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Public health programs succeed and survive if organizations and coalitions address 6 key areas. (1) Innovation to develop the evidence base for action; (2) a technical package of a limited number of high-priority, evidence-based interventions that together will have a major impact; (3) effective performance management, especially through rigorous, real-time monitoring, evaluation, and program improvement; (4) partnerships and coalitions with public- and private-sector organizations; (5) communication of accurate and timely information to the health care community, decision makers, and the public to effect behavior change and engage civil society; and (6) political commitment to obtain resources and support for effective action. Programs including smallpox eradication, tuberculosis control, tobacco control, polio eradication, and others have made progress by addressing these 6 areas.

Background Disrespect and abuse of women during institutional childbirth services is one of the deterrents to utilization of maternity care services in Ethiopia and other low- and middle-income countries. This paper describes the prevalence of respectful maternity care (RMC) and mistreatment of women in hospitals and health centers, and identifies factors associated with occurrence of RMC and mistreatment of women during institutional labor and childbirth services. Methods This study had a cross sectional study design. Trained external observers assessed care provided to 240 women in 28 health centers and hospitals during labor and childbirth using structured observation checklists. The outcome variable, providers’ RMC performance , was measured by nine behavioral descriptors. The outcome, any mistreatment, was measured by four items related to mistreatment of women: physical abuse, verbal abuse, absence of privacy during examination and abandonment. We present percentages of the nine RMC indicators, mean score of providers’ RMC performance and the adjusted multilevel model regression coefficients to determine the association with a quality improvement program and other facility and provider characteristics. Results Women on average received 5.9 (66%) of the nine recommended RMC practices. Health centers demonstrated higher RMC performance than hospitals. At least one form of mistreatment of women was committed in 36% of the observations (38% in health centers and 32% in hospitals). Higher likelihood of performing high level of RMC was found among male vs. female providers ( β ^ = 0.65 , p  = 0.012), midwives vs. other cadres ( β ^ = 0.88 , p  = 0.002), facilities implementing a quality improvement approach, Standards-based Management and Recognition (SBM-R © ) ( β ^ = 1.31 , p  = 0.003), and among laboring women accompanied by a companion β ^ = 0.99 , p  = 0.003). No factor was associated with observed mistreatment of women. Conclusion Quality improvement using SBM-R © and having a companion during labor and delivery were associated with RMC. Policy makers need to consider the role of quality improvement approaches and accommodating companions in promoting RMC. More research is needed to identify the reason for superior RMC performance of male providers over female providers and midwives compared to other professional cadre, as are longitudinal studies of quality improvement on RMC and mistreatment of women during labor and childbirth services in public health facilities.

Effective strategies for reducing maternal mortality depend on the accuracy of data. In sub-Saharan Africa, however, weak health systems often result in significant gaps in data collection and analysis. These gaps can lead to misreporting, missing data, or double-counting at health facilities, ultimately skewing the aggregated data reported by Ministries of Health. This is a big problem given that the data shapes planning and policy of the country. In this study, we assessed the data quality of Post-abortion Care (PAC) records across 20 health facilities in Uganda. A two-stage design was employed. In stage 1, DHIS2 data from 80 public health facilities were reviewed for completeness, timeliness, and internal consistency (2018-2021). In stage 2, 20 facilities that met a predefined eligibility criterion (≥ 50% discrepancy or missing data during stage 1) were purposively selected for in-depth validation. Data were collected retrospectively from facility registers for the last 7 months of 2021 and prospectively for the first 6 months of 2022. Data quality was assessed using adapted WHO data quality review (DQR) metrics. Health facilities achieved a 100% timeliness rate for report submissions, with all documents provided by the 7th day of each month. Although a statistically significant positive correlation was observed between the number of women who received PAC and those who received post-abortion family planning (PAFP) (r = 0.083, p < 0.001), the association was very weak suggesting limited internal consistency between the two indicators and raising questions about the reliability of data linkages between care and follow-up services in routine reporting systems. Moreover, comparing facility records with DHIS2 data revealed that outpatient records were more accurate than inpatient records, with PAC data being more inaccurate than other maternal health indicators. Further analysis by facility type indicated a higher number of case-load outliers at Health Centre IIIs and IIs (1049) compared to hospitals and Health Centre IVs, highlighting disparities in data quality across different levels of healthcare facilities. Despite high submission rates, PAC data accuracy was notably low, highlighting the need for better data management and record-keeping, particularly in lower-level health facilities. Addressing these disparities is crucial for improving maternal health outcomes, emphasizing the necessity for targeted interventions to enhance data accuracy and reliability within Uganda's health system.

This Viewpoint reviews the debate about whether the professionalization of public health practice should be approached through a certification and licensure system. It introduces the recent attempt at professionalizing public health in Taiwan with the newly enacted Public Health Specialists Act of 2020, regulating the Public Health Specialist (PHS) through a state-mandated certificate. The Viewpoint discusses the implications of this new PHS Act on Taiwan’s public health education and professionalization. The PHS model in Taiwan is one of the first of its kind around the globe. Advocates of public health professionalization and public health educators could benefit from Taiwan’s experience.

