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  1. Fulltext Improving primary care management of asthma: do we know what really works?
    Fletcher MJ, Tsiligianni I, Kocks JWH, Cave A, Chunhua C, Sousa JC, et al.
    NPJ Prim Care Respir Med, 2020 06 17;30(1):29.
    PMID: 32555169 DOI: 10.1038/s41533-020-0184-0
    Asthma imposes a substantial burden on individuals and societies. Patients with asthma need high-quality primary care management; however, evidence suggests the quality of this care can be highly variable. Here we identify and report factors contributing to high-quality management. Twelve primary care global asthma experts, representing nine countries, identified key factors. A literature review (past 10 years) was performed to validate or refute the expert viewpoint. Key driving factors identified were: policy, clinical guidelines, rewards for performance, practice organisation and workforce. Further analysis established the relevant factor components. Review evidence supported the validity of each driver; however, impact on patient outcomes was uncertain. Single interventions (e.g. healthcare practitioner education) showed little effect; interventions driven by national policy (e.g. incentive schemes and teamworking) were more effective. The panel's opinion, supported by literature review, concluded that multiple primary care interventions offer greater benefit than any single intervention in asthma management.
    Matched MeSH terms: Health Policy
  2. Fulltext The values and risks of an Intergovernmental Panel for One Health to strengthen pandemic prevention, preparedness, and response
    Hobeika A, Stauffer MHT, Dub T, van Bortel W, Beniston M, Bukachi S, et al.
    Lancet Glob Health, 2023 Aug;11(8):e1301-e1307.
    PMID: 37474236 DOI: 10.1016/S2214-109X(23)00246-2
    The COVID-19 pandemic has shown the need for better global governance of pandemic prevention, preparedness, and response (PPR) and has emphasised the importance of organised knowledge production and uptake. In this Health Policy, we assess the potential values and risks of establishing an Intergovernmental Panel for One Health (IPOH). Similar to the Intergovernmental Panel on Climate Change, an IPOH would facilitate knowledge uptake in policy making via a multisectoral approach, and hence support the addressing of infectious disease emergence and re-emergence at the human-animal-environment interface. The potential benefits to pandemic PPR include a clear, unified, and authoritative voice from the scientific community, support to help donors and institutions to prioritise their investments, evidence-based policies for implementation, and guidance on defragmenting the global health system. Potential risks include a scope not encompassing all pandemic origins, unclear efficacy in fostering knowledge uptake by policy makers, potentially inadequate speed in facilitating response efforts, and coordination challenges among an already dense set of stakeholders. We recommend weighing these factors when designing institutional reforms for a more effective global health system.
    Matched MeSH terms: Health Policy; Policy Making
  3. Dietary changes during pregnancy and the postpartum period in Singaporean Chinese, Malay and Indian women: the GUSTO birth cohort study
    Chen LW, Low YL, Fok D, Han WM, Chong YS, Gluckman P, et al.
    Public Health Nutr, 2014 Sep;17(9):1930-8.
    PMID: 23806144 DOI: 10.1017/S1368980013001730
    OBJECTIVE: To examine changes in food consumption during pregnancy and the postpartum period in women of major Asian ethnic groups.

    DESIGN: Using interviewer-administered questionnaires, we assessed changes in food consumption during pregnancy (26-28 weeks' gestation) and the postpartum period (3 weeks after delivery) as compared with the usual pre-pregnancy diet.

    SETTING: Singapore.

    SUBJECTS: Pregnant women (n 1027) of Chinese, Malay and Indian ethnicity (mean age 30·4 (SD 5·2) years) who participated in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study.

    RESULTS: During pregnancy, participants tended to increase their consumption of milk, fruit and vegetables and decrease their consumption of tea, coffee, soft drinks and seafood (all P < 0·001). Most participants reported adherence to traditional restrictions ('confinement') during the early postpartum period (Chinese: 94·8 %, Malay: 91·6 %, Indian: 79·6 %). During the postpartum period, participants tended to increase their consumption of fish and milk-based drinks and decrease their consumption of noodles, seafood, and chocolates and sweets (all P < 0·001). Ethnic differences in food consumption were pronounced during the postpartum period. For example, most Chinese participants (87·2 %) increased their ginger consumption during the postpartum period as compared with smaller percentages of Malays (31·8 %) and Indians (40·8 %; P for ethnic difference <0·001). Similar ethnic differences were observed for cooking wine/alcohol, herbs and spices, and herbal tea consumption.

