Country Perspective Research Articles

Economic evaluation of adding dapagliflozin to standard care in the treatment of chronic kidney disease: a systematic review

IntroductionChronic kidney disease is a significant public health issue. Dapagliflozin has been shown to improve the quality of life for patients with chronic kidney disease. This review aimed to systematically assess the cost-effectiveness of adding dapagliflozin to standard care compared with standard care alone for treating chronic kidney disease.MethodsThe relevant studies were searched in PubMed, Web of Science, Scopus, Embase, and Cochrane from the inception date to June 1, 2024. The titles, abstracts, and full texts were independently evaluated and screened by two authors. Additionally, the economic evaluation studies were assessed independently by two authors using the consolidated health economic evaluation reporting standards checklist.Results14 studies were included which were about the economic evaluations of adding dapagliflozin in the treatment of chronic kidney disease. The minimum consolidated health economic evaluation reporting standards score for the studies was 0.77, indicating very good quality. Adding dapagliflozin to the standard of care would be more effective and cost-saving in Mexico, Malaysia, Canada, Thailand, and China. The highest incremental cost-effectiveness ratio of dapagliflozin ($67962.75/QALY) originated from the USA. According to the available studies, adding dapagliflozin to standard of care for the treatment of chronic kidney disease is considered cost-effectiveness from both the healthcare system and the payer’s perspective.ConclusionAdding dapagliflozin to standard care in the treatment of chronic kidney disease is cost-effective from both the healthcare system and the payer’s perspective in well-developed countries.

Understanding access to sexual and reproductive health in general practice using an adapted Candidacy Framework; a systematic review and qualitative evidence synthesis.

Background General practice has a key role in reducing inequity in access to sexual and reproductive health (SRH). Unplanned pregnancy, abortion and STIs are increasing and disproportionately affects deprived communities and ethnic minority groups. The candidacy framework offers a practical, theoretical framework for understanding the complex interactional processes of access to SRH in general practice. Aim To use the candidacy framework to explore access of SRH in general practice. The seven interaction stages include, identification of need, navigation of services, permeability of services, appearing and asserting need, adjudication by healthcare professional, offers or resistance of offer and the local operating conditions or local production of candidacy. Design and setting This study involved a systematic review with qualitative evidence synthesis using a framework approach. Methods A systematic search of MEDLINE, EMBASE, PUBMED, and the Web of Science was conducted to identify primary qualitative research studies exploring access to SRH in general practice from practitioner, public, and patient perspectives in countries with universal healthcare. The candidacy framework was used to synthesise the findings. Results Analysis of 42 studies revealed the impact of stigma, shame, and embarrassment among individuals, communities, and healthcare practitioners. Findings showed limited inclusion of demographics such as ethnicity and socio-economic status. Barriers to access were more evident for those from lower socio-economic communities, ethnic minorities and LGBTQ+. There are multiple barriers, which include the behaviours of healthcare professionals who have a crucial role in recognising an individual's SRH need. Conclusions General practice offers a cradle-to-grave healthcare service, which should have SRH as a priority area of provision. Further understanding is needed of the impact of historic harms by medicine and healthcare on racialised individuals and gender minorities.

Does Employee Wellbeing Mediate the Relationship between Job Characteristics and Job Performance in the Banking Industry? An Emerging Country Perspective

Banks play a crucial role in fostering and sustaining economic development within each country. Moreover, the rapid evolution of technology significantly influences the banking industry, ushering in profound changes in work dynamics. The post-COVID-19 era has accentuated the importance of employee well-being as a critical necessity for all workers. This study aims to elucidate the interplay between job characteristics, employee well- being, and job performance. A self-administered survey was conducted with employees working in the Vietnamese banking industry. After 4 months, we received 831 valid responses from 15 Vietnamese joint-stock commercial banks. SMARTPLS software was employed for structural equation modelling analysis. The findings shed light on the intricate relationships between job characteristics, employee well-being, and job performance. Building upon these insights, the study provides recommendations for Vietnamese banks to enhance job performance by refining job characteristics and fostering employee well-being.

