scholarly journals The Practice of Power by Regional Managers in the Implementation of an Indigenous Peoples Health Policy in the Philippines

2020 ◽  
Author(s):  
Ryan C. Guinaran ◽  
Erlinda B. Alupias ◽  
Lucy Gilson
Keyword(s):  
Health Policy ◽  
Policy Implementation ◽  
Health System ◽  
Indigenous Peoples ◽  
Indigenous Health ◽  
Organizational Factors ◽  
The Philippines ◽  
Discretionary Power ◽  
Program Managers ◽  
Health Managers

Background: Indigenous peoples are among the most marginalized groups in society. In the Philippines, a new policy aimed at ensuring equity and culture-sensitivity of health services for this population was introduced. The study aimed to determine how subnational health managers exercised power and with what consequences for how implementation unfolded. Power is manifested in the perception, decision and action of health system actors. The study also delved into the sources of power that health managers drew on and their reasons for exercising power. Methods: The study was a qualitative case study employing in-depth semi-structured interviews with 26 health managers from the case region and analysis of 15 relevant documents. Data from both sources were thematically analyzed following the framework method. In the analysis and interpretation of data on power, VeneKlasen and Miller’s categorization of the sources and expressions of power and Gilson, Schneider and Orgill’s categorization of the sources and reasons for exercising power were utilized. Results: Key managers in the case region perceived the implementation of the new Indigenous health policy as limited and weakly integrated into health operations. The forms of power exercised by actors in key administrative interfaces were greatly influenced by organizational context and perceived weak leadership and their practices of power hindered policy implementation. However, some positive experiences showed that personal commitment and motivation rooted in one’s indigeneity enabled program managers to mobilize their discretionary power to support policy implementation. Conclusion: The way power is exercised by policy actors at key interfaces influences the implementation and uptake of the Indigenous policy by the health system. Middle managers are strategic actors in translating central directions to operational action down to frontlines. Indigenous program managers are most likely to support an Indigenous health policy but personal and organizational factors can also override this inclination.

Health Policy Implementation and Its Barriers

2016 ◽  
pp. 134-150
Author(s):  
Augustine Nduka Eneanya
Keyword(s):  
Health Policy ◽  
Service Delivery ◽  
Policy Implementation ◽  
Health System ◽  
Cultural Barriers ◽  
Vulnerable Groups ◽  
Implementation Barriers ◽  
Demand And Supply ◽  
Policies And Programs ◽  
Health Policy Implementation

The chapter describes policy implementation components of a health system in United States of America and explains how they affect health outcomes (service delivery). It argues that implemented policies affect various components of a health system in terms of service delivery, workforce, information, financing, medical products, technologies, leadership and governance. Using health system as framework of analysis, the paper explains that the outcome of health policy implementation determines the availability, quality and equitability of program service delivery. The chapter goes on to argue that policy implementation barriers, such as demand-and supply-side barriers, market, insufficient resources, cultural barriers, imperfect communication, information, education, coordination, leadership and governance affect the poor and vulnerable groups in developed and developing countries from benefitting from public spending on public health policies and programs.

scholarly journals Health system capacity: maternal health policy implementation in the state of Gujarat, India

2013 ◽  
Vol 6 (1) ◽  
pp. 19629 ◽  
Author(s):  
Linda Sanneving ◽  
Asli Kulane ◽  
Aditi Iyer ◽  
Bengt Ahgren
Keyword(s):  
Health Policy ◽  
Maternal Health ◽  
Policy Implementation ◽  
Health System ◽  
The State ◽  
System Capacity ◽  
Maternal Health Policy ◽  
Health Policy Implementation

Health Policy Implementation

2017 ◽  
pp. 541-552 ◽  
Author(s):  
Khadijeh Rouzbehani
Keyword(s):  
Health Policy ◽  
Service Delivery ◽  
Policy Implementation ◽  
Health System ◽  
Cultural Barriers ◽  
Vulnerable Groups ◽  
Implementation Barriers ◽  
Demand And Supply ◽  
Policies And Programs ◽  
Health Policy Implementation

This research describes policy implementation components of a health system and explains how they affect outcomes. It argues that implemented policies affect various components of a health system in terms of service delivery, workforce, information, financing, medical products, technologies, leadership and governance. Using health system as framework of analysis, the paper explains that the outcome of health policy implementation determines the availability, quality and equitability of program service delivery. The paper goes on to argue that policy implementation barriers, such as demand-and supply-side barriers, market, insufficient resources, cultural barriers, imperfect communication, information, education, coordination, leadership and governance affect the poor and vulnerable groups in developed and developing countries from benefitting from public spending on public health policies and programs.