    CONCLUSIONS: Marked changes in food consumption that reflect both modern dietary recommendations and the persistence of traditional beliefs were observed in Singaporean women during pregnancy and the postpartum period. Traditional beliefs should be considered in interventions to improve dietary intakes during these periods.

    Matched MeSH terms: Nutrition Policy*
  4. Human resources for health in southeast Asia: shortages, distributional challenges, and international trade in health services
    Kanchanachitra C, Lindelow M, Johnston T, Hanvoravongchai P, Lorenzo FM, Huong NL, et al.
    Lancet, 2011 Feb 26;377(9767):769-81.
    PMID: 21269674 DOI: 10.1016/S0140-6736(10)62035-1
    In this paper, we address the issues of shortage and maldistribution of health personnel in southeast Asia in the context of the international trade in health services. Although there is no shortage of health workers in the region overall, when analysed separately, five low-income countries have some deficit. All countries in southeast Asia face problems of maldistribution of health workers, and rural areas are often understaffed. Despite a high capacity for medical and nursing training in both public and private facilities, there is weak coordination between production of health workers and capacity for employment. Regional experiences and policy responses to address these challenges can be used to inform future policy in the region and elsewhere. A distinctive feature of southeast Asia is its engagement in international trade in health services. Singapore and Malaysia import health workers to meet domestic demand and to provide services to international patients. Thailand attracts many foreign patients for health services. This situation has resulted in the so-called brain drain of highly specialised staff from public medical schools to the private hospitals. The Philippines and Indonesia are the main exporters of doctors and nurses in the region. Agreements about mutual recognition of professional qualifications for three groups of health workers under the Association of Southeast Asian Nations Framework Agreement on Services could result in increased movement within the region in the future. To ensure that vital human resources for health are available to meet the needs of the populations that they serve, migration management and retention strategies need to be integrated into ongoing efforts to strengthen health systems in southeast Asia. There is also a need for improved dialogue between the health and trade sectors on how to balance economic opportunities associated with trade in health services with domestic health needs and equity issues.
    Matched MeSH terms: Public Policy/trends
  5. Fulltext Recognize fish as food in policy discourse and development funding
    Bennett A, Basurto X, Virdin J, Lin X, Betances SJ, Smith MD, et al.
    Ambio, 2021 May;50(5):981-989.
    PMID: 33454882 DOI: 10.1007/s13280-020-01451-4
    The international development community is off-track from meeting targets for alleviating global malnutrition. Meanwhile, there is growing consensus across scientific disciplines that fish plays a crucial role in food and nutrition security. However, this 'fish as food' perspective has yet to translate into policy and development funding priorities. We argue that the traditional framing of fish as a natural resource emphasizes economic development and biodiversity conservation objectives, whereas situating fish within a food systems perspective can lead to innovative policies and investments that promote nutrition-sensitive and socially equitable capture fisheries and aquaculture. This paper highlights four pillars of research needs and policy directions toward this end. Ultimately, recognizing and working to enhance the role of fish in alleviating hunger and malnutrition can provide an additional long-term development incentive, beyond revenue generation and biodiversity conservation, for governments, international development organizations, and society more broadly to invest in the sustainability of capture fisheries and aquaculture.
    Matched MeSH terms: Policy
  6. Fulltext Borneo coral reefs subject to high sediment loads show evidence of resilience to various environmental stressors
    Browne N, Braoun C, McIlwain J, Nagarajan R, Zinke J
    PeerJ, 2019;7:e7382.
    PMID: 31428541 DOI: 10.7717/peerj.7382
    For reefs in South East Asia the synergistic effects of rapid land development, insufficient environmental policies and a lack of enforcement has led to poor water quality and compromised coral health from increased sediment and pollution. Those inshore turbid coral reefs, subject to significant sediment inputs, may also inherit some resilience to the effects of thermal stress and coral bleaching. We studied the inshore turbid reefs near Miri, in northwest Borneo through a comprehensive assessment of coral cover and health in addition to quantifying sediment-related parameters. Although Miri's Reefs had comparatively low coral species diversity, dominated by massive and encrusting forms of Diploastrea, Porites, Montipora, Favites, Dipsastrea and Pachyseris, they were characterized by a healthy cover ranging from 22 to 39%. We found a strong inshore to offshore gradient in hard coral cover, diversity and community composition as a direct result of spatial differences in sediment at distances <10 km. As well as distance to shore, we included other environmental variables like reef depth and sediment trap accumulation and particle size that explained 62.5% of variation in benthic composition among sites. Miri's reefs showed little evidence of coral disease and relatively low prevalence of compromised health signs including bleaching (6.7%), bioerosion (6.6%), pigmentation response (2.2%), scars (1.1%) and excessive mucus production (0.5%). Tagged colonies of Diploastrea and Pachyseris suffering partial bleaching in 2016 had fully (90-100%) recovered the following year. There were, however, seasonal differences in bioerosion rates, which increased five-fold after the 2017 wet season. Differences in measures of coral physiology, like that of symbiont density and chlorophyll a for Montipora, Pachyseris and Acropora, were not detected among sites. We conclude that Miri's reefs may be in a temporally stable state given minimal recently dead coral and a limited decline in coral cover over the last two decades. This study provides further evidence that turbid coral reefs exposed to seasonally elevated sediment loads can exhibit relatively high coral cover and be resilient to disease and elevated sea surface temperatures.
    Matched MeSH terms: Environmental Policy
  7. Fulltext Ten Years of Strong Opioid Analgesics Consumption in Malaysia and Other Southeast Asian Countries
    Zin CS
    J Pharm Bioallied Sci, 2020 Nov;12(Suppl 2):S846-S851.
    PMID: 33828388 DOI: 10.4103/jpbs.JPBS_252_19
    Background: It was reported that opioid consumption in developing countries was stagnated or decreased, but precise data on the consumption are unclear. This study examined the trends and patterns of opioid consumption in Malaysia and other four Southeast Asian countries.

