Health policy and planning最新文献

{"title":"Government-led scale-up of task-shifted mental health services in Lagos State, Nigeria: a mixed-methods descriptive-explanatory case study.","authors":"Abiodun O Adewuya, Bolanle Ola, Olurotimi Coker, Olayinka Atilola, Olushola Olibamoyo, Azizat Lebimoyo, Olabisi Oladipo","doi":"10.1093/heapol/czag033","DOIUrl":"10.1093/heapol/czag033","url":null,"abstract":"<p><p>Mental health conditions remain a leading contributor to global disability; however, treatment coverage in low- and middle-income countries (LMICs) stays below 20%; in Nigeria, services are underfunded and largely excluded from primary health care (PHC). This study documents the institutional processes through which the Transition-to-Scale phase of the Mental Health in Primary Care (MeHPriC) initiative scaled up task-shifted mental health services across Lagos State, Nigeria. A retrospective, mixed-methods descriptive-explanatory case study was conducted across 57 PHCs and five general hospitals. The intervention delivered care for five priority mental, neurological, and substance use conditions using the Mental Health Gap Action Programme (mhGAP) framework; 890 health workers were trained, comprising 400 Community Health Extension Workers (CHEWs), 250 nurses, 150 medical officers, 85 lay counsellors, and 5 district psychiatrists, under structured district-level supervision. Data from service registers, supervision checklists, stock audits, provider and client surveys, key informant interviews, focus groups, and policy documents were analysed using descriptive statistics and hybrid deductive-inductive thematic coding organized around the World Health Organization (WHO) Health System Building Blocks and selected Consolidated Framework for Implementation Research (CFIR) constructs. The initiative was associated with institutional changes across governance (establishment of a Mental Health Desk and a multisectoral Stakeholders Council), workforce supervision (fidelity rising from 13% to 92.3% of facilities conducting weekly case reviews), medicines (six psychotropic medications added to the Essential Medicines List; stockouts reduced by 42%), financing (₦75 million allocated through routine government budgeting), service delivery (64 107 clients screened and 9138 initiated on treatment), and health information systems. Interpreted as incremental strengthening within the mental health subsystem, these findings reinforce the feasibility of mhGAP-aligned task-shifted care when supported by structured supervision and governance, while persistent fiscal and operational constraints underscore the fragility of institutional gains.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":"785-797"},"PeriodicalIF":3.5,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13187677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health system response and recovery in Ukraine after 3 years of war: perspectives of front-line communities and internally displaced persons.","authors":"Mark Hellowell, Kateryna Kalendruz, Tetiana Bondar, Oleksiy Ganyukov, Jarno Habicht","doi":"10.1093/heapol/czag049","DOIUrl":"10.1093/heapol/czag049","url":null,"abstract":"<p><p>Communities affected by war can play a vital role in sustaining and restoring health services, yet their perspectives are under-represented in the evidence base. This study examines the experiences of patients and health personnel in three front-line areas of Ukraine, as well as persons internally displaced due to the full-scale invasion of February 2022. Our findings reveal community perspectives on the effects of war-related insecurity, workforce shortages, and infrastructure damage on health system functions and service availability. Respondents identified health worker shortages-driven by safety risks and resource scarcity-as among the most pressing concerns. Amid these challenges, however, recent health financing reforms, notably the Programme of Medical Guarantees and Affordable Medicines Programme, were often viewed as mitigating factors. Internally displaced persons (IDPs) generally reported positive care-seeking experiences in their host communities, though administrative and information-related barriers continue to limit access for some. Capacity constraints in areas hosting large numbers of IDPs are seen as placing further stress on service availability. Respondents valued the coordinated efforts of humanitarian actors and local authorities in restoring services, helping to maintain trust and social cohesion. Many were sceptical about the feasibility of large-scale reconstruction in the short term, prioritizing instead urgent security measures to protect facilities. However, they also acknowledged the importance of defining a long-term recovery strategy and identified workforce strengthening, integration of humanitarian services, and sustained financial protection as critical priorities.