Capacity Gaps Research Articles

Behavior Analysts' Relationship to Relating Relations: A Survey on Perceptions, Acceptability, Knowledge, and Capacity for Derived Stimulus Relations Research and Practice.

The study and application of procedures that result in stimulus relations via relational frame theory (RFT) and stimulus equivalence (applied as equivalence-based instruction; EBI), have made tremendous strides in contemporary behavior analysis. However, applications at scale lag basic and translational research. We turn our attention inward to investigate potential causes. We replicated and extended Enoch and Nicholson (Behavior Analysis in Practice, 13(3), 609-617, 2020) by conducting a survey of behavior analysts (n = 129) to determine their perceptions, experiences, and barriers in carrying out research and practice based on RFT and EBI. Participants indicated an interest in RFT and EBI, and mostly perceive both within the scope of behavior analysis. A majority of behavior analysts reported formal education in EBI (78.3%), in contrast to a minority in RFT (15.5%). Adoption of procedures derived from RFT and EBI may be in proportion to formal education. Compounded with a lack of accuracy on basic knowledge questions, there is a potential gap in capacity in the field in addressing behavior related to complex verbal behavior.

Challenges in and Opportunities for International Collaboration: Costing Flood Damages and Losses across Canada, Mexico, and the United States

Abstract Flooding, including inland and coastal flooding, is one of the most devastating and costly natural hazards in Canada, Mexico, and the United States. Recent research conducted by an international team has focused on understanding the true and comprehensive economic costs of floods, with an eye toward addressing their impacts, allocating adequate resources for monitoring and preparedness, and building resilient communities. Flood-costing methods vary greatly among federal and subnational jurisdictions across the three North American countries. Because the rigor and consistency of existing datasets across the three countries vary significantly, it is also difficult to determine the economic impacts of cross-border events. This paper aims to critically analyze the research methods used to conduct this trinational project and develop recommendations for enhancing impacts of such work in the future. We discuss three major research barriers: gaps in knowledge and research capacity, differences in data collation and analysis methods across the three countries, and linguistic barriers in working across disciplines and economic sectors. We also explore how the COVID-19 pandemic significantly added to these three barriers. We propose creation of new institutional mechanisms that can play a major role in developing comprehensive, consistent, and cohesive data gathering approaches in Canada, Mexico, and the United States.

A global matchmaking web platform facilitating equitable institutional partnerships and mentorship to strengthen health workforce training capacity

The critical human resources deficit in the healthcare sector in low-resource settings (LRS) has an overwhelming impact on health outcomes and disparities in growth and development of the global healthcare workforce. There is a lack of qualified trainers and mentors and this makes it challenging to connect existing capacity gaps with existing expertise and established programs. Through global health partnerships, training programs, and mentorship, individuals and institutions from around the globe can connect to share training resources and strengthen clinical and research capacity in LRSs. Global health partnerships focused on capacity building face many challenges including; unequal access to information about potential partners and training opportunities, a lack of transparency regarding each institutions training priorities, and inequity and absent reciprocity within global health partnerships that have disproportionate power division between high-resource and LRSs. This initiative, the Consortium of Universities for Global Health Capacity Strengthening Platform (CUGH-CPS) (CUGHCapacityBuilding.org), aims to empower institutions and individuals in LRSs to address these challenges and drive partnership engagement through avenues that are beneficial to the LRS agent needs and context by leading the prioritization of training capacity development across clinical and research domains. The CUGH-CPS helps to identify and create a platform for the dissemination of training and mentorship needs from LRS institutions and share this information with the global community. This manuscript describes this new initiative officially launched to a global audience at the April 2023 CUGH meeting.

