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Introduction: The requirement for medical services fluctuates. This study was carried out in order to attempt to extrapolate the service requirements for various cardiology services at Mater Dei Hospital, Malta over the coming five years, based on service demands from previous years.Methods: Past annual data was obtained from hospital records for various services (to 2017). Linear regression was carried out using a bespoke Excel™ spreadsheet in order to extrapolate possible services requirements up to 2022.Results: All services are expected to increase, with forecasts ranging between 41 and 354%, depending on services being considered.Discussion: It is easy to "get on with it" and perform the work required at the workplace but this study has shown that it is equally important to anticipate demands lest lack of planning leads to long and important waiting lists for critical diagnostics and treatments. Health care provision requirements are increasing worldwide. Even using conservative estimates and in the absence of the creation of new services, the demands for extant services are likely to continue to grow. Unless medium term plans are made for hardware, software, physical space and staffing, and the funding thereof, waiting lists for investigations in this speciality are bound to rise. This may be mitigated by novel treatments but since these cannot be predicted, it would be safer and wiser to plan ahead lest we are overwhelmed. This paper has also shown how WASP (Write a Scientific Paper) precepts can be applied to elegantly study a problem and write up a paper. [ABSTRACT FROM AUTHOR]

All countries worldwide have signed up to the United Nations Sustainable Development Goals and have committed to the objective of achieving 'universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all'. During the COVID-19 pandemic and beyond, advancement toward universal health coverage (UHC) will become more difficult for many countries, demonstrating that locally led priority setting is urgently needed to provide health services with appropriate financial protection to all. Because resources are limited and no national constituency can provide an unlimited number of services to their whole population in a sustainable manner, rationing and setting priorities for the selection of interventions to be included in a defined package of services is critical. In this Perspective, we discuss how packages of essential health services can be developed in resource-constrained settings, and detail how experts and the public can decide on principles and criteria, use a comprehensive array of analytical methods and choose which services to be provided free of charge. We illustrate these main steps while drawing on a recently conducted exercise of revising the national essential health services package in Ethiopia, which we compare with examples from other countries that have defined their essential benefits packages. This Perspective also provides recommendations for other low- and middle-income countries on their pathway to UHC.

Desert cities are special type of places that need extra environmental care and additional health planning during the process of growth and development. Special considerations and regards ought to be paid to health-related projects like building hospitals, primary health care (PHC) centers, emergency services, sanitation facilities, etc. In a country like Saudi Arabia, where deserts form a large part of the available biome, selecting which cities and places to focus on during health-related project development can be a difficult process, lacking proper ways of classifying and comparing the general health status of the population. While there are established indices to calculate other health-related qualities, like the Air Quality Health Index, there is no general health quality index. The article presented herein advocates an appropriate formula for a health quality index, HQI, as a tool for quantifying health quality for any given desert community. HQI is intended to offer a unique number, which expresses overall health quality at a certain desert locality, at a specified period of time, which is based on several quality parameters and health indicators. The objective of HQI is to turn complex health quality data into flat, simple information that is understandable and usable by health authorities, the public and desert community members. HQI depicts the composite influence of different public health quality parameters and communicates health quality information to the general public and legislative decision makers. It is intended to represent a reliable picture of the overall health quality within a particular community. [ABSTRACT FROM AUTHOR]

This study explores policy makers’, health-care professionals’ and senior volunteers’ perceptions of senior volunteers. Two Norwegian government white papers regarding older adult care and welfare services, which were published over a period of 19 years, were selected for close examination. Furthermore, focus group interviews with a purposeful sample of five senior volunteers and 15 health-care professionals were conducted. The study explores the discursive formations of senior volunteers in the government white papers and how they are negotiated in the senior volunteers’ and the health-care professionals’ narratives. Two dominant discourses were presented in the white papers: a prevention discourse (in which volunteering was presented primarily as a means to prevent volunteers’ loneliness and need for care services) and a sustainability discourse (in which the volunteers were presented as instrumental in future sustainable care services). Both discourses echo a common overarching discourse about a capacity crisis due to the ageing population. The senior volunteers were positioned as partners and active agents in both their own narratives and the health-care professionals’ narratives. Their position as independent and as spokespersons for the less empowered were evident only in the senior volunteers’ own narratives. Only the health-care professionals referenced the prevention discourse and capacity issues. The senior volunteers presented themselves as competent, efficient political actors, and they resisted both the prevention and sustainability discourses. In the senior volunteers’ narratives, social and political participation were interrelated. The study demonstrates that new discursive landscapes must be created to capture the diversity among senior volunteers and their efforts. While senior volunteers must be meaningfully involved in decision making, planning and design, their positions as independent and active agents must also be ensured. Authentic partnerships between senior volunteers and public care services involve a balance between involvement and independence. [ABSTRACT FROM AUTHOR]

Background: Community participation in health programme planning has gained traction in public health in recent decades. When an idea enters the mainstream, it becomes vulnerable to overuse and dilution, and public health professionals claiming "community participation" may intentionally or unintentionally prevent more meaningful participatory action. The principle of community-centred planning is seldom integrated into programme evaluation. We have previously argued that, to prevent ambiguity and abuse, a stronger and more explicit idea of community ownership is useful. Un-like "participation", "ownership" leaves little room for dilution., Method: This perspective piece explores a framework to support evaluating community ownership in planning, by emphasising decision-making power in health planning and management as a necessary element for evaluation alongside other outcomes. After defining the concept of community ownership, we identify and discuss challenges and research gaps related to implementing community ownership in health programme planning, management, and evaluation. Such issues include considering which communities have claims to programme ownership, alternative approaches to representation and participation that support ownership, gathering community values and preferences, and incorporating them into ongoing programme planning, management and evaluation. We consider methodological issues likely to arise when transitioning from gathering community voices - which is valuable but incomplete work - towards community decision making power in planning and evaluation., Results: We use cases from recent policy and research in Chile as examples to consider through the lens of this framework. Finally, we discuss some current constraints in implementing community ownership in healthcare planning and evaluation., Conclusion: We encourage exploring how to practice evaluation in ways that will further our ability to be helpful professional supporters of community self-determination in finding their paths to health., (© 2022 John Wiley & Sons Ltd.)

