Cost-effective Service Delivery Research Articles

FINANCIAL INCLUSION AND THE INFORMAL SECTOR DURING AND POST-COVID 19 ERAS: STATUS, CHALLENGES AND WAY FORWARD

COVID 19 is one of the major disasters that significantly disrupted the socio-economic statuses of various businesses and nations at large. The purpose of the study was to explore the extent to which COVID 19 affected financial inclusion in Zimbabwe. The quantitative research methodology and the purposive sampling technique were employed. Data was collected using in-depth and focus discussion group interviews from 35 participants. Data was analysed using thematic data analysis approach. Barred people in rural areas from accessing financial services which directly and indirectly increased the magnitude of poverty among people running informal businesses. Financial inclusion, is a key driver to poverty reduction; hence the negative impact of on financial inclusion significantly propels poverty in societies. Digitalizing financial services is one of the strategies which can be utilized to promote financial inclusion in the post- era. Financial institutions should use technology in financial services, so that those in rural areas do not incur transport and logistical costs for accessing financial services. Digital finance and other various financial innovations should be used to achieve financial inclusion in rural areas. Policies that encourage the delivery of formal financial services in rural areas should be developed. Governments should consider granting subsidy to providers of financial services so that they can offer basic financial services at low cost to the excluded population. Thus, governments ought to commit themselves to the delivery of accessible, affordable, appropriate and cost-effective financial services to unserved or underserved households. The study provides managers of financial institutions with various techniques of providing financial services to the informal sector in the post- eras in rural areas. It also provides managers with information pertaining to the risks in providing financial services in post-pandemic era in rural areas. Managers of internet service providers has a role in making sure that the rural folk have access to the facility so that digital banking systems become realizable.

Smart governance for smart cities and nations

There is an increasing emphasis on utilizing ICT to drive global governmental transformation to enhance efficiency and cost-effective service delivery. Smart governance represents a novel and data-driven progressive approach, prioritizing intelligence in operations, upholding an exceptional standard of public administration, and contributing to the development of smart cities and nations. A smart city uses advanced technology and innovation to augment urban life and efficiency to ensure sustainability and a smart nation extends these principles across regions. Although smart governance is a priority in building smart cities and nations, its challenges and strategies are still not well-defined from the perspective of developing a smart nation and city. Smart Bangladesh is an inclusive digital transformation initiative and a grand vision of the government, advancing towards becoming a developed, prosperous, and smart nation by focusing on four key pillars: smart citizens, smart government, smart economy, and smart society. This study involved interviews with multi-level stakeholders and served as a preliminary step toward providing insights into and understanding the significant challenges and priorities in transforming a smart country and building smart cities. The research identifies fourteen prime challenges of smart governance that are pivotal for transforming Bangladesh into a smart nation and creating smart cities. Among these, stakeholders particularly emphasize the need for administrative reform, robust smart infrastructure, finance, uninterrupted electricity, strong data privacy and security, and effective big data management as crucial to the success of the country's vision. The analysis proposes a conceptual framework based on stakeholders' priorities that can serve as a practical guideline for practitioners to develop a strategic roadmap for effective preparedness to transition to a smart nation and build smart cities. The study fills a research gap in governance theory concerning the evolution of transformative technology-based governance, particularly emphasizing the significance of smart governance in the development of smart nations and cities.

Effect of digital financial inclusion on banking for the poor in African emerging economies

PurposeThis paper studies the effect of digital financial inclusion in banking on the poor and deprived populations of African emerging economies from 1997 to 2023.Design/methodology/approachAutomated teller machines, mobile payments and mobile money transactions measure digital financial inclusion. Household consumption expenditure proxies poverty reduction. The autoregressive distributed lag analyzes the study.FindingsThe results indicate that automated teller machines, mobile money transactions and financial deepening positively affect poverty reduction, while mobile payments negatively affect poverty reduction. Digital financial inclusion decreases poverty via increased investment and empowerment.Research limitations/implicationsDigital financial products and services should be expanded to all population segments in the economies. The governments should improve the quality and quantity of institutions that guarantee the operation of digital financial activities through the enforcement of law and order. The quality and quantity of mobile money transactions and financial deepening should be increased. The costs and charges involved in using automated teller machines and mobile payments should be regulated to relieve the burden on the population. The government should facilitate access to digital financial services via power supply, transport and telecommunication networks. Banks and telecommunications service providers should improve the payment system network to ensure cost-effective, convenient and secure financial service delivery. The digital infrastructure and financial services markets should be enhanced to fully capture the gains of financial inclusion and reduce poverty.Originality/valueA literature review provides studies with conflicting findings on the effect of digital financial inclusion on poverty reduction. This study supports that digital financial inclusion decreases poverty.

