scholarly journals How can we strengthen mental health services in Swedish youth clinics? A health policy and systems study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e048922
Author(s):  
Linda Richter Sundberg ◽  
Monica Christianson ◽  
Maria Wiklund ◽  
Anna-Karin Hurtig ◽  
Isabel Goicolea
Keyword(s):  
Health Policy ◽  
National Level ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
Ethical Review ◽  
Second Phase ◽  
First Line ◽  
Programme Theory ◽  
Youth Clinics ◽  
Health Policy And Systems

IntroductionStrengthening first-line mental healthcare services for youth remains a priority for the Swedish government. The government is currently investigating how different sectors involved can be strengthened, but evidence is scarce. Youth clinics play a key role in these discussions, being one of the most trusted services for youth. However, analysis of organisational functions and coordination with other services is important to strengthen youth clinics’ role in first-line mental healthcare. This study investigates these challenges and aims to analyse the integration of mental healthcare within youth clinics to identify strategies to strengthen first-line mental healthcare for youth in Sweden.Methods and analysisThis study adopts a health policy and systems approach. In the first phase, a formative realist evaluation is conducted to ascertain what works in terms of integrating mental healthcare services within youth clinics, for what type of youth subpopulations and under what circumstances. National-level stakeholders will be interviewed to elicit the programme theory that explains how the intervention is supposed to work. The programme theory will then be tested in three–five cases. The cases will be comprised of youth clinics and their stakeholders. Quantitative and qualitative information will be gathered, including via visual methodologies and questionnaires. The second phase includes a concept mapping study, engaging stakeholders and young people to build consensus on strategies to strengthen the integration of mental healthcare into youth clinics.Ethics and disseminationThe Swedish Ethical Review Authority has approved the study (2019-02910 and 2020-04720). The results will be published in open-access peer-reviewed journals and presented at scientific conferences.

Operationalizing the Ethical Review of Global Health Policy and Systems Research: A Proposed Checklist

2021 ◽  
Vol 49 (1) ◽  
pp. 92-122
Author(s):  
Abbas Rattani ◽  
Adnan A. Hyder
Keyword(s):  
Health Policy ◽  
Global Health ◽  
Ethical Review ◽  
Systems Research ◽  
Global Health Policy ◽  
Health Policy And Systems

AbstractThere has been growing consensus to develop relevant guidance to improve the ethical review of global health policy and systems research (HPSR) and address the current absence of formal ethics guidance.

scholarly journals Justice: a key consideration in health policy and systems research ethics

2020 ◽  
Vol 5 (4) ◽  
pp. e001942 ◽  
Author(s):  
Bridget Pratt ◽  
Verina Wild ◽  
Edwine Barasa ◽  
Dorcas Kamuya ◽  
Lucy Gilson ◽  
...  
Keyword(s):  
Health Policy ◽  
Research Ethics ◽  
Ethics Committees ◽  
Ethical Review ◽  
Research Ethics Committees ◽  
Systems Research ◽  
The Social ◽  
Principle Of Justice ◽  
The Rich ◽  
Health Policy And Systems

Health policy and systems research (HPSR) is increasingly being funded and conducted worldwide. There are currently no specific guidelines or criteria for the ethical review and conduct of HPSR. Academic debates on HPSR ethics in the scholarly literature can inform the development of guidelines. Yet there is a deficiency of academic bioethics work relating to justice in HPSR. This gap is especially problematic for a field like HPSR, which can entail studies that intervene in ways affecting the social and health system delivery structures of society. In this paper, we call for interpreting the principle of justice in a more expansive way in developing and reviewing HPSR studies (relative to biomedical research). The principle requires advancing health equity and social justice at population or systems levels. Drawing on the rich justice literature from political philosophy and public health ethics, we propose a set of essential justice considerations to uphold this principle. These considerations are relevant for research funders, researchers, research ethics committees, policymakers, community organisations and others who are active in the HPSR field.

scholarly journals Study protocol: analysis of regional lung health policies and stakeholders in Africa

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Claire Jensen ◽  
◽  
Emma Heneine ◽  
Brenda Mungai ◽  
Violet Murunga ◽  
...  
Keyword(s):  
Health Policy ◽  
National Level ◽  
Regional Level ◽  
Sub Saharan Africa ◽  
Health Policies ◽  
Second Phase ◽  
Health Issues ◽  
Regional Lung ◽  
Lung Health ◽  
Desk Review

