Access To Finance Research Articles

Specialized in trauma surgery-Not a simple way

The question of the need for generalists and specialists in trauma surgery is controversially discussed concerning the challenges in the healthcare system, the interdisciplinary nature of the discipline, and the consequences of increasing specialization. The hospital reform as well as the availability of personnel and financing are discussed as central points. For high-quality patient care it is essential that the balancing act between generalists and specialists is successful. Effective interdisciplinary collaboration and holistic thinking are crucial to overcome the challenges in the healthcare system and to fulfil the needs of patients.

Challenges and strategies in Nigerian agribusiness entrepreneurship for sustainable development

This study examines the challenges and opportunities in Nigeria’s agribusiness sector using qualitative methods, including 28 in-depth interviews, 4 focus group discussions, and 36 key informant interviews across four states. A SWOT analysis highlights strengths like abundant land, a young population, and government support, alongside weaknesses such as low technology use, poor infrastructure, and educational gaps. Opportunities include commercial farming, agrotourism, and foreign investment, while threats involve insecurity, climate change, and skill deficiencies. The study emphasizes public–private collaboration and proposes strategies like improving policy environments, enhancing food safety, boosting human capacity, and increasing financial access to drive productivity and sustainability in the sector. These strategies collectively contribute to SDG 12: Responsible Consumption and Production by promoting sustainable practices in agriculture, which are vital for long-term environmental and economic sustainability.

Financial access of midstream agricultural firms in Africa: Evidence from the LSMS‐ISA and World Bank Enterprise Surveys

AbstractWe use data from the Living Standards Measurement Study—Integrated Surveys on Agriculture and the World Bank Enterprise Survey from seven African countries, to identify agricultural midstream firms and assess their access to credit, comparing them to nonagricultural midstream firms. We find that the agricultural midstream firms are larger and more productive, and are less likely to report barriers to accessing credit, although overall access levels remain low. These findings help build our understanding about the financial needs of micro‐, small‐, and medium‐size enterprises in the agricultural midstream and suggest that more targeted data collection could further this research agenda.

The Examination of Consumer Protection and Digital Lending Law and Practice in Tanzania

Widespread access to digital lending has epitomized a ground-breaking change in financial access. Digital lending offers extraordinary decreases in transaction costs and time wastage; in many countries, digital lending is far outstripping traditional lending. But the same characteristics of digital lending also have the ability to harm customers in the form of unfair competition in the digital credit market, unfair application of consumer protection rules (cybersecurity, consumer data protection and privacy), unfair payment and collection practice, risk of over-indebtedness, as well as different levels of oversight, especially if, consumer protection laws are limited or not strictly enforced. This study critically examines the challenges faced by consumers in digital lending platforms specifically app-based lending. The research explores the legal framework governing financial consumer protection in digital lending in Tanzania specifically app-based microfinance. The study will analyse the findings from the field and analyse the practical aspects of the law governing consumer protection in digital lending in Tanzania

The Role of Law Enforcement in Combating Financial Cybercrime in Tanzania: Examining the Laws and Practice

Financial cybercrime is defined as the use of the internet or computer to commit criminal activity for financial gain. Digital financial services development plays a pivotal role in economic growth despite the rise of financial cybercrime. Not only that but also mobile financial services hold great potential to expand financial access among people. While this progress lingers, some users have engaged themselves in financial cybercrimes for illegal gain. The Cybercrime Act of Tanzania 2015 provided for law enforcement officers including a Police officer with the rank of assistant inspector or an investigator of equivalent rank of inspector and above, a member of the Tanzania National Intelligence Service, Prosecutors and other authorized persons or the officer commanding station (OCS) termed as a law enforcement officer. The report of the Tanzania computer emergence response team beginning from the 9th day of June 2023 to the 15th day of June 2024 shows how financial cybercrime is seriously increasing despite the measurements taken. This paper explores the legal and practical role of law enforcement in combating financial cybercrime examining the adequacy of existing laws, enforcement limitations, and social issues that complicate intervention efforts. Highlighting legal analysis, case studies, and comparative insights, the study discusses potential reforms and offers recommendations for more effective prevention and response mechanisms. This study aims to contribute to an improved understanding of the unique challenges Tanzania faces in combating financial cybercrime that address legal, educational, and technological issues

