Improve Service Delivery Research Articles

Patient Experiences With Group Teletherapy for the Treatment of Mental Illness: A Qualitative Study.

The authors sought to understand patient experiences with group teletherapy to inform improvements in service delivery. From December 2022 to October 2023, semistructured interviews were conducted with 20 adults with depression or bipolar disorder who had received outpatient group teletherapy in the past 2 years. A rapid thematic analysis was conducted by using a matrix to identify patterns and synthesize data. A logic model from the patients' perspective was developed by extracting common themes related to elements of effective group teletherapy. Telehealth allowed for more empowered engagement in group teletherapy and enabled better access and longitudinal attendance for many patients, compared with in-person group therapy. However, many patients reported a reduced sense of emotional intimacy and connectedness with telehealth, and some reported that technology challenges and distractions contributed to feelings of disconnection. Patients were divided in their modality preferences, but many expressed an interest in receiving at least some of their group therapy sessions by telehealth. Although group teletherapy has the potential to meet patients' needs and preferences, more work is needed to improve the quality of the experience for patients.

Co-creation of migrant health interventions in Portugal: Insights from the VO(I)CES project

Abstract Background International migration is increasing both globally and in Europe, highlighting the need for responsive interventions that cater to the diverse needs and strengths of migrants. Although genuine involvement of stakeholders in the design and implementation of interventions is vital to enhance their relevance, responsiveness, and ownership, co-created migrant health interventions remain limited. This study aims to address this gap by collaboratively developing health literacy interventions with meaningful involvement from migrants and professionals from both the social and health sectors. Methods As part of the VO(I)CES project, twelve idea-generation workshops were conducted in Portugal, applying the Ophelia (Optimising Health Literacy and Access) process, engaging over 70 stakeholders (migrants, social and healthcare professionals). To guide discussions, these workshops used case vignettes developed from 16 health literacy profiles that were identified in a previous study among 1,126 migrants. The discussions aimed at eliciting detailed insights into the potential actions that are responsive to migrants’ challenges. Results Several key interventions were identified by the stakeholders, including the enhancement of cultural and linguistic training for healthcare providers, the use of community health agents/mediators to improve service delivery and community engagement, and the creation and dissemination of multilingual, multi-format health information materials. Specific interventions for groups experiencing increased vulnerabilities such as pregnant women were also proposed, alongside suggestions for creating citizen spaces and improving digital skills among healthcare staff. Conclusions The co-creation approach facilitated the development of tailored context-specific interventions that are anticipated to enhance health literacy, improve healthcare accessibility, and promote health equity for migrants. Key messages • Ideas Generation Workshops provide a platform for a wide range of groups to have their say and know their voice is being heard. • Co-creation tailors interventions to diverse needs, avoiding a one-size-fits-all approach.

Determinants of Student’s Satisfaction Towards Bus Service Quality in UiTM Cawangan Selangor

Bus service around the campus is essential for the movement of students to undergo academic and co-curricular activities. Student satisfaction with the quality of the bus service provided needs to be considered. Hence, this study was conducted to determine the relationship between empathy, perceived value, reliability and timeliness and also to examine the greatest predictors among all four variables towards student satisfaction with the quality of bus services at UiTM Cawangan Selangor. In total, 200 undergraduate university students took part in the research as survey respondents. The SPSS version 29 was used to analyze the data. The findings from the analysis revealed that empathy, perceived value, reliability and timeliness were found significantly correlated with student satisfaction. In addition, the reliability was highly significant in determining student satisfaction. The practical and theoretical implications of understanding the characteristics of empathy, perceived value, reliability and timeliness will make university administrators and service providers more concerned with student satisfaction to improve the quality of bus services provided. In addition, the results of this study also aim to provide insights that can be taken into action by the parties concerned in improving service delivery and the overall student experience.

