Local government interventions for improving the health and wellbeing of tenants in private rented housing: developing initial program theory to inform evaluation in the United Kingdom.

BACKGROUND: Housing is an important wider determinant of health. Private Rented Sector (PRS) housing is generally the worst quality of housing stock across tenures. Although a wide range of interventions are available to local governments to manage and improve the quality of PRS housing and therefore the health of tenants, there is limited evidence about the extent to which these are used. This study aims to explore what drives the use of different interventions in different local governments, to better understand and inform local strategies. METHODS: As the first realist evaluation on this topic, the range of available interventions was informed by a Local Government Association toolkit. Consistent with realist approaches, retroductive analysis of intervention-context-mechanism-outcome configurations helped to develop and refine Initial Programme Theories (IPTs). Data sources included local government housing documents, a survey and eleven semi-structured interviews with housing officers. RESULTS: Using data for 22 out of the 30 local governments in the South West region of the United Kingdom, eight IPTs were developed which act on different levels from individual PRS team leaders to system wide. The IPTs include a belief in market forces, risk adverse to legal challenge, attitude to enforcement, relational approaches to partnership working, job security and renumeration, financial incentives drive action, and system-level understanding of the drivers of poor health, inequalities and opportunities for cost-savings. The findings suggest that limited objective health outcomes are being used to understand impact, which hinders interpretation of the effectiveness of all mechanisms. CONCLUSION: Interventions that bring about positive outcomes in managing PRS housing are unlikely to be universal; they depend on the context which differs across place and over time. The proposed IPTs highlight the need for strategies to be tailored considering the local context and should be evaluated in subsequent phases of study.

Implications of the Mandanas-Garcia Ruling on Local Health Systems.

The Supreme Court decision on the Mandanas-Garcia petition regarding the internal revenue allotment given to local government units is a significant ruling in strengthening the concept of decentralized governance and in the delivery of services. While the ruling grants local government greater resources and financial support, the immediate implication is the full devolution of services defined in the Local Government Code, including health services. The urgent concern is how much the Mandanas-Garcia Ruling will affect local health systems. Through a review of related documents and publications, this paper presents some existing and foreseeable issues surrounding the implementation of the Mandanas-Garcia Ruling in relation to the current devolved healthcare system. In particular, challenges in implementing the ruling in relation to health devolution, the local health system process, and the Universal Health Care Act are discussed. Some concrete action points for addressing these issues are also posited for policy-makers and implementors to consider in order to ensure not just the smooth and efficient implementation of the ruling but also the continuity of care for Filipinos.

Adherence to national guidelines for colorectal, breast, and cervical cancer screenings in Japanese workplaces: a survey-based classification of enterprises' practices into "overscreening," "underscreening," and "guideline-adherence screening".

BACKGROUND: Workplace cancer screening programs are determined as part of an employee's benefits package and health checkups are perceived positively. However, the current status of workplace cancer screening programs in Japan is unavailable. This study aimed to assess the adherence to national guidelines for colorectal, breast, and cervical cancer screenings in the workplace among Japanese enterprises and identify factors associated with excessive or inadequate screenings. METHODS: A cross-sectional study design was employed. Data were obtained from a survey conducted by the "Corporate Action to Promote Cancer Control" between November and December 2022 among registered partner enterprises in Japan. The survey included questions on background characteristics, cancer screening practices, and intervention approaches. The analysis included 432 enterprises that provided complete responses regarding colorectal, breast, and cervical cancer screenings. RESULTS: The guideline-adherence rates for colorectal, breast, and cervical cancer screenings in the workplace were 12.7%, 3.0%, and 8.8%, respectively. Enterprises had lower adherence to screening guidelines than local governments. Colorectal (70.8%) and breast (67.1%) cancer screenings were predominantly categorized as "overscreening" and cervical (60.6%) cancer screening, as "underscreening." Factors such as enterprise scale, health insurance associations, and the number of interventional approaches were significantly associated with increased "overscreening" (101-1000: ß = 0.13, p = 0.01; ≥ 1000: ß = 0.17, p < 0.01; health insurance association: ß = 0.23, p < 0.01; and approaches: ß = 0.42, p < 0.01) and reduced "underscreening" (101-1000: ß = -0.13, p = 0.01; ≥ 1000: ß = -0.17, p < 0.01; health insurance association: ß = -0.18, p < 0.01; and approaches: ß = -0.48, p < 0.01). CONCLUSION: Adherence to national guidelines for colorectal, breast, and cervical cancer screenings in the workplace was suboptimal among Japanese enterprises. Therefore, appropriate cancer screening measures and interventions to ensure guideline adherence and optimization of screening benefits while minimizing potential harms should be expeditiously implemented.

