10137 research outputs found
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Governance of the private healthcare sector in low- and middle-income countries: a scoping review of approaches, effectiveness, and enablers
Get PDFSophie Witter - ORCID: 0000-0002-7656-6188 https://orcid.org/0000-0002-7656-6188The private sector’s role in healthcare is growing across many settings. However, the sector remains under-governed in many contexts, particularly in low- and middle income countries. Further, the understanding of the evidence base relating to private sector governance remains inadequate, with limited information available on the effectiveness of various approaches, and factors which facilitate or hinder their functioning. This scoping review was commissioned by the World Health Organization (WHO) to address this gap by synthesising the available literature on the governance of private healthcare financing and delivery.https://www.who.int/publications/i/item/9789240093522pubpu
Efficacy of Nigerian Energy Industry's CSI Initiatives on Sustainable Development Goals (SDGs) Optimization in Niger Delta Communities: A PLS-SEM Analysis
Get PDFNigeria ranked 146 out of 166 on the 2023 SDG index, scoring 54.3/100, despite a GDP per capita of $5,408. The research investigates the effectiveness of Nigerian energy companies' CSI initiatives in the Niger Delta and their impact on achieving Nigeria's SDGs by 2030. Using an exploratory design, an online survey collected responses from 460 members (representing 92% sample rate) of Niger Delta host communities, analysed using the PLS-SEM model. The results show that CSI initiatives (economic, legal, ethical, and philanthropic) are well-practiced among oil and gas firms and correlated with a 68.9% increase in sustainable development indicators in the region. By being backed up by Cronbach’s Alpha (over 0.70) and Composite reliability (over 0.75), the findings criticize the conventional notion that profit-maximization is the sole focus of businesses, particularly in socially and environmentally vulnerable areas. The research suggests implementing a CSI reporting framework, enhancing government oversight, and fostering positive interactions between oil companies and local communities.https://doi.org/10.57233/gijmss.v7i2.017pubpub
The contribution of leaders' and managers' attributes, values, principles, and behaviours to the sustainable implementation of Lean in healthcare: A realist review protocol
Get PDFSeán Paul Teeling - ORCID: 0000-0002-4102-7280
https://orcid.org/0000-0002-4102-7280Background
Global healthcare faces challenges such as rising costs, budget constraints, aging populations, chronic diseases, and increasing patient expectations. Healthcare organisations are deploying continuous improvement methodologies to address these challenges. Lean, derived from the Toyota Production System, focuses on eliminating non-value-adding activity and enhancing efficiency, making it a prominent quality improvement approach in healthcare. Effective implementation of Lean requires robust leadership to sustain improvements and foster a culture of continuous improvement. However, the attributes, values, principles, and behaviours of effective Lean leaders in healthcare remain underexplored.
Methods
This realist review protocol details methods to research how leaders' and managers' attributes, values, principles, and behaviours contribute to the sustainable implementation of Lean in healthcare. Following the RAMESES guidelines, a five-stage structured methodology will be used: defining the scope of the review and developing initial theories, developing the search strategy, reviewing primary studies and extracting data, synthesising evidence and developing conclusions, refining theory iteratively, and disseminating findings. An Expert Panel and reference groups of healthcare managers and leaders will refine candidate programme theories (CPTs) into initial programme theories (IPTs), guiding detailed evidence searches and data extraction.
Conclusion
This realist review will deepen our understanding of the specific mechanisms by which leadership impacts Lean implementation outcomes in the context of acute hospitals. By exploring how leadership attributes, values, principles and behaviours shape outcomes for diverse stakeholders, the review aims to provide critical insights into the dynamics driving the success of Lean in healthcare. The findings will inform policy and practice, enhancing leadership strategies to improve patient and staff experiences, patient outcomes, and organizational performance.Health Research Board Ireland CES-2024-037.https://doi.org/10.12688/hrbopenres.13933.17pubpu
Creative Research Methods for Critical Event Studies [Edited book]
No full textItem is not available in this repository.Rebecca Finkel - ORCID: 0000-0003-2120-6211 https://orcid.org/0000-0003-2120-6211This timely and innovative book offers an introduction to a range of creative methods, providing both empirical and conceptual guidance.
Based upon existing empirical work and richly illustrated throughout, each chapter carefully examines creative methodology and/or methods within an event and festival context. International case studies are incorporated throughout, providing real-world examples of how these methods have been used in practice, as well as highlighting potential ethical issues. Each chapter includes a concise ‘how to’ set of guidelines to help researchers and students employ creative methods in their own work, as well as a series of ‘think points’ to help develop ethical practices. Chapters illustrate new pathways or lessons learned from research during the pandemic and other challenging landscapes.