Understanding the Impact of Social and Facilitating Factors on Drone Adoption in the Takaful Sector of Malaysia and Indonesia

The takaful industry, a sector that is guided by Shariah-compliant principles, is progressively investigating cutting-edge technologies to improve service delivery and operational efficiency. This study investigates the influence of social factors and facilitating conditions on the intention to adopt drone technology within the Takaful sector in Malaysia and Indonesia. A quantitative research design was employed, with data collected from 68 Takaful professionals. The results were analyzed using correlation and regression techniques. The findings revealed that social influence and facilitating conditions significantly impact behavior intention, while performance and effort expectancy were found to be less important. Additionally, the study integrates Maqasid Shariah principles, ensuring that the adoption of drone technology aligns with Islamic ethical considerations. The study also urges more investigation to investigate the generalisability of these results over many cultural and legal environments as well as the possible impact of developing technologies like artificial intelligence and blockchain on the sector.

Impact of Human Resource Policy Implementation on Service Delivery at the Office of the Director of Public Prosecutions, Western Region, Kenya

Efficient implementation of policies has a crucial function in improving service delivery in the public and private domains. The success of policy execution directly impacts how much the policy contributes to enhancing service delivery. To achieve high-quality, efficient, and timely service delivery, the Directorate has adopted a strategy of revamping, retooling, and continuous learning. The Office of the Director of Public Prosecutions (ODPP) follows the Excellence Charter and adheres to the ODPP Strategic Commitments for the period 2020-2023. In this context, the researcher focused on examining the impact of human resource policy implementation on service delivery at the Office of the Director of Public Prosecutions, Western Region, Kenya. Implementation Theory and Organizational Culture Theory guided the study. Descriptive research design was utilized. The target population was 198 individuals working within the ODPP Western Region of Kenya. Individual respondents were selected randomly from Legal, Administration, and Support Staff in region. Data collection was done through questionnaires distributed to staff and document analysis was conducted in the resource centres available in the region. Face-to-face interviews with selected County Heads were carried out by the researcher. Descriptive statistics, such as means, percentages, and frequencies, was used in the research's quantitative and qualitative approaches to analyze the data using SPSS. The findings indicated that human resource has a significant impact on service delivery at the ODPP, Western Region, Kenya. The results upon Analysis of Variance (ANOVA) established human resource policy implementation had an r of 0.265, β = 0.252, t= 3.786, p= 0.05. It was concluded that Policy Implementation had a statistically significant impact on service delivery in the ODPP. The study recommends that ODPP should enhance HR policy implementation and service delivery in the Western Region by improving communication, offering regular training, fostering open dialogue, establishing a robust monitoring framework, deploying dedicated HR Officers, and ensuring transparent and unbiased career progression and training opportunities. The study will be part of references materials for all ODPP Staff, stakeholders, policy makers and other institutions in Kenya as an insightful tool in advancement of efficacy and efficiency in policy implementation.

Enhancing Change Management for Improved Public Service Delivery: A Study of Kampala Capital City Authority (KCCA)

Purpose: This study aimed to investigate the role of change management in improving service delivery within government parastatals in Uganda, specifically focusing on the Kampala Capital City Authority (KCCA). It explored the enabling factors for change management on service delivery and assessed the effects of change management on service delivery within these parastatals. Methodology: The study employed a cross-sectional and exploratory approach, utilizing both quantitative and qualitative methods. The study population consisted of 298 participants from various departments within KCCA. Data collection methods included self-administered questionnaires, interviews with key informants, and documentary reviews. The study instruments were validated using the Content Validity Index, and reliability was assessed using Cronbach’s Alpha coefficient. Quantitative data were analyzed using descriptive statistics, correlation analysis, and bivariate regression, while qualitative data were analyzed through content analysis. Findings: The study concluded that the enabling factors for change management on service delivery in government parastatals in Uganda are not well understood. Additionally, it found that change management does have a significant impact on service delivery within these institutions. Unique contribution to theory, practice and policy (recommendations): Based on the conclusions, it is recommended that KCCA administrators enhance service delivery through a more holistic approach to change management. This should involve addressing various enabling factors and components of the change management framework to optimize service delivery outcomes.

