Abstract Background Organizational Health Literacy (OHL) refers to the extent to which organizations facilitate equitable access, comprehension, and use of health information and services for informed decision-making. Objective This study aimed to (1) review and map existing OHL frameworks and (2) propose an innovative OHL framework that addresses gaps identified in current models. Methods A systematic search of academic (Web of Science, Scopus, MEDLINE) and grey literature from the past 15 years was conducted to identify OHL frameworks. This scoping review followed the PRISMA-ScR guidelines and the Arksey and O’Malley model. A new OHL intervention framework was developed to address gaps in existing models, based on the principles of preventive medicine and the public health action cycle. Results A total of 19 records were included (10 from academic databases and 9 from grey literature), covering diverse approaches and contexts related to OHL. Four intervention levels were identified: integrating HL into formal education, implementing HL assessments, developing interventions for vulnerable populations, and enhancing accessibility to health resources. The proposed framework emphasizes intersectoral collaboration and communication pathways between education and healthcare sectors, facilitating information exchange to continuously adapt interventions to population needs. Conclusion OHL development requires intersectoral collaboration; however, interoperability between sectors remains unaddressed in existing frameworks. This study proposes an innovative model that fosters sectoral connections toward a shared goal, creating a truly collaborative framework.

This study provides a comprehensive overview of wastewater surveillance studies on pathogens, identifies key characteristics of studies that are associated with public health actions, and highlights the actions resulting from these studies. Many studies refer to the value of wastewater surveillance in public health decision-making, but it remains unclear how many studies support public health action and whether this is incorporated into study designs. Therefore, we conducted a scoping review following PRISMA guidelines and used the machine learning tool ASReview to identify wastewater surveillance studies monitoring pathogen circulation in human populations, followed by correlational analyses. A total of 974 studies were included, of which only 84 described public health action. Merely 28 of these incorporated strategies to facilitate action within their study designs. Studies leading to public health action primarily monitored viruses, e.g., SARS-CoV-2 and poliovirus, and since 2024 also influenza A and B virus, respiratory syncytial virus, hepatitis A virus and mpox virus. Furthermore, studies conducted by public health institutes or targeting non-standard locations are more likely to result in action, whereas those with larger population sizes or focusing on residential areas are less likely to result in action. The most common public health actions included informing health authorities and identifying cases. Our findings highlight the value of learning from existing use cases. While wastewater surveillance can support public health actions, evidence of its use is limited. Future studies should improve study designs by, e.g., incorporating strategies for public health actions to maximize their effectiveness and impact on decision-making.

Background: Healthcare workers (HCWs) are at high risk of acquiring and transmitting infections, including COVID-19. Vaccination is a crucial method for preventing the spread of infectious diseases; however, vaccine non-acceptance can hinder optimal vaccine coverage. This research aims to evaluate the level of COVID-19 vaccine acceptance and the associated factors among HCWs in West Africa. Methods: A structured literature review of quantitative cross-sectional studies was conducted, searching databases including Medical Literature Analysis and Retrieval System Online (MEDLINE), African Journals Online, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, and Google Scholar. The review focused on studies from April 2021 to February 2023 that examined factors influencing COVID-19 vaccine acceptance among HCWs in West Africa. Data extraction and quality assessment of the included studies were conducted using Joanna Briggs Institute tools. Results: Five articles met the inclusion criteria, and they reported that the acceptance level of the COVID-19 vaccine ranged from 38.3% to 73.6%. Barriers to acceptance included concerns about vaccine safety and effectiveness, side effects, short duration of clinical trials, limited and false information, and lack of social trust. Conclusions: COVID-19 vaccine acceptance among West African HCWs is influenced by sociodemographic factors, vaccine concerns, and accurate information, necessitating health promotion strategies and multisectoral collaboration for improved acceptance.

