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PubMed2000

The development of a health policy for the Army.

This paper describes the development of the Army Health Policy (AHP), which is a key component of the Army Human Resources Strategy (AHRS). The work on the AHP provided an opportunity for a fundamental review of the delivery of health support to the Army. The AHP will provide the strategic framework by which the Army will ensure the health of its workforce and, where appropriate, their dependents. The methodology used for this work may be a useful model for the development of a health policy for occupational populations.

Delivery of Health Care↗
PubMedDate not supplied

Regulating private health insurance to serve the public interest: policy issues for developing countries.

Private health insurance plays a large and increasing role around the world. This paper reviews international experiences and shows that private health insurance is significant in countries with widely different income levels and health system structures. It contrasts trends in private health insurance expansion across regions and highlights countries with particularly important experiences of private coverage. It then discusses the regulatory approaches and policies that can structure private health insurance markets in ways that mobilize resources for health care, promote financial risk protection, protect consumers and reduce inequities. The paper argues that policy makers need to confront the role that private health insurance will play in their health systems and regulate the sector appropriately so that it serves public goals of universal coverage and equity.

Developing Countries↗
PubMed2005

Green-blue water system innovations for upgrading of smallholder farming systems--a policy framework for development.

Rainfed agriculture and other depletion of water by green flows have as yet an untapped potential for improving livelihoods in semi-arid areas through income and food security. A vivid evidence of this is seen in the fact that, although working full time on food production, majority of smallholder farmers are frequently affected by shortage of food or famines. At the same time enough examples exist to show that productivity of labor, water and land under rainfed farming can be doubled or even trebled through proper land management and improved agronomic inputs supported by modest investments to reduce impacts of dry spells. However, these shining examples remain small 'islands of success' across the entire semi-arid areas. Farmers have not adopted these systems due to poor ratio of benefit to costs brought about by inadequate development or complete lack of food trade among the rural areas. This paper argues that there is a need for policy, strategic and programmatic frameworks which facilitate integrated management of land, water and markets. For this kind of strategy to work, a local market for food should be ensured to absorb at competitive prices the surplus produced by farmers in years of good rains. This will promote wealth creation and asset building among the poor in semi-arid areas. A food-exchange "futures" mechanism based on the principle of virtual water trade is proposed as a basis for achieving this objective.

Agriculture↗
PubMed1998

The role of state maternal and child health programs in the issue of newborn discharge.

OBJECTIVES: Since dramatically shortened newborn hospitalization has shifted the focus of care from the hospital, a central policy question has become how to assure a system of care that extends into the home and community. The objective of this study was to examine the role of the state Maternal and Child Health Title V programs in the assessment of the issue of newborn discharge, the development of policies, and the assurance of appropriate care. METHOD: The director or their designee in all 50 states and the District of Columbia participated in a structured telephone interview lasting 30-60 minutes. RESULTS: Twenty-eight states reported new or previously implemented mandates for 48 hours of private insurance coverage for postpartum hospitalization. Only 6 states reported mandates concerning private insurance coverage of inpatient services, but 20 states reported mandates for postdischarge services. In the assessment function, only 18 maternal and child health (MCH) programs reported that they had undertaken specific studies on the effects of discharge timing in their states. In policy development, 18 of the 51 respondents reported that the MCH program initiated newborn discharge discussions, 23 reported that the agency participated in discussions, and 10 indicated that they did not participate. In assurance, 29 programs reported that they had taken action to provide technical assistance to local communities in developing follow-up systems. The relationship between the performance of core functions and the development of specific discharge policies in the state was minimal. CONCLUSIONS: The MCH programs appear to have played varied, but often limited, roles in the development of discharge policies. It is essential for MCH programs to engage actively in the policy-making process. But in the political environment surrounding newborn discharge policy, where laws and regulations consistent with the well-being of infants and mothers were being enacted, the limited MCH program roles may have been appropriate. Arguing against this conclusion, however, is that only 15 programs believed they had been effective and only 19 were satisfied with the discharge policies in their states, which suggests that a more proactive role may be necessary.

Aftercare↗
PubMed1989

Developing a preservation policy and procedure statement for a health sciences library.

The preconditions for creating a preservation policy document in a health sciences library are an existing preservation policy for the institution of which it is a part and administrative support for preservation. The assumption underlying preservation activity, from the formulation of general guidelines to the detail of operating procedure, is that collection development and preservation are complementary functions. Documentation of operational procedures in some detail should be a part of the statement. Since preservation activity cuts across functional library structures, all management staff should be involved in the planning process and be made aware of their responsibilities. The creation of a preservation policy statement will highlight unaddressed issues, procedural inadequacies, and differences in staff perceptions of priorities, but a written statement provides a framework for setting priorities and making decisions.

Corrosion↗
PubMedDate not supplied

Developing scientific and policy methods that support precautionary action in the face of uncertainty--the Institute of Medicine Committee on Agent Orange.

To be precautionary, decisions must be made to prevent the impacts of potentially harmful activities even though the nature and magnitude of harm have not been proven scientifically. The Institute of Medicine's Committee on the Health Effects in Vietnam Veterans of Exposures to Herbicides provides a novel example of science and policy structures that support precautionary action in the face of uncertainty. What makes this example unique is the clear set of precautionary decision rules that lowered the standard for evidence, which formed the basis for policy. These rules, established by Congress, strongly influenced the way scientific information was weighed and the subsequent compensation decisions. They encouraged committee members to think outside the confines of their disciplines and develop new tools and methods to fit their unique mandate. The result was a methodology, supported by strong institutional structures, that allowed scientists to discuss the evidence as a whole, reach decisions as a group, and clarify uncertainties.

2,4,5-Trichlorophenoxyacetic Acid↗
PubMed1996

Developing a frenotomy policy at one medical center: a case study approach.

The objective of this study was to change procedures in our medical center regarding frenotomy for ankyloglossia (tongue-tie). The medical and breastfeeding outcomes of 36 fullterm infants who received frenotomies were studied. The information was used to develop frenotomy eligibility standards that would guide other physicians and insure timely treatment to avoid breastfeeding cessation.

Breast Feeding↗