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Thondoo M, Mogo ERI, Tatah L, Muti M, van Daalen KR, Muzenda T, Boscott R, Uwais O, Farmer G, Yue A, Dalzell S, Mukoma G, Bhagtani D, Matina S, Dambisya PM, Okop K, Ebikeme C, Micklesfield L, Oni T. Multisectoral interventions for urban health in Africa: a mixed-methods systematic review. Glob Health Action 2024; 17:2325726. [PMID: 38577879 PMCID: PMC11000616 DOI: 10.1080/16549716.2024.2325726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 02/25/2024] [Indexed: 04/06/2024] Open
Abstract
Increasing evidence suggests that urban health objectives are best achieved through a multisectoral approach. This approach requires multiple sectors to consider health and well-being as a central aspect of their policy development and implementation, recognising that numerous determinants of health lie outside (or beyond the confines of) the health sector. However, collaboration across sectors remains scarce and multisectoral interventions to support health are lacking in Africa. To address this gap in research, we conducted a mixed-method systematic review of multisectoral interventions aimed at enhancing health, with a particular focus on non-communicable diseases in urban African settings. Africa is the world's fastest urbanising region, making it a critical context in which to examine the impact of multisectoral approaches to improve health. This systematic review provides a valuable overview of current knowledge on multisectoral urban health interventions and enables the identification of existing knowledge gaps, and consequently, avenues for future research. We searched four academic databases (PubMed, Scopus, Web of Science, Global Health) for evidence dated 1989-2019 and identified grey literature from expert input. We identified 53 articles (17 quantitative, 20 qualitative, 12 mixed methods) involving collaborations across 22 sectors and 16 African countries. The principle guiding the majority of the multisectoral interventions was community health equity (39.6%), followed by healthy cities and healthy urban governance principles (32.1%). Targeted health outcomes were diverse, spanning behaviour, environmental and active participation from communities. With only 2% of all studies focusing on health equity as an outcome and with 47% of studies published by first authors located outside Africa, this review underlines the need for future research to prioritise equity both in terms of research outcomes and processes. A synthesised framework of seven interconnected components showcases an ecosystem on multisectoral interventions for urban health that can be examined in the future research in African urban settings that can benefit the health of people and the planet.Paper ContextMain findings: Multisectoral interventions were identified in 27.8% of African countries in the African Union, targeted at major cities with five sectors present at all intervention stages: academia or research, agriculture, government, health, and non-governmental.Added knowledge: We propose a synthesised framework showcasing an ecosystem on multisectoral interventions for urban health that can guide future research in African urban settings.Global health impact for policy and action: This study reveals a crucial gap in evidence on evaluating the long-term impact of multisectoral interventions and calls for partnerships involving various sectors and robust community engagement to effectively deliver and sustain health-promoting policies and actions.
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Affiliation(s)
- Meelan Thondoo
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Barcelona Institute for Global Health (ISGlobal), Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - Ebele R. I. Mogo
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Barcelona Institute for Global Health (ISGlobal), Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - Lambed Tatah
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Monica Muti
- SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Kim R. van Daalen
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK
- Barcelona Supercomputing Center (BSC), Department of Earth Sciences, Barcelona, Spain
| | - Trish Muzenda
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Rachel Boscott
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Omar Uwais
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - George Farmer
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Adelaide Yue
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Sarah Dalzell
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Gudani Mukoma
- SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
- Department of Biokinetics, Recreation and Sport Science, Faculty of Health Sciences, University of Venda, Thohoyandou, South Africa
| | - Divya Bhagtani
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Sostina Matina
- SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Philip M. Dambisya
- Health Policy and Systems Division, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Centre for Innovation in Learning and Teaching, University of Cape Town, Cape Town, South Africa
| | - Kufre Okop
- Chronic Disease Initiative for Africa (CDIA), Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Charles Ebikeme
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Lisa Micklesfield
- SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Tolu Oni
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
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Cuervo LG, Villamizar CJ, Osorio L, Ospina MB, Cuervo DE, Cuervo D, Bula MO, Zapata P, Owens NJ, Hatcher-Roberts J, Martín EA, Piquero F, Pinilla LF, Martínez-Herrera E, Jaramillo C. Dynamic measurements of geographical accessibility considering traffic congestion using open data: a cross-sectional assessment for haemodialysis services in Cali, Colombia. LANCET REGIONAL HEALTH. AMERICAS 2024; 34:100752. [PMID: 38737772 PMCID: PMC11087994 DOI: 10.1016/j.lana.2024.100752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 03/19/2024] [Accepted: 04/16/2024] [Indexed: 05/14/2024]
Abstract
Background Many cities with traffic congestion lack accessibility assessments accounting for traffic congestion and equity considerations but have disaggregated georeferenced municipal-level open data on health services, populations, and travel times big data. We convened a multistakeholder intersectoral collaborative group that developed a digital, web-based platform integrating open and big data to derive dynamic spatial-temporal accessibility measurements (DSTAM) for haemodialysis services. We worked with stakeholders and data scientists and considered people's places of residence, service locations, and travel time to the service with the shortest travel time. Additionally, we predicted the impacts of strategically introducing haemodialysis services where they optimise accessibility. Methods Cross-sectional analyses of DSTAM, accounting for traffic congestion, were conducted using a web-based platform. This platform integrated traffic analysis zones, public census and health services datasets, and Google Distance Matrix API travel-time data. Predictive and prescriptive analytics identified optimal locations for new haemodialysis services and estimated improvements. Primary outcomes included the percentage of residents within a 20-min car drive of a haemodialysis service during peak and free-flow traffic congestion. Secondary outcomes focused on optimal locations to maximise accessibility with new services and potential improvements. Findings were disaggregated by sociodemographic characteristics, providing an equity perspective. The study in Cali, Colombia, used geographic and disaggregated sociodemographic data from the adjusted 2018 Colombian census. Predicted travel times were obtained for two weeks in 2020. Findings There were substantial traffic variations. Congestion reduced accessibility, especially among marginalised groups. For 6-12 July, free-flow and peak-traffic accessibility rates were 95.2% and 45.0%, respectively. For 23-29 November, free-flow and peak traffic accessibility rates were 89.1% and 69.7%. The locations where new services would optimise accessibility had slight variation and would notably enhance accessibility and health equity. Interpretation Establishing haemodialysis services in targeted areas has significant potential benefits. By increasing accessibility, it would enhance urban health and equity. Funding No external or institutional funding was received.
