Jan
Biographic Data
| ID | 66667 |
|---|---|
| NAME | Jan |
| FAMILY NAME | Jan |
| SIGNATURE | JAN |
| AFFILIATIONS | The George Institute for Global Health |
| ORCID | 0000-0003-2839-1405 |
| VERIFIED | Yes |
| TOTAL WORKS | 65 |
| TOTAL CITATIONS | 50 |
| AUTHOR COUNT | 65 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1995 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 4 |
Gender inequities in the economic burden of anxiety disorders, depressive disorders, migraine, and rheumatoid arthritis in Mexico, 2005–2021
Anxiety disorders, depressive disorders, migraine, and rheumatoid arthritis are common chronic conditions that contribute substantially to disability, recurrent care needs, and productivity losses, yet remain comparatively under-prioritised in health policy. In Mexico, these conditions disproportionately affect women, but their economic burden has not been comprehensively quantified from a gender perspective. To estimate the direct and indirect e…
Ambient PM2.5, residential greenspace, and household healthcare expenditure in Shandong, China
BACKGROUND: Environmental factors such as air pollution and access to greenspace are increasingly recognised as important determinants of population health and healthcare expenditure. This study examined the relationship between ambient PM2.5, urban greenspace, and household healthcare expenditure in China, and assessed how healthcare expenditure was concentrated across these gradients of environmental exposure. METHODS: We conducted a cross-sect…
Health financing inequality in fragmented health systems: Evidence from Mexico, 2000–2023
Universal health coverage (UHC) depends, among other things, on fair and efficient public financing. In many low- and middle-income countries (LMICs), fragmented health systems entrench inequalities by linking entitlements to employment status. In Mexico, persistent segmentation and institutional fragmentation have shaped the structure and distribution of public health financing, exemplifying this challenge through a dual public system that separ…
Modelling the health, financial protection and equity impacts of upscaling the ACT NOW early intervention breast cancer pilot program in the Philippines: An extended cost-effectiveness analysis
INTRODUCTION: Women in the Philippines experience significant health and economic burdens of breast cancer. The Philippines has reformed financial protection for breast cancer but does not have a national early detection and treatment programme. This study aims to model the health and economic impacts of ACT NOW (a pilot breast cancer programme that navigates women through free early detection to treatment) through an extended cost-effectiveness …
Understanding implementation, adoption, and acceptability of the WHO package of essential noncommunicable (PEN) disease interventions in Fiji: Evidence for scale-up
The Package of Essential Noncommunicable (PEN) disease interventions in response to the high prevalence of cardiovascular diseases and diabetes was implemented in Fiji commencing in 2012. This study aimed to understand implementation outcomes, and its contextual influences. Semi-structured interviews with health workers and patients across Fiji was conducted. Thematic analysis was mapped to the health system building blocks to understand PEN serv…
Residential greenspace and multiple chronic health conditions in China: A cross-sectional study
Background: Multiple chronic conditions are imposing an increasing health and economic burden on the Chinese health system. While exposure to residential greenness has been shown to provide various health benefits, its relationship with multiple chronic conditions remains largely unexplored. This study aims to investigate this relationship using high-resolution satellite imagery and data from the 6th Health Services Survey (HSS) cohort in Shandon…
Gendered experience of people living with type 2 diabetes in rural and urban Mexico: An ethnographic study
Gender appears to substantially influence experience of living with T2D. Women were more likely to provide family support and less likely to receive it and reported greater financial barriers to care access in comparison to men. Men were more likely to experience stress in relation to their employment as primary providers for their family, and less likely to adhere to prescribed medical management of their condition. These findings should be cons…
Willingness to pay for assisted reproductive technologies among individuals with infertility in China
Infertility, a widely prevalent condition globally, incurs high economic burdens. Assisted reproductive technologies (ARTs) are effective treatments, but public health financing in low- and middle-income countries (LMICs) rarely covers ART services. In China, where birth rates are declining, willingness to pay (WTP) can inform insurance reimbursement policies by reducing out-of-pocket expenses. However, there is no consensus on WTP thresholds for…
A Qualitative Study of Aboriginal Peoples' Health Care Experiences With Chronic Obstructive Pulmonary Disease
