Health Policy Makers Research Articles

Exploring the state-of-the-art on competencies for policymaking in public health

Abstract Against the complex backdrop characterizing both the nature of public health challenges and the corresponding skills required to face them, this presentation will introduce the state-of-the-art on scholarship concerned with the definition and/or development of competencies for effective policy making in public health. The presentation will focus especially on presenting findings of a scoping review of the state-of the-art involving: 1) research that develops competency frameworks explicitly designed for policymakers operating in public health; and 2) case studies that explore the application of specific competencies (whether explicitly or implicitly) in different public health contexts. By exploring both bodies of literature, the scoping review will take stock of how each study defines the concept of competencies, enumerates areas of knowledge and demonstrable skills pertaining thereto, and uses evidence to establish their significance in the field of public health leadership. The findings of the scoping review will also be brought into comparative perspective, examining whether and how the categories of existing competency frameworks correspond with one another, as well as reflect the insights of single case studies. The proposed presentation will conclude with an overview of findings of a mapping exercise including all competencies identified in the literature, which can serve the workshop audience as both a synthesis and holistic refinement on the state-of-the-art going forward. The proposed presentation will conclude with an overview of findings of a mapping exercise including all competencies identified in the literature, which can serve the workshop audience as both a synthesis and holistic refinement on the state-of-the-art going forward. Speakers/Panelists Anne-Catherine Viso Santé publique France, Saint Maurice, France Charlotte Marchandise EUPHA Kasia Czabanowska Maastricht University, Maastricht, Netherlands

10.B. Scientific session: The European Health Data Space (EHDS): A sea of change for health data in Europe

Abstract A wealth of data is generated every day throughout our health systems which, if leveraged well, can underpin the digital solutions and policies that will transform health and care. However, the complexity and divergence of rules, structures and processes within and across European Member States make it difficult to fully harness that potential at European scale. The European Health Data Space will address this challenge by empowering Europeans to access and control their health data and by offering a harmonised and simplified framework for the reuse of health data, including for research, innovation, and policymaking purposes. During the workshop, we will present an overview of the European Health Data Space framework and its implementation phases and discuss its benefits for targeted stakeholders, including citizens, researchers and policymakers in public health. Objectives 1. Emphasise the importance of leveraging health data for research, innovation and policymaking; 2. Present the European Health Data Space regulation and what actions are being undertaken to prepare for its implementation; 3. Discuss how access to their health data can enable patients and individuals play an active role in their own health journey; 4. Discuss what will be the main benefits for policymakers and researchers in public health resulting from enhanced access to health data. Introduction by Chair for presenting the European Health Data Space and the setting the scene for the session. Short presentations by speakers: 1. Implementing the EHDS: lessons from the EHDS2 pilot - Marianne Benderra, Health Data Hub, presenting his experience on developing and piloting the EHDS infrastructure for secondary use of health data, highlighting key project developments; 2. How can the EHDS enable participatory healthcare? - Henrique Martins, ISCTE, xShare project on how the xShare “Yellow Button” will empower individuals with access to and control over their health data and may foster the development of knowledge and tools necessary for prevention and management of their health; 3. What will the EHDS enable for research and policymaking? - Nienke Schutte, Scienciano, bringing the perspective of a leading European public health institute how the benefits the EHDS framework can bring for policymaking, research and innovation. 15 min Q&A session, taking questions from the audience, possibly also through Slido. Possible guiding questions: How can stakeholders contribute more broadly to the development of the EHDS? What support is needed to ensure that data users and data holders are prepared when the EHDS framework becomes operational? Conclusions 2 min by Chair. Speakers/Panelists Marianne Benderra French Health Data Hub, Paris, France Henrique Manuel Martins ISCTE, Lisbon, Portugal Nienke Schutte Sciensano, Brussels, Belgium

Sleep difficulties as a universal risk factor for injury among adolescents in 46 countries

Abstract Background Poor sleep is common among adolescents and associated with unintentional injuries. The current evidence base is limited by differences in measures of sleep and injury implemented across studies. We examined the potential universality of the relationship between poor sleep and injury cross-nationally using self-reports from 229,589 adolescents in 46 countries that were collected using common procedures and measures. Methods A cross-sectional study was conducted using records from the 2017/18 Health Behaviour in School-aged Children (HBSC): World Health Organization cross-national study. The prevalence of sleep indicators (difficulties in falling asleep, insufficient sleep, social jet lag) and medically treated injuries (overall, multiple) were described across countries and by gender. Multivariable modified Poisson regression analyses were conducted within and across countries to test the consistency of the association between poor adolescent sleep and injuries. Results Overall, indicators of poor sleep were reported by nearly half of adolescents, and varied by gender and across countries. Country-level analyses found consistently positive associations between indicators of poor sleep and injuries. Pooled (multi-country) analyses further demonstrated a universality of these relationships across sleep indicators and injury outcomes. The strength of relationships varied by gender, with more robust associations detected among girls compared to boys. Conclusions Poor sleep is a robust and mainly consistent risk factor for injury among adolescents across countries and regions. Public health officials and policymakers should therefore recognize adolescent sleep as a health priority. The promotion of sleep hygiene may represent a novel target for injury prevention at regional and national levels. Key messages • Poor sleep, in the form of sleep difficulties, insufficient sleep, and social jet lag, were robust and mainly consistent injury risk factors among adolescents across 46 countries. • Public health officials should recognize sleep hygiene as a novel focus for adolescent injury prevention.

