Best practice transfer by public health nurses in Japan: actual conditions and related factors.

BACKGROUND: The workload of public health nurses (PHNs) working for local governments has been increasing as health issues become more diverse and complicated. Even amidst the ongoing administrative and fiscal reforms, there is an urgent need to ensure how effectively and efficiently public health nurses can practice in health service development. The objective of this research was to clarify the actual conditions of best practice transfer (BPT) and its related factors. METHODS: An anonymous postal and self-administered questionnaire survey was conducted among PHNs working at 334 sites, including the local government offices and health centers across Japan, and analysed mainly through logistic regression analysis. RESULTS: One hundred eighty-five of the 334 institutions (55.4%) agreed to participate, and of the 966 questionnaire forms distributed, 709 forms (73.4%) were collected, of which 702 responses (72.7%) were valid. Although less than half (43.2%) have experience in BPT in health service development, more than 80% are willing to perform going forward. Significant factors for both the group with experience in BPT and the group with willingness to perform include an organizational culture that promotes BPT, as well as multiple elements of the workplace environment and facilitating factors related to knowledge and learning. The experienced group recognised the needs for criteria to evaluate the adaptability of best practice, while the willing group, to evaluate the quality of practice. CONCLUSIONS: Through a nationwide survey, this research elucidated for the first time the actual conditions of BPT by PHNs in Japan and related factors. The results indicated the importance of developing a system to promote BPT at the workplace level, also highlighted the importance for practitioners and experts, including researchers, to work together to develop practical guidelines to ensure evidence-based practices. Urgent actions are needed for the national and local governments to develop a system to promote BPT from diverse perspectives, building on the findings of this research.

Phthalates and substitute plasticizers: Main achievements from the European human biomonitoring initiative HBM4EU.

Phthalates and the substitute plasticizer DINCH belong to the first group of priority substances investigated by the European Human Biomonitoring Initiative (HBM4EU) to answer policy-relevant questions and safeguard an efficient science-to-policy transfer of results. Human internal exposure levels were assessed using two data sets from all European regions and Israel. The first collated existing human biomonitoring (HBM) data (2005-2019). The second consisted of new data generated in the harmonized "HBM4EU Aligned Studies" (2014-2021) on children and teenagers for the ten most relevant phthalates and DINCH, accompanied by a quality assurance/quality control (QA/QC) program for 17 urinary exposure biomarkers. Exposures differed between countries, European regions, age groups and educational levels. Toxicologically derived Human biomonitoring guidance values (HBM-GVs) were exceeded in up to 5% of the participants of the HBM4EU Aligned Studies. A mixture risk assessment (MRA) including five reprotoxic phthalates (DEHP, DnBP, DiBP, BBzP, DiNP) revealed that for about 17% of the children and teenagers, health risks cannot be excluded. Concern about male reproductive health emphasized the need to include other anti-androgenic substances for MRA. Contaminated food and the use of personal care products were identified as relevant exposure determinants paving the way for new regulatory measures. Time trend analyses verified the efficacy of regulations: especially for the highly regulated phthalates exposure dropped significantly, while levels of the substitutes DINCH and DEHTP increased. The HBM4EU e-waste study, however, suggests that workers involved in e-waste management may be exposed to higher levels of restricted phthalates. Exposure-effect association studies indicated the relevance of a range of endpoints. A set of HBM indicators was derived to facilitate and accelerate science-to-policy transfer. Result indicators allow different groups and regions to be easily compared. Impact indicators allow health risks to be directly interpreted. The presented results enable successful science-to-policy transfer and support timely and targeted policy measures.

Cross-domain policy adaptation with dynamics alignment.

