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1.
Front Public Health ; 10: 801525, 2022.
Article in English | MEDLINE | ID: covidwho-1775999

ABSTRACT

This is a study of Political Economy, Law & Economics, and Public Choice, applied to COVID-19 crisis management, and how the Spanish healthcare sector has operated under stressful conditions. Market and state failures are evaluated and some improvements are offered, according to the theories of Austrian Economics and New-Institutional Economics. At the macro level, the premise is the decentralization of the Spanish healthcare system a long time ago, to provide a better service to citizens, according to the idiosyncrasies of the Autonomous Communities (similar to federal states). The crisis has evidenced the failures of the Spanish system and its semi-federal model, without coordination to manage the trouble. Also, the General Government's recentralization attempt has failed too, proving Mises's theorem on the impossibility of economic calculation in intervened and coactive systems, with problems of shortages, lack of coordination, etc.; Buchanan-Tullock's theorem on the unfinished agenda of state interventionist and it suppression of private sector was also proven. At the micro level, health institutions (hospitals and health centers) have fallen into the paradox of media overexposure and the fake-news risk, because the more information they have tried to transmit, the more confusion they have caused, reducing the value of the supposed transparency and accountability, in addition to decreasing citizen wellbeing, giving way to a higher level of dissatisfaction and more risk of a syndemic. To perform the analysis of accountability and wellbeing perceived, this paper has used quantitative contrast techniques on secondary sources, such as the surveys of Centro de Investigaciones Sociológicas (part of the Public Sector) or Merco rankings (independent institution).


Subject(s)
COVID-19 , Health Care Sector , Austria , COVID-19/epidemiology , Delivery of Health Care , Humans , Social Responsibility
2.
Front Public Health ; 10: 648593, 2022.
Article in English | MEDLINE | ID: covidwho-1775958

ABSTRACT

Surveillance programs supporting the management of One Health issues such as antibiotic resistance are complex systems in themselves. Designing ethical surveillance systems is thus a complex task (retroactive and iterative), yet one that is also complicated to implement and evaluate (e.g., sharing, collaboration, and governance). The governance of health surveillance requires attention to ethical concerns about data and knowledge (e.g., performance, trust, accountability, and transparency) and empowerment ethics, also referred to as a form of responsible self-governance. Ethics in reflexive governance operates as a systematic critical-thinking procedure that aims to define its value: What are the "right" criteria to justify how to govern "good" actions for a "better" future? The objective is to lay the foundations for a methodological framework in empirical bioethics, the rudiments of which have been applied to a case study to building reflexive governance in One Health. This ongoing critical thinking process involves "mapping, framing, and shaping" the dynamics of interests and perspectives that could jeopardize a "better" future. This paper proposes to hybridize methods to combine insights from collective deliberation and expert evaluation through a reflexive governance functioning as a community-based action-ethics methodology. The intention is to empower individuals and associations in a dialogue with society, which operation is carried out using a case study approach on data sharing systems. We based our reasoning on a feasibility study conducted in Québec, Canada (2018-2021), envisioning an antibiotic use surveillance program in animal health for 2023. Using the adaptive cycle and governance techniques and perspectives, we synthesize an alternative governance model rooted in the value of empowerment. The framework, depicted as a new "research and design (R&D)" practice, is linking operation and innovation by bridging the gap between Reflexive, Evaluative, and Deliberative reasonings and by intellectualizing the management of democratizing critical thinking locally (collective ethics) by recognizing its context (social ethics). Drawing on the literature in One Health and sustainable development studies, this article describes how a communitarian and pragmatic approach can broaden the vision of feasibility studies to ease collaboration through public-private-academic partnerships. The result is a process that "reassembles" the One Health paradigm under the perspective of global bioethics to create bridges between the person and the ecosystem through pragmatic ethics.


Subject(s)
Bioethical Issues , One Health , Humans , Public-Private Sector Partnerships , Social Responsibility
3.
Healthc Policy ; 17(3): 28-33, 2022 02.
Article in English | MEDLINE | ID: covidwho-1761266

ABSTRACT

Declining public trust in government and expert advice is a public health priority, given its impact on vaccination uptake, adherence to guidelines and social cohesion. In the context of the COVID-19 Vaccine Task Force, conflicts of interest that can threaten public trust are handled primarily through disclosures. However, this places the onus on the public to discern the relevance, severity and impact of these conflicts and does little to address whose interests guide decision making. Alternatively, expert advisory committees should adopt more trustworthy strategies, including promoting independence from commercial and political interests.


