Wafa Abuelkheir Mataria | American University in Cairo (original) (raw)
Papers by Wafa Abuelkheir Mataria
Background: The COVID-19 pandemic revealed critical weaknesses in global health systems, many of ... more Background: The COVID-19 pandemic revealed critical weaknesses in global health systems, many of which have roots in the neoliberal policies that have dominated global health governance since the 1980s. Neoliberalism, characterized by market-driven policies, privatization, and reduced government intervention, has profoundly impacted healthcare access, equity, and quality worldwide. Objective: This study aims to analyze the impact of neoliberal reforms on health systems in various countries, focusing on the interplay between governance, policy formulation, and stewardship in the health sector. By examining the outcomes of these reforms, the study seeks to understand how different approaches to neoliberalism have shaped health system performance and equity. Methods: The study employs the Stages Heuristic Model (SHM) to conduct a retrospective comparative analysis of health policy reforms in ten countries, including the United States, Chile, New Zealand, Ecuador, and China. The research synthesizes data from peer-reviewed articles to assess the outcomes of neoliberal policies on healthcare systems. Results: The analysis reveals that in countries such as the United States and Chile, neoliberal reforms led to increased health inequities and a tiered healthcare system, where access to quality care became increasingly dependent on socioeconomic status. In contrast, countries like Taiwan, which balanced neoliberal reforms with strong public health initiatives, managed to maintain more equitable health systems. China and Venezuela, both of which initially adopted more interventionist healthcare policies, made notable early strides in improving access to healthcare and addressing inequities, particularly for underserved populations. However, Venezuela's progress was undermined by economic challenges and insufficient support for higher-level care, leading to a decline in health outcomes over time. Conclusion: The study underscores the need for governance models that prioritize equity and public health in healthcare systems. It suggests that while neoliberal policies can drive economic efficiency, they often do so at the cost of health equity, necessitating a re-evaluation of global health governance and policy approaches.
Eastern Mediterranean Health Journal/Eastern Mediterranean health journal, Feb 25, 2024
Frontiers in public health, Mar 21, 2024
Globalization and Health
Background Covid-19 is not the first pandemic to challenge GHG. Preceding outbreaks and epidemics... more Background Covid-19 is not the first pandemic to challenge GHG. Preceding outbreaks and epidemics were sources of continuous debate on GHG leadership and structure resulting in its current structure. However, Covid-19 proved the presence of many deficits in the current GHG. The response to the Covid-19 pandemic is a cumulative result of all policies and actions of different governments and agencies active in global health. Assessing how Covid-19 is being handled globally provides lessons for ensuring better performance in facing upcoming outbreaks. This study has three main objectives: first, to evaluate the performance of GHG during Covid-19 in general and in relation to Covid-19 vaccine equity in particular. Second, to identify the reasons behind this performance; and third, to propose prospective changes in GHG for better performance. Methods A cross-sectional research design using the Delphi method was applied. A panel of experts participated in the three-round Delphi surveys. T...
Introduction: Inequitable access to COVID-19 vaccines among countries is a pressing global health... more Introduction: Inequitable access to COVID-19 vaccines among countries is a pressing global health issue. Factors such as economic power, political power, political stability, and health system strength contribute to disparities in vaccine distribution. This study aims to assess the inequality in vaccine distribution among countries based on these factors and identify their relationship with COVID-19 vaccine distribution. Methods: A Concentration Index (CI) analysis was conducted to evaluate inequalities in the distribution of COVID-19 vaccines among countries based on four separate variables: GDP per capita, political stability (PS), World Power Index (WPI), and Universal Health Coverage (UHC). Additionally, Multiple Linear Regression (MLR) analysis was employed to explore the relationship between vaccine distribution and these independent variables. Two vaccine distribution variables were utilized for result reliability. Results: The analysis revealed significant inequalities in COVID-19 vaccine distribution according to the countries' GDP/capita, PS, WPI, and UHC. However, the multiple linear regression analysis showed that there is no significant relationship between COVID-19 vaccine distribution and the countries' GDP/ capita and that UHC is the most influential factor impacting COVID-19 vaccine distribution and accessibility. Discussion: The findings underscore the complex interplay between economic, political, and health system factors in shaping vaccine distribution patterns. To improve the accessibility to vaccines in future pandemics, Global Health Governance (GHG) and countries should consider working on three areas; enhance political stabilities in countries, separate the political power from decision-making at the global level and most importantly support countries to achieve UHC.
