Capacity Gaps Research Articles

Tracing the Scientific Legacy: Bibliometric Analysis of LATAM Research in Bariatric Surgery for 33 Years.

Metabolic and bariatric surgery (MBS) has experienced considerable growth, addressing the challenges of obesity and its complications. The lack of a comprehensive bibliometric analysis in Latin America motivates this study, highlighting the need to understand the evolution of research in this area and its impact on clinical decision-making and health policies. A cross-sectional bibliometric study was carried out using the Scopus database. A structured search strategy was designed to identify articles related to bariatric surgery with authors affiliated with Latin American countries. Inclusion and exclusion criteria were applied, followed by a descriptive and bibliometric analysis of the scientific production found. A total of 3553 documents published between 1991 and 2024 were included. There was an annual growth of 11%, with an average age of documents of 7.5years. A concentration was observed in some countries, notably Brazil, Mexico, and Chile. Although scientific output increased, the average number of citations per article showed a downward trend since 2003. Despite the growth in scientific production, the quality and relevance of research is questioned, especially given the decrease in the impact received. It highlights the lack of meaningful regional collaboration, which could limit the sharing of knowledge and resources. Questions are raised about gaps in research capacity and the economic and development implications are discussed. This study provides valuable information to strengthen future research in bariatric surgery in Latin America. It highlights the importance of promoting regional and international collaboration and improving research training in countries with less participation. Clinical intervention strategies can benefit from better understanding research trends and adopting evidence-based practices in a more informed manner.

Coastal fisheries and community-based support systems in post disaster contexts

Pacific Island Countries and Territories are highly exposed to natural disasters, intensified by increases in frequency and force of extreme weather events. Pacific societies, like in Vanuatu, have been shaped in many ways by such natural disasters; reflected in customary practices and social fabric of rural coastal communities. When a natural disaster occurs, government attention justifiably focuses on channelling and coordinating international humanitarian aid to fill gaps in capacity and resourcing national recovery efforts. However, central to disaster recovery, particularly in the immediate aftermath of disruption, are the ways that local people support each other (within and between communities). Disconnects between national and local recovery efforts are common and stand to inhibit effective responses. This study aims to understand horizontal, self-organised community-to-community support systems and communities’ post-disaster engagement with external aid. It draws from two different datasets: i) the observations collected through the emergency relief work led by the National Disaster Management Office in Vanuatu shortly after the 2023 twin tropical cyclones Judy and Kevin hit the country, as well as ii) the loss and damage survey led by the Vanuatu Fisheries Department to estimate the level of damage these cyclones caused in various regions of Vanuatu. Through this process, we highlight the social systems that enable community-to-community support, as well as potential opportunities for external-aid to support communities in a more efficient manner. Results reveal that community-to-community support is critical in the first weeks post-disaster. Recognizing the roles that different support networks play at different stages of disaster response is critical not only to improving people's and institutions' ability to bounce back from particular disruptions, but also in broader efforts to strengthen community resilience in the face of climate change.

Competency Mapping of Key Stakeholders in Procurement and Contracting of the National Tuberculosis Elimination Program Goods and Services in an Eastern Indian State

Abstract Background: The National Tuberculosis Elimination Program is a complex program, and the program officers are involved in the procurement and contracting of goods and services under it. A competency mapping was conducted to highlight the current capacity gaps in contract management at state and district levels under the program. Materials and Methods: A descriptive cross-sectional design was adopted with 15 participants involved in procurement and contracting in two districts of the state using a semi-structured questionnaire, and results were presented using the descriptive statistical analysis. Results: A total of 15 different stakeholders from the National Health Mission, State and District Tuberculosis (TB) Cell, State TB Training and Demonstration Centre, and State Medical Corporation participated in the study. The participants had an average of 10.3 years of experience in contracting, and 20% of them had received some training on contracting. The capacity of these respondents varied based on their involvement, previous training (s) received, and technical background. It was further observed that most of the respondents suggested an in-person physical training instead of virtual training. Most of the respondents requested to issue training certificate. Some of the topics that the participants requested for further training include Digital Signature Certification, Government e-Marketplace, General Financial Rule, Public Financial Management System, monitoring of performance indicators, and bid evaluation techniques. Moreover, 92% of the respondents felt that there is a training need on procurement and contracting. Conclusions: Many a time, the program officers come from a technical background not relevant to the contracting and procurement of goods and services and require regular on-the-job support and training to aid in effective program delivery.