Subject(s)
COVID-19 Vaccines , COVID-19 , COVID-19/epidemiology , COVID-19/prevention & control , Conflict of Interest , Disclosure , Humans , Social Responsibility
4.
Int J Equity Health ; 21(Suppl 1): 41, 2022 03 25.
Article in English | MEDLINE | ID: covidwho-1759756

ABSTRACT

BACKGROUND: Recognition of the value of "social accountability" to improve health systems performance and to address health inequities, has increased over the last decades, with different schools of thought engaging in robust dialogue. This article explores the tensions between health policy and systems research and practice on the one hand, and health equity-focussed activism on the other, as distinct yet interacting processes that have both been impacted by the shock effects of the Covid-19 pandemic. This extended commentary brings multidisciplinary voices seeking to look back at health systems history and fundamental social-institutional systems' behaviors in order to contextualize these current debates over how best to push social accountability efforts forward. ANALYSIS: There is a documented history of tension between long and short processes of international health cooperation and intervention. Social accountability approaches, as a more recent strategy to improve health systems performance, intersect with this overarching history of negotiation between differently situated actors both global and local on whether to pursue sustained, slow, often community-driven change or to focus on rapid, measurable, often top-down interventions. Covid-19, as a global public health emergency, resulted in calls for urgent action which have unsurprisingly displaced some of the energy and aspiration for systemic transformation processes. A combination of accountability approaches and mechanisms have their own legitimacy in fostering health systems change, demanding collaboration between those that move both fast and slow, top-down and bottom-up. CONCLUSION: We argue that social accountability, much like all efforts to strengthen health systems, is "everybody's business" and that we must understand better the historical processes that have shaped the field of practice over time to move forward. These differences of perspective, knowledge-base and positioning vis-a-vis interventions or longer-term political commitment should not drive a conflict of legitimacy but instead be named, subsequently enabling the development of a shared code of conduct that applies to the breadth of actors involved in social accountability work. If we are concerned about the state of/status of social accountability within the context of "building back better" we must approach collaboration with a willingness to create dialogue across distinct disciplinary, technical and politically-informed ways of working.


Subject(s)
COVID-19 , Government Programs , Health Policy , Humans , Pandemics , Social Responsibility
5.
PLoS One ; 17(3): e0264145, 2022.
Article in English | MEDLINE | ID: covidwho-1736505

ABSTRACT

BACKGROUND: Vaccine uptake rates have been historically low in correctional settings. To better understand vaccine hesitancy in these high-risk settings, we explored reasons for COVID-19 vaccine refusal among people in federal prisons. METHODS: Three maximum security all-male federal prisons in British Columbia, Alberta, and Ontario (Canada) were chosen, representing prisons with the highest proportions of COVID-19 vaccine refusal. Using a qualitative descriptive design and purposive sampling, individual semi-structured interviews were conducted with incarcerated people who had previously refused at least one COVID-19 vaccine until data saturation was achieved. An inductive-deductive thematic analysis of audio-recorded interview transcripts was conducted using the Conceptual Model of Vaccine Hesitancy. RESULTS: Between May 19-July 8, 2021, 14 participants were interviewed (median age: 30 years; n = 7 Indigenous, n = 4 visible minority, n = 3 White). Individual-, interpersonal-, and system-level factors were identified. Three were particularly relevant to the correctional setting: 1) Risk perception: participants perceived that they were at lower risk of COVID-19 due to restricted visits and interactions; 2) Health care services in prison: participants reported feeling "punished" and stigmatized due to strict COVID-19 restrictions, and failed to identify personal benefits of vaccination due to the lack of incentives; 3) Universal distrust: participants expressed distrust in prison employees, including health care providers. INTERPRETATION: Reasons for vaccine refusal among people in prison are multifaceted. Educational interventions could seek to address COVID-19 risk misconceptions in prison settings. However, impact may be limited if trust is not fostered and if incentives are not considered in vaccine promotion.


Subject(s)
COVID-19/prevention & control , Prisoners/psychology , Vaccination Refusal/statistics & numerical data , Adult , Alberta , Attitude , British Columbia , COVID-19/epidemiology , COVID-19/virology , Delivery of Health Care , Humans , Interviews as Topic , Male , Middle Aged , Ontario , Risk , SARS-CoV-2/isolation & purification , Social Norms , Social Responsibility , Young Adult
6.
BMC Public Health ; 22(1): 469, 2022 03 09.
Article in English | MEDLINE | ID: covidwho-1736402

