Schools play a key role in mental health problem prevention, reaching most children during critical periods. Leveraging this opportunity requires understanding the complex system underlying school-based prevention, comprising various connections between multiple stakeholders. This study charts the structure and dynamics of a school-based mental health problem prevention system in Estonia using a novel collaborative system mapping method.

Learning health systems (LHS) may improve healthcare access, innovation, coordination, continuity and quality. To ensure implementation success, healthcare organizations must be able to assess their current readiness to adopt an LHS approach; however, there is a paucity of LHS-specific readiness tools in the extant literature. Thus, the overarching aim of this study was to map the depth and breadth of LHS literature to identify the domains and items, alongside barriers, facilitators, implementation strategies and competencies relevant to include in an LHS readiness tool.

Clinical negligence claims represent a significant financial and reputational burden for healthcare systems worldwide. While the United States is often perceived as having a highly litigious medical culture, comparative data between the United Kingdom and United States, especially in general surgery, are limited.

Zoonoses - diseases transmitted between animals and people - disproportionally affect low-resource countries (LRCs). The complex nature of zoonoses adds substantial barriers to implementing multisectoral policies to address them. Research on the policy process could help illuminate the significant factors influencing policy change among the complex systems involved in managing zoonoses. We applied the One Health (OH) approach to describe the policy process among the systems involved in preventing and controlling zoonoses in Peru. The study's purpose is to (1) describe the priority-making process and the driving or limiting factors, (2) describe the process for selecting policy solutions and (3) describe perspectives about organizations' role in zoonoses management and authority in policy-making.

Egypt has made significant strides in strengthening its healthcare system, guided by Vision 2030 and aligned with the United Nations' Sustainable Development Goals (SDGs). Despite progress, challenges persist, including a high burden of non-communicable diseases, strained resources and a fragmented health system. The Universal Health Insurance System (UHIS), launched in 2018, aims to address these issues by providing equitable access to quality health services while ensuring financial protection.

Medical research plays an important role in increasing and improving the health of society. Utilizing the results of research will enable the provision of both material and spiritual support for research centres. It is essential to establish mechanisms for effective communication between researchers and officials. It is of great importance to pay attention to tools that facilitate the process of conducting this research. Therefore, the purpose of this study is to develop the framework of the social impact of medical research utilization (SIMRU).

Health policy and systems research (HPSR) is vital for strengthening health systems, yet its development in West Africa remains constrained by limited capacity. To strengthen capacity, the West African Network of Emerging Leaders in Health Policy and Systems (WANEL) was created to foster peer learning and cross-country collaboration among early- and mid-career HPSR actors. This study used Social Network Analysis (SNA) to examine WANEL's structure and functioning, with the aim of understanding how well the network supports its capacity and HPSR field-building goals.

Evidence, communication, critical thinking and participation are the cornerstones of informed decisions. In this article we discuss each of these in relation to decisions about public health and social measures (PHSM) during the coronavirus disease 2019 (COVID-19) pandemic and implications for future research. Reliable research evidence of the effects of interventions is particularly important for decisions about what to do because it provides the best basis for estimating the wanted and unwanted effects of doing something. There was little reliable research of the effects of PHSM during the pandemic. For research evidence to be useful to decision-makers, it must be effectively communicated, including how sure we can be about effects or other research findings. Research evidence is essential for making informed decisions, but it is not sufficient. Decision-makers and those affected by the decision must be able to think critically about what to believe and what to do. Many people lack competences and dispositions for thinking critically about PHSM or other interventions. Judgements about PHSM require democratic input, not just expert input. However, there was little public participation in deliberative or decision-making processes about PHSM during the pandemic. There are important uncertainties about the effects of PHSM, how to effectively communicate decisions and evidence about PHSM, how to foster critical thinking about PHSM and how to effectively engage the public in deliberative and decision-making processes about PHSM. Pandemic research and preparedness planning should address those uncertainties.

