Where is quality in health systems policy? An analysis of global policy documents

Purpose The purpose of this paper is to scope out European and global policy documents focused on dementia with the purpose of providing a synthesis of the challenges the phenomenon poses and the gaps evident. Design/methodology/approach An adapted PESTEL framework as a data extraction tool resulted in an analysis of the political, economic, social, technological, environmental, organisational, educational and research aspects of dementia policy. Findings Policy documents showed variability of dementia strategy, plan and programme development. All documents recognised rapidly growing ageing populations, and increasing numbers of people living with dementia. Dementia as a public health priority is inconsistent in growth. Global policy documents stress the impact of dementia will be felt most by low- and middle-income countries. Main themes were: a need to raise awareness of dementia and action to reduce stigma around it, the need for early diagnosis and preventative person-centred approaches with integrated care, fiscal investment, further research, training and education for workforces, increased involvement of and support for people living with dementia and care and support close to home. Practical implications By identifying current dementia challenges and policy gap implications this analysis urges engagement with broader frames of reference as potential for enabling bolder and radically better dementia care models. Originality/value This paper offers a review of present global and European dementia policy, outlining the potential implications for the most marginalised in society if it fails to be critical of its own underpinning assumptions.

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Assessment of health equity consideration in masking/PPE policies to contain COVID-19 using PROGRESS-plus framework: a systematic review

BMC Public Health ◽

10.1186/s12889-021-11688-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Anindit Chhibber ◽

Aditi Kharat ◽

Dylan Kneale ◽

Vivian Welch ◽

Mukdarut Bangpan ◽

...

Keyword(s):

Healthcare Workers ◽

Personal Characteristics ◽

Health Inequity ◽

Place Of Residence ◽

Personal Protection Equipment ◽

Policy Documents ◽

One Dimensional ◽

Global Policy ◽

Equity Consideration ◽

Race Ethnicity

Abstract Introduction There is increasing evidence that COVID-19 has unmasked the true magnitude of health inequity worldwide. Policies and guidance for containing the infection and reducing the COVID-19 related deaths have proven to be effective, however the extent to which health inequity factors were considered in these policies is rather unknown. The aim of this study is to measure the extent to which COVID-19 related policies reflect equity considerations by focusing on the global policy landscape around wearing masks and personal protection equipment (PPE). Methods A systematic search for published documents on COVID-19 and masks/PPE was conducted across six databases: PubMed, EMBASE, CINAHL, ERIC, ASSIA and Psycinfo. Reviews, policy documents, briefs related to COVID-19 and masks/PPE were included in the review. To assess the extent of incorporation of equity in the policy documents, a guidance framework known as ‘PROGRESS-Plus’: Place of residence, Race/ethnicity, Occupation, Gender/sex, Religion, Education, Socioeconomic status, Social capital, Plus (age, disability etc.) was utilized. Results This review included 212 policy documents. Out of 212 policy documents, 190 policy documents (89.62%) included at least one PROGRESS-plus component. Most of the policy documents (n = 163, 85.79%) focused on “occupation” component of the PROGRESS-plus followed by personal characteristics associated with discrimination (n = 4;2.11%), place of residence (n = 2;1.05%) and education (n = 1;0.53%). Subgroup analysis revealed that most of the policy documents (n = 176, 83.01%) were focused on “workers” such as healthcare workers, mortuary workers, school workers, transportation workers, essential workers etc. Of the remaining policy documents, most were targeted towards whole population (n = 30; 14.15%). Contrary to “worker focused” policy documents, most of the ‘whole population focused’ policy documents didn’t have a PROGRESS-plus equity component rendering them equity limiting for the society. Conclusion Our review highlights even if policies considered health inequity during the design/implementation, this consideration was often one dimensional in nature. In addition, population wide policies should be carefully designed and implemented after identifying relevant equity related barriers in order to produce better outcomes for the whole society.

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Task shifting and health professionals: a European policy analysis

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.789 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

W De Caro ◽

E Corvo

Keyword(s):

Health Systems ◽

Health Professionals ◽

Health Management ◽

Task Shifting ◽

Advanced Practice Nursing ◽

Policy Documents ◽

Delivery Of Care ◽

Regulatory Frameworks ◽

Set Up ◽

Italian Context

Abstract Issue There is now a growing interest by public health and health policy leader worldwide in task shifting within health professionals. Nurses represent the largest health workforce. Research has displayed that higher level of nursing competencies leads to better outcomes for patients and for the organization. Advanced and specialistic nursing and prescribing nurses is common in anglophone countries but is still in development in other countries and do not have a stable legislative recognition. Methodology We carry out a review of policy documents, models, and frameworks at European level to identify best practices to implement within the Italian context, with particular attention to nursing task shifting in order to set up Advanced Practice Nursing. Following the EU taxonomy, the analysis was carried out in order to classify the different approaches under the three main areas: enhancement, substitution/delegation and innovation. Results There are a number of reports and policy documents suggesting that task shifting is a way to improve health management, however to a mixed extent. Results show that task shifting has a domino effect. It impacts on the whole organization in terms of social and financial sustainability, quality of care, and general strength of the health systems. According to the results, Task shifting could potentially play a big role in the crucial transformation of health systems worldwide, however, it is still strongly influenced by a medically centered approach. Conclusions In the light of the results, there is an overall lack of clarity and well-developed policy approach by policymakers about task shifting competencies. Recent occurrences in terms of overwhelmed hospitals and health systems in general has clearly displayed the need to a major transformation and update of traditional models and regulatory frameworks of delivery of care and cure. Key messages Task shifting for health professionals is the future. task shifting is crucial in emergency and primary care.

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Environmental education and education for sustainable development: Conceptual solutions and dilemmas

Nastava i vaspitanje ◽

10.5937/nasvas2101007o ◽

2021 ◽

Vol 70 (1) ◽

pp. 7-23

Author(s):

Violeta Orlović-Lovren

Keyword(s):

Sustainable Development ◽

Comparative Analysis ◽

Environmental Education ◽

Education For Sustainable Development ◽

Clear Distinction ◽

Policy Documents ◽

Global Policy ◽

Similarities And Differences ◽

The Ideal ◽

Number Of Authors

The focus on education for sustainable development in global policy and literature opens up a range of different views on its relationship with environmental education. While a number of authors make a clear distinction between the two concepts, others believe that education for sustainable development (ESD) has actually displaced environmental education (EE). Different perceptions of these two concepts have implications for their integration into education at all levels. This paper offers a comparative analysis of trends and directions in defining these concepts both in global policy documents and in the literature in this field, with the aim of offering another perspective on their relationship and on the possibility of implementation in practice. The overview of the similarities and differences in their coneptualization has prompted a reconsideration of the dilemmas regarding the need for the existence of both concepts and the possibility of integrating them into education, which should play a key role in the achievement of the ideal of sustainability

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