Top 10 health-policy-systems.biomedcentral.com Competitors

ijhpm.com

health management, policy management, health policy and decision making,

joghr.org

Promoting local research to improve global health

phrp.com.au

The Sax Institute established the annual Public Health Research & Practice Excellence Awards in 2018 to celebrate the high calibre of articles published in the journal. We promote excellence in public health research, practice and policy and recognise inspirational work taking place in Australia and internationally. Papers are judged by a panel…

ccnpps-ncchpp.ca

Ce document vise à mettre en lumière certains facteurs clés et quelques ressources pour aborder les problèmes vicieux, en plus d'offrir aux lecteurs des exemples concrets pour les résoudre. Nous espérons qu'il sera utile aux acteurs de santé publique pour orienter la manière d'aborder certains problèmes précis que doivent surmonter leurs organisations et qu'il les outillera à cette fin.

preventioncentre.org.au

Addressing the root causes of chronic disease can sometimes also benefit other sectors. A co-benefits approach can help governments prioritise action.

ghspjournal.org

### Key Findings ### Key Implications ### Introduction: Oral pre-exposure prophylaxis (PrEP) is an effective and safe option to prevent HIV acquisition and vertical HIV transmission in pregnant and breastfeeding women. Understanding health system factors influencing the integration of PrEP into care for pregnant and breastfeeding women is key to increasing access. We explored managers’ and health care workers’ (HCWs) experiences with integrating PrEP into antenatal care and postnatal care services in primary health care clinics in Cape Town, South Africa. ### Methods: This exploratory qualitative study used codebook thematic analysis, where HCWs were purposively, heterogeneously sampled from an implementation science study. Semistructured individual interviews were conducted with 9 managerial-level staff, and 3 focus group discussions were conducted with HCWs (nurses, midwives, and HIV counselors) providing PrEP (6–7 HCWs per group) between November 2022 and January 2023 (N=28). Interview guides covered health system facilitators, barriers, and recommendations. The Health Systems Dynamics framework guided data analysis and presentation of results. ### Results: PrEP integration into antenatal care services was described as acceptable and feasible; however, changes to HIV testing policy and indicators in breastfeeding women are needed to integrate PrEP into postnatal clinics, together with identification of mother and baby as a dyad in visits. Results showed that supportive policies facilitated wider, simplified PrEP provision. The availability and accessibility of prescribing nurses and lay HIV counselors, PrEP (both within facilities and in communities), and information about PrEP for implementers and pregnant and breastfeeding women will be pivotal to facilitating integration. ### Conclusion: Facilitators for PrEP integration include task-shifting PrEP education and identification of women for PrEP initiation to HIV counselors, changes to national guidelin

rrh.org.au

Published article 7553 Rural and Remote Health

annfammed.org

PURPOSE Unlike in many community-based settings, benzodiazepine (BZD) prescribing to older veterans has decreased. We sought to identify health care system strategies associated with greater facility-level reductions in BZD prescribing to older adults. METHODS We completed an explanatory sequential mixed methods study of health care facilities in the Veterans Health Administration (N = 140). Among veterans aged ≥75 years receiving long-term BZD treatment, we stratified facilities into relatively high and low performance on the basis of the reduction in average daily dose of prescribed BZD from October 1, 2015 to June 30, 2017. We then interviewed key facility informants (n = 21) who led local BZD reduction efforts (champions), representing 11 high-performing and 6 low-performing facilities. RESULTS Across all facilities, the age-adjusted facility-level average daily dose in October 2015 began at 1.34 lorazepam-equivalent mg/d (SD 0.17); the average rate of decrease was −0.27 mg/d (SD 0.09) per year. All facilities interviewed, regardless of performance, used passive strategies primarily consisting of education regarding appropriate prescribing, alternatives, and identifying potential patients for discontinuation. In contrast, champions at high-performing facilities described leveraging ≥1 active strategies that included individualized recommendations, administrative barriers to prescribing, and performance measures to incentivize clinicians. CONCLUSIONS Initiatives to reduce BZD prescribing to older adults that are primarily limited to passive strategies, such as education and patient identification, might have limited success. Clinicians might benefit from additional recommendations, support, and incentives to modify prescribing practices.

ihi.org

This article summarizes rules in health care organizations that their own leaders identified as ones that contribute little or no value to care, impede the work of clinicians, frustrate patients and families, and waste time and resources.