Reform Of System Research Articles

Judicial System Reform in Albania in the Context of Accession Process to the European Union

Judicial System Reform in Albania in the Context of Accession Process to the European Union

Has the Anti-Corruption Campaign Decreased Environmental Pollution? Evidence from China

Whether anti-corruption efforts help reduce environmental pollution is a hot topic in academia. This paper analyzes the impact of anti-corruption on the emissions of environmental pollutants using panel data from 31 provinces (municipalities) in China from 2015 to 2022. By using the 2018 supervision system reform as an exogenous policy shock, a Difference-in-Differences (DID) model is employed to examine the impact of the anti-corruption campaign on environmental pollutant emissions. The results show that the effectiveness of anti-corruption measures has strengthened over time, especially after the 2018 system reform, although these reforms exhibit a lag effect before significantly reducing pollution levels. Furthermore, heterogeneity analysis indicates that due to the high-pollution, high-energy-consumption industrial structure, the pollution reduction effect of anti-corruption measures is more pronounced in resource-based provinces than in non-resource-based provinces. Our findings emphasize the importance of strengthening anti-corruption measures and establishing a sound legal framework to effectively curb corruption and enhance environmental protection.

The Research on Cultivating Pathways for Vocational High School Students' Professional Qualities

The demand structure for talent in today's society is undergoing significant changes. To meet regional economic development needs and achieve the goals of socialist modernization, there is an urgent need to transform the national industrial structure, which in turn drives the enhancement of technical skills among practitioners. Consequently, the vigorous development of vocational education has become a new focal point and endpoint in the current education system, with the cultivation of vocational skills in vocational high school students emerging as a critical issue. This paper, based on an in-depth analysis of the current status of vocational high school education and students' vocational skills in China, explores the existing problems within the current vocational education training system and proposes several improvement paths. The study highlights that despite progress in curriculum design, practical teaching, and teacher development, challenges remain, including an incomplete curriculum system, insufficient practical teaching, and inadequate evaluation mechanisms. To address these issues, the paper suggests strategies such as optimizing the curriculum system, reforming practical teaching, developing a high-quality teaching staff, and establishing a scientific evaluation and feedback mechanism to enhance students' vocational skills and improve the quality of vocational education. The research indicates that systematic reforms and innovations targeting vocational skills can significantly improve the comprehensive abilities of vocational high school students, laying a solid foundation for their career development.

Research on the Linkage Development Strategy of Higher Vocational Education Empowering Rural Revitalization from the Perspective of "Internet +"

With the rapid development of information technology, "Internet +" has become a new engine to promote economic and social development. Rural revitalization is a major national strategy. Higher vocational education has ushered in new opportunities and challenges in empowering rural revitalization. Under the background of the rural revitalization strategy, as an important position for cultivating high-quality technical and skilled talents, higher vocational education should give full play to its own advantages and actively explore the linkage development strategy with rural revitalization. From the perspective of "Internet +", this study deeply analyzes the opportunities brought by "Internet +" to higher vocational education empowering rural revitalization, the significance, current situation and existing problems of higher vocational education empowering rural revitalization, and proposes to build a linkage development model of "Internet +" higher vocational education empowering rural revitalization. And from the aspects of professional setting and curriculum system reform, teaching staff construction, construction of practical teaching system, innovation and entrepreneurship education, and school-local cooperation, it expounds the specific implementation strategies of the linkage development of higher vocational education and rural revitalization, aiming to provide useful references for promoting rural revitalization. And provide theoretical support and practical guidance for higher vocational education to better serve rural revitalization.

