Energy transitions increasingly depend on collective decision-making (CDM) by households, firms, and civic organizations that co-invest, co-operate, and co-govern local energy resources. Yet mainstream energy models still treat behavior as that of a single, perfectly rational actor, under-representing the social dynamics of CDM. This paper presents a decade-scale (2015-2025) systematic review of CDM modeling at community scale. Using a broad search string pairing synonyms of “collective decision” with “energy” across leading databases, hundreds of records were screened and 84 peer-reviewed studies retained that simulate interactions among multiple autonomous actors. A supplementary search-robustness check indicates that broader retrieval adds more game-theoretic and governance-oriented studies, but does not materially alter the main patterns. Methodologically, agent-based simulation is a major strand, alongside game-theoretic formulations, hybrid optimization-agent approaches, and an emerging line of multi-agent reinforcement learning. Most studies focus on electricity communities, especially solar PV, battery storage, and peer-to-peer trading, while heat, mobility, and multi-energy integration remain limited. Peer influence and heterogeneity are often represented, whereas governance processes and diverse actor roles are still rarely modeled. Empirical calibration and validation are improving but remain uneven, limiting policy credibility in practice. The review identifies three field-defining gaps: (i) limited behavioral realism and weak validation; (ii) thin representation of governance and institutional change; and (iii) weak multi-scale socio-technical integration across sectors and levels. In response, the Multi-Scale Integrated Collective-Energy Decision (MICED) framework is proposed as a modular way forward for linking heterogeneous actors, group-decision processes, and socio-technical system dynamics. Together, the review and framework outline an agenda for more credible, equity-aware, and policy-relevant analysis of community-scale energy transitions. • Decade-scale systematic review of energy-related collective decision-making models. • Key gaps: weak behavioral realism, governance, and multi-scale coupling. • Propose framework MICED: multi-scale, learning agents, and explicit governance.

Telemedicine in Africa has evolved from small-scale pilots to an essential tool for enhancing healthcare access, efficiency, and equity. Early efforts faced challenges due to limited infrastructure, high costs, and weak policies. The COVID-19 pandemic accelerated telemedicine adoption, exposing the need for stronger digital health strategies. Despite interest, many countries still struggle with regulation, coordination, and scaling sustainable implementations. This review examines the development and policy adoption of telemedicine across Africa before and after the pandemic, identifying key innovations, ongoing challenges, and lessons to guide future digital health planning. A narrative review was conducted, with study selection guided by PRISMA transparency standards. A structured search was conducted across PubMed, Google Scholar, Web of Science, Cochrane Library, Scopus, and policy databases from the WHO, the African Union, and UNECA. The search included publications from 2000 to 2025, focusing on English-language studies addressing telemedicine policies or implementation in African countries. The COVID-19 pandemic accelerated adoption, driving rapid innovation and policy shifts. In Nigeria, platforms such as MobiHealth, Tremendoc, and Dokilink expanded access via phone and WhatsApp, maintaining care during lockdowns. In South Africa, regulatory reforms enabled consultations without prior doctor-patient relationships, allowing 97% of patients to be managed virtually and reducing hospital burden. Nurse-led teleconsultations improved access, while a remote diabetes program reduced mortality by 20% among high-risk patients. Telepsychiatry expanded mental health services, and SMS-based interventions remained the most widely used due to affordability and accessibility. Despite progress, policy responses were uneven. South Africa's rapid reforms contrasted with Nigeria's fragmented frameworks, which lacked enforceable telemedicine provisions. Persistent challenges include weak data governance, limited interoperability, inadequate funding, and "pilotitis," where projects fail to scale. Telemedicine adoption in Africa has grown markedly since COVID-19 but remains constrained by infrastructural and regulatory weaknesses, and variable acceptance. Strengthening legal frameworks, improving infrastructure, and increasing awareness among providers and communities are vital to sustain progress, integrate telehealth into routine care, foster innovation, and enhance equitable healthcare across the continent.

