Highlights The politicization of a COVID-19 vaccine approval in the United States could undermine people’s beliefs in the safety and efficacy of a vaccine and their willingness to receive it. An announcement of vaccine approval one week before the presidential election, a politically salient event, reduces confidence in the vaccine’s safety and efficacy and uptake intentions relative to an announcement one week after the election. Endorsement of vaccine by political figures, President Donald Trump and House Speaker Nancy Pelosi, has a polarizing effect even among those who express high levels of confidence in vaccines generally. However, endorsement by Dr. Anthony Fauci increases willingness to receive a vaccine and beliefs about its safety and efficacy for all partisan subgroups. Results highlight the importance of understanding the politicization of vaccination and medicine more generally.
This article explores the politics of passage of the sugar-sweetened beverage (SSB) tax in Mexico, using published documents, media articles, and interviews with key stakeholders. The article examines first the period of agenda setting when the tax was included in the President's fiscal reform package; and second, the period of legislative passage, when the bill was introduced in Congress and was passed. The analysis uses Kingdon's three streams theory of agenda setting, to explain how the tax emerged on the agenda and how agenda setting shaped and enabled legislative passage. The article offers five lessons related to the politics of passing the SSB tax in Mexico. First, passing an SSB tax was difficult and required high-level organization, cooperation, planning, and effort. Second, supporters needed an understanding of how to manage the political and economic context, facilitated by a grant from Bloomberg Philanthropies. Third, framing the tax as generating revenue helped get the proposal onto the policy agenda and enabled buy-in from the powerful Ministry of Finance (Hacienda). Fourth, forming networks within the legislature early on allowed tax proponents to have a network of allies within Congress ready when the SSB tax was introduced as a bill. Finally, early public relations campaigns helped shape public perception that Mexico's obesity epidemic was driven in part by SSB consumption. This is the first paper that uses political science theory and primary data collection and interviews with a broad range of stakeholders, to explain how Mexico passed an SSB tax despite opposition from a strong national SSB industry.
BackgroundWhile there is increasing recognition that the non-technical aspects of health care quality – particularly the inter-personal dimensions of care – are important components of health system performance, evidence from population-based studies on these outcomes in low- and middle-income countries is sparse. This study assesses these non-technical aspects of care using two measures: health system responsiveness (HSR), which quantifies the degree to which the health system meets the expectations of the population, and non-technical health care quality (QoC), for which we ‘filtered out’ these expectations. Pooling data from six large middle-income countries, this study therefore aimed to determine how HSR and QoC vary between countries and by individuals’ sociodemographic characteristics within countries.MethodsWe pooled individual-level data, collected between 2007 and 2010, from nationally representative household surveys of (primarily) adults aged 50 years and older in China, Ghana, India, Mexico, Russia, and South Africa. The outcome measure was a binary indicator for a ‘bad’ rating (HSR: “very bad” or “bad” on a five-point Likert scale; QoC: a worse rating of one’s own visit than that of the character in an anchoring vignette) on at least one of seven dimensions for the most recent primary care visit.Results23 749 adults who reported to have sought primary care during the preceding 12 months were includedin the analysis. The proportion of participants who gave a bad rating for their last primary care visit on at least one of seven dimensions varied from 4.3% (95% confidence interval (CI) = 2.8-6.7) in China to 33.1% (95% CI = 23.6-44.2) in South Africa for HSR, and from 17.0% (95% CI = 11.4-24.5) in Russia to 50.8% (95% CI = 46.0-55.6) in Ghana for QoC. There was a strong negative association between increasing household wealth and both bad HSR and QoC in India and South Africa.ConclusionsAchieving universal health coverage (UHC) with good-quality health services (“effective UHC”) will require efforts to improve HSR and QoC across the population in Ghana and South Africa. Additionally, a particular focus on raising HSR and QoC for the poorest population groups is needed in India and South Africa.
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