Context: Organizational leadership is essential for adequate and stable financing, strong governance across jurisdictions and sectors, and a competent public health workforce for effective and resilient public health systems. While there have been some efforts to characterize leadership competencies at the individual level, more focus is needed to understand effective governance of public health organizations and systems through the lens of leadership competencies at the organizational level. Objective: To identify organizational level leadership competencies for effective and equitable public health governance. Design: This scoping review included published academic literature from Scopus, Web of Science, Medline, and ProQuest and grey literature from Google Scholar, Canadian Government websites, Trove, FedSys, and Open Grey, published between 2004 and 2023. The search strategy focused on the concepts of governance, leadership, and pub-lic health organizations. An inductive-deductive approach informed the analysis using reflexive thematic analysis and a framework outlining the six functions of public health governance. Results: A total of 35 records were included for analysis; 22 academic and 13 grey literature records. This review identified 9 themes describing organizational leadership competencies for public health governance: 1) Systems thinking 2) Public policy development, implementation and evaluation, 3) Partnership and collaboration, 4) Equity and justice 5) Organizational learning, 6) Oversight, 7) Resource stewardship, 8) Legal authority, 9) Organizational ethics. Conclusions: This scoping review contributes to our understanding of the leadership competencies needed to enact and sustain effective governance at an organizational level. These identified themes and associated competencies can facilitate the creation of organizational culture and values that align with effective governance tenets in public health. Additional research is needed to further apply and contextualize these competencies in different countries and public health settings.

Background Organizational Health Literacy (OHL) refers to the extent to which organizations facilitate equitable access, comprehension, and use of health information and services for informed decision-making. Objective This study aimed to (1) review and map existing OHL frameworks and (2) propose an innovative OHL framework that addresses gaps identified in current models. Methods A systematic search of academic (Web of Science, Scopus, MEDLINE) and grey literature from the past 15 years was conducted to identify OHL frameworks. This scoping review followed the PRISMA-ScR guidelines and the Arksey and O’Malley model. A new OHL intervention framework was developed to address gaps in existing models, based on the principles of preventive medicine and the public health action cycle. Results A total of 19 records were included (10 from academic databases and 9 from grey literature), covering diverse approaches and contexts related to OHL. Four intervention levels were identified: integrating HL into formal education, implementing HL assessments, developing interventions for vulnerable populations, and enhancing accessibility to health resources. The proposed framework emphasizes intersectoral collaboration and communication pathways between education and healthcare sectors, facilitating information exchange to continuously adapt interventions to population needs. Conclusion OHL development requires intersectoral collaboration; however, interoperability between sectors remains unaddressed in existing frameworks. This study proposes an innovative model that fosters sectoral connections toward a shared goal, creating a truly collaborative framework.

Objectives: The relationship between the volume of medical procedures conducted in hospitals and the resulting health outcomes has been described for various surgical and non-surgical medical interventions. As a policy response to this, several countries have implemented minimum volume standards. However, there is currently a lack of systematically compiled evidence assessing their impact. To close this research gap, we conducted a systematic review on the effects of minimum volume standards in hospitals. Design: Systematic review using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Data sources: MEDLINE, PubMed Central and Bookshelf (PubMed), EMBASE (Elsevier), CENTRAL (Cochrane Library), CINHAL (EBSCO), EconLIT (EBSCO), PDQ-Evidence for Informed Health Policymaking, Health Systems Evidence and three trial registries were searched until June 2023. Additionally, manual searches were conducted. Eligibility criteria for selecting studies: For inclusion in this review, studies must investigate the effects of minimum volume standards. We accepted all categories of outcomes. Following the Cochrane Effective Practice and Organisation of Care (EPOC) criteria, only a strict set of study designs, namely randomised controlled trials, non-randomised controlled trials, controlled before-after studies and interrupted time series studies, were included. No restrictions were placed on language, publication date or publication status. Data extraction and synthesis: Two reviewers independently screened titles and abstracts for eligibility, reviewed the full texts and performed data extraction of the included articles. Risk of bias was assessed using the 'Risk Of Bias In Non-Randomised Studies-of Interventions' (ROBINS-I) tool. Certainty of evidence was rated using the GRADE approach. For data synthesis and statistical analyses, we adhered to the EPOC guidance. Results: We included nine studies into our systematic review. Overall, the outcomes reported in the studies are heterogeneous, which did not allow for a meta-analysis, resulting in a narrative analysis of the found evidence. While travel distance increased and length of stay decreased, other reported outcomes such as complications or reoperations were not affected by the introduction of minimum volume standards. Overall, the risk of bias was considered serious for results on outcomes of seven out of the nine included studies and moderate for the remaining two. The certainty of evidence was rated low for complications, reoperations, length of stay and travel distance and very low for mortality (in-hospital; 30 days). Conclusion: This systematic review does not provide conclusive evidence on the effects of minimum volume standards in hospitals regarding any outcomes. The certainty of evidence for mortality (in-hospital; 30 days) is very low and low for complications, reoperations and travel distance. The results are based on a relatively small number of studies for most outcomes. There is a need for studies researching the effects of minimum volume standards based on a robust study design. Prospero registration number: CRD42022318883.

