Analysis of death causes of residents in poverty-stricken Areas in 2020: take Liangshan Yi Autonomous Prefecture in China as an example

Background Continuous surveillance of death can measure health status of the population, reflect social development of a region, thus promote health service development in the region and improve the health level of local residents. Liangshan Yi Autonomous Prefecture was a poverty-stricken region in Sichuan province, China. While at the end of 2020, as the announcement of its last seven former severely impoverished counties had shaken off poverty, Liangshan declared victory against poverty. Since it is well known that the mortality and cause of death structure will undergo some undesirable changes as the economy develops, this study aimed to reveal the distribution of deaths, as well as analyze the latest mortality and death causes distribution characteristics in Liangshan in 2020, so as to provide references for the decision-making on health policies and the distribution of health resources in global poverty-stricken areas. Methods Liangshan carried out the investigation on underreporting deaths among population in its 11 counties in 2018, and combined with the partially available data from underreporting deaths investigation data in 2020 and the field experience, we have estimated the underreporting rates of death in 2020 using capture-recapture (CRC) method. The crude mortality rate, age-standardized mortality rate, proportion and rank of the death causes, potential years of life lost (PYLL), average years of life lost (AYLL), potential years of life lost rate (PYLLR), standardized potential years of life lost (SPYLL), premature mortality from non-communicable diseases (premature NCD mortality), life expectancy and cause-eliminated life expectancy were estimated and corrected. Results In 2020, Liangshan reported a total of 16,850 deaths, with a crude mortality rate of 608.75/100,000 and an age-standardized mortality rate of 633.50/100,000. Male mortality was higher than female mortality, while 0-year-old mortality of men was lower than women’s. The former severely impoverished counties’ age-standardized mortality and 0-year-old mortality were higher than those of the non-impoverished counties. The main cause of death spectrum was noncommunicable diseases (NCDs), and the premature NCD mortality of four major NCDs were 14.26% for the overall population, 19.16% for men and 9.27% for women. In the overall population, the top five death causes were heart diseases (112.07/100,000), respiratory diseases (105.85/100,000), cerebrovascular diseases (87.03/100,000), malignant tumors (73.92/100,000) and injury (43.89/100,000). Injury (64,216.78 person years), malignant tumors (41,478.33 person years) and heart diseases (29,647.83 person years) had the greatest burden on residents in Liangshan, and at the same time, the burden of most death causes on men were greater than those on women. The life expectancy was 76.25 years for overall population, 72.92 years for men and 80.17 years for women, respectively, all higher than the global level (73.3, 70.8 and 75.9 years). Conclusions Taking Liangshan in China as an example, this study analyzed the latest death situation in poverty-stricken areas, and proposed suggestions on the formulation of health policies in other poverty-stricken areas both at home and abroad.

It runs in the family: parental influence on adolescents’ compliance with social distancing measures during Covid-19 lockdowns

Compliance with public health measures of adolescents who are often unfairly portrayed as spreaders of the Coronavirus is essential for controlling the pandemic. But does adolescents’ compliance develop independently from their parents? Using nationally representative longitudinal data and cross-lagged Structural Equation Panel Models I study compliance with social distancing measures of 6,754 triplets that comprise the adolescent child (age 19), their mother, and father during two national lockdowns in the UK. Results show that adolescents have the lowest and their mothers have the highest levels of compliance, and compliance generally drops over time. Moreover, parents, particularly mothers have significant influence on their adolescent child’s compliance. The child also has, albeit smaller effects on their parents’ compliance. Parental influence on adolescents’ compliance documented here thus redistributes some of the responsibility off adolescents towards all generations and calls for public health policies and campaigns that consider these family dynamics.

‘Health in All Policies’ and the Urge for Coordination: The Work of Public Health Coordinators and Their Impact and Influence in Local Public Health Policies: A Cross-Sectional Study

Building heavily on the Health in All Policies (HiAP) approach, Norway implemented the Public Health Act in 2012 to reduce social inequalities in health. Local public health coordinators (PHCs) at municipal levels were seen as tools to provide local intersectoral public health work. In this study, we examine factors related to intersectoral agency and if intersectoral work is understood as relevant to securing social justice in local policy outcomes. A national web-based survey in 2019 of all Norwegian PHCs (n = 428) was conducted with a response rate of 60%. Data were analysed through multiple linear regression, hierarchical regression modelling and structural equation modelling. Neither factors relating to community contexts nor individual characteristics were associated with intersectoral agency. Organisational factors, especially position size, being organised at the top level and having a job description, were significantly associated with perceptions of intersectoral agency. PHCs seeing themselves as intersectoral agents also found themselves able to affect annual budgets and policy outcomes. We conclude that municipal PHC positions can be important HiAP tools in local public health policies. However, organisational factors affect how PHCs perceive their influence and role in the municipal organisation and thereby their possibilities to influence local policymaking through intersectoral agency.