This paper investigates the extent of compliance by two State-Owned Utility Companies (SOUCs) in Sierra Leone with international best-practice corporate governance principles as prescribed by the Commonwealth Association of Corporate Governance (CACG) Code. The CACG Code (1998) is generally considered a benchmark for best-practice corporate governance in commonwealth and some non-Commonwealth countries worldwide. The study used a descriptive cross-sectional case study survey design with a quantitative approach, in which two purposively selected SOUCs, Electricity Distribution and Supply Authority (EDSA) and Guma Valley Water Supply Company (GVWC) were considered. Primary data were collected through a questionnaire survey of the selected SOUCs supplemented with secondary data from document sources. Quantitative survey data analysis was conducted using SPSS and Excel programs. It used simple descriptive statistics to describe corporate governance compliance of SOUCs. Using a compliance checklist of 39 provisions from the CACG Code, the study found that majority (62%) of the responses recorded a negative opinion about standard corporate governance compliance in the SOUCs, and that both SOUCs have an overall weak (47%) corporate governance compliance, with weak compliance at 48% and 46% in EDSA and GVWC respectively. The results indicate that SOUCs did not adhere to international best practice corporate governance, which could signal a lack of investor appeal. It could also be a signal to stakeholders that necessary steps must be taken to address poor corporate governance mechanisms in the SOUCs.

Identifying health care provider, system, and resource-related factors associated with CLABSIs in ICUs of LMICs: A Scoping Review.

Cross-border biological threats are increasing both in frequency and complexity. Whether of natural, accidental, or deliberate origin, they pose serious risks for public and animal health, economics, and national security. They can also create vulnerabilities capable of being exploited by malicious actors, worsening health crises, and undermining trust in response efforts. Although both the health and security sectors share a common interest in mitigating these threats, they often operate in silos. The One Health approach, which aims at optimizing the health of animals, people, and the environment, has gained momentum in recent years; however, its implementation faces challenges such as weak governance, lack of resources, and, notably, the exclusion of security actors whose roles and capacities remain underrecognized. Security actors play a vital role in preventing, detecting, and investigating criminal activities related to biological incidents as well as supporting health actors with biological threat response. There is a general lack of understanding of the One Health approach within the security community and health is often predominately viewed through a human safety viewpoint often omitting animal and environmental health. This commentary advocates for the mutual integration of One Health and security approaches to strengthen resilience against cross-border biological threats. Concrete examples and recommendations to foster integration are discussed such as updating legislation, formalizing information sharing mechanisms, and undertaking joint capacity building, all while recognizing common challenges in mutual integration. To protect people, animals, and the environment alike, it is time to act to ensure coordinated efforts to mitigate cross-border biological threats.

Every institution whether it is a public or private, and big or small should adopt effective governance system for its survival and development. Low level of performance in the institution often occurs due to weak governance. In this context this article discusses to what extent the corporate governance impact performance of the institution like insurance companies. The article aims to examine the application of corporate governance practices in insurance industries in Nepal. For generating information four major insurance companies such as NECO Insurance, Sagarmatha Insurance, Rastriya Beema, and Shikhar Insurance companies were taken employing both quantitative and qualitative data. The findings reveal that corporate governance has a strong influence on the performance of general insurance industry in Nepal provided effective board oversight to maintain accountability and efficient regulatory compliance along with maintaining stable financial performance are important.

Public universities operate in increasingly complex environment characterized by pressure for accountability, global competition, and demands for quality and innovation. In this context, Human Resource Development (HRD) plays a critical role in enhancing teaching quality, research productivity, and institutional performance. However, the effectiveness of HRD is strongly influenced by governance structures that shape decision-making, resource allocation, and accountability. Weak governance often leads to fragmented HRD practices, limited strategic alignment, and ultimately constrained institutional excellence. This article synthesizes existing scholarly literature to examine how governance mechanisms influence HRD processes and how HRD, in turn, contributes to institutional excellence in public universities. Using a conceptual and narrative review approach, the study integrates insights from research on higher education governance, strategic HRD, and excellence frameworks. Key themes include governance principles and actors, HRD mechanisms such as faculty development and performance management, and multidimensional indicators of institutional excellence. The article offers theoretical clarification by distinguishing between governance and management and positioning HRD as a mediating mechanism between the two. It proposes an integrated conceptual framework that explains this relationship. The findings carry implications for policymakers, university administrators, and future research seeking to empirically test and refine the governance–HRD excellence nexus.

