Public Engagement Research Articles

Organ transplantation, one of the most remarkable achievements of modern medicine, is deeply rooted in definitions of death that are both medically complex and ethically contested. This narrative review explores how brain death and the dead donor rule (DDR) have shaped the practice of organ procurement, while also highlighting persistent controversies that continue to challenge clinicians, policymakers, and ethicists. Through a review of 56 peer-reviewed publications, we examine the variability in brain death determination, advances in donor management, and the promising emergence of Donation after Circulatory Determination of Death (DCDD). The findings of our review reveal significant inconsistencies in diagnostic criteria across institutions and jurisdictions, which not only undermine public trust but also create uncertainty at the bedside. The implementation of standardized donor management strategies, despite their potential to improve graft survival and increase organ yield, remains uneven. The expansion of the donor pool through DCDD is a positive development, but the less favorable outcomes, particularly for thoracic organs, raise ethical concerns. This underscores the urgent need for standardization in the field of organ transplantation. The DDR remains a cornerstone principle, defended as essential for maintaining trust but challenged by scholars who argue it represents a social and legal construct rather than a biological truth. International comparisons highlight the cultural dimensions of these debates: Spain exemplifies the effectiveness of coordinated systems and public engagement, whereas Japan illustrates the challenges posed by cultural resistance to brain-death criteria. Keywords: Brain death, dead donor rule, organ transplantation ethics, donation after circulatory death (DCDD), donor management

Chronic insomnia is a prevalent but under-recognised sleep disorder in the UK, affecting 6.8%-14.9% of adults. It is associated with significant health and economic burdens, yet remains under-diagnosed and poorly managed in primary care. This study aimed to address key gaps in the understanding, diagnosis and management of chronic insomnia and to develop consensus-based recommendations to optimise care pathways across the National Health Service. A modified Delphi consensus study. UK primary care, involving general practitioners, pharmacists and sleep specialists. A multidisciplinary steering group of seven UK healthcare professionals (HCPs) with expertise in chronic insomnia developed 39 statements. These were tested in a two-round Delphi survey distributed to a panel of 201 HCPs. Consensus was defined as ≥75% agreement on a 4-point Likert scale. Consensus was reached for 37 of the 39 statements. Key findings included the recognition of chronic insomnia as a distinct chronic condition, the recommendation to include routine sleep-related screening in primary care and the need for increased HCP training in cognitive behavioural therapy for insomnia and pharmacological treatment. Respondents highlighted the necessity for greater awareness and public engagement regarding insomnia and its treatment options. In spite of mitigating biases, responses may have been subject to acquiescence bias. The study identifies systemic barriers to effective insomnia care and calls for chronic insomnia to be prioritised in UK primary care. The resulting consensus recommendations aim to reduce the burden of untreated insomnia, improve patient outcomes, enhance healthcare delivery and increase economic productivity.

Going slow to go fast: public response and engagement in renewable energy projects

Technological advancements alone, without addressing public responses to social changes cannot ensure inclusive and sustainable smart city transitions as cities and societies comprise diverse individuals and communities with varied socio-demographic backgrounds. Thus, this research investigates social responses to smart city transitions aiming to understand individuals’ social reactions to the changes across diverse socio-demographic profiles, and identify socio-demographic group-specific change management strategies to enhance public engagement and minimise resistance during the transition. Through a questionnaire survey using multivariate analysis, correlations between socio-demographic profiles and social reactions are identified. Age and frustration showed a positive correlation indicating that elderly individuals express greater concerns about unfamiliar smart technologies. Weak negative correlations emerged between income levels and transition-related stress including shock, frustration and depression. Significant differences were revealed between income groups (AUD 126,000+ and below AUD 90,000) associated with job security due to smart technologies and digital automation. Improving digital proficiency through free local government-led training, and reinforcing the benefits of digitally transformed urban environments through timely technical support were identified as the most essential change management strategies. Thus, this research will contribute to enabling local governments and policymakers to have practical insights in developing socially inclusive and community-centric transition plans with minimised social resistance.