Organizational Capacity for Sexual Assault Prevention Within a U.S. Army Installation

ABSTRACT Introduction Preventing military sexual assault (SA) is a DoD priority. Building prevention capacity could strengthen the impact of prevention programs and improve outcomes. Capacity was conceptualized as implementation knowledge and skills using the Getting To Outcomes (GTO) process and organizational-level capacities using the Prevention Evaluation Framework, a framework that applies best practices in prevention and implementation science to prevention at the program and organizational level. The present study assesses implementation knowledge and skills currently possessed by SA prevention personnel in one U.S. Army installation with the goal of identifying preexisting proficiencies and potential gaps. The study uses the Prevention Evaluation Framework organizational-level domains to identify organizational capacities that could be improved. Materials and Methods Fifteen SA prevention program personnel were recruited for individual 1-hour interviews from one U.S. Army installation. A semi-structured interview guide was developed by the study team to assess knowledge and skills within the GTO framework. Applied thematic analysis guided data coding and analysis. Results Participants reported a range of proficiencies and gaps in capacity for SA prevention. Within the prevention workforce capacity, proficiencies were skill in tailoring training, and an existing train-the-trainer model. Gaps were training to facilitate difficult conversations, and an inability to tailor trainings to audience needs. Two proficiencies related to the comprehensive approach were having a victim advocate present during trainings, and providing training across leadership levels. The final proficiency involved data. Existing data sources were viewed as useful for identifying the nature and extent of local problems. However, participants reported a lack of confidence and skill in selecting appropriate outcome measures and collecting and using primary data. Gaps in leadership capacity were cultural norms, lack of trust, leader investment, logistical difficulty working with leaders, and comfort engaging with leaders. Gaps in collaborative relationships were the lack of informal networking within the SA prevention area to include civilians. Conclusions The GTO-specific knowledge and skills of SA prevention personnel at one U.S. Army installation revealed proficiencies and gaps in organizational capacities influencing the prevention mission. Findings indicate that GTO support could be useful for improving the quality of program activities. However, results also indicate that GTO support would be more effective if they were paired with sufficient prevention infrastructure at the organizational level.

CHALLENGES AND GAP CAPACITY OF PALM OIL FARMERS IN ACCESSING DIGITAL EXTENSION AND ASSISTANCE SERVICES

Palm oil cultivation practices in the future must adopt good agricultural practices (GAP) to ensure sustainability and market acceptance. If farmers fail to implement GAP, they will face the threat of being marginalized and even eliminated from the supply chain. Extension services can be a means of disseminating information regarding the palm oil GAP. With the development of ICT, opportunities have opened up to use digital platforms as a medium for extension. In this research, a socio-economic and demographic characteristics of farmers for digital-based extension services was studied. Farmer data from four locations namely East Kotawaringin, Paser, Sekadau, and Central Mamuju were collected. Data from each parameter component at each location was analyzed for variance (Anova) at a 5% level of significance. The results show that the level of education is directly proportional, while age is inversely proportional to the level of ownership of smartphones as a means of digital education. The existence of farmer groups increases the percentage of conventional extension received by farmers, and where farmers also get information regarding the availability of digital extension materials. The variations in the level of importance and type of information needed by farmers are caused by the development phases of oil palm plantations. Recommendations for overcoming challenges and reducing the gap in farmer capacity in accessing digital extension is development of an integrated digital platform specifically for extension on oil palm cultivation that is adaptive to the needs of farmers and to various digital tools to enhance dissemination.

Hospital Staff Perspectives on the Drivers and Challenges in Implementing a Virtual Rehabilitation Ward: Qualitative Study.