The Role of Technology and Automation in Streamlining Business Processes and Productivity for SMEs

Purpose: This research investigates the vital role of automation in enhancing business process efficiency and overall productivity within SMEs. It also discusses how technology can help overcome bottlenecks arising from human operation, resource limitation, and operational inefficiency, which have commonly been experienced by SMEs. Materials and Methods: The study combines an extensive review of existing literature with case studies from various industries to evaluate the effects of automation tools on SME operations. These tools range from cloud-based solutions to AI-powered systems, providing insights into their impact across different business processes. Findings: Research has shown that automation improves productivity in SMEs by up to 30%, reduces manual errors by 25%, and enhances data accuracy by improving employee focus on strategic tasks. In addition, the standardization of processes through automation ensures less variability in output. Automation also impacts customer experience positively by ensuring speed in service delivery and quality improvement in products. High upfront costs, however, combined with a shortage in skilled personnel and integrating new technologies with existing systems, remain barriers to wider adoption by SMEs. Implications to Theory, Practice and Policy: Accordingly, the study recommends that the following measures be taken to counteract the problems posed: phase in automation, cooperate with technology providers who will devise cost-effective solutions, and invest in comprehensive training programs to fill the skills gap. Government incentives, such as tax breaks and subsidies, could also push SMEs toward broader automation. Thereafter, successful integration of automation will enhance the competitiveness of SMEs and create a sustainable growth path in the digital economy.

Power, data and social accountability: defining a community-led monitoring model for strengthened health service delivery.

Despite international commitment to achieving the end of HIV as a public health threat, progress is off-track and existing gaps have been exacerbated by COVID-19's collision with existing pandemics. Born out of models of political accountability and historical healthcare advocacy led by people living with HIV, community-led monitoring (CLM) of health service delivery holds potential as a social accountability model to increase the accessibility and quality of health systems. However, the effectiveness of the CLM model in strengthening accountability and improving service delivery relies on its alignment with evidence-based principles for social accountability mechanisms. We propose a set of unifying principles for CLM to support the impact on the quality and availability of health services. Building on the social accountability literature, core CLM implementation principles are defined. CLM programmes include a community-led and independent data collection effort, in which the data tools and methodology are designed by service users and communities most vulnerable to, and most impacted by, service quality. Data are collected routinely, with an emphasis on prioritizing and protecting respondents, and are then be used to conduct routine and community-led advocacy, with the aim of increasing duty-bearer accountability to service users. CLM efforts should represent a broad and collective community response, led independently by impacted communities, incorporating both data collection and advocacy, and should be understood as a long-term approach to building meaningful engagement in systems-wide improvements rather than discrete interventions. The CLM model is an important social accountability mechanism for improving the responsiveness of critical health services and systems to communities. By establishing a collective understanding of CLM principles, this model paves the way for improved proliferation of CLM with fidelity of implementation approaches to core principles, rigorous examinations of CLM implementation approaches, impact assessments and evaluations of CLM's influence on service quality improvement.

Intergovernmental Relations and the Financial Resource Allocation for the Healthcare Sector in Nairobi City County, Kenya

Since the beginning of devolution of health sector in Kenya in 2013, there have been several concerns regarding heath care service delivery ineffectiveness, which have been attributed to strained ties between the national and county governments. There have been issues with service delivery and medical supply shortages in Nairobi City County's healthcare sector. This study sought to investigate how intergovernmental interactions have affected healthcare in in Nairobi City County. Specifically, the study examined how intergovernmental relations affect the financial allocation for the sector. The study was anchored on resource-based theory. A descriptive research design was employed involving a census for all the 7 administrators working at level 4 and level 5 health facilities in Nairobi City County as well as 78 employees working in the health department of Nairobi City County Government, constituted the sample population. Descriptive analysis was done using the standard deviation and the mean while inferential analysis was done using regression, F-test and ANOVA. The analyzed data was provided as frequency tables, percentages, and charts. Before the data collection, respondents were asked to provide informed consent, and anonymity and secrecy were assured to boost the response rate. The most critical relationship was between intergovernmental relations and financial resource allocation for the healthcare sector in Nairobi City County accounting to 39.4%. The findings suggested that in order to guarantee that financial resources are allocated appropriately, the national and the county government should work to enhance intergovernmental ties. This also helps in ensuring timely release of financial resources to health facilities by the national government. The study recommends that the financial allocation for healthcare should be enhanced so as to improve service delivery. There is also need to enhance own source revenue for the City County so as supplement the shareable revenue from the national government, which collectively will increase the finances available for utilisation in the healthcare sector

Developing an Ideal Change Management Framework for Enhancing Service Delivery in Government Parastatals: A Case Study of Kampala Capital City Authority in Uganda.

