Part 1: Article Summary
Kickbusch & Erk (2009) assess the different determinants of healthcare policy and healthcare quality in a globalized world where countries are not able to advocate for nation based policies. According to the authors, healthcare is a very important aspect that surpasses national boundaries and recognizes the need for all nations to work together towards improving healthcare outcomes globally. Proper healthcare planning goes beyond the health of individuals in the community and there is the need for a more holistic approach in terms of advocating for policies with the consideration of other healthcare determinants such as societal and economic factors that have the potential of influencing global health outcomes. WHO provides a good definition of healthcare which realizes the interconnectedness of healthcare which should be achieved by ensuring physical, mental and social well-being of the world populations which hints that countries and healthcare organizations should work together to achieve these dynamics.
The most aggressive approach of influencing global healthcare is through policy advocacy which involves making important holistic considerations in the different network of health determinants to improve health outcomes. Policies and decisions in other sectors outside healthcare can have a significant impact on healthcare and should be considered in the policy advocacy which raises the importance of a "Health in all policies (HiaP)" approach which is more conclusive. The (HiaP) approach ensures that different intergovernmental agencies present their insight into policy decisions and how the policies even in areas not related in healthcare will have an impact on the health outcomes of the people. More important in this approach is the external dimension of public health which has been brought about by globalization. Pertaining this, Kickbusch & Erk, C. (2009) recognize how globalization has led to the transcendence over national boundaries and health problems go beyond national boundaries which require a new policy approach that is aware of the external aspect of health should be adopted going forward. Foreign policy and diplomacy should be used to help countries to pull together to tackle their common health problems because some health problems such as viruses and bacterial disease breakouts affect countries on a global scale.
Foreign policy and diplomacy should be used as tools to overcome national barriers in terms of healthcare policy by making health part of a foreign policy to ensure collective action in a more sustainable manner. The authors note that this can be achieved by integrating national health policies to ensure they cover regional and continental boundaries. Policy coherence with international health needs at the national level is a good approach to address a more globalized healthcare. Through this approach, nations can be able to bring collective concerns together through a foreign policy which has been recognized in Switzerland and the United Kingdom already with the actions taken at a national level benefiting global healthcare outcomes. Therefore, using foreign policy and diplomacy in creating healthcare solutions to achieve global-oriented health outcomes especially for the problems that transcend national boundaries.
Part 2: Critical Analysis
Useful Information that adds to Healthcare Knowledge
Holistic Healthcare and Healthcare Determinants
The authors point out that healthcare is holistic in nature in that it involves the physical, social and mental needs of individuals. At the same time, healthcare determinants in these areas are many which are interconnected and can be controlled and improved through policy advocacy which ensures that all the elements in the network of health determinants are considered. As such, McDougall (2016) agrees with the authors that the macro level, middle level and the micro level of healthcare determinants should be considered policies and decisions not only in healthcare but outside healthcare. The authors have given an example of a Health in all policies initiative by the European Union as an approach to consolidate all the healthcare determinants and consider healthcare in policies in other sectors.
Global Approach to Healthcare Policy
Globalization has significantly changed how healthcare is perceived from a national oriented approach to a more globalized approach where collective action is required in form of policies to harmonize health care outcomes. Globalization has increased the mobilization of people and animals which has increased the global movement of bacteria and viruses some of which are contagious and fatal. The globalization aspect of healthcare can significantly help to address modern healthcare needs for populations as most of the health problems transcend national boundaries. Therefore, the authors help create an understanding of how the global outlook on healthcare can influence collective actions in terms of policies which can improve healthcare outcomes.
Article Weakness
Failure to Establish Examples of Global Oriented Policies outside Europe
The author's discussion on the "Health in all policies (HiaP)" does not provide exquisite examples on other parts of the world of policy advocacy that is regionally or internationally oriented and aimed at improving health outcomes. There is a significant challenge in achieving the global-oriented health policy advocacy due to the differences in wealth endowment amongst nations which makes it difficult to implement health-oriented advocacy on a global scale. For instance, African and Asian countries face significant healthcare outcomes gap compared to the western countries which make it difficult to implement the global-oriented policies (McDougall, 2016). The author should have discussed on approaches that can be used to empower developing countries to address their healthcare problems which is a significant initiative towards "Health in all policies" direction.
Foreign policy and Healthcare Diplomacy
The article has introduced a new dimension of healthcare policy advocacy which articulates the unique 21st-century healthcare environment. Healthcare policies should be taken to an international level to ensure that global health problems are addressed. The "Health in all policies (HiaP)" can be advanced through foreign policy and diplomacy which can ensure greater representation of healthcare needs in policies which have a global effect. Controlling disease epidemic and other future health threats such as bioterrorism can only be achieved through foreign policy and diplomacy oriented health policies (McDougall, 2016).
I agree with the authors that healthcare determinants are multifaceted and there is a growing global appeal to consolidate policy initiatives to address health care problems. Globalization has made it easy for pathogens to spread which means that an epidemic at one point has the potential of affecting many countries easily today compared to a century ago when the world was less interconnected. The only weakness of the article is that it does not take into account the health gap between developed and low-income countries and how global policy initiatives will affect developing countries.
References
Kickbusch, I., & Erk, C. (2009). Global health diplomacy: The new recognition of health in foreign policy. Realizing the right to health, Swiss Human Rights Book, 3, 517.
McDougall, L. (2016). Discourse, ideas and power in global health policy networks: political attention for maternal and child health in the millennium development goal era. Globalization and health, 12(1), 21.
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