Eye health promotion-oriented policy statements in various national and provincial health policy documents in South Africa

Background: There are many fragmented public health policies that give directives towards various aspects of healthcare needs and implementation. However, none of these policies make specific reference to eye health promotion (EHP) as an enabler for individuals to take control of the determinants of their eye health (EH) needs.Aim: The current study sought to identify EHP messages in the various available policy documents at both national and provincial health department levels with a view to assessing awareness on the available gaps for the development of an integrated EHP policy in South Africa.Setting: The study used documents provided by the National Department of Health and those that were available online from various other provincial Departments of Health in the country.Methods: Content analysis of EH policies requested from the Directorate of Chronic Diseases, Disabilities and Geriatrics was conducted. Various other health policies that were enacted post-1994 and endorsed by the National and Provincial Departments of Health were also considered for analysis.Results: Twenty-four documents were considered for content analysis. The national guidelines on eye healthcare made reference to EH activities such as immunisation of children, vision screening of the elderly, vitamin A supplementation and maternal services to detect sexually transmitted diseases, amongst others. Of the 20 national and provincial health documents analysed, only four made reference to EH. None of these documents made any specific reference to EHP.Conclusion: Although four national guidelines contain content related to EHP, the fragmentation and lack of integration with other health policy documents may lead to eye healthcare messages not being prioritised for dissemination even where they are highly required. Also, public eye healthcare services in general will continue to lag behind as is the case in most provinces in South Africa.

Suspecting the Figures: What Church Leaders Think About Government’s Commitment to Combating COVID-19 in Nigeria

Public trust in government can significantly determine the outcome of health policies in any society. Hence, studies have been gauging peoples’ level of trust in their governments’ commitment and capacity to win the fight against COVID-19. However, these studies have omitted religious leaders. This is despite the fact that religious leaders play key roles in the area of health in many societies. The present study, therefore, explored the opinions church leaders have about the credibility of the COVID-19 statistics and other government responses in Nigeria. Data were collected through semi-structured interviews with 18 church leaders drawn from Anglican, Catholic, and Pentecostal churches in Nigeria. A descriptive narrative approach was employed in the thematic organization and analysis of data. Findings show that only one participant expressed confidence in the credibility of the COVID-19 statistics and other government’s responses. The rest, with the exception of one participant who was uncertain, was distributed between those who believe the statistics and other government efforts are exaggerated and those who believe they are false. The study also found that denominational affiliation mattered with respect to the perceptions about the credibility of the COVID-19 statistics and other government responses. Implications of findings for policy and research are discussed.

Introduction

This edited volume treats policy as an ethnographic object. Examining both policy spaces and sites of practice, the chapters illuminate both professionals’ and lay people’s intimate encounters with health policies. By ‘studying up’ and considering the multiplicity of actors and interests involved in global policies for improving maternal and reproductive health, the ten chapters in this volume track the processes and politics of policymaking and the mechanisms of their implementation in diverse contexts in Asia, Africa, Europe and South America. The chapters provide in-depth analyses of the complexities of policy formulation and implementation, the impact of socio-political contexts, as well as issues of local agency, equity and accessibility. Together, they demonstrate the value of ethnography as well as reproduction as a unique site for the generation of rich insights into the working of global health policies and their impacts. Such critical social science research is increasingly recognised as a crucial part of the evidentiary basis upon which people-centred and equitable health policy and systems everywhere are built. This volume will be of interest to scholars working at the intersection of critical global health, medical anthropology, and health policy and systems research, as well as to global public health practitioners.