Virtual citizen academies are a useful tool in the planner’s toolbox. This paper describes virtual citizen academies and addresses how they support public engagement and community cocreation goals in an increasingly virtual world. The results from the 2021 and 2022 program evaluations of the Tampa Bay Citizens Academy on Transportation (TB-CAT) are used to demonstrate the benefits and limitations of online platforms for citizen academies. TB-CAT was a free 8-week course to familiarize City of Tampa residents with transportation in the city. This academy was initially designed as an in-person course, but to reduce the risk of exposure during the COVID-19 pandemic and provide additional flexibility for participants, TB-CAT was changed from a face-to-face course to a virtual course. Through the TB-CAT evaluations and the experiences of the TB-CAT facilitators, it was evident that online platforms can expand the reach of citizen academies to interested community members and help agencies accomplish public engagement and community cocreation goals. However, they also indicated that intentional and consistent efforts are needed to ensure that all community members, including individuals living in rural areas, can receive the full benefit of online academies. The information provided in this paper provides insights into agencies as they consider how education and technology can be integrated into public engagement practices.

Public engagement, also referred to as community and stakeholder engagement (CSE), and high-quality care are core components of strategies to achieve universal health coverage (UHC), one of the United Nations Sustainable Development Goals. As part of the movement toward achieving UHC, Colombia has developed one of the first national quality of care strategies in the Latin America and Caribbean region. However, the degree to which public engagement was considered in the development and implementation of Colombia’s National Quality of Care Strategy (the Strategy) is not clearly understood. With a growing global consensus on the importance of public engagement in health systems and policy, we use a qualitative case study comprising a document analysis followed by qualitative interviews, to explore how CSE has been considered in the design and implementation of the Strategy. In an analysis guided by the Lavery framework for CSE, we address the following three research objectives: 1) describe how community and stakeholder engagement is reflected in the Strategy; 2) explore approaches undertaken to engage community and stakeholders in the development and implementation of the Strategy and their perceived effectiveness; and 3) report on strengths and opportunities for improving CSE in health policymaking in Colombia. Our findings demonstrate a strong written commitment to CSE. However, the implementation of engagement strategies fell short in including community (i.e., patients and citizens), particularly those from structurally marginalized communities, due in part to inconsistent political and financial support and the absence of evaluation mechanisms. These findings have important implications for Colombia and other comparable jurisdictions aiming to enhance public engagement in health policy making. Our study highlights the need to move beyond symbolic participation toward inclusive, well-resourced, and systematically evaluated engagement strategies.

Waste collection and disposal are a major challenge for many District, Municipal, and Metropolitan Assemblies in Ghana due to rapid economic and population growth. Techiman Municipality and, for that matter, Techiman Township, is no exception. Currently, all the waste generated ends up at the final disposal site without the retrieval of useful materials. This study was the culmination of research carried out to investigate the level of public participation in solid waste management by assessing physical composition and per capita waste generated, as well as the current practice of the public towards municipal waste management. Questionnaire survey and interviews with key stakeholders were also carried out. The results show solid waste composition of 57% biodegradables and 42.5% non-biodegradables. The average per capita waste generated was 0.70 kg/capita/day. The study further revealed that 30% of the respondents were aware of the existence of a dump site in the Techiman Municipality. The public engagement in solid waste management includes waste collection, sorting of waste, transportation, and recycling. Other potential roles of the public identified include the reuse of waste, composting, and waste separation. It is recommended that active participation and public sensitization in solid waste management be carried out through mass education on radio, television, newspapers, and other media.

ABSTRACT This paper explores how children’s active involvement in curating and interpreting exhibitions can transform museum practices, power dynamics, and institutional culture. Focusing on two Australian initiatives, Junior Curators: Mysterious Realms at Ipswich Art Gallery and the Young Gallery Guides program at HOTA, the paper demonstrates how child-led initiatives challenge dominant views of children as passive or disruptive. Drawing on Monica Patterson’s critical children’s museology and Carmen Mörsch’s five functions of cultural mediation, it shows how these programs fostered internal change, interdepartmental collaboration, and shifts in authorship and authority. Far from being tokenistic, the children were positioned as knowledge producers and decision-makers, influencing curatorial processes and public engagement. The paper argues that recognising children as co-curators is not merely about inclusion but about rethinking museums as dynamic, participatory institutions. By engaging children as collaborators, museums can promote epistemological renewal and redefine their role in cultural production.