Aboriginal Australians experience a high prevalence of chronic obstructive pulmonary disease (COPD), with high rates of potentially preventable hospitalisations. However, little is known about Aboriginal peoples' experiences of living with COPD and how they navigate health care systems. This study used thematic analysis and Aboriginal methodology to explore Aboriginal peoples' lived experiences of COPD, their health care journey from receiving a …
Establishing cost-effectiveness threshold in China: A community survey of willingness to pay for a healthy life year
INTRODUCTION: The willingness to pay per quality-adjusted life year gained (WTP/Q) is commonly used to determine whether an intervention is cost-effective in health technology assessment. This study aimed to evaluate the WTP/Q for different disease scenarios in a Chinese population. METHODS: The study employed a quadruple-bounded dichotomous choice contingent valuation method to estimate the WTP/Q in the general public. The estimation was conduct…
Cardiovascular health and economic outcomes under improved air quality in China: A modelling study
INTRODUCTION: China faces the dual challenge of high air pollution and an increasing burden of cardiovascular disease (CVD). We aimed to estimate the healthcare costs associated with CVD and the quality-adjusted life years (QALYs) under scenarios of improved air quality in China. METHODS: A health prediction model was developed to estimate 10-year CVD-related costs and QALY associated with PM2.5 levels in 2015, as well as two hypothetical improve…
The impact of a multi-faceted intervention on non-prescription dispensing of antibiotics by urban community pharmacies in Indonesia: A mixed methods evaluation
Introduction Non-prescription antibiotic dispensing is prevalent among community pharmacies in several low- and middle-income countries. We evaluated the impact of a multi-faceted intervention to address this challenge in urban community pharmacies in Indonesia. Methods A pre-post quasi-experimental study was carried out in Semarang city from January to August 2022 to evaluate a 7-month long intervention comprising: (1) online educational session…
Uptake of mandated pregnancy warnings in the Australian alcoholic ready‐to‐drink beverage market
Implementation of a goal-directed Care Bundle for intracerebral hemorrhage: Results of embedded process evaluation in the Interact3 trial
The third, stepped-wedge, cluster-randomized, Intensive Care Bundle with Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT3), has shown that a goal-directed multi-faceted Care Bundle incorporating protocols for the management of physiological variables was safe and effective for improving functional recovery in a broad range of patients with acute intracerebral hemorrhage (ICH). The INTERACT3 Care Bundle included time- and tar…
Gender disparities in lost productivity resulting from non-communicable diseases in Mexico, 2005–2021
Background: Non-communicable diseases (NCDs) cause long-term impacts on health and can substantially affect people's ability to work. Little is known about how such impacts vary by gender, particularly in low- and middle-income countries (LMICs), where productivity losses may affect economic development. This study assessed the long-term productivity loss caused by major NCDs among adult women and men (20-76 years) in Mexico because of premature …
Influencing and implementing mandatory alcohol pregnancy warning labels in Australia and New Zealand
Alcohol labelling laws and policy are contentious and highly politicized. Very few countries have been able to implement health warnings on alcohol labels due to complex legal and governance systems and coordinated industry lobbying. In 2020, Australia and New Zealand implemented a mandatory and evidence-based legal standard for pregnancy warning labels on alcohol products. This article discusses some of the challenges faced in achieving policy c…
Burden of non-communicable diseases and behavioural risk factors in Mexico: Trends and gender observational analysis
Background: There is scarce gender-disaggregated evidence on the burden of disease (BD) worldwide and this is particularly prominent in low- and middle-income countries. The objective of this study is to compare the BD caused by non-communicable diseases (NCDs) and related risk factors by gender in Mexican adults. Methods: We retrieved disability-adjusted life years (DALYs) estimates for diabetes, cancers and neoplasms, chronic cardiovascular dis…
A codesigned integrated kidney and diabetes model of care improves patient activation among patients from culturally and linguistically diverse backgrounds
BACKGROUND: Little is known about the relationship between patients' cultural and linguistic backgrounds and patient activation, especially in people with diabetes and chronic kidney disease (CKD). We examined the association between culturally and linguistically diverse (CALD) background and patient activation and evaluated the impact of a codesigned integrated kidney and diabetes model of care on patient activation by CALD status in people with…
Incidence of catastrophic health spending in Indonesia: Insights from a Household Panel Study 2018–2019