    Materials and Methods: Data of five strong opioids consumption (morphine, oxycodone, fentanyl, pethidine, and methadone) between 2005 and 2014 from Malaysia, Singapore, Indonesia, Thailand, and Vietnam were extracted from the Pain and Policy Studies Group. Defined daily doses per 1000 inhabitants per day (DDD/1000 inhabitants/day) was used for calculating the annual amount of opioid use.

    Results: The total consumption of five strong opioids was increased in all five Southeast Asian countries during a 10-year study period. Malaysia was recorded with the largest increase of the opioid consumption (993.18%), followed by Indonesia (530.34%), Vietnam (170.17%), Singapore (116.16%), and Thailand (104.66%). Malaysia also had the highest total strong opioid consumption (11.2 DDD/1000 inhabitants/day), primarily for methadone. Among the opioids used for pain management, fentanyl was primarily used in Malaysia and Singapore but the greatest increase in these two countries was for oxycodone. Fentanyl was also primarily used in Indonesia while morphine was predominantly used in Thailand and Vietnam.

    Conclusion: Growing trends of strong opioids consumption in all five Southeast Asian countries demonstrated in this study may indicate improved access to opioid analgesics in these countries. Given the increasing trends, it is important to ensure that the utilization of opioids is according to the guideline to prevent the negative consequences of opioids particularly when used in chronic non-cancer pain.

