Service Delivery Research Articles

Investigation of primary health care service delivery models used in allied health practice in rural and remote areas of Australia: a systematic review

Abstract Introduction In Australia, access to primary health care (PHC) services is limited in comparison to major cities. Allied health professionals play a pivotal role in providing necessary PHC in rural and remote areas. However, there is limited evidence about the most effective allied health specific PHC models of care that can be utilised in these settings. The aim of this review was to describe the PHC models used by allied health professionals in rural and remote areas of Australia and report on their impact and effectiveness in improving care. Methods A search of five databases (MEDLINE, Embase, CINAHL, PsychINFO and Informit Health) was undertaken. Articles were included that related to a refined list of allied health professions that specifically work in PHC settings, these included: dietetics; occupational therapy; physiotherapy; psychology; speech pathology; social work; podiatry; exercise physiology; pharmacy; optometry; and audiology. Articles with a focus on a PHC model of service delivery in a rural or remote area were included. The effectiveness and impact of these models was examined. The Mixed Methods Appraisal Tool was used to assess the quality of the included articles. Results A total of 57 articles met the inclusion criteria, from an initial 1864 unique citations sourced from searches. Of the 57 articles, 22 studies were in the Australian context and were included in this paper. The outcome measures typically included improving access to services, however minimal impact or effectiveness data was reported. Studies were categorised into an existing typology of PHC models: integrated services (n = 9); outreach services (n = 3); virtual outreach services (n = 4); discrete services (n = 4); with an additional model being health promotion (n = 5). Conclusion A range of PHC models were used by allied health disciplines in rural and remote areas of Australia. These models focused on improving access to allied health services in primary care settings to address health inequities faced. Given the limited reporting of the impact of these services, it is recommended that rigorous evaluations of existing allied health models are undertaken. There is a gap in the literature regarding the models of service delivery being used by allied health professionals in non-metropolitan areas.

Enhancing Public Administration at the Union Council Level: A Pathway to Achieving Sustainable Development Goals (SDGs) in Hub

Public administration at the Union Council level is crucial for achieving the Sustainable Development Goals of the United Nations by ensuring efficient governance and service delivery. Union Councils in the Hub area encounter financial restrictions, administrative challenges, and limited public interaction. This research employs a mixed-methods approach, including surveys, interviews, and focus group discussions with key stakeholders, to examine the role of local governance in SDG implementation. Results indicate that while public officials demonstrate a good understanding of the SDGs (72%), community awareness remains low (38%). Officials rate policy creation and service provision higher (means = 4.2 and 3.8) compared to citizens (means = 3.1 and 3.2). Key challenges include financial limitations (25 percent), bureaucratic inefficiencies (27 percent), and limited public involvement. The study emphasizes the necessity for financial sustainability, administrative efficiency, and participatory governance to advance SDG development. Experts advocate for utilizing digital governance systems and public-private partnerships to improve transparency and funding. Well-designed reforms, the integration of technology, and the promotion of collaboration can help Union Councils foster sustainable development in the Hub area and significantly enhance sustainable social, economic, and environmental growth.

Socio-Spatial Adaptation and Resilient Urban Systems: Refugee-Driven Transformation in Zaatari Syrian Refugee Camp, Jordan

The Zaatari Camp in Jordan exemplifies how Syrian refugees transform a planned grid settlement into an organic urban environment through socio-spatial adaptation, reflecting their cultural identity and territorial practices. This study investigates the camp’s morphological evolution, analyzing how refugees reconfigure public and private spaces to prioritize privacy, security, and community cohesion. Using qualitative methods—including archival maps, photographs, and field observations—the research reveals how formal public areas are repurposed into private shelter extensions, creating zones of influence that mirror traditional Arab-Islamic urban patterns. Key elements such as mosques, markets, and hierarchical street networks emerge as cultural anchors, shaped by refugees’ prior urban experiences. However, this organic growth introduces challenges, such as blocked streets and undefined spaces, which hinder safety and service delivery, underscoring tensions between informal urbanization and structured planning. The findings advocate urban resilience and participatory planning frameworks that integrate socio-cultural values, emphasizing defensible boundaries, interdependence, and adaptable design. Refugees’ territorial behaviors—such as creating diagonal streets and expanding shelters—highlight their agency in reshaping urban systems, challenging conventional top-down approaches. This research focuses on land-use dynamics, sustainable cities, and adaptive urban systems in crisis contexts. By bridging gaps between displacement studies and urban theory, the study offers insights into fostering social inclusion and equitable infrastructure in transient settlements. Future research directions, including comparative analyses of refugee camps and cognitive mapping, aim to deepen understanding of socio-spatial resilience. Ultimately, this work contributes to global dialogues on informal urbanization and culturally responsive design, advocating for policies that align with the Sustainable Development Goals to rebuild cohesive, resilient urban environments in displacement settings.

