Poor Service Quality Research Articles

Enablers and barriers of community health programs for improved equity and universal coverage of primary health care services: A scoping review

BackgroundCommunity health programs (CHPs) are integral components of primary health care (PHC) systems and support the delivery of primary care and allied health and nursing care services. CHPs are necessary platforms for delivering health services toward universal health coverage (UHC). There are limited prior studies on comprehensive evidence synthesis on how CHPs strengthen community health systems for the demand and supply of PHC services. Therefore, this scoping review synthesized existing evidence on the interlinkage between CHPs and the community health system and beyond for delivering and utilising PHC services toward UHC.MethodsWe conducted a scoping review of research articles on CHPs. We identified research articles in six databases (PubMed/Medline, CINAHL, Scopus, Cochrane, Web of Science, and Embase) and Google Scholar using search terms under three concepts: CHPs, PHC, and UHC. Of the 3836 records identified, 1407 duplicates were removed, and 2346 were removed based on titles and abstracts. A total of 83 articles were eligible for the full-text review; of them, 18 articles were removed with reasons, and the other 16 were included through hand search. Themes were identified and explained using Sacks and colleagues’ “Beyond the Building Block” framework.ResultsA total of 81 studies were included in the final review. Studies described CHPs as foundations for community health system readiness for PHC services, including decentralization in the health sector, community-controlled governance, resource mobilization, ensuring health commodities (e.g., through community pharmacies), and information evidence. These foundational inputs mediate the actions of CHPs by partnership with community organizations and health workforces (e.g., community health workers). CHPs contributed to improved access to health services by providing health services in public health emergencies, affordable and comprehensive care, and modifying social determinants of health.ConclusionsCHPs are platforms for implementing and delivering PHC services close to communities. They help to modify social determinants of health, promote health and wellbeing, reduce care costs, prevent disease progression, and reduce hospitalisation rates. CHPs are integral parts of community health systems and require investment to improve access to PHC services. Gaps and challenges of CHPs include inadequate funding, limited engagement of the private sector, poor quality of health services, and limited focus on non-communicable diseases (NCDs). Further implementation research is needed to mitigate the burden of NCDs. Health systems efforts focus on increasing resources (e.g., financial and human) required in CHPs to ensure the quality of PHC services provided through CHPs toward better service access, and reaching the unreached and achieve equity and universality of PHC services.

Factors influencing antenatal care attendance in the eight contact era policy: a case of selected maternal health service facilities in Blantyre, Malawi

BackgroundMaternal mortality in sub-Saharan Africa and Malawi remains high. Effective antenatal care (ANC) services can reduce maternal morbidity and mortality. However, attendance to ANC clinics and the quality of services provided remain a challenge. Malawi adopted the 2016 WHO antenatal care model and there is a need to assess factors that influence antenatal care attendance. The main objective of this study was to assess factors influencing attendance in the era of the eight ANC contact policy in Blantyre.MethodsThis was an exploratory qualitative design in which 28 respondents participated using in-depth interviews and focus group discussions for the data collection process. The study sites included two healthcare facilities, namely Queen Elizabeth Central Hospital and Bangwe Health Centre, and a rural community (William Village Bangwe Rural) in Blantyre district. The 28 study participants included 11 ANC attendees, which comprised seven women in their final trimester and four postpartum women who attended ANC during their pregnancy, five midwives running the ANC clinics, and 12 non-users of ANC. The recordings were transcribed verbatim. The data were organized using Microsoft Excel and Microsoft word and analyzed using inductive content analysis.ResultsThe factors promoting ANC attendance in the context of the eight ANC contact policy include; motivation from health workers, family, and spouses and the women’s perceptions of ANC particularly the role it plays in preventing, detecting, and treating illness, but also preventing adverse pregnancy outcomes. On the other hand, the hindering factors to ANC attendance included lack of knowledge of the new ANC visit guidelines, financial constraints, quality of health services provided, attitude of healthcare workers, inadequate availability and training of healthcare workers, perceived poor quality of ANC services and personal beliefs.ConclusionIt is essential to provide comprehensive training to healthcare workers in the antenatal department regarding the new WHO ANC recommendations. This will help improve the quality of services at the antenatal clinics, including ensuring the availability of all necessary resources to encourage attendance. Additionally, promoting comprehensive spousal support, encouraging participation in activities, and adequately planning scheduled visits can help overcome financial barriers and further support antenatal attendance.