Abstract Background Lung health is a critical area for research in sub-Saharan Africa. The International Multidisciplinary Programme to Address Lung Health and TB in Africa (IMPALA) is a collaborative programme that seeks to fill evidence gaps to address high-burden lung health issues in Africa. In order to generate demand for and facilitate use of IMPALA research by policy-makers and other decision-makers at the regional level, an analysis of regional lung health policies and stakeholders will be undertaken to inform a programmatic strategy for policy engagement. Methods and analysis This analysis will be conducted in three phases. The first phase will be a rapid desk review of regional lung health policies and stakeholders that seeks to understand the regional lung health policy landscape, which issues are prioritised in existing regional policy, key regional actors, and opportunities for engagement with key stakeholders. The second phase will be a rapid desk review of the scientific literature, expanding on the work in the first phase by looking at the external factors that influence regional lung health policy, the ways in which regional bodies influence policy at the national level, investments in lung health, structures for discussion and advocacy, and the role of evidence at the regional level. The third phase will involve a survey of IMPALA partners and researchers as well as interviews with key regional stakeholders to further shed light on regional policies, including policy priorities and gaps, policy implementation status and challenges, stakeholders, and platforms for engagement and promoting uptake of evidence. Discussion Health policy analysis provides insights into power dynamics and the political nature of the prioritisation of health issues, which are often overlooked. In order to ensure the uptake of new knowledge and evidence generated by IMPALA, it is important to consider these complex factors.

The Swiss mental healthcare system for people with intellectual disabilities

2018 ◽  
Vol 12 (3/4) ◽  
pp. 135-144
Author(s):  
Dan Georgescu ◽  
Anne Styp von Rekowski
Keyword(s):  
Intellectual Disabilities ◽  
Healthcare System ◽  
National Level ◽  
Mental Healthcare ◽  
Interdisciplinary Approach ◽  
Healthcare Services ◽  
Current Data ◽  
Extensive Literature ◽  
Content Type ◽  
People With Intellectual Disabilities

Purpose The purpose of this paper is to describe the mental healthcare system for people with intellectual disabilities (ID) in Switzerland. It covers the current provision of mental healthcare services as well as educational and research aspects, and summarises both the historical development and the current data on demography, health economics, legislation and national policy. Design/methodology/approach The authors performed an extensive literature research and evaluated the (very sparse) literature, conducted some interviews with recognised experts and carried out extensive internet-based research on the topic. Findings There are numerous, well-funded, well-staffed and well-equipped facilities for people with ID. These facilities have highly trained special education teachers and social education workers. Legislation, the insurance system as well as the policies and strategies on a national level are basically in line with people’s with ID needs. On the other hand, there are too few specialist physicians and psychologists, not enough training centres and too few specialist psychiatric services, both inpatient and outpatient. Medical and psychological research in this field is also insufficient. Practical implications In Switzerland, the development of treatment facilities typically does not start with a decision by a central authority to implement a policy in a top-down process. Usually, these organisations develop on the basis of some local initiatives and spread throughout the country. The process is likely to be similar in the case of services for people with mental health and intellectual disabilities (MHID), and the situation can be expected to be much better throughout the country within a few years. Furthermore, specific training programmes are expected to be created for physicians and psychologists of various disciplines, to promote an interdisciplinary approach. Originality/value This review fills a gap in that there are very few published reviews on the provision of MHID services in Switzerland.

The history of mental health policy in Turkey: tradition, transition and transformation

2020 ◽  
pp. 0957154X2096617
Author(s):  
Merve Kardelen Bilir ◽  
Fatih Artvinli
Keyword(s):  
Mental Health ◽  
Health Policy ◽  
Health Services ◽  
Mental Health Policy ◽  
Mental Healthcare ◽  
Healthcare Services ◽  
Health Policies ◽  
Community Based ◽  
History Of ◽  
Mental Health Policies

This article offers a brief history and the evolution of mental health policy in Turkey. It aims to analyse how mental health policies were transformed and why certain policies were introduced at specific times. The modern history of mental health policy is divided into three periods: the institutionalization of psychiatry and hospital-based mental health services; the introduction of community-based mental healthcare services; and lastly, the policy of deinstitutionalization after the 1980s. These periods have been categorized in a way that basically coincides with Turkey’s modern political history.

Capacity building in the public health field in the Tunisian medical faculties

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Coman ◽  
O Oltean ◽  
M Palianopoulou ◽  
D Plancikova ◽  
C Zedini ◽  
...  
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Health Knowledge ◽  
National Level ◽  
Training Programme ◽  
Local Health ◽  
The Public ◽  
Public Health Training ◽  
Medical Faculties ◽  
Health Field

