Health Policy Framework Research Articles

Hypertension care cascade and their determinants among older adolescents in India: evidence from a nationally representative cross-sectional survey.

Adolescent hypertension in India is an emergent public health concern with lack of programmatic focus on regular screening amongst both individuals and healthcare providers. This study was conducted to assess the hypertension care cascade (prevalence, awareness, treatment and control status of hypertension) from nationally representative data. We used data from the demographic and health surveillance (DHS) comprising India's National Family Health Survey Fifth Round (2019-2021). The prevalence of hypertension among 204,054 older adolescents (15-19 years) was 5.08% (95% CI: 4.94-5.23%) wherein 42.26% (95% CI: 40.69-43.64%) were aware of their condition, 43.70% (95% CI: 41.73-45.70%) of those aware were receiving treatment, and 85.88% (95% CI: 83.83-87.71%) of those on treatment achieved blood pressure control. Overall, there were nearly 60% newly diagnosed hypertension cases detected on screening. Females had significantly lower odds, while those with diabetes and higher waist-hip ratio had significantly higher odds of having hypertension. The awareness of their hypertensive status was higher among females and rural residents, while it was lower among adolescents that were obese and tobacco smokers. Improved blood pressure control was associated with a lower waist-to-hip ratio. In conclusion, nearly five in every hundred older adolescents in India are clinically hypertensive with significantly higher odds linked with obesity and male gender. Awareness and utilization of antihypertensive treatment was lower than the classical rule of halves signifying deficiencies in hypertension screening and management strategies for older adolescents within the existing public health policy framework.

Analysis of convergence between a unified One Health policy framework and imbalanced research portfolio

The One Health (OH) approach is collaborative, multisectoral, and transdisciplinary, acknowledging the interdependence among animal, human and environmental health. It has garnered attention within the scientific community, particularly in response to the rising prevalence and global spread of emerging and re-emerging infectious diseases. Common OH issues include zoonotic diseases, antimicrobial resistance (AMR), food and water safety, and the human-animal bond. Among various OH topics, AMR represents a well-described, long-term, complex issue, with a substantial global death toll and large economic costs. Whereas interdisciplinary and transdisciplinary teamwork seems appropriate to address such complex challenges, effects on knowledge production are poorly known. In this study, we investigate how the scientific community mobilizes “One Health.” A comparative bibliometric analysis of OH and AMR research enabled us to assess the level of transdisciplinary research, identify emerging themes, through a co-occurrence network analysis of keywords, and disciplines mobilized, through a co-citation network analysis of scientific journals, in research, as well as level of international collaboration through analysis of co-authorship among countries. We detected a lack of consideration for non-communicable diseases (e.g., obesity, diabetes, cardiovascular diseases) and the well-being of human and animal populations in analysis of themes. Furthermore, although many disciplines are involved in OH and AMR research, little attention was given to social sciences, environmental health, economics, and politics. There was a strong influence of major global economic powers, including the United States and China, in scientific research on OH and AMR, as well as substantial collaboration among European countries. The present results indicated that guidelines are needed to address the mentioned concerns, and specific funds are required for underrepresented countries.

Body Perceptions and Psychological Well-Being: A Review of the Impact of Social Media and Physical Measurements on Self-Esteem and Mental Health with a Focus on Body Image Satisfaction and Its Relationship with Cultural and Gender Factors.

This narrative review examines the interplay among body image perceptions, social media influence, physical measurements, and their impact on psychological well-being, focusing on the roles of cultural and gender differences and the need to understand the research methodologies employed in this field. In the age of digital proliferation, platforms like Instagram and Facebook have reshaped body image concerns, often leading to increased dissatisfaction and psychological distress due to constant exposure to idealized images and a culture of social comparison. Physical attributes such as weight, height, and BMI are scrutinized under societal standards of health and attractiveness, contributing to a spectrum of mental health issues including low self-esteem, depression, and eating disorders. This examination reveals how cultural norms and gender expectations further complicate body image perceptions, affecting individuals differently based on societal and personal ideals. It synthesizes current research and types of methods to illuminate how these factors together influence mental health and self-esteem, advocating for comprehensive interventions and policy measures aimed at mitigating body dissatisfaction and promoting a healthier, more inclusive understanding of body image. By delving into the complexities of body image satisfaction and its psychological implications, this review highlights the necessity of addressing these concerns within public health and social policy frameworks, underscoring the importance of a multifaceted approach to enhance individual and societal well-being.