Patients’ perceptions on reluctance to undergo cataract surgery in Sedibeng district hospital, Gauteng province

Background: Over 50 million people are blind, and 135 million people suffer from severe visual impairments, with cataracts contributing to 51% of global blindness cases. Despite efforts to promote cataract surgery (CS), many patients remain hesitant, underscoring the importance of understanding their perspectives.Aim: This study aimed to explore and describe patients’ perceptions regarding reluctance to undergo CS to improve awareness and increase surgery uptake.Setting: The research was conducted in the Sedibeng District, Gauteng province, South Africa.Methods: A qualitative descriptive phenomenological design was employed to capture the lived experiences of patients through face-to-face, individual semi-structured interviews with 15 patients aged 38 – 72 years prior to their CS. Purposive sampling was used to select participants, and Colaizzi’s seven-step analysis was used for data analysis.Results: The findings highlight several barriers perceived by participants, including long waiting times; fear; lack of knowledge; limited financial, material and human resources; power outages; uncontrolled blood sugar levels; and coronavirus disease 2019 (COVID-19) pandemic restrictions. Nevertheless, some view it positively as a means to avert blindness and enhance vision.Conclusion: To address the challenges, the study recommends boosting the number of eye health care professionals, prioritising budget allocation, addressing electricity interruptions and conducting community outreach educational programmes to improve access to CS in the district.Contribution: The insights gained from this study can help health care providers and policymakers optimise care and support for CS patients through policy formulation and education. Addressing these knowledge gaps will likely increase surgery uptake and improve patients’ quality of life.

Climate Change, Air Pollution, African Dust Impacts on Public Health and Sustainability in Europe

Abstract Climate change poses a significant threat to environmental sustainability and public health, leading to extreme weather events, rising sea levels, and biodiversity loss. Research on air pollution from African dust adversely associated with climate change highlights its significant role in trapping heat in the atmosphere and causing heat-related illnesses, cardiovascular disorders, and respiratory ailments. Smog, dust, acid rain, and ozone depletion also negatively impact ecosystems. The methods of the study also include the dynamics of climate change-induced air pollution. The implications for public health and environmental sustainability through GWR modeling and MODIS-NDVI analysis of controlling air pollution are crucial for reducing the climate crisis, safeguarding public health, and maintaining ecosystem sustainability. Results from particulate matter (PM 2.5-10), which consists of tiny particles with varying diameters, can enter the respiratory system through inhalation. This can lead to a diameter of less than 10 μm (PM 2.5-10). According to the relevant legislation, the limit value refers to the daily average value and must not exceed 50 μg/m3. While ozone in the stratosphere serves a protective function against ultraviolet radiation, excessive levels at ground level can be harmful and have been recorded in atmospheric samples ranging from 146.6 μg/m3 up to 702.3 μg/m3. impacting the respiratory and cardiovascular systems. Policy leaders, businesses, and individuals need to be proactive in reducing air pollution, adopting clean energy technology, and implementing stricter pollution rules. Stricter pollution rules, environmentally friendly transportation choices, and the adoption of clean energy technology. The sustainability of the ecosystem and public health are significantly impacted by climate change linked to air pollution. To solve these global problems and move toward a healthier, cleaner future for future generations, we must act now on climate justice. Key messages • Examine the impact of African dust air pollution on public health and its significant impacts from climate change, provide solutions to mitigate its effects on environmental sustainability in Europe. • Public health workers, Policymakers and stakeholders must prioritize reducing emissions and enforcing strict air quality laws to mitigate the negative impact of African dust on European populations.