Background: The Global Health Governance (GHG) response to the COVID-19 pandemic has been critici... more Background: The Global Health Governance (GHG) response to the COVID-19 pandemic has been criticized, particularly regarding vaccine management, and changes in the roles of GHG actors have been recommended. Aim: To investigate the perception of experts regarding changes in the roles of different GHG actors following the COVID-19 pandemic. Methods: This study used a 3-round Delphi survey to collect data from 30 global health experts between May and December 2022. The GHG roles investigated were stewardship, production of guidelines and policies, promotion of solidarity and collaboration, and management of global health challenges. Social network analysis was performed and collected data was converted into a 1-mode network. Degree centrality and Eigenvector centrality were calculated using the UCINET 6.757 modelling programme. Results: There were variations between the current and future roles in degree centrality and eigenvector centrality for the 19 GHG actors in each of the 4 functions investigated. For stewardship, WHO, governments and the World Bank had the highest degree centrality and eigenvector centrality during both the current and future periods. In terms of production of guidelines and policies, WHO maintained the highest current and future eigenvector centralities, while research agencies, UNICEF and Gavi upheld their current eigenvector centrality measure. For the promotion of solidarity and collaboration, WHO had the highest centrality measures, followed by UNICEF, governments and Gavi. Regarding the function "management of global health challenges", WHO lost its position to UNICEF as the most central, while UNDP, FHI 360 and research agencies were predicted to have a more central role in the future. Conclusion: The findings position WHO as the current and future top actor in stewardship, production of guidelines and policies, and promoting solidarity and collaboration, and UNICEF as the upcoming most central actor in managing global health challenges. Governments were major actors in all GHG functions except for managing global health challenges. Funding actors were central in all GHG functions, indicating finance as an important factor in obtaining a central role in GHG. Research organizations received a high centrality rating, indicating their importance in GHG.
Background Covid-19 is not the first pandemic to challenge GHG. Preceding outbreaks and epidemics... more Background Covid-19 is not the first pandemic to challenge GHG. Preceding outbreaks and epidemics were sources of continuous debate on GHG leadership and structure resulting in its current structure. However, Covid-19 proved the presence of many deficits in the current GHG. The response to the Covid-19 pandemic is a cumulative result of all policies and actions of different governments and agencies active in global health. Assessing how Covid-19 is being handled globally provides lessons for ensuring better performance in facing upcoming outbreaks. This study has three main objectives: first, to evaluate the performance of GHG during Covid-19 in general and in relation to Covid-19 vaccine equity in particular. Second, to identify the reasons behind this performance; and third, to propose prospective changes in GHG for better performance. Methods A cross-sectional research design using the Delphi method was applied. A panel of experts participated in the three-round Delphi surveys. Their scores were used to perform consensus, performance and correlation analysis. Results GHG performance limited the achievement of Covid-19 vaccines' global equity. GHG performance is a product of the existing GHG system, its actors and legal framework. It is a collective result of individual GHG actors' performance. The most influential actors in decision-making regarding Covid-19 vaccine are the vaccine manufacturers and governments. While the most invoked power to influence decision are economic and political powers. Covid-19 decisions underlying value, although had human right to health at the base, overlooked the concept of health as a global public good and was skewed towards market-oriented values. GHG mal-performance along with its underlying factors calls for four main changes in GHG structure: assigning a clear steward for GHG, enhanced accountability, centralized authority, more equitable representation of actors, and better legal framework. Conclusion GHG structure, actors' representation, accountability system, and underlying priorities and value require future modification for GHG to achieve better future performance and higher health equity levels.
Frontiers in Public Health
BackgroundVaccination is the most effective method to prevent the spread of infectious diseases. ... more BackgroundVaccination is the most effective method to prevent the spread of infectious diseases. Nevertheless, vaccine hesitancy has been an issue. Parental hesitancy toward vaccines is a major part of the problem. COVID-19 vaccine acceptance is no different, it poses another challenge in facing the pandemic. In Low- and Middle-Income Countries (L&MICs) several studies measured parents' acceptance to vaccinate their children against COVID-19 and resulted in different acceptance proportions.AimsThe paper aims at obtaining a precise estimate of the overall proportion of L&MICs' parents accepting to vaccinate their children against COVID-19 and identifying the main determinant of their decisions.MethodsThis meta-analysis follows the PRISMA 2020 statement on updated guidelines and the checklist for reporting systematic reviews. Studies published between December till February 2022 were assessed for inclusion. The final effect size (i.e., the proportion of parents in L&MICs accep...
