Health Policy Commons^™

Rethinking Ethics For An Era Of Trusted Computational Tools, Kristin M Kostick-Quenet, Meghan Hurley, John Herrington, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Computer perception (CP) technologies are poised to deliver near real-time behavioral insights with high precision. As technical barriers recede, our field's ethical focus must shift from "Can we trust the data?" to "Should we use it here, and how?" We propose a contextual ethics framework that: (1) defines the appropriate scope of CP integration; (2) advocates codesigned roadmaps to manage expectations and epistemic conflict; (3) expands evaluation beyond performance metrics to humanistic outcomes; and (4) anticipates future high performance systems to safeguard dignity, empathy, and shared decision-making in clinical care.

Accessibility And Daily Cigarette Consumption Among Indonesian Adolescents: A Descriptive Study, Noviana Lathifah, Istiqomah Hanifah Rachman, Anisa Isnaini, Gloria Threesia Piliphinsa Simatupang

Journal of Indonesian Health Policy and Administration

Despite restrictive regulations, Indonesia faces a high prevalence of adolescent smoking, facilitated by easy access to tobacco products. This descriptive study aims to describe cigarette accessibility patterns and daily consumption trends among Indonesian adolescents. A cross-sectional study was conducted using secondary data from the 2019 Global Youth Tobacco Survey (GYTS) involving 9,208 respondents. Descriptive analysis was performed to examine the distribution of age at smoking initiation, daily cigarette consumption, and purchasing accessibility. The majority of respondents started smoking at ≥14 years of age. Daily cigarette consumption showed an increasing trend with age, with older adolescents more likely to consume more …

Deadline-Chasing In Digital Health: Forecasting Emr Adoption Dynamics And Regulatory Impact In Indonesian Primary Care, Suryo Satrio, Bukhori Muhammad Aqid

Journal of Indonesian Health Policy and Administration

Indonesia is accelerating digital health adoption under Minister of Health Regulation No. 24/2022, which mandates the use and integration of Electronic Medical Records (EMRs) with SATUSEHAT. However, evidence on how quickly primary health care facilities (Fasilitas Kesehatan Tingkat Pertama – FKTP) are adopting EMRs and what the adoption curve looks like remains limited. Survey findings also suggest key barriers and enablers, including security and data migration concerns, as well as human resource and infrastructure constraints. This observational study used provider-network data from a single EMR vendor. Key measures included cumulative registered facilities, monthly registrations, same-month activation (total_active/monthly inflow) as …

Factors Associated With The Performance Of Essential Public Health Efforts At Primary Health Centers In Jember Regency, Griselda Ardelia Hibatullah, Nuryadi Nuryadi, Yennike Tri Herawati

Journal of Indonesian Health Policy and Administration

Performance assessment of primary health centers is essential to ensure the quality of healthcare services, including the delivery of essential public health efforts. The performance target for essential public health efforts in Jember Regency is set at ≥82%. This study aimed to analyze factors associated with the performance of essential public health efforts. The study employed an analytical cross-sectional design conducted from April to May 2025, with a sample of 37 out of 50 units selected through simple random sampling. Primary data were collected using questionnaires, while secondary data were obtained from primary health center (Pusat Kesehatan Masyarakat – …

Referral Patterns From Primary Care To Referral Care By Icd-10 Codes In Indonesia: Cross-Sectional Analysis Of National Claims Data (2017–2024), Della Dwi Ayu, Syarif Rahman Hasibuan, Putu Erma Pradnyani, Nisrina Widyasanti

Journal of Indonesian Health Policy and Administration

Primary health care (PHC) facilities serve as gatekeepers within Indonesia’s tiered health system. However, PHC referral patterns to hospitals still show substantial variation and remain insufficiently characterized by disease groupings based on the International Classification of Diseases, 10th Revision (ICD-10). This study aimed to identify the most frequently referred diagnoses from PHC to secondary or tertiary care facilities and to determine the participant characteristics associated with referrals. This observational study employed a cross-sectional design using secondary data from the National Health Insurance (Jaminan Kesehatan Nasional – JKN) claims database for the period 2017–2024. The unit of analysis was each …

Optimizing Vitamin A Intervention: Strengthening Supplementation With Targeted Biscuit Fortification, Mayfa Yemima Simanjuntak, Nadia Amanda, Yuli Berliana Simanjuntak, Carissa Wityadarda, Lesta Livolina Simamora