Purpose: This study aims to develop an ideal change management framework specifically tailored to government parastatals in Uganda, focusing on the Kampala Capital City Authority (KCCA), to enhance service delivery. Methodology: The research adopted a cross-sectional and exploratory approach, utilizing both quantitative and qualitative methods. The study population comprised 298 participants from various departments within KCCA. Data collection involved self-administered questionnaires, interviews with key informants, and documentary review. Validation of study instruments was conducted using the Content Validity Index, and reliability was assessed through Cronbach’s Alpha coefficient. Quantitative data were analyzed using descriptive statistics, correlation analysis, and bivariate regression, while qualitative data underwent content analysis. Findings: The study concluded that the change management process for service delivery in government parastatals in Uganda is well-defined. However, the ideal change management framework necessary for improving service delivery among these parastatals remains unidentified. Recommendations: Based on the findings, it is recommended that KCCA administrators adopt a more holistic approach to change management, addressing various enabling factors and components necessary to enhance service delivery effectively.

“Do I feel safe here?” Organisational climate and mental health peer worker experience

BackgroundIn Australia, lived experience peer support workforces are expanding making it one of the fastest growing emerging disciplines in transdisciplinary mental health settings. This article provides insight for organisations on the contextual realities peer workers face, increases understanding of peer support services to improve service delivery environments and contributes to mental health systems reform. This study aimed to qualitatively explore peer support workers experience integrating into and working within transdisciplinary mental health service teams.MethodSemi-structured interviews were undertaken with 18 peer support workers currently working in mental health services in Australia. The research was a qualitative descriptive study design. All data collected were analysed utilising thematic analysis.ResultsPeer workers found their experience in the workplace was influenced by their colleagues and the organisation’s understanding of the peer role. Factors relating to organisational culture and climate were a central theme throughout discussions noting that a negative climate was perceived as harmful to peer workers. Themes established through results include (1) the role of leadership, (2) attitudes and behaviours of colleagues, (3) provision of psychologically safe environments, (4) the organisations messaging and use of language and (5) organisational structures and policy.ConclusionThis study contributes to evidence for the impact of organisational culture on integrating and supporting peer support workers in mental health service delivery. This study provides insights into peer worker experiences integrating into transdisciplinary teams, confirming findings established in previous studies, highlighting a lack of movement or change in workplace culture to support peer worker integration into mental healthcare settings.

Point-of-care biochemistry for primary healthcare in low-middle income countries: a qualitative inquiry

BackgroundAccess to essential diagnostics is crucial for primary healthcare (PHC) in low-and-middle income countries (LMICs). Many LMICs have invested in equipping PHC with point-of-care (PoC) diagnostics for infectious diseases, however there has been no similar investment to improve PHC capacities for clinical chemistry. The biochemistry gap is among the deterrents to universal health coverage.MethodsA social sciences project was conducted with the aim to understand the key PHC stakeholders’ insights on the pertinence of PoC biochemistry for PHC in LMICs. Data generation was conducted between July-November 2023 in Mongolia, Nigeria and Peru. Decision-makers in healthcare delivery, healthcare professionals, and patient and community advocates were engaged using a combination of sampling techniques. Unstructured individual and group conversations, and non-participant observation were conducted. Analysis involved an inductive line-by-line coding on printed transcripts, followed by a deductive coding and theme-by-theme analysis on digitized transcripts.ResultsFifteen, 51 and 20 informants from Mongolia, Nigeria and Peru, respectively, participated. Fifty-five of the 94 informants were female. Most informants considered that PoC biochemistry in PHC would be pertinent, from a clinical and a resources-saving perspective. Those households that currently bear the burden of referrals (i.e., the poor, the bedridden, the older adults) would benefit the most from the deployment of PoC biochemistry for essential biochemistry parameters. Improved access to PoC glycated hemoglobin (HbA1c), lipid, liver and kidney profile was perceived as helpful to inform clinicians’ decision-taking. The value of PoC biochemistry for the management of noncommunicable diseases (diabetes, hypertension) and infectious conditions (dengue, malaria, tuberculosis), to improve child health outcomes (severe dehydration in children with diarrhea and/or malnutrition) and to reduce preventable causes of death (dengue-related renal failure) was highlighted.ConclusionsPoC biochemistry holds potential to revert the impact that the biochemistry gap has for patient care in some LMICs’ PHC settings. PoC equipment for parameters such as HbA1c, urea, creatinine or electrolytes could enhance community-level management of preventable causes of mortality, improve service delivery for patients affected by locally-prevalent infectious conditions, and improve the psychosocial and economic wellbeing of patients facing the burden of referrals to remote biochemistry-equipped centers.Trial RegistrationNot applicable.

