Health policy and planning最新文献

{"title":"Examining evidence use in vaccine policymaking in Kenya: a qualitative case study.","authors":"Dennis Waithaka, Simon Lewin, Jacinta Nzinga, Unni Gopinathan, Claire Glenton, Edwine Barasa, Benjamin Tsofa","doi":"10.1093/heapol/czag100","DOIUrl":"10.1093/heapol/czag100","url":null,"abstract":"<p><p>Although evidence-informed health policymaking is widely promoted, evidence use in vaccine policymaking and the institutional and actor dynamics shaping it remain poorly understood. This study investigates what types of evidence was used and how it was used in vaccine policymaking in Kenya. Using a qualitative case study design, we focused on the introduction and roll-out of HPV and malaria vaccines. Data collection included 34 in-depth interviews with national Ministry of Health officials, Kenya National Immunization Technical Advisory Group members, County Expanded Programme of Immunization logisticians, international partners, and local civil society organizations; 417 hr of observation of vaccine-related policy and planning meetings; and a review of relevant policy and planning documents. Framework analysis was used to analyse the data, guided by two analytical frameworks: (i) a spectrum approach for categorizing evidence along two dimensions-scientific to tacit and global to local-and (ii) Weiss's models of research use, which interpret patterns of evidence utilization in policymaking. The findings show that international actors, through their financial and technical authority, substantially influenced national policymakers' adoption of global guidance and scientific evidence. Local programmatic expertise played a crucial role in validation and contextualization of global guidance and scientific evidence to fit local contexts. The dominance of medical and public health professionals in decision-making spaces led to the prioritization of evidence on vaccines' public health benefits over socio-political considerations. Local civil society's influence in vaccine policymaking was limited, with its community-based experiential knowledge primarily informing advocacy, communication, and social mobilization, rather than vaccine prioritization and policy decisions. We conclude that strengthening evidence-informed policymaking requires more inclusive approaches that value diverse evidence types. Addressing power imbalances that shape what counts as credible evidence and integrating local civil society perspectives throughout the policymaking process can enhance the legitimacy, acceptability, and effectiveness of policy decisions.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":"1511-1526"},"PeriodicalIF":3.5,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The One Health national policy network to combat antimicrobial resistance in Senegal.","authors":"Léo Delpy, Mouhamadou Moustapha Sow, Mamadou Ciss, Assane Gueye Fall, Marion Bordier","doi":"10.1093/heapol/czag104","DOIUrl":"10.1093/heapol/czag104","url":null,"abstract":"<p><p>Antimicrobial resistance (AMR) is a health threat globally and particularly in low- and middle-income countries. Senegal, like many other African countries, faces significant challenges in addressing the AMR crisis. This article aims to investigate the policy-making process that supports efforts to combat AMR in Senegal since the adoption of the country's 2017 National Multisectoral Action Plan Against Antimicrobial Resistance. A survey was conducted between January and August 2023 with key organizations involved in the policy-making process related to AMR at the national level. We collected both quantitative data describing the policy networks and qualitative data characterizing the beliefs of organizations. These mixed data were analysed using a dual approach, employing the policy network analysis and the advocacy coalition framework, to investigate the complexity of the national policy-making process. This article provides empirical evidence that the policy network has a centre-periphery structure, with a coalition of three organizations at its heart. Additionally, this article highlights the importance of technical and financial partners in the process of making policies to combat AMR in Senegal.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":"1556-1567"},"PeriodicalIF":3.5,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Making birth companionship work in rural district hospitals: experiences of a health worker-led intervention in South Africa.","authors":"Silondile Luthuli, Christiane Horwood, Lyn Haskins M Tech, Vaughn M John, Sphindile Mapumulo, Veronique Filippi, Loveday Penn-Kekana, Sandra Land, Cleo Phewa, Neil Moran, Rose Sibiya, Hlengiwe Myeza, Tanya Doherty","doi":"10.1093/heapol/czag118","DOIUrl":"https://doi.org/10.1093/heapol/czag118","url":null,"abstract":"<p><p>Birth companionship is an essential component of high-quality maternal care, associated with better clinical outcomes and improved childbirth experiences. Despite policy support, implementation in low-and-middle income countries, remains limited. STAR (Strengthening Teamwork and Respect) was a health