Public Sector Corporate Social Investments in Namibia: The Case of the Mobile Telecommunications Company

A bias in research has seen studies focus mostly on corporate social investments (CSIs) in the private sector. The current study aims to provide an alternative perspective to the traditional association of CSIs with private sector organisations by including public sector entities such as public enterprises (PEs), using the case of the Mobile Telecommunications Company (MTC) in Namibia. A qualitative research method and a single case study research design focusing on MTC was used, and data were analysed through themes and deductive reasoning. The major findings of this study show that MTC is exemplary in practicing CSI in Namibia’s public sector. MTC has various impactful socio-economic and environmental focus areas of CSI, which contribute to the development agenda of the Namibian government. The issue of CSI in the public sector is intriguing and could be usefully explored in further research, particularly from a developing country perspective. It is now possible to conclude that PEs can also be dominant players in the CSI sphere, particularly from a public sector perspective. The findings in this study make important contributions to the literature by providing a public sector institutional perspective of CSI that is different from the traditional view that mostly associates CSIs with the private sector.

Retraction notice: Achieving organizational performance by integrating industrial Internet of things in the SMEs: a developing country perspective

Retraction notice: Achieving organizational performance by integrating industrial Internet of things in the SMEs: a developing country perspective

Determinants of e-grocery purchase retention and buyer profiling: A developing country perspective

The COVID-19 pandemic has accelerated the growth of e-grocery, leading to a steady increase in e-grocery shoppers worldwide. E-grocery businesses, having invested in their operations, rely on continuous sales growth. However, few studies focus on purchase retention or shopper profiles within Malaysia's e-grocery sector. This study aims to address these gaps. Its objectives are to identify factors that influence e-grocery purchase retention and to profile e-grocery buyers. A total of 200 responses were gathered using convenience sampling. Data analysis was conducted using SPSS software (version 28), employing independent t-tests, ANOVA, and correlation analysis. Factors such as convenience, product availability, perceived security, efficiency, fulfillment, system availability, and privacy were found to impact purchase retention. Additionally, demographic factors like spending level and prior e-grocery experience showed a significant positive relationship with purchase retention. Gender differences in retention were also noted, and spending and e-grocery experience positively correlated with convenience, perceived security, efficiency, fulfillment, system availability, and privacy. Age, however, was negatively correlated with product availability. This research offers valuable insights for e-grocery retailers aiming to enhance their operations and provides a foundation for future research on this topic.

Exploring the dynamics of socio-technical transitions: Advancing grid-connected wind and solar energy adoption in Nigeria

Globally, countries are transitioning their national electricity grid system to meet the obligations of the Paris Agreement. National grid-connected renewable electricity provides an opportunity to reduce greenhouse gas emissions. Specifically, in a developing country like Nigeria, renewable energies such as solar and wind power can play a critical role not only in transitioning away from fossil-fuel based electricity systems but also to address prevalent energy security challenges, electricity supply deficit and gaps in energy access. Policies, plans, and strategies to ensure grid-connected renewable energy have been put in place, but these measures have proved ineffective. Likewise, there are limited studies that investigate these transition problems, including drivers and enablers from a developing country perspective. This research fills that gap in knowledge by investigating these transition dynamics through a qualitative approach applying the multi-level perspective framework. Thirty-one (31) key energy and non-energy actors were interviewed, and the transcripts thematically analysed. Findings indicate that there is prospect for Nigeria to transform its electricity system. However, there are major deterrents including institutional, infrastructural, incumbent electricity system instability and economic barriers. The paper highlights that there is a level of regime stability/instability that will enable renewable energy development. In addition, practical and policy insights are offered to overcome identified challenges towards accelerating electricity system transformation. Future studies should also explore the degree of instability, stability and change in developing country settings necessary for energy transition to occur. Finally, this paper advances debates in energy transition and socio-technical system studies.

Revitalizing faith: an inquiry into political Sufism and religious continuity in contemporary Kazakhstan.

