Availability Of Human Resources Research Articles

Complexities of implementing Maternal and Perinatal Death Surveillance and Response in crisis-affected contexts: a comparative case study

BackgroundMaternal and Perinatal Death Surveillance and Response (MPDSR) systems provide an opportunity for health systems to understand the determinants of maternal and perinatal deaths in order to improve quality of care and prevent future deaths from occurring. While there has been broad uptake and learning from low- and middle-income countries, little is known on how to effectively implement MPDSR within humanitarian contexts – where disruptions in health service delivery are common, infrastructural damage and insecurity impact the accessibility of care, and severe financial and human resource shortages limit the quality and capacity to provide services to the most vulnerable. This study aimed to understand how contextual factors influence facility-based MPDSR interventions within five humanitarian contexts.MethodsDescriptive case studies were conducted on the implementation of MPDSR in Cox’s Bazar refugee camps in Bangladesh, refugee settlements in Uganda, South Sudan, Palestine, and Yemen. Desk reviews of case-specific MPDSR documentation and in-depth key informant interviews with 76 stakeholders supporting or directly implementing mortality surveillance interventions were conducted between December 2021 and July 2022. Interviews were recorded, transcribed, and analyzed using Dedoose software. Thematic content analysis was employed to understand the adoption, penetration, sustainability, and fidelity of MPDSR interventions and to facilitate cross-case synthesis of implementation complexities.ResultsImplementation of MPDSR interventions in the five humanitarian settings varied in scope, scale, and approach. Adoption of the interventions and fidelity to established protocols were influenced by availability of financial and human resources, the implementation climate (leadership engagement, health administration and provider buy-in, and community involvement), and complex humanitarian-health system dynamics. Blame culture was pervasive in all contexts, with health providers often facing punishment or criminalization for negligence, threats, and violence. Across contexts, successful implementation was driven by integrating MPDSR within quality improvement efforts, improving community involvement, and adapting programming fit-for-context.ConclusionsThe unique contextual considerations of humanitarian settings call for a customized approach to implementing MPDSR that best serves the immediate needs of the crisis, aligns with stakeholder priorities, and supports health workers and humanitarian responders in providing care to the most vulnerable populations.

Life cycle assessment of Luffa‐reinforced epoxy composites: Untreated versus chemically treated fibers

AbstractThis research conducts a comprehensive cradle‐to‐gate life cycle assessment, comparing four distinct epoxy composites with each other and with the pure matrix. The composites investigated include epoxy resin reinforced with 25% and 50% untreated Luffa cylindrica fiber mats and 25% and 50% chemically treated Luffa cylindrica mats. The study defines the functional unit concerning the load at the fracture point and explores a real‐world scenario related to a potential industrial installation in southeastern Europe. The assessment utilizes 22 ReCiPe 2016 endpoint indicators to quantify impacts on human health, ecosystems, and resource availability. The findings indicate that the 50% chemically treated Luffa cylindrica‐reinforced epoxy has the least environmental impact, closely followed by the 50% untreated Luffa cylindrica. All four composites exhibit lower impacts than the pure epoxy resin. Notably, the 50% Luffa‐reinforced composites stand out as significantly environmentally favorable due to the substitution of fossil‐derived resin with natural fibers. This study underscores the potential of Luffa cylindrica as a promising and eco‐friendly reinforcement for epoxy composites.

Life cycle assessment of Luffa‐reinforced epoxy composites: Untreated versus chemically treated fibers

AbstractThis research conducts a comprehensive cradle‐to‐gate life cycle assessment, comparing four distinct epoxy composites with each other and with the pure matrix. The composites investigated include epoxy resin reinforced with 25% and 50% untreated Luffa cylindrica fiber mats and 25% and 50% chemically treated Luffa cylindrica mats. The study defines the functional unit concerning the load at the fracture point and explores a real‐world scenario related to a potential industrial installation in southeastern Europe. The assessment utilizes 22 ReCiPe 2016 endpoint indicators to quantify impacts on human health, ecosystems, and resource availability. The findings indicate that the 50% chemically treated Luffa cylindrica‐reinforced epoxy has the least environmental impact, closely followed by the 50% untreated Luffa cylindrica. All four composites exhibit lower impacts than the pure epoxy resin. Notably, the 50% Luffa‐reinforced composites stand out as significantly environmentally favorable due to the substitution of fossil‐derived resin with natural fibers. This study underscores the potential of Luffa cylindrica as a promising and eco‐friendly reinforcement for epoxy composites.