    Matched MeSH terms: Policy
  8. Fulltext A snapshot of the global policies and practices of medicine use reviews by community pharmacist in chronic diseases: A narrative review
    Mubarak N, Raja SA, Khan TM, Zin CS
    J Pak Med Assoc, 2021 Mar;71(3):950-965.
    PMID: 34057955 DOI: 10.47391/JPMA.058
    Medicine use review is a tool to improve medication adherence and safety. Current narrative review was planned to explore global policies and practices of medicine use review by community pharmacists in chronic diseases and its impact and way forward for low- and middle-income countries. Key words, such as ″medicine use review″, ″medication therapy management″ and ″community pharmacy″ were used for search on PubMed and CINAHL databases for articles published from 2004 to 2019. Medicine use review has opened an avenue of ongoing collaboration between community pharmacists and general practitioners. High-income countries have witnessed a gradual yet cautious adoption of these services through effective policy shift. In terms of practices and impact, the situation in high-income countries was promising where on an average ″type-II″ medicine use review was widely in practice and had improved clinical, humanistic and economic outcomes in chronic disease. However, in low- and middle-income countries, a paucity of effective policies was noted. Nevertheless, an emergent recognition of the potential of community pharmacists to contribute to the management of chronic diseases was evident.
    Matched MeSH terms: Policy
  9. Fulltext Current issues facing the introduction of human papillomavirus vaccine in China and future prospects
    Wong LP, Han L, Li H, Zhao J, Zhao Q, Zimet GD
    Hum Vaccin Immunother, 2019;15(7-8):1533-1540.
    PMID: 31017500 DOI: 10.1080/21645515.2019.1611157
    The introduction of human papillomavirus (HPV) vaccination in China aims to prevent HPV infection in all women. The issues that China might face include high cost of vaccines made in other countries, shortage in HPV vaccine supply, negative events attributed to vaccination (whether justified or not) that jeopardizes the general public's confidence in the HPV vaccine, cultural and literacy barriers, and sensitivity to receiving a vaccine for a sexually transmitted disease. Ensuring the effective delivery of the HPV vaccine in China, a country with vast economic, geographical, and cultural complexities, will require a commitment of significant resources. In light of the high price of imported vaccines, the availability of locally manufactured HPV vaccines would greatly facilitate the national HPV vaccination program. New evidence supporting the efficacy of a two-dose regime in younger adolescents would also be advantageous in terms of affordability and logistical simplicity of vaccine administration. Furthermore, it would potentially enhance the compliance and uptake, especially for hard to reach women in remote regions.
    Matched MeSH terms: Health Policy*
  10. An analysis of the development assistance for health (DAH) allocations for STD control in Africa
    Furuoka F, Hoque MZ, Jacob RI, Ziegenhain P
    Health Econ Policy Law, 2020 Oct;15(4):458-476.
    PMID: 30968812 DOI: 10.1017/S1744133119000197
    The Sustainable Development Goals set by the United Nations recognize the importance of making progress in the eradication and treatment of sexually transmitted deceases (STD). STD are among the most widespread diseases in the world and have the highest prevalence in Sub-Saharan Africa. The current study explored the associations between the allocation of the development assistance for health (DAH) in 54 African countries and key development indicators - STD incidence, Gross Domestic Product per capita, health expenditure, and life expectancy at birth. It employed descriptive statistical methods, the matrix scatter plot analysis and the Pearson correlation test for this purpose. The findings indicated that there was a considerable increase in the volume of the DAH given to control and prevent STD in Africa over the period of 2002-2011. A statistically significant positive association was detected between the STD incidence and the health aid allocations. At the same time, the imbalance in the distribution of the health aid between the major and minor aid recipients in the continent increased. The study concludes by discussing policy implications that can be drawn from these findings.
    Matched MeSH terms: Policy
  11. Innovative autocrats? Environmental innovation in public participation in China and Malaysia
    Yew WL, Zhu Z
    J Environ Manage, 2019 Mar 15;234:28-35.
    PMID: 30599327 DOI: 10.1016/j.jenvman.2018.12.081