worker-led participatory learning and action intervention implemented in nine rural hospital maternity units in KwaZulu-Natal, South Africa. Through structured reflection, STAR teams identified locally driven change projects to improve maternity care; seven hospital teams chose to support birth companionship and were included in this study. This was a mixed-methods study. Quantitative cross-sectional surveys were conducted among postpartum women, at baseline and after STAR implementation, to assess access to birth companions. Semi-structured in-depth interviews with maternity unit health workers (HWs) explored attitudes and experiences of birth companionship before and after implementation of change projects. Embedded within the study methods was a continuous process evaluation to document implementation in each facility. We found that more women were allowed a birth companion after implementation of birth companionship (37% vs 12%), and at endline most women (64%) stated they would choose to have a companion for a future delivery. At baseline, most HWs were apprehensive about birth companions, citing understaffing, limited space, inadequate privacy, and concerns about cultural acceptability. STAR teams developed standard operating procedures for birth companions and promoted birth companions in antenatal clinics. Each STAR team designed context-specific strategies, including guidelines for companions, rearrangements in labour ward to improve privacy, name badges and registers for companions and, in some cases, providing accommodation. Following implementation, HWs reported positive experiences, stating that companions assisted both mothers and HWs, and improved communication. Thus, participatory, HW-led approaches can facilitate implementation of policy changes in low-resource settings, including practices that have been resistant to improvement. The STAR model could provide a scalable strategy for translating evidence-based recommendations into routine practice.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Continued Use of Mission Health Facilities in Ghana: A Facility-Exit Survey of User Perceptions.","authors":"Joseph Atta Amankwah, Emmanuel Kwasi Afriyie, Justine Ti-Baliana Martha Naab, Reginald Kofi Sefa Nkansah, Enoch Nana Kwabena Osafo, Kofi Akohene Mensah, Peter Agyei-Baffour","doi":"10.1093/heapol/czag115","DOIUrl":"https://doi.org/10.1093/heapol/czag115","url":null,"abstract":"<p><p>Partnerships between the state and faith-based providers, such as the Christian Health Association of Ghana (CHAG), are crucial for expanding healthcare coverage in lower-middle-income countries. However, limited evidence exists on how communities perceive these services and what factors are associated with continued use among those who access them. We conducted a quantitative cross-sectional facility-exit survey among 799 current and past users recruited at CHAG facility exits across four regions between October and December 2024. Data were collected using a structured questionnaire guided by the Sustainability of Innovation Framework. Descriptive statistics, chi-square tests, and exploratory multivariable logistic regression evaluated factors associated with continued use of CHAG facilities among existing users. Among this facility-exit sample, continued use was remarkably high (94.1%) and 95.1% preferred mission facilities over alternatives. Geographic access and socioeconomic status were not significantly associated with continued use patterns (p>0.05), though this finding reflects the sampling strategy that over-represents users and should not be interpreted as community-level prevalence. Perceptual factors dominated the exploratory regression analysis: positive self-rated health (AOR=3.88, 95% CI: 1.98-7.63), perceived service quality (AOR=7.48, 95% CI: 3.46-16.18), and feeling safe at the facility (AOR=9.12, 95% CI: 4.36-19.08) were exploratorily associated with continued use. These effect sizes should be interpreted with caution given the near-complete separation in the outcome (94% users) and the small number of non-users (n=47), which may inflate odds ratios in logistic regression. Objective factors, paying fees and medication stock-outs were not significant in the adjusted model (p>0.05). Among non-users (n=47), key barriers were high cost and service unavailability. Continued use of state-faith-based partnership facilities are exploratorily associated with trust rooted in perceived quality, safety, and responsiveness. Persistent challenges with medication stock-outs and costs highlight areas for systemic strengthening. Future community-based research is needed to identify determinants of non-utilization and test generalizability.