Background: Vaccination is the most e ective method to prevent the spread of infectious diseases.... more Background: Vaccination is the most e ective method to prevent the spread of infectious diseases. Nevertheless, vaccine hesitancy has been an issue. Parental hesitancy toward vaccines is a major part of the problem. COVID-vaccine acceptance is no di erent, it poses another challenge in facing the pandemic. In Low-and Middle-Income Countries (L&MICs) several studies measured parents' acceptance to vaccinate their children against COVID-and resulted in di erent acceptance proportions. Aims: The paper aims at obtaining a precise estimate of the overall proportion of L&MICs' parents accepting to vaccinate their children against COVID-and identifying the main determinant of their decisions. Methods: This meta-analysis follows the PRISMA statement on updated guidelines and the checklist for reporting systematic reviews. Studies published between December till February were assessed for inclusion. The final e ect size (i.e., the proportion of parents in L&MICs accepting to vaccinate their children against COVID-) was measured using the Arcsine proportions method. Analysis was done using R program. Results: The proportion of parents in L&MICs accepting to vaccinate their children against COVID-is %. The major reason for their acceptance is their belief that COVID-vaccine is fundamental to the fight against the pandemic while the most common factor for parents' hesitancy to vaccinate their children against COVID-is their concerns about vaccine e cacy, safety, and possible side e ects. Conclusion: The proportion of parents in L&MICs accepting to vaccinate their children against COVID-is lower than the global level. To increase parental acceptance, responsible authorities should concentrate on increasing their population's trust in the government and in vaccine manufacturers. As well as concentrating on increasing acceptance of the vaccine idea in general.
Frontiers in Public Health
During pandemics, the ethicists, public health professionals, and human rights advocates raise a ... more During pandemics, the ethicists, public health professionals, and human rights advocates raise a red flag about different public health actions that should, at best, be addressed through integrated, global policies. How to rationalize the healthcare resources and prioritize the cases is not a recent challenge but the serious concern about that is how to achieve this while not increasing the vulnerability of the disadvantaged population. Healthcare professionals use different scoring systems as a part of their decision-making so the medical teams and triage committees can allocate resources for predictable health outcomes and prognosis as well as to appropriately triage the patients accordingly. However, the value of the existing scoring systems to manage COVID-19 cases is not well-established yet. Part of this problem includes managing non-COVID patients with chronic medical conditions like non-communicable diseases and addressing their medical needs during the pandemic complex cont...
Healthcare, 2022
Background: Health equity is an important aspect of responsible governance. COVID-19 exposed exis... more Background: Health equity is an important aspect of responsible governance. COVID-19 exposed existing shortfalls of Global Health Governance (GHG). A considerable amount of related literature is produced. This scoping review aims at mapping the present knowledge and at identifying research gaps. Methods: This scoping review is based on the Joanna Briggs Institute’s guideline for standardized methods and PRISMA-ScR guidelines for reporting. Documents published from December 2019 to October 2021 were searched using PubMed, Scopus, Google Scholar, World cat, and WHO-Global Index Medicus. Two reviewers screened and reviewed eligible studies in three stages: duplicates identification and elimination, title and abstract screening, and full-text assessment. Data was charted and results were classified into conceptual categories. Analysis was done in three stages: open descriptive coding, focused thematic analysis, and frequency, commonality and significance analysis. Results: forty-nine st...
Abstract Background: Health equity is an important aspect of responsible governance. COVID-19 exp... more Abstract
Background: Health equity is an important aspect of responsible governance. COVID-19 exposed existing shortfalls of Global Health Governance (GHG). A considerable amount of related literature is produced. This scoping review aims at mapping the present knowledge and at identifying research gaps. Methods: This scoping review is based on the Joanna Briggs Institute’s guideline for standardized methods and PRISMA-ScR guidelines for reporting. Documents published from December 2019 to October 2021 were searched using PubMed, Scopus, Google Scholar, World cat, and WHO-Global Index Medicus. Two reviewers screened and reviewed eligible studies in three stages: duplicates identification and elimination, title and abstract screening, and full-text assessment. Data was charted and results were classified into conceptual categories. Analysis was done in three stages: open descriptive coding, focused thematic analysis, and frequency, commonality and significance analysis. Results: forty-nine studies met the inclusion criteria. Areas of research were grouped into seven themes: “human rights and inequities”, “solidarity, collaboration and partnership”, “GHG structure change”, “political and economic power and finance”, “approaches to address inequity”, “law and regulations”, and “private investment and public-private partnerships (PPPs) in GHG”. The highest number of papers were in the first theme, “human rights and inequities”. However, the themes are interrelated. Authors who contributed to research were mostly affiliated to developed countries indicating a gap in knowledge and expertise in developing countries. Conclusion: Through this scoping review we found that the seven themes are interconnected. Disciplinary collaboration in research relating GHG to health inequities is solicited. Collaboration in research, information sharing, and research capacity development are in needed in developing countries.