Evaluation study of the urban governance of the COVID-19 crisis in the city of Antwerp.

BACKGROUND: The COVID-19 pandemic has demanded crisis management at all governance levels. While most research has focused on responses of national governments, city-level governance had significant potential to develop tailored approaches. This study explored how the local COVID-19 response was organised and adapted to the specific city population and context in the City of Antwerp, Belgium. METHODS: A case study using semi-structured interviews was set up with 20 key informants with a central role in the coordination and implementation of the city-level COVID-19 response in Antwerp. Thematic analysis of transcripts was guided by an adapted version of the OECD risk management cycle. RESULTS: Respondents' accounts provide a granular understanding of pandemic preparedness, crisis management, and response and adaptation to the COVID-19 crisis in a mid-size European city. Its size was large enough to have a strong capacity within its government bodies, to utilise the expertise of strong partners in the area and to mobilise a critical mass for action, yet small enough to quickly establish connections and trust. In addition to a universal approach, they developed tailored responses to specific neighbourhoods and groups. Well-established community and organisational ties enhanced the effectiveness of grassroots initiatives. The perceived feeling of joint action contributed to a strong collective agency, but respondents noted the need for a system for monitoring and learning. CONCLUSIONS: Local governments are important to develop tailored strategies and organise a locally relevant crisis response in cities. They need expertise and agency, with enough flexibility to experiment. To harness promising practices and avoid repeating errors in future crises, it is crucial to develop a system that better evaluates and monitors local responses, before, during and after crises.

Planning healthy food environments: An analysis of local government municipal public health and wellbeing policy in regional Victoria.

ISSUE ADDRESSED: While there has been an increased focus on how local governments can support the creation of healthy food environments through healthy public policy, little is known about how this is reflected in public health policy in regional areas. The aim of this study was to understand how improvements to the food environment are prioritised, implemented and evaluated by local governments in regional Victoria. METHODS: Using a qualitative descriptive approach, content analysis was undertaken of Municipal Public Health and Wellbeing Plans and Council Plans from 10 regional local governments in Victoria, Australia. RESULTS: Seventeen policy documents were analysed including 10 Council Plans, 6 Municipal Public Health and Wellbeing Plans and 1 Food Systems Strategy. Findings highlight regional public health and wellbeing plans have very few concrete actions in place to improve food environments. CONCLUSION: There is an opportunity for Australian regional local governments to include in their public health and wellbeing plans a greater emphasis on supporting healthy food behaviours, and therefore seeking opportunities to improve food environments through clearly aligned priorities, objectives, actions and measures of success. SO WHAT?: Improving the quality of public health and wellbeing plans can support local government to use policy to drive improvements in food environments leading to improved health and wellbeing for regional communities.

Climate change and public health: An evaluation framework for local government.

