Policy Reform Research Articles

Accessing the Impact of Policy Reforms on the Rights to Education: A Comparative Study of Emerging and Developed Economies (Nigeria and the U.S. )

This study examined the impact of education policy reforms on the right to education in emerging and developed economies, focusing on Nigeria and the United States. It analyzed how policy interventions shaped access to education, the quality of educational outcomes, and equity in both countries. The key research questions investigated the effectiveness of education reforms in improving access, addressing regional and socioeconomic disparities, and ensuring quality education. The study adopted a comparative case study methodology, analyzing secondary data, policy documents, and education statistics from both nations. Theoretical frameworks such as Human Capital Theory and a rights-based approach to education were used to evaluate the policies' impact. Findings revealed that while Nigeria made significant strides in increasing school enrollment through policies like the Universal Basic Education (UBE) program, it struggled with quality, funding, and regional disparities. In contrast, the U.S. achieved widespread access to education but faced persistent challenges related to racial and socioeconomic inequities, influenced by the shortcomings of standardized testing and uneven funding allocation. The study’s implications suggested that addressing policy implementation, funding, and equity issues is essential for advancing the right to education. Recommendations were provided to strengthen reforms, improve funding mechanisms, and promote equitable access to quality education in both contexts.

Pharmacists in global primary healthcare systems: A comprehensive model for community health empowerment

Pharmacists play an increasingly important role in global primary healthcare systems, evolving from traditional dispensers to active participants in patient-centered care. This paper advocates for the stronger integration of pharmacists into healthcare teams to improve patient outcomes, medication adherence, and overall healthcare delivery. Through a comprehensive review, we examine the evolving role of pharmacists, the key challenges to their full integration, and the substantial opportunities they present, particularly in managing chronic diseases, providing preventative care, and enhancing patient education. We propose a model for empowering pharmacists to contribute more effectively to community health, especially in underserved areas. The paper also highlights the potential global impact of pharmacists in reducing healthcare costs, improving disease management, and promoting public health initiatives. Lastly, recommendations for future policy reforms, education enhancements, and research directions are offered to support the continued expansion of pharmacists' roles in primary healthcare systems worldwide.

Exploring the impact of obesity and community health programs on enhancing endometrial cancer detection among low-income and native American women through a public health lens

This review examines the intricate relationship between obesity, endometrial cancer detection, and the role of community health programs, with a particular focus on low-income and Native American populations. Obesity is identified as a significant modifiable risk factor for endometrial cancer, disproportionately affecting vulnerable communities, which exacerbates existing health disparities. The paper explores the epidemiological link between obesity and endometrial cancer, highlighting disparities in detection and the compounded risks faced by underserved populations. It also reviews the effectiveness of public health initiatives aimed at improving cancer screening rates and obesity prevention among these groups. Despite the progress made through various community health programs, substantial gaps remain, particularly in ensuring culturally competent, accessible, and sustainable care. A lack of longitudinal studies evaluating the long-term impact of these programs on cancer detection and obesity management underscores the need for more robust research. Additionally, social, psychological, and systemic barriers continue to hinder screening uptake, further perpetuating health inequities. This review concludes by emphasizing the need for integrated public health approaches that combine obesity prevention with cancer screening, as well as policy reforms to enhance healthcare access and provider availability in underserved communities. Recommendations are provided for future research that addresses these gaps, with the goal of improving early detection and overall health outcomes for low-income and Native American women.

Breaking barriers: The impact of girls’ education on poverty eradication in northern Nigeria – A Focus on Sokoto State

This research explores the critical role of girls' education in alleviating poverty in Sokoto State, Nigeria. It highlights the significant gender disparities in educational access, driven by cultural norms that prioritize boys' education, which impede both individual potential and broader economic growth. The research underscores that educated women contribute to workforce participation and family income, thereby fostering community development and reducing poverty. Despite some progress, challenges such as socio-cultural attitudes, inadequate infrastructure, and economic constraints persist, necessitating a multi-faceted approach involving policy reforms and community engagement. The study employs a mixed-methods methodology, revealing that while enrolment rates have improved, gender inequities remain pronounced. It advocates for targeted interventions and community involvement to shift perceptions and enhance girls' educational opportunities, ultimately aiming for sustainable development goals in Northern Nigeria.