Abstract Over the past years, Tunisia has experienced important reforms in the field of public health. The Tunisian medical faculties (Universities of Sfax, Tunis el Manar, Sousse and Monastir) play a key role in this endeavor by training public health professionals who can contribute to the modernization of the health system. Funded by the EC through Erasmus+ programme, the CONFIDE project (coordinated by Babes-Bolyai University, having as EU partners the Universities of Southern Denmark and Trnava, and the above mentioned Tunisian universities) has established the Research into Policy training programme by strengthening their capacity to provide public health training. The Research into Policy training programme has been delivered by the Centres for Evidence into Health Policy (C4EHPs) established within the Tunisian partner universities for the needs of CONFIDE. The training programme was implemented in four steps: (1) train the trainer sessions - the European experts trained 18 Tunisian trainers; (2) shadowing sessions - the trainers participated in shadowing sessions in the European partner institutions; (3) training delivery - the CONFIDE trainers, assisted by the European experts, delivered the training to an interdisciplinary group of 25 students and professionals; (4) internships - the students participated in internships in local health institutions. Three modules have been built within the Research into Policy training programme: Public health research, Health promotion policies and Evidence based public health policy. They contributed to increasing the public health knowledge and skills of the professionals trained. The training programme was well received by the Tunisian universities and the material developed so far during the project was adapted to the Tunisian context in the third step of implementation. On the long term, the project is expected to have an impact at the national level and produce updates at curricula level in the Tunisian medical faculties. Key messages Research into Policy training programme developed by the EC partners and culturally adapted by the Tunisian partners to the Tunisian public health context. Research into Policy training is a well-received tool for the high quality learning process in the public health field in Tunisian medical faculties.

scholarly journals Did the poor gain from India’s health policy interventions? Evidence from benefit-incidence analysis, 2004–2018

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Sakthivel Selvaraj ◽  
Anup K. Karan ◽  
Wenhui Mao ◽  
Habib Hasan ◽  
Ipchita Bharali ◽  
...  
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Access To Health Care ◽  
Healthcare Services ◽  
Care Utilization ◽  
Public Subsidy ◽  
Policy Interventions ◽  
The Poor ◽  
Benefit Incidence Analysis ◽  
The Rich

Abstract Background Health policy interventions were expected to improve access to health care delivery, provide financial risk protection, besides reducing inequities that underlie geographic and socio-economic variation in population access to health care. This article examines whether health policy interventions and accelerated health investments in India during 2004–2018 could close the gap in inequity in health care utilization and access to public subsidy by different population groups. Did the poor and socio-economically vulnerable population gain from such government initiatives, compared to the rich and affluent sections of society? And whether the intended objective of improving equity between different regions of the country been achieved during the policy initiatives? This article attempts to assess and provide robust evidence in the Indian context. Methods Employing Benefit-Incidence Analysis (BIA) framework, this paper advances earlier evidence by highlighting estimates of health care utilization, concentration and government subsidy by broader provider categories (public versus private) and across service levels (outpatient, inpatient, maternal, pre-and post-natal services). We used 2 waves of household surveys conducted by the National Sample Survey Organisation (NSSO) on health and morbidity. The period of analysis was chosen to represent policy interventions spanning 2004 (pre-policy) and 2018 (post-policy era). We present this evidence across three categories of Indian states, namely, high-focus states, high-focus north eastern states and non-focus states. Such categorization facilitates quantification of reform impact of policy level interventions across the three groups. Results Utilisation of healthcare services, except outpatient care visits, accelerated significantly in 2018 from 2004. The difference in utilisation rates between poor and rich (between poorest 20% and richest 20%) had significantly declined during the same period. As far as concentration of healthcare is concerned, the Concentrate Index (CI) underlying inpatient care in public sector fell from 0.07 in 2004 to 0.05 in 2018, implying less pro-rich distribution. The CI in relation to pre-natal, institutional delivery and postnatal services in government facilities were pro-poor both in 2004 and 2018 in all 3 groups of states. The distribution of public subsidy underscoring curative services (inpatient and outpatient) remained pro-rich in 2004 but turned less pro-rich in 2018, measured by CIs which declined sharply across all groups of states for both outpatient (from 0.21 in 2004 to 0.16 in 2018) and inpatient (from 0.24 in 2004 to 0.14 in 2018) respectively. The CI for subsidy on prenatal services declined from approximately 0.01 in 2004 to 0.12 in 2018. In respect to post-natal care, similar results were observed, implying the subsidy on prenatal and post-natal services was overwhelmingly received by poor. The CI underscoring subsidy for institutional delivery although remained positive both in 2018 and 2004, but slightly increased from 0.17 in 2004 to 0.28 in 2018. Conclusions Improvement in infrastructure and service provisioning through NHM route in the public facilities appears to have relatively benefited the poor. Yet they received a relatively smaller health subsidy than the rich when utilising inpatient and outpatient health services. Inequality continues to persist across all healthcare services in private health sector. Although the NHM remained committed to broader expansion of health care services, a singular focus on maternal and child health conditions especially in backward regions of the country has yielded desired results.

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