Objectives: To develop and pilot an evaluation framework for assessing the engagement of local government public health teams in England on climate change and sustainability. These teams are uniquely positioned to address local health impacts of climate change and promote health co-benefits of mitigation. No statutory framework currently exists to support their engagement in this agenda. Study design: Literature review and two cross sectional surveys. Methods: A group of public health professionals conducted a literature review and agreed on criteria based on statutory responsibilities and remit of these teams, available information, and opportunities for local government action. With the resulting framework, this group evaluated all 11 local governments in the East of England region, and then conducted a follow-up survey to assess the framework's impact and acceptability. Results: An evaluation framework was developed with 21 criteria in two sections. The first assessed overall local government action and leadership in climate change and sustainability, to understand the context in which the public health team was situated. The second assessed the climate change related actions undertaken by the public health team.All 11 local governments in the East of England region completed the evaluation. Results indicated inconsistencies in local public health team action on and engagement with climate change and health. Ten local governments completed the follow-up survey on acceptability and impact, reporting that the evaluation was easy to complete. Seven out of ten respondents found that the evaluation had influenced change or reflection within their organisation, for example through identifying gaps and prompting more collaboration between teams. Conclusions: This evaluation framework is a useful and acceptable tool to assess local government public health engagement and leadership on climate change and sustainability. If used more widely, it could help to support public health teams to advance much-needed action in this area.

Perceived Public Participation and Health Delivery in Local Government Districts in Uganda.

Citizen participation is a crucial aspect of the national health system, empowering individuals to contribute to improving local health services through Health Committees (HCs). HCs promote the participation of citizens in the delivery of primary healthcare services. The study explores the perceptions of citizen participation in the context of the Ruhama County Ntungamo local government area, Uganda. This study aims to understand the impact of HCs on healthcare service delivery. Using a qualitative approach of inquiry grounded in thematic analysis and rooted in principal-agent theory in a single case study, this study examined citizens' participation in the delivery of a local healthcare service. The study is based on interviews with 66 participants comprising health workers, patients, residents, health administrators, local councillors, and HC members. The findings reveal a notable absence of a health committee in healthcare delivery in Ruhama County. The absence is attributed to a need for a formalised citizen participation structure in managing health facilities and service delivery. It raises concerns about the limited influence of citizens in shaping healthcare policies and decision-making processes. The study recommends the incorporation of health committees into the local health systems to enhance participation and grant communities greater influence over the management of health facilities and service delivery. Incorporating health committees into local health systems strengthens citizen participation and leads to more effective and sustainable healthcare services aligned with people's needs and preferences. Integrating health committees within Itojo Hospital and similar facilities can grant citizens a meaningful role in shaping the future of their healthcare.

Conflict or coordination? The cross-departmental interaction in local environmental governance of China.

Organizational coordination has been regarded as a vital factor to determine the environmental governance efficiency of local authority, while existing empirical studies mainly discuss the vertical decentralization but largely ignore the horizontal cross-departmental interaction within single government. Based on the data of 31 Chinese provinces from 2003 to 2017, this paper uses a panel vector autoregression (PVAR) approach, two-way fixed-effect models and dynamic panel regression with system generalized method of moments estimation (SYS-GMM) to investigate the environmental strategic interaction between two representative departments (finance department and environmental protection department) within local governments. The results indicate, on the whole, their environmental governance strategies show a significantly co-directional coordination. However, the cross-departmental interaction obviously varied in different periods and regions (even showed as conflict sometimes), and was synchronized with the dynamic trade-off between economic and environmental targets of China. This research helps understand the inner logic of environmental governance of Chinese government, and can be valuable guidance for other countries to accomplish multi-departmental sustainable development goal.

"They don't have the luxury of time": interviews exploring the determinants of public health research activity that contextualise embedded researcher roles in local government.

BACKGROUND: Embedded researchers are a novel intervention to improve the translation of research evidence into policy and practice settings, including public health. These roles are being implemented with increasing popularity, but they often lack clear evaluative frameworks. Understanding initial levels of research activity, including associated barriers and opportunities, is essential to developing theories of change and thus shaping the roles and defining expectations. We aimed to identify the principal determinants of research activity in public health that contextualise embedded researcher roles, including attributes of the embedded researcher themselves. METHODS: We undertook seventeen semi-structured interviews with embedded researchers in diverse public health settings in English local government. Interviews were analysed using thematic analysis. RESULTS: We identified thirteen interlinked determinants of research activity within local government public health settings. Research and interpersonal skills, as well as pre-existing connections and knowledge within local government, were highly valued individual attributes for embedded researchers. Resource deficiencies (funding, time, and infrastructure) were primary barriers to research activity, whereas a strong local appetite for evidence informed decision making presented a valuable opportunity. However, there was inconsistencies across public health teams relating to perceptions of what constituted "research" and the resources that would be required. CONCLUSIONS: Our results suggest that successful embedded researchers will have equally strong research and communication skills and should be offered mentorship and clear career progression pathways. Perceptions of research within local government are closely linked to resource deficiencies and senior endorsement. Embedded researchers could benefit from taking the time to develop locally contextualised knowledge of this research culture. Theories of change for embedded researchers should conceptualise the interconnections across individual, interpersonal, and organisational barriers and opportunities underlying local government research activity. Further research is needed to identify methods for exploring the influence of embedded researchers as well as to unpack the stages of research activity within local government and the associated behaviours.

