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Chavula MP, Silumbwe A, Munakampe MN, Zulu JM, Zulu W, Michelo C, Mulubwa C. Halting and re-issuing of the Zambia community health strategy (2017-2021): a retrospective analysis of the policy process and implications for community health systems. BMC Health Serv Res 2024; 24:971. [PMID: 39174915 PMCID: PMC11342636 DOI: 10.1186/s12913-024-11419-9] [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: 02/18/2023] [Accepted: 08/09/2024] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND Over the years, low-and middle-income countries have adopted several policy initiatives to strengthen community health systems as means to attain Universal Health Coverage (UHC). In this regard, Zambia passed a Community Health Strategy in 2017 that was later halted in 2019. This paper explores the processes that led to the halting and re-issuing of this strategy with the view of drawing lessons to inform the development of such strategies in Zambia and other similar settings. METHODS We employed a qualitative case study comprising 20 semi-structured interviews with key stakeholders who had participated in either the development, halting, or re-issuing of the two strategies, respectively. These stakeholders represented the Ministry of Health, cooperating partners and other non-government organizations. Inductive thematic analysis approach was used for analysis. RESULTS The major reasons for halting and re-issuing the community health strategy included the need to realign it with the national development framework such as the 7th National Development Plan, lack of policy ownership, political influence, and the need to streamline the coordination of community health interventions. The policy process inadequately addressed the key tenets of community health systems such as complexity, adaptation, resilience and engagement of community actors resulting in shortcomings in the policy content. Furthermore, the short implementation period, lack of dedicated staff, and inadequate engagement of stakeholders from other sectors threatened the sustainability of the re-issued strategy. CONCLUSION This study underscores the complexity of community health systems and highlights the challenges these complexities pose to health policymaking efforts. Countries that embark on health policymaking for community health systems must reflect on issues such as persistent fragmentation, which threaten the policy development process. It is crucial to ensure that these complexities are considered within similar policy engagement processes.
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Affiliation(s)
- Malizgani Paul Chavula
- Department of Community and Family Medicine, School of Public Health, University of Zambia, Lusaka, Zambia
- Department of Epidemiology and Global Health, Umeå University, Umeå, Umeå, 901 87, Sweden
| | - Adam Silumbwe
- Department of Epidemiology and Global Health, Umeå University, Umeå, Umeå, 901 87, Sweden.
- Department of Health Policy and Management, School of Public Health, University of Zambia, P.O Box 50110, Lusaka, Cell, +260976085894, Zambia.
| | - Margarate Nzala Munakampe
- Department of Health Policy and Management, School of Public Health, University of Zambia, P.O Box 50110, Lusaka, Cell, +260976085894, Zambia
| | - Joseph Mumba Zulu
- Department of Health Policy and Management, School of Public Health, University of Zambia, P.O Box 50110, Lusaka, Cell, +260976085894, Zambia
| | - Wanga Zulu
- Department of Public Health, National TB and Leprosy programme, Ministry of Health, Lusaka, Zambia
| | - Charles Michelo
- Strategic Centre for Health Systems Metrics (SCHEME), Global Health Institute, Nkwazi Research University, PO Box 50650, Lusaka, Zambia
| | - Chama Mulubwa
- Department of Community and Family Medicine, School of Public Health, University of Zambia, Lusaka, Zambia
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Jeon H, Shin H, Muratbekova M, Zhamankulova M. Policy suggestions for improving nursing education in a low- and middle-income country: A modified Delphi study. Nurs Outlook 2024; 72:102222. [PMID: 38908293 DOI: 10.1016/j.outlook.2024.102222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 05/12/2024] [Accepted: 05/21/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND Health policy critically influences a national healthcare system and nurse's roles, working conditions, and professional development opportunities, especially in low- and middle-income countries. PURPOSE To explore and prioritize the major challenges and solution, and establish policy directions for improving nursing education in the Kyrgyz Republic. METHODS The key stakeholders of nursing practice, education, policymaking, and regulation were involved in this modified Delphi study. Following two rounds of exploring priority issues and potential strategies, the participants of the final round assembled for consensual discussions on the establishment of policy directions. DISCUSSION Innovations in nursing education systems, building educational capacity, and ensuring educational outcomes were suggested and agreed upon for the sequential improvement of nursing education. Timely enactment of these policies will enable the Kyrgyz Republic to mitigate nursing shortages, improve the quality of healthcare services, and enhance overall public health outcomes. CONCLUSION The policy suggestions derived from this study, including the improvement of nursing education quality and the assurance of nurses' competencies, have great potential for improving quality healthcare practice and sustaining an effective healthcare system.