Generating evidence to inform responsive and effective actions for Aboriginal and Torres Strait Islander adolescent health and well-being: a mix method protocol for evidence integration ‘the Roadmap Project’

BackgroundAustralia does not have a national strategy for Aboriginal and Torres Strait Islander adolescent health and as a result, policy and programming actions are fragmented and may not be responsive...

Role of Social Determinants in Reshaping the Public Health Policies: A Comprehensive Study

This comprehensive study delves into the pivotal role of social determinants of health (SDOH) in shaping public health policies. Social determinants encompass a wide range of social, economic, and environmental factors that significantly influence health outcomes and disparities. By analyzing the intricate interplay between social determinants and public health policies, this study aims to elucidate the mechanisms through which societal factors influence population health and well-being. Drawing upon empirical evidence, case studies, and critical analysis, the study explores the impact of social determinants on health disparities, health behaviors, healthcare access, and quality. Furthermore, it examines the challenges and barriers in addressing social determinants within public health policy frameworks, including systemic inequalities and data measurement issues. The study also identifies strategies for integrating social determinants into public health policies, including policy recommendations, collaborative approaches, and community empowerment initiatives. Ultimately, this study underscores the imperative of adopting a socioecological approach to public health policymaking, one that recognizes and addresses the underlying social determinants to promote health equity and improve population health outcomes. Keywords: Social Determinants, Reshaping, Public Health Policies, Comprehensive Study

Alcohol-associated liver disease and public health policies.

Alcohol-associated liver disease (ALD) rates have increased substantially in the United States (US) and elsewhere around the globe. These increases are largely the result of increases in alcohol use. While there are many levels at which alcohol use interventions can be implemented in order to reduce alcohol use and its negative health consequences, public policy initiatives have emerged as a powerful way to intervene across a population. In this narrative review, we will review major US national as well as worldwide alcohol related public health policies with a particular focus on describing how such policies have influenced rates of ALD and its complications and outcomes. We will describe global alcohol public health policy frameworks, review key alcohol policy models, describe existing notable policies and their impacts, and highlight gaps in ALD policy literature where further research and policy interventions could reduce rates mortality from ALD.

Introduction to the Special Issue: Indigenous Self-determination in Health System Reforms

Across Canada, First Nations, Inuit and Métis peoples and communities live in rural, remote, Northern and reserve places, as well as urban places, and experience health inequities when compared with non-Indigenous peoples. These inequities are founded by pervasive colonial ideologies, policies, systems, and practices, many of which persist today resulting in multiple disparities in health as well as social, political, and economic areas (Adelson 2005; Allan and Smylie 2015). In Canada, the federal government’s role in the provision of health services is primarily through the limited public health and prevention services offered by the First Nations and Inuit Health Branch (FNIHB), now Indigenous Services Canada (ISC). Services are offered to status (registered) First Nations living on-reserve and to Inuit living in their traditional territories. They provide non-insured health benefits (NIHB) such as prescription drugs, dental, and vision coverage to all status/registered First Nations and Inuit, regardless of where they live; however, non-insured health benefits are not offered to Métis or non-status First Nations. As a result of historical legislative vagueness, and the multiplicity of authorities that has resulted, the First Nations, Inuit and Métis legislation and health policy framework is very complex, which itself results in a great deal of diversity in health service provision across provinces and territories. The framework fails to adequately address the health care needs of the Métis or First Nations and Inuit people who are either not registered or not living on reserve or in their traditional territory (Lavoie and Gervais 2012). [continued in PDF / HTML]

Scopes of practice for advanced practice nursing and advanced practice midwifery in Kenya: A gap analysis.

There is increasing global evidence on the impact of advanced nursing and midwifery practitioners, and Kenya's healthcare system has an excellent opportunity to develop scopes of practice and other regulatory frameworks for the integration of these roles. The primary purpose of this gap analysis was to explore the existing evidence on opportunities and threats toward the integration of the advanced practice nursing (APN) and advanced practice midwifery (APM) roles in Kenya's healthcare system. The study team conducted a structured electronic database search of PubMed, CINAHL, Scopus, EBSCOhost Academic Search Complete, and PsycINFO to retrieve articles and credible websites for reports highlighting the opportunities and threats toward the integration of the APN and APM roles in Kenya's healthcare systems. The retrieved articles were screened for relevance and synthesized for reporting using the traditional literature review approach. The Kenya Health Policy Framework 2014-2030, growing population needs, and implementation of universal health coverage provide an opportunity to harness and leverage advanced practice roles in nursing and midwifery. There is also momentum to develop advanced practice because of strategic alliances and global evidence showing the contributions and quality of services offered by advanced practice nurses and advanced practice midwives. However, lack of financial support, structural challenges, and lack of national policies, regulations, and legislation continue to obstruct progress. Developing scopes of practice for APN and APM in Kenya will benefit the professions, the country's healthcare delivery system, and the population. Achieving universal health coverage depends on a health workforce trained and practicing at optimal levels in tandem with education and training to deliver quality care.