Background In their safety evaluations of bisphenol A (BPA), the U.S. Food and Drug Administration (FDA) and a counterpart in Europe, the European Food Safety Authority (EFSA), have given special prominence to two industry-funded studies that adhered to standards defined by Good Laboratory Practices (GLP). These same agencies have given much less weight in risk assessments to a large number of independently replicated non-GLP studies conducted with government funding by the leading experts in various fields of science from around the world. Objectives We reviewed differences between industry-funded GLP studies of BPA conducted by commercial laboratories for regulatory purposes and non-GLP studies conducted in academic and government laboratories to identify hazards and molecular mechanisms mediating adverse effects. We examined the methods and results in the GLP studies that were pivotal in the draft decision of the U.S. FDA declaring BPA safe in relation to findings from studies that were competitive for U.S. National Institutes of Health (NIH) funding, peer-reviewed for publication in leading journals, subject to independent replication, but rejected by the U.S. FDA for regulatory purposes. Discussion Although the U.S. FDA and EFSA have deemed two industry-funded GLP studies of BPA to be superior to hundreds of studies funded by the U.S. NIH and NIH counterparts in other countries, the GLP studies on which the agencies based their decisions have serious conceptual and methodologic flaws. In addition, the U.S. FDA and EFSA have mistakenly assumed that GLP yields valid and reliable scientific findings (i.e., “good science”). Their rationale for favoring GLP studies over hundreds of publically funded studies ignores the central factor in determining the reliability and validity of scientific findings, namely, independent replication, and use of the most appropriate and sensitive state-of-the-art assays, neither of which is an expectation of industry-funded GLP research. Conclusions Public health decisions should be based on studies using appropriate protocols with appropriate controls and the most sensitive assays, not GLP. Relevant NIH-funded research using state-of-the-art techniques should play a prominent role in safety evaluations of chemicals.

IMPROVING STIGMA BY FOCUSING ON HEALTH IMPROVEMENT The benefits of integrating behavioral health and primary care can be understood in the conceptual framework of the Triple Aim approach described by Berwick et al.: (1) improving the patient experience of care (including quality and satisfaction), (2) improving the health of populations, and (3) reducing the cost of health care.4 From a patient-level perspective, stigma about mental illness (including self-imposed and perceived stigma) is a major factor that contributes to lack of treatment or undertreatment. Because the risk factors for physical disease and mental illness are often the same, emphasis by primary care providers on healthy lifestyles and decreasing overall health risk factors for disease can also promote mental health.

The COVID-19 pandemic prompted the scientific community to collaborate in an unprecedented way, with the rapid and urgent generation and translation of new knowledge about the disease and its causative agent. Iteratively, and at different levels of government and globally, population-level guidance was created and updated, resulting in the need for a living catalog of guidelines, the eCOVID-19 Recommendations Map and Gateway to Contextualization (RecMap). This article focuses on the approach that was used to analyze barriers and opportunities associated with using the RecMap in public health in Canada. A mixed qualitative and quantitative approach data were used to inform this knowledge mobilization project and inform feedback on implementation of the eCOVID-19 RecMap. This approach involved surveying 110 attendees from a public health webinar. Following this webinar, an evidence brief and series of case studies were created and disseminated to 24 Canadian public health practitioners who attended a virtual workshop. This workshop identified barriers and opportunities to improve RecMap use. This study helped to shed light on the needs that public health practitioners have when finding, using, and disseminating public health guidelines. Through the workshop that was conducted, opportunities for public health guidelines can be categorized into 4 categories: 1) information access, 2) awareness, 3) public health development, and 4) usability. Barriers that were identified can also be categorized into 4 categories: 1) usability, 2) information maintenance, 3) public health guidance, 4) awareness. This work will help to inform the development and organization of future public health guidelines, and the needs that public health practitioners have when engaging with them.

Theories about health behavior are commonly used in public health and often frame problems as ascribed or related to individuals' actions or inaction. This framing suggests that poor health occurs because individuals are unable or unwilling to heed preventive messages or recommended treatment actions. The recent United Nations call for strategies to reduce the global disease burden of noncommunicable diseases like diabetes requires a reassessment of individual-based approaches to behavior change. W e argue that public health and health behavior intervention should focus more on culture than behavior to achieve meaningful and sustainable change resulting in positive health outcomes. To change negative health behaviors, one must first identify and promote positive health behaviors within the cultural logic of its contexts. To illustrate these points, we discuss stigma associated with obesity and human immunodeficiency virus and acquired immune deficiency syndrome. W e conclude that focusing on positive behaviors and sustaining cultural and personal transformations requires a culturally grounded approach to public health interventions, such as that provided by the PEN-3 model.

Objective This study aims to establish a comprehensive evaluation system for assessing public health practice teaching quality, addressing the shortcomings of traditional evaluation methods. The framework integrates the Context, Input, Process, and Product (CIPP) model with the Analytic Hierarchy Process (AHP) and Entropy Weight Method to provide precise and balanced weightings for evaluation indicators. AHP was selected for its ability to incorporate expert judgment with consistency checks, ensuring structured decision-making, while the Entropy Weight Method enhances objectivity by assigning weights based on data variability, reducing potential biases in expert evaluations. Methods The development process included two rounds of Delphi expert consultations to refine the evaluation indicators and achieve consensus among experts. AHP and the Entropy Weight Method were applied to calculate and verify the weights of indicators. Statistical methods were used to ensure the reliability and validity of the framework. Results High consensus was achieved on key evaluation factors, emphasizing the critical roles of teaching facilities and information technology in public health education. The evaluation system combines expert insights with data-driven metrics, demonstrating strong reliability and adaptability. Findings underscore the system’s ability to identify strengths and weaknesses in teaching quality effectively. Conclusion This evaluation system provides a practical and scientifically grounded framework for improving resource allocation, policymaking, and quality enhancement in public health education. Its flexible structure enables dynamic adjustments to meet evolving educational standards and diverse teaching contexts. This tool offers valuable guidance for educators, policymakers, and stakeholders to enhance the effectiveness of public health teaching practices.