Concussion Recovery: The Essential Role of School-Based Occupational Therapy Practitioners.

Concussions are prevalent in youth and often contribute to occupational challenges related to postconcussion syndrome within the educational setting. Despite the advancements that have been made in the occupational therapy management of concussion, school-based occupational therapy practitioners are seeking clarity in service delivery because there is no clear framework that guides service provision for postconcussed youth within the educational setting. In this column, we emphasize the role of school-based occupational therapists as an existing source of support within the school structure, describe school-based occupational therapy as a viable service for postconcussed youth, and highlight a feasible framework that can be applied to service delivery within the educational setting to support the recovery of postconcussed youth.

Scalable Digital Solutions from India’s Aadhaar and UPI Frameworks

Abstract: India’s Aadhaar and Unified Payments Interface (UPI) frameworks represent two of the most ambitious and scalable digital infrastructure projects in the world, revolutionizing identity verification and real-time financial transactions. This research paper examines the architectural design, operational dynamics, and socio-economic impact of these systems, emphasizing their role in promoting financial inclusion, digital governance, and economic resilience. Through empirical data analysis, policy evaluation, and case studies, the paper highlights how Aadhaar’s biometric identification and UPI’s interoperable payment ecosystem have addressed systemic inefficiencies and enabled citizen-centric service delivery at scale. Furthermore, the study explores the replicability of these models in diverse global contexts and evaluates their potential for adaptation in emerging economies. By integrating insights from digital public infrastructure, cybersecurity, and inclusive policy design, this paper presents Aadhaar and UPI as paradigms of scalable, secure, and transformative digital solutions for the modern state. Keywords: Aadhaar, UPI, digital identity, real-time payments, financial inclusion, digital public infrastructure, scalable digital solutions, IndiaStack, biometric authentication, digital governance

A multi-site evaluation of clinicalpharmacist time, motion, interventions and interruptions.

Patient centred clinical pharmacy activities have demonstrated improvements in patient outcomes. There are limited published data on workflow practices of pharmacists to assist with clinical pharmacy service delivery improvement. To determine the amount of time clinical pharmacists spend each day performing their work tasks, interventions and interruptions. To determine the proportion of time performing clinical tasks and tasks face-to-face with patients. Trained pharmacy students observed clinical pharmacists and recorded clinical activities using the timer app Clockify™ on a smart device (phone or tablet) at four hospitals over 9days between 29th July and 8th August 2024. Pharmacy students recorded the number and types of patients seen, interventions and interruption patterns. A total of 678.3h of pharmacist activity were recorded. The mean time spent per day per patient type was 25.9min (discharge patient), 23.5min (new patient) and 10.3min (review patient). Pharmacists spent the largest proportion of time (21.9%) on discharge patients followed by review patients (21.6%). Over 80% of pharmacist time was spent performing clinical activities, of which almost 12% was spent face-to-face with patients. Pharmacists were interrupted 34 times per day and performed 67 interventions per 100 patients. Pharmacists spend over 80% of their work time performing clinical activities for patients, of which almost 12% is spent face-to-face with patients. The largest proportion of time is spent with discharge patients followed by review patients.

Incremental financial costs of strengthening large-scale child nutrition programs in Bangladesh, Ethiopia, and Vietnam: retrospective expenditure analysis

Abstract Background Inattention to young child growth and development in a transitioning global environment can undermine the foundation of human capital and future progress. Diets that provide adequate energy and nutrients are critical for children’s physical and cognitive development from 6 to 23.9 months of age and beyond. Still, over 70% of young children do not receive foods with sufficient nutrition particularly in low-and-middle income countries. Program evaluations have documented the effectiveness of large-scale behavior change interventions to improve children’s diets, but the budgetary implications of programs are not known. This paper provides the incremental financial costs of strengthening three large-scale programs based on expenditure records from Bangladesh, Ethiopia, and Vietnam. Results The programs reached between one and 2.5 million mothers and children annually per country at unit costs of between $0.9 to $1.6 per mother and child reached. An additional 0.7 to 1.6 million people who were influential in supporting mothers and achieving scale were also engaged. The largest cost component was counselling of mothers. Rigorous external impact evaluations showed that over 434,500 children benefited annually from consuming a minimum acceptable diet in all countries combined, at an annual cost per country of $6.3 to $34.7 per child benefited. Conclusions Large scale programs to improve young children’s nutrition can be affordable for low- and middle-income countries. The study provides the incremental costs of selectively strengthening key program components in diverse settings with lessons for future budgeting. The costs of treating a malnourished child are several-fold higher than prevention through improved improving young children’s dietary practices. Differences across countries in program models, coverage, costs, and outcomes suggest that countries need a minimum investment of resources for strengthening high-reach service delivery and communication channels and engaging relevant behavioral levers and community support for mothers to achieve impact at scale.

