SSM - Health Systems最新文献

{"title":"“I am the bridge”: Examining intersectoral collaboration among community health workers to address maternal and child health in the Philippines","authors":"Warren Dodd ,&nbsp;Laura Jane Brubacher ,&nbsp;Monica Bustos ,&nbsp;Melinda Kelly Mijares ,&nbsp;Krisha Lim-Mar ,&nbsp;Matthew Little ,&nbsp;Lincoln Lau","doi":"10.1016/j.ssmhs.2025.100057","DOIUrl":"10.1016/j.ssmhs.2025.100057","url":null,"abstract":"<div><h3>Introduction</h3><div>Community health workers (CHWs) are uniquely positioned to act as a bridge between local maternal and child health needs and the broader health system. However, there is a need to examine the specific strategies CHWs use to facilitate intersectoral collaboration and support community-level maternal and child health service delivery.</div></div><div><h3>Methods</h3><div>This study was conducted in partnership with a Philippines-based NGO and their CHW program. In total, 64 semi-structured interviews were conducted with CHWs from six locations in Negros Oriental, Philippines. Data collection focused on CHWs’ efforts to address maternal and child health and collaborate across sectors to support health service delivery. Qualitative data were analyzed with a hybrid inductive-deductive approach.</div></div><div><h3>Results</h3><div>CHWs (all females; ages 21–60) leveraged the multiple roles and social networks they held, including with local health system and government actors, to address maternal and child health. CHWs viewed their role as addressing service gaps and providing continuity of care with the public health system (service extenders); liaising between communities and both the NGO and public sector to support service navigation (cultural brokers); and working to address complex social and ecological determinants of health within their communities (social change agents).</div></div><div><h3>Conclusion</h3><div>This study provides insights into how NGO-public sector collaboration is facilitated by CHWs to support maternal and child health in communities. In addition, this study demonstrates how broader health system governance arrangements and decentralization may impact the experiences and roles of CHWs affiliated with NGO-led programs.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"4 ","pages":"Article 100057"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143176588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What influences the impact of health financing reforms? Using qualitative comparative analysis to identify patterns in health financing systems and their effects on financial protection","authors":"Justine Hsu ,&nbsp;Matthew Jowett ,&nbsp;Anne Mills ,&nbsp;Kara Hanson","doi":"10.1016/j.ssmhs.2025.100055","DOIUrl":"10.1016/j.ssmhs.2025.100055","url":null,"abstract":"<div><h3>Background</h3><div>Policy interventions to improve financial protection do not always work as expected and their impact can vary across settings, suggesting that underlying health financing attributes (i.e. system arrangements for revenue raising, pooling and purchasing) matter. The objective of this study is to systematically identify patterns of health financing system attributes which influence the impact of policy interventions on financial protection.</div></div><div><h3>Methods</h3><div>We conducted a systematic literature review to identify studies evaluating the impact of health financing interventions on financial protection. We searched across five databases from their earliest record to October 2023 and applied no geographic restrictions. Data were extracted on the measured outcome of catastrophic health expenditures and on underlying attributes of the health financing system. Patterns in the relationship between system attributes and financial protection were identified using qualitative comparative analysis (QCA). QCA compares and contrasts different combinations and assesses through formal statistical tests the degree to which combinations are present (or absent) when the intervention has been successful (or not) in obtaining the outcome of interest. Results from QCA tests were illustrated by selected studies.</div></div><div><h3>Findings</h3><div>We identified 128 studies in our literature review from which a rich dataset was formed, representing diverse health financing systems and country reform experiences. The QCA approach to synthesize the literature provided unique insights regarding the pathway from policy intervention to impact on financial protection. We found empirical support for the significance of system attributes influencing intervention impact on financial protection. Findings indicated that combinations of more than one attribute were needed for positive impact on catastrophic health expenditures whereas only an individual attribute was needed to avoid negative impact. Attributes can have a direct or indirect effect on impact and can be synergistic, opposing or mitigating in relation to improving financial protection.