Financial Sustainability Research Articles

Population ageing and health financing: A method for forecasting two sides of the same coin

Abstract There is a perception that population ageing will have deleterious effects on future health financing sustainability. Given the positive association between health care utilization and increasing calendar age, many analysts assume population ageing will result in considerable growth in health spending. Since this expenditure tends to be sourced primarily from public funds, there is great policy interest to quantify how population ageing is likely to affect health expenditure trends. We propose a new method-the Population Ageing financial Sustainability gap for Health systems (or alternatively, the PASH)-to explore how changes in the population age mix will affect health expenditures and revenues. Using a set of six countries in Europe and the Western Pacific representing a diverse range of health financing systems (Australia, Bulgaria, Japan, Slovenia, United Kingdom, Vietnam), we forecast the size of the ageing-attributable gap between health revenues and expenditures from 2020 to 2100 under current health financing arrangements. The largest gap by 2100 is expected to be in Vietnam, where the gap between revenues and expenditure is expected to increase by around $170 per person in 2018 PPPs or 2.3% of GDP; 87.1% of this increase is due to expected growth in expenditures. In Slovenia, where the gap is forecast in line with the forecast for Japan (the oldest country in the world), nearly half of the gap (44.2%) is due to reductions in revenue generation. All countries face some health financing gap due to ageing under current financing arrangements. The PASH analysis highlights the wide range of policy options available to manage health financing as the population ages, such as changing sources for health revenues and reducing expenditure by promoting healthy ageing.

Examining the triple impact of eco-intellectual capital on the financial, social and environmental sustainability performance of SMEs in emerging economies

The way business has been conducted in modern times has traversed the need to achieve financial gains. Globally, it has become imperative for organisations to thrive competitively on the basis of ecologically conciousness and sustainability. Hence, the primary aim of this investigation is to determine how Eco-Intellectual Capital (EIC) influences the sustainability performance of small and medium enterprises (SMEs). The study made use of primary data and employed a quantitative research approach using a survey for data collection. The main data collection instrument used was a structured questionnaire. Data for the study were solicited from a group of 500 employees and owners managing SMEs in Ghana. Data collected from the questionnaires were analysed using IBM SPSS Statistics version 24 and IBM SPSS AMOS (26.0) Graphics. The results showed that EIC had a favourable effect on the social and environmental dimensions of sustainability performance. On the economic (financial) dimension, however, the effect was not significant. Aside from magnifying Eco-Intellectual Capital and Sustainability Performance literature, this research study is one of the few that looks at how green human, structural and relational capital work together to improve the economic, social and environmental sustainability of SMEs in emerging economies.

Natural resource management in Vietnam: Merging circular economy practices and financial sustainability approach

This study provides circular economy principles in natural resource management (NRM) in Vietnam when merging financial sustainability. Prior studies have neglected NRM in terms of utilizing circular economy principles (CEP) with the support of financial sustainability (FS). The main goal is to improve CEP in NRM utilizing the FS. This study employs the novel hybrid method to explore the multi-hierarchical NRM structure, address the interrelationships among CE and NRM attributes, and identify the attributes for improvement with the support of FS. This study proposes 85 criteria across 13 aspects base on the natural resource-based view. The results reveal a valid set of 20 criteria spanning six aspects. The aspects comprise operational digitalization, Fintech application and environmental strategy. The practical criteria include digital ecosystem collaborations, automation and robotics operations, compliance with environmental standards and laws, blockchain adoption, and data security. The FS is indicated as the decisive perspective for improving the CEP in NRM.

How Fintech Adoption, Digital Payment Systems, and Consumer Trust Shape Financial Performance of MSMEs

This study investigates the impact of fintech adoption, digital payment systems, and consumer trust on the financial performance of micro, small, and medium enterprises (MSMEs). Using data from 400 MSMEs, the research employs multiple regression analysis to explore the relationships between these factors. The results reveal that fintech adoption has the strongest positive influence on financial performance, followed by digital payment systems and consumer trust. Additionally, consumer trust moderates the relationship between digital payment systems and financial performance, highlighting the importance of customer confidence in driving business success. These findings emphasize the need for MSMEs to embrace digital financial solutions and build trust with their customers to improve their financial outcomes. The study provides practical implications for MSME owners, policymakers, and industry leaders, encouraging the adoption of fintech and digital payment systems as crucial tools for achieving competitive advantage and financial sustainability.