The effect of strengthening nurse practitioners’ competency in occupational health services for agricultural workers exposed to pesticides in primary care units, Thailand: a before-and-after study

Purpose: This study aimed to evaluate the effect of the Strengthening Nurse Practitioners’ Competency in Occupational Health Service (SNPCOHS) program. It was hypothesized that nurse practitioners (NPs) participating in the program would demonstrate increased competency in providing occupational health services to agricultural workers exposed to pesticides in primary care units (PCUs) compared to their baseline competency and to a comparison group.Methods: A quasi-experimental study was conducted between August and December 2023. The 4-week intervention included five hours of an e-learning program, three hours of online discussion, and two hours dedicated to completing an assignment. The program was evaluated at three time points: pre-intervention, post-intervention (week 4), and follow-up (week 8). Sixty NPs volunteered to participate, with 30 in the experimental group and 30 in the comparison group. Data on demographics, professional attributes, knowledge, skills, and perceived self-efficacy were collected using self-administered questionnaires via Google Forms. Data analysis involved descriptive statistics, independent t-tests, and repeated measures ANOVA.Results: The experimental group demonstrated significantly higher mean scores in professional attributes, knowledge, skills, and perceived self-efficacy in providing occupational health services to agricultural workers exposed to pesticides compared to the comparison group at both week 4 and week 8 post-intervention.Conclusion: The SNPCOHS program is well-suited for self-directed learning for nurses in primary care units, supporting effective occupational health service delivery. It should be disseminated and supported as an e-learning resource for nurse practitioners in PCUs.

Understanding implementation, adoption, and acceptability of the WHO package of essential noncommunicable (PEN) disease interventions in FIJI: Evidence for scale-up

The Package of Essential Noncommunicable (PEN) disease interventions in response to the high prevalence of cardiovascular diseases and diabetes was implemented in Fiji commencing in 2012. This study aimed to understand implementation outcomes, and its contextual influences. Semi-structured interviews with health workers and patients across Fiji was conducted. Thematic analysis was mapped to the health system building blocks to understand PEN service delivery. The PEN program was well received by health workers formally trained. The frequency of use of PEN guidelines was influenced at the individual level by motivation, capability and capacity as well as external factors outside of the health workers’ control. The key challenges to routine use were lack of essential medicines and equipment for CVD risk screening and management, shortage of health workers, high turnover of staff, limited formal training, and no designated focal person. However, at the country level, the PEN program improved the quality of care by providing patients with regular follow-up visits depending on their CVD risk levels. The patients found care to be comprehensive when they were also seen by dieticians and physiotherapists. In most instances, the barrier to access to care were cost and distance of travel and non-availability of essential medicines. To improve use of PEN program requires strengthening health system components: 1) need for efficient supply chain system for medicines and equipment, 2) improving healthcare workforce retention, 3) establishing accountability mechanisms embedded within the health centres, 4) health information system to track patient level data and 5) multi-level governance structures across the health system.

Workload model in school-based occupational therapy practice: Administrators’ perspectives

ABSTRACT School-based occupational therapy practitioners (OTPs) experience burnout related to the excessive work demands associated with a commonly used approach, in which compensation is tied to students-facing time. The workload model has the potential to alleviate this burnout, in part because it compensates an OTP for all tasks performed. This model, promoted by the American Occupational Therapy Association for more than a decade, is not widely used in the United States. The reasons for this slow espousal are not yet understood. School administrators are believed to be the linchpin to a broader use of the workload model. A preliminary study aimed to understand school district administrators’ perspectives on the factors that influence occupational therapy compensation. To this aim, a qualitative study was conducted with school administrators (n = 7). Analytic rigor was ensured through audit trail, reflexivity journal, multiple coders, and triangulation via artifacts. Deductive analysis of transcribed semi-structured interviews revealed three interrelated themes: external factors, beliefs/knowledge, and service delivery. The external factors, such as finances, impact service delivery; compensation decision was affected by a combination of regulatory and fiscal factors, both real and perceived; administrator knowledge of the workload model remains limited; and occupational therapy is clearly valued within the school setting. The study, while giving voice to a key stakeholder group, identified factors influencing occupational therapy service delivery and compensation and avenues for promoting workload model adoption.

