High Level Of Commitment Research Articles

Preliminary Workforce Outcomes of an Urban Longitudinal Integrated Clerkship.

The authors examined whether students participating in an urban longitudinal integrated clerkship (LIC) with a curriculum focused on care for underserved populations have a sustained commitment to urban underserved care through residency training and into practice. This mixed-methods study collected data from medical student application essays to the Denver Health LIC (DH-LIC), end-of-course surveys, residency match outcomes, and postgraduation surveys annually for academic years 2014 to 2022. The authors analyzed students' responses to the surveys on interest in working with underserved patients, understanding the rewards and challenges of working in safety net institutions, working in the community to improve health, and working at DH. The authors qualitatively coded the 70 application essays of all selected students using summative content analysis. Seventy DH-LIC students were compared with 1,450 medical students between 2014 and 2022. Qualitative analysis of LIC application essays revealed 3 themes: interest in working with underserved populations, work experience with underserved populations, and personal experience with medical vulnerability. Fifty-seven DH-LIC participants (81.4%) expressed high levels of career interest in working with underserved populations, 45 (64.3%) had high levels of work experience with underserved populations, and 18 (25.7%) expressed high levels of personal experience. Graduates of the DH-LIC program demonstrated a high degree of continuing interest in practicing in urban underserved settings throughout medical school and postgraduate training. Ten graduates (71.4%) in practice work in urban underserved settings. Participants reported a high or very high level of interest and commitment to working with underserved populations (96.7%-100%), understanding the safety net health care system (91.7%-98.6%), and working in communities (95.0%-100%) at all time points studied. Early data indicate high rates of graduates working in urban underserved settings. These preliminary outcomes suggest the LIC may support the development of a committed workforce for urban underserved communities.

The Tunisian experience of participatory health governance: the Societal Dialogue for Health (a qualitative study)

BackgroundTunisia has been engaged in the Societal Dialogue (SD) for Health process since 2012, a participatory health governance process aimed at bringing in people’s voice into health policy-making. Its first success was the recently released National Health Policy 2030. This paper aims to document the SD process and to bring out the lessons learned to inspire other countries.MethodsThis study was based essentially on a qualitative analysis of semi-structured interviews with citizen jury members and health experts that took place from May to September 2018. The qualitative analysis adopted an inductive-deductive approach according to a cross-matrix between the themes of the interview of the two groups of interviewees.ResultsThe qualitative analysis of the data highlighted that the Societal Dialogue created a health democracy dynamic with inclusive dialogue spaces for the population, communities, and civil society to participate in health system design. It constituted a multi-actor and multidisciplinary coordination platform to increase consensus building among actors. Initial government support and high levels of volunteer commitment allowed the process to achieve a certain level of sustainability. However, this process faced and still faces many challenges such as overreliance on volunteers; a crisis of trust; political instability and the lack of an effective communication strategy. These challenges negatively influence the policy uptake of recommendations made by the Societal Dialogue for Health.ConclusionThe Tunisian societal dialogue experience highlights both the successes and challenges of a structured participatory platform, as well as the effort and perseverance it takes to keep such a process functional and relevant. A key lesson from this study is that this model of participatory health governance eventually reaches a stage where population, community, and civil society participation needs to be more institutionalized within the government routine so that it can credibly feed into health policy review processes and inform decision-makers on a regular basis.

In-between duty and hope for recognition, the experience of physiotherapists working in a university hospital during the COVID-19 first wave in Switzerland: a qualitative study based on focus groups.