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

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

The efficient enforcement challenge of secured transactions law reforms in civil law systems—self-help repossession, strict foreclosure, and other methods for the acceleration of enforcement of security interests

Abstract Although the forging of an efficient system for enforcement of security interest is one of the central expectations of secured transaction law reforms in civil law systems, the results hardly give reason for satisfaction. As the reforms tend to be supported and influenced by various international organizations’ projects (especially the World Bank, the European Bank for Reconstruction and Development, the International Institute for the Unification of Private Law, and the United Nations Commission on International Trade Law), most out-of-court methods of enforcement of security interests have played a central role. Yet due to civil law’s general hostility towards self-help as such, either the introduction of the concept has been rejected or the local limited-reach kin have been merely ‘paper tigers’. Similarly, although security interests on several types of collateral (accounts, investment property) or on the workhorse of the English financial system—the floating charge—have also been enforced extrajudicially (save the exceptions), little attention has been attributed to these enforcement modalities. The same applies to strict foreclosure in civil law systems still being prohibited, or restricted, and thus rarely resorted to, due to the inherited hostility towards the doctrine of lex commissoria. Rethinking local laws on preliminary and temporary court orders to match them with such globally known ex parte preliminary measures as the English Mareva Injunction or the French Saisie Conservatoire, which allow creditors to swiftly freeze debtors’ assets and thus substitute self-help repossession, has also been given short shrift. The enforcement segment, consequently, remains the Achilles’ heel of secured transaction law reforms in civil law systems. This article desires to contribute to reform literature by addressing these deficiencies and by offering tested, fully or partially fitting, functional equivalents of self-help repossession.

Amir Temur's State and It’s Department

This study explores the governance system and administrative reforms implemented by Amir Timur, drawing from historical texts that highlight his consolidation of power and state-building efforts. Initially adopting Mongol administrative structures, Timur gradually reformed these systems to create a highly centralised state apparatus. Amir Timur’s state-building initiatives merged traditional Central Asian governance models with the Mongol administrative legacy. Initially adopting the Mongol structure, Timur later implemented extensive reforms to centralise authority and strengthen his empire. He established a complex administrative system divided into seven ministries, each responsible for functions such as taxation, trade, and justice. Timur's governance was deeply influenced by Islamic principles, emphasising sharia law and council deliberations to ensure stability. The "suyurgol" system allowed Timur to distribute land holdings among his descendants while retaining centralized control over key resources and military power. Through a blend of military conquests and diplomatic alliances, Timur expanded his empire, integrating vast territories and securing vital trade routes along the Silk Road, contributing to a unified and prosperous state.

Influence of the transformation of the legal system of Ukraine on the development of the theory of the state and law

The article is devoted to the analysis of modern challenges for the theory of the state and law in the context of the development of the legal system of Ukraine. Starting with the introduction, the author emphasises the relevance of the topic and emphasises the need to consider these issues in the Ukrainian context. The theoretical part of the article deals with a historical overview of the state and law, in particular, their development in Ukraine. The author draws attention to the key aspects of the formation of the theoretical foundations that formed the basis of the country’s modern legal system. Modern trends in the development of the legal system of Ukraine are also considered. The author analyzes various aspects such as corruption, human rights and the implementation of reforms. The problems and challenges faced by the Ukrainian legal system are highlighted, and possible ways to overcome them are outlined. A separate part is devoted to the influence of globalisation on changes in the concepts of the state and law. The author considers the phenomenon of globalisation as a factor affecting the modern legal system of Ukraine and highlights its consequences and opportunities for further development. In addition, the article examines the role of the Constitution of Ukraine in the formation of the legal system. The author analyzes the basic principles of the state and law enshrined in the Constitution and their significance for the functioning of the country’s legal system. Attention is drawn to international experience in solving challenges for the theory of the state and law. The author conducts a comparative analysis of different countries, which allows to highlight the best practices and use them to improve the legal system of Ukraine. A separate aspect is the role of civil society in the formation of the legal system. The author emphasises the importance of active participation of citizens in the legal process and their influence on the development of the legal system. In the conclusion, the author sums up the research and highlights the main conclusions regarding modern challenges for the theory of the state and law in Ukraine. It is noted that the further development of the country’s legal system requires complex measures and systemic reforms, as well as the active implementation of best practices and experience of other countries.

