Health Policy Commons^™

Cervical Cancer Screening Strategies For Aboriginal Women, Agnes T. Black

Aboriginal Policy Research Consortium International (APRCi)

No abstract provided.

Community Conditions As Factors Of Health, Economic Outlook, And Mobility: Survey Data And Aboriginal People In Manitoba, Christopher Adams

Aboriginal Policy Research Consortium International (APRCi)

No abstract provided.

Community Influences On The Mental Health Of First Nations Children In Canada: Health Information And Research Division, Statistics Canada, Dafna Kohen, Lisa Oliver

Aboriginal Policy Research Consortium International (APRCi)

No abstract provided.

Strengths-Based Programming For First Nations Youth In Schools: Building Engagement Through Healthy Relationships And Leadership Skills, Claire V. Crooks, Debbie Chiodo, Darren Thomas, Ray Hughes

Aboriginal Policy Research Consortium International (APRCi)

FirstNationsyouthinCanadademonstratedisproportionatelyhighratesofnegative behaviors such as violence, substance abuse, and leaving school early. An understanding of historical context and current environment helps explain these patterns. Providing culturally relevant opportunities for youth to build healthy relationships and leadership skills has the potential to increase youth engagement. Over the past four years our multidisciplinary team of researchers, educators, program developers, and community leaders have worked together to develop a number of school-based initiatives that focus on increasing youth engagement through building on strengths and the promotion of healthy relationships. Specific strategies include peer mentoring, a credit-based academic course, and transition conferences for grade 8 …

The Role Of Medicaid In Promoting Access To High-Quality, High-Value Maternity Care, Anne R. Markus, Sara J. Rosenbaum

Health Policy and Management Faculty Publications

The main purpose of this article is to analyze and describe the role of Medicaid in facilitating access to care for pregnant women and ensuring high-quality maternity care that is affordable. It first summarizes the federal Medicaid requirements regarding eligibility, coverage of benefits, financing, and service delivery, with a special emphasis on existing quality provisions. Then, it discusses current issues and recommends several Medicaid reforms, particularly in the area of quality assessment and improvement. All reforms, including Medicaid reforms, should seek to support the IOM-identified aims. Much of the emphais in Medicaid policy development has been focused on access to …

The Diabetes Primary Prevention Initiative Interventions Focus Area: A Case Study And Recommendations, Deborah S. Porterfield, Laurie Hinnant, David M. Stevens, Ernest Moy, Dppi-Ifa Case Study Group

Health Policy and Management Faculty Publications

Background: In 2005, CDC began the Diabetes Primary Prevention Initiative Interventions Focus Area (DPPI-IFA), which funded fıve state Diabetes Prevention and Control Programs (DPCPs) to translate diabetes primary prevention trials into real-world settings by developing and implementing a framework for state-level diabetes primary prevention.

Purpose: The purpose of this case study, conducted in 2007, was to describe DPPI-IFA implementation, including facilitators and challenges to the initiative. Methods: Case studies of the fıve DPCPs in the DPPI-IFA involving site visits with key informant interviews of state staff and partners and archival record collection.

Results: Partners recruited for DPPI-IFA activities included …

The Health Information Technology Provisions In The American Recovery And Reinvestment Act Of 2009, Taylor Burke

Health Policy and Management Faculty Publications

This installment of Law and the Public’s Health explores the comprehensive reforms contained in the American Recovery and Reinvestment Act of 2009, whose implementation is expected to transform the use of health information technology as part of Medicare, Medicaid, and public health practice.

Can The Deployment Of Community Health Workers For The Delivery Of Hiv Services Represent An Effective And Sustainable Response To Health Workforce Shortages? Results Of A Multicountry Study, Francesca Celletti, Anna Wright, John Palen, Seble Frehywot, Anne R. Markus, Alan E. Greenberg, Rafael Augusto Teixeira De Aguiar, Francisco Campos, Eric Buch, Badara Samb

Health Policy and Management Faculty Publications

In countries severely affected by HIV/AIDS, shortages of health workers present a major obstacle to scaling up HIV services. Adopting a task shifting approach for the deployment of community health workers (CHWs) represents one strategy for rapid expansion of the health workforce. This study aimed to evaluate the contribution of CHWs with a focus on identifying the critical elements of an enabling environment that can ensure they provide quality services in a manner that is sustainable. The method of work included a collection of primary data in five countries: Brazil, Ethiopia, Malawi, Namibia, and Uganda. The findings show that delegation …

