Policy Gaps Research Articles

Respiratory syncytial virus (RSV) vaccine effectiveness against RSV-associated hospitalisations and emergency department encounters among adults aged 60 years and older in the USA, October, 2023, to March, 2024: a test-negative design analysis

Respiratory syncytial virus vaccines first recommended for use during 2023 were efficacious against lower respiratory tract disease in clinical trials. Limited real-world data regarding respiratory syncytial virus vaccine effectiveness are available. To inform vaccine policy and address gaps in evidence from the clinical trials, we aimed to assess the effectiveness against respiratory syncytial virus-associated hospitalisations and emergency department encounters among adults aged at least 60 years. We conducted a test-negative design analysis in an electronic health records-based network in eight states in the USA, including hospitalisations and emergency department encounters with respiratory syncytial virus-like illness among adults aged at least 60 years who underwent respiratory syncytial virus testing from Oct 1, 2023, to March 31, 2024. Respiratory syncytial virus vaccination status at the time of the encounter was derived from electronic health record documentation, state and city immunisation registries, and, for some sites, medical claims. Vaccine effectiveness was estimated by immunocompromise status, comparing the odds of vaccination among respiratory syncytial virus-positive case patients and respiratory syncytial virus-negative control patients, and adjusting for age, race and ethnicity, sex, calendar day, social vulnerability index, number of underlying non-respiratory medical conditions, presence of respiratory underlying medical conditions, and geographical region. Among 28 271 hospitalisations for respiratory syncytial virus-like illness among adults aged at least 60 years without immunocompromising conditions, vaccine effectiveness was 80% (95% CI 71-85) against respiratory syncytial virus-associated hospitalisations, and vaccine effectiveness was 81% (52-92) against respiratory syncytial virus-associated critical illness (ICU admission or death, or both). Among 8435 hospitalisations for respiratory syncytial virus-like illness among adults with immunocompromising conditions, vaccine effectiveness was 73% (48-85) against associated hospitalisation. Among 36 521 emergency department encounters for respiratory syncytial virus-like illness among adults aged at least 60 years without an immunocompromising condition, vaccine effectiveness was 77% (70-83) against respiratory syncytial virus-associated emergency department encounters. Vaccine effectiveness estimates were similar by age group and product type. Respiratory syncytial virus vaccination was effective in preventing respiratory syncytial virus-associated hospitalisations and emergency department encounters among adults aged at least 60 years in the USA during the 2023-24 respiratory syncytial virus season, which was the first season after respiratory syncytial virus vaccine was approved. The Centers for Disease Control and Prevention.

Service-policy gaps in the settlement journey of Arabic-speaking immigrant newcomer and refugee older adults in Edmonton, Canada.

Immigrant newcomers and refugees (INRs) are two migrant categories that experience consistent systemic barriers to settlement and integration in Canada as older adults. This paper explores the challenges experienced by Arabic-speaking INR older adults in Edmonton, Canada, during settlement and discusses policy and service implications. A qualitative description study using community-based participatory research principles was implemented to evaluate and support digital literacy in Arabic-speaking INR older adults. We included men and women aged 55 and older who identified as immigrants or refugees and spoke Arabic. Experiences of settlement challenges were consistently identified during data collection and engagement of INR older adult participants. A thematic sub-analysis of interviews with (10 individuals and one couple) of participants' narratives was completed in 2022 and was used to identify themes related to settlement barriers for this population. Two main themes were identified: (1) Limited English skills and digital literacy gaps create service barriers for INR older adults, and (2) Gaps in services and policies as basic needs remain unmet. We describe key challenges experienced by INR older adults, such as language barriers, precarious finances, poor access to health care services and lack of transportation and employment opportunities, which hinder successful integration into the new society. This study showcases the ongoing challenges with early settlement and integration that continue despite Canada's well-developed immigration settlement landscape. INR older adults often remain invisible in policy, and understanding their experiences is a first step to addressing their needs for resources that support healthy aging in the post-migration context.