Talent Development Practises at Higher Education Institutions in Malaysia during COVID-19 Pandemic: A Case of a Public University in the Southern Region

Talent Development (TD) is important for every institution, including higher education. However,fewinstitutions regard TD as one of their most crucial elements. During Covid-19, academics experienced stress and faced challenges when they had to alter their regular teaching and learning activities, such as switching to an online learning platform during the pandemic. This study, therefore, examined how the pandemic has affected TD practises in higher education institutions as human capital is the most important resource to an organisation. The research objective was to examine TD practises at a public Higher Education Institution (HEI) in Malaysia during the pandemic. This study employed a qualitative research methodology, namely phenomenological interviews, which enabled the researcher to capture the respondents’ actual experiences. In this study, two HR representatives and two academics from the sameuniversity participated as interviewees. Performance management, coaching, leadership development, and talent acquisition were themes that emerged from the interviews, along with several subthemes like hybrid, webinar courses, talent pool, and requirements. This study is significant in that it highlighted the value of TD practises in the higher education sector, particularly during the COVID-19 pandemic. In addition, as a guide for HEI administrators, this study helps in the revision of their existing strategies and understanding of the capacity gaps between the current academic skill level and the changing employment requirements to ultimately establish a coordinated TD.

Implementation of Virtual Mobility and Internationalization at Home in Albania’s Higher Education: A Catalogue of Recommendations for Action


 Purpose: Despite progressing research in the field of Virtual Mobility and Internationalization at Home, recent theories and technologies are challenging to implement for Higher Education Institutes (HEIs). The present paper focuses particularly on Albania, where the current education system has not been able to sufficiently incorporate Virtual Mobility and Internationalization in higher education programs. 
 
 
 Study design/methodology/approach: This paper analyses the prevalent situation within Albania’s higher education system regarding Virtual Mobility and Internationalization at Home activities. The underlying data has been collected in qualitative semi-structured interviews, conducted with teaching staff and students from Albanian universities who are experienced with Virtual Mobility modules. It was evaluated through a mixed approach of qualitative content analysis by Mayring (2014) using inductive and deductive category formation.
 
 
 Findings: The results show the benefits that an increasing integration of Virtual Mobility activities in the education system could facilitate for students and teachers in Albania’s HEIs. Nevertheless, it became clear that in order to implement a higher degree of Virtual Mobility at university level, it is necessary to overcome the legal obstacles set by the Ministry of Education as well as structural obstacles within the HEIs.
 
 
 Originality/value: Due the actual lack of development, concepts, infrastructures, and legal foundations, the implementation of Virtual Mobility as an affordable instrument to foster the international experience of Albanian students is of high importance. This could raise the quality of academic education and tackle capacity gaps in the education system of Albania towards the grade of international experiences of students.

Effects Of Covid-19 On The Performance Of National Teachers' Colleges In Uganda

Purpose: This study attempted to investigate the effects of COVID-19 on the performance of National Teachers’ Colleges (NTCs) supported by Enabel.Methodology/approach: The study adopted a cross sectional research design. The study population consisted of staff working in the NTCs purposely or randomly selected. The self-administered questionnaire was used to collect the data that was analysed using both descriptive and inferential analysis.Findings: The research findings showed that programmes disruptions (r = 0.496); funding disruptions (r = .403) and capacity gap (r = .556) are moderately significant and positively associated with NTC performance respectively. Overall, the variables studied explain 33.9 percent of the variation in the organizational performance of NTCs.Implications/limitations: The research findings have shown that whereas programme disruptions and capacity gaps significantly contributed to the explanation of performance in NTCs during the lockdown, funding disruptions do not. The study recommends the continued adoption of innovative approaches to realize the objective of quality teacher training and education. Research into the effects of Covid-19 on the students in NTC is recommended, as this current study did not explore the component of students.Originality/value: While the effects of Covid-19 on the education sector have been studied, this has been mainly done at the primary and secondary levels of education in Uganda. This paper has attempted to investigate Covid-19 effects on NTCs supported by Enabel.Keywords: Covid-19; programme disruptions; funding disruptions; capacity gaps; organizational performancePaper type: Research paper

Evidence for "Whole Family Approach" in accelerating uptake of COVID-19 and routine immunizations among integrated primary health services in Nigeria.

