Human Resource Barriers Research Articles

Telephone hotlines for infectious disease outbreaks in Africa: A review and qualitative study.

Mobile health interventions like telephone hotlines face challenges that may threaten their use, adoption and sustainability in Africa. We sought to understand the barriers and facilitators for sustainability of telephone hotlines used in infectious disease outbreaks in Africa using a scoping review and a qualitative study. Participants form 12 African countries and Database searches. Databases were searched for articles on the barriers and/or facilitators in operating telephone hotlines for outbreaks in Africa. One-on-one interviews and focus group discussions with 30 participants from 12 African countries were also conducted. Emerging themes from the review and interviews were identified and synthesised to focus on barriers and facilitators for the sustainability of the hotlines. The search identified 1153 citations, and 25 studies were finally included. The articles were from 20 African countries. The government was the main source of funding in four countries. Barriers with calls and data management were the most frequent. Human resource barriers such as limited staff, high staff turnover, a lack of incentives and motivation were also significant. Financial barriers were the high cost of operation and huge dependence on external funders. Technological and infrastructural hurdles included limited Internet and phone coverage, malfunction and a lack of interoperability of software. Transitioning to either complete or shared government ownership with diversification and integration of the hotline into routine use was the main facilitator for sustainability. Strengthening technical capacity in telephone hotlines and ensuring financial sustainability are critical. Increased government support is needed. More studies on costing will help in developing financial sustainability models for Africa.

Embracing drones and the Internet of drones systems in manufacturing – An exploration of obstacles

The manufacturing sector attributes the growing prominence of Drones and the Internet of Drones (IoD) systems to their multifaceted utility in delivery, process monitoring, infrastructure inspection, inventory management, predictive maintenance, and safety inspections. Despite their potential benefits, adopting these technologies faces significant obstacles that need systematic identification and resolution. The current literature inadequately addresses the barriers impeding the adoption of Drones and IoD systems in manufacturing, indicating a research gap. This study bridges this gap by providing comprehensive insights and facilitating the organisational transition towards embracing Drone and IoD technologies. This research identifies 20 critical barriers to deploying Drones and IoD in manufacturing. These barriers are validated through a global quantitative survey of 120 Drone experts and analyzed via Exploratory Factor Analysis (EFA). EFA categorises these challenges into six distinct dimensions. Utilizing the Analytical Hierarchy Process (AHP), these dimensions and individual barriers are ranked, incorporating feedback from five Drone specialists. The study highlights ‘Safety and Human Resource Barriers’ and ‘Payload Capacity and Battery Barriers’ as the most predominant obstacles. Key concerns include limited battery life, explosion risks, and potential damage to assets and individuals. This research significantly advances the existing literature by presenting a practical methodology for categorising and prioritising Drone and IoD adoption barriers. Employing EFA and AHP offers a globally relevant framework for stakeholders to strategically address these challenges, advancing the integration of drones and IoD systems in the manufacturing domain.

IMPLEMENTATION OF PUBLIC SERVICE REFORM IN ENHANCING THE WELFARE OF BIMA DISTRICT COMMUNITY: CHALLENGES AND OPPORTUNITIES

This study examines the implementation of public service reforms in Bima District with the goal of enhancing community welfare. Utilizing a qualitative and descriptive approach, primary data were gathered through in-depth interviews with local stakeholders, while secondary data were sourced from policy documents and statistical reports. Thematic analysis was employed to categorize findings based on research objectives. Results show positive changes like improved health service accessibility and quality. However, challenges persist in management, service standards compliance, and policy alignment with community needs due to bureaucratic rigidity and lacking leadership. The research concludes that while reforms have benefits, there's substantial room for improvement, particularly in management, transparency, and service delivery innovation. It emphasizes the need for strong commitment across government levels to drive innovation, address infrastructure and human resource barriers, and enhance institutional coordination, thereby directly impacting community welfare in Bima District.

