Social Mobilization Research Articles (Page 1)

Monitoring strategies after the incorporation of vaccines into national immunization programs: a systematic review.

The transition from extractive to sustainable economies represents a complex challenge for post-mining regions in Indonesia. This study explores the emergence and development of locally initiated tourism villages in Membalong and Tanjung Rusa Villages, Belitung, as a model of socio-ecological transformation from tin-extractive landscapes toward creative tourism economies. Employing a qualitative-descriptive approach through in-depth interviews and a literature review, this study analyzes the processes of social mobilization, tourism narrative construction, and landscape regeneration undertaken by local communities to transform mining voids (kolong or camui) and environmental degradation into valuable tourism assets. The transformation model is supported by five pillars : (1) revitalization of mining voids into tourism lakes and ecological parks, (2) diversification of eco-friendly local products (pandan thorn handicrafts and natural culinary), (3) integration of traditional gardening and fishing practices as coastal tourism attractions, (4) preservation of hospitable coastal Malay culture as social capital for welcoming tourists, and (5) capacity building in homestay management and tour guiding aligned with SAPTA PESONA principles (represents Indonesia's seven tourism hospitality standards: safety, order, cleanliness, beauty, friendliness, memorable experiences, and comfort) integrated with enhanced English communication competencies to serve international tourist mobility. Despite its success, the model faces critical callenges : dependency on external financing, managerial capacity gaps, limited foreign language proficiency, inadequate marketing communication strategies, and risks of pseudo-empowerment in governing village enterprises (BUMDes) and tourism awareness groups (Pokdarwis). This study contributes to community-based tourism (CBT) theory by demonstrating how environmental rehabilitation can simultaneously cultivate socio-economic and communicative capacities at the grassroots leve. The findings provide valuable practical models for other post-mining regions in Indonesia to develop inclusive, competitive, and sustainable tourism destinations.

Background: The Government of Nepal has recognized Information and Communication Technology (ICT) as a transformative tool for promoting development, improving public service delivery, and fostering good governance. The 2015 National ICT Policy outlines key priorities for leveraging technology across sectors. E-governance, in particular, is envisaged as an enabler of efficient, transparent, and citizen-centered governance, with local municipalities serving as critical platforms for its implementation. However, the journey from policy to practice is often challenged by infrastructural, institutional, and human capacity constraints. Objectives: This study aims to investigate the role of e-governance in promoting transparency, accountability, and corruption reduction in local governance. Specifically, it explores the use of ICT in e-governance within the context of Dhangadhi Sub-Metropolitan City, an established municipality in Nepal. Methods: The research adopted a positivist paradigm and a descriptive research design. Data were collected through structured questionnaires and interviews with 130 municipal staff members of Dhangadhi Sub-Metropolitan City, selected via simple random sampling. Secondary data were obtained from government publications, policy documents, and relevant literature. Quantitative data were analyzed to assess the status of ICT infrastructure, software application, and digital service delivery. Findings: The findings reveal a mixed implementation status. While foundational ICT infrastructure, such as computer availability and maintenance, is reasonably established (mean scores 3.2-3.6), key digital governance features are underdeveloped. Core administrative software for accounting, tax collection, and e-procurement is widely used and well-regarded (mean scores up to 4.2). However, systems for citizen interaction, grievance handling, social mobilization, and office automation are largely absent or poorly implemented (mean scores 1.2-2.7). Municipalities have official websites and emails, but lack advanced features like content management systems and interactive service portals. Social media is primarily used for one-way information dissemination, not for participatory engagement. Conclusion: The study concludes that while Nepal has made significant strides in establishing the technological foundations for e-governance at the local level, its implementation remains partial and fragmented. The gap between technological availability and effective utilization highlights significant socio-technical barriers, including bureaucratic resistance, limited digital literacy among staff, and a lack of citizen-centric service design. For e-governance to fulfill its potential in enhancing transparency and accountability, a shift from a technology-driven to a people-centered approach is necessary. Implications: The findings imply that future e-governance strategies in Nepal must move beyond infrastructure provision to address deeper institutional and human capacity challenges. Policy should focus on: Institutional Reform: Incentivizing digital innovation within the bureaucracy and fostering a culture of accountability and transparency. Capacity Building: Implementing continuous and widespread digital literacy and technical training programs for civil servants. Citizen-Centric Design: Developing interoperable systems that prioritize citizen needs, such as integrated grievance redressal mechanisms, interactive service portals, and open data initiatives. Scalable Models: Replicating successful participatory models, like those initiated by the Rural Urban Partnership Programme (RUPP), which combine technology with community mobilization.