Impact of a Local Government Funded Free Cat Sterilization Program for Owned and Semi-Owned Cats.

In most states of Australia, local governments (councils) are responsible for the enforcement of legislation relating to domestic cats. Traditional methods used for cat management based on trap-adopt or euthanize programs have been ineffective, with cat-related calls and cat impoundments continuing to increase, resulting in many healthy cats being euthanized. This has detrimental effects on the mental health of animal management officers, staff in shelters and council facilities, and cat caregivers. The city of Banyule, Victoria, implemented a free cat sterilization, microchipping, and registration (licensing) program in 2013/14. Initially, it was targeted at three low-socioeconomic suburbs with the highest cat-related calls and intake, and was microtargeted at call locations. An average of 4.1 cats/1000 residents per year were sterilized over eight years. The program included stray cats being fed by caregivers, provided they took ownership. The program was later expanded city-wide. Over eight years, city-wide cat intake decreased by 66%, euthanasia by 82%, and cats reclaimed by owners increased from 6% of intake (2012/13) to 16% (2020/21). Cat-related calls decreased in the target area by 51%, and city-wide by 36%. The council realized cost savings of AU $440,660 associated with reduced costs for cat-related calls to council (AU $137,170) and charges from the contracted welfare agency (AU $303,490), for an outlay of AU $77,490 for sterilization costs. Instead of the traditional management of urban cats, proactive management based on targeted sterilization should be utilized by government and animal welfare agencies in Australia and internationally. These types of programs are effective at reducing cat intake and euthanasia and are cost-effective.

The timing of local SARS-Cov-2 outbreaks and vaccination coverage during the Delta wave in Melbourne.

OBJECTIVE: This article presents a longitudinal analysis of COVID-19 infection and vaccination coverage in Melbourne metropolitan local government areas (LGAs) during the 2021 Delta wave. METHODS: COVID-19 vaccination and infection data from 12 July to 27 November 2021 were sourced from government websites. Summary statistics and associated 95% confidence intervals (95% CI) were compared by LGA ranked according to socioeconomic status: total "burden" (total infections per thousand), "peak" (highest weekly infection rate), "lag" (interval between peak and 70% double vaccination). RESULTS: LGAs in the bottom five deciles for social advantage experienced higher infection rates (39.0 per thousand [95% CI: 38.5, 39.5] vs. 14.8 [14.7, 14.9]), and had lower two-dose vaccination coverage (23.8% [23.6, 23.9] vs. 32.7% [32.6, 32.7]) compared with LGAs in the top five deciles. LGAs that achieved 70% coverage two weeks or more after the infection peak experienced nearly twice the total infection burden (27.7 per 1000 [27.3, 28.0] compared with 14.9 [14.7, 15.0]) than LGAs with a shorter lag. CONCLUSIONS: Exposure and transmission risk factors cluster within disadvantaged LGAs. The potential for large local outbreaks is heightened if vaccination uptake trails in these communities. IMPLICATIONS FOR PUBLIC HEALTH: In a pandemic, decision-makers must prioritise disease control and harm reduction interventions for at-risk LGAs.

Developing the embedded researcher role: Learning from the first year of the National Institute for Health and Care Research (NIHR), Health Determinants Research Collaboration (HDRC), Doncaster, UK.

