BackgroundScientific knowledge is a fundamental tool for making informed health policy decisions, but the link between health research and public policy decision-making is often missing. This study aims to identify and prioritize a national set of research gaps in mental health.MethodsA multi-approach method to identify gaps in knowledge was developed, including (1) document analysis and identification of possible research questions, (2) interviews to Ministry of Health key informants, (3) focus groups with different stakeholders, and (4) a web consultation addressed to academics. The identified gaps were translated to a standardized format of research questions. Criteria for prioritization were extracted from interviews and focus groups. Then, a team of various professionals applied them for scoring each question research.FindingsFifty-four people participated in the knowledge gaps identification process through an online consultation (n = 23) and focus groups (n = 18). Prioritization criteria identified were: extent of the knowledge gap, size of the objective population, potential benefit, vulnerability, urgency and applicability. 155 research questions were prioritized, of which 44% were related to evaluation of systems and/or health programs, and 26% to evaluation of interventions, including questions related to cost-effectiveness. 30% of the research questions came from the online consultation, and 36% from key informants. Users groups contributed with 10% of total research questions.ConclusionA final priority setting for mental health research was reached, making available for authorities and research agencies a list of 155 research questions ordered by relevance. The experience documented here could serve to other countries interested in developing a similar process.Electronic supplementary materialThe online version of this article (doi:10.1186/s13033-017-0168-9) contains supplementary material, which is available to authorized users.
Aims To comprehensively review enacted and proposed alcohol laws and existing impact evaluations of national alcohol policies in Chile. Methods We searched enacted laws in the Chilean National Library of Congress, proposed laws in the websites of the House of Deputies and Senate and impact evaluations in PubMed, Web of Science, Scopus, Scielo, JSTOR, Epistemonikos and OpenGrey from inception to February 2019. Eligibility criteria included enacted laws and proposed laws on national alcohol policies and research studies evaluating the impact of national alcohol policies. One author screened enacted laws and proposed laws; two authors independently screened research records. We included any national alcohol policy intervention and classified policies according to 10 World Health Organization (WHO) alcohol policy domains. We used the Cochrane EPOC Review Group criteria to assess risk of bias of research records. We registered the review protocol in PROSPERO, registration record CRD42016050156. Results We identified and screened 229 enacted laws, 138 proposed laws and 1538 research records. Of these, 72 enacted laws, 118 proposed laws and three research articles were eligible for synthesis. We found enacted policies in all WHO alcohol policy domains. Regarding the most cost‐effective policies, Chile has made limited use of taxation, has not regulated alcohol marketing and has weakened alcohol availability regulation. We found a large number of proposed laws, 79% of which would strengthen alcohol control. The few impact evaluation studies examined drink‐driving policies and found a short‐term reduction of alcohol‐related injuries and deaths. Conclusions Chile has enacted alcohol policies in all World Health Organization policy domains, but has not adopted policies with highest likely cost‐effectiveness. Only the impact of drink‐driving policies has been evaluated.
Giesbrecht, N., Sapag, J. C., Pemjean, A., Marquez, J., Khenti, A., Rehm, J., & Minoletti, A. (2013). A National Alcohol Strategy For Chile: Rationale, Development, Content and Status Of Implementation. International Journal of Alcohol and Drug Research, 2(2), 17-29. doi: 10.7895/ijadr.v2i2.128 (http://dx.doi.org/10.7895/ijadr.v2i2.128)Aim: This paper describes the rationale for the Chilean strategy on alcohol, how it was developed, its key recommendations, which of its dimensions have been implemented, and remaining challenges.Design: The paper is based on archival data, a literature review, and survey data from Chilean sources. It draws on presentations at two seminars in Santiago, and a background document commissioned by the Chilean Ministry of Health. Building on ongoing initiatives in Chile, it was informed by international research on the global and regional burden of disease from alcohol.Setting and Context:In 2008 the Ministry of Health, Government of Chile, embarked on developing a national alcohol strategy. The strategy’s rationale was informed by the high rate of alcohol-related trauma, including drinking and driving; the high rate of liver cirrhosis mortality and morbidity; the high rate of heavy drinking, including among youth and young adults; and gender differences.Measures: The main recommendations focused on several themes: pricing and taxation interventions, controlling physical availability, curtailing alcohol marketing, promoting server intervention, controlling drinking and driving, promoting community-based interventions, facilitating screening and brief interventions, and monitoring and tracking local and national developments on alcohol issues.Findings & Conclusions: Since 2008, there has been progress in several areas, including a National Strategy for brief interventions in primary care; a new law on legal blood alcohol content; proposals to increase taxes on spirits, introduce warning labels on beverage containers, and limit promotion of alcoholic beverages; and the integration of alcohol-related goals within the National Health Strategy 2011–2020. Nevertheless, challenges remain: the broad acceptance of drinking, including high-risk drinking; the importance and influence of the alcohol industry; and the need for an evidence-based inter-sector response.
Chile has two major national health systems, the public one, which serves nearly 80% of the country's close to 17 million population, and the private one, which serves the other 20%. The public primary healthcare system has been developing in Chile since before the Alma Ata Conference in 1978 (which produced the first international declaration on the importance of primary healthcare).
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