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The approach to integrate concepts from different disciplines so as to solve the problems facing smallholder farmers has gained momentum in recent years. However, very little is known about how word-of-mouth (WOM) dimensions can be used in agricultural marketing to explain market participation among smallholder farmers. Therefore, this study investigates the perceived usefulness of WOM in explaining smallholder farmers’ market participation.

The cross-sectional design was carried out to survey a sample of 467 smallholder farmers. This study used partial least squares structural equation modelling (PLS-SEM) in SmartPLS 4 to test hypotheses.

The results revealed that WOM dimensions such as expertise differential, strong tie and trustworthiness among smallholder farmers significantly influence the WOM message delivery. Likewise, the findings suggest that WOM message delivery significantly influences market participation among smallholder farmers. Finally, it was revealed that WOM message delivery significantly mediates the relationship between WOM dimensions and market participation.

This study provides useful insights to smallholder farmers on how to use WOM dimensions to enhance more market participation in formal markets, especially through proper WOM message delivery.

The current study solves the problem of information asymmetry among smallholder farmers through WOM. It is perhaps the first study to establish the link between WOM dimensions and market participation among smallholder farmers in the context of developing countries.

Healthcare organisations are often described as less innovative than other organisations, since organisational culture works against innovations. In this paper, the authors ask whether it has to be that way or whether is possible to nurture an innovative culture in a healthcare organisation. The aim of this paper is to describe and analyse nurturing an innovative culture within a healthcare organisation and how culture can support innovations in such a healthcare organisation.

Based on a qualitative case study of a healthcare unit that changed, within a few years, from having no innovations to repeatedly generating innovations, the authors describe important aspects of how innovative culture can be nurtured in healthcare. Data were analysed using inductive and deductive analysis steps.

The study shows that it is possible to nurture an innovative culture in a healthcare organisation. Relationships and competences beyond healthcare, empowering structures and signalling the importance of innovation work with resources all proved to be important. All are aspects that a manager can influence. In this case, the manager's role in nurturing innovative culture was very important.

This study highlights that an innovative culture can be nurtured in healthcare organisations and that managers can play a key role in such a process.

The paper describes and analyses an innovative culture in a healthcare unit and identifies important conditions and strategies for nurturing innovative culture in healthcare organisations.

The purpose of this paper is to contribute knowledge on ethical issues and reasoning in expert reports concerning healthcare governance, commissioned by the Swedish healthcare system.

An in-depth analysis of ethical issues and reasoning in 36 commissioned expert reports was performed. Twenty-seven interviews with commissioners and producers of the reports were also carried out and analysed.

Some ethical issues were identified in the reports. But ethical reasoning was rarely evident. The meaning of ethical concepts could be devalued and changed over time and thereby deviate from statutory ethical goals and values. Several ethical issues of great concern for the Swedish public healthcare were also absent.

The commissioner of expert reports needs to ensure that comprehensive ethical considerations and ethical analysis are integrated in the expert reports.

Based on an extensive data material this paper reveals an ethical void in expert reports on healthcare governance. By avoiding ethical issues there is a risk that the expert reports could bring about reforms and control models that have ethically undesirable consequences for people and society.

This paper presents findings from a qualitative study of healthcare professionals’ practice, where learning is taking place when a digital artefact is implemented for identification of patients’ cognitive impairment. The use of digital artefacts is increasing in various workplaces, to include professionals in healthcare. This paper aims to explore the following research question: How is the professional learning unfolding in patient-based work when a digital artefact transforms the practice?

Various data collection methods are used for this study, consisting of dialogue meetings, interviews and a reference-group meeting. Thematic analysis is used to inductively bring forth the themes of the collected data.

Professionals’ knowledge and experience are of vital importance in learning and changing work practices. Together with their ability to reflect on changes, their knowledge and experience constitute the prefiguration when the introduction of a digital application brings about indeterminacy in the work practice.

This paper makes a contribution to practice-based research as it consolidates previous research and identifies professionals knowledge and learning in a healthcare context. This can be used to further explore and advance the field, as well as to establish the evidence-based importance of transforming practices based on implementation of digital artefacts.

This study aims at evaluating the technical efficiency (TE) of healthcare systems in the Arab region and exploring the key factors that affect the efficiency performance.