The family is the simplest unit but possesses the strongest bond in society. These qualities - bond and proximity - that exist both within and across neighboring families, according to our research, can be instrumental in shaping a new kind of health promotion strategy that can transform health behaviors in communities. The Whole Family Approach (WFA) is a government-sanctioned approach to increase uptake of COVID-19 vaccines in Nigeria. The approach entails leveraging the high family-based demand for some primary health services, such as malaria, diabetes, hypertension, and reproductive services, to generate demand for COVID-19 and routine immunizations. However, since the announcement in 2021, there has been no available evidence to show the impact of the approach on COVID-19 vaccine uptake, though global literature generally favors family-centered health approaches. This study tests the effectiveness of the approach in increasing the utilization of target services in a Nigerian community and further provides a theoretical framework for the strategy. Two primary healthcare facilities were selected in two communities located in Abuja in a quasi-experimental design. After a small-sample landscape assessment of the communities and the facilities, family-targeting health promotion activities were facilitated in the intervention community (integrated health education by trained community health influencers) and facility (opportunistic health promotion through in-facility referrals) for one month. Anonymized service utilization data were acquired from both facilities over a period of four months to analyze their respective month-by-month service utilization trends. Time trend analysis was conducted and revealed that WFA significantly increased service utilization (N = 5870; p < 0.001, α = 0.01, 99% CI) across all the package services provided at the intervention facility. A supplementary Pearson's correlation analysis further presented a positive relationship (r = 0.432-0.996) among the services which favored the result. It can therefore be concluded that the "Whole Family Approach" of health promotion is efficacious in accelerating uptake of priority health services such as COVID-19 and routine immunizations. While there is more to be understood about this interesting approach, we recommend the improvement of communication and capacity gaps in Nigeria's primary healthcare system to ensure that promising strategies such as the WFA are adequately implemented at the community and facility levels.

COVID-19 surveillance in Democratic Republic of Congo, Nigeria, Senegal and Uganda: strengths, weaknesses and key Lessons

IntroductionAs part of efforts to rapidly identify and care for individuals with COVID-19, trace and quarantine contacts, and monitor disease trends over time, most African countries implemented interventions to strengthen their existing disease surveillance systems. This research describes the strengths, weaknesses and lessons learnt from the COVID-19 surveillance strategies implemented in four African countries to inform the enhancement of surveillance systems for future epidemics on the continent.MethodsThe four countries namely the Democratic Republic of Congo (DRC), Nigeria, Senegal, and Uganda, were selected based on their variability in COVID-19 response and representation of Francophone and Anglophone countries. A mixed-methods observational study was conducted including desk review and key informant interviews, to document best practices, gaps, and innovations in surveillance at the national, sub-national, health facilities, and community levels, and these learnings were synthesized across the countries.ResultsSurveillance approaches across countries included - case investigation, contact tracing, community-based, laboratory-based sentinel, serological, telephone hotlines, and genomic sequencing surveillance. As the COVID-19 pandemic progressed, the health systems moved from aggressive testing and contact tracing to detect virus and triage individual contacts into quarantine and confirmed cases, isolation and clinical care. Surveillance, including case definitions, changed from contact tracing of all contacts of confirmed cases to only symptomatic contacts and travelers. All countries reported inadequate staffing, staff capacity gaps and lack of full integration of data sources. All four countries under study improved data management and surveillance capacity by training health workers and increasing resources for laboratories, but the disease burden was under-detected. Decentralizing surveillance to enable swifter implementation of targeted public health measures at the subnational level was a challenge. There were also gaps in genomic and postmortem surveillance including community level sero-prevalence studies, as well as digital technologies to provide more timely and accurate surveillance data.ConclusionAll the four countries demonstrated a prompt public health surveillance response and adopted similar approaches to surveillance with some adaptations as the pandemic progresses. There is need for investments to enhance surveillance approaches and systems including decentralizing surveillance to the subnational and community levels, strengthening capabilities for genomic surveillance and use of digital technologies, among others. Investing in health worker capacity, ensuring data quality and availability and improving ability to transmit surveillance data between and across multiple levels of the health care system is also critical. Countries need to take immediate action in strengthening their surveillance systems to better prepare for the next major disease outbreak and pandemic.

