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Fulltext A qualitative study of governance of evolving response to non-communicable diseases in low-and middle- income countries: current status, risks and options

Rani M, Nusrat S, Hawken LH

BMC Public Health, 2012;12:877.
PMID: 23067232 DOI: 10.1186/1471-2458-12-877

Segmented service delivery with consequent inefficiencies in health systems was one of the main concerns raised during scaling up of disease-specific programs in the last two decades. The organized response to NCD is in infancy in most LMICs with little evidence on how the response is evolving in terms of institutional arrangements and policy development processes.

Matched MeSH terms: Policy Making
Fulltext A review of hypertension in Nigeria and the 'Rule of halves'

Ahmed Dahiru Balami, Musa Mohammed Baba

Journal of Advanced Review on Scientific Research, 2017;34(1):1-10.
MyJurnal

Hypertension is a condition associated with adverse vascular complications. Its
prevalence is on the increase globally and same is true for Nigeria. Very few studies
have assessed the prevalence, awareness, treatment and blood pressure control
among hypertensive patients in Nigeria. The few available studies generally show
figures less than 50% for all the three indicators of success with regards to
hypertension. These studies are however deficient in their coverage, country
representativeness and methodology, and as such, they fail to provide the evidence
for which conclusions can be drawn. There is need to intensify blood pressure
screening at both hospital and community levels. More comprehensive research with
wider coverage and sound methodologies are also needed to determine those
associated factors and to discover better treatment options for hypertension in
Nigeria. These findings would guide health promotion activities and policy making.

Matched MeSH terms: Policy Making
A role for low-order system dynamics models in urban health policy making

Newell B, Siri J

Environ Int, 2016 10;95:93-7.
PMID: 27553880 DOI: 10.1016/j.envint.2016.08.003

Cities are complex adaptive systems whose responses to policy initiatives emerge from feedback interactions between their parts. Urban policy makers must routinely deal with both detail and dynamic complexity, coupled with high levels of diversity, uncertainty and contingency. In such circumstances, it is difficult to generate reliable predictions of health-policy outcomes. In this paper we explore the potential for low-order system dynamics (LOSD) models to make a contribution towards meeting this challenge. By definition, LOSD models have few state variables (≤5), illustrate the non-linear effects caused by feedback and accumulation, and focus on endogenous dynamics generated within well-defined boundaries. We suggest that experience with LOSD models can help practitioners to develop an understanding of basic principles of system dynamics, giving them the ability to 'see with new eyes'. Because efforts to build a set of LOSD models can help a transdisciplinary group to develop a shared, coherent view of the problems that they seek to tackle, such models can also become the foundations of 'powerful ideas'. Powerful ideas are conceptual metaphors that provide the members of a policy-making group with the a priori shared context required for effective communication, the co-production of knowledge, and the collaborative development of effective public health policies.

Matched MeSH terms: Policy Making*
Abbreviated report of the WHO Western Pacific Region Workshop on National Plans of Action for Nutrition: key elements for success, constraints and future plans

Tee ES

Biomed Environ Sci, 2001 Jun;14(1-2):87-91.
PMID: 11594485

A workshop on National Plans of Action for Nutrition: Constraints, Key Elements for Success, and Future Plans was convened and organized by the WHO Regional Office for the Western Pacific in collaboration with the Institute for Medical Research Malaysia and co-sponsored with FAO and UNICEF from 25-29 October 1999. It was attended by representatives of 25 countries in the region and resource persons, representatives from WHO and other international agencies. The objectives of the workshop were to review the progress of countries in developing, implementing and monitoring national plans of action for nutrition (NPANs) in the Western Pacific Region and to identify constraints and key elements of success in these efforts. Most of the countries have NPANs, either approved and implemented or awaiting official endorsement. The Plan formulation is usually multisectotal, involving several government ministries, non-governmental organizations, and international agencies. Often official adoption or endorsement of the Plan comes from the head of state and cabinet or the minister of health, one to six years from the start of its formulation. The NPAN has stimulated support for the development and implementation of nutrition projects and activities, with comparatively greater involvement of and more support from government ministries, UN agencies and non-governmental agencies compared to local communities, bilateral and private sectors and research and academic institutions. Monitoring and evaluation are important components of NPANs. They are, however, not given high priority and often not built into the plan. The role of an intersectoral coordinating body is considered crucial to a country's nutrition program. Most countries have an intersectoral structure or coordinating body to ensure the proper implementation, monitoring and evaluation of their NPANs. The workshop identified the constraints and key elements of success in each of the four stages of the NPAN process: development, operationalization, implementation, and monitoring and evaluation. Constraints to the NPAN process relate to the political and socioeconomic environment, resource scarcity, control and management processes, and factors related to sustainability. The group's review of NPAN identified successful NPANs as those based on recent, adequate and good quality information on the nutritional situation of the country, and on the selection of strategies, priorities and interventions that are relevant to the country and backed up by adequate resources. Continued high level political commitment, a multisectoral approach, and adequate participation of local communities are other key elements for success. The participants agreed on future actions and support needed from various sources for the further development, implementation, monitoring and evaluation of their NPANs. The recommendations for future actions were categorized into actions pertaining to countries with working NPAN, actions for countries without working NPAN and actions relevant to all countries. There was also a set of suggested actions at the regional level, such as holding of regular regional NPAN evaluation meetings, inclusion of NPAN on the agenda of regional fora by the regional organizations, and strengthening of regional nutrition networks.