Climate change impacts on maternal health and pregnancy outcomes in Africa

ABSTRACT The review examines how climate change adversely affects maternal health and pregnancy outcomes in Africa, a region particularly vulnerable to climate-related disasters. It highlights the increased incidence of tropical and waterborne illnesses due to climate change, disproportionately impacting expectant mothers. The study thoroughly evaluates the effects of extreme weather events like heatwaves and floods on maternal health, both directly and indirectly. It underscores significant gaps in policy and research within African health sectors regarding these issues. Key findings reveal that maternal death rates remain alarmingly high, with risks like preterm birth, stillbirth, and maternal hypertension exacerbated by climate change. The review calls for urgent action, including enhanced research, increased funding for climate adaptation, and the integration of maternal health into broader climate resilience strategies. Additionally, it emphasizes the need for greater awareness and international collaboration to strengthen health systems in Africa, particularly addressing the vulnerabilities of pregnant women. This work aims to enhance understanding among policymakers and researchers about the critical health impacts of climate change on pregnant women in Africa.

Carbon footprints, dynamic capabilities, and financial inclusion in G7 and E7 nations

This study explores the impact of financial inclusion on CO2 emissions in G7 and E7 countries over the period 2004 to 2020. Through fuzzy set qualitative comparative analysis (fsQCA), the research reveals that financial inclusion interacts with key factors such as income levels, energy consumption, urbanization, and foreign direct investment, shaping emissions outcomes in these countries. Trade openness is identified as a significant driver of environmental degradation, further complicating the relationship between financial systems and ecological impact. Despite these interactions, the study finds a clear gap in policies that directly connect financial inclusion with CO2 reduction efforts. The findings emphasize the need for governments to align financial inclusion strategies with environmental policies to foster more sustainable economic and ecological development.

A qualitative exploration of policy interventions to improve the health-related quality of life of people living with HIV AIDS and co-morbidities of hypertension and/or diabetes in Ghana.

The intersection of infectious diseases, such as HIV, with chronic conditions like hypertension and diabetes poses a significant challenge in global health. While advancements in antiretroviral therapy have transformed HIV into a manageable chronic condition, a growing number of individuals with HIV now grapple with coexisting non-communicable diseases, impacting their Health-Related Quality of Life (HRQoL). Despite strides in HIV care, there is a notable policy gap that undermines efforts to address HIV-associated co-morbidities, particularly hypertension and diabetes, especially efforts to improve access, early detection, and ultimately HRQoL for individuals with HIV and co-morbidities. This study seeks to explore policy interventions aimed at improving the quality of life of HIV patients with hypertension or diabetes. The study utilized a qualitative descriptive design to explore the experiences and perspectives of healthcare professionals and support staff regarding policy interventions for managing HIV patients with hypertension and/or diabetes co-morbidities in three regions of Ghana. The research was conducted in the Upper West, Ashanti, and Greater Accra regions among 11 participants, chosen purposively from professions involved in HIV patient care to understand their views on the implementation of policy interventions to HRQoL for individuals with HIV and co-morbidities. In-depth interviews were conducted face-to-face and tape-recorded. Thematic analysis approach was used to analyze the data. The study involved 11 participants from three regions with varied years of experience. Implemented policies that potentially improve the HRQoL for individuals with HIV and co-morbidities involve support groups, home visits, provision of free drugs, and counselling. Barriers to policy implementation included non-adherence to medication, stigma, cost of non-communicable diseases (NCDs) medications, accessibility issues to NCDs services, lack of interest or understanding among implementers, and high staff turnover. Facilitators encompassed in-service training, guidelines in common platforms, knowledge sharing, external resources, regular check-ups, and motivational packages for patients. Individuals with HIV and comorbidities face complex challenges impacting their HRQoL, including emotional and financial dimensions. The study identifies critical policies and barriers, underscoring the need for tailored, patient-centered approaches. Facilitators like in-service training and regular check-ups offer actionable insights for effective policy implementation, emphasizing improved health outcomes for those with comorbid conditions. The study recommends integrated care approach and adherence support programs that address the unique challenges faced by people living with HIV.

Unlocking the potential: Insights from industry on barriers, solutions and policy gaps in Ireland's energy storage sector

The energy storage sector across Europe faces many financial, regulatory and policy barriers which has to date hindered development in many countries. This study documents industry perspectives from Ireland, a country which requires a significant increase in the development of energy storage due to security of supply concerns, its isolation from Europe’s central transmission network and its reliance on wind energy as a primary intermittent renewable energy resource. Using focus groups and a survey with the renewable energy and storage sector, we document perspectives on the critical barriers, innovative solutions and policy gaps identified by industry stakeholders and policy makers. Our participants believe energy storage will play a crucial role in unlocking Ireland’s substantial wind energy potential in order to meet its energy security and climate aspirations. However, our respondents suggest that unlocking this potential will require a coherent national energy storage strategy designed to reduce curtailment, identify storage technologies with duration-specific targets and establish a more comprehensive renewable energy plus storage power procurement mechanism designed for the Irish market which supports the grid, rewards low carbon technologies and reduces emissions.

