A more interdisciplinary approach can help us understand why research evidence does or doesn’t make it into policy

Effective communication of research is often cited as being most important to gaining the attention of policymakers. This arguably underestimates the sheer complexity of the policymaking process, assuming a linear route from evidence to policy and practice. Fiona Blyth and Carmen Huckel Schneider explain why breaking down walls between different academic disciplines could enhance our understanding of why research evidence does − or doesn’t − make it into policy, and also suggest questions that researchers might ask as a “gateway” to understanding these different approaches to evidence-informed policymaking

Implementing system-wide risk stratification approaches: a review of critical success and failure factors

An Evidence Check rapid review brokered by the Sax Institute for the NSW Agency for Clinical Innovatio

Conceptualizing oral health care systems for comparative analysis – public, private and statutory

The Global Burden of Disease Study 2010 put the worldwide figure at 15 million disability adjusted life years due to oral health disorders considerably varying across countries. Epidemiological factors like Socio-demographics, diets, age and oral hygiene habits are known for the most common oral diseases. However, little is known about the health system factors and its influence on oral health outcomes. Whilst there is ample evidence on comparative health system functioning and its outcome, the oral health tributary of it needs to be reveale

Evaluation of Project ECHO (Persistent Pain)

Western Victoria Primary Health Network (WVPHN) in partnership with the Transport Accident Commission (TAC) and WorkSafe Victoria (‘WorkSafe’) implemented Project ECHO (Persistent Pain) Series 1 in February-June 2020 and Series 2 in July-December 2020. The Menzies Centre for Health Policy and Economics, University of Sydney was commissioned by WVPHN to undertake the evaluation of Project ECHO (Persistent Pain) Series 2

Moving from silos to synergies:Strengthening governance of food marketing policy in Thailand

BACKGROUND: Governance processes play an important role in shaping the formulation and implementation of policy measures such as restrictions on marketing of ultra-processed foods. However, there is limited analysis of the factors that affect governance for nutrition, especially in low- and middle-income countries such as Thailand and the Southeast Asia region. This study aimed to examine governance factors that create opportunities and challenges for the introduction of policy to restrict food marketing in Thailand, in line with the WHO recommendations to restrict food marketing to children. METHODS: A qualitative study design was used. Interviews were conducted with 20 actors with experience and in depth knowledge of food marketing in Thailand, including government, civil society, industry and international organisations. Open questions were asked about experiences and perceptions of the governance processes related to policies for restricting food marketing in Thailand. Themes were derived from the 3-i Framework which relates to interests, ideas and institutions influencing the introduction of food marketing policy were identified and analysed using abductive methods. RESULTS: Actors viewed institutional challenges as a significant barrier to advancing effective regulation of food marketing. Three major clusters emerged from the data: interests (priorities, relationships), institutions (formal structures, informal structures, broader institutional strategies), and ideas (norms). The study has three major findings in relation to these factors, highlighting the influence of formal structures, institutional interests in food marketing issues, and ideas in promoting multisectoralism. The siloed nature of policymaking was reflected in the government failing to stimulate engagement among key actors, posing challenges for implementation of effective policy change. Contested interests led to disagreements between actors over food marketing agenda and thus competing policy priorities. Consistent with these findings, the lack of effective mechanisms to promote multisectoral coordination across diverse actors reinforced barriers to policy change. CONCLUSION: The findings highlight ongoing challenges to the government’s aim to strengthen policy to restrict food marketing which, without greater coordination in governance mechanisms, will hinder effective regulation and the achievement of public health goals. This analysis suggests that the Government should prioritise the development of a holistic, multisectoral approach to improve governance for better nutrition outcomes by overcoming policy silos

Protecting children from unhealthy food marketing:A comparative policy analysis in Australia, Fiji and Thailand

Restrictions on marketing of unhealthy foods and beverages to children is a globally recommended policy measure to improve diets and health. The aim of the analysis was to identify opportunities to enable policy learning and shift beliefs of relevant actors, to engender policy progress on restrictions on marketing of unhealthy foods to children. We drew on the Advocacy Coalition Framework to thematically analyse data from qualitative policy interviews conducted Australia (n = 24), Fiji (n = 10) and Thailand (n = 20). In all three countries two clear and opposing advocacy coalitions were evident within the policy subsystem related to regulation of unhealthy food marketing, which we termed the 'strengthen regulation' and 'minimal/self regulation' coalitions. Contributors to policy stasis on this issue were identified as tensions between public health and economic objectives of government, and limited formal and informal spaces for productive dialogue. The analysis also identified opportunities for policy learning that could enable policy progress on restrictions on marketing of unhealthy foods to children as: taking an incremental approach to policy change, defining permitted (rather than restricted) foods, investing in new public health expertise related to emerging marketing approaches and scaling up of monitoring of impacts. The insights from this study are likely to be relevant to many countries seeking to strengthen regulation of marketing to children, in response to recent global recommendations.</p