Background: Strategies to embed research knowledge into decision making contexts include the Embedded Research (ER) model, which involves the collocation of academic researchers in non-academic organisations such as hospitals and local authorities. A local authority in Doncaster, United Kingdom (UK) has adopted an embedded researcher model within the National Institute for Health and Care Research (NIHR), Health Determinants Research Collaboration (HDRC). This five-year collaboration enables universities and local authorities to work together to reduce health inequalities and target the social determinants of health. Building on previous embedded research models, this approach is unique due to its significant scale and long-term investment. In this opinion paper Embedded Researchers (ERs) reflect on their experiences of the first year of the collaboration. Study design: A reflective consultation exercise. Methods: Observation of HDRC delivery meetings, as well as informal discussions and a short proforma with ERs (N = 8). Results: ERs valued the five-year timeframe which provided a unique opportunity for strengthened relationships and to apply formative learning as the programme progressed. However, differences in knowledge of undertaking research across the HDRC team and between practitioners and academics require each to respect different professional experiences and to avoid potential power imbalances. Diverse projects required researchers to be generalists, applying their expertise to multiple topics. This requires careful priority setting alongside workload and expectation management. Conclusions: The significant scale and investment of the HDRC provides a unique opportunity for developing the ER role by applying formative learning as the programme progresses. However, success will require careful management of workload allocation and relationships between ERs and practitioners. Further learning on how to embed ERs within local authority contexts will emerge as the programme matures.

A Geographical Approach to China's Local Government Debt.

Since the 2010s local government debt has boomed in China because the government relies on debt financing for infrastructure investment. The debt mainly consists of the issuance of Chengtou bonds and later local government bonds. Using data from more than 300 cities from 2009 to 2020, this article maps its spatial dynamics to further the understanding of intergovernmental relations in the studies on local government debt. We find that, from 2009 to 2014, most cities had large bond-issuing amounts. The dynamics were affected by the economic stimulus target set by the central government and the interjurisdictional competition in borrowing among local governments. After 2015 the cities with better economies issued more bonds because the central government tried to match local government debt with local fiscal capacity to maintain financial security. The spatial dynamics show the increasing intervention by the central government in local fiscal income and expenditure, reflecting fiscal centralization. Fiscal centralization did not effectively contain the financial risk in the less-developed cities. Motivated by the competition, the less-developed cities did not use bonds efficiently and had higher ratios of bond issuance to fiscal income, experiencing higher financial risk.

Desde el 2010, la deuda de los gobiernos locales en China se ha disparado debido a que las administraciones recurren a la financiación por medio de deuda para inversión en infraestructura. La deuda consiste primordialmente en la emisión de bonos Chengtou y, más tarde, bonos del gobierno local. Usando datos de más de 300 ciudades, entre 2009 y 2020, este artículo mapea la dinámica espacial para lograr un mayor entendimiento de las relaciones intergubernamentales en los estudios sobre deuda de los gobiernos locales. Encontramos que, de 2009 a 2014, la mayoría de las ciudades emitieron grandes volúmenes de bonos. Las dinámicas se afectaron por el objetivo del estímulo económico establecido por el gobierno central y por la competencia interjurisdiccional en el endeudamiento entre los gobiernos locales. Después de 2015, las ciudades con mejores economías emitieron más bonos debido a que el gobierno central trató de equiparar la deuda del gobierno local con la capacidad fiscal local para conservar la seguridad financiera. La dinámica espacial deja ver la creciente intervención del gobierno central en los ingresos y gastos fiscales locales, lo cual refleja la centralización fiscal. La centralización fiscal no contuvo eficazmente el riesgo financiero en las ciudades menos desarrolladas. Motivadas por la competencia, las ciudades menos desarrolladas no utilizaron eficientemente los bonos y tuvieron ratios más altas de emisión de bonos respecto a los ingresos fiscales, experimentando un riesgo financiero más alto.

A study of the evolutionary game of carbon offset involving tourism stakeholders under incentive and constraint mechanisms.