Factors influencing perceptions of processed baby foods and feeding practices among Indian mothers: a qualitative investigation

ObjectiveTo explore how professionally qualified, working Indian mothers conceptualize healthy foods in general, perceive processed infant and baby foods available commercially and what feeding practices they actually follow with their children at home.DesignFive focus groups with 8–12 participants were conducted around the participants’ conceptualization of healthy food, their perceptions about commercially available processed baby and infant foods and their actual feeding practices that they routinely follow with their children. Discussion transcripts were analyzed using an inductive coding approach.SettingIndia.ParticipantsFifty-one professionally qualified, working women with at least one child under 5 years of age.ResultsParticipants agreed that fresh food is healthiest. They also had favorable opinions about processed infant and baby foods with regards to healthfulness, hygiene and safety. Healthy foods were largely conceptualized in relation to nutrient claims, ingredients and discernible health outcomes. They use cues, such as health claims, brand, price, package design and others to determine healthfulness of the product. Perception was heavily influenced by these extrinsic cues rather than by participants’ own nutrition knowledge. Despite having the knowledge, most participants admitted to using these foods on account of factors such as their own inability to lactate, social pressure, lack of time and convenience.ConclusionsMost educated and well off people continue to use these products. While they rue the lack of stringent regulatory measures in India, they feel there is an urgent need to address this huge policy gap by way of legislation and regulation.

Cardiovascular Disease Training Programmes: Three Schemes to Train Leaders for Future Challenges.

Cardiovascular disease (CVD) represents the largest burden of disease globally and despite the availability of strong evidence supporting cost-effective treatments for people with CVD, the implementation of these treatments remains low, especially in low-income settings. Shortages in workforce have led to focus on how to increase clinical capacity. However, a simplistic focus on training clinicians will not fill the gaps in research, policy and implementation, which also need to be addressed at the same time. There are multiple efforts to develop early career capacity across diverse areas at national and international level to address these gaps. To-date, there have been limited efforts to compare or evaluate such programmes, and there are no efforts to harmonise such programmes to take advantage of synergies. We now compare three international programmes on global cardiovascular research to train individuals in their early- and mid-career by aims, experience and outputs.

A Preliminary Methodological Framework of the Potential Hydrogen Economy for a Sustainable Transport in Malaysia

The transition to a hydrogen economy is vital for achieving sustainable transport in Malaysia, particularly in mitigating the environmental impact of heavy-duty mobility. This paper proposes a preliminary methodological framework to evaluate hydrogen's potential as a transformative solution for decarbonizing the transportation sector, focusing on key areas such as hydrogen production, storage, distribution, and vehicle integration, with an emphasis on green hydrogen from renewable sources. Our assessment reveals the significant potential of hydrogen to reduce greenhouse gas emissions and air pollutants, positioning it as a viable alternative to fossil fuels and battery-electric vehicles, especially in heavy-duty applications. The study assesses the technological feasibility, economic viability, and environmental benefits of adopting hydrogen in Malaysia, considering current infrastructure, production capabilities, and regulatory frameworks. Key challenges identified include the high costs of hydrogen production and infrastructure, technological barriers in storage and vehicle integration, and gaps in policy and market readiness. To address these, we propose strategic recommendations for stakeholders, highlighting the need for government support, public-private partnerships, and international collaborations. This framework aims to guide Malaysia’s transition to a hydrogen-powered transport sector, aligning with the nation’s sustainability and energy security goals while positioning Malaysia as a leader in hydrogen technology in Southeast Asia.