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Affiliation(s)
| | | | - Lyda Osorio
- School of Public Health, Universidad del Valle, Cali, Colombia
| | | | | | | | | | | | - Nancy J. Owens
- Independent Content and Communications Consultant, Fairfax, VA, USA
| | - Janet Hatcher-Roberts
- School of Epidemiology and Public Health in the Faculty of Medicine, and Bruyère Research Institute, University of Ottawa, Ottawa, ON, Canada
| | | | - Felipe Piquero
- Patient Advocate and Author of an Autopathography, Bogotá, Colombia
| | | | | | - Ciro Jaramillo
- School of Civil and Geomatic Engineering of the Universidad del Valle, Cali, Colombia
| | - The AMORE Project Collaborationp
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- School of Public Health, Universidad del Valle, Cali, Colombia
- Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- National Disability Board of Colombia, Bogotá, Colombia
- IQuartil SAS, Bogotá, Colombia
- Independent Researcher, Bogotá, Colombia
- Independent Content and Communications Consultant, Fairfax, VA, USA
- School of Epidemiology and Public Health in the Faculty of Medicine, and Bruyère Research Institute, University of Ottawa, Ottawa, ON, Canada
- Colombian Association of Transplanted Athletes, Bogota, Colombia
- Patient Advocate and Author of an Autopathography, Bogotá, Colombia
- Universidad de la Sabana, Campus del Puente del Común, Chía, Cundinamarca, Colombia
- National Faculty of Public Health, Universidad de Antioquia, Medellín, Colombia
- School of Civil and Geomatic Engineering of the Universidad del Valle, Cali, Colombia
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Lozan O, Mîţa V, Demişcan D, Buzeti T, Beznec P, Sava V, Curteanu A, Rîmiş C, Canavan R, Prytherch H. Assessing capacities to strengthen intersectoral collaboration in Territorial Public Health Councils in the Republic of Moldova. PLoS One 2024; 19:e0303821. [PMID: 38814932 DOI: 10.1371/journal.pone.0303821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 05/01/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND The government of the Republic of Moldova, endorsed the principle of Health in All Policies (HiAP) through its health sector reforms to address the rising burden of non-communicable diseases and health inequalities. Territorial Public Health Councils (TPHCs) were created to ensure the coordination and management of the population's health in their respective district. This study assessed the capacities of the TPHCs to identify areas in need of support for strengthening their intersectoral collaboration role in public health at local level. METHODS A mixed-method approach, using qualitative and quantitative techniques, was used to compare the perceptions of all TPHC members (n = 112) and invitees (n = 53) to council meetings from 10 districts covering all geographical areas of Moldova. The quantitative information was obtained using a cross-sectional survey, while the qualitative aspects were assessed within focus group discussions (FGDs). RESULTS Half of all TPHC members, including 75% from groups with a non-medical background, did not attend a public health course within the last three years. Overall, groups with a medical background were more aware of the legislation that governs TPHC activity and intersectoral collaboration compared with those with a non-medical background. The FGDs of TPHC meetings revealed that members had an insufficient level of understanding of intersectoral collaboration to solve public health issues and lacked clarity about their place and role within the TPHC. CONCLUSIONS HiAP implementation was found to be suboptimal with insufficient capacity at local level. TPHC members' ability to deal with public health issues were severely impaired by a general lack of knowledge and understanding of how to utilize the TPHC platform for maximum benefit. Reforming TPHC regulation is required in addition to extensive capacity building for TPHC members to increase member understanding of their roles as intended by TPHC regulations, including the facilitation of intersectoral collaborations.
