School health and nutrition programmes are effective strategies to address the health problems among school-going children and adolescents. We examined the policy environments, successes and bottlenecks associated with school health and nutrition programmes in Tanzania. We used the \'policy triangle framework\' to examine 22 national and regional school health and nutrition policies and programmes in Tanzania. We also interviewed 16 key informants to gain further insights into school health and nutrition programmes. Several school health and nutrition policies in Tanzania outline the basic elements of school-based health and nutrition services. Yet, these documents neither recognise vulnerable groups, recommend age-appropriate strategies to address children\'s and adolescents\' varied and transient needs, nor provide a framework for implementing and tracking recommended activities. In these documents, underweight and infectious diseases, including human immunodeficiency virus/acquired immunodeficiency syndrome, are frequently identified as major concerns of young people, with little or no consideration of social determinants. Diverse strategies including school feeding, water and sanitation services, health and nutrition education and promotion of healthy behaviours are identified. In doing so, these documents adequately define the roles and responsibilities of all government actors, but young people and their guardians are not actively engaged in design and implementation. Additionally, there are several challenges to implementing these policies including budgetary constraints, limited resources, a lack of inter-sectoral coordination and insufficient capacity within targeted schools. To improve the health and nutritional status of school-going children and adolescents in Tanzania, adequate budgets, strengthened coordination and implementation efforts, the development of school-based stakeholders\' capacity, as well as the involvement of all other stakeholders, including adolescents, are imperative.

BACKGROUND: Internationally qualified nurses are highly sought after as a labour source due to continued shortages in the nursing profession in most developed countries. However, the lack of clear policies and procedures for nurses in the host country to use specialty nursing skills can result in the underutilisation of their expertise.
OBJECTIVE: To review the registration processes of internationally qualified nurses in 20 developed countries, with a focus on the transferability of specialised skills gained overseas.
METHODS: A multicentre policy review design was used, using the STROBE reporting guidelines. The study sourced policy information from nurse registration bodies in developed countries and reviewed and removed redundant policies.
RESULTS: Out of 34 policies initially identified, 26 were used to show the registration process of nurses after immigration to developed countries. Only four of the 20 countries reviewed indicated the option of specialised nurse registration on their website for internationally qualified nurses, with a university qualification required before years of experience. All other countries indicated the general registration pathway only.
CONCLUSIONS: More attention is needed to address the lack of well-defined policies that guide the utilisation of internationally qualified nurses\' specialised skills. Transparent procedures are essential to fully benefit from their expertise in the host country\'s health workforce.

Background: Despite existing international standards for the prison management of incarcerated trans people, carceral policies across Australian jurisdictions vary in their availability, breadth, and appropriateness. Trans populations in prison represent a vulnerable population, having specific needs surrounding their health, safety, and wellbeing. Prior reviews into Australian carceral policies highlight where contemporary prison practices fall short of meeting those specific needs. Aims/method: A review was conducted on the available carceral policy documents of each Australian correctional service regime, examining their coverage of issues including healthcare access, placement decisions, and classification systems against international standards and prior Australian recommendations. Forty-one relevant policy documents were reviewed against eighteen benchmark recommendations, along with supplementary data. Results: Australian jurisdictions varied widely on the coverage of the reviewed areas. Benchmark attainment ranged from twelve out of eighteen (Victoria and Western Australia) to three out of eighteen (Queensland). The use of administrative segregation was identified as the area in most need of policy reform. No jurisdiction met every benchmark.Conclusions: This review highlights the need for carceral policy reform across Australian jurisdictions in order to meet the unique needs of incarcerated trans people, especially in the areas of administrative segregation and healthcare access. The review also highlights the need for carceral policy reform to bring Australian jurisdictions in line with each other on the management of incarcerated trans people, to reduce disparate outcomes across states and territories.