Learning more about the physiotherapists' experience, perceived role and perception of events during the COVID-19 crisis, as well as their recovery and projection into the post-crisis future, may be useful to inform stakeholders about the impact of the crisis. The objective of this study was to investigate the experience of physiotherapists working in a university hospital in Switzerland during the 1st wave of the COVID-19 crisis, more specifically their subjective experience, professional involvement, perception of management and perceived implications for the future. This interpretative qualitative study investigated the subjective experience of a purposeful sample of 12 physiotherapists using two 2h semi-directive focus group interviews conducted by a physiotherapist in June 2020. Data were recorded, transcribed, and analysed using a thematic analysis approach. The report was approved by participants and the study was audited by a health anthropologist. The most impressive points were the unprecedented nature of the crisis, the health threat, the hospital's capacity to reorganise on a large scale and the solidarity between colleagues. Participants expressed a high level of commitment to their role despite the potentially serious repercussions at an individual level. Pride and stress coexisted for those directly involved in the crisis, while those working in a reduced activity department felt anxious and idle. The need for immediacy in decision-making and action led to a flattening of hierarchies and an increase of uncertainties. Communication management was seen as the main area for improvement. Physiotherapists hoped that their involvement would improve recognition of the profession but feared that working conditions would deteriorate after the crisis. The physiotherapists expressed high dedication to their profession and pride to be part of the "war effort" during the crisis. The stress level was partly tempered by the solidarity amongst health professionals and distraction by engaging in action. Despite the mental load, this situation was also seen as an opportunity to grow at a personal and professional level. The healthcare system capacity having not been exceeded in Switzerland, less distress related to death and powerlessness were expressed than in other studies investigating healthcare professionals' experience of the COVID-19 crisis.

Teachers’ Perceived Barriers to Technology Integration during Online Learning

The COVID-19 pandemic has had a significant impact on education, forcing schools to close and move to remote learning. Prospective math teachers are particularly challenged by technology integration. This is because mathematics is a subject that is often taught in a traditional, lecture-based format. It can be challenging for prospective math teachers to find effective ways to use technology online to demonstrate teaching and learning mathematics. In this study, the researchers investigated the perceived barriers to technology integration experienced by prospective math teachers during emergency remote learning. This study used a descriptive correlational survey design given to fifty-one (51) respondents enrolled at Surigao del Norte State University (SNSU). Data analysis was performed using SPSS. Moreover, the researchers utilized descriptive statistics such as frequency distributions and measures of central tendency, and non-parametric tests such as Fisher’s exact tests to treat the data. The results showed that the respondents demonstrated moderately positive beliefs regarding the appropriateness of curriculum content for the technology used and the complementarity of technology and content in the course. Second, the respondents generally had a high level of commitment to attending synchronous online learning sessions. Third, gender, age, and income class do not play a significant role in determining respondents' perceived barriers to technology integration. Lastly, there was no significant relationship between respondents' perceived barriers to technology integration and their self-reported attendance (p = 0.099). However, the p-value was close to the conventional threshold for statistical significance (p 0.05), suggesting that there may be a weak association between these two variables.

Dietary intervention in gestational diabetes: a qualitative study of the acceptability and feasibility of a novel whole-diet intervention in healthcare professionals.

Gestational diabetes is treated with medical nutrition therapy, delivered by healthcare professionals; however, the optimal diet for affected women is unknown. Randomised controlled trials, such as the DiGest (Dietary Intervention in Gestational Diabetes) trial, will address this knowledge gap, but the acceptability of whole-diet interventions in pregnancy is unclear. Whole-diet approaches reduce bias but require high levels of participant commitment and long intervention periods to generate meaningful clinical outcomes. We aimed to assess healthcare professionals' views on the acceptability of the DiGest dietbox intervention for women with gestational diabetes and to identify any barriers to adherence which could be addressed to support good recruitment and retention to the DiGest trial. Female healthcare professionals (n 16) were randomly allocated to receive a DiGest dietbox containing 1200 or 2000 kcal/d including at least one weeks' food. A semi-structured interview was conducted to explore participants' experience of the intervention. Interviews were audio-recorded, transcribed verbatim and analysed thematically using NVivo software. Based on the findings of qualitative interviews, modifications were made to the dietboxes. Participants found the dietboxes convenient and enjoyed the variety and taste of the meals. Factors which facilitated adherence included participants having a good understanding of study aims and sufficient organisational skills to facilitate weekly meal planning in advance. Barriers to adherence included peer pressure during social occasions and feelings of deprivation or hunger (affecting both standard and reduced calorie groups). Healthcare professionals considered random allocation to a whole-diet replacement intervention to be acceptable and feasible in a clinical environment and offered benefits to participants including convenience.

Gratitude to God and relational virtues

ABSTRACT Despite the flourishing psychological literature on gratitude that has accumulated over the past several decades, researchers have only recently started to programmatically study Gratitude to God (GTG). Given that gratitude has consistently demonstrated positive relationships with relational virtues, the current study examined the degree to which GTG is associated with forgiveness, relational humility, and altruism, above and beyond domain-general gratitude and religious commitment. Participants (N = 582 undergraduates) rated themselves on measures of religious commitment, domain-general gratitude, GTG, forgiveness, relational humility, and altruism. GTG positively predicted forgiveness over and above domain-general gratitude. GTG positively predicted relational humility over and above domain-general gratitude in participants with high levels of religious commitment. For altruism, neither GTG nor domain-general gratitude was a significant predictor, but religious commitment was a positive predictor. We conclude with a discussion of methodological limitations and suggestions for future research.