Preferences for oral and injectable PrEP among qualitative sub-study participants in HPTN 084.

HPTN 084 compared the safety and efficacy of long-acting injectable cabotegravir (CAB) to daily oral TDF/FTC for prevention of HIV-1 in uninfected African women. Like a similar trial in MSM/TGW (HPTN 083), the trial was stopped early for efficacy, expediting the need to consider introduction strategies for different populations. We examine survey and qualitative data from a four-country sub-study to examine oral and injectable PrEP acceptability and considerations for CAB access among African women. Participants completed baseline and follow-up surveys on HIV risk perception, sexual behavior. product acceptability and adherence during the blinded trial. Additionally, up to two in-depth interviews each with 73 sub-study participants explored product use and trial-related experiences, during the blinded and unblinded study periods. Using survey data, we classified participants as: engaged in female sex work (FSW), having multiple non-transactional partners, or monogamous. A study statistician identified participants' assigned study arm. We followed a thematic analysis process to read transcripts, develop a codebook and apply codes in NVivo to transcripts with intermittent intercoder reliability checks; using Excel matrices to explore differences across risk categories and study arms. Participants overwhelmingly preferred injections to pills, appreciating the ease, convenience, and privacy of a long-acting formulation. Many participants described challenges with contraceptive and/or study pill adherence, impeded by late night work, unexpected travel, or heavy drinking. Women in the TDF/FTC arm were more likely to describe side effects, compared to those in the CAB arm. Pain also varied widely by study arm. When considering post-trial access to CAB, limited PrEP knowledge, cost and concerns around stigma and poor service quality were potential access barriers. Women's desire for privacy and ease of use outweighed injectable concerns, resulting in a strong preference for CAB. Cost and accessibility will need to be addressed by implementation programs.

SUBSCRIPTION FRAUD DETECTION USING AUTOENCODER IN CASE OF ETHIOTELECOM

Nowadays, telecom services are becoming an essential communication and business facilitators. However, the development of telecom services motivates fraudsters for illegal use. Hence, telecom fraud becomes a serious challenge in telecommunication sector by losing telecom revenue. It also results in poor quality of services for their customers. Telecom data, SMS and voice call are not free from security issues. Despite SMS, and USSD services becomes good options over installable mobile based or web based applications due to lesser cost and real time support, the methods provide fixed amount requirements which is not dynamic way to address the need of these services subscribers. The other challenge of these services is that; the services are not safe from frauds as such, especially in GSM switches. Subscription fraud is one type of fraud in today’s telecom business which is a common telecom fraud. The need of fraudsters is to make money illegally or getting telecom services with the intention of not to pay for the service they used. The prime objective of this study is to build a predictive model using deep auto-encoder to detect subscription fraud in case of Ethiotelecom. The performance of fraud detection model is 98.95% validation accuracy on ethiotelecom call detail record dataset using deep neural network autoencoder and CNN-LSTM autoencder algorithms at threshold of 0.0103 and 0173 respectively.