Improving Cover Crop Interseeding in Northern Climates

AbstractExtensive research has found that cover cropping can increase the overall health of agricultural systems by scavenging excess nutrients, increasing water infiltration, reducing surface runoff, increasing biodiversity, and building organic matter. Furthermore, cover cropping can help enhance the benefits of other farming practices such as no‐till planting, creating synergies that increase farm financial and environmental sustainability. In northern climates, there are significant challenges to establishing cover crops due to the short growing window following corn silage harvest. The authors of this article share their experiences, challenges, and successes of integrating cover crops into northern climates. Earn 0.5 CEUs in Crop Management by reading this article and taking the quiz at https://web.sciencesocieties.org/Learning‐Center/Courses.

Building Healthy, Equitable, and Resilient Communities: Lessons Learned From Multisector Community Partnerships Addressing the Social Determinants of Health.

Multisector community partnerships play a pivotal role in public health strategy for understanding and addressing social determinants of health (SDOH) and promoting health equity. The work of these partnerships is well aligned with building community resilience. The Year 2 Improving Social Determinants of Health-Getting Further Faster (GFF) retrospective evaluation was designed to gather practice-based evidence that can inform future community-driven partnerships to improve chronic disease outcomes and advance health equity by addressing social determinants of health (SDOH). This paper sought to determine how the efforts of multisector community partnerships could also support community resilience. Guided by CDC's Framework for Program Evaluation in Public Health and health equity principles, the GFF evaluation engaged 14 Multisector Community Partnerships to better understand how their SDOH interventions contribute to community changes that improve chronic diseases and advance health equity. Data collection included qualitative discussions along with additional quantitative analyses of SDOH outcomes, costs, and prevention impacts. This paper focuses on insights gathered from qualitative discussions (2 virtual 60-minute discussions with members of each of the 14 Partnerships) around community resilience. Results from qualitative discussions demonstrate how Partnerships' SDOH efforts created parallel opportunities for nurturing community resilience. For example, Partnerships engaged community members in the design and implementation of SDOH interventions in ways that nurtured a sense of belonging and empowerment to shape their community. To further build community resilience, Partnerships mentioned the importance of sustained and flexible funding, help building stronger partnerships, and a shared goal to build resilience and engage community members. Findings indicate that community partnerships working to address SDOH can drive reciprocal improvements in community resilience-contributions that are critical for advancing health equity. Partnerships suggested that health departments may have opportunities to enhance community resilience through their role as funder, facilitator, and convener.

Do board characteristics affect financial sustainability? The COVID-19 pandemic experience

Do board characteristics affect financial sustainability? The COVID-19 pandemic experience

Integrating social work into general practice in Australia: protocol of an intervention study

PurposeThis study protocol provides an overview of research aimed to evidence social work contributions to general practitioner (GP) clinics and evaluating the value of social workers and students in such settings. The research will facilitate and evaluate 12 months service delivery by social workers and students who will be employed in North Queensland GP clinics.Design/methodology/approachThe study will be conducted in three phases. The first phase will involve developing partnerships and contractual arrangements to co-fund social workers to be employed in GP clinics. In the second phase, social workers and social work students will be practicing in GP settings and systematically recording basic demographics about their patients, areas of health and interventions. This data will be collated and correlated. Patient feedback surveys and a pre- and post-well-being scale will be applied to evaluate the outcomes of interventions. In the final phase, feedback about the value and contribution of social work in a GP setting will be sought from key GP practice stakeholders via an online survey tool to evaluate the research.FindingsFurther data is needed to evidence the contribution and outcomes of social work practice in Australia and elsewhere. It is important that social work and GPs work together to evidence and evaluate the outcomes and contribution of social work to develop sustainable funding pathways for embedding social work in GP clinics.Originality/valueThis is an innovative study design that will use various data sources to identify, quantify and evaluate the contribution of social work in general practice. It allows for stakeholders feedback that can contribute to policy review and the development of funding pathways to advance the inclusion of social work in integrated team care.