Extracorporeal cardiopulmonary resuscitation for refractory OHCA: lessons from three randomized controlled trials-the trialists' view.

Extracorporeal cardiopulmonary resuscitation is a promising treatment for refractory out-of-hospital cardiac arrest. Three recent randomized trials (ARREST trial, Prague OHCA study, and INCEPTION trial) that addressed the clinical benefit of extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest yielded seemingly diverging results. The evidence for extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest, derived from three recent randomized controlled trials, is not contradictory but rather complementary. Excellent results can be achieved with a very high level of dedication, provided that strict selection criteria are applied. However, pragmatic implementation of extracorporeal cardiopulmonary resuscitation does not necessarily lead to improved outcome of refractory out-of-hospital cardiac arrest. Centres that are performing extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest or aspire to do so should critically evaluate whether they are able to meet the pre-requisites that are needed to conduct an effective extracorporeal cardiopulmonary resuscitation programme.

Connecting Neuroscience Principles and Education People Profile of Culture and Leadership: A Labour Market Approach

Neurosciences, based on the founding idea of “neuroplasticity”, have helped to clarify the issue of initial (and integral) training of individuals based on the balanced structuring of the respective brain system. From what has been said, we would say that initial parental education, in times of an increasingly urban life (where parents delegate the education of children to school) does not seem to facilitate this balance of integrated development. It is important to discuss the connection between the neurosciences and education, concluding that this joint approach would be essential to guide quality levels and the researchers admit that the applicability of neuroscience research, for the improvement of pedagogy, has been, paradoxically, very limited. In general, we can define organizational culture as a set of beliefs, values and norms that influence the climate of a company, aligning employee behaviour and the strategic way in which the company positions itself in the market. Organizational culture is the essence of an organization. The supportive culture or clan culture presents a pleasant work environment, with a united organization that endures through loyalty and traditions, where interpersonal relationships are created, success is defended by teamwork, participation and consensus between employees and the organization. Leaders are considered mentors and there is a high level of commitment. In accordance with the updated works of Miranda, which seeks to reconcile the previous author and the OCAI model of R. Quinn and collaborators, a questionnaire was constructed, with twenty-eight questions, involving as many others adjectives that characterize a cognitive profile. In a first approximation, and taking only the descriptive statistics data into account, and taking only the sample data, there is a striking curiosity: the respondent students consider that the school made a visible and verifiable effort to correct the dominant profile. limbic pointing to a right cortical profile: intuition, entrepreneurship, vision.

Care workers’ sense of responsibility, working conditions, and the quality of care in South Korea

As countries like South Korea expand their paid care services, ensuring quality care has become critical. Since care work involves significant emotional labor, a worker’s sense of responsibility for the care recipient's well-being affects the quality of care delivered. In this study, we explore this particular determinant of quality care that has been underexplored to better understand its nature. However, a worker's sense of responsibility or commitment level is not static and varies depending on various factors including working conditions. Using 2018 Korean childcare and eldercare survey data, we empirically examine the relationship between a worker's commitment levels and working conditions by conducting Tobit and generalized maximum entropy (GME) analyses. Results indicate that training, shorter commutes, predictable schedules, and easy interactions with the care recipient’s family are associated with higher levels of commitment. Our findings highlight the importance of supportive working conditions in promoting quality care.

The influence of work experience and communication on secretary performance in five star hotels in Bali

The purpose of this study was to examine the impact of work experience and communication on the performance of secretaries at Bali's Five-Star Hotels. This study was quantitative in nature. In this study, the population consisted of 98 secretaries from 50 five-star hotels in Bali that had been registered since 2021. This study's sample consisted of 98 Executive Secretaries and Departmental Secretaries selected using the side saturation or “Sampling Jenuh” technique. The data used were primary data derived from respondents' responses, which were then analyzed using multiple linear regression analysis techniques. The strategy for collecting data consisted of a Google Form questionnaire. In this study, it was found that 1) work experience has a positive and substantial influence on secretary performance, 2) communication has a positive and significant influence on secretary performance, and 3) both work experience and communication have a positive and significant influence on secretary performance. As for the guidance that may be given to Five Star Hotels in Bali, particularly the secretarial division, it is suggested that the secretary's excellent performance must be supported by a high level of commitment to performing responsibilities in line with the job description.

