Provision Of Incentives Research Articles

Genesis of People’s Medicine Centre (PMC) for popularisation of generic medicine: A critical qualitative inquiry

IntroductionThe concerns of inaccessibility to essential medicines in India are well-studied and documented. Pradhan Mantri Bhartiya Janaushadhi Priyojana (PMBJP) is one of the policy initiatives to address the inaccessibility of essential medicine. Janaushadhi Kendra (People's Medicine Centre), which is part of PMBJP is being enquired in a limited way to understand its effectiveness. The province of Odisha has been chosen as the study area for the evaluation of People's Medicine Centres. ObjectiveThe present study intends to inquire into the nature of People's Medicine Centre ownership, pharmacists' motivations and incentives to engage in business, perceived customers' trust and satisfaction, scheme beneficiaries, and challenges. MethodsA qualitative research approach has been adopted to evaluate the broader subjective accounts of the pharmacists and People's Medicine Centre. An open-ended interview guide was used. The topics of ownership, motivation, incentives, trust, satisfaction, perceived benefits, and challenges has been recorded from the participants. A total of seventeen in-depth interviews were conducted in the province of Odisha, India. ResultsThe study found that the ownership of People's Medicine Centre was of two types in the province of Odisha: public-NGO-owned People's Medicine Centres and public-private-owned People's Medicine Centres. The financial incentive provisions in the scheme attracted the private pharmacists. Pharmacists highlighted about the lower price of generic medicines compared to branded medicines, which is very popular among patients. They also pointed out that there is no difference in the efficacy of both medicines. The attitude of physicians, especially private physicians, were considered problematic for popularity and acceptance. ConclusionThe People's Medicine Centres in Odisha established themselves as trusted outlets despite physicians' unfavourable attitudes. Although the centres have not reached the required geographical coverage, economically developed regions have large number of centres, while backward regions have minimal presence. The scheme needs to be more conducive to the welfare of the masses living in remote and rural areas.

A Qualitative Study on Nurses' Experiences Working in Burn Units in South Punjab, Pakistan.

Background: Nurses play an integral role in the multidisciplinary team managing care for burn patients. Their unique insights and experiences in such high-stress environments are crucial yet often underexplored. This study aims to illuminate the challenges and experiences of nurses in burn units within tertiary care hospitals in South Punjab, Pakistan. Objective: To explore and document the experiences of nurses working in burn units, focusing on the challenges they face and the coping mechanisms they employ. Methods: A qualitative study was conducted in 2022 using purposeful sampling to select 16 nurses from burn units at tertiary care hospitals in South Punjab, Pakistan. Data were collected through semi-structured, in-depth interviews and analyzed using thematic analysis to identify key themes and sub-themes. Results: Analysis of the interview data revealed four main themes and sixteen sub-themes. The main themes identified were Workload, Spiritual Beliefs in Patient Care, Nursing Education Services in Hospitals, and Work-Life Balance. These themes encompass the physical, emotional, and spiritual challenges faced by nurses, as well as their educational needs and the impact of their work on personal life. Conclusion: Nurses in burn units encounter numerous challenges that affect both their professional duties and personal lives. There is a critical need for better support structures, including modern facilities, continuous training, and more attentive administrative practices. Enhancements such as increased staffing, unit rotation, and provisions for financial and motivational incentives are necessary to improve care for burn patients and support the well-being of nurses.

Building integrated primary health care: the role of the government in China and Thailand

ABSTRACT While the importance of primary health care (PHC) as a foundation for a strong healthcare system is widely accepted, the policies needed to achieve it remain deeply controversial. Some proponents call for a greater role for market and user choice in expanding and strengthening PHC, whereas others recommend a greater role for the government in directing its development. The objective of this paper is to assess these arguments by comparing the experience of China and Thailand in strengthening PHC. We find that tight government steering of the healthcare system in Thailand has produced better integration and eventually outcomes than the more decentralized and competitive system in China. The Chinese government’s massive administrative and fiscal efforts to strengthen PHC have been undermined by systemic barriers in the wider health system, notably fee-for-service and out-of-pocket financing that distort the incentives of healthcare providers. A key conclusion to emerge from the analysis is that central stewardship and steering accompanied by appropriate incentives to promote integration are critical to building effective primary health care.