Over the past decade, the adoption of virtual wards has surged. Virtual wards aim to prevent unnecessary hospital admissions, expedite home discharge, and enhance patient satisfaction, which are particularly beneficial for the older adult population who faces risks associated with hospitalization. Consequently, substantial investments are being made in virtual rehabilitation wards (VRWs), despite evidence of varying levels of success in their implementation. However, the facilitators and barriers experienced by virtual ward staff for the rapid implementation of these innovative care models remain poorly understood. This paper presents insights from hospital staff working on an Australian VRW in response to the growing demand for programs aimed at preventing hospital admissions. We explore staff's perspectives on the facilitators and barriers of the VRW, shedding light on service setup and delivery. Qualitative interviews were conducted with 21 VRW staff using the Nonadoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework. The analysis of data was performed using framework analysis and the 7 domains of the NASSS framework. The results were mapped onto the 7 domains of the NASSS framework. (1) Condition: Managing certain conditions, especially those involving comorbidities and sociocultural factors, can be challenging. (2) Technology: The VRW demonstrated suitability for technologically engaged patients without cognitive impairment, offering advantages in clinical decision-making through remote monitoring and video calls. However, interoperability issues and equipment malfunctions caused staff frustration, highlighting the importance of promptly addressing technical challenges. (3) Value proposition: The VRW empowered patients to choose their care location, extending access to care for rural communities and enabling home-based treatment for older adults. (4) Adopters and (5) organizations: Despite these benefits, the cultural shift from in-person to remote treatment introduced uncertainties in workflows, professional responsibilities, resource allocation, and intake processes. (6) Wider system and (7) embedding: As the service continues to develop to address gaps in hospital capacity, it is imperative to prioritize ongoing adaptation. This includes refining the process of smoothly transferring patients back to the hospital, addressing technical aspects, ensuring seamless continuity of care, and thoughtfully considering how the burden of care may shift to patients and their families. In this qualitative study exploring health care staff's experience of an innovative VRW, we identified several drivers and challenges to implementation and acceptability. The findings have implications for future services considering implementing VRWs for older adults in terms of service setup and delivery. Future work will focus on assessing patient and carer experiences of the VRW.

Why Do Universities Outsource Management of Their Online Programs?

ABSTRACT The U.S. online program manager (OPM) market has grown substantially in the past decade, as many colleges and universities have sought third-party servicers to help expand and develop their online offerings. Yet, the approach of contracting with OPMs has raised concerns of policymakers, think tanks, higher education critics, and even some campus leaders – with discussions and advocacy of federal policy changes governing higher education’s use of third-party servicers. To understand why universities engage with these for-profit companies, despite the extensive criticisms they have received, we examined the drivers to outsource with OPMs as an organizational strategy. Findings suggest four primary drivers that comprise the College Curation Strategy Framework: react to competitive pressures with speed; access initial, upfront capital; address gaps in capacity and capabilities; and learn and scale-up in house. This framework may help guide decision making when HEIs consider outsourcing. Implications for research and practice are discussed.

Mixed-methods exploration of challenges to stoma care for ostomates in four low- and middle-income countries: STomacARe For Improvement reSearcH (STARFISH) study

Background Little is known about the challenges of stoma care and potential solutions for patients in low- and middle-income countries (LMICs). This study aimed to assess the outcomes and experience of care for patients with stomas in LMICs using a mixed methods approach. Methods A cross-sectional survey of hospitals assessed health system characteristics relevant to stoma care. A six-month retrospective audit collected data on all patients undergoing new stoma formation, and postoperative complications. Semi-structured interviews with stoma patients and informal caregivers, and key informant interviews with healthcare providers were conducted to gather information on experiences, challenges and coping strategies relating to stoma care. The results were triangulated to develop a questionnaire-based tool to assess patients’ and carers’ knowledge and attitudes towards stoma and stoma care. Results Six hospitals from the Philippines, Malawi, Nigeria and India participated in the study. Data from 446 patients demonstrated diversity case mix, outcomes and postoperative stoma counselling. Interview data from the Philippines highlighted the lack of knowledge on stoma care of the patients and carers, poor access to stoma care and resources and the lack of affordable stoma care supplies. Triangulating these inputs, a 33-item questionnaire was developed to facilitate task sharing of expert stoma care to non-expert nurses and caregivers. Conclusions This study highlighted gaps in capacity to provide stoma counselling and poor access to and affordability of stoma care supplies for patients in LMICs. This novel questionnaire can help close these gaps and improve care for new ostomates in resource limited settings. Registration The study is registered in the Philippine Health Research Registry PHRR No.210805-003783 (https://registry.healthresearch.ph/index.php/registry)

Assessment of capacity and performance of points of entry in detection of public health events, reporting and responding to public health emergencies, Uganda, July–September 2022