Cross-cultural adaptation of the Quebecois Patient-Centered Coordination by a Care Team Questionnaire for use in France

BackgroundThe prevalence of chronic disease and multimorbidity is increasing and the associated disease and treatment burden is particularly heavy. Coordinated multidisciplinary, patient-centered care is particularly important for people living with chronic disease or multimorbidity. There was no valid tool to measure the quality of coordinated patient-centered care from the patient’s perspective until the Patient-Centered Coordination by a Care Team (PCCCT) questionnaire was recently developed in Canada (Quebec/Ontario). The Quebecois version has been validated but is not directly transferable to France due to linguistic, cultural and health system differences between the two countries. To perform a cross-cultural adaptation of the Quebecois PCCCT questionnaire is therefore necessary to obtain a questionnaire’s new version adapted for use in France, ensuring item and semantic equivalence.MethodsThe adaptation process consisted of two stages, both of which were supervised by a scientific committee made up of five healthcare professionals. The first stage was a Delphi consensus involving a multidisciplinary healthcare professional panel to evaluate and harmonize the clarity and appropriateness of the questionnaire for patients in the French health system. During the second stage, adult patients with one or more chronic diseases, from various age, sex, socio-occupational categories, assessed the comprehensibility and conformity of the adapted version of the questionnaire resulting from stage 1 and improved it if necessary. This was achieved using cognitive interviews.ResultsDuring Stage 1, two rounds were undertaken with 10 professional experts resulting in consensual reformulation of 10 out of the 14 items. These newly formulated items and the 4 remaining items were submitted to patients in Stage 2. Cognitive interviews were undertaken with 14 patients, testing 3 successively adapted versions of the questionnaire, until three consecutive patients did not find any ambiguity or misunderstanding. The final version resulting from the cross-cultural adaptation process aimed at being used in France, has item and semantic equivalence to the original Quebecois version.ConclusionsMeasurement equivalence will be addressed in a future study. This French version is intended to be a useful resource for the health system reforms aimed at promoting more integrated and patient-centered care pathways.

An examination of direct and indirect taxation in OECD countries and the case of Greece

This paper attempts to analyze and interpret the principles of direct and indirect taxation. Initially, a theoretical approach to the general concepts and principles governing tax law is presented. It is followed by a presentation of the Greek tax and financial system. The key points demonstrating the harmonization of tax legislation, in accordance with the OECD (Organization for Economic Cooperation and Development) guidelines so far are highlighted. Any future reform of the Greek national tax system should incorporate the fundamental principles of national tax policy. Additionally, it must be in line with OECD principles and guidelines. The further implementation of the Organization's recommendations will shift the balance between direct and indirect taxation, leading to strengthening the first and reducing the second. Over the last decades, the ratio of direct to indirect taxes has been on the increase, particularly in developed countries. The main reason is that direct taxation is socially just and effective. Direct taxation is attributed by the liable person, while indirect taxation is transferred according to the ability of each person to react to the relevant market. The OECD supports, for member countries, the strengthening of direct taxation, which takes into account income and other social criteria and satisfies both the criterion of efficiency and the criterion of fair distribution of economic burdens. On the contrary, indirect taxation is reduced to inversely progressive taxation in terms of the income of consumers and is not consistent with the OECD principles of socially just and effective taxation in economically developed countries. The taxation of the citizens in general follows the principle of the citizens contributing to the public burdens according to their powers, for there is nothing more unjust than to treat unequal men as equals. From this proportional treatment of the taxing units, the constitutional principle of equality is also satisfied by reflection.

Reflections on the Development and Reform of Medical Education Systems in China

Reflections on the Development and Reform of Medical Education Systems in China

Experiences of parents with very premature-born children at risk of neurodevelopmental disorders: A qualitative study.

Premature birth is a traumatic and stressful situation for parents who are immediately separated from their infant because of the newborn's need for specialized care. The staff of these units are in charge of following the principles of family-centred care and practices for neonates at risk of neurodevelopmental disorders, including providing training to the family during their hospital stay and after being discharged. The aim of this study is to explore the perceptions of parents of premature children at risk of neurodevelopmental disorders in regard to care, interventions and assistance provided during the first months of their child's life. A qualitative descriptive study was carried out through individual interviews. The data analysis was conducted through a thematic analysis. The methodology and results were reported following the standards for preparing qualitative research reports and recommendations. Twenty-one parents of premature children were interviewed. From these interviews, three main themes emerged: (i) parents' perspectives on preterm birth risk communication, (ii) navigating parental support and early interventions in preterm birth and (iii) perceptions of preterm birth protective and challenging factors. The parents of premature children need to receive better communication about the care and interventions for their child, and it is necessary that health personnel are better trained in terms of management and administration of public resources. Strategies must be implemented that continuously guide parents on the follow-up and care of their premature child not only during their first moments of life but also after being discharged from the hospital. This study highlights the need to improve care for parents with premature infants at risk, emphasizing the necessity for health care system reforms and support structures, allowing health care professionals to enhance attention and care.