Evidence-based management and the nurse's decision-making process

The managerial decision-making process is a competence of nurses in the hospital and primary care context, which makes them a highly requested professional for solving problems involving the unit and the care provided to the user. Such a process must be informed by evidence, with a view to achieving the best results. To discuss the use of scientific evidence by nurses in the health management process. An integrative literature review, carried out in the PubMed/MEDLINE, LILACS, BDENF, and SciELO databases, through the DeCS/MESH "Evidence-Based Nursing" AND "Health Management" OR "Evidence-Informed Policy", 694 studies were identified and 07 were included. Evidence-based decision-making is important for the delivery of effective and cost-effective public health services, this decision-making process consists of the integration of the best available research evidence, along with consideration of local context, community and policy preferences, professional experience, and resources in public health decision-making. It is, therefore, crucial to improve the quality of management decisions, consequently improving service delivery, and increasing effectiveness and efficiency, in addition to contributing to patient safety. It is concluded that evidence-based management is essential to improve the quality of management decisions and, therefore, to improve the optimization and allocation of resources in the health system.

Measuring the effects of electronic government services and corrupt practices on information exchange: a comparison of public and private hospitals

PurposeHealth Information Exchange (HIE) is essential for the efficient and cost-effective delivery of health-care services. The provider’s administrative structure and external environment can substantially influence adopting technologies involving inter-organizational linkages, such as HIE. Using the theoretical lens of institutional theory, this study aims to compare how public and private hospitals' engagement in HIE is influenced by corruption and government online services or e-government usage.Design/methodology/approachThe study uses the positivist research design of secondary data analysis to test the six hypotheses proposed. Data from multiple third-party reliable sources, including the European Commission and World Bank, are combined into the final dataset consisting of observations from 1,442 hospitals across 30 countries in Europe. A multilevel modeling approach is used to associate country and hospital-level variables and test the hypothesis.FindingsThe study finds that, on average, a 10% increase in corruption leads to a 6.3% decrease, while a 10% increase in e-government leads to a 7% increase in the probability of HIE engagement for a hospital. The negative impact of corruption on average is 18% more in public than private hospitals, while the positive impact of e-government is 75% stronger in public in comparison to private hospitals. The study also finds that HIE engagements in health systems with predominantly public hospitals are more sensitive to corruption and e-government.Originality/valueTo the best of the authors’ knowledge, the study is one of the first to use the institutional view to test the influence of government actions and public providers' concentration on HIE engagement. The comparison of public and private institutions enriches our understanding of promoters and inhibitors of HIE.

Effectiveness of a Culturally Responsive mHealth Gaming Application to Improve Diabetes Health Literacy in India: A Randomized Controlled Trial.

The purpose of this study was to determine the effectiveness of a culturally responsive interactive gaming mHealth educational application designed to improve diabetes health literacy among an underserved urban population in India when compared with a traditional approach of verbal education. In addition, relationships between participant sociodemographic variables and participant knowledge were assessed. A randomized controlled trial was conducted using a two-arm parallel, single-blinded intervention and control group design. The parallel groups were the mHealth Education group serving as the intervention group and the Verbal Education group serving as the control group. The mHealth application was as effective in improving diabetes health literacy as verbal education. Results for the difference in posttest and pretest score between the two groups indicated there was no statistically significant difference between groups (P = .9306). However, there was a significant improvement in the difference in posttest and pretest scores for each group (P < .0001), indicating that the culturally responsive type 2 diabetes educational content was effective in improving type 2 diabetes health literacy among both groups. This study answers a call by the World Health Organization that advocates for evidence-based mHealth interventions that offer unique opportunities for cost-effective informatics service delivery in low- and middle-income countries.