Dealing with Mental Health Problems and Work Performance Among Frontline Healthcare Workers Through the Influence of Digital Platform in Malaysian Private Hospitals: A conceptual analysis

The purpose of this study to examine mental health problems of frontline healthcare workers and their impact on work performance through exploring the influence of digital platforms in Malaysian private hospitals. This research is essential in addressing previous knowledge and theoretical gaps on the antecedents that denote to mental health problems and how digital platforms are used to improve mental health wellbeing. Basically, this study discusses the impact of four independent variables which are categorized as depression, anxiety, insomnia and distress factors whereas dependent variable is work performance. This study also will discuss problems concerning work performance of frontline healthcare workers (doctors, nurses, medical assistance, pharmacists and HR Management), specifically on poor service quality, turnover intention, work-related burnout, and exhaustion in Malaysian private hospitals. Hence, this study explores new solutions on the employees’ work performance related issues to create awareness for the Malaysian private hospitals in improving mental health issues among front-line healthcare workers to enhance their work performance through the influence of digital platforms. Private hospitals in Malaysia are experiencing critical situations related to poor employees’ performance which indirectly influence the overall productivity. Thus, private hospitals need to provide serious attention towards these related issues. A conceptual framework was formulated based on identified research gaps through the literature review. It is expected that this study will enhance the awareness for the management in Malaysian private hospitals on dealing with mental health problems which impacts work performance by exploring digital platforms as a solution.

A Novel View on Dental Service Management Optimization Using Markov Processes

To develop a mathematical model for managing dental services as a Markov random process based on the state graph of the process of providing dental care to the population. Markov chains, limiting probabilities of states and equations of A.N. Kolmogorov, and a graph of possible states of the dental care provision process, enabling to mathematically describe and optimize the process of managing dental services using a Markov random process in Moscow. With a full return of patients for correction of defects in the same dental medical organization where the poor-quality service was provided and a maximum warranty period of 5 years, the average financial result (gross profit) of the considered dental medical organization and the relative average increase in the financial result are maximum and equal to Rub 5,018,18 and 64.42%, respectively. It is shown that with a slight increase in the warranty period from one to three years, the financial result (gross profit) grows faster than with a warranty period of 3 to 5 years. To achieve a relative average increase in financial results by a factor of 1.5, the warranty period for dental services provided should be 3.13 years. Doi: 10.28991/HEF-2024-05-03-05 Full Text: PDF

Beyond the margins: antenatal health and healthcare behaviours among homeless women in Kolkata Municipal Corporation, India.

Despite high childbearing rates among homeless women in India, the antenatal health and healthcare behaviours among such population remain poorly understood. To address this research gap, a mixed-methods approach was employed in the present study, involving interviews with a sample of 400 women aged 15-49 years, utilising time and location sampling techniques. Additionally, a purposeful sample of 52 women from the same age group participated in in-depth interviews. The respondents exhibited rampant socio-economic backwardness, including chronic homelessness (36%), no formal education (54%), engagement in rag picking (31%), and low income levels. About 56% of the women reported poor self-rated health (SRH), notably higher among those aged 35 and above and those living alone (68%). Poor SRH was also prevalent among the ever married (61%), ragpickers (61%), beggars (62%), chronic homeless individuals (62%), tobacco (60%) and alcohol consumers (61%), and those with chronic diseases (61%). Common health issues included depression or anxiety (56%) and iron deficiency anaemia (35%). The level of unmet healthcare needs was 41%, with significant variation across diseases. Lack of reproductive health rights and awareness, socio-cultural beliefs, stigma, socio-economic poverty, poor quality of public healthcare services, irregularity in charity-run healthcare, and time constraints hindered antenatal care visits. The study underscores the urgent need for population-centric programmes and policies aimed at promoting reproductive health to achieve Sustainable Development Goal 3 of 'Good health and wellbeing' by 2030.