Introduction: Goal-setting in any practice context is vague unless the process is based on a framework that produces good goals. Popular goal-setting frameworks construct Specific, Measurable, Attainable, Realistic, and Time-bound (SMART) goal statements. Yet, research of how healthcare goals that are foundational to health plans are formulated is scanty. This case study explored the goal-setting practice of an organisation in Nigeria to discover the theoretical frameworks for setting the goals of their leprosy projects., Methods: The study triangulated individual semi-structured interviews of 10 leprosy managers with a review of their project plans and a participant observation of the organisation's annual planning event. A five-stage thematic analysis was used to serially identify, code, and integrate goal-setting themes from the data collected., Findings: This produced three final emergent themes: stakeholders, strategy, and goal statements, with 11 associated conceptual frameworks. All were further theoretically integrated into one general framework that illustrates the organisational goal-setting practice at the time of study. This revealed a practice with a four-staged linear centre-driven process that led to a top-down, problem-based goal formulation, and produced assigned project plans based on hierarchical non-SMART goal statements., Conclusion: Collaborative goal-setting process is proposed for Specific, Measurable, Attainable, Realistic, Timed, and Agreeable statements of project objectives and aims written with Change, Beneficiaries, Indicator, Target, Timeframe and Change, Beneficiaries, Location, and Timeframe models respectively., (© 2022 John Wiley & Sons Ltd.)

People with learning disabilities are living longer. Older people with learning disabilities should be included in policies and plans that are for all older people. National plans and policies for older people often do not say anything about older people with learning disabilities, and it is hard to know whether older people with learning disabilities are benefiting. People who plan services locally often do not have good information on older people with learning disabilities. Using the Equalities Act 2010 could help people who plan services and write policy to think about older people with learning disabilities but this is not happening at the moment. People who work with older people with learning disabilities should be aware of policy for all older people, so that older people with learning disabilities do not miss out. This paper seeks to explore the opportunities and challenges generated by current policy, guidance and legislation in England relating to older people, in terms of the practical implications for older people with learning disabilities. Using the broad themes housing, employment, social inclusion and isolation, care and support, and promoting better health and well-being, this paper discusses potential practical opportunities and concerns for older people with learning disabilities arising from policy and legislation such as current initiatives regarding integration, personalisation and the dementia policy. Consideration is given to the implications of changing policy and practice for both current and future generations of people with a learning disability as they reach older age. This discussion paper concludes that whilst there is potential for older people with a learning disability to benefit from policy and practice aimed at improving the lives of older people generally, the tendency for policy to be targeted at specific groups without adequately considering the diversity of those groups often leaves those with a learning disability at the margins of being able to make the most of changes. [ABSTRACT FROM AUTHOR]

Steering health systems towards universal health coverage requires research on themes that are of particular interest to health planning, management, policy and systems researchers. Some issues, such as strikes regarded as illegal and health sector corruption, because of their social and political sensitivity have, for too long, remained outside adequate research inquiry. Their emergence in the research agenda raises some challenges for Human Research Ethics Committees, particularly related to their conflicts of interests as reviewers, that need clarification., (© 2021 John Wiley & Sons Ltd.)

Objective: To assess how priority setting exercises for nutrition research are considered in publication.Design: Cross-sectional design.Settings: First, a citation analysis of priority setting exercises found in nutrition research until 2019 was conducted. The reasons for citation were extracted from the text of citing papers and the reasons were defined as: (i) acting on the research questions identified as priorities, (ii) acknowledging the priority setting exercise, (iii) using the same method, or (iv) previous knowledge to support evidence. Second, a survey with authors of the priority setting exercises was done to understand priority setters' perspectives on the impact and satisfaction of their work.Participants: Twenty-one priority setting exercise papers were included. In all, 434 citing papers were found, of which 338 were considered in the citation analysis. A sample of 17 authors representing 13 priority setting exercise papers completed the impact and satisfaction survey.Results: Half of the priority setting exercise papers were published by 2013. After excluding self-citations (n = 60), the priority setting papers had on average 18 citations. Priority setting exercises had a median of 1 (IQR = 0-1) citing manuscript that acted on the recommendations produced from priority setting exercises. Authors of the priority setting exercises expressed a desire for increased uptake of the results of the priority setting exercises by funding agencies. Key barriers for uptake were identified as challenges in involving stakeholders and the general public for participation in the priority setting exercise.Conclusions: Priority settings exercises are important efforts to guide nutrition research toward effective allocation of resources. However, there seems to be a limited consideration of these priority setting exercises in research papers. [ABSTRACT FROM AUTHOR]

Cyprus is a nation of great history, old and new, that makes up a controversial and often stressful environment in which social work is practiced. The intent of this paper is to highlight the Cypriot context and discuss how the Global Agenda is integrated in it. Drawing on the key objectives of the Global Agenda — promoting social and economic equalities; promoting the dignity and worth of peoples; promoting community and environmental sustainability; and, strengthening recognition of the importance of human relationships — the paper explores the challenges and barriers that social work in the nation faces in an attempt to promote the wellbeing and growth of communities, families and individuals. With consideration to the many and rich initiatives toward increasing social solidarity, collaboration and community engagement, the paper makes suggestions to overcome the challenges that prevent social work from fully committing to the agenda. [ABSTRACT FROM AUTHOR]

The article discusses the call for papers on building a health economy for all in 2023. Topics covered include the existing structural and economic inequalities exposed by the pandemic, and the reorientation of economies for health towards a vision in which every person and people can flourish physically and mentally with dignity and opportunity in a healthy living planet. Also noted are the four themes to build economies for health that the World Health Organization (WHO) Council focuses on.

Background: Disasters can cause casualties and significant financial loss. In accordance with the Sendai Framework for Disaster Risk Reduction, areas affected by disasters must be built back better. Accurate post-disaster damage and loss assessments are critical for the success of recovery programs. This scoping review aimed to identify the components and entities of the healthcare sector's post-disaster damage and loss assessment program. Methods: An comprehensive search for relevant literature was performed using several databases, including the Web of Science, PubMed, Scopus, ProQuest, and Magiran. The search was limited to papers published between 2010 and 2022. In addition, we searched the grey literature for resources related to post-disaster damage and loss assessments. Study selection and data extraction were evaluated by a third reviewer. The main themes were determined through a consensus process and agreement among team members. Results: A total of 845 papers were identified, 41 of which were included in the review. The grey literature search yielded 1015 documents, 23 of which were associated with the study's purpose. The findings were classified into five main themes, 20 subthemes, and 876 codes. The main-themes include the following: Concepts and Definitions; Post-Disaster Damage and Loss Assessment Procedures; Healthcare sector procedures; Assessments Tools, and Methods; Intra-sectoral, Inter-sectoral, and cross-cutting issues. Conclusions: The existing corpus of literature on post-disaster damage and loss assessment programs within the healthcare sector offers only limited insights into the entities and components involved. It is of great importance that stakeholders have an extensive grasp of these pivotal concepts and principles, as they are fundamental in enabling effective responses to disasters, informed decision-making, and facilitating rehabilitation and reconstruction efforts. Consequently, there is a considerable scope for further investigation in this area. Scoping review registration number: https://osf.io/nj3fk. [ABSTRACT FROM AUTHOR]