Examining the impact of organizational and management variables on sport service delivery in Ethiopia

There is an observed general low performance of Ethiopian Sport Governing Bodies (SGBs) in service delivery. Evidence shows that the trend can be corrected with proper understanding and insight into the process of organizational and management factors of these SGBs. This study aimed to investigate the contribution of organizational and management factors as determinants in effective service delivery in SGBs. For this study, a cross-sectional research design was employed. Purposive sampling was used to choose 350 samples from 154 internal and 196 external stakeholders. The instruments used for the study were the key informant interview and the questionnaire. Pearson Product Moment Correlation Coefficient and multiple regression were used to analyze the data at the 0.05 significant level while qualitative data were content analyzed. The findings confirmed that organizational and management factor variables had a significant positive relationship with sport service delivery (organizational structure (r=0.515), organizational capabilities (r=0.701), communication (r=0.549), management practice (r=0.571), materials & resources (r=0.527) and stakeholders satisfaction (r=0.742). Management factors jointly predicted effective sport service delivery (F (3, 329)= 165.868, R2= 0.612); organizational factors had a joint significant contribution to effective sport service delivery (F(3, 329) = 148.743, R2= 0.576). Further, organizational and management factor variables had a joint relative significant influence on effective sport service delivery in Ethiopian SGBs (F (6, 326) =130.81, R2= 0.707). Interviews revealed that there are weak relations with stakeholders, an unaligned structure of regional sport bodies with federal bodies, and managers with improper experience and knowledge in sport which influences effective sport service delivery in Ethiopian SGBs. Therefore, working together with stakeholders, structural advancement, designing rules and regulations that can serve a longer time, taking correction based on feedback from stakeholders, networked structures and collaborations with local sports organizations as means of improving service delivery employing shared burden and coordinated effort are recommended. Keywords: Management, Organization, Service delivery, Sport governing bodies

Mapping refugee populations at high resolution by unlocking humanitarian administrative data

BackgroundInforming local decision-making, improving service delivery and designing household surveys require having access to high-spatial resolution mapping of the targeted population. However, this detailed spatial information remains unavailable for specific population subgroups, such as refugees, a vulnerable group that would significantly benefit from focused interventions. Given the continuous increase in the number of refugees, reaching an all-time high of 35.3 million people in 2022, it is imperative to develop models that can accurately inform about their spatial locations, enabling better and more tailored assistance.MethodsWe leverage routinely collected registration data on refugees and combine it with high-resolution population maps, satellite imagery derived settlement maps and other spatial covariates to disaggregate observed refugee totals into 100-m grid cells. We suggest a deterministic grid cell allocation inside monitored refugee sites based on building count and a random-forest-derived grid cell allocation outside refugee sites based on geolocating the textual geographic information in the refugee register and on high-resolution population mapping. We test the method in Cameroon using the registration database monitored by the United Nations High Commissioner for Refugees.ResultsUsing OpenStreetMap, 83% of the manually inputted information in the registration database could be geolocated. The building footprint layer derived from satellite imagery by Ecopia AI offers extensive coverage within monitored refugee sites, although manual digitization was still required in rapidly evolving settings. The high-resolution mapping of refugees on a 100-m grid basis provides an unparalleled level of spatial detail, enabling valuable geospatial insights for informed local decision-making.ConclusionsGathering information on forcibly displaced persons in sparse data-setting environment can quickly become very costly. Therefore, it is critical to gain the most knowledge from operational data that is frequently collected, such as registration databases. Integrating it with ancillary information derived from satellite imagery paves the way for obtaining more timely and spatially precise information to better deliver services and enhance sampling frame for target data collection exercises that further improves the quality of information on people in need.