Introduction: Bystander cardiopulmonary resuscitation (bCPR) can double or triple survival yet only 40% of out-of-hospital sudden cardiac arrest (SCA) victims receive bCPR before paramedics arrive. Despite its life-saving potential, cultural norms, gender-related discomfort, and the lack of inclusive training deter individuals from intervening, contributing to persistent disparities in SCA outcomes. Research Questions: How do gender, body image, cultural and language barriers impact administration of bCPR? Can video-based community CPR education be tailored to overcome sociocultural barriers and improve confidence, efficacy and administration of bCPR in underserved populations? Goals Analyze key sociocultural barriers and their intersectionality in bCPR. Review the efficacy of community and video-based CPR interventions in diverse populations. Propose an informed framework of an inclusive, community CPR education initiative, focusing on accessibility, cultural competence, and public engagement. Methods: Following PRISMA guidelines, articles described public attitudes or studied interventions surrounding video efficacy in bCPR training, community CPR initiatives, and/or demographic differences in SCA outcomes were included. Results: Of 643 initial publications, 54 were indexed: 18 on gender and body image, 16 on cultural and linguistic barriers, 8 on video training, 12 bystander training. Inequities in the administration and efficacy of bCPR for women, those with non-lean body habitus, or cultural minorities were found in 87% of reviewed papers. Perceived barriers included concerns about chest exposure, fear of victim injury, inadequate culturally adapted training on female or non-lean manikins, limited English proficiency, and fear of system distrust. Although video interventions successfully build skills with similar performance of CPR to instructor-led training, they do not address public perceptions around bCPR. Conclusion: Women and those with non-normative bodies are less likely to receive CPR due to social discomfort and non-inclusive training. Racial minorities face additional barriers including limited access to CPR education, language obstacles, and system distrust. While video resources improve skills and confidence, they often overlook critical sociocultural factors. Culturally tailored, inclusive, and sustainable programs are essential to improving CPR uptake and survival after cardiac arrest.

BackgroundIncorporating public and patient perspectives is essential to advancing personalised prevention. Personalised prevention focuses on preventing disease onset, progression, and recurrence by tailoring interventions on the basis of an individual’s biological, environmental, behavioural, socioeconomic, and cultural characteristics. This study explored what patients and the public want for better engagement and empowerment in prevention, aiming to develop key considerations across three domains (Research, Care, and Governance), and offering practical points to consider for improving personalised prevention strategies.MethodsIn cocreation with the European Patients Forum (EPF) and Cittadinanzattiva APS-Active Citizenship Network (ACN), semi-structured individual interviews and focus groups were conducted with 29 participants, comprising of 17 citizen advocates and 12 patients (including advocates) across 16 European countries, with experience in seven distinct disease groups. The participants were recruited through ACN and EPF via newsletters and mailing lists. Thematic analysis was performed via MAXQDA software. This study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ).ResultsFindings were clustered into three key themes for better engagement in personalised prevention: (i) Information and Communication, where patients and the public emphasised the need for clear and accessible health information and user-friendly digital platforms; (ii) Representation and Inclusivity, highlighting calls for inclusive research, community engagement, and mental health integration; and (iii) Ethical and Regulatory Considerations, with concerns over equity and the potential shift from solidarity-based care to individual risk assessment, underscoring the need for robust privacy protection and equitable policies.ConclusionsEnhancing patient and public engagement in personalised prevention requires more focus on communication, inclusivity, and secure data use. The findings provide actionable insights, promoting systematic engagement across Research, Care, and Governance. Clear information about prevention strategies and treatment options must be accessible, while diverse voices should be represented in decision-making. Collaboration with communities and better use of patient data can enhance prevention efforts. Policies should ensure ethical implementation, address data protection, and promote equity, transparency, and patient and public empowerment in healthcare, ultimately fostering a more inclusive approach to personalised prevention.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12889-025-24925-0.