This study demonstrated that the overall incidence of CHS decreased in Indonesia between 2018 and 2019. OOP payments for health care and the risk of CHS still loom high among JKN members and among the lowest income households. More needs to be done to further contain OOP payments and further research is needed to investigate whether CHS pushes households below the poverty line
A mixed methods study of Aboriginal health workers’ and exercise physiologists’ experiences of co-designing chronic lung disease ‘yarning’ education resources
PROSPERO (registration number: CRD42019111405)
Evaluation of a state-wide intervention on salt intake in primary schoolchildren living in Victoria, Australia
Objective: In 2015, the Victorian Salt Reduction Partnership launched a 4-year multifaceted salt reduction intervention designed to reduce salt intake by 1 g/d in children and adults living in Victoria, Australia. Child-relevant intervention strategies included a consumer awareness campaign targeting parents and food industry engagement seeking to reduce salt levels in processed foods. This study aimed to assess trends in salt intake, dietary sou…
Priority setting for non-communicable disease prevention - Co-producing a regulatory agenda informing novel codes of practice in Australia
The effects of government policies targeting ethics and governance processes on clinical trial activity and expenditure: A systematic review
Governments have attempted to increase clinical trial activity in their jurisdictions using a range of methods including simplifying the ethics review and governance process of clinical trials. This study’s objective was to systematically review the effects of government actions targeting ethics reviews or governance processes on clinical trial activity. The data sources of Pub Med, Scopus, Sage, ProQuest, Google, Google Scholar and reference lis…
A study of the quality of cardiovascular and diabetes medicines in Malang District, Indonesia, using exposure-based sampling
BACKGROUND: The WHO has warned that substandard and falsified medicines threaten health, especially in low and middle-income countries (LMICs). However, the magnitude of that threat for many medicines in different regions is not well described, and high-quality studies remain rare. Recent reviews of studies of cardiovascular and diabetes medicine quality recorded that 15.4% of cardiovascular and 6.8% of diabetes samples failed at least one qualit…
“We face the same risk as the other health workers”: Perceptions and experiences of community pharmacists in Indonesia during the Covid-19 pandemic
In many countries, community pharmacies have played an important role during the COVID-19 pandemic, providing essential medicines and personal protective equipment (PPE), disseminating information on disease prevention and management, and referring clients to health facilities. In recognition of this, there are increasing calls for an improved understanding of the challenges and experiences faced by these providers during the COVID-19 pandemic, w…
Towards people-centred health systems: A multi-level framework for analysing primary health care governance in low- and middle-income countries
Although there is evidence that non-government health system actors can individually or collectively develop practical strategies to address primary health care (PHC) challenges in the community, existing frameworks for analysing health system governance largely focus on the role of governments, and do not sufficiently account for the broad range of contribution to PHC governance. This is important because of the tendency for weak governments in …
Staking a claim for claims: A case study of resource allocation in Australian Aboriginal health care
A holistic approach to the economic evaluation of health programs using institutionalist methodology
Exploring the determinants of distress health financing in Cambodia
Borrowing is a common coping strategy for households to meet healthcare costs in countries where social health protection is limited or non-existent. Borrowing with interest, hereinafter termed distress health financing or distress financing, can push households into heavy indebtedness and exacerbate the financial consequences of healthcare costs. We investigated distress health financing practices and associated factors among Cambodian household…
A politico-economic analysis of decision making in funding health service organisations
Institutional analysis of health system governance
It is important that researchers who study health system governance have a set of collective understandings of the meanings of governance, which can then inform the methods used in research. We present an institutional framing and definition of health system governance; that is, governance refers to making, changing, monitoring and enforcing the rules that govern the demand and supply of health services. This pervasive, relational view of governa…
Accounting for institutional change in health economic evaluation: A program to tackle HIV/Aids and gender violence in Southern Africa