Fragmentation In Mental Health Benefits And Services: A Preliminary Examination Into Consumption And Outcomes, Barak D. Richman, Daniel Grossman, Frank Sloan

Faculty Scholarship

In this chapter, we examine consumption patterns and health outcomes within a health insurance system in which mental health benefits are administered under a carved-out insurance plan. Using a comprehensive dataset of health claims, including insurance claims for both mental and physical health services, we examine both heterogeneity of consumption and variation in outcomes. Consumption variation addresses the regularly overlooked question of how equal insurance and access does not translate into equitable consumption. Outcomes variation yields insights into the potential harms of disparate consumption and of uncoordinated care. We find that even when insurance and access are held constant, consumption …

Curtis Fogel On Dying Inside: The Hiv/Aids Ward At Limestone Prison. By Benjamin Fleury-Steiner & Carla Crowder. Ann Arbor, Mi: University Of Michigan Press, 2008. 238pp., Curtis Fogel

Human Rights & Human Welfare

A review of:

Dying Inside: The HIV/AIDS Ward at Limestone Prison. By Benjamin Fleury-Steiner & Carla Crowder. Ann Arbor, MI: University of Michigan Press, 2008. 238pp.

Beyond The Brink: Somalia’S Health Crisis, Bryson Brown

Human Rights & Human Welfare

Somalia is approaching a daunting anniversary: in 2011, the country will begin its twentieth consecutive year without an effective centralized government. The fall of the Soviet supported Siad Barre government in 1991 created a power vacuum that was filled by warlords, clans and, most recently, Islamists. Fourteen interim governments have failed to supplant those forces. Health infrastructure and the general health of the population have been devastated as a result. Precious few organizations are still providing health-related services. Unfortunately, recent events suggest that this crisis is going to get worse before it gets better.

Increasing Institutional Delivery And Access To Emergency Obstetric Care Services In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council

Reproductive Health

The Population Council conducted a formative in rural Uttar Pradesh (UP), India to determine the impact of the Janani Suraksha Yojana (JSY) scheme on the current status of institutional delivery in the region, to understand the facilitating factors and barriers in delivering in a health facility, and to identify programmatic and behavior change communication (BCC) initiatives that could accelerate the adoption of institutional delivery. JSY was launched as an intervention to address the barriers to institutional delivery, through the introduction of community-based women volunteers. The study shows that with the introduction of the JSY the rate of institutional delivery jumped …

Referral Mechanism Improves Uptake Of Art Services For Hiv+ Fp Clients, Population Council

Reproductive Health

An operations research intervention by the Population Council in Kenya aimed to design a referral framework for linking HIV‐positive family planning (FP) clients to treatment and care in selected health facilities. The project also assessed the acceptability and effectiveness in increasing the number of eligible HIV‐positive FP clients receiving HIV care and treatment services. This summary details the effort to improve the linkage between FP services and comprehensive care centers that led to a dramatic increase in the proportions of HIV-positive clients in FP clinics who go on to receive HIV/AIDS treatment and care services at the same facility. Recommendations …

Gendered Disparities In Take-Ups Of Employee Health Benefits, Jennifer Reid Keene, Anastasia H. Prokos

Sociology Faculty Research

Using a sample of 2,271 workers from the 2002 National Study of the Changing Workforce whose employers offered personal health insurance, this article investigates the gendered nature of health insurance benefit take-ups. These analyses include family and employment characteristics in addition to employers’ contributions to health insurance premiums, a measure that is unexamined in sociological analyses of health benefits. Progressive logistic regression models predict the effects of gender and family characteristics. Results indicate that women with employed spouses are less likely to take up their own health benefits than are comparable men, net of basic employment characteristics. Gender differences disappear, …

Snapshot 2010: Maine Workers With Disabilities, Maine’S Commission On Disability And Employment, Choices Ceo Project

Disability & Aging

No abstract provided.

The Relationship Between Obesity And Skin And Soft Tissue Infections, Juliana Swiney

MPA/MPP/MPFM Capstone Projects

The Problem:

It is well known that our country is experiencing an obesity epidemic: 33.9% of all adults are obese (BMI>30) and 67% of adults are either overweight or obese (BMI>25). Obesity is a risk factor for several serious disease states such as, diabetes, stroke, hypertension, heart disease and some types of cancer. It also has a less well defined relationship with skin and soft tissue infections.