교정간호의 실태와 개선방안에 관한 연구

Correctional medical personnel in prisons are recognized as workplaces that do not want to work due to low wages, insufficient medical facilities at the clinic level, and stigma of hate facilities, and are always insufficient from the past to the present. The lack of correctional medical personnel can negatively affect the treatment of inmates and lead to poor quality of medical services. In particular, orthodontists do medical treatment unrelated to their major, so the recipients do not trust the orthodontists' treatment and want video or external treatment. However, video or external treatment must be performed at a designated time with cooperative hospitals on an appointment date, so inmates may not be able to receive timely treatment. The lack of correctional medical personnel is causing an excess of work because correctional nurses have to take over for work. Therefore, the purpose of the study is to present practical and effective alternatives to expanding medical personnel. The scope of the study is to understand the actual state of prison correctional medical care based on previous studies, correctional statistics, and Internet data, and to derive various problems through this to find countermeasures. The countermeasure is to provide concrete and practical alternatives so that it can contribute to the expansion of correctional medical personnel. As a result of the study, in order to solve the shortage of orthodontic medical personnel, AI doctors and pharmacists are introduced and operated in the medical department of orthodontic facilities. Another option is to first introduce a traveling pharmacist system for orthodontic pharmacists, so that one orthodontic pharmacist is in charge of three to four correctional facilities. Next, rather than hiring correctional doctors only, correctional facilities with many elderly inmates are also hired and operated by oriental doctors. Finally, in order to hire excellent orthodontic nurses, it is necessary to allow correction facilities and schools to cooperate to conduct nursing practice in the medical department of orthodontic facilities so that they can understand and publicize the specificity of correction so that they can provide a lot of support when hiring.

Factors that Influence PLHIV's Compliance with ARV Therapy in the World Year 2018 – 2022

ARV therapy is important in treating HIV cases. Even though it does not cure, ARVs help suppress the growth of the virus. Adherence to therapy is essential to achieve optimal results. The objective was to decide the components that impact the adherence of PLHIV in ARV treatment. This could be a story writing audit think about conducted by looking at articles through the Science Coordinate and PubMed databases. The catchphrases utilized are Variables impacting adherence to antiretroviral treatment among HIV/AIDS patients, HIV patient adherence to ART, and "adherence" and ART HIV/AIDS patients, with inclusion criteria: Articles published in 2018-2022, published in Indonesian language or English, original research, available in full text. Exclusion criteria: articles published before 2018, review articles, and qualitative studies, do not discuss factors for adherence to ARV therapy. 20 articles satisfy the review criteria, various factors that affect adherence to ARV therapy are socio-demographic factors, clinical factors, therapeutic factors, healthcare facilities factors, and other contextual factors. Poor quality of health services, level of education, younger age, social support, community stigma, COVID-19 pandemic, and ability and understanding of ART act as risk factors for PLHIV’s adherence to ARV treatment. The discoveries of these different variables ended up reference for wellbeing offices to move forward the quality of administrations and public awareness of optimal ARV therapy adherence.

A conceptual framework of service quality on patient’s behavioral assessment: Insight from Pakistan

The healthcare sector is progressively modest and patients expect higher service quality; therefore, healthcare practitioners’ and academic researchers’ attention upsurges in exploring service quality, intensifying satisfaction and generating behavioral intention. Despite the significance of the healthcare sector and the importance of quality-related matters, there is a paucity of research and publications dealing with healthcare service quality. This conceptual review evaluates the service quality in Pakistani healthcare sector rendering patients’ perspective. The proposed model emphasizes patients’ switching intention caused by poor or inadequate service quality through intervening constructs of satisfaction and alternative attractiveness. Additionally, current review explored the alternative attractiveness as mediator which was neglected in healthcare context. The model also attempts to propose the association between alternative attractiveness and outcome variable by switching costs regarding patients’ perspectives. The conceptual framework enables hospital managers to comprehend how patients assess healthcare quality provided in the presence of alternatives. The perception of patients would assist them in allocating healthcare resources and hospital management attain performance feedback through service quality parameters. Present review developed an inclusive framework as a novel injector in healthcare sector for patients’ perceived service quality.

