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At least 289 records · Page 16Linked to original sources
PubMed2004

Health sector policy in the first decade of Nepal's multiparty democracy. Does clear enunciation of health priorities matter?

Nepal experienced a significant political regime shift in 1990 from the partyless Panchyat system to the present multiparty form of democracy. While political instability existed in the decade of the 1990s, reflected in the approximately one government per year, there had been continued enunciation of health policy priorities toward the rural sector, as reflected in the Nepal National Health Policy, 1991 (NHP (1991)) and subsequent plans. The objective of the paper is to assess whether clear enunciation of health priorities have translated into beneficial health outcomes, reflected in reduction of the child death rate, child morality rate, infant mortality rate and increase in the life expectancy rate. This question is assessed empirically over the 10-year period of fiscal year 1989/1990 to 1999/2000 using mainly secondary data published by His Majesty's Government of Nepal (HMG/N), through the perspectives of input-output model and extension of health services, along with an indicative regression of a Nepalese health production function. The results (i.e. empirical observations) suggest that while there have been clear enunciation of health priorities, there have not been significant positive effects on health sector outcomes. The paper ends with a number of recommendations and concludes with the necessity for effective and appropriate implementation.

Adult↗
PubMed2003

Review and analysis of incremental approaches to meeting the needs of the uninsured and under-insured.

The US healthcare delivery system, by all accounts, is the most advanced and sophisticated healthcare system in the world. Clinical advances in diagnostic and therapeutic regimens, superior performance in biomedical research, and the development and use of the latest management and medical technologies are all hallmarks of the system. While the US healthcare system has been extremely successful, concerns remain about access to care for a large segment of the population. This article examined the various approaches that have been adopted and those that are being proposed to bridge the existing gap in health insurance coverage. The underlying assumptions of the proposed strategies were examined, and the conditions necessary for the successful implementation of these strategies were also discussed.

Adolescent↗
PubMed1998

Improving the quality of healthcare for children: implementing the results of the AHSR research agenda conference.

OBJECTIVE: To describe the rationale, development, content, and results of the AHSR-sponsored conference on developing a research agenda focused on improving the quality of care for children. DATA SOURCES AND METHODS: Planning documents, background papers, and conference proceedings. PRINCIPAL FINDINGS: The conference developed the research agenda focused on (1) monitoring the health of children; (2) evaluating the efficacy and effectiveness of health services for children; (3) assessing the quality of healthcare provided to children; (4) improving the quality of healthcare within health systems; (5) assessing the performance of community systems for children; (6) exploring the impact of different financial incentives on the provision of pediatric healthcare; and (7) developing and disseminating clinical practice guidelines and other information to physicians, families, and consumers. Specific issues and research questions in each area are also presented. Strategies for implementing the research agenda are presented and include: (1) expanding the child health services research workforce; (2) developing child healthcare quality improvement research centers; (3) conducting research in specific high-priority areas; (4) focusing research on improving the health of vulnerable populations; (5) improving child health data and collection systems at the national level; (6) developing better community health monitoring for children; (7) building and supporting research networks and a consortium of research users; and (8) developing a coordinated interagency federal effort to advance this agenda and to provide accountability for its completion. CONCLUSION: The proposed research agenda should be a national priority so that all Americans can be assured that children are receiving the best quality of care that the United States can provide.

Child↗
PubMed2001

Public health responses for skin cancer prevention: the policy framing of Sun Safety in Australia, Canada and England.

This paper employs the policy analytic approaches of framing and narrative to examine national differences in public health policies using a case study of Sun Safety programs in Australia, Canada and England. The study shows how a single public health issue identified at the global scale (rising skin cancer rates) is framed differently based upon specific social, cultural and political situations. The result is a different story, or narrative, embedded in each national policy. This study provides an example of how health policy is defined, constrained and limited through the process of problem identification and policy resolution. The paper concludes that framing and narrative analysis are powerful tools for understanding the place-specific implementation of public health policies and initiatives.