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Affiliation(s)
- Oleg Lozan
- School of Public Health Management, Nicolae Testemitanu State University of Medicine and Pharmacy, Chișinău, Republic of Moldova
| | - Valentin Mîţa
- School of Public Health Management, Nicolae Testemitanu State University of Medicine and Pharmacy, Chișinău, Republic of Moldova
| | - Daniela Demişcan
- School of Public Health Management, Nicolae Testemitanu State University of Medicine and Pharmacy, Chișinău, Republic of Moldova
| | - Tatjana Buzeti
- WHO European Office for Investment for Health and Development, Venice, Italy
| | - Peter Beznec
- The Centre for Health and Development Murska Sobota (CHD), Murska Sobota, Slovenia
| | - Valeriu Sava
- Swiss Agency for Development and Cooperation (SDC), Chisinau, Republic of Moldova
| | - Ala Curteanu
- Healthy Life Project: Reducing the Burden of Non-Communicable Diseases in Moldova, Chisinau, Republic of Moldova
- Mother and Child Institute, Chisinau, Republic of Moldova
| | - Constantin Rîmiş
- Healthy Life Project: Reducing the Burden of Non-Communicable Diseases in Moldova, Chisinau, Republic of Moldova
| | - Robert Canavan
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Helen Prytherch
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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Singh S, Miller E, Closser S. Nurturing transformative local structures of multisectoral collaboration for primary health care: qualitative insights from select states in India. BMC Health Serv Res 2024; 24:634. [PMID: 38755604 PMCID: PMC11100027 DOI: 10.1186/s12913-024-11002-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 04/17/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Multisectoral collaboration is essential for advancing primary health care (PHC). In low- and middle-income countries (LMICs), limited institutional capacities, governance issues, and inadequate stakeholder engagement impede multisectoral collaboration. India faces similar challenges, especially at the meso-level (districts and subdistricts). Owing to its dependence on context, and insufficient evidence, understanding "How" to improve multisectoral collaboration remains challenging. This study aims to elicit specific recommendations to strengthen meso-level stewardship in India for multisectoral collaboration. The findings from this study may offer lessons for other LMICs. METHODS Using purposive, maximum variation sampling, the study team conducted semi-structured interviews with 20 diverse participants, including policymakers, implementers, development agency representatives, and academics experienced in multisectoral initiatives. The interviews delved into participants' experiences, the current situation, enablers, and recommendations for enhancing stakeholder engagement and capacities at the meso-level for multisectoral collaboration. RESULTS Context and power are critical elements to consider in fostering effective collaboration. Multisectoral collaboration was particularly successful in three distinct governance contexts: the social-democratic context as in Kerala, the social governance context in Chhattisgarh, and the public health governance context in Tamil Nadu. Adequate health system input and timely guidance instil confidence among local implementers to collaborate. While power plays a role through local leadership's influence in setting agendas, convening stakeholders, and ensuring accountability. To nurture transformative local leaders for collaboration, holistic, equity-driven, community-informed approaches are essential. The study participants proposed several concrete steps: at the state level, establish "central management units" for supervising local implementers and ensuring bottom-up feedback; at the district level, rationalise committees and assign deliverables to stakeholders; and at the block level, expand convergence structures and involve local self-governments. Development partners can support data-driven priority setting, but local implementers with contextual familiarity should develop decentralised plans collaboratively, articulating rationales, activities, and resources. Finally, innovative training programs are required at all levels, fostering humility, motivation, equity awareness, leadership, problem- solving, and data use proficiency. CONCLUSION This study offers multiple solutions to enhance local implementers' engagement in multisectoral efforts, advocating for the development, piloting, and evaluation of innovative approaches such as the block convergence model, locally-led collaboration efforts, and novel training methods for local implementers.
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Affiliation(s)
- Shalini Singh
- Department of International Health, Johns Hopkins Bloomberg School of Public Health (JHSPH), Baltimore, USA.
- Johns Hopkins India Private Limited, New Delhi, India.
| | - Emily Miller
- Department of International Health, Johns Hopkins Bloomberg School of Public Health (JHSPH), Baltimore, USA
| | - Svea Closser
- Department of International Health, Johns Hopkins Bloomberg School of Public Health (JHSPH), Baltimore, USA
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Amri M, Yang J, Jessiman-Perreault G, Haikal A, Barrett K, Bump JB. Equity and gender mainstreaming in public policy: A scoping review protocol. PLoS One 2024; 19:e0299124. [PMID: 38394263 PMCID: PMC10890743 DOI: 10.1371/journal.pone.0299124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Despite growing attention paid to health equity and efforts to promote gender mainstreaming-a global strategy to promote gender equality-how policymakers have 'institutionalized' this in their work is less clear. Therefore, this planned scoping review seeks to search the peer-reviewed and grey literature to compile evidence on the ways in which policymakers have routinely or systematically considered equity and/or gender in their work. METHODS A scoping review will be undertaken by drawing on the PRISMA guidelines for Scoping Reviews (PRISMA-ScR). With the expert guidance of a research librarian, Ovid MEDLINE, Ovid EMBASE, PAIS Index, and Scopus databases will be searched, in addition to custom Google searches of government documents. The search will be conducted from 1995 and onwards, as there were no hits prior to this date that included the term "gender mainstream*" in these databases. The inclusion criterion is that: (i) texts must provide information on how equity and/or gender has been considered by government officials in the development of public policy in a routine or systematic manner (e.g., descriptive, empirical); (ii) both texts produced by government or not (e.g., commentary about government action) will be included; (iii) there are no restrictions on study design or article type (i.e., commentaries, reports, and other documents, would all be included); and (iv) texts must be published in English due to resource constraints. However, texts that discuss the work of nongovernmental or intergovernmental organizations will be excluded. Data will be charted by: bibliographic information, including the authors, year, and article title; country the text discussed; and a brief summary on the approach taken. DISCUSSION This protocol was developed to improve rigour in the study design and to promote transparency by sharing our methods with the broader research community. This protocol will support a scoping review of the ways in which policymakers have routinely or systematically considered equity and/or gender in their work. We will generate findings to inform government efforts to initiate, sustain, and improve gender and equity mainstreaming approaches in policymaking.