The implementation of robotic reinforcement learning is hampered by problems such as an unspecified reward function and high training costs. Many previous works have used cross-domain policy transfer to obtain the policy of the problem domain. However, these researches require paired and aligned dynamics trajectories or other interactions with the environment. We propose a cross-domain dynamics alignment framework for the problem domain policy acquisition that can transfer the policy trained in the source domain to the problem domain. Our framework aims to learn dynamics alignment across two domains that differ in agents' physical parameters (armature, rotation range, or torso mass) or agents' morphologies (limbs). Most importantly, we learn dynamics alignment between two domains using unpaired and unaligned dynamics trajectories. For these two scenarios, we propose a cross-physics-domain policy adaptation algorithm (CPD) and a cross-morphology-domain policy adaptation algorithm (CMD) based on our cross-domain dynamics alignment framework. In order to improve the performance of policy in the source domain so that a better policy can be transferred to the problem domain, we propose the Boltzmann TD3 (BTD3) algorithm. We conduct diverse experiments on agent continuous control domains to demonstrate the performance of our approaches. Experimental results show that our approaches can obtain better policies and higher rewards for the agents in the problem domains even when the dataset of the problem domain is small.

Policy communities, devolution and policy transfer: The case of alcohol pricing in Wales.

This study investigates how processes of horizontal policy transfer can unfold in the context of devolution, examining the development of legislation on minimum unit pricing (MUP) in Wales, following on from Scotland's earlier policy decision. The study draws on a range of sources, including primary documents, media coverage, and interviews with policy participants. Our analysis identifies the importance of the specific character of Welsh political institutions, particularly the emphasis given to participation and consultation in policymaking. In the case of MUP, we document a process of policy-oriented learning, where policymakers made a concerted effort to draw on an assortment of expertise and experiences, including but not limited to the Scottish model. We also find that the Welsh public health policy community was well placed to support the framing of MUP and to address limitations in policy capacity. The findings hold implications for future studies of learning, devolution, and alcohol policy more generally.

Accreditation of primary health care centres in the KSA: Lessons from developed and developing countries.

Background/Objectives: In 2013, the KSA made Central Board for Accreditation of Healthcare Institutions (CBAHI) accreditation mandatory for all healthcare facilities, including primary health care centres (PHCs) and set a target to have 502 PHCs accredited by 2020. However, there is a real gap in knowledge and research on the impact of CBAHI accreditation on PHCs. This absence of research has been linked to the lack of understanding of the accreditation programme. Therefore, it was recommended by scholars that the KSA could learn from the experience of other countries to improve policy implementation and avoid future complications. Methods: This study aimed to explore lessons that KSA can draw from developed and developing countries that have implemented accreditation programmes for PHCs. We performed a literature review using a systematic approach to identify articles related to the accreditation of PHCs. The identified articles were examined by applying evaluation criteria in respect of prospective policy transfer. Results: The research results yielded 22 publications from different countries. There were variations among the countries in the specific information acquired. However, Denmark had the highest number of articles providing detailed information. Regarding their aims, most studies shared the same goal of improving quality and patient safety. Generally, there was limited discussion of policy failure compared with policy success. In addition, most of the countries were in the process of implementing local accreditation. Almost all of the countries that had implemented external programmes were developing countries. In terms of application criteria, most cases made recommendations for the programme or for PHCs. Conclusion: Analysis indicated that because of the differences in information between countries and settings, there is no ideal country-based experience from which the KSA can transfer lessons. Lessons from outside the KSA would need careful consideration when adopting them in the local context of the Kingdom.

Design, adoption and implementation of electronic waste policies in India.

