Strengthening the primary health care response to COVID-19: an operational tool for policymakers

Aims: The aim of this paper is to introduce an operational checklist to serve as a tool for policymakers in the WHO European Region to strengthen primary health care (PHC) services and address the COVID-19 pandemic more effectively and to present the results from piloting the tool in Armenia. Backgrounds: PHC has the potential to play a fundamental role in countries’ responses to COVID-19. However, this potential remains unrealized in many countries. To assist countries, the WHO Regional Office for Europe developed a guidance document – Strengthening the Health Systems Response to COVID-19: Adapting Primary Health Care Services to more Effectively Address COVID-19 – that identifies strategic actions countries can take to strengthen their PHC response to the pandemic. Based on this guidance document, an operational checklist was developed to serve as a tool for policymakers to operationalize the recommended actions. Methods: The operational checklist was developed by transforming key points in the guidance document into questions in order to identify potentially modifiable factors to strengthen PHC in response to COVID-19. The operational checklist was then piloted in Armenia in June 2020 as part of a WHO mission to provide technical advice on strengthening Armenia’s PHC response to COVID-19. Two WHO experts performed semi-structured, face-to-face interviews with nine key informants (both facility managers and clinical staff) in three PHC facilities (two in a rural and one in an urban area). The data collected were analyzed to identify underlying challenges limiting PHC providers’ ability to effectively and efficiently respond to COVID-19 and maintain essential health services. Findings: The paper finds that making adjustments only to health services delivery will be insufficient to address most of the challenges identified by PHC providers in the context of COVID-19 in Armenia. In particular, strategic responses to the pandemic were missed, due, in part, to the absence of COVID-19 management teams at the facility level. Furthermore, the absence of PHC experts in Armenia’s national pandemic response team meant that health system issues identified at the facility level could not easily be communicated to or addressed by policymakers. The checklist therefore helps policymakers identify critical challenges – at both the facility and health system level – that need to be addressed to strengthen the PHC response to the COVID-19 pandemic

Health and well-being for all: an approach to accelerating progress to achieve the Sustainable Development Goals (SDGs) in countries in the WHO European Region

Background Forty-three out of 53 of the WHO European Member States have set up political and institutional mechanisms to implement the United Nations (UN) 2030 Agenda for Sustainable Development. This includes governance and institutional mechanisms, engaging stakeholders, identifying targets and indicators, setting governmental and sectoral priorities for action and reporting progress regularly. Still, growing evidence suggests that there is room for advancing implementation of some of the Sustainable Development Goals (SDGs) and targets at a higher pace in the WHO European Region. This article proposes the E4A approach to support WHO European Member States in their efforts to achieve the health-related SDG targets. Methods The E4A approach was developed through a 2-year, multi-stage process, starting with the endorsement of the SDG Roadmap by all WHO European Member States in 2017. This approach resulted from a mix of qualitative methods: a semi-structured desk review of existing committal documents and tools; in-country policy dialogs, interviews and reports; joint UN missions and discussion among multi-lateral organizations; consultation with an advisory group of academics and health policy experts across countries. Results The E—engage—functions as the driver and pace-maker; the 4 As—assess, align, accelerate and account—serve as building blocks composed of policies, processes, activities and interventions operating in continuous and synchronized action. Each of the building blocks is an essential part of the approach that can be applied across geographic and institutional levels. Conclusion While the E4A approach is being finalized, this article aims to generate debate and input to further refine and test this approach from a public health and user perspective

Beyond Building Back Better: Imagining a Future for Human and Planetary Health

COVID-19 is disrupting and transforming our world. We argue that transformations catalyzed by this pandemic should be harnessed to improve human and planetary health and well-being. This paradigm shift requires us to go ‘Beyond Building Back Better’ by nesting the economic domain of sustainable development within social and environmental domains. Drawing on the E4As approach (Engage, Assess, Align, Accelerate, Account) to implementing the 2030 Agenda for Sustainable Development, we explore the implications of this kind of radical transformative change, focusing particularly on the role of the health sector. We conclude that recovery and transition from COVID-19 that delivers the future we want, and need, requires more than a technical understanding of the transformation at hand. It also requires commitment and courage from leaders and policymakers to challenge dominant constructs and to imagine a truly thriving, equitable and sustainable future in order to create a world where the economy is not an end in itself, but a means to secure the health and wellbeing of people and the planet

Understanding social policy as a tool of foreign policy

Adopting an exploratory approach, this thesis seeks to understand social policy as a tool of foreign policy by addressing the following two research questions: ‘What explains the relationship between social policy and foreign policy post-WWII?’; and ‘Is there a relationship between welfare state type and the social sector foreign aid of donors?’. The thesis argues that social policy has not only a substantial, but also a relational foundation; therefore, the exercise of social policy is context specific. Through quantitative exploratory analysis and the construction of historical narratives examining this relationship in the cases of the British Empire and the United States, this thesis finds that the relationship between social policy and foreign policy is neither mechanical nor deterministic. Together, these cases illustrate the importance of understanding foreign aid in the social sector not only in relation to domestic politics and policy, but also within the geopolitical relationships underpinning the use of this instrument. These findings contribute to broader efforts to understand welfare state regimes in global context and to understand social policymaking in transnational relief, with implications for global social governance

Colonial empires, actor constellations, and their legacies

Colonialism is a multifaceted phenomenon characterized by the establishment of political control, the subjugation of local populations, and economic exploitation. Even though most of today’s nation states have been colonized and subordinated to others at some point, many questions about how colonial legacies influence past and contemporary polities, politics, and policies in former colonies remain unanswered. In this paper, we address colonialism as a particular kind of transnational governance and put actors, their constellations, and strategic interactions at the center of the analysis. We argue that this actor-centric approach serves as an analytical and heuristic tool to bring about a more comprehensive and specific understanding of how colonial legacies manifest. This helps us to detect differences and similarities across and within Empires and also to identify changes and continuities between the pre- and post-independence eras

Universal social protection: is it just talk?