Mindful Transportation: A Conceptual Framework for Enhancing Accessibility for People with Disabilities in Malaysia

This conceptual paper explores the integration of mindfulness principles into the development of transportation services for people with disabilities (PWDs) in Malaysia. Transportation plays a critical role in promoting inclusivity and enhancing the quality of life for PWDs, yet accessibility remains a significant challenge due to infrastructural barriers, lack of awareness, and limited empathy from service providers. Drawing on the concepts of mindfulness, which are rooted in awareness, empathy, and responsiveness, this paper proposes a framework that emphasizes inclusivity, respect, and collaboration among key stakeholders. The proposed framework emphasizes the need for a holistic approach that incorporates physical accessibility, staff training, and policy reforms. Inclusivity involves modifying infrastructure to meet universal design standards, while empathy requires transport providers to understand the unique challenges faced by PWDs and offer compassionate, tailored services. Responsiveness, a key element of mindfulness, calls for flexible and adaptive transport services that cater to the real-time needs of PWDs, ensuring that they can access public transportation with ease and dignity. By applying this mindful approach, the transportation system can become more accommodating and respectful toward PWDs, thereby reducing social exclusion and improving their mobility. This paper contributes to the growing body of literature on disability inclusion and provides actionable strategies for policymakers, transport providers, and disability organizations to work together in creating a more accessible public transportation system. Future research should investigate the practical application of this framework and its potential to drive policy changes that benefit PWDs across Malaysia.

Embedding a text message recall system to increase the uptake of cardiovascular screening in Australian general practice. Results of the Text to Detect randomised controlled trial

Abstract Background Australian guidelines recommend cardiovascular disease (CVD) risk screening for adults aged 45-74 years, but less than one in three have blood pressure and cholesterol recorded within their general practitioner (GP) records. Medicare subsidised ‘Heart Health Checks’ were introduced in primary care in 2019, however uptake has been suboptimal. Purpose The aims of this study were to; 1) implement a text mediated Heart Health Check recall program within general practice at scale, 2) determine whether uptake can be increased with nudge reminder text messages and 3) evaluate the impact on risk factor measurement and medication prescription. Methods Australian general practices were invited via advertisement and mailing list. Medical record software identified patients eligible for a Heart Health Check. Practices were randomised to one of three arms: 1) standard SMS: 1 SMS inviting patients to see their GP for a Heart Health Check, 2) nudge reminder: standard SMS + nudge reminder two weeks later, 3) control: no SMS. Aggregate, deidentified, practice-level data was extracted at baseline and 3-months. The primary outcome was the proportion of Heart Health Checks delivered at a practice level. Secondary outcomes included updated CVD risk factor assessment and new medication prescriptions. Analyses used ANOVA and Tukey's HSD. Results Between 2022 and 2023, 206 general practices participated, each with 560 median eligible patients (IQR:297-909). A total of 70,679 recall text messages and 34,406 nudge reminder messages were sent. Heart Health Check uptake was 11 and 16 times higher in the standard and nudge arms (respectively) compared to control (0.4 vs 4.5 vs 6.3 per 100 patients, p<0.001), with a 40% statistically significant increase (p=0.02) for 2 SMS vs 1 SMS. Updated cholesterol values were 31.6 and 60.2% higher in standard and nudge arms (respectively) compared to control (13.7 vs 16.8 vs 17.4 per 100 patients, p=0.02). Both active arms were statistically significantly different from control (standard p=0.047, nudge p=<0.001). Updated blood pressure was 23.0 and 26.8% higher in the standard and nudge arms (respectively) compared to control (13.7 vs 16.8 vs 17.4 per 100 participants), however only the nudge arm was statistically significantly different (p=0.38). New medication prescription (lipid or blood pressure-lowering) was 36.8% higher in the nudge arm compared to control (32.1 vs 43.9 patients per practice, p=0.03). Conclusions This study demonstrates the effectiveness of text mediated recall of eligible patients to increase the uptake of cardiovascular risk screening in Australian general practice. The findings will inform the implementation of new Australian guidelines and policy reform.