ABSTRACT

BACKGROUND: Combating viral outbreaks extends beyond biomedical and clinical approaches; thus, public health prevention measures are equally important. Public engagement in preventive efforts can be viewed as the social responsibility of individuals in controlling an infectious disease and are subjected to change due to human behaviour. Understanding individuals' perception of social responsibility is crucial and is not yet explored extensively in the academic literature. We adopted the grounded theory method to develop an explanatory substantive theory to illustrate the process of how individual responded to the outbreak from a social responsibility perspective. METHODS: In-depth interviews were conducted among 23 Malaysians either through telephone or face-to-face depending on the participant's preference. Both purposive and theoretical sampling were used. Participants were invited to share their understanding, perceptions and activities during the COVID-19 pandemic. They were further probed about their perceptions on complying with the public health interventions imposed by the authorities. The interviews were audio-recorded and transcribed verbatim. Data was analysed via open coding, focus coding and theoretical coding, facilitated by memoing, sketching and modelling. RESULTS: Study findings showed that, social responsibility is perceived within its role, the perceived societal role responsibility. In a particular context, an individual assumed only one of the many expected social roles with their perceived circle of responsibility. Individuals negotiated their actions from this perspective, after considering the perceived risk during the outbreak. The four types of behaviour depicted in the matrix diagram facilitate the understanding of the abstract concept of negotiation in the human decision-making process, and provide the spectrum of different behaviour in relation to public response to the COVID-19 pandemic. CONCLUSIONS: Our study adopted the grounded theory approach to develop a theoretical model that illustrates how individual response to COVID-19 preventive measures is determined by the negotiation between perceived societal role responsibility and perceived infection risk. This substantive theoretical model is abstract, thus has relevance for adoption within similar context of an outbreak.


Subject(s)
COVID-19 , Grounded Theory , Humans , Pandemics/prevention & control , SARS-CoV-2 , Social Responsibility
7.
Rev. Esc. Enferm. USP ; 56: e20210466, 2022.
Article in English, Portuguese | WHO COVID, LILACS (Americas) | ID: covidwho-1736588

ABSTRACT

ABSTRACT Objective: To implement and signify entrepreneurial interventions in Nursing, with a view to the social emancipation of women working in an Association of Recyclable Materials. Method: Action-research with an intervention process based on an action alluding to Mother's Day, carried out in a pandemic period, with the participation of 28 women from a Recycling Association. Results: The reflexive thematic analysis, which enabled the systematic recording of ideas, insights and the meanings of the intervention, gave rise to two categories: From apparent isolation to professional reinvention and from invisibility to dignity and the feeling of social equality. Conclusion: The interventions carried out in an Association of Recyclable Materials in a pandemic period provided, for its female workers, a sense of life, survival, dignity and empowerment, when they expected little or nothing. Enabling a social identity for the women of a Recycling Association implies, in short, overcoming linear interventions focused on assistance.


RESUMEN Objetivo: Implementar y significar intervenciones emprendedoras de Enfermería hacia la emancipación social de mujeres trabajadoras de una Asociación de Materiales Reciclables. Método: Se trata de una Investigación-acción, cuyo proceso de intervención tuvo como escenario una acción alusiva al Día de las Madres, en período pandémico, con la participación de 28 mujeres de una Asociación de Reciclaje. Resultados: Del análisis temático de tipo reflexivo, que permitió registrar sistemáticamente las ideas, las percepciones y el sentido de la intervención realizada, resultaron dos categorías: Del aislamiento aparente a la reinvención profesional y De la invisibilidad a la dignidad y al sentido de igualdad social. Conclusión: El significado de las intervenciones llevadas a cabo en una Asociación de Materiales Reciclables durante el período pandémico les dio a las mujeres/Madres trabajadoras un sentido de supervivencia, dignidad y empoderamiento a su vida cuando esperaban poco o nada. Brindar identidad social a mujeres de una Asociación de Reciclaje implica, en definitiva, superar las intervenciones lineales y asistencialistas.


RESUMO Objetivo: Implementar e significar intervenções empreendedoras de Enfermagem, com vistas à emancipação social de mulheres trabalhadoras de uma Associação de Materiais Recicláveis. Método: Pesquisa-ação, cujo processo de intervenção teve como cenário uma ação alusiva ao Dia das Mães, em período pandêmico, com a participação de 28 mulheres de uma Associação Recicláveis. Resultados: Da análise temática do tipo Reflexive, que possibilitou o registro sistemático de ideias, insights e a significação da intervenção realizada, resultaram duas categorias: Do aparente isolamento à reinvenção profissional e Da invisibilidade à dignidade e à sensação de igualdade social. Conclusão: O significado das intervenções realizadas em uma Associação de Materiais Recicláveis em período pandêmico significou, para as mulheres/Mães trabalhadoras, sentido de vida, sobrevivência, dignidade e empoderamento, quando pouco ou nada esperavam. Possibilitar uma identidade social às mulheres de uma Associação de Reciclagem implica, em suma, superar intervenções lineares e assistencialistas.