The giant African snail ( Lissachatina fulica ) is among the world’s most damaging invasive species, threatening biodiversity, agriculture, and public health. Effective management requires understanding public perceptions, awareness, and engagement, yet sociodemographic drivers of these remain understudied. Here, we evaluate how education, age, and awareness influence attitudes toward L. fulica and its management in the Brazilian Federal District. Using structured questionnaires from 613 respondents, we assessed: (1) sociodemographic correlates of perceived knowledge on invasive species, (2) public perceptions and attitudes of invasive species in general and specifically towards L. fulica , and (3) evaluation of trust in governmental communication and management efforts. Older and more educated individuals exhibited significantly greater awareness of invasive species and L. fulica specifically. However, while higher awareness predicted more negative perceptions of the snail, it did not correlate with proactive control behaviors. Public satisfaction with government management efforts was strongly tied to self-reported knowledge of the snail’s impacts, highlighting a gap between awareness and actionable responses. Our results underscore the need for targeted outreach programs prioritizing younger and less-educated demographics. We propose that generalized education on biological invasions can bolster the success of species-specific campaigns. These insights are critical for designing inclusive policies that enhance community participation in L. fulica management, offering a model for engagement in regions facing similar invasion challenges.

This study aims to provide a Christocentric theological and pastoral framework for understanding vaccination, offering a theological and epistemological tool (Theological Epistemology) that distinguishes observation and reason (OR) from beliefs inconsistent with biblical doctrine, thereby enabling trust in the veracity of scientific OR. This study is motivated by two pressing concerns within the Christian community: a growing mistrust of scientific observation and reason (OR), particularly regarding vaccination, and a theological gap in understanding how vaccination aligns with Christ’s redemptive mission. The study critiques existing theological literature on vaccination, identifying gaps in either scientific or theological rigour. In response, this study proposes a balanced integration of theological and scientific reasoning (Theological Reflection), presenting vaccination as participation in Christ’s redemptive mission to “destroy the works of the enemy” (1 John 3:8). Public health successes, such as smallpox eradication, are framed as missional acts, supported by scientific observation and reason (OR) that reinforce the theological argument. The paper responds to common objections (Systematic Theology), including concerns about aborted foetal cell lines, bodily sanctity, divine healing, and moral implications of certain vaccines, through biblical reasoning and pastoral sensitivity. Thus, the method is a three-step process: Theological Epistemology, Theological Reflection and Systematic Theology. This Christocentric framework enables church leaders to guide congregations toward informed, compassionate vaccination choices, aligning with their missional and pastoral responsibilities. This significance lies in its potential to foster faith-informed public health engagement and promote life-affirming theological reflection.

The Data Innovation, Program Implementation, and Community Action (DIPICA) Observatory for Surgical, Anesthesia, and Obstetric (SAO) Care in India convened in December 2024 in New Delhi. This two-day program brought together experts from global surgery, public health, health policy, and clinical practice to address planned challenges in SAO care, focusing on data-driven approaches, sustainable financing, and workforce development. The discussions emphasized leveraging data to strengthen SAO care systems by creating practical data products for localized planning and community engagement. Participants advocated for dynamic observatories to support data-driven research and policy implementation, making SAO care more accessible and efficient. Sustainable financing emerged as a key focus, with experts discussing innovative approaches that move beyond conventional models. Community-based solutions, decentralized funding, and performance-based models were discussed as strategies to optimize resource allocation. Establishing partnerships involving government, private, and community sectors was highlighted as crucial for achieving financial sustainability, particularly in underserved areas. Workforce development discussions addressed competency-based training and task-sharing initiatives to reduce disparities. The attendees agreed on the need for structured training to enhance surgical skills, especially for general practitioners in rural areas. Regulatory policies on task-sharing and task-shifting were considered essential to maintaining care quality while expanding access. Improving trauma care and emergency response through targeted training and rural workforce retention also remained key priorities. Advocacy efforts focused on integrating SAO care into national health priorities through data-driven communication and public engagement. The observatory aims to sustain progress through collaborative research, advocacy, and policy dialogues to ensure equitable, accessible, and high-quality SAO care across India.

This scoping review systematically maps empirical research on journalism and euthanasia, filling a gap left by prior health-focused reviews by centring media studies perspectives. The analysis encompassed 30 studies indexed in Web of Science and Scopus up to October 2025, revealing a thematic emphasis on news coverage related to euthanasia, euthanasia deaths, and end-of-life decisions. Most of these studies employed qualitative content and discourse analysis methods. A strong Global North bias constrains geographic and epistemic diversity. The fragmentation across journals and scientific domains reflects an emerging but methodologically diverse interdisciplinary field. Key media frames emphasised individual autonomy and suffering alleviation while marginalising alternative viewpoints. Significant gaps remain regarding public engagement with media coverage and content production dynamics. The review advocates for geographically diverse, integrative research and evidence-based ethical guidelines. Policymakers must consider media framing's impact on public opinion and ethical debates surrounding end-of-life care.

