Decision-making Authority Research Articles

Exploring the association between unintended pregnancies and unmet contraceptive needs among Ugandan women of reproductive age: an analysis of the 2016 Uganda demographic and health survey

BackgroundUnintended pregnancy and unmet contraceptive needs pose significant public health challenges, particularly in developing nations, where they contribute to maternal health risks. While previous research has explored determinants of unintended pregnancies, there remains a gap in understanding the association between unplanned pregnancies and unmet contraceptive needs among Ugandan women of reproductive age. This study aimed to assess unmet contraceptive needs and their correlation with unintended pregnancies and other factors in Uganda, utilizing a nationally representative sample.MethodsData was extracted from the 2016 Uganda Demographic Health Survey (UDHS), a cross-sectional survey conducted in the latter half of 2016. The study encompassed 18,506 women aged 15–49 with a history of at least one prior pregnancy. The primary outcome variable was the planning status of the most recent pregnancy, while the principal independent variable was unmet contraceptive need. Additional variables were controlled in the analysis. Data analysis was performed using STATA version 17, involving descriptive analysis, cross-tabulation, chi-square testing, and logistic regression. Statistical significance was set at p < 0.05.ResultsA substantial proportion of women reported unintended pregnancies (44.5%), with approximately 21.09% experiencing an unmet need for contraception. In the adjusted model, women with unmet contraceptive needs had 3.97 times higher odds of unintended pregnancy (95% CI = 3.61–4.37) compared to those with met contraceptive needs. Significant factors linked to unintended pregnancies included women's age, place of residence, household wealth status, decision-making authority regarding contraceptive use, educational attainment, husband's occupation, and educational level.ConclusionThis study revealed that both the rate of unintended pregnancies and unmet contraceptive needs in Uganda exceeded the global average, warranting urgent policy attention. Addressing unmet contraceptive needs emerges as a potential strategy to curtail unintended pregnancies. Further qualitative research may be necessary to elucidate the sociocultural and behavioral determinants of unwanted pregnancies, facilitating context-specific interventions.

Implementation of Exercise Management Services Among Sports Medicine Physicians in the United States.

Assessment of physical activity and exercise prescription has been widely supported by many organizations, yet provision of such services remains limited in the United States. We sought to uncover why such services have not been widely adopted. The American Medical Society for Sports Medicine organized a task force to canvas physicians and survey the American Medical Society for Sports Medicine membership. Peer-to-peer and telecommunication discussions and web-based questionnaires. Sports medicine physicians in the United States. None. Percentage of sports medicine physicians who provide exercise management services and mechanisms of billing for exercise management, identify barriers to such services, and identify industry collaborations for promoting physical activity through physicians. Three of 4 sports medicine physicians spend at least 1 min encouraging exercise with patients, using Evaluation and Management codes to bill or receive credit. Exercise counseling is often bundled within other patient care. Few health plans leverage the patient's relationship with a primary care physician to promote exercise. Most employed sports medicine physicians do not receive incentives to incorporate exercise counseling into practice, and only 1 in 6 have decision-making authority to hire an exercise professional. Major obstacles are the lack of a business model and knowledge about exercise prescription. The existing E&M codes adequately characterize the work, but physicians desire greater payment or credit for providing exercise management services. Physicians desire to do more exercise prescription, but health system bureaucracy, inadequate support, and economic disincentives are barriers to the provision of exercise management services.

INTRA HOUSE HOLD RESOURCE ALLOCATION AND WOMEN'S EMPOWERMENT: A COLLECTIVE MODEL PERSPECTIVE

"Intrahousehold Resource Allocation and Women's Empowerment: A Collective Model Perspective" examines the intricate dynamics of resource distribution within households and its impact on women's empowerment. Employing a collective model approach, this study explores how bargaining power and decision-making authority are shaped by the allocation of resources within familial units. Through empirical analysis and theoretical frameworks, the research sheds light on the complex interplay between intrafamily dynamics, cultural norms, and socioeconomic factors that influence women's agency and well-being. By elucidating these dynamics, the study contributes to a deeper understanding of gender relations and offers insights for policymakers and practitioners seeking to promote gender equality and women's empowerment.

