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Health Systems and Policy Research

At a global level, international institutions, donors, grants, and conditional loans are increasingly influencing the financing and organization of health systems in much of the world, with implications for equity in access to care. There is a renewed global push for universal health coverage but lack of agreement on how it should be funded or administered. Private financing for health systems in many countries is rising; there is a critical shortage of human resources for health; out-of-pocket payments continue to push people into ‘medical poverty’; and the high costs of new medical technologies or therapeutics too often available only to the few pose a challenge to appropriate funding levels for comprehensive primary health services essential to the many. 

Papers submitted under this section will explore how globalization-related processes are affecting the development of national and regional health systems, with a focus on how such systems improve health equity in terms of access, coverage, and financing. We are not accepting articles on health systems that do not attend to how they are being affected by globalization.

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  1. Refugees often face psychosocial complexity and multi-dimensional healthcare needs. Community-Based Participatory Research (CBPR) methods have been previously employed in designing health programs for refugee ...

    Authors: Tali Filler, Pardeep Kaur Benipal, Nazi Torabi and Ripudaman Singh Minhas
    Citation: Globalization and Health 2021 17:103
  2. As Arab countries seek to implement the ‘Guideline on Good Pharmacovigilance Practice (GVP) for Arab countries’, understanding policy implementation mechanisms and the factors impacting it can inform best impl...

    Authors: Hamza Y. Garashi, Douglas T. Steinke and Ellen I. Schafheutle
    Citation: Globalization and Health 2021 17:97
  3. International medical electives are a well-established part of the curriculum of many western medical schools. It is widely accepted that these electives contribute to improved clinical examination and communi...

    Authors: Maximilian Andreas Storz, Ann-Kathrin Lederer and Eric Pieter Heymann
    Citation: Globalization and Health 2021 17:90
  4. The ripple effects of protracted armed conflicts include: significant gender-specific barriers to accessing essential services such as health, education, water and sanitation and broader macroeconomic challeng...

    Authors: Kristen Meagher, Bothaina Attal and Preeti Patel
    Citation: Globalization and Health 2021 17:88
  5. International evidence suggests migrants experience inequitable access, outcomes and treatment quality across the cancer care continuum. There is currently limited research assessing equity across the cancer c...

    Authors: Brighid Scanlon, Mark Brough, David Wyld and Jo Durham
    Citation: Globalization and Health 2021 17:87
  6. Suboptimal health status (SHS), an intermediate state between chronic disease and health, is characterized by chronic fatigue, non-specific pain, headaches, dizziness, anxiety, depression, and functional syste...

    Authors: Yunlian Xue, Zhuomin Huang, Guihao Liu, Zicheng Zhang, Yefang Feng, Mengyao Xu, Lijie Jiang, Wenyuan Li and Jun Xu
    Citation: Globalization and Health 2021 17:86
  7. Non-communicable diseases (NCDs) have recently become a global public health burden and a leading cause of premature death, mainly in low- and middle-income countries (LMICs). The aim of the study was to explo...

    Authors: Alexander Cheza and Boikhutso Tlou
    Citation: Globalization and Health 2021 17:82
  8. In 2015, the President’s Emergency Plan for AIDS Relief undertook policy shifts to increase efficiencies in its programming, including transitioning HIV/AIDS funding away from low burden areas. We examine the ...

    Authors: Mary Qiu, Ligia Paina, Daniela C. Rodríguez, Jess A. Wilhelm, Ezinne Eze-Ajoku, Alexandra Searle, Henry Zakumumpa, Freddie Ssengooba, Caroline MacKenzie and Sara Bennett
    Citation: Globalization and Health 2021 17:80
  9. With the aim to support further understanding of scaling up and sustaining digital health, we explore digital health solutions that have or are anticipated to reach national scale in South Africa: the Perinata...

    Authors: Alison Swartz, Amnesty E. LeFevre, Shehani Perera, Mary V. Kinney and Asha S. George
    Citation: Globalization and Health 2021 17:77
  10. There has been greater recognition of the importance of country ownership in global health and development. However, operationalising country ownership to ensure the scale up and sustainability of proven inter...

    Authors: Lisa Mwaikambo, Sarah Brittingham, Saori Ohkubo, Ruwaida Salem, Denis Joel Sama, Fatimata Sow, Deepti Mathur and Nneoma Nonyelum Anieto
    Citation: Globalization and Health 2021 17:75
  11. Of the close to 2.6 million stillbirths that happen annually, most are from low-income countries where until recently policies rarely paid special attention to addressing them. The global campaigns that follow...