Globally, E-waste is experiencing an unprecedented growth in the recent years. This growth will be fueled further by the COVID-19 pandemic owing to the new work culture where people are becoming more dependent on their electronic products than ever before. However, governance of E-waste, particularly in the Global South, has been a complex phenomenon. Considering this, the current study attempted to assess the design, adoption, and implementation of E-waste policies in India-a major electronics manufacturing hub with a massive consumer electronics market. Taking hints from theoretical concepts such as policy transfer, policy convergence, and policy effectiveness, the study addressed the primary research question: why India adopts E-waste policy approaches that seem inadequate and ineffective in its local contexts and attempts to identify alternative approaches. Through expert interviews and policy document analysis, it was observed that E-waste policy approaches in India are largely influenced by the European Union's Waste Electrical and Electronic Equipment (WEEE) Directive. All the experts interviewed recognized absence of the informal sector in India's policy efforts of both 2011 and 2016 as a significant lacuna in the country's E-waste policy responses. In this paper, the author argues that there should be policy change towards a healthy collaboration between the informal and formal sector where best-of-the-two-worlds could be wisely used for sustainable E-waste governance in India.

AHSCs as Health Policy Transfer: Some Emergent Evidence From Australia Comment on "Academic Health Science Centres as Vehicles for Knowledge Mobilisation in Australia? A Qualitative Study".

This commentary discusses Edelman et al 2020's recent exploratory study of the early development of 4 Academic Health Services Centres (AHSCs) in Australia. AHSCs were originally invented in the United States, but have then diffused to the United Kingdom and Canada over the last decade or so and now to Australia so they are a good example of health policy transfer. They are dedicated to advancing more speedy knowledge translation (KT)/mobilization ('from bench to bedside') and also the more effective commercialization of scientific inventions. The commentary argues some interesting if preliminary findings are identified in their study. Its limitations will also be considered. Finally, suggestions for future research are made, including more cross national and comparative studies.

How are global health policies transferred to sub-Saharan Africa countries? A systematic critical review of literature.

BACKGROUND: Most sub-Saharan Africa countries adopt global health policies. However, mechanisms with which policy transfers occur have largely been studied amongst developed countries and much less in low- and middle- income countries. The current review sought to contribute to literature in this area by exploring how health policy agendas have been transferred from global to national level in sub-Saharan Africa. This is particularly important in the Sustainable Development Goals (SDGs) era as there are many policy prepositions by global actors to be transferred to national level for example the World Health Organization (WHO) policy principles of health financing reforms that advance Universal Health Coverage (UHC). METHODS: We conducted a critical review of literature following Arksey and O'Malley framework for conducting reviews. We searched EBSCOhost, ProQuest, PubMed, Scopus, Web of Science and Google scholar for articles. We combined the concepts and synonyms of "policy transfer" with those of "sub-Saharan Africa" using Boolean operators in searching databases. Data were analyzed thematically, and results presented narratively. RESULTS: Nine articles satisfied our eligibility criteria. The predominant policy transfer mechanism in the health sector in sub-Saharan Africa is voluntarism. There are cases of coercion, however, even in the face of coercion, there is usually some level of negotiation. Agency, context and nature of the issue are key influencers in policy transfers. The transfer is likely to be smooth if it is mainly technical and changes are within the confines of a given disease programmatic area. Policies with potential implications on bureaucratic and political status quo are more challenging to transfer. CONCLUSION: Policy transfer, irrespective of the mechanism, requires local alignment and appreciation of context by the principal agents, availability of financial resources, a coordination platform and good working relations amongst stakeholders. Potential effects of the policy on the bureaucratic structure and political status are also important during the policy transfer process.

Why and How Have Korean Cities Embraced the World Health Organization's Age-Friendly Cities and Communities Model?

This study examined forces leading Korean cities to join the WHO Global Network of Age-Friendly Cities and Communities (AFCC) and implement the WHO guidelines, from the perspectives of multiple streams theory and policy transfer theory. We conducted interviews with stakeholders from six member cities and identified relevant themes using directed content analysis. Political motivation was the strongest factor in seeking Network membership, but the lack of political motivations after gaining membership resulted in lackluster local implementation efforts. The national capital cities may need to take a stronger leadership role to encourage the expansion of the WHO AFCC Network in Asia.

Born in the USA? A Comparison of "Inspired" Health Care Reforms in Germany and France.