Socioeconomic And Mental Health Challenges: Lessons From The COVID-19 Era

Abstract The relationship between work arrangements, financial difficulties, compliance with COVID-19 sanitary measures, and preexisting mental health issues amidst the ongoing pandemic is multifaceted. By merging data from the TEMPO cohort and other European cohort studies during the RESPOND European project, we seek to provide comprehensive about these dynamics for developing targeted interventions and policies aimed at mitigating the adverse impact of pandemics on mental well-being. Our analyses reveal significant associations between unemployment, financial strain, and elevated levels of symptoms of anxiety and depression during the COVID-19 pandemic. Even after controlling for pre-pandemic socioeconomic and mental health factors, individuals experiencing unemployment or financial difficulties were more likely to report heightened mental distress. Additionally, our findings highlight gender-specific patterns in compliance with COVID-19 sanitary measures, with women exhibiting increased compliance amidst mental health difficulties, while men, particularly those with lower educational attainment, demonstrated decreased compliance. These preliminary results underscore the complex interplay between socioeconomic factors, mental health, and public health behaviours during pandemics. In conclusion, our study underscores the urgent need for targeted interventions and strategies to address the intersecting challenges of mental health, employment, financial strain, and compliance with public health measures during the COVID-19 pandemic. The findings emphasize the importance of considering socioeconomic disparities in designing effective interventions aimed at promoting public well-being and resilience in the face of future pandemics. By leveraging these insights, public health practitioners and policymakers can develop evidence-based approaches to support individuals and communities experiencing heightened vulnerabilities during times of crisis.

1.Y.2. Children’s mental health problems explode. Can exposome research offer a solution?

Abstract Background A week-long, multidisciplinary workshop at the Lorentz Institute explored the expectations of exposome research on child health. Exposome research investigates how combined exposures affect health. Currently we see an increase in adolescent mental health problems in Europe. We explore at the workshop if and how exposome research can be part of the solution to tackle this health issue. Findings The workshop aims were to analyze how monitoring data from exposome research can be best used for improving health policy in relation to improving (environmental) health policy in relation to children’s health. By taking a deep dive into solution-finding, we explored creative solutions to better utilize existing exposome data from digital data platforms, such as cohort data. And to facilitate working across disciplines using innovative tools of working transdisciplinary across research, policymakers and other professionals. Furthermore, we study how to enhance, harmonize and interpretation of data on child health. Furthermore, we look how child health depends not only on the quality of a healthcare system, but also on the magnitude of negative or positive influencing factors, such as social and environmental factors. Identifying such stressors and reducing their impact through adequate policies can improve child health on local, national, or even global scales. One innovative way of identifying such stressors is the exposome approach. The exposome approach is the characterization of the non-genetic drivers of health and disease. The exposome comprises aspects of the Built environment (characteristics of where we live); the Social environment (with whom we interact, social networks and income); the Physio-Chemical environment (chemical and environmental factors exposure) and the Lifestyle/Food environment (what we eat, how much we exercise) over the entire life-course. Workshop aims: - Provide a background on the urgency of adolescent mental health problems in Europe. - Compare approaches of stakeholders and researchers: stakeholders’ input from the practical field can shape the approach of the research process. The second benefit is to derive implications for creating effective interventions and policies to prevent adverse effects of environmental exposures and to foster positive health in children and later in life. - Explore existing interventions on child health for issues, experiences and possible solutions to the governance and organization of health adaptation in urban and social planning. - How to act in the process of research to intervention to public policies. The workshop consists of three short presentations followed by interactive panel discussions. We end with the audience actively engaging in the debate, as well as entering their questions. The workshop will end by identifying the current and future necessary roles, responsibilities, capacities of the public health researchers, policymakers, and professionals for child health protection in complicated exposure settings. Key messages • Child mental health issues are increasing in an unexplainable way. • Engaging stakeholders into an exposome research process can help to form a child health strategy in Europe.

10.Q. Scientific session: Evolving landscape of scientific publishing practices: implications for public health

Abstract In the landscape of scientific publishing, questionable research practices pose significant threats to the integrity and reliability of health research. This is occurring alongside notable changes in both the quantity and quality of published work. This scientific session aims to dissect the implications of such changes and practices on public health, fostering a critical examination and encouraging proactive discourse among public health professionals, researchers, and policymakers. Meta-research can explore the nuances of publishing ethics and the idea behind this session is seeking to heighten awareness of these issues and initiate meaningful discussions among public health professionals on maintaining the integrity of scientific literature in the health domain. The session will delve into the complexities of contemporary publishing, including the proliferation of mega-journals, trends in retracted papers, journals delisted from scientific databases, and the disturbing trend of paper mills which produce fraudulent research papers. Each aspect will be scrutinized for its potential impact on the credibility of health research and the consequential risks to public health. Structured as an interactive panel discussion, the format of this session is designed to maximize engagement and foster an open exchange of ideas. Participants will be encouraged to contribute their experiences and perspectives after each of the three presentations, enriching the dialogue and enhancing collective understanding. The distinct topics presented will underscore the pervasive nature of publishing practices and malpractices across different aspects of health research, highlighting the interconnectedness of ethical challenges and their broader implications. This session will merge meta-research empirical evidence with practical repercussions, offering attendees a comprehensive perspective on how publishing ethics might be shaping public health outcomes. It aims to equip participants with the knowledge to identify dubious practices and advocate for higher standards in scientific publishing. Improving research integrity is a cornerstone for effective health policies and interventions. The subject matter is poised to stimulate debate, invite scrutiny, and inspire action. Through this discourse, the session will articulate key messages about the urgency of upholding ethical standards in publishing to safeguard health research, providing clear, actionable insights for attendees to implement in their respective fields Key messages • Unethical publishing practices endanger health research integrity and might have consequences for public health outcomes. • Acknowledging good publishing practices and combating malpractices will foster higher ethical standards in health research.