Population Health Management – often abbreviated to PHM – is a relatively new approach for healthcare planning, requiring the application of analytical techniques to linked patient level data. Despite expectations for greater uptake of PHM, there is a deficit of available solutions to help health services embed it into routine use. This paper concerns the development, application and use of an interactive tool which can be linked to a healthcare system's data warehouse and employed to readily perform key PHM tasks such as population segmentation, risk stratification, and deriving various performance metrics and descriptive summaries. Developed through open-source code in a large healthcare system in South West England, and used by others around the country, this paper demonstrates the importance of a scalable, purpose-built solution for improving the uptake of PHM in health services. [ABSTRACT FROM AUTHOR]

Background: Achieving universal health coverage (UHC) in the context of limited resources will require prioritising the most vulnerable and ensuring health policies and services are responsive to their needs. One way of addressing this is through the engagement of marginalised voices in the priority setting process. Public engagement approaches that enable group level deliberation as well as individual level preference capturing might be valuable in this regard, but there are limited examples of their practical application, and gaps in understanding their outcomes, especially with rural populations. Objective: To address this gap, we implemented a modified priority setting tool (Choosing All Together—CHAT) that enables individuals and groups to make trade‐offs to demonstrate the type of health services packages that may be acceptable to a rural population. The paper presents the findings from the individual choices as compared to the group choices, as well as the differences among the individual choices using this tool. Methods: Participants worked in groups and as individuals to allocate stickers representing the available budget to different health topics and interventions using the CHAT tool. The allocations were recorded at each stage of the study. We calculated the median and interquartile range across study participants for the topic totals. To examine differences in individual choices, we performed Wilcoxon rank sum tests. Results: The results show that individual interests were mostly aligned with societal ones, and there were no statistically significant differences between the individual and group choices. However, there were some statistically significant differences between individual priorities based on demographic characteristics like age. Discussion: The study demonstrates that giving individuals greater control and agency in designing health services packages can increase their participation in the priority setting process, align individual and community priorities, and potentially enhance the legitimacy and acceptability of priority setting. Methods that enable group level deliberation and individual level priority setting may be necessary to reconcile plurality. The paper also highlights the importance of capturing the details of public engagement processes and transparently reporting on these details to ensure valuable outcomes. Public Contribution: The facilitator of the CHAT groups was a member from the community and underwent training from the research team. The fieldworkers were also from the community and were trained and paid to capture the data. The participants were all members of the rural community‐ the study represents their priorities. [ABSTRACT FROM AUTHOR]

In 2016 WHO launched the priority assistive products list (APL) consisting of 50 products and recommended that using this as a reference, countries should develop their own contextually relevant national APLs. This paper describes the development of Malawi's APL. Two hundred and ninety-six persons with disabilities participated in a rapid Assistive Technology Assessment (rATA) survey. Six focus group discussions (FGDs) with people with various types of disabilities were conducted. The rATA questionnaire and FGDs collected data on assistive products (APs) participants used, APs they needed and the challenges they experienced. Data collection was done in six districts spread across the three regions in Malawi. All age groups were included in the survey. Persons with disabilities aged less than 18 participated but went with their guardians. All persons who participated in this study provided consent. Survey and FGDs results were presented at an APL consensus meeting with policymakers, service providers, disabled peoples' organizations and development partners in the disability sector. Based on the results and further discussions, a consensus was reached on the priority APs for Malawi. More than a third of respondents used wheelchairs (32%), followed by auxiliary crutches (25%), walking sticks (13%), reading glasses (11%), prosthesis (10%), elbow crutches (9%) and orthosis (8%). There is also a high demand for products such as pull-up underwear (incontinence products) (79%), hearing aids (70%), reading glasses (59%) and diapers (63%). After intensive discussions during a consensus meeting, an agreement was reached on the 22 priority APs for Malawi. There is a wide range of APs being used by people with different functional limitations in Malawi. There is also a demand for APs that are not readily available. When developing an APL, the list should include products in use, those in demand, and those recommended by service providers. Following the development of the priority assistive products list (APL) by WHO, member states should develop their own contextually based APL. The development of the APL should be based on research evidence. All key stakeholders including persons with disabilities and other functional limitations, government, and development partners should participate in this process. The APL should be part of the national health system or community services. The Department of Disability and Elderly Affairs in the Ministry of Gender, Community Development, being the Government of Malawi line ministry coordinating disability issues participated actively in this study including inviting participants in the stakeholders' validation workshop. [ABSTRACT FROM AUTHOR]

The prevalence and attributable risk of disease due to physical inactivity require it to be made a public health priority. Public health planning allows for prioritization and resource allocation, particularly at the state and local levels. The extent to which state planning efforts for physical activity exist in the United States is unknown. The purpose of this paper is to describe the scope in which physical activity is incorporated in state-level public health plans in the United States, with an emphasis on alignment with the national guidelines and the National Physical Activity Plan. A standardized internet search audit was developed and conducted for each of 50 US states and the District of Columbia between May 2017 and January 2018 to determine the prevalence and characteristics of health planning documents that include physical activity. Data abstracted for analysis used a standardized search protocol that included the components of the Physical Activity Guidelines for Americans and the US National Physical Activity Plan. Results found that most states had between 4 and 6 chronic disease prevention and control plans that mention physical activity; however, it was inconsistently aligned with recommendations from both the Guidelines and the National Plan. Only 2 states had stand-alone public health planning documents explicitly dedicated to physical activity promotion. No state planning documents addressed children and adolescents, adults, and older adults simultaneously. To be maximally effective, state public health planning for physical activity should be made a priority and these efforts should align as much as possible with current guidance from the Physical Activity Guidelines for Americans and the US National Physical Activity Plan. [ABSTRACT FROM AUTHOR]