Proceduralism and its role in economic evaluation and priority setting in health
Economic evaluation of a combined microfinance and gender training intervention for the prevention of intimate partner violence in rural South Africa
OBJECTIVE: Assess the cost-effectiveness of an intervention combining microfinance with gender and HIV training for the prevention of intimate partner violence (IPV) in South Africa. METHODS: We performed a cost-effectiveness analysis alongside a cluster-randomized trial. We assessed the cost-effectiveness of the intervention in both the trial and initial scale-up phase. RESULTS: We estimated the cost per DALY gained as US$7688 for the trial phas…
Cross-border medical travels from Cambodia: Pathways to care, associated costs and equity implications
In low- and middle-income countries, patients may travel abroad to seek better health services or treatments that are not available at home, especially in regions where great disparities exist between the standard of care in neighbouring countries. While awareness of South–South medical travels has increased, only a few studies investigated this phenomenon in depth from the perspective of sending countries. This article aims to contribute to thes…
The government cannot do it all alone’: Realist analysis of the minutes of community health committee meetings in Nigeria
Since the mid-1980s, the national health policy in Nigeria has sought to inspire community engagement in primary health care by bringing communities into partnership with service providers through community health committees. Using a realist approach to understand how and under what circumstances the committees function, we explored 581 meeting minutes from 129 committees across four states in Nigeria (Lagos, Benue, Nasarawa and Kaduna). We found…
How community preferences can more effectively shape equity policy
A holistic approach to the economic evaluation of health programs using institutionalist methodology
Staking a claim for claims: A case study of resource allocation in Australian Aboriginal health care
A politico-economic analysis of decision making in funding health service organisations
Accounting for institutional change in health economic evaluation: A program to tackle HIV/Aids and gender violence in Southern Africa
Health professionals, patients and chronic illness policy: A qualitative study
BACKGROUND AND OBJECTIVE: This study investigates health professionals' reactions to patients' perceptions of health issues - a little-researched topic vital to the reform of the care of chronic illness. METHODS: Focus groups were undertaken with doctors, nurses, allied health staff and pharmacists (n = 88) in two Australian urban regions. The focus groups explored responses to patient experiences of chronic illness (COPD, Diabetes, CHF) obtained…
Community Preferences for the Allocation & Donation of Organs - The PAraDOx Study
By providing a better understanding of current community preferences in relation to organ donation and allocation, the PAraDOx study will highlight options for firstly, increasing the rate of organ donation and secondly, allow for more transparent and equitable policies in relation to organ allocation
Trade and the Nutrition Transition: Strengthening Policy for Health in the Pacific
This article describes pathways through which trade policy change in two Pacific Island countries has contributed to changes in the food supply, and thereby to the nutrition transition. The effect of various trade policies from 1960 to 2005 on trends in food imports and availability is described, and case studies are presented for four foods associated with the nutrition transition and chronic disease in the Pacific. Trade policies (including lib…
Economic evaluation of a combined microfinance and gender training intervention for the prevention of intimate partner violence in rural South Africa
OBJECTIVE: Assess the cost-effectiveness of an intervention combining microfinance with gender and HIV training for the prevention of intimate partner violence (IPV) in South Africa. METHODS: We performed a cost-effectiveness analysis alongside a cluster-randomized trial. We assessed the cost-effectiveness of the intervention in both the trial and initial scale-up phase. RESULTS: We estimated the cost per DALY gained as US$7688 for the trial phas…
Are rehabilitation services following stroke accessed equitably in Australia: Findings from the psychosocial outcomes in stroke (Poise) cohort study
ANZCTRN12608000459325
Embedding sustainable physical activities into the everyday lives of adults with intellectual disabilities: A randomised controlled trial
ISRCTN77889248 (18 April 2012)
The relationship between economic characteristics and health-related quality of life in newly diagnosed cancer patients in Southeast Asia: Results from an observational study
Towards people-centred health systems: A multi-level framework for analysing primary health care governance in low- and middle-income countries