The future of nutrition education for health systems capacity building

Abstract In the ever-evolving landscape of global health, nutrition education plays a pivotal role in shaping the well-being of populations. The future of nutrition education encompasses a holistic understanding of health, considering not nutritional adequacy in health and disease, but also cultural, social, and environmental factors. Tomorrow’s health professionals must also be equipped to address the interconnectedness of nutrition with mental health, sustainability, and community dynamics. Nutrition education will increasingly involve collaboration across disciplines. Health professionals, educators, policymakers, and community leaders must work together to create a comprehensive ecosystem that fosters nutrition literacy. This collaboration extends beyond traditional healthcare settings to schools, workplaces, and local communities. Furthermore, digital transformation will also revolutionise nutrition education. Online platforms, mobile apps, and virtual simulations will enhance learning experiences whilst interactive modules, webinars, and gamified content will engage learners and facilitate continuous professional development. Moreover, telehealth and tele-nutrition will bridge geographical gaps, ensuring access to quality education globally. Cultural sensitivity in nutrition education is also needed across geo-demographic boundaries to appreciate diverse dietary practices, food taboos, and traditional knowledge. Nutrition education should also empower health professionals to advocate for policy change across food systems, promote sustainable practices, and address food insecurity and therefore understanding policy frameworks and participating in advocacy efforts will be key. Finally, embracing the future requires a commitment to lifelong learning to remain at the forefront of nutrition science and its cutting edge as the questions may remain the same but the answers vary significantly as we garner new evidence to navigate evolving global challenges.

Fast lane for decision making: The PHIRI Rapid Exchange Forum

Abstract Issue & Problem The COVID-19 pandemic demanded swift, yet structured exchange of knowledge, data and good practices between experts and institutions supporting national governments in decision making for crisis response. Thus, in March 2020 population health experts from several European countries started to meet online, complementing the more formal EU Health Security Committee meetings. The European Commission understood the high need of Member States for evidence-based, and structured cross-country exchange and supported it as part of the Population Health Research Infrastructure (www.PHIRI.eu) project. Since then, the PHIRI Rapid Exchange Forum (REF) is a knowledge-sharing platform that brings together public health researchers, practitioners, policymakers, and other stakeholders to share information, experiences, and best practices in public health implementation research even if the EU co-funded PHIRI project has ended. The forum aims to promote collaboration and networking, facilitate the dissemination of research findings, and accelerate the translation of evidence into policy and practice. Lessons Through the PHIRI REF, participants can engage in interactive discussions, workshops, and presentations on various public health topics, including infectious diseases, digitalisation, health emergency simulations, health systems strengthening, and community health interventions. The platform is designed to be user-friendly and accessible to all, with a particular focus on European countries. By May 2024, the REF-Secretariat at the Austrian National Public Health Institute GÖG had organised 60 REF meetings, with in average 20 attendees from 12-15 countries. The monthly 1-hour online meetings cover in a moderated, structured format pre-agreed topics that are proposed by the participating countries. All findings and topics are documented and publicly available at the EU Health Information Portal (https://www.healthinformationportal.eu/rapid-exchange-forum). Key messages • The success of the Rapid Exchange Forum highlights the importance of collaboration and information exchange between population health experts in addressing global health challenges. • Having a pre-established information exchange network on urgent public health issues is of utmost importance as it enables rapid and trustworthy communication among relevant stakeholders.

3.O. Scientific session: Migrant labour exploitation and health: How can research foster protection of migrant workers?

