The International journal of health planning and management
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Int J Health Plann Manage · Jan 2019
Low prioritization of latent tuberculosis infection-A systemic barrier to tuberculosis control: A qualitative study in Ontario, Canada.
Eliminating tuberculosis (TB) in low-incidence countries is an important global health priority, and Canada has committed to achieve this goal. The elimination of TB in low-incidence countries requires effective management and treatment of latent tuberculosis infection (LTBI). This study aimed to understand and describe the system-level barriers to LTBI treatment for immigrant populations in the Greater Toronto and Hamilton Area, Ontario, Canada. ⋯ This multiperspective study identified barriers beyond the typical socioeconomic determinants and highlighted important upstream factors that hinder treatment initiation and adherence. Addressing these factors is critical if Canada is to meet the WHO's global call to eradicate TB in all low incidence settings.
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Int J Health Plann Manage · Jan 2019
Health in All local Policies: Lessons learned on intersectoral collaboration in a community-based health promotion network in Denmark.
Health promotion increasingly involves collaboration with civil society organisations and the private sector rather than being implemented exclusively by public sector stakeholders. Health in All Policies (HiAP) is an approach that promotes health in policy-making across public sectors. This study explored intersectoral integration and collaboration for health promotion at a local community level through a qualitative single case study of a local community network in Denmark: the Husum Health Network. ⋯ Integration was fostered by knowledge sharing, face-to-face interaction, and communal events. However, the loose structure of the network was a challenge to its sustainability and achievement. We argue that Health in All local Policies is a meaningful concept in the context of local community development only when referring to the polices and strategies of all stakeholder organisations involved in decision-making and agenda setting, and not just local government institutions.
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Int J Health Plann Manage · Jan 2019
Inequality trends in the demographic and geographic distribution of health care professionals in China: Data from 2002 to 2016.
China has long been negatively affected by a shortage and maldistribution of health workers. This study aimed to examine the national and regional trends in the demographic and geographic distribution inequality of health care professionals in China from 2002 to 2016. Based on data from the China Health and Family Planning Statistical and China Statistical Yearbooks, we calculated the Gini coefficient and the Theil T and Theil L indices based on the number of health care professionals per capita and per geographic area to measure the inequalities in their demographic and geographic distribution, respectively. ⋯ To conclude, the distribution equality of health care professionals by population was satisfactory, whereas the corresponding distribution inequality by area was severe. Different types of distribution inequality of health care professionals existed regionally and nationally despite their increasing quantities and densities. Factors beyond population size should be considered when the government introduces health workforce allocation policies.
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Int J Health Plann Manage · Jan 2019
ReviewConditional cash transfer policies in maternal health service utilization in Nepal: Analysis of safe delivery incentive program (Aama Surakshya Karyakram) using Kingdon's multiple streams framework.
Various factors limit access to and utilization of health services even when provided at subsidized cost. This results in poor utilization of services that contributes to further economic impoverishment and health care disparity. Many countries are experimenting with various approaches to tackle the poor utilization of health care services including demand-side financing policy. ⋯ Furthermore, there was commitment from external development partners (EDPs) for investment in maternal health. Together, these problem, policy, and politics opened Kingdon's "windows of opportunity" for formulation of conditional cash transfer policy. This paper presents evolution of Aama Surakshya Karyakram and uses Kingdon's multiple streams framework to explain how problem, policy, and politics streams converged together to allow this program to be introduced in Nepal.
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Int J Health Plann Manage · Jan 2019
Association between patient attachment to a regular doctor and self-perceived unmet health care needs in Canada: A population-based analysis of the 2013 to 2014 Canadian community health surveys.
Although Canada operates a universal health care insurance system, equitable access to required health care services when needed still poses a challenge for some. The aim of this study was to examine the relationship between patient attachment to a family physician and self-perceived unmet health care needs (UHN) in Canada, after adjusting for predisposing, enabling, and need factors of the behavioral model of health services use. ⋯ Ongoing public discourses on improving primary health care performance and reducing the burden of UHN in Canada should prioritize efforts that promote and facilitate the use of a regular family physician.