IntroductionExpanded human mobility has increasingly led to the spread of disease outside of the areas in which it first occurs. Consequently, there is an enhanced focus on building capacity to detect disease at points of entry (PoEs). We assessed capacity and performance in the detection of public health events, reporting, and responding to public health emergencies (PHEs) at PoEs in Uganda.MethodsWe conducted a cross-sectional assessment from June 27 to September 12, 2022, at official PoEs in Uganda. We adopted a standardised assessment tool for the World Health Organisation’s (WHO) PoE capacity requirements. Capacity areas included coordination and communication, routine prevention and control measures expected at all times, and response to PHEs. We abstracted and analysed surveillance data on the performance of PoEs including completeness of PoE reporting, proportion of travellers screened, and proportion of suspected ill travellers isolated, investigated and referred for further care if necessary.ResultsWe assessed all 53 gazetted PoEs (4 airports, 16 inland ports, and 33 ground crossings). Most (94%) reported communication capacities with national and sub-health authorities with 88% completeness of reporting. Forty-two per cent provided access to appropriate medical services for assessment and care of ill travellers, 42% had access to sanitary facilities, 21% had access to safe water, and 23% had appropriate waste management and vector control. Regarding the capacity to respond to PHEs, all designated PoEs had a public health emergency contingency plan,74% provided screening of all travellers but screened 56% of the travellers, 38% had the capacity to quarantine and isolate suspected human cases, and 15% had the capacity to transport suspected cases to referral health facilities. Twenty three percent of the suspected ill travellers were isolated, investigated and referred for further care if necessary. Only 8% assessed animals being transported through PoEs for priority animal transboundary diseases.ConclusionExisting capacity and performance gaps in detection and response to PHEs may limit the ability to respond effectively to potential PHEs if they occur. There is a need to establish infrastructure, equipment and personnel for and assessment, isolation and quarantine of humans and animals.

Dolutegravir Resistance in African Programmatic Settings Among Patients With Failure of Dolutegravir-based ART.

Dolutegravir resistance is emerging in routine clinical contexts in southern Africa, primarily in patients with prior treatment experience failing dolutegravir-based antiretroviral therapy (ART). This potential issue was raised by The Nucleosides and Darunavir/Dolutegravir in Africa trial that compared dolutegravir and boosted protease inhibitor-based therapy as second-line ART, in which new dolutegravir resistance was observed at failure. However, recent data suggest that also at risk are patients who were transitioned to dolutegravir from non-nucleoside reverse transcriptase inhibitor-based ART while viremic. Identifying patients experiencing failure of dolutegravir with resistance will be difficult given current gaps in viral load monitoring and limited capacity for genotypic resistance testing. As a result, in the short term, most patients affected will go unrecognized, with particularly important implications for patients affected who have advanced HIV or who are pregnant/breastfeeding. Prospective research is needed to understand the scope of the problem, identify additional risk factors, and determine best management. In the short term, for most patients with dolutegravir resistance and prior non-nucleoside reverse transcriptase inhibitor exposure, the best option will be a timely switch to a regimen anchored by a boosted protease inhibitor, with a high genetic barrier to resistance.

Global perspective of barriers in research among oncologists from low-middle income countries.

e13781 Background: Cancer research in low-middle income countries (LMICs) face unique challenges, hindering advancements in patient care. Understanding the practices, barriers and strategic needs encountered by oncologists in LMICs is essential for enhancing research capacities and patient outcomes. This study aimed to assess the barriers and facilitators of research among oncologists in LMICs. Methods: This online cross-sectional survey engaged a diverse group of practicing oncologists from LMICs between December 8, 2023 and February 6, 2024. Respondents include both oncology trainees and consultants primarily from Asia (63%), Africa (18%) and Europe (10%). Using a validated questionnaire (test-retest reliability: 0.98), data analysis was performed using frequency and percentages to detail the survey responses, with 95% confidence intervals calculated to ensure the findings reliability. Results: A total of 276 participants from 29 countries, with a mean age of 38 years, responded to the survey. Fifty three percent (n=146) were male and 46% (n = 126) were female, four participants chose not to disclose. Majority of the respondents were trained in medical oncology and related specialties, 71% (n = 196). Forty one percent (n = 113) of them had less than 5 years’ experience as a cancer physician, while a significant proportion were mid-career oncologists with 5 to 15 years of experience. Regarding individual level barriers; 3% (n = 7) had 60 - 100% protected research time, 3% (n = 8) had local and international mentors, 36% (n = 100) had no biostatistical training, 50% (n = 138) had no clinical trial design training, 11% (n = 29) had utilized qualitative design, 60% (n = 165) had not participated in a population-based study, and 83% (n = 228) had not participated in translational research. In relation to system-level barriers; 30% (n = 84) had inadequate research infrastructure and 43% (n = 120) had no clinical trials unit. Respondents rated the degree of implementation of new research findings into local clinical practice as 3 on a five-point Likert scale. Conclusions: This study highlights the critical gaps in research capacity, resource availability, and infrastructure among oncologists from LMICs. Addressing these barriers through targeted interventions is imperative for advancing cancer research and improving patient outcomes in LMIC settings.

