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1.
JMIR Public Health Surveill ; 7(4): e20699, 2021 04 21.
Article in English | MEDLINE | ID: covidwho-2141282

ABSTRACT

BACKGROUND: Daily new COVID-19 cases from January to April 2020 demonstrate varying patterns of SARS-CoV-2 transmission across different geographical regions. Constant infection rates were observed in some countries, whereas China and South Korea had a very low number of daily new cases. In fact, China and South Korea successfully and quickly flattened their COVID-19 curve. To understand why this was the case, this paper investigated possible aerosol-forming patterns in the atmosphere and their relationship to the policy measures adopted by select countries. OBJECTIVE: The main research objective was to compare the outcomes of policies adopted by countries between January and April 2020. Policies included physical distancing measures that in some cases were associated with mask use and city disinfection. We investigated whether the type of social distancing framework adopted by some countries (ie, without mask use and city disinfection) led to the continual dissemination of SARS-CoV-2 (daily new cases) in the community during the study period. METHODS: We examined the policies used as a preventive framework for virus community transmission in some countries and compared them to the policies adopted by China and South Korea. Countries that used a policy of social distancing by 1-2 m were divided into two groups. The first group consisted of countries that implemented social distancing (1-2 m) only, and the second comprised China and South Korea, which implemented distancing with additional transmission/isolation measures using masks and city disinfection. Global daily case maps from Johns Hopkins University were used to provide time-series data for the analysis. RESULTS: The results showed that virus transmission was reduced due to policies affecting SARS-CoV-2 propagation over time. Remarkably, China and South Korea obtained substantially better results than other countries at the beginning of the epidemic due to their adoption of social distancing (1-2 m) with the additional use of masks and sanitization (city disinfection). These measures proved to be effective due to the atmosphere carrier potential of SARS-CoV-2 transmission. CONCLUSIONS: Our findings confirm that social distancing by 1-2 m with mask use and city disinfection yields positive outcomes. These strategies should be incorporated into prevention and control policies and be adopted both globally and by individuals as a method to fight the COVID-19 pandemic.


Subject(s)
Air Microbiology , COVID-19/prevention & control , COVID-19/transmission , Policy , COVID-19/epidemiology , China/epidemiology , Cities/epidemiology , Disinfection , Global Health , Humans , Masks , Physical Distancing , Policy Making , Republic of Korea/epidemiology , SARS-CoV-2
2.
Int J Environ Res Public Health ; 19(22)2022 Nov 13.
Article in English | MEDLINE | ID: covidwho-2110106

ABSTRACT

Although endeavours to protect mental well-being during the COVID-19 pandemic were taken at national and regional levels, e.g., mental support in school, a COVID-19 emergency toll-free number for psychological support, these were sporadic conjunctural financing interventions. In this Communication, the authors conducted a systematic search for programmatic and policy documents and reports with a solid literature and policy analysis concerning the main objective, which is to analyse the appropriateness in implementing gender- and age-sensitive, integrated, youth-centred mental health services in Italy. The Italian National Action Plan for Mental Health reports a highly fragmented situation in the Child and Adolescent Neuropsychiatry services, in terms of an integrated and comprehensive regional network of services for the diagnosis, treatment, and rehabilitation of neuropsychological disorders in young people. Wide-ranging interventions, systemic actions should be implemented, funded, and included in an overall structural strengthening of the healthcare system, including those dedicated to transition support services. In this context, the National Recovery and Resilience Plan (NRRP), may represent an opportunity to leverage specific funds for mental health in general, and for youth in particular. Finally, mental health service governance should be harmonized at both national and regional EU levels-with the adoption of best practices implemented by other Member States. This includes, among others, health information system and data collection, which is critical for analysing epidemiological trends and for monitoring and evaluating services, to offer a public and integrated system for the care and protection of young people, in line with the Convention on the Rights of the Child.