Bio-templating approach and DFT study of ZrMo@KIT-6 catalyst for the conversion of deep fried oil into sustainable biodiesel production

In this study, highly porous ZrMo@KIT-6 heterogeneous catalyst was developed using Aloevera gel along with Pluronic as a mixed template. The catalytic activity was executed in biodiesel production from low valued deep fried oil to develop a sustainable energy approach. The physiochemical properties of the developed catalyst were assessed in depth using different analytical techniques including, TGA, XRD, BET, TPD-NH3, FESEM- EDX and XRD analyses. It was noted that the catalyst synthesized with Aloevera gel and Pluronic mixed template possessed improved texture, morphological properties and evenly distributed active centers with total acidity of 0.95 mmol/g and surface area of 741.46 m2/g. These experimental results were further endorsed by DFT analysis. Moreover, the designed catalystexhibited paramounted catalytic efficacy in transesterification reaction of deep fried oil into biodiesel, providing a phenomenal 97.7 % biodiesel yield under optimal reaction conditions. Apart from this, the designed catalyst sustained catalytic activity up to five times with biodiesel yield 87 %. Thus, the designed catalyst presents a novel fuel strategy which will bring both financial and environmental sustainability in the future.

Évaluation de l’impact économique et du parcours patient lors du traitement de l’occlusion coronaire totale chronique

Chronic total occlusion (CTO) of coronary arteries is defined as complete absence of antegrade coronary flow without iodine passage, since more than 3 months. Coronary revascularization is a highly resource-intensive angioplasty procedure involving numerous medical devices (MDs). Its consumption and associated costs are not covered by either the medical act classification (CCAM) or the hospitalization fees and additional MD funding. The primary aim of this study is to analyze the financial sustainability of this activity for a public healthcare institution and to assess the budgetary impact of CTO treatment on the most expensive items of expenditure. The secondary aim is to describe the patient's intra-hospital pathway. CTO revascularization stays are categorized under the code 05K06 "Vascular Stents without Myocardial Infarction". Major cost items were identified using national coded expenditure data and compared with those from our cost study. Every CTO intervention from January to November 2021 were retrospectively retrieved. Establishment purchase prices in 2021 were used to determine MD costs. Clinical data were extracted from electronic patient records. Operative data (procedure duration, professionals involved, and MD used) were extracted. Human Resources (HR) costs were integrated into the calculations. A Sankey diagram was created. Data are expressed as mean ± standard deviation. In our study, 41 patients underwent 45 interventions. The median was 65 years. 78% of interventions were successful with a median duration of 113 minutes. 222 different MD references were used, with 27% reimbursed additionally and 73% funded within the homogeneous group of stays (HGS). The total cost of MD described in the coded expenditure data is 2142euro, of which 721euro is funded within the HGS. In our cohort, it represented averages of 2736euro ± 1393euro and 1710euro ± 926euro, respectively. Regarding HR, the total cost described in the coded expenditure data was 442euro compared to 410euro ± 169euro in our cohort. Finally, patient pathway analysis showed an average length of stay (LOS) of 1.8 days. Two pathways were identified depending on admission context: weekday hospitalization or cardiac intensive care. CTO revascularization is a planned intervention with a short LOS and a highly standardized patient pathway. Our study highlights a proliferation of MD references used during CTO revascularization due to innovative industrial developments. The cost differential with coded expenditure data confirms the need for a revision of the procedure and its categorization within an HGS, which is currently non-specific.

Understanding evidence ecosystems: What influences the production, translation, and use of modeled evidence in Burkina Faso, Nigeria, India, and Kenya?

