Vulnerability and risk perception in the management of HIV/AIDS: Public priorities in a global pandemic

Understanding the way perception of risk is shaped and constructed is crucial in understanding why it has been so difficult to mitigate the spread of HIV/AIDS. This paper uses the Pressure and Release (PAR) model, used to predict the onset of natural disasters as the conceptual framework. It substitutes vulnerability and risk perception as the trigger factors in the model, in making the case that HIV/AIDS can be characterized as a slow onset disaster. The implications are that vulnerability must be managed and reduced by addressing root causes, dynamic pressures, and unsafe conditions that contribute to the HIV/AIDS pandemic. HIV/AIDS programs must be culturally appropriate and work toward influencing risk perception, while addressing social norms and values that negatively impact vulnerable populations. By impacting cultural and social expectations, individuals will be able to more readily adopt safer sex behaviors. The development of policies and programs addressing the issues in context, as opposed to individual behaviors alone, allows for effective public health intervention. This may have implications for public health measures implemented for combating the spread of HIV/AIDS

A Health Systems Policy Framework on “How to” Build Cross-Sector Collaboration: Perspectives From Health Administrators and Leaders

There are many barriers/challenges bringing multiple stakeholders within health and non-health together to collaborate to address population health. This study aims to identify the key components to build successful cross-sector collaboration and develop a policy framework for health systems integration and transformation. We conducted quantitative surveys and qualitative interviews with health administrators and leaders who volunteered to participate on six newly established teams or “Tables” to improve population health locally in Ontario, Canada. Using thematic analysis and methodological triangulation, we identified emergent themes that were confirmed by member checking. The Relational Coordination survey response rate was 62% (n=45). The survey results were correlated with the twelve interviews and member checking. Drawing from the perspectives of the health administrators and leaders of the “Tables”, the emergent themes identified for successful cross-sector collaboration were: 1) systems change mindset, 2) inter-dependency, 3) inter-organizational relationships, and 4) self-organizing capacity. A health systems policy framework on “how to” build cross-sector collaboration was developed to support and achieve health systems integration

COVID-19 – An Opportunity to Redesign Health Policy Thinking

Coronavirus disease 2019 (COVID-19) dramatically unveiled the fragile state of the world's health and social systems - the lack of emergency health crisis preparedness (under-resourced, weak leadership, strategic plans without clear lines of authority), siloed policy frameworks (focus on individual diseases and the lack of integration of health into the whole of societal activity and its impact on individual as well as community well-being and prosperity), and unclear communication (misguided rationale of policies, inconsistent interpretation of data). The net result is fear - about the disease, about risks and survival, and about economic security. We discuss the interdependencies among these domains and their emergent dynamics and emphasise the need for a robust distributed health system and for transparent communication as the basis for trust in the system. We conclude that systems thinking and complexity sciences should inform the redesign of strong health systems urgently to respond to the current health crisis and over time to build healthy, resilient, and productive communities

Collaborative competitive relationships within an integrated public sector network

A phenomenon of recent times has been the increased complexity of society's problems and the need for organizations to work together to find solutions while in competition with each other for scarce resources. This has created the need to better understand how organizations can best collaborate under such conditions. A qualitative study was conducted. In all, twenty-one participants were purposefully selected through snowball sampling and interviewed. These were individuals who represented their organizations in an interorganizational effort to address mutual benefits or common interests through a process of information exchange and resource sharing. The nature of interorganizational relationships was determined by each participant verbalizing the contents and meanings of the contacts of his/her organization with other organizations within the action set. Results revealed that organizations that control vital resources to the operations of others are in a position to control the actions of others. They also revealed that social relationships developed through organizational interaction with the environment both facilitate and constrain organizational action. Most notably, organizations in relationships of dependency with the government can use social capital to access social networks in their communities to build countervailing power to change a relationship of compliance to one of collaboration. In addition, results reveled that collaboration is most likely to occur when organizations perceive their actions toward goal attainment to facilitate each other's goals and less likely to occur if there is a lack of perceived interdependence, a lack of shared ideology, and a lack of trust. This study's findings reveal the importance of forging social networks to gain leverage over constraining dependencies in resource dependence relationships. This study examines collaborative relationships in an action set of five national non-government AIDS organizations (NGOs) competing for funds, and having Health Canada as their main funder. The aim of the study was to better understand how social relationships embedded in the organizational environment shape interorganizational collaboration in relationships of dependency and what conditions support such organizational behavior. Resource dependence theory was used as the conceptual schema for explaining organizational behavior observed under conditions of resource scarcity, interdependence, and uncertainty, as these are key variables in relationship building among these organizations.Ph.D

Chronic disease management and the home-care alternative in Ontario, Canada

The pressure on our health-care system to deliver efficient, quality and cost-effective care is increasing. The debate on its sustainability is also expanding. These challenges can be managed with revisions to our health-care policy frameworks governing how and what public health-care services are delivered. Chronic disease management and home care can together ease many of the present and future pressures facing the health-care system. However, the current level of investment and the present policy are not effectively supporting movement in this direction. Updating the Canada Health Act to reflect the realities of our health-care system, and developing policies to support the areas of interdisciplinary teamwork and system integration are needed to facilitate chronic disease management and home care in Canada. This article lays out the challenges, highlights the impending issues and suggests a framework for moving forward. </jats:p