This narrative review examines the literature on complementary and integrative practices (CIPs) and their incorporation into Brazil's national health system (Sistema Unico de Saude --SUS) in an ...attempt to understand the strengths and weaknesses of the implementation of the National Policy on Complementary and Integrative Practices in the SUS (PNPIC, acronym in Portuguese). A search was conducted of the MEDLINE, LILACS, and SciELO databases, resulting in final sample of 25 articles. Our analysis identified five key themes in the literature related to the strengths and weaknesses of policy implementation: 1) Professional training in CIPs in the SUS; 2) structuring the provision of CIPs, access, and health promotion; 3) knowledge, access, and acceptance of service users in relation to CIPs; 4) knowledge of SUS professional staff and managers in relation to the PNPIC; and 5) scope and monitoring and evaluation of the PNPIC. In consonance with the -- conclusions of the PNPIC management reports, the findings provide a deeper insight into policy implementation problems and reinforce the need to empower the actors involved in this process to tackle these challenges. Key words Review, Complementary Therapies, Unified Health System, Public Policy Esta revisao narrativa tem por objetivo analisar a producao cientifica sobre as Praticas Integrativas e Complementares (PIC) no Sistema Unico de Saude (SUS) visando compreender as potencialidades e fragilidades do processo de implantacao da Politica Nacional de Praticas Integrativas e Complementares (PNPIC). Apos busca nas bases de dados, 25 artigos foram selecionados e os seus resultados analisados criticamente. Da analise do material emergiram cinco temas principais que explicitaram potencialidades e fragilidades de implantacao da politica: 1) Formacao profissional em PIC para o SUS; 2) Estruturacao da oferta em PIC, acesso e promocao da saude; 3) Conhecimento, acesso e aceitacao de usuarios em relacao as PIC; 4) Conhecimento de profissionais e gestores em relacao a PNPIC; e 5) Escopo, monitoramento e avaliacao da PNPIC. Os resultados se alinham aos relatorios de gestao da PNPIC aprofundando o conhecimento acerca da implantacao da politica e reforcando a necessidade de empoderamento dos atores do SUS para o enfrentamento de seus desafios. Palavras-chave Revisao, Terapias Complementares, Sistema Unico de Saude, Politica Publica
This narrative review examines the literature on complementary and integrative practices (CIPs) and their incorporation into Brazil's national health system (Sistema Unico de Saude --SUS) in an ...attempt to understand the strengths and weaknesses of the implementation of the National Policy on Complementary and Integrative Practices in the SUS (PNPIC, acronym in Portuguese). A search was conducted of the MEDLINE, LILACS, and SciELO databases, resulting in final sample of 25 articles. Our analysis identified five key themes in the literature related to the strengths and weaknesses of policy implementation: 1) Professional training in CIPs in the SUS; 2) structuring the provision of CIPs, access, and health promotion; 3) knowledge, access, and acceptance of service users in relation to CIPs; 4) knowledge of SUS professional staff and managers in relation to the PNPIC; and 5) scope and monitoring and evaluation of the PNPIC. In consonance with the -- conclusions of the PNPIC management reports, the findings provide a deeper insight into policy implementation problems and reinforce the need to empower the actors involved in this process to tackle these challenges.
Having a tax-funded and supposedly 'National' Health Service (NHS), one might assume that the UK is well-positioned to roll out eHealth innovations at scale. Yet, despite a strong policy push, the ...English NHS has been limited in the extent to which it has exploited the potential of eHealth.
This paper considers a range of macro, meso and micro factors influencing eHealth innovation in the English NHS.
While barriers to eHealth innovation exist at all scales, the fragmentation of the NHS is the most significant factor limiting adoption and diffusion. Rather than addressing problems of fragmentation, national policy seems to have intensified the digital divide. As the recently published NHS Long Term Plan places great emphasis on the role of digital transformation in helping health and care professionals communicate better and enabling people to access the care they need quickly and easily, the implications for the digital divide are likely to be significant for effectiveness, efficiency and equity.