CONTEXT: Despite numerous examples of health policy transfer in Western health systems, the nature of such "inspired" reforms has received little detailed attention. The aim of this article is to apply and refine a specific theoretical angle for the analysis of these reforms using the theoretical frameworks of transfer and translation. METHODS: The design is based on a comparative case study: the introduction of disease management programs (DMPs) for diabetes in Germany in 2002 and in France in 2008, drawing on a literature review and semistructured interviews. FINDINGS: In introducing its DMP, Germany chose and combined several components in a process of selective borrowing, while France opted for copying a specific foreign program and adapting it. Such differences in process are linked to distinct system structures, in particular the setup of health insurance and the representation of physicians. Furthermore, the displayed versus actual degree of inspiration varied significantly, with a branding strategy in Germany (high display of foreign influence) and the inverse picture in France (high degree of actual inspiration). CONCLUSIONS: This analysis has applied the dual perspective of transfer and translation. Both perspectives proved complementary and necessary, and translation appeared as a main determinant of implementation success.

Explaining Brazil as a rising state, 2003‒2014: the role of policy diffusion as an international regulatory instrument.

In this paper, we examine Brazil's international activism and ascent to the status of rising state during the presidencies of Luiz Inácio Lula da Silva (2003-2010) and his chosen successor, Dilma Rousseff (2011-2014). We focus on the dissemination of social policies under an innovative model of development that reflected the political and economic context of a developing country. We argue that this activism was framed in terms of Brazil's socio-economic and cultural peculiarities, whereby these were treated not as obstacles but as positive contributions to developing states' attempts to reform global governance structures. We argue that this reflects an alternative form of foreign policy politicisation in which the social dilemmas, particularities and contradictions of the Brazilian experience are incorporated in the foreign policy agenda to leverage its international stature as a rising state. We explain how Brazil's international cooperation through transferring its public policies and development models (policies for fighting hunger and poverty, agrarian development and income generation) to its Southern partners has been discursively articulated as representing Brazil's normative potential to contribute to political and institutional solutions, and rebuild norms and standards that affect the distribution of international power and wealth.

What does Bill Gates' call mean? A policy transfer analysis on creating an early warning system to prevent the next pandemic.

OBJECTIVES: The purpose of this study is to discuss the need for an early warning system in order to prevent a new epidemic that may occur in the future and, if necessary, which system will be and how this warning system will be designed. METHODS: A qualitative analysis through the World Health Organization (WHO) documents, an interview with a key expert, and a policy transfer analysis was conducted. RESULTS: An early warning system is needed for new outbreaks that may occur in the future. We have seen that the Early Warning Alert and Response system (EWARs), which is implemented by WHO as a policy transfer in Syria, is successful in this area and the system can be easily adapted and established. The implementation of the system in Syria and the successful performance of the early warning system can be systematically transferred to other regions of the world with the policy transfer approach as a public health policy and the implementation phases in the study. The successful transfer of EWARs from WHO to Syria provides a good sample for the integration of a system developed by international and/or non-governmental organizations into an administration system of a state under pandemic and crises conditions.

Educação permanente em saúde na transferência da política do tratamento diretamente observado da tuberculose: uma abordagem de métodos mistos / Permanent health education in the transfer of the policy of directly observed treatment of tuberculosis: a mixed methods approach