On some features of the recognition of an administrative offense in the field of traffic as insignificant

The subject of the study was the legal norms contained both in Article 2.9 and in other norms of the Code of Administrative Offences of the Russian Federation, which empower a law enforcement officer, when considering a case of an administrative offense in the field of traffic, to release a person from administrative responsibility if the administrative offense is insignificant.The object of the study was the administrative legal relations that arise when a law enforcement officer implements the legal institution of releasing a person from administrative responsibility if an administrative offense is insignificant. The authors analyzed the positions of scientists who have studied this legal institution at various times. Special attention is paid to the decisions of the highest judicial authorities and judicial practice in this area by district and regional courts. The article proposes criteria for determining an administrative offense as a gross one, and substantiates the position that a gross administrative offense cannot be recognized as insignificant under any circumstances. The methodological basis of the research was the dialectical method of cognition, the fundamental principles of the scientific worldview. In the course of the study, methods of historical, comparative legal, concrete sociological, and statistical analysis were used. When preparing a scientific article, the authors of the article conducted a survey of traffic police officers. As a result of the conducted research, the following conclusions were formulated: 1. The range of public relations in the field of public administration protected by legislation on administrative offenses is so wide that it makes it impossible to establish specific criteria for recognizing an administrative offense as insignificant. 2. In order to fill this gap, the higher judicial authorities establish specific compositions of administrative offenses that cannot be recognized as insignificant. 4. It is necessary to introduce the concept of "gross administrative offense" in the Administrative Code of the Russian Federation, which should be understood as "administrative offenses, the repeated commission of which entails criminal liability." 5. Article 2.9 of the Administrative Code of the Russian Federation should be supplemented with the second part, which will contain the following legal norm: "Persons who have committed such administrative offenses, for which the repetition of their commission entails criminal liability, cannot be released from administrative responsibility in connection with the recognition of an act as insignificant."

Information Technology and Value-Based Healthcare Systems: A Strategy and Framework.

Value-based healthcare offers a pathway for enhancing patient satisfaction and population health and reducing healthcare costs. In addition, it provides a means to enhance physicians' perception and experience in healthcare delivery. The foundation of the said systemis the notion that community wellness can only be benefited when the health effects of many people are also addressed. The provision of healthcare services incurs costs. However, a value-based model addresses this issue by establishing teams that cater to individuals with similar needs. This approach fosters expertise and efficiency, ultimately leading to cost savings without rationing. Furthermore, entrusting decision-making authority regarding healthcare delivery to the clinical team enhances doctors' professionalism and the integrity of clinician-patient interactions, resulting in more effective and relevant treatments. Currently, various information technology (IT)-based solutions are the main focus for accomplishing the desired value-based healthcare system. The establishment of a coordinated framework that can help organizations create value-based healthcare systems is covered in the current article. Additionally listed are many IT-based solutions used to create a value-based healthcare system.

Abstract WP72: National Assessment of Trainee and Non-Vascular Neurology Acute Stroke Decision-Making at StrokeNet Regional Coordinating Centers