The article embarks upon a study of political Sufism in contemporary Kazakhstan and patterns of religious continuity through an examination of Islamic manifestations that stretch back centuries, juxtaposed with the current state religious policy. It examines the role of the Muftiate's "official Islam" in shaping the life of religious communities, exploring the intricate interplay between religious identity, secularism, and public perception in the post-Soviet landscape. The author employed a multi-faceted research approach, integrating historical analysis, policy examination, and an ethnographic study of contemporary religious dynamics in the country. The historical analysis provides a foundation of the religious landscape, while policy analysis examines the state's contemporary role in shaping religious practices. Ethnography, focusing on groups such as the Jahriyya, Naqshbandiyya, and the Suhba, involves respondents from diverse regions of Kazakhstan, offering firsthand insights into the experiences and perceptions of Sufi communities at the grassroots level, which enriches the study with a contextual perspective. Notably, fieldwork surveys, where the author engaged with respondents, provide valuable insights into the diverse experiences shaping the dynamics of political Sufism and religious continuity. They involved a diverse group of respondents, including religious leaders, community members, and secular intellectuals, from multiple regions of Kazakhstan at both urban and rural levels. The article is of scientific and practical significance as it enhances understanding of religious dynamics in the country, offering policymakers, scholars, and practitioners valuable perspectives for informed decision-making and policy development. The research's limitations include its focus on specific Sufi groups within Kazakhstan, which may not represent the full spectrum of Islamic practices across the region. The recommendations emphasize the need for further analysis of how prioritizing doctrinal adherence over individual freedoms contributes to the erosion of authentic religious institutions and the politicization of Islam. It also recommends to investigate the roles of Sufi groups in filling spiritual and social vacuums, their potential for politicization, and how this interplay affects religious freedom and national identity in Kazakhstan. This is particularly significant given the state's efforts to appropriate Islamic traditions for ideological purposes, which has led to a separation between Islamic doctrine and its lived expressions. Finally, it emphasizes the need for further comparative research on Sufi movements across Central Asia to better understand how different state policies impact religious communities.

Deterrence strategies for a small state: Analysis and survey

Abstract Classical deterrence theory has its origins in the era of the Cold War and the nuclear arms race between the USA and the Soviet Union. Therefore, deterrence is mainly studied from the perspective of the superpowers. This study approaches deterrence from the less explored perspective of a small country by analysing academic deterrence literature and further deepening this perspective by means of a survey. As a result, the study produced a new view of how a small state can be positioned in modern deterrence theories, by introducing national and international enabling and preventive factors. The main findings of the research suggest that national enabling factors, such as a strong national defence and the resilience of the society, are important for a small state in terms of compensating for the deficit in influence in relation to superpowers. Limited options for building deterrence can be augmented by means of international enabling factors, such as military and political alliances. Deficits in terms of available military resources and international status could translate into national preventive factors, such as weakness in the eyes of the aggressor. The aggressor’s political intentions and history could appear as international preventive factors if they influence decision-making in an undesirable manner.

Who benefits from strong patent protection? An oil‐dependent country's perspective

AbstractIn this paper, a complex interplay is demonstrated, indicating that the impact of intellectual property rights (IPR) and patent protection varies in certain trade contexts. We review the IPR and patent laws in Oman and subsequent amendments following the signing of free trade agreements and investigate how strong protection of patents and IPRs affects Oman's trade. A panel data set comprising the majority of Oman's trading partners from 2000 to 2021 was utilized to achieve this objective. Under the Oman Intellectual Property (IP) Laws, 5617 patent applications were used to calculate the patent index scores. This study contributes four significant findings. First, it analyzes how strong IP and patent protection affect Oman's exports and imports. Second, it assesses the variation in overall trade flows and manufacturing trade flows. Third, while most studies use the IPR index, this study offers a more specific perspective by examining the patent index, particularly concerning manufacturing trade, which is primarily associated with patent‐protected technologies. Fourth, this study provides the first comprehensive analysis of a GCC country that is heavily dependent on oil. This study reveals that Oman's strong IPR and patent regimes significantly enhance overall exports. Strong patent protection promotes the import of high‐tech goods, whereas robust IPR protection unexpectedly reduces manufacturing trade.

