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This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and cut off from health-care services.

This research combines an integrated literature review and an instrumental case study. The literature review comprises two targeted reviews to provide insights: one on conflict zones and one on mobile clinics. The case study describes the process and challenges faced throughout a mobile clinic deployment during and after the Iraq War. The data was gathered using mixed methods over a two-year period (2017–2018).

Armed conflicts directly impact the populations’ health and access to health care. Mobile clinic deployments are often used and recommended to provide health-care access to vulnerable populations cut off from health-care services. However, there is a dearth of peer-reviewed literature documenting decision support tools for mobile clinic deployments.

This study highlights the gaps in the literature and provides direction for future research to support the development of valuable insights and decision support tools for practitioners.

In the UK signposting services can be developed as enhanced support for people with health and social care needs or service diversion to help primary and urgent care services manage their workload. This review considers these two conflicting purposes.

The review used a realist approach, initial searches to identify theory; we then selected 22 publications and extracted programme theories, from which we developed questions from three viewpoints: the service user, the front-line service provider and the commissioner. A rich sample of studies were found from purposive searching. To optimise the applicability of synthesis findings predominantly UK studies were included.

Users value signposting service that understand their needs, suggest a range of options and summarise potential actions. People with complex health and social care needs generally require extended time/input from signposting services. Front-line providers require initial and ongoing training, support/supervision, good knowledge of available services/resources and the ability to match users to them and a flexible response. Commissioned signposting services in England are diverse making evaluation difficult.

Meaningful evaluation of signposting services requires greater clarity around roles and service expectations. Signposting services alone fulfil the needs of a small number of users due to the unreconciled tension between efficient (transactional) service provision and effective (relational) service provision. This is underpinned by competing narratives of whether signposting represents diversion of inappropriate demand from primary care and other urgent care services or improved quality of care through a joined-up response encompassing health, social care and community/voluntary services.

The aim of this paper is to describe and detail a new workforce initiative developed by a third sector organisation: the Multi-Modality Practitioner (MMP) approach, in the provision of support for individuals and families presenting in the community with multiple and varied needs.

This paper presents a case study on a third sector organisation’s pioneering workforce initiative – the MMP approach.

The MMP approach has been developed as an alternative to existing approaches designed to address “single issues”, providing those working in the fields of health and social care and beyond, with a range of technically eclectic interventions from different modalities and approaches, to enable them to appropriately meet the needs of individuals and families presenting with multiple needs.

This case study is limited to providing a rationale for the development of the MMP approach and a description. It does not include any formal analysis as a future evaluative paper will report on an independent theory-based examination of the MMP approach via Theory of Change and Contribution Analysis methodologies.

This case study describes the innovative role that the MMP approach as a workforce innovation plays in meeting multiple needs in the community when deployed as either a stand-alone approach, or one that can be integrated with existing community-based services including, but not limited to, mental health, employability, addiction, housing, homelessness, public health and child and family services.

The MMP approach constitutes a disruptive, pionneering, client-centred, workplace innovation that is trauma-informed, relational, strengths-based and continuity of care focused, capable of supporting individuals and families with multiple needs, negating onward referral and with potential to reduce demand on public services. It also provides those working in a range of health and social care roles with the opportunity to expand their therapeutic repertoire through high-quality, multi-skilled training in evidence-based and societally important, technically eclectic interventions drawn from a range of modalities.

Pluralistic practice and multimodal theories have been in existence for over two decades, the MMP approach however, whilst sharing some of these concepts and philosophies, differs in that it provides those trained in the approach with a ‘toolkit’ of interventions that are technically eclectic, drawn from a range of modalities and approaches and aimed at meeting multiple needs in a pragmatic and accessible manner. Furthermore, the Diploma in Multi-Modality Practice is the first training course of its kind available at postgraduate level.

People with complex health conditions must often navigate landscapes of uncoordinated public, private and voluntary health-care providers to obtain the care they need. Complex health conditions frequently transcend the scope of typical health-care service systems. The purpose of this paper is to explore and characterize such unique assemblages of actors and services as “user-defined ecosystems”.

Building on literature on customer ecosystems, this paper introduces the concept of the user-defined ecosystem (UDE). Using an abductive approach, the authors apply the concept in an interpretive, qualitative study of ten families with special needs children.

This study uncovers complex UDEs, where families actively combine a broad range of services. These ecosystems are unique for each family and extend beyond the scope of designed service ecosystems. Thus, the families are forced to assume an active, coordinating role.