Background: The impact of acute stroke treatment changes, including development of Vascular Neurology, advances in neuroimaging, and endovascular treatment (EVT), on stroke team trainee utilization and decision-making are unknown. For insight into high-performance teams, we surveyed StrokeNet Regional Coordinating Centers (RCCs). Methods: A confidential, self-administered, pilot-tested survey was distributed to the site PIs of all 27 StrokeNet RCCs. The survey assessed in-person acute stroke response staffing, involvement of trainees, decisional autonomy, and attitudes regarding decision-makers. Absent data fields excluded. Descriptive statistics presented. Results: 18 of 27 RCCs completed the survey (gross response rate 66%). 67% (12/18) reported trainees (Resident and/or Fellow) always respond to ED and inpatient activations and 39% (7/18) that trainees always respond to EVT activations. 44% (7/16) and 27% (4/15) reported Nurse Practioner (NP) and Physician Assistant (PA) involvement in ED stroke responses, respectively. Thrombolytic decision-making authority (prior to attending staffing) rested with Fellows and Residents in 61% (11/18) and 18% (3/17), respectively. No NP or PA independent use was identified (0%). 89% (16/18) reported attending Emergency Physicians did not order thrombolytics prior to stroke team consultation. Apart from Vascular Neurology, which was universally acceptable, acceptability by attending specialty for thrombolytic ordering was: Emer Med (88%), Gen Neurology (75%), Neurosurgery (33%), Fam Med (12%), Int Med (11%) and Radiology (6%). Acceptability for EVT decisions was Neurosurgery (94%), Gen Neurology (59%), Radiology (50%), Emer Med (44%), Fam Med (12%) and Int Med (11%). Conclusions: At StrokeNet RCCs, acute stroke teams have significant trainee involvement in both ED and inpatient acute stroke responses and allow trainees significant autonomy. Stroke team involvement likely occurs early in the ED, as few reported attending emergency physicians ordering thrombolytics prior to consultation. Respondents varied in acceptability of different specialties as decision-makers for both thrombolytics and EVT. These findings have potential workforce, education, and training implications.

Нормативно-правовые и организационные аспекты обеспечения безопасности дорожного движения в середине XX столетия (на материалах Донбасса)

In the presented scientific study, the author, based on little-known archival documents and materials, meaning-fully analyzes the legal and organizational aspects of ensuring road safety in the middle of the last century on the territory of Donbass. From a historical and legal perspective, the organizational and legal activities of local authorities in the field of countering road traffic injuries are considered. The features of the decisions taken, their prerequisites and results are revealed. It is noted that there is a systematic and purposeful nature in the development and adoption of regulatory legal acts in the field of road safety, constant monitoring of the situa-tion in this area and close cooperation between local authorities and the State Automobile Inspectorate. The author concludes that in the late 1940s – early 1950s, problems in the field of road safety began to become more acute in Donbass, the need to find new forms and methods of countering accidents, their legal consolida-tion in the decisions of local authorities, which eventually allowed to stabilize the situation.

Proposed Knowledge Management System for the Time Efficient in R&amp;D Department of PT Automotive Lumina

The automotive industry has grown post-Covid 19, positively impacting related sectors like car lighting. Due to high demand, PT Automotive Lumina, a lamp manufacturer specializing in OEM car lights, needs better time management. Responding to RFQs for new car models poses significant challenges due to delays caused by dependence on Juoku Technology. To tackle this, the company initiated an independent R&amp;D process, but the need for more effective knowledge management worsens the situation, affecting competitiveness in a rapidly changing market. This research addresses two key questions: What Knowledge Management system can be proposed for time efficiency in the R&amp;D Department of PT Automotive Lumina? and How to implement the suggested Knowledge Management system for time efficiency in the R&amp;D Department of PT Automotive Lumina? Qualitative research methods were employed to study these questions, including interviews with key stakeholders. Analysis revealed eight sub-causes contributing to the observed problems, including a lack of skilled personnel, ineffective knowledge management, reliance on Juoku’s R&amp;D schedule, rapid technological advancements, inefficient processes, limited decision-making authority, limited testing equipment in the R&amp;D department, and most importantly, the absence of a knowledge management system. Several solutions to these challenges are presented based on the SECI, PPT framework, and Core, Advanced, and Innovative knowledge framework. Direct training, knowledge capture, and collaboration tools are among the planned knowledge management programs at PT Automotive Lumina. Preparation procedures were conducted in November and December 2023, with the proposed solution implementation set to begin in February 2024. Following deployment, knowledge management activities will be evaluated, and necessary modifications will be made for future improvements. PT Automotive Lumina aims to enhance time efficiency and support independent R&amp;D through improved knowledge management procedures.