MENTAL HEALTH POLICIES: A COMPARATIVE REVIEW BETWEEN THE USA AND AFRICAN NATIONS

This comparative review examines mental health policies in the United States and various African nations, shedding light on the divergent approaches taken to address the complex challenges posed by mental health disorders. The analysis underscores the contextual nuances that shape mental health policy formulation and implementation in these distinct regions. In the United States, a comprehensive mental health policy framework has evolved over the years, characterized by a combination of federal and state initiatives. The Mental Health Parity and Addiction Equity Act, alongside the Affordable Care Act, has sought to integrate mental health services into mainstream healthcare, promoting accessibility and reducing stigma. Additionally, the National Institute of Mental Health plays a pivotal role in advancing research and evidence-based interventions. Contrastingly, African nations exhibit a wide spectrum of mental health policy landscapes, reflecting the diverse socioeconomic and cultural contexts across the continent. Some countries have made significant strides in policy development, emphasizing community-based approaches and integration with primary healthcare systems. However, challenges persist, including limited resources, mental health workforce shortages, and stigma associated with mental health conditions. The review explores the role of cultural factors in shaping mental health policies, emphasizing the need for culturally sensitive approaches in African nations. It also highlights the disparities in resource allocation and mental health infrastructure between the USA and African countries, contributing to variations in service accessibility and quality of care. Furthermore, the study emphasizes the importance of ongoing efforts to destigmatize mental health issues, improve public awareness, and strengthen community support systems. The review concludes by calling for increased international collaboration, knowledge exchange, and resource mobilization to address the mental health disparities between the USA and African nations, fostering a global commitment to holistic mental healthcare.
 Keywords: Health, Policies, Mental, Care, Stigmatize.

Exploring Barriers to Accessing Sexual and Reproductive Health Services among Adolescents and Young People with Physical Disabilities in South Africa.

Despite South Africa having a progressive and liberal sexual and reproductive health (SRH) policy framework, adolescents and young people with disabilities (AYPWDs) are less likely to receive sexual and reproductive healthcare, being consequently predisposed to a long-term detrimental impact on their health. Our study explored the barriers to accessing sexual and reproductive health services (SRHSs) in clinics among AYPWDs in Mpumalanga, South Africa. We conducted a descriptive qualitative study with twenty-seven AYPWDs in four focus group discussions using semi-structured interviews, audiotaped and transcribed verbatim, and then applied a thematic analysis of the data. Employing a socio-ecological model, the findings show a poor socioeconomic status, lack of information on SRH, and the attitudes of AYPWDs as barriers at the individual level, hindering AYPWDs from accessing SRHSs in clinics. AYPWDs also faced difficulties to talk about SRH with parents, a lack of support to seek SRHSs, improper care from family/parents, and negative attitudes of friends, at the interpersonal level. They further expressed barriers at the community/societal level as negative attitudes of non-disabled community members and poor infrastructure for wheelchair use. At the organization level, their access to SRHSs was negatively affected by HCWs' maltreatment, described in the forms of negative attitudes, being judgmental using verbal abuse, discrimination, and bullying. Furthermore, AYPWDs described difficulties in communication with HCWs, as well as violating their confidentiality and misconceived ideas on their sexuality. Intensified efforts to strengthen public health strategies are needed to improve access to SRHSs by AYPWDs in South Africa, as well as enhancing the proficiency and communication skills of HCWs and educating AYPWDs, parents, and non-disabled community members on SRH.

Tackling the non-communicable disease epidemic: a framework for policy action in low- and middle-income countries.

Health policy frameworks for the prevention and control of non-communicable diseases have largely been developed for application in high-income countries. Limited attention has been given to the policy exigencies in lower- and middle-income countries where the impacts of these conditions have been most severe, and further clarification of the policy requirements for effective prevention is needed. This paper presents a policy approach to prevention that, although relevant to high-income countries, recognizes the peculiar situation of low-and middle-income countries. Rather than a narrow emphasis on the implementation of piecemeal interventions, this paper encourages policymakers to utilize a framework of four embedded policy levels, namely health services, risk factors, environmental, and global policies. For a better understanding of the non-communicable disease challenge from a policy standpoint, it is proposed that a policy framework that recognizes responsible health services, addresses key risk factors, tackles underlying health determinants, and implements global non-communicable disease conventions, offers the best leverage for prevention.

