eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2013-09-21
1
3
187
188
10.15171/ijhpm.2013.34
2777
The Many Meanings of Evidence: Implications for the Translational Science Agenda in Healthcare
Gill Harvey
gillian.harvey@flinders.edu.au
1
Manchester Business School, University of Manchester, Manchester, UK
Health systems across the world are concerned with the quality and safety of patient care. This includes investing in research and development to progress advances in the treatment and management of individuals and healthcare organisations. The concept of evidence- based healthcare has gained increasing currency over the last two decades; yet questions persist about the time it takes for new research evidence to find its way into day to day healthcare decision-making. This paper explores the reasons for this apparent gap between research and healthcare practice, management and policy-making. In particular, the paper argues that different meanings attached to the word ‘evidence’ fundamentally influence the way in which the research-practice gap is conceptualised and subsequent strategies that are implemented to increase the uptake of research.
https://www.ijhpm.com/article_2777_cf7172b9b453a2cff59685628e621652.pdf
Knowledge Translation
Evidence-Based Healthcare
Research Utilisation
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2013-08-19
1
3
189
192
10.15171/ijhpm.2013.35
2765
How to Facilitate Social Contagion?
Karl Blanchet
karl.blanchet@lshtm.ac.uk
1
Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
Achieving the Millennium Development Goals has proven to be a real challenge. Providing evidence on cost-effective interventions did not prove to be sufficient to secure the trust of national authorities, health care providers and patients. Introducing change in a health system requires a good understanding of the relationships between the actors of the system. Social network analysis can provide a new avenue to analyse the diffusion of innovations within a health system or a health organisation and analyse the structure and the properties of a health system. Evidence has been generated on the necessity of not only identifying the actors of a system but also qualifying the relationships between these actors.
https://www.ijhpm.com/article_2765_965dcd7aac8f59010b110137eb5a269c.pdf
Social Network Analysis
Health System
Innovations
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2013-09-06
1
3
193
199
10.15171/ijhpm.2013.36
2769
Corporate Wellness Programs: Implementation Challenges in the Modern American Workplace
Bahaudin G. Mujtaba
mujtaba@nova.edu
1
Frank J. Cavico
cavico@nova.edu
2
The H. Wayne Huizenga School of Business and Entrepreneurship, Nova Southeastern University, Ft. Lauderdale, Florida, USA
The H. Wayne Huizenga School of Business and Entrepreneurship, Nova Southeastern University, Ft. Lauderdale, Florida, USA
Being healthy is important for living well and achieving longevity. In the business realm, furthermore, employers want healthy employees, as these workers tend to be more productive, have fewer rates of absenteeism, and use less of their health insurance resources. This article provides an overview of corporate “wellness” efforts in the American workplace and the concomitant challenges which employers will confront in implementing these programs. Consequently, employers and managers must reflect upon wellness policies and objectives, consult with professionals, and discuss the ramifications thereof prior to implementation. The authors herein explore how employers are implementing policies that provide incentives to employees who lead “healthy” lifestyles as well as ones that impose costs on employees who lead “unhealthy” lifestyles.The distinctive contribution of this article is that it proactively explores wellness program implementation challenges and also supplies “best practices” in the modern workplace, so employers can be better prepared when they promulgate wellness policies, and then take practical steps to help their employees become healthier and thereby help to reduce insurance costs. The article, moreover, addresses how wellness policy incentives—in the form of “carrots” as well as penalties—in the form of “sticks” could affect employees, especially “non-healthy” employees, as well as employers, particularly legally. Based on the aforementioned challenges, the authors make practical recommendations for employers and managers, so that they can fashion and implement wellness policies that are deemed to be legal, ethical, and efficacious.
https://www.ijhpm.com/article_2769_4526f6a160296b641b5d44a00b329251.pdf
Wellness Programs
American Workplace
Carrots and Sticks
Healthy Lifestyle
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2013-09-28
1
3
201
205
10.15171/ijhpm.2013.37
2781
Avicenna’s Educational Views with Emphasis on the Education of Hygiene and Wellness
Mohadeseh Borhani Nejad
mohadese_borhani@yahoo.com
1
Mohammad Rashidi
mo.rashidi84@gmail.com
2
Mohammad Mehdi Oloumi
oloumi@uk.ac.ir
3
Research Centre for Health Services Management, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
Research Centre for Social Determinants of Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
Faculty of Veterinary Medicine, Shahid Bahonar University, Kerman, Iran
Today, on the contrary of the last ten decades, the necessity of teaching hygienic issues, and caring the children’s health, is pretty obvious. Avicenna (10 AC), the famous Iranian physician and philosopher, scrutinized the health and hygiene with a deep insight to the matter. He considered the wellness not only as the recovery from the disease, but emphasized the maintenance of health by suggesting special points and instructions. In Islamic education, paying attention to cleanliness, health and physical strength is very important and considered as the intermediate goals for the achievement of “pure life”, which is the ultimate goal. Avicenna paid special attention to physical purity, health and wellness, and devoted the major parts of his book to them. The present article analyzes the Avicenna’s educational opinions, specially his viewpoints regarding hygiene and health in three stages of childhood, teenage years, and youth.