Условия лояльности военно-служилой и торгово-промышленной администрации по отношению к центральной власти

The article deals with investigation into the conditions of loyalty of commercial as well as industrial and military-service administration to the central power. The analysis is based on comparing cases which demonstrate different levels of loyalty. A relatively high level of loyalty was shown by the “power” of the Stroganovs (merchants), including both the merchants and the population of their fiefdoms in the 16th–17th centuries, whereas the Volga, Don and Yaik Cossacks (16th–18th centuries) demonstrated a relatively low level of loyalty. It was revealed that the level of loyalty of military and commercial administration in Russia in the 16th–18th centuries was affected by processes of different social scale. The defeat of Novgorod by Moscow and the termination of the eхpeditions of Novgorod pirates named Ushkuyniks both in the North-East (Northern Urals) and in the South-East led to taking this niche in the Volga basin by the Cossacks that continued extracting revenues through the use of violence. The Cossacks’ growing dependence on the Tsar’s pay, combined with their skills and means of violence, caused revolts and rebellions in the 17th and 18th centuries that can be considered as a form of bargaining with the authorities for symbolic recognition and material supplementation. In the northern Ural, geopolitical changes resulted in introducing a new strategy in exploring the region – industrial (salt production) and agricultural colonization with tax exemptions and socio-economic patronage for the Stroganovs’ kholops (serfs) under conditions of underdeveloped state institutions, which resulted in relatively low levels of ethno-social conflicts in the region without the need to maintain a strong enforcement apparatus, which could become a resource for disloyalty to central power. Favorable conditions for the salt trade in the domestic Russian market (high price, limited competition) further strengthened the loyalty of salt producers.

Effect of Emotional Intelligence and Organizational Commitment on Service Quality Mediated by Organizational Citizenship Behaviour

This study aims to determine the effect of emotional intelligence and organizational commitment on service quality with organizational citizenship behaviour as a mediation variable. This study is located on BPJS Kesehatan KC Pekalongan, with a total population amounted 75 employees, and the sample is about 40 employees. The sampling technique in this study uses judgment sampling. The analysis technique used path analysis with SPSS 25 as a hypothesis testing tool. The study found that emotional intelligence significantly affects organizational citizenship behaviour. However, organizational commitment hasn’t a significant effect on organizational citizenship behaviour because employees who have a high level of organizational commitment do not always mean that these employees also exhibit OCB behavior. Emotional intelligence, organizational commitment, and organizational citizenship behaviour significantly affect service quality.

Work Motivation, Work Commitment and Performance of Public School Teachers: Basis for an Intervention Program

This descriptive correlational study determined the level of work motivation, work commitment, and performance of Public School Teachers in the Division of Passi City as basis for an Intervention Program. The participants of the study were the 226 public school teachers in the Division of Passi City, Iloilo. Data were gathered using the Work Motivation Questionnaire and the Organizational Commitment Questionnaire and were statistically analyzed using the mean, t-test, ANOVA and Pearson’s r set at 0.05 alpha level. Data with significant findings were further subjected to Scheffe test. Findings of the study showed that majority of the teachers were female who earned Masters units in teaching and have been teaching for more than a decade. Teachers have high level of work motivation in terms of need for achievement, need for power, and need for affiliation and high level of work commitment in terms of loyalty towards work, personal commitment, and security of tenure. The teachers have very satisfactory level of performance as reflected in their IPCR. No significant difference existed in the level of work motivation and work commitment of teachers in terms of age, sex, highest educational attainment and length of service. Also, no significant difference existed in the performance of teachers when classified as to districts. Significant differences occurred in the teacher’s level of work motivation and work commitment when classified according to different dimensions. No significant relationship existed between the work motivation and performance of teachers as well as their work commitment and performance while a significant relationship occurred in the level of work motivation and work commitment. The behavior of the students is the most common problem encountered by the teachers. The organizational development program is recommended to further motivate and enhance the commitment and performance of teachers.