5.L. Round table: Gaining or losing ground? Leveraging social innovation to improve abortion access in Europe

Abstract Sexual and reproductive health services are fundamental to ensuring a wide range of human rights, including the right to health. This includes guaranteeing access to abortion care, which international human rights bodies and the World Health Organization have recognised as a critical component of states’ obligation to respect and ensure human rights. Abortion regulation in Europe continues to evolve along a continuum from restrictive to liberal. For decades, the legislative trend across Europe has been towards the expansion of entitlements to abortion, and the repeal of legal and policy restrictions. In the last ten years, over 15 European countries have undertaken reforms to modernize their laws, including Belgium, France, Ireland, the Netherlands, and Spain. Currently, new progressive reforms are being considered in several countries. However, more restrictive reforms have also been adopted. Health system structures and sociopolitical, cultural, ethical, and moral dimensions shape access to abortion services, while abortion regulation often causes tensions in countries. The landscape is complex, with debates over legalisation and decriminalisation of abortion, and the procedural steps to ensure service provision. Differences in regulation across and within countries result in myriad access inequalities. Understanding abortion regulation in Europe is vital to assessing service equity and access. Exploring the sociopolitical contexts of abortion helps identify potential actions for ensuring access to abortion care. In exploring the range of potential actions, we focus on social innovation, i.e., new social practices to better meet social needs and the processes undertaken to get there. The country expert (HSPM) network of the European Observatory has launched a cross-country study of the state of abortion services in 19 high-income countries since 2018. This workshop will outline the legal, regulatory, service-delivery, and sociopolitical contexts of abortion in Europe, identifying challenges to access. It will take recent experiences in Germany, Ireland, and Portugal to examine differential access, ongoing political debates, and social positioning of abortion in Europe, and as a springboard to discuss the role of social innovation in shaping legal and regulatory changes. Lastly, this workshop will explore how the public health research community can contribute to evidence-based abortion policymaking and implementation. This interactive workshop will start with a presentation of findings from the European Observatory’s cross-country comparison. Then, country experts from the 3 case studies and a representative from the Center for Reproductive Rights will examine the sociopolitical environment of abortion policymaking in Europe. Discussion with audience interventions will reflect on opportunities for social innovation and movement building toward better access to abortion care in Europe and explore the role of the public health research community. Key messages • European abortion laws constantly evolve with a prevalent legislative trend towards expanding access and removing barriers; social innovation can be a lever to progressive law and policy reforms. • In all countries, those seeking abortion care continue to experience multiple access barriers, including those related to policy, regulation, financing, geography, and culture. Speakers/Panelists Katherine Polin Berlin University of Technology, Berlin, Germany Miriam Blümel Berlin University of Technology, Berlin, Germany Catherine Conlon Trinity College Dublin, Dublin, Ireland Ines Fronteira National School of Public Health - NOVA University of Lisbon, Lisbon, Portugal Adriana Lamačková Center for Reproductive Rights, Geneva, Switzerland

Teaching the Professional Dimension of Translation in Academic Translation Programmes