https://www.ijhpm.com/article_2781_0957a64b7eeb81262196e3748c0c02d3.pdf
Avicenna
Education
Hygiene
Health
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2013-08-29
1
3
207
211
10.15171/ijhpm.2013.38
2767
TB/HIV Co-Infection Care in Conflict-Affected Settings: A Mapping of Health Facilities in the Goma Area, Democratic Republic of Congo
Berthollet Bwira Kaboru
berthollet.kaboru@oru.se
1
Brenda A. Ogwang
bre.ogwang@yahoo.com
2
Edmond N. Namegabe
ntabenamegabe2006@gmail.com
3
Ndemo Mbasa
ndemombasa@yahoo.fr
4
Deka Kambale Kabunga
dekakabunga@yahoo.fr
5
Kambale Karafuli
karafuli2001@yahoo.fr
6
School of Health and Medical Sciences, Örebro University, Örebro, Sweden
Division of Global Health (IHCAR), Karolinska Institutet, Stockholm, Sweden
Faculté des Sciences de Santé et Developpement Communautaires, Université Libre des Pays des Grands Lacs, Goma, Democratic Republic of Congo
Faculté des Sciences de Santé et Developpement Communautaires, Université Libre des Pays des Grands Lacs, Goma, Democratic Republic of Congo
Inspection Provinciale de la Santé, Goma, Democratic Republic of Congo
Faculté des Sciences de Santé et Developpement Communautaires, Université Libre des Pays des Grands Lacs, Goma, Democratic Republic of Congo
Background HIV/AIDS and Tuberculosis (TB) are major contributors to the burden of disease in sub-Saharan Africa. The two diseases have been described as a harmful synergy as they are biologically and epidemiologically linked. Control of TB/HIV co-infection is an integral and most challenging part of both national TB and national HIV control programmes, especially in contexts of instability where health systems are suffering from political and social strife. This study aimed at assessing the provision of HIV/TB co-infection services in health facilities in the conflict-ridden region of Goma in Democratic Republic of Congo. Methods A cross-sectional survey of health facilities that provide either HIV or TB services or both was carried out. A semi-structured questionnaire was used to collect the data which was analysed using descriptive statistics. Results Eighty facilities were identified, of which 64 facilities were publicly owned. TB care was more available than HIV care (in 61% vs. 9% of facilities). Twenty-three facilities (29%) offered services to co-infected patients. TB/HIV co-infection rates among patients were unknown in 82% of the facilities. Only 19 facilities (24%) reported some coordination with and support from concerned diseases’ control programmes. HIV and TB services are largely fragmented, indicating imbalances and poor coordination by disease control programmes. Conclusion HIV and TB control appear not to be the focus of health interventions in this crisis affected region, despite the high risks of TB and HIV infection in the setting. Comprehensive public health response to this setting calls for reforms that promote joint TB/HIV co-infection control, including improved leadership by the HIV programmes that accuse weaknesses in this conflict-ridden region.
https://www.ijhpm.com/article_2767_511fb473a9cbca7bc9cdd478554b2c90.pdf
TB
HIV
Co-Infection
Integrated Services
Disease Control
Congo
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2013-09-04
1
3
213
218
10.15171/ijhpm.2013.39
2768
Importance of Pre-pregnancy Counseling in Iran: Results from the High Risk Pregnancy Survey 2012
Mohammad Eslami
parhamii@hotmail.com
1
Mahdieh Yazdanpanah
2
Robabeh Taheripanah
3
Parnian Andalib
4
Azardokht Rahimi
5
Nouzar Nakhaee
nakhaeen@yahoo.com
6
Department of Population and Family Health, Ministry of Health and Medical Education, Tehran, Iran
Department of Population and Family Health, Ministry of Health and Medical Education, Tehran, Iran
Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Department of Population and Family Health, Ministry of Health and Medical Education, Tehran, Iran
Department of Population and Family Health, Ministry of Health and Medical Education, Tehran, Iran
Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
Background To identify the prevalence of behavioural (Pre-pregnancy), obstetrical and medical risks of pregnancy in Iranian women. Methods A total of 2993 postpartum women who delivered in 23 randomly selected hospitals of six provinces were enrolled in this nationwide cross-sectional study. A structured questionnaire was completed based on interviewees’ self-reports and medical record data, consisting of socio-demographic characteristics, behavioural, obstetrical and medical risks, before and during pregnancy. Results Less than 6.0% had no health insurance and 5.0% had no prenatal visit before labour. Unintended pregnancy was reported by 27.5% of women. Waterpipe and/or cigarette smoking was reported by 7.1% of them and 0.9% abused opiates during pregnancy. Physical abuse by husband in the year before pregnancy occurred in 7.5% of participants. The rate of cesarean section was 50.4%. Preterm birth, low birth weight, and stillbirth were seen in 6.8, 7.7, and 1.2% of deliveries respectively. The most frequent medical risk factors were urinary tract infection (32.5%), anemia (21.6%), and thyroid disease (4.1%). Conclusion More effort should be devoted by health policymakers to the establishment of a preconception counselling (health education and risk assessment) and surveillance system; although obstetrical and medical risks should not be neglected too.