Subject(s)
COVID-19 , Mental Health Services , Child , Adolescent , Humans , Public Health , COVID-19/epidemiology , Pandemics , Policy Making
4.
Int J Environ Res Public Health ; 19(20)2022 Oct 21.
Article in English | MEDLINE | ID: covidwho-2093856

ABSTRACT

BACKGROUND: The World Health Organization identified climate change as the 21st century's biggest health threat. This study aimed to identify the current knowledge base, evidence gaps, and implications for climate action and health policymaking to address the health impact of climate change, including in the most underserved groups. METHODS: The Horizon-funded project ENBEL ('Enhancing Belmont Research Action to support EU policy making on climate change and health') organised a workshop at the 2021-European Public Health conference. Following presentations of mitigation and adaptation strategies, seven international researchers and public health experts participated in a panel discussion linking climate change and health. Two researchers transcribed and thematically analysed the panel discussion recording. RESULTS: Four themes were identified: (1) 'Evidence is key' in leading the climate debate, (2) the need for 'messaging about health for policymaking and behaviour change' including health co-benefits of climate action, (3) existing 'inequalities between and within countries', and (4) 'insufficient resources and funding' to implement national health adaptation plans and facilitate evidence generation and climate action, particularly in vulnerable populations. CONCLUSION: More capacity is needed to monitor health effects and inequities, evaluate adaptation and mitigation interventions, address current under-representations of low- or middle-income countries, and translate research into effective policymaking.


Subject(s)
Climate Change , Population Health , Public Health , Policy Making , World Health Organization
5.
Am J Public Health ; 112(S6): S615-S620, 2022 08.
Article in English | MEDLINE | ID: covidwho-2079887

ABSTRACT

This article uses a health stewardship perspective to interpret the strengths of and challenges to national health authorities' capacities to respond to the COVID-19 pandemic through the renewed essential public health functions (EPHF) framework. Based on a literature review, this article argues that the institutional capacities required by countries to respond to the COVID-19 pandemic in the Americas included all 4 stages of the new EPHF policy cycle: assessment, policy development, allocation of resources, and access. While health authorities provided these key functions (e.g., data analysis, intersectoral policy dialogues, allocation of additional funds), the interventions implemented depended on each country's own institutional structures. Health authorities faced significant challenges including fragmentation and the lack of institutional and personnel capacities, thus compromising the delivery of an effective and equitable response. In addition, the response to the pandemic has been uneven because of weaknesses in central leadership and coordination capacity, the politicization of the response, and differences in the capacity to respond at subnational levels. Such challenges reflect structural weaknesses that existed before the onset of the pandemic, as well as the low prioritization of public health in agendas for health systems strengthening. A future agenda should prioritize improving structural elements while strengthening the stewardship capacities of health authorities and developing institutional structures that guarantee access to and universal coverage of health services. (Am J Public Health. 2022;112(S6):S615-S620. https://doi.org/10.2105/AJPH.2022.306750).


Subject(s)
COVID-19 , Government Programs , Humans , Pandemics/prevention & control , Policy Making , Public Health
6.
Int J Environ Res Public Health ; 19(19)2022 Oct 09.
Article in English | MEDLINE | ID: covidwho-2066083

ABSTRACT

Policy is an important support for risk society to prevent and resolve crises. Based on the content analysis of the policy text and PMC-Index model, this paper takes texts of 327 public health emergency response policies (PHERP) at the central level in China from 1989 to 2022 as the analysis object, designs an indicator system, and combines qualitative and quantitative methods to evaluate the existing policies. The results of content analysis indicate that current policy focuses on emergency rather than preventive control, the main policy-making and issuing authority is the Ministry of Health and policies are mostly issued in the form of notice. The PMC-Index of ten selected policies is all ranked above acceptable, which means that the overall quality of policy text is relatively high. However, the PMC-Surface shows that there is still considerable variability in the scores of the main indicators for each policy. The top three main scoring indicators are policy nature, policy evaluation and policy instrument, while the bottom three are policy time, policy release agency and policy target groups, which reminds us that the design of policy text can still be improved in terms of optimizing policy time, policy issuing institutions and expanding policy target groups. In response to these problems, this paper puts forward six suggestions for optimization.