I would like to express my gratitude and thanks to my thesis advisor Dr. Shahjahan Bhuiyan, the C... more I would like to express my gratitude and thanks to my thesis advisor Dr. Shahjahan Bhuiyan, the Chair of the Department of Public Policy and Administration at The American University in Cairo, for his continuous support and trust throughout my Masters Degree journey and especially during the thesis writing. Likewise, I would like to acknowledge my debt to Dr. Artan Karini and Dr. Hamid Ali of the Department of Public Policy and Administration at the American University in Cairo, for their valuable comments as the readers of my thesis. I also would like to thank all the interviewees for accepting to spare some of their valuable time and for openly sharing their indispensable knowledge and experience with me for this thesis. Finally, I would like express my deep appreciation to my family: my parents, husband and children, for their support and encouragement throughout my years of study and thesis writing. This accomplishment would not have been possible without them.
Frontiers in Public Health, 2021
During pandemics, the ethicists, public health professionals, and human rights advocates raise a ... more During pandemics, the ethicists, public health professionals, and human rights advocates raise a red flag about different public health actions that should, at best, be addressed through integrated, global policies. How to rationalize the healthcare resources and prioritize the cases is not a recent challenge but the serious concern about that is how to achieve this while not increasing the vulnerability of the disadvantaged population. Healthcare professionals use different scoring systems as a part of their decision-making so the medical teams and triage committees can allocate resources for predictable health outcomes and prognosis as well as to appropriately triage the patients accordingly. However, the value of the existing scoring systems to manage COVID-19 cases is not well-established yet. Part of this problem includes managing non-COVID patients with chronic medical conditions like non-communicable diseases and addressing their medical needs during the pandemic complex cont...
Foreign Aid (FA) is considered a tool for promoting economic and human development. Considerable ... more Foreign Aid (FA) is considered a tool for promoting economic and human development. Considerable amounts of FA is directed towards the health sector. The role of FA in development, as well as in health, has been a subject of debate with inconclusive results on its impact. This study concentrates on FA in the health sector in Palestine during the period following the establishment of the Palestinian National Authority in 1994. A qualitative research approach was used throughout the study to explore, describe and explain the roles, procedures and challenges of FA in the health sector. The research concluded that FA has a positive impact on the health sector outcomes in Palestine. FA contributed to the establishment of institutional structures and capacities within the health sector, as well as in service provision. Nevertheless, the following challenges still need to be addressed in order to increase FA effectiveness: the Israeli occupation; the continuing influence of donors' agendas; the politicization of aid; the competition between different FA recipients; the low accountability of donors towards recipients; and the miscommunication and inadequate coordination between various actors.
Drafts by Wafa Abuelkheir Mataria
Governmental health sectors around the world are facing financial and administrative deficiencies... more Governmental health sectors around the world are facing financial and administrative deficiencies and inefficiencies. These deficiencies impact populations health and give space to other actors to emerge. NGOs have been known for their role in gap filling for the government. A positive relation between the government and NGOs is an indispensable to help in reaching a higher level of health care provision and accessibility. In Palestine, NGOs play a major role in the provision and financing of health care. However, the performance of Palestinian NGOs is affected by their relation with the MoH. This study aims at determining the factors affecting the relation between the government and NGOs working in the health sectors in Palestine for better health sector performance.
Descriptive quantitative and explorative qualitative methods where used in this study. Data was collected through desk review and semi-structured in depth interviews. The sample was a purposive sample done through snowballing. An oral consent was obtained from each participant prior to the interview.
The study concluded that NGOs are prominent service providers with many advantages needed by the MoH to access marginalized populations, the relation between MoH and health centered NGOs is progressing towards complementarity despite the differences in viewpoints and minor competition and the main factors affecting MoH- NGO relation are: the political background of the PNA and NGOs, the unclear role of each side, the un-institutionalization of the rules governing the MoH-NGOs relation, the absence of the legislative body, donors influence and the changing role of NGOs.