Reform policies in higher education have brought about changes in attitudes regarding the education of translators. One of the latest challenges concerns the concept of professionalization of translation and the need for a type of training that would provide students with the specific skills required for the translator’s profession. Indeed, most translation programmes today aim at educating highly qualified translators on a competence-based training. Μore particularly, the emphasis is on metacognitive competence acquisition and the reflexive capacity development taking into account students’ motivation and expectations, their general background knowledge as well as individual learning styles. The present paper proposes a didactic approach on a professionally-oriented basis that would help students enter most effectively the translation industry by realizing at the same time the importance of acquiring a strong theoretical background on translation. Among the main issues to be addressed are the contribution of translation theory to the practice of translation, the role of the translator as cultural mediator, his social responsibilities as well as the translator’s psychological traits and their effect on translation quality. Finally, it proposes a variety of learning activities that are closely related to the act of translating together with a number of student assessment methods bearing a strong professional orientation.

4.D. Scientific session: From policy to implementation: Learnings around health system reforms and Universal Health Coverage

Abstract In this session, the authors and audience have the opportunity to engage in discussions around health policy integrity and reform implementation. Introducing and implementing health system reform has been a perennial issue for countries around the world over the past number of decades. Recently, the introduction and implementation of Universal Health Coverage (UHC) has been of particular focus, with 193 countries committed to introducing UHC by 2030. At the same time, European countries that previously established national health systems are introducing new reforms in the hope of making their health systems more efficient and equitable. However, there are a number of challenges along the path of policy development and implementation with which all countries must grapple, and how individual countries go about reforming their health systems depends on their social, political, cultural and economic contexts. Learnings from around the world have highlighted that reforms can be challenged or stalled in both the design and implementation phases. This workshop, which conceptualises implementation as the “acid test” of a policy, thus explores, through three case studies, the factors that facilitate or challenge the implementation of reforms. At the same time, we discuss policy integrity, exploring reasons for why policies pivot away from original design and intent. Furthermore, we discuss the implications of health reform on equity, cognisant that the primary objective of this collective reform work is to reduce the financial burden of healthcare on households and improve access. The first presentation will provide the framework for audience discussions, outlining international lessons in relation to UHC reforms and equity. The second presentation will provide a snapshot of the Finnish experience of introducing a “big bang” structural reform. The third presentation highlights lessons from the Portuguese experience of primary healthcare reforms, the opportunity these offer for creating patient-centred care and the integral role that politics and governance play in the reform process. Finally, the Irish case study highlights the experiences of a High Income County attempting to introduce UHC much later than its European counterparts, and negotiations between the public and private sectors. Through this, we hope to hold the tensions and stimulate debate about policy robustness and resilience, and reform implementation. Each presenter will be given a strict deadline of 10 minutes each by the chair and then the audience will be invited to debate the problems identified and strategies proposed to discuss: (i) what are the facilitators and barriers to reform implementation, (ii) what are the factors that encourage policy integrity and change and (iii) whether greater cooperation across Europe regarding health reforms can be more effective in supporting robust health systems. Key messages • For reforms to be facilitated, there must be cohesion and commitment across the political, social, economic and cultural systems, and no fragmentation across health system functions. • As policy implementation is attempted, there is a tension between remaining true to key values and adapting to new circumstances.

Legal perspectives on climate change and inequalities

Abstract In many areas of public health policy, litigation has delivered significant, long-lasting impacts. Examples include tobacco control, increasing access to treatments for HIV, and addressing air pollution and climate change. Litigation is an established part of public health’s advocacy toolbox in national courts, and increasingly in international courts and tribunals. In responding to climate change, in addition to potential policy and law reform, climate change litigation creates opportunities for public scrutiny and debate by raising awareness of inaction or harm caused by governments or private sector polluters, and sparking wider community mobilisation for climate action. Where climate change litigation is based on human rights claims, credible science-based evidence of the health and other human rights impacts of climate change is essential. Public health professionals are increasingly involved in assembling and presenting such evidence, often focusing on vulnerable populations. However, the multiple intersecting identities of vulnerable populations have not been sufficiently explored. For example, how does intersectional disadvantage influence the ways in which evidence of the impact of climate change is assembled and assessed? How are these issues addressed in the courts? Examples include older women (KlimaSeniorinnen v. Switzerland), young people, from both the global South and global North, in urban or remote areas, or with different pre-existing health conditions (Sacchi et al. v. Argentina et al), and Indigenous people, including women and children (Daniel Billy and others v. Australia; Teitiota and others v. New Zealand). Multiple identities can compound vulnerability. For example, young people may be more vulnerable both due to their physical immaturity and due to eco-anxiety and other mental health impacts. This presentation will explore these issues, and the critical role of public health professionals in legal action to address climate change.

