The future of public health policymaking after COVID-19: a qualitative systematic review of lessons from Health in All Policies

Background: ‘Health in All Policies’ (HiAP) describes the pursuit of health equity. It has five main elements: treat health as a human right; identify evidence of the ‘social determinants’ of health inequalities, recognise that most powers to affect health are not held by health departments, promote intersectoral policymaking and collaboration inside and outside of government, and generate political will. Studies describe its potential but bemoan a major implementation gap. Some HiAP scholars learn from policymaking research how to understand this gap, but the use of policy theories is patchy. In that context, our guiding research question is: How does HiAP research use policy theory to understand policymaking? It allows us to zoom-out to survey the field and zoom-in to identify: the assumed and actual causes of policy change, and transferable lessons to HiAP scholars and advocates. Methods: Our qualitative systematic review (two phases, 2018 and 2020) identified 4972 HiAP articles. Of these, 113 journal articles (research and commentary) provide a non-trivial reference to policymaking (at least one reference to a policymaking concept). We use the 113 articles to produce a general HiAP narrative and explore how the relatively theory-informed articles enhance it. Results: Most articles focus on policy analysis (identifying policy problems and solutions) rather than policy theory (explaining policymaking dynamics). They report a disappointing gap between HiAP expectations and policy outcomes. Theory-informed articles contribute to a HiAP playbook to close that gap or a programme theory to design and evaluate HiAP in new ways. Conclusions: Few HiAP articles use policy theories for their intended purpose. Policy theories provide lessons to aid critical reflection on power, political dilemmas, and policymaking context. HiAP scholars seek more instrumental lessons, potentially at the cost of effective advocacy and research.

Transformative health promotion: what is needed to advance progress?

Transformative health promotion actions are needed to achieve health equity and the Sustainable Development Goals (SDGs), advance human and planetary wellbeing, and ensure that we build back better post-COVID-19. Health policies and systems need to be aligned with the values, principles and strategies of health promotion and investment made in strengthening essential health promotion functions. This paper considers how transformative health promotion can be advanced, by reflecting critically on what progress needs to be made and the structures and processes that are required to strengthen health promotion at a systems level. Progress in implementing health promotion is variable, and there is a general lack of investment in developing the necessary health promotion systems for substantive progress to be made. Key enablers and system requirements for comprehensive health promotion are examined, including the following critical elements: (i) effective advocacy for the concept and practice of health promotion; (ii) enabling policy structures for universal health promotion actions on a cross-sectoral basis; (iii) effective implementation systems, support mechanisms and workforce capacity for multisectoral health promotion action; (iv) investment in innovative research methods and knowledge translation to inform transformative health promotion approaches. In strengthening capacity to implement transformative health promotion actions, political will needs to be mobilized to ensure that dedicated and sustainable funding is made available, and the organizational and workforce capacity to deliver effective health promotion interventions is in place. The International Union for Health Promotion and Education (IUHPE) plays a central role in advancing transformative health promotion through mobilising and supporting its global members and partners in strengthening health promotion systems.

The shift to cause framing in Egyptian LGBT advocacy after the January 25 revolution

This study sheds light on LGBT activists’ recourse to the rights frame as a means to overcome social and political restrictions and develop an effective advocacy in an authoritarian context. While the literature has de-emphasized social movements’ recourse to cultural resources in authoritarian contexts, this study presents cause framing and its interactionist approach, cultural opportunity structure, as a means of adaptation to repression. Thanks to the rights frame, activists used cultural resources in the formulation of their cause based on feelings of common injustice and the development of a flexible transnational cyber-advocacy calling for the end to the state’s violation of individual rights.

The Lawyer's Duty to Arbitrate in Good Faith and with Civility

Van Vechten (Johnny) Veeder delivered the 2001 Goff Lecture in Hong Kong on the topic of ‘The Lawyer’s Duty to Arbitrate in Good Faith’. He was especially concerned that there should be a ‘level playing field’ for advocates who come from different jurisdictions and who are subject to different national deontological rules. His concerns were echoed and amplified by other leading voices. This led to the issue being addressed in guidelines drafted by some arbitral institutions and organisations (such as the LCIA, the IBA arbitration committee and ICCA). While not addressed in his Goff lecture, Veeder was also concerned that advocates should treat each other with civility. This article, written as a tribute to Veeder, explores the extent to which various ethical codes of conduct, changes in law firm culture, issues of mental wellbeing, and effective advocacy, require lawyers to treat each other with courtesy, respect and civility.