Este estudo objetivou analisar as contribuições da Educação Permanente em Saúde na transferência da Política de Controle da Tuberculose. Trata-se de uma pesquisa de métodos mistos, do tipo paralelo convergente, realizada em dois municípios do interior de Minas Gerais. Foram utilizados dados quantitativos provenientes da aplicação do instrumento: "Avaliação da Transferência de Políticas - Inovação, Informação e Conhecimento em Tuberculose". Os dados qualitativos foram obtidos por meio da aplicação de entrevistas semidirigidas aos coordenadores municipais e profissionais de referência das equipes do Programa de Controle da Tuberculose, e os resultados foram organizados no software ATLAS.ti 6. Na etapa quantitativa participaram os profissionais de saúde de nível médio e superior das equipes de Atenção Primária à Saúde, 2. A coleta de dados ocorreu no período entre fevereiro de 2020 a fevereiro de 2021. Empregou-se, a fusão da análise dos dados para comparar os resultados, sendo adotada a mostra conjunta, com a adoção de categorias para a análise dos dados. Para o tratamento dos elementos quantitativos foi realizada a análise de estatísticas descritiva e multivariada, sendo utilizados o software Statistical Package for Social Sciences versão 24, e o software Statistica 7, da Statsoft.Inc. A análise dos elementos quantitativos foi realizada à luz do referencial teórico-metodológico da Análise de Discurso. A pesquisa atendeu a Resolução número 466/2012 do Conselho Nacional de Saúde. Participaram da etapa quantitativa 202 pessoas, destas 26,2% eram técnicos em Enfermagem, 51,5% enfermeiros, e 22,3% médicos; sendo 58,9% do "município 1" e 41,1% do "município 2". Na etapa qualitativa participaram cinco enunciadores. Os dados quantitativos foram organizados de acordo o domínio geral da Educação Permanente em Saúde e os subdomínios "ações da gestão para a equipe/unidade de saúde", "ações da equipe/unidade de saúde", "ações individuais do profissional e estratégias/ferramentas educativas". Identificou-se um melhor desempenho nas variáveis sobre a liberação da equipe para as ações de capacitação e treinamentos, reconhecimento da equipe sobre a importância do Tratamento Diretamente Observado e sobre a adoção das diretrizes do Tratamento Diretamente Observado. Já, as variáveis com desempenho inferior foram as relacionadas à frequência dos treinamentos oferecidos pelo Programa de Controle da Tuberculose, e o oferecimento de treinamentos aos profissionais recém-contratados. Os resultados qualitativos foram organizados em famílias temáticas. Os resultados da mostra conjunta possibilitaram a apresentação em três categorias: "o campo de interação entre o Programa Municipal de Controle de Tuberculose e as equipes de Atenção Primária à Saúde", "Atenção Primária e a gestão do cuidado: Tratamento Diretamente Observado e o controle da Tuberculose" e "Manifestação da Educação Permanente em Saúde: o que evidenciam as equipes e o que dizem os profissionais dos Programa Municipal de Controle de Tuberculose". Este estudo corrobora e oferece subsídio para o reconhecimento do protagonismo da Atenção Primária à Saúde na gestão do cuidado e controle da Tuberculose, e confirma a Educação Permanente em Saúde como instrumento para a efetivação da transferência dessa política. Assim a Educação Permanente em Saúde pode se valer da Educação Continuada, assim como ocorre no cotidiano, sustentada pela micropolítica do trabalho e interação na roda