The rise in working-age mortality rates in the United States in recent decades largely reflects stalled declines in cardiovascular disease (CVD) mortality alongside rising mortality from ...alcohol-induced causes, suicide, and drug poisoning; and it has been especially severe in some U.S. states. Building on recent work, this study examined whether U.S. state policy contexts may be a central explanation. We modeled the associations between working-age mortality rates and state policies during 1999 to 2019. We used annual data from the 1999-2019 National Vital Statistics System to calculate state-level age-adjusted mortality rates for deaths from all causes and from CVD, alcohol-induced causes, suicide, and drug poisoning among adults ages 25-64 years. We merged that data with annual state-level data on eight policy domains, such as labor and taxes, where each domain was scored on a 0-1 conservative-to-liberal continuum. Results show that the policy domains were associated with working-age mortality. More conservative marijuana policies and more liberal policies on the environment, gun safety, labor, economic taxes, and tobacco taxes in a state were associated with lower mortality in that state. Especially strong associations were observed between certain domains and specific causes of death: between the gun safety domain and suicide mortality among men, between the labor domain and alcohol-induced mortality, and between both the economic tax and tobacco tax domains and CVD mortality. Simulations indicate that changing all policy domains in all states to a fully liberal orientation might have saved 171,030 lives in 2019, while changing them to a fully conservative orientation might have cost 217,635 lives.
This contribution proposes a decentred conceptualization of European Union (EU) international influence based on the external ramifications of its internal policies. It views the EU's international ...role less as that of an emerging unitary actor than as conglomerate of loosely coupled sectoral regimes expanding their prescriptive scope towards third countries in differentiated ways. Combining conceptual approaches to (EU) power with empirical-analytical research on external governance and policy diffusion, the contribution defines the mechanisms of regulatory extension, specifies their scope conditions, and highlights the role of transgovernmental networks, often involving international organizations, in 'co-opting' third country regulators into EU policies.
As the second largest country in South Asia, Pakistan has succeeded relatively well in tackling COVID-19 after it broke out in 2020. Due to this, it is necessary to inquire into Pakistan's statecraft ...to find out how it responded to the pandemic issue, first domestically and then globally. As one of the key neighboring countries of China where the large-scale pandemic started, Pakistan has been very vulnerable to the epidemic. However, the Pakistani government led by Imran Khan has achieved a remarkable record in controlling COVID-19. No doubt, the domestic progress in Pakistan is destined to enhance its reputation abroad. For example, the international community has extended encouraging words and deeds to Pakistan, while some developed EU countries have policies designed by Pakistani Goverment because Islamabad has adopted successful social security and financial stimulus strategies. This study aims to give a balanced understanding of what policy, approaches, and strategies have been used by the current ruling elites of Pakistan; and how the domestic achievements have effectively bolstered its prestigious image on the global stage.
Standard works on international environmental governance assume single-issue regimes with binding obligations designed to govern the behaviour of states. Yet many of the most pressing global ...environmental problems, including climate change, forest degradation and biodiversity loss, are governed by an array of mechanisms—legal, non-legal, governmental and non-governmental—in complex arrangements. Examining the combined effects of these international and transnational efforts on domestic or firm policies and practices—the usual targets of such efforts—requires expanding a focus on regime 'compliance' and 'effectiveness' to 'influence' factors from beyond state borders. To facilitate such a move, the authors develop a framework that distinguishes four distinct pathways through which actors and institutions influence domestic policies: international rules; international norms and discourse; creation of, or interventions in, markets; and direct access to domestic policy processes. Propositions are then developed on the conditions under which, and processes through which, actors and institutions affect domestic and firm policies and practices along each pathway. The framework is applied to the case of forest governance, a prototypical example of complex global environmental governance.
High quality data are needed for decision-making at all levels of the public health system, from guiding public health activities at the local level, to informing national policy development, to ...monitoring the impact of global initiatives. Although a number of approaches have been developed to evaluate the underlying quality of routinely collected vaccination administrative data, there remains a lack of consensus around how data quality is best defined or measured.
We present a definitional framework that is intended to disentangle many of the elements that have confused discussions of vaccination data quality to date. The framework describes immunization data in terms of three key characteristics: data quality, data usability, and data utilization. The framework also offers concrete suggestions for a specific set of indicators that could be used to better understand immunization those key characteristics, including Trueness, Concurrence, Relevancy, Efficiency, Completeness, Timeliness, Integrity, Consistency, and Utilization.
Being deliberate about the choice of indicators; being clear on their definitions, limitations, and methods of measurement; and describing how those indicators work together to give a more comprehensive and practical understanding of immunization data quality, usability, and use, should yield more informed, and therefore better, programmatic decision-making.
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