Abstract Migrant workers sustain essential industries such as the food supply chain, construction, and domestic and care work. They tend to perform onerous and risk-laden tasks at low pay without employment or health protections, and often under exploitative terms (e.g., debt bonding, piecework). Current evidence on associations between migration, employment terms and conditions, and health indicates profound inequities in work-related health outcomes for migrant workers. Although the COVID-19 pandemic highlighted these disparities and their potential social and public health implications, migrant workers continue to be overlooked by public health scholars and policymakers. Supranational regulations (such as EU directives) and national policies rarely consider migrants in their role as workers, and little research is dedicated to questions at the intersection of migration, employment, and health. The invisibility of migrant workers is also a matter of disciplinary and sectoral silos, with different aspects of migrant labour regulated separately by Ministries of Immigration, Labour, Agriculture, Health, and others. These silos create incompatible, context-contingent definitions, terminologies, and administrative categorizations, leading to inconsistent data collection and data gaps which, in turn, translate into policy blind spots. Data that are comparable across contexts and that refer to migration, employment/work and health are generally scarce. For some sectors and contexts, virtually no data exist; e.g., for migrant workers in agriculture, construction, and domestic work, and for migrant workers in low- and middle-income countries. There is barely any evidence about interventions to improve the structures that dictate migrant workers’ employment conditions or obligations of employers. Given the limited participatory research with migrant workers, we have a very poor understanding of their views and viable intervention options, and migrant workers’ voices thus also remain absent from policymaking. This workshop aims to contribute to greater visibility of - and ultimately action on - migrant labour exploitation in research and policy. To this end, it will map current challenges and shortcomings in generating evidence on the links between migration, work/employment, and health; and it will suggest ways to improve research and interventions to address migrant workers’ health, based on the speakers’ experience in developing intervention-focused evidence in different contexts. The workshop will conclude with an open discussion to identify further relevant questions and elaborate steps towards better research and greater protections for mobile worker populations. Key messages • Harm from exploitative working conditions among migrant workers is substantial, yet data collection methods and intervention designs are limited. • For public health research to effectively help protect the health and rights of migrant workers, it is essential to share methods and insights across disciplines to drive research for action.

Traceability for strengthening supply chain systems and enhancing real-time visibility: Focus of NAFDAC on advancing vaccine traceability in Nigeria

This study explores the successful implementation of activities aimed at scaling traceability for COVID-19 and routine immunization (RI) vaccines to the local government area and selected healthcare facilities in Nigeria, funded by the Bill and Melinda Gates Foundation. The study was executed by the National Agency for Food and Drug Administration and Control (NAFDAC) and sought to enhance supply chain systems by deploying advanced traceability mechanisms and ensuring real-time stock visibility. The article discusses the accomplishments, challenges, and regulatory framework of NAFDAC, emphasizing GS1 technology-driven traceability, and presents the results of the field scanning activities conducted in July 2023. The approach involved a phased public sector pilot, showcasing the feasibility and challenges of tracking vaccine movement through the supply chain. The result shows the detection of 43 unique products across 1022 facilities from a total of 110,113 scans, offering valuable insights into vaccine distributions. The strategic goals of the project aligned with developing safety surveillance systems in low- and middle-income countries (LMICs) to facilitate patient access to global health products. Similarly, significant improvement in traceability through automated data capture (barcode scanning) and expanded coverage for COVID-19 and selected RI vaccines in Nigeria was found. Against this background, the information derived from this report will build confidence in patients regarding vaccine authenticity, establish a transparent and robust supply chain, and foster pharmacovigilance capability through integration with the track-and-trace systems. Thus, the study provides invaluable insights and opportunities for global health practitioners, policymakers, and researchers to incorporate track-and-trace into regulatory systems by other national regulatory authorities.

2.A. Practice session: Policy labs: getting public health research into policy and practice

Abstract The process of translating health research into policy and practice benefits is often too slow, taking an average of 17 years globally. Additionally, health policy changes fail when they have an inadequate understanding of the communities and challenges they seek to address. The Policy Institute at King’s College London has developed an innovative ‘Policy Lab’ method, which convenes diverse policy and practice stakeholders such as health workers, patients and policymakers, to discuss a policy challenge, assess the evidence and co-produce viable policy options. The proposed workshop introduces this method in a practical, impactful session aimed at helping participants from any country and research background mobilise their research to improve health outcomes. Policy Labs have been shown to be highly successful method. Previous Policy Lab outcomes include influencing changes to the Mental Health Act in the UK, new international guidance on treatment of type 2 diabetes, and a global coalition on paying for prevention in dentistry. The method can be adapted to different health challenges and considers the potential for change in local, national and international arenas. The workshop teaches this method in a way that enables researchers to apply it to their own work, harnessing the potential of research to improve health outcomes. Objectives of the workshop The workshop aims to teach people the skills to design and run a Policy Lab so that they can better mobilise their research into policy and practice. Participants will learn To develop policy-relevant questions from their research; Stakeholder mapping; To design a policy lab agenda; To develop a research engagement plan. What is the added value of the workshop? The workshop teaches an innovative method that helps researchers greatly increase the policy impact from their work. It provides attendees with practical tools to employ in their own work and bridge gaps between their research and policy and practice changes. The format of the workshop will involve a short presentation on Policy Labs by facilitators, followed by four brief interactive activities for participants, as follows: Facilitator presentation: (10 mins) Introducing the Policy Lab method; Group work 1: (10 mins) Developing a policy-relevant question; Group work 2: (10 mins) Stakeholder mapping; Group work 3: (10 mins) Designing a lab agenda; Group work 4: (10 mins) Developing a research engagement plan. We have allowed 10 minutes to adapt to any arising demands, as well as to bring the session to a close with some key messages. Participants will be guided by the facilitators, and we will use template handouts for participants to complete during the session to reinforce learning. The handouts also ensure that those who wish to work independently rather than in groups may do so if preferred, and will provide participants with the practical tools necessary should be they arrive late or need to leave early. Key messages • Policy Labs are an effective way for researchers to have policy and practice impact with their work. • Participants will learn how to run a successful Policy Lab, and improve their research impact.