Influence of Internal Control and Implementation of Accounting Information Systems on The Quality of Regional Government Financial Reports

This study aims to ascertain how internal control and the use of accounting information systems affect the caliber of financial reports produced by local governments. The study's independent variables are internal control and the adoption of accounting information technology, whereas the dependent variable is the caliber of local government financial reports. Bandung City's regional government agencies (SKPD) work units make up the study's population. Employees from the Inspectorate, BPK, BPPD, Department of Communication and Information, Department of Library and Archives, Investment and Integrated Services Agency, Department of Spatial Planning and Infrastructure, and Administrative and Financial Assistant in the financial section, as well as those with decision-making authority like department heads and sub-section heads, were included in the purposive sample that was chosen using this sampling technique. Fifty respondents from these agencies were given questionnaires as part of the data collection process. Using SPSS 23.0 for Windows, multiple linear regression analysis is used in this study. The study's findings show that internal control makes up 47.2% of the total contribution to the quality of local government financial reports, which is positive and significant. Implementing accounting information systems makes up 23.6% of the total contribution and positively and significantly affects the quality of local government financial reports. Additionally, accounting information systems and internal control simultaneously impact 55.3% and 44.7%, respectively, on the caliber of local government financial reports.

Implementation of Public Policy for Street Vendors Arrangements in Bandung City

This research delves into the complex issues surrounding the implementation of public policy aimed at organizing street vendors in Bandung City. The presence of street vendors has become intertwined with concerns related to public order and security, frequently culminating in conflicts between these vendors and government authorities seeking to regulate their presence in prohibited public areas. Motivated to resolve disputes without violence, the Bandung City Government has called for immediate measures to manage street vendors effectively. This study seeks to understand the factors hindering the effective implementation of the policy on street vendor arrangement, exploring whether the policy execution aligns with the planned actions and its subsequent impact on both individuals and groups within society. Utilizing qualitative research methods, including observation, in-depth interviews, and document studies, this research engages key informants such as executing officials, beneficiaries, affected groups, and relevant stakeholders involved in the Local Regulation on Structuring of Street Vendors in Bandung City. Employing the implementation theory and model from Grindle (2017), examining policy implementation considers the nuances contributing to its ineffectiveness. The findings reveal many challenges, including conflicting interests, ongoing debate on policy benefits, overlapping goals, limited decision-making authority, inadequate resources, and contextual conflicts between governmental and non-governmental entities. The study concludes that a comprehensive strategy is required to address these challenges and foster stakeholder collaboration to enhance the policy's effectiveness.

How Public Health Organizational Structure Affected the Response to the COVID-19 Pandemic: A Case Study in British Columbia, Canada.

Objectives: This study sought to examine how public health organizational structures affected decision-making and provides recommendations to strengthen future public health crisis preparedness. Methods: The Institutions-Politics-Organizations-Governance (IPOG) framework and an organizational lens was applied to the analysis of COVID-19 governance within British Columbia (BC). Organizational charts detailing the structure of public health systems were compiled using available data and supplemented with data collected through key informant interviews. Results: In response to the COVID-19 pandemic, BC initiated several changes in its public health organization. BC's COVID-19 response attempted to utilize a centralized command structure within a decentralized health system. Four key themes were identified pertaining to the 1) locus of decision-making and action; 2) role of emergency structures; 3) challenges in organizational structure; and 4) balance between authority and participation in decision-making. Conclusion: The organizational adaptations enabled a substantively effective response. However, our findings also illustrate deficiencies in organizational structure in the current public health system. Two recommendations for consideration are: 1) a more formal vertical organizational structure; and 2) developing new mechanisms to link health and general emergency response structures.

Transboundary hydropower projects: allocation of competence and cooperation between the federation and its federating units in Switzerland

(i) The Swiss Constitution places cantons (federating units) in charge of managing all water uses. At the same time, it gives the federation decision-making authority over transboundary water uses, including for hydropower purposes. (ii) It further mandates the Federation to consult and consider the concerns and interests of the affected cantons when deciding on transboundary hydropower projects. (iii) Aside from the possibility of intertwining competence between the Federation and cantons on the transboundary hydropower project, the situation creates ambiguity around the obligation to consult between parties on such projects. (iv) Cooperation in good faith in implementing relevant procedural rules of consultation between parties seems to be the most promising approach to finding solutions acceptable to all.

