scholarly journals Can “Becoming Breastfeeding Friendly” Impact Breastfeeding Protection, Promotion, and Support in Mexico? A Qualitative Study

2018 ◽  
Vol 39 (3) ◽  
pp. 393-405 ◽  
Author(s):  
Cara Safon ◽  
Gabriela Buccini ◽  
Isabel Ferré ◽  
Teresita González de Cosío ◽  
Rafael Pérez-Escamilla
Keyword(s):  
Public Policy ◽  
Committee Member ◽  
National Level ◽  
Scale Up ◽  
Shared Vision ◽  
Policy Agenda ◽  
Theory Approach ◽  
Structured Interviews ◽  
Enabling Environment ◽  
Becoming Breastfeeding Friendly

Background: The Becoming Breastfeeding Friendly (BBF) initiative includes a guide that helps countries worldwide assess their readiness to scale up national breastfeeding programs. Country committees of breastfeeding experts across government, academia, and civil society engage with BBF by applying the BBF toolbox that includes (1) the BBF Index (BBFI) to measure and score a country’s breastfeeding environment, (2) case studies that illustrate how countries have created enabling environments for breastfeeding, and (3) a 5-meeting process, during which country committees develop policy recommendations intended to improve breastfeeding outcomes based on the BBFI scores. Objective: This study seeks to understand how the application of the BBF toolbox impacted plans to improve the enabling environment for breastfeeding in Mexico. Methods: Semi-structured interviews were conducted with Mexico’s 11 BBF country committee members about the 5-meeting process between May and June 2017. Audio recordings were transcribed and were coded and analyzed using a grounded theory approach. Results: Three major themes emerged: (1) the unique enabling environment for breastfeeding consisted of obstacles and opportunities for improvement, (2) favorable country committee member dynamics positively affected the utility of the BBF toolbox, and (3) BBF revealed and shaped country committee members’ shared vision of change that laid the foundation for a shared public policy agenda. Conclusions: Becoming Breastfeeding Friendly can generate multisectoral breastfeeding champions who can advance the public policy agenda to improve breastfeeding outcomes at the national level both in Mexico and elsewhere.

scholarly journals Scaling Up Breastfeeding in Myanmar through the Becoming Breastfeeding Friendly Initiative

2019 ◽  
Vol 3 (8) ◽  
Author(s):  
May Khin Than ◽  
Soe Nyi Nyi ◽  
Lwin Mar Hlaing ◽  
Swe Le Mar ◽  
Theingi Thwin ◽  
...  
Keyword(s):  
Scale Up ◽  
Scaling Up ◽  
Lessons Learned ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Enabling Environment ◽  
Infant And Young Child ◽  
Save The Children ◽  
Policies And Programs ◽  
Becoming Breastfeeding Friendly

ABSTRACT Background Optimal breastfeeding practices in Myanmar are above global averages, and the Ministry of Health and Sports (MoHS) has demonstrated its commitment to support nutrition and breastfeeding through continued policy and program actions. In 2017, the MoHS, in partnership with Save the Children, led the piloting of the Becoming Breastfeeding Friendly (BBF) Initiative. BBF provides a guide for countries to assess the enabling environment for breastfeeding and a country's readiness to scale up breastfeeding policies and programs. Objective The aim of this study was to document the BBF process and outcomes in Myanmar. Methods A Working Group (WG) of 14 members, led by a chair and 2 cochairs, conducted the BBF assessment using the BBF Index (BBFI), generated and prioritized recommendations, and disseminated the findings over the course of 5 meetings. Additional meetings were held to gain stakeholder endorsement and approval of the BBF process and WG before commencement and MoHS endorsement of the findings. Results The BBFI score for Myanmar was 1.2 out of 3.0, which indicates a moderate environment for scaling up breastfeeding policies and programs. The Funding and Resources gear earned the lowest score (0.5), whereas Political Will earned the highest score (2.0). Overall, 4 gears were weak and 4 were moderate in strength. Nine recommendation themes were generated and prioritized. The top priority recommendation was to form a National Infant and Young Child Feeding Alliance. The MoHS endorsed the 9 recommendations in December 2018 and has provided leadership for the formation of the alliance. Conclusions The BBF Initiative was successfully conducted in Myanmar, resulting in 9 prioritized recommendations for strengthening the breastfeeding enabling environment and substantial interagency collaborations. Adaptations to the BBF process were made for the context, and we note numerous lessons learned that should be considered by other countries that plan to commit to the BBF Initiative.