Subject(s)
Emergencies , Public Health , China , Health Policy , Humans , Policy Making , Public Policy
7.
PLoS One ; 17(9): e0270160, 2022.
Article in English | MEDLINE | ID: covidwho-2054311

ABSTRACT

Mask-wearing is the simplest yet most effective preventive behavior during COVID-19. However, it has sparked great controversy, particularly in America. Little is known about what psychosocial factors predict people's decision to mask. This research challenges three myths about mask-wearing. First, does mask-wearing provide a false sense of security? Second, is knowledge of COVID-19 a more robust predictor than political ideology of mask-wearing behavior? Third, does resistance to masks reflect anti-authoritarianism or a lack of trust in government? With nationally representative samples across two cultures (N = 1,121), findings reveal a significant positive correlation between mask-wearing and other preventive behaviors. Moreover, knowledge of COVID-19 and trust in government significantly predicted mask-wearing. Implications of the results are also discussed in the cross-cultural context. Critically, findings could provide practical implications for public education and policymaking by uncovering how to more effectively promote compliance with recommended preventive behaviors during our ongoing struggle with COVID-19.


Subject(s)
COVID-19 , COVID-19/prevention & control , Government , Humans , Knowledge , Policy Making , Trust
8.
Bull World Health Organ ; 100(9): 562-569, 2022 Sep 01.
Article in English | MEDLINE | ID: covidwho-2022470

ABSTRACT

With the onset of the coronavirus disease 2019 (COVID-19) pandemic, public health measures such as physical distancing were recommended to reduce transmission of the virus causing the disease. However, the same approach in all areas, regardless of context, may lead to measures being of limited effectiveness and having unforeseen negative consequences, such as loss of livelihoods and food insecurity. A prerequisite to planning and implementing effective, context-appropriate measures to slow community transmission is an understanding of any constraints, such as the locations where physical distancing would not be possible. Focusing on sub-Saharan Africa, we outline and discuss challenges that are faced by residents of urban informal settlements in the ongoing COVID-19 pandemic. We describe how new geospatial data sets can be integrated to provide more detailed information about local constraints on physical distancing and can inform planning of alternative ways to reduce transmission of COVID-19 between people. We include a case study for Nairobi County, Kenya, with mapped outputs which illustrate the intra-urban variation in the feasibility of physical distancing and the expected difficulty for residents of many informal settlement areas. Our examples demonstrate the potential of new geospatial data sets to provide insights and support to policy-making for public health measures, including COVID-19.


Avec l'apparition de la pandémie de maladie à coronavirus 2019 (COVID-19), des mesures de santé publique telles que la distanciation physique ont été mises en place afin de limiter la transmission du virus à l'origine de la maladie. Néanmoins, adopter la même approche dans toutes les régions sans tenir compte du contexte pourrait réduire l'efficacité de ces mesures et avoir des conséquences négatives imprévues, comme la perte des moyens de subsistance et l'insécurité alimentaire. Avant de planifier et de déployer des mesures utiles et adaptées à la situation en vue de ralentir la transmission au sein des communautés, il est impératif d'identifier les contraintes liées notamment aux lieux où la distanciation physique est impossible à respecter. Le présent document se concentre sur l'Afrique subsaharienne. Nous y avons présenté et évoqué les défis auxquels sont confrontés les habitants des implantations urbaines sauvages au cours de l'actuelle pandémie de COVID-19. Nous décrivons comment intégrer les nouveaux ensembles de données géospatiales pour obtenir des informations plus détaillées sur les contraintes locales liées à la distanciation physique et trouver des solutions alternatives permettant de limiter la transmission de la COVID-19 d'une personne à l'autre. Nous citons une étude de cas réalisée dans le comté de Nairobi, au Kenya, dont les résultats cartographiés illustrent les variations intra-urbaines qui déterminent la faisabilité de la distanciation physique et les difficultés que les habitants de nombreuses implantations sauvages sont susceptibles de rencontrer. Nos exemples révèlent le potentiel des nouveaux ensembles de données géospatiales dans l'analyse et l'élaboration des politiques et mesures de santé publique, y compris pour la COVID-19.