This study reviews national-level policies regulating cross-border healthcare in mainland China after it acceded to the World Trade Organization (WTO). Policy documents from official websites of the State Council and 19 ministries were screened, from which 487 policy documents were analyzed. WTO\'s five modes of trade and WHO\'s six building blocks of healthcare system were used to guide the analysis of policymaking patterns, charting of policy evolution process, identification of key policy areas, differentiation of 29 detailed policy themes, and identification of major countries/regions involved in cross-border healthcare. The findings lead to four policy recommendations: (1) to establish a national-level committee to govern cross-border healthcare, (2) to build an information system to comprehensively integrate various information on cross-border healthcare consumption and provision, (3) to take more proactive policy actions in healthcare internationalization, and (4) to carry out reform experiments in key sub-national regions to fully explore various possibilities in developing and regulating cross-border healthcare.

OBJECTIVE: National policies can be used to reveal structural stigma and discrimination in relation to mental health. This review assesses how structural stigma and discrimination are manifested in the policies and legislations of Government of Nepal.
METHODS: Scoping review methodology was followed to review policy documents (acts of parliament, legislation, policies, strategies, guidelines and official directives) drafted or amended after 2010.
RESULTS: Eighty-nine policies were identified related to health, social welfare, development and regulations which were relevant to people with psychosocial and mental disabilities or have addressed the mental health agendas. Several critical policy failings and gaps are revealed, such as the use of stigmatizing language (e.g., \'insane\' or \'lunatic\'), inconsistencies within and between policies, deviation from international protocols defining legal capacity and consent, lack of inclusion of the mental health agenda in larger development policies and lack of cost-effective interventions and identification of financing mechanisms. Provisions for people living with mental health conditions included adequate standard of living; attaining standard mental health; the right to exercise legal capacity, liberty and security; freedom from torture or discrimination; and right to live independently. However, other policies contradicted these rights, such as prohibiting marriage, candidacy for and retention of positions of authority and vulnerability to imprisonment.
CONCLUSIONS: Mental health-related structural stigma and discrimination in Nepal can be identified through the use of discriminator language and provisions in the policies. The structural stigma and discrimination may be addressed through revision of the discriminating policies, integrating the mental health agenda into larger national and provincial policies, and streamlining policies to comply with national and international protocols.

Our research examines the development of social health insurance (SHI) in Vietnam between 1992 and 2016 and SHI\'s role as a financial mechanism towards achieving universal health coverage (UHC). We reviewed and analysed legislation from the Government of Vietnam (GoV) and performance data from the GoV and the World Bank. Stages of development were identified from legislative change leading to change in SHI functioning as a public financing mechanism: revenue collection, pooling of risk, and purchasing. Movement towards UHC was assessed relative to: population coverage, benefit coverage, and financial protection. Vietnam has implemented SHI through five stages: Stage I (1992-1998), Stage II (1998-2005), Stage III (2005-2008), Stage IV (2008-2014), and Stage V (2014 onwards). Coverage has widened from a compulsory scheme for civil servants and pensioners and a voluntary scheme for others, to a scheme that targets the entire population. However, UHC has not been achieved with 19% of the population uninsured in 2016 and high out-of-pocket payments. The benefit package includes a wide range of services and many expensive medications and considered to be generous. It is recommended that Vietnam focus on improving population coverage rather than further expanding the benefit package to achieve UHC.

This study aims to review China\'s national policies related to non-communicable disease (NCD) prevention and control at the primary health care (PHC) level since China\'s 2009 health system reform. Policy documents from official websites of China\'s State Council and 20 affiliated ministries were screened, where 151 out of 1,799 were included. Thematic content analysis was performed, and fourteen \'major policy initiatives\' were identified, including the basic health insurance schemes and essential public health services. Several areas showed to have strong policy support, including service delivery, health financing, and leadership/governance. Compared with WHO recommendations, several gaps remain, including lack of emphasis on multi-sectoral collaboration, underuse of non-health-professionals, and lack of quality-oriented PHC services evaluations. Over the past decade, China continues to demonstrate its policy commitment to strengthen the PHC system for NCD prevention and control. We recommend future policies to facilitate multi-sectoral collaboration, enhance community engagement, and improve performance evaluation mechanisms.