    Much of the environmental policy literature tends to focus on democratic contexts where environmental innovation is a product of pluralistic interactions among state and non-state actors. By bringing the (authoritarian) politics into the analysis, this article seeks to discover the processes leading to environmental innovation under nondemocratic conditions. We utilise case studies in China and then-nondemocratic Malaysia, both grappling with the twin imperatives of rapid development and social control, where the governments initiated environmental innovations to expand space for public participation and monitoring against noxious plants. We adapt the conceptual framework of "environmental innovation strategies" to illustrate the mechanisms underpinning innovative practices that address environmental issues by going beyond pre-existing public regulatory provisions. We highlight aspects distinguishing the interactive processes under authoritarianism. First, the drivers of environmental innovation are contingent on the government's role and concerns over social control and state legitimacy. Second, due to limits over political space, environmental nongovernmental organisations (ENGOs) act as issue entrepreneurs-instead of policy entrepreneurs-who turn conditions into problems deserving government attention and solution, as they engage in conflictual interactions with state authorities. Third, such innovations can strengthen nondemocratic governance while not fully plugging the gaps in existing environmental regulations. This contributes to illuminating the behaviours of state-based environmental innovators under illiberal political regimes, potentially offering lessons to activists on how to stimulate further innovations in such contexts.
    Matched MeSH terms: Environmental Policy*
  12. Fulltext Achieving sustainable soil and water protection: The perspective of agricultural water price regulation on environmental protection
    Chou L, Dai J, Qian X, Karimipour A, Zheng X
    Agric Water Manag, 2021 Feb 28;245:106583.
    PMID: 33100487 DOI: 10.1016/j.agwat.2020.106583
    With the development of Chinese economy, more and more attention has been paid to environmental protection, the implementation of water price policy affects economic and environmental changes in China. This paper analyzes the impact of water price policy on agricultural land use and the scale of water pollution discharge in 240 cities in China between 2001 and 2017, by including data from China Urban Statistical Yearbook and China Land & Resources Almanac. The theoretical analysis of this study indicates that the optimal scale of pollution depends on the local initial endowment, economic investment capital and the marginal cost of environmental pollution caused by government's economic activities. Furtherly, the economic activities have a worsening impact on environmental pollution, but when the government implements environmental protection and water price policy measures in response to environmental pollution caused by economic activities, it has a significant impact on the decline in the scale of pollution. The government has promoted the pollution suppression model in the formulation of water prices, which has internalized the external cost of pollution in economic activities and can effectively reduce the scale of agricultural water pollution discharge.
    Matched MeSH terms: Policy
  13. Fulltext Watershed Horizontal Ecological Compensation Policy and Green Ecological City Development: Spatial and Mechanism Assessment
    Lin X, Baskaran A, Zhang Y
    Int J Environ Res Public Health, 2023 Feb 02;20(3).
    PMID: 36768047 DOI: 10.3390/ijerph20032679
    Green ecological development has become an inevitable choice to achieve sustainable urban development and carbon neutrality. This paper evaluates the level of green ecological city development in the Xin'an watershed as measured by green total factor productivity (GTFP), analyzes the direct and spatial effects of the Watershed Horizontal Ecological Compensation policy on GTFP, and further examines the moderating effect of the Research and Development (R&D) incentives, industrial structure, and income gap. This paper conducts difference-in-differences (DID) and spatial regression analysis on 27 cities from 2007 to 2019. The results show that GTFP progresses to varying degrees across cities over time, especially in the pilot cities. Crucially, the Watershed Horizontal Ecological Compensation policy significantly improved GTFP, although the effect was slight. Interestingly, the increase in GTFP in pilot cities that implemented the policy spatially suppressed the increase in GTFP in cities that did not implement the policy. Our evidence also shows that the positive effect of the policy is higher in regions with higher R&D incentives and industrial structure upgrading, which indicates that R&D incentives and industrial upgrading are crucial. In comparison, the income gap has not made the expected negative adjustment effect under the Chinese government's poverty alleviation policy. However, the positive policy effect is heterogeneous in the downstream and upstream pilot cities. The "forcing effect" of the policy on the downstream cities is more favorable than the "compensating effect" on the upstream cities. Therefore, policymakers should pay more attention to ensuring the effectiveness of the Watershed Horizontal Ecological Compensation policy in enhancing GTFP as a long-term strategy to guarantee the sustainability of green ecological development in Chinese cities.
    Matched MeSH terms: Policy
  14. Novice driver crashes: The relation between putative causal factors, countermeasures, real world implementations, and policy - A case study in simple, scalable solutions
    Fisher DL, Agrawal R, Divekar G, Hamid MA, Krishnan A, Mehranian H, et al.
    Accid Anal Prev, 2024 Apr;198:107397.
    PMID: 38271896 DOI: 10.1016/j.aap.2023.107397