Contributions of the History and Philosophy of Science and Methodology of Problematization to the Public Health Policies teaching and their connection with the Environment

This paper aims to report and analyze a pedagogical practice developed for Public Health Policies teaching in a course held at the Federal University of Lavras, in the first semester of 2018. For the development of this paper, a class was created and taught in a Public Health Policies teaching course based on the History and Philosophy of Science and Problem-solving Methodology, seeking to understand how these pedagogical strategies contribute to the teaching of this theme and its connection with the environment. At the end of the class, students were asked to evaluate the practice, pointing out the strengths and points to be improved. These feedbacks were organized and analyzed qualitatively through the Content Analysis and, later, were discussed. The results of the analyzes indicate that Environmental Education cannot be conservative of social conditions, but rather present the connection between man and nature, highlighting the link between the exploration of nature and the production of goods. In addition, the History and Philosophy of Science, starting with questions about the reality of students, can enhance the teaching-learning process, since it can avoid fragmentation of knowledge, allowing an approximation of students to scientific knowledge and its social use.

Tramas históricas a respeito da psiquiatrização, disciplina e medicalização em algumas lentes de Michel Foucault

Este artigo busca traçar em formato de ensaio teórico uma trama histórica de alguns operadores analíticos dos procedimentos de psiquiatrização da sociedade e da medicalização dos corpos por meio de práticas sociais normalizadoras e disciplinares. Pensar estes acontecimentos e como são interrogados e trabalhados por Michel Foucault é uma proposta importante e nos auxilia a fazer perguntas a respeito do presente na medida em que diversas análises permitem correlações com a atualidade vivida e, assim, possibilita problematizar a considerável força da psiquiatria social hoje, reconfigurando as políticas de saúde mental disciplinadoras por um viés medicalizante e normalizador cada vez mais intenso em nome da defesa da sociedade. Logo, o presente texto contribui para diversas áreas de modo transdisciplinar no trabalho atento de desnaturalização histórica dos processos de medicalização e psiquiatrização da vida como norma disciplinar e social.Palavras-chave: História da psiquiatrização. Medicalização. Sociedade. Disciplina. Norma.Historical plots about psychiatry, discipline and medicalization in some of Michel Foucault's lensesABSTRACTThis article seeks to trace, in a theoretical essay format, a historial plots of some analytical operators of the psychiatric procedures of society and the medicalization of bodies through normalizing and disciplinary social practices. Thinking about these events and how they are interrogated and worked on by Michel Foucault is an important proposal and helps us to ask questions about the present, as several analyzes allow correlations with the current experience and, thus, make it possible to problematize the considerable strength of social psychiatry. today, reconfiguring disciplinary mental health policies through an increasingly intense medicalizing and normalizing bias in the name of defending society. Therefore, this text contributes to several areas in a transdisciplinary way in the careful work of historical denaturalization of the processes of medicalization and psychiatrization of life as a social and disciplinary norm.Keywords: History of psychiatrization. Medicalization. Society. Subject. Standard.

Use of Information Technology in evaluation of access and quality Primary Health Care in Brazil: qualitative study (Preprint)

BACKGROUND The increased applicability of information technology for evaluating health policies, programs, and care requires advancements in understanding trends, influences, its use by evaluators, and the implications for quality standards of evaluation. OBJECTIVE This study aimed to assess the applicability of information technology in evaluation the Access and quality of primary health care in Brazil considering international quality standards. METHODS We conducted a qualitative case study during the External Evaluation of Brazil’s National Program for Improving Primary Care Access and Quality. Data collection consisted of interviews, focus groups, and document analysis. Seven technicians from the Ministry of Health and 47 researchers from various high education and research institutions across the country participated in the study. Data were categorized using the software Atlas.ti, according to the quality standards of the Joint Committee on Standards for Education Evaluation, followed by Bardin’s content analysis. RESULTS Results related to feasibility, thematic scope, field activity management, standardized data collection, data consistency, and transparency, demonstrate improvements and opportunities for advancements in evaluation mediated by the use of Information Technology, favoring the emergence of new practices and remodeling of existing ones, taking into account the multiple components required by the complex assessment of access and quality in primary health care. Difficulty in operating, inoperative system, and lack of investment in equipment and human resources are challenges to increase the effectiveness of information technology in evaluation. CONCLUSIONS The strategic and intelligent use of information technology offered evaluators a greater opportunity to stakeholder engagement, to insert different organizational, operational, and methodological components, capable of triggering influences and confluences, with connections in collaborative and synergistic networks to increase the quality and allow the development of a more consistent and efficient evaluation with greater possibility of incorporating the results into public health policies.