frameworks around welfare provision and has instituted increasingly gender-responsive government policy plans. The health and social protection sectors, in particular, have witnessed the introduction of large-scale measures expanding social policy implementation. However, social policy delivery remains two-tiered, with differences in provisions for women in the formal and informal sectors.

Originality/value

Social policy delivery and implementation have increased and diversified in Sub-Saharan Africa (SSA) during the new millennium, with a growing integration of gender-specific policy objectives. However, limited social policy scholarship has focused on the gendered effects of broader social policy models in SSA. The article remedies the concomitant knowledge gaps by examining various social policies and their impacts on working-age women in Mainland Tanzania. The authors also engage with the theoretical welfare regime literature and present an analytical framework for gender-sensitive assessment of emerging social policy models in the Global South.

Details

International Journal of Sociology and Social Policy, vol. 44 no. 13/14
Type: Research Article
ISSN: 0144-333X

Keywords

Open Access
Article
Publication date: 24 January 2024

Bonnie Poksinska and Malin Wiger

Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a…

Abstract

Purpose

Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a shift from acute, episodic and reactive hospital-centered care toward longitudinal, person-centered and proactive home-centered care. The purpose of this paper is to contribute to the knowledge of a comprehensive development strategy for designing and providing home-centered care of older people.

Design/methodology/approach

The study design is based on qualitative research with an inductive approach. The authors study development initiatives at the national, regional and local levels of the Swedish health and social care system. The data collection methods included interviews (n = 54), meeting observations (n = 25) and document studies (n = 59).

Findings

The authors describe findings related to policy actions and system changes, attempts to achieve collaboration, integration and coordination, new forms of care offerings, characteristics of work settings at home and differences in patients' roles and participation at home and in the hospital.

Practical implications

The authors suggest home-centered care as a solution for providing person-centered and integrated care of older people and give examples of how this can be achieved.

Originality/value

The authors outline five propositions for research and development related to national policies, service modularity as a solution for customized and coordinated care, developing human resources and infrastructure for home settings, expanding services that enable older people living at home and patient co-creation.

Details

Journal of Health Organization and Management, vol. 38 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 14 August 2023

Olusola Joshua Olujobi and Tunde Ebenezer Yebisi

The purpose of this study is to examine the corruption prevalent in the distribution of COVID-19 palliatives during the lockdown and movement restrictions in the country. This…

Abstract

Purpose

The purpose of this study is to examine the corruption prevalent in the distribution of COVID-19 palliatives during the lockdown and movement restrictions in the country. This study seeks to analyse the current state of corruption in the distribution of COVID-19 palliatives and public health facilities in Nigeria while also providing a legal insight and strategic blueprint to combat corruption. To this end, this study will address the current legal framework for combating corruption and build upon this to formulate a working strategy for tackling corruption in the future.

Design/methodology/approach

Using a doctrinal legal research methodology, this study draws upon existing literature, tertiary data sources and information from the Nigeria Centre for Disease Control. The collected data is analysed and compared with current literature to identify key findings. Rent-seeking and utilitarian theories of the law were examined to guide this study. This study offers useful insights into combating corruption. The use of this method is justified, as it enhances the credibility of the findings on the importance of strategies for future emergencies. This legal research approach is consistent with the law and can be easily verified. The empirical aspect of this study involved a survey of multidimensional health-care and economic data set of 36 states in Nigeria plus the Federal Capital Territory on COVID-19 in Nigeria. A survey linearised regression model was estimated to determine the influence of government revenue and public health-care facilities in the control of the virus spread in Nigeria.

Findings

This study reveals the need for emphasis on the imperative of combating corruption in the distribution of COVID-19 palliatives and establishing economic resilience through transparent and accountable practices, supported by legal frameworks.

Research limitations/implications

Rent-seeking and utilitarian theories of law are evaluated because of their impacts on combating corruption. The limitation of this study is the intricacy of gathering data on COVID-19 palliatives corruption in Nigeria because of secrecy and the absence of reliable data on the subject.

Practical implications

Estimating the exact number of stolen palliatives and their fiscal impact on Nigeria's economy proves to be a formidable task because of the covert nature of corruption. This study equips policymakers in Nigeria with a better understanding of the legal challenges posed by corruption in the health care sector and provides an effective strategy to combat it.

Social implications

The lack of reliable data on the extent of palliative theft hinders the ability of lawmakers to enact effective legislation and strategies for combating corruption in the distribution of COVID-19 palliatives and addressing future emergencies in Nigeria. The policy implications of this study can assist policymakers in Nigeria and other countries in formulating measures to combat corruption in the distribution of COVID-19 palliatives and other future emergencies. Furthermore, it recommends the overhaul of anti-corruption laws and mechanisms in Nigeria to ensure effective measures against corruption.

Originality/value

In conclusion, this study contributes to knowledge by proposing a legal model centred on people's participation to enhance transparency and accountability in future palliative distribution processes. This study recommends legal strategies that can effectively address corruption in future emergencies or shocks. This study proposes a strategic blueprint to tackle corruption in the future. This blueprint includes an analysis of existing laws and regulations, as well as potential policy changes and legislative reform. This study also includes recommendations for improved enforcement and oversight mechanisms and for improved public awareness and education. As part of this, this study considers the potential for public–private partnerships to increase transparency and accountability in public health and health-care services.

Details

Journal of Financial Crime, vol. 31 no. 3
Type: Research Article
ISSN: 1359-0790

Keywords

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