Key barriers to the provision and utilization of maternal health services in low-and lower-middle-income countries; a scoping review

BackgroundThe preservation and promotion of maternal health (MH) emerge as vital global health objectives. Despite the considerable emphasis on MH, there are still serious challenges to equitable access to MH services in many countries. This review aimed to determine key barriers to the provision and utilization of MH services in low- and lower-middle-income countries (LLMICs).MethodsIn this scoping review, we comprehensively searched four online databases from January 2000 to September 2022. In this study, the approach proposed by Arksey and O’Malley was used to perform the review. Consequently, 117 studies were selected for final analysis. To determine eligibility, three criteria of scoping reviews (population, concept, and context) were assessed alongside the fulfillment of the STROBE and CASP checklist criteria. To synthesize and analyze the extracted data we used the qualitative content analysis method.ResultsThe main challenges in the utilization of MH services in LLMICs are explained under four main themes including, knowledge barriers, barriers related to beliefs, attitudes and preferences, access barriers, and barriers related to family structure and power. Furthermore, the main barriers to the provision of MH services in these countries have been categorized into three main themes including, resource, equipment, and capital constraints, human resource barriers, and process defects in the provision of services.ConclusionsThe evidence from this study suggests that many of the barriers to the provision and utilization of MH services in LLMICs are interrelated. Therefore, in the first step, it is necessary to prioritize these factors by determining their relative importance according to the specific conditions of each country. Consequently, comprehensive policies should be developed using system modeling approaches.

Digital technologies and carbon neutrality goals: An in-depth investigation of drivers, barriers, and risk mitigation strategies

Prior research has primarily concentrated on non-digital and process-oriented methods for achieving carbon neutrality (CN) in the context of mitigating climate change (CC), while the potential of digital technology (DT) has hardly been investigated. This study addresses this gap by answering four research questions: How are firms utilizing DT to achieve CN? What drives the adoption of DT for achieving CN? What are the barriers that prevent the adoption of DT for achieving CN? What risk mitigation strategies can be adopted by firms to overcome these barriers? An inductive method using open-ended essays has been adopted to gather data from firms that have already implemented DT for CN. The findings revealed four distinct dimensions. Utilization of DT for CN includes enhancing business value, managing one's carbon footprint, enabling smart solutions, and enhancing efficiency. The drivers for adopting DT for CN included driving business growth, external pressures, competitive advantage, and environmental consciousness. Key barriers included financial barriers, technological barriers, human resource barriers, and external barriers. Risk mitigation strategies included pre-implementation strategies, detailed planning and evaluation, ensuring employees' buy-in and readiness, and external stakeholder engagement. This study offers a broad-based foundation for designing DT strategies for achieving CN.

Exploring the implementation of multidisciplinary collaboration at nursing homes in Jakarta, Indonesia: A descriptive phenomenological study.

A well-functioning multidisciplinary team optimizes resource utilization and reduces care redundancy, fragmentation, and wastage. Collaborative efforts yield a clearer understanding of older people's needs and desires, significantly reducing hospitalization days. Despite limited studies, particularly in Indonesia, investigating professionals' experiences in implementing multidisciplinary collaboration in government nursing homes, nursing care quality remains a concern. This study aimed to explore the implementation of multidisciplinary collaboration in nursing homes from the perspectives of various disciplines. A descriptive phenomenological study was used with semi-structured interviews and focus group discussions with multidisciplinary care providers, including nurses, doctors, social workers, physiotherapists, psychologists, occupational and recreational activity instructors, and clergy in nursing homes owned by the Jakarta provincial government. A total of 64 participants were involved, and data were collected from September 2022 to July 2023. Data were analyzed using content-based analysis. Three main themes emerged: 1) context of multiple collaborations, 2) barriers to implementing multiple collaborations, and 3) impacts of non-optimal multidisciplinary collaborations. Nursing home management's multidisciplinary teams predominantly implement professional-centered care with limited support systems. While providers generally perceive collaboration positively, shared responsibility and joint work among professionals are lacking. This study highlights the need to improve multidisciplinary collaboration in nursing homes to enhance care quality for older individuals. While providers view collaboration positively, barriers like a lack of shared responsibility and joint work persist. Enhancing teamwork cohesion through improved communication and integrated case reporting systems is crucial. Addressing human resource and systemic barriers is also vital. By overcoming these challenges, nursing homes can optimize resource use, reduce care redundancy, and better meet the diverse needs of older residents.