This significant volume offers festival and event researchers and students a different approach to their work that could result in better research, reaching hidden and marginalised groups.https://doi.org/10.4324/9781032686424inpressinpres
A Pig's Progress An arts-based research project exploring animation as a way to process setting up an art therapy service in an NHS Community Mental Health Team
No full textThis piece of arts-based research (ABR) uses animation to communicate the trials, tribulations and rewards of establishing an art therapy service as a trainee in an NHS Community Mental Health Team (CMHT). Although there are few resources on the topic, I propose that animation is useful to the art therapy profession and experiment with the art form by creating an animated response artwork. In the accompanying text, the research is grounded in existing literature exploring the therapeutic potential of animation, the difficulties that may arise when setting up a service and thoughts around response art by art therapists. As ABR, this project seeks to bridge the space between medicine and art. Animating does require time and some technical ability, but the findings suggest that it helped me to process my work, look after myself and make an accessible form of research. Additionally, there were many parallels to be found between the processes of animating and building an art therapy service. Subsequently, I recommend that other art therapists try animation themselves and share more about their experiences of setting up services. Animation is an empowering process that gives directorial power to its creator, so I also suggest that animating could be used by future clients to promote a sense of agency
A process study of early achievements and challenges in countries engaged with the WHO Special Initiative for Mental Health
Get PDFFrom Springer Nature via Jisc Publications RouterHistory: received 2024-02-07, registration 2024-10-13, accepted 2024-10-13, epub 2024-10-21, online 2024-10-21, collection 2024-12-01Acknowledgements: We thank Md Rezaur Rahman, Zeina Jamal, and Alla Lysa for their work in document review, interviews, and preliminary thematic analysis, Paul Kadetz for quality assurance, and Dave Madinger for statistical analysis. The following WHO staff input into the review process: Ben Adams (WHO HQ), Hadeel Alfa (WHO Jordan), Joana Ansong (WHO Ghana), Sadhana Bhagwat (WHO Bangladesh), Sudipto Chatter (WHO HQ), Dan Chisholm (WHO HQ), Sajeeva Ranaweera (WHO South East Asia Regional Office, SEARO), and Giovanni Sala (WHO HQ).Publication status: PublishedFunder: World Health Organization; doi: http://dx.doi.org/10.13039/100004423; Grant(s): RFP 08/2022/SIMH/MidtermLearnings, RFP 08/2022/SIMH/MidtermLearningsAlastair Ager - ORCID: 0000-0002-9474-3563
https://orcid.org/0000-0002-9474-3563Background: There is increasing awareness of the importance of the transformation of mental health systems. Launched in 2019, the WHO Special Initiative for Mental Health seeks to accelerate access to quality and affordable care for mental health conditions as an integral component of Universal Health Coverage. Nine countries are currently engaged with the initiative. Methods: This study reviewed processes of implementation—and progress achieved—across all settings by late 2022. It involved review of 158 documents provided by WHO relating to Special Initiative activities and 42 interviews with country-level stakeholders, WHO Regional and HQ personnel engaged with the initiative, and core donors. Documents were thematically coded using a template based upon the WHO framework of health system building blocks. Responses to structured interviews were coded based on an emergent thematic framework. Results: Documentation reported similar achievements across all domains; however challenges were reported most frequently in relation to service delivery, leadership and governance, and workforce. Issues of financing were notable in being twice as likely to be reported as a challenge than a success. Interviews indicated four major areas of perceived achievement: establishing a platform and profile to address mental health issues; convening a multi-stakeholder, participatory engagement process; new, appropriate services being developed; and key developments in law, policy, or governance around mental health. The planning process followed for the initiative, senior country-level buy-in and the quality of key personnel were the factors considered most influential in driving progress. Ambivalent political commitment and competing priorities were the most frequently cited challenges across all interviewees. Conclusions: The role of the Special Initiative in raising the profile of mental health on national agendas through a participatory and inclusive process has been widely valued, and there are indications of the beginnings of transformational shifts in mental health services. To secure these benefits, findings suggest three strategic priorities: increasing political prioritisation and funding for systems-level change; clearly articulating sustainable, transformed models of care; and promoting feasible and contextualised measures to support accountability and course correction. All are of potential relevance in informing global strategies for mental health systems transformation in other settings.pubpu
