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Social prescribing has gained attention internationally as a health-promoting way to address patients’ nonmedical needs, yet research in the Nordic healthcare context remains limited. This theory-informed process evaluation set out to unpack the early implementation of a social prescribing model in Swedish primary care, developed to reduce loneliness and promote health among older adults. Guided by Normalization Process Theory (NPT) and the Consolidated Framework for Implementation Research (CFIR), this study assessed how and under what conditions the model was implemented across 10 primary care centres between May 2023 and December 2024. Data were triangulated from interviews with prescribers and patients, alongside prescribing and follow-up materials. Thematic analysis indicated that while the approach was perceived as relevant and timely, implementation was hindered by a selective use of the routine screening question and lack of person-centredness in the prescribing process, reflecting poor fidelity to core principles. Leadership engagement and managerial support that appeared symbolic rather than active further constrained implementation by limiting integration into organizational workflows, rendering the approach peripheral or optional to other clinical and statutory tasks. The model’s operationalization also lacked alignment with community resources and bridging structures, limiting implementation by failing to meet patients’ needs and expectations. While the Swedish social prescribing approach aligns with national policy discourse and prescribers’ values, its scale-up will require clearer guidance on components needing high-fidelity delivery, necessary organizational structures, accessible local resources, and mechanisms linking primary care with the wider community. These findings contribute to the international evidence base on social prescribing and inform refinements of the Swedish model.

BACKGROUND: During the COVID-19 pandemic, health system managers and policymakers were vital in shaping response strategies, allocating resources, and overseeing healthcare delivery. Despite this, limited research has examined their perspectives on the health system response to the crisis, especially in the Latin American context. This study addresses that gap by exploring the health system's response to this pandemic in Cochabamba, Bolivia, through the lens of these key stakeholders.

METHODS: We conducted a qualitative study using semi-structured interviews with 10 health system managers and policymakers responsible for the pandemic response. Reflexive thematic analysis guided the development and interpretation of the themes.

RESULTS: Our findings shed light on how the pandemic revealed and intensified pre-existing vulnerabilities within the health system sectors. Political instability and centralized decision-making delayed the response, increased public unrest, and hindered resource mobilization. Fragmented governance structures and inadequate coordination between the public and social security sectors further weakened the health system's capacity. Health services, already strained before the pandemic, faced critical shortages in personnel, equipment, and infrastructure. Stay-at-home regulations, short-term staffing policies, and financial barriers exacerbated staff attrition. However, innovations such as telemedicine and non-conventional healthcare strategies helped mitigate gaps in service delivery.

CONCLUSIONS: Our findings highlight governance weaknesses, human resource limitations, and structural fragmentation of service delivery, which constrained the Bolivian health system's ability to respond effectively to the pandemic. Addressing these challenges requires strengthening intersectoral coordination and communication, improving workforce sustainability, and investing in better future public health emergency preparation. Improving governance mechanisms, allocating resources equitably, and integrating service delivery could enhance the health system's resilience capacity.

This paper investigates municipal government initiatives targeting ‘local development’ and community sustainability in municipal peripheries in rural Västerbotten, Sweden. Analysing planning documents, we identify 142 initiatives from 2022 to 2023 using a social determinants of health (SDH) framework, particularly focusing on labour, business development, technology adoption, municipality-business collaboration, supporting village associations, and alternative modes of service delivery. We conclude that municipalities are attempting to support individual villages and place-based communities in determining their own development paths across all SDH domains, suggesting a shift from central-place to decentralised planning models.

Background and purpose: Loneliness is a complex public health issue that can lead to increased morbidity, with higher prevalence among older adults. Social prescribing may be one way to ease loneliness. This study aims to explore stakeholders’ perceptions of prerequisites for implementing a social prescribing program in a Swedish context.

Method: Reflexive thematic analysis was used to analyse individual semi-structured interviews with eleven stakeholders whose experience were considered relevant for implementing a social prescribing program in the Swedish context. They were selected to provide diverse perspectives related to organisation, position, and geography.

Results: From the analysis three themes were constructed; Where to implement–Necessity to bridge organisational gaps, How to implement–Balancing professional expectations, and For whom to implement–Addressing those with ‘real’ needs. These themes highlight the perceived prerequisites, including barriers and facilitators, for successful implementation of social prescribing.

Conclusions: The participants’ perceptions are suggesting that Sweden has several practical advantages in place for implementing social prescribing, such as robust organisations responsible for citizens’ health and well-being and a range of activities available. If organisations can collaborate by prioritizing patients’ needs and overcoming organisational divisions and responsibilities, there is potential for successfully implementing social prescribing in Sweden in the future. Nevertheless, implementation may be hampered by limited resources within health care, and challenges to evaluate program effects.

In response to increasingly complex and cross-sectoral public health challenges, coordination has emerged as a key strategy for aligning efforts across fragmented systems. However, despite its widespread endorsement, coordination remains conceptually ambiguous and difficult to operationalise in practice. This qualitative study explores how public health coordination is enacted at the local level in Sweden, where municipalities employ public health coordinators to promote population health and reduce inequalities. Semi-structured interviews with 21 public health coordinators across diverse Swedish municipalities were conducted and through an inductive thematic analysis four key themes were developed: driving targeted efforts and holding processes together; connecting activities to policy goals through purposeful planning; creating conditions for collaboration by engaging relevant stakeholders; and building a knowledge support function through acquiring and sharing new knowledge. The findings reveal that coordination is a dynamic and adaptive function requiring strategic thinking, relational skills, and contextual sensitivity. Effective coordination depends not only on individual competencies, such as communicative, diplomatic, and administrative abilities but also on structural conditions, including political mandates, formalised goals, and sufficient time and resources. Coordinators often operate without formal authority, relying on trust and leadership support to navigate complex and shifting responsibilities. The study concludes that coordination is essential for enabling collaboration, sustaining public health efforts, and aligning activities with policy goals. It highlights the need for clearer role definitions, supportive frameworks, and further research into how coordination contributes to long-term public health outcomes across different domains and local contexts.