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aid cuts, health financing fragility, and maladaptive resilience in Sierra Leone: a rapid mixed-methods study.","authors":"Augustus Osborne, Maria Paola Bertone, Halimatu Kamara, Ayesha Idriss, Sophie Witter","doi":"10.1093/heapol/czag117","DOIUrl":"https://doi.org/10.1093/heapol/czag117","url":null,"abstract":"<p><p>Sierra Leone's health system remains highly dependent on external aid, with donor funding accounting for approximately 47% of total health expenditure between 2020 and 2024, compared with a government contribution of around 25-26%. Recent reductions in development assistance for health, including a sharp in-year contraction of USAID-supported health programming during 2024-25 and an approximately 15% reduction in Global Fund allocations, have exposed major structural vulnerabilities in the health financing system. We conducted a rapid mixed-methods study to examine the effects of recent and anticipated aid reductions and the resilience responses emerging across Sierra Leone's health system. The study drew on a review of 19 documents and 11 key informant interviews with stakeholders from government, development partners, civil society, non-governmental organisations, and independent experts. Documentary and interview data were analysed descriptively and thematically, and findings were integrated during interpretation. Several service areas were identified as highly exposed to financing disruption, including reproductive, maternal, newborn and child health, HIV, tuberculosis, immunisation, and pharmaceutical supply chains. However, available evidence indicates that immediate service disruptions have so far been limited, and current data do not support firm conclusions about which services have been most affected. Maternal health and immunisation indicators remained comparatively stable in the short term. Documents and interviewees indicated that absorptive responses have prioritised core commodities and selected priority services, while reducing expenditure on outreach, supervision, training, logistics, and other enabling functions. Interviewees reported that households were absorbing much of the financial burden through increased out-of-pocket spending, forgone care, and informal coping mechanisms. Sierra Leone's response shows elements of absorptive and adaptive resilience, but several coping strategies show features consistent with maladaptive resilience and risk becoming maladaptive if prolonged, because they shift costs downward, threaten to deepen inequity, and erode the operational foundations of the health system.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'The Opportunity to Catch Up': From Emergency Response to Immunization Sustainability in Cameroon.","authors":"Jean Christophe Fotso, Adalbert Tchetchia, Ferdinard Ngong, Victoria Ngako, Olaitan Elihou Adje","doi":"10.1093/heapol/czag116","DOIUrl":"https://doi.org/10.1093/heapol/czag116","url":null,"abstract":"<p><p>The COVID-19 pandemic severely disrupted routine immunization globally and across Cameroon, causing a surge in 'zero-dose' (ZD) children and exacerbating 'missed opportunities for vaccination' (MOV). This necessitated accelerated recovery initiatives like the Big Catch-Up (BCU). This study explores BCU's operationalization, implementation and sustainability in Cameroon, assessing how vertical funding interacted with national health systems to reach ZD and under immunized (UI) children. Focusing on four districts (urban, conflict-affected, isolated island, and remote rural), we triangulated data from 34 document reviews (e.g., national policies, operational plans, budget frameworks, and EPI reports), 37 key informant interviews across all health system levels, and 11 Focus Group Discussions (FGD) with 86 community stakeholders, including caregivers. Thematic analysis reveals that while BCU remained a campaign-style intervention with parallel reporting structures, its funding acted as a critical accelerator to operationalize Cameroon's pre-existing but under-implemented 2021 National Policy and Guidelines on Catch-up Immunization. However, centralized financial control created top-down pressures that were mitigated through bottom-up co-creation during local micro-planning. Operationally, reducing MOV required a shift from passive screening to active 'Catch and Vaccinate' models, necessitating context-specific delivery adaptations in conflict zones and island populations. Despite these operational successes, stakeholders expressed deep concern regarding the long-term institutionalization due to an impending fiscal cliff. The system's heavy reliance on external donor financing threatens the sustainability of Community Health Workers' (CHW) incentives essential for demand generation. Furthermore, while the parallel IASO digital platform enabled real-time geolocation of missed children, it created double-reporting burdens, highlighting the structural challenge of synchronizing campaign tools with the national routine health information system. Ultimately, while recovery funding can successfully catalyze national policies and drive immediate equity gains, sustained resilience requires an urgent transition to domestic financing, the embedding of adaptive service delivery models into routine primary care, and the harmonization of digital tracking systems.