Impact of organisational injustice on health and wellbeing of female police: A meta-ethnography

Abstract Background Female police officers face more bias, discriminatory treatment, and insufficient support compared to male officers, resulting in poorer health outcomes. This meta-ethnographic review investigates beyond individual responsibilities to explore the dimensions of policing, and their effects on the health and well-being of female police officers. Methods The study reviewed qualitative and mixed-method studies (2000-2022) on the health and well-being of female police officers. Ten databases were searched using keywords related to health, well-being, women, police, and qualitative study. Twenty-one papers were synthesised, analysed, and interpreted using a seven-phase inductive and interpretative meta-ethnographic approach. Results The data analysis unveiled a distinct outcome, indicating a strong correlation and significant impact of organisational injustice on the health and well-being of women in law enforcement. Our research findings imply that organisational injustice, including procedural, relational, distributive, and gendered injustice, notably affects the health and well-being of female officers, with mental health being frequently cited, followed by effects on social, workplace, and physical health. Furthermore, the consequences of these four types of organisational injustice, alongside related cultural, systemic, and structural risk factors, reach beyond the immediate health and well-being of individual female officers. They also hinder various aspects of their professional lives, such as career advancement and maintaining a healthy work-life balance, potentially exacerbating long-term health and well-being issues. Conclusions This review emphasizes addressing organisational injustice and related cultural, systemic, and structural determinants in policing for healthier work environments for female officers. Policy makers must scrutinize gender-neutral policies affecting women, enabling transformative action for safer, supportive, and healthier workplaces. Key messages • Organisational injustice in various forms, significantly impact health and wellbeing of female police officers, necessitating policy reforms. • Addressing organisational injustice embedded in seemingly gender-neutral policies and practices, is vital for ensuring equitable treatment and health promotion of female police officers.

1.X.1. Achieving universal health coverage: international lessons from Irish policy implementation

Abstract Health systems all over the world are struggling to meet population health needs and provide timely access to universal healthcare in the context of the COVID-19 pandemic. COVID-19 occurred in Ireland in the early years of implementation of a national plan for universal healthcare, called Sláintecare. While many health systems are experiencing a retrenchment on universalism in the context of COVID-19, in Ireland despite tediously slow Sláintecare implementation, the pandemic provided a boost to reform implementation and universalism. The reason for this workshop is to draw on a publicly funded Health Research Board Applied Partnership Award, entitled ‘Foundations’, harnessing lessons from the Irish COVID-19 health system response to inform Sláintecare’s implementation https://hrbopenresearch.org/articles/3-70/v1 The objectives of the workshop are to 1) provide academic research evidence from the Irish experience of universal health system reform during and since COVID-19; 2) to give participants space to reflect on the implications of the Irish universal health system reform on international health systems and policy; 3) to actively involve workshop participants in an engaged discussion on implementing universal health coverage in the context of COVID-19. The added value of the workshop is to share learnings from an academic research programme, which is coproducing evidence in partnership with the Irish health system, in a worldwide context, providing relevant and thought-provoking discussion and analysis for an international audience. Four separate inter-related presentations will draw on aspects of the Foundations’ research project. Presentation 1, Prof Sara Burke will outline recent academic literature on universalism and the politics of reform implementation in the context of COVID-19 and present a timeline of universal healthcare reform implementation since 2018 when Sláintecare was adopted by the Irish government (14 mins). Presentation 2, Dr Sarah Parker will detail a specific study which set out to advance understanding of how and to what extent COVID-19 has highlighted opportunities for change that enabled better access to universal, integrated care in Ireland, with a view to informing universal health system reform and implementation (10 mins). Presentation 3, Dr Katharine Schulmann and Carlos Bruen will present findings on the governance of reform implementation and implications for all health systems (10 mins). Presentation 4, Dr Philip Crowley, Health Service Executive (HSE) National Director of Strategy and Research and Chair of the Foundations’ research steering group will reflect how research findings can inform implementing reform and their implications for all health systems (6 mins). There will be four presentations totalling 40 mins, followed by questions and discussion chaired by an international expert/academic on universal health systems. Key messages • COVID-10 has highlighted how universal health coverage is more important than ever, however the pandemic has resulted in some retrenchment on universalism. • While data and research drove health system decision making during the pandemic, embedding research evidence into health system and policy reform remains challenging and can be politically opposed.