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Affiliation(s)
- Michelle Amri
- School of Public Policy, Simon Fraser University, Harbour Center, Vancouver, BC, Canada
- Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States of America
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jinny Yang
- Faculty of Arts, McGill University, Dawson Hall, Montreal, Quebec, Canada
| | | | - Amne Haikal
- School of Public Policy, University of Calgary, Calgary, AB, Canada
| | - Kathryn Barrett
- University of Toronto Scarborough Library, Scarborough, ON, Canada
| | - Jesse B. Bump
- Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States of America
- Bergen Centre for Ethics and Priority Setting, University of Bergen, Norway, Bergen, Norway
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Tait C, Tonelli M. The Importance of Indigenous Leadership for Reducing Inequities in the Treatment of Kidney Failure. Am J Kidney Dis 2024; 83:127-129. [PMID: 37952142 DOI: 10.1053/j.ajkd.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/04/2023] [Accepted: 10/11/2023] [Indexed: 11/14/2023]
Affiliation(s)
- Caroline Tait
- Faculty of Social Work, University of Calgary, Calgary, Canada; Cumming School of Medicine, University of Calgary, Calgary, Canada.
| | - Marcello Tonelli
- Cumming School of Medicine, University of Calgary, Calgary, Canada
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Collaço N, Lippiett KA, Wright D, Brodie H, Winter J, Richardson A, Foster C. Barriers and facilitators to integrated cancer care between primary and secondary care: a scoping review. Support Care Cancer 2024; 32:120. [PMID: 38252169 PMCID: PMC10803398 DOI: 10.1007/s00520-023-08278-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 12/18/2023] [Indexed: 01/23/2024]
Abstract
PURPOSE This scoping review identifies and characterises reported barriers and facilitators to providing integrated cancer care reported in the international literature, and develops recommendations for clinical practice. METHODS This scoping review included literature published between 2009 and 2022 and describes the delivery of integrated cancer care between primary and secondary care sectors. Searches were conducted of an online database Ovid Medline and grey literature. RESULTS The review included thirty-two papers. Barriers and facilitators to integrated cancer care were identified in three core areas: (1) at an individual user level around patient-healthcare professional interactions, (2) at an organisational level, and (3) at a healthcare system level. The review findings identified a need for further training for primary care professionals on cancer care, clarity in the delineation of primary care and oncologist roles (i.e. who does what), effective communication and engagement between primary and secondary care, and the provision of protocols and guidelines for follow-up care in cancer. CONCLUSIONS Information sharing and communication between primary and secondary care must improve to meet the increasing demand for support for people living with and beyond cancer. Delivering integrated pathways between primary and secondary care will yield improvements in patient outcomes and health economic costs.
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Affiliation(s)
- Nicole Collaço
- Centre for Psychosocial Research in Cancer (CentRIC+), School of Health Sciences, University of Southampton, Southampton, SO17 1BJ, England
| | - Kate A Lippiett
- School of Health Sciences, University of Southampton, Southampton, England
| | - David Wright
- Centre for Psychosocial Research in Cancer (CentRIC+), School of Health Sciences, University of Southampton, Southampton, SO17 1BJ, England
| | - Hazel Brodie
- School of Health Sciences, University of Southampton, Southampton, England
| | - Jane Winter
- Wessex Cancer Alliance, Oakley Road, Southampton, England
| | - Alison Richardson
- School of Health Sciences, University of Southampton, Southampton, England
- University Hospital Southampton NHS Foundation Trust, Southampton, England
| | - Claire Foster
- Centre for Psychosocial Research in Cancer (CentRIC+), School of Health Sciences, University of Southampton, Southampton, SO17 1BJ, England.
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Biermann O, Nordenstam A, Muwonge T, Kabiri L, Ndeezi G, Alfvén T. Sustainable preventive integrated child health care: reflections on the importance of multidisciplinary and multisectoral stakeholder engagement. Glob Health Action 2023; 16:2173853. [PMID: 36762539 PMCID: PMC9930826 DOI: 10.1080/16549716.2023.2173853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Worldwide, 85% of all children who die are under the age of five. A recent scoping review examining the literature from 2000 to 2021 shows the importance of sustainable integrated preventive child health care for improving child health, enhancing the uptake of preventive child health services, and decreasing health-care costs. In 2022, we organised a stakeholder workshop in Uganda to discuss and contextualise the findings of the scoping review. The workshop took place under the umbrella of the Centre of Excellence for Sustainable Health, a virtual collaborative centre co-hosted by Makerere University in Uganda and Karolinska Institutet in Sweden. The workshop convened multidisciplinary and multisectoral stakeholders, including parents, nurses, paediatricians, nutritionists, village health team members, religious leaders, social workers, teachers, lawyers, health and climate researchers, and representatives from the police, the agricultural sector, the Ministry of Health, the World Health Organization, and other international and national non-governmental organisations, among others. We reflect on the importance of multidisciplinary and multisectoral stakeholder engagement, not only in building bridges between research and practice but also in linking sectors and connecting people for sustainable preventive integrated child health care. Though an important step, this workshop was only a first step; over time, relationships must be nurtured, multisectoral systems built and research and policy closely connected. We hope this workshop will not remain a one-off event but becomes an institutionalised effort that sparks action for sustainable preventive integrated child health care in Kampala and beyond, and sustainable health for all.