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Affiliation(s)
- Hyejin Jeon
- College of Nursing Science, Kyung Hee University, Seoul, Republic of Korea
| | - Hyunsook Shin
- College of Nursing Science, Kyung Hee University, Seoul, Republic of Korea.
| | - Medina Muratbekova
- College of Nursing Science, Kyung Hee University, Seoul, Republic of Korea
| | - Madina Zhamankulova
- Department of Nursing, I. K. Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic
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Haq ZU, Yunus S, Jafri N. Building confidence in the COVID-19 vaccine in a polio-endemic country: strategic communication lessons from Pakistan. BMJ Glob Health 2024; 9:e015200. [PMID: 38599665 PMCID: PMC11015175 DOI: 10.1136/bmjgh-2024-015200] [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: 01/29/2024] [Accepted: 03/31/2024] [Indexed: 04/12/2024] Open
Abstract
In a health emergency, governments rely on public trust in their policy, and anticipate its compliance to protect health and save lives. Vaccine hesitancy compromises this process when an emergency involves infections. The prevailing discourse on vaccine hesitancy often describes it as a static phenomenon, ignoring its expanse and complexity, and neglecting the exploration of tools to address it. This article diverges from the conventional perspective by explaining the case of Pakistan and its communication strategy for the COVID-19 vaccine. Decades of polio vaccine hesitancy, rooted in the country's fight against terrorism, constitute its history. On the other hand, the first-ever launch of typhoid conjugate vaccine involving 35 million kids during 2019-2021 was a success. Against this backdrop, the country considered vaccine hesitancy as a dynamic phenomenon, interwoven with the social ecology and the responsiveness of the healthcare system. Its communication strategy facilitated those willing to receive the vaccine, while being responsive to the information needs of those still in the decision-making process. In the face of both hesitancy and a scarcity of vaccine doses, the country successfully inoculated nearly 70% (160 million) of its population in just over 1 year. People's perceptions about the COVID-19 vaccine also improved over time. This achievement offers valuable insights and tools for policymakers and strategists focused on the demand side of vaccine programmes. The lessons can significantly contribute to the global discourse on improving vaccine confidence and bolstering global health security.
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Affiliation(s)
| | | | - Naveed Jafri
- Expanded Programme on Immunisation, Pakistan Ministry of National Health Services Regulations and Coordination, Islamabad, Pakistan
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Mukisa GW, Shumba TW, Lourens A. Policy framework that addresses malnutrition in Namibia: A retrospective qualitative review. Nutr Health 2024; 30:39-48. [PMID: 37431739 DOI: 10.1177/02601060231185815] [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] [Indexed: 07/12/2023]
Abstract
BACKGROUND Although Namibia has made strides in improving the policy enabling environment, eradication of malnutrition is still elusive. OBJECTIVE This review was aimed at determining the extent to which food and nutrition-related policies in Namibia address malnutrition. METHODS This study used a qualitative approach by retrospectively analysing policy frameworks that address malnutrition in Namibia from 1991 to 2022. The analysis employed the policy triangle framework to elucidate the contextual factors, content, actors and process involved in the policy development. Moreover, a comparative analysis of Namibian policies and those of other southern African countries was undertaken. RESULTS The review showed that there is a considerable degree of coherence in policy goals and strategies to address malnutrition despite parallel coordination structures. Policy process involved limited consultations with local communities which might have jeopardised the formulation of community problem-tailored interventions, ownership and participation in policy implementation. There is a strong political commitment to the eradication of malnutrition in Namibia. The Office of the Prime Minister played a leading role in policy development. Influential actors such as the UN agencies elevated the nutrition agenda. Further, the Namibian policy framework was generally similar to those of other southern African countries. CONCLUSIONS The review showed that Namibia has relevant and comprehensive policies to address malnutrition, however, contextual factors indicated high levels of malnutrition still exist in the communities. Further research is needed to understand the barriers and enablers to optimal nutrition for children under five years in Namibia.