Teaching Documents by Wafa Abuelkheir Mataria
Background: The COVID-19 pandemic revealed critical weaknesses in global health systems, many of ... more Background: The COVID-19 pandemic revealed critical weaknesses in global health systems, many of which have roots in the neoliberal policies that have dominated global health governance since the 1980s. Neoliberalism, characterized by market-driven policies, privatization, and reduced government intervention, has profoundly impacted healthcare access, equity, and quality worldwide. Objective: This study aims to analyze the impact of neoliberal reforms on health systems in various countries, focusing on the interplay between governance, policy formulation, and stewardship in the health sector. By examining the outcomes of these reforms, the study seeks to understand how different approaches to neoliberalism have shaped health system performance and equity. Methods: The study employs the Stages Heuristic Model (SHM) to conduct a retrospective comparative analysis of health policy reforms in ten countries, including the United States, Chile, New Zealand, Ecuador, and China. The research synthesizes data from peer-reviewed articles to assess the outcomes of neoliberal policies on healthcare systems. Results: The analysis reveals that in countries such as the United States and Chile, neoliberal reforms led to increased health inequities and a tiered healthcare system, where access to quality care became increasingly dependent on socioeconomic status. In contrast, countries like Taiwan, which balanced neoliberal reforms with strong public health initiatives, managed to maintain more equitable health systems. China and Venezuela, both of which initially adopted more interventionist healthcare policies, made notable early strides in improving access to healthcare and addressing inequities, particularly for underserved populations. However, Venezuela's progress was undermined by economic challenges and insufficient support for higher-level care, leading to a decline in health outcomes over time. Conclusion: The study underscores the need for governance models that prioritize equity and public health in healthcare systems. It suggests that while neoliberal policies can drive economic efficiency, they often do so at the cost of health equity, necessitating a re-evaluation of global health governance and policy approaches.
Eastern Mediterranean Health Journal/Eastern Mediterranean health journal, Feb 25, 2024
Frontiers in public health, Mar 21, 2024
Globalization and Health
Background Covid-19 is not the first pandemic to challenge GHG. Preceding outbreaks and epidemics... more Background Covid-19 is not the first pandemic to challenge GHG. Preceding outbreaks and epidemics were sources of continuous debate on GHG leadership and structure resulting in its current structure. However, Covid-19 proved the presence of many deficits in the current GHG. The response to the Covid-19 pandemic is a cumulative result of all policies and actions of different governments and agencies active in global health. Assessing how Covid-19 is being handled globally provides lessons for ensuring better performance in facing upcoming outbreaks. This study has three main objectives: first, to evaluate the performance of GHG during Covid-19 in general and in relation to Covid-19 vaccine equity in particular. Second, to identify the reasons behind this performance; and third, to propose prospective changes in GHG for better performance. Methods A cross-sectional research design using the Delphi method was applied. A panel of experts participated in the three-round Delphi surveys. T...
Introduction: Inequitable access to COVID-19 vaccines among countries is a pressing global health... more Introduction: Inequitable access to COVID-19 vaccines among countries is a pressing global health issue. Factors such as economic power, political power, political stability, and health system strength contribute to disparities in vaccine distribution. This study aims to assess the inequality in vaccine distribution among countries based on these factors and identify their relationship with COVID-19 vaccine distribution. Methods: A Concentration Index (CI) analysis was conducted to evaluate inequalities in the distribution of COVID-19 vaccines among countries based on four separate variables: GDP per capita, political stability (PS), World Power Index (WPI), and Universal Health Coverage (UHC). Additionally, Multiple Linear Regression (MLR) analysis was employed to explore the relationship between vaccine distribution and these independent variables. Two vaccine distribution variables were utilized for result reliability. Results: The analysis revealed significant inequalities in COVID-19 vaccine distribution according to the countries' GDP/capita, PS, WPI, and UHC. However, the multiple linear regression analysis showed that there is no significant relationship between COVID-19 vaccine distribution and the countries' GDP/ capita and that UHC is the most influential factor impacting COVID-19 vaccine distribution and accessibility. Discussion: The findings underscore the complex interplay between economic, political, and health system factors in shaping vaccine distribution patterns. To improve the accessibility to vaccines in future pandemics, Global Health Governance (GHG) and countries should consider working on three areas; enhance political stabilities in countries, separate the political power from decision-making at the global level and most importantly support countries to achieve UHC.