Public Policy Agenda Adapts to Needs

ASHA Leader ◽  
2012 ◽  
Vol 17 (15) ◽  
pp. 23-23
Author(s):  
George Lyons
Keyword(s):  
Public Policy ◽  
Policy Agenda

A general practice provider federation in a mixed health economy in England: a case study investigation

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X696929
Author(s):  
Jill Mitchell
Keyword(s):  
General Practice ◽  
Shared Vision ◽  
Health Economy ◽  
Structured Interviews ◽  
The North ◽  
Common Strategy ◽  
Common Purpose ◽  
Collaborative Working ◽  
The Impact

BackgroundThere is an emerging debate that general practice in its current format is out-dated and there is a requirement to move to a federated model of provision where groups of Practices come together. The emergence of federations has developed over the past 5 years but the factors that influence how federations develop and the impact of this new model is an under researched area.AimThe study explored the rationale around why a group of independent GP practices opted to pursue an alternative business venture and the benefits that this strategy offered.MethodA single organisational case study of a federation in the North of England was conducted between 2011–2016. Mixed methods data collection included individual and group semi-structured interviews and quantitative surveys.ResultsFederations promote collaborative working, relying on strategic coherence of multiple individual GP practices through a shared vision and common purpose. Findings revealed many complexities in implementing a common strategy across multiple independent businesses. The ability of the federation to gain legitimacy was two dimensional – externally and internally. The venture had mixed successes, but their approach to quality improvement proved innovative and demonstrated outcomes on a population basis. The study identified significant pressures that practices were experiencing and the need to seek alternative ways of working but there was no shared vision or inclination to relinquish individual practice autonomy.ConclusionOrganisational development support is critical to reform General Practice. Whether central funding through the GP Five Year Forward View will achieve the scale of change required is yet to be evidenced.

Career Guidance: Living on the Edge of Public Policy

2020 ◽  
Author(s):  
John McCarthy ◽  
Tibor Bors Borbély-Pecze
Keyword(s):  
Public Policy ◽  
Social Inclusion ◽  
Career Guidance ◽  
Evaluation Studies ◽  
National Level ◽  
Policy Instruments ◽  
Economic Incentives ◽  
Policy Formation ◽  
Education And Employment

Public policy formation and implementation for career guidance provision are complex issues, not least because in most countries career guidance is a peripheral part of legislation for education, employment, and social inclusion. Policy solutions are compromises by nature. Regulations and economic incentives are the main policy instruments for career guidance provision, but there is often incoherence between the intentions of the regulations and the economic incentives provided for policy implementation. The intermediary organizations that serve to implement policy add significant variability to policy effects. International bodies and organizations have shown significant interest in the role of career guidance in education and employment policies through the undertaking of policy reviews, the formulation of recommendations for career guidance, and, in some cases, providing economic incentives to support their implementation. However, there is a dearth of evaluation studies of policy formation and implementation at the national level.

scholarly journals Evaluating the integration of palliative care in national health systems: an indicator rating process with EAPC task force members to measure advanced palliative care development

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Natalia Arias-Casais ◽  
Eduardo Garralda ◽  
Miguel Antonio Sánchez-Cárdenas ◽  
John Y. Rhee ◽  
Carlos Centeno
Keyword(s):  
Primary Care ◽  
Palliative Care ◽  
Long Term Care ◽  
Task Force ◽  
National Level ◽  
Structured Interviews ◽  
Term Care ◽  
Care Facilities ◽  
Rating Process