Inovasi Teknologi Digital sebagai Penggerak Reformasi dalam Sistem Pendidikan

Digital technology innovation has become the main driver in reforming the education system in the modern era. The use of digital technologies, such as online learning platforms, artificial intelligence, and data-based education management systems, has changed the way education is learned, taught, and managed. These innovations not only increase the accessibility and flexibility of learning, but also enable the personalization of the learning experience for students. This article aims to examine the role of digital technological innovation in driving education system reform, as well as highlighting the opportunities and challenges faced in the transformation process. The results of this research conclude that digital technology innovation has great potential to encourage education system reform, as long as it is accompanied by supportive policies, increasing the competency of teaching staff, and equitable development of technological infrastructure. It is hoped that this reform can create an education system that is more inclusive, adaptive and relevant to future challenges.

Punishment for Perpetrators with Special Needs (Disability) in the Current Criminal Process

General background of this research emphasizes the state's vital role in ensuring the rights of persons with disabilities within the legal framework, particularly in criminal proceedings. The specific background highlights the challenges these individuals face in the justice system, often encountering biases that hinder their access to justice. The knowledge gap identified indicates a lack of comprehensive research on the legal treatment and punishment of offenders with disabilities in Indonesia, especially under the new Criminal Code. This research aims to analyze punishment implementation for such offenders and the collaboration between judges and psychiatrists for fair legal processes. The results reveal that a normative descriptive method, incorporating expert assessments and judicial discretion, is crucial for adjudicating these cases. The novelty lies in proposing a collaborative approach that encourages judges to consider legal principles alongside individual circumstances. The implications advocate for systemic reforms to enhance protections and treatment of persons with disabilities in the criminal justice system, ensuring equitable rights and justice for all citizens. This study contributes to the dialogue on legal reform and social justice, urging policymakers to foster an inclusive legal environment. Highlights: Emphasizes the importance of integrating expert assessments in legal proceedings for offenders with disabilities. Advocates for a collaborative approach between judges and psychiatrists to ensure fair treatment. Highlights the need for systemic reforms to protect the rights of persons with disabilities in the justice system. Keywords: Disability, Punishment, Legal Reform, Equality, Criminal Offenders

Workplace-based learning in district health leadership and management strengthening: a framework synthesis.

Effective leadership and management has been identified as critical in enabling health systems to respond adequately to their population needs. The changing nature of low- and middle-income countries' health systems, given resource scarcity, a high disease burden and other contextual challenges, has also led to learning-including workplace-based learning (WPBL)-being recognized as a key process supporting health system reform and transformation. This review used a framework synthesis approach in addressing the question: 'What forms of WPBL, support leadership and management development; and how does such learning impact district health leadership and management strengthening?'. A search for English language empirical qualitative, mixed-methods and quantitative studies and grey literature published from January 1990 to May 2024 was conducted using four electronic databases (PubMed, EBSCOhost, Scopus and Web of Science). Twenty-five articles were included in the synthesis. The findings reveal that over the last decade, WPBL has received consideration as an approach for leadership and management development. While WPBL interventions differed in type and nature, as well as length of delivery, there was no conclusive evidence about which approach had a greater influence than others on strengthening district health leadership and management. However, the synthesis demonstrates the need for a focus on the sustainability and institutionalization of interventions, including the need to integrate WPBL interventions in health systems. To support sustainability and institutionalization, there should be flexibility in the design and delivery of such interventions and they are best supported through national or regional institutions.

Identifying and addressing health-related social needs: a Medicaid member perspective.