Improving Supply Chain Performance of a Start-Up Company: A Case Study of Avakino Limited

Effective supply chain management is critical for the success of a business, ensuring efficient and cost-effective delivery of products and services while minimizing risks and enhancing the customer experience. This paper presents a case study on Avakino Ltd's supply chain management, analyzing its nature, challenges, and proposed recommendations. The study reveals that Avakino Ltd has an agile and global supply chain, sourcing products from low-cost suppliers in Asia and Africa. However, the company faces challenges due to unreliable suppliers, low production capacity, and supply chain inefficiencies, hindering its aim of providing fast and high-quality products to customers. To address these issues, the study proposes a relationship-building strategy between Avakino Ltd and its suppliers, through long-term contracts, improved communication, and developing low production capacity suppliers through sourcing reliable Tier 2 suppliers. Implementing these recommendations can help Avakino Ltd maintain its competitive advantage and achieve its goal of delivering timely, affordable, and high-quality products to its customers.

A current review of the digital component of cardiac rehabilitation via telemonitoring

The increasing availability of information technologies in modern society has created the opportunity to provide technology-based health care in both hospital and community settings. In this way, telemedicine has become a topic of debate; this can ensure the delivery of accessible, cost-effective and specific health care services at different times and at a distance. Communication technologies have also shown incredible promise in rehabilitation, encouraging the development of a fresh branch of telemedicine known as telerehabilitation. Extensive research has shown that telerehabilitation is equal to or more effective and less expensive compared to traditional rehabilitation in such areas as recovery post-myocardial infarction, post-coronary bypass and post-percutaneous coronary intervention. This literature synthesis aims to highlight the importance of the involvement of telemedicine on cardiac recovery in order to improve the quality of life, reduce the morbidity and mortality of patients in the context of the use of information and communication technologies that allow obtaining important parameters in quantifying the risk of heart failure and, respectively, of cardiovascular events. The comprehensive structure of knowledge, the evolutionary path and research strengths of telerehabilitation from the perspective of the cardiac patient in Moldova, is poorly visualized, thus, the final objective of the study is to study the effectiveness of telemedically monitored home rehabilitation versus the unsupervised one in order to improve the quality and prognosis of patients’ lives with ischemic heart disease after coronary revascularization.

The epidemiological impact and cost-effectiveness of key population-led PrEP delivery to prevent HIV among men who have sex with men in Thailand: A modelling study.

Although key populations (KPs), such as men-who-have-sex-with-men (MSM) are disproportionately affected by HIV, many prevention and treatment services are not easily accessible for KP members. To address the needs of KPs, Thailand established pre-exposure prophylaxis (PrEP) service delivery together with and led by KP members. This study determines the epidemiological impact and cost-effectiveness of key population-led (KP-led) PrEP. We calibrated a compartmental deterministic HIV transmission model to the HIV epidemic among Thai MSM. Besides KP-led PrEP, we included other Thai service delivery models of PrEP (fee-based PrEP, the government PrEP program).Data on consistent PrEP use (5 years daily use, 95% effectiveness for preventing HIV) came from Thai PrEP delivery models. For the period 2015-2032, we ranged the number of PrEP starters (40,000-120,000), effectiveness of PrEP (45%-95%), and proportion of consistent users (10%-50%). The analysis started in 2015 when PrEP was introduced. A cost-effectiveness ratio of <160,000 Baht per quality-adjusted life year (QALY) over 40 years was cost-effective. Without PrEP, 53,800 (interquartile range 48,700-59,700) new HIV infections are expected in 2015-2032. KP-led PrEP was found to have the strongest epidemiological impact of all delivery models averting 58% of infections compared to without PrEP. The epidemiological impact depends on the number of PrEP starters and proportion of consistent use. Although all PrEP service delivery models are cost-effective, KP-led PrEP is most cost-effective with incremental cost-effectiveness ratios of 28,000-37,300 Thai Baht per QALY. Our model projects KP-led PrEP having the greatest epidemiological impact and being the most cost-effective service delivery model of PrEP in Thailand. This study was supported by the US Agency for International Development and U.S. President's Emergency Plan for AIDS Relief through the Linkages Across the Continuum of HIV Services for Key Populations cooperative agreement (AID-OAA-A-14- 0045) managed by FHI 360.