Analisis SWOT sebagai Strategi dalam Peningkatan Kinerja Pegawai Pemerintahan

This research aims to formulate strategies that must be implemented for performance development by analyzing the company's strengths, weaknesses, opportunities, and threats through analysis on the Government. This research is qualitative descriptive research with a SWOT analysis method that aims to improve the performance of Government employees. Data collection is carried out through observation, interviews, and documentation. Data analysis is carried out qualitatively consisting of data reduction, data presentation, and conclusion drawing. Based on the results and discussions that have been carried out previously, the author concludes that: the strategy used to improve employee performance is the SO (Strengths–Opportunities) strategy, actions that can be taken in the strengths strategy by increasing competence, extensive work experience and high competence. Meanwhile, the opportunities strategy is with the development of new technology that can improve work efficiency and reduce costs, the availability of quality human resources that can strengthen the work team.

Evaluation Of The Implementation Of Elementary Teacher Certification Policies Through Teacher Professional Education Programs In Gorontalo City

This study aims to comprehensively evaluate the implementation of the elementary school teacher certification policy through the teacher professional education program in Gorontalo City from four different aspects. The evaluation shows that in terms of context, the implementation of this policy is considered very good with an achievement of 92%, which is in accordance with the Standard Operating Procedures as the organizer of PPG activities. In addition, in terms of input, the evaluation showed excellent results with a percentage of 97%, supported by the availability of adequate Human Resources and the qualifications of instructors in accordance with government requirements. In terms of process, the study found excellent performance with an achievement of 95%, showing that PPG activities were carried out in accordance with the SOP set by the Ministry of Research, Technology and Higher Education. On the product side, the evaluation showed excellent results with a percentage of 93%, emphasizing that a well-organized process in implementing the PPG program contributed to the quality of the final product produced. Overall, these findings confirm that the teacher certification policy through the teacher professional education program in Gorontalo City has been successfully implemented from all aspects evaluated, providing an important view for the development of future education policies and the importance of compliance with operational standards to achieve optimal results in teacher professional education.

Quality of hospital labour and delivery care: A multilevel analysis in Southern Nations and Nationalities People's Region of Ethiopia.

Ethiopia has one of the highest maternal mortality ratios in Africa. Few have examined the quality of labour and delivery (L&D) care in the country. This study evaluated the quality of routine L&D care and identified patient-level and hospital-level factors associated with the quality of care in a subset of government hospitals. This was a facility-based, cross-sectional study using direct non-participant observation carried out in 2016. All mothers who received routine L&D care services at government hospitals (n = 20) in one of the populous regions of Ethiopia, Southern Nations Nationalities and People's Region (SNNPR), were included. Mixed effects multilevel linear regression modeling was employed in two stages using hospital as a random effect, with quality of L&D care as the outcome and selected patient and hospital characteristics as independent variables. Patient characteristics included woman's age, number of previous births, number of skilled attendants involved in care process, and presence of any danger sign in current pregnancy. Hospital characteristics included teaching hospital status, mean number of attended births in the previous year, number of fulltime skilled attendants in the L&D ward, whether the hospital had offered refresher training on L&D care in the previous 12 months, and the extent to which the hospital met the 2014 Ethiopian Ministry of Health standards regarding to resources available for providing quality of L&D care (measured on a 0-100% scale). These standards pertain to availability of human resource by category and training status, availability of essential drugs, supplies and equipment in L&D ward, availability of laboratory services and safe blood, and availability of essential guidelines for key L&D care processes. On average, the hospitals met two-thirds of the standards for L&D care quality, with substantial variation between hospitals (standard deviation 10.9 percentage points). While the highest performing hospital met 91.3% of standards, the lowest performing hospital met only 35.8% of the standards. Hospitals had the highest adherence to standards in the domain of immediate and essential newborn care practices (86.8%), followed by the domain of care during the second and third stages of labour (77.9%). Hospitals scored substantially lower in the domains of active management of third stage of labour (AMTSL) (42.2%), interpersonal communication (47.2%), and initial assessment of the woman in labour (59.6%). We found the quality of L&D care score was significantly higher for women who had a history of any danger sign (β = 5.66; p-value = 0.001) and for women who were cared for at a teaching hospital (β = 12.10; p-value = 0.005). Additionally, hospitals with lower volume and more resources available for L&D care (P-values < 0.01) had higher L&D quality scores. Overall, the quality of L&D care provided to labouring mothers at government hospitals in SNNPR was limited. Lack of adherence to standards in the areas of the critical tasks of initial assessment, AMTSL, interpersonal communication during L&D, and respect for women's preferences are especially concerning. Without greater attention to the quality of L&D care, regardless of how accessible hospital L&D care becomes, maternal and neonatal mortality rates are unlikely to decrease substantially.