Background: This research focuses on improving epidemic monitoring systems by incorporating advanced technologies to enhance the surveillance of diseases more effectively than before. Considering the drawbacks associated with surveillance methods in terms of time consumption and efficiency, issues highlighted in this study includes the integration of Artificial Intelligence (AI) in early detection, decision support and predictive modeling, big data analytics in data sharing, contact tracing and countering misinformation, Internet of Things (IoT) devices in real time disease monitoring and Geographic Information Systems (GIS) for geospatial artificial intelligence (GeoAI) applications and disease mapping. The increasing intricacy and regular occurrence of disease outbreaks underscore the pressing necessity for improvements in public health monitoring systems. This research delves into the developments and their utilization in detecting and handling infectious diseases while exploring how these progressions contribute to decision making and policy development, in public healthcare. Methodology: This review systematically analyzes how technological tools are being used in epidemic monitoring by conducting a structured search across online literature databases and applying eligibility criteria to identify relevant studies on current technological trends in public health surveillance. Results: The research reviewed 69 articles from 2019 to 2023 focusing on emerging trends in epidemic intelligence. Most of the studies emphasized the integration of artificial intelligence with technologies like big data analytics, geographic information systems, and the Internet of Things for monitoring infectious diseases. Conclusions: The expansion of publicly accessible information on the internet has opened a new pathway for epidemic intelligence. This study emphasizes the importance of integrating information technology tools such as AI, big data analytics, GIS, and the IoT in epidemic intelligence surveillance to effectively track infectious diseases. Combining these technologies helps public health agencies in detecting and responding to health threats.

Objectives: Considering the growing inter of biobanks, artificial intelligence (AI) and omics research, and their critical impact on public health, this study aimed to explore the current and future public health implications and challenges of AI and omics-driven innovations in biobanking. Study design: Narrative literature review. Methods: A structured literature search was conducted in Scopus, PubMed, Web of Science and IEEExplore databases using relevant search terms. Additional references were identified through backward and forward citation chaining. Key themes were aggregated and analysed through thematic analysis. Results: Thirty-seven studies were selected for analysis, leading to the identification and categorisation of key developments. Several key technical, ethical and implementation challenges were also identified, including AI model selection, data accessibility, variability and quality issues, lack of robust and standardised validation methods, explainability, accountability, lack of transparency, algorithmic bias, privacy, security and fairness issues, and governance model selection. Based on these results, potential future scenarios of AI and omics integration in biobanking and their related public health implications were considered. Conclusions: While AI and omics-driven innovations in biobanking offer specific transformative public health benefits, addressing their technical, ethical and implementation challenges is crucial. Robust regulatory frameworks, feasible governance models, access to quality data, interdisciplinary collaboration, and transparent and validated AI systems are essential to maximise benefits and mitigate risks. Further research and policy development are needed to support the responsible integration of these technologies in biobanking and public health.