Matched MeSH terms: Policy Making
Ahead with Cairo. Monitoring country activities

Danguilan M, Wainer J, Widyantoro N, Capoor I, Huq N, Ashino Y, et al.

Arrows Change, 1995 Apr;1(1):6-7.
PMID: 12346439
Matched MeSH terms: Policy Making*
Applying data mining in healthcare: an info-structure for delivering 'data-driven' strategic services

Abidi SS

Stud Health Technol Inform, 1999;68:453-6.
PMID: 10724926

Presently, there is a growing demand from the healthcare community to leverage upon and transform the vast quantities of healthcare data into value-added, 'decision-quality' knowledge, vis-à-vis, strategic knowledge services oriented towards healthcare management and planning. To meet this end, we present a Strategic Knowledge Services Info-structure that leverages on existing healthcare knowledge/data bases to derive decision-quality knowledge-knowledge that is extracted from healthcare data through services akin to knowledge discovery in databases and data mining.

Matched MeSH terms: Policy Making
Assessing the comparative advantage of broiler production in Peninsular Malaysia using policy analysis matrix

Benalywa ZA, Ismail MM, Shamsudin MN, Yusop Z

Trop Anim Health Prod, 2019 Feb;51(2):321-327.
PMID: 30112733 DOI: 10.1007/s11250-018-1690-8

Broiler meat is the largest and cheapest protein source in Malaysia. Using the policy analysis matrix (PAM), this study examines the comparative advantage of broiler production in Peninsular Malaysia. Three hundred and ten farms in Peninsular Malaysia were involved in a field survey. The results of the domestic resource cost (DRC) show that Malaysia has a comparative advantage in all scales of broiler production. Sensitivity analysis indicates that the changes in input prices have a significant effect on comparative advantage. Nonetheless, the industry should reduce its dependence on corn-based feed, which is expensive and has an unstable price, to increase competitiveness in further securing its comparative advantage.

Matched MeSH terms: Policy Making*
Fulltext Assessing the competitiveness and comparative advantage of broiler production in Johor using policy analysis matrix

Elsedig, E.A.A., Mohd, M.I., Fatimah, M.A

International Food Research Journal, 2015;22(1):116-121.
MyJurnal

Malaysian poultry policy aims to provide remunerative prices for producers and to guarantee a steady supply of poultry products at stable and affordable prices to consumers. Broiler meat is the most important and the cheapest protein source in Malaysia and trade protection could stimulate the local industry and enhance food security. The study attempts to evaluate the competitiveness and comparative advantage of three different scales of broiler production in Johor using policy analysis matrix (PAM). The existing protection and the level of comparative advantage are ascertained through PAM indicators. The results show that Malaysia has strong competitiveness position in every scale of broiler production especially the largest scale. But, the protection through import curtailment resulted in higher domestic prices than the world price. To increase competitiveness, the broiler industry should reduce the dependence on expensive and unstable cost of corn based feed.

Matched MeSH terms: Policy Making
Barcelona 2002: law, ethics, and human rights. Global battle cry: health is a right, not a commodity

Fernandez I

Can HIV AIDS Policy Law Rev, 2002 Dec;7(2-3):80-4.
PMID: 14743815

Health is a fundamental right, not a commodity to be sold at a profit, argues Irene Fernandez in the second Jonathan Mann Memorial Lecture delivered on 8 July 2002 to the XIV International AIDS Conference in Barcelona. Ms Fernandez had to obtain a special permit from the Malaysian government to attend the Conference because she is on trial for having publicly released information about abuse, torture, illness, corruption, and death in Malaysian detention camps for migrants. This article, based on Ms Fernandez' presentation, describes how the policies of the rich world have failed the poor world. According to Ms Fernandez, the policies of globalization and privatization of health care have hindered the ability of developing countries to respond to the HIV/AIDS epidemic. The article decries the hypocrisy of the industrialized nations in increasing subsidies to farmers while demanding that the developing world open its doors to Western goods. It points out that the rich nations have failed to live up their foreign aid commitments. The article concludes that these commitments--and the other promises made in the last few years, such as those in the United Nations' Declaration of Commitment on HIV/AIDS--can only become a reality if they are translated into action.

