No abstract

Background: Internationally, mental health and social care systems face significant challenges when implementing policy to prevent and respond to domestic violence (DV). This paper reviews the policy process pertaining to the national law on domestic violence prevention and control (DVPC) within the health system in Vietnam from 2003 to 2018, and critically examines the policy-making process and content, the involvement of key actors and the barriers to implementation within the health system. Methods: 63 policy documents, 36 key informant interviews and 4 focus group discussions were conducted in Hanoi city, Bac Giang and Hai Duong provinces. The policy triangle framework was used to analyse the development and implementation process of the Law on DVPC. Results: The Vietnamese government developed the law on DVPC in response to the Millennium Development Goals reporting requirements. The development was a top-down process directed by state bodies, but it was the first time that international agencies and civil society groups had been involved in the health policy development process. The major themes that emerged in the analysis include: policy content, policymaking and implementation processes, the nature of actors' involvement, contexts, and mechanisms for policy implementation. Policy implementation was slow and delayed due to implementation being optional, decentralization, socio-cultural factors related especially to sensitivity, insufficient budgets, and insufficient cooperation between various actors within the health system and other related DV support systems. Conclusion: The initial development process for DVPC Law in Vietnam was pressured by external and internal demands, but the subsequent implementation within the health system experienced protracted delays. It is recommended that the policy be revised to emphasise a rights-based approach. Implementation would be more effective if monitoring and evaluation mechanisms are improved, the quality of training for health workers is enhanced, and cooperation between the health sector and related actors in the community is required and becomes routine in daily work.

This paper explores the extent to which global health governance – in the context of the early implementation of the Sustainable Development Goals is grounded in the right to health. The essential components of the right to health in relation to global health are unpacked. Four essential functions of the global health system are assessed from a normative, rights‐based, analysis on how each of these governance functions should operate. These essential functions are: the production of global public goods, the management of externalities across countries, the mobilization of global solidarity, and stewardship. The paper maps the current reality of global health governance now that the post‐2015 Sustainable Development Goals are beginning to be implemented. In theory, the existing human rights legislation would enable the principles and basis for the global governance of health beyond the premise of the state. In practice, there is a governance gap between the human rights framework and practices in global health and development policies. This gap can be explained by the political determinants of health that shape the governance of these global policies. Current representations of the right to health in the Sustainable Development Goals are insufficient and superficial, because they do not explicitly link commitments or right to health discourse to binding treaty obligations for duty‐bearing nation states or entitlements by people. If global health policy is to meaningfully contribute to the realization of the right to health and to rights based global health governance then future iterations of global health policy must bridge this gap. This includes scholarship and policy debate on the structure, politics, and agency to overcome existing global health injustices.

A profile of the roles performed by Australian health professionals working in international health was constructed to identify the core competencies they require, and the implications for education and training of international health practitioners. The methods used included: literature review and document analysis of available training and education; an analysis of competencies required in job descriptions for international health positions; and consultations with key informants. The international health roles identified were classified in four main groups: Program Directors, Program Managers, Team Leaders and Health Specialists. Thirteen 'core' competencies were identified from the job analysis and key informant/group interviews. Contributing to international health development in resource poor countries requires high level cultural, interpersonal and teamwork competencies. Technical expertise in health disciplines is required, with flexibility to adapt to new situations. International health professionals need to combine public health competencies with high level personal maturity to respond to emerging challenges.

There are currently no frameworks developed specifically for assessing community-based dengue control project sustainability. We first review the literature for frameworks for assessing project sustainability and second validate the framework criteria against the oldest community-based intervention using Mesocyclops in Xuan Phong commune, Nam Dinh province, north Vietnam, the subject of an intervention in 1998-2000. The framework used 13 criteria, clustered into three categories: 1) maintenance of health benefits from the original project, 2) continued delivery of community activities, and 3) human resource development. To provide consistency between criteria and to allow comparison both over time and with non-intervention communes, a five-point scale for each criterion was used, with the overall sustainability score calculated as the mean of all criteria. The framework offers a practical tool for assessing sustainability, and is amenable to adaptation for specific interventions without compromising the framework as a whole.