Создание нового порта: фактор влияния на развитие транспортной логистики региона

The process of formation, construction and development of a new international port on a section of the river bank received from another country, which has direct access to the sea, is considered. The analysis of the advantageous location and favorable conditions for the creation of the port, including the conditions for entry into the port of sea and river vessels, the availability and accessibility of road, rail and air transport, is carried out. The created structure of the port is illustrated, as well as brief characteristics, capabilities and features of various port terminals for cargo transshipment and passenger transportation are considered. The organizational and technological experience in creating a logistics hub in the region was studied, taking into account the needs of producers, recipients and the characteristics of transport carriers, including the features of asset management. The analysis of indicators of the volume of transshipment of various cargoes was carried out, the main directions of the port's development in the near future were determined. In the process of studying the experience of creating port infrastructure, the created conditions for business development and investment attraction, the peculiarities of the tax and customs regime, as well as the distinctive features of the port's free economic zone from other similar territories are considered. Calculations of the availability of human resources in the port area and their attractiveness for transport companies are given. The process of development of the merchant fleet of the Republic of Moldova is analyzed, and the role of port infrastructure and transport logistics in the development of maritime activities of the state and the region as a whole is shown. A comparative analysis of the development of similar ports in the region was carried out according to the main indicators. Conclusions are drawn about the impact of the intensity of development of ports and transport logistics in the region on strengthening the state’s maritime potential, its infrastructure and trade.

Evaluation of the accelerate stunting reduction program through stunting care houses (Rumah Pesta) Wakatobi district

Wakatobi Regency as an island region in 2022 has a stunting prevalence of 29.9%, higher than the average prevalence rate for Southeast Sulawesi province of 27.7%. This regency has a high commitment to accelerating the reduction of stunting prevalence through the strategic initiative of stunting care home innovation activities (Rumah Pesta). Serving as a venue for organizing the mobilization and execution of internalizing the acceleration of the reduction of stunting through synchronization and cooperation between stakeholders, village administrations, and agencies. To evaluate the stunting reduction acceleration program through the Stunting Care House (Rumah Pesta) Wakatobi Regency. Qualitative descriptive research, content analysis was carried out on the conditions of natural objects from the context in which the event occurred in an effort to describe the incident through key informants, main informants and supporting informants based on knowledge about the stunting reduction acceleration program policy. This research uses in-depth interviews with tools in the form of recording devices, interview guides, review of rules and documents to answer research objectives using the CIPP model evaluation approach. In the context evaluation, the regional stunting reduction acceleration program policy has influenced the prevalence of stunting through the the Stunting Care House or Rumah Peduli Stunting (Rumah Pesta) innovation program which was implemented through the Decree of the Head of the P2 &amp; KB Department. Input evaluation: The main budgetary support for activities comes from self-help, including the APBN and APBD budgets through related SKPD intermediaries who are directly involved in stunting activities. Human resource capacity is inadequate and there is no support for sustainable training programs through Rumah Pesta. Support for facilities and infrastructure for service activities in the building is inadequate, there are facilities to support stunting activities. Evaluation process: Activity planning house party activities are participatory in nature as a form of implementation of policies to accelerate stunting reduction to realize the mobilization of strategic initiative steps by the relevant SKPD leaders in the form of innovation activities, referring to 29 main indicator service coverage designed through creativity in the form of independent activities with at-risk families, local cultural approaches. Product Evaluation: Contributing directly to reducing the prevalence of stunting in Wakatobi district through interventions through assistance activities for at-risk families which are still ongoing today, Sustainability of programs or activities to accelerate stunting reduction requires synergy and support from data sources, use of accurate data through a good human resource availability approach, supporting infrastructure that meets standards at all levels of implementation of activities to accelerate stunting reduction.