Dimensions of Local Authority: Mapping Local Political Institutions in Canada's Cities

Abstract Our knowledge of the institutional features of local government in Canadian cities is surprisingly fragmentary. The academic literature has long identified dominant tendencies in Canadian local institutions, but systematic empirical data has been missing. In this article, we address this gap in knowledge in two ways. We introduce the Canadian Municipal Attributes Portal (CMAP), a new open-access database that contains information on dozens of institutional features of local government for nearly 100 of the most populous municipalities in Canada. We then propose a new multidimensional index of authority concentration, which is designed to capture variation in the local structure of decision-making authority in a systematic and nuanced manner. We apply this index to a systematic pan-Canadian subsample of 65 CMAP municipalities. The result is a rich portrait of institutional variety, one that both corroborates and substantially extends our current understanding of the shape of municipal institutions in Canadian cities.

The impact of the decision-making role on perceived satisfaction, value for money, and reinvest intentions at varying levels of perceived financial performance in the context of Big Data Marketing Analytics

ABSTRACT Business resources and processes such as Big Data Marketing Analytics (BDMA) are becoming increasingly focused on meeting the needs and objectives of customers. Consequently, this research aims to use PLS-SEM to explain the interaction and relationships between the core user-centric performance measures of BDMA, such as user satisfaction, value for money and reinvestment intention. Also, the significance of the decision-making role was explored in this context. Finally, the impact of perceived financial performance was investigated to see its impact on the examined relationships. The impact of value for money on user satisfaction, the impact of the decision-making role on user satisfaction, and finally, the impact of the decision-making role on the reinvestment intentions were found to be significant for individuals who scored either low or high perceived financial performance. Furthermore, all the observed relationships in the dataset were positive, whereas only three were positive and significant for individuals who scored low on perceived financial performance. Overall, it is clear that perceived financial performance has a vital role in BDMA deployment, where understanding the influence of user authority in decision-making enables managers to design better organizational plans by integrating inputs from multiple organizational cross-layers. Also, the results indicate that a user’s decision-making role influences user-centric measures in BDMA deployment, which reveals how user perceptions and authority play a vital role in the context of BDMA in firms.

Critical Success Factors for Deployment of Primary Health Care Networks and their Impact in Kenya