Social Cost of Carbon as an International Benchmark to Drive Countries’ Carbon Pricing during the Transition

Building on updated estimates of the social cost of carbon obtained from the most recent literature, this article proposes a social cost of carbon-based benchmark for carbon pricing to drive world countries’ carbon pricing policies up to 2050, consistent with the Paris Agreement targets. By using a dataset on net effective carbon rates developed by the Organisation for Economic Co-operation and Development (OECD), we firstly compare both explicit and implicit carbon pricing in 2021 in 71 OECD and non-OECD countries with the social cost of carbon benchmark for 2021 and calculate the degree of internalization of the social cost of carbon averagely related to their carbon pricing instruments. We find that there is a serious gap in current climate policies, which are far from creating optimal pricing conditions to reduce global emissions to levels needed by the Paris Agreement. The economic and distributional feasibility of a full implementation of the carbon pricing benchmark is tested in the same set of countries using two indicators, which are calculated for 2025, 2030, 2040 and 2050. Since the test results are income-regressive among income country groups, benchmark implementation by countries within the cooperative approaches of Paris Agreement art. 6 should be accompanied by the creation of an international cooperative fund aimed to recycle at least part of the revenues collected by high-income countries to compensate affected population in lower-income countries.

Water resource management and policy evaluation in Middle Eastern countries: Achieving sustainable development goal 6

This study explores the challenges and management strategies of water resources in 15 Middle Eastern countries, framed within the context of Sustainable Development Goal 6 (SDG6). This study used 123 water resource policies in Middle Eastern countries as data and employed a pre-trained large language model based on RoBERTa, trained on the SNLI and MNLI datasets, to perform text classification tasks. In combination with the TF-IDF algorithm for keyword extraction, this approach is used to systematically evaluate and compare the water resource policies of these countries. The results reveal that the region faces significant water stress, exacerbated by high population growth, climate variability, and political instability. While countries like Kuwait and the UAE utilize advanced desalination technologies to mitigate water scarcity, policy gaps in sanitation and transboundary cooperation persist. Jordan's innovative partnerships for water resource management highlight the potential of collaborative frameworks to enhance regional water security. The findings suggest that comprehensive water management strategies, including technological innovation and public-private partnerships, are essential for addressing the region's pressing water challenges. This research contributes to understanding the complexities of water governance in arid regions and offers practical implications for policymakers aiming to achieve sustainable water resource management.

Influencing Policy to Advance Paediatric Surgery in Africa

My aim in this lecture was to address the critical role of policy in advancing paediatric surgery in Africa. I highlight the policy gaps hindering progress in paediatric surgery, discuss supportive ongoing policy initiatives and outline the short-term impacts of these initiatives. Globally, an estimated 1.7 billion children lack access to safe and timely surgical care. In Nigeria, policy gaps have contributed to significant challenges in paediatric surgical care, including poor access and inequities in the distribution of paediatric surgeons and anaesthesiologists. To address this situation, key innovations including inclusion of children's surgery in Nigeria’s National Surgical, Obstetrics, Anaesthesia, and Nursing Plan (NSOANP) has led to infrastructure improvements, critical care training, and the creation of a birth defects registry. These initiatives have shown significant gains, such as increased surgical volumes and cost-effective infrastructure investments. Efforts to strengthen the workforce for paediatric surgery through mentoring, training, and tasksharing are underway to address the shortage of paediatric surgeons and paediatric anaesthesiologists. Furthermore, children's surgery is gaining emphasis in new policies and plans across Africa, including initiatives such as the Africa Surgical Initiative and Pan African Surgical Healthcare Forum. Paediatric surgeons must actively engage in public health policy and decision-making to create sustainable impacts on global child surgical healthcare. Continued efforts are needed to broaden engagement beyond surgical networks and platforms to achieve lasting improvements in paediatric surgical care.

A Multi-State Examination of School District Policies to Address Teen Dating Violence.

In 2021, 13.6% of United States (U.S.) high school students reported experiencing teen dating violence (TDV). Most states have at least one law for addressing TDV in high schools through policies and/or educational programs. Limited research has been done to analyze the content and variability of school district TDV policies across the U.S., and its association with TDV victimization. Twenty-three large urban school districts across the U.S. were included in the analysis. School district TDV policies were obtained through an online search and were coded for the presence or absence of information pertaining to the scope, prevention education, response to TDV, and implementation of the policy. Self-reported TDV victimization was also obtained for each school district from the 2021 Youth Risk Behavior Survey. Overall, 18 school districts had a written TDV policy available online, with 15 school districts defining TDV in the policy. In terms of prevention education, only two school districts used culturally responsive language for diverse populations in the policy. Although 17 school districts included disciplinary consequences for TDV perpetration in the policy, only 6 school districts specified the consequences. All school districts with a TDV policy designated a liaison for TDV coordination. Overall, the prevalence and odds of self-reported TDV victimization was higher in school districts without a TDV policy compared to school districts with a TDV policy. Although most of the school districts had a TDV policy, there was substantial variation in the content of these TDV policies. Identifying and addressing gaps in school district TDV policies can potentially lead schools to preventing and responding to TDV more comprehensively, ultimately creating safer school environments.