    Novice drivers are at a greatly inflated risk of crashing. This led in the 20th century to numerous attempts to develop training programs that could reduce their crash risk. Yet, none proved effective. Novice drivers were largely considered careless, not clueless. This article is a case study in the United States of how a better understanding of the causes of novice driver crashes led to training countermeasures targeting teen driving behaviors with known associations with crashes. These effects on behaviors were large enough and long-lasting enough to convince insurance companies to develop training programs that they offered around the country to teen drivers. The success of the training programs at reducing the frequency of behaviors linked to crashes also led to several large-scale evaluations of the effect of the training programs on actual crashes. A reduction in crashes was observed. The cumulative effect has now led to state driver licensing agencies considering as a matter of policy both to include items testing the behaviors linked to crashes on licensing exams and to require training on safety critical behaviors. The effort has been ongoing for over a quarter century and is continuing. The case study highlights the critical elements that made it possible to move from a paradigm shift in the understanding of crash causes to the development and evaluation of crash countermeasures, to the implementation of those crash countermeasures, and to subsequent policy changes at the state and federal level. Key among these elements is the development of simple, scalable solutions.
    Matched MeSH terms: Policy
  15. Dietary Guidelines for the Asia Pacific Region
    Binns CW, Lee MK, Kagawa M, Low WY, Liqian Q, Guldan GS, et al.
    Asia Pac J Public Health, 2017 Mar;29(2):98-101.
    PMID: 28325079 DOI: 10.1177/1010539517694295
    Nutrition is a major determinant of health throughout all stages of life and together with smoking is the most important risk factor for morbidity and mortality in the Asia Pacific Region. The workshop participants examined Dietary Guidelines and Food Guides that are in use in our region, together with additional materials from the World Health Organization, UNICEF and the World Cancer Research Foundation. The resulting set of guidelines is meant as a reminder of the main issues to be covered in a general public health education program. It may also be of value in reminding public health practitioners, educators, administrators, and policy makers of current nutrition issues. It may additionally be useful as a checklist of the issues to be considered in public health programs and regulations. The main areas of nutrition that are included in the Guidelines are eating a variety of foods, including vegetables, fruits, whole grain cereals, and nuts. Choose fish, poultry, and meats grown in a sustainable way. Appropriate growth, including avoiding obesity, and physical activity are important. Breastfeeding is the basis of infant nutrition and nutrition of mothers is an important public health measure. Negative factors in the Asian diet include salt, refined sugar, alcohol and fats. The APACPH Dietary Guidelines will need to be kept under review and modified to meet regional differences in food supply. The Guidelines will be useful as a checklist of the issues to be considered in public health programs, addressing both acute and chronic diseases.
    Matched MeSH terms: Nutrition Policy*
  16. The Role of Public Health Nutrition in Achieving the Sustainable Development Goals in the Asia Pacific Region
    Binns C, Lee MK, Low WY, Zerfas A
    Asia Pac J Public Health, 2017 Oct;29(7):617-624.
    PMID: 29094630 DOI: 10.1177/1010539517736441
    The Sustainable Development Goals (SDGs) replaced the Millennium Development Goals (MDCs) in 2015, which included several goals and targets primarily related to nutrition: to eradicate extreme poverty and hunger and to reduce child mortality and improve maternal health. In the Asia-Pacific Academic Consortium for Public Health (APACPH) member countries as a group, infant and child mortality were reduced by more than 65% between 1990 and 2015, achieving the MDG target of two-thirds reduction, although these goals were not achieved by several smaller countries. The SDGs are broader in focus than the MDGs, but include several goals that relate directly to nutrition: 2 (zero hunger-food), 3 (good health and well-being-healthy life), and 12 (responsible consumption and production-sustainability). Other SDGs that are closely related to nutrition are 4 and 5 (quality education and equality in gender-education and health for girls and mothers, which is very important for infant health) and 13 (climate action). Goal 3 is "good health and well-being," which includes targets for child mortality, maternal mortality, and reducing chronic disease. The Global Burden of Disease Project has confirmed that the majority of risk for these targets can be attributed to nutrition-related targets. Dietary Guidelines were developed to address public health nutrition risk in the Asia Pacific region at the 48th APACPH 2016 conference and they are relevant to the achievement of the SDGs. Iron deficiency increases the risk of maternal death from haemorrhage, a cause of 300000 deaths world-wide each year. Improving diets and iron supplementation are important public health interventions in the APACPH region. Chronic disease and obesity rates in the APACPH region are now a major challenge and healthy life course nutrition is a major public health priority in answering this challenge. This article discusses the role of public health nutrition in achieving the SDGs. It also examines the role of APACPH in education and advocacy and in fulfilling the educational needs of public health students in public health nutrition.