The Government of Kenya through the Bottom-up Economic Transformational Agenda (BETA) acknowledges Primary Health Care (PHC) as a cost-effective and efficient means to achieve Universal Health Coverage (UHC). The aim is to enhance equitable access to high-quality and affordable healthcare for all Kenyan citizens. Primary Health Care Networks (PCNs) are gaining traction as the main mode of achieving PHC in Low- and Middle-Income Countries, and Kenya is no exception. In Kenya, PCNs approach seeks to empower local communities at subcounty level through mobilizing resources and strengthening their decision-making authority to address context specific healthcare needs. The investment in PCNs is geared towards advancing equitable access to quality healthcare at the community level, mitigating fragmentation of health care services, strengthening preventive and promotive healthcare hence creating a more resilient and efficient healthcare system. The Ministry of Health in Kenya, in collaboration with County Governments and Development partners, initiated a Rapid Results Initiative (RRI) to deploy PCNs across the country in August, 2023. The goal was to establish 315 Primary Health Care Networks (PCN) across the 47 counties in Kenya. This was preceded by a Pilot phase in 3 Counties (Kisumu, Garissa, and Kwale) which was conducted in 2021. The pilot phase informed cost-effective approaches for the deployment and critical success factors for scale-up of PCNs countrywide. The nationwide deployment of PCNs followed a 10-step process of establishing PCNs as stipulated in Kenya PHC Guidelines. Data on experiences, progress in implementation and lessons learnt was abstracted from grey literature including reports from PCN establishment at County level, Stakeholder meetings through Accelerator and Sustainability taskforce and data from PCN observatory. The average time taken to establish a PCN was 3 weeks and costed approximately USD 34,000 for its full establishment. As at 20th December, 2023 (within 4 months of initiating the RRI), of the target of 315 PCNs, 93(30%) PCNs were fully established, 27(9%) PCNs were in progress and 195(62%) yet to start. Out of the 47 counties, 37(79%) counties have at least a fully established PCN, 4 Counties are in the process of establishing the first PCN and 6 are awaiting partner readiness. The eight main critical success factors for successful establishment included: County ownership and commitment, availability of Key Policy guidelines and strategies for reference, funding from development partners and donors, leveraging on existing National and County governance structures, multisectoral collaborations and partnerships, tracking of PCN establishment through National PCN observatory and Community engagement. Key process enablers to successful role out included: Meaningful engagement of development and implementing partners, Execution through County trained TOTs, Community engagement through Community Health Workforce and support from National Government. Over time, the Established PCNs in 3 pilot counties have demonstrated significant reduction in facility based maternal mortality, increased access to NCD screening services, coordinated health care workers through MDTs and improved forward and backward referrals. Additionally, incorporated innovation models within PCNs have improved access to medical supplies and specialized healthcare services at level 2 and 3 facilities. To achieve successful scale up of PCNs and sustainability for impact it is critical to contextualize PCNs to the County needs, establish sustainable primary health care financing mechanism for PCN activities, Strengthen PCN governance structures and utilise PCN observatory to continuously track PCN performance measurements and decision making. Adoption of a unified focus on PCN performance improvement including one PCN strategy, one action plan on how to optimally implement PCNs and one monitoring framework is critical. If implemented successfully, PCNs will contribute to long term social return on investments and improved health indicators for the Country

Governing decentralized autonomous organizations as digital commons

Effective governance plays a pivotal role in aligning the interests of diverse stakeholders and shaping the strategic directions of organizations. However, the dominant model of corporate governance often concentrates power among a limited group of directors, leading to concerns about potential power imbalances that may distort fair representation and compromise decision-making integrity. Decentralized autonomous organizations (DAOs) present an alternative model that distributes power among a broader base of stakeholders, fostering a more democratic approach to collective decision making and governance. However, the openness and fluidity inherent in DAOs can expose them to coordination challenges, governance complexities, and potential exploitation by malicious entities. In response to possible governance challenges, we consider DAOs as digital commons and adapt Ostrom's eight principles for governing the commons to propose a new governance framework for DAOs. This governance framework is designed to foster the collective stewardship of shared digital assets and the equitable distribution of decision-making authority in the Web3 era. As DAOs emerge as a novel organizational structure, our governance framework aims to maintain their resilience, inclusiveness, and decentralization, reinforcing their crucial role in the evolving Web3 landscape.

Characterizing Community Forests in the United States

Abstract Research on community forests (CFs), primarily governed and managed by local forest users in the United States, is limited, despite their growth in numbers over the past decade. We conducted a survey to inventory CFs in the United States and better understand their ownership and governance structures, management objectives, benefits, and financing. The ninety-eight CFs in our inventory are on private, public, and tribal lands. They had various ways of soliciting input from, or sharing decision-making authority with, local groups, organizations, and citizens. Recreation and environmental services were the most important management goals, but timber production occurred on more than two-thirds of CFs, contributing to income on many CFs, along with a diversity of other income sources to fund operations. We discuss the difficulties in creating a comprehensive CF inventory and typology given the diversity of models that exist, reflecting local social and environmental conditions and the bottom-up nature of community forestry in the United States. Study Implications: Despite their small footprint in the United States, community forests are a rapidly developing model of forest ownership, governance, and management that helps protect forestlands and open space and demonstrates how market and nonmarket forest goods and services can be produced for broad and enduring community benefits. This study inventories and characterizes community forests in the United States to increase understanding of this model, its prevalence, and its potential. It provides a baseline of information that serves as a foundation for further exploration and research on the impacts and contributions of community forests.