Nutritional Status of Children in Bangladesh: Changes and Challenges for Development

Despite suffering from widespread poverty, Bangladesh has made remarkable improvements in the nutritional status of children over the past three decades. This paper describes the trends in the nutritional status of children in Bangladesh by age groups, explores factors associated with these trends, and concludes with a description of future challenges for development in Bangladesh. The national-level survey (BDHS), national plan and policy paper, and literature were used for the study. It is remarkable for Bangladesh that stunting, underweight, and wasting among children under five years old has improved gradually. Children 12- 23 months of age are the most vulnerable. Living in a rural vs urban area, wealth status and maternal education are the main determinants linked to the nutritional status of children. Poverty reduction, improved water and sanitation, strengthened maternal and child health care, education and other policies linked to food and dietary practices and many other policies and programs could continue to improve nutritional levels in children in Bangladesh. Attention is also needed to under five mortality and the double burden of malnutrition. Addressing gaps in policies and programs to achieve the goals of national plans and SDG targets will pay health dividends for the entire population.

Providing Effective Support to All Children in the Aftermath of Disasters: A Persistent Gap in Research, Policy, and Practice

Providing Effective Support to All Children in the Aftermath of Disasters: A Persistent Gap in Research, Policy, and Practice

Leveraging machine learning to optimize renewable energy integration in developing economies

The integration of renewable energy sources into power grids is a critical challenge for developing economies, where infrastructure limitations, unpredictable energy demand, and policy gaps hinder effective energy transitions. Machine learning (ML) offers transformative potential in addressing these challenges, enabling more efficient and reliable energy systems through advanced data analytics, predictive modeling, and real-time decision-making. This review explores how ML can optimize renewable energy integration by improving forecasting accuracy, enhancing grid stability, and optimizing resource allocation in solar, wind, and hydropower systems. Machine learning algorithms are particularly effective in predicting energy demand and renewable resource availability, allowing for better alignment between energy supply and consumption patterns. By leveraging ML-based predictive models, grid operators can mitigate the risks of energy shortages or oversupply, improve grid stability, and reduce operational costs. Furthermore, the application of ML in renewable energy systems provides opportunities for developing economies to leapfrog traditional energy infrastructure limitations by adopting smart grids that integrate real-time data to enhance decision-making and efficiency. This review also reviews case studies from Africa and Latin America, highlighting successful implementations of ML in renewable energy systems. These examples underscore the potential for ML to accelerate the deployment of sustainable energy solutions, while also addressing technical, economic, and policy barriers that exist in developing contexts. With continued advancements in machine learning, combined with supportive regulatory frameworks and investment in digital infrastructure, developing economies have the potential to realize substantial gains in renewable energy integration. This review concludes by discussing future trends, challenges, and opportunities for leveraging machine learning to optimize renewable energy integration, ultimately contributing to sustainable development and energy security in emerging markets.

Policy analysis of the triple burden of malnutrition in children below 5 years of age in Oman

Background: Oman faces the triple burden of malnutrition (TBM) among children under 5 years of age, characterized by stunting, overweight, and wasting. This critical issue impacts children’s healthy development and the country’s progress toward the UN Sustainable Development Goal three addressing good health and well-being. Methods: This study employs secondary data analysis to investigate the prevalence and trends of stunting, overweight, and wasting among children under 5 years of age in Oman, compared with selected Gulf Cooperation Council countries and the Organization for Economic Co-operation and Development (OECD) countries. Data sources include the United Nations International Children’s Emergency Fund, the World Health Organization, and the World Bank Group. Kingdon’s Multiple Streams Framework (MSF) and Howlett’s Policy Implementation Theory are used to critically analyze Oman’s strategies for improving child malnutrition. Results: The prevalence of stunting in Oman decreased from 12.3% in 2012 to 11.6% in 2022. The percentage of children who are overweight increased significantly from 2.9% in 2012 to 6.5% in 2022, surpassing trends in OECD countries. The incidence of wasting was 9.3% in 2017. Conclusion: The three critical aspects to address TBM in Oman are (1) policy gaps (the need for regular follow-up of children under the age of 5 years), (2) implementation barriers (need for regular program review and stakeholder engagement), and (3) the need for tailored interventions. These challenges can be rectified by (1) implementing an expansion of nutrition programs through early education in childcare facilities, (2) increasing parental awareness, and (3) increasing collaboration with healthcare providers (through childcare health programs) for continuous monitoring and support.