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Affiliation(s)
- George Waliomuzibu Mukisa
- Department of Preventative Health Sciences, School of Health Sciences, Faculty of Health, Natural Resources and Applied Sciences, Namibia University of Science and Technology (NUST), Windhoek, Namibia
| | - Tonderai W Shumba
- Department of Occupational Therapy and Physiotherapy, Faculty of Health Sciences and Veterinary Medicine, University of Namibia (UNAM), Windhoek, Namibia
| | - Andrit Lourens
- Department of Preventative Health Sciences, School of Health Sciences, Faculty of Health, Natural Resources and Applied Sciences, Namibia University of Science and Technology (NUST), Windhoek, Namibia
- Division of Emergency Medicine, Department of Family, Community and Emergency Medicine, University of Cape Town (UCT), Cape Town, South Africa
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Dimitrova M, Snair M. Classifying disaster risk reduction strategies: conceptualizing and testing a novel integrated approach. Global Health 2024; 20:7. [PMID: 38191369 PMCID: PMC10773016 DOI: 10.1186/s12992-023-01006-8] [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: 09/29/2022] [Accepted: 12/11/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Although disaster risk reduction (DRR) addresses underlying causes and has been shown to be more cost-effective than other emergency management efforts, there is lack of systematized DRR categorization, leading to insufficient coherence in the terminology, planning, and implementation of DRR. The aim of this study was to conceptualize and test a novel integrated DRR framework that highlights the intersection between two existing classification systems. METHODS Grounded theory was used to conceptualize a novel DRR framework. Next, deductive conceptual content analysis was used to categorize interventions from the 2019 Cities100 Report into the proposed DRR framework. The term "connection" indicates that an intervention can be categorized into a particular section of the novel integrated approach. A "connection" was determined to be present when the intervention description stated an explicit connection to health and to the concept within one of the categories from the novel approach. Further descriptive statistics were used to give insight into the distribution of DRR interventions across categories and into the application of the proposed framework. RESULTS The resulting framework contains nine intersecting categories: "hazard, prospective", "hazard, corrective", "hazard, compensatory", "exposure, prospective", "exposure, corrective", "exposure, compensatory", "vulnerability, prospective", "vulnerability, corrective", and "vulnerability, compensatory". The thematic analysis elucidated trends and gaps in the types of interventions used within the 2019 Cities100 Report. For instance, exposure-prospective, exposure-compensatory, and vulnerability-compensatory were the most under-utilized strategies, accounting for only 3% of the total interventions. Further descriptive statistics showed that upper middle-income countries favored "hazard, corrective" strategies over other DRR categories while lower middle-income countries favored "exposure, corrective" over other DRR strategies. Finally, European cities had the highest percentage of DRR connections (51.39%) compared to the maximum possible DRR connections, while African cities had the lowest percentage of DRR connections (22.22%). CONCLUSIONS The study suggests that the proposed DRR framework could potentially be used to systematically evaluate DRR interventions for missing elements, aiding in the design of more equitable and comprehensive DRR strategies.
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Affiliation(s)
- Mariya Dimitrova
- University of Gothenburg, Gothenburg, Sweden.