Assessing and overcoming the barriers for healthcare waste management in India: an integrated AHP and Fuzzy TOPSIS approach

PurposeDue to the coronavirus disease 2019 (COVID-19) pandemic, the world faces different issues, and proper healthcare waste (HCW) treatment is one of them. If appropriate disposal of HCW is not performed, it will have hazardous effects on humanity. This paper has identified the significant barriers hindering the proper treatment of healthcare waste management (HCWM) with the strategies to overcome these barriers.Design/methodology/approachThis paper has identified the significant barriers hindering the proper treatment of HCWM with the strategies to overcome these barriers, and different barriers are identified and categorized into organizational, waste handling, human resource and technical barriers. The analytical hierarchy process (AHP) process is used to rank the barriers and sub-barriers. Then, the Fuzzy Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method evaluates the strategies for proper implementation of HCWM.FindingsThe results show that organizational barriers are the most significant barrier, with a lack of coordination of hospitals with other authorities and no priority given to waste management issues as highly ranked barriers. The results of the Fuzzy TOPSIS method indicate that “Increase govt support and policies” and “Enhance training and awareness of employees” are the most feasible strategies to overcome these barriers for the successful implementation of HCWM.Practical implicationsThis study will be helpful in policy formulations for the proper treatment of HCW in an efficient manner. This paper helps to complete the research gap by providing the different characteristics of barriers.Originality/valueThis paper fills the research gap by expanding the limited knowledge in this field and providing further evidence on this phenomenon. The study also enables the distinctive characteristics of barriers to be understood within a particular context.

Exploring preoperative preparation adherence and barriers in private hospitals in Vietnam: A mixed-method evaluation

ABSTRACT Methods A total of 151 patients with 151 operations were observed and retrospectively recorded. All medical staff (including doctors, nurses, and midwives) participating in the preparation of patients were invited to participate in the study. A total of 38 health workers were observed and evaluated. Seven in-depth interviews and focus group discussions were performed. Results Compliance preparation for preoperative preparation among medical staff is low, with only 45.7% adherence to the process, while 76.8% comply with physical preparation. The overall compliance rate is 67.5%. The study also reveals incomplete surgical review systems, inadequate human resources, and insufficient supervision. Type of surgery and surgical department are factors associated with poor preoperative preparation. Conclusion Study results highlighted that the level of compliance with the pre-operative patient preparation process of the private hospital in this study was still low. Appropriate strategies are needed to improve human resource barriers and monitor and improve administrative systems, thereby improving the ability of medical staff to comply with the process at the hospital.

Implementasi Perbup Kediri Tentang Pengelolaan Keuangan Desa Melalui SISKEUDES di Desa Wanengpaten Kabupaten Kediri

This article or article aims to describe and analyze the implementation along with the driving and inhibiting factors of the Kediri Regent Regulation Number 47 of 2018 concerning village financial management through the SISKEUDES application in Wanengpaten Village, Gampengrejo District, Kediri Regency. The problem is focused on policy implementation. In order to approach this problem, Edward III's theoretical references are used which consist of communication, resources, disposition, and bureaucratic structure. The research method in this research is descriptive qualitative. The data were collected through interviews and observation. This study concludes that it shows that the implementation of this regulation has not been fully implemented optimally. This can be seen from the top down communication dimension, so that the communication tends to be force majeure. The quality of the resources handling this program is far from being good. The educational background of village officials still does not meet the specifications to implement this policy. It is different from the dispositional dimension, related to the attitude and motivation of policy actors, which can be said to be positive. Activity executors have high enthusiasm and are solid in the context of the success of the SISKEUDES policy. Meanwhile, in terms of bureaucratic structure, there is no flow or policy implementation guidelines made by the internal village office. Factors that are key determinants of the successful implementation of this policy are the existence of adequate supporting facilities, and the existence of intense cooperation. Meanwhile, the factors that have the potential to cause the implementation of this policy to fail are inadequate human resource barriers, software that always experiences errors, and a lack of technical guidance which results in the slow development of operational mastery of the village apparatus.