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Affiliation(s)
- Olivia Biermann
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden,Centre of Excellence for Sustainable Health, Makerere University, Kampala, Uganda,Centre of Excellence for Sustainable Health, Karolinska Institute, Solna, Sweden,CONTACT Olivia Biermann Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18a, 17177Solna, Sweden
| | - Alma Nordenstam
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden,Centre of Excellence for Sustainable Health, Makerere University, Kampala, Uganda,Centre of Excellence for Sustainable Health, Karolinska Institute, Solna, Sweden
| | - Tonny Muwonge
- School of Public Health, Makerere University, Kampala, Uganda
| | - Lydia Kabiri
- School of Health Sciences, Department of Nursing, Makerere University, Kampala, Uganda
| | - Grace Ndeezi
- Centre of Excellence for Sustainable Health, Makerere University, Kampala, Uganda,Centre of Excellence for Sustainable Health, Karolinska Institute, Solna, Sweden,School of Medicine, Makerere University, Kampala, Uganda
| | - Tobias Alfvén
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden,Centre of Excellence for Sustainable Health, Makerere University, Kampala, Uganda,Centre of Excellence for Sustainable Health, Karolinska Institute, Solna, Sweden,Sachs’ Children and Youth Hospital, Stockholm, Sweden
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Raymond IJ, Burke KJ, Agnew KJ, Kelly DM. Wellbeing-responsive community: a growth target for intentional mental health promotion. Front Public Health 2023; 11:1271954. [PMID: 38152662 PMCID: PMC10751296 DOI: 10.3389/fpubh.2023.1271954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/24/2023] [Indexed: 12/29/2023] Open
Abstract
With mental illness remaining a significant burden of disease, there is an ongoing need for community-based health promotion, prevention, and responses (or "mental health promotion activities"). The health promotion, community development, and positive psychology literature identifies significant heterogeneity in the design and delivery of these activities. This variability spans: (1) individual vs. group outcomes, (2) psychological vs. sociological determinants of change, (3) promoting wellbeing vs. reducing mental health symptoms, and (4) the degree activities are contextualized vs. standardized in design and delivery. Mental health promotion activities do not easily accomplish this level of complexity within design and implementation. This has led to the emergence of the complexity-informed health promotion literature and the need for innovative tools, methods, and theories to drive this endeavor. This article directly responds to this call. It introduces "wellbeing-responsive community": a vision and outcome hierarchy (or growth target) for intentionally delivered mental health promotion. The construct enables the design and implementation of interventions that intentionally respond to complexity and contextualization through the drivers of co-creation, intentionality, and local empowerment. It represents a community (support team, programme, agency, network, school, or region) that has the shared language, knowledge, methods, and skills to work together in shared intent. In other words, to integrate best-practice science with their local knowledge systems and existing strengths, and intentionally co-create and deliver contextualized wellbeing solutions at both the individual and community levels that span the "system" (e.g., whole-of-community) to the "moment" (e.g., intentional support and care). Co-creation, as applied through a transdisciplinary lens, is emerging as an evidence-based method to respond to complexity. This article describes the rationale and evidence underpinning the conceptualization of a wellbeing-responsive community through the integration of three key disciplines: (1) positive psychology, (2) ecological or systems approaches, and (3) intentional practice (implementation science). A definitional, contextual, and applied overview of the wellbeing-responsive community is provided, including a hierarchy of outcomes and associated definitions. Its purported application across education, mental health, community service, and organizational settings is discussed, including its potential role in making complexity-informed health promotion practical for all knowledge users.
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Affiliation(s)
| | - Karena J. Burke
- College of Psychology School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Adelaide, SA, Australia
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Morgan MJ, Stratford E, Harpur S, Rowbotham S. Local government's roles in community health and wellbeing in Australia: Insights from Tasmania. Health Promot J Austr 2023. [PMID: 38050655 DOI: 10.1002/hpja.831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 10/18/2023] [Accepted: 11/15/2023] [Indexed: 12/06/2023] Open
Abstract
ISSUE ADDRESSED Local governments are well-placed to respond to communities' health and wellbeing needs. However, in the Australian state of Tasmania, the sector's roles in that respect are unclear. METHODS We interviewed 10 municipal personnel in Tasmania to understand their views on local governments' community health and wellbeing functions. RESULTS Participants had an integrative understanding of community health and wellbeing and recognised that collective effort from all tiers of government, community members, and other place-based stakeholders would improve outcomes. They identified several roles local governments have to support and drive such improvements, including in relation to diverse place-specific determinants of health and wellbeing. Capacity and capability to fulfil what is needed varied, with rural and remote councils generally less able than urban counterparts to respond consistently or comprehensively to community members' complex needs. However, in the presence of clear expectations and parameters, and appropriate support from other tiers of government, participants were eager for their councils to do more to improve their communities' health and wellbeing, including via a mandate in legislation. CONCLUSION Local governments have the potential to do more to improve health and wellbeing outcomes in Tasmania, and the greatest gains could be made by addressing spatial inequalities faced by the sector. That insight is extensible to other comparable jurisdictions. SO WHAT?: We argue the need both for a shared societal goal of equitable wellbeing supported by all tiers of government and for actions proportionate to the needs of council areas.
