Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
BMC Health Serv Res. 2021 Nov 4;21(1):1193. doi: 10.1186/s12913-021-07240-3.
The growing globalization has changed the goals and methods of diplomacy. Due to the challenges and complexities of dealing with noncommunicable diseases (NCDs) at the national and international levels, policy makers require global health diplomacy (GHD) to achieve the goals of prevention and control of NCDs. The purpose of this systematic review was to identify the challenges and opportunities in GHD for NCDs.
A systematic review of articles was conducted by searching MEDLINE via PubMed, Web of Science, Scopus, and Embase and by using Google and Google Scholar search engines. Additional articles were identified by reviewing reference lists and a number of special journals. The inclusion criteria include literature published in English from 2007 to 2020, and the exclusion criteria are literature published in any language other than English, absence of full text, dissertations, and duplicates. Overall, 32 articles met the requirements for inclusion in this review and were analyzed using content analysis in MAXQDA 10.
There are 32 published articles on GHD for NCDs. Identified challenges were classified into three levels: global (global health governance), national (Governance at the state level, health sector, and civil society), and industry. The progress on global health issues has created opportunities for the development of GHD for the prevention and control of NCDs. These opportunities were divided into three levels: international, national, and individual level.
Various challenges at the global level, national level, and industry led to less engagement of policymakers in GHD for prevention and control of NCDs and, as a consequence, a less coordinated approach to address prevention and control of NCDs worldwide. So, there is a need for more efforts of collective action and negotiation for tackling NCDs. Policymakers and managers of the health system should increase the advocacy, building a coalition with civil society, use negotiation and diplomacy to engage with other sectors and organizations, manage industry conflicts, and leverage foreign policy to promote health and welfare.
全球化的发展改变了外交的目标和方法。由于在国家和国际层面上应对非传染性疾病(NCDs)所面临的挑战和复杂性,政策制定者需要全球卫生外交(GHD)来实现 NCD 预防和控制的目标。本系统评价旨在确定 GHD 在 NCD 方面面临的挑战和机遇。
通过在 MEDLINE 上的 PubMed、Web of Science、Scopus 和 Embase 以及 Google 和 Google Scholar 搜索引擎进行系统检索,对文章进行了系统评价。通过审查参考文献列表和一些专业期刊,确定了其他文章。纳入标准包括 2007 年至 2020 年发表的英文文献,排除标准为非英文文献、无全文、学位论文和重复文献。共有 32 篇文章符合纳入本综述的要求,并使用 MAXQDA 10 进行内容分析。
共有 32 篇关于 NCD 全球卫生外交的已发表文章。确定的挑战分为三个层次:全球(全球卫生治理)、国家(国家一级的治理、卫生部门和民间社会)和工业。全球卫生问题的进展为预防和控制 NCD 方面的 GHD 发展创造了机会。这些机会分为三个层次:国际、国家和个人层面。
全球层面、国家层面和工业层面的各种挑战导致政策制定者较少参与预防和控制 NCD 的 GHD,因此,全球范围内预防和控制 NCD 的方法不够协调。因此,需要采取更多的集体行动和谈判来解决 NCD 问题。卫生系统的政策制定者和管理者应加强宣传,与民间社会建立联盟,利用谈判和外交与其他部门和组织接触,管理行业冲突,并利用外交政策促进健康和福利。