Abstract Background Palliative care (PC) development cannot only be assessed from a specialized provision perspective. Recently, PC integration into other health systems has been identified as a component of specialized development. Yet, there is a lack of indicators to assess PC integration for pediatrics, long-term care facilities, primary care, volunteering and cardiology. Aim To identify and design indicators capable of exploring national-level integration of PC into the areas mentioned above. Methods A process composed of a desk literature review, consultation and semi-structured interviews with EAPC task force members and a rating process was performed to create a list of indicators for the assessment of PC integration into pediatrics, long-term care facilities, primary care, cardiology, and volunteering. The new indicators were mapped onto the four domains of the WHO Public Health Strategy. Results The literature review identified experts with whom 11 semi-structured interviews were conducted. A total of 34 new indicators were identified for national-level monitoring of palliative care integration. Ten were for pediatrics, five for primary care, six for long-term care facilities, seven for volunteering, and six for cardiology. All indicators mapped onto the WHO domains of policy and education while only pediatrics had an indicator that mapped onto the domain of services. No indicators mapped onto the domain of use of medicines. Conclusion Meaningful contributions are being made in Europe towards the integration of PC into the explored fields. These efforts should be assessed in future regional mapping studies using indicators to deliver a more complete picture of PC development.

scholarly journals Considering treatment-as-prevention scale-up for Australian prisons: a qualitative sub-study of expert stakeholders from the Australian ‘surveillance and treatment of prisoners with hepatitis C’ project (SToP-C)

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Jake Rance ◽  
◽  
Lise Lafferty ◽  
Carla Treloar
Keyword(s):  
Hepatitis C ◽  
Primary Prevention ◽  
Critical Role ◽  
Scale Up ◽  
Treatment As Prevention ◽  
Structured Interviews ◽  
Hcv Treatment ◽  
Public Health Response ◽  
Direct Acting ◽  
Levels Of Support

Abstract Background With direct-acting antivirals dramatically reshaping the public health response to the hepatitis C virus (HCV), prisons are set to play a critical role in elimination efforts. Despite the theoretical demonstration of HCV treatment-as-prevention in prison in mathematical modeling, limited empirical data exist. The Australian ‘Surveillance and Treatment of Prisoners with Hepatitis C’ project (SToP-C) is the world’s first trial of HCV treatment-as-prevention in prison. Drawing on interviews with HCV expert stakeholders, this paper explores the factors respondents identified as crucial to the success of future scale-up. Accounting for such perspectives matters because of the influence expert discourse has in shaping implementation. Methods Semi-structured interviews were conducted with nineteen HCV experts working across key policy, advocacy, research and clinical dimensions of the Australian HCV response. Data were coded using qualitative data management software (NVivo 11). Analysis proceeded via a hybrid deductive and inductive approach. Results Notwithstanding concerns regarding the lack of primary prevention in Australian prisons, stakeholders reported broad levels of support for the intervention and for the future scale-up of HCV treatment. A number of considerations, both external and internal to the prison system, were identified as key. The principal external factor was an enabling political-cum-policy environment; internal factors included: obtaining support from prisons’ executive and custodial staff; promoting health within a security-first institutional culture; allocating time for treatment within prisoners’ tightly regulated schedules; ensuring institutional stability during treatment given the routine movement of prisoners between prisons; prioritizing the availability of retreatment given the paucity of primary prevention; and securing sufficient clinical space for treatment. Conclusion The challenges to implementation are considerable, ranging from macrolevel concerns to in-prison logistical matters. Nonetheless, we argue that prisons remain an obvious setting for treatment scale-up, not only for prevention and potential elimination benefit, but for the treatment opportunities they afford a socially disadvantaged and underserved population. While noting widespread concerns among respondents regarding the paucity of primary prevention in Australian prisons, results indicate broad levels of support among expert stakeholders for HCV treatment scale-up in prison.

scholarly journals What matters to patients? A mixed method study of the importance and consideration of oncology patient demands

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mathias WAELLI ◽  
Etienne Minvielle ◽  
Maria Ximena Acero ◽  
Khouloud Ba ◽  
Benoit Lalloué
Keyword(s):  
Cancer Patients ◽  
Mixed Method ◽  
New Technologies ◽  
Care Pathway ◽  
Scale Up ◽  
Healthcare Delivery ◽  
Delivery Systems ◽  
Breast Cancer Patients ◽  
Structured Interviews ◽  
Oncology Patient