This paper shows how to identify ecosystems from the user’s point of view, based on the selected user unit (such as a family) and the focal value-creating function of the ecosystem for the user.

This paper highlights how service providers can support and adapt to UDEs and, thus, contribute to user value and well-being. This can be used to understand users’ perspectives on service and systems in health and social care.

This study develops the concept of the UDE, which represents a customer-focused perspective on actor ecosystems and contrasts it with a provider-focused and a distributed perspective on ecosystems. This study demonstrates the practical usefulness of the conceptualization and provides a foundation for further research on the user’s perspective on ecosystems.

Indonesia subscribes to rights-based principles of family planning. However, a chasm between principles and practice has long been noted on a global basis, and progress has not been well-documented. This paper aims to assess the extent to which the Indonesian national family planning program has evolved in a manner that is consistent with rights-based principles.

The primary source of data was five Indonesian Demographic Health Surveys undertaken from 1997 to 2017. The analyses were organized around three major categories of family planning-related human rights. Trend analysis and logistic regression were used in analyzing the data.

Indonesian women have considerable autonomy in family planning decision, reporting that family planning decisions were mainly made by themselves or jointly with their spouse. Although contraceptive method awareness and demand for family planning are high, Indonesia fares poorly with regard to informed choice in contraceptive method selection. Access to family planning services is comparatively high as judged by contraceptive prevalence, family planning demand satisfaction and unmet need for family planning. However, significant geographic and socioeconomic inequity were observed on many indicators, with eastern Indonesian provinces consistently lagging behind.

This paper focuses on married couple, as Indonesia has a restrictive policy to limiting access and information of family planning for other groups, unmarried youth in particular.

This paper makes an important contribution to document how effectively the prohuman rights policy orientation toward family planning has been translated into services.

The COVID-19 pandemic has forced countries to consider how to reach vulnerable communities with extended outreach services to improve vaccination uptake. The authors created an optimization model to align with decision-makers' objective to maximize immunization coverage within constrained budgets and deploy resources considering empirical data and endogenous demand.

A mixed integer program (MIP) determines the location of outreach sites and the resource deployment across health centers and outreach sites. The authors validated the model and evaluated the approach in consultation with UNICEF using a case study from The Gambia.

Results in The Gambia showed that by opening new outreach sites and optimizing resource allocation and scheduling, the Ministry of Health could increase immunization coverage from 91.0 to 97.1% under the same budget. Case study solutions informed managerial insights to drive gains in vaccine coverage even without the application of sophisticated tools.

The research extended resource constrained LMIC vaccine distribution modeling literature in two ways: first, endogenous calculation of demand as a function of distance to health facility location enabled the effective design of the vaccine network around convenience to the community and second, the model's resource bundle concept more accurately and flexibly represented complex requirements and costs for specific resources, which facilitated buy-in from stakeholders responsible for managing health budgets. The paper also demonstrated how to leverage empirical research and spatial analysis of publicly available demographic and geographic data to effectively represent important contextual factors.

COVID-19 has caused unprecedented disruption to health systems. There is much to be gained by capturing what was learned from changes and adaptations made by health services and systems. The Ministry of Health in New South Wales (NSW), Australia, sought to prioritise health services research (HSR) to address critical issues arising from the COVID-19 pandemic. We tested a priority setting methodology to create priorities for a specific funding opportunity and to extract generalisable lessons.

A virtual roundtable meeting of key stakeholders was held in June 2020. We used a modified Nominal Group Technique (NGT) for priority setting, with potential items (n = 35) grouped under headings. Data was analysed through a reflective deliberative process.

We engaged 89 senior policy makers, health service executives, clinicians and researchers in the roundtable. The NGT proved an efficient method with participants reaching consensus on eight priorities. Findings included strong support for learning from the rapid response to COVID-19 and addressing needs of vulnerable populations and the health workforce. Opinions differed about strategic areas investment and where learnings should be via internal evaluation rather than funded research. Three of the eight recommended priorities were included in the funding opportunity.

Coronavirus disease 2019 (COVID-19) required unprecedented change and adaptations within health systems, and rapid, applied health services research can help to create, understand and (where relevant) sustain change beyond the immediate impact of the pandemic. While final decisions may be dependent on a wider range of considerations by government, stakeholder enthusiasm for engagement in priority setting exercises may be dampened if they do not perceive their application in decision-making.