Australia↗
PubMed1997

Implementation of ethnic health policy in community mental health centres in Melbourne.

The implementation of ethnic health policy in community mental health centres was investigated by using structured interviews with coordinators and staff of 13 centres in Melbourne. The major finding was that most policy recommendations were not implemented and that work on ethnic issues resulted from the initiatives of individual staff. The study demonstrates that the successful implementation of ethnic health policy requires higher priority from policy makers and government, greater attention to mechanisms to require or encourage implementation, and a strategy to ensure that resources (new or redirected) are allocated to the implementation process.

Adolescent↗
PubMed2005

Evidence-based treatment: why, what, where, when, and how?

Research and clinical perspectives are blended in this commentary on the rapidly emerging requirement for evidence-based treatment (EBT) in substance abuse programs. Although, historically, it has not been a standard of care in behavioral health, there are sound scientific, ethical, and compassionate reasons to learn and deliver an EBT as it becomes available. This article explores a series of issues, including the following: (1) Why should EBTs be used in substance abuse treatment? (2) What kinds of treatment are EBTs, and how are they determined? (3) Where can EBTs be implemented--at what levels of service delivery? (4) When should EBTs be used? and (5) How do clinicians learn EBTs? Potential pitfalls in implementing EBTs are also considered.

Evidence-Based Medicine↗
PubMed2002

Implementation of a teacher-delivered sex education programme: obstacles and facilitating factors.

Interventions are unlikely to achieve their desired aims unless they are implemented as intended. This paper focuses on factors that impeded or facilitated the implementation of a specially designed sex education programme, SHARE, which 13 Scottish schools were allocated to deliver in a randomized trial. Drawing on qualitative and quantitative data provided by teachers, we describe how this intervention was not fully implemented by all teachers or in all schools. Fidelity to the programme was aided by intensive teacher training, compatibility with existing Personal and Social Education (PSE) provision, and senior management support. It was hindered by competition for curriculum time, brevity of lessons, low priority accorded to PSE by senior management, particularly in relation to timetabling, and teachers' limited experience and ability in use of role-play. The nature of the adoption process, staff absence and turnover, theoretical understanding of the package, and commitment to the research were also factors influencing the extent of implementation across and within schools. The lessons learned may be useful for those involved in designing and/or implementing other teacher-delivered school-based health promotion initiatives.

Adolescent↗
PubMed2005

Influenza vaccine scarcity 2004-05: implications for biosecurity and public health preparedness.

In the event of a bioterrorist event or a pandemic flu outbreak, it might be necessary to ration vaccine or other treatments. In this article, researchers examine how medical and public health decision makers negotiated the unanticipated 2004-05 influenza vaccine shortage, using the regional hospital system headquartered in Pittsburgh, Pennsylvania, as the focal study site. This account of that case study describes the circumstances that contributed to the national and local vaccine shortage; the improvisation by health policymakers, hospital administrators, physicians, and nurses to prevent influenza cases despite the shortfall; and some of the legal, fiscal, logistical, social, and political pressures that local health professionals faced in deciding who should receive the limited supply of influenza vaccine. This instance of an acute vaccine shortage provided an opportunity to examine the practical and ethical dilemmas of managing medical resources during a public health emergency.

Bioterrorism↗
PubMedDate not supplied

Heart health promotion: predisposition, capacity and implementation in Ontario Public Health Units, 1994-96.

The Canadian Heart Health Initiative-Ontario Project (CHHIOP) investigates predisposition and capacity in Ontario public health departments to implement community-based heart health promotion activities. The research draws upon diffusion of innovations theory and recent work on ecological approaches to health promotion within which public health agencies are seen to play a central role. Mail-back surveys were completed by heart health staff in all 42 health departments in 1994 and 1996. Predisposition and capacity were measured as the importance and effectiveness ascribed to 18 organizational practices supportive of community heart health activities. Level of implementation was reported for 74 activities spanning a range of risk factors and settings. Predisposition, capacity and implementation scores increased between 1994 and 1996. The findings confirm positive correlations between predisposition and capacity and between capacity and implementation.