The Cultural Self-Construals and the Romantic Relationship Experiences of Turkish Young Adults

ABSTRACT The capacity to form and maintain committed romantic relationships is a key aspect of young adulthood. Yet, little is known about the role of cultural factors, in particular cultural self-construal, and their links to romantic relationships. The goal of the current study was to examine the cultural concepts of autonomous and related self-construal as defined by Kağıtçıbaşı’s Family Change Theory and their association with the quality and satisfaction of non-marital romantic relationships. The sample included 621 Turkish young adults (74.4% female, 83.7% undergraduate students, ages 18–25) who were currently in an exclusive and heterosexual romantic relationship for at least three months. Participants completed informed consent and a 15-minute online survey through Qualtrics. Hierarchical linear regression analysis indicated that autonomy self-construal was positively associated with relationship quality and satisfaction, while relatedness self-construal was linked to relationship quality but not satisfaction. Additionally, high levels of commitment significantly predicted better relationship outcomes. The findings suggest a need to explore cultural self-construal and relationship outcomes across cultures.

Variations of work engagement and psychological distress based on three working modalities during the COVID-19 pandemic.

With the onset of the COVID-19 pandemic, the rapid spread of the SARS-CoV-2 virus became a global health threat affecting people's mental and physical health, as well as working conditions and modalities. The reorganization of the work environment also affected work engagement and psychological distress levels. This manuscript assesses how work engagement and distress vary according to gender and age across three working modalities. We used a voluntary response sampling strategy to collect data on psychological distress and work engagement between August 2021 and January 2022. Results are from 542 people working in Ecuador during the COVID-19 pandemic. Overall, participants experienced psychological distress; women and younger participants presented higher psychological distress. Regarding engagement, the sample showed average levels of total engagement, average levels of vigor, and high levels of dedication and absorption. Men presented higher levels of total work engagement and vigor. Psychological distress was significantly and negatively correlated with total work engagement scores and its three factors. There were no differences in work engagement according to the different modalities. However, teleworkers reported significantly higher levels of psychological distress than hybrid workers. Findings are discussed considering ideas for decision-makers to explore the benefits of flexible working practices.

40 Yaş Üstü Kadınların Dini Bağlılık Düzeylerinin Kozmetik Cerrahiye Bakış Açısına Etkisi

Objective: With ageing, physical attractiveness decreases, and weight gain and wrinkles increase, which leads to an increase in the tendency towards plastic surgery. However, the level of religious attitude can influence this tendency. This study was conducted to determine the effect of the religious commitment level of women over 40 years on their perspectives on cosmetic surgery. Materials and Methods: This descriptive and cross-sectional study was conducted with 452 women aged 40-65 who visited a hospital's outpatient clinic in Türkiye.. Results: It was determined that 61.5% of the women who participated in the study had a high religious commitment. The women with high levels of religious commitment were found to have a lower desire for cosmetic surgery (p<0.001). Conclusion: The cosmetic surgery perspective was found to be adversely affected by the frequency of devotion and worship practices.

Factors determining the implementation of green practices in airport management. The case study of Polish airports

The main objective of this article was to assess the significance of factors that determine pro-environmental orientation in airport management. A survey conducted among Polish airports showed that the assessment of the factor's significance depended not only on air traffic volume but also on the degree of airports' commitment to green practices. For airports with a high level of commitment, the most important barrier was the cost. In the case of airports with a medium level of commitment, the most significant barriers were unawareness of the potential benefits, and a low priority assigned to green practices in the airport's strategic goals. For airports with a low degree of commitment, in addition to the costs, the most important barrier was the conviction that their impact on the environment was low. The most important stimulants were the same for airports with medium and high levels of pro-environmental commitment: good financial condition, pro-environmental orientation of airport authorities, and political pressure. For the airports with a low degree of commitment, growth rates of passenger traffic were the most important stimulant. All the analyzed Polish airports saw benefits primarily in the possibility of identifying, monitoring, and reducing their negative impacts on the environment (meeting the legal and political requirements), and increasing the environmental awareness of the airport authorities and employees. In terms of managerial implications, our research has demonstrated that there is a strong need to provide expert assistance to airport authorities in the field of environmental management. The objectives of European Union policy are among the most ambitious and rigorous in the world. European airports committed to net zero carbon emissions under their control by 2050 or even earlier, and a few of them have already achieved Net Zero. Nevertheless, Polish airports undertake pro-environmental measures to a very limited extent, despite the dynamic high growth of passenger traffic, and despite being subjected to the pressure of the same European policy. In this context, support from the EU policy and domestic policy is of key importance.