This study examined the relationship between land governance, security dynamics, and food security in rural Niger South (Zone A), Niger State, Nigeria. The study investigated how land tenure ambiguity, farmer–herder conflicts, communal violence, judicial delays, and weak institutional coordination undermine agricultural productivity and rural livelihoods. A qualitative exploratory research design was adopted using secondary data derived from court records, policy documents, conflict databases, media reports, and scholarly literature. Key data sources included reports from the Food and Agriculture Organization (FAO), Armed Conflict Location and Event Data Project (ACLED), World Bank, and Nigerian government publications. The study was anchored on Human Security Theory and Political Ecology of Conflict, while the FAO’s four dimensions of food security availability, access, utilisation, and stability provided the analytical framework. Findings revealed that weak land governance systems, prolonged litigation, overlapping customary and statutory land tenure structures, and insecurity have contributed to farmland abandonment, destruction of irrigation facilities, displacement of farming households, and disruption of local food markets. The study further established that food insecurity in Niger South is driven more by governance failures and institutional insecurity than by insufficient agricultural potential. The interaction between insecurity, weak judicial processes, and poor land administration has significantly reduced agricultural productivity and increased rural vulnerability. The study concludes that sustainable food security and rural development in Niger South require integrated reforms in land governance, judicial administration, rural security, and agricultural infrastructure. It recommends digitisation of land records, accelerated dispute resolution mechanisms, strengthening of community-based peacebuilding structures, rehabilitation of rural infrastructure, and improved institutional coordination to enhance agricultural sustainability and rural livelihoods.

The Sindh Empowerment of Persons with Disabilities Act 2018 (SEPD Act) mandates inclusive health services for persons with disabilities. This study examines the challenges faced in implementing the disability Act’s health-related provisions, with a focus on children with disabilities in Sindh, Pakistan. A qualitative exploratory study was conducted in four districts of Sindh province. A total of 40 key informant interviews were undertaken with government officials, health administrators, pediatricians, and disability activists using a purposive sampling technique. The data were analyzed through inductive and deductive thematic analysis using the Missing Billion disability-inclusive health system framework. We identified several critical systemic gaps in the implementation of the SEPD Act in Sindh province. Weak governance, including limited intersectoral coordination, frequent bureaucratic turnover, and lack of private-sector engagement impedes implementation progress. The absence of sanctioned budget for inclusive health initiatives, particularly the lack of structured health insurance programs and limited availability of assistive devices, restrict healthcare utilization for children with disabilities and forces families to incur substantial out-of-pocket expenses for rehabilitation and healthcare. Effective delivery of health services are constrained by inadequate disability-inclusive infrastructure, insufficiently trained healthcare providers, and lack of newborn screening programs for early detection and timely intervention. Furthermore, lack of systematic collection and reporting of disability-specific data within the Health Information System limits evidence-informed policy and decision-making and the development of effective referral mechanisms for diagnosis, treatment, and rehabilitation of children with disabilities. Systemic weaknesses impede the delivery of disability-inclusive healthcare in Sindh, despite the presence of supportive legal frameworks. Our findings recommend strengthening the implementation of the SEPD Act through strategic planning, coordination, and priority setting at both provincial and district levels. Furthermore, it is essential to integrate strategies for a disability-inclusive health system at all administrative levels to ensure that the needs of persons with disabilities are prioritized.