The veterinary profession has been at the forefront of ensuring that health planning is now widely adopted in the farm animal sector; however, health planning is not widely undertaken in the goat sector. This may in part be due to the relatively small number of goats kept in the UK, but also to the wide variety of reasons for which goats are kept, from commercial dairy herds to hobby purposes. This article describes the areas that should be considered when constructing a health plan for goats. [ABSTRACT FROM AUTHOR]

Introduction: Achieving universal health coverage requires using research evidence to inform decision-making. However, little information is available on the use of research evidence in planning in lower middle-income countries, including Tanzania. This paper presents a protocol that aims to investigate the usage of research evidence in health planning, determinants and readiness of the planning team members to use knowledge translation tools in Tanzania., Methods and Analysis: This study will employ a sequential exploratory mixed-methods design, with participants selected from national, regional and council levels. Qualitative data will be collected through a maximum of 52 in-depth interviews and 12 focused group discussions until saturation. To collect quantitative data, a structured questionnaire will be used to survey 422 participants, and a document review will be conducted from health facilities. Qualitative data will be analysed using thematic analysis, while descriptive and inferential analyses will be employed for quantitative data., Ethics and Dissemination: The study participants will provide written informed consent, and all recorded data will be stored on a secured research server accessible only to the investigators. Ethical approval has been obtained from the University of Dodoma Research Ethics Committee (ref. MA.84/261/02/'A'/64/91). The findings of this study will inform policymakers, researchers and implementers in the country on the use of research evidence in decision-making. We will disseminate our findings through publications, conferences, workshops and interactive communication with national, regional, council and health facility planning teams., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The health benefits of regular physical activity (PA) in youth are well-documented. Yet the adherence rate to PA guidelines among youth worldwide is alarmingly deficient with only 19% of youth worldwide adhering to the World Health Organization guidelines. This is reflective of a global proliferation of a physical inactivity pandemic among youth. The negative consequences of physical inactivity on health are profound, as they threaten to persist into adulthood, exacerbating the burden of preventable health issues. There is persuasive evidence that vigorous PA generates physical fitness and health benefits surpassing those of low- or moderate-intensity activity in youth. In addition, indications show that the adherence rate to vigorous PA among youth exceeds that relative to for low- or moderate-intensity activity. As a result, promoting vigorous PA can help mitigate the global issue of low adherence to PA in youth. Therefore, in this Current Opinion paper, we argue that vigorous PA, compared to low or moderate-intensity activity, holds greater significance for youth's health and physical fitness. Additionally, the potential implications derived from the existing evidence regarding vigorous PA on the current guidelines for youth are discussed. Key Points: The health benefits of regular physical activity in youth are well-established. Yet the adherence rate to physical activity guidelines among youth worldwide is alarmingly deficient with around 80% of youth worldwide not adhering to the World Health Organization guidelines. Persuasive evidence derived from observational, controlled interventions, as well as narrative and systematic reviews with meta-analysis, indicate that vigorous physical activity generates positive effects exceeding those induced by low- or moderate-intensity activity on youth health and physical fitness. The next generation of physical activity recommendations should place a greater emphasis on the significance of vigorous physical activity for youth. [ABSTRACT FROM AUTHOR]

Palliative care is expanding in Africa as the continent faces a rising disease burden. As the specialty takes form, it is important to acknowledge the cultural mores regarding health and disease. Many Africans perceive health as more than the individual's physical body, instead include the spirituality and well-being of family, community and ancestors. Much of living is done with the goal of becoming an ancestor, which is tied to the individual's burial and ceremonies. Despite their importance, conversations about death are often thought to be culturally taboo. This poses a challenge to palliative care which is based on the individual preferences and priorities, usually identified through shared decision-making. Little is known about the end-of-life priorities and preferences in Africa, leading to the research question: What are the end-of-life preferences and priorities for community dwelling adults in Mozambique? This paper examines instruments that can be used to measure end-of-life preferences. [ABSTRACT FROM AUTHOR]

Lao People's Democratic Republic (Lao PDR) aims at graduating from least developed country status by 2026 and must increase the level of domestic financing for health. This paper examines how the government has prepared for the decline of external assistance and how donors have applied their transition approaches. Adapting a World Health Organization (WHO) framework, reflections and lessons were generated based on literature review, informal and formal consultations and focus group discussions with the Lao PDR government and development partners including budget impact discussion. The government has taken three approaches to transition from external to domestic funding: mobilizing domestic resources, increasing efficiency across programs and prioritization with a focus on strengthening primary health care (PHC). The government has increased gradually domestic government health expenditures as a share of the government expenditure from 2.6% in 2013 to 4.9% in 2019. The Ministry of Health has made efforts to design and roll out integrated service delivery of maternal, newborn, child, and adolescent health services, immunization and nutrition; integrated 13 information systems of key health programs into one single District Health Information Software 2; and prioritized PHC, which has led to shifting donors towards supporting PHC. Donors have revisited their aid policies designed to improve sustainability and ownership of the government. However, the government faces challenges in improving cross-programmatic efficiency at the operational level and in further increasing the health budget due to the economic crisis aggravated during Coronavirus disease 2019 (COVID-19). Working to implement donor transition strategies under the current economic situation and country challenges, calls into question the criteria used to evaluate transition. This criterion needs to include more appropriate indicators other than gross national income per capita, which does not reflect a country's readiness and capacity of the health system. There should be a more country-tailored strategy and support for considering the context and system-wide readiness during donor transition., (© World Health Organization, 2024. All rights reserved. The World Health Organization has granted the Publisher permission for the reproduction of this article.)