State Mental Health Policy: Implementation of Computerized Medication Prescribing Algorithms in a Community Mental Health System

2009 ◽  
Vol 60 (8) ◽  
pp. 1010-1012 ◽  
Author(s):  
Karen K. Milner ◽  
Daniel Healy ◽  
Kristen L. Barry ◽  
Frederic C. Blow ◽  
Cheryl Irmiter ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Policy ◽  
Community Mental Health ◽  
Policy Implementation ◽  
Health System ◽  
Mental Health System ◽  
Mental Health Policy ◽  
State Mental Health ◽  
Health Policy Implementation ◽  
State Mental

scholarly journals Health reform and Indigenous health policy in Brazil: contexts, actors and discourses

2020 ◽  
Vol 35 (Supplement_1) ◽  
pp. i107-i114
Author(s):  
Ana Lucia de M Pontes ◽  
Ricardo Ventura Santos
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Indigenous Peoples ◽  
Health Reform ◽  
Indigenous Health ◽  
Holistic Health ◽  
Political Agenda ◽  
Final Report ◽  
The Right ◽  
Specific Health

Abstract Given the challenges related to reducing socio-economic and health inequalities, building specific health system approaches for Indigenous peoples is critical. In Brazil, following constitutional reforms that led to the universalization of health care in the late 1980s, a specific health subsystem was created for Indigenous peoples in 1999. In this paper, we use a historical perspective to contextualize the creation of the Indigenous Health Subsystem in Brazil. This study is based on data from interviews with Indigenous and non-Indigenous subjects and document-based analysis. In the 1980s, during the post-dictatorship period in Brazil, the emergence of Indigenous movements in the country and the support for pro-Indigenous organizations helped establish a political agenda that emphasized a broad range of issues, including the right to a specific health policy. Indigenous leaders established alliances with participants of the Brazilian health reform movement, which resulted in broad debates about the specificities of Indigenous peoples, and the need for a specific health subsystem. We highlight three main points in our analysis: (1) the centrality of a holistic health perspective; (2) the emphasis on social participation; (3) the need for the reorganization of health care. These points proved to be convergent with the development of the Brazilian health reform and were expressed in documents of the Indigenist Missionary Council (CIMI) and the Union of Indigenous Nations (UNI). They were also consolidated in the final report of the First National Conference on the Protection of Indigenous Health in 1986, becoming the cornerstone of the national Indigenous health policy declared in 1999. Our analysis reveals that Indigenous people and pro-Indigenous groups were key players in the development of the Indigenous Health Subsystem in Brazil.

scholarly journals The RIPPLES of Meaningful Involvement: A Framework for Meaningfully Involving Indigenous Peoples in Health Policy Decision-Making

2019 ◽  
Vol 10 (3) ◽  
Author(s):  
Alycia J. Fridkin ◽  
Annette J. Browne ◽  
Madeleine Kétéskwēw Dion Stout
Keyword(s):  
Decision Making ◽  
Health Policy ◽  
Indigenous Peoples ◽  
Indigenous Health ◽  
Policy Decision ◽  
Power Dynamics ◽  
Policy System ◽  
Meaningful Involvement ◽  
Health Policy Decision ◽  
Policy Decision Making

Indigenous Peoples experience the greatest health inequities in Canada and other colonized countries, yet are routinely excluded from health-related policy decisions. Those advocating for Indigenous health equity are often left wrestling with the question: What constitutes, and what can foster, meaningful involvement of Indigenous Peoples in the contemporary health policy climate? Twenty (n = 20) in-depth, open-ended interviews with Indigenous and non-Indigenous leaders in health and health policy were conducted with a view to understanding what constitutes meaningful involvement of Indigenous Peoples in health policy decision-making. The analysis suggests meaningful involvement requires attuning to underlying power dynamics inherent in policy making and taking action to decolonize and transform the policy system itself. Based on these findings, the authors offer a framework for meaningful involvement.

scholarly journals The deconstruction exercise

2016 ◽  
Vol 9 (1) ◽  
pp. 28-48 ◽  
Author(s):  
David Sjorberg ◽  
Dennis McDermott
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care Professional ◽  
Indigenous Peoples ◽  
Indigenous Health ◽  
Indigenous Studies ◽  
Health Profession ◽  
Power Imbalance ◽  
Academic Setting ◽  
Learning Journey

The ‘deconstruction exercise’ aims to give non-Indigenous health profession students the ability to recognise language that is imbued with power imbalance, so as to avoid the perpetuation of racialised ways of interacting with Indigenous peoples in the health system. Informed by Ngarrindjeri and Malak Malak perspectives, this is a measured anti–racism strategy, one able to address unexamined, racist language in a manner that avoids the emotive or combative nature of unstructured discussions around the impacts of racism. ISSN: ISSN 1837-0144 © International Journal of Critical Indigenous Studies 29 We argue that once a health care professional is able to exhibit decolonised language, together with a re-orientation towards decolonised practice, a door opens; one vital for the development of a more-effective, culturally-safe practitioner. In an academic setting, this ‘Ngarrindjeri way’ has shaped the deconstruction exercise, which ensures that students are ‘having the hard conversations’ in a pragmatic manner that challenges ‘whiteness’, whilst honouring each student’s dignity, on a learning journey that is informed by Indigenous methodologies.