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing global measurement guidance to strengthen adolescent well-being data generation and use at country level.","authors":"Sarah C Keogh, Holly Newby, Titus Divala, Parviz Abduvahobov, Sarah Baird, Tapas Chatterjee, Julianna Deardorff, Evelyne Degraff, Renée de Jong, Sithembile Dlamini-Nqeketo, Danielle Engel, Tamrat Gebremichael, Priya Karna, Jonathan D Klein, Constance Mackworth-Young, Terrance Magoro, Abdullah Al Mamun, Jose Marquez, Hlamalani Queen Nenzhelele, Mily Ramirez Ruiz, Jennifer Requejo, Zoya Ali Rizvi, Anshu Mohan, Regina Guthold","doi":"10.1093/heapol/czaf106","DOIUrl":"https://doi.org/10.1093/heapol/czaf106","url":null,"abstract":"<p><p>Adolescence is a critical life stage marked by rapid physical, cognitive, and social development with implications for well-being in adulthood and of subsequent generations. Although global attention to adolescent well-being has grown over the past decade, efforts to measure it remain fragmented, sector specific, and include a greater number of indicators of risks and negative outcomes compared to positive well-being. To address these challenges, the World Health Organization, in collaboration with the Partnership for Maternal, Newborn and Child Health and other United Nations (UN) partners, developed new measurement guidance to support countries in assessing adolescent well-being in a holistic, multisectoral way across the five domains of the UN's consensus Adolescent Well-being Framework (AWF) focused on health and nutrition, connectedness, safety, learning, and agency and resilience. This article describes the process and results of the guidance development. The process incorporated adolescent and youth perspectives, was supported by a multidisciplinary Expert Consultative Group and included several steps, starting with operationalizing the AWF for measurement. Draft guidance was then developed, and the feasibility of its implementation was assessed in Colombia, India, and South Africa. Feedback from country stakeholders led to substantial revisions-clarifying linkages to the broader measurement landscape, strengthening implementation information, and improving usability-before finalization. The guidance supports countries to identify and assemble existing data across all domains of the AWF, identify data gaps, assess current government-led efforts to improve adolescent well-being, and translate findings into action. Rather than prescribing new indicators or data collection efforts, it provides a structured approach and an Excel-based data tool to improve the use of existing data. By promoting a practical, country-led approach and building on existing systems, the guidance aims to support governments in strengthening insight, accountability, and action for adolescent well-being.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":"41 Supplement_2","pages":"ii57-ii68"},"PeriodicalIF":3.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108867","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":"Monitoring commitments for adolescent well-being: bridging the gaps between promise, implementation and impact.","authors":"Thahira Shireen Mustafa, Gareth Jones, Lucy Fagan, Philip Idoko, Petar Mladenov, Arlene B Tickner, Kathleen Sherwin, Anshu Mohan, Rajat Khosla","doi":"10.1093/heapol/czag007","DOIUrl":"https://doi.org/10.1093/heapol/czag007","url":null,"abstract":"<p><p>This paper presents a timely and critical analysis of the translation of global commitments made at the landmark 2023 Global Forum for Adolescents into national action to prioritize adolescent well-being. The Partnership for Maternal, Newborn & Child Health is monitoring implementation of these commitments. Employing a mixed methods approach, the paper examines the nature of these multi-stakeholder commitments and their early implementation in four diverse country contexts, specifically Bulgaria, Colombia, Malawi, and Nigeria. Key findings highlight the critical role of multi-sectoral coordination, the imperative of fostering genuine adolescent and youth engagement, and the complexities inherent in managing policy synergies and trade-offs within varied national realities. The analysis reveals that while the Global Forum for Adolescents successfully catalyzed unprecedented attention and pledges for adolescents, effective and sustainable realization of these commitments at the national and local level is an urgent imperative contingent upon overcoming persistent structural barriers and adopting adaptive, systems-informed policy responses. The paper examines the roles of various actors including governments, civil society, and young people, and concludes with a set of recommendations aimed at supporting systemic, long-term change through enhanced cross-sectoral collaboration and integrated policies and programs; and underscores the importance of a continued focus on accountability for adolescent well-being.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":"41 Supplement_2","pages":"ii69-ii81"},"PeriodicalIF":3.