The study applies a two-stage Data Envelopment Analysis (DEA) approach to a sample of 20 Arab countries. In the first stage, a DEA model is used to calculate the TE scores of the examined healthcare systems in 2019 and 2010, following both the output and input orientations of efficiency. In the second stage, a censored Tobit model is estimated to investigate the determinants of healthcare efficiency.

DEA results of 2019 indicate that achievable efficiency gains of the Arab countries range from 0.4% to 16% under the output and input orientations, respectively. Six countries are efficient under both orientations. Although the average efficiency scores of the Arab countries have deteriorated between 2010 and 2019, Djibouti and Sudan had the greatest efficiency improvements between the two years. Bahrain, Mauritania, Morocco and Qatar proved to be efficient in 2010 and 2019 under the two orientations of efficiency and according to the two DEA specifications followed. The Tobit model reveals that corruption and government health expenditure tend to have an adverse impact on healthcare efficiency.

The author evaluates healthcare efficiency and healthcare's efficiency determinants in the Arab countries. Regardless Arab countries' diversity, these countries are facing common health challenges, including diminishing role of governments in healthcare financing; increased out-of-pocket healthcare spending; poor healthcare outputs and prevalence of health inequities resulting from weak governance institutions. Comparing the efficiency of healthcare systems between 2010 and 2019 gives insights on the potential impact of the Arab spring uprisings on healthcare efficiency. Moreover, examining the determinants of healthcare efficiency allows for better understanding of how to improve the efficiency of healthcare systems in the region.

This study aims to identify empirically proven strategies for reducing healthcare supply chain inventory costs.

The author conducted in-depth interviews in 80 hospitals covering different supply chains. The author treated the healthcare firm as the unit of analysis and examined Vrat's taxonomy of inventory models based on the static and dynamic complexity theories of inventory models to identify an appropriate approach. The author addressed 33 highly priced and moderately priced stock-keeping units from 1,432 items and test several inventory policies. Next, the author applied combinations of inventory models, testing probabilistic hybrid inventory models.

The study finds that medical supplies, equipment, and medications are indispensable for a quality healthcare system. Hence, healthcare supply chain management (SCM) professionals must adopt basic inventory cost-reduction strategies, implementing inventory software functionalities effectively and efficiently. This study shows that probabilistic hybrid inventory techniques in healthcare SCM effectively determine an optimal stocking level, significantly reducing costs.

This study analyzes data from primary care and (to some extent) secondary care institutions. Although tertiary and quaternary care systems do not represent a large portion of the healthcare system, future research should also address these highly specialized organizations' needs.

This study proposes practical strategies to help continuously improve supply chain operations in healthcare organizations worldwide.

This study suggests probabilistic hybrid inventory models as empirically proven solutions for evaluating stock-keeping units in the healthcare sector. In doing so, the study provides a new healthcare supply chain approach, proposing a modified taxonomy of inventory models.

Unequal social conditions that provide people with unequal opportunities to live healthy lives are considered unjust and associated with “health inequity”. Governing power is impacting people's lives through laws, policies and professional decisions, and can be used intentionally to combat health inequity by addressing and changing people's living- and working conditions. Little attention is paid to how these ways of exercising governing power unintentionally can structure further conditions for health inequity. In this paper, the authors coin the term “governance determinants of health” (GDHs). The authors' discussion of GDHs potential impact on health inequity can help avoid the implementation of governing strategies with an adverse impact on health equality. This paper aims to discuss the aforementioned objective.

The authors identify Governance Determinants of Health, the GDHs. GDHs refer to governance strategies that structurally impact healthcare systems and health equality. The authors focus on the unintended, blind sides of GDHs that maintain or reinforce the effects of socioeconomic inequality on health.

The power to organize healthcare is manifested in distinct structural approaches such as juridification, politicalization, bureaucratization and medical standardization. The authors explore the links between different forms of governance and health inequalities.

The authors' discussion in this article is innovative as it seeks to develop a framework that targets power dynamics inherent in GHDs to help identify and avoid GDHs that may promote unequal access to healthcare and prompt health inequity. However, this framework has limitations as the real-world, blurred and intertwined aspects of governing instruments are simplified for analytical purposes. As such, it risks overestimating the boundaries between the separate instruments and reducing the complexity of how the GDHs work in practice. Consequently, this kind of theory-driven framework does not do justice to the myriad of peoples' complex empirical practices where GDHs may overlap and intertwine with each other. Nevertheless, this framework can still help assist governing authorities in imagining a direction for the impacts of GDHs on health equity, so they can take precautionary steps to avoid adverse impacts.