Multiple state and national health care organizations have invested in activities to screen for and address the health-related social needs (HRSNs) of their patients. However, patient perspectives concerning HRSN screening discussions and facilitated referrals to supports are largely unexplored. The main objectives of this study were to explore the ways in which Massachusetts Medicaid (MassHealth) members engage with their health care clinicians to discuss HRSNs, to identify common needs discussed, and to describe whether members feel these needs are being addressed by health care clinicians and staff. The study team performed a cross-sectional, qualitative research study that included in-depth, open-ended interviews with 44 adult MassHealth members. Interviews were conducted between June and October 2022. Interviews were recorded, transcribed, and systematically coded for analysis, and common themes were reported. The data collected for this study were part of a larger independent evaluation of MassHealth's 2017-2022 Section 1115 Demonstration that granted authority from CMS to implement health care delivery system reforms in Massachusetts. In this qualitative study of Medicaid members, some reportedly felt comfortable freely discussing all of their clinical and social needs with their health care clinicians, while others noted feelings of apprehension. Several members recalled being asked about their HRSNs in various clinical or community settings, while others did not. The majority of members endorsed having an unmet HRSN, including housing, nutrition, financial, or transportation issues, and many barriers to addressing these HRSNs were discussed. Finally, many members cited a preference for discussing HRSNs with community-based care coordinators and social workers at the community partner organizations rather than with their health care clinicians. Community-based care coordinators were lauded as essential facilitators in making the connection to necessary resources to help address HRSNs. Study results highlight an opportunity to increase the effectiveness of HRSN screening and referral practices within the health care setting through relationship building between Medicaid members and diverse interdisciplinary care teams that include staff such as community health workers. Continued investment in cross-sector partnerships, screening workflows, and patient-clinician relationships may contribute to establishing an environment in which members can comfortably discuss HRSNs and connect with needed services to improve their health.

On the question of administrative-delicit law of Ukraine

The article notes that the active development of social relations affected the renewal of the doctrinal foundations of Ukrainian administrative law, as a result of which there are constant discussions in the modern science of administrative law of Ukraine, including those directly related to administrative-legal relations. And therefore, the prospects of administrative and legal science, as well as the fields of administrative law, are connected with modern tasks that science sets before itself in accordance with social requirements, which must be solved, including through the application of measures. It is emphasized that administrative law regulates a significant number of different social relations, among which a special place is occupied by administrative-delict relations, which cover a variety of relations that are subject to the norms of administrative law, which is currently in the stage of systemic reform and is mostly connected with relations to ensure implementation of human and citizen rights and freedoms, consideration of administrative disputes, application of measures of administrative responsibility, bringing to disciplinary responsibility persons of public law. Attention is drawn to the attempts to reform the administrative-tort legislation, since the codified act of the administrative-tort legislation adopted in Soviet times does not meet the realities and requirements of today. Therefore, the issue of updating the administrative-delict legislation occupies a prominent place in the scientific developments of domestic legal scientists. Existing scientific discussions on the separation of administrative-tort law into an independent branch of law exist to this day, but we must state that administrative-tort law, despite its own specificity, a significant number of various functions (regulatory, binding, permitting, protective, educational etc.), is a sub-branch of administrative law, which has a special subject of legal regulation, which is a set of legal norms that regulate relations arising from the doctrine of administrative tort. It is emphasized that the formation of modern administrative-delict law involves interaction with the institutions of administrative responsibility provided for by the sectoral norms of laws, which may include the procedure of bringing a person to administrative responsibility, completely different from that regulated by the Code of Administrative Offenses, which requires new theoretical views on the establishment of a system of administrative penalties.

Healthcare Access for Patients With Inflammatory Bowel Disease in the United States: A Survey by the Crohn's & Colitis Foundation.