Legitimität und Weltregieren in der globalen Gesundheitspolitik

This dissertation is concerned with health governance on the global level, where over the past fifteen years a number of new organisations have emerged that address major global public health issues. Three examples are the Global Fund to Fight AIDS, Tuberculosis and Malaria, (GFATM), the Global Alliance for Vaccines and Immunisation (GAVI Alliance), and Joint United Nations Programme on HIV/AIDS (UNAIDS), each of which are examined in depth in the dissertation. These organisations differ significantly from intergovernmental organisations such as the WHO and can be classified as organisations of ‘global governance’. Two basic observations provide the motivation for study. First, the work of each of these organisations can be said to be based on principles that shift away from intergovernmentalism, towards managerialism and cosmopolitanism. Second, despite this break with the conventional model of intergovernmentalism, these organisations are increasing their operational scope in terms of determining rules for action, and gaining funding. The dissertation proceeds to address the question of how GHG Organisations – having moved away from the conventional model of global level governance of intergovernmentalism – come to be accepted as legitimate governing organisations. Following a historical tracing of the evolution of governance in the area of global health, the dissertation proceeds to provide a basis for examinations into the legitimacy of GHG organisations via a systematic description of what legitimacy entails, the formulation of a conceptualisation of the legitimacy suitable for the global level, and the development of methods suitable for empirically examining the legitimacy of GHG organisations. The second part of the book contains an examination of three GHG organisations and how they have come to experience differing levels of legitimacy amongst stakeholders.Diese Dissertation befasst sich mit Gesundheitspolitik auf globaler Ebene, wo in den letzten 15 Jahren mehrere Organisationen entstanden sind, die auf spezielle, bedeutende globale Gesundheitsthemen fokussiert sind. Drei Beispiele hierfür sind der Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), die Global Alliance for Vaccines and Immunisation (GAVI Alliance) und das Joint United Nations Programme on HIV/AIDS (UNAIDS), die in dieser Dissertation eingehend betrachtet werden. Diese Organisationen unterscheiden sich bedeutend von zwischenstaatlichen Organisationen, wie der WHO und können als Organisationen des „Global Governance“ klassifiziert werden. Zwei grundlegende Beobachtungen begründen eine genauere Untersuchung dieser Organisationen. Erstens: Die Arbeitsweise dieser Organisationen wendet sich von zwischenstaatlichen Prinzipien hin zu ‚Managerialism‘ und kosmopolitischen Prinzipien. Zweitens: Trotz dieses Bruches, mit dem traditionellen Modell der Zwischenstaatlichkeit, erweitern diese Organisationen ihre operativen Möglichkeiten hinsichtlich Festlegung von Handlungsregeln und Refinanzierung. Nachfolgend befasst sich die Dissertation mit der Frage, wie derartige GHG Organisationen (die sich von dem bisherigen Modell der Zwischenstaatlichkeit abgewandt haben) erreichen können, als legitime regierende Organisationen akzeptiert zu werden. Die Dissertation fährt fort mit einer Untersuchung der historischen Entwicklung des Regierens im Bereich der globalen Gesundheitspolitik. Nachfolgend wird eine Basis zur Untersuchung der Legitimität von GHG Organisationen auf globaler Ebene geschaffen, indem ein Konzept der Legitimität auf globaler Ebene formuliert wird, Voraussetzungen für Legitimität systematisch beschrieben werden und Methoden zur empirischen Untersuchung der Legitimität von GHG Organisationen entwickelt werden. Abschließend werden diese Methoden in drei Fallstudien auf die oben genannten Organisationen angewandt, um zu erklären, wie diese unterschiedliche Grade von Legitimität bei internationalen Akteuren erlangt haben

Macro-health system governance and the UHC agenda : key learnings from the COVID-19 pandemic

This STG Resilience Paper is part of the Commission Research Report and Interim Progress Report (June 2021) published by Reform for Resilience.• Prior to the Covid-pandemic, the ‘Political Declaration of the High-Level Meeting on Universal Health Coverage’ signalled a high point for an approach to global health focussed on health systems. • The Covid pandemic has served to highlight the critical importance of the fundamental goals of Universal Health Coverage ie broad and equitable access to services and essential technologies; multi-stakeholder participation in decision making; increased funding; and, protecting citizens against debilitating health care costs. • The Covid pandemic has also demonstrated the need to delve deeper into the organisation and administration of health systems as the key factor in achieving universal health coverage and effective pandemic control. • Four elements of health system governance have been exposed as key to maintaining resilient, adaptable, strong and equitable health systems and are manifest in how the relationships within health systems are organised, legitimised and maintained. First, relationships between levels and types of health services; second, relationships between levels of government and health administration; third, relationships between technical experts and decision makers; and fourth, relationships between public and private actors in health. • Global health policy, the Universal Health Coverage paradigm and the drive to improve health will be strengthened by increasing attention to these factors and the empirical evidence base for improved health governance and administratio