Journal of Indonesian Health Policy and Administration

Vitamin A deficiency (VAD) remains a persistent public health challenge in Indonesia, particularly among children under five and breastfeeding mothers. This study aimed to analyze the distribution of vitamin A interventions and assess the potential of biscuit fortification as a complementary strategy. This study employs a literature review using the Health Policy Triangle (HPT) framework, examining policy context, content, key actors, and implementation processes related to vitamin A interventions. The analysis was conducted using secondary data from government reports, international agencies, and peer-reviewed literature published between 2018 and 2025, with comparative evidence from Vietnam, Bangladesh, and Ghana. The findings show …

Determinants Of Musculoskeletal Disorder In Formal And Informal Workers In Indonesia, Herlina J. El-Matury, Nabila Syahlan, Mohd Rafee B. Baharuddin

Kesmas

Musculoskeletal disorders (MSDs) are a leading cause of disability globally and are strongly influenced by occupational conditions. Evidence comparing MSD risk between formal and informal workers remains limited, particularly in developing countries. This study examined the association between individual and job-related factors with MSD symptoms among formal and informal workers in Indonesia. A cross-sectional study was conducted among 1,089 workers in North Sumatra Province, Indonesia, from August 2024 to December 2025. Participants were recruited using stratified convenience sampling from both the formal (office and health workers) and informal (drivers, traders, and farmers) sectors. MSD symptoms were assessed using the Nordic …

The Feasibility Of Long-Term Care Within Indonesia’S National Health Insurance Scheme: A Qualitative Study, Atikah Adyas, Wan Aisyiah Baros, Khaterina Kristina Manurung, Dedy Revelino, Dewi Susanna, Vetty Yulianty, Anita Pebrina Lubis, Arum Atmawikarta, Iis Sinsin Nuryasini, Ahmad Jet Alamin

Kesmas

The rising prevalence of chronic diseases and disabilities, along with the aging of the population, has reduced individual independence and increased the demand for long-term care (LTC). This study aimed to assess the feasibility of integrating home healthcare services into Indonesia’s National Health Insurance (NHI) scheme. A qualitative study using purposive sampling was conducted in Bandar Lampung, Yogyakarta, and Jakarta, Indonesia, selected based on disease burden, proportion of older adults, and regional development. Data was collected through in-depth interviews, focus group discussions, and observation between August and September 2024, involving 68 informants, including regulators, community members, and health facility staff. …

Resilience And Social Support On Depression Risk For Chronic Obstructive Pulmonary Disease Patients In South Tangerang, Indonesia, Adhityawarman Menaldi, Sali Rahadi Asih, Farah Ainul Mardhiyyah

Kesmas

Chronic obstructive pulmonary disease (COPD) is a major public health concern with psychosocial impacts, such as reduced resilience and depression. This study examined the moderating role of perceived social support on the relationship between resilience and depression among individuals diagnosed with COPD in South Tangerang, Indonesia. A quantitative cross-sectional study was conducted between January and February 2024 using self-administered questionnaires. Participants were adult patients with clinically diagnosed COPD, recruited from all public health centers (PHC) in South Tangerang. A total of 125 participants met the inclusion criteria and were included in the analysis. Participants had a mean age of 41.46±15.69 …

The Capital Gap: Mitigating Banking Barriers For Nonprofit Providers In Mental Health And Educational Systems, Jinhee Lee, Josefina Martinez

Pepperdine Policy Review

Nonprofit organizations are vital contributors to public welfare, yet they are systematically excluded from conventional banking systems, creating a liquidity crisis that undermines their capacity to deliver essential services. This paper discusses the structural issues of the banking sector that hinder nonprofits in acquiring credit and explains how this problem can be solved. Specifically, it aims at investigating liquidity constraints faced by schools providing mental health services and education programs. With the help of information asymmetry and relationship lending theories, the paper explains why traditional credit approaches cannot work, considering the distinctive features of the financial model of mission-oriented institutions. …

Care Ecologies Between Knots, Eliza R. Marris

Masters Theses

Discarded fibers like raw wool behave the way harm reduction does. Harm reduction resists stigma and works to move beyond assumptions and oversimplifications of substance use and addiction. Wool is irregular, complicated, and emotionally charged. It resists compression and maintains its own being even when pulled apart. Working with raw wool is in relationship with complexity, as is harm reduction.

At its core, harm reduction is grounded in thoughtfulness and empathy towards people, their lived experience, and its nuances. It is a witness to lives, memories, and imprints, acknowledging the entangled realities of addiction. Our detachment from fiber remainders, materials …

Governing Longevity: Biopolitics And Economic Restructuring In East Asian Aging Societies, Sherlyn She

Dartmouth College Master’s Theses

How do rapidly aging societies govern longevity when demographic change threatens established welfare arrangements? This thesis examines aging governance in China, Japan, and South Korea to show how states simultaneously manage aging as a public-health problem and build it into an economic sector through what I term life capitalism.