A Theoretical Analysis of Digital Finance Enabling Green Innovation

This paper explores the development of digital finance as a force for promoting green innovation. It discusses how digital finance can be developed in high quality and how it can promote the theoretical mechanism of green innovation. Finally, policy recommendations for the development of digital finance and green innovation are presented. Digital finance primarily supports green innovation in three ways. Firstly, it facilitates the development of green enterprises and promotes high-quality and sustainable economic growth through convenient and efficient financial services. Secondly, it employs digital technology to enhance the coverage of financial services. Finally, it encourages the adoption of sustainable practices through the provision of financial incentives. Secondly, digital finance has facilitated the development of green financial products and services, expanded financing opportunities for enterprises, and lowered the cost of financing green projects. Thirdly, the integration of digital finance and green innovation has contributed to the enhancement and upgrading of industrial structure, as well as the transition towards a greener economy. Therefore, it is imperative to support the advancement of digital finance for green innovation from various perspectives.

Cancer control co-benefits of the climate-related provisions in the American Inflation Reduction Act.

The American Inflation Reduction Act (IRA) of 2022 contains climate-related provisions that may have noteworthy implications for cancer control and prevention. This commentary assesses the potential co-benefits of the IRA for cancer control efforts, specifically policies and programs to reduce carcinogen exposure via air quality monitoring and air pollution reduction. Allocations through the IRA for air quality improvement, paired with its environmental justice provisions, hold promise for advancing cancer prevention by targeting resources to communities most susceptible to environmental hazards. Moreover, climate resilience measures dictated by the IRA are crucial for oncology professionals grappling with the dual challenges of climate change and cancer care. Climate-driven extreme weather events can exacerbate carcinogen exposure and disrupt access to cancer care, underscoring the need for resilient health-care infrastructure. The IRA's provisions for clean energy incentives and infrastructure upgrades offer oncology care institutions opportunities to mitigate emissions and bolster resilience against climate-related disruptions, ultimately improving cancer outcomes. Climate-related initiatives funded by the IRA present a unique and timely avenue to advance equitable cancer control efforts. This commentary underscores the critical intersection between climate resilience policy and oncology care, highlighting the potential to promote a healthier and more resilient future for all.

Strategi Marketing Public Relations Crayoone Event Organizer

This research is motivated by the competition for school yearbooks in high schools, junior high schools, elementary schools and equivalent in the Jakarta area and its surroundings which is quite tight. In this tight competition, a strategy is needed to promote Crayoone Event Organizer to become the best School Yearbook Company. This research was conducted in Central Jakarta.This research aims to find out what Crayoone Event Organizer does in its Marketing Public Relations strategy, find out Pull, Push and Pass Strategy, and find out the opportunities and obstacles to its Marketing Public Relations strategy. This research was conducted based on the theory of Thomas L Harris, Three Ways Strategies namely Pull, Push and Pass Strategy.This research method uses descriptive analysis with a qualitative approach. The data collection techniques used in this study were interviews, observation and documentation. The research results show that the push strategy is the main strategy used by Crayoone, by dividing marketer areas and aiming to be invited for presentations. The provision of incentives per collaboration and annual accumulative is carried out by the Crayoone Event Organizer. A pull strategy is also being pursued through social media to attract consumers via Tiktok and Instagram. The pass strategy used is sponsorship for student and non-student activities. The opportunity to carry out this strategy is better known through social media, and it is easier to convince potential service users. Distance barriers in terms of production outside the work area.

