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The study compares how distinct mechanisms that connect pre-established policy objectives to professionals' practices, and the health policy implementation context influenced different approaches to frontline staff participation. The authors analysed 26 teams in six cities from two Brazilian states, during the last cycle of the National Program for Improving Access and Quality of Primary Care (PMAQ).

About 172 in-depth interviews were conducted with frontliners – community health workers (78), nurses (37), doctors (30) – and managers (27). Interview guides were based on key issues identified in the implementation and pay-for-performance (P4P) literature. Drawing on thematic analysis and synthesis of the literature, three types of participation mechanisms were identified: relational, motivational and incremental learning. They were analysed considering distinct contexts at the local level to understand how they influenced different forms of participation: mere adherence, result-oriented and transformative.

Administrations with stronger institutional organizational structures were able to control work processes and reduce professional discretion. However, sustained participation was more likely where there was greater integration between management and frontline health care teams. Motivation based only on financial incentives could not bring about transformative participation. This depended on the degree of professional's ideational motivation towards primary care. Finally, contexts with unfavourable working conditions tend to demotivate professionals, but incremental learning helps teams cope with these obstacles.

The study overcomes gaps in the literature in relation to PMAQ's implementation process. Overall, the study delves into which/how mechanisms alter frontliners participation in performance-oriented health programs.

The recent increase in the number of infections and mortality rates in many regions has emphasized the cyclical nature of this pandemic, with new variants emerging constantly. Understanding what has been done by efficient administrations to contain the outbreak is essential while new immunization developments for the new variants are not available.

This work adapts the traditional Banker, Charnes and Cooper (BCC) Variable Returns to Scale model for including panel data on the Brazilian Federal Government spending over the first pandemic months in Pernambuco to identify efficient municipalities and conduct a benchmark on the best practices, reactions and implications that can serve as a guide for the post-Covid recurrence era.

The results provide an interesting panorama of municipal response to the pandemic and some quantitative and qualitative prospects on potentials for improvements from the perspective of efficient and inefficient cities. Only one administration (São Bento do Una) was identified as efficient for the entire period. The authors’ benchmark and discussion are focused on this municipality.

The authors believe this work has two innovative components. The first is a robust and systematic methodology integrating the advances in testing convexity and returns to scale in the construction of a production frontier based on panel data. The second is a discussion on what drives efficiency (benchmarking of best practices) in addition to how to quantitatively attain such efficiency prospects. To the best of the authors’ knowledge, both methodological and empirical implications are original to the present manuscript.

Climate hazards in the form of cyclones are projected to become more intense under the pressures of future climate change. These changes represent a growing hazard to low lying coastal cities like Beira, Mozambique. In 2019, Beira experienced the devastating impact of Cyclone Idai. One of the many impacts resulting from this Cyclone was disrupted drinking water access. This investigation explores the distribution of Cyclone Idai’s impact on drinking water access via an environmental justice lens, exploring how preexisting water access characteristics may have predisposed households to the impacts of Cyclone Idai in Beria.

Relying on household survey data collected in Beira, the investigation applied a decision tree algorithm to investigate how drinking water disruption was distributed across the household survey sample using these preexisting vulnerabilities.

The investigation found that households that mainly relied upon piped water sources and experienced inconsistent access to water in the year prior to Cyclone Idai were more likely to experience disrupted drinking water access immediately after Cyclone Idai. The results indicate that residents in formal areas of Beira, largely reliant upon piped water supply, experienced higher rates of disrupted drinking water access following Cyclone Idai.

These findings question a commonly held assumption that informal areas are more vulnerable to climate hazards, like cyclones, than formal areas of a city. The findings support the inclusion of informal settlements in the design of climate change adaptation strategies.

This study aimed to identify the potential for economic activities related to the ocean economy in Brazil to become blue economy (BE) activities, in which the concept of the Sustainable Development Goals (SDGs) is central.

To achieve the aim, the authors collected information on the SDGs and estimated data from the ocean economy sectors for the 256 Brazilian coastal cities. The authors predicted the indices for potential development of territories and sectors in the BE using two parameters: employed persons (EP) and sectoral added value (AV).

The results show that the capitals of coastal states present the highest potential indices for the BE, especially Rio de Janeiro, which accounted for 83.3% of sectoral added value in the Brazilian ocean economy with potential for sustainable development and generated 107,800 active formal jobs (26.9% of the country's total). In addition, restaurants, hotels and similar establishments are, on the Brazilian coast, the most frequent on the coastal zone and have the highest potential for BE activities.

Regarding its contributions, this research innovates by developing an indicator that can help stakeholders understand the similarities and differences between cities and regions, whether through a social, economic, or environmental lens. Therefore, by following this methodological path for measuring the BE, viewing the distinct patterns of sustainable development by area is possible, thereby supporting action plans for the fulfillment of the 2030 Agenda and the implementation of a marine spatial planning process for the country in the context of the Ocean Decade (2021–2030).

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-02-2023-0112