Background This study sought to document and understand facilitators and barriers to producing, translating, and using modeled evidence in decision-making in Burkina Faso, Nigeria, India, and Kenya. We explored researcher-decision-maker engagement mechanisms as key facilitators of evidence use, with a focus on knowledge brokers and boundary organizations. Methods The study used sequential mixed methods drawing on data collected from surveys and key informant interviews, complemented by a rapid desk review to map modeling activities and actors. The survey was conducted online while the qualitative research entailed in-depth interviews with modelers, knowledge brokers, and decision-makers working in a representative variety of health fields, organizations, and levels of government. This study was approved by Health Media Lab IRB (Institutional Review Board) in the United States and a local IRB in each study country and conducted between September 2021 and June 2022. Results Informants interviewed for this study described a range of factors that facilitate and inhibit the use of modeled evidence in public health decision-making at the individual, organizational, and environmental levels. Key themes included the capacity to produce, translate, and use modeled evidence; the timing and relevance of modeling outputs; the existence of communications channels between modelers and decision-makers; the strength of underlying data systems; the role of sustained funding; and the impact of global crises. Conclusion This study highlights the importance of taking an ecosystem approach to supporting modeling activities, considering individual, organizational, and environmental factors and how different actors and interact to inform the production, translation, and use of modeled evidence. Structured interaction that promotes dialogue, debate, and joint sense making between the producers and users of evidence is critical to informing and influencing the use of evidence in decision-making.

Female leadership and financial sustainability of MFIs: the moderating role of female borrowers

PurposeThe purpose of this study was to investigate whether the percentage of female borrowers moderate the effect of female leadership on financial sustainability of microfinance institutions (MFIs).Design/methodology/approachThe study collected an unbalanced panel data of 821 MFIs between 2007 and 2018 from the Microfinance Information Exchange (MIX). MFIs’ financial sustainability was measured as operational self-sufficiency (OSS). The data were analyzed using the fixed effect regression model.FindingsThe study found that having women participation in managerial and board positions has a positive effect on OSS. The results further demonstrated that the proportion of female loan officers and female borrowers had a negative effect on OSS. In addition, the study’s findings revealed that the percentage of female borrowers moderated the relationship between female board members, female managers, female loan officers and OSS.Practical implicationsThese findings may offer important insights to policymakers and practitioners in formulating strategies to improve financial inclusion for women by examining the inherent link between female borrowers and women’s participation in leadership roles within MFIs, which affects the financial sustainability of these entities.Originality/valueThis study is among the few that have examined the interaction between the proportion of female borrowers and other forms of female participation, including loan officers, managers and board members, and its effect on the financial sustainability of MFIs.

A Study on Evaluating Determinants of Factors Influencing Environmental Social and Governance (ESG) Investments

Investments that take social responsibility, environmental sustainability, and corporate governance into account are referred to as ESG investments. It supports businesses that put sustainability and moral behavior first to foster long-term success. Financial gains can be obtained through ESG investments while ensuring beneficial social benefits and risk management. The increasing recognition of ESG investments as an essential aspect of sustainable finance, that emphasise the significance of grasping the variables influencing investor choices in this field. The purpose of the study was to evaluate determinants of Factors influencing ESG investments. The technique used in the current study is the Structural Equation Model. The findings of the study indicated that there is a significant impact of attitude, Environmental concern, perceived behavioral control, and subjective norms on behavioural intention towards ESG investments. The study is extended by adding Environmental concern construct to the base theory of planned behavior.

Characterizing Collegiate Recovery Programs in the US and Canada: A Survey of Program Directors.

Collegiate Recovery Programs (CRPs) play a vital and expanding role in supporting students in recovery from substance use disorders and behavioral addictions at higher education institutions. Despite their importance, there is a lack of comprehensive research characterizing CRPs, including their program directors and the nature and influence of their funding streams. A survey was administered to 70 CRP directors across the US and Canada. Directors reported on their CRPs across a variety of site physical features, policy and program offerings, and funding sources, with "sustainable" funding defined as two or more sources. CRP directors were predominantly non-Hispanic, White, and female, with representation from gender and sexual minorities. The highest concentration of directors responding were in the US states of North Carolina, California, and Texas. CRPs with more than one funding source served twice as many students and had significantly more space, drop-in facilities, and relapse management policies. CRP directors had positive perceptions of harm reduction principles. Additionally, results highlighted the robust availability of All Recovery meetings and the wide diversity of mutual-help group meetings offered within CRPs and directors' positive perceptions of these meetings. This research lays a foundation for enhancing CRPs within higher education settings, emphasizing the significance of sustained funding and an inclusive support framework for the program directors that run CRPs. Future studies should further explore the effectiveness of CRPs and their impacts on the schools and students they serve.