ESG Strategies in Educational Quality Management: An Empirical Study on Fostering Student Loyalty and Sustainability

This study investigates how service quality, emotional experience, and Environmental, Social, and Governance (ESG) practices jointly influence students’ behavioral intentions in higher education. Drawing from the SERVQUAL model, the Theory of Planned Behavior (TPB), and ESG-related frameworks, this research develops and empirically tests a comprehensive conceptual model using Confirmatory Factor Analysis (CFA) and Structural Equation Modeling (SEM). The study employed a stratified sampling strategy and collected 462 valid responses from university students across various disciplines, regions, and academic levels in Taiwan. The results reveal that both service quality and ESG practices significantly and positively impact students’ behavioral intentions, with emotional experience serving as a critical mediating variable. Service quality—characterized by responsiveness, reliability, assurance, empathy, and tangible resources—was found to shape students’ affective responses and loyalty behaviors, such as recommending the university and engaging in alumni activities. Likewise, ESG initiatives, such as green campus practices, community involvement, and transparent governance, enhanced students’ emotional attachment and behavioral support. Hierarchical regression analysis, conducted alongside SEM, confirmed the robustness of the model and further highlighted demographic variations. This study contributes to the literature by integrating ESG principles into the higher education service quality framework and validating the mediating role of emotional experience. It provides both theoretical advancement and actionable insights for university administrators. Practical recommendations include enhancing frontline service delivery, embedding ESG practices into institutional culture, and designing emotionally engaging student experiences. The findings underscore the strategic value of adopting a holistic, value-based approach to educational quality management in fostering long-term student loyalty and institutional sustainability.

Artificial intelligence Integration for Financial Inclusion: a Study in pakistan

Artificial Intelligence (AI) integration into financial systems has been given important attention due to its potential to enhance financial inclusion, particularly in developing economies like Pakistan. This research examines the potential of AI integration for financial inclusion through mediating variables. The primary aim of this study is to uncover AI solution benefits that improve financial inclusion when these important factors interact. This quantitative study aims to look into the role of AI integration in Pakistan's financial inclusion. Data was collected from 200 financial services users in Pakistan. Data is analyzed using statistical techniques such as PLS-SEM. PLS-SEM modeling was implied to examine the research framework of the study. The study confirms that AI integration has a positive role in mediating variables. The study has implications, that can be recognized and used by policymakers to shape targeted interventions, and policies, which improve financial access by enhancing user knowledge about financial matters and promoting the acceptance of AI system utilization. Findings enable practitioners to create better financial education programs and inclusive financial service delivery so that people can easily understand and access desired outcomes. This study enhanced the academic knowledge of the utilization of AI technology to promote economic growth in developing economies. Keywords: Artificial Intelligence, Financial Inclusion, Financial Literacy, User adoption, Finance.

Evaluating the Impact of AI-Powered Chatbots and Virtual Assistants on Guest Satisfaction and Operational Efficiency in Luxury and Budget Hotels: A Cross-Continental Comparative Research Analysis

This study evaluates the impact of AI-powered chatbots and virtual assistants on guest satisfaction and operational efficiency in luxury and budget hotels, adopting a cross-continental comparative approach. As the hospitality industry increasingly embraces artificial intelligence to enhance service delivery, this research aims to examine how AI tools influence both guest experiences and hotel operations across different market segments. The study focuses on luxury and budget hotels, recognizing the distinct needs and operational models of these two categories. AI-powered chatbots and virtual assistants are analyzed for their role in streamlining guest interactions, from booking and check-ins to addressing inquiries and resolving complaints. In luxury hotels, where personalized service is a key expectation, the study explores how AI contributes to guest satisfaction through tailored services and personalized recommendations. Conversely, in budget hotels, the focus is on operational efficiency, where AI technologies are deployed to automate routine tasks, reduce labor costs, and enhance the speed of service. Data is collected through surveys, interviews, and case studies from hotels in North America, Europe, and Asia, reflecting diverse technological adoption rates and cultural attitudes towards AI. The findings indicate that while AI improves guest satisfaction in luxury hotels by offering personalized, timely, and efficient service, it enhances operational efficiency in budget hotels by automating repetitive tasks, thus reducing operational costs and increasing service speed. The cross-continental analysis highlights regional differences in AI adoption, revealing how local technological infrastructure and cultural expectations shape the use and effectiveness of AI tools in hospitality. This study contributes to understanding the global impact of AI in hospitality, providing valuable insights for hotel operators seeking to optimize the integration of AI technologies to enhance both guest experience and operational performance.