Mammalian community responses in relation to anthropogenic disturbances and resource gradients in the shade coffee forest ecosystem of Southwestern Ethiopia

Understanding the effects of variation in resource availability and habitat disturbance on the ecology of mammals is vital for successful conservation management. In this study, we examined how human disturbances, resource availability and elevation gradients influence mammal assemblages in both managed coffee forest and natural forest of the Belete-Gera National Forest Priority Area, southwestern Ethiopia. We surveyed mammals using motion-detecting infrared camera traps in 90 locations for a total of 4142 camera days. We measured distance from main roads and settlements as disturbance factors, and distance from water sources, key grazing sites, and forest edges and woody plant diversity as resource variables. We assessed the mammal assemblages in coffee forest and natural forests using generalized linear models. Further, we used linear modelling to compare the relationships of mammal detection rates by feeding guilds and body size to resource variables. In total, we recorded 8815 videos identifying 23 different mammal species. The mammal assemblages in coffee forests were negatively associated with increasing distances from key grazing sites, water sources, and elevation. In contrast, the association with increasing distance from the road and woody plant diversity was positive. In addition, herbivores and large (25–200 kg) and very large (≥200 kg) mammals, were all negatively associated with increasing distance from the natural forest edges. With the conversion of natural forest to coffee forest and the intensification of coffee forest management, sustainable management of key grazing sites, water sources, and diverse woody plant species will be essential to the conservation of mammals. In addition, to ensure mammal conservation, adjacent natural forests around coffee forests should also be protected.

Inclusion and the availability of educational resources – capturing stakeholder voices

ABSTRACT Background Greater provision of inclusive education is an important goal for education systems internationally. Frequently identified barriers to progress include a lack of resources to support students with special educational needs (SEN) in mainstream education settings. Purpose This study from Spain sought to gain insight into the availability of educational resources to support students with SEN in mainstream schools in the region of Murcia, by exploring the perceptions of stakeholders. Methods Participants were 27 stakeholders involved in the development and operation of special classrooms in mainstream settings for students with SEN who require highly specialised attention. Perceptions were gathered from participants across 18 mainstream centres in the region, via semi-structured interviews and focus groups. Data were analysed qualitatively, according to an existing categorisation that distinguished between material, human and teaching space resources. Findings In-depth analysis suggested that, according to many stakeholders, an insufficiency of educational resources constituted one of the main barriers to achieving inclusive education. Participants believed that material resources in education centres should be increased to support students with SEN, reporting a lack of digital resources and the necessary teacher education for their application in the classroom. Limited availability of human resources was also highlighted, with participants desiring a more substantial presence of professionals in mainstream centres and a deeper commitment towards inclusion. They considered that there should be more space in the centres to conduct multisensory and motivating activities for students with SEN. Conclusions Catering to the diverse learning needs of all students is a key concern globally. This study underscores the significance of different types of resources in inclusive provision. It draws attention to the importance of increasing the availability of resources in mainstream educational settings to support students with SEN.

The role of healthcare providers and caregivers in monitoring critically ill children: a qualitative study in a tertiary hospital, southern Malawi

BackgroundCritically ill children require close monitoring to facilitate timely interventions throughout their hospitalisation. In low- and middle-income countries with a high disease burden, scarce paediatric critical care resources complicates effective monitoring. This study describes the monitoring practices for critically ill children in a paediatric high-dependency unit (HDU) in Malawi and examines factors affecting this vital process.MethodsA formative qualitative study based on 21 in-depth interviews of healthcare providers (n = 12) and caregivers of critically ill children (n = 9) in the HDU along with structured observations of the monitoring process. Interviews were transcribed and translated for thematic content analysis.ResultsThe monitoring of critically ill children admitted to the HDU was intermittent, using devices and through clinical observations. Healthcare providers prioritised the most critically ill children for more frequent monitoring. The ward layout, power outages, lack of human resources and limited familiarity with available monitoring devices, affected monitoring. Caregivers, who were present throughout admission, were involved informally in monitoring and flagging possible deterioration of their child to the healthcare staff.ConclusionBarriers to the monitoring of critically ill children in the HDU were related to ward layout and infrastructure, availability of accurate monitoring devices and limited human resources. Potential interventions include training healthcare providers to prioritise the most critically ill children, allocate and effectively employ available devices, and supporting caregivers to play a more formal role in escalation.