Exploring Spectacle Usage Patterns: A Thematic Analysis of Refractive Disorder Patients in Medan, Indonesia

Objectives: This study explores the behavioral patterns of spectacle users with refractive errors in Medan City, Indonesia, and identifies the key factors influencing the decision-making process in choosing and using glasses, contributing to SDG 3 (Good Health and Well-being) by addressing vision health. Theoretical Framework: The research is guided by the Precede-Proceed model and the Theory of Planned Behavior, which provide a framework for understanding health-related behaviors, including spectacle usage and its impact on overall well-being. Method: A qualitative methodology was employed, involving in-depth interviews with 30 Medan City residents diagnosed with refractive errors. This was supplemented by focus group discussions and consultations with eyewear experts. Data were analyzed using a descriptive-analytical approach. Results and Discussion: Key themes influencing spectacle usage behavior were identified, including needs, comfort, fashion, quality, perception, economy, and knowledge. Among these, needs, comfort, and quality emerged as the most significant factors influencing users’ choices of glasses. The findings suggest that people with refractive errors should prioritize glasses that meet health standards to ensure comfort and improve visual impairments, aligning with the goals of SDG 3 to promote health and well-being. Research Implications: Health practitioners, particularly optometrists, play a critical role in educating the community about the importance of using high-quality eyewear and addressing common misconceptions related to spectacle use, thus contributing to SDG 3 (Good Health and Well-being). Originality/Value: This study provides novel insights into the behavioral patterns of spectacle users in a specific cultural context, offering valuable information for health professionals and policymakers to improve vision care services in Medan City in support of SDG 3.

Mapping the Public Health and Health Promotion Capacity in Oman

Abstract Background An essential condition to enabling people to increase control over their health is to have sufficient capacity for public health (PH) and health promotion (HP). Despite the recognition of its importance, a comprehensive view of the PH and HP capacity in the sultanate of Oman is not yet available. This study provides a mapping of the country’s PH and HP capacity at national, governorate and district levels. Methods An online quantitative survey was performed amongst 70 health policy maker and experts in PH and HP using a questionnaire based on the PH capacity framework of Aluttis et al., yielding data on the country specific context with relevance for PH and 6 PH capacity domains, each divided in subdomains: leadership and governance; organizational structures, workforce, financial resources, partnerships, and knowledge development. Internal consistencies of the scales measuring the capacity subdomains ranged from .75 to .99. Results The survey revealed relatively low scores, representing partial development of capacities, for most of the public health capacity domains. The highest levels of capacity were observed for knowledge development (health information and monitoring systems, reporting systems and knowledge infrastructure), organizational structures (institutional capacity, program delivery structures, PH within health services, and response emergencies) and partnerships (formal consortia, informal partnerships and multisectoral coordination). In contrast, leadership and governance, workforce development, and financial resources score lower. Conclusions Mapping the strengths and weaknesses of PH and HP capacity in Oman allows to make recommendations for improving population health. Whereas all domains of PH and HP capacity are partially developed, there is a need to further improve capacity in all domains. Key messages • PH and HP capacities are partially developed in Oman. • Mapping the PH and HP capacity allows to identify strengths and weaknesses and make recommendations for improving public health.

Integrating international lifestyle management of acute coronary syndrome and type 2 diabetes mellitus: a rapid review of guidelines