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":"719-730"},"PeriodicalIF":3.5,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13187625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147672529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Partial pictures: what routine health data can and cannot tell us about the quality of maternal and neonatal health services in Tanzania.","authors":"Jil Molenaar, Amani Kikula, Zamoyoni Julius, Claudia Hanson, Josefien van Olmen, Andrea Barnabas Pembe, Lenka Beňová","doi":"10.1093/heapol/czag030","DOIUrl":"10.1093/heapol/czag030","url":null,"abstract":"<p><p>Measurement of contact coverage of maternal and newborn health services may overestimate the benefits of the care that is provided, because the quality of care is not captured. It is therefore important to better understand the opportunities and challenges of capturing elements of care quality in routine health information systems (RHIS). This study explored healthcare workers' (HCWs), health sector managers' and policymakers' perspectives on the value and limits of routine health data to understand the quality of maternal and neonatal health services in Tanzania. We conducted qualitative research during two periods to capture perspectives across facility, district, regional and national levels. In Mtwara region in 2023, we conducted ethnographic observations at two hospital labour wards and 29 in-depth interviews with healthcare workers, hospital leaders, and district/regional managers. In 2025, we carried out 17 additional interviews with regional managers in Mtwara and with key national-level stakeholders. Our findings demonstrate that Tanzania's RHIS provides a valuable but partial picture of quality of care for maternal and neonatal health services. Care processes-including both provision and experience of care-are captured only to a limited extent. Using boundary object theory, we highlight how the same health information must serve diverse stakeholder needs. While there are opportunities to integrate more quality-of-care indicators, standardized RHIS cannot be expected to comprehensively capture the multifaceted nature of care quality. For quality measurement to support meaningful local health service improvement, a flexible, bottom-up approach is essential. However, the current emphasis on top-down oversight acts as a barrier for local-level data use. Relevant and feasible measurement of the quality of facility-based care requires a fundamental shift in current RHIS priorities-from systems that extract data for those 'up there' to platforms that also create value for those who provide care.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":"747-760"},"PeriodicalIF":3.5,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13187646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain, policy, and the opioid dilemma in sub-Saharan Africa: a systematic review of access, regulation, and health governance from 1990 to 2024.","authors":"Simon Nyarko, Roger A Atinga, Julius Caesar Mahama","doi":"10.1093/heapol/czag035","DOIUrl":"10.1093/heapol/czag035","url":null,"abstract":"<p><p>Sub-Saharan Africa (SSA) faces a dual opioid dilemma: widespread undertreatment of moderate to severe pain due to limited access to essential opioid analgesics, alongside increasing concern about misuse and diversion in selected contexts. Opioids are clinically indicated for severe cancer-related pain, advanced chronic illness, major trauma, surgery, and end-of-life care; yet, regional consumption remains disproportionately low relative to documented disease burden, indicating systemic under-provision rather than low need. This systematic review synthesizes evidence on opioid policy, regulation, access, and governance in SSA to examine how legal frameworks, institutional arrangements, political dynamics, and data systems shape medical availability. Following PRISMA and SWiM guidance, we reviewed peer-reviewed and gray literature addressing national drug control laws, regulatory implementation, procurement and supply systems, prescribing authority, and surveillance capacity; 33 studies met inclusion criteria. Across settings, restrictive or ambiguously interpreted legislation, multi-layered administrative controls, fragmented mandates across health and enforcement institutions, weak forecasting and distribution systems, concentrated prescribing authority, professional risk aversion, and chronic data gaps were consistently associated with constrained access. Concurrently, rising political and media attention to non-medical use, particularly of tramadol, has reinforced enforcement-oriented narratives that may further limit reform space. Persistent deficiencies in routine consumption data and unmet need assessment contribute to conservative import quotas and regulatory inertia. Addressing this imbalance requires proportionate, sequenced reform that strengthens data and forecasting systems, clarifies and aligns legal mandates with public health objectives, invests in workforce capacity and supply chains, and embeds safeguards against diversion while correcting avoidable under-treatment.