‘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.

Evolution of policy for the treatment of substance use disorders in Qatar

There is a marked paucity of published evidence on the extent and nature of substance use disorders in the State of Qatar. This is mirrored by a dearth of information on the policy for the treatment of substance use disorders in the public domain. Between 2007 and 2017, substance use disorders have risen from the third to leading cause of disability in Qatar. More recently, Qatar has shifted from applying a punitive only paradigm in managing substance use problems to recognizing the role of treatment and care for people with substance use disorders. Recently published official documents in Qatar define addiction as a disease and as a chronic condition where people with substance use disorders should be treated as patients who need care and assistance. This shifts the onus of providing, and developing services, for individuals with substance use disorders with healthcare providers rather than purely with the criminal justice system. Following cabinet approval, the recently established Permanent Committee for Addiction Treatment headed by the Minister of Public Health, signals the need to institutionalize systems and structures to upscale demand reduction programmes in the country. This article is a descriptive examination of the shifts in substance abuse treatment policy in Qatar, the major factors influencing this evolution, and will utilise some of the policy science theories to describe and analyse policy outcomes. The article will also frame the substance use problem in Qatar for the first time, based on documents published by various government organisations.

Welfare Mediators as Game Changers? Deconstructing Power Asymmetries Between EU Migrants and Welfare Administrators

Under EU law, EU citizens constitute a particular group of immigrants, as they can, mostly without restrictions, move to, and reside in, another EU country, enjoying equal treatment with nationals in terms of accessing employment and social rights. However, as this article demonstrates, the settlement of EU citizens in another member state does not happen without hurdles. Through a careful in‐depth study of access to transnational welfare rights in practice, we analyse knowledge and resulting power asymmetries impacting interactions between certain EU migrant claimants and street‐level bureaucrats in Austrian and German social administrations. Following an inductive approach, based on an extensive data set of 144 qualitative interviews, this article first unpacks the different types of knowledge asymmetries relating to administrative procedures, formal social entitlements and the German language. We then analyse how such knowledge asymmetries may open space for welfare mediation in order to compensate for a lack of German language skills and to clarify misunderstandings about legal entitlements and obligations embedded in the claims system. Finally, our contribution offers a typology of welfare mediators and their characteristics, as not all types can be regarded as equally effective in reshaping power asymmetries. Overall, this article allows for insights into how welfare mediators, as more or less institutionalised opportunity structures, can shift policy outcomes in unexpected ways, enabling access to social benefits and services for otherwise excluded EU migrant citizens working, or seeking to work, in another EU member state.

Let's End HepC: Modelling Public Health Epidemiological Policies Applied to Hepatitis C in Spain

Background: The WHO has defined international targets toward the elimination of hepatitis C by 2030. Most countries cannot be on track to achieve this goal unless many challenges are surpassed. The Let's End HepC (LEHC) tool aims to contribute to the control of hepatitis C. The innovation of this tool combines the modelling of public health policies (PHP) focused on hepatitis C with epidemiological modelling of the disease, obtaining a unique result that allows to forecast the impact of policy outcomes. The model was applied to several countries, including Spain.Methods: To address the stated objective, we applied the “Adaptive Conjoint Analysis” for PHP decision-making and Markov Chains in the LEHC modelling tool. The tool also aims to be used as an element of health literacy for patient advocacy through gamification mechanisms and country comparability. The LEHC project has been conducted in several countries, including Spain. The population segments comprised in the project are: People Who Inject Drugs (PWID), prisoners, blood products, remnant population.Results: A total of 24 PHP related to hepatitis C were included in the LEHC project. It was identified that Spain had fully implemented 14 of those policies to control hepatitis C. According to LEHC's model forecast, the WHO's Hepatitis C elimination goal on reducing the number of patients living with Hepatitis C to 10% can be achieved in Spain by 2026 if current policies are maintained. The model estimates that the total population in Spain, by 2026, is expected to comprise 26,367 individuals living with hepatitis C. Moreover, if the 24 PHP considered for this study are fully implemented in Spain, the elimination goal may be achieved in 2024, with 29,615 individuals living with hepatitis C by that year.Conclusion: The findings corroborate the view that Spain has set great efforts in directing PHP toward Hepatitis C Virus (HCV) elimination by 2030. However, there is still room for improvement, namely in further implementing 10 of the 24 PHP considered for the LEHC project. By maintaining the 14 PHP in force, the LEHC model estimates the HCV elimination in the country by 2026, and by 2024 if further measures are employed to control the disease.