Designing A Paradigmatic Model of Barriers to Innovation Management in Ahvaz Primary Schools

Objective: The purpose of the present study was to design a paradigmatic model of innovation management barriers in primary schools of Ahvaz city. Method: The research method was qualitative and, in terms of purpose, applied. The statistical population included experts in schools and universities, selected through purposive and snowball sampling. The research tool included semi-structured interviews, whose validity was established through face validity, and reliability was determined using the inter-coder agreement coefficient, resulting in 0.81. Data were analyzed using grounded theory method. Results: The findings revealed that causal conditions included understanding innovation characteristics, feeling the necessity for innovation, identifying individual differences among employees, managing information and communication technology, organizational culture, risk-taking in school employees, organizational structure, material resources, and transformative leadership; contextual conditions included individual characteristics of employees, employee experiences, individual characteristics of the manager, management style, organizational rules and regulations, organizational climate, and having an innovation model. Moreover, intervening conditions included psychological barriers, intolerance of ambiguity and failure, educational barriers, research barriers, performance evaluation barriers, structural barriers, human resource barriers, managerial barriers, and cultural barriers within the organization. Finally, strategic conditions included internal and external networking, division of labor, strategic management, committed and specialized human resources, politicization, having an innovative spirit among employees, the existence of a suggestion acceptance system in schools, administrative hierarchy, delegation of authority by the manager to subordinates, employee support, strategic planning, and the outcomes included increased mental health of employees and students, a creative school environment, a reward system for innovative and creative employees, a research-oriented culture, a learning organization, and improved educational quality. Conclusion: Based on the results, it can be said that the barriers to innovation management in primary schools of Ahvaz city are various factors, and the sub-system of education and management should prioritize and address these barriers.

Policy stakeholder perspectives on barriers and facilitators to launching a community-wide mass drug administration program for soil-transmitted helminths

BackgroundRecent evidence suggests that soil-transmitted helminth (STH) transmission interruption may be feasible through community-wide mass drug administration (cMDA) that deworms community members of all ages. A change from school-based deworming to cMDA will require reconfiguring of STH programs in endemic countries. We conducted formative qualitative research in Benin, India, and Malawi to identify barriers and facilitators to successfully launching a cMDA program from the policy-stakeholder perspective.MethodsWe conducted 40 key informant interviews with policy stakeholders identified as critical change agents at national, state/district, and sub-district levels. Participants included World Health Organization country office staff, implementing partners, and national and sub-national government officials. We used the Consolidated Framework for Implementation Research to guide data collection, coding, and analysis. Heat maps were used to organize coded data and differentiate perceived facilitators and barriers to launching cMDA by stakeholder.ResultsKey facilitators to launching a cMDA program included availability of high-quality, tailored sensitization materials, and human and material resources that could be leveraged from previous MDA campaigns. Key barriers included the potential to overburden existing health workers, uncertainty of external funding to sustain a cMDA program, and concerns about weak intragovernmental coordination to implement cMDA. Cross-cutting themes included the need for rigorous trial evidence on STH transmission interruption to gain confidence in cMDA, and implementation evidence to effectively operationalize cMDA. Importantly, if policy stakeholders anticipate a cMDA program cannot be sustained due to cost and human resource barriers in the long term they may be less likely to support the launch of a program in the short term.ConclusionsOverall, policy stakeholders were optimistic about implementing cMDA primarily because they believe that the tools necessary to successfully implement cMDA are already available. Policy stakeholders in this study were cautiously optimistic about launching cMDA to achieve STH transmission interruption and believe that it is feasible to implement. However, launching cMDA as an alternative policy to school-based deworming will require addressing key resource and evidence barriers.Trial registration This study was registered in the U.S. National Library of Medicine Clinical Trials registry (NCT03014167).