Employee Performance in Population Services Quality Timeliness and Technology Use

General Background: Employee performance in public administration is crucial for service quality. Specific Background: This study examines employee performance in population administration services at Kupang Village, Jabon District, Sidoarjo Regency, focusing on community needs and technological adaptation. Knowledge Gap: While prior research has addressed public service performance, gaps exist regarding specific performance indicators in local contexts. Aims: This study aims to analyze performance using five indicators: Work Quality, Timeliness, Initiative, Ability, and Communication. Results: Findings show optimal work quality and initiative, yet timeliness and ability are partially lacking due to attendance issues and varying technological skills. Novelty: This research highlights the interplay between employee competencies and community demographics. Implications: Enhancing training in technology and establishing clear protocols could significantly improve service delivery and community satisfaction, fostering better governance and public trust. Highlights: Optimal Work Quality: Employees demonstrate high-quality service through detailed work and effective communication with the community. Need for Timeliness: Issues with employee punctuality impact overall service delivery and community satisfaction. Technological Competency: Varying levels of technology use among employees highlight the need for targeted training and support. Keywords: Employee Performance, Service Quality, Community Needs, Population Administration

PADV-01 CHALLENGES OF NEURO-ONCOLOGY CARE IN ZIMBABWE

Abstract Due to the advent of covid 19 coupled with the socio-economic crisis in Zimbabwe, this has resulted in numerous challenges in terms of health care access and resultant diagnostic and treatment barriers for neuro-oncology cases. A retrospective analysis of the burden of neuro-oncology cases which have been seen at a single center in Zimbabwe over the past 5 years and the resultant diagnostic and treatment barriers that have incurred. METHODS An audit of brain tumor cases was done through the analysis of Outpatient department records, Neurosurgery Admission records, and Neurosurgery theatre records at Sally Mugabe Central hospital. RESULTS Total number of cases recorded for the period were 71. Meningiomas 11 (15,5%), Posterior fossa tumors 12 (17%), Gliomas 6 (0.08%), Craniopharyngiomas 6(0.08%), Metastasis 5(0.07%), Pituitary tumors 4(0.06%), choroid plexus papilloma 3(0.04%), Lymphoma 2(0.03%), Pineal region tumor 1(0.01%). 21(30%) tumors were unclassified. Posterior fossa tumors were most common in the pediatric population less than 10years of age. Meningiomas had a female to male ratio of 1.75: 1. 9 (12%) patients were operated on during the same period mostly pediatric tumors. CONCLUSION There is a great deal of institutional as well as patient related factors affecting the diagnosing and treatment of neuro-oncology care in Zimbabwe. This includes lack of operating time, inadequate intensive care facilities, a general unavailability of medical imaging services, delay in pathological reporting, unavailability and costly adjuvant treatment. This is leading to late diagnosis and suboptimal treatment of the various tumors. Although brain tumors are rare, they are not uncommon and there is thus need to improve service delivery to ensure early diagnosis and treatment to have good outcomes.

Development of a tool to assess financial advocacy service delivery.

21 Background: In 2023, the Association of Cancer Care Centers (ACCC) Financial Advocacy Network published Financial Advocacy Services Guidelines developed through an expert-led, consensus-driven process (1). The Guidelines provide a framework for equitable delivery of financial advocacy (FA) services to address patients’ financial concerns. The Guidelines cover 3 domains: financial advocacy services and functions, program management functions, and partner engagement functions. ACCC adapted the Guidelines into a Financial Advocacy Services Assessment Tool to help cancer care organizations assess and improve service delivery and to advance research of organization-level FA practices across the U.S. Methods: ACCC convened an expert task force to guide this work. ACCC conducted a scan of implementation science literature and health care organizational assessments to inform the development of a rating system for each of the 43 guidelines. Four service delivery levels were identified, and a score was assigned to each level (Table). The tool was programmed in Qualtrics to provide a total score and average score per guideline for each FA domain and sub-domain. The task force added unscored questions about organizational demographics, barriers, and readiness to enable aggregate research and sub-group analysis. ACCC invited members of the Financial Advocacy Network to participate in a pilot via email invitation and provided opportunities for open-ended feedback. Results: 20 cancer centers participated in the pilot between March-May 2024. 15% were academic institutions and 85% were community-based programs (18% of which are directly affiliated with an academic institution). Respondents reported the tool was easy to use and informative for quality improvement efforts. See Table 1 for total scores for initial pilot. Conclusions: Pilot results reflect that all participating cancer centers are already engaged in some level of FA services. Broader dissemination and analysis is ongoing. The assessment provides centers with a practical resource to assess alignment to guidelines and identify opportunities for quality improvement. Regular review of aggregate results will help ACCC provide benchmarks for areas of service delivery, identify barriers to implementation, and monitor trends in FA staffing. 1. Kajdic Hodzic R, Liang MI, et al. Developing consensus-based oncology financial advocacy services guidelines. JCO Oncol Pract. 2023;19(suppl 11):38. Levels of FA service delivery and pilot total scores. Level Description % of pilot cancer centers Level 1 Not performing financial advocacy services. 0% Level 2 Making progress with financial advocacy services, but it is done informally or inconsistently. 35% Level 3 Performing financial advocacy services consistently in at least one key area of the organization. 60% Level 4 Reliably performing financial advocacy services across all key areas of the organization. 5%