This study aimed to analyze the contributions of Permanent Health Education in the transfer of Tuberculosis Control Policy. This is a mixed-methods research, of the convergent parallel type, carried out in two municipalities in the interior of Minas Gerais. Quantitative data from the application of the instrument "Evaluation of Policy Transfer - Innovation, Information and Knowledge in Tuberculosis" were used. Qualitative data was obtained through the application of semi-directed interviews to municipal coordinators and reference professionals of the Tuberculosis Control Program teams, and the results were organized in the software ATLAS.ti 6.. In the quantitative stage, the participation of middle and upper level health professionals from Primary Health Care teams, 2. Data collection occurred in the period between February 2020 and February 2021. The fusion of data analysis was used to compare the results, with the adoption of categories for data analysis. For the treatment of the quantitative elements, the analysis of descriptive and multivariate statistics was performed, using the Statistical Package for Social Sciences software version 24, and the Statistica 7 software, from Statsoft.Inc. The analysis of the quantitative elements was conducted in light of the theoretical and methodological framework of Discourse Analysis. The research met the Resolution number 466/2012 of the National Health Council. In the quantitative stage 202 people participated, 26.2% were nursing technicians, 51.5% nurses, and 22.3% physicians; 58.9% from "municipality 1" and 41.1% from "municipality 2". In the qualitative stage, five enunciators participated. The quantitative data were organized according to the general domain of Continuing Health Education and the subdomains "management actions for the team/health unit", "team/health unit actions", individual professional actions", and "educational strategies/tools". A better performance in the variables about the release of staff for capacity building and training actions, staff recognition about the importance of Directly Observed Treatment and about the adoption of Directly Observed Treatment guidelines was identified. The variables with lower performance were those related to the frequency of training offered by the Tuberculosis Control Policy., and the offering of training to newly hired professionals. The qualitative results were organized into thematic families. The results of the joint exhibition allowed the presentation in three categories: "the field of interaction between the Municipal Tuberculosis Control Program and the Primary Health Care teams", "Primary Health Care and the management of care: Directly Observed Treatment and Tuberculosis control", and "Manifestation of Continuing Education in Health: what the teams evidence and what the professionals from the Municipal Tuberculosis Control Program "say". This study corroborates and offers subsidies for the recognition of the protagonism of Primary Health Care in the management of care and control of Tuberculosis, and confirms the Permanent Health Education as an instrument for the effective transfer of this policy. Thus, Permanent Health Education can draw on Continuing Education, as it occurs in everyday life, supported by the micropolitics of work and interaction in the wheel

International transfer and translation of an end of life care intervention: the case of the Liverpool Care Pathway for the dying patient.

We explore how and why the Liverpool Care Pathway (LCP) for the dying patient was transferred to 20 countries beyond the UK, and with what consequences for policy and practice. Our paper synthesises findings from 95 publications contained in a historical narrative literature review on the implementation of the LCP outside the United Kingdom, alongside data from 18 qualitative interviews with 19 key actors involved with the LCP in 14 countries. We use the review to explore the timelines and patterns of development and implementation in the specific countries, to consider what forms of research and evaluation about the LCP were undertaken to establish its effectiveness, and to summarise the resulting findings and their consequences. We use the interviews to gain insights into the elements, processes and dynamics that shaped the transfer and translation of the LCP from one location to another, across national boundaries. Using six questions from the policy transfer literature we then explain who were the key actors involved; what was transferred; from where lessons were drawn; the different degrees of transfer that took place; what restricted or facilitated transfer; and how transfer was related to 'success' or 'failure'. We conclude that the spread of the LCP took place mostly in prosperous countries, and was sustained over around 15 years.  It took in differing geographies and cultures, and a variety of linguistic, policy and practice contexts. If it did not succeed in a wider transformational goal, it appears to have been well received and perceived as beneficial in many contexts, largely avoiding accusations of mis-use and harm that had occurred in the UK, and in some cases fostering a sustained international collaboration and ongoing use of local variants, even after withdrawal in its country of origin in 2014.

Experiences With Health Care Services in Switzerland Among Immigrant Women With Chronic Illnesses.

Introduction: Descriptive data indicate a high burden of chronic illness among immigrant women in Switzerland. Little is known about how immigrant women with chronic illnesses experience healthcare services. This paper presents a methodological approach theoretically informed by Sen's capability approach and Levesque's framework of access to healthcare to study patient-reported experiences (PREs) of Swiss healthcare services among immigrant women with chronic conditions. Methods: We conducted 48 semi-structured qualitative interviews in Bern and Geneva with Turkish (n = 12), Portuguese (n = 12), German (n = 12), and Swiss (n = 12) women. Participants were heterogenous in age, length of stay, SES, and educational attainment, illness types and history. We also conducted semi-structured interviews with healthcare and social service providers (n = 12). Interviewed women participated in two focus group discussions (n = 15). Interviews were transcribed verbatim and analyzed using Atlas.ti software, based on Gale et al.'s framework approach. Findings informed three stakeholder dialogues in which women as well as healthcare providers and policymakers from various territorial levels participated. Results: Our methodological approach succeeded in integrating women's perspectives-from initial data collection in interviews to identify issues, focus group discussions to increase rigor, and stakeholder dialogues to develop tailored recommendations based on PREs. Discussion: This is one of the first studies in Switzerland that used PREs to research healthcare services and healthcare needs among immigrant women with chronic illnesses. This paper provides new insights on how to better understand existing challenges and potentially improve access to and quality of care.