Assessing the role of non-state actors in health service delivery and health system resilience in Myanmar
Get PDFFrom Springer Nature via Jisc Publications RouterHistory: received 2024-05-22, registration 2024-09-30, accepted 2024-09-30, epub 2024-10-24, online 2024-10-24, collection 2024-12-01Acknowledgements: We acknowledge the support from Dr Hnin Kalayar Kyaw and Lucy Godfrey in the earlier phases of the study and in particular for the document review. We would like to thank all the participants to this study who contributed their views and insights, despite the challenging security situation.Publication status: PublishedFunder: Foreign, Commonwealth and Development Office; doi: http://dx.doi.org/10.13039/501100020171Maria Paolo Bertone - ORCID: 0000-0001-8890-583X
https://orcid.org/0000-0001-8890-583XSophie Witter - ORCID: 0000-0002-7656-6188
https://orcid.org/0000-0002-7656-6188Background: Due to the weaknesses of the public health system and its low reach, especially in border areas, provision of health services by non-state actors (NSAs) has historically played an important role in Myanmar. NSAs include local and international NGOs and civil society organisations (CSOs), but also Ethnic Health Organisations (EHOs) in the border areas, as well as the private (for profit) sector. This study aims to understand the changing role of NSAs in the shifting political environment of Myanmar between 2010 and 2022, and to explore their contribution to health system resilience. Methods: Our study includes three main components: a documentary review (n = 22), key informant interviews (KIIs) at central level (n = 14) and two township-level case studies (13 KIIs, 4 FGDs). Mostly qualitative data were collected in 2022 and synthesized, using a health system resilience framework to structure the analysis. Results: During the transition period (2010–2014) and the new political era (2015–2020), while the country gradually transitioned to a democratic system, the government increasingly recognized NSAs. Initially, engagement with NSAs remained focused on disease-specific activities and government oversight was limited, but later it expanded to health system strengthening, including the start of a “convergence” with ethnic health systems. Progress was relatively slow, but defined by a clear vision and plans. The military coup of February 2021 brought a halt to this progress. Collaboration between government and NSAs was interrupted, and NSAs restored previous practices and parallel systems. Initially, most health service provision stopped, but with time coping strategies emerged, which showed the capacity of NSAs to absorb the shocks (focusing on basic services; using informal communication channels; maintaining buffer stocks of supplies) and adapt (changing modes of delivery and supply chains, and adjusting HRH training). Conclusions: The study highlights the role of NSAs during crises, and provides insights on how the resilience capacities built over time by NSAs to provide services in adverse circumstances have informed the response to the latest crisis. While strategies of absorption and adaptation are noted in the study, we did not identify any transformation strategy – which might indicate the difficulty of NSAs to introduce radical changes when subjected to multiple shocks and a hostile political environment.pubpu
Effects of Hybrid Custom Foot Orthoses on Running Economy, Running Mechanics and Comfort: A Double-Blinded Randomized Crossover Study
Get PDFMarietta van der Linden - ORCID: 0000-0003-2256-6673 https://orcid.org/0000-0003-2256-6673Derek Santos - ORCID: 0000-0001-9936-715X https://orcid.org/0000-0001-9936-715XObjective: This study examined the effects of orthotic materials on running economy (RE), running mechanics, and footwear comfort. Design: A double-blinded randomized crossover study design was used. Method: Eighteen athletes ran on an instrumented treadmill for six minutes at speeds corresponding to 10% below their first ventilatory threshold (average: 9.9 ± 1.3 km/h) in four footwear conditions [control (CON), Ethyl vinyl acetate (EVA), Thermoplastic Polyurethane (TPU), and a combination of EVA and TPU (HYB)]. Results: No differences were found in RE between conditions (p=0.099). All CFO materials reduced peak heel impact force vs CON (p<0.001). TPU reduced hysteresis at heel impact vs CON (-47.8%, p=0.016). Shorter flight time (-3.8%, p=0.016; -3.1%, p=0.021) and lower mean vertical loading rate (-4.0%, p=0.003; -7.1%, p<0.001) occurred for HYB vs TPU and CON, respectively. Higher peak vertical loading rates (+7.4%, p=0.002) and earlier impact peaks (-5.7%, p<0.001) were found for HYB vs TPU. HYB exhibited longer propulsive phase duration (+2.0%, p=0.003) but lower peak propulsive force (-3.3%, p=0.009) vs CON. Reduced ‘overall comfort’ (-26.4%, p=0.004), ‘comfort of heel cushioning’ (-43.3%, p<0.001), and ‘comfort of forefoot cushioning’ (-18.3%, p=0.048) was found for HYB vs TPU, but ‘comfort of forefoot cushioning’ (+48.0%, p=0.032) showed an increase vs EVA. Conclusions: Combining materials could enhance comfort during running causing subtle changes in running mechanics. Overall, neither EVA, TPU nor their combination significantly improved RE compared to CON.https://dx.doi.org/10.2139/ssrn.499633
Retail Pharmacists’ Practices that Contribute to Antimicrobial Resistance in South West Nigeria.