The role of innovative entrepreneurship and emerging technologies in South Africa's Small, Medium and Micro Enterprises

Small, Medium and Micro Enterprises (SMMEs) are crucial to South Africa's economy, significantly contributing to job creation and innovation. However, they face challenges such as limited access to finance, skills shortages, and difficulties in adopting emerging technologies, which hinder their growth and sustainability. This study aims to explore the role of innovative entrepreneurship and technology in enhancing SMME performance. Through a systematic literature review and thematic analysis, the research identifies twelve key themes that underscore how innovative entrepreneurship can drive adaptability, improve operational efficiency, and facilitate market access. Findings indicate that innovative business models and practices are essential for SMMEs to overcome financial and operational barriers, enabling them to respond effectively to market demands. The study recommends that the South African government and private sector collaborate to enhance financial accessibility, develop targeted training programmes, and improve infrastructure. By fostering a supportive environment for innovative entrepreneurship, SMMEs can leverage emerging technologies more effectively, ultimately driving economic growth and social development in the country.

Strategy to Increase the Availability and Accessibility of Funds for AIDS, Tuberculosis and Malaria (ATM) Programs in Indonesia: Literature Review

This literature review explores Indonesia's strategies to enhance funding accessibility for AIDS, Tuberculosis, and Malaria (ATM) programs, with a focus on its collaboration with the Global Fund (GF). It outlines the critical role of funding in combating ATM and Indonesia's extensive health diplomacy efforts with the GF. Utilizing a systematic review approach, findings from four studies between 2019 and 2024 were synthesized. Results reveal varied findings, including challenges in TB treatment services during the COVID-19 pandemic, deficiencies in TB Multi Drug Resistant (MDR) control programs, and insights into Indonesia's partnership with the GF. The analysis of HIV/AIDS expenditure highlights a decline in funding, emphasizing the need for advocacy and revised funding mechanisms. In conclusion, Indonesia's efforts in ATM combat through health diplomacy, notably with the GF, are substantial. Diversified funding sources, sustained collaboration, and increased self-sufficiency are crucial for meeting global health targets. Strengthening domestic resources, optimizing program implementation, and fostering partnerships are imperative to ensure equitable access to healthcare services and sustain progress in addressing ATM challenges. Innovative financing mechanisms can bolster initiatives, contributing significantly to achieving Sustainable Development Goals (SDGs) by 2030.

A case of disseminated nocardia infection with initial symptoms manifesting as cognitive impairment: Case report and literature review.

Nocardia infections, although rare, pose significant challenges in diagnosis and treatment, especially when involving the central nervous system (CNS). Mortality rates in such cases can be high, highlighting the need for early recognition and tailored antimicrobial therapy. A 58-year-old male with a history of chronic obstructive pulmonary disease, antineutrophil cytoplasmic antibody-associated glomerulonephritis, and steroid-induced diabetes mellitus presented with disorganized speech, fever, cough, dyspnea, and psychiatric symptoms. The patient was diagnosed with severe pneumonia, left pneumothorax, bilateral pulmonary bullae, and CNS involvement. Next-generation sequencing (NGS) identified Nocardia farcinica as the causative agent. Initial treatment with ceftriaxone was ineffective. Upon identification of N. farcinica via NGS, the patient was started on a tailored antimicrobial regimen consisting of sulfamethoxazole, linezolid, and meropenem. Despite initial clinical improvement, the patient was discharged early due to financial constraints. Unfortunately, he later succumbed to the infection. This case underscores the difficulty of diagnosing Nocardia infections, particularly when they involve the CNS. The use of advanced diagnostic tools such as NGS, along with early and appropriate antimicrobial therapy, is crucial for improving patient outcomes. Financial and healthcare access challenges may impact the success of treatment, emphasizing the importance of comprehensive follow-up and patient support.