https://www.ijhpm.com/article_2768_b63d4512078923ad54ad92c534e43dde.pdf
Pregnancy
Risk Factors
Women`s Health
Health Planning
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2013-09-09
1
3
219
222
10.15171/ijhpm.2013.40
2770
An Epidemiological Survey of the Suicide Incidence Trends in the Southwest Iran: 2004-2009
Farid Najafi
fnajafi@kums.ac.ir
1
Jafar Hassanzadeh
jhasanzad@sums.ac.ir
2
Mehdi Moradinazer
moradi.mehdi1363@yahoo.com
3
Hossain Faramarzi
hossainfaramarzi@yahoo.com
4
Alireza Nematollahi
nematollahi@susc.ac.ir
5
Research Center for Environmental Determinants of Health (RCEDH), School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran
Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran
Department of Social Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
Department of Statistics, College of Sciences, Shiraz University, Shiraz, Iran
Background Elimination of suicide attempts is impossible, but they can be reduced dramatically by an organized planning. The present study aimed to survey the suicide trends in Fars province (Iran), during 2004-2009 to better understand the prevalence and status of suicide. Methods This survey was a cross-sectional study. The demographic data were collected from the civil status registry between 2004 and 2009. Suicide and suicide attempt data were collected of three sources including the affiliated hospitals of Shiraz University of Medical Sciences, mortality data of Vice Chancellery of Health in Fars province and data from forensic medicine. Then, they were analyzed by Excel and SPSS. Chi-square and regression analyses were used for data analysis. Results During the study, 10671 people attempted suicide, of which 5697 (53%) were women and 4974 (47%) were men. Among them, 1047 people (9.8%) died, of which 363 (34%) were women and 679 (64%) were men. There was a significant relationship between gender and fatal suicide. The mean suicide attempt for both genders was 53 per 100,000 and 49, 57 for men and women, respectively. The trends in the incidence of Suicidal attempts were decreasing. Conclusion Without implementing effective preventive measures, the health care system in Iran will face a further burden of fatal suicides among young people. Therefore; enhancing the primary health care and specialized mental health services for those with unsuccessful suicide attempts can effectively reduce the burden of suicide.
https://www.ijhpm.com/article_2770_649e3201d997a198fb9967ecf28cd089.pdf
Fatal Suicide
Suicide Attempt
Epidemiologic Trend
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2013-09-14
1
3
223
225
10.15171/ijhpm.2013.41
2771
Nutritionism, Commercialization and Food; Comment on “Buying Health: The Costs of Commercialism and an Alternative Philosophy”
Anne Barnhill
anne.barnhill@gmail.com
1
Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, PA, USA
In “Buying Health: the Costs of Commercialization and an Alternative Philosophy”, Larry R. Churchill and Shelley C. Churchill discuss the commercialization of health and, in particular, the commercialization of nutrition. In this commentary on their article, I draw a connection between Churchill and Churchill’s account of the commercialization of nutrition and Michael Pollan’s critique of “nutritionism”. I also offer a friendly amendment to Churchill and Churchill’s account, suggesting that the commercialization of nutrition is not a monolithic experience but it is rather widely challenged.
https://www.ijhpm.com/article_2771_04c692ea66cbcc83571a30aaa4076653.pdf
Nutrition
Food Ethics
Food Studies
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2013-09-14
1
3
227
228
10.15171/ijhpm.2013.42
2772
Patient Choice Has Become the Standard Practice in Healthcare Provision: It is Time to Extend its Meaning; Comment on “Is Patient Choice the Future of Health Care Systems?”