Service Quality in Planned Preventive Maintenance: A Preliminary Study at UiTM Campuses

Planned Preventive Maintenance (PPM) is an essential component under facilities management (FM) carried out to ensure the functionality, effectiveness, reliability and safety of the asset and facilities. Poor service quality, lack of monitoring and performance assessment, low level customer satisfaction are among issues arises and has gained a lot of attention, especially among interested parties. In Universiti Teknologi Mara (UiTM) campuses context, FM normally outsourced to third parties namely concessionaires under Private Finance Initiative (PFI) campuses and contractors for conventional campuses. The main objective of this preliminary study was to investigate current practices in terms of service quality aspect of PPM works delivered by concessionaires and contractors in UiTM. A questionnaire was distributed to 27 respondents consist of 12 engineers and 15 assistant engineers from Office of Facilities Management UiTM and analysed using descriptive analysis. Based on the results, current practice to measure PPM work performance is by the number of works completed. Apart from that, there is no defined standard method available to be used as performance measurement in the aspect of service quality of PPM works delivered by concessionaires and contractors in UiTM. In addition, all the respondents agreed that there is indeed a necessity to develop a standard performance measurement in the aspect of service quality of PPM works delivered by concessionaires and contractors. The impact of this finding is to the Office of Facilities Management UiTM, in which they can focus and start to develop standard performance measurement in the aspect of service quality of PPM works delivered by concessionaires and contractors, so the services provided commensurate with the payment made and satisfy customer needs.

Multi-Agent Reinforcement Learning Optimization Framework for On-Grid Electric Vehicle Charging from Base Transceiver Stations Using Renewable Energy and Storage Systems

Rapid growth in a number of developing nations’ mobile telecommunications sectors presents network operators with difficulties such as poor service quality and congestion, mostly because these locations lack a dependable and reasonably priced electrical source. In order to provide a sustainable and reasonably priced energy alternative for the developing world, this study provides a detailed examination of the core ideas behind renewable energy technology (RET). A multi-agent-based small-scaled smart base transceiver station (BTS) site reinforcement strategy is presented to manage energy resources by boosting resilience so to supply power to essential loads in peak demand periods by leveraging demand-side management (DSM). Diverse energy sources are combined to create interconnected BTS sites, which enable energy sharing to balance fluctuations by establishing a market that promotes economical energy. A MATLAB simulation model was developed to assess the effectiveness of the proposed system by using real load data and fast electric vehicle charging loads from five different base transceiver stations (BTSs) located throughout Pakistan’s southern area. In this proposed study, the base transceiver station (BTS) sites can share their energy through a multi-agent-based system. From the results, it is observed that, after optimization, the base transceiver station (BTS) sites trade their energy with the grid at rate of 0.08 USD/kWh and with other sites at a rate of 0.04 USD/kWh. Therefore, grid dependency is decreased by 44.3% and carbon emissions are reduced by 71.4% after the optimization of the base transceiver station (BTS) sites.

Correlates of oral pre-exposure prophylaxis cessation among men who have sex with men in China: implications from a nationally quantitative and qualitative study