Quality of life, compliance with treatment, and challenges among patients undergoing cardiac intervention.

Cardiovascular disease is the leading cause of mortality and disability worldwide, with important economic and quality-of-life implications. Effective treatment relies on drug adherence, which is impacted by a variety of factors; noncompliance increases morbidity, mortality, and healthcare costs. This study examines the quality of life, treatment adherence factors, and challenges that cardiac patients encounter during their treatment regimen. A cross-sectional study among 111 cardiac patients through purposive sampling was done at the All India Institute of Medical Sciences Deoghar between January 2023 and April 2024. Data on demographics, clinical characteristics, quality of life, and treatment adherence were gathered and analyzed using descriptive and inferential statistics while adhering to ethical guidelines and participant privacy. The research of 111 cardiac patients (76.6% male, mean age 56.45 years) revealed that the majority had undergone coronary artery bypass grafting surgery (83.8%), with many preferring private hospitals (58.6%). High medication adherence (82.0%) and regular follow-up (71.2%) were noted, although lifestyle improvements such as smoking cessation were less prevalent. Significant concerns in barriers were reported, including financial difficulties (35.1%) and accessibility of prescribed drugs (45.9%). Quality of life was generally reported as high, with most patients reporting no significant problem. This study reveals excellent adherence to medications and regular follow-up among participants. However, significant impediments such as financial constraints and accessibility issues for prescribed drugs continue to have an influence on treatment. Despite these limitations, patients often report a high quality of life, underscoring the complex interplay of medical, economic, and lifestyle aspects in cardiovascular health management.

The Importance of Hiking and Mountain Trips in Leisure and Extracurricular Activities of Students – Part 2/ Interpretation of the Utility and Effects-financial Accessibility Components

Background and Study Purpose: Physical activities in the mountain environment are recognised for their multiple benefits on health, fitness levels, stress reduction and communication. The research aims to identify differences in the usefulness, effects, and affordability of trips and hiking for pre-university students. Material and Methods: The sociometric research investigated a group of 647 students. A 3-component structured questionnaire based on closed-ended items with five levels investigated students' responses to the usefulness and financial effects/financial accessibility of trips and hiking. Results: We obtained the gender difference for all utility factor items, with higher scores attributed to females. Gender differences were also significant in favour of females for the effects/accessibility factor, except affordability (P>0.05). The F-values for the rural-urban difference are all significant and in favour of rural students for both components, except affordability, which is higher for urban. Conclusions: At the level of the utility component, the highest scores are obtained by the items associated with the level of health, socialization group integration, and personality formation. For the effects component, high scores are obtained for items associated with stress reduction/recreation, then optimising endurance and fitness levels. Financial accessibility of trips and hiking scores lower, with only 50% of students perceiving them as affordable and very affordable. Rural students have higher values of confidence in the usefulness of hiking vs. urban students, and this is maintained for the effects component items, the only exception being for financial accessibility, where urban has significantly better values than rural.

Mergers & Acquisitions of Banking Institutions and Customer Satisfaction in Rwanda: A Case of KCB Rwanda & BPR

Purpose: The core aim of this research was to analyse the impact of mergers and acquisitions on consolidated banks’ service quality, by applying modified SERVQUAL model that served as a tool to show the change reflected in the service quality matrix after M&A through service quality demands grouped in dimensions of tangibility, assurance, responsiveness, empathy, employee skills, convenience, reliability, access, and financial aspect in the context of Rwandan banks. Methodology: The target population is composed of 428,000 clients of the two banks at the time of their merger while the sample is 385 clients, number arrived at by using the formula by Mugenda and Mugenda. A descriptive case and explanatory study strategy was utilized as the research sake to define client perception of the quality of service and further aimed to clarify the link between M&A and the quality of service and how it impacts client satisfaction. Findings: The findings from the research revealed that service quality demands are satisfactorily responded in both situations of before and after M&A given that in each situation clients’ expectation is generally met, in the range from 63% to 75% before M&A and 58% to 88% after M&A. The t-tests and ANOVA methods were used to examine the field data gathered with emphasis on statistical significance. The research results then provided the extent of the impact of mergers and acquisitions on the overall quality of service and therefore on clients approval. The analysis shows that M&A exercise allowed the increase of overall clients’ satisfaction from the pre-merger positive overall gap of 0.021 to a post-merger positive gap of 0.135. This positive variation was due to improvement of 8 service quality dimensions in the order of Tangibility for 0.207, Empathy for 0.203, Reliability for 0.194, Assurance for 0.171, Employee Competences for 0.149, Convenience for 0.114, and Financial Aspects and Access for 0.031 each. The decrease of satisfaction was observed only on one quality dimension of Responsiveness for -0.073. For the client satisfaction benefit, the research identified “Promptness” as an area of service quality attributes to improve post-2021 mergers and acquisitions at BPR Bank. Unique Contribution to Theory, Practice and Policy: We recommend that during the exercise of M&A, new banking institutions strive to put in place measures for respecting the promised timing of service delivery.