THE MEDIATING EFFECT OF ORGANIZATIONAL COMMITMENT ON THE RELATIONSHIP BETWEEN WORKPLACE RESILIENCE AND TEACHER PROFESSIONAL IDENTITY

The purpose of this study was to determine the mediating effect of organizational commitment on the relationship between workplace resilience and teacher professional identity. Utilizing quantitative, non-experimental design via correlational technique, data were obtained from 300 respondents who are public elementary school teachers of the three national high schools in the province of Davao Del Sur. The researcher utilized a stratified random sampling technique and an online survey mode of data collection. The researcher also utilized the statistical tools mean, Pearson r, and Medgraph using Sobel z-test. From the results of the study, it was found out that there is a very high level of mean score for workplace resilience, a very high level of mean score for teacher professional identity and a high level of organizational commitment. Also, results revealed that there is a significant relationship between workplace resilience and teacher professional identity, a significant relationship between workplace resilience and organizational commitment and a significant relationship between organizational commitment and teacher professional identity. Further, it was revealed that there was full mediation on the effect of organizational commitment on the relationship between workplace resilience and teacher professional identity.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0005/a.php" alt="Hit counter" /></p>

Behavioral Reactions to Job Insecurity Climate Perceptions: Exit, Voice, Loyalty, and Neglect.

Past work has extensively documented that job insecurity predicts various work- and health-related outcomes. However, limited research has focused on the potential consequences of perceived job insecurity climate. Our objective was to investigate how the psychological climate about losing a job and valuable job features (quantitative and qualitative job insecurity climate, respectively) relate to employees' exit, voice, loyalty, and neglect behaviors, and whether such climate perceptions explain additional variance in these behaviors over individual job insecurity. Data were collected through an online survey using a convenience sample of employees working in different organizations in Türkiye (N = 245). Hierarchical multiple regression analyses showed that quantitative job insecurity climate was associated with higher levels of loyalty and neglect, while qualitative job insecurity climate was related to higher levels of exit and lower levels of loyalty. Importantly, job insecurity climate explained additional variance over individual job insecurity in exit and loyalty. Our findings underscore the importance of addressing job insecurity in a broader context regarding one's situation and the psychological collective climate. This study contributes to addressing the knowledge gap concerning job insecurity climate, an emerging construct in the organizational behavior literature, and its incremental impact beyond individual job insecurity. The foremost implication is that organizations need to pay attention to the evolving climate perceptions about the future of jobs in the work environment, because such perceptions are related to critical employee behaviors.

From External to Local: Opportunities and Lessons Learned from Transitioning COMSA-Mozambique.

Donor transitions, where externally funded programs transfer to country ownership and management, are increasingly common. The Countrywide Mortality Surveillance for Action - Mozambique (COMSA) project established a nationwide surveillance system capturing vital events at the community level with funding from the Bill and Melinda Gates Foundation. COMSA was implemented in partnership between Johns Hopkins University (a U.S.-based academic institution) and the Instituto Nacional de Saúde (National Institute for Health) and Instituto Nacional de Estatística (National Institute for Statistics), two Mozambican public institutions. Midway through the project, the Gates Foundation directed COMSA's partners to develop and implement a transition plan that ensured COMSA's activities could be institutionalized after Gates Foundation funding ended. Here we describe the process and activities that COMSA underwent for transition planning, including stakeholder engagement and advocacy, securing financial commitments, documenting operational activities, capacity building, and supporting strategic planning. Facilitators included a project model that already embedded significant implementation and management responsibility with local agencies, high-level commitment to COMSA's activities from local stakeholders, establishing dedicated personnel and budget to manage transition, and fortuitous timing for financing. Challenges included needing to engage multiple government agencies to ensure buy-in, navigating tensions around future roles and responsibilities, reviewing and adjusting existing implementation structures, and the reality that this transition involved shifting financing from one development partner to another. Transition implementation was also constrained by the COVID-19 pandemic because key stakeholders were engaged in response efforts. COMSA's experience highlights lessons and threats for future programs facing donor transition in uncertain environments.