A design approach for financial literacy curriculum targeting smallholders in Papua New Guinea

ABSTRACT Agricultural extension plays a vital role in closing the capacity gaps of smallholder farmers throughout low- and middle-income countries, and there is an increasing interest to improve extension outcomes due to its central role in improving livelihood outcomes. Central to this interest is widening the scope of extension content to cover essential agribusiness skills, which, due to the challenges in breaking down this nuanced content into culturally appropriate content and delivery, have been largely absent from agricultural extension. This research details an approach used in Papua New Guinea to develop a series of learner- and problem-centred coursebooks to assist smallholder farmers to overcome the dominant agribusiness challenge facing smallholders throughout the world – accessing finance. The coursebooks were designed from ‘the space between’, an emerging perspective of community membership where deep content knowledge and anthropological insights of the learning culture combine to envision new ways for nuanced content to be culturally placed. The approach detailed in this research can serve as an important reference to other practitioners working to design extension curricula for agribusiness skills within agricultural extension.

World Organization for Animal Health Platform on Animal Welfare for Europe Survey on Veterinary Service Preparedness for Natural Disasters

Introduction:National Veterinary Services of World Organization for Animal Health (WOAH) are responsible for a wide range of activities including animal health, animal welfare and veterinary public health. The WOAH European Region member countries were surveyed to determine and quantify the level of capacity to respond to natural disasters, determine the types of disasters experienced, determine their levels of education and training and identify gaps in capacity and specific needs of Member Countries for disaster response.Method:A web-based Qualtrics survey on Animal Welfare in Natural Disasters was conducted by Lincoln Memorial University in conjunction with the World Organization for Animal Health (OIE) Platform on Animal Welfare for Europe. The 50 question survey was distributed by email link to Member Countries points of contact provide by OIE. The survey was emailed to 53 OIE European Member Countries with reminder emails to complete. Survey results were compiled and tabulated. Only aggregate data is published and presented.Results:Forty-nine countries responded to the survey for a 92% completion rate. Floods, earthquakes and fire were the three most commonly encountered disasters. Fifty-two percent indicated they incorporated animal welfare into their disaster planning. Thirty-one percent indicated they had no or limited legal authority to manage animal emergencies in natural disasters. The species covered in the national response plan ranged from laboratory animals at 17% to livestock at 48%. Eighty-two percent had no or limited standard operating procedures and 73% had no training to respond to animal welfare in disasters. Budgets, trained personnel, equipment/supplies and legal authority were the most frequently identified gapsConclusion:The survey demonstrated there is a wide range of European Member Countries capacity to respond to animal welfare in natural disasters. This provides the baseline for the OIE Platform for Animal Welfare Europe to provide focused and actionable support to Member Countries

Assessing Institutional Capacity of Business Associations in Tanzania

ABSTRACT This article explores the institutional characteristics and capacity of the BAs to effectively perform the representative and service delivery functions for their members. Based on a qualitative study of BAs in Tanzania, it is evident that they were inclined to deliver the influence function and compromised the service function. The main institutional capacity gaps found in BAs were inadequate governance and accountability, inadequate management and staff, weak membership base, lack of membership and communication strategy, and inadequate office facilities and information technology platforms. Although they had partnerships and networks with the government, development partners and other associations, their sustainability was not guaranteed mainly because of overdependence on donor funding and insufficient membership subscriptions. The article advances the collective action theory and corporatism view by proposing a strategic bundling approach that advocates integrating the service, influence and strategy logics to enhance sustainability of BAs.

Foreign direct investment and relative capacity: Theory and evidence

AbstractThis paper builds a bilateral FDI‐output model to study intermediary roles played by the relative differences in human capital and technology in triggering the gross‐output‐enhancing effect of inward foreign direct investment (FDI). Our model develops several testable hypotheses to assess how these intermediary factors—the differences between leader and follower countries' capabilities—determine the technology transfer and shorten the gross output gap between the frontier and follower countries. In our empirical work, we employ country‐level panel data that contain 67 countries from 1977 to 2013 and find that the differences in human capital and technology, which take into account the gap in capacity between the leader and follower countries, are the determinants that trigger the gross‐output‐enhancing effect of FDI. Our results are robust to the non‐linear effects, cyclical fluctuations, endogeneity of FDI per se, and the variation of the host countries' institutions and inflation.