Subject(s)
Entrepreneurship , Community Health Nursing , Social Responsibility , Pandemics , COVID-19
9.
Lancet ; 399(10325): 626-627, 2022 02 12.
Article in English | MEDLINE | ID: covidwho-1683781
10.
Lancet Respir Med ; 9(10): 1097-1098, 2021 10.
Article in English | MEDLINE | ID: covidwho-1671352
13.
Scand J Public Health ; 49(7): 815-820, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1632133

ABSTRACT

AIM: Not only is the coronavirus pandemic about science and facts, it also raises a number of ethical questions. Some of the most important questions in this context are related to responsibility. First, what is a government's primary responsibility? Second, how should both the government and individuals consider personal moral responsibility in this context? METHOD: This paper uses conceptual and normative analysis to address responsibility in the context of the pandemic. The paper also refers to reports published by the German Ethics Council, the Malaysian Bioethics Community and the Swedish National Council on Medical Ethics. RESULTS: The primary responsibility of governments is to create a balance between individual values and rights, one hand, and the health of the population, on the other. There are good reasons to conceive of individual responsibility as a virtue, having to do with the development of crucial character traits and habits. The responsibility of governments is connected to individual responsibility through the values of trust and solidarity. CONCLUSIONS: Governments need to communicate clearly (a) how they balance conflicts between collective health and individual rights and values and (b) what the chosen strategy entails in terms of collective and individual responsibility. Success requires attention to ethical values from all involved. Individuals will need to develop new character traits to help manage this pandemic and to prevent new ones. Governments must facilitate the development of such character traits by building trust and solidarity with and among citizens.


Subject(s)
Bioethics , Coronavirus , Government , Humans , Morals , Pandemics/prevention & control , Social Responsibility
14.
BMJ Glob Health ; 7(1)2022 01.
Article in English | MEDLINE | ID: covidwho-1622049

ABSTRACT

WHO launched the Good Governance for Medicines (GGM) programme in 2004 with the aim of fighting the problem of corruption in the pharmaceutical sector. Zimbabwe adopted the GGM programme in 2015 and developed its own implementation framework (GGM-IF) in 2017 based on the WHO global guidelines and recommendations. Zimbabwe's GGM-IF emerged from; (1) home-based expertise, (2) extensive local consultations and (3) effective incorporation into existing institutions. The GGM-IF committed to implementing a focused programme over a 5-year period from 2017 to 2022 with the expressed goal of improving transparency and accountability in the pharmaceutical sector as a key enabler to improve access to medicines. Midway through its projected lifespan, some notable achievements materialised attributed to key success drivers, including mutual collaboration with the Ministry of Health and Child Care's existing Global Fund supported Quality Assurance Programme. Key challenges faced include limited funding for the programme, a shifting policy environment driven by a political transition and reorientation of priorities in the wake of the COVID-19 pandemic. This manuscript articulates 3-year operationalisation of Zimbabwe's GGM-IF highlighting the success drivers, implementation challenges and lessons learnt.


Subject(s)
COVID-19 , Pandemics , Humans , SARS-CoV-2 , Social Responsibility , Zimbabwe
18.
J Prof Nurs ; 38: 97-103, 2022.
Article in English | MEDLINE | ID: covidwho-1591877

ABSTRACT

Publishing is a measure of faculty performance, yet barriers often include getting started, time management, and difficulty finishing. Manuscript submissions also lack deadlines, which creates additional challenges. Writing accountability groups (WAGs) are associated with increased faculty writing productivity. The purpose of this paper is to provide an overview of WAGs, including the process, participants, writing productivity outcomes, benefits, challenges, and unintended consequences. To maintain our writing progress during the COVID-19 pandemic, we moved our WAG sessions to a virtual platform. Our WAG protocol (both face-to-face and virtual) is shared to help other faculty members or doctoral students implement writing accountability groups. We also advocate for hybrid WAG sessions to promote attendance. In addition to facilitation of scholarly writing and improved writing habits, our WAG created opportunities for scholarly communication and networking with colleagues.


Subject(s)
COVID-19 , Pandemics , Faculty , Humans , SARS-CoV-2 , Social Responsibility , Writing
19.
Am J Phys Med Rehabil ; 101(1): 53-60, 2022 01 01.
Article in English | MEDLINE | ID: covidwho-1574749

ABSTRACT

ABSTRACT: The COVID-19 pandemic has propelled an unprecedented global implementation of telemedicine and telerehabilitation as well as its integration into the healthcare system. Here, we describe the clinical implementation of the A3E framework for the deployment of telerehabilitation in the inpatient and outpatient rehabilitation continuum by addressing accessibility, adaptability, accountability, and engagement during the COVID-19 pandemic. By using an organized, coordinated, and stratified approach, we increased our telerehabilitation practice from 0 to more than 39,000 visits since the pandemic began. Learning from both the successes and challenges can help address the need to increase access to rehabilitation services even beyond the COVID-19 pandemic.


Subject(s)
COVID-19/epidemiology , Health Services Accessibility , Pandemics , Telerehabilitation/methods , Humans , SARS-CoV-2 , Social Responsibility , United States/epidemiology
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