Although there is evidence that non-government health system actors can individually or collectively develop practical strategies to address primary health care (PHC) challenges in the community, existing frameworks for analysing health system governance largely focus on the role of governments, and do not sufficiently account for the broad range of contribution to PHC governance. This is important because of the tendency for weak governments in …
Proceduralism and its role in economic evaluation and priority setting in health
Strengthening health systems in low-income countries by enhancing organizational capacities and improving institutions
BACKGROUND: This paper argues that the global health agenda tends to privilege short-term global interests at the expense of long-term capacity building within national and community health systems. The Health Systems Strengthening (HSS) movement needs to focus on developing the capacity of local organizations and the institutions that influence how such organizations interact with local and international stakeholders. DISCUSSION: While instituti…
How decentralisation influences the retention of primary health care workers in rural Nigeria
BACKGROUND: In Nigeria, the shortage of health workers is worst at the primary health care (PHC) level, especially in rural communities. And the responsibility for PHC - usually the only form of formal health service available in rural communities - is shared among the three tiers of government (federal, state, and local governments). In addition, the responsibility for community engagement in PHC is delegated to community health committees. OBJE…
Priority Setting in Indigenous Health: Why We Need an Explicit Decision Making Approach
Indigenous Australians have significantly poorer health outcomes than the non-Indigenous population worldwide. The Australian government has increased its investment in Indigenous health through the "Closing the Health Gap" initiative. Deciding where to invest scarce resources so as to maximize health outcomes for Indigenous peoples may require improved priority setting processes. Current government practice involves a mix of implicit and explici…
Transaction costs of access to health care: Implications of the care-seeking pathways of tuberculosis patients for health system governance in Nigeria
Health care costs incurred prior to the appropriate patient-provider transaction (i.e., transaction costs of access to health care) are potential barriers to accessing health care in low- and middle-income countries. This paper explores these transaction costs and their implications for health system governance through a cross-sectional survey of adult patients who received their first diagnosis of pulmonary tuberculosis (TB) at the three designa…
Ten best resources for conducting financing and benefit incidence analysis in resource-poor settings
Many low- and middle-income countries are seeking to reform their health financing systems to move towards universal coverage. This typically means that financing is based on people’s ability to pay while, for service use, benefits are based on the need for health care. Financing incidence analysis (FIA) and benefit incidence analysis (BIA) are two popular tools used to assess equity in health systems financing and service use. FIA studies examin…
The government cannot do it all alone’: Realist analysis of the minutes of community health committee meetings in Nigeria
Since the mid-1980s, the national health policy in Nigeria has sought to inspire community engagement in primary health care by bringing communities into partnership with service providers through community health committees. Using a realist approach to understand how and under what circumstances the committees function, we explored 581 meeting minutes from 129 committees across four states in Nigeria (Lagos, Benue, Nasarawa and Kaduna). We found…
Healthcare expenditure on Indigenous and non-Indigenous Australians at high risk of cardiovascular disease
Australian New Zealand Clinical Trials Registry ACTRN 126080005833347
Institutional analysis of health system governance
It is important that researchers who study health system governance have a set of collective understandings of the meanings of governance, which can then inform the methods used in research. We present an institutional framing and definition of health system governance; that is, governance refers to making, changing, monitoring and enforcing the rules that govern the demand and supply of health services. This pervasive, relational view of governa…
Investing in non-communicable disease prevention and management to advance the Sustainable Development Goals
Cardiovascular disease risk and comparison of different strategies for blood pressure management in rural India
Clinical Trials Registry of India CTRI/2013/06/003753 , 14 June 2013
Generating sustainable collective action: Models of community control and governance of alcohol supply in Indigenous minority populations
Medicine (52 works) · Economics (30 works) · Environmental health (29 works) · Nursing (29 works) · Health care (27 works) · Economic growth (26 works) · Political science (26 works) · Business (25 works) · Public health (21 works) · Global Maternal and Child Health (18 works)