Closing the pneumococcal conjugate vaccine (PCV) introduction gap: an archetype analysis of last-mile countries

ABSTRACT Background Pneumonia remains the leading infectious cause of global childhood deaths, despite the availability of pneumococcal conjugate vaccine (PCV) products and widespread evidence of their safety and efficacy. Objective To map the landscape of countries that are yet to fully include PCV in their National Immunization Programs, we conducted an archetype analysis of country indicators related to barriers and facilitators for PCV decision-making. Methods We created a country matrix focused on three key domains – health characteristics, immunisation factors, and policy framework, and identified ten related indicators. We scored countries based on indicator performance and subsequently ranked and grouped them into three archetypes of low-, moderate-, and high-barrier countries with regard to PCV introduction. Results Our results indicated 39 countries (33 low- and middle-income countries [LMICs] and 6 high-income countries) that are yet to introduce PCV. Among LMICs, 15 countries were classified as ‘low-barrier,’ indicating factors favourable for PCV introduction such as high immunisation coverage of common childhood vaccines, supportive governments, and substantial disease burden and eligibility for Gavi support. Countries classified in the ‘moderate-barrier’ (12) and ‘high-barrier’ (6) archetypes demonstrated adequate capacity in immunisation systems but had competing national priorities and cost barriers that impeded policy decision-making on PCV introduction. Conclusions The current health and policy indicator-based categorisation provides an actionable framework to design tailored PCV advocacy within these last-mile countries. Policy approaches emerging from this framework can lead to strengthened decision-making on vaccine introduction and sustained vaccine access that can enhance child survival worldwide.

Factors associated with early initiation of breastfeeding in central Saudi Arabia: a hospital-based survey

BackgroundEarly initiation of breastfeeding is central to the success of infant feeding. The World Health Organization (WHO) therefore recommends breastfeeding within the first hour of birth and has set a target to increase the rate to 70% globally by 2030. This suggests the necessity of systematic investigations to capture trends in early initiation of breastfeeding to avail health systems of up-to-date information in the interest of appropriate policy making. Hence, this study was designed to investigate the factors associated with early initiation among mothers who delivered babies in public healthcare facilities in the Al-Qassim Region, Saudi Arabia.MethodsThe research was a hospital-based, cross-sectional study which featured the recruitment of 546 mothers from March 2021 to June 2021 in five public hospitals. A questionnaire was the tool used for data collection and this was administered via face-to-face, structured interviews. Data were analyzed using binary logistic regression including unadjusted (UOR) and adjusted odds ratio (AOR) with a 95% confidence interval (CI).ResultsThe prevalence of early initiation of breastfeeding was 23.1% (120 of 519 respondents). Maternal and paternal socio-demographic variables, household characteristics, parity, age of the previous child, breastfeeding the previous child or otherwise and the sex of the newborn were not associated with the early initiation of breastfeeding. Mode of delivery and antenatal education about breastfeeding were significant factors. Postnatal care practices were also significant: the provision of help in positioning babies for breastfeeding (AOR 3.5; 95% CI 1.62, 7.57), 24-hour rooming-in (AOR 6.26; 95% CI 1.31, 29.8) and encouragement to practice early initiation of breastfeeding (AOR 3.05; 95% CI 1.71, 5.43) were good, better and the best factors associated with early initiation of breastfeeding respectively.ConclusionThe prevalence of early initiation of breastfeeding is poor and represents a threat to child survival in the study area. Postnatal care practices are crucial factors strongly predisposing mothers to early initiation of breastfeeding and should therefore be institutionalized in health policy frameworks to promote the same in Saudi Arabia.

A Framework for Digital Health Policy: Insights from Virtual Primary Care Systems Across Five Nations.