PENGARUH DISIPLIN KERJA DAN PEMBERIAN INSENTIF TERHADAP KINERJA KARYAWAN PT WISATALOKA

Human resources (HR) are an important part of a company. This is because HR is an asset for the company, which contributes to the progress of a company. Employees are required to continue to improve their performance, which in turn can significantly improve company performance. The company has made various efforts to encourage employees to continue to improve their performance. Work discipline is one of the factors that can influence employee performance. Disciplinary attitudes arise from employees and also need to be supported by the company, for example with regulations. Another factor that encourages employee performance is the provision of incentives. The company policy provides incentives to encourage employees to work harder. The aim of this research is to examine the influence of work discipline and incentives on employee performance, both partially and simultaneously. The research method used was quantitative with a sample of 50 respondents. Data collection was carried out through observation, questionnaires and documentation. Work discipline (X1) and incentives (X2) are the independent variables and the dependent variable is employee performance (Y). By using the SPSS 26 application for multiple linear regression analysis. The results of this research show that partially, work discipline has a significant effect on employee performance and providing incentives has a significant effect on employee performance. Furthermore, work discipline and providing incentives simultaneously influence employee performance.

Stakeholder Implementation Considerations for PATH (Plan for Appropriate Tailored Healthcare in Pregnancy) Social Needs Recommendations [ID 2683568

INTRODUCTION: Unmet social needs negatively affect health care access and outcomes, and are disproportionately experienced by groups marginalized by racism, socioeconomic status, and geography. The Plan for Appropriate Tailored Healthcare in Pregnancy (PATH), a consensus-based prenatal care recommendation developed by a multidisciplinary panel of prenatal care experts, includes two recommendations regarding social needs: 1) early screening for medical and social determinants of health; and 2) management of social needs in prenatal care. A national listening tour was conducted to capture stakeholder feedback for implementing social needs recommendations into practice. METHODS: We conducted nine, 120-minute virtual focus groups with more than 25 organizations including professional (8), patient advocacy (8), public health (5), and payer groups (4). Focus groups were transcribed, coded by recommendation, and analyzed with matrix coding across patient, clinic, and policy level implementation considerations. RESULTS: Focus groups included 110 participants. Patient-level considerations for implementation included the importance of relationship building, shared decision-making, resources-first screening, and delivery of trauma-informed, culturally concordant care. On the clinic level, participants stressed robust clinic-level processes for providing effective social needs care, including multidisciplinary care navigation, social needs toolkit utilization, dynamic patient needs assessments, and provision of closed-loop referrals. Policy-level considerations included the need for improved provider incentives, interprofessional group collaboration, evidence-based research, and social needs infrastructure. CONCLUSION: Key considerations for implementing social needs care at the individual, clinic, and policy levels must be operationalized for successful integration into routine prenatal care. Further evidence is needed to identify and test the best approaches to addressing unmet social needs across practice settings.

ANALYSIS OF PROVIDING INCENTIVES IN INCREASING EMPLOYEE LOYALTY AT PT. SUNAN RUBBER

Abstract: Employees of PT Sunan Rubber receive monthly and yearly rewards based on their performance and working hours. If the production department meets its goals, it will receive additional rewards. On the other hand, personnel who are on probation, perform poorly, visit infrequently, or are taken over by management are not given any incentives. The purpose of this study is to ascertain how offering incentives can boost worker loyalty. The investigation was carried out at PT Sunan Rubber, with the aim of examining the workers in the production division of the company. In this study, primary and secondary data sources were used. Literature reviews, surveys, and interviews are the methods utilized to collect data. Purposive sampling, which looks at the criteria for respondents based on gender, age, most recent education, and duration of service, is the sample technique employed in this study. There were 54 responders in the sample that this study utilized. This study employs a qualitative approach along with descriptive analysis. Given that both variables scored in the "very good" range, it is anticipated that offering incentives will stimulate staff members and foster a greater sense of commitment to the organization. This is evident from the 82.4% incentive provision rate and the 85.6% employee loyalty percentage of the outcomes.