Monitoring health is key for identifying priorities in public health planning and improving healthcare services. Life expectancy has conventionally been regarded as a valuable indicator to compare the health status of different populations. However, this measure is simply the mean of the distribution of the length of life and, as such, neglects individual disparities in health outcomes. In this paper, we use life tables from the UN World Population Prospects to develop the most comprehensive dataset of lifespan inequality and polarization for 258 countries and areas for the period 1950–2021. These extensive series on lifespan distributions provide access to crucial information for researchers, practitioners, and the general public, thus contributing to a better understanding of health differences within and between nations. [ABSTRACT FROM AUTHOR]

Attaining Sustainable Development Goal 3 (SDG 3: Health and Well‐Being) faces a dual challenge of diminishing returns of established intervention designs, and a threat to future gains from complex inter‐connected global health challenges like antimicrobial resistance and global biodiversity loss. The growing movement of context‐sensitive approaches could help realise yet untapped potential for intervention designs, but contemporary global health policy and research still remain dominated by a model of individual market style choices. This paper therefore aims to support the development of global health planning processes that are more grounded and integrative across the SDGs. Reiterating calls for disruptive policy change is unlikely to impact the modus operandi of global health policy and research. This paper therefore builds on a logic that already finds widespread and intuitive application in their underlying planning processes: 'the market'. However, it challenges the dominant supply‐and‐demand approach to healthcare markets and redefines them from a strategic marketing perspective. Translated to the interface of populations and health systems, the strategic market is a site for solving problems that are defined by people with multidimensional health needs. This framework offers four guiding questions to define the strategic market and six premises as a simple intellectual starting point and checklist for more grounded and inter‐sectorial action across the SDGs. The analysis of data from one of the largest behavioural survey data sets, covering 6683 villagers across China, India, Lao PDR and Thailand, demonstrates the relevance of the premises empirically. [ABSTRACT FROM AUTHOR]

Introduction: Although Jordan has made significant progress toward expanding the utilization of facility‐based intrapartum care, prior research highlights that poor service quality is still persistent. This study aimed to identify quality gaps between women's expectations and perceptions of the actual intrapartum care received, while exploring the contributing factors. Methods: Utilizing a pre–post design, quality gaps in intrapartum care were assessed among 959 women pre‐ and postchildbirth at a prominent tertiary hospital in northern Jordan. Data were gathered using the SERVQUAL scale, measuring service quality across reliability, responsiveness, tangibles, assurance, and empathy dimensions. Results: The overall mean gap score between women's expectations and perceptions of the quality of intrapartum care was −0.60 (±0.56). The lowest and highest mean gap scores were found to be related to tangibles and assurance dimensions, −0.24 (±0.39) and −0.88 (±0.35), respectively. Significant negative quality gaps were identified in the dimensions of assurance, empathy, and responsiveness, as well as overall service quality (p < 0.001). The MLR analyses highlighted education (β = 0.61), mode of birth (β = −0.60), admission timing (β = −0.41), continuity of midwifery care (β = −0.43), physician's gender (β = −0.62), active labour duration (β = 0.37), and pain management (β = −0.33) to be the key determinants of the overall quality gap in intrapartum care. Conclusion: Our findings underscore the importance of fostering a labour environment that prioritizes enhancing caregivers' empathetic, reassuring, and responsive skills to minimize service quality gaps and enhance the overall childbirth experience for women in Jordan. Patient or Public Contribution: This paper is a collaborative effort involving women with lived experiences of childbirth, midwives, and obstetrics and gynaecologist physicians. The original idea, conceptualization, data generation, and coproduction, including manuscript editing, were shaped by the valuable contributions of stakeholders with unique perspectives on intrapartum care in Jordan. [ABSTRACT FROM AUTHOR]

This paper aims to pay tribute to Mariupol and its inhabitants, the Ukrainian city which was entirely destroyed by the Russian army. Before the full-scale invasion, significant developments were happening in the field of mental health. The experience gained in that city, examples of good practices and active collaboration between the city administration, local professionals and the international development project "Mental Health for Ukraine", formed the foundation of interventions that were transferred to other regions in Ukraine. This paper describes the key steps, actions undertaken in 2019 to 2021 and achievements of the programme. Personal reflections also describe the context and experiences. [ABSTRACT FROM AUTHOR]

Health services research is underpinned by partnerships between researchers and health services. Partnership-based research is increasingly needed to deal with the uncertainty of global pandemics, climate change induced severe weather events, and other disruptions. To date there is very little data on what has happened to health services research during the COVID-19 pandemic. This paper describes the establishment of an Australian multistate Decolonising Practice research project and charts its adaptation in the face of disruptions. The project used cooperative inquiry method, where partner health services contribute as coresearchers. When the COVID-19 pandemic hit, data collection needed to be immediately paused, and when restrictions started to lift, all research plans had to be renegotiated with services. Adapting the research surfaced health service, university, and staffing considerations. Our experience suggests that cooperative inquiry was invaluable in successfully navigating this uncertainty and negotiating the continuance of the research. Flexible, participatory methods such as cooperative inquiry will continue to be vital for successful health services research predicated on partnerships between researchers and health services into the future. They are also crucial for understanding local context and health services priorities and ways of working, and for decolonising Indigenous health research. [ABSTRACT FROM AUTHOR]

Simple Summary: As COVID-19 shifts from pandemic to endemic, emerging variants may be more or less virulent. Predicting whether an emerging COVID-19 variant has of high risk of causing severe disease is needed to plan for potential burdens on hospital capacity and protecting vulnerable populations. However, it takes time to do laboratory and animal experiments to determine whether a new genetic variant might be more severe, and the results may not be representative of when the virus infects humans. By the time there is epidemiological data on the severity of disease associated with a new variant, it can be too late for designing an optimal public health response. There is a critical need for computer models that can predict severe disease risk from genetic sequence data, which can be obtained from just the first few infections in a potential incoming wave. Two key challenges make computer modeling difficult: (1) sequence changes are complex, and (2) using historical data to predict future disease requires accounting for the confounding effects of changing patient demographics, improving therapeutics, and increased vaccination. In this paper, we introduce a novel interpretable deep learning architecture to solve this problem, demonstrating that it can make robust predictions for emerging variants. Through the COVID-19 pandemic, SARS-CoV-2 has gained and lost multiple mutations in novel or unexpected combinations. Predicting how complex mutations affect COVID-19 disease severity is critical in planning public health responses as the virus continues to evolve. This paper presents a novel computational framework to complement conventional lineage classification and applies it to predict the severe disease potential of viral genetic variation. The transformer-based neural network model architecture has additional layers that provide sample embeddings and sequence-wide attention for interpretation and visualization. First, training a model to predict SARS-CoV-2 taxonomy validates the architecture's interpretability. Second, an interpretable predictive model of disease severity is trained on spike protein sequence and patient metadata from GISAID. Confounding effects of changing patient demographics, increasing vaccination rates, and improving treatment over time are addressed by including demographics and case date as independent input to the neural network model. The resulting model can be interpreted to identify potentially significant virus mutations and proves to be a robust predctive tool. Although trained on sequence data obtained entirely before the availability of empirical data for Omicron, the model can predict the Omicron's reduced risk of severe disease, in accord with epidemiological and experimental data. [ABSTRACT FROM AUTHOR]