The global rise in pharmaceutical production and consumption has led to an increase in pharmaceutical waste, posing significant risks to both public health and the environment. Improper disposal methods contribute to environmental degradation, including disruptions to aquatic ecosystems and the spread of antimicrobial resistance. Despite these growing concerns, a comprehensive review of pharmaceutical waste management and disposal practices is still lacking. To address this gap, a scoping review was conducted, analyzing 4269 records from three databases (Medline OVID, Web of Science, and Embase) and grey literature, with 67 studies ultimately included. The initial records were identified through a comprehensive search across the aforementioned databases using a structured strategy based on three core concepts: medication waste, disposal methods, and environmental or human health impacts. This was followed by a two-stage screening process guided by the PCC framework and predefined inclusion criteria. The review aims to assess disposal practices and their impacts, identify research gaps, and guide future research toward effective strategies for managing pharmaceutical waste while protecting ecological balance and public health. The publications timeline shows increasing interest in the topic, particularly with a surge in studies during 2022 and 2023. The findings reveal a significant regulatory gap, especially in the Global South, where limited infrastructure and public awareness lead to reliance on household waste disposal. In contrast, medication take-back programs are more common in the Global North. This disparity underscores the urgent need for policy development. Addressing pharmaceutical waste effectively requires coordinated efforts from the pharmaceutical industry, healthcare providers, regulatory bodies, and local communities. Key strategies should include regulatory action, public education, technological innovation, and addressing issues like drug misuse and overconsumption, particularly of antibiotics, which contribute to antimicrobial resistance. A holistic approach is essential to mitigate both environmental and public health risks.

Objective: By studying the Technology-Organization-Environment Framework (TOE), this research explores the impact of various indicators in technology, organization, and environment on the performance of family doctor services during major public health emergencies. It aims to identify the driving paths to improve performance. Methods: A stratified sampling of 34 community health service centers in Shanghai was conducted, using the comprehensive performance score of family doctors as the outcome variable. The Average Internet Medical Service Person-times and the Information Technology Expenditure per Thousand Population were considered as technology-related variables. The Fiscal Allocation per Thousand Population (/1,000), the Family Doctor Team Members per Thousand Population, and the Medical Social Workers and Volunteers per Thousand Population were identified as organization-related variables. The Proportion of Older Adult Population, Fiscal Allocation per Thousand Population, and the number of patient self-education organizations per thousand population were taken as environment-related variables. Fuzzy-set Qualitative Comparative Analysis (fsQCA) was employed to conduct necessity analysis, truth table analysis, and configurational analysis of antecedent conditions, with robustness tests performed by adjusting consistency thresholds and case frequencies. Results: The study found that the performance of family doctor services was influenced by multiple factors, with no single decisive factor. In overall communities, five configurations, including per capita fiscal allocation and community participation, affected performance, explaining 4.2% of the variance. In central urban areas, information technology expenditure and the Proportion of Older Adult Population were core conditions, influencing 27.5% of performance paths. In non-central urban areas, core conditions such as financial support and IT covered 53.9% of data cases. The fsQCA results, which were robustly tested, begin to provide a strong basis for resource allocation and policy formulation. Conclusion: This study begins to fill the gap in research on family doctor service performance during major public health emergencies, exploring the synergistic effects and causal asymmetry among multiple indicators such as technology, organization, and environment from a holistic, or configurational, perspective.

India's healthcare system faces substantial challenges, including a high burden of communicable and non-communicable diseases, limited access to healthcare in rural areas, and a shortage of skilled healthcare professionals. Artificial intelligence (AI) offers promising solutions to address these gaps by enhancing diagnostic accuracy, improving disease prediction, and optimizing treatment management. This scoping review examines AI's role in early detection, treatment, and disease prevention in community health settings. A comprehensive literature search was conducted in PubMed, Embase, Scopus, and Google Scholar from January 2013 to July 2024. Eligible studies focused on the application of AI in public health, emphasizing early detection, disease prevention, and treatment interventions. Data on AI models, health outcomes, and performance metrics were extracted and analyzed in line with PRISMA-ScR guidelines. Forty-eight studies were analyzed and categorized into diagnostic accuracy, disease prediction, treatment management, and clinical validation. AI-based tools, such as AIDMAN for malaria detection, demonstrated high diagnostic accuracy (95%) and AUC (0.96). Predictive models for chronic kidney disease (93% accuracy) and diabetes (91% accuracy) showed substantial promise. TB screening using AI-powered cough analysis achieved 86% accuracy. The studies also emphasized AI's role in managing chronic diseases, facilitating early interventions, and reducing healthcare burdens in resource-limited settings. AI has the potential to revolutionize healthcare delivery in India, particularly in underserved regions, by enhancing early detection and treatment. However, challenges related to data privacy, algorithmic bias, and infrastructure require attention. Continued research and policy development are essential to fully harness AI's capabilities in improving public health outcomes.

