Trust matters: The Addressing Vaccine Hesitancy in Europe Study.

This article presents the design of a seven-country study focusing on childhood vaccines, Addressing Vaccine Hesitancy in Europe (VAX-TRUST), developed during the COVID-19 pandemic. The study consists of (a) situation analysis of vaccine hesitancy (examination of individual, socio-demographic and macro-level factors of vaccine hesitancy and analysis of media coverage on vaccines and vaccination and (b) participant observation and in-depth interviews of healthcare professionals and vaccine-hesitant parents. These analyses were used to design interventions aimed at increasing awareness on the complexity of vaccine hesitancy among healthcare professionals involved in discussing childhood vaccines with parents. We present the selection of countries and regions, the conceptual basis of the study, details of the data collection and the process of designing and evaluating the interventions, as well as the potential impact of the study. Laying out our research design serves as an example of how to translate complex public health issues into social scientific study and methods.

The Covid-19 pandemic reinforces the need for sustainable health planning.

The 2030 Agenda for Sustainable Development highlighted the growing attention to the adequacy of health planning models to sustainable development. A re-reading of the results of a round table debate on "sustainable planning", which took place at the 5th National Congress of Tropical Medicine (Portugal, 2019) under a participant observation strategy, framed by the findings of a "synthesis of better evidence" literature review and cross-referenced with the reflections of different authors and experts about the momentum created by the COVID-19 pandemic, underlined the challenges to sustainable health planning that have emerged and are projected beyond the current pandemic context. Variable perceptions of the term "sustainable health development", leading to the potential loss of their relevance in guiding the elaboration of policies and strategic plans, and the potential higher effectiveness of the participatory approaches of health planning in achieving sustainable health were highlighted in the debate and literature, in general and in public health emergency contexts. Those results gained new relevance during the current COVID-19 pandemic, bringing back to the forefront a reflection of the inadequate planning framework that has usually been used to understand and respond to global health challenges, despite the already existing experience, evidence and support instruments.

The InfAct proposal for a sustainable European health information infrastructure on population health: the Distributed Infrastructure on Population Health (DIPoH).

BACKGROUND: In Europe, data on population health is fragmented, difficult to access, project-based and prone to health information inequalities in terms of availability, accessibility and especially in quality between and within countries. This situation is further exacerbated and exposed by the recent COVID-19 pandemic. The Joint Action on Health Information (InfAct) that builds on previous works of the BRIDGE Health project, carried out collaborative action to set up a sustainable infrastructure for health information in the European Union (EU). The aim of this paper is to present InfAct's proposal for a sustainable research infrastructure, the Distributed Infrastructure on Population Health (DIPoH), which includes the setup of a Health Information Portal on population health to be maintained beyond InfAct's time span. METHODS: The strategy for the proposal was based on three components: scientific initiatives and proposals to improve Health Information Systems (HIS), exploration of technical acceptability and feasibility, and finally obtaining high-level political support.. The technical exploration (Technical Dialogues-TD) was assumed by technical experts proposed by the countries, and political guidance was provided by the Assembly of Members (AoM), which gathered representatives from Ministries of Health and Science of EU/EEA countries. The results from the AoM and the TD were integrated in the sustainability plan compiling all the major outputs of InfAct. RESULTS: The InfAct sustainability plan was organized in three main sections: a proposal of a new research infrastructure on population health (the DIPoH), new health information tools and innovative proposals for HIS, and a comprehensive capacity building programme. These activities were carried out in InfAct and are being further developed in the Population Health Information Research Infrastructure (PHIRI). PHIRI is a practical rollout of DIPoH facilitating and generating the best available evidence for research on health and wellbeing of populations as impacted by COVID-19. CONCLUSIONS: The sustainability plan received wide support from Member States and was recognized to have an added value at EU level. Nevertheless, there were several aspects which still need to be considered for the near future such as: (i) a commitment of stable financial and political support by Member States (MSs), (ii) the availability of resources at regional, national and European level to deal with innovations, and (iii) a more direct involvement from EU and international institutions such as the European Centre for Disease Prevention and Control (ECDC), the World Health Organization (WHO) and the Organisation for Economic Cooperation and Development OECD for providing support and sustainable contributions.

[Availability and Readiness Assessment of Facilities with Hospital Admission Capacity in Two Regions of Guinea-Bissau]. / Análise da Disponibilidade e Prontidão de Estruturas Sanitárias com Capacidade de Internamento em Duas Regiões da Guiné-Bissau.

INTRODUCTION: The weaknesses of Guinea-Bissau's health system have long been highlighted. The purpose of this study is to contribute with evidence for decision-making on the reform of the country's healthcare map, by analyzing the availability and readiness of services at the facilities that may become part of a Hospital Complex in Bissau, proposed in the National Health Development Plan. MATERIAL AND METHODS: We analyzed 13 public and private facilities with inpatient capacity, located in Bissau and Biombo. Service Availability and Readiness Assessment (SARA) tools were used for data collection, treatment and analysis. RESULTS: A comprehensive overview of these facilities has been provided, describing their general capacity to provide care and their readiness to implement it, along with the availability and readiness of specific services: diagnosis, family planning, mother and child health, obstetrics, communicable and non communicable diseases, blood transfusion and surgery. We observed a greater concentration of beds and professionals in the facilities of public sector, the only that provides all the specific services analyzed. Private sector services with agreements to supply the public sector have higher readiness levels and the private sector has the lowest operating capacity. DISCUSSION: Findings reflect the lack of equipment, infrastructure and resources, the predominance of the public sector and the growth of the private for-profit and non-profit sectors, as well as inadequacies in planning and regulation. Similarities and differences between our findings and those described in the literature for other African countries are identified. CONCLUSION: This study reinforces the relevance of developing integrated and rational responses of health services and provides evidence for this.

Introdução: As debilidades do sistema de saúde da Guiné-Bissau estão há muito sinalizadas. O objetivo deste estudo é contribuir com evidência para tomada de decisão sobre a reforma do mapa sanitário do país, pela análise à disponibilidade e prontidão de serviços das estruturas sanitárias que poderiam vir a integrar um complexo hospitalar em Bissau, como proposto no Plano Nacional de Desenvolvimento Sanitário (2018-2022). Material e Métodos: Analisámos 13 estruturas sanitárias (públicas e privadas) com internamento, situadas nas regiões de Bissau e Biombo. Para recolha, tratamento e análise de dados foram utilizadas ferramentas do Service Availability and Readiness Assessment (SARA). Resultados: Obtivemos uma visão abrangente destas estruturas, descrevendo a sua capacidade genérica para disponibilizarem cuidados e a prontidão para operacionalizarem serviços de diagnóstico, planeamento familiar, saúde materna, infantil e adolescente, obstetrícia, doenças transmissíveis e não transmissíveis, cirurgia e transfusão de sangue. Observou-se maior concentração de camas e meios humanos nas estruturas do setor público, o único que disponibiliza todos os serviços específicos analisados. Os serviços do setor convencionado apresentam maiores níveis de prontidão e os do setor privado lucrativo uma menor capacidade operacional. Discussão: Os resultados refletem a carência de equipamentos, infraestruturas e recursos, predominância do setor público e crescimento dos setores privado lucrativo e convencionado, bem como insuficiências no planeamento e regulação. Identificámos semelhanças e diferenças entre os nossos achados e os descritos na literatura para outros países africanos. Conclusão: Este estudo reforça a pertinência de desenvolver respostas integradas e racionais dos serviços de saúde e fornece evidência para tal.