    Authors: Eric Ssegujja and Michelle Andipatin
    Citation: Globalization and Health 2021 17:66
  12. Efficacious health interventions tested through controlled trials often fail to show desired impacts when implemented at scale. These challenges can be particularly pervasive in low- and middle-income settings...

    Authors: Michael J. Penkunas, Shiau Yun Chong, Emma L. M. Rhule, Evangelia Berdou and Pascale Allotey
    Citation: Globalization and Health 2021 17:63
  13. Task shifting could help address limited human resources available for the delivery of quality health care services in low-resource settings. However, the role of medical devices in supporting task shifting is...

    Authors: Amir Sabet Sarvestani, Marianna Coulentianos and Kathleen H. Sienko
    Citation: Globalization and Health 2021 17:60
  14. Evidence exists about synergies among universal health coverage, health security and health promotion. Uniting these three global agendas has brought success to the country’s health sector. This study aimed to...

    Authors: Amare Worku Tadesse, Kassu Ketema Gurmu, Selamawit Tesfaye Kebede and Mahlet Kifle Habtemariam
    Citation: Globalization and Health 2021 17:53
  15. Health innovations are generally oriented on a techno-economic vision. In this perspective, technologies are seen as an end in themselves, and there is no arrangement between the technical and the social value...

    Authors: Marietou Niang, Sophie Dupéré, Hassane Alami and Marie-Pierre Gagnon
    Citation: Globalization and Health 2021 17:46
  16. The ongoing pandemic of coronavirus disease 2019 (COVID-19) has the potential to reverse progress towards global targets. This study examines the risks that the COVID-19 pandemic poses to equitable access to e...

    Authors: Floriano Amimo, Ben Lambert, Anthony Magit and Masahiro Hashizume
    Citation: Globalization and Health 2021 17:42
  17. The vulnerability of cardiovascular disease (CVD) patients’ health abilities, combined with the severity of the disease and the overlapping risk factors, leads such people to bear the economic burden of the di...

    Authors: Meiyan Ma, Wanxin Tian, Jian Kang, Yuze Li, Qi Xia, Nianshi Wang, Wenqing Miao, Xiyu Zhang, Yiyun Zhang, Baoguo Shi, Han Gao, Tao Sun, Xuelian Fu, Yanhua Hao, Heng Li, Linghan Shan…
    Citation: Globalization and Health 2021 17:36
  18. Twenty-five years into South Africa’s constitutional democracy provides an opportunity to take stock of the social and structural determinants of adolescent health. Those born in democratic South Africa, commo...

    Authors: Tanya Jacobs and Asha George
    Citation: Globalization and Health 2021 17:35
  19. With the ongoing COVID-19 outbreak, healthcare systems across the world have been pushed to the brink. The approach of traditional healthcare systems to disaster preparedness and prevention has demonstrated in...

    Authors: Shuangyi Sun, Zhen Xie, Keting Yu, Bingqian Jiang, Siwei Zheng and Xiaoting Pan
    Citation: Globalization and Health 2021 17:14
  20. Notwithstanding extensive general discussion of the effects of upstream forces on health, there has been limited empirical examination, let alone systematic evidence documenting policy responses to such pathwa...

    Authors: Prince A. Adu, Jerry M. Spiegel and Annalee Yassi
    Citation: Globalization and Health 2021 17:11
  21. During isolation, sharing physical activity experiences on social network sites (SNS) can enhance individual social connectedness. The objective of the present study was to examine the associations between sha...

    Authors: Yifan Zuo, Yudan Ma, Mu Zhang, Xiaoyuan Wu and Zhanbing Ren
    Citation: Globalization and Health 2021 17:10
  22. Peer supervision improves health care delivery by health workers. However, in rural Uganda, self-supervision is what is prescribed for licensed private drug sellers by statutory guidelines. Evidence shows that...

    Authors: Arthur Bagonza, Stefan Peterson, Andreas Mårtensson, Milton Mutto, Phyllis Awor, Freddy Kitutu, Linda Gibson and Henry Wamani
    Citation: Globalization and Health 2020 16:106
  23. The continued spread of the coronavirus disease 2019 (COVID-19) has a serious impact on everyone across the globe, both physically and psychologically. In addition to proactive measures addressing physical sur...