Implementation of Vaccination Policy for Controlling Foot and Mouth Disease in Livestock in the Fisheries and Service Office

This research is motivated by the problem of effectiveness, efficiency and distribution of vaccines for Foot and Mouth Disease (FMD) in livestock in Bogor Regency. The purpose of this study is to analyze how the implementation of vaccination policies on livestock in Bogor Regency and what factors support and do not support the implementation of FMD vaccination. This research uses a qualitative descriptive research method using the model developed by George C. Edward III that policy implementation is influenced by 4 factors. Edward III that policy implementation is influenced by 4 (four) variables, namely communication, resources, disposition, and bureaucratic structure. The results showed that the implementation of FMD vaccination policy in Bogor District has been running well and successful in tackling FMD in livestock. The results include decreased FMD cases, improved livestock health and productivity. Communication, disposition, and bureaucratic structure variables are supporting factors for the successful implementation of FMD vaccination policy. Meanwhile, the resource dimension is a factor that does not support the implementation of FMD vaccination. This can be seen from the lack of staff (vaccination officers), inadequate vaccine storage (cool boxes), and lack of budget. Collaborative efforts with third parties (non-governmental organizations, private sector, universities) in terms of providing supporting facilities to ensure vaccine storage facilities meet the required standards and meet the availability of trained human resources.

Investasi, Inflasi dan Konsumsi: Pengaruhnya terhadap Pertumbuhan Ekonomi di Kalimantan Selatan

Economic growth is used as an important indicator in measuring the success or failure of economic development. A growing economy indicates economic development that each economic sector has achieved within a certain period. This research aims to determine the economic growth in South Kalimantan in terms of investment, inflation, and consumption. The research method used in this research is multiple linear regression analysis using hypothesis testing, namely the t-test and F-test, based on data obtained in time-series form with an observation period from 2006 to 2021. Secondary data from published data from the Agency The Statistics Center (BPS) of South Kalimantan Province forms investment performance values, inflation, and consumption as independent variables. Meanwhile, the dependent variable is economic growth. The research results prove that economic growth is partially influenced by inflation and consumption; high unstable inflation will hurt economic growth, and high consumption will encourage economic performance. Meanwhile, investment does not affect the economic growth of South Kalimantan because the amount of investment depends on the efficiency and accuracy of policy targets, the availability of adequate human resources and infrastructure, and a stable political situation. Investment, inflation, and consumption variables influence the simultaneous test of economic growth in South Kalimantan.

Investasi, Inflasi dan Konsumsi: Pengaruhnya terhadap Pertumbuhan Ekonomi di Kalimantan Selatan

Economic growth is used as an important indicator in measuring the success or failure of economic development. A growing economy indicates economic development that each economic sector has achieved within a certain period. This research aims to determine the economic growth in South Kalimantan in terms of investment, inflation, and consumption. The research method used in this research is multiple linear regression analysis using hypothesis testing, namely the t-test and F-test, based on data obtained in time-series form with an observation period from 2006 to 2021. Secondary data from published data from the Agency The Statistics Center (BPS) of South Kalimantan Province forms investment performance values, inflation, and consumption as independent variables. Meanwhile, the dependent variable is economic growth. The research results prove that economic growth is partially influenced by inflation and consumption; high unstable inflation will hurt economic growth, and high consumption will encourage economic performance. Meanwhile, investment does not affect the economic growth of South Kalimantan because the amount of investment depends on the efficiency and accuracy of policy targets, the availability of adequate human resources and infrastructure, and a stable political situation. Investment, inflation, and consumption variables influence the simultaneous test of economic growth in South Kalimantan.