Con el inicio de la pandemia de la enfermedad por coronavirus de 2019 (COVID-19), se recomendaron medidas de salud pública como el distanciamiento físico para reducir la transmisión del virus causante de la enfermedad. Sin embargo, el mismo enfoque en todas las áreas, sin tener en cuenta el contexto, puede llevar a que las medidas sean de eficacia limitada y tengan consecuencias negativas imprevistas, como la pérdida de medios de vida y la inseguridad alimentaria. Un requisito previo para planificar y aplicar medidas eficaces y adecuadas al contexto para ralentizar la transmisión en la comunidad es conocer las limitaciones, como los lugares en los que no sería posible el distanciamiento físico. En este documento, centrado en el África subsahariana, se describen y discuten los desafíos a los que se enfrentan los residentes de los asentamientos urbanos informales en la actual pandemia de la COVID-19. Se describe cómo los nuevos conjuntos de datos geoespaciales pueden integrarse para proporcionar información más detallada sobre las limitaciones locales al distanciamiento físico y pueden informar la planificación de vías alternativas para reducir la transmisión de la COVID-19 entre las personas. Se incluye un estudio de caso del condado de Nairobi, Kenia, con resultados cartográficos que ilustran la variación intraurbana en la viabilidad del distanciamiento físico y la dificultad prevista para los residentes de muchas áreas de asentamientos informales. Los ejemplos que aquí se presentan demuestran el potencial de los nuevos conjuntos de datos geoespaciales para proporcionar información y apoyo a la elaboración de políticas sobre medidas de salud pública, entre ellas las relacionadas con la COVID-19.


Subject(s)
COVID-19 , Physical Distancing , COVID-19/epidemiology , Humans , Kenya/epidemiology , Pandemics/prevention & control , Policy Making
9.
BMJ Qual Saf ; 31(8): 561-564, 2022 08.
Article in English | MEDLINE | ID: covidwho-2020093
10.
Int J Environ Res Public Health ; 19(17)2022 Sep 02.
Article in English | MEDLINE | ID: covidwho-2010034

ABSTRACT

This study explores the institutional reasons for and logical mechanism of the Chinese government's rapid positive results and major strategic achievements in coronavirus disease 2019 (COVID-19) pandemic prevention and control. Based on the ROST Content Mining System version 6.0 (ROST) and VOSviewer V1.6.1 (VOSviewer), we conduct an econometric visualization analysis of COVID-19 pandemic prevention and control policies to explore which strengths of Chinese political institutions have been brought into play by the Chinese government and how to systematically analyze the approaches by which these strengths support effective public governance. The findings show that: (1) "institutional strength", "medical terminology", "policy content", "policy implementation object", "policy implementation requirement", and "policy-making and implementation actor" are the six groups of high-frequency keywords in prevention and control policies. (2) The occurrences, links, and total link strength of the seven Chinese institutional strength keywords are very high. These results mean that the Chinese government has made full use of its institutional strengths to prevent and control COVID-19. These findings indicate that institutional strengths are critical to public health crisis prevention and control. They also illustrate that institutional strength is the prerequisite and key factor for achieving effective governance in the policy process. Scientific policymaking, efficient policy implementation, and strict oversight are undeniably necessary for effective governance during public health crises.


Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , COVID-19/prevention & control , China/epidemiology , Humans , Pandemics/prevention & control , Policy , Policy Making
11.
BMJ Glob Health ; 7(8)2022 08.
Article in English | MEDLINE | ID: covidwho-2001827

ABSTRACT

BACKGROUND: While an estimated 70%-75% of the health workforce are women, this is not reflected in the leadership roles of most health organisations-including global decision-making bodies such as the World Health Assembly (WHA). METHODS: We analysed gender representation in WHA delegations of Member States, Associate Members and Observers (country/territory), using data from 10 944 WHA delegations and 75 815 delegation members over 1948-2021. Delegates' information was extracted from WHO documentation. Likely gender was inferred based on prefixes, pronouns and other gendered language. A gender-to-name algorithm was used as a last resort (4.6%). Time series of 5-year rolling averages of the percentage of women across WHO region, income group and delegate roles are presented. We estimated (%) change ±SE of inferred women delegation members at the WHA per year, and estimated years±SE until gender parity from 2010 to 2019 across regions, income groups, delegate roles and countries. Correlations with these measures were assessed with countries' gender inequality index and two Worldwide Governance indicators. RESULTS: While upwards trends could be observed in the percentage of women delegates over the past 74 years, men remained over-represented in most WHA delegations. Over 1948-2021, 82.9% of delegations were composed of a majority of men, and no WHA had more than 30% of women Chief Delegates (ranging from 0% to 30%). Wide variation in trends over time could be observed across different geographical regions, income groups and countries. Some countries may take over 100 years to reach gender parity in their WHA delegations, if current estimated trends continue. CONCLUSION: Despite commitments to gender equality in leadership, women remain gravely under-represented in global health governance. An intersectional approach to representation in global health governance, which prioritises equity in participation beyond gender, can enable transformative policymaking that fosters transparent, accountable and just health systems.