Analysis of wrong blood in tube events at a hospital-based blood centre in a tertiary care referral hospital: A perspective from a lower middle-income country.

Wrong blood in tube (WBIT) continues to be a preventable cause of unintended harm to the patient. The literature describing extent of the problem, its consequences and factors leading to WBIT from the perspective of lower middle-income countries (LMICs) is limited. The present study describes WBIT and its outcome in a hospital-based blood centre from an LMIC. WBIT events occurring during the study period were analysed to identify the root cause. In addition, they were analysed according to discipline, department and time of sample draw. Root causes were divided and compared with standard operating procedure (SOP) for sample collection for blood requests. All WBIT events were followed and their outcomes analysed. WBIT events occurred at a rate of 4.8/10,000 blood requests, with a higher rate in urgent requests (5.2/10,000 requests). The average rate of WBIT was higher in surgical disciplines compared to medical and acute care services (6.58 vs. 4.43 vs. 3/10,000 requests). The highest rate of WBIT was observed when requests were received during 8:00 PM-2:00 AM (p = 0.02). Deviations from SOP with contribution from human and organizational elements were identified as the root cause. The consequences ranged from delay in providing blood to acute haemolytic transfusion reactions. We found that WBITs occurred at a rate comparable to that reported from developed countries. Use of software and automation may reduce the rate of WBIT but not eliminate it completely. Strict adherence to SOPs and continuous training of phlebotomy staff would help reduce it to a minimum. Blood centres need to develop specific strategies with respect to their root causes.

A comparative study of home and host country effects on the academic performance of Chinese students in transnational education

ABSTRACT This study examines the impact of intercultural learning, from the perspective of home versus host country, on the academic performance of Chinese students in an Australian university’s transnational education program. It integrates transformative learning theory and cognitive load theory as the conceptual framework and compares the academic performance of students who remained in China with those who went to Australia to complete the same Australian university degree. Using a difference-in-differences approach, our analysis revealed a significant performance difference between the Australia-based and China-based groups by year level after controlling for academic ability. The findings have practical and policy implications for student support and transnational education program management in Australian universities. The study highlights the need for tailored support to help Chinese (and possibly other international) students during their first year of arrival in Australia. It also calls for embedding intercultural learning into discipline-specific programs.

Evaluating customer satisfaction with the quality of online banking services after COVID-19: developing country perspective

Evaluating customer satisfaction with the quality of online banking services after COVID-19: developing country perspective

International Student Mobility: Pushing-Pulling Factors for International Students

International student mobility (ISM) has been considered as a key factor for many higher education institutions (HEIs) in terms of benefits that it generates. Recent literature highlights the influence of ISM in the reconfiguration of the form of educational system making it more competitive and attractive for international students. In this regard, students are paying attention to the opportunities and benefits that an international student mobility programme, such as the Erasmus programme offers. Nevertheless, it is important to take in consideration challenges and barriers that international students have to cope during their study experience abroad. The aim of this study is to analyse which are the pushing and pulling factors for international students when choosing a country as the abroad study destination. An online survey is used to Albanian international students that has previously experienced ISM programme and are currently experiencing ISM programme abroad. Findings offer important insights on understanding factors that impact international students’ decision when choosing a foreign country as a study destination. This study offers contribution in enriching the existent literature on ISM and in particular on the decision-making of international students from a developing country perspective. The study’s implications suggest that higher education institutions can boost their global attractiveness and competitiveness by addressing the key factors influencing international students’ decisions, as identified in this study. Received: 20 July 2024 / Accepted: 20 September 2024 / Published: 05 November 2024

Ibero-American consensus statement on migraine treatment

Introduction and objectivesMigraine is the most common reason for neurology outpatient consultation; more than 80% of patients with migraine suffer some degree of associated disability. Migraine is an underdiagnosed disorder and patients frequently receive inappropriate treatment, which is why it is necessary to establish recommendations to improve patient management. The objective of this document is to establish a consensus position on the pharmacological treatment of migraine, including general measures and detailed analysis of the different options for the treatment of attacks and their prevention, from the perspective of Ibero-American countries. Methods and resultsBased on the recommendation documents published by the scientific societies of different Ibero-American countries, 2 surveys were prepared; through the application of the Delphi methodology and discussions in subsequent meetings, a document was developed in consensus format, supported by evidence from the literature and expert recommendations. ConclusionsA series of recommendations were agreed upon for the treatment of episodic migraine and chronic migraine, both for the acute management of attacks and for their prevention. These recommendations are based on the consensus process and a literature review, and are adapted to the regional conditions of the Ibero-American countries.

