16 research outputs found

    The corporatization of global health: The impact of neoliberalism

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    Concomitant with the emergence of a neoliberal precept for global health is the decline in support for publicly funded programs working to alleviate health disparities in poor countries. An unequivocal faith in the privatization and marketization of public health services is evident in current day national policy reforms.  Commodification of health services is perceived as a cure-all. Privatization of global health initiatives contrasts with the past institutional paradigm. Corporate and philanthropic power trumps intergovernmental governance. The epistemological precept is clear: Global health is best served with mandated private initiatives. Powerful foundations cause critical shifts in the balance of power among stakeholders and become preeminent players in global health policy agenda formation. The ethics of consequentialism have attained current day prominence. This contrasts with the merits and relevancy of de-ontological ethics in which rules and moral duty are central. In this paper, authors make a case for contesting the ethos of effective altruism or venture philanthropy, suggesting that this approach keeps nations and people from recognizing the oppressive nature of neoliberalism as a governing precept for global health

    Global health in transition: The coming of neoliberalism

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    Global health as a transnational, intergovernmental, value-based initiative led by the World Health Organization (WHO), working toward improving health and achieving equity in health for all people worldwide, has for years yielded to a growing reliance on corporate-led solutions. Private organizations, non-governmental organizations (NGO), religious and other philanthropic and charitable organizations, increasingly serve a dominant role in setting the global health agenda. Short-term success in combating epidemics and in the provision of funding for project-based initiatives appeals to supporters of marketization of health services. For 30 years, a neoliberal paradigm has dominated the international political economy and hence the governance of global health. A utilitarian logic or the ethics of consequentialism have attained prominence under such banners as effective altruism or venture philanthropy.  This contrasts with the merits and relevance of deontological ethics in which rules and moral duty are central. This paper seeks to explain how neo-liberalism became a governing precept and paradigm for global health governance. A priority is to unmask terms and precepts serving as ethos or moral character for corporate actions that benefit vested stakeholders.   &nbsp

    Positive postpartum depression screening practices and subsequent mental health treatment for low-income women in Western countries: a systematic literature review

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    Problem statement and significance Left undiagnosed and/or untreated, the short-and long-term sequelae of postpartum depression may negatively impact both mother and child. In Western countries, access to mental health care is influenced by socioeconomic factors. The objective of this systematic literature review is to compile factors that hinder and improve access to postpartum depression treatment in low-income women after a positive screen for postpartum depression. The key question of focus is: what are the characteristics associated with access to mental health treatment for low-income women with a positive postpartum depression screen in Western countries? Methods A PRISMA-based systematic literature review was conducted of studies published in English before February 2016 that looked at treatment for postpartum depression in low-income women who had been identified with the condition. PubMed and EBSCO databases were searched using MESH and key terms and found 100 articles that met the selection criteria. After review by two independent researchers, 18 studies with 17 unique populations were included in the literature review. Results Two independent abstractors searched the included articles for themes surrounding impediments and advantages for low-income women identified with postpartum depression in obtaining mental health treatment. Characteristics of successful mental health treatment included studies that employed the use of a home visitor and those that separated outcomes for women with previous mental health treatment. Themes that emerged as treatment obstacles included cultural barriers, physical barriers, systemic health care barriers, and social barriers. Implications for practice This review will help to better inform screening and treatment priorities for those in the medical field who may encounter women experiencing postpartum depression and are not aware of the various barriers to care specific to low-income women. This review will also help policymakers identify specific obstacles that are not addressed in postpartum screening mandate policies which can affect the implementation of these policies

    Global health in transition: The coming of neoliberalism

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     Global health as a transnational, intergovernmental, value-based initiative led by the World Health Organization (WHO), working toward improving health and achieving equity in health for all people worldwide, has for years yielded to a growing reliance on corporate-led solutions. Private organizations, non-governmental organizations (NGO), religious and other philanthropic and charitable organizations, increasingly serve a dominant role in setting the global health agenda. Short-term success in combating epidemics and in the provision of funding for project-based initiatives appeals to supporters of marketization of health services. For 30 years, a neoliberal paradigm has dominated the international political economy and hence the governance of global health. A utilitarian logic or the ethics of consequentialism have attained prominence under such banners as effective altruism or venture philanthropy.  This contrasts with the merits and relevance of deontological ethics in which rules and moral duty are central. This paper seeks to explain how neo-liberalism became a governing precept and paradigm for global health governance. A priority is to unmask terms and precepts serving as ethos or moral character for corporate actions that benefit vested stakeholders.  