Minnesota Public Health Corps: A New Model For Building The Governmental Public Health Workforce.

Governmental public health agencies in the US are understaffed, and ongoing shortages will have a detrimental effect on their ability to provide basic public health services and protections. Public Health AmeriCorps was established in 2022 to support efforts to create a stronger and more diverse public health workforce nationwide. The Minnesota Public Health Corps, one of the largest Public Health AmeriCorps models, is a capacity-building program that places AmeriCorps members directly into governmental public health settings across the state. We used data from the first year of the Minnesota Public Health Corps (2022-23) to describe the experiences of thirty-five sites participating in the program. We also examined preliminary findings about how it shaped AmeriCorps members' skills and prospects related to career development in public health. Corps members were younger and more diverse than the current public health workforce in Minnesota, and the majority said that they intended to pursue a public health career. Host sites reported improved capacity to deliver public health services and indicated that corps members helped them reach new populations. Our evaluation demonstrates that this statewide program may be a scalable model to address parts of the acute capacity gaps at public health agencies, as well as long-term efforts to revitalize the workforce.

Reliability and Availability of Renewable Energy Sources in Kenya: A Review

The research sought to evaluate the reliability and availability of renewable energy sources in Kenya by examining the available literature regarding the state of energy production and consumption of the renewable energy sources. Several studies have been conducted to establish the capacity of the renewable electrical power sources including hydroelectric power, geothermal sources, wind power, solar energy and biofuels. Regarding production of electricity, the existing capacity is barely able to keep up with demand. The research used systematic review as the methodology of collecting relevant data for analysis. Given that more than 38% (2021) of Kenya’s electricity comes from hydropower, the situation is particularly difficult during the dry months of the year when water levels are low. Capacity gaps are then compensated by expensive thermal generation based on fossil fuels. Geothermal power has the capacity to be the most significant source of renewable energy with a potential of up to 7000MW. The reliability indices of the renewable energy sources, based on System Average Interruption Frequency Index (SAIFI) are at 1.98 (SAIFI) and at 4.37, based on the Customer Average Interruption Duration Index (CAIDI), which are below the international global standards. The research concluded that increased consumption of electricity, availability of alternate energy sources, amount of restoration time and number of planned interruptions have a significance influence on the reliability of a renewable energy source, with restoration time being the most significant. It is therefore recommended that new technologies and innovations that lead to reduced power interruptions and greenhouse gas emission be adopted.

Infection prevention and control: Qualitative study of the preparedness and response of Christian health Association of Ghana to Marburg virus disease in Ghana

ObjectiveRecent disease outbreaks underscore the importance of robust disease surveillance and infection prevention and control (IPC) programmes to bolster Africa's public health response system. Yet, available evidence shows extensive gaps in the emergency response capacity of faith-based healthcare providers on the continent. Accordingly, this study examines the IPC and surveillance strategies adopted by a faith-based healthcare provider and the challenges encountered during Marburg Virus Disease outbreak (MVD) in Ghana. MethodWe collected data from 15 clinical and nonclinical health workers from the Christian Health Association of Ghana (CHAG) and the Ghana Health Service (GHS). Data was collected through online interviews to examine two pillars of the WHO COVID-19 SPRP-AFR (2021) framework. We analyzed the data using Braun and Clarke's thematic analysis. FindingsThe facility performed creditably well with contact tracing and other quarantine protocols during MVD outbreak in Ghana. However, it also encountered several challenges in the enforcement of IPC protocols, including human resource constraints, the lack of decontamination equipment, and limited infrastructure, among others. Given these limitations, we assessed that the facility cannot handle major outbreaks. ConclusionDue to numerous infectious disease outbreaks in Sub-Saharan Africa in recent years, the government of Ghana and faith-based healthcare providers must resource their facilities with the relevant equipment and qualified human resources against future disease outbreaks.