Digital health technologies used in primary care, referred to as, virtual primary care, allow patients to interact with primary healthcare professionals remotely though the current iteration of virtual primary care may also come with several unintended consequences, such as accessibility barriers and cream skimming. The World Health Organization (WHO) has a well-established framework to understand the functional components of health systems. However, the existing building blocks framework does not sufficiently account for the disruptive and multi-modal impact of digital transformations. In this review, we aimed to develop the first iteration of this updated framework by reviewing the deployment of virtual primary care systems in five leading countries: Canada, Finland, Germany and Sweden and the United Kingdom (England). We found that all five countries have taken different approaches with the deployment of virtual primary care, yet seven common themes were highlighted across countries: (1) stated policy objectives, (2) regulation and governance, (3) financing and reimbursement, (4) delivery and integration, (5) workforce training and support, (6) IT systems and data sharing, and (7) the extent of patient involvement in the virtual primary care system. The conceptual framework that was derived from these findings offers a set of guiding principles that can facilitate the assessment of virtual primary care in health system settings.

The relationship between children’s oral health behaviours and oral health-related quality of life: a cross-sectional study

BackgroundUnderstanding oral health behaviour s and their impact on Oral Health-Related Quality of Life (OHRQoL) may serve as an instrument to articulate the conventional oral health policy framework, thereby ameliorating the overall health of young individuals in the long term.ObjectiveThe aim of this study was to investigate the relationship between children’s oral health behaviour s and Oral Health-Related Quality of Life in the capital governorate, Kuwait.MethodsA cross-sectional study involving 607 children aged 12–14 years, randomly selected from schools in Kuwait Capital Region. A validated Oral Health Behaviour s and OHRQoL Child Perception Questionnaires (CPQ12-14) was used to collect the data. Chi-square, t-tests, and ANOVA were used to examine the association between oral behaviour s and children’s OHRQoL.ResultsAbout 52.2% of participants were males and the overall response rate was 93.8%. The mean ± SD for total OHRQoL impact was 3.1 ± 0.58, while the total mean for individual domains- for oral symptoms, functional limitations, emotional well-being and social well-being were 2.89 ± 0.63, 2.89 ± 0.72, 3.1 ± 0.91 and 3.4 ± 0.61, respectively. There was no significant difference in total OHRQoL impact score by frequency of last dental visit, flossing, use of mouth rinse or chewing gum (p > 0.05) but for the overall OHRQoL, frequency of soft drink intake was the only significant predictor associated with 0.2-unit decrease (B = -0.207, 95% CI, p = 0.002) in total OHRQoL scores.ConclusionsHigh frequency of soft drink consumption was related to poorer OHRQoL. Behaviour changing interventions based on OHRQoL inferences coupled with clinical intervention are needed.

Human rights and the social determinants of mental health: fostering interdisciplinary research collaboration

There is a developing body of research indicating that individual and population-based mental health is affected by a range of ‘social determinants’. Discrimination, poverty, inadequate access to housing and education as well as exposure to violence, conflict and disaster have all been associated with poor mental health and mental illness. International human rights treaties identify many of the social determinants of mental health as matters of human rights. However, limited attention has been paid to the connection between social determinants and the right to enjoyment of the highest attainable standard of mental health. This paper explores the potential for incorporating elements of both social determinants and human rights approaches to provide a new framework for mental health research, policy and practice. While acknowledging potential challenges, it identifies advantages to collaborating across disciplinary boundaries. The social determinants approach provides a foundation for understanding the interconnectedness of rights and draws attention to individual and collective needs, while a human rights approach can help identify the measures that are required to secure the social determinants of good mental health and wellbeing.

Self‐managed abortions in Ghana: A health policy framework analysis

AbstractBackgroundSelf‐managed abortions (SMAs) remain a public health challenge; and are worst in deprived settings. In this policy review, we sought to analyze the legal and policy frameworks within which SMA occurs and look at how these may help improve abortion outcomes in Ghana.MethodsWe searched and reviewed documents on “self‐induced” or “self‐managed” abortion in Ghana from 2015 to 2022. Databases searched included Ghana Digital Attorney, PubMed Central, Google Scholar, and Repositories of Public Universities in Ghana. The key documents reviewed included the abortion law (Act 29) of Ghana, the fourth (2021) edition of the Ghana Health Services’ Comprehensive Abortion Care Standards and Protocols, and the 2017 Maternal Health Survey report. Key documents reviewed included amended Act 29, Comprehensive Abortion Care policy, and standards. We then performed policy analysis using Walt and Gilson's policy triangle framework regarding the context, practice, processes, and key players.ResultsAfter a careful review of the literature, the following key themes emerged in the framework analysis: the policy environment for SMA, the practice of SMAs, key players of SMAs, consequences of induced abortions, the abortion law, and criminal connotations of SMA. We found that SMAs remain criminalized in Ghana but the local practice persists with the use of registered and unregistered abortifacients. We also observed frequent criminal connotations of SMAs in the literature but no evidence of related prosecutions. There was limited empirical evidence on the safety and efficacy of SMAs in Ghana.ConclusionFrom our findings, we contend that there is an unduly high criminal connotation of SMA in Ghana. We, therefore, recommend a multilevel stakeholder engagement to decriminalize SMAs to ensure improved access to safe abortions in Ghana.