High-quality health research is essential for evidence-based policymaking and health system strengthening. Indonesia has undergone major reforms in its health research governance. However, the country’s National Health Research System (NHRS) remains insufficiently mapped. This study aimed to assess the current status of Indonesia’s NHRS using the WHO framework, which includes four domains: governance, financing, creating and sustaining resources, and producing and using research. A qualitative approach was employed, combining an expert panel discussion and key informant interviews with 13 participants consisting of national and subnational stakeholders from government agencies, research organisations, and universities from May to December 2024. Data were analysed using the Framework Method guided by the NHRS framework and supplemented by the WHO Questionnaire on Country Resources for Health Research. This study found that, despite progress in Indonesia’s NHRS, weak governance, particularly poor coordination between national and subnational levels, remains the main challenge. Overall, the system is still fragmented, even though formal structures and institutions are in place. Governance is characterised by a highly centralised, top-down approach to agenda setting, with limited engagement of local institutions. Research financing is mainly programmatic and proposal-based, aligned with national priorities, but is constrained by limited sustainable domestic funding and unequal access to funding. In terms of resources, advanced research infrastructure and growing international collaboration indicate national commitment to health research; however, mismatches between infrastructure and human resource capacity persist. Finally, although research production and utilisation focus on measurable outputs and are supported by mechanisms for evidence use, effective pathways for translating research into policy and practice remain limited. Improving Indonesia’s health research system calls for an integrated national research agenda, well-defined institutional roles, and streamlined coordination between national and regional levels.

Asia faces significant barriers to accessing newer antibiotics despite a high burden of antimicrobial resistance. We conducted a literature review to identify key gaps and challenges in access to newer antibiotics in Asian countries. Peer-reviewed and gray literature from January 2010 to October 2024 were searched for articles discussing access to Food and Drug Administration (FDA)-approved antibiotics post-2010 with an Asian perspective. A total of 134 articles were reviewed. Key challenges spanned 7 main stakeholders: pharmaceutical industries, drug regulatory agencies, health technology assessment agencies, funders/nongovernmental organizations, healthcare practitioners, patient advocates, and ministries of health/policymakers. These challenges included limited and fragmented epidemiological data, insufficient health economic assessments, manufacturing constraints, complex regulatory frameworks, inefficient distribution systems, poor affordability in low-resource settings, and weak governance structures. These findings underscore the urgent need for a deeper understanding of stakeholder- and context-specific perspectives to address critical gaps and improve antibiotic access in the region.

Critical factors for sustainable perishable food supply chains: Insights from Malawi banana supply chain

Purpose Despite growing discussion on the potential harm of the metaverse, there remains limited understanding of the factors driving cyber-aggression on metaverse platforms. Addressing this gap, this study focuses on the influence of platform scene design and governance rules on user behavior. Design/methodology/approach We adopted a mixed-methods approach. First, we conducted 36 in-depth interviews with users from four metaverse platforms and applied grounded theory to analyze the qualitative data. The resulting conceptual framework was then empirically tested using PLS-SEM on survey data collected from 515 respondents. Findings The qualitative analysis revealed that platform designs with greater fidelity and autonomy can amplify users' propensity toward cyber-aggression, while insufficient governance mechanisms allow such behaviors to occur and persist. The quantitative results further support these findings by showing, among other relationships, the positive moderating effect of moral disengagement on the link between presence and cyber-aggression. Although experiences of harm are commonly reported, their immediate impact is limited. Originality/value This study advances the emerging literature on metaverse governance by characterizing cyber-aggression, exploring its associated factors, and assessing its potential harms. It proposes a speculative scenario-building framework, the wicked valley hypothesis, which theorizes how the convergence of immersive technological design and weak governance may shape user interactions. The findings provide forward-looking implications for the sustainable development of metaverse platforms, emphasizing the importance of aligning immersive technological trajectories with real-world regulatory structures.