A Novel Strategy for VNF Placement in Edge Computing Environments

Network function virtualization (NFV) is a novel technology that virtualizes computing, network, and storage resources to decouple the network functions from the underlying hardware, thus allowing the software implementation of such functions to run on commodity hardware. By doing this, NFV provides the necessary flexibility to enable agile, cost-effective, and on-demand service delivery models combined with automated management. Different management and orchestration challenges arise in such virtualized and distributed environments. A major challenge in the selection of the most suitable edge nodes is that of deploying virtual network functions (VNFs) to meet requests from multiple users. This article addresses the VNF placement problem by providing a novel integer linear programming (ILP) optimization model and a novel VNF placement algorithm. In our definition, the multi-objective optimization problem aims to (i) minimize the energy consumption in the edge nodes; (ii) minimize the total latency; and (iii) reducing the total cost of the infrastructure. Our new solution formulates the VNF placement problem by taking these three objectives into account simultaneously. In addition, the novel VNF placement algorithm leverages VNF sharing, which reuses VNF instances already placed to potentially reduce computational resource usage. Such a feature is still little explored in the community. Through simulation, numerical results show that our approach can perform better than other approaches found in the literature regarding resource consumption and the number of SFC requests met.

O009 Keep The Chin Up: Evidence-based standardised care pathway for infants with Pierre Robin Sequence (PRS)

Abstract Background Management of upper airway obstruction in neonates with Pierre Robin Sequence (PRS) is challenging given difficulties in grading severity of disease, difficulties obtaining early polysomnography (PSG) and variable practices with no widely accepted standard protocol. We aimed to develop a standardised care pathway for infants with PRS. Methods Total 190 publications were identified of which 21 were reviewed in detail. Majority were review articles or retrospective studies. Consultation was obtained from the Complex Airway Team (multidisciplinary team of neonatologist, paediatric sleep specialist, otolaryngologist, plastic surgeon, clinical nurse specialist and speech pathologist), geneticists, audiologists, the consumer group “PRS Australia” and ANZ paediatric sleep physicians. Final recommendations were based on consensus and quality of the evidence. Results We developed a pathway outlining sequential interventions to manage OSA based on functional assessment by PSG (7-14 day of life) and structural assessment by flexible nasal endoscopy “FNE” (0-7 day of life). Conduct of bedside PSG in NICU instead of sleep lab enables innovative, timely, patient-centred and cost-effective service delivery. We standardised reporting of glossoptosis (Yellon classification), laryngomalacia (Olney et.al) and airway (Seattle DISE scoring) on FNE. Early multidisciplinary involvement, structured assessment of feeding, synchronous airway lesions and associated genetic syndromes is also considered. The pathway allows for standardised management and discharge planning with clearly defined multidisciplinary follow-ups. Intended outcome/impact This project is likely first in Australia to standardise care pathway for infants with PRS encompassing collaborative, innovative and structured care delivery principles. The project provides foundation for future clinical and research collaboration.

Scoring Systems to Predict Survival or Neurological Recovery after Out-of-hospital Cardiac Arrest.

Numerous prediction scores have been developed to better inform clinical decision-making following out-of-hospital cardiac arrest (OHCA), however, there is no consensus among clinicians over which score to use. The aim of this review was to identify and compare scoring systems to predict survival and neurological recovery in patients with OHCA. A structured literature search of the MEDLINE database was carried out from inception to December 2021. Studies developing or validating scoring systems to predict outcome following OHCA were selected. Relevant data were extracted and synthesised for narrative review. In total, 16 scoring systems were identified: one predicting the probability of return of spontaneous circulation, six predicting survival to hospital discharge and nine predicting neurological outcome. NULL-PLEASE and CAST are recommended as the best scores to predict mortality and neurological outcome, respectively, due to the extent of external validation, ease of use and high predictive value of the variables. Whether use of these scores can lead to more cost-effective service delivery remains unclear.

A vision of a One Health system for Australia: on the need to rethink our health system.

A vision of a One Health system for Australia: on the need to rethink our health system.