    Matched MeSH terms: Nutrition Policy
  17. Fulltext Public awareness of HIV/AIDS: how media play a role?
    Tham JS, Zanuddin H
    Southeast Asian J. Trop. Med. Public Health, 2015 Jul;46(4):669-79.
    PMID: 26867387
    Abstract. This paper examines the effectiveness of media in public awareness of the HIV/AIDS issue among the public in an area in central Selangor, comprising Kuala Lumpur and its surroundings and suburbs in Malaysia. Cross-sectional survey questionnaires were distributed to 384 respondents about accessing the public awareness of modes of HIV transmission, perceptions and attitudes towards people living with HIV/AIDS, as well as people's understanding about government policies to curb HIV/AIDS. Health care practitioners and newspapers were the preferred sources of information seeking on HIV/AIDS among the public. Most of the respondents were aware of the modes of HIV transmission. However, they were some respondents who still have misconceptions about the modes of transmission. Most of the respondents were not aware about the government's significant policies to address HIV/AIDS in the region. Overall, the respondents had certain knowledge about HIV transmission modes and moderate positive perceptions and attitudes towards people living with HIV/AIDS. Future studies should be conducted to examine about who sets the agenda in the media, and apart from gatekeepers, who are the real decision makers in deciding what is important to inform the public.
    Matched MeSH terms: Health Policy*
  18. Fulltext Are our healthcare workers well protected during COVID-19? learning from current experiences and challenges
    Siti Munira Yasin,, Kamarulzaman Muzaini, Ely Zarina Samsudin, Mohamad Ikhsan Selamat, Zaliha Ismail
    Journal of Clinical and Health Sciences, 2020;5(2):4-18.
    MyJurnal
    The outbreak of novel coronavirus disease 2019 (COVID-19) has been declared a Public
    Health Emergency of International Concern by the World Health Organization. The incidence
    of this pandemic continues to rise, with 40,665,438 confirmed cases and 1,121,843 deaths
    worldwide by 21 October 2020. During this public health crisis, healthcare workers are at the
    frontline of the COVID-19 outbreak response, and as such are at risk of being infected and
    developing job burnout while in the line of duty. This study reviews the history of COVID-19
    outbreak, infection control measures in hospitals during COVID-19 outbreak, healthcare
    workers’ risk of infection and other health effects from battling COVID-19, and challenges and
    recommendations for protecting healthcare workers during this pandemic. At present,
    healthcare workers are every country’s most valuable resources, and their safety must thus
    be ensured. Strong medical leadership, clear pandemic planning, policies and protocols,
    continuous educational training, adequate provision of personal protective equipment,
    psychological support, and the provision of food, rest, and family support for healthcare
    workers would augment a climate of safety in the workplace, ensure their wellbeing, and
    improve their capacity to battle this ongoing pandemic.
    Matched MeSH terms: Policy
  19. Fulltext Making Fair Choices on the Path to Universal Health Coverage: Applying Principles to Difficult Cases
    Voorhoeve A, Tan-Torres Edejer T, Kapiriri L, Norheim OF, Snowden J, Basenya O, et al.
    Health Syst Reform, 2017 Oct 02;3(4):301-312.
    PMID: 30359178 DOI: 10.1080/23288604.2017.1324938
    Abstract-Progress toward universal health coverage (UHC) requires making difficult trade-offs. In this journal, Dr. Margaret Chan, the World Health Organization (WHO) Director-General, has endorsed the principles for making such decisions put forward by the WHO Consultative Group on Equity and UHC. These principles include maximizing population health, priority for the worse off, and shielding people from health-related financial risks. But how should one apply these principles in particular cases, and how should one adjudicate between them when their demands conflict? This article by some members of the Consultative Group and a diverse group of health policy professionals addresses these questions. It considers three stylized versions of actual policy dilemmas. Each of these cases pertains to one of the three key dimensions of progress toward UHC: which services to cover first, which populations to prioritize for coverage, and how to move from out-of-pocket expenditures to prepayment with pooling of funds. Our cases are simplified to highlight common trade-offs. Though we make specific recommendations, our primary aim is to demonstrate both the form and substance of the reasoning involved in striking a fair balance between competing interests on the road to UHC.
    Matched MeSH terms: Health Policy
  20. Fulltext Tobacco control environment: cross-sectional survey of policy implementation, social unacceptability, knowledge of tobacco health harms and relationship to quit ratio in 17 low-income, middle-income and high-income countries
    Chow CK, Corsi DJ, Gilmore AB, Kruger A, Igumbor E, Chifamba J, et al.
    BMJ Open, 2017 03 31;7(3):e013817.
    PMID: 28363924 DOI: 10.1136/bmjopen-2016-013817
    OBJECTIVES: This study examines in a cross-sectional study 'the tobacco control environment' including tobacco policy implementation and its association with quit ratio.