    Authors: Yumeng Ju, Yan Zhang, Xiaoping Wang, Weihui Li, Roger M. K. Ng and Lingjiang Li
    Citation: Globalization and Health 2020 16:102
  24. Due to economic development and an increase in the aging population, the demand for medical resources is increasing. A good doctor-patient relationship (DPR) can optimize patients’ medical experience and impro...

    Authors: Tianqing Sang, Hongli Zhou, Muhan Li, Wenting Li, Haibo Shi, Haibin Chen and Hongguang Zhou
    Citation: Globalization and Health 2020 16:99
  25. The outbreak of Coronavirus Disease is causing considerable acute risk to public health and might also have an unanticipated impact on the mental health of children and adolescents in the long run. This study ...

    Authors: Shitao Chen, Zeyuan Cheng and Jing Wu
    Citation: Globalization and Health 2020 16:96
  26. Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) outbreak, called coronavirus disease - 2019 (COVID-19), has affected more than 200 countries across the globe with a higher fatality rate among the ...

    Authors: Alok Ranjan and V. R. Muraleedharan
    Citation: Globalization and Health 2020 16:93
  27. In the UK, according to the 1967 Abortion Act, all abortions must be approved by two doctors, reported to the Department of Health and Social Care (DHSC), and be performed by doctors within licensed premises. ...

    Authors: Jacy Zhou, Rebecca Blaylock and Matthew Harris
    Citation: Globalization and Health 2020 16:91
  28. A recent editorial urged those working in global mental health to “change the conversation” on coronavirus disease (Covid-19) by putting more focus on the needs of people with severe mental health conditions. ...

    Authors: Richard Mpango, Jasmine Kalha, Donat Shamba, Mary Ramesh, Fileuka Ngakongwa, Arti Kulkarni, Palak Korde, Juliet Nakku and Grace K. Ryan
    Citation: Globalization and Health 2020 16:90
  29. Health care workers exposed to COVID-19 might be at increased risk of developing mental health problems. The study aimed to identify factors associated with anxiety, depression and insomnia among health worker...

    Authors: Pratik Khanal, Navin Devkota, Minakshi Dahal, Kiran Paudel and Devavrat Joshi
    Citation: Globalization and Health 2020 16:89
  30. The lack of training and education of Community-Based Rehabilitation (CBR) workers poses one of the most significant barriers to receiving effective occupational, physical and speech therapy for individuals wi...

    Authors: Bria Mitchell-Gillespie, Hiba Hashim, Megan Griffin and Rawan AlHeresh
    Citation: Globalization and Health 2020 16:82
  31. The Economic Commission of the West African States (ECOWAS), through her specialised health Institution, the West African Health Organization (WAHO) is supporting Members States to improve health outcomes in W...

    Authors: Chigozie Jesse Uneke, Issiaka Sombie, Ermel Johnson, Bilikis Iyabo Uneke and Stanley Okolo
    Citation: Globalization and Health 2020 16:73
  32. The current study builds upon a previous situation analysis of the extent to which grants from the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) are being utilized to support operational re...

    Authors: Salvador Camacho, Dermot Maher, Edward Mberu Kamau, Jasmina Saric, Luis Segura, Rony Zachariah and Kaspar Wyss
    Citation: Globalization and Health 2020 16:67
  33. Coronavirus Disease is impacting the entire world. As the first country that has needed to confront this disease, China has responded with unprecedented and hugely successful public health initiatives. Almost ...

    Authors: Shitao Chen, Feihan Li, Chaihua Lin, Yuge Han, Xilun Nie, Robert N. Portnoy and Zhihong Qiao
    Citation: Globalization and Health 2020 16:59
  34. Health technology assessment (HTA) is an effective tool to support priority setting and generate evidence for decision making especially en route to achieving universal health coverage (UHC). We assessed the c...

    Authors: Benjamin S. C. Uzochukwu, Chinyere Okeke, Niki O’Brien, Francis Ruiz, Issiaka Sombie and Samantha Hollingworth
    Citation: Globalization and Health 2020 16:58
  35. Low-and Middle-Income Countries (LMICs) in the Middle East and North Africa (MENA) region are facing increasing global health challenges with a reduced ability to manage them. Global Health Capacity Building (...

    Authors: Hady Naal, Maria El Koussa, Melissa El Hamouch, Layal Hneiny and Shadi Saleh
    Citation: Globalization and Health 2020 16:56
  36. During the COVID-19 pandemic, as a large city located in Southwest China, Chengdu was mainly affected by imported cases. For a psychiatric hospital, the enclosed management model, the crowded wards and the unc...