The future of public health policymaking after COVID-19: a qualitative systematic review of lessons from Health in All Policies

Background: ‘Health in All Policies’ (HIAP) describes the pursuit of health equity. It has five main elements: treat health as a human right; identify evidence of the ‘social determinants’ of health inequalities, recognise that most powers to affect health are not held by health departments, promote intersectoral policymaking and collaboration inside and outside of government, and generate political will. Studies describe its potential but bemoan a major implementation gap. Some HIAP scholars learn from policymaking research how to understand this gap, but the use of policy theories is patchy. In that context, our guiding research question is: How does HIAP research use policy theory to understand policymaking? It allows us to zoom-out to survey the field and zoom-in to identify: the assumed and actual causes of policy change, and transferable lessons to HIAP scholars and advocates. Methods: Our qualitative systematic review (two phases, 2018 and 2020) identified 4972 HIAP articles. Of these, 113 journal articles (research and commentary) provide a non-trivial reference to policymaking (at least one reference to a policymaking concept). We use the 113 articles to produce a general HIAP narrative and explore how the relatively theory-informed articles enhance it. Results: Most articles focus on policy analysis (identifying policy problems and solutions) rather than policy theory (explaining policymaking dynamics). They report a disappointing gap between HIAP expectations and policy outcomes. Theory-informed articles contribute to a HIAP playbook to close that gap or a programme theory to design and evaluate HIAP in new ways. Conclusions: Few HIAP articles use policy theories for their intended purpose. Policy theories provide lessons to aid critical reflection on power, political dilemmas, and policymaking context. HIAP scholars seek more instrumental lessons, potentially at the cost of effective advocacy and research.

Community Participation Approaches for Effective National COVID-19 Pandemic Preparedness and Response: An Experience From Oman

Oman, like other countries in the world, was affected by the COVID-19 pandemic. Since the WHO's declaration of the pandemic, the Ministry of Health of Oman has initiated its preparedness and response to the pandemic, with community participation as one of the key components of the national preparedness and response plan. This paper is a descriptive study aims at describing the three community approaches that exist in Oman and reviewing their role in preparedness and response strategies to COVID-19 pandemic and discuss the lessons learned. Community participation approaches in Oman were translated into action during the pandemic through empowering community members, mobilizing resources, and strengthening the ownership among the local community to ensure effective advocacy, proper networking, and dissemination of information and, subsequently, actions at the level of the community. The first community participation approach is community organizations within the healthy cities and villages initiative, which facilitated networking and acted as a platform for community engagement, reviewing the health information and updating them accordingly to meet evloving demands. The second approach is Willayat (District) health committees, with their unique multi-sectoral structure, that enhanced collaboration at the state level with different community leaders and groups to develop pandemic action plans, which were implemented using available local resources. The third approach is community volunteers that remain the key information providers, particularly when physical access becomes limited due to physical distancing measures. Based on this review, we advocate to further strengthen these approaches and recommends that they are implemented for the protection and promotion of health and well-being, including for health emergencies.

Counselling Psychology and Under-Represented Groups: A Vision for Advocacy as Mutual Transformation

The discipline of counselling psychology in Canada has aligned consistently with social justice principles. Consistent with this, a working group at the 2018 Canadian Counselling Psychology Conference was assigned to consider the role of Canadian counselling psychology in advocating for the needs of members of under-represented groups. This brief report captures insights from the working group and focuses on two primary themes: a critical reformulation of advocacy as mutual transformation for personal and social change and a need to engage with change processes at multiple levels. The group conceptualized effective advocacy as recentring historically marginalized perspectives while decentring “expert” roles and traditionally dominant perspectives.

Afterword

In this afterword, the authors emphasize that all school-based mental health providers must be advocates for the emotional well-being of our youth. They emphasize that advocates are made, not born, and discuss specific knowledge and skills necessary for effective advocacy. They then discuss three top advocacy priorities: (a) increasing the number of mental health professionals in the schools; (b) promoting programs, policies, training, and research that supports the emotional well-being of youth; and (c) supporting models, frameworks, and positions developed by the National Association of School Psychologists, the American Psychological Association, and many other mental health associations that support children’s needs. In closing, they discuss how to be advocates for all children and, most important, our most vulnerable student populations at the personal, local (including school), state, national, and international levels.