BackgroundSeveral studies have demonstrated the population-level effectiveness of oral PrEP in reducing the risk of HIV infection. However, oral PrEP utilization among MSM in China remains below 1%. While existing literature has primarily focused on oral PrEP preference and willingness, there is limited exploration of the underlying factors contributing to oral PrEP cessation in China. This study aims to fill this gap by investigating the factors associated with oral PrEP cessation among MSM in China.MethodsAssisted by MSM community organizations, we collected 6,535 electronic questionnaires from 31 regions across China, excluding Taiwan, Hong Kong, and Macau. The questionnaire focused on investigating MSM's awareness, willingness, usage, and cessation of oral PrEP. Additionally, 40 participants were randomly chosen for key informant interviews. These qualitative interviews aimed to explore the reasons influencing MSM discontinuing oral PrEP.ResultsWe eventually enrolled 6535 participants. Among the 685 participants who had used oral PrEP, 19.70% (135/685) ceased oral PrEP. The results indicated that individuals spending > ¥1000 on a bottle of PrEP (aOR = 2.999, 95% CI: 1.886–4.771) were more likely to cease oral PrEP compared to those spending ≤ ¥1000. Conversely, individuals opting for on-demand PrEP (aOR = 0.307, 95% CI: 0.194–0.485) and those using both daily and on-demand PrEP (aOR = 0.114, 95% CI: 0.058–0.226) were less likely to cease PrEP compared to those using daily PrEP. The qualitative analysis uncovered eight themes influencing oral PrEP cessation: (i) High cost and low adherence; (ii) Sexual inactivity; (iii) Lack of knowledge about PrEP; (iv) Trust in current prevention strategies; (v) Poor quality of medical service and counseling; (vi) PrEP stigma; (vii) Partner and relationship factors; (viii) Access challenges.ConclusionsThe cessation of oral PrEP among MSM in China is associated with various factors, including the cost of oral PrEP medication, regimens, individual perception of HIV risk, stigma, and the quality of medical services. It is recommended to provide appropriate regimens for eligible MSM and develop tailored combinations of strategies to enhance PrEP awareness and acceptance among individuals, medical staff, and the MSM community. The findings from this study can support the refinement of HIV interventions among MSM in China, contributing to efforts to reduce the burden of HIV in this population.

Assessing the Gap Between Women's Expectations and Perceptions of the Quality of Intrapartum Care in Jordan: A Two-Stage Study Using the SERVQUAL Model.

Although Jordan has made significant progress toward expanding the utilization of facility-based intrapartum care, prior research highlights that poor service quality is still persistent. This study aimed to identify quality gaps between women's expectations and perceptions of the actual intrapartum care received, while exploring the contributing factors. Utilizing a pre-post design, quality gaps in intrapartum care were assessed among 959 women pre- and postchildbirth at a prominent tertiary hospital in northern Jordan. Data were gathered using the SERVQUAL scale, measuring service quality across reliability, responsiveness, tangibles, assurance, and empathy dimensions. The overall mean gap score between women's expectations and perceptions of the quality of intrapartum care was -0.60 (±0.56). The lowest and highest mean gap scores were found to be related to tangibles and assurance dimensions, -0.24 (±0.39) and -0.88 (±0.35), respectively. Significant negative quality gaps were identified in the dimensions of assurance, empathy, and responsiveness, as well as overall service quality (p < 0.001). The MLR analyses highlighted education (β = 0.61), mode of birth (β = -0.60), admission timing (β = -0.41), continuity of midwifery care (β = -0.43), physician's gender (β = -0.62), active labour duration (β = 0.37), and pain management (β = -0.33) to be the key determinants of the overall quality gap in intrapartum care. Our findings underscore the importance of fostering a labour environment that prioritizes enhancing caregivers' empathetic, reassuring, and responsive skills to minimize service quality gaps and enhance the overall childbirth experience for women in Jordan. This paper is a collaborative effort involving women with lived experiences of childbirth, midwives, and obstetrics and gynaecologist physicians. The original idea, conceptualization, data generation, and coproduction, including manuscript editing, were shaped by the valuable contributions of stakeholders with unique perspectives on intrapartum care in Jordan.

An Analytical Study on the Logic of Tourism Consumption Policies under the Perspective of Multi-Stream Theory in the Post-Epidemic Era---Taking Harbin City as an Example

In recent years, the tourism industry was one of the first sectors to be seriously affected by the New Crown epidemic. Therefore, in the post-epidemic era, China has introduced a series of policies to promote tourism consumption. Based on a multiple streams perspective, this paper explores the internal logic behind the formulation of tourism consumption policies by taking Harbin City as an example, which involves issues, policies, and political perspectives. The study finds that there are problems, policies, and politics behind the formulation of a policy and the setting of an agenda at the social level. Problem streams such as the single structure of tourism consumption and poor service quality are the main sources of policy change; the research results of experts and scholars are the policy stream of policy change; and social opinion and the direction of national sentiment are the political stream of policy change. The three streams converge at a certain point in time and open the window of policy. To further promote the development and improvement of the tourism consumption market, Harbin City should establish a sense of the problem and adhere to the problem orientation in the future; widely solicit suggestions and adhere to the policy formulation from multiple angles; and uphold the concept of service and create a good public opinion environment.