Benjamin Ewert
benjamin.ewert@uni-siegen.de
1
Justus Liebig University Giessen, Giessen, Germany
The key argument of this commentary is that patient choice has a broader meaning than suggested by consumerist choice models. In increasingly marketized health care systems with diversified and knowledge-based service arrangements, patients are continuously obliged to choose insurers, physicians or hospitals and treatments—whether they like it or not. However, health care users refer to a wide range of roles and resources while taking health-related decisions. They are patients, consumers and co-producers at the same time. Therefore, as it is argued, healthcare policies have to recognize users’ multiple identities by providing more balanced choice frameworks. In particular, two aspects are crucial: first, opportunities for users to voice worries and concerns and to co-design default options of health care choices; secondly, taking the significance of interpersonal trust in choice-making processes into account.
https://www.ijhpm.com/article_2772_56a6dcd87d0117919eb10e3c545be188.pdf
Patient Choice
Healthcare Users’ Roles
Voice
Interpersonal Trust
Equity
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2013-09-14
1
3
229
230
10.15171/ijhpm.2013.43
2774
Commercialism, Holism, and Individual Responsibility; Comment on “Buying Health: The Costs of Commercialism and an Alternative Philosophy”
Berit Bringedal
berit.bringedal@legeforeningen.no
1
LEFO, Institute for Studies of the Medical Profession, Oslo, Norway
Churchill and Churchill’s editorial discusses negative (health) effects of commercialism in the provision of health care and nutrition. Three parts of their argument are commented: the claim that the fundamental problem of markets is the decomposition of the whole into parts (“reductionism”); the call for individual responsibility; and the notion of holism. On the three aspects the commentary concludes thus: Because provision of health and food must be controlled and managed in some form, an alternative to some kind of decomposition is hard to see. The call for individual responsibility is controversial due to its lack of attention to socioeconomic inequalities. The concept of “holism” is problematic due to its epistemological and normative status.
https://www.ijhpm.com/article_2774_d4e2da416ea702eed3262a61cb38e86a.pdf
Commercialism
Individual Responsibility
Holism
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2013-09-14
1
3
231
232
10.15171/ijhpm.2013.44
2773
Prioritizing Healthcare Delivery in a Conflict Zone; Comment on “TB/HIV Co-Infection Care in Conflict-Affected Settings: A Mapping of Health Facilities in the Goma Area, Democratic Republic of Congo”
Robin Wood
robin.wood@uct.ac.za
1
Eugene T Richardson
etr@stanford.edu
2
Desmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Division of Infectious Diseases and Geographic Medicine, Department of Anthropology, Stanford University, CA, USA
Nowhere are the barriers to a functional health infrastructure more clearly on display than in the Goma region of Democratic Republic of Congo. Kaboru et al. report poorly integrated services for HIV and TB in this war-torn region. Priorities in conflict zones include provision of security, shelter, food, clean water and prevention of sexual violence. In Goma, immediate health priorities include emergency treatment of cholera, malaria, respiratory illnesses, provision of maternal care, millions of measles vaccinations, and management of an ongoing rabies epidemic. It is a daunting task to determine an essential package of medical services in a setting where there are so many competing priorities, where opportunity costs are limited and epidemiologic information is scarce. Non-governmental agencies sometimes add to the challenge via an insidious reduction of state sovereignty and the creation of new levels of income inequality. Kaboru et al. have successfully highlighted many of the complexities of rebuilding and prioritizing healthcare in a conflict zone.
https://www.ijhpm.com/article_2773_8cec363f89f2fe2dd40ef4044bd6604e.pdf
Congo
HIV
Tuberculosis
Conflict
Integrated Services
NGO
Mission Creep
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2013-09-17
1
3
233
234
10.15171/ijhpm.2013.45
2775
How to Set up an Effective Food Tax?; Comment on “Food Taxes: A New Holy Grail?”
Céline Bonnet
celine.bonnet@tse-fr.eu
1
Toulouse School of Economics, University of Toulouse 1 Capitole, Toulouse, France
Whereas public information campaigns have failed to reverse the rising trend in obesity, economists support food taxes as they suggest they can force individuals to change their eating behavior and make the agro-food industry think more about healthy food products. Excise taxes based on the unhealthy nutrient content would be more effective since they impact more on unhealthy food products than VAT (value-added-tax) taxes. Taxes based only on junk food products would avoid perverse effects on healthy nutrient. However, as eating behavior of consumers is complex, a modeling analysis would allow to assess unexpected effects on other unhealthy nutrients or products.