    Authors: Jiajia Chen, Maoxiang Xiong, Zongling He, Wen Shi, Yuchuan Yue and Manxi He
    Citation: Globalization and Health 2020 16:53
  37. The World Health Organization and other institutions are considering Artificial Intelligence (AI) as a technology that can potentially address some health system gaps, especially the reduction of global health...

    Authors: Hassane Alami, Lysanne Rivard, Pascale Lehoux, Steven J. Hoffman, Stéphanie Bernadette Mafalda Cadeddu, Mathilde Savoldelli, Mamane Abdoulaye Samri, Mohamed Ali Ag Ahmed, Richard Fleet and Jean-Paul Fortin
    Citation: Globalization and Health 2020 16:52
  38. In 2016–2017, Vietnam’s Ministry of Health (MoH) implemented an event-based surveillance (EBS) pilot project in six provinces as part of Global Health Security Agenda (GHSA) efforts. This manuscript describes ...

    Authors: Alexey Clara, Anh T. P. Dao, Anthony W. Mounts, Christina Bernadotte, Huyen T. Nguyen, Quy M. Tran, Quang D. Tran, Tan Q. Dang, Sharifa Merali, S. Arunmozhi Balajee and Trang T. Do
    Citation: Globalization and Health 2020 16:38
  39. Leadership and management training has become increasingly important in the education of health care professionals. Previous research has shown the benefits that a network provides to its members, such as acce...

    Authors: Andrea M. Prado, Andy A. Pearson, Nathan S. Bertelsen and José A. Pagán
    Citation: Globalization and Health 2020 16:34
  40. In Italy an important contribution to the spread of global health education (GHE) grew from the establishment and work of the Italian Network for Global Health Education (INGHE). INGHE gave a national shared d...

    Authors: Giulia Civitelli, Gianfranco Tarsitani, Alessandro Rinaldi and Maurizio Marceca
    Citation: Globalization and Health 2020 16:30
  41. Available evidence on mental health and psychosocial problems in Lebanon is limited. Recent quantitative data suggests a high prevalence among Syrian refugees and their Lebanese host communities, with signific...

    Authors: Aya Noubani, Karin Diaconu, Lilian Ghandour, Maria El Koussa, Giulia Loffreda and Shadi Saleh
    Citation: Globalization and Health 2020 16:28
  42. While great strides have been achieved in fighting malaria through the Roll Back Malaria (RBM) strategy, the recent world malaria report shows an increase in malaria-related deaths compared to previous years. ...

    Authors: Tumaini Malenga, Frances E. Griffiths, Marrit van den Berg, Henk van den Berg, Michèle van Vugt, Kamija Samuel Phiri, Lucinda Manda-Taylor and Eric Umar
    Citation: Globalization and Health 2020 16:25
  43. Cooperation in public health and in oncology in particular, is currently a major issue for the island of Martinique, given its geopolitical position in the Caribbean region. The region of Martinique shares cer...

    Authors: Clarisse Joachim, Thierry Almont, Moustapha Drame, Cédric Contaret, Mylène Vestris, Fatiha Najioullah, Aude Aline-Fardin, Patrick Escarmant, Nicolas Leduc, Nathalie Grossat, Xavier Promeyrat, Stefanos Bougas, Eva Papadopoulou, Vincent Vinh-Hung, Emmanuelle Sylvestre and Jacqueline Veronique-Baudin
    Citation: Globalization and Health 2020 16:20
  44. The third Sustainable Development Goal (SDG − 3) aims to ensure healthy lives and promote well-being for all at all ages. SDG-3 has a specific target on universal health coverage (UHC), which emphasizes the im...

    Authors: Yibeltal Assefa, Peter S. Hill, Wim Van Damme, Judith Dean and Charles F. Gilks
    Citation: Globalization and Health 2020 16:17
  45. Given the paradigmatic shift represented by the Sustainable Development Goals (SDGs) as compared to the Millennium Development Goals - in particular their broad and interconnected nature - a new set of health ...

    Authors: Sara Bennett, Nasreen Jessani, Douglas Glandon, Mary Qiu, Kerry Scott, Ankita Meghani, Fadi El-Jardali, Daniel Maceira, Dena Javadi and Abdul Ghaffar
    Citation: Globalization and Health 2020 16:5