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":"898-912"},"PeriodicalIF":3.5,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13187638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Local level health governance strengthening for universal health coverage: implementing the Bayang Malusog-Municipal Leadership Development Program in Aklan, Philippines.","authors":"Veincent Christian F Pepito, Catherine A Chung, Theo Prudencio Juhani Z Capeding, Angeli A Comia, Anthony Rosendo G Faraon, Daystar S Sedillo, Ma Eden C Sualog, Alice C Prieto-Carolino, Philip Ian P Padilla, Manuel M Dayrit","doi":"10.1093/heapol/czag039","DOIUrl":"10.1093/heapol/czag039","url":null,"abstract":"<p><p>The devolution of health systems development to local governments in the Philippines in 1991 brought with it unintended consequences as local chief executives found themselves with new responsibilities for which they were not prepared. These unintended consequences were exacerbated with the implementation of the country's Universal Health Care Act in 2019. To address this problem, the Zuellig Family Foundation, a non-profit and non-government organization based in the Philippines with the aim of improving health outcomes, has designed a local level health governance strengthening intervention: the Bayang Malusog (literally Healthy Communities) Municipal Leadership Development Program (BM-MLDP). The BM-MLDP is a 12-month capacity building intervention for local chief executives and local health officials consisting of deep dive immersions, change management and leadership sessions, sustainability of health reform sessions, and co-design sessions to improve population health outcomes. Its implementation on the municipalities of Balete and New Washington in 2022-2023 contributed to improving and sustaining optimal population health outcomes despite resource constraints. This highlights the potential of health governance and capacity building interventions like the BM-MLDP in improving population health outcomes and advancing the implementation of universal health coverage in resource-constrained, devolved healthcare settings.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":"922-927"},"PeriodicalIF":3.5,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13187665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147498738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WHO guidelines on physical activity, sedentary behaviour, and sleep for children under 5: a qualitative study of Mongolian stakeholder perceptions.","authors":"Ankhmaa Byambaa, Rachel A Jones, Anthony D Okely","doi":"10.1093/heapol/czag037","DOIUrl":"10.1093/heapol/czag037","url":null,"abstract":"<p><p>WHO's '24-hour movement guidelines' provide integrated recommendations for physical activity, sedentary behaviour, and sleep to improve health outcomes in children aged 0-5. This study aimed to examine stakeholders' perceptions about these guidelines to inform its future adoption, adaptation, and implementation decisions in Mongolia. Key stakeholders involved in young children's health and development were recruited through purposive sampling and snowball methods. Semi-structured interviews spanning 30-50 minutes were conducted with 38 participants using an interview guide in Mongolian language: caregivers (n = 19), kindergarten teachers (n = 14), health and policy professionals (n = 5). Audio-recorded data were transcribed, translated to English, and thematically analysed using deductive thematic analysis. Four main themes were identified: (i) awareness and appropriateness, (ii) understanding of the guidelines, (iii) perceived factors influencing adoption and implementation, and (iv) dissemination and implementation strategies. Stakeholders were mostly unaware of the WHO guidelines but perceived them as useful, feasible and culturally appropriate. Stakeholders identified barriers including competing priorities (e.g. work/family obligations), environmental challenges (lack of child-friendly spaces, cold weather, air pollution), and knowledge and capacity gaps. Stakeholder-recommended strategies for effective dissemination and implementation were kindergarten-based integration, training for caregivers and teachers, and adequate resource provision. Dissemination should use multichannel communication approaches emphasizing benefits, potential consequences of non-adherence, and provide specific, culturally relevant examples. This study provides first examination of stakeholder perspectives on WHO 24-hour movement guidelines in Central Asia. These preliminary findings suggest that successful adoption may require cultural adaptation, stakeholder education, and leveraging existing infrastructure and policy frameworks, though education sector consultation would be needed for comprehensive feasibility assessment.