- SGNL Solutions, Evergreen, Colorado, United States.
| | - Megan Snair
- SGNL Solutions, Evergreen, Colorado, United States
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Mans PA, Yogeswaran P, Adeniyi OV. Building Consensus on the Point-of-Care Ultrasound Skills Required for Effective Healthcare Service Delivery at District Hospitals in South Africa: A Delphi Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7126. [PMID: 38063556 PMCID: PMC10705875 DOI: 10.3390/ijerph20237126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Despite the widespread availability of ultrasound machines in South African district hospitals, there are no guidelines on the competency in point-of-care ultrasound (POCUS) use required by generalist doctors in this setting. This study aimed to define the required POCUS competencies by means of consensus via the Delphi method. METHODS An online Delphi process was initiated in June 2022, using the existing American Academy of Family Physicians' ultrasound curriculum (84 skillsets) as the starting questionnaire. Panelists were selected across the country, including two from district hospitals in each province and two from each academic family medicine department in South Africa (N = 36). In each iterative round, the participants were asked to identify which POCUS skillsets were essential, optional (region-specific), or non-essential for South African district hospitals. This process continued until consensus (>70% agreement) was achieved on all of the skillsets. RESULTS Consensus was achieved on 81 of the 84 skillsets after 5 iterative rounds (96.4%), with 3 skillsets that could not achieve consensus (defined as <5% change over more than 2 consecutive rounds). The final consensus identified 38 essential, 28 optional, and 15 non-essential POCUS skillsets for the South African district hospital context. CONCLUSIONS The list of essential POCUS skillsets provided by this study highlights the predominance of obstetric- and trauma-based skillsets required for generalist healthcare workers in South African district hospitals. The findings will require priority setting and revalidation prior to their implementation across the country.
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Affiliation(s)
- Pierre-Andre Mans
- Department of Family Medicine, Cecilia Makiwane Hospital, Mdantsane, East London 5201, South Africa;
- Department of Family Medicine and Rural Health, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5117, South Africa;
| | - Parimalaranie Yogeswaran
- Department of Family Medicine and Rural Health, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5117, South Africa;
- Department of Family Medicine, Mthatha Regional Hospital, Mthatha 5100, South Africa
| | - Oladele Vincent Adeniyi
- Department of Family Medicine, Cecilia Makiwane Hospital, Mdantsane, East London 5201, South Africa;
- Department of Family Medicine and Rural Health, Faculty of Health Sciences, Walter Sisulu University, Mthatha 5117, South Africa;
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Bam K, Olaiya MT, Cadilhac DA, Donnan GA, Murphy L, Kilkenny MF. Enhancing primary stroke prevention: a combination approach. THE LANCET PUBLIC HEALTH 2022; 7:e721-e724. [DOI: 10.1016/s2468-2667(22)00156-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/06/2022] [Accepted: 06/10/2022] [Indexed: 01/13/2023] Open
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Ruwanpura V, Neukom J, Grietens KP, Price RN, Thriemer K, Lynch CA. Opening the policy blackbox: unravelling the process for changing national diagnostic and treatment guidelines for vivax malaria in seven countries. Malar J 2021; 20:428. [PMID: 34717642 PMCID: PMC8556862 DOI: 10.1186/s12936-021-03959-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/18/2021] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The changing global health landscape has highlighted the need for more proactive, efficient and transparent health policy-making. After more than 60 years of limited development, novel tools for vivax malaria are finally available, but need to be integrated into national policies. This paper maps the malaria policy-making processes in seven endemic countries, to identify areas where it can be improved to align with best practices and optimal efficiency. METHODS Data were collected during a workshop, convened by the Asia Pacific Malaria Elimination Network's Vivax Working Group in 2019, and subsequent interviews with key stakeholders from Cambodia, Ethiopia, Indonesia, Pakistan, Papua New Guinea (PNG), Sri Lanka and Vietnam. Documentation of policy processes provided by respondents was reviewed. Data analysis was guided by an analytic framework focused on three a priori defined domains: "context," "actors" and "processes". RESULTS The context of policy-making varied with available funding for malaria, population size, socio-economic status, and governance systems. There was limited documentation of the process itself or terms of reference for involved actors. In all countries, the NMP plays a critical role in initiating and informing policy change, but the involvement of other actors varied considerably. Available evidence was described as a key influencer of policy change; however, the importance of local evidence and the World Health Organization's endorsement of new treatments and diagnostics varied. The policy process itself and its complexity varied but was mostly semi-siloed from other disease specific policy processes in the wider Ministry of Health. Time taken to change and introduce a new policy guideline previously varied from 3 months to 3 years. CONCLUSIONS In the medium to long term, a better alignment of anti-malarial policy-making processes with the overall health policy-making would strengthen health governance. In the immediate term, shortening the timelines for policy change will be pivotal to meet proposed malaria elimination milestones.