Data gathering and utilization: humanitarian targeting and ethical issues in northeastern Nigeria

IntroductionThere are lapses in Nigeria’s data ecosystems with the consequences of imprecise and inaccurate data on humanitarian crises limiting accurate interventions. Therefore, we examined the data targeting processes in the humanitarian sector of Northeast Nigeria and the ethical concerns that arise when such data is collected and used to advance understanding and improve humanitarian protection systems.MethodsThe fieldwork was done in two phases in Maiduguri Borno, North-East Nigeria, between 2021 and 2022. This period was selected because it was the climax of IDP camps in the Northeastern part of the country. Maiduguri was selected for the study because it is the capital of Borno state which is the epicenter of insurgency and internal displacements in Nigeria. Hence, a lot of the most vibrant IDP camps in Nigeria were in Maiduguri for care and security reasons. Fifty in-depth interviews were conducted among the displaced persons across five camps. We also interviewed twenty stakeholders and practitioners working with IDPs to understand Nigeria’s data-based humanitarian contexts of internal displacement. The interviews were tape-recorded and transcribed verbatim by a language expert. The data were coded, and content analyzed to provide context and explore significant operational and ethical issues in data-driven humanitarian protection.ResultsThere are discrepancies in the definition of vulnerability in data gathering, putting into question how targeting is carried out to identify vulnerable people and its implications for exclusion. Different data banks and reliability issues across institutions and actors make room for a multiplicity of data and problematic synergy relative to data and ethics. Inconsistent ethical systems guide data gathering and utilization in IDP camps; for instance, there are ineffective norms of recording and securing informed consent during data gathering. States, partners, and IDP camps confront debilitating capacity gaps and equipment deficits that make updated data gathering, storing, retrieval, and utilization. Paper and digital data storage processes were often used with restricted access to only a few key stakeholders. There is vast data expropriation without standard recourse to justice and beneficence as ethical procedures in the humanitarian data space of northeastern Nigeria as a microcosm of Sub-Saharan African realities.ConclusionThere are enormous implications for effective and efficient targeting processes and outcomes, strategic inclusion, and ethical practices in conflict management, humanitarian interventions, and internal displacement in sub-Saharan Africa.

Stakeholders’ perspectives on the development of an Africa-focused postgraduate diploma to address public mental health training needs in Africa: a qualitative study

BackgroundDespite the significant contribution of mental health conditions to the burden of disease, there is insufficient evidence from Africa to inform policy, planning and service delivery. Thus, there is a need for mental health research capacity building, led by African public mental health researchers and practitioners, to drive local research priorities. The aim of African mental health Researchers Inspired and Equipped (ARISE) was to develop a one-year postgraduate diploma (PGDip) in public mental health to address the current gaps in public mental health training.MethodsThirty-six individual interviews were conducted online with three groups of participants: course convenors of related PGDips in South Africa, course convenors of international public mental health degree programmes and stakeholders active in public mental health in Africa. The interviewers elicited information regarding: programme delivery, training needs in African public mental health, and experiences of facilitators, barriers and solutions to successful implementation. The transcribed interviews were analysed by two coders using thematic analysis.ResultsParticipants found the Africa-focused PGDip programme acceptable with the potential to address public mental health research and operational capacity gaps in Africa. Participants provided several recommendations for the PGDip, including that: (i) the programme be guided by the principles of human rights, social justice, diversity and inclusivity; (ii) the content reflect African public mental health needs; (iii) PGDip faculty be skilled in teaching and developing material for online courses and (iv) the PGDip be designed as a fully online or blended learning programme in collaboration with learning designers.ConclusionsThe study findings provided valuable insight into how to communicate key principles and skills suited to the rapidly developing public mental health field while keeping pace with changes in higher education. The information elicited has informed curriculum design, implementation and quality improvement strategies for the new postgraduate public mental health programme.

The feasibility analysis of integrating community-based health insurance schemes into the national health insurance scheme in Uganda.