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":"809-820"},"PeriodicalIF":3.5,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13187624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147473369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aid cut, lives lost: estimating the impact of USAID's withdrawal on maternal mortality in six African countries.","authors":"Matthew Cummins","doi":"10.1093/heapol/czag034","DOIUrl":"10.1093/heapol/czag034","url":null,"abstract":"<p><p>In January 2025, the US government suspended and subsequently terminated the majority of United States Agency for International Development (USAID) programs. This study estimates the impact of that decision on maternal mortality in six highly vulnerable countries in West and Central Africa: Burkina Faso, Central African Republic, Chad, Mali, Niger, and Nigeria. Using a deterministic model grounded in regional health expenditure elasticities, the analysis projects how the sudden withdrawal of foreign aid affects health spending among populations in humanitarian need, under the assumption that no immediate domestic or external financing substitutes for the lost resources, and the resulting changes in maternal mortality ratios (deaths per 100 000 live births). The results indicate that the funding cuts could cause maternal deaths to increase by 45%, on average, among populations in need. This increase is estimated relative to a baseline of approximately 2900 maternal deaths predicted in 2025, yielding approximately 1000 additional deaths across the countries within a single year. The magnitude of impact varies, with Niger experiencing the largest proportional increase (over 90%) and Nigeria the largest absolute increase (more than 300 additional deaths). Sensitivity analyses confirm that the results are robust to alternative elasticity scenarios. The findings illustrate the degree to which maternal health outcomes in fragile settings are sensitive to financing discontinuities. The results are presented as conditional estimates and are intended to inform ongoing discussions on health financing sustainability, transition planning, and risk mitigation.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":"731-737"},"PeriodicalIF":3.5,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13187630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147432588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying a gender and equity matrix for a contextualized antimicrobial stewardship intervention in Pakistan.","authors":"Saad Alam Khan, Muhammad Ahmar Khan, Ingrid Lynch, Nida Khan, Shaheer Ellahi Khan, Farah Zafar, Cèlia Ventura-Gabarró, Erica Westwood, Anna Kalbarczyk, Rosemary Morgan, Muhammad Amir Khan","doi":"10.1093/heapol/czag029","DOIUrl":"10.1093/heapol/czag029","url":null,"abstract":"<p><p>Antimicrobial resistance (AMR) is a growing global health threat that extends beyond biomedical dimensions, as it is profoundly shaped by social and structural determinants such as gender, socioeconomic status, and access to care. However, research exploring these factors remains limited. This study adapts and applies a gender and equity matrix to examine how these factors intersect to affect AMR risks in rural Pakistan. We synthesized literature on antibiotic prescription and use in Pakistan and similar sociocultural and economic context settings, focusing on upper respiratory tract and diarrhoeal infections. We then integrated these findings with insights from a structured consultation with gender and public health experts. The gender and equity matrix mapped inequities across three topic-specific domains-susceptibility/vulnerability to infection, care provision (during facility visits), and care uptake (before and after facility visits)-cross-referenced with biological and social stratifiers along with gender analysis domains. Findings were synthesized into cross-cutting themes to identify actionable drivers of AMR. The context analysis highlighted persistent gender- and equity-related barriers in access to care, including women's limited mobility, lower health literacy, and restricted decision-making autonomy. We also identified structural constraints, including limited household financial resources that result in women being deprioritized for care, alongside gender-insensitive health care service delivery. In rural low- and middle-income countries' settings, addressing these barriers requires gender-responsive health system design, equitable provider-patient communication, and interventions that reduce economic and physical barriers to care uptake. The gender and equity matrix offers a structured approach to reveal how social and structural determinants interact to drive AMR risks, providing a practical tool for systematically integrating gender and equity considerations into AMR policy and programming.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":"761-775"},"PeriodicalIF":3.5,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13187641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147591832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of an educational campaign on contraception seeking in Northern Nigeria: an interrupted time series analysis using routine health information system data.","authors":"Arnold I Okpani, Andrea Stucchi, Lucy Cheng, Khadeejah L Hamza, Dawn Mooney, Prince Adu, Seraphine Zeitouny, Karen A Grépin, Jennifer Hutcheon, Laura Schummers, Michael R Law","doi":"10.1093/heapol/czag045","DOIUrl":"10.1093/heapol/czag045","url":null,"abstract":"<p><p>In Nigeria, unmet need for contraception results in 3 million unintended pregnancies annually. Despite no-cost