Two interpretations of East Asian aging policy are widely circulated: that it is a peripheral case of Western neoliberalism, or a residue of Confucian familism. I reject both: the neoliberal reading captures marketization but misses the state as its active builder, since these states are expanding rather than retreating; the Confucian …

Global Health Financing Of Diagonal Interventions: Building Resilient And Sustainable Health Systems In Sub-Saharan Africa, Lucy Kim

Master in Public Policy Theses

Background: Global health financing has historically prioritized disease-specific “vertical” programs over broader “horizontal” strengthening of general health systems. Vertical programs in HIV have led to unprecedented reductions in mortality worldwide, but HIV remains a significant public health threat in sub-Saharan Africa, where vertical strategies have long been criticized for creating fragmented health systems. In response, global health strategies have shifted towards combining vertical investments with broader horizontal activities, commonly referred to as “diagonal” programming. While evidence suggests that diagonal programming has the potential to create more resilient and sustainable health systems, evaluating its value for money is challenging due to …

Beyond The Ban: Chhaupadi Abolition And The Governance Of Menstrual Autonomy In Western Nepal, Nikita Paudel

Master in Public Policy Theses

This thesis examines how two decades of efforts to abolish chhaupadi have shaped the everyday conditions under which women and girls experience menstruation in western Nepal. Chhaupadi, commonly understood as menstrual seclusion, has been addressed through Supreme Court directives, national policy, criminal law, municipal implementation instruments, hut demolition campaigns, public health programming, and rights-based advocacy. Yet the practice has persisted, adapted, and in some cases moved into less visible spaces. Rather than treating this as a simple gap between law and practice, this thesis asks how abolition efforts themselves have become part of the regulatory regime through which menstruation is …

Menstruation Behind Bars: A Mixed-Methods Study On Menstrual Product Access And Distribution Practices In Mississippi County Jails, Eron Hendrix

Honors Theses

This study examines menstrual product access and distribution practices in Mississippi county jails. It highlights the impact of period poverty as a critical yet underexplored public health and human rights issue within the corrections system. While existing research documents widespread inequities in access to menstrual products women’s healthcare in the correctional system, limited attention has been given to menstrual health at the local jail level. Using a mixed-methods approach, this study combines qualitative interviews with jail correctional staff and quantitative survey data from formerly incarcerated women to better understand institutional practices and lived experiences.

Interviews were conducted with sheriffs, jail …

How Do Minimum Wages Affect Workplace Injuries?, Michael Davies, R. Jisung Park, Anna Stansbury

Employment Research Newsletter

No abstract provided.

Characterizing Core Outcomes Of Responsible Stewardship For Human Genomic Data In The Cloud, Vasiliki Rahimzadeh, Bronwyn Walsh, Heidi L Rehm, Mildred Cho, Amy L Mcguire

Center for Medical Ethics and Health Policy Staff Publications

We present findings from a scoping review of the genomic data sharing literature used to inform a core outcomes set for responsible data stewardship in the cloud. Genomic and related health data stemming from government funded research have undergone mass migration to the cloud where they can be more securely stored, accessed, and analyzed within shared computing environments. While this migration reflects a shift in privacy and security infrastructure for cloud-based repositories as oversight becomes more globalized, it also necessitates new data stewardship responsibilities to align authorized data access with ethical data use. Responsible data stewardship refers to the ethical …

Reimagining Maternal Health: The Crucial Role Of Social And Behavioural Change Communication In Lmics, Sneha Chetri Ms, Monica Koachar

Journal Of Indian Physician Associates

Preventable maternal mortality is still remarkably high in low and middle-income nations, despite growing investments in maternal health systems. Conventional methods have mostly concentrated on expanding access to services, ignoring important social and behavioural factors that affect how people seek health care. In order to bridge the gap between the availability and actual consumption of maternal health treatments, this opinion piece makes the case for the critical role that social and behavioural change communication plays. The article uses real-world examples from Bangladesh, Nepal, India, Ethiopia, Nigeria, Ghana, and Uganda to show how SBCC can empower women, change the dynamics of …

Community-Based Substance Use Prevention Handbook, Rachael M. Kupper

Capstone Projects and Master's Theses

In Santa Cruz County, too many youth have issues with substance use and abuse. These issues extend beyond Santa Cruz County, but the county exhibits trends similar to those observed nationwide. Community members face challenges related to knowledge and the ability to organize effectively. The YEAH unit (Youth Empowerment Action for Health) and CPP (Community Prevention Partners) are working to address youth substance use, but need help from community members in the smaller jurisdictions across the county. This requires building workgroups across the county, composed of community members, parents, and professionals. The project is a roadmap handbook for forming a …