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108832","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 economic case for increased investment in the treatment of adolescents with common mental disorders in Colombia and South Africa.","authors":"Kim Sweeny, Nicola Reavley, Bruce Rasmussen, Hlamalani Queen Nenzhelele, Renée De Jong, Mily Johana Ramírez Ruiz, Beatrice Nyamwenge Okech, Rose September, Anshu Mohan, Sarah Kline","doi":"10.1093/heapol/czag075","DOIUrl":"https://doi.org/10.1093/heapol/czag075","url":null,"abstract":"<p><p>Adolescence is a critical period for the emergence of mental health disorders. The prevalence of depression and anxiety among adolescents in high- and middle-income countries has increased over the past three decades. According to the Global Burden of Disease Study (2025), mental disorders account for 21.4% of the adolescent burden of disease in high socio-demographic index (SDI) countries and 16.1% and 18.6% in the middle- and low-SDI countries. Despite the high and rising burden, adolescent mental health remains less prioritized in policy and funding. Treatment rates in low- and middle-income countries are low, with fewer than one in ten affected adolescents receiving care in some settings. Poor mental health in adolescence is associated with long-term losses in educational attainment, productivity and social participation. There is growing evidence suggesting that mental health interventions for depression and anxiety can be cost-effective even in resource constrained settings. This paper presents new evidence on the return on investment from scaling up interventions for adolescent depression and anxiety in two middle-income countries: Colombia and South Africa. Using the OneHealth tool and an economic model previously applied in global adolescent investment cases, we estimate health, education and economic benefits under a scale-up scenario. Scaling-up treatment for depression and anxiety in Colombia results in a benefit-cost ratio (BCR) for economic benefits alone of 13.9 and for combined economic and social benefits of 15.4. For South Africa the BCRs are 13.0 and 13.9, respectively. Our findings offer policy-relevant evidence to support increased investment in adolescent mental health in settings where data and resources remain limited.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":"41 Supplement_2","pages":"ii43-ii56"},"PeriodicalIF":3.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149107748","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":"What young people want to improve their health and well-being: insights from over 1.5 million young people.","authors":"Ashrita Saran, David A Ross, Renée De Jong, Howard White, David Gomez, Maria El Bizri, Rajat Khosla, Dinah Salunda, Jordan Njinowo, Merette Khalil, Etienne V Langlois, Anshu Mohan","doi":"10.1093/heapol/czaf108","DOIUrl":"https://doi.org/10.1093/heapol/czaf108","url":null,"abstract":"<p><p>Knowing young people's views on what they want is essential to effective policies and programmes to promote their health and well-being. The What Young People Want hybrid online/in-person survey invited young people (10-24 years) to complete the statement: 'To improve my well-being, I want…' Responses from the 1 510 004 respondents were analysed by content and thematic analysis using natural language processing techniques, followed by word frequency analysis to identify and quantify keywords and phrases. The respondents' 'wants' were classified into five domains [good health and optimum nutrition ('Health'); connectedness, positive values and contribution to society ('Connection'); safety and a supportive environment ('Safety'); learning, competence, education, skills and employability ('Learning'); and agency and resilience ('Agency')] and 27 sub-domains of adolescent well-being, or as general statements of well-being. About 1 509 904 responses (>99.9%) were classified. Since each response could contain multiple 'wants', 1 714 027 individual 'wants' were identified at the domain level and 2 072 657 at the sub-domain level. Respondents were from 89 countries, with >99.9% from low- or middle-income countries (LMICs) and 1 397 735 (92.5%) from three WHO Regions (Africa (AFR); 48.9%), South-East Asia (SEAR); 33.3%; and Eastern Mediterranean (EMR); 10.3%, 112 125 (7.4%) from the Americas (AMR) but only 138 (<0.1%) and N = 6 (<0.1%) from the European (EUR) and Western Pacific Regions (WPR), respectively. About 90.4% were youth (15-24 years), and 50.5% self-identified as female. The greatest number of 'wants' related to the 'Learning' domain (36.3%), followed by the 'Safety' (28.4%) and 'Health' (20.9%) domains. Despite under-representation of high-income countries, AMR, and especially EUR and WPR, the results showed that young people gave importance to all five domains of well-being, especially 'Learning'; 'Safety'; and 'Health', across all four WHO Regions with adequate representation. The results emphasize that adolescent well-being is multi-faceted and that multi-sectoral policies and programmes will be essential to the successful promotion of adolescents' health and well-being.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":"41 Supplement_2","pages":"ii4-ii17"},"PeriodicalIF":3.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108015","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}