Health system governance is essential for effective and equitable healthcare delivery. In Colombia, persistent challenges, including delays, denials, barriers to care, and poor system coordination, suggest weaknesses in local governance. This study aimed to explore local health system governance in Colombia by assessing institutional practices, decision-making processes, and perceptions of public health sector officials. Exploratory cross-sectional study using self-administered online surveys (May-July 2025) with a convenient non-probabilistic sample of 44 health sector officials in stewardship, planning, and oversight roles. Descriptive analyses were performed. While we identified high institutional planning capacity, respondents reported limited decision-making autonomy, external pressures on planning and budget allocation, poor integration of information systems, perceived insufficiency of the benefits package and capitation payment, irregular provider payments, and tariff variability. Findings suggest weak local health system governance in Colombia, highlighting the need to implement a comprehensive reform including strengthened stewardship, information systems integration, adequate financing, and fair provider payments.

The One Health (OH) approach, which gained international prominence in the early 2000s and was formally articulated through a unified definition in 2022, promotes coordinated action across human, animal and environmental health sectors. Despite increasing global recognition, its integration into national health systems remains inconsistent. This review synthesizes global evidence on challenges, opportunities and strategic directions for embedding OH within health system structures. A systematic review with narrative synthesis. This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Peer-reviewed studies published between 1 June 2013, and 1 April 2025 were identified through searches conducted in January-February 2025 in Scopus, PubMed, Web of Science and ProQuest Health and Medicine. Supplementary searches included Google Scholar and backward reference screening. Two reviewers independently screened studies and applied predefined eligibility criteria. Findings were synthesized narratively. Of 2606 records identified, 17 studies were included. The studies represented Africa, Europe, Asia, Australia and multi-country settings across varying income levels. Key challenges included weak governance arrangements, limited legal and policy support, inadequate financing, workforce capacity constraints and persistent sectoral fragmentation. Opportunities were linked to heightened awareness of zoonotic threats and antimicrobial resistance, growing institutional endorsement, academic engagement and emerging multisectoral coordination mechanisms. Sustainable integration of OH requires embedding it within governance, financing and service delivery systems rather than implementing it as parallel initiatives.

Urban malaria is an emerging public health challenge in Sub-Saharan Africa (SSA), where rapid urbanization, socioeconomic disparities, and environmental degradation create conditions conducive to malaria transmission. This systematic review examines the socioeconomic and environmental determinants shaping malaria risk in urban and peri-urban settings across SSA. Evidence from multiple studies indicates that poverty, overcrowded housing, inadequate sanitation, poor drainage systems, and unplanned urban growth significantly elevate malaria vulnerability among urban populations. While urbanization can reduce transmission through improved housing and infrastructure, informal settlements often lacking essential services, serve as persistent malaria hotspots. This review highlights the interconnected roles of social inequality, environmental mismanagement, and weak urban governance in sustaining malaria risk. Strengthening vector control, enhancing urban planning, and addressing socioeconomic inequities are essential to achieving sustainable malaria reduction in African cities. Keywords: Urban malaria, Sub-Saharan Africa, socioeconomic determinants, environmental factors.

ABSTRACT Rapid urban population growth and increasing waste generation pose serious challenges to human security, animal welfare, and sustainable development. In many Nigerian cities, weak waste governance has created space for informal waste actors, commonly known as scavengers. While scavenging emerges largely from failures in formal waste management, poverty, and unemployment, its implications for urban security remain insufficiently examined. This study investigates the roles of scavengers and how their activities shape security dynamics in Abeokuta, southwest Nigeria. Using a qualitative approach, data were collected through in-depth interviews, participant observation, and photographic documentation involving scavengers, residents, community leaders, and security personnel across selected communities. Anchored in human security and routine activity theories, the findings show that scavengers play an important role in waste recovery, informal livelihoods, and local recycling economies, particularly in contexts of weak state capacity. However, unregulated scavenging has also contributed to insecurity, public health risks, and strained community relations, driven by poverty, unemployment, weak policing, and unregulated scrap markets. The study recommends inclusive waste governance, formal recognition and protection of scavengers, strengthened community policing, and effective enforcement of regulatory frameworks to enhance urban safety, sustainability, and human security.