Uganda has a draft National Health Insurance Bill for the establishment of a National Health Insurance Scheme (NHIS). The proposed health insurance scheme is to pool resources, where the rich will subsidize the treatment of the poor, the healthy will subsidize the treatment of the sick, and the young will subsidize the treatment of the elderly. However, there is still a lack of evidence on how the existing community-based health insurance schemes (CBHIS) can fit within the proposed national scheme. Thus, this study aimed at determining the feasibility of integrating the existing community-based health financing schemes into the proposed National Health Insurance Scheme. In this study, we utilized a multiple-case study design involving mixed methods. The cases (i.e., units of analysis) were defined as the operations, functionality, and sustainability of the three typologies of community-based insurance schemes: provider-managed, community-managed, and third party-managed. The study combined various data collection methods, including interviews, survey desk review of documents, observation, and archives. The CBHIS in Uganda are fragmented with limited coverage. Only 28 schemes existed, which covered a total of 155,057 beneficiaries with an average of 5,538 per scheme. The CBHIS existed in 33 out of 146 districts in Uganda. The average contribution per capita was estimated at Uganda Shillings (UGX) 75,215 = equivalent to United States Dollar (USD) 20.3, accounting for 37% of the national total health expenditure per capita UGX 51.00 = at 2016 prices. Membership was open to everyone irrespective of socio-demographic status. The schemes had inadequate capacity for management, strategic planning, and finances and lacked reserves and reinsurance. The CBHIS structures included promoters, the scheme core, and the community grass-root structures. The results demonstrate the possibility and provide a pathway to integrating CBHIS into the proposed NHIS. We however recommend implementation in a phased manner including first providing technical assistance to the existing CBHIS at the district level to address the critical capacity gaps. This would be followed by integrating all three elements of CBHIS structures. The last phase would then involve establishing a single fund for both the formal and informal sectors managed at the national level.

Model ensembles of ecosystem services fill global certainty and capacity gaps

Sustaining ecosystem services (ES) critical to human well-being is hindered by many practitioners lacking access to ES models ("the capacity gap") or knowledge of the accuracy of available models ("the certainty gap"), especially in the world's poorer regions. We developed ensembles of multiple models at an unprecedented global scale for five ES of high policy relevance. Ensembles were 2 to 14% more accurate than individual models. Ensemble accuracy was not correlated with proxies for research capacity, indicating that accuracy is distributed equitably across the globe and that countries less able to research ES suffer no accuracy penalty. By making these ES ensembles and associated accuracy estimates freely available, we provide globally consistent ES information that can support policy and decision-making in regions with low data availability or low capacity for implementing complex ES models. Thus, we hope to reduce the capacity and certainty gaps impeding local- to global-scale movement toward ES sustainability.

Responsibilization dynamics in naṭural resource management: Insights from two protected areas in Cameroon

The theoretical construct on responsiblization is gaining grounds as a novel analytical lens in the field of governmentality – an approach to the study of strategies for shaping people’s conduct and decisions in line with specific objectives. However, not enough scientific evidence exists on the mechanisms through which protected area communities are rendered responsible by international conservation agencies, and the (un)intended outcomes linked to this process. Through a synthesis of 14 project intervention reports in two Protected Areas (PAs) in Cameroon – the Bakossi National Park (BNP) and the Campo Ma’an National Park (CMNP), complemented by expert interviews (N = 10), this paper: (i) explores the mechanisms employed by conservation responsibilizers in the two PAs, and (ii) examines the (un)intended protected area management outcomes. The thematic and directed content analysis led us to three key findings: Firstly, while interventions in the CMNP are embedded in the ecotourism development model, the case of the BNP centres on the Green Business and Sustainable Oil Palm Production models. This validates the claim that responsibilization and targeted interventions are intertwined and discursively constructed to shape the conduct of local people towards specific goals. Secondly, responsibilization in both cases manifest through poor institutionalization and fragmented capacity building interventions; this undermines the importance of responsive governance. Third, both cases established the incongruence between the capabilities of responsibilizees and the targets set by responsibilizers. This paper provides context-specific evidence to edify the on-going theoretical construct on responsiblization and underscores the need for studies to identify pathways to overcome the capacity gaps of responsibilizees. Policy wise, there is an urgent need to defragment the interventions by responsibilizers to assure long-term strategic interventions.