The national implementation of 'Proactive Health Support' in Denmark since 2017: Expectations and challenges for the telephone-based self-management program.

In Denmark, as in many other Western countries, a small group of people are major hospital users and account for a large proportion of health care spending. Proactive Health Support (PaHS) is the first national Danish program that aims to reduce health care consumption targeting people at risk of becoming major users of health services. PaHS was part of the government's The sooner-the better national health policy, which includes a focus on policy programs targeting the weakest and most complex chronic patients at risk of high health care consumption. PaHS is a telephone-based self-management support program that uses a prediction model to identify people at high risk of acute hospital admissions. Reducing preventable hospital admissions and enhancing quality of life are central policy goals. The Danish policy was inspired by a Swedish policy program, and PaHS has been implemented based on policy transfer with political expectations that the Swedish results can be replicated in Denmark. The effects of PaHS are currently under study, and time will show whether expectations can be met. This paper discusses institutional conditions and expectations related to replicating a policy program and its outcomes. In addition, it highlights implementation issues that may affect the success of the policy program.

The development of hospital accreditation in low- and middle-income countries: a literature review.

Hospital accreditation has been transferred from high-income countries (HICs) to many low- and middle-income countries (LMICs), supported by a variety of advocates and donor agencies. This review uses a policy transfer theoretical framework to present a structured analysis of the development of hospital accreditation in LMICs. The framework is used to identify how governments in LMICs adopted accreditation from other settings and what mechanisms facilitated and hindered the transfer of accreditation. The review examines the interaction between national and international actors, and how international organizations influenced accreditation policy transfer. Relevant literature was found by searching databases and selected websites; 78 articles were included in the analysis process. The review concludes that accreditation is increasingly used as a tool to improve the quality of healthcare in LMICs. Many countries have established national hospital accreditation programmes and adapted them to fit their national contexts. However, the implementation and sustainability of these programmes are major challenges if resources are scarce. International actors have a substantial influence on the development of accreditation in LMICs, as sources of expertise and pump-priming funding. There is a need to provide a roadmap for the successful development and implementation of accreditation programmes in low-resource settings. Analysing accreditation policy processes could provide contextually sensitive lessons for LMICs seeking to develop and sustain their national accreditation programmes and for international organizations to exploit their role in supporting the development of accreditation in LMICs.

The movement and translation of drug policy ideas: The case of 'new recovery'.

INTRODUCTION: 'New recovery' can be conceptualised as both a social movement and a broader policy agenda to restructure treatment service systems towards 'recovery-oriented systems of care'. Emerging initially out of the United States, new recovery has gained currency as a policy agenda in other jurisdictions - perhaps most distinctly in the United Kingdom. In 2012, the ideas behind 'new recovery' were debated in the Australian alcohol and other drug field as the Victorian government sought to incorporate recovery principles into policy and service design. This paper uses the policy transfer and policy translation literature to understand how international policy ideas about 'new recovery' were negotiated in the Australian context, focusing specifically on the role of non-government actors in the process. METHODS: This paper draws on an analysis of policy documents, organisational documents and interviews with representatives from the Australian non-government alcohol and other drug sector to consider how new recovery was translated into Victorian drug policy. RESULTS: The interactions between organisations and actors - including bureaucrats, governmental agencies and policy entrepreneurs - facilitated the circulation and translation of policy ideas in the Victorian context. Despite this, the analysis suggests that policy transfer was largely a symbolic exercise: overall, some of the key features of new recovery policy from the United States and the United Kingdom, such as encouraging peer-led recovery and mutual aid, were not incorporated in the Victorian policy. NGOs resisted what they considered to be some of the more problematic elements of 'new recovery', and informed the local translation of the policy. DISCUSSION: The results have implications for understandings of the relationship between social movements, non-government organisations and the state, as well as the dynamics of knowledge transfer in drug policy.

