Vaccine hesitancy presents significant challenges to public health, exacerbated by a lack of cohesive policies in Europe. Recognized as a complex social phenomenon influenced by various factors, vaccine hesitancy threatens health systems and public trust. This paper analyses the political background and current gaps in policies addressing vaccine hesitancy, with a specific focus on the role of healthcare authorities, organizations and professionals in shaping effective responses. The VAX-TRUST project, funded by H2020 and conducted in seven European countries, provides a framework for translating social scientific research into actionable strategies within healthcare settings. Using methodologies such as the Delphi method, the project developed the ASTARE model, which encompasses six dimensions: Awareness, Support, Training, Agency, Recognition, and Engagement. These dimensions guide tailored recommendations to strengthen the capacity of healthcare professionals, organizations, and authorities in addressing vaccine hesitancy, enhancing public trust, and vaccine confidence and uptake. The paper highlights the necessity of evidence-based, collaborative, and adaptive policies that raise public awareness, counteract misinformation, and support healthcare professionals. Effective policymaking requires understanding legislative processes, leveraging scientific evidence, and fostering stakeholder participation. By emphasizing context-sensitive interventions and culturally informed strategies, this study provides a comprehensive approach for health systems to address vaccine hesitancy and improve public health outcomes across Europe.

Evidence suggests that healthcare professionals often feel uncomfortable discussing vaccination with patients, largely due to a lack of training on the topic. In line with the scientific evidence gathered from the VAX-TRUST project, it is crucial to invest in training healthcare professionals and developing political measures to effectively address vaccine hesitancy. This paper explores the importance of training healthcare professionals to address vaccine hesitancy and provides concrete strategies for its implementation. A quantitative research design was used. The findings are based on a comprehensive Delphi survey conducted with a panel of 112 experts. Additionally, the study involved practical interventions carried out across seven European countries, engaging a total of 694 participants. These participants included general practitioners (GPs), paediatricians, nurses, as well as medical and nursing students. This robust and diverse dataset provides a well-rounded perspective on the subject matter, ensuring that the insights gained are both extensive and representative of various healthcare professionals across Europe. Three key themes emerged from the findings: the need for effective strategies to address communication challenges with vaccine-hesitant individuals, the importance of using evidence-based communication practices to improve these interactions, and the necessity of integrating social scientific knowledge on vaccination into the training of healthcare professionals. Training healthcare professionals is essential to equip them with skills and knowledge needed to deal with the complexities of vaccine hesitancy. Evidence was gathered on ways to reflect and act to develop this capacity, namely, by increasing the ability to communicate empathetically, responding to patients' concerns with evidence-based information, and to building stronger and more collaborative relationships with them.

Introduction: The weaknesses of Guinea-Bissau's health system have long been highlighted. The purpose of this study is to contribute with evidence for decision-making on the reform of the country's healthcare map, by analyzing the availability and readiness of services at the facilities that may become part of a Hospital Complex in Bissau, proposed in the National Health Development Plan. Material and Methods: We analyzed 13 public and private facilities with inpatient capacity, located in Bissau and Biombo. Service Availability and Readiness Assessment (SARA) tools were used for data collection, treatment and analysis. Results: A comprehensive overview of these facilities has been provided, describing their general capacity to provide care and their readiness to implement it, along with the availability and readiness of specific services: diagnosis, family planning, mother and child health, obstetrics, communicable and non communicable diseases, blood transfusion and surgery. We observed a greater concentration of beds and professionals in the facilities of public sector, the only that provides all the specific services analyzed. Private sector services with agreements to supply the public sector have higher readiness levels and the private sector has the lowest operating capacity. Discussion: Findings reflect the lack of equipment, infrastructure and resources, the predominance of the public sector and the growth of the private for-profit and non-profit sectors, as well as inadequacies in planning and regulation. Similarities and differences between our findings and those described in the literature for other African countries are identified. Conclusion: This study reinforces the relevance of developing integrated and rational responses of health services and provides evidence for this.

Digital health is increasingly promoted to address rural health and care workforce shortages. However, its workforce consequences are usually evaluated through implementation or service-delivery outcomes rather than the conditions that enable rural workers to remain, develop, and practice sustainably. We conducted a Joanna Briggs Institute-informed scoping review reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. The protocol was prospectively registered on the Open Science Framework. Five databases were searched for studies published between 2015 and 2025 in English, Spanish, and Portuguese. Two reviewers independently screened records and charted data using a prespecified framework. Synthesized entries were verified against full texts, with disagreements resolved by a third reviewer. Fifty-five sources were included. Telehealth or telemedicine was the most common intervention, followed by tele-education or distance education and multicomponent interventions. Direct retention or workforce-stability outcomes were uncommon, whereas most outcomes concerned proximal determinants of retention or implementation-related sustainability. Digital interventions most frequently influenced professional connection, supervision, continuing education, clinical confidence, and workflow support. Interpretive synthesis identified four workforce redistribution pathways (labor, authority, dependency, and infrastructure risk) through which interventions may strengthen or undermine rural workforce sustainability. Current evidence concerns retention pathways more than retention effects. Digital health should therefore be evaluated as a sociotechnical workforce intervention, extending beyond implementation success to examine how interventions redistribute labor, authority, dependency, and infrastructure risk across rural health systems.