The role of governance in shaping health system reform: a case study of the design and implementation of new health regions in Ireland, 2018–2023

Abstract Background This study focuses on the development of new regional health structures in Ireland in the period 2018-2023, one part of a broader health system reform programme aimed at greater universalism, in order to scrutinise how aspects of governance impact on the reform process, from policy design through to implementation. Methods This qualitative, multi-method study draws on document analysis of official documents relevant to the reform process, as well as twelve semi-structured interviews with key informants from across the health sector. Interviews were analysed according to thematic analysis methodology. Conceiving governance as comprising five domains (Transparency, Accountability, Participation, Integrity, Capacity) the research uses the TAPIC framework for health governance as a conceptual starting point and as initial, deductive analytic categories for data analysis. Results The analysis reveals important lessons for policymakers across the five TAPIC domains of governance. These include deficiencies in accountability arrangements, poor transparency within the system and vis-à-vis external stakeholders and the public, and periods during which a lack of clarity in terms of roles and responsibilities for various process and key decisions related to the reform were identified. Inadequate resourcing of implementation capacity, competing policy visions and changing decision-making arrangements, among others, were found to have originated in and continuously reproduced a lack of trust between key institutional actors. Conclusions Large scale health system reform is a complex process and its governance presents distinct challenges and opportunities for stakeholders. To understand and be able to address these, and to move beyond formulaic prescriptions, critical analysis of the historical context surrounding the policy reform and the institutional relationships at its core are needed

Bridging the Skills Gap Through Education Supply Chain to Meet Industry Requirements

In Bangladesh, a persistent mismatch exists between the skills fresh graduates possess and the competencies demanded by employers. This gap affects graduate employability and hampers economic growth. This article explores how key components— Program Curriculum Development (PCD), Instructor Portfolio Management (IPM), University Culture and Networking Platform (UCN), and University Facilities (UF)—can collectively address this issue. By integrating these elements into the educational supply chain, universities can produce skilled graduates who are better equipped to meet industry needs. The proposed framework offers a comprehensive approach to align academic outputs with labor market demands. The study highlights the importance of adapting curricula, engaging industry professionals in teaching, fostering strong university-industry connections, and investing in modern facilities to close the skills gap. This holistic approach ensures that graduates are employable, contributing to national development and societal betterment. The article concludes by emphasizing the need for further research on technological advancements and policy reforms to enhance higher education in Bangladesh.

