Protecting healthcare workers in the COVID-19 pandemic: respirator shortages and health policy responses in South America

A volume on health reforms under the Coalition must necessarily expand its focus beyond Westminster to consider the larger UK policy context. Legislation enacted in 1998 established devolved assemblies in Scotland, Wales and Northern Ireland with power to make law or issue executive orders in certain specified areas, including health services. This meant that an English NHS overseen by the Westminster Parliament now existed alongside separate NHS systems accountable to devolved governments in the other UK countries. Thus, the major Coalition health reforms heralded by the Health and Social Care Act 2012 applied in the main to England only. However, devolved administrations needed to formulate appropriate policy responses that either maintained differences or moved closer to the English policies. This chapter describes the divergent approaches between the four UK NHS systems, but also sheds light on the nature of coalition policy making.

Download Full-text

Health Policy Reform in South America

The Palgrave International Handbook of Healthcare Policy and Governance ◽

10.1057/9781137384935_13 ◽

2015 ◽

pp. 204-221

Author(s):

Ligia Giovanella ◽

Mariana Faria

Keyword(s):

Health Policy ◽

South America ◽

Policy Reform ◽

Health Policy Reform

Download Full-text

Disability and COVID-19: improving legal and policy responses through grassroots disability ethics

Northern Ireland Legal Quarterly ◽

10.53386/nilq.v72is1.903 ◽

2021 ◽

Vol 72 (S1) ◽

pp. 91-116

Author(s):

Ivanka Antova

Keyword(s):

Health Policy ◽

Disabled People ◽

Policy Responses ◽

Grassroots Level

The emergency legal and policy responses to COVID-19 attempt to avoid discrimination against disabled people. But they do not address deeper ableist and disableist narratives and practices embedded in emergency health policy. Adopting a disability ethics approach to the guidelines that emerged during the COVID-19 pandemic shows that they rest on dubious ethical grounds. However, emergency legal and policy responses to COVID-19 can be improved by adopting an approach based on disability ethics principles that emerge from grassroots level.

Download Full-text

Frontline healthcare workers’ experiences in implementing the TB-DM collaborative framework in Northern Ghana

BMC Health Services Research ◽

10.1186/s12913-021-06883-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rita Suhuyini Salifu ◽

Khumbulani W. Hlongwana

Keyword(s):

Health Policy ◽

Healthcare Workers ◽

Theoretical Framework ◽

World Health ◽

Health Concern ◽

Northern Ghana ◽

Lead Author ◽

Street Level ◽

Frontline Healthcare Workers ◽

Street Level Bureaucracy

Abstract Background Over the past decade, global health policy has increased its focus on measures to halt further increase in tuberculosis (TB) incidence and management of diabetes mellitus (DM). However, the vertical management of these two diseases have not achieved much in addressing the adverse effects of the rising tuberculosis-diabetes co-epidemic. This necessitated the World Health Organisation and the International Union Against Tuberculosis and Lung Disease to develop a framework to manage this dual disease burden. TB-DM co-epidemic is a public health concern in Ghana, adversely threatening the country’s fragile health systems. Since frontline healthcare workers are critical in health policy implementation, this study used Lipsky’s theoretical framework of street-level bureaucracy to explore their experiences in implementing the collaborative framework at the health facility level in Ghana. Methods This qualitative study was conducted between July to September 2019 using an exploratory design. Data was generated using a semi-structured interview guide designed to elicit information on knowledge of TB-DM comorbidity as well as systems for co-management. Twenty-three in-depth interviews were conducted among purposively selected frontline healthcare workers (doctors, nurses, TB task- shifting officers, TB institutional coordinators and hospital managers) from three health facilities in the Northern Region of Ghana. The lead author also conducted observations and document reviews, in order to fully address the study objectives. Thematic analysis was guided by the Lipsky’s theoretical framework of street level bureaucracy. Results The findings revealed three main themes and six sub-themes. Main themes were Prioritisation of TB/HIV co-infection while negating TB-DM comorbidity, Poor working conditions, and Coping mechanisms, whereas sub-themes were Low knowledge and awareness of TB-DM comorbidity, Limited awareness of the collaborative framework, High workload in TB & DM Clinics, Multiple roles, Inadequate training, and Space shortage. Conclusions Frontline healthcare workers had limited knowledge of TB-DM comorbidity and the collaborative framework, which, in turn adversely affected the effectiveness in implementing the framework. The effective implementation of the framework begins with raising awareness about the framework through in service training amongst the frontline healthcare workers. Additionally, an integrated screening tool to detect both TB and DM would help achieve early detection of TB-DM comorbidity.

Download Full-text

The economic costs of biological invasions in Central and South America: a first regional assessment

NeoBiota ◽

10.3897/neobiota.67.59193 ◽

2021 ◽

Vol 67 ◽

pp. 401-426 ◽

Cited By ~ 2

Author(s):

Gustavo Heringer ◽

Elena Angulo ◽

Liliana Ballesteros-Mejia ◽

César Capinha ◽

Franck Courchamp ◽

...

Keyword(s):

South America ◽

Biological Invasions ◽

Alien Species ◽

Eichhornia Crassipes ◽

Invasive Alien Species ◽

Terrestrial Environment ◽

Policy Responses ◽

Damage Costs ◽

Geographical Regions ◽

Region Ii

Invasive alien species are responsible for a high economic impact on many sectors worldwide. Nevertheless, there is a scarcity of studies assessing these impacts in Central and South America. Investigating costs of invasions is important to motivate and guide policy responses by increasing stakeholders’ awareness and identifying action priorities. Here, we used the InvaCost database to investigate (i) the geographical pattern of biological invasion costs across the region; (ii) the monetary expenditure across taxa and impacted sectors; and (iii) the taxa responsible for more than 50% of the costs (hyper-costly taxa) per impacted sector and type of costs. The total of reliable and observed costs reported for biological invasions in Central and South America was USD 102.5 billion between 1975 and 2020, but about 90% of the total costs were reported for only three countries (Brazil, Argentina and Colombia). Costs per species were associated with geographical regions (i.e., South America, Central America and Islands) and with the area of the countries in km2. Most of the expenses were associated with damage costs (97.8%), whereas multiple sectors (77.4%), agriculture (15%) and public and social welfare (4.2%) were the most impacted sectors. Aedes spp. was the hyper-costly taxon for the terrestrial environment (costs of USD 25 billion) and water hyacinth (Eichhornia crassipes) was the hyper-costly taxon for the aquatic environment (USD 179.9 million). Six taxa were classified as hyper-costly for at least one impacted sector and two taxa for at least one type of cost. In conclusion, invasive alien species caused billions of dollars of economic burden in Central and South America, mainly in large countries of South America. Costs caused by invasive alien species were unevenly distributed across countries, impacted sectors, types of costs and taxa (hyper-costly taxa). These results suggest that impacted sectors should drive efforts to manage the species that are draining financial sources.

Download Full-text