Law and democracy in the globalisation of infrastructure as an asset class

ABSTRACT In 2018, the G20 endorsed the ‘Roadmap to Infrastructure as an Asset Class’. This document crystallizes a roaring policy agenda focused on transforming ‘infrastructure’ into a homogeneous, tradeable investment opportunity, attractive to global financial markets. Although the Roadmap is formally a mere policy blueprint, this article studies it as a legal document—one whose purpose is to code infrastructures into capital. Specifically, the article makes three claims, two analytical and one normative. First, that the Roadmap’s way of attracting investors ultimately consists in shielding the decision-making processes related to the design and maintenance of infrastructures from democratic interference. Second, that these restrictions are enforced through global governance mechanisms that push the relevant decision-making authority from the national to the global. And third, that the Roadmap’s agenda is problematic from a democratic standpoint, because it disempowers those who should have a say over the development and maintenance of these infrastructures.

Using a 5P Strategic Medical Stockpile model to build an optimal and resilient supply chain in health emergencies

Background: The healthcare sector witnessed the occurrences and impacts of disruptions on supply chains during the coronavirus disease (COVID-19) pandemic. Consequently, it is essential to strengthen institutional medical supply chain systems by addressing the key attributes of strategic stockpile plan renewal: flexibility, traceability and transparency, perseverance and responsiveness, global independence, and equitable access. Aim and objective: To establish a resilient supply chain integrated into the emergency management cycle by proposing a sustainable 5P Strategic Medical Stockpile model. Settings: Online evidence, available literature, and lessons learned during the COVID-19 response in the Emirate of Abu Dhabi. Methods: This review employed a systematic methodology of identification, selection, assessment, synthesis, and interpretation of data from peer-reviewed articles, review reports, and response frameworks spanning the years 2012 to 2020. Additionally, media reports and announcements were analyzed to determine the implications of COVID-19 on the supply chain from 2020 to 2022. Recommendations are formulated in response to the identified shortcomings revealed during the review process, as well as considering experiences and lessons resulting from responses to address COVID-19 in the Abu Dhabi Health Sector. Results: Our analysis revealed a deficiency in effective operational protocols for building a robust supply chain. The experience gained from responding to COVID-19 has highlighted deficiencies such as unclear issues with stockpiles, inadequate resources, insufficient planning, the absence of established procedures, and a lack of performance monitoring. The pandemic had a tremendous impact on health systems and medical supply chains worldwide. Our suggested model necessitates aligning responses with national contingency protocols. Accountability may fluctuate during each phase of an emergency, depending on decision-making authority and jurisdictional capabilities. Conclusion: The proposed 5P model can support policymakers, health regulators, institutions, and professionals in formulating strategies to establish a resilient stockpile system that serves as a medical supply chain buffer when supplies are not instantly accessible.

Clinical Services, Barriers, and Public Perspectives of Community Pharmacies in Saudi Arabia: A Cross-Sectional Study.

In the Kingdom of Saudi Arabia, there is an increasing demand for community pharmacists to provide the highest level of clinical knowledge and services. However, evidence regarding Saudi public awareness of the clinical services offered by community pharmacies (CPs) and the barriers to using them is limited. In this cross-sectional study, we used an online questionnaire developed by adapting the Consolidated Framework for Implementation Research. A total of 273 participants completed the survey. Half the participants were generally aware of the availability of some CP services but were not informed about the full range on offer, eg, medication reviews (84%) and online counseling (89%). Most of the participants (69.6%) did not identify differences in the care provided by community pharmacists versus hospital pharmacists (P = 0.02). A commonly reported barrier to using CP services was a general preference for other healthcare professionals to seek pharmaceutical help (85.7%). Many other barriers were also reported, impacting the participants' use of these services. The decision-making authorities should consider improvements to increase patients' awareness and utilization of clinical services and enhance community pharmacists' performance in clinical-oriented pharmaceutical care.