Abstract Background The rising prevalence of comorbidity has been described as an international health priority. There has been a dramatic increase in the levels of Type 2 Diabetes Mellitus (T2DM) among those with Acute Coronary Syndrome (ACS), with approximately 25-40% of patients admitted to hospital for ACS, also having diabetes. Comorbid ACS-T2DM provides a more complex set of symptoms for patients and clinicians to manage, and health policy makers to plan for. Those living with comorbid ACS-T2DM are at increased risk of death, another heart attack, re-hospitalisation, heart failure, reduced physical and psychological health, increased health service use and poorer quality of life. Due to shared disease determinants such as obesity, low physical activity levels and poorer dietary habits; individuals with ACS are more likely to have a comorbid T2DM. Care for patients with comorbidities is fragmented, siloed and poorly organised as it reflects a tradition of single disease management meaning comorbidity is rarely considered. Robust evidence is required to shape provision and guidance for those with comorbid ACS-T2DM and the clinicians involved in their care; with an emphasis on redesigning service provision and practice to address the needs of this growing population. Purpose To identify opportunities in existing clinical guidance to improve integrated care strategies and streamline management for those with comorbid ACS-T2DM. Methods Following Cochrane rapid review recommendations, a Population, Concept, and Context (PCC) framework guided eligibility. Guidelines for adults with ACS, T2DM, or both conditions in high-income countries were considered. Nineteen guidelines from the UK, Australia, Canada, Europe, Ireland, New Zealand, and the USA were compared, covering ACS (n = 10), T2DM (n = 6), and comorbid ACS-T2DM (n = 3). Lifestyle factors examined included diet/nutrition, physical activity, weight management, clinical and psychological aspects. Results The review identified consistent lifestyle recommendations for both ACS and T2DM, with overlaps in guidance for diet, physical activity, weight management, clinical, and psychological factors. The findings offer opportunity for integrated care strategies, potentially reducing duplicated lifestyle management efforts. The results lay the groundwork for more cohesive management of comorbid ACS-T2DM. Conclusions This research is relevant for healthcare providers, policymakers, and patients living with comorbid ACS-T2DM. Understanding the shared lifestyle factors provides valuable insights into the potential for integrated care. Recognising the overlap in existing clinical guidelines points to opportunity for a more streamlined and effective approach to managing comorbid ACS-T2DM. This knowledge can contribute to improved patient outcomes and seek to optimise healthcare resources.

11.H. Round table: Making the case for public investment in health

Abstract Across the European Union (EU), public budgets are facing pressures and policy makers are becoming increasingly concerned about how to adequately and sustainably fund their health systems to keep up with need and demand. In recognition of this, in 2022 a Technical Support Instrument (TSI) project funded by the Directorate-General for Structural Reform Support (DG REFORM) was launched together with three European Union (EU) Member States with the goal of strengthening capacity to make the case for public investments in health. To support these efforts, the European Observatory on Health Systems and Policies (OBS) conducted an exercise to map relevant analytical approaches and tools for making the case for public investment in health. As a contribution to this workshop, OBS will present the key results from this exercise, including a framework that has been designed to support health policy makers, advisors and advocates by providing five key lines of argument and selected examples of tools, data, indicators and methods that can be used to successfully make the case for public funding for health. This will be complemented by two presentations on country experiences (in Austria and Malta) of navigating negotiations between health and finance and securing public funding for health. These will highlight both successes and challenges in practice. By looking at examples from MS on making the case for public investment in health, these presentations will frame the panel discussion that follows. The chairs will facilitate a discussion closely engaging the audience on how to build better narratives and exchanges which facilitate trust and alignment between health and finance stakeholders in the pursuit of strengthening the capacity to make the case for public investment in health. The workshop will highlight five lines of argument and practical examples of tools, data, indicators and methods that can be used to support the case for public investment in health. It will also focus on the important enablers (e.g. cooperation, communication, transparency, accountability, trust) for successful budget negotiations and discuss how these can be facilitated. Key messages • Budget cases for public funds for health tend to be most successful when they align well with the goals and objectives of finance stakeholders, and certain narratives and arrangements can foster this. • Data and evidence can help steer decision makers to make good choices (or at least avoid bad ones), but other factors serve as the fuel to push the budget case for health forward successfully. Speakers/Panelists Rebecca Forman European Observatory on Health Systems and Policies, London, UK Jonathan Cylus European Observatory on Health Systems and Policies, London, UK Stefan Eichwalder Ministry of Health, Vienna, Austria Neville Calleja Department of Health Information and Research, G’Mangia, Malta

The corporate political activity of Portugal’s food industry: enhancing public health transparency