BackgroundA lack of general vaccine confidence has been identified as a potential barrier to the introduction of new tuberculosis (TB) vaccines. In the absence of TB-specific vaccine confidence surveys, analysis of general national vaccine confidence data can provide a useful proxy to determine where demand generation strategies may need to be focused ahead of future TB vaccine introductions.MethodsWe analysed 2023 Vaccine Confidence Index (VCI) data from 18 of the 49 countries present on at least one of the three World Health Organisation (WHO) high TB burden lists, and together containing 65% of the global TB burden, to explore overall confidence in vaccines in high TB burden countries. Based on collected answers to three different statements, we categorised responses 1–2 as ‘positive’ (vaccine confident) and 3–4 as ‘negative’ (vaccine hesitant) and calculated a total vaccine confidence score using the mean proportion of positive responses across the three statements.ResultsIn 2023, over 80% of respondents in 14 of the 18 countries analysed, and over 60% of respondents in all 18 countries, believed that ‘vaccines are important for people of all ages’. India, accounting for around 30% of global TB cases, demonstrated confidence levels exceeding 90%, as did Vietnam, Ethiopia and Sierra Leone. South Africa, the country with the seventh highest TB burden (280,000 incident cases in 2023), Russia and Cameroon exhibited a relatively low vaccine confidence score of 75.5% or lower, signalling a potential area for concern. These countries may require focused awareness-raising and advocacy efforts prior to the rollout of new TB vaccines, though additional research on TB-specific confidence indicators is needed.ConclusionsThis analysis underscores the importance of monitoring vaccine confidence levels to address emerging challenges to maintaining or bolstering the public’s trust in vaccination. Our findings could help determine which countries to prioritise for social mobilisation and demand generation efforts to boost vaccine confidence, and thus improve readiness for new TB vaccines.Supplementary InformationThe online version contains supplementary material available at 10.1186/s44263-025-00216-z.

Aim: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic, and effective drug treatments for COVID-19 remain unavailable. Isotretinoin (ISO), a retinoic acid derivative commonly used for severe acne, is a potent down-regulator of ACE2 receptors, which play a key role in the pathophysiology of COVID-19. This study aims to investigate the effect of ISO treatment on COVID-19 infection in patients with acne vulgaris. Materials and Methods: Between January 2021 and April 2021, 520 ISO users with acne vulgaris and 400 controls were included in the study. Data were collected using an electronic questionnaire distributed via social media, e-mail and mobile phones. Results: Among ISO users, 66 (12.7%) had COVID-19 compared to 89 (22.3%) in the control group, indicating a significantly lower infection rate in the ISO group (p

ABSTRACT Sustainable tourism in natural areas has been encouraged to promote social and economic inclusion and mitigate social and environmental conflicts. The formalization of local arrangements has significant potential to promote visitation in protected areas. The objective of this paper is to analyze the actions carried out by a community-based association and partners to establish an agreement with the environmental agency for the community management of the Perequê Center, Cardoso Island State Park. This socio-environmental intervention project was conducted between June to December 2022. By recognizing the promotion of socioeconomic development and quality of life, this was an unprecedented partnership and promising alternative in the debate on the management of public use in protected areas. Establishing cooperation between environmental agencies and local communities requires commitment from everyone involved. It is necessary to recognize the existence of indigenous peoples and traditional communities’ territories and establish plural dialogue considering different knowledge systems.

Abstract In Nigeria social mobilization and ethnic unity have been facilitated by the spread of social media and the emergence of the tech-savvy generation of the twenty-first century. The #EndSARS movement sought to abolish police brutality in Nigeria by pressuring the government to reform the police. Social media can effectively motivate young Nigerians to take social and political action, even when it is not used for destructive in-group organizing. The #EndSARS movement in Nigeria served as an example of this. Using a qual-dominant mixed methods approach, this study assesses the contribution of social media to collective mobilization during the demonstrations. In Nigeria, where the political elite regularly employs negative in-group mobilization to infuriate out-groups and obstruct concerted efforts to combat poor governance. The findings demonstrate that social media presents an opportunity for youth from a range of ethnic and religious backgrounds to join social movements and support political change.