Health service providers’ perspective on barriers and strategies to tuberculosis treatment adherence in Obuasi Municipal and Obuasi East District in the Ashanti region, Ghana: a qualitative study

Abstract Background Despite the substantial improvement in treatment success rate over the past two decades in Ghana, some districts in the country still record high rates of tuberculosis (TB) deaths and lost-to-follow-up. The high incidence of these adverse outcomes suggests that the TB programme is not performing well in these districts which could be due to some barriers in the programme implementation. This paper explored the perspectives of healthcare providers on the barriers to TB treatment adherence and the potential strategies to address them in two high-burden districts in the Ashanti Region of Ghana. Methods This study utilised an explorative qualitative study design among 16 purposively selected healthcare providers directly involved in TB care in the Obuasi Municipal and Obuasi East District. Key informant interviews were used to collect data, which were audio-recorded and transcribed word-for-word. The transcriptions were then imported into Atlas.ti version 8.4 software for thematic content analysis. Results Findings from this study revealed significant socioeconomic and individual barriers to TB treatment adherence. Key socioeconomic barriers included income insecurity, transportation cost, food insecurity, lack of public education on TB and frequent shortage of TB diagnostic tools. The individual barriers identified were misconception of TB causation, perceived full recovery after intensive phase treatment, inadequate patient privacy and noncompliance to treatment transfer protocol. The strategies recommended by healthcare providers to address these barriers were home-based treatment, provision of food incentives, frequent education on TB, and usage of reminder systems for follow-ups. Conclusion The barriers to TB treatment adherence from the healthcare providers’ perspective were mainly socioeconomic and individual. The suggested strategies offer actionable steps towards addressing these barriers. Thus, it is recommended that the TB programme and other supporting stakeholders take into account these barriers and adopt these strategies when planning for TB control to enhance treatment adherence and improve patient health outcomes.

The Impact of Preferred Provider Incentives on Demand and Negotiated Prices

The Impact of Preferred Provider Incentives on Demand and Negotiated Prices

Game theoretical analysis of incumbent platform investment and the supplier entry strategies in an e-supply chain

We investigate the interaction of platform investment strategy and a supplier entry strategy in an e-supply chain with a supplier and two e-commerce platforms. In addition to selling through the incumbent platform, the supplier may enter the entrant platform. The incumbent platform may prevent this by investing in the supplier to reduce production costs (indirect investment) or investing in its value-added service to enhance its own demand (direct investment). We analyze the incumbent platform's investment strategy with and without supplier entry to the entrant platform. Without entry, the incumbent platform prefers indirect investment only when the production cost is high and the indirect investment cost is low. With entry, however, the incumbent platform prefers indirect investment when the direct investment cost is high. We also explore the effect of the incumbent platform's investment strategy on the supplier's entry strategy. Counterintuitively, we find that direct investment by the incumbent platform increases the supplier's incentive to enter the entrant platform. Under certain conditions, the incumbent platform can effectively prevent this entrance through an indirect investment strategy. Even if the supplier enters the entrant platform, it is optimal for the incumbent platform to maintain investment. Furthermore, we further extend that the two platforms have the same commission rate to the case where the two platforms have different commission rates and show that the main results still hold. We have also expanded the situation where both platforms have investments. Interestingly, we find that when the production cost is high, the supplier's entry into the entrant platform and the entrant platform's indirect investment may benefit the incumbent platform.

Should contingency management protocols and dissemination practices be modified to accommodate rising stimulant use and harm reduction frameworks?

Stimulant-related overdoses have increased dramatically, with almost 50% of overdoses in the United States now involving stimulants. Additionally, harm-reduction approaches are increasingly seen as key to reducing the negative impact of substance use. Contingency management (CM), the provision of financial incentives for abstinence, is the most effective treatment for stimulant use disorder, but historically has not been widely implemented. Many recent, large-scale implementation efforts have relied upon foundational CM protocols that may not sufficiently account for recent increases in the prevalence and lethality of stimulant use nor the growing preference for harm reduction versus abstinence-only frameworks. We argue the need to (1) consider whether and how CM protocols might be modified to address rising stimulant use and harm reduction frameworks and (2) make CM widely accessible so that it can reduce population-level stimulant use while ensuring that it is delivered with fidelity to its basic principles. Proposed changes include changing CM reinforcement schedules to emphasize treatment engagement and reductions in use in addition to abstinence, changing guidelines on the duration of and re-engagement in CM, investing in research on virtual CM, incentivizing providers and health systems to deliver CM, making it easier to purchase and use point-of-care drug screens, using direct-to-consumer marketing to increase demand for CM and adapting CM to the community in which it is being implemented. Our proposed modifications to contingency management (CM) protocols and accessibility may more effectively address rising stimulant use and align CM more closely with harm-reduction frameworks. Given the urgent need to reduce overdose deaths, developing and testing modified CM protocols may need to rely upon methods other than randomized controlled trials. Efforts to disseminate CM widely to reduce population-level stimulant use must be balanced with the need to maintain fidelity to CM's basic principles.