Governance and health system reform: a case study of new health regions in Ireland, 2018-2023

Abstract Background While the significance of good governance is recognised within health systems research, its role in health system reform is underexplored. This research focuses on the establishment of new decentralised regional health structures in Ireland in the period 2018-2023, examining how aspects of governance impacted the decentralisation reform process, from policy design through to implementation. Methods The research applied a qualitative, multi-method approach involving analysis of official documents relevant to the regional decentralisation process, and 12 semi-structured interviews with key informants from across the health sector. The research applies the TAPIC framework for health governance as its analytic framework and the data is analysed using thematic analysis. Results Deficiencies in accountability arrangements, poor transparency within the system and vis-à-vis external stakeholders, and a lack of clarity of roles and responsibilities for various process and key decisions related to the reform were identified as undermining progress at various stages of Ireland’s decentralisation reform process. An underlying distrust between key institutional actors was identified. These findings are grounded in complex social, cultural, and political and institutional developments in Ireland’s history. Also of note is the interwovenness of the five TAPIC domains and the importance of engaging with the complexity and relationality intrinsic to health system reform processes to achieve the aim(s) of the reform in question. Conclusions Large scale health system reform is a complex process and its governance presents distinct challenges and opportunities for stakeholders. To understand and address these, critical analysis of the historical context surrounding the policy reform and the institutional relationships at its core are needed. Key messages • Governance plays a crucial if overlooked role in health systems reform. Effective governance arrangements are central to the successful design and implementation of reform initiatives. • Ensuring a strong link between policy design and implementation processes is crucial to the success of health systems reform.

Failure to treat: an American policy perspective.

Throughout its two and a half centuries in existence, US mental health policy has repeatedly failed people living with schizophrenia. The failures are cyclical-the inhumane conditions uncovered in the first 75years of existence were addressed with the construction of state asylums to deliver moral treatment. One hundred years later, the asylums were themselves revealed to be inhumane. Deinstitutionalization, the response to the failure of asylums starting in the 1960s, now drives outcomes such as homelessness, incarceration, and early death for people living with psychotic illnesses. In all cases, well-intentioned policy reform has failed at the level of implementation, largely due to a lack of accountability. The result has been a consistent failure to adequately treat people living with schizophrenia, which is now understood to be a highly treatable condition. As the country passes into a quarter millennium in existence, reform is once again underway. Unlike other points in history, there is good news. Other countries, such as Italy, have successfully leveraged reform to achieve greatly improved outcomes. Understanding US history and the successful implementation of policy change in other countries is imperative and teaches us that accountability in implementation is necessary to break the cycle of policy failure.

Integrating SDGs, One Health and transdisciplinarity into AMR Education Strategies

Abstract Introduction The increasing prevalence of Antimicrobial Resistance (AMR) threatens modern medicine, undermines food security, and impedes environmental sustainability. The complexity of AMR requires various stakeholders to contribute to mitigate this challenge. We discuss the critical need for integrating the One Health framework, transdisciplinarity, and Sustainable Development Goals (SDGs) within AMR education; and demonstrate how these integrations enhance the effectiveness of educational strategies against AMR. Methods Through a review of existing literature and analysis of multiple interventions, we synthesize findings from instances where One Health strategies have been applied. We assess their effectiveness in fostering cross-sector collaboration and enhancing health outcomes, thereby providing a grounded framework for developing integrated educational strategies. Results Our analysis reveals that AMR education programs incorporating the SDGs and One Health principles are more likely to foster interprofessional collaboration and a deeper understanding of AMR. Case studies demonstrate that such educational approaches significantly improve the preparedness of health professionals in managing AMR through innovative and cooperative approaches. Despite the significant potential of One Health education in impacting global health positively, current interventions lack specific SDG indicators directly related to AMR, suggesting a gap in policy and global health prioritization. Conclusions By aligning AMR education with SDGs and One Health, there is an opportunity to enhance global health security. We call for a paradigm shift in educational strategies to effectively combat AMR, advocating for policy reforms and curriculum adjustments to incorporate these integrated approaches. The findings are crucial for educators, policymakers, and healthcare professionals aiming to redesign AMR education to be more comprehensive and globally oriented. Key messages • AMR education integrated with SDGs and One Health enhances interprofessional collaboration and understanding, improving health professionals’ preparedness to manage AMR effectively. • Current AMR educational strategies lack specific SDG indicators; aligning education with SDGs and One Health can significantly boost global health security.