</div></div><div><h3>Conclusion</h3><div>This is the first application of QCA to health financing data. The pathway between impact on financial protection and a health financing intervention is complex and mediated by combinations of explanatory factors. Further research is needed for more comprehensive analyses across all health financing functions. Taking into account the underlying attributes of the health financing system and their interactions is critical to ensuring effective policies and progress on financial protection.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"4 ","pages":"Article 100055"},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supports and barriers to creating and implementing person-centred plans in the community care sector in Canada: A qualitative analysis of three perspectives","authors":"Samina Idrees ,&nbsp;Megann Dong ,&nbsp;Gillian Young ,&nbsp;Leslie Meredith ,&nbsp;Dana Ryan ,&nbsp;Yona Lunsky ,&nbsp;Maria Mathews","doi":"10.1016/j.ssmhs.2025.100054","DOIUrl":"10.1016/j.ssmhs.2025.100054","url":null,"abstract":"<div><h3>Background</h3><div>The community care sector manages the delivery of health and social services in people’s homes and local communities. The sector supports individuals with intellectual and developmental disabilities, physical disabilities, and complex medical needs. Person-centred plans (PCPs) have been recognized as evidence-based practice across various care settings, however there is limited literature on the factors impacting this process. This study aims to identify the supports and barriers to creating and implementing PCPs in the community care sector.</div></div><div><h3>Methods</h3><div>We partnered with PHSS, a not-for-profit community care organization based in Ontario, Canada. We conducted a total of 42 semi-structured interviews, 18 with persons receiving care (i.e., persons-supported) at PHSS, 1 with a family member of a person-supported, 11 with frontline staff at PHSS, and 12 with representatives from different community care organizations in Ontario, Canada. We asked participants about the PCP process at their organization, including relevant supports and barriers. We analyzed the data thematically, using a pragmatic, qualitative, descriptive approach.</div></div><div><h3>Results</h3><div>We identified four key factors impacting the creation and implementation of PCPs: (1) the health and capacity of the person-supported, (2) community care sector challenges, (3) integration across community care and health sectors, and (4) community connections, accessibility, and inclusion. Participants described how the health and capacity of the person-supported could impact the PCP process, particularly for individuals who were non-speaking or had difficulty communicating. Inadequate funding and staffing were described as community care sector challenges. Participants also described a need for increased integration with other sectors including acute care systems. Strong connections with the community were integral to implementing PCPs; participants also encountered barriers to inclusion and accessibility.</div></div><div><h3>Conclusions</h3><div>The creation and implementation of PCPs is impacted by individual health and capacity, organizational funding and staffing, intersectoral integration, and broader community factors. These findings highlight the importance of addressing challenges through targeted intervention strategies designed to optimize PCP creation and implementation and ensure equitable outcomes across diverse populations.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"4 ","pages":"Article 100054"},"PeriodicalIF":0.0,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143176594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of universal health coverage in secondary prevention: A case study of Ghana’s National Health Insurance Scheme and early-onset hypertension","authors":"Samuel Owusu Achiaw,&nbsp;Claudia Geue,&nbsp;Eleanor Grieve","doi":"10.1016/j.ssmhs.2025.100053","DOIUrl":"10.1016/j.ssmhs.2025.100053","url":null,"abstract":"<div><h3>Background</h3><div>Launched in 2003, Ghana’s National Health Insurance Scheme (NHIS) was a move towards Universal Health Coverage. There is a dearth of studies that have since investigated the effect of the scheme on non-communicable diseases (NCDs) like hypertension. While a major cause of mortality and morbidity, hypertension remains mostly undiagnosed in Ghana. Secondary prevention comprising early detection and prompt treatment is, hence, important in reducing disease burden. This study assessed the association between active NHIS membership and the likelihood of having early-onset hypertension detected and treated.