People experiencing marginalisation tend to be systematically excluded from policy decisions. Engaging people with lived experiences of marginalisation is increasingly considered critical for developing equitable and effective noncommunicable disease (NCD) policies. It remains unclear how the voices and experiences of people who are harmed by systems of marginalisation due to gender, ethnicity, sexuality, disability and social position have been included in NCD prevention policies.

Photovoice is an innovative community-based participatory research methodology that uses photography to capture key issues in a local setting. In Photovoice, photographs are taken to record and reflect on community strengths and challenges, facilitate critical dialogue among participants and researchers, and reach various stakeholders to make change. Although the use of Photovoice has increased in recent years, its utilisation in health policy and systems research is still limited.

Corporate social responsibility (CSR) activity in the pharmaceutical industry is frequently directed towards improving patient access to medicines amongst low-income populations. This research reports on findings from a mixed literature and key informant study of pharmaceutical sector CSR activity and its applicability in the high-cost novel therapeutics space.

Health technology assessment sets explicit priorities to maximize health gains and support universal health coverage. Health Technology Assessment in India (HTAIn) was set up to ensure efficient allocation of public health expenditure impacting 1.4 billion Indians. We conducted an analysis to summarize the research undertaken by HTAIn thus far and recommend the way forward.

The ways in which we understand and respond to perinatal substance use are explicitly and implicitly driven by policy. Perinatal substance use is a visible manifestation of intersecting systems of oppression, shaped by racist, colonial and sexist discourses surrounding mothering and drug use. Policies related to perinatal substance use and mental health have far-reaching impacts on families, communities and generations. This scoping review examined the conceptualization and operationalization of equity within foundational perinatal policies in one Canadian province, British Columbia (BC), between 2005 and 2025. Documents were included if they were: (1) provincial-level policy documents that either (a) guided perinatal service delivery generally or (b) focused on mental health promotion, prevention of mental disorders or harms of substance use; (2) publicly available; and (3) published within the study timeframe. Inductive content analysis and sensitizing questions were used to explore how equity concepts were conceptualized and integrated. In total, 30 documents met inclusion criteria. Equity was mentioned in 15, but only 4 provided explicit definitions. Often, implied proxy terms for equity were substituted to discuss equity considerations, such as risk, disadvantage, social determinants of health, vulnerable, marginalized and harm reduction, with limited direction on public health system roles or accountability in addressing root causes of inequities. Content analysis yielded the following missed opportunities in the results: an absence of clear definitions; focus on accessibility; inattention to structural conditions; and incoherent concepts of equity. Given BC's reputation as a leader in equity-oriented perinatal substance use policy, these gaps are notable. In the context of an expanding drug poisoning crisis and increasing global recognition of equity as foundational to public health, it is imperative to examine how equity is understood and actioned in policy to strengthen alignment between intentions and outcomes.

Health-system leaders are increasingly faced with making decisions about whether and how to use a wide range of current and emerging health-system innovations to address complex system and policy challenges. Health-system innovations can broadly include new ways of doing things at a system level, such as new approaches to govern health systems, care delivery, funding models, health policy or better ways to integrate health and social services. However, Canada has historically struggled with the adaptation and uptake of health-system innovations. This multicomponent study aimed to explore the challenges, approaches and implementation considerations for creating an integrated innovation system that enables the adaptation and uptake of health-system innovations from the perspectives of citizens and health system leaders in Canada.