Access to maternal health services for Indigenous women in low- and middle-income countries: an updated integrative review of the literature from 2018 to 2023.

Ninety-seven per cent of Indigenous Peoples live in low-and middle-income countries (LMICs). A previous systematic integrative review of articles published between 2000 and 2017 identified numerous barriers for Indigenous women in LMICs in accessing maternal healthcare services. It is timely given the aim of achieving Universal Health Coverage in six years' time, by 2030, to undertake another review. This article updates the previous review exploring the recent available literature on Indigenous women's access to maternal health services in LMICs identifying barriers to services. An integrative review of literature published between 2018 and 2023 was undertaken. This review followed a systematic process using Whittemore and Knafl's five-step framework for integrative reviews and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 944 articles were identified from six databases: Academic Search Premier, MEDLINE, Psychology and Behavioral Sciences Collection, APA PsycInfo, CINAHL Plus with Full Text and APA PsycArticles (through EBSCOhost). The search was undertaken on 16 January 2023. After screening of the title/abstract and the full text using inclusion and exclusion criteria 26 articles were identified. Critical appraisal resulted in 24 articles being included in the review. Data were extracted using a matrix informed by Penchansky and Thomas's taxonomy, extended by Saurman, which focused on six dimensions of access to health care: affordability, accessibility, availability, accommodation, acceptability and awareness. Ten studies took place in Asia, 10 studies were from the Americas and four studies took place in the African region. Seventeen articles were qualitative, two were quantitative and five were mixed methods. The methods for the integrative review were prespecified in a protocol, registered at Open Science Framework. Barriers identified included affordability; community awareness of services including poor communication between providers and women; the availability of services, with staff often missing from the facilities; poor quality services, which did not consider the cultural and spiritual needs of Indigenous Peoples; an overreliance on the biomedical model; a lack of facilities to enable appropriate maternal care; services that did not accommodate the everyday needs of women, including work and family responsibilities; lack of understanding of Indigenous cultures from health professionals; and evidence of obstetric violence and mistreatment of Indigenous women. Barriers to Indigenous women's access to maternal health services are underpinned by the social exclusion and marginalisation of Indigenous Peoples. Empowerment of Indigenous women and communities in LMICs is required as well as initiatives to challenge the stigmatisation and marginalisation that they face. The importance of community involvement in design and interventions that support the political and human rights of Indigenous Peoples are required. Limitations of this review include the possibility of missing articles as it was sometimes unclear from the articles whether a particular group was from an Indigenous community. More research on access to services in the postnatal period is still needed, as well as quality quantitative research. There is also a lack of research on Indigenous groups in North Africa, and in sub-Saharan Africa - especially hunter-gatherer groups - as well as the impact of COVID-19 on access to services.

A Political Economy Analysis of Social Work’s Development in China: A Social Development Perspective

This paper examines the phenomenal growth of social work in China and the complexities and challenges faced by the profession and related stakeholders in the context of neoliberal economic practice within a hierarchical top-down political system. It proposes developmental social work as a viable indigenous social work practice mode. This analysis based on a collection of academic papers and relevant government reports sheds light on the interplay between welfare developmentalism, institutional dynamics, and professional challenges in the broader sociopolitical context, not least the neoliberal co-optation of social development aligned increasingly with economic goals to the detriment of broader social and structural issues. It shows how the political parameters of the Chinese Communist Party and its pursuit of community integration and social development shaped China’s approach to social work. It sees the necessity for a system of welfare services to address socio-structural issues and the indigenization and cultural adaption of social work in China as an expressly political process. Regarding the former, the government’s strategy of outsourcing public services to accord with its agenda has resulted in a contractual relationship between social organizations, including nongovernment and social work organizations, and the state. This has limited the independence and hindered the development of a strong civil society, and curtailed social workers’ autonomy, exacerbating professional challenges relating inter alia to the low number of qualified social work practitioners, limited job opportunities outside major urban centers, high staff turnover, and poor quality services provided by those without formal social work training. To enhance professional recognition in China, the paper suggests a holistic developmental approach that involves the resolution of individual problems through investing in people, helping them to build their capacity, drawing on social capital, and capitalizing on market opportunities to promote self-reliance, thereby contributing to community and social development.