Navigating Higher Education: Waves Of Success Mentorship Initiative, Roberto M. Davila

Capstone Projects and Master's Theses

Too many undocumented students and students from mixed-status backgrounds face obstacles and don’t receive enough support while navigating higher education. Undocu-Success at CSUMB orients its services to meet the needs of undocumented students and students with mixed-status backgrounds. In collaboration with Undocu-Success Center staff, the Waves of Success mentorship initiative is a new resource to increase students' preparedness during their academic journey and increase awareness of resources accessible to CSUMB students through mentor-mentee relationships. The capstone project was to create a new program which involved conducting research, recruitment, management, and building campus partnerships. Evaluation included an interview conducted with the …

Abortion Politics And Policy: Stigma And Access In The Silver State, Celene Fuller

Lincy Institute Events

In the aftermath of the Supreme Court’s Dobbs v. Jackson Women’s Health Organization (2022) overturning Roe V. Wade, states have taken divergent paths in regulating access to abortion services. In 2024, Nevada voters overwhelmingly passed Question 6 proposing to codify abortion rights into the state constitution. In November 2026, Question 6 will again be on the ballot for final confirmation. If it passes, these rights will be protected from future legislative action.

Despite Nevadans’ strong support for abortion rights, the state’s dearth of abortion providers limits access to these services. As this lecture explores, both providers and individuals seeking abortions, …

Mitigation Of Race-Based Antihypertensive Prescribing, Victoria Scaccia Msn Rn Cnl Dnp, Bridget O'Brien Dnp, Stephanie Crane Md, Amanda Bradke Md

North American Conference to End Race-Based Medicine

No abstract provided.

Six Steps To Squats: A Training Protocol To Guide Functional Rehabilitation Following Isolated Lower Extremity Fractures, Batoul Baydoun, Abdurrahman Ehsan, Manar Chebli, Zarrar Chauhdri, Ahmed Memon, Ahmad Almaat Bs, Omar Abdalla Bs, Haytham Alqasmi Bs, Ameen Suhrawardy Md, Rahul Vaidya Md

North American Conference to End Race-Based Medicine

No abstract provided.

Reconsidering The Use Of Race & Ethnicity In Clinical Decision-Making: The Path Towards Liberation Medicine, Donna Ahmadian Ms, Mph

North American Conference to End Race-Based Medicine

No abstract provided.

Sleeve Gastrectomy Vs. Glp-1 Agonists (Semaglutide): A Cost-Effectiveness Perspective On Long-Term Obesity Management, Naushad Khan, Luv Agarwal, Ritesh Sheth Md

North American Conference to End Race-Based Medicine

No abstract provided.

Contemplating Race In Clinical Algorithms: Educating The Physicians Of Tomorrow, Adam Gaetz

North American Conference to End Race-Based Medicine

No abstract provided.

Reimagining Black Maternal Health Narratives: Embracing A Vitality Framework For Joy, Liberation, And Healing, Ijeoma Nnodim Opara, Yasmine M. Elmi

North American Conference to End Race-Based Medicine

No abstract provided.

Voices From The Field: Provider Perspectives On The Implementation And Impact Of Race-Neutral Pfts, Kumbie Madondo Phd, Zoelene Hill Phd, Kimberly Murdaugh Md Ms, Natoushka Trenard Md

North American Conference to End Race-Based Medicine

No abstract provided.

Gender Disparities In Medical Student Clinical Experiences During Obstetrics And Gynecology Rotations In The Usa, Naushad Khan, Luv Agarwal, Ritesh Sheth Md, Rehana Sheikh

North American Conference to End Race-Based Medicine

No abstract provided.

Governing Addiction: An Anthropological Comparison Of Care In The United States And The Netherlands, Kiren K. Bagga

Bates College Journal of Political Studies

This article examines addiction care as a form of moral governance through a comparative anthropological analysis of the United States and the Netherlands. Drawing on a Foucauldian theory of biopolitics alongside this study argues that approaches to addiction treatment reveal how states differentially value life, citizenship, and vulnerability. Joan Tronto's relational definition of ethical care is used to move beyond a solely moral context, towards an ethical understanding of both caretakers and those who require care. In the United States, addiction policy has historically functioned as a punitive and moralizing project, shaped by racialized drug criminalization, neoliberal ideals of individual …