OBJECTIVE: To clarify factors that support a policy change from pandemic to endemic status and to examine options for non-medical responses to reduce COVID-19 transmission.
BACKGROUND: Critical factors to be considered in pandemic response decisions are not limited to medical options or public health orders, although these are important.
METHODS: All evidence drawn from publicly available sources is presented through the lens of the authors\' nursing, management, education, policy and research experience.
CONCLUSIONS: As COVID-19 variants cause infections to surge nurses and other health practitioners, who are the de facto implementers of public and health policy, need to consider the evidence supporting a pandemic policy change to endemic status. Non-medical options for reducing transmission and variant mutations are needed to enable at-risk populations to avoid infection.
CONCLUSIONS: Public policy that shifts infection risks onto the general population requires close scrutiny of the evidence base for such decisions and warrants open debate and review. If people are to manage risks arising from policy decisions, they need access to non-medical virus detection options as well as access to effective medicines and treatment.
CONCLUSIONS: Nurses have an extension to their advocacy role when policy changes about infectious disease status are declared. Evaluation of policy in terms of validity, equity and scientific basis is part of nursing\'s public responsibility. Policies that fail to reflect what is happening at the patient care level need to be questioned and modified where necessary. Only policies deemed \'good\' policy by nurses should be implemented without challenge. Access to devices for environmental detection of the virus would enable real-time estimation of infection risks and inform individual decisions about the real risk of participating in work or other activities.
UNASSIGNED: Policy decisions to transition from pandemic to endemic status must be evidence based. Clear messaging about risks and options assists policy implementation. Terminologies describing stages of infectious disease spread from \'outbreak, epidemic, endemic and pandemic\' are not interchangeable, although they will expand and contract across the range in response to interventions such as public health safety measures (PHSM), quarantine, vaccinations, antivirals and fatalities that alter the case count in defined locations for those who avoid or survive an infection.

A range of public health and social measures have been employed in response to the disproportionate impact of COVID-19 in Latin America and the Caribbean (LAC). Yet, pandemic responses have varied across the region, particularly during the first 6 months of the pandemic, with Uruguay effectively limiting transmission during this crucial phase. This review describes features of pandemic responses which may have contributed to Uruguay\'s early success relative to 10 other LAC countries - Argentina, Chile, Ecuador, El Salvador, Guatemala, Haiti, Honduras, Panama, Paraguay, and Trinidad and Tobago. Uruguay differentiated its early response efforts from reviewed countries by foregoing strict border closures and restrictions on movement, and rapidly implementing a suite of economic and social measures. Our findings describe the importance of supporting adherence to public health interventions by ensuring that effective social and economic safety net measures are in place to permit compliance with public health measures.

Self-care is the ability and empowerment of individuals to maintain health through informed health-care decisions, with or without the support of a health provider. High-income countries have made advances to their conceptualization, research and institutionalization of self-care, given its reported benefits to patients, the health system and economy. A similar undertaking in low- and middle-income countries (LMICs) with already fragile health systems is warranted as highlighted by the coronavirus disease 2019 pandemic. Our article therefore aimed to describe and analyse the policy environment of self-care using the Philippines as a case study, which may have relevance to other similar countries and settings that are transitioning towards Universal Health Care (UHC) to reform and strengthen their primary care systems. We conducted 13 key informant interviews and 2 focus group discussions among representatives from the government, the pharmaceutical retail/industry, community retail pharmacy, primary health physicians and health workers, an infirmary administrator and patients and/or patient advocates. We triangulated our qualitative data with findings from our policy review. We found a total of 13 relevant policies on self-care in the Philippines recently drafted and/or implemented from 2016 to 2021 that fall under the broad categories of unifying frameworks and road maps, capacity building and institutional streamlining, regulations and disease guidelines. Our case study highlights the role of the UHC Law as a driver for self-care and patient empowerment towards better health outcomes with its passage resulting in the promulgation of self-care-related policies. Our findings also suggest that changes in the local policy and built environment, and the formal educational and health systems, are needed to foster a culture of responsible self-care. There are notable exemplars in advancing self-care in the region, including Thailand, from which LMICs like the Philippines can draw lessons to make progress on institutionalizing self-care and, ultimately, realizing UHC and Health For All.