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Affiliation(s)
- Michelle J Morgan
- School of Geography, Planning, and Spatial Sciences, University of Tasmania, Hobart, Tasmania, Australia
- Department of Health, Public Health Services, Tasmanian Government, Hobart, Tasmania, Australia
| | - Elaine Stratford
- School of Geography, Planning, and Spatial Sciences, University of Tasmania, Hobart, Tasmania, Australia
| | - Siobhan Harpur
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Samantha Rowbotham
- School of Geography, Planning, and Spatial Sciences, University of Tasmania, Hobart, Tasmania, Australia
- Menzies Centre for Health Policy and Economics, Sydney School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
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Amri M, Sam O, Anye M, Zibwowa Z, Karamagi H, Nabyonga-Orem J. Assessing the governance environment for private sector engagement in health in Africa: Results from a multi-country survey. J Glob Health 2023; 13:04113. [PMID: 37800302 PMCID: PMC10556972 DOI: 10.7189/jogh.13.04113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
Background The role of the private sector in health is clear in many countries but engagement can be improved. The World Health Organization (WHO) developed a global strategy in 2020 focused on engaging the private sector in health service delivery through governance in mixed health systems and detailed six governance behaviours to guide its Member States. To operationalise these global ideas into practice, the Regional Office for Africa conducted a multi-country study to understand perceptions around the six governance behaviours. This article examines the perceptions of respondents from 13 African countries on the governance environment for private sector engagement in health. Methods Data were collected through an online survey that was distributed to individuals from ministries of health and their partner organisations, private sector institutions and initiatives in countries and development organisations (n = 81) across 13 countries. The survey was based on the following six governance behaviours: build understanding, enable stakeholders, nurture trust, foster relations, align structures and deliver strategy. Results Results showed that respondents had mixed perceptions of the governance environment for private sector engagement in health in their respective countries. Although 88% of respondents (n = 63/72) were familiar with the general inclusion of the private sector in national health sector plans, 63% of respondents (n = 45/71) noted there was limited or no integration of the private sector in the health system, and further, 28% of respondents noted there was no private sector reporting in health information systems (n = 19/69). Key opportunities presented in more than one governance behaviour include: (i) increasing private sector engagement in public sector activities, (ii) establishing clear roles and responsibilities through formal partnership agreements, (iii) improving data sharing through shared health information systems, (iv) incentives and subsidies, (v) capacity building, (vi) creating norms, guidelines, and regulations and (vii) conducting joint monitoring and evaluation. Many of these outlined overlapping concepts are not exclusive to one behaviour, thus, it is evident that when targeted, there is the potential to improve numerous governance behaviours. This further reiterates the view that the governance behaviours should be understood as connected and not unrelated areas. Conclusions The study provides insight into the perceptions of respondents from select African countries on the governance environment for private sector engagement in health. These findings can inform the development of strategies and interventions to support and enhance private sector engagement in health in the region.
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Affiliation(s)
- Michelle Amri
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
- Takemi Program in International Health, Harvard School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Omar Sam
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Muriel Anye
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Zandile Zibwowa
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Humphrey Karamagi
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
| | - Juliet Nabyonga-Orem
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
- Centre for Health Professions Education, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
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Stephen C, Walzer C. The continuum of care as a unifying framework for intergenerational and interspecies health equity. Front Public Health 2023; 11:1236569. [PMID: 37860805 PMCID: PMC10582321 DOI: 10.3389/fpubh.2023.1236569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/19/2023] [Indexed: 10/21/2023] Open
Abstract
Introduction Unlocking the full potential of different people and organizations to address existential health threats requires shared goals and frameworks that allow people to see themselves contributing to a common and shared continuum of care. A new narrative to help people implement collective action for collective problems is needed. Methods This paper is draw from the co-authors experience working from the local to international level on planetary health problems. Results The proposed conceptual framework expands the socioecological model of health to help formulate multilevel approaches that foster healthier circumstances for all by revealing the mutual benefits that emerge from pooling expertise, funding, and political will to solve multiple problems with coordinated investment of resources and effort. It is intended to support program planning and communication. This framework is a response to the absence of systematic attempts to concurrently counteract the social and environmental conditions leading to disease, dysfunction and deficits which is increasingly seen as being problematic, especially as the root causes of health problems and solutions converge across species, sectors, and generations. The framework is embedded in the idea of interspecies and intergenerational health equity. Discussion Ensuring interspecies and intergenerational health equity requires each actor to fulfill their roles along the continuum while supporting the needs of others. A socio-ecological continuum of care provides bundled options that combine knowledge from different sectors, disciplines and perspectives to guide interventions over time across a comprehensive array of services and support spanning all levels of needs, species and generations.
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Affiliation(s)
| | - Chris Walzer
- Wildlife Conservation Society, New York, NY, United States
- Research Institute of Wildlife Ecology, University of Veterinary Medicine, Vienna, Austria
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Naem M, Amri M, O'Campo P. Health Equity Cannot Be Sought Without the Consideration of Racism In Equity-Focused Urban Health Initiatives. J Urban Health 2023; 100:834-838. [PMID: 37580547 PMCID: PMC10447814 DOI: 10.1007/s11524-023-00770-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 08/16/2023]
Abstract
Given that racism is present worldwide, we believe it is imperative to address racism in the pursuit of health equity in cities. Despite the strengths of global urban health efforts in improving health equity, these initiatives can be furthered by explicitly considering systemic racism. Because racism is a major contributor to health issues, utilizing critical race theory (CRT) and taking an anti-racist perspective can help key players understand how racial health differences are initiated and sustained, which will subsequently inform solutions in seeking to address urban health inequities. Applying CRT within policymaking can happen in a variety of ways that are explored in this article. Ultimately, by acknowledging and responding to the effect of racism on groups within cities and the increased difficulties racialized minorities face, international players may use their power to transfer data and resources to cities that could benefit from specialized support.
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Affiliation(s)
- Mariem Naem
- Department of Health and Society, University of Toronto Scarborough, 1265 Military Trail, Toronto, ON, M1C 1A4, Canada
| | - Michelle Amri
- Takemi Program in International Health, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Bldg. 1, Boston, MA, 02115-6021, USA.