contraception availability at health facilities, only 38% of reproductive-aged women in Nigeria used effective contraception methods in 2023. We evaluated the impact of a radio-based contraception education campaign on contraception seeking in Kano State, Nigeria. Using monthly, facility-level data from Nigeria's national health management information system, we measured contraception seeking according to the number of 'family planning clients counselled' and 'new family planning acceptors' divided by facility catchment population estimates derived from Geo-referenced Infrastructure and Demographic Data for Development (GRID3). Using controlled interrupted time series analyses, we estimated contraception seeking before (January 2019-September 2021) and after (November 2021-December 2024) the radio campaign intervention in Kano. We controlled for preintervention trends and estimated changes relative to the neighbouring control state of Jigawa. Among 376 health facilities in Kano and 241 facilities in Jigawa with sufficient data points, we observed an increasing preintervention trend in family planning clients counselled and new family planning acceptors. The radio campaign was associated with a small nonsignificant decrease in family planning clients counselled in Kano immediately postintervention compared to Jigawa. This was offset by a decrease in the trend of 0.27 fewer clients per 1000 women per month in Kano thereafter [95% confidence interval (CI): 0.10-0.44], meaning the effects were not sustained. Similarly, new family planning acceptors increased by 1.62 (95% CI: 0.12-3.12) in Kano relative to Jigawa. This effect was also offset by a relative decline in the trend of 0.29 per 1000 fewer women per month (95% CI: 0.22-0.36). The introduction of a radio-based campaign in Kano, Nigeria, had no long-term effect on contraception seeking at health facilities. Alternative strategies are needed to increase contraception service use in Nigeria and similar contexts.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":"776-784"},"PeriodicalIF":3.5,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13187670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147591819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building sustainable public health data science and informatics capacity: possibilities for Eastern Europe and Central Asia.","authors":"George Gotsadze, Mariam Gelashvili, Elene Zhuravliova, Tamar Barbakadze, Jennifer Gilvydis, Ruth Levine, Steven Becknell","doi":"10.1093/heapol/czag046","DOIUrl":"10.1093/heapol/czag046","url":null,"abstract":"<p><p>Prevention, detection, and response to pandemic-prone diseases involve collecting, analyzing, and applying data swiftly at scale. Achieving these goals requires adequate information technology and a skilled public health workforce capable of translating data into action. While public health informatics and data science programs are established in parts of the Western world, Eastern Europe and Central Asia (EECA) face significant gaps in educational pathways. This study mapped the educational and labor market structures in Georgia, Kazakhstan, and Moldova, identified barriers to training and retaining professionals in public health informatics and data science, and proposed sustainable models for integrating training into national systems. A mixed-methods approach included a review of 111 policy and regulatory documents, labor-market analysis, 147 semistructured interviews, seven focus groups, and two expert workshops (n = 72) that validated findings and prioritized policy options. Although all three countries demonstrate strategic commitment to digital transformation, investment in human capital remains insufficient. Educational programs are isolated, with no accredited degrees in these professions, and accreditation processes delay educational innovations. Employers lack awareness of the value of these professions, and salary gaps between the health and information technology sectors, as well as between public and private sectors, weaken workforce retention. The absence of occupational recognition in national regulations further constrains workforce development. Stakeholders endorsed modular, competency-based training-integrated into Master of Public Health programs and in-service certificates-as the most feasible way to scale capacity. Building a sustainable workforce requires short-term measures such as problem-based and continuing training, along with long-term policies that (i) prioritize human capital development in national digital health strategies, (ii) adjust educational and occupational classifications, (iii) modernize accreditation processes for modular credentialing, and (iv) align incentives to attract and retain talent. Together, these actions could enable EECA health systems to harness digital innovation for better health outcomes.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":"821-830"},"PeriodicalIF":3.5,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13187639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147608723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}