Although it is known that excessive weight increases the opportunity for harmful skin conditions, this relationship has not been as well studied. Some of the mechanisms that predispose obese people to …

Données Démographiques Pour Développement Ii—De La Recherche À L'Intervention: Améliorer L'Accès Et L'Utilsation Des Données Par Les Médias, Population Council

Poverty, Gender, and Youth

This policy brief describes the Population Council’s project to improve access and use of demographic, health, and other public sector data that are essential evidence for development policy planning and evaluation. In many countries, access to data is limited and, when data are available, the format is rarely user-friendly for nonprofessionals, limiting their potential applications. In recent years, the Population Council has examined access to and sharing of data through case studies in Ethiopia, Ghana, Senegal, and Uganda. In phase II of the project, the Council will strive to promote domestic demand for data by working with key intermediaries—the media.

Guidelines For Pilot Study On Introducing Pay-For-Performance (P4p) Approach To Increase Utilization Of Maternal, Newborn And Child Health Services In Bangladesh, Directorate General Of Health Services (Dghs), Population Council, Unicef

Reproductive Health

The Population Council launched a pilot study to test two Pay-for-Performance (P4P) strategies to improve MNCH services in Bangladesh. This document presents guidelines for offering incentives to providers, distributing coupons, and forming P4P and/or Coupon Committees and Quality Assurance Groups. The guidelines were developed over the course of five policy-level and consensus-building workshops with national and local-level program managers and service providers, organized under the leadership of the DGHS, in consideration of the local context and sustainability in case of nationwide replication in the country. These guidelines will come into effect upon receiving approval from the DGHS, Ministry of Health …

Role Of The Corporate Sector In Promoting Family Health In Uttar Pradesh: Implications For Behavior Change Communication, Population Council

Reproductive Health

The Confederation of Indian Industry, a partner in the Population Council–led Consortium, took the lead to explore a) the role of the corporate sector in family health in Uttar Pradesh, India; b) the possibility of partnering with this sector to design, leverage, and implement a behavior change communication (BCC) strategy; and c) the support and assistance the sector would require to ensure better planning and implementation of their corporate social responsibility (CSR) activities. Based on the findings, this policy brief identified the following, with implications for BCC strategy: corporate partnerships have the potential to scale up initiatives; companies can leverage …

Increasing Postpartum Contraception In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council

Reproductive Health

The Population Council conducted a formative study in rural Uttar Pradesh, India to assess the level of adoption of postpartum contraception for spacing among low parity women, identify the facilitating factors and barriers to the adoption of this target behavior, and identify programmatic and behavior change communications (BCC) initiatives that could accelerate the adoption of postpartum contraception for spacing and improve the service delivery system, if required, to facilitate the process. Barriers included low awareness of consequences of closely spaced births, misconceptions about contraceptive methods, lack of counseling by health workers, reluctance to include husbands, and programmatic emphasis on limiting …

Une Stratégie Pour La Réduction De La Mortalité Maternelle Et Néonatale, Population Council

Reproductive Health

As part of the strategies to reduce maternal and neonatal mortality, the introduction of a minimum integrated package of maternal and newborn care including Active Management of the Third Stage of Labor (AMTSL) and Essential Newborn Care (ENC) are simple and inexpensive approaches in poor countries. This brief reports on a study conducted by the Senegal Ministry of Health and Prevention, with support from IntraHealth and the Population Council, whose objectives included: 1) evaluating the functional capacity of the targeted health structures to offer the AMTSL and ENC, 2) evaluating the knowledge and skills of the providers, and 3) identifying …

Private Sector's Role In Health Service Provision In Senegal, Population Council

Reproductive Health

In Senegal, private providers are a major source of health services, including contraceptive services, and private sector partnerships are a key component of the Ministry of Health strategy toward achieving national health objectives. This brief reports on SMNI/PF/PALU—a five-year USAID-bilateral project aiming to foster high-quality service delivery, and build strong links between all levels of the health system and communities, including between private and public health sectors. In Senegal, private businesses have hosted innovative advocacy activities, committed to health supplies and information management, and demonstrated a general interest in supporting a collaborative movement toward national health objectives. With private sector’s …

Rôle Du Secteur Privé Dans L'Offre De Services De Santé Au Sénégal, Population Council