Aims: The World Health Organization (WHO) Health Emergency Programme funded three systematic reviews to inform development of guidance for emergency preparedness in health emergencies. The current review investigated the type of learning interventions that have been developed and used during health emergencies, and how they were developed. Methods: We searched PubMed, CINAHL, Communication and Mass Media Complete (EBSCO), and Web of Science. Study quality was appraised by WHO-recommended method-specific checklists. Findings were extracted using a narrative summary approach. Results: 187 studies were included. Studies were split between online, in-person, and hybrid modalities, conducted mostly by hospitals and universities, and most frequently training nurses and doctors. Studies emphasized experiential learning to develop and reinforce skills; online learning for knowledge dissemination; multi-sectoral partnerships, institutional support and carefully constructed planning task forces, rapid training development and dissemination, and use of training models. Conclusion: It Most studies evaluated only knowledge or self-confidence of trainees. Relatively few assessed skills; evaluations of long-term outcomes were rare. Little evidence is available about comparative effectiveness of different approaches, or optimum frequency and length of training programming. Based on principles induced, six recommendations for future JIT training are presented.

Containment policies were essential in controlling the spread of the COVID-19 pandemic in the United States, but they also introduced significant economic challenges. This scoping review aimed to examine the macroeconomic indicators used to assess COVID-19 closure and containment policies in the United States. We reviewed 42 eligible studies from 4516 records identified across PubMed, Web of Science, and EconLit. These studies explored various economic impacts, focusing on employment, labor market indicators, consumer spendings, etc., primarily using publicly available sources. During the pandemic, high-frequency data (eg, mobility and card transactions) became newly accessible and played a key role in evaluating the real-time effects of mitigation policies. Our review summarizes macroeconomic indicators investigated and provides researchers and policymakers with a list of data sources for assessment of economic impacts in the future. This review emphasizes the need for comprehensive evaluations to balance public health measures with economic considerations in future pandemic responses.

Objectives: This systematic review (SR) highlights principles for nutrient clinical trials and explore the diverse physiological functions of vitamin D beyond its traditional role in the musculoskeletal system related to clinical study designs. Background: Thousands of published research articles have investigated the benefits of vitamin D (a nutrient example taken in this SR) beyond the musculoskeletal system, including the immune, pulmonary, and cardiovascular systems; pregnancy; autoimmune disorders; and cancer. They illustrated vitamin D's molecular mechanisms, interactions, and genomic and nongenomic actions. Methods: This SR was designed to identify shortcomings in clinical study designs, statistical methods, and data interpretation that led to inconsistent findings in vitamin D-related publications. SR also highlights examples and insights into avoiding study design errors in future clinical studies, including randomized controlled clinical trials (RCTs). The SR adheres to the latest PRISMA statement, guidelines, and the PICOS process. Results: Inappropriate or flawed study designs were frequent in clinical trials. Major failures discussed here include too short clinical study duration, inadequate or infrequent doses, insufficient statistical power, failure to measure baseline and achieved levels, and recruiting vitamin D-sufficient participants. These design errors have led to misleading interpretations. Thus, conclusions from such studies should not be generalized or used in guidelines, recommendations, or policymaking. Conclusion: Adequately powered epidemiological studies and RCTs with sufficient vitamin D and duration in individuals with vitamin D deficiency reported favorable clinical outcomes, enriching the literature, enabling to understand its physiology and mechanisms. Proper study designs with rigorous methodologies and cautious interpretation of outcomes are crucial in advancing the nutrient field. The principles discussed apply not only to vitamin D, but also other micro-nutrients and nutraceutical research. Adhering to them enhances the credibility and reliability of clinical trials, SRs, and meta-analysis outcomes. The study emphasizes the importance of focused, hypothesis-driven, well-designed, statistically powered RCTs to explore the diverse benefits of nutrients, conducted in index nutrient deficient participants, and avoidance of study design errors. Findings from such studies should be incorporated into clinical practice, policymaking, and public health guidelines, improving the health of the nation and reducing healthcare costs.