Chronological Progress of Blockchain in Science, Technology, Engineering and Math (STEM): A Systematic Analysis for Emerging Future Directions

The emergence of Industry 4.0 has awoken the adoption of blockchain as a key factor to enhance the industrial supply chain across the globe, enabling cost-effective and fast-paced delivery of products and services, ownership of products with privacy, and high security as well as traceability. This new digital horizon is underpinning the future direction of humankind, aligning with the Sustainable Development Goal themes of Good Health and Well-being (SDG3) and Sustainable Cities and Communities (SDG 11). Thus, the main objective of this paper is to elucidate the adoption of blockchain technology in Science, Technology, Engineering, and Math (STEM) disciplines by determining of the key academic research players and the evolution of blockchain in different fields. It begins by clarifying the definition of these concepts, followed by a discussion regarding the chronological progress of blockchain over time, an evaluation of the adoption of blockchain technologies in different key research areas, and lastly, providing comments on several directions to guide practitioners in developing a sustainable global blockchain roadmap in education science.

Smart Governance Through Bigdata Digital Transformation of Public Agencies

Abstract: Bigdata is a potential instrument to transform traditional governance into smart governance. There are a long debate and discussion on the application of big data for the transformation of traditional public administration to modern and smart public administration in the academician, researchers, and policymakers. This study aims to explore the suitability and applicability of big data for smart governance of public agencies. A systematic review of literature and metaanalysis method is employed with various levels of scales and indicators. Literature survey shows that a number of models have been developed to explain smart governance but systematic research on the suitability and applicability of big data for smart governance of public agencies is still lacking. This article argues that the application of big data for smart governance in the public sector can increase the efficiency of the public agencies fastest public service delivery, enhancing transparency, reducing public hassle and helping to the become a smart agency. This paper further argues that implementation of big data for smart governance has a significant role in timely, error-free, appropriate and costeffective service delivery to citizens which leads to the sustainable economic development of a country. The findings suggest that every public-sector agency should be brought under smart governance which should be a fully promoted under big data technologies for easy access, transparent and accountable, and hassle-free public agencies

The changing concept of radiographer's role in UAE: An analysis of radiologists' opinions and acceptance

IntroductionThe role of radiographers in the United Arab Emirates (UAE) is currently focused on image acquisition. However, many advances have been made in different countries in recent years whereby radiographers who receive appropriate education and training, can provide image interpretation/reports. When implemented, this role development has enabled a more cost effective and efficient service delivery whilst relieving the burden off radiologists, allowing them to concentrate on more complex imaging examinations. This role development is commonplace in many countries but not in the UAE. AimThis study aims to investigate the radiologists' opinions, perceptions, and willingness to accept the advanced practice role of reporting radiographers in the UAE and determine their level of support for implementing these roles. MethodsData was collected utilizing a mixed-methods study design that included a survey and focus group discussions (FGD). Study participants included radiologists who currently work in UAE public and private health organizations. The survey link was emailed directly to the radiologists, together with a covering letter and participants' information sheet outlining the study's aim. Participants indicated on the survey if they wanted to participate in FGD. Two online FGD were conducted using Zoom software (Zoom Video Communications Inc., San Jose, California, United States) and aimed to explore possible reasons for participant's opinions. Ethical approval was obtained from the Ministry of Health, and all methods were performed as per study protocol. ResultsA total of 69 radiologists participated in the survey, 48 males and 21 females aged between 41 and 60 years and with between 11 and 16 years of experience. Most participants (n = 54, 78.2%) believe that radiographers should only perform advanced tasks in image interpretation after obtaining adequate training and under the supervision of a radiologist. According to 55% of radiologists, the development of the radiographer role could draw more UAE nationals to the field. Six participants were recruited to FGD and declared mixed opinions that emphasized the need to improve the radiographers knowledge and experience to enable role development. ConclusionRadiologists' worries about radiographer engagement in image interpretation may be alleviated if they participate in education and training for new responsibilities. In addition, this could boost the confidence of radiologists and improve trust in radiographer competency and training. Implications for practiceGuidelines and work standards must be developed jointly by radiologists and radiographers to ensure the governance and acceptability of new radiographer reporting roles. Some radiologists perceive that radiographer reporting is possible in UAE when radiographers are trained to set guidelines and with supervision from radiologists. Change is taking place, and many radiologists express optimism for the future, though the rate of change will be determined by a willingness to change attitudes and perceptions.