Advocacy coalitions and the transfer of nutrition policy to Zambia.

Stunted growth in children and multisectoral action to address it are dominant ideas in the international nutrition community today, and this study finds that these ideas are increasingly evident over time in nutrition policy in Zambia, with stunting largely displacing other framings of nutrition. This study is based on key informant interviews (70 interviews with 61 interviewees), policy document review, and social network mapping, with iterative data collection and analysis taking place over 6 years (2011-2016). Analysis was based on two established political science theories: policy transfer theory and the Advocacy Coalition Framework. Policy changes in Zambia are shown to result from the international community's nutrition agenda, transferred to national policy through the normative promotion of certain ways of understanding the issue of malnutrition, largely propagated through advocacy, technical assistance and funding. With its focus on multisectoral action to reduce stunting, the recent nutrition policy narrative impinges directly on an existing food security narrative as it attempts to alter agriculture policy away from maize reliance. The nutrition policy sub-system in Zambia is therefore split between an international coalition promoting action on child stunting, and a national coalition focused on food security and hunger, with implications for both sides on progressing a coherent policy agenda. This study finds that it is possible to understand policy processes for nutrition more fully than has so far been achieved in much nutrition literature through the application of multiple political science theories. These theories allow the generalization of findings from this case study to assess their relevance in other contexts: the study ultimately is about the transfer of policy being explained by the presence of advocacy coalitions and their different beliefs, resources and power, and these concepts can be investigated wherever the nutrition system reaches down from international to national level.

Transferring 24/7 sobriety from South Dakota to South London: the case of MOPAC's Alcohol Abstinence Monitoring Requirement Pilot.

BACKGROUND AND AIMS: During the past three decades an expansive literature has emerged that is dedicated to analysing the processes of policy transfer. One neglected pathway involves subnational agents emulating crime control innovations that have emerged in subnational jurisdictions of other nations. This paper presents the case of the London Mayor's Office for Policing and Crime's (MOPAC) Alcohol Abstinence Monitoring Requirement (AAMR) Pilot to examine the multi-level factors that facilitate and/or constrain international-subnational crime and justice policy transfer. METHODS: A qualitative case study design reconstructed the (in)formal events that led to components of the South Dakota 24/7 Sobriety Project (USA) being either abandoned or integrated into MOPAC's AAMR Pilot. Evidence is drawn from elite interviews and documentary materials. RESULTS: A series of inter/transnational-, macro-domestic-, meso- and micro-level factors enabled and/or obstructed processes of complete international-subnational policy transfer. Exclusion of domestic violence perpetrators from the London Pilot was fuelled by interest-group hostility and mobilization. Use of alcohol tags rather than breathalysers to monitor compliance was a result of political-economic constraints, concern surrounding intrusion, technological innovation and policy-orientated learning. The decision to omit an 'offender pays' funding mechanism was a consequence of legal incompatibility and civil service reluctance, while 'flash incarceration' for breach was not implemented due to European policy harmonization. CONCLUSIONS: The London Alcohol Abstinence Monitoring Requirement Pilot was a policy 'synthesis' that combined ideas, goals, vocabulary, principles, technology and practices from the South Dakota model with the existing English and Welsh criminal justice framework. Structural factors and the actions of particular agents limited the extent to which policy transfer occurred.