Subject(s)
Global Health , Leadership , Female , Health Workforce , Humans , Income , Male , Policy Making
12.
J Health Organ Manag ; ahead-of-print(ahead-of-print)2022 Jan 18.
Article in English | MEDLINE | ID: covidwho-1932033

ABSTRACT

PURPOSE: This illustrative case study describes and evaluates drivers of effective inter-organizational collaboration to mitigate the impact and spread of COVID-19 among homeless people in two cities in the Netherlands. The aims of this study are: (1) to explore the strategic and operational policy responses in two local integrated care settings at the start of the crisis, (2) to identify best policy practices and lessons learned. The authors interpret and evaluate the findings by combining insights from the population health management (PHM) and collaborative governance literature. DESIGN/METHODOLOGY/APPROACH: The authors describe and illustrate the experiences of two Dutch municipalities, Rotterdam and The Hague, in the early policy responses to sudden operational challenges around the impact of COVID-19 on homeless people as experienced by local decision-makers, medical doctors and clients. FINDINGS: The authors show that best policy practices revolve around (1) using data and risk stratification methods for identifying and targeting populations at-risk in local policy making, and (2) having an inter-organizational data sharing architecture in place ex ante. These two factors were clear prerequisites for tailor-made policy responses for newly-defined groups at risk with the existing and well-documented vulnerable population, and executing crisis-induced tasks efficiently. ORIGINALITY/VALUE: This paper is among the first to illustrate the potential of combining collaborative governance and PHM perspectives to identify key drivers of effective local governance responses to a healthcare crisis in an integrated care setting.


Subject(s)
COVID-19 , Delivery of Health Care, Integrated , Health Policy , Humans , Policy , Policy Making , SARS-CoV-2
14.
East Mediterr Health J ; 28(6): 459-460, 2022 06 29.
Article in English | MEDLINE | ID: covidwho-1924930
15.
Clin Geriatr Med ; 38(3): 605-620, 2022 08.
Article in English | MEDLINE | ID: covidwho-1914221

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has had strong adverse impacts on vulnerable populations, such as frail older adults. The success of COVID-19 vaccine development, together with extensive global public health efforts, has brought hope to the control of the COVID-19 pandemic. Nevertheless, challenges in COVID-19 vaccine development and vaccination strategies among older people remain. This article reviews vaccinations in older adults, compares COVID-19 vaccine platforms, the efficacy and safety of COVID-19 vaccines in frail older people in long-term care settings, and the challenges of COVID-19 vaccine development and policy making for vaccination strategies in older adults.


Subject(s)
COVID-19 , Vaccines , Aged , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Humans , Pandemics/prevention & control , Policy Making , Vaccination , Vaccine Development
16.
BMJ Glob Health ; 7(Suppl 3)2022 06.
Article in English | MEDLINE | ID: covidwho-1909734

ABSTRACT

Health research, innovation and knowledge management remain major priorities of the WHO's response to the COVID-19 pandemic. WHO's Eastern Mediterranean Regional Office (EMRO) supports priority research initiatives that address gaps in current knowledge regarding the COVID-19 pandemic. Through a specific call for proposals, 122 research proposals were received and reviewed in 2020, of which 17 were recommended for funding from eight countries. Ten countries in the region participated in the global solidarity trial to assess potential therapies for COVID-19. In addition, WHO advocated for early serological and epidemiological investigations ('COVID-19 Unity Studies') on the general population, healthcare workers, pregnant women and neonates, and extending technical, financial and material support for them.Starting in early 2020, scholarly articles on COVID-19 have been published in every issue of the Eastern Mediterranean Health Journal More than 6300 publications on COVID-19 were made available on the WHO knowledge management portal in the last year alone. WHO is also supporting countries in conducting studies to assess the field effectiveness of vaccines deployed nationally. To build and strengthen country capacities, regional webinars and intercountry meetings were conducted on research ethics, national health information systems and evidence-based health policy making. With support from WHO EMRO's new research and knowledge management pillar, countries in the region were well equipped to contribute to a global understanding of the novel virus's characteristics, as well as employ a national response based on informed evidence.