Attitude of Health Personnel↗
PubMed2004

[Chances for advancement of outpatient rehabilitation in Germany].

Rehabilitation has a long tradition in Germany compared to other countries and is based upon a differentiated, social law foundation. Rehabilitative offers are provided as standard benefits by different social insurance schemes (pension insurance, health insurance, accident insurance, etc.) and are an independent task of care not included in acute care. A high degree of institutionalisation and specialisation are specific characteristics of rehabilitation in Germany. A country-wide network of indication specific, mostly larger institutions is available for medical rehabilitation in Germany. This emergence of centres and the location of many institutions in more rural regions give rise to the fact that rehabilitation often cannot take place close to the places of residence of those who are in need of rehabilitative offers. Until the mid-nineties, rehabilitative benefits have been performed almost exclusively on an inpatient basis, which is another characteristic of medical rehabilitation in Germany. Since then the discussion about ambulant rehabilitation has been increasing. Several initiatives are aimed at supplementing the present in-patient offers through ambulant measures. This article describes and analyses the present efforts for the development of ambulant rehabilitation. In reference to the guidelines of the BAR (Federal Rehabilitation Council) concerning ambulant medical rehabilitation, adopted by all institutions involved in 2000, the current situation and the state of implementation are discussed, and advancements necessary in the authors' view are considered.

Ambulatory Care↗
PubMed2005

Coronary heart disease: an update on progress of the NSF.

Coronary heart disease (CHD) is a preventable disease, yet is kills over 100,000 people a year in the UK. CHD was among the first conditions to be addressed by a national service framework (NSF), published in 2000. Five years on, this article discusses the key tenets of the NSF that apply to primary care and how they should be being implemented, and discusses what else the Government is doing to tackle this common and costly condition.

Coronary Disease↗
PubMed1996

The Education Act 1993: working with health services to implement the Code of Practice.

Whereas the 1981 Education Act led to emphasis on written statements of special educational needs for 2% of pupils, the 1993 Act seeks to recruit help for all children with such needs at earlier stages in the teaching process. Such help includes that available from the health services. The organization of health services has gone through considerable change since the 1993 Act was drafted so special efforts will be required to implement the intentions of the Act.

Child↗
PubMed2006

Implementation of an online tailored physical activity intervention for adults in Belgium.

It has been argued that the Internet is a promising channel for distribution of health promoting programs, because of its advantage to reach a wide variety of people at once, at any time and location. However, little research is done to study how we could prompt people to use these online health promoting programs. Therefore the main objective of the present study was to assess if a face-to-face contact stimulates adults to visit a recently developed tailored physical activity website to promote more physical activity in the general Belgian population. The second objective was to test the website under real-life conditions in a small sample. Therefore, 200 flyers, with a call for evaluating the new tailored physical activity website, were distributed to hospital visitors in two different ways. One group of visitors were personally approached by a research assistant and handed over a flyer. Another 100 visitors could simply take a flyer home, without initial personal contact. After two months, telephone interviews were done to make a qualitative evaluation of the website. The results showed that obviously more participants with an initial face-to-face contact (46%) registered on the website in comparison with the participants without personal contact (6%). The used strategy reaches participants of both sexes as well as regular and irregular Internet users. Secondly, the telephone interviews indicated that the website was accepted well, without major problems. We could conclude that distributing flyers combined with a short face-to-face contact, increased the number of visitors compared with distributed flyers without contact and that the tailored physical activity website could be used in real-life situations to promote an active lifestyle in Belgium. However, a controlled study with a larger sample size should be done to test the effectiveness of the tailored intervention in increasing physical activity.

Adult↗