Zoonotic disease dynamics (ZDD), encompassing pathogen spillover, transmission pathways and host-pathogen interactions, are widely acknowledged as drivers of emerging infectious diseases. Yet, the extent to which recent pandemic prevention, preparedness and response (PPPR) policies - the integrated frameworks guiding international efforts to anticipate and manage infectious disease threats - are grounded in this expanding body of scientific research remains unclear. This study examines how research on ZDD is cited in six influential global policy reports published between 2021 and 2023. We employed citation network analysis and qualitative profiling to compare references cited in these reports with those cited by a systematically identified set of broad-scope scientific publications on ZDD. Of the 313 references across the six reports, only 59 (19%) pertained to ZDD, a relatively small proportion considering that zoonotic diseases are framed as primary drivers of pandemic risk in these same reports. The academic literature is highly diverse and predominantly focused on specific pathogens (66%), with few studies offering a broad-scope perspective (4%) that addresses the complexity of ZDD. The citation network of the selected broad-scope literature was fragmented revealing low convergence of the knowledge base. Shared references between reports and scientific literature (n = 31) were mostly modelling studies (45%) or reviews (35%). Secondary data predominated (45%), and only 6% relied primarily on original field or laboratory data. Foundational studies were often overrepresented. This narrow and selective evidence base risks obscuring key uncertainties and limiting the diversity of perspectives that inform global PPPR strategies. Our findings highlight the value of more systematic approaches to scientific evidence use in PPPR policy documents. Strengthening the science-policy interface in PPPR requires greater engagement with emerging research, epistemic diversity, and the acknowledgment of uncertainty - essential steps toward building more adaptive, equitable and resilient strategies.

Despite the substantial health benefits of physical activity across the lifespan, most youth and adults are insufficiently physically active. To combat this trend, numerous policies and interventions have been developed, many of which have had modest effects. The limited effectiveness of such interventions has been linked to the lack of or minimal community involvement. Consequently, there have been calls for solutions with greater community buy-in. In particular, there has been a rise in the use of co-creation in physical activity research, where stakeholders are engaged in understanding and defining problems and designing localised and contextual solutions. While there are many benefits to co-creation (for example, collaboration and empowerment), there are also challenges, including the underreporting of co-creation approaches and methodologies used in physical activity research. We argue that human-centred design thinking can be a tool for approaching, complementing, and elevating co-creation. We discuss human-centred design thinking and offer strengths for how it can augment co-creation, such as through the Double Diamond model, toolkits and field guides, established activities, reporting guideline's and asking different questions to spark social innovation. We also present a case study to showcase how human-centred design thinking as an approach to co-creation can look.

Effective health policy is informed by research evidence; however, there are challenges to using up-to-date research evidence to inform policy decisions. The living evidence syntheses (LES) approach aims to overcome some of these challenges by providing decision-makers with summaries of the research evidence on topics of interest, updated as new evidence becomes available. As yet, little is known about when, why and how policymakers use LES, and the implications of this use. The aim of this study was to describe policymakers' perceptions of LES and characterize opportunities for, and challenges to, using LES to inform health policy in Australia.

Universal health coverage (UHC) requires strong institutional capacity, equity-oriented policies, sustained political and financial commitment and public trust. However, public confidence in many health systems, including Mexico's, has been chronically undermined. This study aims to document Mexico's health coverage trajectory by offering a comprehensive, disaggregated and longitudinal assessment of insurance coverage from 2000 to 2023 - highlighting both achievements and setbacks in the context of UHC2030 goals.

Cannabis use initiation is highly common among youth. Harm reduction in cannabis use (HR-c) has proven effective in minimizing the potential harms of the substance. However, its adoption by health and social services (HSS) practitioner's remains limited owing to several obstacles. This study marks the final phase of a broader research initiative. It aims to: (1) present the implementation of a knowledge translation (KT) plan developed to enhance HR-c adoption and formulate actionable strategies to support its applicability; and (2) evaluate its immediate and short-to-medium-term effects.

Exergaming, which combines physical exercise with video gaming, has shown benefits for individuals with chronic conditions. Implementation occurs at different levels and phases and influenced by various factors. To address the factors that influence the implementation of exergaming in healthcare, we aimed to explore stakeholder's experiences of strengths, weaknesses, opportunities and threats to the implementation of exergaming (in preparation, execution and continuation) for individuals with chronic conditions, in healthcare at the micro, meso and macro level.

Measuring and monitoring health system performance and resilience is key for planning and managing resilience-building activities. Recurrent simultaneous shocks, particularly in fragile contexts which are home to nearly one quarter of the world's population, underscore the need for resilient health systems able to provide the needed health care. This scoping review aims to examine how the performance and resilience of the health system have been assessed and measured in fragile, low-income contexts, identify gaps and provide recommendations to improve resilience measurement.