Challenges of Incorporating Sustainable Development Goals Into South African Higher Education Curricula

This paper highlights several challenges that the adoption and implementation of the seventeen United Nations Sustainable Development Goals (SDGs) pose for South African Higher Education institutions’ (HEIs) curricula design. It also reflects on the experiences of some institutions who have embraced SDGs in their teaching and learning, research, management (governance and operations), and public engagement strategies (Sustainable Development Solutions Network, 2017). SD4 seeks to “ensure inclusive and equitable quality education and promote lifelong learning opportunities for all”. This paper is intended to contribute to policy debates on issues that are seemingly being given little attention in curriculum design, in the advance towards the target 2030 date for achieving SDGs. The research is motivated by the absence of guidelines and frameworks from South African education governing bodies regarding SDGs, leading to knowledge and capacity gaps that frustrate academics who are increasingly being required to include SDGs in their courses. The author uses a qualitative methodology (document review) and focuses on literature published between 2019 and 2023 on the implementation of SDGs into South African curricula. This study recommends that private HEIs be included in the development of SDG governing frameworks and policies. It also recommends that HEIs develop a South African ranking system to track progress towards SDG attainment.

Strengthening district health management and planning: an evaluation of a multi-country initiative in Eastern and Southern Africa

Background District health management and leadership capacity is increasingly recognised as critical to health system performance. District health managers play a central role in effective implementation and tailoring of national health policies, and they need adequate skills and support. The District Health System Strengthening Initiative (DHSSi) was implemented over 2019-22 in Malawi, Kenya, Tanzania and Uganda to strengthen sub-national capacity for evidence-based planning and a broader set of management competencies needed to operationalize district plans. To support learning and adaptation, a three-year evaluation was conducted to assess progress against outcomes and to inform ongoing implementation and future investment. Methods The evaluation used a mixed-methods theory-based approach. Evaluation questions were structured using criteria of relevance, coherence, efficiency, effectiveness, sustainability and impact, and corresponded to outputs, outcomes and impacts in the DHSSi Theory of Change. The evaluation was conducted over three annual rounds, and combined data from document review, observation, interviews and group discussions with cross-country, national and district stakeholders, and analysis of secondary quantitative data. Results Experience of DHSSi implementation indicated the relevance of supporting district management and planning, with gaps in current capacity, government interest, and indications of the potential to improve district practice. DHSSi experience also highlighted challenges to effective achievement of stronger capacity, and to translation of skills to improved management practice and, ultimately, to improved service delivery. A range of factors beyond skills affected district capacities, motivation and opportunities for effective planning and management, including areas such as funding, planning templates, health information systems, staff turnover, partner alignment and political structures. Conclusions Strengthening sub-national health management is an important agenda in efforts to expand high-quality primary health care. Future initiatives should prioritize detailed understanding of the range of influences on district management, and work to strengthen the enabling environment for effective district practice.

Developing a Community of Practice through Social Media to Facilitate Continuing Education of Medical Practitioners in Medical Research

The emergence of COVID-19 has highlighted the significance of research in medical practice, particularly in low- and middle-income countries (LMICs) like Indonesia, where healthcare challenges are prominent. Therefore, this study introduces Arcandcoresearch, a non-institutional-based virtual Community of Practice (vCoP), aiming to address the research capacity gaps among medical practitioners. This study aimed to understand the possibility of using several social media platforms (Instagram, YouTube, and WhatsApp) in the vCoP for continuing medical education of general practitioners regarding medical research. Through Instagram, the project has gained substantial follower growth (1003 followers within 19 months); most were 25-34 years old (69%). Within six months, 124 medical practitioners participated in five sharing sessions via Zoom meetings. All participants who completed the feedback form were satisfied with the content delivery of the sessions. The recorded sharing sessions were then uploaded to the YouTube channel. It already had 150 subscribers until September 2023, with 397 viewers for the videos uploaded in 2022. We facilitated participants to discuss any concerns related to medical research in the WhatsApp group, which already had 24 participants. These preliminary results highlight the potential of Arcandcoresearch to impact medical research culture positively in LMICs. The next steps should be conducting thorough program evaluations and developing strategies for sustaining virtual engagement.