A population-based cross-sectional study on the situation of cervical cancer screening in Liaoning, China

BackgroundCervical cancer (CC) screening is currently recognized as an effective intervention for CC. Previous studies found that the proportion of screening was low in China, especially in Liaoning. Therefore, we performed a population-based cross-sectional survey to investigate the situation of cervical cancer screening and analyze their related factors for providing a decision-making basis for sustainable and effective development of cervical cancer screening.MethodsThis population-based cross-sectional study involved aged 30 to 69 years in nine counties/districts in Liaoning from 2018 to 2019. Data were collected using the quantitative data collection methods, and analyzed in SPSS version 22.0.ResultsOverall, only 22.37% of 5334 respondents reported having ever been screened for cervical cancer in past 3 years, and 38.41% of respondents reported having the willingness for cervical cancer screening in next 3 years. In the rate of CC screening, multilevel analysis indicated that age, marital status, education level, type of occupation, medical insurance, family income, place of residence and regional economic level had a significant impact on proportion of screening. In the rate of CC screening willingness, multilevel analysis indicated that age, family income, health status, place of residence, regional economic level and CC screening still had a significant impact, but marital status, education level and medical insurance type had no significant impact. There was no significant difference in marital status, education level and medical insurance type after the factors of CC screening were added in the model.ConclusionOur study found both proportion of screening and willingness were at a low level, and age, economic and regional factors were the main factors for implementation of CC screening in China. In the future, targeted policies should be formulated according to the characteristics of different groups of people, and reduce the gap in the current health service capacity between different regions.

Interregional and intersectoral interaction of digital economy in China

With the continuous advancement of the integration of the world’s digital economy, the economic development of various regions has become increasingly interdependent. However, the interregional interactions of digital industries have yet to be further elucidated. Here, based on the Multi-Regional Input-Output model, we take China, for example, and analyze the impact of digital industries on the economy from the industrial and regional. At the industry level, we discuss the economic spillover relationship between the digital industry and the three traditional industries, and analyzes the spatial and temporal differentiation in the inter-industry spillover status of China’s 30 provinces; at the regional level, we discuss the digital industrial economic spillover links and spillover states. The results show that: 1) The self-generating ability within the digital industry sector is the most significant factor influencing the industrial growth of China’s digital economy, followed by the interrelated effect between industry sectors, while the inter-industry feedback effect has a weak impact on the economic system. 2) There is a clear gap in the economic spillover capacity of the digital industry in 30 provinces, and the overall performance is decreasing in the eastern, central and western regions. 3) The intra-regional multiplier effect of digital industry shows a slowly decreasing trend, and the intra-regional digital economic spillover-feedback effect shows a growing trend. At the same time, the inter-regional digital economy interaction tends to decay in distance, indicating that regional accessibility has a significant impact on the inter-regional spillover effect.

Surgical Capacity in Public and Private Health Facilities After a Five-Year Strategic Plan Implementation in Ethiopia: A Cross Sectional Study.

Surgical capacity is critical for ensuring optimum access to safe, affordable, and timely emergency and essential surgical care (EESC) in low- and middle-income countries (LMICs) like Ethiopia. A five-year strategic plan has been implemented during 2016-2020 in Ethiopia to improve surgical capacity. This study aims to evaluate the impact of the five-year strategy in surgical capacity in the country. A cross sectional survey was conducted in 172 health care facilities in Ethiopia from December 30, 2020, to June 10, 2021. Descriptive statistical analysis was done using STATA statistical software Version 15. A total of 2,312 surgical workforces were available and, the surgical workforce to population ratio ranged from 1.13:100,000 for public specialized hospitals to 10.8:100,000 for health centre operation room (OR) blocks. Surgical bed to population ratio was 0.03:1000 population, and the average numbers of OR tables per facility were 34. Nearly 25% and 10% of OR tables were not functional in public primary hospitals and private hospitals, respectively. The average surgical volume to population ratio was 189:100,000. Following the implementation of surgical care strategy, the surgical workforce density has increased. However, the study revealed that there is still a huge unmet gap in surgical capacity. The improvement in surgical volume is very low compared to the increment in the surgical workforce density. In addition to the investment being made to build surgical capacity, emphasis needs to be put on surgical system design and strengthening surgical system efficiency.