Vivian Lin

universal health coverage (uHC), part of the post-2015 development agenda, is an aspiration widely shared across the world and promoted by numerous international organizations.In 2012 the united Nations General assembly adopted a resolution for uHC, which urges governments to move towards 'providing all people with access to affordable, quality healthcare services'. the World Health Organization (WHO), which has a leading role in supporting countries to respond to the challenge of uHC and monitors its implementation, describes global support for uHC as gathering momentum.1Margaret Chan, Director-General of WHO has said: "I regard universal health coverage as the single most powerful concept that public health has to offer. It is inclusive. It unifies services and delivers them in a comprehensive and integrated way, based on primary health care".One of the challenges of uHC is the global shortage of all types of health workers, which has been a concern for many countries and forms a central plank of the work of WHO and many other global and regional organizations such as the World Bank, Bill & Melinda Gates Foundation and the Clinton Foundation. WHO's strategy on Human resources for Health (HrH)2 seeks to ensure that all people have equitable access to an adequately trained, skilled and supportive health workforce, in order to attain the highest possible level of health. the third Global Forum on HrH in Brazil in 2013 resulted in the bolstering of political commitments on HrH, based on technical evidence, in order to accelerate progress towards uHC, and it began the process of developing a global strategy.these are crucial developments, but despite uHC being a major public health concern confronting the world and the significant global effort to address health workforce concerns, the place of the public health workforce seems invisible in these discussions. this commentary presents a brief review of the public health workforce in the context of the uHC and HrH agendas, together with a consideration of the opportunities for greater intersection, and therefore greater success.UNIVERSAL HEALTH COVERAGEuHC - which is not a new concept - has been broadly defined as all people having access to needed service of appropriate quality without suffering financial hardship. the definition covers both individual and population health services - including promotion, prevention, acute treatment, rehabilitation and palliation.uHC is consistent with the definition of health in the WHO Constitution and the Declaration of alma ata,3 and has been more recently articulated in the Health Systems Knowledge Network of the Commission for Social Determinants of Health,4 and the World Health reports on renewal of Primary Care5 and Health Financing.6In practice, however, the differing understandings of uHC have either led to a focus on health insurance, or on delivery of individual health services. the monitoring indicators developed by WHO and the World Bank emphasize financial protection and impoverishment on the one hand, and service coverage for a variety of 'vertical' programmes, such as maternal and child health, on the other, albeit including some population-level health services.7 the financing and delivery of population-level health interventions seem to be largely sitting in the background, and the issue of public health system preparedness and public health system strengthening are largely absent from the discourse.HUMAN RESOURCES FOR HEALTHthe global HrH conversation has been concerned with addressing health worker migration, and promoting improved workforce planning and educational development at the national level. Labour market studies are increasingly being undertaken as part of understanding the dynamics of health workforce recruitment and retention.However, this workstream has some gaps. It is largely focused on countries experiencing HrH crisis - i.e. insufficient numbers of health workers to deliver healthcare. …

The use of gender-sensitive indicators is a critical component in the effort for effective gender mainstreaming. Gender mainstreaming was endorsed to promote equity between women and men at the Fourth World Conference on Women in Beijing in 1995, and more recently, in 2006, in a resolution of the Economic and Social Council (ECOSOC, 2006). International organizations regularly collect data from member states and publish voluminous collections of national statistics. The importance of this for gender mainstreaming has recently been underscored by Sen and colleagues in their report to the WHO Commission on Social Determinants of Health, Knowledge Network on Women and Gender Equity, which proposed the following strategy: Ensure collection of data disaggregated by sex, socioeconomic status, and other social stratifiers by individual research projects as well as through larger data systems at regional and national levels, and the classification and analysis of such data towards meaningful results and expansion of knowledge for policy. (Sen et al., 2007: x)

The WHO launched a Global Action Plan on antimicrobial resistance (AMR) in 2015. World leaders in the G7, G20 and the UN General Assembly have declared AMR to be a global crisis. World leaders have also adopted universal health coverage (UHC) as a key target under the sustainable development goals. This paper argues that neither initiative is likely to succeed in isolation from the other and that the policy goals should be to both provide access to appropriate antimicrobial treatment and reduce the risk of the emergence and spread of resistance by taking a systems approach. It focuses on outpatient treatment of human infections and identifies a number of interventions that would be needed to achieve these policy goals. It then shows how a strategy for achieving key attributes of a health system for UHC can take into account the need to address AMR as part of a UHC strategy in any country. It concludes with a list of recommended priority actions for integrating initiatives on AMR and...

