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Subject: search.filters.subject.440706 Health policy

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    A composite index of provincial alcohol control policy implementation capacity in Thailand : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Public Health, Massey University, Auckland, New Zealand
    (Massey University, 2025-03-05) Jankhotkaew, Jintana
    Implementing effective alcohol control policies remains challenging, especially in low- and middle-income countries. Monitoring and evaluation are crucial for strengthening policy implementation. This study is the first to develop a composite index of alcohol control policy implementation at the subnational level in Thailand. Data were collected from various sources, including key informants responsible for policy implementation and secondary data from relevant organisations. Findings reveal significant variation in the composite index across provinces and an association between the index and alcohol consumption per drinker. This study calls for effective implementation of effective alcohol control policies to reduce alcohol consumption.
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    Investigating the New Zealand policy response to residential methamphetamine contamination : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Public Health, SHORE & Whāriki Research Centre, College of Health, Massey University, New Zealand. EMBARGOED until further notice.
    (Massey University, 2023) Sanchez Lozano, Claudia Denisse
    Introduction: Methamphetamine use and manufacture has been an on-going issue in New Zealand since the early 2000s. Clandestine manufacture of methamphetamine is associated with hazardous chemicals that contaminate the area in which this activity occurs, with potential health harms to occupants of these structures. From 2010, a set of policies addressing methamphetamine contamination of housing were implemented in the residential sector to determine whether a property is contaminated and the appropriate response. In 2018, a scientific review prompted a dramatic change in the recommended contamination thresholds and related policies, particularly those of Housing New Zealand. This PhD thesis aims to investigate and critically evaluate the policy process and change in approach to residential methamphetamine contamination in New Zealand. Methods: This research applied a qualitative approach to case study research. The methods used included analysis of local and overseas literature, official reports, guidelines, and policy documents, analysis of legal decisions, comparative case study analysis, and qualitative interviews of stakeholders and key experts. More specifically, thematic and content analyses of legal decisions addressing methamphetamine contamination in housing before (N = 685) and after the change in approach (N = 195) were completed. A comparative analysis of the policy responses and outcomes for public housing authorities in the United States and New Zealand was also conducted. In addition, a thematic analysis was carried out on the transcripts from semi-structured interviews with 13 New Zealand key informants (KI) from government, industry, the residential and academic sectors. Results: A range of unintended consequences from residential methamphetamine contamination policies were observed, including termination of tenancies and substantial financial expenditure on testing and remediation. Tenants were particularly disadvantaged by the policies, with public housing tenants facing additional consequences including their suspension from the public housing list. Stakeholders highlighted the need for additional guidance and industry regulation. Inconsistencies in the adoption and interpretation of policies were observed across the residential sector, particularly in the analysis of Tenancy Tribunal decisions. The US public housing authority shared many similarities in policy response and outcomes to Housing New Zealand, starting with a zero-tolerance to eventually moving to a harm reduction approach. Conclusions: Limited scientific evidence of the health risks from methamphetamine contamination in houses enhanced the influence of the political context and fundamental attitudes to drug use in the development and implementation of these policies in New Zealand. Additional guidance is required and it should balance scientific uncertainties with the outcomes of policy implementation. Evaluation of future interventions is needed to avoid further unintended consequences.
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    A critical discourse analysis of a Serbian Roma social inclusion strategy, its construction of Roma people, health and the implications for Roma people's access to health and healthcare in Serbia : a thesis presented in partial fulfilment of the requirements of Master of Arts in Psychology at Massey University, Distance, New Zealand
    (Massey University, 2022) Novakov, Iva
    Roma communities often face vast social and health inequalities and inequities in Europe, including Serbia, and this could be due to several possible multi-level factors. Recent national, regional and international initiatives have sought to reduce these disparities by developing or amending policies, with limited success across countries. Past research on such Roma inclusion policies points to the need to consider the discourses in these texts. In this mixed-methods study, I explored how Roma health policy discursively constructs Roma people and health issues in Serbia and consider the social implications of such constructions for health justice for Roma. I used Fairclough’s critical discourse analysis (CDA) to critically analyse the current Serbian Roma social inclusion (health) strategy and the interview talk of those who have developed and implemented such policy. The strategy analysis found three dominant discourses of health: (1) neoliberal discourse, (2) neoliberal human rights discourse, (3) holistic human rights discourse. The discourses associated with neoliberalism contained the assumptions that raising awareness and providing information on health and health-related rights and economic integration into the labour market would enable better health access and health for Roma. These discourse types worked to individualise Roma health issues, placing most of the responsibility for achieving health on Roma people themselves. In comparison, the holistic human rights discourse worked with broader social determinants of health framework, which framed health and associated health-related resources as fundamental human rights and called for more government accountability. The interview participants’ talk analysis revealed that while a neoliberal discourse on health information dissemination was evident, there was also a significant emphasis on the macro-social constraints impeding access to health, namely poor infrastructure, discrimination and cultural bias. Findings thus indicate multiple, at times contesting, ways of constructing Roma people and Roma health issues within the policy circle. Such diverse constructions can have important implications for Roma health. Overall, findings extend discourse literature on European Roma health and inclusion policy, supporting and challenging dominant constructions of Roma health problems and solutions, and point to the need for more nuanced analyses of different countries’ Roma policy and the talk of key stakeholders.