Background: The Global Health Governance (GHG) response to the COVID-19 pandemic has been critici... more Background: The Global Health Governance (GHG) response to the COVID-19 pandemic has been criticized, particularly regarding vaccine management, and changes in the roles of GHG actors have been recommended. Aim: To investigate the perception of experts regarding changes in the roles of different GHG actors following the COVID-19 pandemic. Methods: This study used a 3-round Delphi survey to collect data from 30 global health experts between May and December 2022. The GHG roles investigated were stewardship, production of guidelines and policies, promotion of solidarity and collaboration, and management of global health challenges. Social network analysis was performed and collected data was converted into a 1-mode network. Degree centrality and Eigenvector centrality were calculated using the UCINET 6.757 modelling programme. Results: There were variations between the current and future roles in degree centrality and eigenvector centrality for the 19 GHG actors in each of the 4 functions investigated. For stewardship, WHO, governments and the World Bank had the highest degree centrality and eigenvector centrality during both the current and future periods. In terms of production of guidelines and policies, WHO maintained the highest current and future eigenvector centralities, while research agencies, UNICEF and Gavi upheld their current eigenvector centrality measure. For the promotion of solidarity and collaboration, WHO had the highest centrality measures, followed by UNICEF, governments and Gavi. Regarding the function "management of global health challenges", WHO lost its position to UNICEF as the most central, while UNDP, FHI 360 and research agencies were predicted to have a more central role in the future. Conclusion: The findings position WHO as the current and future top actor in stewardship, production of guidelines and policies, and promoting solidarity and collaboration, and UNICEF as the upcoming most central actor in managing global health challenges. Governments were major actors in all GHG functions except for managing global health challenges. Funding actors were central in all GHG functions, indicating finance as an important factor in obtaining a central role in GHG. Research organizations received a high centrality rating, indicating their importance in GHG.
Background Covid-19 is not the first pandemic to challenge GHG. Preceding outbreaks and epidemics... more Background Covid-19 is not the first pandemic to challenge GHG. Preceding outbreaks and epidemics were sources of continuous debate on GHG leadership and structure resulting in its current structure. However, Covid-19 proved the presence of many deficits in the current GHG. The response to the Covid-19 pandemic is a cumulative result of all policies and actions of different governments and agencies active in global health. Assessing how Covid-19 is being handled globally provides lessons for ensuring better performance in facing upcoming outbreaks. This study has three main objectives: first, to evaluate the performance of GHG during Covid-19 in general and in relation to Covid-19 vaccine equity in particular. Second, to identify the reasons behind this performance; and third, to propose prospective changes in GHG for better performance. Methods A cross-sectional research design using the Delphi method was applied. A panel of experts participated in the three-round Delphi surveys. Their scores were used to perform consensus, performance and correlation analysis. Results GHG performance limited the achievement of Covid-19 vaccines' global equity. GHG performance is a product of the existing GHG system, its actors and legal framework. It is a collective result of individual GHG actors' performance. The most influential actors in decision-making regarding Covid-19 vaccine are the vaccine manufacturers and governments. While the most invoked power to influence decision are economic and political powers. Covid-19 decisions underlying value, although had human right to health at the base, overlooked the concept of health as a global public good and was skewed towards market-oriented values. GHG mal-performance along with its underlying factors calls for four main changes in GHG structure: assigning a clear steward for GHG, enhanced accountability, centralized authority, more equitable representation of actors, and better legal framework. Conclusion GHG structure, actors' representation, accountability system, and underlying priorities and value require future modification for GHG to achieve better future performance and higher health equity levels.
Frontiers in Public Health
BackgroundVaccination is the most effective method to prevent the spread of infectious diseases. ... more BackgroundVaccination is the most effective method to prevent the spread of infectious diseases. Nevertheless, vaccine hesitancy has been an issue. Parental hesitancy toward vaccines is a major part of the problem. COVID-19 vaccine acceptance is no different, it poses another challenge in facing the pandemic. In Low- and Middle-Income Countries (L&MICs) several studies measured parents' acceptance to vaccinate their children against COVID-19 and resulted in different acceptance proportions.AimsThe paper aims at obtaining a precise estimate of the overall proportion of L&MICs' parents accepting to vaccinate their children against COVID-19 and identifying the main determinant of their decisions.MethodsThis meta-analysis follows the PRISMA 2020 statement on updated guidelines and the checklist for reporting systematic reviews. Studies published between December till February 2022 were assessed for inclusion. The final effect size (i.e., the proportion of parents in L&MICs accep...