Aim: This paper explores the principles of co‐design with Aboriginal and Torres Strait Islander communities by reflecting on the literature, learning from experiences of allied health professionals, and considering how co‐design can be applied in rural and remote allied health practice. Context: This paper has been authored by a working group from Services for Rural and Remote Allied Health (SARRAH). SARRAH is a member‐based allied health organisation, working to improve health outcomes for rural and remote Australians. SARRAH has been representing and supporting allied health professionals in rural and remote Australia for over 20 years, with a member base that includes students, practitioners, programme managers, policy makers and academics. As a non‐Indigenous organisation, SARRAH works in partnership and receives guidance from the peak organisation, Indigenous Allied Health Australia (IAHA). Approach: Over a period of 3 months, a group of eleven SARRAH members and staff came together to review available literature, seek member perspectives and share their experiences and understandings of co‐design. Working group discussions were grounded in the knowledge and experiences shared by two Aboriginal and Torres Strait Islander group members. Conclusion: This paper proposes that successful co‐design with Aboriginal and Torres Strait Islander communities places legitimate value on different knowledge systems, is built on strong and trusting relationships, promotes inclusive involvement and requires authentic partnerships. Using these principles, SARRAH will engage with members and stakeholders to influence meaningful change in allied health practice in rural and remote Australia. [ABSTRACT FROM AUTHOR]

Background: In most developed countries, the number of cancer survivors is expected to increase in the coming decades because of rising incidence and survival rates and an aging population. These patients are heterogeneous in terms of health service demands: from recently diagnosed patients requiring first-course therapy to patients with extensive care needs and severe disabilities to long-term survivors who only need minimal care. Therefore, in terms of providing healthcare planners and policymakers with useful indicators for addressing policies according to health service demands, it is worth supplying updated measures of prevalence for groups of patients based on the level of care they require. The aim of this paper is to illustrate a new method for estimating short-term projections of cancer prevalence by phase of care that applies to areas covered by cancer registration. Methods: The proposed method combines linear regression models to project limited duration prevalence derived from cancer registry data and a session of the freely available software COMPREV to estimate the projected complete prevalence into three distinct clinically relevant phases of care: initial, continuing, and final. The method is illustrated and validated using data from the Veneto region in Italy for breast, colorectal, and lung cancers. Results: Prevalence is expected to increase in 2015-2026 for all considered cancer sites and sexes, with average annual variations spanning from 2.6% for women with lung cancer to 0.5% for men with colorectal cancer. The only exception is lung cancer prevalence in men, which shows an average annual decrease of 1.9%. The majority of patients are in the continuing phase of care, followed by the initial and final phases, except for lung cancer, where the final phase of care prevails over the initial one. Discussion: The paper proposes a method for estimating (short-term) future cancer healthcare needs that is based on user-friendly and freely available software and linear regression models. Validation results confirm the applicability of our method to the most frequent cancer types, provided that cancer registry data with at least 15 years of registration are available. Evidence from this method is addressed to policymakers for planning future cancer care, thus improving the cancer survivorship experience for patients and caregivers. [ABSTRACT FROM AUTHOR]

It is uncontroversial to claim that the extent to which health care interventions benefit patients is a relevant consideration for health care priority setting. However, when effects accrue to the individual patient, effects of a more indirect kind may accrue to other individuals as well, such as the patient's children, friends, or partner. If, and if so how, such relational effects should be considered relevant in priority setting is contentious. In this paper, we illustrate this question by using disease‐modifying drugs for Alzheimer's disease as a case in point. The ethical analysis begins by sketching the so‐called prima facie case for ascribing moral weight to relational effects and then moves on to consider a number of objections to it. We argue that, whereas one set of objections may be dismissed, there is another set of arguments that poses more serious challenges for including relational effects in priority setting. [ABSTRACT FROM AUTHOR]

This paper offers a new child‐centred methodology that explores children's visions of their futures, encourages self‐reflection and depth and shares children's voices with peers and researchers, as unbrokered as possible. This final stage of a longitudinal, arts‐based, social science‐informed project was delivered by partnering with schools in socially disadvantaged areas of Bristol, a UK city. Our two‐phase activity used a Tree metaphor to explore children's hopes, ambitions and support, looking forward to recovery from the COVID‐19 pandemic. The analysis combined multi‐disciplinary thematic and visual‐narrative analysis, and revealed diversity, intersection and individuality in themes that scaled out from the child and their family over different timescales. Themes included emotion (concerns; empathy), experiences (happenings, resources skills; aspirations) and relationships, linked to their recent experiences of COVID‐19 mitigation. The paper reflects critically on children's and researchers' positionality, and the complexities involved in developing research methods that encourage children's autonomy, agency and authenticity. [ABSTRACT FROM AUTHOR]

This paper seeks to explore how hospitals can be reconfigured to adopt more 'health-promoting' approaches and values. Specifically, the paper focuses on the role of hospital chaplaincy and argues that spiritual care should be considered alongside other health domains. Using semi-structured interviews, the aim of the paper is to explore the experiences of patients who accepted (n = 10) and declined (n = 10) hospital chaplaincy services. Data were analysed drawing on principles of interpretative phenomenological analysis (IPA). The findings suggested that participants who accessed chaplaincy services reported using the chaplains for pastoral, religious and spiritual care which contributed positively to their sense of well-being. This included religious rituals and supportive conversations. The majority of these participants had existing links with a faith institution. Participants who declined chaplaincy services reported having personal religious or spiritual beliefs. Other reasons cited, included: that the offer was made close to discharge; they had different support mechanisms; they were unaware of what the chaplaincy service offered. Participants identified a number of skills and attributes they associated with chaplains. They perceived them as being religious but available to all, somebody to talk to who was perceived as impartial with a shared knowledge and understanding. The paper concludes by highlighting the important role of chaplaincy as part of a holistic health-promoting hospital. This has implications not only for the design, delivery and promotion of chaplaincy services but also for health promotion more broadly to consider spiritual needs. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to delineate the relationships between actors and contextual factors associated with the development of the advanced practice role in Catalonia. Methods: A complementary data analysis was conducted based on the social network analysis (SNA) method. The primary study design was qualitative, descriptive and explanatory. Participants from diverse perspectives of practice, organization and external environment were engaged to participate in semi‐structured focus groups. Data collection was conducted between March and May 2016 in Catalonia, Spain. Participants were asked to report on various dimensions of the role development context: understanding of the role, felt needs, perceived outcomes, barriers and facilitators. Results: Primary data analysis performed for 44 participants identified 71 related contextual factors associated with role development. Complementary network analysis revealed multiple relationships and agreements among participants and context‐related themes. Professional roles and disciplines clustered around topics show consensus and the significance of topics. Conclusion: Understanding the level of interactions and consensus among participants and contextual factors will ultimately allow better insight into how complex contexts influence the development of advanced practice nursing in healthcare organizations. Significant, consensual contextual factors should be used to influence further development and implementation of new roles that affect patient care and outcomes. Summary statement: What is already known about this topic? Comprehensive understanding of context at various levels should generate greater knowledge about what affects advanced practice role development locally and globally.What this paper adds? Findings could help organizations to make sense of the full dimension of context and to predict or act on development of advanced practice nursing roles.The implications of this paper: Significant, consensual contextual factors should be used to influence further development and implementation of new roles that affect patient care and outcomes. [ABSTRACT FROM AUTHOR]