LIABILITY OF EXPEDITION SERVICE COMPANIES FOR LOSSES SUFFERED BY CONSUMERS

Abstract Background. Development in science and technology has an impact on making human work easier in an efficient era. One of them is that the existence of this goods delivery service makes it very easy for people to send goods between cities and islands. The problem is if the goods promised within the specified time do not arrive according to the estimated time or experience delays. Losses experienced by consumers are goods received that are defective, destroyed, or lost. In this case, the consumer can file a lawsuit regarding the losses suffered by consumers against the expedition provider in a civil manner regarding consumer protection. Aims. The purpose of this writing is to find out how responsible expedition service companies are for losses experienced by consumers. Methods. By using 2 (two) types of research methods, namely the library research method (Library Research). Refers to data or research materials that have been previously researched related to the topic of discussion. In this research, the normative juridical research method was used, namely by conducting a literature review, studying the provisions of legislation regarding consumer protection. Conclusion. The efforts made by the expedition service to ensure protection for its service users are also subject to the conscience of the people, who abide by the agreement/peace voluntarily, without anyone feeling defeated, because each provides insurance for the goods shipped. Implementation. This shows that the expedition service company has made efforts to implement articles 7 and 19 of the UUPK, 468 Criminal Code, 1366 Criminal Code, and 188 Laws Number 22 of 2009, which stipulates that the company must provide compensation if the consumer's product is damaged at the time of delivery. However, the compensation provided is not complete if it is not accompanied by insurance.

Evaluating the Impact of Servicescape and Information Systems on University Students’ Academic Performance in Malang

In the ever-changing world of higher education services, examining factors that impact students’ performance is important in making sure that student’s learning experience can be improved to reach academic success. This research investigates the impact of University Servicescape (USc) and Information Systems Implementation Quality (ISQ) on student performance in higher education institutions in Malang. USc refers to the physical environment and facilities provided by the university. At the same time, the ISQ pertains to the effectiveness and efficiency of the technological systems employed for academic and administrative purposes. Both factors have been deeply researched separately in the context of higher education service management, but no research has delved into both at the same time. A quantitative empirical survey-based study is employed to examine this topic. The sample consists of university students studying in Malang, East Java, Indonesia. The results empirically show that USc and ISQ significantly impact university student performance in higher education, particularly within institutions in Malang, East Java, Indonesia. These findings should be useful for policymakers, university administrators, and educators in enhancing the delivery of educational services in higher education institutions across Indonesia

Service Quality and Perceived Value Toward Customer Satisfaction in E-Commerce Delivery: The Role of Trust

The rise of online shopping has transformed consumer behavior, shifting from traditional face-to-face transactions to digital purchasing through e-commerce platforms. This development has encouraged e-commerce companies to enhance the customer experience, including logistics services. However, issues such as delivery delays or damaged goods remain common problems. This study aims to examine the influence of service quality and customer perceived value on customer satisfaction in e-commerce delivery services, with customer trust as a mediating variable. A quantitative causal research design was used, involving 205 respondents residing in Jakarta who had shopped online and used e-commerce delivery services. Data were collected through questionnaires using a Likert scale and analyzed using Structural Equation Modeling (SEM) with SmartPLS 4.0. The results indicate that service quality and customer perceived value significantly influence customer satisfaction. Customer trust also has a significant effect on satisfaction and serves as a full mediator between service quality and satisfaction, as well as between perceived value and satisfaction. These findings suggest that improving service responsiveness and delivery accuracy can enhance customer satisfaction through increased trust. E-commerce delivery providers are advised to focus on building trust by ensuring reliable and high-quality services

The Evaluation of Spatial Allocation and Sustainable Optimization Strategies for Sports Venues in Urban Planning Based on Multi-Source Data: A Case Study of Xi’an