A prior survey disseminated in 2017 identified that healthcare access barriers exist and significantly affect patients with inflammatory bowel disease (IBD). We sought to identify, through an updated survey, the healthcare access barriers that patients continue to face, with a focus on socioeconomic factors and patient awareness of resources to navigate existing barriers. A 52-question online survey evaluating (1) access to healthcare professionals, medications, and procedures; (2) associated financial challenges; and (3) patient awareness of education and advocacy tools to navigate IBD care barriers, was disseminated through multiple channels to IBD patients and their caregivers. Of the 2281 completed responses, patients on advanced specialty medications, younger than 65 years of age, or on employer insurance experienced significantly greater issues with insurance barriers to accessing medications and coverage of medically necessary tests/treatments. Patients who live in areas of concentrated poverty were more likely to experience poor health outcomes when subjected to step therapy compared to patients who did not. Additionally, patients were more likely to experience one or more financial barriers or trade-offs if the patient used an advanced specialty medicine or lived in an area with concentrated poverty. While there have been significant and numerous advancements in IBD treatments, patients with IBD continue to experience barriers to healthcare access and treatment and financial struggles. Ongoing awareness and advocacy efforts focused on healthcare system reform and related policies to further minimize care disparities and barriers remain vital.

O SISTEMA PRISIONAL NO BRASIL: UMA ANÁLISE DOS DESAFIOS E PERSPECTIVAS DE REFORMA

The Brazilian prison system is a complex and challenging issue that has raised heated debates over the years. With a growing prison population and precarious conditions in prisons, the reality of penitentiary institutions in the country presents a worrying picture. The purpose of prisons, which should be the rehabilitation of inmates, is often distorted by overcrowding, violence and lack of opportunities for social reintegration. In this context, this work aims to analyze the challenges faced by the Brazilian prison system and explore the reform perspectives that can be adopted to face such problems. It is crucial to understand the historical roots of this system, as well as the contemporary factors that have contributed to its current situation. Throughout this study, a comprehensive bibliographical review will be carried out, gathering data and analyzes from research, government reports and academic studies that focus on the subject. It is essential to emphasize that an effective reform of the prison system does not only imply improving the physical conditions of prisons, but also promoting actions that favor social reintegration and the reduction of criminal recidivism. In addition, civil society participation and dialogue between the various actors involved are crucial elements for building sustainable and humanized solutions.

Transition and change: opportunities and challenges of CHW programme reform for community health systems and vertical disease programmes in Liberia

BackgroundGlobally, community health worker (CHW) programmes are critical to addressing health worker shortages and have been recognised as critical pillars within the drive towards universal health coverage (UHC). In 2016, the Liberian Ministry of Health launched the National Community Health Services Policy 2016–2021, which included significant CHW programme reform to address ongoing health workforce capacity gaps in the country. However, little consideration was given to the impact of such reforms on ongoing health interventions that rely heavily on the use of CHW cadres. Our study explores how CHW programme reform in Liberia influenced performance of CHWs involved in the delivery of Neglected Tropical Disease (NTD) programmes to elucidate how health systems reform can impact the delivery of routine health interventions and vice versa.MethodsWe used a qualitative case study approach conducted between March 2017 and August 2018. Our instrumental case study approach uses qualitative methods, including document review of five CHW and NTD program-related policy documents; 25 key informant interviews with facility, county, and national level decision-makers; and 42 life and job histories with CHWs in Liberia. Data were analysed using a thematic framework approach, guided by Kok et al. framework of CHW performance. Data were coded in QRS NVIVO 11 Pro.ResultsOur findings show that CHW programme reform provides opportunities and challenges for supporting enhanced CHW performance. In relation to health system hardware, we found that CHW programme reform provides better opportunities for: formal recognition of CHWs; strengthening capacity for effective healthcare delivery at the community level through improved and formalised training; a more formal supervision structure; and provision of monthly incentives of 70 US dollars. Efficiency gaps in routine intervention delivery can be mitigated through the strengthening of these hardware components. Conversely, supervision deficits in routine CHW functioning can be supported through health interventions. In relation to systems software, we emphasise the ongoing importance of community engagement in CHW selection that is responsive to gendered power hierarchies and accompanied by gendered transformative approaches to improving literacy.ConclusionsThis study shows how CHW programme reform provides opportunities and challenges for health system strengthening that can both positively and negatively impact the functioning of routine health interventions. By working together, CHW programmes and routine health interventions have the opportunity to leverage mutually beneficial support for CHWs, which can enhance overall systems functioning by enhancing CHW performance.