ANALYSIS OF FACTORS INFLUENCING THE RETURNS ON BROILERS PRODUCTION IN UYO LOCAL GOVERNMENT AREA OF AKWA IBOM STATE, NIGERIA

The study analysed the factors influencing the returns on broilers production in Uyo Local Government Area of Akwa Ibom State. Simple random sampling technique was used to select 100 poultry farmers practicing deep litter system for the study. The data were obtained from a cross-sectional survey of broiler farmers in the study area. The study revealed that male farmers (52%) dominated the broiler production in the study area. The total cost of broilers production was N786,303.60 while the total revenue was N1,430,329.8. The gross margin and net farm income were N 682,052.76 and N 644,026.20 respectively. The study also revealed that the high cost of feed accounted for 80.18% of the total cost of broilers production inversely affected the profitability of broilers production in the study area. The study also reaved that, despite the high cost of feeds deep litter system of broilers production is profitable as depicted by the net farm income of N 644,026.20. Besides, the return on a naira invested was N 0.819 implying that for every N1 invested 81.9k was return as profit. The study concluded that high cost of feeds and lack of funds are the major factors influencing the returns on broilers production in the study area. Based on the findings, it was therefore recommended; Subsidy on feed cost, simple procedures for credit facilities, increase in flock size to enhance profitability, Provision of adequate incentives and financial services to farmers for increase productivity, as well as stoppage of the arbitrary fees levied such as environmental fee, business premises fee and other levies that were introduced by the local government authorities to restore sanity and create a conducive environment for investment in poultry industry.

Does Support for Professional Development in Early Childhood and Care Settings Matter? A Study in Four Countries

AbstractProfessional Development (PD) can be a powerful lever for improving the quality of teacher-child interactions in early childhood education and care (ECEC) and teachers’ feelings of support and competence. However, there is a dearth of studies examining different formats of PD and their links with workplace features. The present study aims to understand (a) different types of PD participation (structured and center-embedded) and their levels of interest of preschool teachers in four European countries (Cyprus, Greece, Portugal, and Romania), and (b) the extent to which they are associated with PD incentives and perceived support. Participants were preschool teachers from Cyprus (N = 93; Mage = 41; SD = 7.47), Greece (N = 92; Mage = 40; SD = 9.81), Portugal (N = 92; Mage = 45; SD = 9.65), and Romania (N = 97; Mage = 40; SD = 10.40). The vast majority of participants were women (95-99%). Participants reported on PD attendance – structured (courses/seminars, conferences) and center-embedded (e.g., observation visits, peer and/or self-observation) –, levels of interest in PD; PD incentives (e.g., release from working with children; reimbursement/payment of costs); and perceived workplace support. Results from the Multi-Group Path Models showed that, in all countries, the provision of incentives was associated with increased participation in center-embedded PD, but not in structured PD. Additionally, the perceived support from their setting was positively associated with greater interest in PD. Understanding what best supports different types of PD can be critical to inform policy efforts aiming to increase PD attendance.