This paper aims to explore the dual effects of cultural soft power on empowering grassroots political mobilization. In the context of globalization, culture, as a core political resource, plays an increasingly prominent role in consolidating social consensus and shaping the political ecology. Focusing on the theme of "cultural soft power empowering grassroots political mobilization", this paper integrates and analyzes existing literature, and discusses the ways in which state and non-state actors use cultural soft power to carry out social mobilization. The research results indicate that although cultural soft power has the potential to empower, in practice, forms dominated by external funds or the state tend to make grassroots political participation formalized and lack autonomy, thus losing their community foundation. This not only fails to inspire large-scale public participation but may also turn empowerment into dependence and integration. Therefore, to achieve real grassroots empowerment, it is necessary to guard against power imbalance and agenda dominance in mobilization, and explore a more open, citizen-driven mobilization model that meets local needs.

This article highlights the role of data imaginaries in shaping narratives about social movement mobilization. Weaving together critical data studies and social movement studies, it examines how activists imagine, negotiate, and resist the politics of datafication, which may further construct collective understandings of political opportunity structures and shape their repertoires of action. Empirically, we analyzed discussions about digital data and surveillance in Hong Kong's 2019–2020 Anti-Extradition Bill (Anti-ELAB) movement. These discussions took place on LIHKG, a Reddit-like online forum that served as a crucial site for framing and mobilizing the Anti-ELAB movement. The analysis identified three data imaginaries. The first envisioned CCTV, transaction, biometric, locational, and mobile phone data as everyday omnipresent surveillance infrastructures. Second, participants imagined how police could weaponize their personal data against them, reflecting deep institutional distrust. Third, participants envisioned how smart lamppost sensor and biometric data, and CCTV could be integrated into a trans-border regime of surveillance, rendering data surveillance an object of contention. Each imaginary articulated a distinctive framing of the threats of datafication and mobilized specific anticipatory tactical responses. Together, they conveyed unease about the present and possible futures of techno-authoritarian control. This study contributes to understanding how activists develop collective visions of data surveillance—data imaginaries—that enable them to identify threats, devise counter-strategies, and foster mobilization within datafied movements.

New media technologies have transformed social interactions, offering connectivity but also drawbacks such as phubbing – the act of ignoring others by using mobile phones during face-to-face interactions. This study examines the psychological consequences of being phubbed and how individuals cope through mobile use based on the temporal need-threat model. A lab experiment was conducted where participants interacted with partners and were phubbed. Results showed that phubbed individuals felt socially excluded, experienced threats to fundamental needs, and reported lower mood than those in the no-phubbing condition. Phubbing also led to less favorable attitudes toward the partners and lower interaction intention. Analysis of mobile use during a break after phubbing revealed no significant differences in social versus non-social mobile use. Interestingly, individuals with high social mobile use reported increased need threats. These findings highlight the impact of phubbing and its implications for need satisfaction and social interactions in the digital age.

Farmers’ movements have been a defining force in India’s socio-political history, reflecting both agrarian distress and the resilience of rural communities. This paper traces their evolution from the 20th century, when farmers stood at the forefront of anti-colonial struggles, to the 21st century, where they act as democratic negotiators of rights and policies. In the colonial era, peasant agitations such as Champaran, Bardoli, Tebhaga, and Telangana were deeply intertwined with the nationalist movement. Farmers not only resisted exploitative revenue systems and oppressive tenurial arrangements but also lent mass legitimacy to India’s freedom struggle. Their mobilization under leaders like Gandhi, Patel, and Swami Sahajanand transformed local economic grievances into symbols of national dignity and sovereignty. The 21st century, by contrast, has produced movements framed within democratic contestation. Protests such as the Tamil Nadu drought agitation (2017), Maharashtra’s long march (2018), and the nationwide farm law protests (2020–21) highlight the ongoing agrarian crisis shaped by globalization, market volatility, and ecological stress. These movements differ from their predecessors by focusing on policy correction, using symbolic dramatization, social media mobilization, and urban-centered strategies to amplify their voices. While they underscore the resilience of democracy and the continuing centrality of farmers in India’s polity, they also face challenges of fragmentation, politicization, and allegations of infiltration by separatist or foreign elements. The comparative analysis in this paper shows that while 20th-century farmer movements were unequivocally nationalist and contributed directly to independence, contemporary protests are more complex. They often serve as democratic correctives but occasionally risk undermining national unity when discipline falters or external agendas intrude. The critical analysis underscores the dual role of farmers as nation-builders and as potential instruments vulnerable to appropriation. The study concludes that the farmer remains central to India’s nationhood, both as a cultivator of food and as a cultivator of democratic values. For future progress, it is imperative that farmers’ movements retain their nationalist ethos, governments engage constructively, and civil society ensures solidarity rooted in unity and integrity.