Integrating Out-of-Pocket Costs Into Shared Decision-Making for Heart Failure With Reduced Ejection Fraction: A Stepped-Wedge Trial (POCKET-COST-HF).

Guideline-directed medical therapy for heart failure (HF) with reduced ejection fraction can entail high out-of-pocket (OOP) costs, prompting concerns about financial toxicity and access. OOP costs are generally unavailable during encounters. This trial assessed the impact of providing patient-specific OOP costs to patients and clinicians. This trial was conducted between June 2021 and August 2023 at 6 clinics in 2 health systems using a stepped-wedge, clinic-level cluster-randomized design. Adult patients with HF with reduced ejection fraction (left ventricular ejection fraction ≤40%) were enrolled. The intervention was built upon the EPIC-HF (Electronically Delivered, Patient-Activation Tool for Intensification of Medications for Chronic Heart Failure with Reduced Ejection Fraction) checklist of approved HF with reduced ejection fraction medications. Patients and clinicians received this checklist with (intervention) or without (control) patient-specific OOP cost estimates for higher-cost medications at the time of encounter. Estimates were obtained by providing pharmacy benefit information to a financial navigation firm. Encounters were audio-recorded, and patients were surveyed 2 weeks later. The primary outcome was cost-informed decision-making, defined by mentioning HF medication cost during the encounter. The primary analysis used a generalized linear mixed model. Secondary outcomes were assessed via transcript subcoding and analysis of survey responses. Demographic characteristics of 247 patients (mean age, 62.9 years; 29.5% female; 26.3% Black; and 3.2% Hispanic/LatinX) treated by 39 clinicians in intervention and control periods were similar. In the primary model, the rate of cost-informed decision-making was higher in the intervention group than the control group (68% versus 49%; P=0.021). Baseline rates of cost discussions and the impact of the intervention varied across sites. When cost discussions were present, fewer discussions in the intervention group involved contingency plans to address potential costs (16.5% versus 31.9%; P=0.028). Most other secondary outcomes were not significantly different. Disclosing comprehensive OOP medication costs to patients with HF with reduced ejection fraction increased cost-informed decision-making. Further work is needed to optimize implementation and assess the impact on medication choices and adherence. URL: https://www.clinicaltrials.gov; Unique identifier: NCT04793880.

How to open up: Factors influencing receptivity to ecosomatic education

Concerns about redundancy of ecosomatic education due to its niche nature or inaccessibility may be overestimated. This study interviewed ecosomatics students to examine which factors are involved in piquing interest in this form of education and knowledge production. Findings can inform how ecosomatic education can best be promoted and organized to attract under-reached demographics. Receptivity to ecosomatic education does not require previous interest in either somatics or the environment, but can be driven by other incentives, such as interest in adjacent activities, academic credit rewards, physical health improvement, financial access or recommendations, suggesting that how programmes are institutionally validated and presented as beneficial to the student has implications for reach and impact. This study offers guidance on relevant factors and challenge assumptions about who engages with ecosomatics.