Health Policy Implementation and Its Barriers

2016 ◽  
pp. 42-63 ◽  
Author(s):  
Augustine Nduka Eneanya
Keyword(s):  
Health Policy ◽  
Service Delivery ◽  
Policy Implementation ◽  
Health System ◽  
Cultural Barriers ◽  
Vulnerable Groups ◽  
Implementation Barriers ◽  
Demand And Supply ◽  
Policies And Programs ◽  
Health Policy Implementation

The chapter describes policy implementation components of a health system in United States of America and explains how they affect health outcomes (service delivery). It argues that implemented policies affect various components of a health system in terms of service delivery, workforce, information, financing, medical products, technologies, leadership and governance. Using health system as framework of analysis, the paper explains that the outcome of health policy implementation determines the availability, quality and equitability of program service delivery. The chapter goes on to argue that policy implementation barriers, such as demand-and supply-side barriers, market, insufficient resources, cultural barriers, imperfect communication, information, education, coordination, leadership and governance affect the poor and vulnerable groups in developed and developing countries from benefitting from public spending on public health policies and programs.

Health Policy Implementation

2016 ◽  
pp. 1284-1295
Author(s):  
Khadijeh Rouzbehani
Keyword(s):  
Health Policy ◽  
Service Delivery ◽  
Policy Implementation ◽  
Health System ◽  
Cultural Barriers ◽  
Vulnerable Groups ◽  
Implementation Barriers ◽  
Demand And Supply ◽  
Policies And Programs ◽  
Health Policy Implementation

This research describes policy implementation components of a health system and explains how they affect outcomes. It argues that implemented policies affect various components of a health system in terms of service delivery, workforce, information, financing, medical products, technologies, leadership and governance. Using health system as framework of analysis, the paper explains that the outcome of health policy implementation determines the availability, quality and equitability of program service delivery. The paper goes on to argue that policy implementation barriers, such as demand-and supply-side barriers, market, insufficient resources, cultural barriers, imperfect communication, information, education, coordination, leadership and governance affect the poor and vulnerable groups in developed and developing countries from benefitting from public spending on public health policies and programs.

scholarly journals Historical foundations and contemporary expressions of a right to health care in Circumpolar Indigenous contexts

Elem Sci Anth ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Josée G. Lavoie ◽  
Jon Petter Stoor ◽  
Elizabeth Rink ◽  
Katie Cueva ◽  
Elena Gladun ◽  
...  
Keyword(s):  
Health Care ◽  
Health Policy ◽  
Indigenous Peoples ◽  
Access To Health Care ◽  
Indigenous Health ◽  
The United States ◽  
Native People ◽  
Culturally Appropriate ◽  
Access To Health ◽  
The Impact

Although numerous comparative Indigenous health policy analyses exist in the literature, to date, little attention has been paid to comparative analyses of Circumpolar health policy and the impact these policies may have on Indigenous peoples’ rights to health. In this article, we ground our discussion of Indigenous peoples’ right to access culturally appropriate and responsive health care within the context of the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP). Under UNDRIP, signatory states are obligated to guarantee that Indigenous peoples have access to the same services accessible to all citizens without discrimination. Signatory states must also guarantee access to services that are grounded in Indigenous cultures, medicines, and practices and must address Indigenous peoples’ determinants of health at least to the same extent as their national counterparts. Our analysis finds that the implementation of this declaration varies across the Circumpolar north. The United States recognizes an obligation to provide health care for American Indian and Alaska Native people in exchange for the land that was taken from them. Other countries provide Indigenous citizens access to care in the same health care systems as other citizens. Intercultural models of care exist in Alaska and to some extent across the Canadian territories. However, aside from Sámi Norwegian National Advisory Unit on Mental Health and Substance Use in northern Norway, intercultural models are absent in Nordic countries and in Greenland. While Russia has not ratified UNDRIP, Russian policy guarantees access to health care to all citizens, although access is particularly limited in rural and remote environments, including the Russian Arctic. We conclude that Circumpolar nations should begin and/or expand commitments to culturally appropriate, self-determined, access to health care in Circumpolar contexts to reduce health inequities and adhere to obligations outlined in UNDRIP.

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