Barriers to sustainable sourcing in the apparel and fashion luxury industry

The fashion industry's transition to Sustainable Sourcing (SS) is crucial to address some of the social and environmental problems faced by societies. While previous research has identified SS implementation barriers in the mainstream fashion industry, this article provides a methodical identification, validation, and prioritization of the 20 key SS implementation barriers for the global apparel and fashion-luxury sector. The paper employs a multi-phase research methodology to benchmark the SS implementation barriers in the apparel and fashion-luxury sector. These barriers were analysed through 154 responses received from global SS professionals by employing a survey questionnaire. Through an Exploratory Factor Analysis (EFA), the barriers were categorized into six unique dimensions. To establish their importance, an analytical hierarchy process (AHP) analysis further provided a global ranking of the identified barriers. The results of the study revealed that ‘Management, Government Support, and Infrastructure Barriers’ hold the most significant importance among all barrier dimensions, followed by ‘Material Barriers’, ‘Finance Barriers’, ‘Supplier Barriers’, ‘Certificates and Customer Perceptions’, and ‘Sustainable Packaging and Human Resource Barriers’. Furthermore, the results showed that specific barriers such as ‘Undersupply of Sustainable Raw Materials’, ‘Insufficient Commitment from Top Management’, and ‘Inadequate Awareness’ are the top three barriers according to global ranking. The research theoretically contributes by identifying and ranking the SS barriers that may hinder the efforts of the fashion sector to become more sustainable. This will facilitate researchers, sourcing professionals, fashion retailers, policymakers, and governing bodies in the formulation and deployment of dynamic strategies to overcome them and successfully implement SS practices.

Investigating the Causes of Entrepreneurs Failure to Start-up Greenhouse Business in Isfahan Province, Iran

Despite the impact of entrepreneurships on economic development, it has not received much attention over the last few decades. Most studies in the field of entrepreneurship have been based on the experiences of successful entrepreneurs. Although the success and failure of entrepreneurs are two sides of the same coin, studying the causes of entrepreneurial failure provides us with much more important information for analyzing the entrepreneurial ecosystem in a country. Therefore, by examining the failure of entrepreneurs, the entrepreneurial ecosystem can be changed to improve the conditions for future success of entrepreneurs. The present study examines factors caused to failure start-up greenhouse business by licensed entrepreneurs in province of Isfahan located at central part of Iran. This study considers population who obtained license to start greenhouse business but failed to do so at last. This study applied qualitative research technique and related data were collected through semi-structured telephone interviews with totally 450 interviewee and 264 of them participated in the study. To analysis the collected data, the structural content analysis technique of grounded theory was applied. Due to importance of factors, vocabulary counting technique was applied. As a result, 575 Barriers are expressed by entrepreneurs. At the open coding stage, the extracted phrases are integrated in 19 terms of meaningful expressions by integrating the same items and removing repetitive cases. At the axial coding stage, 19 integrated concepts are obtained. Subsequently, the extracted phrases create six main factors. At the selective coding stage, the entrepreneurs' basic barriers are categorized into three categories: Human Barriers, Economic barriers, Infrastructure facilities and supportive policies. This study well revealed that weak infrastructure facilities, poor supportive system, economy barriers and problems with human resource barriers respectively had powerful deterrent factors which caused license holders to give up starting a greenhouse business.

Research, education and capacity building priorities for violence, abuse and mental health in low- and middle-income countries: an international qualitative survey

PurposeDespite the World Health Organization and United Nations recognising violence, abuse and mental health as public health priorities, their intersection is under-studied in low- and middle-income countries (LMICs). International violence, abuse and mental health network (iVAMHN) members recognised the need to identify barriers and priorities to develop this field.MethodsInformed by collaborative discussion between iVAMHN members, we conducted a pilot study using an online survey to identify research, education and capacity building priorities for violence, abuse and mental health in LMICs. We analysed free-text responses using thematic analysis.Results35 senior (29%) and junior researchers (29%), non-government or voluntary sector staff (18%), health workers (11%), students (11%) and administrators (3%) completed the survey. Respondents worked in 24 LMICs, with 20% working in more than one country. Seventy-four percent of respondents worked in sub-Saharan Africa, 37% in Asia and smaller proportions in Latin America, Eastern Europe and the Middle East. Respondents described training, human resource, funding and sensitivity-related barriers to researching violence, abuse and mental health in LMICs and recommended a range of actions to build capacity, streamline research pathways, increase efficiency and foster collaborations and co-production.ConclusionThe intersection between violence, abuse and mental health in LMICs is a priority for individuals with a range of expertise across health, social care and the voluntary sector. There is interest in and support for building a strong network of parties engaged in research, service evaluation, training and education in this field. Networks like iVAMHN can act as hubs, bringing together diverse stakeholders for collaboration, co-production and mutually beneficial exchange of knowledge and skills.