Digitalization of the financial market and green coal trade

In recent years, fintech advancements have influenced global coal trade patterns. This study analyzes the impact of fintech on coal trade across 80 countries from 2012 to 2019. Findings from the MGARDL model reveal that increased fintech activity reduces coal imports while boosting exports, suggesting enhanced trade efficiency and access to capital. Income inequality and private infrastructure investment negatively impact coal trade, likely due to restricted financial access and infrastructure limitations. Meanwhile, ICT development supports coal trade by streamlining logistics and finance. The study confirms a bidirectional relationship between fintech and coal trade, emphasizing mutual influence. Policy recommendations include promoting fintech adoption, encouraging sustainable investments, improving financial access, and expanding ICT infrastructure to foster a more sustainable coal trade.

How does local government debt governance affect corporate credit mismatches? Evidence from implementing the New Budget Law

This study explores the impact of the New Budget Law, representing local government debt governance, on corporate credit discrepancies. Findings indicate that the New Budget Law can reduce corporate credit mismatch allocation based on the data from 2011 to 2022. Furthermore, the positive effects are achieved by reducing financing costs, increasing the availability of corporate finance, and reducing the negative impact of corporate credit mismatch. The results contribute to the restructuring of the local debt management system by providing a basis for decision-making and insights into establishing an efficient government and attaining robust economic growth.

Financial Services Accessibility And Financial Performance Of Small And Medium Enterprises In Kiambu County, Kenya

Despite their positive contribution, the operation of Small and Medium Enterprises has been confronted by various challenges such as loan repayment default, inadequate capital as well as the persistent regulations which negatively affects their performance leading to high failure rate of one for every five startups within three years. The SMEs in Kiambu County have similar challenges though operating in a densely populated County. Consequently, their performance is negatively affected. The study purposed to examine the influence of financial accessibility on success of SMEs in Kiambu County, Kenya. The research specifically identified the effect of access to credit, access to insurance and explore the influence of entrepreneurial training on financial performance of SMEs in Kiambu County, Kenya. The research was underpinned on Credit Access Theory, Asymmetric Information Theory and Bank Lending Channel Theory. Using a causal research design, this research study targeted a population of 2750 registered SMEs in Kiambu County. Stratified random sampling approach was employed where 10% (275) respondents participated in the study. Both descriptive analysis and multiple regression analysis were adopted in data analysis. Charts and tables were utilized to present research results. The study findings indicate that access to credit has a positive and significant effect on SMEs financial performance with a p- value 0.025 < 0.05. On access to business insurance, the study found that in case of damages, SMES that have insurance will have improved performance. This is shown by a p- value 0.000. < 0.05. Entrepreneurial training has a positive and significant effect on SMES performance in Kiambu County. The study nevertheless recommends for enhanced entrepreneurial training, insurance and more credit to improve performance

WOMEN ENTREPRENEURIAL AND ENVIRONMENTAL FACTORS ENCOURAGING GOALS ATTAINMENT IN THE SOCIETY

The main drivers of women's entrepreneurship span from entrepreneurial framework conditions, socio-cultural influences, gender-specific challenges, and economic contributions to innovation and sustainability. This paper examines the effects of the above elements on growth, resilience, and sustainability in women-owned enterprises through a thematic analysis of empirical studies that investigate how these different aspects have influenced the development of women-owned enterprises. Some findings also show that women entrepreneurs face specific obstacles in establishing and sustaining enterprises, scaled by constraints in accessing finance, induced biases by gender conditions, and inadequacy in managerial training. However, supportive socio-cultural dynamics, the adoption of digital technologies, and targeted policy frameworks have been imperative to foster entrepreneurial success. This study takes cognizance of the role played by women entrepreneurs from an economic and social perspective. This role was targeted to reduce poverty and enhance community development to strategically achieve both Sustainable Development Goal (SDG) 1-(Poverty Reduction) and SDG 8-(Economic Growth). The theoretical framework for the study is ‘social feminist theory’, which postulates that patriarchal structures in society are one of the avenues for unequal distribution of resources, power, and decision-making, thus shaping the female gender's actions in entrepreneurship. The policy recommendations for this study include identifying enhanced financial access, and digital transformation among others.