    SETTING: 545 communities from 17 high-income, upper-middle, low-middle and low-income countries (HIC, UMIC, LMIC, LIC) involved in the Environmental Profile of a Community's Health (EPOCH) study from 2009 to 2014.

    PARTICIPANTS: Community audits and surveys of adults (35-70 years, n=12 953).

    PRIMARY AND SECONDARY OUTCOME MEASURES: Summary scores of tobacco policy implementation (cost and availability of cigarettes, tobacco advertising, antismoking signage), social unacceptability and knowledge were associated with quit ratios (former vs ever smokers) using multilevel logistic regression models.

    RESULTS: Average tobacco control policy score was greater in communities from HIC. Overall 56.1% (306/545) of communities had >2 outlets selling cigarettes and in 28.6% (154/539) there was access to cheap cigarettes (<5cents/cigarette) (3.2% (3/93) in HIC, 0% UMIC, 52.6% (90/171) LMIC and 40.4% (61/151) in LIC). Effective bans (no tobacco advertisements) were in 63.0% (341/541) of communities (81.7% HIC, 52.8% UMIC, 65.1% LMIC and 57.6% LIC). In 70.4% (379/538) of communities, >80% of participants disapproved youth smoking (95.7% HIC, 57.6% UMIC, 76.3% LMIC and 58.9% LIC). The average knowledge score was >80% in 48.4% of communities (94.6% HIC, 53.6% UMIC, 31.8% LMIC and 35.1% LIC). Summary scores of policy implementation, social unacceptability and knowledge were positively and significantly associated with quit ratio and the associations varied by gender, for example, communities in the highest quintile of the combined scores had 5.0 times the quit ratio in men (Odds ratio (OR) 5·0, 95% CI 3.4 to 7.4) and 4.1 times the quit ratio in women (OR 4.1, 95% CI 2.4 to 7.1).

    CONCLUSIONS: This study suggests that more focus is needed on ensuring the tobacco control policy is actually implemented, particularly in LMICs. The gender-related differences in associations of policy, social unacceptability and knowledge suggest that different strategies to promoting quitting may need to be implemented in men compared to women.

    Matched MeSH terms: Health Policy*
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