The Urgency of Green Banking Regulations in Indonesia in the Implementation of Sustainable Development

This research highlights significant gaps in Indonesia's green banking regulations, particularly the lack of stringent sanctions and clear enforcement frameworks for sustainable finance principles. While the Financial Services Authority Regulation No. 51/POJK.03/2017 addresses environmental sustainability, it fails to impose effective penalties on banks that contribute to environmental degradation. As a result, green banking in Indonesia remains largely a voluntary initiative due to insufficient regulatory measures. This research employs a normative legal research design, utilizing both conceptual and statutory approaches. It advocates for the implementation of stricter penalties and enhanced oversight to ensure compliance with sustainability standards among financial institutions, thereby facilitating the transition to a green economy. Furthermore, the Sustainable Development Goals (SDGs) underscore the importance of indicators related to economic, social, and environmental sustainability, which green banking can help achieve. The proposed revised regulatory framework should include stringent sanctions for violations by both banks and customers, ensuring that financial institutions actively contribute to environmental protection.

Implementing sustainability taxonomies to redirect capital flows: the case of South Africa

ABSTRACT Sustainability taxonomies are comprehensive classification systems that define what constitutes a sustainable economic activity. They aim to increase transparency in financial markets and redirect capital flows to sustainable investments. Such sustainable finance policies can be important levers for the transformation of the economy towards climate neutrality, as today’s investments will shape economic production processes for decades to come. While sustainability taxonomies have been developed in recent years in many countries, existing research on taxonomies has so far often focused on the European Union and has hardly addressed questions of policy implementation. This case study focuses on South Africa’s Green Finance Taxonomy (GFT) and addresses the question of what factors influence the adoption of sustainability taxonomies by potential users. Based on 44 semi-structured expert interviews with taxonomy stakeholders from the private sector, government, civil society and academia, it finds that one year after its publication, the GFT has hardly been used in practice. Important factors hindering an effective implementation are a lack of regulatory embedding, the absence of a legal recognition of the GFT by the European Union (EU), hesitance among financial market participants to build capacity to collect the necessary data, and fossil-fuel path dependencies in South Africa’s economy. Given the difficulties many jurisdictions currently face in implementing their newly developed sustainability taxonomies, these findings have important policy implications not only for South Africa but also for other countries.

A Study on Evaluating Determinants of Factors Influencing Environmental Social and Governance (ESG) Investments

Investments that take social responsibility, environmental sustainability, and corporate governance into account are referred to as ESG investments. It supports businesses that put sustainability and moral behavior first to foster long-term success. Financial gains can be obtained through ESG investments while ensuring beneficial social benefits and risk management. The increasing recognition of ESG investments as an essential aspect of sustainable finance, that emphasise the significance of grasping the variables influencing investor choices in this field. The purpose of the study was to evaluate determinants of Factors influencing ESG investments. The technique used in the current study is the Structural Equation Model. The findings of the study indicated that there is a significant impact of attitude, Environmental concern, perceived behavioral control, and subjective norms on behavioural intention towards ESG investments.

Implementation of Digital Initiatives in Higher Education in India: Problems and Solutions

The education system is gradually becoming technology-oriented. The Ministry of Education of India has initiatives numerous digital platforms, tools, and devices like (SWAYAM, SWAYAM Prabha, Shodhganga, Shodhshuddhi, NDL, NAD, e-PG Pathshala, e-Yantra, FOSSE, SAMARTH, IRINS, spoken tutorials and Virtual Labs and so on) to ensure that everyone can access advance and quality education. The study explores problems and solutions regarding implementing digital initiatives in higher educational institutions. This study adopted secondary data from different papers published in journals, newspaper pieces, and various government policies and reports with the help of content analysis. Due to a lack of knowledge and awareness, many problems are faced in successfully implementing digital initiatives in India's higher Education. The problems encountered include limited digital resources and tools, poor internet connectivity in rural institutions, and a lack of proper policy guidelines and rules and regulations when implementing digital initiatives. This paper explores solutions to the problems regarding implementing digital initiatives, such as regular training and workshop programme arrangements that help to increase knowledge and awareness among academics, researchers, and students. Provide adequate internet infrastructure, especially in rural areas, and require sustainable funding to implement digital initiatives in higher Education successfully. The outcome will be highly beneficial if the students can learn digitally. It is valuable for faculty members to develop professional skills.