Health workforce has become a major concern and a significant health policy issue around the world in recent years. With recent international and national initiatives and models being developed and implemented in Australia and other countries, it is timely to understand the need and the rationale for a better trained and educated public health workforce for the future. Much more attention should also be given to evaluation and research in this field. Through this thematic series on Workforce and Public Health, we have drawn on the diverse nature of public health, workforce implications, education and training and national and international case examples of ongoing improvements and issues in this sector.

Abstract: Diarrhoeal disease is a persistent and leading cause of morbidity in Wajir county, in northeast Kenya near Somalia, an area inhabited by an ethnic minority group. This paper examines Kenyas' policy on groundwater and sanitation generally and in relation to Wajir using ...

The Chinese Medicine Registration Act 2000 was passed in May 2000, the culmination of five years of policy research, development and debate. While transparent mechanisms for protection of public health and safety have been put into place, the effectiveness of the regulatory process in ensuring acceptable standards of health care delivery ultimately rests with the community. This article explores the extent to which the objectives of the Victorian Chinese Medicine Registration Act 2000 have been met.

Twelve years have now passed since the influential WHO Report on the Social Determinants of Health (SDoH) in 2008. A group of senior international public health scholars and decision-makers met in Italy in mid-2019 to review the legacy of the SDoH conceptual framework and its adequacy for the many challenges facing our field as we enter the 2020s. Four major categories of challenges were identified: emerging “exogenous” challenges to global health equity, challenges related to weak policy and practice implementation, more fundamental challenges related to SDoH theory and research, and broader issues around modern research in general. Each of these categories is discussed, and potential solutions offered. We conclude that although the SDoH framework is still a worthy core platform for public health research, policy, and practice, the time is ripe for significant evolution.

This article examines policy capacity in the context of Australian health authorities in relation to the challenges confronting policy workers and senior managers in these agencies. The article reports the challenges identified by our informants in relation to political structures, roles and responsibilities of other portfolios and governments, interactions between policy officials and with the minister and the minister's office, whole of government policy approaches, stakeholder and public demands and expectations, and media pressures. The experience of these senior managers and policy workers is then reinterpreted in terms of a nodal governance model. The findings from the Australian study on policy capacity, interpreted in the context of nodal governance, is then used to discuss the features of “governance capacity” as articulated in the matrix model of policy capacity developed by Wu, Ramesh and Howlett (2015).

This paper reports on an evaluation of a national action learning set for health policy managers from three Australian state/territory health authorities, conducted during 2010–2011. We collected and analysed qualitative data about the major problems the participants encountered in their work, their experiences of the learning set and their perceptions of the outcomes. The predominant concerns of participants were ‘wicked problems’ in four areas: managing the environment, managing the policy process, managing the self and managing the policy team. Participants reported that the learning set had assisted them to gain greater awareness of and ability to navigate their environment, developed their judgement, strategic and problem-solving skills, contributed to empowerment and self-efficacy, and assisted them in providing support for their staff and building capacity in their organisation. Aspects of the method that contributed to learning included engaging with problems experienced by ...

Although some areas of clinical health care are becoming adept at implementing continuous quality improvement (CQI) projects, there has been limited experimentation of CQI in health promotion. In this study, we examined the impact of a CQI intervention on health promotion in four Australian Indigenous primary health care centers. Our study objectives were to (a) describe the scope and quality of health promotion activities, (b) describe the status of health center system support for health promotion activities, and (c) introduce a CQI intervention and examine the impact on health promotion activities and health centers systems over 2 years. Baseline assessments showed suboptimal health center systems support for health promotion and significant evidence-practice gaps. After two annual CQI cycles, there were improvements in staff understanding of health promotion and systems for planning and documenting health promotion activities had been introduced. Actions to improve best practice...

CHAPTER 10 Regulating complementary and alternative medicine practitioners Vivian Lin and Rachel Canaway The usage of complementary and ... chiropractors to seek registration as a means of gaining greater institutional and professional recognition (Bentley 2005, Martyr ...