Matched MeSH terms: Policy Making*
Bringing new HIV infections to zero - opportunities and challenges offered by antiretroviral-based prevention in Asia, the Pacific and beyond: An overview of this special issue

Zablotska IB, Whittaker B, de Wit J, Kamarulzaman A, Ananworanich J, Wright E, et al.

Sex Health, 2014 Jul;11(2):97-100.
PMID: 25017549 DOI: 10.1071/SH14071

This editorial to the special issue of Sexual Health on antiretroviral-based prevention of HIV infection is dedicated to showcasing research and practice in this area. It aims to promote debate regarding the potential of new antiretroviral-based prevention approaches and the challenges encountered in moving prevention innovations into the community. This special issue covers the breadth of innovative HIV prevention research, including that undertaken in the fields of epidemiology, clinical research, social and behavioural science, public health and policy analysis, and with special emphasis on Asia and the Pacific region. Most importantly, it provides an indication of how the region is progressing towards embracing new prevention approaches to combat HIV epidemics across the region.

Matched MeSH terms: Policy Making
Cancer control reform in Nigeria

Fatokun O

Lancet Oncol, 2017 01;18(1):19-20.
PMID: 28049569 DOI: 10.1016/S1470-2045(16)30650-7
Matched MeSH terms: Policy Making
Clandestine labor migration to Taiwan

Tsay C

Asian Pac Migr J, 1992;1(3-4):637-55.
PMID: 12285774

"Illegal migration to Taiwan is a recent phenomenon but with a rapid rate of increase. Most illegal foreign workers enter on visitor's visas and overstay. This paper's detailed analysis of official data reveals that Malaysia, Philippines, Indonesia and Thailand are the major sources, providing a stock of mostly male workers numbering around 40,000. Sociodemographic and attitudinal changes among Taiwanese workers coupled with labor shortages in low-skilled jobs are pressuring the Taiwanese government to formulate plans for a systematic importation of foreign labor."

Matched MeSH terms: Policy Making*
Fulltext Combating insolvency and business recovery problems in the oil industry: proposal for improvement in Nigeria's insolvency and bankruptcy legal framework

Olujobi OJ

Heliyon, 2021 Feb;7(2):e06123.
PMID: 33659729 DOI: 10.1016/j.heliyon.2021.e06123

Insolvency and business recovery laws in Nigeria have not evolved to incorporate reorganisation, reforming insolvent oil firms' operations to boost commercial oil firms' steadiness and economic suitability like other moderately developed countries. In Nigeria, liquidation is understood by many as the panacea to indebtedness. The research evaluates the Nigerian insolvency and business recovery legal regime to sustain indebted oil firms from economic shocks due to the global decline in the oil price to avert imminent business failures due to insufficient cash flows. The aim is to fill the gaps in Nigeria's insolvency and business recovery laws by recommending a model for the sustenance of oil firms and to suggest the reform of the gaps identified in the existing laws and the extant literature on the subject. The paper opted for conceptual legal review, comparative legal and policies analyses of solvency and business recovery legislations in Nigeria, Malaysia, India, South Africa, the United Kingdom and the United States. These nations were designated for this study because their insolvency and business recovery legal regime are business rescued driven, not winding up centred. The study is library research-based to address some of the flaws in Nigeria's insolvency and business recovery laws. The study finds that Nigerian legislation on insolvency is flawed in oil firms' salvage, improvement and rearrangement. It ends that, statutory bodies in the designated case study nations are efficient than those in Nigeria due to the strong political will of their governments in supporting insolvent oil firms for successful financial recovery, to safeguard jobs, to protect creditors and to enhance the wealth of their nations through sound business recovery policies and laws. The study, advocates, remodel of Nigeria's insolvency and business recovery legislations and policies in compliance with the international standards on insolvent oil firms salvaged and creditors focused policies for a robust economy. The study concludes with the recommendation for further study to consider quantitative analysis research methodology to project further scholarship on the subject.