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Affiliation(s)
- Varunika Ruwanpura
- Global Health Division, Menzies School of Health Research and Charles Darwin University, PO Box 41096, Casuarina, Darwin, NT, 0811, Australia
| | | | - Koen Peeters Grietens
- Institute of Tropical Medicine, Antwerp, Belgium
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Ric N Price
- Global Health Division, Menzies School of Health Research and Charles Darwin University, PO Box 41096, Casuarina, Darwin, NT, 0811, Australia
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Kamala Thriemer
- Global Health Division, Menzies School of Health Research and Charles Darwin University, PO Box 41096, Casuarina, Darwin, NT, 0811, Australia.
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Sritart H, Tuntiwong K, Miyazaki H, Taertulakarn S. Disparities in Healthcare Services and Spatial Assessments of Mobile Health Clinics in the Border Regions of Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10782. [PMID: 34682527 PMCID: PMC8535297 DOI: 10.3390/ijerph182010782] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 01/21/2023]
Abstract
Reducing the disparities in healthcare access is one of the important goals in healthcare services and is significant for national health. However, measuring the complexity of access in truly underserved areas is the critical step in designing and implementing healthcare policy to improve those services and to provide additional support. Even though there are methods and tools for modeling healthcare accessibility, the context of data is challenging to interpret at the local level for targeted program implementation due to its complexity. Therefore, the purpose of this study is to develop a concise and context-specific methodology for assessing disparities for a remote province in Thailand to assist in the development and expansion of the efficient use of additional mobile health clinics. We applied the geographic information system (GIS) methodology with the travel time-based approach to visualize and analyze the concealed information of spatial data in the finer analysis resolution of the study area, which was located in the border region of the country, Ubon Ratchathani, to identify the regional differences in healthcare allocation. Our results highlight the significantly inadequate level of accessibility to healthcare services in the regions. We found that over 253,000 of the population lived more than half an hour away from a hospital. Moreover, the relationships of the vulnerable residents and underserved regions across the province are underlined in the study and substantially discussed in terms of expansion of mobile health delivery to embrace the barrier of travel duration to reach healthcare facilities. Accordingly, this research study addresses regional disparities and provides valuable references for governmental authorities and health planners in healthcare strategy design and intervention to minimize the inequalities in healthcare services.