Objective: To apply an intersectional lens to explore how the interconnected social identities of women across global settings impact access experiences for gender-based violence (GBV) supports. Design: A scoping review. Data sources: We systematically searched seven databases to identify studies published in English from the database inception to January 2023. Inclusion criteria: We included peer-reviewed studies with a primary objective of examining the access experiences of populations who self-identify as women (aged 15 years or older) who have experienced GBV, have intersecting identities (ie, racialisation, poverty, etc) that can further contribute to marginalisation and utilised or sought support services. Methods: Two reviewers independently completed title/abstract, full-text screening and data charting. Integrating intersectionality theory and the McIntyre access framework, we analysed support service access and utilisation across social identities, axes of marginalisation and geographic contexts. Results: 210 papers (195 distinct studies) met the inclusion criteria. Most studies (60%) were published since 2015 and used qualitative methods (63%). Findings reflected intersectional differences in women's experiences of accessing GBV services across contexts and lived experiences. Common findings indicate that seeking GBV support was motivated and enabled by informal supports and positive prior experiences in accessing services. However, findings highlight that structural and systemic constraints in existing support systems (in all study settings) impact access to necessary support services and their alignment with women's needs. Few studies examined health and non-health outcomes associated with unhindered access to care. Conclusions: Women's experiences with GBV support systems in different geopolitical contexts highlight barriers across axes of racialisation, poverty, multidimensional violence and other systemic factors, which are often eclipsed in generic one-size-fits-all models of support. This research can inform transformational policy development and tailored interventions to improve outcomes for all women who experience GBV and thus advance gender equality and equity goals.

Background: The Saudi Food and Drug Authority (SFDA) plays a pivotal role in safeguarding public health through robust pharmacovigilance. Since establishing its signal detection in 2015, SFDA has implemented a comprehensive framework to monitor and evaluate drug safety through proactive data collection, advanced analytical methods, and international collaborations. Objective: To provide a comprehensive analysis of the current practices in signal detection at SFDA, assess the effectiveness of its regulatory framework, in-house priority system, active surveillance programme, and global collaborations, and to offer recommendations for future enhancements in pharmacovigilance. Methods: A scientific review was conducted using publicly available literature, official SFDA guidelines, and internal reports. The evaluation focused on the regulatory mandate, data collection methodologies, signal generation processes (including weekly scanning of diverse sources), case validation, and the integration of advanced statistical techniques. Special emphasis was given to the in-house priority algorithm, active surveillance initiatives, and collaborative efforts with international bodies. Results: The review highlights that SFDA's robust regulatory framework and innovative in-house priority algorithm have enhanced the efficiency of signal detection. The active surveillance programme has significantly increased the capacity for real-time monitoring, while global collaborations have facilitated knowledge exchange and harmonised methodologies. However, challenges persist regarding data quality, resource allocation, and the need for continuous training and improved communication among stakeholders. Conclusion: SFDA's signal detection system effectively contributes to drug safety in Saudi Arabia by combining rigorous regulatory practices with innovative analytical methods and international cooperation. Addressing current challenges through advanced technologies, enhanced resource allocation, and strengthened stakeholder communication is recommended to further improve pharmacovigilance practices and ensure public health protection.

Aim: To pose an argument for health systems to improve responses to armed conflict by investing in developing the advanced practice nursing workforce. Background: Armed conflict catalyzes infectious disease, noncommunicable disease, and physical and psychological trauma. Health systems in countries at war face challenges in meeting the health service needs for affected populations while providing sufficient care for the rest of the public. Integrating advanced practice nurses into the workforce is one solution to address the demand for health services during war. Importantly, policies facilitating a quick, efficacious advanced practice nurse response during war must be in place before armed conflict arises. Sources of evidence: A critical narrative review of peer-reviewed articles was conducted. The review focused on the benefits of advanced practice nurses during crises and systemic policy setbacks preventing advanced practice nurse workforce development. A case study from the Israel-Hamas War is presented. Discussion: Holistic, patient-centered care positions advanced practice nurses to care for the physical and psychological needs of the population arising from war. Evidence from other public health crises, such as the COVID-19 and H1N1 pandemics, reinforces this notion. However, common policy setbacks, such as an ill-defined scope of practice and a lack of interprofessional awareness of the role, prevent advanced practice nurses from providing care when conflict arises. Israel's policy efforts before and during the Israel-Hamas War exemplify advanced practice nursing workforce policy development that facilitated an effective response to crisis. Conclusion: Addressing expanded advanced practice nurse authorities before conflict starts will facilitate an improved health system response. Implications for health policy: Research examining the effectiveness of advanced practice nursing care quality during armed conflict will facilitate national-level investment in advanced practice nursing workforce development.