Background: Vaccination is the most e ective method to prevent the spread of infectious diseases.... more Background: Vaccination is the most e ective method to prevent the spread of infectious diseases. Nevertheless, vaccine hesitancy has been an issue. Parental hesitancy toward vaccines is a major part of the problem. COVID-vaccine acceptance is no di erent, it poses another challenge in facing the pandemic. In Low-and Middle-Income Countries (L&MICs) several studies measured parents' acceptance to vaccinate their children against COVID-and resulted in di erent acceptance proportions. Aims: The paper aims at obtaining a precise estimate of the overall proportion of L&MICs' parents accepting to vaccinate their children against COVID-and identifying the main determinant of their decisions. Methods: This meta-analysis follows the PRISMA statement on updated guidelines and the checklist for reporting systematic reviews. Studies published between December till February were assessed for inclusion. The final e ect size (i.e., the proportion of parents in L&MICs accepting to vaccinate their children against COVID-) was measured using the Arcsine proportions method. Analysis was done using R program. Results: The proportion of parents in L&MICs accepting to vaccinate their children against COVID-is %. The major reason for their acceptance is their belief that COVID-vaccine is fundamental to the fight against the pandemic while the most common factor for parents' hesitancy to vaccinate their children against COVID-is their concerns about vaccine e cacy, safety, and possible side e ects. Conclusion: The proportion of parents in L&MICs accepting to vaccinate their children against COVID-is lower than the global level. To increase parental acceptance, responsible authorities should concentrate on increasing their population's trust in the government and in vaccine manufacturers. As well as concentrating on increasing acceptance of the vaccine idea in general.
Frontiers in Public Health
During pandemics, the ethicists, public health professionals, and human rights advocates raise a ... more During pandemics, the ethicists, public health professionals, and human rights advocates raise a red flag about different public health actions that should, at best, be addressed through integrated, global policies. How to rationalize the healthcare resources and prioritize the cases is not a recent challenge but the serious concern about that is how to achieve this while not increasing the vulnerability of the disadvantaged population. Healthcare professionals use different scoring systems as a part of their decision-making so the medical teams and triage committees can allocate resources for predictable health outcomes and prognosis as well as to appropriately triage the patients accordingly. However, the value of the existing scoring systems to manage COVID-19 cases is not well-established yet. Part of this problem includes managing non-COVID patients with chronic medical conditions like non-communicable diseases and addressing their medical needs during the pandemic complex cont...
Healthcare, 2022
Background: Health equity is an important aspect of responsible governance. COVID-19 exposed exis... more Background: Health equity is an important aspect of responsible governance. COVID-19 exposed existing shortfalls of Global Health Governance (GHG). A considerable amount of related literature is produced. This scoping review aims at mapping the present knowledge and at identifying research gaps. Methods: This scoping review is based on the Joanna Briggs Institute’s guideline for standardized methods and PRISMA-ScR guidelines for reporting. Documents published from December 2019 to October 2021 were searched using PubMed, Scopus, Google Scholar, World cat, and WHO-Global Index Medicus. Two reviewers screened and reviewed eligible studies in three stages: duplicates identification and elimination, title and abstract screening, and full-text assessment. Data was charted and results were classified into conceptual categories. Analysis was done in three stages: open descriptive coding, focused thematic analysis, and frequency, commonality and significance analysis. Results: forty-nine st...
Abstract Background: Health equity is an important aspect of responsible governance. COVID-19 exp... more Abstract
Background: Health equity is an important aspect of responsible governance. COVID-19 exposed existing shortfalls of Global Health Governance (GHG). A considerable amount of related literature is produced. This scoping review aims at mapping the present knowledge and at identifying research gaps. Methods: This scoping review is based on the Joanna Briggs Institute’s guideline for standardized methods and PRISMA-ScR guidelines for reporting. Documents published from December 2019 to October 2021 were searched using PubMed, Scopus, Google Scholar, World cat, and WHO-Global Index Medicus. Two reviewers screened and reviewed eligible studies in three stages: duplicates identification and elimination, title and abstract screening, and full-text assessment. Data was charted and results were classified into conceptual categories. Analysis was done in three stages: open descriptive coding, focused thematic analysis, and frequency, commonality and significance analysis. Results: forty-nine studies met the inclusion criteria. Areas of research were grouped into seven themes: “human rights and inequities”, “solidarity, collaboration and partnership”, “GHG structure change”, “political and economic power and finance”, “approaches to address inequity”, “law and regulations”, and “private investment and public-private partnerships (PPPs) in GHG”. The highest number of papers were in the first theme, “human rights and inequities”. However, the themes are interrelated. Authors who contributed to research were mostly affiliated to developed countries indicating a gap in knowledge and expertise in developing countries. Conclusion: Through this scoping review we found that the seven themes are interconnected. Disciplinary collaboration in research relating GHG to health inequities is solicited. Collaboration in research, information sharing, and research capacity development are in needed in developing countries.