Modelling human resource dimension of international project risk management

Purpose Project risk management (PRM) and human resource management (HRM) are the two critical success factors (CSFs) for international project management. This paper aims to correlate these two CSFs, identify the human resource (HR) barriers, develop a hybrid model for risk management and develop strategies to overcome the HR barriers to effective risk management in international projects. Design/methodology/approach In total, 20 key HR barriers have been identified through a literature survey and verified by project professionals. These HR barriers are ranked according to their ability to trigger other barriers by analysing their interactions using the decision-making trial and evaluation laboratory (DEMATEL) method. Based on Ulrich’s revised model for HR functions, a hybrid framework for international PRM has been proposed. Findings DEMATEL analysis categorized nine barriers as cause barriers and 11 as affected barriers. The “PROJECTS” model proposed for HR strategy development suggests eight strategies to overcome these nine cause barriers. The hybrid PRM framework developed includes the effect of the HR dimension. Research limitations/implications This paper presents the generalized prioritization of HR barriers to international PRM. For a specific international project, the HR barriers and their prioritization may change slightly. The hybrid framework for PRM and the strategy development model suggested are yet to be validated. Originality/value Correlating two CSFs in international project management, i.e. HRM and PRM and ranking the HR barriers using the DEMATEL method is the uniqueness of this research paper. The hybrid framework developed for PRM based on HR functions in Ulrich’s revised model and the proposed new HR strategy development model “PROJECTS” are unique contributions of this paper.

Evaluation of management and human resource challenges in the establishment of telemedicine in bandar abbas social security hospital, 2017

Objective: The emergence of internet and its development has made a lot of changes in every science and industry, medical science is not an exception, and the internet, in addition to the effects it has made on its own development, has also had significant effects on the development and improvement of medical services.Research method: This research is descriptive-qualitative with a phenomenological approach, which has been carried out in 2017 at Bandar Abbas Social Security Hospital (Persian Gulf). The information has been collected through a semi-structured interview with nine hospital staff.Results: The maxqud10 software was used to encode the collected data. As a result, 76 codes have been extracted out of two main components of management and human resource factors affecting on the establishment of telemedicine, which have been grouped into eight main categories.Discussion and conclusion: The results of this research can be used to identify managerial and human resource barriers in organizational planning for healthcare organizations. Keywords: remote treatment - telemedicine - challenges of telemedicine establishment  - remote medicine

Prioritization of barriers to energy generation using pine needles to mitigate climate change: Evidence from India

Forest fires due to pine needles in the northwestern Himalayas during summers are a very common phenomenon every year causing major harm to flora and fauna. They are a major contributor to climate change as forest fires destroy hectares of land covered by forest and emit greenhouse gases in the atmosphere. One possible solution to this problem is to generate energy from the bio residue of pine tree. This paper intends to identify, categorize and prioritize the major factors that hinders and are barriers to energy generation using pine needles in the state of Uttarakhand, India. This paper adopts a multi-criteria decision-making approach based on the technique of fuzzy Analytical Hierarchy Process. Sensitivity analysis is also used to test the robustness of this technique. The study finds that Legal and regulatory factors are the most critical and categorized as major influences of such renewable energy generation project, which includes government policy, project guidelines, financial support, technical support, and government clearances. The second barrier is economic which majorly includes cost factor associated with the development and sustenance of such energy generation projects. Technological and market related factors are next on the priority to energy generation using pine needles through limitations such as topography, hilly terrain, seasonal availability, supply chain, poor marketing. Human resource barriers stands at the fifth place and has less influence on such energy generation initiatives. This paper will help the policy makers to understand the priorities while solving energy generation issues to reduce forest fires and contribute to mitigate climate change.