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Affiliation(s)
- Hiranya Sritart
- Faculty of Allied Health Sciences, Thammasat University, Pathumthani 12120, Thailand;
| | - Kuson Tuntiwong
- School of Dentistry, King Mongkut’s Institute of Technology Ladkrabang, Bangkok 10520, Thailand;
| | - Hiroyuki Miyazaki
- Center for Spatial Information Science, Tokyo University, Chiba 277-8568, Japan;
| | - Somchat Taertulakarn
- Faculty of Allied Health Sciences, Thammasat University, Pathumthani 12120, Thailand;
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Holtzhausen JDV, Downing C, Poggenpoel M, Ndawo G. Concept Analysis: The Scope of Practice of a Nurse Anesthetist in South Africa. J Perianesth Nurs 2021; 36:672-677. [PMID: 34548239 DOI: 10.1016/j.jopan.2021.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 03/07/2021] [Accepted: 03/14/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE The purpose of this article is to propose a definition for the concept "scope of practice" as it applies to a nurse anesthetist in South Africa. DESIGN Concept analysis. METHODS Walker and Avant's procedure of concept analysis was followed. The actions included "Select a concept"; "Determine the purpose of analysis"; "Identifying uses of the concept"; "Determining the defining attributes"; "Identifying antecedents and consequences"; "Define empirical referents"; "Identify model case"; and "Identifying additional cases." FINDINGS The concept 'scope of practice' as it applies to the nurse anesthetist in South Africa can be defined as the individual's competence, accountability, and responsibility as a health professional. The nurse anesthetist is (1) competent: ready to use skills and judgement in practice; (2) accountable: able to be registered as a nurse anesthetist and willing to abide by the regulations; and (3) responsible: upholding professionalism and demanding recognition from the public and peers. CONCLUSIONS A definition (revealing the concept's structure) and it's uses (revealing the concept's function) for "scope of practice" of a South African nurse anesthetist is proposed for the consideration of introducing nurse anesthesia to provide safe and affordable anesthesia services in South Africa. This article forms part of a larger study titled "A Model for Nurse Anaesthesia Practice in South Africa."
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Affiliation(s)
- Jan Dirk Visagie Holtzhausen
- Doctor of Nursing Science candidate, Department of Nursing, University of Johannesburg, Johannesburg, South Africa
| | - Charlené Downing
- Department of Nursing, University of Johannesburg, Johannesburg, South Africa.
| | - Marie Poggenpoel
- Department of Nursing, University of Johannesburg, Johannesburg, South Africa
| | - Gugu Ndawo
- Department of Nursing, University of Johannesburg, Johannesburg, South Africa
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Affiliation(s)
- Fariha Sohil
- Department of Education, The Women University, Multan, Pakistan
| | | | - Javid Shabbir
- Department of Statistics, Quaid-i-Azam University, Islamabad, Pakistan
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Rasul G. A Framework for Improving Policy Priorities in Managing COVID-19 Challenges in Developing Countries. Front Public Health 2020; 8:589681. [PMID: 33154960 PMCID: PMC7591500 DOI: 10.3389/fpubh.2020.589681] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 08/28/2020] [Indexed: 12/04/2022] Open
Abstract
The COVID-19 pandemic has brought unprecedented challenges to societies and threatened humanity and global resilience. All countries are challenged, but low-income and developing countries are facing a more challenging situation than others due to their limited health infrastructure, limited financial and human resources, and limited capacity of governments to respond. Further, the interconnected nature of the COVID-19 pandemic crisis demands an integrated approach and coordinated action, which complicates decision making even more. Identifying the best set of policies and instruments to address COVID-19 challenges, and aligning them with broader social goals will be critically important for sustainable recovery from the pandemic. The key practical challenge facing the policy makers of developing countries is how to prioritize policies to achieve the interconnected goals of managing the health crisis, recovering the economy, and achieving environmental sustainability. We present a framework for identifying and prioritizing policy actions to address the COVID-19 challenges and ensure sustainable recovery. The framework outlines principles and criteria and provides insights into developing shared policy goals, identifying smart strategies, assessing policy compatibility, aligning policy instruments, and factoring sustainability into short and long-term policy decisions. This framework can assist policy makers in linking short and long-term goals, mapping the interactions of different policy options, and assessing anticipated consequences and cross-sectoral implications. This will enable policy makers to prioritize policy choices and allocate limited resources in such a way that they are directed toward actions that generate synergy and co-benefits, have multiplier effects, and achieve interconnected solutions for health, the economy and environment.
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Affiliation(s)
- Golam Rasul
- International Centre for Integrated Mountain Development, Lalitpur, Kathmandu, Nepal
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