Matched MeSH terms: Policy Making
Condom use still unacceptable to many in Singapore regions

AIDS Wkly Plus, 1996 Oct 21.
PMID: 12320477
Matched MeSH terms: Policy Making*
Constraints on the retreat from a welfare-orientated approach to public health care in Malaysia

Barraclough S

Health Policy, 1999 Apr;47(1):53-67.
PMID: 10387810

Both in its articulation of values and through incremental changes, the Malaysian government has signalled a change in attitude towards the welfare approach which had hitherto characterized public health care policy. This change envisions an end to reliance upon the state for the provision and financing of health services and the fostering of a system of family-based welfare. In the future citizens should finance their own health care through savings, insurance or as part of their terms of employment. While the state will still accept a degree of responsibility for those unable to pay for their health care, it wishes to share this burden with the corporate sector and non-government organizations as part of a national policy of the 'Caring Society'. In this article the retreat from a commitment to a welfare model of public health care is documented and some of the serious obstacles to such a policy are discussed. It is concluded that the government's aspirations for reforming the welfare model will need to be tempered by both practical and political considerations. Moreover, the socio-economic consequences of the Asian currency crisis of 1997 are likely to increase the need for government welfare action.

Matched MeSH terms: Policy Making
Controlling water pollution in developing and transition countries--lessons from three successful cases

Kathuria V

J Environ Manage, 2006 Mar;78(4):405-26.
PMID: 16171929

The policy prescription for solving environmental problems of developing countries and countries-in-transition (CIT) is slowly getting polarized into two viewpoints. One group of researchers and policy advocates including multilateral organizations upholds extensive use of market based instruments (MBIs) in these countries. The other group argues that institutions need to be built first or the policy makers should select the incremental or tiered approach taking into account the existing capabilities. The group also insists that the financial, institutional and political constraints make environmental regulation in these countries more problematic than in industrialized countries. In the short-run, the immediate needs of the developing countries can be addressed effectively by learning lessons from the difficulties encountered by a few successful cases and accordingly evolving an appropriate policy instrument. In this paper an attempt has been made to highlight three such cases from three different parts of the world--Malaysia (Asia-pacific), Poland (Eastern Europe) and Colombia (Latin America). The paper looks into what policy instruments led to a fall in water pollution levels in these countries and what role did MBIs play in this pollution mitigation? The case studies suggest that it is a combination of instruments--license fee, standards, charge and subsidies--reinforced by active enforcement that led to an overall improvement in environment compliance.

Matched MeSH terms: Policy Making
Defining a global research and policy agenda for betel quid and areca nut

Mehrtash H, Duncan K, Parascandola M, David A, Gritz ER, Gupta PC, et al.

Lancet Oncol, 2017 12;18(12):e767-e775.
PMID: 29208442 DOI: 10.1016/S1470-2045(17)30460-6

Betel quid and areca nut are known risk factors for many oral and oesophageal cancers, and their use is highly prevalent in the Asia-Pacific region. Additionally, betel quid and areca nut are associated with health effects on the cardiovascular, nervous, gastrointestinal, metabolic, respiratory, and reproductive systems. Unlike tobacco, for which the WHO Framework Convention on Tobacco Control provides evidence-based policies for reducing tobacco use, no global policy exists for the control of betel quid and areca nut use. Multidisciplinary research is needed to address this neglected global public health emergency and to mobilise efforts to control betel quid and areca nut use. In addition, future research is needed to advance our understanding of the basic biology, mechanisms, and epidemiology of betel quid and areca nut use, to advance possible prevention and cessation programmes for betel quid and areca nut users, and to design evidence-based screening and early diagnosis programmes to address the growing burden of cancers that are associated with use.

Matched MeSH terms: Policy Making
Embedding rapid reviews in health policy and systems decision-making: Impacts and lessons learned from four low- and middle-income countries

Robson RC, Thomas SM, Langlois ÉV, Mijumbi R, Kawooya I, Antony J, et al.