</div></div><div><h3>Methods</h3><div>A cross-sectional analysis of the 2014 Ghana Demographic and Health Survey (male dataset) was conducted. Unadjusted analysis used binary logistic regression with active NHIS membership as the independent variable and detection of early-onset hypertension as the dependent variable. Early-onset hypertension was defined as the onset of hypertension at 55 years or younger. Covariates for the adjusted regression models were age, BMI, smoking status, place of residence, wealth, and education level. The association between membership and treatment was also assessed.</div></div><div><h3>Results</h3><div>Unadjusted and adjusted results showed that the odds of early-onset hypertension being detected in participants with active NHIS membership were respectively 2.4 (95 % CI:1.56 – 3.59, p = 0.000) and 2.2 (95 % CI 1.43 – 3.24, p = 0.000) that of those without active membership. There was no significant association between membership and treatment.</div></div><div><h3>Conclusion</h3><div>This study suggests that NHIS membership may play a beneficial role in the secondary prevention of NCDs in Ghana. Further research is, nevertheless, needed to understand how membership, NCDs, and other contextual factors are interrelated.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"4 ","pages":"Article 100053"},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143176593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How can health systems better prepare for the next pandemic? A qualitative study of lessons learned from the COVID-19 response in Nigeria","authors":"Chinyere Cecilia Okeke ,&nbsp;Nkolika Pamela Uguru ,&nbsp;Benjamin Uzochukwu ,&nbsp;Obinna Onwujekwe","doi":"10.1016/j.ssmhs.2025.100052","DOIUrl":"10.1016/j.ssmhs.2025.100052","url":null,"abstract":"<div><div>Fragile health systems can become overwhelmed during public health crises, further exacerbating the human, economic, and political toll. It is then necessary as a country, to assess, understand, document, and report the activities/measures that are considered nationally and sub-nationally significant, both in terms of COVID-19 responses and strengthening of the health system for the future. Data collection was through a scoping review of 198 publications that were comprised of official documents, journal articles, and media reports that were published from December 2019 to December 2020. Journal articles were sourced from online journals in PubMed, Google Scholar, and Scopus using search terms/queries. Published official documents were retrieved from relevant websites of government agencies and development partners and media searches were performed in FACTIVA. In addition, qualitative data using in-depth interviews of key informants were collected from 38 respondents in April 2022. The transcripts from the IDIs were coded, and thematic analysis and narrative synthesis of data were done using NVivo version 12 using Palagyi et al.’s framework. Our findings revealed the need to institutionalize some COVID-19 response activities and to efficiently prioritize financial and material resources during a pandemic response. Also, to introduce flexibility in financial response activities. Pooling and funds management was found useful but the integration of response activities into already existing epidemic response pillars must be prioritized. Research should be incorporated early in pandemic responses. The need to use evidence in decision-making and include all levels of government in planning response actions was found necessary to enhance trust and compliance. This study demonstrates the value of applying the Palagyi et al. framework on systems preparedness towards emerging infectious diseases to understand how the health systems can be better prepared for the next pandemic. It highlighted specific strengths and areas of potential growth for pandemic response in Nigeria.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"4 ","pages":"Article 100052"},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143176592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women’s experiences of and interactions with the health system in post-Doi Moi Vietnam","authors":"Kimberly Lakin ,&nbsp;Dinh Thu Ha ,&nbsp;Bui Thi Thu Ha ,&nbsp;Tolib Mirzoev ,&nbsp;Irene Akua Agyepong ,&nbsp;Sumit Kane","doi":"10.1016/j.ssmhs.2025.100051","DOIUrl":"10.1016/j.ssmhs.2025.100051","url":null,"abstract":"<div><div>How people experience their interactions with their health systems are central to the notion of health systems responsiveness. These experiences may be ‘personal’, but they are also shaped by the broader historical, political, cultural, social, and economic contexts within which they occur. Yet, few studies on people’s experiences of care, particularly those focused on health systems responsiveness, explicitly take this into account. In this study, and drawing on in-depth interviews with 28 pregnant and postpartum women in a rural province of Vietnam, we use a novel approach that draws on the work of Archer and Chalari to uncover and analyse women’s ‘internal conversations’, in which they reflect upon and make sense of their maternity care-related