Strategi Pengembangan Ekowisata Mangrove di Pesisir Pantai Kertomulyo, Kecamatan Trangkil, Kabupaten Pati

This research aims to find out the strategy for developing Mangrove ecotourism in the coastal area of Kertomulyo village, Trangkil sub-district, Pati Regency. This research is classified as a type of field research, with a qualitative-descriptive method. The data collection techniques use observation, interviews and documentation. And data analysis using SWOT theory. The results of this research show that the strengths possessed by the organization in carrying out the strategy that has been determined are the availability of applicable laws and regulations, the availability of human resources both in quality and quantity, sufficient availability of supporting facilities and infrastructure, and awareness from the public. The weaknesses that an organization has in implementing the strategy that has been determined can be an obstacle to the success of the strategy, such as: Lack of professionalism of the employee apparatus. Public awareness regarding the implementation of development has not yet accumulated. Accurate data regarding the development that will be implemented is not yet available. There has not been a culture of transparency in budget management and good management. Opportunities or opportunities that an organization has in carrying out a predetermined strategic plan can be supporting factors that will have a positive impact on the success of the strategy, including: The existence of business opportunities. There is development in the business world. The occurrence is cross-sectoral. Increased mobility of goods and services. There is coordination from related agencies. Threats definitely occur in every organization which can be a trigger to increase an organization's efforts and creativity in carrying out planned strategies. Some of the threats in tourism strategies are: High business competition, lack of development of facilities and infrastructure, lack of government role, and lack of attractiveness and uniqueness of tourist attractions.

Overcoming Barriers in Hospital-Based Health Technology Assessment (HB-HTA): International Expert Panel Consensus.

The purpose of this article is to investigate the common facilitators and barriers associated with the implementation of hospital-based health technology assessment (HB-HTA) across diverse hospital settings in seven countries. Through a two-round Delphi study, insights were gathered from a panel of 15 HTA specialists from France, Hungary, Italy, Kazakhstan, Poland, Switzerland, and Ukraine. Experts initially conducted a comprehensive review of the HB-HTA implementation in their respective countries, identifying the barriers and facilitators through descriptive analysis. Subsequently, panel experts ranked these identified barriers and facilitators on a seven-point Likert scale. A median agreement score ≥ 6 and interquartile range (IQR) ≤ 1 was accepted as reaching a consensus. Out of the 12 statements categorized as external and internal barriers and facilitators, the expert panel reached consensus on six statements (two barriers and four facilitators). The external barrier, which achieved consensus, was the lack of the formal recognition of the role of HB-HTA in national or regional legislations. The internal barrier reaching consensus was the limited availability of human resources dedicated to HB-HTA. This qualitative study indicates that HB-HTA still has progress to make before being formally accepted and integrated across most countries, although by building on the facilitating factors we identified there may be an opportunity for the implementation of internationally developed strategies to strengthen HB-HTA practices.

Exploring the determinants of disaster and climate resilience building in Zimbabwe’s rural communities

AbstractWith the burgeoning threats from natural hazards and extreme weather events driven by climate change in every section and sector of society, building resilience against disasters and risks posed by climate change has become an unescapable discourse. The study’s main thrust is to establish the determinants of resilience building in Zimbabwe’s rural communities. The study adopted the qualitative constructivist grounded theory approach in conjunction with participatory action research to gain insights from community members and traditional leaders. A total of forty-six participants from Chimanimani District, Zimbabwe participated in the study. The findings revealed that the availability of natural and human resources, collective efficacy, government and development agency support systems, indigenous knowledge systems, and livelihood diversification were crucial determinants of resilience building for rural communities in Zimbabwe. The identified determinants for resilience building signal that these determinants need to be harnessed to inform policy and practice interventions. Furthermore, the availability of the identified determinants implies that rural communities can minimise, and prevent losses, reduce exposure to natural hazards, disasters and climate change risks and manage the impacts of natural hazards whenever they emerge. The study recommends that these determinants be complemented by access to technology, resilient community infrastructures, robust social protection systems, and hazard risk assessment participatory processes by rural communities. In addition, effective emergency and health services, among other contingent measures essential to improve community resilience.