Many intergovernmental organizations (IGOs) now place a high priority on universal social protection as a means for achieving sustainable development. Is this shift toward universal social protection just talk, or does it signify a more substantial emphasis on welfare within development policy? We present a theoretical framework for understanding discursive changes in global policy as rebranding, fads, trends, or paradigm shifts. We then conduct a comparative, semi-structured review of official language related to social protection used by six key IGOs (International Labour Organization, International Monetary Fund, United Nations Children's Fund, United Nations Development Programme, World Bank, and World Health Organization) across five dimensions of social protection (labor market, health, family, housing, and education) before the introduction of the United Nations 2030 Agenda for Sustainable Development. Then, employing the framework, we analyze the findings of this review to determine the significance of the discursive shift toward universal social protection in the context of the 2030 Agenda. We document that, at present, universal social protection is an influential policy trend that has shaped how IGOs understand and act on social issues. These findings inform theoretical debates on the relationship between discursive and substantive policy change and contribute to a growing literature on transnational social protection. They also have implications for efforts across agencies and sectors to enhance social protection and achieve the Sustainable Development Goals

Migrant and minority health in Europe: the way forward: Report on the Salzburg Workshop on Migrant and Minority Health, 3–9 April 2016

Migrant and minority health has always been an issue of special concern in public health. While migration is not a new phenomenon, the number of refugees and migrants across the globe grew rapidly in 2015, with large numbers from the Middle East and Africa. Furthermore, the recent migrant crisis in Europe—sparked by civil wars in Syria and Libya and continuing conflict in Iraq and Afghanistan—has escalated to the level of a humanitarian emergency requiring immediate action. We conducted an international workshop on migrant and minority health in Salzburg from 3 to 9 April 2016 to examine migrant and minority health issues in greater depth, sponsored by the American Austrian Foundation and in cooperation with the Association of Schools of Public Health in the European Region (ASPHER) and Public Health Reviews (PHR). To continue this discussion within the academic literature, PHR’s special issue on migrant and minority health includes articles from conference participants and other experts in medicine and public health from the European region and beyond. Informed by the contribution of senior representatives of the European Union, the International Organization for Migration (IOM), Médecins Sans Frontières (MSF), and public health practitioners and investigators from over 30 countries, this editorial summarizes recommendations of the conference participants for improving migrant and minority health in Europe. They include (i) developing a conceptual framework for health care intervention for migrants, (ii) oversight and coordination of migrant and minority health activities, (iii) reaching a consensus on implementation practices, and (iv) mobilizing sufficient resources for addressing the health needs of migrants

Regional social policies: aspirations, vernacularisation, or new forms of solidarity?

Kaasch A, Shriwise A, Agartan T, Cook S, Seekings J, Sukhampha R. Regional social policies: aspirations, vernacularisation, or new forms of solidarity? In: De Lombaerde P, ed. Handbook of Regional Cooperation and Integration. Edward Elgar Publishing; 2024: 243-265.This chapter provides an overview of the emergence and spread of regional social policies and their potential to transform transnational governance. It therefore examines the multiple meanings of regional social policies, reviews the reasons for their emergence, and provides concise reviews of several regional social policies that have been developed and implemented. The transformative potential of regional social policies is discussed, with a reflection on recent global crises. The chapter concludes that regional social policies are increasingly important in facilitating policy development and a common discourse and are characterised by complex, interactive processes between associated countries, with global interests and influences shaping their ideas and discourses. The chapter highlights the need for more knowledge at the intersection of regional social policies and calls for further comparative analysis of different regional social policies. It also shows that regional social policy is not just a function of interest or capability in terms of developing such policies but also about a reluctance of member states to provide the regional level with the competency to regulate and implement social policies. Finally, the chapter suggests that regional organisations can amplify the voice of smaller states in international politics and regional cooperation

Performance Portable Monte Carlo Particle Transport on Intel, NVIDIA, and AMD GPUs

OpenMC is an open source Monte Carlo neutral particle transport application that has recently been ported to GPU using the OpenMP target offloading model. We examine the performance of OpenMC at scale on the Frontier, Polaris, and Aurora supercomputers, demonstrating that performance portability has been achieved by OpenMC across all three major GPU vendors (AMD, NVIDIA, and Intel). OpenMC's GPU performance is compared to both the traditional CPU-based version of OpenMC as well as several other state-of-the-art CPU-based Monte Carlo particle transport applications. We also provide historical context by analyzing OpenMC's performance on several legacy GPU and CPU architectures. This work includes some of the first published results for a scientific simulation application at scale on a supercomputer featuring Intel's Max series "Ponte Vecchio" GPUs. It is also one of the first demonstrations of a large scientific production application using the OpenMP target offloading model to achieve high performance on all three major GPU platforms