Broadening energy resilience: How does the digital economy affect the global energy value chain?

The frequent occurrence of global economic black swan events has affected the development of the global energy value chain (GEVC) and exposed countries to considerable uncertainty. However, digital economy development can offer new solutions and perspectives for countries to mitigate external shocks, ensure energy security and improve energy resilience. This study examines 71 countries from 2010 to 2019, innovatively obtaining GEVC from input–output tables to explore the impact and mechanism of the digital economy on GEVC in terms of countries’ dimensions of participation and position. The relevant results are threefold. First, the digital economy increases countries’ participation in GEVC and pushes them to move downstream of the GEVC. This result still holds after robustness tests. Second, the mechanism test demonstrates that the digital economy can influence factor allocation and innovation to affect countries’ GEVC participation. Third, the effect of the digital economy on a nation's ability to participate in the GEVC varies depending on the external and internal threats that the nation faces. This study enriches the research on global value chains and has important implications encouraging countries to advance digital economy development, navigate external shocks and accelerate digital economy and GEVC integration.

Users’ perspectives of public library for a knowledge-based society: Implications for developing countries

Rationale of Study – In today’s fast-paced, ever-changing world, knowledge has become a commodity and a capital that provides the basis for a knowledge-based society (KBS). Public libraries, however, are trying to stay relevant as a knowledge hub in such societies by expanding their roles in local communities. This research investigated the relationship among demography, accessibility, environment,digitalisation, and the library’s perceived role in a KBS. Methodology – Following cross-sectional quantitative research design, data was collected from 112 respondents using a structured questionnaire survey on the premises of the Pabna Government Public Library in Bangladesh. The 9-item scale showed acceptable internal consistency (α = .713) and using SPSS 25, descriptive analyses, Chi-square test, and Spearman correlation were carried out.Findings – The role of a public library in terms of readership and awareness in the community had a statistically significant (p-value <0.001) positive correlation with accessibility (ρ=.334) and library environment (ρ=.513). At the same time, a negative association was observed with respondents’ level of education (ρ=-.265, p-value <0.01). However, a weak relationship existed between profession andperception of the library environment (ρ=.186, p-value <0.05). Implications – In similar developing country contexts, libraries must attract diverse users beyond educated youths and create a conducive library environment where it becomes a part of their community. Public libraries can consequently stay relevant and contribute to building a KBS. Originality – This paper reports the findings of an original study regarding users’ perceptions of public libraries in KBS from a developing country perspective.

2.H. Round table: Health system description and comparison: lessons from the WHO/Observatory Insights series