With the development of the economy and improvements in living standards, public demand for sports activities has continued to increase. However, the supply–demand relationship of urban sports venues remains unbalanced in many cities. Existing theoretical research on the spatial allocation of sports venues predominantly focuses on macro-level functional configuration and the equitable distribution of sports resources, lacking more rigorous and quantitative evaluation frameworks for evaluating spatial allocation. This study innovatively integrates multi-source data into the assessment and sustainable optimization of sports venue allocation in urban planning, using Xi’an as a case study. By analyzing geographic information, road network topology, OpenStreetMap (OSM), population distribution, and social media Points of Interest (POI), and using analytical tools such as ArcGIS 10.8 and Stata 17, the appropriateness of resource distribution of public sports venues in Xi’an’s main urban area is evaluated from three dimensions: accessibility, equity, and spatial activity. The results reveal the appropriateness of venue distribution in urban spatial allocation, the equitable distribution of resources, and imbalances in spatial activity and resource distribution. Finally, the study proposes a series of sustainable optimization strategies, including increasing venue coverage in low-supply areas, adaptive reuse of idle industrial buildings into sports venues guided by green sustainability principles, constructing a “15-min fitness circle” spatial system, optimizing low-carbon mobility networks around venues, enhancing the compatibility of sports venues, and improving commercial operation and management capabilities. These strategies aim to optimize the distribution of public sports venues in Xi’an to improve fairness and operational efficiency in service delivery while promoting sustainable urban development.

Multisensory cues and revisit intention to restaurants: the mediating roles of food quality and service experience

ABSTRACT This study aimed to investigate the differences in consumer service experience, perceived food quality, and revisit intention when a restaurant used different multisensory (visual, auditory, and olfactory) cues in the service delivery environment. A field experiment using 2 × 2 × 2 multisensory (visual, auditory, and olfactory) cues factorial design was conducted at a participating restaurant involving 240 participants. This study found that when multisensory cues were used, dine-in consumers would have a better service experience, better food quality perception, and a stronger intention to revisit the restaurant than when no cues were used. Food quality and service experience fully mediated the impact of multisensory cues on revisit intention.

Child Immunization during COVID-19: A Mixed Methods Case Study of Pathanamthitta District, Kerala

Abstract Background: Child immunization is a critical public health intervention to reduce the risk of infectious diseases. However, emergencies from disease, calamity, or conflict significantly disrupt the provision of immunization services through the primary healthcare system. This study aims to assess the impact of the Coronavirus Disease-2019 (COVID-19) pandemic on routine immunization in selected public health facilities in Pathanamthitta district, Kerala, and understand aspects of planning and service delivery and the perspectives of primary stakeholders. Materials and Methods: This mixed methods study of concurrent nested design in a Critical Realist paradigm assesses immunization patterns of 292 two-year-olds who sought routine immunization in 2020 and 2021. Quantitative data were analyzed using descriptive statistics in SPSS v. 16, and thematic analysis was performed on qualitative data. Triangulation of results involved comparing both datasets to generate a discussion of themes corresponding to immunization coverage and outcomes. Results: Immunization coverage across vaccines dropped in March 2020, followed by intense catching-up efforts in the subsequent months. Median delays in immunization uptake in the sample during the state lockdown (42 days) were higher than those experienced during the national lockdown (25 days). COVID-induced anxiety in parents, physical infrastructure, and accessibility of the health centers determined children’s right to vaccines during the pandemic. Conclusion: Decontextualized guidelines, continuation with existing microplans, infrastructural deficiencies, and poor vaccine perceptions of parents/guardians triggered delays in vaccine uptake and a far-from-perfect immunization service delivery. Programme planning and implementation issues should be mitigated to prepare for future health emergencies without disrupting immunization services.

From Presence to Performance: Mapping the Digital Maturity of Romanian Municipalities

In recent years, technological advancements have significantly transformed the public sector, with many institutions embracing digital solutions to enhance service delivery. Romanian city halls are actively incorporating digitalization into their sustainable development strategies, aiming to improve service efficiency and accessibility. This study examines the adaptability of Romanian city halls in the face of technological changes. By evaluating the official web portals of all 103 municipalities in Romania using 23 indicators, the research provides a comprehensive analysis of the current state (mid 2024) of e-services delivered via the web portals of the respective municipality. Even though the study findings are indicating a certain degree of maturity in digitalization, with most municipalities offering online services such as property tax payments, public transportation information, and civil status documents, it also reveals significant disparities in the quality and availability of these services across the country, underscoring the need for more standardized digitalization efforts. This research contributes valuable insights for policymakers and public institutions aiming to enhance service delivery through digital means and highlights the crucial role of technology in public sector transformation. The conclusions emphasize the importance of the adaptability of public institutions to ensure continuity and efficiency in service delivery.