The role of fintech in U.S. entrepreneurship: How AI is shaping the future of financial services

This study explores the transformative role of financial technology (FinTech) and artificial intelligence (AI) in driving entrepreneurship and reshaping financial services in the United States. Using data spanning from 2010 to 2022, the research evaluates the interplay between AI investment, financial inclusion, governmental programs, and societal perceptions to determine their impact on entrepreneurial activity. By employing regression analysis and diagnostic tests, the study provides a nuanced understanding of these relationships. The findings reveal that AI-related variables, particularly AI investment and technology usage, significantly enhance entrepreneurial activity by fostering innovation, improving decision-making, and optimizing business operations. Conversely, traditional financial metrics, such as credit availability and account ownership, show limited or negative impacts, highlighting inefficiencies in their allocation or accessibility. Surprisingly, governmental programs and societal perceptions of high entrepreneurial status exhibit negative associations with entrepreneurship, suggesting that exclusivity and inefficient interventions may deter broader participation in entrepreneurial ventures. These insights underscore the importance of rethinking financial strategies and policies to align with technological advancements. The study emphasizes the need for accessible AI-driven solutions, improved financial accessibility, and inclusive policies to foster a more equitable entrepreneurial ecosystem. By challenging conventional perspectives, this research contributes valuable recommendations for stakeholders to harness FinTech and AI for sustainable growth and innovation.

Strategi Inovasi Produk Keuangan Syariah untuk Meningkatkan Inklusi Finansial

This study aims to analyze strategies for product innovation in Islamic finance to enhance financial inclusion, a significant challenge in countries with large Muslim populations such as Indonesia. The research employs a qualitative approach, utilizing data from various literature sources, including academic journal articles, reports from Islamic financial institutions, and government regulations. The findings reveal that Islamic financial product innovation can be categorized into new product development, digital technology adoption, improvement of Islamic financial literacy, and cross-sectoral collaboration. Products such as microfinance based on Sharia contracts, digital waqf savings, and technology-driven Takaful insurance exemplify innovations aligned with modern societal needs. Additionally, Islamic fintech platforms have expanded financial access for remote communities, despite challenges such as low digital literacy and limited infrastructure. Islamic financial literacy emerges as a crucial element influencing public trust and participation in formal financial systems. In practice, cross-sector collaboration among Islamic financial institutions, governments, and the technology sector serves as a strategic approach to address regulatory barriers, competition with conventional sectors, and inconsistent global standards. This study recommends strengthening regulations, enhancing financial literacy, developing inclusive digital technologies, and fostering international cooperation to support the sustainable growth of the Islamic finance sector. With integrated strategies, Islamic finance holds significant potential not only to improve financial inclusion but also to create a fairer, more inclusive financial system that aligns with Islamic values in the modern era.

The Strategy and Effectiveness of Baitul Maal wa Tamwil in Eradicating Loan Shark Practices in Java and Sumatra

This study aims to analyze the role of Baitul Maal wa Tamwil (BMT) as an Islamic microfinance institution in eliminating loan shark practices in communities, particularly in Java and Sumatra. Loan shark practices persist due to the ease and speed of loan disbursement, despite the high interest rates that entrap small communities in difficult-to-escape debt cycles. BMT offers a fair and interest-free Islamic financing solution based on profit-sharing principles and a more inclusive approach. This study discusses BMT’s financing strategies, such as lenient requirements, fast processing, and financial education programs designed to compete with loan sharks. The main findings indicate that BMT plays a significant role in providing fairer financing access to small communities and helping reduce their dependence on loan sharks. However, this study also reveals several challenges BMT faces, such as limited capital, strict regulations, and low financial literacy among the public. These challenges hinder BMT's ability to effectively compete with loan sharks in terms of speed and accessibility. The results of this study emphasize the importance of strengthening BMT’s capital, developing human resources, and innovating Islamic financing products so that BMT can play a more prominent role in eradicating loan shark practices in the community. With the right strategy and support from various stakeholders, BMT has great potential to continue growing as a more equitable and empowering financing solution.