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The World Health Organization has pointed out that the majority of developing countries currently rely on imported drugs, in spite of the fact that there is potential for them to produce their own drugs. The purpose of this paper is to present a framework as an innovation policy model that can strategically predict the outcome of drug development investment in developing countries.

In order to explore a model relevant to the policy-making process, the literature was systematically reviewed with a focus on the impact of policy changes on drug development in developing countries.

An innovation policy model consists of the relational influences of contextual variables of pharma capabilities, innovation incentives and political factors affecting drug development in developing countries, derived from a dissenting policy-making perspective. This was built to test two hypotheses of a positive relationship between the above variables; and a perspectives gap between the pharmaceutical companies and the policymakers. These hypotheses address issues related to the lack of drug development in developing countries.

This paper presents a conceptual framework for the evaluation and provides examples of its use, but it is currently at a relatively early stage of research. Further work is currently underway and will later be presented to the same journal.

Domestic drug development in developing countries needs to be feasible in order to ensure drug security. This predictive policy model provides a comprehensive approach to health policy reforms to examine innovation strategies.

This model includes measures to explore whether pharma capabilities, innovation incentives and/or political factors have an effect on domestic drug development in developing countries. It bridges the policy implementation’s operational process between pharmaceutical companies and policymakers.

This study was aimed to evaluate the implementation of an integrated antenatal care (ANC) scheme through a retrospective document study using a checklist for measuring the adequacy of the cohort ANC register documented by midwives in an urban area and to describe the barriers for the midwives during the ANC record process.

An exploratory descriptive study using a sequential mixed method was utilised where a quantitative method was employed by collecting secondary data of 150 entries of the cohort ANC register and followed by in-depth interviews among midwives and community health workers.

The results show that the cohort registry indicators for integrated care such as laboratory and management were poorly recorded. Several barriers were found and categorised during the implementation of the integrated ANC, namely (1) governance and strategy, (2) process of care, (3) organisation and management support.

The contribution of this present research is that it provides empirical data of the integrated ANC implementation in primary health care (PHC) which has the responsibility to deliver an integrated level of care for ANC using a cohort registry for pregnancy registration monitoring which facilitates the continuity and quality of care.

Practical implication of the finding is that functional integration such as the clinical information system to facilitate an efficient and effective approach during the implementation of integrated ANC in primary care should be considered to support the clinical, professional, organisational, system and normative integration.

Since only limited studies have been conducted to assess the quality of the cohort ANC registry and to investigate the barriers against integrated ANC implementation in Indonesia, the research findings are valuable information for the national and local governments to improve the ANC service in Indonesia.

The prevalence of stunting in children under five years old is high (37.9 percent). The health advantage of breast milk as a prevention is recognized. The purpose of this paper is to examine the relationship of early initiation to breastfeeding, wherein a child is breastfed within an hour of birth, as a means of preventing stunted growth in 6–59 month old children in Jambi province, Indonesia.

This paper used data from the 2015 National Nutrition Survey in Jambi province. A total of 2,502 children aged 6–59 months were analyzed by binary logistic regression.

The results showed that as many as 27.5 percent (95% CI: 25.2–29.9) children aged 6–59 months were stunted and 54.1 percent (95% CI: 51.1–57.1) had not been introduced to breastfeeding soon after birth. The analysis showed that delayed initiation to breastfeeding is a significant factor in stunting amongst 6–59 month old children. (p=0.024; AOR=1.3; 95% CI: 1.0–1.6). Other results of the analysis showed a significant association between water source and birth weight issues as causes for stunting.

Research revealed that delayed initiation into breastfeeding results in a 1.3 times higher risk of stunting. Furthermore, early initiation to breastfeeding reduces the risk of consuming polluted river water that is a health risk and cause of stunting.

The purpose of this paper is to develop a common theme between the six research articles submitted for IJHG 24.3.

All articles are read and themes extracted which are used to write a review summarising the key points in each while developing an overarching theme for the issue of IJHG. Other literature supporting the development of this theme is also reviewed and used to contribute insights.

The findings consist of the common themes developed. In this issue, the common theme was improving care while saving costs in healthcare and the theme was explored in each article in relation to a lean healthcare management/governance philosophy.

The review section of IJHG allows readers to gain a quick overview of the content and then select the articles they wish to read in full.

IJHG is the only journal in the Emerald portfolio with a review section of this kind. Thus it provides added value.

Hospital structures serve to protect and improve public health; however, they are recognized as a major source of environmental degradation. Thus, an effective performance evaluation framework is required to improve hospital sustainability. In this context, this study presents a holistic methodology that integrates the sustainability balanced scorecard (SBSC) with fuzzy Delphi method and fuzzy multi-criteria decision-making approaches for evaluating the sustainability performance of hospitals.

Initially, a comprehensive list of relevant sustainability evaluation criteria was considered based on six SBSC-based dimensions, in line with triple-bottom-line sustainability dimensions, and derived from the literature review and experts’ opinions. Then, the weights of perspectives and their respective criteria are computed and ranked utilizing the fuzzy analytic hierarchy process. Subsequently, the hospitals’ sustainable performance values are ranked based on these criteria using the Fuzzy Technique for Order of Preference by Similarity to Ideal Solution.

A numerical application was conducted in six public hospitals to exhibit the proposed model’s applicability. The results of this study revealed that “Patient satisfaction,” “Efficiency,” “Effectiveness,” “Access to care” and “Waste production,” respectively, are the five most important criteria of sustainable performance.

The new model will provide decision-makers with management tools that may help them identify the relevant factors for upgrading the level of sustainability in their hospitals and thus improve public health and community well-being.

This is the first study that proposes a new hybrid decision-making methodology for evaluating and comparing hospitals’ sustainability performance under a fuzzy environment.

The pharmaceutical industry in Indonesia appears hesitant to make the transition from inventor to innovator and instead continues with the process of formulation and packaging. Evidence-based policy has been advocated for Indonesia and, in general, this is more likely to hold. This study aims to establish a model for a policy-making process that is strategically able to predict strategies that would encourage drug development in Indonesia.

A quantitative approach with the survey method was designed to obtain appropriate data from a population of pharmaceutical industries in Indonesia and relevant government institutions to assess the relationship of various factors capable of triggering domestic drug development, including pharma capability, political feasibility and innovation incentives. The construct was validated using a set of techniques pertaining to the calculation of structural equation modeling.

The model demonstrates how it matters when applied to the policy-making process. It proves that pharma capability, political feasibility, and innovation incentives correlated to pharma capability are major catalysts in the promotion of drug development. These are largely explained by market opportunity, pull factors, government power, and position. Although all of the elements were moderately to strongly related to the promotion of drug development, this study has revealed the predictive impact on drug development in Indonesia to be only 46%.

This study adds values to policy-makers as it attempts to predict strategies that would encourage a successful policy when being implemented. Encompassing both pharma industries and government institutions, this study captures a real situation and provides an empirical contribution to the concept of the integrated research of drug development in developing countries.