More that unites us than divides us? A qualitative study of integration of community health and social care services

BackgroundThe integration of community health and social care services has been widely promoted nationally as a vital step to improve patient centred care, reduce costs, reduce admissions to hospital and facilitate timely and effective discharge from hospital. The complexities of integration raise questions about the practical challenges of integrating health and care given embedded professional and organisational boundaries in both sectors. We describe how an English city created a single, integrated care partnership, to integrate community health and social care services. This led to the development of 12 integrated neighbourhood teams, combining and co-locating professionals across three separate localities. The aim of this research is to identify the context and the factors enabling and hindering integration from a qualitative process evaluation.MethodsTwenty-four semi-structured interviews were conducted with equal numbers of health and social care staff at strategic and operational level. The data was subjected to thematic analysis.ResultsWe describe three key themes: 1) shared vision and leadership; 2) organisational factors; 3) professional workforce factors. We found a clarity of vision and purpose of integration throughout the partnership, but there were challenges related to the introduction of devolved leadership. There were widespread concerns that the specified outcome measures did not capture the complexities of integration. Organisational challenges included a lack of detail around clinical and service delivery planning, tensions around variable human resource practices and barriers to data sharing. A lack of understanding and trust meant professional workforce integration remained a key challenge, although integration was also seen as a potential solution to engender relationship building.ConclusionsGiven the long-term national policy focus on integration this ambitious approach to integrate community health and social care has highlighted implications for leadership, organisational design and inter-professional working. Given the ethos of valuing the local assets of individuals and networks within the new partnership we found the integrated neighbourhood teams could all learn from each other. Many of the challenges of integration could benefit from embracing the inherent capabilities across the integrated neighbourhood teams and localities of this city.

Ayurveda education in India: Addressing the human resource barriers to optimize the delivery

Ayurveda currently is passing through a phase of global renaissance. Its growing popularity however is not matching with quality driven human resource development to meet the growing expectations. Teachers holding the responsibility of inspiring the newer generation for their adherence to quality are often de-motivated for various reasons and eventually fail to deliver optimally. Although promoting Ayurveda by increasing its visibility is a priority approach in policy and planning, much is desired to be done on the fronts of its actual delivery. Not much is done to ensure the quality driven human resource development in Ayurveda, accounting for a major cause of its dismal show on the fronts like education, practice and research. Ayurveda in India in general is still striving to achieve the minimal standards in these key functioning areas. Uncertain career opportunities, poor recruitment and discriminatory promotional policies, erratic salary structures, meager opportunities for early and mid-career advancements and negligible resources for in job skill enhancements are prominent reasons of de-motivation among Ayurveda teachers. An identity crisis of being unfit in the larger community of higher or medical education further adds to the misery as the advantages given to these communities are not generally shared with Ayurveda teachers. The outcome of an education imparted by a demotivated teacher can have its far reaching and diverse effects on the society. A poor performance of Ayurveda in the country of its origin has its roots in the inappropriate handling of its key functionaries like teachers. Ayurveda teachers playing the role of service providers and educators can create the foundation of quality driven education and health care in Ayurveda, if they themselves are harnessed well for their potential. The teachers are essentially the spine of any step related to qualitative benchmarking of Ayurveda and hence their miseries and misappropriations are needed to be accounted and addressed. Ayurveda teachers also deserve to be nurtured well to bloom to their fullest potential so to serve Ayurveda with all their strength and capacity.

The Barriers Against the Entrepreneurship Development of Medical and Healthcare Tourism Industry: Evidence From Kermanshah, Iran

Background: Medical and healthcare tourism is an important area influencing destination development. Considering the geographical location of Kermanshah City, Iran and presence of the associated experts, the medical and healthcare tourism and entrepreneurship development are among the key resources for the sustainable development of Kermanshah. Objectives: The present study aimed to investigate the barriers against the entrepreneurship development of medical and healthcare tourism in Kermanshah. Methods: This explorative study was conducted with a mined design using the mixed-methods approach, involving both qualitative and quantitative methods. The sample population consisted of experts, tourists, skilled individuals in the areas of health, medicine, and tourism. Results: The main barriers against entrepreneurship development in medical and healthcare tourism in Kermanshah included infrastructural barriers, marketing and promotion barriers, human resource barriers, management barriers, governmental barriers, barriers related to rules and regulations, cultural barriers against tourism development, and issues in the cooperation of private and governmental sectors. Conclusions: According to the results, the severity of the impact of the barriers against entrepreneurship and tourism development was classified into three levels, and the implications were also discussed.