Quantifying land use land cover (LULC) dynamics in vulnerable ecosystems of the Ethiopian highlands is crucial for understanding the drivers of environmental degradation and informing sustainable land management to protect ecosystem integrity. The Jema River Sub-basin, a critical contributor to the Upper Blue Nile, is highly vulnerable to agricultural expansion, the loss of native vegetation, and landscape fragmentation. This study quantified the spatiotemporal dynamics of LULC change and identified potential drivers between 1994 and 2024, to support evidence-based climate-resilient land-use planning in this basin. A machine-learning framework was implemented on the Google Earth Engine (GEE) platform to classify LULC. We utilized Landsat 5 TM, Landsat 7 ETM+, Landsat 8 OLI, and Sentinel-2 MSI imageries, which were classified using the Random Forest (RF) algorithm. The classification was optimized by integrating spectral indices, including the Normalized Difference Vegetation Index (NDVI), Normalized Difference Built-up Index (NDBI), and Modified Normalized Difference Water Index (MNDWI), along with topographic variables (slope and elevation). Classification accuracy, assessed using 3100 ground-truth samples, exceeded 87% overall accuracy with Kappa coefficients above 83%. Temporal change detection, transition matrices, and trend analyses quantified alterations across seven LULC classes. The results show that farmland expanded by 37.4%, and built-up area by 23.5%, while natural vegetation and grazing land declined by 56% and 67.4%, respectively. Focus group discussions and key informant interviews identified population pressure, agricultural intensification, and weak governance as the dominant socio-economic drivers. The integration of multi-temporal geospatial analysis with local knowledge indicates substantial anthropogenic landscape modification and provides empirical evidence to inform sustainable land-use planning and ecosystem restoration initiatives in the Jema Sub-basin.

Community-based health insurance (CBHI) schemes are widely implemented in low- and middle-income countries to improve access to health care and protect households from catastrophic health expenditures. Despite their potential benefits, many CBHI schemes face serious financial sustainability challenges, including scheme insolvency. While quantitative studies have identified structural and financial factors associated with scheme failure, limited qualitative evidence exists to explain the underlying mechanisms driving insolvency in Ethiopia. This study explored stakeholders' perspectives on the financial sustainability of CBHI schemes in North Shewa Zone, Oromia Region. A descriptive qualitative study design was conducted from March to April 2025 in North Shewa Zone, Ethiopia. Twenty key informant interviews (KIIs) were conducted with stakeholders involved in the implementation and management of CBHI schemes. A Purposive sampling technique was used to select participants for KIIs. Data were coded, categorized, and analysed manually by using inductive thematic analysis and the result was presented in narrative forms to stakeholders' perspectives on the financial sustainability of CBHI schemes. Four major themes emerged from the analysis: (1) rising health service utilization and escalating health-care costs, (2) premium inadequacy and revenue constraints, (3) inefficiencies in claims management and weak medical audit systems, and (4) governance and accountability challenges. The study highlights multiple structural, financial, and governance-related factors contributing to CBHI scheme insolvency in the study area. Addressing these challenges requires revising premium structures, strengthening claims management systems, improving medical audit capacity, and enhancing governance and accountability mechanisms within CBHI programs.

ABSTRACT Artificial intelligence holds transformative potential for public services, yet its adoption in developing countries remains underexplored. This study examines AI adoption in Philippine public sector, addressing gaps in understanding challenges during later adoption stages in resource-constrained environments. Guided by the Technology-Organization-Environment (TOE) framework and Technology Affordances and Constraints Theory (TACT) and using a qualitative multiple case study based on semi-structured interviews with 10 key stakeholders from seven Philippine public sector AI projects, we analyze seven cases across the AI life cycle: design, development, and deployment. Findings reveal affordances and constraints influencing AI adoption in developing countries: strong leadership facilitates early design, but limited infrastructure, financial instability, talent attrition, and weak governance hinder development and deployment—challenges less prominent in developed contexts. This study contributes theoretically by integrating TOE and TACT with a life cycle perspective and empirically by uncovering AI adoption in developing countries, while offering actionable recommendations for practitioners.