In response to emerging challenges that intersect humans, animals, and environments, there is growing international exigent need to adopt 'One Health' approaches. While One Health efforts are emerging in British Columbia in Canada, there are still challenges to overcome in the adoption of a One Health approach in policymaking. We conducted a comparative analysis of One Health policies in Asia, specifically, Singapore, Hong Kong, Bangladesh, and Thailand, which have well-established and sophisticated One Health approaches, to determine good practices in the implementation of One Health that could be considered for adoption in British Columbia. We conducted a literature review and scan of public-facing One Health websites, strategic action plans, and health databases, complemented by 13 semi-structured interviews with researchers, educators, service providers, human and animal health experts, and policymakers in our chosen Asian jurisdictions and British Columbia. While there was diversity in the One Health approaches taken by four jurisdictions, three key characteristics were present in policymaking processes in all of them: a national One Health strategic action plan, inter-ministerial coordination, and flexibility in the working relationships of public servants. One Health presents an opportunity for British Columbia to take a novel approach to public health policymaking, the one that is more holistic and effective at addressing shared health challenges.

Objectives: The COVID-19 pandemic has had a disproportionate impact on the health of Indigenous Peoples in Canada, Australia, New Zealand and the USA, as reflected in the growing literature. However, Indigenous Peoples are often homogenised, with key differences often overlooked, failing to capture the complexity of issues and may lead to suboptimal public health policy-making. The objective of this review was to assess the extent to which the heterogeneity of the Indigenous Peoples in Canada, Australia, New Zealand and the USA has been reflected in COVID-19 research. Design: This study took the form of a scoping review. Data sources: Medline, Embase, CINAHL and Web of Science were searched for studies investigating COVID-19 pandemic outcomes among Indigenous Peoples in Canada, Australia, New Zealand and the USA. The search dates included January 2019 to January 2024. Eligibility criteria: All citations yielded by this search were subjected to title and abstract screening, full-text review and data extraction. We included original, peer-reviewed research investigating COVID-19-related outcomes among Indigenous Peoples in Canada, Australia, New Zealand or the USA. Data extraction and synthesis: Data extraction was conducted as an iterative process, reaching consensus between two of the study authors. All included studies were analysed through a combination of quantitative descriptive summary and qualitative thematic analysis. Results: Of the 9795 citations found by the initial search, 428 citations were deemed eligible for inclusion. Of these citations: 72.9% compared Indigenous participants to non-Indigenous participants; 10.0% aggregated Indigenous and non-white participants; and 17.1% provided findings for Indigenous participants exclusively. Conclusions: By overlooking the heterogeneity that exists among Indigenous Peoples in Canada, Australia, New Zealand and the USA, researchers and policy-makers run the risk of masking inequities and the unique needs of groups of Indigenous Peoples. This may lead to inefficient policy recommendations and unintentionally perpetuate health disparities during public health crises.

Abstract Palliative care is a crucial discipline that alleviates suffering and enhances the quality of life for patients with life-limiting illnesses and their families. However, there is gap globally between the need for and availability of these services. Integrated health service networks offer a promising solution to address this gap in rural areas, by coordinating care across different levels and sectors. This scoping review aimed at identifying the key characteristics of palliative care networks in rural communities. A broad search without time limits was conducted in four databases. Analysis and synthesis were conducted using Latent Dirichlet Allocation topic modeling. Sixteen studies were included, revealing four key themes regarding the development of palliative care networks in rural areas: community engagement is essential to secure the reach of rural networks, tailored approaches acknowledging diversity enrich these networks, team-centric efforts involving stakeholder coordination ensure successful implementation, and a multifaceted approach-empowering non-traditional stakeholders and incorporating technology resources into primary health services-dynamizes palliative care delivery in rural areas. These findings underscore the potential of collaborative and innovative approaches to enhance the accessibility and effectiveness of palliative care in underserved rural communities. Further cost-effectiveness studies are warranted to better understand the impact these strategies can have on health systems.