‘The voice of the child? The child has no voice’: an Irish study exploring the voice of young children in decisions regarding contact

Since January 2016, Irish family law courts have been obliged to take into consideration the voices of children in proceedings where decisions regarding contact with parents are being made. This article examines the findings of an Irish study that shed light on how young children’s voices are heard in decisions regarding contact with parents who do not, or no longer, live together. The views of key stakeholders who have some involvement with contact arrangements for young children in the 0–6 years age category are highlighted. A thematic analysis of the data was conducted in order to understand various perspectives on how and under what circumstances young children are heard in contact cases. The findings demonstrate that the voices of young children are virtually absent in family law decisions regarding contact. Determining factors relate to the infrastructure of the courts, a significant lack of resources to support the Irish family law system and significant variation in practice approaches between social and legal professionals. As a result of these findings, suggestions are proposed for informing practice and improving service delivery in family law in a way that best meets the needs and rights of young children.

Intersections of Compassion, Science, and Spiritual Care in Global Health for Public Health Benefits.

Across the globe, spiritual care is offered by individuals, healthcare chaplains, and humanitarian, social and related spiritual groups on account of zeal, voluntary and paid services. Sometimes, services are provided without understanding the connectivity of compassion, spiritual care, and scientific protocols. There are instances where health professionals and managers disagree with spiritual caregivers or reject spiritual services because of poor service deliveries in conflict with healthcare protocols. Against this background, this article focuses on how spiritual care services can be provided scientifically to improve service delivery. It presents leading questions to link the scientific and compassionate approach to spiritual care. These include-What is science? What is compassion? What is spiritual care? What makes compassion and spiritual care scientific? Are there tenets of compassion in religions? How are compassion, science and spiritual care linked? What are the implications of the intersections for public health and safety? Hopefully, the provided answers may improve the service delivery performance of spiritual caregivers and their collaboration with healthcare professionals, social workers, and related groups.

The Roles of SERVICOM in Service Delivery in Nigeria

Governments all over the world including Nigeria, have preferred better ways to provide welfare services to the citizens with fewer resources. Service Compact (SERVICOM) with all Nigerians was a direct response to improving service delivery in Nigeria which sought ways to provide welfare services to all the citizens with limited resources, enhancing transparency and accountability of public servants. This paper examined the extent to which the application of SERVICOM as a public policy has improved upon service delivery of the Nigerian public service, arising from the background that it serves as the machinery upon which governmental policies are implemented. This paper brought to the fore the critical importance of public service delivery to the citizens in a timely, honest, appreciable and effective manner under democratic dispensation. The importance of SERVICOM has resonated in all public organizations, with an emphasis on healthcare delivery and education sector. The paper however unearthed that some of the reforms of government including SERVICOM has not changed the attitudes of some public servants and other public officers. This paper relied heavily on secondary data collection which included review of related literature, online analysis of some related reforms, use of some periodicals, upon which findings were made. This paper recommended amongst others training, and retraining with ICT touch, and the establishment of monitoring teams to enforce adequate compliance. The national orientation agency should also be empowered to commence enlightenment campaigns for the entire citizens.