This study details the Iligan City Hardcore Punk Movement as a subculture in the music scene with its own style, event preferences and ideologies. The lifeworld of the Punx, as members are called, is described using focus ethnography through the sociological lens of Emile Durkheim's notion of the collective effervescence and the New Social Movements Theory. The study examines the Punx experiences in terms of their sense of collective identity and through its adapted influences. This also describes how the local music scene operates as an influence itself. The study reveals that during events (shows and gigs), this movement comes together and spontaneously communicates collective thoughts and ideologies in a collective effervescence as one unified unit. It is argued that this is an emerging New Social Movement as punk operates in social mobilization through cultural innovation, identity and lifestyle transformation, with self-limiting radicalism against the social establishments and existing structures. The Iligan City Hardcore Punk Movement is a collective of individuals that exists under the nose of mainstream music culture. They are often misunderstood and branded negatively but persists on preserving their autonomous and often-underappreciated contribution to the music community in particular, and the public in general.

BackgroundPersistently low fertility in the European Union has drawn attention to the gap between desired and intended fertility, often linked to enduring gender inequalities. Clarifying how individual, partner, and contextual factors jointly shape short-term fertility intentions can inform policy across diverse gender regimes. Objective: To examine short-term fertility intentions among partnered individuals in Finland, Germany, and Spain, representing Scandinavian, Continental, and Mediterranean gender regimes, respectively.MethodsWe use harmonized data from the Generations and Gender Survey (GGS) and Spain’s National Institute of Statistics (INE). We apply Classification and Regression Trees (CART) to capture non-linear interactions among individual, partner, and contextual factors (including employment status, caregiving responsibilities, and gender values), and to identify profiles associated with higher vs. lower short-term intentions to have a child.ResultsFamily size, caregiving burdens, and economic stability emerge as central determinants of fertility intentions, with marked gendered and contextual differences across countries. Patterns are particularly pronounced among individuals with no children or one child, where combinations of stable employment and lower caregiving loads align with higher intentions, while economic insecurity and heavier (gendered) care burdens depress intentions. CART uncovers country-specific thresholds and configurations consistent with each gender regime.ConclusionShort-term fertility intentions reflect unmet gender-mediated needs and serve as an early indicator of latent potential for social and political mobilization. Our findings highlight the influence of gender regimes on reproductive decision-making and support policies that address structural inequalities, especially in employment and care, to enable the realization of reproductive desires across heterogeneous socioeconomic contexts.

Commentators and scholars have considered the shift to post-material value orientation among young people in Hong Kong as a driver of the rise of social mobilization since the 2000s. However, post-materialism is theoretically premised on a sense of security. As young people face both economic precarity and political inhibition in the post–National Security Law era, will their value orientation shift? We use an interpretive approach to address this question. While survey data show a rise of materialism, focus group data suggest that young people’s value orientation can best be understood as suspended post-materialism. Changing economic and political conditions have led young people to reconsider the feasibility and even desirability of certain non-material goals at the societal level. Yet they can remain committed to non-material goals at the personal or community level. The findings have implications for value change in Hong Kong and the study of post-materialism in general.