Exploring factors of service adoption using SERVQUAL paradigm: Its impact on millennials’ adoption of services in the self-drive rental sector

The self-drive rental sector has witnessed exponential growth in recent years due to rising demand for long and short-distance drives among millennials. This study aims to investigate the quality of services in the self-driving rental sector and its impact on customer adoption or rejection of service in India. The conceptual framework was developed using the SERVQUAL model and other important factors affecting consumers’ service adoption. A quantitative research method was deployed, and data were gathered through a survey method using a structured questionnaire (based on a 5-point Likert scale). The sample size comprised 385 respondents, 23-38 years old millennials (with 69% of males and 31% of females). The population sample was chosen from Delhi, Mumbai, and Bangalore, India. The data were collected in March 2023. The factor and regression analyses were applied along with chi-square and SEM analyses to test the research hypotheses. The results indicated that the absence of low prices (42%), customer assistance (28 %), and security issues is responsible for consumer rejection. The factors leading to dissatisfaction are the absence of consumer schemes and discounts, a lack of staff interaction and assistance, and poor service quality. The brands must focus on the negative impact arising from the absence of these factors and effectively address the areas of improvement to regain customer trust and garner customer loyalty.

IP Development Strategy for Traditional Scenic Spots in the Digital Era

With the advent of the digital era, traditional scenic spots in China are facing transformation. Through a questionnaire survey analyzing the current tourism situation of visitors, this article identifies issues such as outdated tourism products, high prices, lack of innovative entertainment activities, and poor service quality. To address these problems, this article proposes a traditional scenic spot IP development strategy based on the digital context, including innovative digital products, implementing intelligent pricing strategies, upgrading digital entertainment, improving service quality, and innovative promotional strategies. The aim is to rejuvenate traditional scenic spots, inject new vitality into their tourism industry, and enhance visitor satisfaction.

Delay to Attendance for Elective Surgery: Analysis of Individual and Organizational Factors at Hospital Islam Sakinah Mojokerto

Background: Poor service quality will cause waste of time and resources, increase errors in service implementation and the risk of other. Purpose: The Purpose of this study was to examine the influence of individual and organizational factors on the delay in the presence of doctors and nurses in elective surgery. Method: This research is quantitative, sample is 49 nurses and doctors. An instrument for obtaining data from questionnaires. The independent variables are individual factors and organizational factors, the dependent variable is late attendance. Place of research: Sakinah Islamic Hospital in Mojokerto, statistical test using logistic regression. Results: The results of the study obtained the results of individual factors, namely attitudes and personality that influenced the delay in the presence of doctors and nurses in elective surgery. The factors of understanding of instructions, quality of interaction, confidence, personal responsibility, and closeness of authority figures do not affect the delay in the presence of doctors and nurses in elective surgery. Organizational factors in the form of location status affect the delay in the presence of doctors and nurses in elective surgery while other factors, namely supervision, peer support, legitimacy of authority figures, and authority figure status do not affect the delay in the presence of doctors and nurses in elective surgery. Conclusion: Individual factors, namely attitudes, and personality, affect the delay in the presence of doctors and nurses in elective surgery. Organizational factors in the form of location status affect the delay in the presence of doctors and nurses in elective surgery.