TRANSPARENCY IN HEALTH SERVICES AT MAJENE REGIONAL GENERAL HOSPITAL, WEST SULAWESI

The research objective was to determine the transparency of the implementation of health services and the driving factors for the transparency of the implementation of health services at the Regional General Hospital Majene, West Sulawesi. This research uses a qualitative approach, this type of research is classified as qualitative descriptive research. Data collection through observation made direct observations in the field about events related to the object of research, while interviews conducted interviews with informants to obtain information on implementation transparency issues and driving factors affecting health services, and documentation is research by collecting data in the form of documents such as decrees and regulations. regulations relating to the object of the problem. For analysis starting from data collection, data reduction, data presentation and conclusion. The results of the study show that the transparency of the implementation of health services is transparent because of several indicators, namely, the suitability of service standards, the information system has been published clearly, and the requirements and administration of services are carried out properly and by those set by the hospital. The driving factor that affects the transparency of the implementation of health services at the Majene Regional General Hospital, West Sulawesi, is the availability of Human Resources, namely employees who are tasked with wearing identification and carrying out their duties and responsibilities according to their respective fields, and facilities and infrastructure have been provided to satisfy health services to the community.

IJCM_206A: Building a demographic, developmental and environmental surveillance site in an urban slum and resettlement colony in Delhi, India: processes, engagement, and challenges – a SWOT analysis

Background: Demographic, developmental and environmental surveillance sites (DDESS) enable accurate and prospective health-related data collection amongst socioeconomically disadvantaged populations that facilitate health planning and interventions. Objectives: We explored the community-engagement strategies, enablers, and barriers in building a DDESS site in an urban slum and resettlement colony-based field practice area of a government medical college in Delhi. Methodology: We conducted qualitative research through SWOT analysis that identified both internal (strength and weaknesses), and external (opportunities and threats) factors in building the DDESSS. Informal interviews with multiple stakeholders including researchers, field investigators, project staff, local medical officers, resident doctors, community health workers, local residents, and leaders were conducted. Results: The themes related to SWOT analysis were identified as: (1). Internal factors – Strengths (a). Pre-existing linkage with the community especially provision of comprehensive primary care services (b). Establishment of community-advisory boards (c). Community needs assessment (2): Internal factors - Weaknesses (a). Perceived lack of individual benefit in residents (b). Dissatisfaction with functioning of existing health services (c). Inadequate digital literacy among senior staff hindering generation and adoption of health data to meet population healthcare needs (c) Concerns over privacy in questions related to socioeconomic status and mapping of the area. (3). External factors – Opportunities (a). Employment of field workers belonging to the community to demonstrate trust and build confidence (b). Outreach health services including noncommunicable screening camps, and child vaccination. (4). External factors - Threats (a). Inefficient functioning of health system such as out-of-stock drugs, delayed vaccination, unavailability of diagnostic services in existing primary health facilities. (b). ensuring availability of adequate human and financial resources beyond the project period. (c) dominance of CABs by influential individuals or groups. Conclusion: Garnering community support and active community engagement enable the process of establishment of medical college based DDESS sites.

Human resources for health and maternal mortality in Latin America and the Caribbean over the last three decades:a systemic-perspective reflections.

The role of human resources for health in the operation of health systems is crucial. However, training and incorporating them into institutions is a complex process due to the continuous misalignment between the supply and demand of health personnel. Taking the case of the Latin American and Caribbean region countries, this comment discusses the relationship between the availability of human resources for health and the maternal mortality ratio for the period 1990-2021. It proposes the need to resume planning exercises from a systemic perspective that involves all areas of government and the private sector linked to the training and employment of health workers. We used secondary data from a global source to show patterns in the relationship between these two aspects and identify gaps in the Latin American and Caribbean regions. The results show enormous heterogeneity in the response of regional health systems to the challenge of maternal mortality in the region. Although most countries articulated specific programs to achieve the reduction committed by all countries through the Millennium Development Goals, not all had the same capacity to reduce it, and practically none met the target. In addition, in the English Caribbean countries, we found significant increases in the number of health personnel that do not explain the increases in the maternal mortality rate during the period. The great lesson from the data shown is that some countries could articulate responses to the problem using available resources through effective strategies, considering the specific needs of their populations. Although variations in maternal mortality rate cannot be explained solely through the provision of health personnel, it is important to consider that it is critical to find new modalities on how human resources for health could integrate and create synergies with other resources to increase systems capacity to deliver care according to conditions in each country.