What is known about the topic? When assessing real growth in costs, it is important to adjust for inflation through indexation to the Consumer Price Index (CPI). The change in prices or costs over time can be calculated in constant currency amounts by adjusting by a ratio of the CPI in the year of interest to the CPI in the baseline year. What does this paper add? Rosenberg et al. (2022) did not calculate out-of-pocket costs in constant currency, which does not give an accurate estimation of costs adjusted for inflation. What are the implications for practitioners? We calculated examples to illustrate the impact of such adjustments, which substantially impact the results of the study. [ABSTRACT FROM AUTHOR]

Background: Adaptation to climate change (CC) is a priority for Small Island Developing States (SIDS) in the Caribbean, as these countries and territories are particularly vulnerable to climate-related events. Primary health care (PHC) is an important contributor to CC adaptation. However, knowledge on how PHC is prepared for CC in Caribbean SIDS is very limited. The aim of this paper is to discuss health system adaptation to climate change, with a focus on PHC. Methods: We explored the perspectives of PHC professionals in Dominica on PHC adaptation to climate change. Focus group discussions (FGDs) were conducted in each of the seven health districts in Dominica, a Caribbean SIDS, between November 2021 and January 2022. The semi-structured interview guide was based on the Essential Public Health Functions: assessment, access to health care services, policy development and resource allocation. Data coding was organized accordingly. Results: Findings suggest that health care providers perceive climate change as contributing to an increase in NCDs and mental health problems. Climate-related events create barriers to care and exacerbate the chronic deficiencies within the health system, especially in the absence of high-level policy support. Healthcare providers need to take a holistic view of health and act accordingly in terms of disease prevention and health promotion, epidemiological surveillance, and ensuring the widest possible access to healthcare, with a particular focus on the environmental and social determinants of vulnerability. Conclusion: The primary health care system is a key stakeholder in the design and operationalization of adaptation and transformative resilience. The Essential Public Health Functions should integrate social and climate and other environmental determinants of health to guide primary care activities to protect the health of communities. This study highlights the need for improved research on the linkages between climate events and health outcomes, surveillance, and development of plans informed by contextual knowledge in the SIDS. [ABSTRACT FROM AUTHOR]

While innovation is known to catalyse solutions to global sustainable development challenges, lack of engagement from stakeholders during conceptualisation and development may influence the degree of success of implementation. This paper presents a complete and novel engagement methodology, developed from value led business modelling approaches, for working with multi-sector stakeholders. The methodology can be used to determine barriers and facilitators to clinical practice innovations or translational research, within a country-specific context. The approach has then been applied in the Cambodian prosthetics and orthotics sector to provide a practice-based exemplar application of the framework. This approach seeks to ensure the suitability and sustainability of clinical practice and research programmes being implemented within a complex ecosystem. A theoretical basis, drawn from academic and business innovation sectors, has been consolidated and adapted for practical application to design, direct, and inform initiatives in low resource settings. The methods presented provide a way to both develop and articulate the mission, vision, and goals of any proposed change, and to effectively communicate these with stakeholders in a way that engages the personal and professional values that exist in their ecosystem. It provides a structured process through which meaningful conversations can happen, and a basis for relationship management with key stakeholders; intrinsic to enable a sustained legacy from research and development. The engagement from stakeholders during conceptualisation and throughout development can determine the success, or not, of any implementation and scale of innovation. This paper presents a conceptual stakeholder-led engagement methodology, developed from value led business modelling approaches, for determining barriers and facilitators to translational global healthcare research in a country-specific context, in this case the Cambodian prosthetics and orthotics sector. Subsequent research and development work in this area needs to carefully manage and negotiate influencing factors identified through the application of the described methodology, to ensure initiatives (whether research or wider national development work) are sustainable and successful. [ABSTRACT FROM AUTHOR]

Influenza, surpassing all other respiratory diseases in both morbidity and mortality, annually triggers seasonal epidemics responsible for approximately 500,000 global deaths. Mathematical epidemic models serve as valuable tools for forecasting potential outbreaks and predicting the trajectory of the disease. This paper represents a comprehensive SEIRVS model tailored to the context of Influenza transmission dynamics in North Macedonia. In this paper the classical Susceptible- Exposed- InfectiousRecovered (SEIR) model is enhanced by incorporating vaccination and a death compartment while examining their impact on the spread of Influenza through the population. Simulations are conducted using data from the 2022/2023 season, focusing on a case study of North Macedonia. The simulations were conducted utilizing both the actual vaccination rate in N. Macedonia for that season and an increased vaccination rate to observe the influence of vaccination. The simulation results emphasize the need to increase the vaccination rate. The findings contribute valuable insights for public health planning and policy making. [ABSTRACT FROM AUTHOR]

This paper sets out the Collaborative Service Design Playbook, to guide planning, design, and implementation of co-created health services. Successful health service development and implementation is best guided by theoretically informed approaches; however, organisations often lack design and implementation know-how and have difficulty applying it. This study seeks to improve health service design and potential for scale-up by proposing a tool to guide an end-to-end process, drawing together service design, co-design, and implementation science; and exploring the tool's feasibility to establish a sustainable service solution developed with participants and experts that is scalable and sustainable. The Collaborative Service Design Playbook phases include, (1) Define the opportunity and initiatives, (2) Design the concept and prototype, (3) Deliver to scale and evaluate; and (4) Optimise to transform and sustain. This paper has implications for health marketing through providing an end-to-end approach with phased guidance for health service development, implementation, and scale up. [ABSTRACT FROM AUTHOR]