An Evaluation of Education Policy in England since 2010 and the Policy Consequences for Small Primary Schools

The fate of small primary schools (pupils aged five–eleven years old) in England is linked to education policy reforms. This paper presents an evaluation of selected education policy reforms in England since 2010 with suggested consequences for small primary schools. The research was undertaken using a qualitative research methodology that employed a document analysis method to create a Policy Document Analysis Frame (PDAF) for the policy evaluation. The implications of the policy reforms for small primary schools were examined through the conceptual lens of Educational Isolation. Educational Isolation identifies the limiting factors of place for a school’s access to the resources required for school improvement. Education policy reform is focused on school improvement. Small primary schools in England are typically located in rural neighbourhoods with sparse populations, resulting in an average of just over 100 pupils per school. The findings suggest that the contextual factors of place and size for small primary schools in England present disadvantages in relation to the selected national education policy reforms. The national funding formula, Multi Academy Trusts (groups of schools independently regulated but centrally funded by the state), and National Standards are the key policy reforms, driven by a neo-liberal ideology, that are suggested to have implications for the future of small schools. Recommendations are offered to the new 2024 Labour government that would support the re-instatement of small primary schools as an integral part of the education landscape in England.

Type, Complications and Treatment of Abortion in a Tertiary Hospital

Background: Abortion remains a critical public health issue, particularly in low-resource settings like Bangladesh, where access to safe abortion services is often restricted. This study aimed to analyze the types of abortions, treatment methods, and post-abortion complications in a tertiary hospital in Bangladesh. Methods: A cross-sectional study was conducted from January to December 2017, including 100 cases of abortion at a 250-bed district hospital in Joypurhat, Bangladesh. Data were collected from patient records, focusing on demographic characteristics, type and nature of abortion, treatment methods, and complications. Descriptive statistics were used for analysis. Results: The majority of patients (42%) were aged 26–30 years, and 58% were primigravida. Most abortions (75%) occurred before 13 weeks of gestation, with incomplete abortions accounting for 86% of cases. Spontaneous abortions constituted 86%, and D&C was the primary treatment method in 83% of cases. Post-abortion complications were infrequent, with incomplete D&C (8%), shock (6%), and septicemia (3%) being the most common. Conclusion: Incomplete abortions and spontaneous abortions are the most common types observed, with D&C being the predominant treatment method. Although complications were low, the findings underscore the need for better access to safe abortion methods, including medical abortion, and the reduction of unsafe practices through improved healthcare education and policy reform.

Digital tax policies and compliance challenges for MSMEs in Indonesia

As digital Micro, Small, and Medium Enterprises (MSMEs) rapidly grow in Indonesia, ensuring their compliance with tax regulations has become an urgent priority. This study delves into the challenges and innovative solutions to enhance tax compliance, focusing mainly on digital content creators. This study examines the challenges and solutions for improving tax compliance among digital Micro, Small, and Medium Enterprises (MSMEs) in Indonesia, mainly digital content creators. The research aims to analyze the impact of tax sanctions, modernization of tax administration, and tax policy reforms on the compliance behavior of these entities. A qualitative approach was employed, utilizing interviews and focus group discussions (FGDs) with informants selected through purposive sampling. The findings indicate that tax sanctions significantly influence compliance, but modernization of tax systems improves transparency and efficiency, thus enhancing compliance. Policy reforms, particularly those tailored to the unique needs of digital businesses, offer the flexibility needed for fulfilling tax obligations. The novelty of this research lies in the proposed model that integrates tax sanctions, administrative modernization, and policy reforms, addressing the unique characteristics of digital MSMEs. The practical implications suggest that implementing a user-friendly digital tax system, supported by clear guidelines and targeted reforms, can simplify compliance for digital MSMEs, leading to better tax reporting. These findings provide actionable insights for policymakers in designing effective, adaptive tax policies for Indonesia's rapidly growing digital economy.