The authors develop and explore – and demonstrate – the relevance of a framework that can assist governing authorities in anticipating the impacts of GDHs on health inequity.

The new Italian National Recovery and Resilience Plan (NRRP) has prioritised a new healthcare model that will establish the additional community healthcare facilities (CHFs). The paper proposes a methodology for supporting decision-making on location of the future facilities according to new parameters that consider how proximity to healthcare benefits communities. Rethinking the spatial parameters for locating future CHFs, focusing on fragile areas, creates a novel decision support system.

The methodology is based on multifactor analysis and on geographic information system (GIS) mapping to simulate the potential and risks associated with the proposed location of CHFs, focusing on territorial contexts of metropolitan cities, medium-sized cities, and Inner Areas, characterized by different fragilities. This method aims to innovate urban planning practices by updating the practice of per-capita urban planning standards and promoting implementation of the 15-minute city model.

The method defines new spatial parameters useful to inform the appropriate location of CHFs in Italy's Inner Areas. This offers a new integrated approach to spatial design mixing urban planning and healthcare dimensions.

The methodology will bring about an integrated urban planning approach, which guides both transformative urban choices and health services' implementation according to the needs of communities.

This study investigates the effect of user fees on access and waiting time in Nigeria. For access, the effect of user fees on both preventive and curative care; and the effect of user fees on waiting time at public healthcare facilities were examined. User fees are vital for the fiscal sustainability of healthcare provision for most African economies. Its imposition could debar healthcare access by the poor while its removal can reduce quality of care and induce longer waiting time.

The wave 3 of the Nigerian General Household Survey (2015/16) data was used for users of public health facilities. Access to healthcare was modelled using utilization data in a logistic regression model while waiting time was through the Negative Binomial Regression Model (NBRM).

The analyses showed significant effects of user fees on access to both preventive and curative care and on time spent waiting to make use of healthcare services. Individuals were able to access healthcare services regardless of amounts paid. Also, there was a non-negative effect of user fee imposition on waiting time.

Nigeria should improve healthcare facilities to address the enormous demand for healthcare services when designing policy for health sector.

This paper shows that even with the imposition of user fees, healthcare facilities could still not cater for the rising healthcare needs of the populace but cautioned that its abolition may not be a preferred option.

As healthcare continues to become more expensive and complex, considering the voice of the patient in the design and operation of healthcare practices is important. Wound care and rural healthcare scenarios pose additional complexities for providers and patients. This study sought to identify key determinants of patient service quality in wound care.

Patients at the wound care/ostomy clinic (WOC) in a rural hospital were surveyed using the Kano model. The Kano model enables the categorization of quality attributes based on the attributes' contribution to the subject's overall satisfaction (and dissatisfaction). Chi-square goodness-of-fit testing, multinomial analysis and power analysis were then used to determine the Kano categories for each satisfaction-related attribute.

The analyses resulted in 14 one-dimensional attributes and 3 indeterminable attributes. For the one-dimensional attributes, customer satisfaction is directly proportional to the level of performance for that attribute. The one-dimensional attributes included providing correct care on the first, provision of necessary supplies for care, appropriately qualified medical staff and confidence in care provided by medical staff, among others. Understanding the attributes important to the patient drive patient-centered care, which improves positive patient outcomes and recovery. These attributes can then be used by healthcare professionals to design patient-centric processes and services. This research provides a framework for incorporating the voice of the patient into healthcare services.

While the research methodology can be used in other healthcare settings, the findings are not generalizable to other wound care clinics. This research was conducted in one small, rural hospital. In addition, the sample size was small due to the size of the wound clinic; therefore, an analysis of the differences between demographics could not be performed.

Considering the perspectives of rural wound care patients is important, as the patients are an under-served population with unique challenges related to patient care. The research findings detail rural patients' expectations during wound care treatments, which enable the clinic to focus on improving patient satisfaction. This research contributes to understanding the factors that are important to patient satisfaction in wound care. Further, the methodology presented can be applied to other healthcare settings.

While studies exist using the Kano model in healthcare and the literature is sparse in rural healthcare, this is the first case study using the Kano model in wound care to understand patient preferences.