https://www.ijhpm.com/article_2775_48afa6c20a81510ea4af31f0ab7f37df.pdf
Food Taxes
Excise
VAT
Obesity
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2013-09-21
1
3
235
236
10.15171/ijhpm.2013.46
2776
There Are Many Purposes for Conditional Incentives to Accessing Healthcare; Comment on “Denial of Treatment to Obese Patients—the Wrong Policy on Personal Responsibility for Health”
Sridhar Venkatapuram
sridhar.venkatapuram@kcl.ac.uk
1
Department of Social Science Health & Medicine, King’s College London, London, UK
This commentary is a brief response to Nir Eyal’s argument that health policies should not make healthy behaviour a condition or prerequisite in order to access healthcare as it could result in the people who need healthcare the most not being able to access healthcare. While in general agreement due to the shared concern for equity, I argue that making health behaviour a condition to accessing healthcare can serve to develop commitment to lifestyle changes, make the health intervention more successful, help appreciate the value of the resources being spent, and help reflect on the possible risks of the intervention. I also argue that exporting or importing the carrot and stick policies to other countries without a solid understanding of the fiscal and political context of the rise of such policies in the US can lead to perverse consequences.
https://www.ijhpm.com/article_2776_7f6b743c1186e18354a8ebdac83d60af.pdf
Personal Responsibility for Health
Obesity
Carrots and Sticks
Chronic Diseases
Public Health Ethics
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2013-09-28
1
3
237
238
10.15171/ijhpm.2013.47
2778
The Errors of Individualistic Public Health Interventions: Denial of Treatment to Obese Persons; Comment on “Denial of Treatment to Obese Patients—the Wrong Policy on Personal Responsibility for Health”
Daniel S. Goldberg
goldbergd@ecu.edu
1
Department of Bioethics & Interdisciplinary Studies, Brody School of Medicine, East Carolina University, Greenville, USA
I agree entirely with Nir Eyal’s perspective that denying treatment to obese patients is morally wrong. However, the reasons for this belief differ in some ways from Eyal’s analysis. In this commentary, I will try to explain the similarities and differences in our perspectives. My primary claim is that the denial of treatment to obese patients is wrong principally because (i) it eschews a whole-population approach to the problem of poor nutrition and is therefore likely to be ineffective; (ii) it is likely to expand obesity-related health inequities; and (iii) it is likely to intensify stigma against already-marginalized social groups. I shall consider each in turn, and explore the extent to which Eyal would be likely to agree with my claims.
https://www.ijhpm.com/article_2778_dc35c3187140411fd3e9c60a64634c85.pdf
Methodological Individualism
Inequalities
Whole-Population Approach
Stigma
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2013-09-29
1
3
239
240
10.15171/ijhpm.2013.48
2780
A Doctor’s First, and Last, Responsibility is to Care Comment on “Denial of Treatment to Obese Patients—the Wrong Policy on Personal Responsibility for Health”
Lachlan Forrow
lforrow@bidmc.harvard.edu
1
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
The obesity epidemic raises important and complex issues for clinicians and policy-makers, such as what clinical and public health measures will be most effective and most ethically-sound. While Nir Eyal’s analysis of these issues is very helpful and while he correctly concludes that “conditioning the very aid that patients need in order to become healthier on success in becoming healthier” is wrong, further discussions of these issues must include unequivocal support for safeguarding the fundamental moral basis of the doctor-patient relationship. Regardless of any patients’ failures to demonstrate effective responsibility for their own health, each patient needs and deserves a physician whose caring is never in doubt. Policy- makers need to ensure that our health systems always make this a top priority.
https://www.ijhpm.com/article_2780_f88b5fadec0a7a5d7af0471ed5d30821.pdf
Obesity
Doctor-Patient Relationship
Caring
Moral Responsibility
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2013-08-27
1
3
241
241
10.15171/ijhpm.2013.49
2766
Food Taxes: How Likely Are Likely Effects?
Ignaas Devisch
ignaas.devisch@ugent.be
1
Artevelde University College, University of Ghent, Belgium
https://www.ijhpm.com/article_2766_9eb25678e7ece607d7183b38ae080652.pdf
eng
Kerman University of Medical Sciences
International Journal of Health Policy and Management
2322-5939
2013-09-29
1
3
243
244
10.15171/ijhpm.2013.50
2779
Why Even the Logic of Re-Defined Choice May Still Contradict the Logic of Care in Public Health Systems?
Marianna Fotaki
marianna.fotaki@wbs.ac.uk
1
Warwick Business School, University of Warwick, Coventry, UK
https://www.ijhpm.com/article_2779_9890e29d30903e546450d42058a4aefa.pdf
Choice
Public Health Systems
Economic Constructs