Landscape planning is now a mandatory element of local spatial planning in Ukraine. Introduced as part of recent planning reforms, it is now required in Comprehensive Spatial Development Plans for Hromadas. Based on the German methodological model, the Ukrainian approach has been adapted to local conditions. This article draws on the author’s practical experience to explore how landscape plans are developed and integrated into comprehensive plans. It provides examples from selected Hromadas, analyses how environmental objectives are reflected in final planning decisions, and discusses regulatory and practical challenges. The conclusions reveal key factors influencing integration, including legal clarity, data availability, coordination, and public engagement.

National Institute for Health and Care Excellence (NICE) technology appraisal processes assume that the standard of care (SoC) is itself cost effective. However, many treatments in use in the UK National Health Service (NHS), particularly in rare diseases, were historically commissioned without formal value assessment and are priced without reference to cost-effectiveness thresholds. Cost-ineffective comparators distort how value is ascribed to new technologies, undermining the coherence of NICE's decision-making framework, and imposing substantial opportunity costs on the NHS. Using late-onset Pompe disease (LOPD) as an exemplar, we demonstrate the implications of a cost-ineffective comparator in assessments of innovative therapies. A clinically superior enzyme replacement therapy (ERT) may command a lower value-based price than current ERTs, whilst a hypothetical curative gene therapy is valued at over £4 million against current ERT, but just £629,392 when re-anchored against best supportive care. Here, value is driven by displacement of costs rather than health gain, raising affordability concerns that may limit access to genuine innovation. The 2025 NHS 10-Year Plan grants new NICE statutory powers to withdraw access to cost-ineffective therapies, presenting an opportunity to reform technology appraisal. We propose several policy responses, including comprehensive reassessment of active guidance with decisions made with respect to a standard cost-effectiveness frontier, reviews triggered by new comparators, and use of flexible decision rules within existing frameworks. These changes could allow the evolving value of medicines to be reflected in NHS practice, redefining NICE as a body that takes a dynamic, whole-lifecycle view of value. Deliberative public and stakeholder engagement is essential for success, given the potential consequences for manufacturers and patients.

One Health clinics integrate human, animal, and environmental health to provide interdisciplinary health care and community resources to people experiencing homelessness (PEH). Five mobile, public health-led One Health clinics were newly implemented in Pima County, Arizona, during October 2023-February 2024. Clinic locations included parks, libraries, and homeless shelters to reduce transportation-related barriers and integrate public health, veterinary, and housing services. Originally designed for PEH and their pets, Pima County One Health clinics were open to everyone in neighborhoods where clinics were hosted to promote community engagement with clinics and strengthen relationships with public health. We evaluated the performance of these clinics by describing service patterns, client perceptions, and lessons learned to support development of clinics by other jurisdictions. During clinic visits, basic demographic information was collected for people and pets, along with data on housing status, environmental and resource concerns, use of clinic services, and perceptions of clinics. The first 5 monthly mobile community clinics served 108 clients and 93 pets; 44% of clients were unhoused or unstably housed, 36% of clients were housed, and housing status was unknown for 20% of clients. Clinics facilitated partnership among service providers and with housed and unhoused community members. Clinics supported vaccine uptake among people and their pets and identified 3 cases of sexually transmitted infections that might otherwise have remained undetected. By implementing a One Health Clinic framework, our local health department helped address gaps in human and veterinary health care services. Other public health agencies might consider implementing similar models to enhance public health engagement with local communities.

Abstract Wildlife management is increasingly challenged by ecological pressures and public controversy, particularly in relation to pest control strategies in Australia and globally. As invasive species and human–wildlife conflicts intensify, understanding public support for wildlife management has become essential to the design and legitimacy of effective interventions. This study aimed to quantify public support for novel control interventions utilizing semiochemicals to manage crown-of-thorns starfish (COTS) outbreaks on the Great Barrier Reef (GBR). A national survey ( n = 1,061) of Australian residents was conducted in 2024 to better understand how people perceive the benefits and risks of both conventional and semiochemical-based control interventions, which influence COTS behavior, whether they support research and implementation of these interventions, and factors associated with support for scaled deployment across the GBR. Public support for both conventional and semiochemical-based COTS control was high across all stages of research and development from the provision of research funding to laboratory research and small-scale trials, while support for large-scale outdoor use was medium to strong. Support for large-scale use was particularly high among Aboriginal and Torres Strait Islander respondents, those with high self-assessed knowledge of the technology, those convinced of its environmental and economic feasibility, and men. Support was lower among those who voted for independent political candidates and minor parties, and those who know COTS are native to the GBR. Poor respondent knowledge of COTS and inconsistent relationships between knowledge and support suggest public communication and engagement about the rationale for innovation in COTS control will be critical to successful implementation.