    Increasing fruit and vegetable consumption in Ireland

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    Context: Following recommended dietary guidelines, Ireland has since 2010 implemented a  0% Value Added Tax (VAT) on fruits and vegetables to increase consumption. Eleven years after policy implementation, the Irish still do not meet recommended intake for fruit and vegetable consumption, consuming 3.9 portions a day compared to 7 daily portions recommended. Policy Options: Four alternatives for improvement were assessed and compared:            1) retain the status quo of reduced VAT for healthy foods, 2) VAT only for locally produced fruits and vegetables, 3) increased VAT for salty and sweet foods with a subsidy for fruits and vegetables, and 4) an education-based policy. Four evaluation criteria were applied for the comparison: economic feasibility, effectiveness, political feasibility, and equity. Recommendations: The status quo remains the best option for Ireland. However, further assessment of this 0% VAT policy on fruits and vegetables is warranted, pending the availability of additional data to enable an in-depth understanding of policy implementation. &nbsp

    Sustainable Reform of European Union (EU): Common Fisheries Policy

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    Context:Oceans are encountering great loss of biodiversity. Global overfishing and overconsumption of aquatic foods prompted the European Union to create the Common Fishery Policy (CFP) with the intention of supporting sustainability of the environment, economy, and society, and to protect the long-term supply of aquatic foods. The Mediterranean Sea is a vulnerable European region due to fishing at unsustainable levels. Factors exacerbating the situation in this region include socio-economic conditions, weakregulatory power of the EU, poor communication and low levels of consensus among stakeholders.Policy Options:Three policy options are highlighted: 1) Fish-restricted areas (FRA) in eight Mediterranean regions to maintain or reverse fish collapse, as a means to recover fish stocks in regions with higher exploitation rates: 2) Supporting and improving small-scale fisheries (SSF) to reduce the impact on marine wildlife and increase selectivity, including standard gear and size restrictions,as well asstrict seasonal closures; 3) Integration of Participatory Action Research (PAR) to improve stakeholder compliance with the landing obligation.Recommendations:Policy options were assessed by four evaluation criteria (economic feasibility, effectiveness, political feasibility, and equity). Integrating the PAR into the CFP was deemed to be the best option of those examined. A positive impact on the economy, political feasibility, and equity for stakeholders would be expected outcomes of implementation of this alternative. Regular evaluation and continuous improvement would increase the likelihood of policy success

    Strategic leadership capacity building for Sub-Saharan African health systems and public health governance: a multi-country assessment of essential competencies and optimal design for a Pan African DrPH

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    Leadership capacity needs development and nurturing at all levels for strong health systems governance and improved outcomes. The Doctor of Public Health (DrPH) is a professional, interdisciplinary terminal degree focused on strategic leadership capacity building. The concept is not new and there are several programmes globally–but none within Africa, despite its urgent need for strong strategic leadership in health. To address this gap, a consortium of institutions in Sub-Saharan Africa, UK and North America have embarked on a collaboration to develop and implement a pan-African DrPH with support from the Rockefeller Foundation. This paper presents findings of research to verify relevance, identify competencies and support programme design and customization. A mixed methods cross sectional multi-country study was conducted in Ghana, South Africa and Uganda. Data collection involved a non-exhaustive desk review, 34 key informant (KI) interviews with past and present health sector leaders and a questionnaire with closed and open ended items administered to 271 potential DrPH trainees. Most study participants saw the concept of a pan-African DrPH as relevant and timely. Strategic leadership competencies identified by KI included providing vision and inspiration for the organization, core personal values and character qualities such as integrity and trustworthiness, skills in adapting to situations and context and creating and maintaining effective change and systems. There was consensus that programme design should emphasize learning by doing and application of theory to professional practice. Short residential periods for peer-to-peer and peer-to-facilitator engagement and learning, interspaced with facilitated workplace based learning, including coaching and mentoring, was the preferred model for programme implementation. The introduction of a pan-African DrPH with a focus on strategic leadership is relevant and timely. Core competencies, optimal design and customization for the sub-Saharan African context has broad consensus in the study setting

    The corporatization of global health: The impact of neoliberalism

    Get PDF
    Concomitant with the emergence of a neoliberal precept for global health is the decline in support for publicly funded programs working to alleviate health disparities in poor countries. An unequivocal faith in the privatization and marketization of public health services is evident in current day national policy reforms.  Commodification of health services is perceived as a cure-all. Privatization of global health initiatives contrasts with the past institutional paradigm. Corporate and philanthropic power trumps intergovernmental governance. The epistemological precept is clear: Global health is best served with mandated private initiatives. Powerful foundations cause critical shifts in the balance of power among stakeholders and become preeminent players in global health policy agenda formation. The ethics of consequentialism have attained current day prominence. This contrasts with the merits and relevancy of de-ontological ethics in which rules and moral duty are central. In this paper, authors make a case for contesting the ethos of effective altruism or venture philanthropy, suggesting that this approach keeps nations and people from recognizing the oppressive nature of neoliberalism as a governing precept for global health.  

    Increasing fruit and vegetable consumption in Ireland

    Get PDF
    Context: Following recommended dietary guidelines, Ireland has since 2010 implemented a  0% Value Added Tax (VAT) on fruits and vegetables to increase consumption. Eleven years after policy implementation, the Irish still do not meet recommended intake for fruit and vegetable consumption, consuming 3.9 portions a day compared to 7 daily portions recommended. Policy Options: Four alternatives for improvement were assessed and compared:            1) retain the status quo of reduced VAT for healthy foods, 2) VAT only for locally produced fruits and vegetables, 3) increased VAT for salty and sweet foods with a subsidy for fruits and vegetables, and 4) an education-based policy. Four evaluation criteria were applied for the comparison: economic feasibility, effectiveness, political feasibility, and equity. Recommendations: The status quo remains the best option for Ireland. However, further assessment of this 0% VAT policy on fruits and vegetables is warranted, pending the availability of additional data to enable an in-depth understanding of policy implementation. &nbsp
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