Tourism carbon offsetting is a crucial pathway to achieving peak carbon and carbon neutrality in the tourism industry. Accurately grasping the collaborative evolutionary mechanisms among local governments, tourism enterprises, and tourists is key to promoting the implementation of tourism carbon offsetting. By constructing an evolutionary game model involving local governments, tourism enterprises, and tourists in carbon offsetting, this study uses MATLAB to simulate the evolutionary stable strategies under various conditions. Additionally, it dynamically simulates the collaborative strategies of the three parties under the influence of local government incentive and constraint mechanisms. The results indicate that under strong governmental constraint mechanisms, there is a promotion of active participation in carbon offsetting by local governments, tourism enterprises, and tourists. Incentive policies at certain levels also play a positive guiding role. As incentives increase, local subsidies and intervention costs also rise, leading to an evolution towards less enthusiastic participation among the three parties. Appropriately balanced government incentives and penalties are beneficial in achieving an equilibrium of benefits among multiple stakeholders involved in carbon offsetting, thus helping to attain carbon neutrality goals.

Evidence-based decision-making in a climate of political expediency: insights from local government.

AIMS: Local authorities in England are responsible for public health and health promotion. This article sought to explore how research and decision-making co-exist in a local authority in England. METHODS: An Embedded Researcher was based within the local authority and used qualitative methodology to address the research aim. Interviews and focus groups were employed to ascertain a range of stakeholder views in the local authority. All transcripts were coded on NVivo 12 by the Embedded Researcher and two members of the research team cross-checked a sample for coding accuracy. Data were analysed using framework analysis. RESULTS: The data suggest several barriers to using research to inform decision-making in health promotion and public health. The study shows that research is valued in local authorities, but not always privileged - this is due to cultural factors and practical political reasons which often means that decisions need to be made expediently. Participants outlined a juxtaposition between academic credibility; timeliness to complete the research and the financial cost associated with it; against the independence and credibility that independent academics could bring. CONCLUSION: Policy formulation and delivery is an integral aspect of health promotion and critical to achieving improved population health and reductions in health inequalities. However, there exists tensions between gathering research evidence and making research-informed decisions. The article concludes by advocating the use of Embedded Researchers to fully understand how research is gathered and used to support public health and health promotion policymaking.

Intersectoral Partnerships Between Local Governments and Health Organisations in High-Income Contexts: A Scoping Review.

BACKGROUND: Local governments are the closest level of government to the communities they serve. Traditionally providing roads, rates and garbage services, they are also responsible for policy and regulation, particularly land use planning and community facilities and services that have direct and indirect impacts on (equitable) health and well-being. Partnerships between health agencies and local government are therefore an attractive proposition to progress actions that positively impact community health and well-being. Yet, the factors underpinning these partnerships across different contexts are underdeveloped, as mechanisms to improve population health and well-being. METHODS: A scoping review was conducted to gain insight into the concepts, theories, sources, and knowledge gaps that shape partnerships between health and local governments. The search strategy followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines and was informed by a critical realist approach that identifies necessary, contingent and contextual factors in the literature. MEDLINE, Scopus, Web of Science, and ProQuest Central databases were searched for studies published between January 2005 and July 2021. RESULTS: The search yielded 3472 studies, after deleting duplicates and initial title and abstract screening, 188 papers underwent full text review. Twenty-nine papers were included in the review. Key themes shaping partnerships included funding and resources; partnership qualities; governance and policy; and evaluation and measures of success. The functional, organisational and individual aspects of these themes are explored and presented in a framework. CONCLUSION: Given that local government are the closest level of government to community, this paper provides a sophisticated roadmap that can underpin partnerships between local government and health agencies aiming to influence population health outcomes. By identifying key themes across contexts, we provide a framework that may assist in designing and evaluating evidence-informed health and local government partnerships.

An Investigation into the Prevalence of Methamphetamine Related Enquiries to Local Government Environmental Health Officers.