Health workforce strategies during COVID-19 response: insights from 15 countries in the WHO Africa Region

IntroductionThe COVID-19 pandemic unveiled huge challenges in health workforce governance in the context of public health emergencies in Africa. Several countries applied several measures to ensure access to qualified and skilled health workers to respond to the pandemic and provide essential health services. However, there has been limited documentation of these measures. This study was undertaken to examine the health workforce governance strategies applied by 15 countries in the World Health Organization (WHO) Africa Region in responding to the COVID-19 pandemic.MethodsWe extracted data from country case studies developed from national policy documents, reports and grey literature obtained from the Ministries of Health and other service delivery agencies. This study was conducted from October 2020 to January 2021 in 15 countries - Angola, Burkina Faso, Chad, Eswatini, Ghana, Guinea, Guinea Bissau, Ivory Coast, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal and Togo.ResultsAll 15 countries had national multi-sectoral bodies to manage the COVID-19 response and a costed national COVID-19 response plan. All the countries also reflected human resources for health (HRH) activities along the different response pillars. These activities included training for health workers, and budget for the recruitment or mobilization of additional health workers to support the response, and for provision of financial and non-financial incentives for health workers. Nine countries recruited additional 35,812 health workers either on a permanent or temporary basis to respond to the COVID-19 with an abridged process of recruitment implemented to ensure needed health workers are in place on time. Six countries redeployed 3671 health workers to respond to the COVID-19. The redeployment of existing health workers was reported to have impacted negatively on essential health service provision.ConclusionStrengthening multi-sector engagement in the development of public health emergency plans is critical as this promotes the development of holistic interventions needed to improve health workforce availability, retention, incentivization, and coordination. It also ensures optimized utilization based on competencies, especially for the existing health workers.

Perception of Leadership Role among Agricultural Extension Frontliner’s Job Satisfaction in Oyo and Osun state ADP, Nigeria

The study determined perception of leadership roles among agricultural extension frontliners’ job satisfaction in Oyo and Osun State Agricultural Development Programme Nigeria. Simple random sample technique was used to select 123 respondents from the study area. Data were analyzed using mean and regression analysis. The mean age of the respondents was 43.4years while 63.6% were male respondents. Major leadership roles include supervision of employees’ work ( ­=3.67), goal-oriented roles ( =3.39), effective dissemination of information among the employees ( =3.35) and creation of a friendly work environment. Major employees’ satisfaction were employees work together with their colleagues ( =3.54) and interact freely with their colleagues ( =3.51). Major challenges affecting employees job satisfaction were inadequate funding ( =3.30), irregular leave bonus ( =3.29), climate and weather condition ( =3.08) and inadequate incentive ( =3.02). Regression analysis show a positive significant coefficient (P<0.05) exists between educational status (1.701) year of service (β = 0.551), leadership roles (β = 0.513), challenges faced by respondents (β = 2.091) and employees’ job satisfaction. The study concluded that leadership roles have significant relationship with employees’ satisfaction. For adequate job satisfaction among agricultural employees, organization should pay attention to disbursement of training funds, provision of incentive and leadership recognition. Keywords: Perception, Leadership roles, Agricultural extension frontliners and Job satisfaction

The Efficacy of the Wellness Program in Enhancing the Health of the Teaching and Non-Teaching Staff in Selected Private Higher Educational Institutions (HEIs) in the Second District of Albay

Employees are the most valuable asset that a company may have since they are the foundation of its success. Their overall health must be cared for to perform at their best. Thus, having a wellness program is a great initiative for any organization. This study evaluated the efficacy of wellness programs on the overall health of teaching and non-teaching staff in selected Private Higher Educational Institutions (PHEIs) in the Second District of Albay. Multimethod design was utilized using structured interviews and survey questionnaires administered to the 192 participants. Findings revealed that the wellness program of the PHEIs has a common purpose and that the activities offered to the staff were also similar. The provision of incentives for employees' improvement is found missing but necessary. The wellness program and physical and mental health were moderately efficient. Although there were some correlations and non-correlations among the respondents regarding the effectiveness of the wellness program on their physical and mental health, these were not statistically significant. Top 3 challenges met by the respondents were lack of engagement, no incentives or awards, and no employee wellness policy. Suggested wellness programs may be adopted and implemented by the three private HEIs under study and other HEIs in the province.