The Challenges for EU User Testing Policies for Patient Information Leaflets.

Patient information leaflets (PILs) are essential tools in healthcare, providing crucial information about medication use. In the European Union, the European Medicines Agency (EMA) oversees the regulation and standardisation of PILs to ensure their readability and accessibility. However, challenges persist in ensuring these documents are comprehensible and user-friendly. This study employs a qualitative analytical approach, reviewing existing literature and regulatory documents to identify gaps in the EU user testing policies for PILs. It focuses on the diversity of participant samples, the independence of the testing process, and the robustness of user testing protocols. Findings indicate that current user testing practices often lack diversity and may be biased when pharmaceutical companies conduct their own tests. Additionally, there is a lack of user testing protocols for translated PILs, potentially compromising their accuracy and cultural relevance. To improve the efficacy of PILs, it is essential to include diverse and representative samples in user testing, mandate independent third-party evaluations, implement protocols for user testing on translated PILs, and ensure continuous updates to guidelines based on the latest best practices in health communication. These measures will enhance patient safety and understanding of medication information.

Bangladesh's national education policy for English teaching: Policy direction and gaps over the last decade

This study aims to demonstrate the perceived differences between the direction and the gaps in the execution of Bangladesh's National Education Policy (NEP) for English Teachers. It specifically examines the changing requirements of English teachers over the past decade by enhancing their proficiency and teaching methodologies. In this study, we show that communicative language teaching (CLT) approaches significantly modify the existing structure of educational policy in Bangladesh. The present study is grounded in the constructivist research paradigm and utilized a qualitative case study approach from diverse sources. The data was gathered via document analysis, classroom observations, and interviews with six secondary school English teachers from a pool of educators representing four schools in different areas of Bangladesh. The data was analyzed using theme analysis via NVivo 11 software. The findings indicate several areas where the objectives of Bangladesh's NEP could be better aligned with their practical execution. These areas include reforming elementary and secondary schools and restructuring school leadership, teacher education, teacher status, and classroom pedagogy. Furthermore, this study is a valuable contribution toward advancing a more robust and efficient education policy at the national level, which can effectively improve the standard of education for all to provide quality teaching.

Improving contraceptive care for minors in Israel: practice, policy, and training gaps among OBGYNs

BackgroundSexually active adolescents sometimes seek contraceptives without parental consent, posing challenges due to minors' confidentiality and consent regulations. This is especially the case under the un-nuanced Israeli legal scheme regarding adolescents' care.MethodsIsraeli OBGYNs were contacted through mailing lists and social media groups and asked to fill an online questionnaire regarding their experience and protocols concerning prescription of contraceptives to minors. They were also asked about their comprehension of the relevant legal obligations, the importance they ascribe to different ethical interests and considerations, as well as their training.ResultsOf the 177 responding gynecologists, 132 (74.58%) consulted minors about contraceptives during the past year, regardless of a vast lack of training on providing care to minors. More than a third of respondents believed that there is no legal requirement to involve parents in the process, and only 8% assumed a legal obligation for parental involvement in all minors under the age of 18. Three quarters would "almost always" prescribe contraceptives without parental knowledge, if requested, while 20% never would. No correlation was found between respondents' practices and their perception of the relevant legal obligations. Participants agreed that the risk to the health of the minor as a result of having sex without contraceptives is of utmost importance. Yet, those willing to prescribe gave greater weight to this consideration, while those who do not prescribe were more concerned with the legal ramifications of such an act. The majority identified the age of 15 as the threshold for consistently prescribing contraceptives to minors without parental involvement.ConclusionThis study highlights the significant gaps in both the legal framework and the training of Israeli OBGYNs, and further supports confidential prescription of contraceptives to minors 15 years and older, via Article 6 of the Israeli Legal Competence and Guardianship Law. Legislative reform, professional guidelines and education and training programs are all needed to ensure consistent and legally sound practices, that safeguard the health and rights of minors. It is imperative to guide healthcare providers, including OBGYNs prescribing contraceptives to minors, on managing the care of minors refusing parental involvement, clarifying the legal framework and ethical considerations involved.