Methamphetamine contamination of residential properties remains a serious public health concern for members of the public. External stakeholders including Environmental Health Officers (EHOs) and testing and remediation technicians are engaged on investigating whether contamination has occurred from manufacturing or smoking processes. More specifically, local council EHOs are responsible for managing clandestine drug laboratories when notified by police and also for responding to public enquiries. However, the full scope of these contaminated properties is not seen by any single stakeholder, making it very challenging to quantify these situations. To evaluate the prevalence of methamphetamine related enquiries from the general public to EHOs, this study surveyed and interviewed officers from around Australia. It was found that public enquiries were infrequent with only 6% of respondents having received enquiries in the last month, which indicates that people are seeking information from other sources. Interestingly, there were case study scenarios that also mentioned issues with awareness and the flow of information. Concerns regarding difficult cases, police notifications, and site visits were also highlighted. The results of this study provide a benchmark of how methamphetamine related cases are managed and highlight the need for trustworthy information that is available to EHOs, governments, industry members, and the public in a unified location.

Analyzing the dynamics of meningococcal vaccinations initiatives by local government units in Poland (2017-2021) - Scope, challenges and recommendations.

INTRODUCTION: Meningococcal vaccinations are recommended by Polish public health authorities but lack coverage under health insurance, prompting Local Government Units (LGUs) to implement local health policy programs. This study examines the effectiveness and impact of LGU-driven meningococcal vaccination initiatives in Poland between 2017 and 2021. MATERIAL AND METHODS: A retrospective analysis utilized data from reports on local public health interventions submitted annually to the Ministry of Health in Poland. The study focused on the number of meningococcal vaccination programs, their scope, the vaccinated population, and associated program costs. Additionally, nationwide data on meningococcal disease incidence and vaccine uptake were analyzed. RESULTS: Within LGUs programs, 48,617 individuals received meningococcal vaccinations, constituting approximately 10% of all vaccinations in Poland during the study period. Notably, cities with poviat rights spearheaded programs covering 54% of the total participants. The total cost incurred by these initiatives amounted to EUR 2,553,661. CONCLUSIONS: While LGUs activities positively contributed to increased meningococcal vaccination rates, the overall engagement of local governments remains limited. The findings underscore the importance of expanding local government involvement in meningococcal vaccination programs to address public health needs effectively. Improved collaboration and increased funding may enhance the reach and impact of these initiatives.

Food waste tectonics: Points of friction between policy push and practice pull in council-led household-food-waste interventions in Australia.

Household food waste is increasingly recognised as a global wicked problem for its greenhouse gas emissions, economic damage, and resource loss. Although targeted in the UN's Sustainable Development Goals, countries can only respond according to their capacity. For Australia, national policy has put the pressure on states and territories to divert food waste away from landfill into a nascent circular economy. For councils, this increasingly means implementing a FOGO (Food Organics/Garden Organics) kerbside collection. Despite funding and infrastructure development, many are resisting. Framed by the tenets of policy diffusion, this paper presents the results of a nationwide exploratory survey aimed at identifying how and why council-based waste services staff resist, emulate or lead FOGO implementation. By assessing participants current kerbside systems and their attitudes towards household food waste management, the survey found costs, contamination, and capacity and were key concerns. However, responses to these varied considerably despite similarities of situation, often relating more to collaborative attitudes across waste services, council, and councillors. This paper recognises that a conducive environment for change is urgently needed for Australia to achieve organics diversion targets and shift household food towards a circular economy. It provides a starting point for further research into the complex and nuanced dynamics between council waste services and FOGO implementations, from external drivers and council paradigms to individual attitudes and perceptions.

What drives the green development behavior of local governments? A perspective of grounded theory.

Although the elements that lead local governments to adopt sustainable development behaviors have been examined, the underlying processes that local governments adopt to accomplish green development behavior (GDB) lack systematic theoretical analysis. This study aims to investigate the determinants influencing local governments' implementation of GDB from the organizational internal and external perspectives. This study employed grounded theory to analyze the data and develop an influencing factor model of local government green development behavior (GDB-LG) after interviewing 53 Chinese local officials. Additionally, through integrating process organization research with new institutional theory, the mechanism that explains how these elements influence GDB was investigated. The results of the study demonstrate that the influencing factors model could give municipal governments clear guidance when creating sensible green development policies, further enhancing the efficacy of GDB.