This manuscript explores how knowledge mobilisation (KMb), through a multi-stakeholder workshop, can advance decarbonisation in general practice by interpreting findings from the GPNET-0 study, which includes a systematic review, a GP survey and longitudinal case studies. The KMb workshop serves as a platform to interpret and disseminate its findings, thereby informing the development and refinement of outputs (i.e., Policy Brief and Factsheet) and the tailoring of audience-specific dissemination strategies. Fifteen stakeholders were selected from key groups across the United Kingdom, including public representatives, policymakers and general practitioners. The workshop was structured with presentations, group discussions and interactive activities to encourage targeted dialogue. Pre-workshop materials, including a Policy Brief and Factsheet, were shared with participants to promote informed discussions. The workshop's design ensured that stakeholder input was actively integrated into the development and refinement of outputs. The KMb workshop provided valuable insights and views into the barriers, opportunities and priorities for general practice decarbonisation. The analysis identified four overarching views: 'bridging knowledge and resource gaps', 'organisational and cultural barriers', 'enhancing public engagement and messaging', and 'policy and leadership as drivers of change'. The KMb effectively engaged stakeholders in reflecting on decarbonisation challenges and opportunities, informing the development of targeted dissemination strategies. The KMb workshop demonstrated the critical role of stakeholder engagement in refining outputs for maximal impact of research findings and outputs. Patients and members of the public were closely involved throughout the study. Two lay representatives served as co-investigators, and a nine-member PPI panel provided input across all stages, including study design, development of the Policy Brief and Factsheet, and the knowledge mobilisation workshop, and one lay representative is a co-author of this article.

This study investigates the mechanisms, challenges and pathways through which digital technology platforms empower social governance, focusing on the comprehensive administrative law enforcement command and dispatch platform in Mengzi City. Employing the ‘structural adaptation - process collaboration - functional optimization’ framework grounded in adaptive governance theory and sociotechnical systems theory, we analyze operational data from 12,703 cases processed in 2024, supplemented by field interviews and policy document reviews. Our findings reveal that, despite the platform achieving a 95% case resolution rate and improving governance transparency via a unified command system and real-time data dashboards, significant structural disconnections persist. Specifically, a 40% shortage of grassroots personnel is evident, there is a misalignment between standardized work processes and local governance requirements, and cross-departmental incidents continue to depend on manual coordination. Moreover, the emergence of data silos, exacerbated by incompatible standards and policy constraints, has further undermined the ‘trustless collaboration’ mechanism facilitated by blockchain technology. In terms of public participation, the feedback mechanism remains superficial, resulting in citizen involvement being limited to a mere 6.8% of reported cases. Furthermore, This study identifies three paradoxes that impede digital governance in developing jurisdictions. First, advanced platform architectures conflict with under-resourced implementation, creating a techno‑structural friction that undermines system performance. Second, high technical specifications coexist with incomplete data integration, leaving information silos that frustrate decision‑making. Third, participatory interfaces exist alongside constrained public engagement, so opportunities for civic input fail to translate into meaningful participation. Theoretically, we extend the application of adaptive governance theory by showing how institutional inertia impedes technological assimilation in multi‑ethnic border regions. At the practical level, we propose a tripartite solution. Dynamic government-enterprise partnerships can address hardware and capacity gaps at the fron-tline, and algorithmic responsibility‑matching systems automate interagency coordination by routing tasks according to jurisdictional competence and workload. Meanwhile, blockchain-anchored incentive ecosystems stimulate civic participation can be stimulated by establishing blockchain-anchored incentive ecosystems. These strategies offer feasible pathways to reconcile ambitious digital governance goals with the contextual realities in developing countries.