Using the IFASIS (Inventory of Factors Affecting Successful Implementation and Sustainment) to Advance Context-Specific and Generalizable Knowledge of Implementation Determinants: Case Study of a Digital Contingency Management Platform.

Contingency management (CM) is the most effective treatment for stimulant use disorder but is underutilized by opioid treatment programs (OTPs), despite the high prevalence of stimulant use in this setting. As part of a state-wide initiative, we piloted a novel assessment, the Inventory of Factors Affecting Successful Implementation and Sustainment (IFASIS), to examine determinants of implementation of a digital CM platform across a set of OTPs. We describe how the IFASIS was used to elucidate both generalizable and context-specific implementation determinants, and to guide the provision of implementation facilitation. Six OTPs received a multi-level implementation strategy (including facilitation) to promote programmatic uptake of a digital CM platform. Pre-implementation, OTPs completed the IFASIS, a 27-item questionnaire that assesses both the valence (positive/negative) and importance of determinants across 4 domains: outside the organization, within the organization, about the intervention, and about intervention recipients. OTP staff completed the IFASIS as a team, identifying consensus ratings during recorded discussions. Transcripts of IFASIS recordings were analyzed using rapid qualitative analysis. Quantitative IFASIS results were aggregated into medians and ranges within and across organizations. Implementation facilitation meeting notes were analyzed to examine how the IFASIS was used to guide facilitation. Quantitative ratings and qualitative feedback revealed common barriers to implementation of the digital CM platform, including a lack of sustainable funding sources, absence of external and organizational policies, insufficient higher-level leadership support, and mixed attitudes among staff members toward CM. Common implementation facilitators included enthusiasm and commitment among organization leadership and the perception that the digital CM platform would reduce the workload and burden on OTP counselors. The IFASIS was used to guide facilitation in several ways, including stimulating discussion about barriers and facilitators, brainstorming strategies to address barriers rated as "very important", and identifying facilitators that could be harnessed as part of implementation efforts. The IFASIS identified important determinants of CM implementation in OTPs and was instrumental in shaping facilitation. The IFASIS may be a valuable assessment for the implementation science community to identify and address generalizable and context-specific implementation determinants.

Sustainability Assessment of the Performance of Parmigiano Reggiano PDO Firms: A Comparative Analysis of Firms’ Legal Form and Altitude Range

Geographical indications (GIs), protected by the European Union with the collective marks of PDO (protected designation of origin), PGI (protected geographical indication), and TSG (traditional specialty guaranteed), play an important role in the social and economic system. They not only guarantee food needs, but promote correct consumer information, protect local food, and play a role in the environmental and social sustainability of rural areas. In Italy, Parmigiano Reggiano (PR-RE) PDO cheese is ranked second in foods with the GI protection mark by turnover. This research aims to assess the financial sustainability of the firms registered in the PR-RE PDO consortium using financial statement (FINSTAT) analysis. Financial ratios (FR) and the EM-Score were applied to assess firms’ performance, financial risk, and credit score. The analysis distinguished firms by legal form, cooperative and non-cooperative, and altitude range—plain hill and mountain. The main findings of the research were as follows: (1) a better performance of lowland non-cooperative firms and lower financial risk, (2) a longer duration of the inventory cycle of cooperative firms, and (3) a greater financial risk in mountain cooperatives. The results provide indications for improving firms’ performance and for designing financial instruments for the sector. To our knowledge, this is the first research to carry out an analysis of all the available FINSTATs of firms in the PR-RE PDO sector.