Toward Sustainable Healthcare Systems: A Low and Middle-Income Country's Case for Investing in Healthcare Reforms.

Pakistan, a lowand middle-income country (LMIC), faces challenges in providing sustainable health care to its population due to inadequate financing, weak healthcare infrastructure, and insufficient health human resources. These challenges are not unique to Pakistan and are faced by many LMICs globally. In this paper, we aim to identify key strategies for achieving sustainable healthcare systems in Pakistan and to draw lessons for LMICs globally, keeping in view the healthcare reforms in Pakistan. We conducted a comprehensive literature review of existing policies and practices related to healthcare financing, service delivery, health information and communication technologies (ICTs), governance and leadership, and health human resources in Pakistan and other LMICs. We also reviewed relevant global policies and frameworks, including the Sustainable Development Goals (SDGs) and the World Health Organization's (WHO) health system strengthening guidelines. To achieve sustainable healthcare systems in Pakistan, we recommend comprehensive healthcare financing policies, including increasing budgetary allocations for health, social health protection through universal coverage, and supporting health and economic development processes. Service delivery can be improved through restructuring public health facilities, incorporating behavioral and social health determinants into primary health care, aligning healthcare delivery with the community, and promoting collaborative leadership between the public and private sectors. The use of ICT can be expanded by implementing e-health policies, disseminating authentic public health information, and enabling telemedicine services. Effective healthcare governance and leadership can be promoted through meritorious, transparent, and accountable reforms, stable healthcare structures at all community levels, and appropriate health policy and organizational frameworks. Finally, strengthening health human resources can be achieved through compliant policy implementation and revisions in laws and policies governing medical teaching institutions. Achieving sustainable healthcare systems in Pakistan and LMICs globally requires comprehensive strategies for healthcare financing, service delivery, health ICT, governance and leadership, and health human resources. By drawing on global policies and frameworks and lessons from other LMICs, Pakistan can overcome its healthcare challenges and contribute to the achievement of the SDGs.

Barriers and Facilitators to Point-of-Care Ultrasound Use in Rural Australia.

This study explores the barriers and facilitators to point-of-care ultrasound (POCUS) use and adoption in rural healthcare since POCUS is a useful resource for rural clinicians to overcome the challenges associated with limited on-site clinical support, such as limited diagnostic imaging services and infrastructure. A qualitative descriptive study was employed, interviews with ten rural clinicians were conducted, and the data were analysed using the Walt and Gilson health policy framework to guide interpretation. Barriers include a lack of standardised training requirements, the cost of the devices and challenges recouping the costs of purchase and training, difficulty with the maintenance of skills, and a lack of an effective method to achieve quality assurance. Coupling POCUS with telemedicine could address the issues of the maintenance of skills and quality assurance to facilitate increased POCUS use, leading to positive patient safety and social and economic implications.

Employing the policy capacity framework for health system strengthening

Abstract The policy capacity framework offers relevant analytical ideas that can be mobilized for health system strengthening. However, the employment of this framework in the health field constitutes a relevant interdisciplinary gap in knowledge. This themed issue explores the relationships between the policy capacity framework and health system strengthening, in a multidimensional and interdisciplinary way, in high-income and low–middle-income countries. This introduction unpacks the dynamic interrelationships between the policy capacity framework and health system strengthening, bringing together common and distinct elements from both fields and summarizing possible relationships between them. The analysis shows that both fields together can increase our knowledge on health policies and system’s critical themes and reforms. This challenge could be followed by exploring the convergences between them, as far as concepts/themes (types of capacities and other themes) and levels of analysis are concerned. Although in varied ways, papers in this issue (based on European countries, China, Canada, New Zealand, India, Australia, and Brazil) advance the use of the policy capacity framework for health policy or system strengthening. They give two main interdisciplinary contributions. Critical capacities can be incorporated into the policy capacity framework for the analysis of system strengthening—capacity to adapt, contexts of mixed and complex systems, dynamic view of policy capacity, and policy capacity as a relational power. Policy capacity is contextually interpreted (relative to the problem frame) and dynamic and adaptive (processual and relational), in relation to the properties of a health system, particularly with regard to the existing and developing mixed and complex systems.