No full textIntroduction: Antimicrobial resistance (AMR) accounts for over 700,000 deaths annually and over 263,000 deaths in Nigeria.
Objectives: To assess how retail pharmacists’ antibiotic dispensing, purchasing, and disposal practices in South West Region in Nigeria, contribute to antibiotic resistance (ABR) in Nigeria.
Method: This is a secondary data analysis of research by Arkland Health Initiative that assessed retail pharmacists’ practices in Nigeria. A subset of the data from the South West region was analysed. Responses collected over a 5-point Likert scale underwent descriptive analysis using SPSS while quotes were analysed using thematic analysis.
Results: Almost half (42.7%) of the pharmacists reported dispensing antibiotics without prescription, and only 57.3% always or often performed quality checks to identify substandard or falsified (SF) medicines, which have been associated with AMR. Pharmacists reported never buying medicines not accredited by NAFDAC (53.1%) or from the open market (63.5%), reducing exposure to SF antibiotics. Maximum academic qualifications, years of experience, non-pharmacy ownership of pharmacy, and frequency of consulting ethical guidelines were not statistically associated with pharmacists dispensing antibiotics without prescriptions (P-value > 0.05). Findings revealed that non-prescription antibiotic dispensing (NPAD) was primarily driven by economic reasons, as well as the fear of losing customers, managerial pressure, and poor regulation. This research is limited by a small sample size (n=96) caution is advised in generalising findings.
Conclusion: Providing grants to manage retail pharmacies, training on antimicrobial stewardship, imposing sanctions on pharmacists who dispense antibiotics without prescription, and improved regulation are recommended to limit NPAD
Understanding and Addressing Domestic and Gender Based Violence in India.
No full textThe study examined how gender-based violence affects women in India. The investigation uncovered a complicated tapestry that allows violence to continue. The origins are firmly ingrained in patriarchal ideals, inflexible gender roles, and little legal protection. The current legal frameworks are discriminatory and unequal, reflecting and encouraging patriarchal and sexist behaviour. Nonetheless, a paradigm shift is essential to improve response and efficacy in preventing gender-based violence.
The study's strength lies in its extensive assessment of several facets of gender-based violence in India. The analysis offers a thorough knowledge of the challenges that women encounter. The incorporation of cross-cutting problems such as patriarchy, caste, class, and societal behaviours helps to provide analytical research that portrays India's complex realities. The report acknowledges the limits of traditional legal remedies. Investigating specific legal limits and potential remedies may improve the study's validity.
The study suggests personalised therapy that addresses the vulnerabilities of various groups. Strategies include raising cultural standards, empowering women, improving legal and social services, and encouraging accountability. The report emphasised the necessity for legislative changes. However, the focus on India may restrict its generalizability, as metropolitan regions differ; thus, it is critical to exercise caution when extrapolating findings to diverse geographical and cultural settings.
Future Directions: To have a more comprehensive understanding of DGBV across several geographies, future studies should focus on metropolitan areas in India. A thorough analysis of the legal framework and proposed adjustments will result in more effective activities. Future research will assess the efficacy of existing therapies in various situations, identifying their successes and shortcomings. The longitudinal evaluation of the success of DGBV interventions could be a valuable source of information for improving and reshaping approaches to understanding and controlling DGBV.
This research highlights the prevalence of gender-based violence (DGBV) in India, which is rooted in patriarchal attitudes and lacks proper legal protection. The report emphasises the urgent need for specialised interventions that address different groups' individual vulnerabilities, as well as legislative reforms to build a more equitable legal framework. While the focus on India gives useful insights, caution should be given when generalising findings to other situations. Future studies should strive to broaden the scope of research to include metropolitan regions and analyse intervention effectiveness over time. By doing so, we can better understand and address the complexity of DGBV, ultimately leading to a more just and equitable society for everyone
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