- School of Public Policy, Simon Fraser University, 515 West Hastings Street, Vancouver, BC, V6B 4N6, Canada.
| | - Patricia O'Campo
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, Toronto, ON, M5B 1T8, Canada
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Hellevik S, Mustafa S, Zhang Y, Shirsat A, Saikat S. Multisectoral action towards sustainable development goal 3.d and building health systems resilience during and beyond COVID-19: Findings from an INTOSAI development initiative and World Health Organization collaboration. Front Public Health 2023; 11:1104669. [PMID: 37275502 PMCID: PMC10235755 DOI: 10.3389/fpubh.2023.1104669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/14/2023] [Indexed: 06/07/2023] Open
Abstract
This article is part of the Research Topic 'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict'. As the world faces global health crises such as pandemics, epidemics, climate change and evolving disease burdens and population demographics, building strong and resilient public health systems is of critical importance. The need for an integrated approach to building health system resilience; the widening of inequalities; and fears of vulnerable populations being left behind are critical issues that require Supreme Audit Institutions (SAIs) enquiry as independent public oversight bodies. Each country has a Supreme Audit Institution with a remit to audit public funds as an effective, accountable, and inclusive institution. Government audits are key components of effective public financial management and Good Governance. SAIs contribute to the quality of government engagement and better state-society relations through their work. As SAIs provide independent external oversight and contribute to follow up and review of national targets linked to the Sustainable Development Goals (SDGs) in their respective countries, they can play an important role in national recovery efforts. WHO and INTOSAI Development Initiative (IDI) have been collaborating in facilitating SAIs' audits of strong and resilient national public health systems linked to the national target of SDG 3.d in 40 countries across Africa, Americas, Asia and Oceania between 2021 and 2022. This paper aims to convey key lessons learned from the joint multisectoral collaboration for facilitating the 3.d audits that can contribute to building health systems resilience in ongoing recovery efforts. The collaboration included facilitation of the audits through professional education and audit support using a health systems resilience framework. The 3.d audits are performance audits and follow IDI's SDG Audit Model (ISAM). Following the ISAM implies that the SAI should focus on a whole-of-government approach, policy coherence and integration, and assess both government efforts at 'leaving no one behind' and multi-stakeholder engagement in implementing the chosen national SDG target linked to 3.d. WHO's Health Systems Resilience team has supported IDI and SAIs by delivering training sessions and reviewing working papers and draft reports of the SAIs from a health systems resilience perspective. IDI has provided the technical expertise on performance audits through its technical team and through in-kind contributions from mentors from many SAIs in the regions participating in the audit. In the 3.d audit, SAIs can ask how governments are acting to enhance capacity in some or all of the following, depending on their own national context and risk: forecasting, preventing and preparing for public health emergencies (PHEs) and threatsadapting, absorbing and responding to PHEs and threatsmaintaining essential health services in all contexts (including during emergencies/crises). The audits are expected to highlight current capacities of health systems resilience; the extent to which a whole-of-government approach and policy coherence have been utilised; and government efforts related to multistakeholder engagement and leaving no one behind in building health systems resilience related to progressing towards achieving the national target linked to 3.d by 2030. An overall positive achievement noted was that undertaking a complex health audit in the middle of a pandemic is possible and can contribute to building health systems resilience and recovery efforts. In their review of audit plans, draft summaries, and other work by the SAIs, both WHO and IDI have observed that SAIs have used the training and supplementary materials and applied various parts of it in their audits. This collaboration also demonstrates key considerations needed for successful partnership across multisectoral partners at global, regional and national levels. Such considerations can be applied in different contexts, including socioeconomic and health system recovery, to ensure whole-of-society and whole-of-government action in building health systems resilience and monitoring and evaluation to maintain and accelerate progress towards the national target linked to SDG3.d, health security and universal health coverage (UHC), as well as broader socioeconomic development.
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Affiliation(s)
| | - Saqif Mustafa
- World Health Organization (Switzerland), Geneva, Switzerland
| | - Yu Zhang
- World Health Organization (Switzerland), Geneva, Switzerland
| | | | - Sohel Saikat
- World Health Organization (Switzerland), Geneva, Switzerland
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Amri M, Bump JB. Where Is Equity in HiAP? Comment on "A Realist Explanatory Case Study Investigating How Common Goals, Leadership, and Committed Staff Facilitate Health in All Policies Implementation in the Municipality of Kuopio, Finland". Int J Health Policy Manag 2023; 12:7611. [PMID: 37579409 PMCID: PMC10461894 DOI: 10.34172/ijhpm.2023.7611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 03/18/2023] [Indexed: 08/16/2023] Open
Abstract
Health equity is no longer a central feature of Health in All Policies (HiAP) approaches despite its presence in select definitions of HiAP. In other words, HiAP is not just about considering health, but also health equity. But as HiAP has become more mainstream, its success around health equity has been muted and largely non-existent. Given the normative underpinning and centrality of equity in HiAP, equity should be better considered in HiAP and particularly when considering what 'successful' implementation may look like. Raising health on the radar of policy-makers is not mutually exclusive from considering equity. Taking an incremental approach to considering equity in HiAP can yield positive results. This article discusses these ideas and presents potential actions to restore HiAP's once central equity objectives, which include: seeking synergies focused on health equity with those who hold different convictions, both in terms of goals and measures of success; considering the conditions that allow HiAP to be fostered, such as good governance; and drawing on research on HiAP and other multisectoral approaches.