This policy brief examines young people’s views on the future of mobility and immobility in rural areas across four countries: Italy, Portugal, Sweden, and Türkiye. Between April and May 2025, one participatory workshop was conducted in each country, with 64 young people from Cremona in Italy (17 participants), Vila Real in Portugal (10 participants), Vindeln in Sweden (17 participants), and Eskişehir in Türkiye (20 participants). By considering future views on both mobility and immobility (i.e., henceforth im/mobility), our goal was to explore young people’s opportunities and capabilities to leave, stay in, and return to rural areas. Across the four contexts, participants envisioned a future where rural areas are more responsive to their diverse needs, aspirations, and identities, and where they have greater flexibility and agency. Both mobility and immobility were seen as part of a dynamic, self-directed process rather than a static state and as a social right that is often constrained by structural factors. Participants from Italy and Türkiye also emphasised the importance of gender dynamics, family ties, and traditional values, as these factors are likely to continue shaping im/mobility in the future. Based on the findings, three main implications and recommendations are discussed. Firstly, we propose a shift in how im/mobility is perceived and framed in research, policymaking, and community interventions. Im/mobility should be approached as a right and a self-directed continuum. Secondly, while specific policies targeting im/mobility are needed, these should focus on the structural barriers to im/mobility. This means that addressing im/mobility is impossible without considering other key issues, such as education and employment opportunities, housing conditions, and the cost-of-living crisis. Finally, facilitating a youth-based rights approach to rural im/mobility requires a concerted effort to create opportunities for rural youth to imagine and co-construct policies addressing issues relevant to them, such as im/mobility.

This chapter focuses on factors that facilitate community-based projects for providing effective and sustainable responses to the challenges faced by young people Not in Employment, Education, or Training (NEETs) in rural areas and more specifically to promote their quality of life and social inclusion. In line with Bronfenbrenner’s bioecological model (1977, 1979) and considering community-based projects as part of the exosystem, we aim to identify the barriers and constraints faced by projects targeting young NEETs in rural areas. As part of the collaborative research developed by the members of the “WG1—Rural NEETs Social Networks and Social Inclusion” of the Rural NEET Youth Network, we identified five promising community-based projects in Portugal, Italy, Sweden, North Macedonia, and Lithuania and conducted semi-structured interviews with the project coordinators. Our analysis showed that the identified projects take into account the different levels of the bioecological model and the need to involve how young people and local communities. Both these factors are crucial for their success and sustainability over time.

Background: The COVID-19 pandemic prompted varied policy responses globally, with LatinAmerica facing unique challenges. A detailed examination of these policies’ impacts on healthsystems is crucial, particularly in Bolivia, where information about policy implementation andoutcomes is limited.

Objective: To describe the COVID-19 testing trends and evaluate the effects of quarantinemeasures on these trends in Cochabamba, Bolivia.

Methods: Utilizing COVID-19 testing data from the Cochabamba Department Health Servicefor the 2020–2022 period. Stratified testing rates in the health system sectors were firstestimated followed by an interrupted time series analysis using a quasi-Poisson regressionmodel for assessing the quarantine effects on the mitigation of cases during surge periods.

Results: The public sector reported the larger percentage of tests (65%), followed by theprivate sector (23%) with almost double as many tests as the public-social security sector(11%). In the time series analysis, a correlation between the implementation of quarantinepolicies and a decrease in the slope of positive rates of COVID-19 cases was observedcompared to periods without or with reduced quarantine policies.

Conclusion: This research underscores the local health system disparities and the effective-ness of stringent quarantine measures in curbing COVID-19 transmission in the Cochabambaregion. The findings stress the importance of the measures’ intensity and duration, providingvaluable lessons for Bolivia and beyond. As the global community learns from the pandemic,these insights are critical for shaping resilient and effective health policy responses.

This study explores the experiences of young people who are not in education, employment, or training (NEET) within the context of the COVID-19 pandemic in Sweden, using resonance theory as an analytical lens. It contributes knowledge about the importance of school and work (or lack thereof) for these youths during a time of uncertainty and gives insight into their quality of life and well-being from a social and relational perspective. The findings shed light on how the COVID-19 pandemic aggravated an already strained situation for this group while highlighting the importance of relationships, not only with friends and family, but with society as a whole. Adopting a non-materialistic approach to NEET situated young people's quality of life and well-being allowed resonant experiences to become evident in various aspects of their lives, which may be overlooked if the norms of an educationally underpinned work-centrism are in focus. The study calls for a broadened view on what constitutes or characterizes a good life for young people at the margins of the labor market and education system, while emphasizing the need to move beyond narrow concerns about integration into education or employment, towards focusing on their well-being.

The aim of this study was to understand how and why relational welfare works to support young people who are not in employment, education or training (NEET). It builds on research discussing the limitations of work-first and human capital strategies in social policy while responding to calls for theory-driven insights into initiatives that move beyond employability and rapid employment. The material for this realist evaluation includes programme documents, fieldnotes and 75 interviews with practitioners and participants in community-based multicomponent initiatives delivered by Swedish municipalities. These data were scrutinised against programme theories while integrating literature on relational welfare as underpinned by co-creation and capability approaches. The results illustrate how flexible, challenging and coordinated programming strengthen beings and doings of young people in NEET situations while improving their wellbeing by overcoming isolation and forming a future orientation. The study provides guidance for supporting NEET-situated young people through a relational approach to welfare. It also offers a model against which local initiatives provided to a youth group high on the policy agenda can be mapped.