Abstract Background This study in Portugal aims to monitor the Corporate Political Activity (CPA) in the food industry. Portugal provides a compelling case study due to its robust implementation of public health policies. Methods A systematic qualitative approach proposed by Mialon et al., a part of the INFORMAS Module 3, was employed. This method is based on the analysis of publicly available information. Key industry actors were selected through expert consultation and market analysis using EuroMonitor data. Information sources included industry, government, and academic materials accessed via websites and news. A thematic qualitative analysis was conducted involving iterative steps: identifying CPA practices based on predefined strategies - Taxonomy of Action Strategies: access and influence policymaking, use the law to obstruct policies, manufacture public support, shape evidence, displace and usurp public health, and manage reputations -, recording methods in a database, and saving evidence. Data collection spanned October 2023 to April 2024, covering materials from 2022 to 2023. Results Twenty-five key players were identified, including processed food and non-alcoholic beverage manufacturers, fast food companies, food retailers, and national trade associations. Food retailers, notably Jerónimo Martins, Lidl, Mercadona, and Sonae, showcased a higher prevalence of CPA. Nestlé and Sumol+Compal also emerged as prominent actors. The food industry in Portugal employs diverse strategies and tactics primarily focused on shaping evidence and managing reputations. While instances of displacing public health priorities and manufacturing public support were observed, they were relatively fewer. Only APED and FIPA showed engagement in policymaking influence. Conclusions Vigilant monitoring of CPA in the food industry in Portugal reveals dominant tactics of shaping evidence and managing reputations. Understanding these strategies is vital for policymaking to safeguard public health. Key messages • The food industry in Portugal employs diverse strategies, primarily shaping evidence and managing reputations, to influence public health policies. • Monitoring the Corporate Political Activity is key to preserving the integrity of public health policymaking in Portugal’s food industry.

Screening for congenital Chagas disease in a non-endemic area: a cost-effectiveness analysis

Abstract Background Due to climate changes, immigration, and globalization, Chagas Disease (CD) also afflicts nations without vector transmission. In Europe, congenital CD (cCD) is a significant public health issue, perpetuating the disease: it is crucial to perform CD screening in pregnant women at risk, as the treatment of infants is effective in eradicating the infection. Only a few European regions have a definite algorithm for diagnosing cCD, but no official guidance has been published at the national or European level. To support policymakers, this study aims to outline a cost-effectiveness analysis of CD screening in non-endemic areas, such as Italy, in pregnant women born or arriving from endemic countries and in their newborns. Methods To measure the economic impact of cCD screening, a decision tree model will be used to compare the test option (screening, diagnosis, treatment, follow-up) with no test option (no screening, progression of disease). Model parameters will be taken from relevant scientific literature. The primary outcome will be the Incremental Cost-Effectiveness Ratio (ICER) between the two options. Sensitivity analyses will be conducted to determine how changes in prevalence, transmission rate, screening adherence, and treatment adherence may affect the ICER. Results We expect the ‘test’ option to be cost-effective even with significant reductions in prevalence, transmission rate, adherence to screening or treatment. Threshold levels of these variables will allow to critically extend the results to areas with reduced immigration, patchy distribution of migrants at risk, health logistical limitations, and limited access to care for immigrants. Conclusions Our findings can help policymakers implement official screening programs and diagnostic algorithms for cCD in Italy and other non-endemic countries. This contributes to SDG 3 by combating the spread and burden of neglected tropical diseases and contributing to maternal, child, and migrant health. Key messages • Screening for congenital Chagas Disease in a non-endemic area may be cost-effective and cost-saving. • Study findings could provide useful information for health policymakers to combat Chagas Disease in Europe.

Data dashboards in health inequalities monitoring - A qualitative study of subnational policy-makers

Abstract Background Despite sustained improvements in life expectancy and health during past decades, substantial health inequalities persist. Subnational jurisdictions are increasingly recognised for their pivotal role in addressing health inequalities. While data dashboards offer a promising solution for monitoring health inequalities, their utilisation in supporting local policies to reduce inequalities remains largely unexplored. This study examines the utilisation of health equity data and data dashboards (i.e. Sotkanet, Sotekuva, Tietotarjotin and Hyvinvointivajemittaristo) for health policy-making in Finnish wellbeing services counties, identifies barriers in using existing dashboards and determines the data needs for improved health inequalities monitoring. Methods A qualitative case study design with reflexive thematic analysis will be used. The study will be pre-registered in the OSF framework. Semi-structured interviews will be conducted with policy-makers involved in health policy development. Data analysis will involve open and axial coding to identify themes in participants’ responses. Themes will be organised into a coding framework, and the analysis will continue iteratively until data saturation is achieved. The study will include a pre-approved interview guide and peer debriefing sessions. Findings will be reported according to the Consolidated criteria for reporting qualitative research (COREQ) guidelines, with thematic diagrams illustrating key themes and sub-themes. The study is expected to reveal varying levels of utilisation of data and data dashboards among local policymakers, along with specific challenges and gaps in their current use. Policymakers may express needs for additional data or new features in dashboards to better monitor health inequalities. The study will conclude with recommendations for improvements in current data dashboards. Work is under development but by funders requirement the results will be ready by November 2024. Key messages • Data dashboards offer a promising solution for monitoring health inequalities, but their utilisation in supporting local policies to reduce inequalities remains largely unexplored. • This study examines the utilisation of data dashboards for health policy-making subnationally, identifies barriers for use and determines the data needs for improved health inequalities monitoring.