The objective of this study was to identify and analyze the influence of climate change and human activities that led to changes in the water system of Chacororé and Sinhá Mariana lakes in order to propose a strategy for establishing a sustainability agenda for the region. The strategies include the socio-environmental identification of affected areas, workshops for intercultural dialogue with traditional communities, and other social groups such as rural producers, environmental agencies (IBAMA, SEMA, ICMBio, etc.) and other public bodies and educational institutions, tourism operators, state and municipal politicians, and other stakeholders. The Chacororé-Sinhá Mariana Lake System in the Mato Grosso Pantanal faced a severe water crisis in 2020. This research was developed within the scope of interinstitutional cooperation between the Public Prosecutor's Office and Unemat through the Long-Term Ecological Program (PELD). The agenda was developed based on the following steps: a) dissemination of information about the extreme drought in Chacororé Lake on social media; b) identification of affected areas; c) social mobilization for socio-environmental certification; d) development of research; e) recommendations for establishing a sustainability agenda for socio-environmental governance in the territory. The results showed that there was a reduction in the area of Chacororé Lake caused by a combination of climatic factors and anthropogenic actions, including the construction of dams, inadequate paving of the MT-040 highway, the construction of drains, barrages, and embankments in corixos, silting of Chacororé Lake, destruction of Permanent Preservation Areas, lack of consultation with the local community, absence of regional planning for control of the APM Manso hydroelectric plant, absence of social participation in decision-making, fishing restrictions with an impact on food sovereignty, and environmental laws incompatible with ecological and cultural resilience. The study recommends changing the dam model, restoring Permanent Preservation Areas (APPs), and implementing an ecological hydrograph on the Cuiabá River, as well as ongoing monitoring and evaluation of the measures to be implemented. Restoring the system is crucial for maintaining hydrological, ecological, and cultural connectivity. Implementing these strategies will result in structuring the commitments of the sustainability agenda for the Chacororé-Sinhá Mariana Lake System.

Background: The convergence of tourism and communication has evolved substantially over the past 60 years, driven by the pervasive influence of Information and Communication Technologies (ICTs). As these domains have increasingly intersected, tourism communication has emerged as a vital field of academic inquiry. Aim: This study advances the field of tourism communication by identifying key convergence points between tourism and communication scholarship and by outlining a structured research agenda for the future. Setting: The analysis focused on peer-reviewed journal articles in the social sciences indexed in the Scopus database, with specific emphasis on English-language publications addressing tourism and communication. Method: It employed bibliometrics to analyze 3597 publications using performance analysis and science mapping. VOSviewer and Biblioshiny were used to visualise institutional and thematic networks within the field. Results: It revealed prominent publication trends, influential authors and institutions, and emerging thematic clusters, which encompass the role of ICT and social media in tourism management, social context mobile (SoCoMo) marketing strategies, user-generated content in tourism communication, smart tourism and destination marketing. Conclusion: It demonstrates that tourism communication has matured into a distinct and dynamic research area. The identification of key themes provides valuable direction for future studies. The practical implications include the integration of social media and ICT use into the tourism business, the adoption of resilient crisis management strategies, and the sustainable practices in the tourism sector. Contribution: This study offers a comprehensive overview of six decades of research in tourism communication and by establishing a robust foundation for future scholarly exploration in this interdisciplinary field.

BackgroundThe World Health Organization (WHO) recommends the use of malaria vaccines for the prevention of Plasmodium falciparum malaria in moderate to high transmission areas, administered in a 4-dose schedule in children from 5 months of age. The vaccine is a ground-breaking new tool to add to the existing package of recommended malaria interventions to reduce malaria morbidity and mortality. Ghana, Kenya, and Malawi were the first countries to introduce the RTS,S/AS01E (RTS,S) malaria vaccine into their childhood immunization programmes in 2019 as part of a pilot programme called the Malaria Vaccine Implementation Programme (MVIP).MethodsThe WHO’s post-introduction evaluation (PIE) methodology was adapted to evaluate malaria vaccine implementation in each of the three pilot countries at least a year after the vaccine’s introduction. Semi-structured questionnaires were used to interview immunization staff at national, sub-national, and health facility levels, supplemented with systematic observations of vaccination sessions and vaccine storage sites. At the health facility, a sample of caregivers of eligible children was also interviewed. Sites were purposively selected to include a range of past immunization coverage and varied demographics among the populations served.ResultsAll three countries successfully introduced the malaria vaccine during the MVIP. Reported malaria vaccine median coverage at least 2 years after the start of the pilot ranged from 69–91% for dose 1, 62–82% for dose 2, to 58–81% for dose 3 by 24–30 months from the start of the pilot. Coverage for dose 4 was lower as fewer children were eligible during the PIE reporting timeframe. Best practices identified during the PIEs included: early involvement of subnational stakeholders; advance updating and distribution of recording and reporting tools to include malaria vaccine; pre-assessment of cold chain capacity and scale-up; investment of time and resources in health worker trainings and refreshers; involvement of community health workers; robust defaulter tracing mechanisms; ensuring community “dialogue” with continuity of advocacy, communication, and social mobilization activities after initial introduction; regular onsite supervisory visits before, during and after introduction; and use of social media for messaging.ConclusionsMalaria vaccine is an important intervention as part of a comprehensive malaria control strategy. Conducting a PIE is useful to identify best practices and lessons learned. New vaccination contacts take time to establish and achieve high coverage as communities become aware of and understand when, why, and how to access the malaria vaccine. The malaria vaccine was successfully introduced as part of the routine childhood immunization programme with strong intersectoral collaboration and planning, involving both immunization and malaria stakeholders, comprehensive training, and social mobilization efforts pre- and post-introduction.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12936-025-05590-5.