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Affiliation(s)
- Michelle Amri
- Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jesse B. Bump
- Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Bergen Centre for Ethics and Priority Setting, University of Bergen, Bergen, Norway
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Amri M, Mohamood L, Mansilla C, Barrett K, Bump JB. Conceptual approaches in combating health inequity: A scoping review protocol. PLoS One 2023; 18:e0282858. [PMID: 36920932 PMCID: PMC10016682 DOI: 10.1371/journal.pone.0282858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 02/19/2023] [Indexed: 03/16/2023] Open
Abstract
INTRODUCTION What are the different ways in which health equity can be sought through policy and programs? Although there is a central focus on health equity in global and public health, we recognize that stakeholders can understand health equity as taking different approaches and that there is not a single conceptual approach. However, information on conceptual categories of actions to improve health equity and/or reduce health inequity is scarce. Therefore, this study asks the research question: "what conceptual approaches exist in striving for health equity and/or reducing health inequity?" with the aim of presenting a comprehensive overview of approaches. METHODS A scoping review will be undertaken following the PRISMA guidelines for Scoping Reviews (PRISMA-ScR) and in consultation with a research librarian. Both the peer-reviewed and grey literatures will be searched using: Ovid MEDLINE, Scopus, PAIS Index (ProQuest), JSTOR, Canadian Public Documents Collection, the World Health Organization IRIS (Institutional Repository for Information Sharing), and supplemented by a Google Advanced Search. Screening will be conducted by two independent reviewers and data will be charted, coded, and narratively synthesized. DISCUSSION We anticipate developing a foundational document compiling categories of approaches and discussing the nuances inherent in each conceptualization to promote clarified and united action.
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Affiliation(s)
- Michelle Amri
- Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States of America
- Dalla Lana School of Public Health, Toronto, Ontario, Canada
- * E-mail:
| | - Liban Mohamood
- Department of Health and Society, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Cristián Mansilla
- McMaster Health Forum, McMaster University, Hamilton, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Kathryn Barrett
- University of Toronto Scarborough Library, Scarborough, ON, Canada
| | - Jesse B. Bump
- Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States of America
- Bergen Centre for Ethics and Priority Setting, University of Bergen, Bergen, Norway
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Coronado F, Melvin SC, Bell RA, Zhao G. Global Responses to Prevent, Manage, and Control Cardiovascular Diseases. Prev Chronic Dis 2022; 19:E84. [PMID: 36480801 DOI: 10.5888/pcd19.220347] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Fátima Coronado
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.,Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS S107-1, Atlanta GA 30341
| | - Sandra Carr Melvin
- Institute for the Advancement of Minority Health, Ridgeland, Mississippi
| | - Ronny A Bell
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Guixiang Zhao
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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An umbrella review of intersectoral and multisectoral approaches to health policy. Soc Sci Med 2022; 315:115469. [PMID: 36403353 DOI: 10.1016/j.socscimed.2022.115469] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 09/06/2022] [Accepted: 10/18/2022] [Indexed: 11/18/2022]
Abstract
Despite the widespread acceptance of the need for intersectoral and multisectoral approaches, knowledge around how to support, achieve, and sustain multisectoral action is limited. While there have been studies that seek to collate evidence on multisectoral action with a specific focus (e.g., Health in All Policies [HiAP]), we postulated that successes of working cross-sectorally to achieve health goals with one approach can glean insights and perhaps translate to other approaches which work across sectors (i.e., shared insights across HiAP, Healthy Cities, One Health, and other approaches). Thus, the goal of this study is to assemble evidence from systematic approaches to reviewing the literature (e.g., scoping review, systematic review) that collate findings on facilitators/enablers of and barriers to implementing various intersectoral and multisectoral approaches to health, to strengthen understanding of how to best implement health policies that work across sectors, whichever they may be. This umbrella review (i.e., review of reviews) was informed by the PRISMA guidelines for scoping reviews, yielding 10 studies included in this review. Enablers detailed are: (1) systems for liaising and engaged communication; (2) political leadership; (3) shared vision or common goals (win-win strategies); (4) education and access to information; and (5) funding. Barriers detailed were: (1) lack of shared vision across sectors; (2) lack of funding; (3) lack of political leadership; (4) lack of ownership and accountability; and (5) insufficient and unavailable indicators and data. These findings provide a rigorous evidence base for policymakers to inform intersectoral and multisectoral approaches to not only aid in the achievement of goals, such as the Sustainable Development Goals, but to work towards health equity.
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Cuervo LG, Martínez-Herrera E, Cuervo D, Jaramillo C. Improving equity using dynamic geographic accessibility data for urban health services planning. GACETA SANITARIA 2022; 36:497-499. [PMID: 35697568 DOI: 10.1016/j.gaceta.2022.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Luis Gabriel Cuervo
- Biomedical Research Methodology and Public Health, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Eliana Martínez-Herrera
- Faculty at the National School of Public Health, Universidad de Antioquia, Medellín, Colombia; Research Group on Inequalities in Health, Environment and Employment Conditions (GREDS-EMCONET); Department of Political and Social Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Ciro Jaramillo
- School of Civil Engineering and Geomatics, Universidad del Valle, Cali, Colombia
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Abstract
Background The Healthy Cities project supports municipal policymakers in the struggle to safeguard the health of urban citizens around the world (and in other limited geographies such as islands). Although Healthy Cities has been implemented in thousands of settings, no synthesis of implementation experiences have been conducted. In this article, we develop a scoping review protocol that can be applied to collect evidence on process evaluations of Healthy Cities. Methods To develop a scoping review protocol that could identify experiences evaluating the Healthy Cities project, we followed the PRISMA guidelines for Scoping Reviews (PRISMA-ScR). We applied these guidelines in consultation with a research librarian to design a search of the peer-reviewed literature, specifically Ovid Medline, Ovid Embase, Web of Science Core Collection, and Scopus databases, and a grey literature search. Discussion In addition to the aim of collecting evidence on Healthy Cities process evaluation experiences, the broader goal is to spark discussions and inform future evaluations of Healthy Cities. This work can also inform other evaluations of initiatives seeking to raise socio-political change, such as those focused on enhancing intersectoral and multisectoral action.
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