This position paper from the Digital Public Health Section of the German Public Health Association defines digital public health (DiPH) and describes its goals and potential. It also addresses the current situation and challenges as well as the need for action in Germany. The focus here is on the presentation of the nationwide promotion of (digital) health literacy; the application of DiPH in prevention, health promotion, and healthcare; the use of innovative preventive strategies for the prevention of non-communicable diseases; and the teaching of DiPH in academic public health programs. Finally, relevant measures and demands to strengthen DiPH in Germany are summarized.

Child maltreatment is a significant problem in Germany. Hospital data on child maltreatment serve as a crucial foundation for planning effective prevention measures. These data enable an assessment of the extent to which at-risk children and adolescents are identified, supported, and protected. A systematic evaluation and classification of all hospital data relevant to child maltreatment in Germany is still lacking. Therefore, the aim of this article is to gain an overview of the data in this field and thus bridge the gap.

Families in Germany who live in poverty receive citizens' benefits (Bürgergeld) within the context of welfare legislation. Basic rates for children and adolescents are included in these benefits and staggered into three groups according to age. The need for nutrition is the largest category of the basic rate. The Optimized Mixed Diet (OMD) is a practical concept of a healthy diet for children and adolescents aged 1-18 years. Traditional and home-cooked meals are preferred. The aim of this project was to calculate the food costs of the OMD based on the underlying 7‑day meal plan.

Person-centered care is a fundamental principle of healthcare in Germany. The concept focuses on the preferences, needs, and values of individuals in the healthcare system. Studies show that unintentionally pregnant women seeking to terminate their pregnancy may encounter legal regulations, stigmatization, and ethical and moral concerns from healthcare providers. In Germany, the implementation of person-centered care in the care of unintentionally pregnant women has been scarcely researched. The goals of the CarePreg study (running from November 2020 to July 2024) were to evaluate person-centered care in psychosocial and medical care (1) from the perspective of healthcare providers as well as (2) from the perspective of women experiencing an unintended pregnancy and abortion, and (3) to derive recommendations for the current care situation. A mixed-methods approach was chosen for the study.This article presents the methodology of the CarePreg study and reports on the findings from two workshops involving 18 experts as part of the first study phase. Participants in the workshops were professionals from psychosocial and medical services for individuals with unintended pregnancies. They considered person-centered care highly relevant to abortion services, emphasizing dimensions such as "access to care," "personalized information," and "equal collaboration and involvement in decision-making." Barriers to person-centered care discussed included the stigmatization of abortion and those providing related services as well as the current legal framework.

Abortion continues to be a highly contentious issue. This article provides an overview of the historical, ethical, and legal aspects of the abortion debate in Germany with a focus on the developments since the reunification. It delves into the background of the 1995 reform of the German abortion law, which centers around mandatory counseling before having an abortion. Furthermore, it outlines the implications of the medical indication for abortion and legal areas of tension. In light of the emerging shift in the status of abortion from a prohibited act under criminal law to a reproductive right, the article presents various legal viewpoints and practical considerations in the ongoing discussion.

The COVID-19 pandemic has had a drastic impact on healthcare systems. They had to react, adapt and innovate in order to build resilience, that is maintain healthcare access and health equity. For example, access to abortion services during the pandemic was increasingly facilitated through "Telehealth for Early Medical Abortion" (TEMA).This narrative review article compares Germany, France and Great Britain in terms of abortion numbers, methods and settings from 2018 to 2023. Changes in the availability of services and legislation during the pandemic are presented, and the differences between the countries, as well as various innovation factors, are discussed. We used national statistics and conducted a literature and online search (Rapid Review).In the three countries, there are differences in abortion rates, the share of medical abortions and the impact of the pandemic. In France and Great Britain, where medical abortion is the main method of abortion and where abortion care was more accessible before the pandemic than in Germany, a series of innovations were officially introduced to facilitate access during the pandemic. They included teleconsultations and the mailing of abortion medication. Most changes have been sustained since then, contributing to addressing historic and systemic health inequities in terms of access. In Germany, innovations during the pandemic have been crafted mainly by civil society organisations, offering for the first time teleabortion services.The COVID-19 pandemic provoked or accelerated innovation in terms of abortion care in France, Germany and Great Britain. The sustainability and scaling-up of those innovations remain fragile, especially in Germany, where the disruptive approach of civil society organisations has not yet found its way into mainstream healthcare services.

After a decline in the number of annual abortions from around 130,000 in the years 1996 to 2004 to around 100,000 since 2013/14, there was recently a certain increase again to 106,000 abortions in 2023. The decline from 2004 to 2013 was driven by a decrease in the number of women of childbearing age and a lower probability of having an abortion in the key age groups. When comparing the result structures over time, the constant development towards the use of Mifegyne® is noticeable. Regarding the duration of the terminated pregnancy, the proportion of early abortions has increased in recent years.There are differences in structures between the federal states. The probability of an abortion by age is relatively low in the south of the Republic but is above average in the city states and the new federal states. Further differences between the federal states can be identified with regard to the type of intervention used or the provider. The proportion of abortions carried out in another federal state also varies. The number of reporting healthcare providers can offer basic statistical information. Legal developments have been initiated, primarily for improved regionalization of data-while respecting statistical confidentiality.

