(1) Background: The motivational determinants of health professionals to choose and remain in the public sector have been increasingly addressed, including the customized approach of Public Service Motivation (PSM). However, to date, no systematic research overview has been performed in this domain, leaving the body of literature unstructured. This article fills this gap by assessing the motivational factors of choice for the public sector in the health field, and the conceptual and methodological trends of this research stream. (2) Methods: This study follows the PRISMA protocol to ascertain patterns in past research and inform researchers, practitioners, and policymakers. Eighty-nine documents published between 1998 and 2021 were retained after selecting them according to their theme and outlined goals. (3) Results: Common motivational determinants are remuneration, available resources, work conditions, and frequency of contact and interaction with patients. The PSM construct and scale are often employed as main frameworks, but there is also a concern in assessing motivation drawing on psychological constructs that reflect the challenging line of work and environment that is health care, such as presenteeism, stress, and perception of hindrances. (4) Conclusions: By focusing on health professionals’ motivation, this study contributes to a timely systematization in challenging times for health institutions and their human resources.

The 2030 Agenda for Sustainable Development now guides public administrations in conveying all their functions. The 17 Sustainable Development Goals (SDG), directly or indirectly, need effective public services and officials for successful implementation. Although working in public entities has been related to ‘a sense of duty and morality’, literature reports that motivation and sense of self-worth among public officials have been declining for many years, which in turn can endanger their performance, diminish their willingness to attend to civic affairs, and become committed to their organisation. Public officials’ motivation has been widely addressed through the lens of public service motivation and public sector motivation. Fewer studies, however, have focused on the factors of choice at a pre-level entry. This paper intends to address this gap by pondering on what influences student’s intention to work in the public sector. Understanding what drives potential future public officials’ motivation is crucial for public service sector effectiveness. Following a case study approach with a sample of 2251 undergraduate and post-graduate students of a Portuguese university, findings show an attribution of similar strengths and shortcomings to public and nonprofit sectors, a more positive perception of the private sector and job stability as the strongest motivation.

International and national guidelines have been promoting active aging while creating the necessary means for decision-makers and other relevant actors to work together (governance mechanisms) to implement local and active aging policies. This is especially important in the present COVID-19 pandemic context, posing greater challenges on older people who tend to be self-isolated. How are local actors conceptualizing active aging? What are their priorities related to a healthy life for older people? Which governance mechanisms are used to implement such policies? These are some of the questions addressed in this paper, targeting Portugal, a southern European country. A mixed-methods sequential explanatory design combining a survey conducted at a national level and interviews with key actors in the NUTS III Aveiro Region was employed to identify and understand the underpinning governance mechanisms. Findings confirm the ‘passive organization type’ in which European politico-territorial studies tend to place Portugal, as there are gaps in the way policies are formulated, implemented and evaluated, as well as a lack of coordination. Results of this study have important impacts on the way local governments and other stakeholders will prepare themselves in the post-pandemic period to design and implement policies addressing active aging.

This article addresses a gap in the literature regarding the design and implementation of health and well-being strategies by local governments. It presents a conceptual framework that can help local governments to include health and well-being among their political priorities by promoting the participation of local stakeholders and the community in general. The article also highlights the important role that local governments play in public health, especially in times of crisis, such as the COVID-19 pandemic. To demonstrate the approach, the manuscript explores the recent shift toward decentralization in Portugal and the resulting emphasis on local governments leading new approaches to health governance. The planning process for Arouca’s Health Strategy, an inland municipality, is used as a case study to demonstrate the approach, which emphasizes the meaningful participation of the entire local community. The article concludes by noting that there is still significant room for improvement in all areas related to health and well-being and a need to adopt new multistakeholder governance arrangements to sustain the institutional capacity for upcoming strategies.

The depletion of health professionals’ morale and motivation in the aftermath of the COVID-19 pandemic sparked an interest in understanding what drives workers to choose and remain motivated in the health sector. This study contributes to a better understanding of this phenomenon by specifically analyzing the sociodemographic underpinnings of health professionals’ public service motivation (PSM) in Portugal. The rationale is to analyze whether PSM varies among health professionals according to gender, age, education, and managerial position in an unexplored area (health) and context (Portugal). A shorter version of the PSM scale was applied to health professionals (doctors and nurses) (n = 413). The results suggest that there are differences regarding gender and age, specifically with female and older participants presenting higher levels of PSM. The same is true for those who hold a managerial position. Our results align with patterns found in studies conducted within other cultural contexts. Most importantly, however, by exploring higher and lower PSM levels according to different sociodemographics, we provide relevant clues for future qualitative studies and formulate practical measures to tackle these issues, thereby strengthening evidence-based policy formulation.

The sustainability of public health systems relies not only on technical and financial resources but also on the motivated commitment of healthcare professionals. In contexts marked by demographic pressures, burnout, and workforce shortages, it is paramount to understand if and how institutional policies acknowledge and address healthcare professionals’ motivation. In this study, we explore how the motivation, and underpinning personality traits, and values held by public healthcare professionals are perceived, recognised, or overlooked within institutional governance and health policy frameworks in Portugal. We adopt a qualitative research design combining semi-structured interviews with key decision-makers from two hospital centres and national policy influencers, with a discourse analysis of six strategic policy documents published between 2019 and 2024, including government programmes and national health plans. The findings reveal that while institutional discourse increasingly emphasises efficiency, innovation, and human resources planning, it consistently neglects the ethical and relational dimensions of healthcare work. Policy documents rarely reference values such as compassion, empathy, or public duty, portraying professionals primarily as instruments of system performance. In contrast, interviewees emphasise the need for a strong intrinsic motivation, ethical commitment, and frustration over the lack of symbolic and institutional recognition. Attuning political discourse and professional ethos of healthcare workers is essential for strengthening commitment, retention, and the quality of care within the National Health Service (SNS). These findings offer critical insights for the future development of more human-centred and ethically grounded health workforce policies and underscore the importance of aligning health system governance with intrinsic motivational drivers to enhance staff engagement, support sustainable human resource models, and promote integrated, high-performing health services.