How do policy transfer mechanisms influence policy outcomes in the context of authoritarianism in Vietnam?

The literature on policy transfer shows that it may result in simultaneous policy convergence and policy divergence. However, little is known about how such results happen when transferring from multiple and possibly contrasting sources. This study finds that civil service reforms in Vietnam’s merit-based policies are influenced by both western and Asian models of meritocracy. This makes them both closer to universal ‘best practices’ and at the same time sharpens the distinctiveness of Vietnam’s policy. The calculations of political actors in combination with the context of a one-party authoritarian state have led to policy transfer through mechanisms of translation and assemblage which brings about a hybrid of convergence and divergence. This study enhances understanding of policy transfer in the context of Asian authoritarianism. In finding hybridity in transfer outcomes in this national context, the article shows the uniqueness of resultant policy change and develops an analytical framework for the influence of policy transfer on policy outcomes.

Representative Bureaucracy, Institutional Support, and Clientele Need: The Case of Undocumented Students

The theory of representative bureaucracy posits that passive representation is associated with improvements in policy outcomes for represented groups. This research examines the institutional conditions under which representative bureaucracy is enhanced or limited. It posits that the benefits of representation will be enhanced when institutional supports are stronger and when clientele need is greatest. Using a unique longitudinal, multi-level dataset, this paper tests competing theoretical conditions (including resource constraints, and task difficulty) under which representative bureaucracy is enhanced or constrained. The analysis tracks student-level performance of 400,000 undocumented students in Texas public schools from 2003 to 2011 providing a powerful empirical test as well as practical policy implications for administrators. It finds that the effects of representation are strongest when resources are abundant and clientele need is greatest. This suggests representative may be even more valuable to organizations than previously thought.

Rethinking Language Education policy in the Context of Multilingual/ Multicultural English

Globalization has brought about a phenomenal spread of English. This spread has led to the emergence of the newborn varieties which has created serious challenges to language teaching pedagogy and language education policy. Bangbose (2003) has clearly pointed to this issue, stating “as researchers in world Englishes, we cannot consider our job done if we turn a blind eye to the problems of educational failure or unfavorable language policy outcomes” (as cited in the Council of Europe, 2007, p. 31). It seems that there is a mismatch between the advances that happened in the field of applied linguistics and language education policy. This paper focuses on language education policy in the context of global English because it is considered one of the influential factors in the gap between English lingua franca reality and English as a native language. First, it gives a brief overview of the recent situation with regard to English and shows the recent reality of multilingual English and its multifarious aspect (Rahal, 2018 & 2019). It also discusses the conceptual gap in language education policy. It points to the conceptual gap between the sociolinguistic reality of English and the language education policy that is still oriented towards English as a native language. Then, the paper points to the need for a language policy that includes linguistic diversity.

Synergy Development of “State-Representative Apparatus” in Accelerating Social Forestry Policy Outcomes in Ngawi Regency, East Java

Social forestry is a new approach to solving problems around forests, such as poverty, social inequality, and massive deforestation. Indonesia’s new social forestry policy has given local communities greater rights and legal certainty regarding their involvement in forest management. However, local communities cannot stand alone in their implementation but must collaborate with other relevant stakeholders. A qualitative descriptive approach is used in this paper to capture efforts to build synergies between stakeholders in forest management and empowerment of forest communities in Ngawi Regency and identify opportunities and challenges afterward. The results of our analysis found that the signing of the MoU can be the first step to accelerate the achievement of social forestry policy outcomes. The dichotomy between “forest” and “social” affairs is increasingly visible in the division of tasks of each stakeholder involved. There is a need for clear legal rules regarding the roles and limits of allowable intervention for Regency governments. In addition, an urgent issue that needs to be addressed is the acceleration of capacity building and the capability of local communities, which are identified as essential factors in the success of social forestry policies.