Dengue is endemic in Mexico, with epidemic cycles occurring approximately every three to five years, associated with the introduction of new viral serotypes into susceptible populations. This study analysed the relationship between climatological variables and dengue incidence in Morelos, Mexico, during the period 1999–2009, aiming to identify favourable conditions to inform territorially focused prevention and control measures, using spatial analysis methods. The analysis of the influence of climate on dengue transmission in Morelos demonstrated the importance of precipitation in developing early warning systems for potential epidemics. It is recommended that territorially focused preventive strategies be implemented, such as the elimination of breeding sites, fumigation, and social mobilisation in areas at risk due to environmental, social, and epidemiological factors.

ABSTRACT Political violence can have dire implications given its scope and extent leading to destruction of property, key infrastructure and mass casualties, while instigating political instability. Institutions have evolved to prevent violent conflict. The work presented aims to explore the relationship between political violence and institutions. We have explored the frustration-aggression hypothesis. The first step in this regard was estimating the social mobilization-institutionalization and technological change gap. Then its impact on violence and its intensity is explored and discussed. Further, non-linearity of the relationship between mobilization-institutionalization-development gap and incidence and intensity of political conflict was investigated by introducing the squared gap in the analysis. The results depict that by recognizing the challenges posed by unmet aspirations, societies can proactively address these issues, fostering peaceful change during periods of significant social transformation.

Background Child mortality in Nigeria, significantly affected by malaria and malnutrition, remains a public health concern in the country. Seasonal Malaria Chemoprevention (SMC) and Vitamin A supplementation (VAS) are effective interventions that can be delivered through integrated health campaigns to reduce this mortality. This study assesses the cost implications of integrating these two interventions among under-5 children in Northeast Nigeria. Methods A cost analysis compared standalone SMC (Cycle 1 in July 2021) with SMC-VAS integrated campaign (Cycle 4 in October 2023) in two Local Government Areas (LGAs) in Bauchi State. The number of children reached by the SMC-only campaign was 168,820 and for the SMC + Vit A campaign, the number was 170,681. Data collection utilized a mixed-methods approach, drawing from primary and secondary sources, including programmatic, financial, and coverage records. Costs were categorized into distribution, Sulphadoxine-Pyrimethamine plus Amodaiquine (SPAQ) for SMC, Vitamin A, training, supplies, meetings, labor, supervision, and social mobilization costs. Sensitivity analyses evaluated the effect of a 10% fluctuation in the costs of distribution, labor, SPAQ, and supplies on the cost per child. Results The total cost for the SMC standalone campaign was US$158,934, and the SMC-VAS integration was US$186,426. Distribution and drug costs were the largest contributors in the integrated and SMC-only campaign. The SMC-only cost per child was $0.94 and $1.18 when eligible children received both SMC and VAS. The integration of VAS into the SMC campaign cycle incurred an additional US$27,492 over Cycle 1 cost (US$186,426 – US$158,934). Fluctuations in distribution costs were the most influential component of the cost per child. Conclusion Integrating VAS with SMC campaigns increases the cost by US$0.24 per child, a modest increment considering the potential health benefits. The results support the feasibility of this integration, in terms of cost, to combat child mortality from malaria and malnutrition in Nigeria. Further research is recommended to explore the cost-effectiveness of this integrated distribution model.