Abstract Background A patient-centred approach is increasingly the mandate for healthcare delivery, especially with the growing emergence of chronic conditions. A relevant but often overlooked obstacle to delivering person-centred care is the identification and consideration of all demands based on individual experience, not only disease-based requirements. Mindful of this approach, there is a need to explore how patient demands are expressed and considered in healthcare delivery systems. This study aims to: (i) understand how different types of demands expressed by patients are taken into account in the current delivery systems operated by Health Care Organisations (HCOs); (ii) explore the often overlooked content of specific non-clinical demands (i.e. demands related to interactions between disease treatments and everyday life). Method We adopted a mixed method in two cancer centres, representing exemplary cases of organisational transformation: (i) circulation of a questionnaire to assess the importance that breast cancer patients attach to every clinical (C) and non-clinical (NC) demand identified in an exploratory inquiry, and the extent to which each demand has been taken into account based on individual experiences; (ii) a qualitative analysis based on semi-structured interviews exploring the content of specific NC demands. Results Further to the way in which the questionnaires were answered (573 answers/680 questionnaires printed) and the semi-structured interviews (36) with cancer patients, results show that NC demands are deemed by patients to be almost as important as C demands (C = 6.53/7 VS. NC = 6.13), but are perceived to be considered to a lesser extent in terms of pathway management (NC = 4.02 VS C = 5.65), with a significant variation depending on the type of non-clinical demands expressed. Five types of NC demands can be identified: demands relating to daily life, alternative medicine, structure of the treatment pathway, administrative and logistic assistance and demands relating to new technologies. Conclusions This study shows that HCOs should be able to consider non-clinical demands in addition to those referring to clinical needs. These demands require revision of the healthcare professionals’ mandate and transition from a supply-orientated system towards a demand-driven approach throughout the care pathway. Other sectors have developed hospitality management, mass customisation and personalisation to scale up approaches that could serve as inspiring examples.

scholarly journals Barriers for kangaroo mother care (KMC) acceptance, and practices in southern Ethiopia: a model for scaling up uptake and adherence using qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Selamawit Mengesha Bilal ◽  
Henok Tadele ◽  
Teshome Abuka Abebo ◽  
Birkneh Tilahun Tadesse ◽  
Mekonnen Muleta ◽  
...  
Keyword(s):  
Research Study ◽  
Service Providers ◽  
Scale Up ◽  
Formative Research ◽  
Kangaroo Mother Care ◽  
Southern Ethiopia ◽  
Theory Approach ◽  
Structural Factors ◽  
Implementation Model ◽  
Health Service Providers

Abstract Background Globally, approximately 15 million babies are born preterm every year. Complications of prematurity are the leading cause of under-five mortality. There is overwhelming evidence from low, middle, and high-income countries supporting kangaroo mother care (KMC) as an effective strategy to prevent mortality in both preterm and low birth weight (LBW) babies. However, implementation and scale-up of KMC remains a challenge, especially in lowincome countries such as Ethiopia. This formative research study, part of a broader KMC implementation project in Southern Ethiopia, aimed to identify the barriers to KMC implementation and to devise a refined model to deliver KMC across the facility to community continuum. Methods A formative research study was conducted in Southern Ethiopia using a qualitative explorative approach that involved both health service providers and community members. Twenty-fourin-depth interviewsand 14 focus group discussions were carried out with 144study participants. The study applied a grounded theory approach to identify,examine, analyse and extract emerging themes, and subsequently develop a model for KMC implementation. Results Barriers to KMC practice included gaps in KMC knowledge, attitude and practices among parents of preterm and LBW babies;socioeconomic, cultural and structural factors; thecommunity’s beliefs and valueswith respect to preterm and LBW babies;health professionals’ acceptance of KMC as well as their motivation to implement practices; and shortage of supplies in health facilities. Conclusions Our study suggests a comprehensive approach with systematic interventions and support at maternal, family, community, facility and health care provider levels. We propose an implementation model that addresses this community to facility continuum.

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