Despite the social and political importance of abortion, little quantitative research has been done on the individual circumstances of women who have had abortions in Germany. This article takes an empirical and descriptive look at the individual, economic, and partnership conditions under which such decisions are made.

About ten years ago, studies on health literacy in Germany indicated that population health literacy was low. This prompted a group of distinguished experts to initiate the development of a National Action Plan for Health Literacy (NAP-HL) for Germany, modeled after those of other countries. This article explains the origins and development of the plan in Germany, provides an overview of the steps taken during its creation, and summarizes its content. Subsequently, the transfer strategy, including the three steps of diffusion, dissemination, and implementation, is discussed. The concluding assessment evaluates the plan's achieved impacts and critically reflects on the implementation strategy. Overall, numerous impulses were provided for agenda setting and the promotion of health literacy. The challenge remains to develop sustainable interventions for strengthening health literacy, accompanied by systematic research.

In acute crises such as the COVID-19 pandemic, scientific questions need to be addressed quickly in order to protect the health of the population and to maintain the function of the healthcare system. The prevailing urgency and the large number of issues to be addressed, combined with the limitation of time, personnel, or monetary resources make prioritization indispensable. In the COVID-19 Evidence Ecosystem (CEOsys) project initiated by the University Medicine Network (NUM), a procedure for the rapid prioritization of questions was used specifically for evidence syntheses and clinical guideline recommendations, which was further developed in the follow-up project PREparedness and Pandemic Response in Germany (PREPARED).The result is a concept paper on the prioritization of research questions and topics with a more generic orientation. The content of the concept is presented in this article. The core subjects are basic principles of successful prioritization as well as an explicit seven-step process with information on organizational framework conditions and the procedure. The concept offers possibilities for adaptation, as research prioritization is highly context-dependent.The application of such a systematic, transparent prioritization process contributes to comprehensible and informed decisions about which research questions are relevant and urgent, in which order they should be processed, and which issues are not critically urgent or have to be postponed.

The Institute for Quality and Efficiency in Health Care (IQWiG) was commissioned by the Federal Ministry of Health to provide support for the further development of the S2k guideline on first-trimester abortion into an S3 guideline. To this end, the responsible guideline group formulated research questions that were answered in IQWiG evidence reports. One of the questions to be addressed was the evidence regarding the psychological consequences of an abortion in the first trimester compared to no abortion in the first trimester in pregnant women who wish to have an abortion. A systematic search identified one relevant prospective comparative cohort study that reported results on the outcomes of clinically diagnosed depression and clinically diagnosed anxiety disorders. The evidence was evaluated in accordance with the methodological requirements of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group, as specified by the IQWiG methods. No significant differences were observed between the study groups with regard to the outcomes mentioned. The certainty of the evidence was rated as very low and downgraded due to study limitations and imprecision of the effects. Prospective comparative cohort studies that approach the research question under investigation should, inter alia, have adequate control for relevant confounders, a sufficient number of participants, and a carefully planned collection of data on relevant outcomes.

Barriers to accessing abortion care can delay access to services, which can lead to delayed abortion and health risks. Barriers include geographical accessibility, confidentiality, waiting times, stigmatization, poor or inaccessible information and the cost of abortion. This article examines barriers to accessing abortion care in Germany. This includes barriers in the availability and accessibility of care services, access to information, costs associated with abortion and organisational barriers.

The termination of a pregnancy in the first trimester is regulated by law. Guidelines serve the purpose of presenting the current state of medical science in order to enable the best possible care. S3 guidelines represent the highest level of guideline development and contain all elements of systematic development, including systematic research, evaluation of the evidence, and structured consensus-building using formal technology. The existing S2k guideline is to be raised to an S3 level. For this purpose, the Institute for Quality and Efficiency in Health Care (IQWiG) conducted an evidence search on eight central questions. The result showed a predominantly very poor level of evidence. The article describes the development of the S3 guideline and the existing problems and limitations.

Health literacy is a central resource for health-related decisions. Since the 1970s, however, the understanding of this term has changed in several ways. Initially, health literacy was considered only from the point of view of individual competencies, but in recent decades it has evolved into a more contextual understanding. Despite this conceptual evolution, current social and health challenges are still not adequately addressed.This article reflects on the developments in the understanding of the concept and on the relevance of health literacy in the face of the current polycrisis. Reference is made to a recent concept paper developed by the authors, which shows that health literacy is a central resource at the interface of healthcare, disease prevention, and health promotion and that it can occur at different levels and in different forms. The discussion on health literacy also highlights the need to consider the challenges of systems, organizations, and settings, as decisions about health and well-being are made in all these contexts.The importance of health literacy as a key resource is increasing, particularly in addressing current social challenges, and is gaining additional relevance as a social determinant of health. Health literacy interventions can only be effectively developed, implemented, and evaluated if a shared understanding of health literacy exists, current challenges and contexts are considered, and key stakeholders act together when implementing measures.

Digital information sources provide adolescents with quick access to health-related information. Schools are ideal for promoting digital health literacy and enabling students to handle such information safely. The aim of this paper is to present initial results from a representative study on learning digital health literacy in schools, with a focus on sociodemographic and socioeconomic differences.