Reproductive Health

In Senegal, private providers are a major source of health services, including contraceptive services, and private sector partnerships are a key component of the Ministry of Health strategy toward achieving national health objectives. This brief reports on SMNI/PF/PALU—a five-year USAID-bilateral project aiming to foster high-quality service delivery, and build strong links between all levels of the health system and communities, including between private and public health sectors. In Senegal, private businesses have hosted innovative advocacy activities, committed to health supplies and information management, and demonstrated a general interest in supporting a collaborative movement toward national health objectives. With private sector’s …

Proceedings And Presentations From The Free State Child Abuse Indaba, Population Council

Reproductive Health

The Free State Department of Health and its partners held a “first-of-its kind” Child Sexual Assault Indaba (conference) in South Africa to streamline relationships between services for effective prevention and management of child abuse. This report details the presentations delivered at the conference, which was a resounding success, with participation from a wide range of stakeholders. The recurring theme of all the presentations was the urgent need to unite and fight against child sexual assault. The most appropriate strategy was unanimous—information—and clarity in terms of the role of each stakeholder. The Free State Department of Health will coordinate the development …

Mainstreaming Emergency Contraception Pills In Kenya, Jill Keesbury, Monica Wanjiru, Katherine Maina

Reproductive Health

To improve access to emergency contraception (ECP) and ensure that adequate information is provided to all users, the Kenyan Ministry of Public Health and Sanitation, the Population Council, and Population Services International-Kenya undertook a three-year effort to mainstream ECP in Kenya. This brief presents the results of this initiative and discusses strategies for further strengthening ECP provision. Kenya has emerged as a leader in ECP programming in the region and has demonstrated that it is possible to strengthen ECP services in both the public and private sectors while at the same time increasing public awareness, knowledge, and use of the …

Training Service Providers Increases Tb Screening In Postnatal Care, Population Council

Reproductive Health

This document summarizes a Population Council operations research project undertaken in collaboration with the Kenya Ministry of Health to develop and pilot-test an intervention to improve TB screening, case detection, treatment, and care among postnatal clients. The intervention demonstrated that it is feasible to use postnatal care services as a platform to increase TB screening and case detection. Training providers, giving them job-aids, and strengthening client flow within the facility also improved the overall quality of care that the clients received. The actual number of cases of TB detected was extremely low, however; thus the report recommends that the Ministry …

Health Care Expenditure And Income In The Oecd Reconsidered: Evidence From Panel Data, Badi H. Baltagi, Francesco Moscone

Center for Policy Research

This paper reconsiders the long-run economic relationship between health care expenditure and income using a panel of 20 OECD countries observed over the period 1971-2004. In particular, the paper studies the non-stationarity and cointegration properties between health care spending and income. This is done in a panel data context controlling for both cross-section dependence and unobserved heterogeneity. Cross-section dependence is modeled through a common factor model and through spatial dependence. Heterogeneity is handled through fixed effects in a panel homogeneous model and through a panel heterogeneous model. Our findings suggest that health care is a necessity rather than a luxury, …

Performance Measures And Pilot Evaluation Of Georgia’S Medical Assistance Program For Population Below The Poverty Line, Tamar Chitashvili

Muskie School Capstones and Dissertations

In recent years the Georgian health care system has been undergoing fundamental reforms aimed at improving the population’s health status by increasing financial and geographic access to high-quality health care. To address limited financial access to health services of the poor, and protect them from catastrophic expenditures associated with illnesses and improve equity, the government restructured the centralized, financially and administratively unsustainable social security system, with a liberal welfare system focusing on providing a safety net for the poor.

Understanding School Travel: How Residential Location Choice And The Built Environment Affect Trips To School, Yizhao Yang, Marc Schlossberg, Robert Parker, Bethany Johnson

TREC Final Reports

This project investigates issues related to parents’ decisions about children’s school transportation. This has become an important area of research due to the growing concerns that increased reliance on private automobile in school travel has led to adverse health impacts on children and negative impacts on environment. This study examines school transportation in the context of where families live and how families make decisions about school travel in the process of choosing their residence.

Using a middle-sized school district in Oregon State, we conducted a 5500-household survey and a number of interviews and focus groups. The study shows that parents …

When Is A Lot Still Not Enough? Health Information, The Public Good And Privacy Rights, Robert J. Mcgrath

The University Dialogue

No abstract provided.