PENERAPAN INSENTIF DAN TUNJANGAN TERHADAP KINERJA KARYAWAN PADA PT. ARAB WINGS MADURA

Arab Wings is one of the building companies that sells materials for building purposes that pay attention to human resources or employees to achieve company goals. To ensure the achievement of company goals, the company must provide motivation and pay attention to employees by providing a system of incentives and benefits based on the performance of company employees. The provision of incentives and benefits can make employees morale and responsible in their work. The encouragement of employees to do their jobs well is due to the large number of incentives and benefits obtained. The problem in this study is how to apply incentives and benefits to employee performance at PT. Arab Wings Madura. The purpose of this study is to determine the application of incentives and benefits to employee performance at PT. Arab Wings Madura. Incentives provided by PT. Arab Wings Madura can be said to be good, this can show if the incentives at PT. Arab Wings Madura is a review in improving employee performance. While allowances can be assessed as good because this shows allowances are a concern for PT. Arab Wings Madura in improving employee performance, although it still requires special attention in the application of benefits. In providing incentives and benefits is one of the efforts made by the company as a form of appreciating employee performance. The provision of incentives and benefits is expected to be an encouragement for employees to work better and optimally. Based on this description, the author is interested in conducting research entitled "Application of Incentives and Benefits to Employee Performance at PT. Arab Wings Madura". The purpose of this study is to determine how much is done by the effect of incentives and benefits on employee performance

Subsidized gestational diabetes mellitus screening and management program in rural China: a pragmatic multicenter, randomized controlled trial

BackgroundThe increasing prevalence of gestational diabetes mellitus (GDM) is a major challenge, particularly in rural areas of China where control rates are suboptimal. This study aimed to evaluate the effectiveness of a GDM subsidy program in promoting GDM screening and management in these underserved regions.MethodsThis multicenter, randomized controlled trial (RCT) was conducted in obstetric clinics of six rural hospitals located in three provinces in China. Eligible participants were pregnant women in 24–28 weeks’ gestation, without overt diabetes, with a singleton pregnancy, access to a telephone, and provided informed consent. Participants were randomly assigned in a 1:1 ratio to either the intervention or control groups using an internet-based, computer-generated randomization system. The intervention group received subsidized care for GDM, which included screening, blood glucose retesting, and lifestyle management, with financial assistance provided to health care providers. In contrast, the control group received usual care. The primary outcomes of this study were the combined maternal and neonatal complications associated with GDM, as defined by the occurrence of at least one pre-defined complication in either the mother or newborn. The secondary outcomes included the GDM screening rate, rates of glucose retesting for pregnant women diagnosed with GDM, dietary patterns, physical activity levels, gestational weight gain, and antenatal visit frequency for exploratory purposes. Primary and secondary outcomes were obtained for all participants with and without GDM. Binary outcomes were analyzed by the generalized linear model with a link of logistic, and odds ratios (OR) with 95% confidence intervals (CIs) were reported. Count outcomes were analyzed by Poisson regression, and incidence rate ratios with 95% CIs were reported.ResultsA total of 3294 pregnant women were randomly assigned to either the intervention group (n = 1649) or the control group (n = 1645) between 15 September 2018 and 30 September 2019. The proportion of pregnant women in the intervention group who suffered from combined maternal and/or neonatal complications was lower than in the control group with adjusted OR = 0.86 (0.80 to 0.94, P = 0.001), and a more significant difference was observed in the GDM subgroup (adjusted OR = 0.66, 95% CI 0.47 to 0.95, P = 0.025). No predefined safety or adverse events of ketosis or ketoacidosis associated with GDM management were detected in this study. Both the intervention and control groups had high GDM screening rates (intervention: 97.2% [1602/1649]; control: 94.5% [1555/1645], P < 0.001). Moreover, The intervention group showed a healthier lifestyle, with lower energy intake and more walking minutes (P values < 0.05), and more frequent blood glucose testing (1.5 vs. 0.4 visits; P = 0.001) compared to the control group.ConclusionIn rural China, a GDM care program that provided incentives for both pregnant women and healthcare providers resulted in improved maternal and neonatal health outcomes. Public health subsidy programs in China should consider incorporating GDM screening and management to further enhance reproductive health.Trial registrationChina Clinical Trials Registry ChiCTR1800017488. https://www.chictr.org.cn/