Artıfıcıal Intellıgence Methods in Oncology

Artificial intelligence has contributed significantly to solving various medical problems, including cancer, over the past decade. Artificial intelligence is being applied more and more in various fields of cancer research. Today, artificial intelligence methods provide physicians with important privileges in making decisions, providing more effective service to managers and minimizing costs, reducing the workload of healthcare professionals, and receiving the treatment with the highest accuracy rate for the patient and the least error rate. This review can be evaluated in two categories. First of all, common diseases in the field of oncology and the use of artificial intelligence in the field of oncology are supported with examples. In the second category, 23 recent studies in the field of oncology in the literature summary table; artificial intelligence methods are divided into categories and accuracy rates are presented. It is thought that the rapidly developing artificial intelligence technology will continue to have a great impact in the field of cancer in the near future. As a result, it is thought that physicians and researchers should include artificial intelligence training courses in their multidisciplinary study and training curricula, keeping pace with the digitalizing new age in healthcare, with the widespread use of artificial intelligence-based clinical decision support systems, personalized medicine, time in diagnosis and treatment, reducing the error rate and it will provide an important advantage in terms of patient and employee satisfaction and both cost-effective and quality service delivery.

Comparing Three Models of Community-Based Diabetic Retinopathy Screening, Treatment, and Awareness Creation Services in Southern India / South Kerala.

The aim of the study was to evaluate the effectiveness of three models of diabetic retinopathy (DR) screening from an economic perspective and their effectiveness in awareness creation, screening, and ability to deliver treatment. Analysis of a prospective screening program for diabetes mellitus and DR in South Kerala was done. Three models were created: Model 1: blood screening camp, Model 2: comprehensive eye camp, and Model 3: institution-based screening camp. Forty-seven camps were conducted in Model 1, 438 in Model 2, and 18 in Model 3. Of 94,993 people screened, the percentage of diabetes was 17.4. Of the diabetics screened, the percentage of retinopathy was 22.8. Model 1 was most economically viable to detect a large number of new diabetics. Model 2 was more economically challenging but had the best overall pickup rate for new DR patients. Model 3 had a lesser pickup of new DR patients. Model 1 is effective in picking up new diabetics but poor for DR screening. Model 3 is cost-efficient with very high DR detection rates. Cost-effective screening activities and service delivery are best achieved through a well-planned Model 2 camp which has the best overall detection rate for DR.

Telehealth for patients with interstitial lung diseases (ILD): results of an international survey of clinicians

IntroductionClinicians and policymakers are promoting widespread use of home technology including spirometry to detect disease progression for patients with interstitial lung disease (ILD); the COVID-19 pandemic has accelerated this. Data...

Emerging Challenges and Prospects of Digital Transformation and Stakeholders Integration in Urban Land Administration in Ethiopia

There is global consensus on the need for information and communication technology (ICT) to support digital transformation in public administration. This is specifically true in decentralized public administration, where the stakeholders need a modern technology that integrates them. This study examines the emerging challenges and prospects of digital transformation and the stakeholders’ integration in urban land administration in Mekelle City, Ethiopia. An interpretive paradigm, qualitative analytical method, and case study strategy were adopted for this study. A total of 78 interviewees comprising 30 auctioneers, 20 experts, 20 officials, 4 judges, and 4 prosecutors participated based on the data saturation principle. The study revealed that digitalized land administration offers opportunities to reduce civil servants’ workload, improve cost-effective service delivery, and enhance trust between the municipal government and its clients. However, the system of urban land administration in the city is not digitalized due to financial limitations and leadership challenges. Furthermore, this study revealed a low level of stakeholders’ integration in Mekelle due to the lack of proper implementation of e-government, e-service, and e-participation, including lack of commitment by the stakeholders. Thus, a non-digitalized land administration system, insufficient capacity, and weak monitoring and evaluation systems impeded the client’s pursuit of enhanced municipal government services.