Subject(s)
COVID-19 , Female , Humans , Infant, Newborn , Knowledge Management , Pandemics/prevention & control , Policy Making , Pregnancy , World Health Organization
18.
Glob Health Promot ; 29(2): 3-4, 2022 06.
Article in English | MEDLINE | ID: covidwho-1902324
19.
Health Res Policy Syst ; 20(1): 67, 2022 Jun 18.
Article in English | MEDLINE | ID: covidwho-1896356

ABSTRACT

WHO promotes the use of research in policy-making to drive improvements in health, including in achieving Sustainable Development Goals such as tobacco control. The European Union's new €95 billion Horizon Europe research framework programme parallels these aims, and also includes commitments to fund economic evaluations. However, researchers often express frustration at the perceived lack of attention to scientific evidence during policy-making. For example, some researchers claim that evidence regarding the return on investment from optimal implementation of evidence-based policies is frequently overlooked. An increasingly large body of literature acknowledges inevitable barriers to research use, but also analyses facilitators encouraging such use. This opinion piece describes how some research is integrated into policy-making. It highlights two recent reviews. One examines impact assessments of 36 multi-project research programmes and identifies three characteristics of projects more likely to influence policy-making. These include a focus on healthcare system needs, engagement of stakeholders, and research conducted for organizations supported by structures to receive and use evidence. The second review suggests that such characteristics are likely to occur as part of a comprehensive national health research system strategy, especially one integrated into the healthcare system. We also describe two policy-informing economic evaluations conducted in Spain. These examined the most cost-effective package of evidence-based tobacco control interventions and the cost-effectiveness of different strategies to increase screening coverage for cervical cancer. Both projects focused on issues of healthcare concern and involved considerable stakeholder engagement. The Spanish examples reinforce some lessons from the global literature and, therefore, could help demonstrate to authorities in Spain the value of developing comprehensive health research systems, possibly following the interfaces and receptor model. The aim of this would be to integrate needs assessment and stakeholder engagement with structures spanning the research and health systems. In such structures, economic evaluation evidence could be collated, analysed by experts in relation to healthcare needs, and fed into both policy-making as appropriate, and future research calls. The increasingly large local and global evidence base on research utilization could inform detailed implementation of this approach once accepted as politically desirable. Given the COVID-19 pandemic, increasing the cost-effectiveness of healthcare systems and return on investment of public health interventions becomes even more important.


Subject(s)
COVID-19 , Pandemics , Cost-Benefit Analysis , Health Policy , Humans , Policy Making
20.
Soc Sci Med ; 306: 115140, 2022 08.
Article in English | MEDLINE | ID: covidwho-1886081

ABSTRACT

In this conceptual paper, we argue that at times of crisis, what is sometimes called "evidence-based" or "science-driven" policymaking-establishing scientific truths and then implementing them-must be tempered by a more agile, deliberative and inclusive approach which acknowledges and embraces uncertainty. We offer pragmatism as one potential option, using examples from the UK to illustrate how such an approach might have changed particular crisis decisions and led to better outcomes. We propose that to better prepare for the next public health crisis, five pragmatism-informed shifts are needed in the science-policy relationship: from scientism to science-informed narrative rationality that emerges from practice; from knowledge-then-action to acting judiciously under uncertainty; from hierarchies of evidence to pluralist inquiry; from polarized camps to frame-reflective dialogue; and from an "inside-track" science-policy dialogue to greater participatory democracy. We suggest an agenda for a pragmatist-informed program of applied research on crisis public health policymaking.


Subject(s)
Policy Making , Public Health , Humans , Knowledge , Policy , Uncertainty
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