A modified nominal group technique can be used to set research priorities in constrained conditions by engaging large numbers of stakeholders in rankings and then using an online delivery of a roundtable and to reach consensus on priorities in real time. Recommended priorities for health services research can be readily generated through rapid engagement but does not guarantee their application.

Australia’s swift response to COVID-19 pandemic in 2020 was perceived as a relative success due to the rapid public health and policy response and a relatively low number of cases. This response was underpinned by systematic knowledge mobilisation including support for targeted and prioritised health services research to fill knowledge gaps.

Setting priority processes can provide rich, engaged input to support government funding decisions about HSR. A wide range of dynamic and iterative processes influence decision-making in a rapidly evolving situation in the health system response to COVID-19. It is crucial to consider how major investment decisions will support a value-based healthcare system.

To promote access to their services, health-care companies provide various communication channels to their customers (beneficiaries) to enable the receipt of requests, such as authorization for examinations, procedures and hospitalizations. Under the approach of innovation studies, the management of customer relationship channels for health-care companies is characterized as a knowledge-intensive business service (KIBS). The purpose of this study is presenting innovation as a strategy to increase customer service productivity, as well as the monitoring of the quality of the service, the generation of health information for beneficiaries and compliance with the regulation set by the Brazilian National Health Agency (ANS).

The study is characterized as an applied research, as it proposes solutions to problems faced by supplemental health-care companies using the strategy of action research, i.e. an independent, social research with an empirical basis.

The result of this study shows that a computerized health-care system can increase productivity by 21.96%, and it presents an innovative solution for health-care companies to guarantee the process of meeting the demands and requests of their beneficiaries, ensuring the compliance with ANS regulations.

These results can be replicated to other healthcare companies and contribute to those seeking innovation, increased productivity and quality improvements in their services.

This work was also motivated by the lack of lstudies in the areas of health-care companies in Brazil.

The purpose of this paper is to review the barriers in the dissemination of effective smoking cessation treatments and services globally. Offering tobacco users help to stop using tobacco is a key demand reduction measure outlined under Article 14 of the World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC). Implementing Article 14 can reap great dividends for the billion plus tobacco users around the world and their families, friends and societies.

A review of the status of the global implementation of Article 14 using available literature on smoking cessation products, services and national guidelines. Discussing innovative approaches being currently explored in South Asia that can lead to faster adoption and implementation of Article 14 globally.

Major gaps remain in cessation products’ availability and resource allocation for cessation services globally. Current licensed products are falling short on delivering and sustaining smoking cessation. Innovation in cessation products and services needs to build on learnings in nicotine pharmacokinetics, behavioural insights from consumer research and tap into 21st century tools such as mobile based apps. National implementation of FCTC’s Article 14 needs to follow guidelines that encourage integration into existing health programmes and health-care practitioners’ (HCPs) upskilling.

Smoking cessation is a desirable health outcome and nicotine replacement products are a means of achieving cessation through tobacco harm reduction. E-cigarettes are sophisticated nicotine replacement products. Innovation is urgently needed to fill the gaps in smoking cessation products and services, and for converting global policy into local practice. In low- and middle-income countries (LMICs), HCPs’ knowledge, attitudes and practice regarding tobacco use and cessation may hold the key to rapidly scaling up cessation support and delivery to achieve FCTC objectives sooner. Additionally, HCPs can play an important role in offering smoking cessation support in existing national health programmes for TB, cancer screening and maternal and child health. Also, widely prevalent smartphone devices may deliver smoking cessation through telemedicine in LMICs sooner, leapfrogging the hurdles of the existing health-care infrastructure.

The COVID-19 pandemic has disrupted the ‘real’ world and substantially impacted the virtual world and thus the Internet ecosystem. It has caused a significant exogenous shock that offers a wealth of natural experiments and produced new data about broadband, clouds, and the Internet in times of crisis. In this chapter, we characterise and evaluate the evolving impact of the global COVID-19 crisis on traffic patterns and loads and the impact of those on Internet performance from multiple perspectives. While we place a particular focus on deriving insights into how we can better respond to crises and better plan for the post-COVID-19 ‘new normal’, we analyse the impact on and the responses by different actors of the Internet ecosystem across different jurisdictions. With a focus on the USA and Europe, we examine the responses of both public and private actors, with the latter including content and cloud providers, content delivery networks, and Internet service providers (ISPs). This chapter makes two contributions: first, we derive lessons learned for a future post-COVID-19 world to inform non-networking spheres and policy-making; second, the insights gained assist the networking community in better planning for the future.