Objective: Pharmacotherapeutic Follow-up is the Professional Pharmaceutical Care Service aimed at detecting Drug-Related Problems for the prevention and resolution of negative medicine outcomes. The Dader Method is considered a clear and simple tool to develop Pharmacotherapeutic Follow-up. This research aims to analyze the evolution of the international scientific production related to Pharmacotherapeutic Follow-up and the Dader Method to show the current situation of this Professional Pharmacy Assistance Service. In addition, from the data obtained, we give a critical perspective on the implementation of the Dader Method in Community Pharmacy, considering its advantages and disadvantages based on the published scientific literature. Methods: Using bibliometrics tools, indicators were obtained to analyze the international production of scientific articles on Pharmacotherapeutic Follow-up and the Dader Method during the period (1999-2022) through the Scopus database. Results: The results showed a growth in the international scientific production of publications on Pharmacotherapeutic Follow-up, obtaining 30,287 papers, placing the United States, the United Kingdom, Australia, Canada and Spain as the five most productive countries. The publication of 83 papers on the Dader Method places Spain with the highest number of publications, followed by other Spanish or Portuguese speaking countries, among which Brazil and Colombia have the most prominent number of published papers in Latin America. The most frequent international journal covering the topic of Pharmacotherapeutic Follow-up was the American Journal of Health-Pharmacy (12.4%), while on the Dader Method, the journal Pharmaceutical Care Spain (21.7%) is in the first position, followed by Farmacia Hospitalaria (8.4%). Conclusion: The publications on the Dader method highlighs the greater productivity of the University of Granada and the author María José Faus Dáder. The inclusion of patients in the PTF service using the Dader Method, is more frequent in the hospital context, and is based on the presence of defined chronic pathologies (mainly diabetes), polymedication or specialized care follow-up, with elderly population being the most represented in all cases. [ABSTRACT FROM AUTHOR]

Investing in nursing and its leadership has been a key global priority in achieving world health. This paper aims to explore what it means to invest in nursing and its leadership and whether we are progressing in its endeavour. Consideration is given to whose responsibility it is to invest, the importance of education to support strategic nurse leaders and enable them to have a voice to lead as well as create a culture in which their staff wish to stay. Further, the paper explores the importance of each country accepting responsibility for developing and funding its strategic workforce plan and paying nurse professionals fairly and taking steps to reduce workforce shortages. Finally, the paper examines the progress the United Kingdom is making and concludes that investment in nursing is everyone's business, the government, healthcare organisations, society and above all nurses themselves. Collectively, we must step up to influence change and have nursing voices heard. [ABSTRACT FROM AUTHOR]

In response to the recent Productivity Commission report into mental health, the previous Federal Government announced its intention to produce a new national agreement that lays the platform for Australia's sixth national mental health plan. It has been recommended mental health move to a more regional model of governance and planning, away from a centralised, top‐down approach, partly in response to broader reforms affecting health care, and partly in direct response to consistent inquiry evidence that the mental health system remains in crisis. The past 30 years of mental health planning have been centralised. Successive national plans set a broad framework, with real decisions about mental health funding and service allocation made in the health departments of our capital cities. Will the next plan sponsor or inhibit regionality in mental health planning? This paper assesses Australia's historical approach to health planning particularly as it affected mental health and the costs arising. In learning these lessons, we propose the necessary ingredients to facilitate a regional, innovative, and effective approach to decentralised planning, for better mental health outcomes. We cannot afford to replicate the failed planning approaches of the past. Summary at a glance Mental health has been challenged to replace historical, centralised approaches for decentralised regional planning approaches to foster choice, innovation, and effective service provision. The past 30 years of central planning have demonstrated its limitations. Federal and State governments should create an enabling environment to free‐up local implementation and operationalise a social determinants approach. [ABSTRACT FROM AUTHOR]

During the emergence of a novel pandemic, predictive modelling process is more important in the phase of public health planning and response. Relating models to data provides a view into unseen variables, such as the occurrence of cryptic transmission and the prevalence of infection. These models allow exploration of counterfactuals and hypothetical interventions. Predictive modelling is a valuable model based on the clear definition and estimation of the variables. Researchers or policy makers who use the model outputs have a clear understanding of what can and cannot be achieved by this method. The results of this study are suggested that substantially more cases were present in many countries than were reported in the official statistics. In this paper we have identified the potential discrepancy between reported cases and true disease burden provided a crucial early warning to the international community. In this research paper we proposed statistical modelling and data-driven computer simulations provided accurate projections of global epidemic dispersal, quantifying the role of physical distancing in places and reductions in international travel on the spatiotemporal pattern of spread of COVID-19 based on Linear regression analysis. [ABSTRACT FROM AUTHOR]

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Background: Little is known about the interventions required to build the capacity of mental health policy-makers and planners in low- and middle-income countries (LMICs). We conducted a systematic review with the primary aim of identifying and synthesizing the evidence base for building the capacity of policy-makers and planners to strengthen mental health systems in LMICs. Methods: We searched MEDLINE, Embase, PsycINFO, Web of Knowledge, Web of Science, Scopus, CINAHL, LILACS, ScieELO, Google Scholar and Cochrane databases for studies reporting evidence, experience or evaluation of capacity-building of policy-makers, service planners or managers in mental health system strengthening in LMICs. Reports in English, Spanish, Portuguese, French or German were included. Additional papers were identified by hand-searching references and contacting experts and key informants. Database searches yielded 2922 abstracts and 28 additional papers were identified. Following screening, 409 full papers were reviewed, of which 14 fulfilled inclusion criteria for the review. Data were extracted from all included papers and synthesized into a narrative review. Results: Only a small number of mental health system-related capacity-building interventions for policy-makers and planners in LMICs were described. Most models of capacity-building combined brief training with longer term mentorship, dialogue and/or the establishment of networks of support. However, rigorous research and evaluation methods were largely absent, with studies being of low quality, limiting the potential to separate mental health system strengthening outcomes from the effects of associated contextual factors. Conclusions: This review demonstrates the need for partnership approaches to building the capacity of mental health policy-makers and planners in LMICs, assessed rigorously against pre-specified conceptual frameworks and hypotheses, utilising longitudinal evaluation and mixed quantitative and qualitative approaches. [ABSTRACT FROM AUTHOR]