Health Res Policy Syst, 2023 Jun 06;21(1):45.
PMID: 37280697 DOI: 10.1186/s12961-023-00992-w

BACKGROUND: Demand for rapid evidence-based syntheses to inform health policy and systems decision-making has increased worldwide, including in low- and middle-income countries (LMICs). To promote use of rapid syntheses in LMICs, the WHO's Alliance for Health Policy and Systems Research (AHPSR) created the Embedding Rapid Reviews in Health Systems Decision-Making (ERA) Initiative. Following a call for proposals, four LMICs were selected (Georgia, India, Malaysia and Zimbabwe) and supported for 1 year to embed rapid response platforms within a public institution with a health policy or systems decision-making mandate.
METHODS: While the selected platforms had experience in health policy and systems research and evidence syntheses, platforms were less confident conducting rapid evidence syntheses. A technical assistance centre (TAC) was created from the outset to develop and lead a capacity-strengthening program for rapid syntheses, tailored to the platforms based on their original proposals and needs as assessed in a baseline questionnaire. The program included training in rapid synthesis methods, as well as generating synthesis demand, engaging knowledge users and ensuring knowledge uptake. Modalities included live training webinars, in-country workshops and support through phone, email and an online platform. LMICs provided regular updates on policy-makers' requests and the rapid products provided, as well as barriers, facilitators and impacts. Post-initiative, platforms were surveyed.
RESULTS: Platforms provided rapid syntheses across a range of AHPSR themes, and successfully engaged national- and state-level policy-makers. Examples of substantial policy impact were observed, including for COVID-19. Although the post-initiative survey response rate was low, three quarters of those responding felt confident in their ability to conduct a rapid evidence synthesis. Lessons learned coalesced around three themes - the importance of context-specific expertise in conducting reviews, facilitating cross-platform learning, and planning for platform sustainability.
CONCLUSIONS: The ERA initiative successfully established rapid response platforms in four LMICs. The short timeframe limited the number of rapid products produced, but there were examples of substantial impact and growing demand. We emphasize that LMICs can and should be involved not only in identifying and articulating needs but as co-designers in their own capacity-strengthening programs. More time is required to assess whether these platforms will be sustained for the long-term.

Matched MeSH terms: Policy Making
Fulltext Empirically derived guidance for social scientists to influence environmental policy

Marshall N, Adger N, Attwood S, Brown K, Crissman C, Cvitanovic C, et al.

PLoS One, 2017;12(3):e0171950.
PMID: 28278238 DOI: 10.1371/journal.pone.0171950

Failure to stem trends of ecological disruption and associated loss of ecosystem services worldwide is partly due to the inadequate integration of the human dimension into environmental decision-making. Decision-makers need knowledge of the human dimension of resource systems and of the social consequences of decision-making if environmental management is to be effective and adaptive. Social scientists have a central role to play, but little guidance exists to help them influence decision-making processes. We distil 348 years of cumulative experience shared by 31 environmental experts across three continents into advice for social scientists seeking to increase their influence in the environmental policy arena. Results focus on the importance of process, engagement, empathy and acumen and reveal the importance of understanding and actively participating in policy processes through co-producing knowledge and building trust. The insights gained during this research might empower a science-driven cultural change in science-policy relations for the routine integration of the human dimension in environmental decision making; ultimately for an improved outlook for earth's ecosystems and the billions of people that depend on them.

Matched MeSH terms: Policy Making*
Establishing mercury-free medical facilities: a Malaysian case study

Amir Sultan MM, Goh CT, Wan Puteh SE, Mokhtar M

Int J Health Care Qual Assur, 2019 Feb 11;32(1):34-44.
PMID: 30859864 DOI: 10.1108/IJHCQA-08-2017-0161

PURPOSE: Mercury is widely used in medical and healthcare facilities as dental amalgam, mercury-added medical devices, thiomersal-containing vaccines, laboratory analysis and for other general applications despite the hazards. Various agencies consistently promote mercury-free medical facilities through mercury-free alternatives and better management practices, which are in line with the Minamata Convention on Mercury that aims to protect human health and environment from anthropogenic mercury release. The paper aims to discuss these issues.
DESIGN/METHODOLOGY/APPROACH: The authors conducted a gap analysis on recommended practices gathered from the literature and current practices gathered through semi-structured interviews with Malaysian medical personnel. A life cycle approach was adopted covering mercury use: input, storage, handling, accident, waste disposal and governance phases.
FINDINGS: The authors found that there are significant gaps between recommended and current mercury management practices. Analysis indicates improper mercury management as the main contributor to these gaps. The authors found from recommended practices that core components needing improvement include: mercury management action plan, mercury use identification team, purchasing policy, proper guidelines and monitoring systems.
PRACTICAL IMPLICATIONS: This study helps us to understand mercury management practices and suggests essential steps to establish a mercury-free medical facility.
ORIGINALITY/VALUE: This study explored the gaps between recommended and current mercury management practices in a medical facility and contributes to the Minamata Convention on Mercury aspirations.

Matched MeSH terms: Policy Making

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