Healthcare policies
Wits School of Governance, University of the Witwatersrand (Onsite)
Taxation of Sugar-sweetened Beverages as Health Policy Instrument to Reduce Unhealthy Dietary Behaviour and Its Acceptance among Public Health Stakeholders: A Study from Poland
Paper Presentation in a Themed Session Katarzyna Brukało
There is a growing trend worldwide to use a variety of tools to address the growing problem of overweight and obesity in population. One of them are the taxation mechanisms applied to sugar-sweetened beverages, which are expected to influence the common eating behaviours, but also have impact on the market and public finances. This makes this solution to be highly entangled in the complex of social and intersectoral interests and its feasibility may depend on effective identification of opportunities and threats arising of the social and economic environment. Identification of barriers and facilitators that may affect the adoption of SBB taxation. We used semi-structured interviews with 20 individuals representing key public health stakeholders in Poland, including patient and health-related non-governmental organizations, food producers and retailers, political parties, medical professionals, and public institutions responsible for shaping nutrition policy to identify most important standpoints and acceptance of the SSB tax. We used MAXQDA v2020 to analyse the collected data. Initial results show that stakeholders tend to expressed conflicting views on the effectiveness, relevance and socio-economic impact of the SSB tax. The allocation of additional tax revenues was raising doubts. On the other hand, the political debate was highly superficial with strong populism arising of the presented positions. Initial conclusions indicate the necessity to conduct a thorough public debate and improvements in terms of public communication to increase social awareness, sealing and refining the implemented solutions. Close cooperation with market players and non-governmental organizations is highly recommended.
It’s All about the Context: A Meta Review of Context Determinants of Implementing Policies on Healthy Diet and Physical Activity View Digital Media
Paper Presentation in a Themed Session Krzysztof Kaczmarek
Contextual factors are commonly accepted as determinants of successful implementation of public policies. The aim of the study is to identify which context-related implementation determinants are reported to be frequently present and impacting the process of implementation of obesity prevention policies, targeting healthy diet and physically active lifestyle. The study is based on a systematic review and analysis of data from 9 databases as well as documentation from 9 major stakeholders involved in the implementation of relevant policies. The review was preregistered (PROSPERO #CRD42019133341). The context-related determinants were considered strongly supported if they were indicated in ≥ 60% of the reviews/stakeholder documents. To assure the quality of the review the research team used both the ROBIS tool and the Methodological Quality Checklist-SP. Results: Out of 57209 documents identified by research team, a total of 42 documents were included in this meta-review. The Context and Implementation of Complex Interventions (CICI) framework was used as the basis for categorizing the determinants. Across documents, 6 determinants from 3 CICI domains received strong support. These were: economic resources at the macro-level (66.7% of analyzed documents) and the meso/micro-level (71.4%); socio-cultural context determinants at the meso/micro-level, referring to knowledge/beliefs/abilities of target groups (69.0%) and implementers (73.8%); political context determinants (interrelated policies supported in 71.4% of analyzed reviews/documents; policies within organizations - 69.0%). The results of meta-review point out to the socio-cultural, economic, and political contexts as potentially affecting the implementation process of healthy diet and physical activity/sedentary behaviors policies.
Framework Design for Interprofessional Competence and Implementation in Health Professions Curricula View Digital Media
Paper Presentation in a Themed Session Serela Ramklass
Collaborative interprofessional practice (IPP) is a desired competence to enhance health outcomes within models of person-centred and community-based care. The South African healthcare policy and graduate competency profile identified team-based care and collaboration as key elements for implementation of primary healthcare. Despite its advantages for healthcare provision, IPP is underdeveloped within health professional curricula in Kwazulu-Natal, South Africa. Individual interviews and focus group discussions were conducted among leadership, faculty, and students from the College of Health Sciences at the University of Kwazulu-Natal to explore conceptions of IPP from different vantage points. All constituencies agree that IPP should be included in health professional curricula. Students highlight the need for theoretical notions of team-based care to be translated into actual practice. An IPP competency framework that was contextually relevant for effective collaboration, was identified. An implementation framework for IPP among students identified methods of teaching and learning for the introduction, immersion and mastery stages of interprofessional education. Discipline champions were recognised as critical for disrupting silos and promoting interprofessional education. Faculty development on interprofessional education was necessary to promote the shift towards collaborative practice in healthcare environments.