experiences. Women’s ‘internal conversations’ reflected their need for short waiting times and high-quality ultrasonography, concerns regarding privacy and confidentiality, expectations of receiving dignified care, and their experiences of decision-making relating to caesarean section. Our findings reveal how women’s preferences, demands, and expectations have likely evolved in response to the Doi Moi-related shifts that have changed the organisation and structure of Vietnam’s economy, society, and health system. We make the case for health systems researchers and actors to consciously take into account the society and health system-level evolutions and changes when researching or developing interventions for improving responsive health systems.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"4 ","pages":"Article 100051"},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143176591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of hospital care during the COVID-19 pandemic: Lessons learnt from five European countries","authors":"Markus Kraus ,&nbsp;Christoph Stegner ,&nbsp;Miriam Reiss ,&nbsp;Monika Riedel ,&nbsp;Anne Sofie Børsch ,&nbsp;Karsten Vrangbæk ,&nbsp;Morgane Michel ,&nbsp;Kathleen Turmaine ,&nbsp;Krisztián Horváth ,&nbsp;Gergő Túri ,&nbsp;Roberto Dandi ,&nbsp;Angelo Rossi Mori ,&nbsp;Thomas Czypionka","doi":"10.1016/j.ssmhs.2025.100050","DOIUrl":"10.1016/j.ssmhs.2025.100050","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic required significant adjustments in hospital management across Europe. This article explores the challenges faced and lessons learnt in managing hospital care, aiming to improve future pandemic preparedness and resilience.</div></div><div><h3>Methods</h3><div>Hospital management during the pandemic in Denmark, France, Germany, Hungary and Italy was investigated using a qualitative case study approach based on document analysis and 57 semi-structured interviews with senior hospital staff conducted in the spring and summer of 2022. The country case studies were subjected to an overarching analysis focusing on successes and failures in hospital pandemic management.</div></div><div><h3>Results</h3><div>Hospitals faced an overwhelming surge of patients, leading to the conversion of regular wards into COVID-19 units and the postponement of elective surgery, affecting the care of chronically ill and non-urgent patients. Telemedicine was crucial but faced challenges in terms of acceptance by elderly patients and physicians. Staff shortages and high workloads affected patient care and staff wellbeing. In addition, shortages of medical supplies led to a re-evaluation of logistics and warehousing. Many hospitals found existing policies and pandemic plans inadequate, leading to the formation of internal task forces.</div></div><div><h3>Conclusion</h3><div>The pandemic highlighted gaps in hospital preparedness and the need for improved resilience. Strategies to improve pandemic resilience, such as better working conditions and collaboration with primary care, would also improve health system performance in \"normal times\". Pandemic-specific measures, such as postponing elective surgery, are necessary but need to be carefully managed to minimise the negative impact on overall patient care.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"4 ","pages":"Article 100050"},"PeriodicalIF":0.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143176587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rigorously accounting for the role of social values in health systems: Guidance for health policy and systems researchers","authors":"Eleanor Beth Whyle,&nbsp;Jill Olivier","doi":"10.1016/j.ssmhs.2025.100049","DOIUrl":"10.1016/j.ssmhs.2025.100049","url":null,"abstract":"<div><div>Health systems are complex social systems and play an important role in reinforcing social values. This capacity to communicate social values is a product of systems complexity and, over time, social values become institutionalised in health systems. This means that social values are not only drivers of policy change, but also form part of the context in which policy processes unfold, and constrain change. However, in health policy and systems research, social values are often studied only as drivers of policy change. We present an analytical framework to guide analysts in accounting for values-based complexity in health systems change. Rigorously accounting for social values as both driving and constraining change requires recognising that policy processes unfold in complex social health systems; that social values comprise part of an ideational context that constrains actor choices; that this ideational context may change in important ways over time; and that past policy decisions embed values in social institutions, creating feedback loops that constrain change. The analytical framework centres moments of policy decision-making in their ideational context; emphasises the points of interaction between health systems, policy decisions and social values; and points the analyst towards the tangible contextual realities that shape the ideational context.