I would like to express my gratitude and thanks to my thesis advisor Dr. Shahjahan Bhuiyan, the C... more I would like to express my gratitude and thanks to my thesis advisor Dr. Shahjahan Bhuiyan, the Chair of the Department of Public Policy and Administration at The American University in Cairo, for his continuous support and trust throughout my Masters Degree journey and especially during the thesis writing. Likewise, I would like to acknowledge my debt to Dr. Artan Karini and Dr. Hamid Ali of the Department of Public Policy and Administration at the American University in Cairo, for their valuable comments as the readers of my thesis. I also would like to thank all the interviewees for accepting to spare some of their valuable time and for openly sharing their indispensable knowledge and experience with me for this thesis. Finally, I would like express my deep appreciation to my family: my parents, husband and children, for their support and encouragement throughout my years of study and thesis writing. This accomplishment would not have been possible without them.
Frontiers in Public Health, 2021
During pandemics, the ethicists, public health professionals, and human rights advocates raise a ... more During pandemics, the ethicists, public health professionals, and human rights advocates raise a red flag about different public health actions that should, at best, be addressed through integrated, global policies. How to rationalize the healthcare resources and prioritize the cases is not a recent challenge but the serious concern about that is how to achieve this while not increasing the vulnerability of the disadvantaged population. Healthcare professionals use different scoring systems as a part of their decision-making so the medical teams and triage committees can allocate resources for predictable health outcomes and prognosis as well as to appropriately triage the patients accordingly. However, the value of the existing scoring systems to manage COVID-19 cases is not well-established yet. Part of this problem includes managing non-COVID patients with chronic medical conditions like non-communicable diseases and addressing their medical needs during the pandemic complex cont...
Foreign Aid (FA) is considered a tool for promoting economic and human development. Considerable ... more Foreign Aid (FA) is considered a tool for promoting economic and human development. Considerable amounts of FA is directed towards the health sector. The role of FA in development, as well as in health, has been a subject of debate with inconclusive results on its impact. This study concentrates on FA in the health sector in Palestine during the period following the establishment of the Palestinian National Authority in 1994. A qualitative research approach was used throughout the study to explore, describe and explain the roles, procedures and challenges of FA in the health sector. The research concluded that FA has a positive impact on the health sector outcomes in Palestine. FA contributed to the establishment of institutional structures and capacities within the health sector, as well as in service provision. Nevertheless, the following challenges still need to be addressed in order to increase FA effectiveness: the Israeli occupation; the continuing influence of donors' agendas; the politicization of aid; the competition between different FA recipients; the low accountability of donors towards recipients; and the miscommunication and inadequate coordination between various actors.
Governmental health sectors around the world are facing financial and administrative deficiencies... more Governmental health sectors around the world are facing financial and administrative deficiencies and inefficiencies. These deficiencies impact populations health and give space to other actors to emerge. NGOs have been known for their role in gap filling for the government. A positive relation between the government and NGOs is an indispensable to help in reaching a higher level of health care provision and accessibility. In Palestine, NGOs play a major role in the provision and financing of health care. However, the performance of Palestinian NGOs is affected by their relation with the MoH. This study aims at determining the factors affecting the relation between the government and NGOs working in the health sectors in Palestine for better health sector performance.
Descriptive quantitative and explorative qualitative methods where used in this study. Data was collected through desk review and semi-structured in depth interviews. The sample was a purposive sample done through snowballing. An oral consent was obtained from each participant prior to the interview.
The study concluded that NGOs are prominent service providers with many advantages needed by the MoH to access marginalized populations, the relation between MoH and health centered NGOs is progressing towards complementarity despite the differences in viewpoints and minor competition and the main factors affecting MoH- NGO relation are: the political background of the PNA and NGOs, the unclear role of each side, the un-institutionalization of the rules governing the MoH-NGOs relation, the absence of the legislative body, donors influence and the changing role of NGOs.