Developing a Community of Practice through Social Media to Facilitate Continuing Education of Medical Practitioners in Medical Research

The emergence of COVID-19 has highlighted the significance of research in medical practice, particularly in low- and middle-income countries (LMICs) like Indonesia, where healthcare challenges are prominent. Therefore, this study introduces Arcandcoresearch, a non-institutional-based virtual Community of Practice (vCoP), aiming to address the research capacity gaps among medical practitioners. This study aimed to understand the possibility of using several social media platforms (Instagram, YouTube, and WhatsApp) in the vCoP for continuing medical education of general practitioners regarding medical research. Through Instagram, the project has gained substantial follower growth (1003 followers within 19 months); most were 25-34 years old (69%). Within six months, 124 medical practitioners participated in five sharing sessions via Zoom meetings. All participants who completed the feedback form were satisfied with the content delivery of the sessions. The recorded sharing sessions were then uploaded to the YouTube channel. It already had 150 subscribers until September 2023, with 397 viewers for the videos uploaded in 2022. We facilitated participants to discuss any concerns related to medical research in the WhatsApp group, which already had 24 participants. These preliminary results highlight the potential of Arcandcoresearch to impact medical research culture positively in LMICs. The next steps should be conducting thorough program evaluations and developing strategies for sustaining virtual engagement.

Strengthening the role of innovation brokers in the livestock advisory services system of Pakistan

Context This article assesses development and implementation of a non-traditional training ‘whole-family extension approach’ (WFEA) that contributes to the innovation-brokering capacity of farm advisors within the current livestock advisory services system of Pakistan. Aims The primary objectives of the research were to explore how the WFEA training leads to improved capacity and knowledge of farm advisors and then examine these through the lens of innovation brokers and the difference they can make within the extension system, including (1) articulation of problems and possibilities, (2) network building and (3) supporting negotiation and learning in networks. Methods A qualitative investigation was conducted during four facilitated discussions and three field follow-up visits following project interventions to build the capacity of 50 farm advisors from across a network of 22 organisations that are part of the Pakistani’s livestock extension system. Data were collected by using the following two qualitative approaches: (1) facilitated discussions, during each of the four separate training workshops; and (2) field follow-up visits, where farm advisors were interviewed following a set of semi-structured questions. The data were analysed to assess the changes observed across the different farm advisors during the training interventions and subsequent mentoring provided by the project team. Key results Gaps in innovation-brokering capacity from WFEA were identified and include co-designing and more institutional support of various collaborating organisations, use of visioning tools, scenario analysis to predict possible future for the farm-advisor training and training of farm advisors on analytical skills to capture the household impacts; these should be incorporated in WFEA training. Conclusions A holistic extension training intervention approach (the WFEA) can positively influence the innovation-brokering capacity of farm advisors within the current livestock advisory services system of Pakistan. Implications This article has contributed to the literature on innovation-brokering roles in the livestock advisory systems by highlighting key additional functions of innovation-brokering in a developing-country context. Furthermore, examples from Pakistan can be used to show how farm advisors can develop skills in articulating problems and possibilities, network building and supporting negotiation and learning in networks.

A Geospatial Analysis of the Availability, Distribution, and Accessibility of Neurosurgical Facilities, Workforce, and Infrastructure in Nigeria; and Projection Towards 2050

There has been a modest but progressive increase in the neurosurgical workforce, training, and service delivery in Nigeria in the last 2decades. However, these resources are unevenly distributed. This study aimed to quantitatively assess the availability and distribution of neurosurgical resources in Nigeria while projecting the needed workforce capacity up to2050. An online survey of Nigerian neurosurgeons and residents assessed the country's neurosurgical infrastructure, workforce, and resources. The results were analyzed descriptively, and geospatial analysis was used to map their distribution. A projection model was fitted to predict workforce targets for 2022-2050. Out of 86 neurosurgery-capable health facilities, 65.1% were public hospitals, with only 17.4% accredited for residency training. Dedicated hospital beds and operating rooms for neurosurgery make up only 4.0% and 15.4% of the total, respectively. The population disease burden is estimated at 50.2 per 100,000, while the operative coverage was 153.2 cases per neurosurgeon. There are currently 132 neurosurgeons and 114 neurosurgery residents for a population of 218 million (ratio 1:1.65 million). There is an annual growth rate of 8.3%, resulting in a projected deficit of 1113 neurosurgeons by 2030 and 1104 by 2050. Timely access to neurosurgical care ranges from 21.6% to 86.7% of the population within different timeframes. Collaborative interventions are needed to address gaps in Nigeria's neurosurgical capacity. Investments in training, infrastructure, and funding are necessary for sustainable development and optimized outcomes.