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"4 ","pages":"Article 100049"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143176590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the determinants of readiness to utilize knowledge translation tools among health planning teams in Tanzania: A qualitative study","authors":"Pius Kagoma ,&nbsp;Richard Mongi ,&nbsp;Joel Seme Ambikile ,&nbsp;James Kengia ,&nbsp;Albino Kalolo","doi":"10.1016/j.ssmhs.2024.100044","DOIUrl":"10.1016/j.ssmhs.2024.100044","url":null,"abstract":"<div><h3>Background</h3><div>Knowledge translation (KT) tools are vital for achieving universal health coverage (UHC) through Evidence-Informed Decision-Making (EIDM). While EIDM is known to improve decision outcomes, the use of KT tools in public health, especially among health planning teams, is less documented. This study aimed to evaluate the readiness of health planning teams to use KT tools in Tanzania's public health system and identify associated factors.</div></div><div><h3>Methods</h3><div>A qualitative approach was used, involving health planning team members from regional and local government authorities. Data were collected through focus group discussions with six planning teams and in-depth interviews with 34 key informants at the council, regional, and national levels. The information was transcribed verbatim and analyzed thematically.</div></div><div><h3>Results</h3><div>Participants were generally ready to use KT tools, but readiness varied based on contextual factors. Key factors influencing readiness included; access to research experts or knowledge-producing institutions, such as universities, availability of facilities like reliable internet and computers, funding to make KT tools available, capability to access and use KT tools, and availability of KT tools in their settings.</div></div><div><h3>Conclusion</h3><div>The study revealed that the readiness to use KT tools was low and varied based on the availability of resources and support structures. The findings emphasize the need for interventions like capacity building, policy integration, improved collaboration, regular monitoring, and the development of a knowledge management framework to enhance the use of KT tools during health planning.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"4 ","pages":"Article 100044"},"PeriodicalIF":0.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143176097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paradoxes in the implementation of public policies in mental health: A case study of the Colombian context","authors":"Felipe Agudelo-Hernández ,&nbsp;Laura Inés Plata-Casas ,&nbsp;Helena Vélez-Botero","doi":"10.1016/j.ssmhs.2024.100048","DOIUrl":"10.1016/j.ssmhs.2024.100048","url":null,"abstract":"<div><h3>Objective</h3><div>Mental health policies are essential to promote and encourage a comprehensive approach to mental health. The objective of this research was to explore the challenges for the implementation of public mental health policy in Colombia from the experience and perspective of key actors in mental health.</div></div><div><h3>Methods</h3><div>A qualitative approach research was carried out, whose data were collected through semi-structured interviews and a recorded and transcribed discussion group, in which 447 mental health professionals from multiple regions of Colombia participated, within the framework of a strategy to strengthen the primary health care. The data were analyzed thematically for causal loop diagram.</div></div><div><h3>Results</h3><div>Four relevant categories were identified, which question the effectiveness of the guidelines that guide mental health in Colombia, around the meanings attributed to human rights, financial profitability, quality and access to services, and stigma and discrimination. The thematic analysis allowed the construction of a diagram of causal loops that involve the categories described above, evidencing the interrelationships between the different factors identified in the thematic analysis that influence the effective implementation of public mental health policies in Colombia.</div></div><div><h3>Conclusions and implications for practice</h3><div>The findings of this study show the paradoxes and challenges faced by the implementation of public policies on mental health in Colombia. Despite having some solid regulatory elements consistent with international guidelines, it has other regulations that make the implementation of this evidence difficult, especially in financing.</div></div>","PeriodicalId":101183,"journal":{"name":"SSM - Health Systems","volume":"4 ","pages":"Article 100048"},"PeriodicalIF":0.0,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143175516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}