Abstract The European Observatory on Health Systems and Policies has been working for more than 25 years on the systematic description, analysis and comparison of health systems in Europe. This workshop explores experiences so far with a new series of health system profiles, the Health Systems in Action (HSiA) Insights, launched in 2021 in collaboration with the WHO Regional Office for Europe. The first round of the Insights in 2021 was a pilot series, covering just five countries (Georgia, Kyrgyzstan, North Macedonia, Ukraine, and Uzbekistan). Since then, the series has grown to 13 countries in 2022 and in 2024 is covering almost all WHO Member States that are outside of the European Union (EU). The Insights aim to provide short and easily accessible documents that provide core information on a country’s health system, its key strengths and challenges, how it compares to other health systems in Europe, and how it impacts on the health of its population. This roundtable provides a platform for sharing experiences with devising, writing and using the series so far, bringing in country and comparative perspectives and involving the audience. The objectives of the roundtable are to a) identify best practices for the comparative description and analysis of health systems in the form of a series of country profiles; b) explore the challenges of drawing up country profiles where comparative data are lacking, incomplete or politicized; c) identify ways of disseminating and using country profiles; d) establish an opportunity for cross-country learning and skills development for the writing of health system descriptions and analyses. The roundtable will consist of four speakers. It will start with three very brief country presentations on the Insights for Israel, North Macedonia and Kazakhstan, followed by a brief comparative perspective on how to capture, compare and analyse health workforce trends across a broad set of countries, which is the Spotlight section of the 2024 round of Insights. This will be followed by a broad discussion with audience interventions to bring in the experience of other experts and countries. The moderated discussion will emphasise key learning points on how to devise a comparative series, how to write health system profiles and how best to use them to inform health policy-making. Key messages • The regular monitoring of health systems and policies is challenging, but essential for improving them. • Health system summaries require systematised approaches and up-to-date comparative data. Speakers/Panelists Ruth Waitzberg Technische Universitat Berlin, Berlin, Germany Yerbol Spatayev WHO Country Office Kazakhstan, Astana, Kazakhstan Simona Atanasova WHO Country Office North Macedonia, Skopje, Republic of North Macedonia Tomas Zapata WHO/Europe, Copenhagen, Denmark

Corporate tax avoidance and narrative disclosure tone: a developing country perspective

Purpose This study aims to examine the link between tax avoidance, corporate governance and narrative disclosure tone using a sample of public companies in Pakistan. Design/methodology/approach Data for 125 companies listed on the Pakistan Stock Exchange (PSX) are collected over 10 years from 2011 to 2020. Sentiment analysis is conducted to determine the disclosure tone, and regression analysis is used to test the association between the variables. Findings This paper finds that firms that engage in tax avoidance tend to use a more positive disclosure tone and are more likely to engage in impression management. Moreover, promoting sound governance through board independence and gender diversity is associated with a less positive disclosure tone. However, firms with more family board members and higher foreign ownership are more likely to use a more positive disclosure tone. Practical implications Regulators can use this information to develop better guidelines to protect investors and ensure faithful disclosures to address both positive and negative news. Originality/value The study contributes to the literature by examining corporate tax avoidance as a determinant of narrative disclosure tone, a relationship that has not been widely explored. Moreover, as most disclosure tone research has been conducted in developed countries, this paper provides valuable evidence from a developing country.

Silence in the Synchronous Virtual Classroom: A Developing Country Perspective

This paper addresses the pervasive absence of student verbal participation in the virtual classroom in a developing country context. While student non-verbal participation is not new, it has taken on new significance in the context of the virtual classroom as many institutions of higher learning continue to embrace online teaching post-COVID-19. The study focuses sharply on Botswana. A structured questionnaire that sought to capture students’ perception of the extent and impact on learning of student non-verbal participation in the virtual classroom was distributed to students at the largest university by student population in the country. Since the study is set in a developing country context, and such contexts are usually characterized by a pervasive lack of resources, the questionnaire also sought to capture students’ perceptions of the availability of resources to participate in virtual classrooms. The data collected were subjected to quantitative methods of analysis, with the help of STATA. The study revealed that student non-verbal participation in virtual classrooms is not unique to developed countries. The study also highlighted that students have different preferences regarding non-verbal participation in the virtual classroom: some prefer classroom engagement, while some prefer to listen to instructors rather than speak. The emerging policy implication is that it is essential for instructors to balance the needs and expectations of these different categories of students. There is an emerging literature that considers how instructors can enhance interaction in the virtual classroom. The best approach depends on context. The study also underlined the important role that institutions of higher learning can play in making online teaching accessible to students from different social backgrounds through program design. At the University of Botswana for instance, all students are introduced to information and communications technology (ICT) training in the first year of their programmes, equipping them with the necessary skills to gainfully participate in virtual classes. In terms of resource availability, the study revealed gaps that require policy intervention: there is a need for the government to consider subsidizing government-sponsored students to purchase digital devices within the context of their scholarships; it is also important for the government to continue investing in ICT infrastructure and developing pricing policies that make internet services accessible.