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Sexual and reproductive health (SRH) interventions demand diverse services, encompassing medical, social and psychological care to ensure the overall wellbeing of service users. In the absence of multidisciplinary response to SRH interventions, service users could be deprived of crucial SRH services, which could undermine their safety and wellbeing. Based on this knowledge, our study was designed to map the interprofessional space in primary healthcare (PHC) facilities in Ebonyi State, Nigeria that deliver SRH services.

Interviews with 20 health workers and group discussions with 72 young people aged 15–24 years provided the data for the study. We analyzed data deductively, focusing on the assessments of the presence or absence of specific professionals that are typically expected to provide different aspects of SRH services.

We found conspicuous absence of laboratory diagnostic, social care, psycho-cognitive and some medical services expected of primary care. These absences necessitated unnecessary referrals, encouraged breaches in confidentiality, undermined social care and justice, increased cost of care and discouraged young clients from utilizing SRH services provided in PHCs. Our study, therefore, emphasizes the need for integrated care in the delivery of SRH services, which would involve relevant diverse professionals contributing their expertise toward comprehensive care for SRH service users.

The study provides human resource insights toward strengthening primary healthcare in Nigeria vis-à-vis efficient delivery of SRH services to guarantee the health security of service users.

This paper aims to focus on a medical goods distribution problem and pharmacological waste collection by plug-in hybrid vehicles with some real-world restrictions. In this research, considering alternative energy sources and simultaneous pickup and delivery led to a decrease in greenhouse gas emissions and distribution costs, respectively.

Here, this problem has been modeled as mixed-integer linear programming with the traveling and energy consumption costs objective function. The GAMS was used for model-solving in small-size instances. Because the problem in this research is an NP-hard problem and solving real-size problems in a reasonable time is impossible, in this study, the artificial bee colony algorithm is used.

Then, the algorithm results are compared with a simulated annealing algorithm that recently was proposed in the literature. Finally, the results obtained from the exact solution and metaheuristic algorithms are compared, analyzed and reported. The results showed that the artificial bee colony algorithm has a good performance.

In this paper, medical goods distribution with pharmacological waste collection is studied. The paper was focused on plug-in hybrid vehicles with simultaneous pickup and delivery. The problem was modeled with environmental criteria. The traveling and energy consumption costs are considered as an objective function.

The COVID-19 pandemic had a disastrous impact on a substantial number of Filipino seafarers. The government agencies played a crucial role in helping the seafarers. This paper aims to explore the challenges that the Filipino seafarers faced amid the pandemic and initially evaluate the Philippine government’s countermeasures.

This paper reviewed academic literature and secondary data to identify and analyze the impact of the COVID-19 pandemic on seafarers. To identify the full range of policies and measures that have been adopted by the Philippines’ government amid the pandemic to mitigate the impact on seafarers, an extensive survey of various sources was conducted. Furthermore, an analytic hierarchy process (AHP) survey was conducted from seafarers' perspective to analyze the priority of these government initiatives.

This study identifies four key challenges for seafarers during the pandemic: crew change crisis, healthcare shortages, certification and the derived problems including financial and mental health issues. Notably, mental health problems are prevalent but receive limited government attention. Despite the government’s efforts to assist seafarers, the AHP survey identifies crew change assistance as the most crucial issue, possibly impacting all others.

This paper recognizes the significant information regarding aid in recovery management and provides much-needed assistance to seafarers during the pandemic and similar crisis situations. It bridges the research gaps and contributes knowledge to the government, stakeholders and various entities such as shipping companies, ship management firms and seafarers' manning agencies.

The learning objectives have been prepared following Bloom’s taxonomy (Bloom et al., 1956). After completing the case study, the students will be able to identify and recall the prerequisites necessary for establishing a pathology laboratory. (knowledge); analyze the micro- and macroenvironmental factors considered by Mr Sabihul Haque in the development of the strategic plan for Healthcare Laboratories (HCL) (knowledge and application); explain the key components of the Porter’s value chain and their significance in the operation of HCL (comprehension and evaluation); use the TOWS analysis to map the internal strengths, weaknesses, opportunities and threats of HCL (application and synthesis); and analyze the challenges faced by protagonist in managing HCL and generate suggestions for addressing the challenges (analysis and synthesis).

HCL, an enterprise established in 2018 in Sahdeo Khap, Gaya, Bihar, India, aims to provide high-quality pathological diagnostic services in semi-urban and rural areas. This health-care initiative is pioneering, offering pathology services to make high-quality, low-cost diagnostic services accessible in rural India. In rural settings, numerous health-care hurdles make it challenging for individuals to access the care they need. Since its inception, HCL has expanded its reach to connect more areas, facilitating diagnostic services for people in remote regions. The establishment of laboratories in semi-urban areas aims to reduce patient travel time, costs and health risks by bringing services directly to their doorstep. Haque, the chief executive officer of the lab, grappled with multiple challenges, including selecting an appropriate location for the lab, recruiting and retaining skilled workforce, managing logistics supply, collaborating with local health-care providers, dispelling the stigma among the population that superior services are only available in cities and enhancing health literacy in rural communities. Following numerous meetings with Ms Ummati Naiyyer, head of operations, they worked collaboratively to address these challenges, developing a blueprint and future plan to operate services in rural areas. This case study provides insights into the obstacles faced by HCL striving for success in rural areas. It elucidates the beneficial application of the Porter’s value chain, along with an analysis of macro- and microenvironmental factors. Unique challenges such as societal stigma and mistrust are specifically emphasized. Students engaging with this case study will enhance their problem-solving skills through brainstorming and providing recommendations, contributing to potential solutions for HCL’s difficulties.

The teaching notes for the HCL case is designed to enhance the learning experience of undergraduate and graduate students within the context of the course. This case study serves as a valuable teaching tool, allowing students to apply theoretical knowledge to real-world scenarios in the health-care industry. The notes provide a framework for instructors to facilitate discussions, encourage critical thinking and promote a deeper understanding of key concepts related to establishing diagnostic laboratories in rural areas.

Teaching notes are available for educators only.

CSS3: Entrepreneurship.

In early 2014, recent Stanford University graduate Tyler Shultz was in a quandary. He had been working at Theranos, a blood-diagnostic company founded by Elizabeth Holmes, a Stanford-dropout wunderkind, for almost a year. Shultz had learned enough about the company to realize that its practices and the efficacy of its much-touted finger-prick blood-testing technology were questionable and that the company was going to great lengths to hide this fact from the public and from regulators.

Theranos and Holmes were Silicon Valley darlings, enjoying positive press and lavish attention from potential investors and technology titans alike. Just as companies like PayPal had revolutionized the stagnant payments industry and Uber had upended the for-hire transportation sector, Theranos had been positioned as the latest technology firm to substantially disrupt yet another mature sector: the medical laboratory business. By the start of 2014, the company had raised more than $400 million in funding, and had an estimated market valuation of $9 billion.

Shultz's situation was exacerbated by the fact that his grandfather, the highly respected former US Secretary of State George Shultz, was on the Theranos board and was one of Elizabeth Holmes's biggest supporters.

But Tyler Shultz worried about the customers he was convinced were receiving highly unreliable and often inaccurate blood-test results. With so much at stake, Shultz wondered how he should proceed. Should he raise his concerns with the firm's investors? Blow the whistle externally? Report to industry regulators? Go away quietly?

This case and its subsequent four brief follow-up cases are based largely on interviews with Tyler Shultz, and outline the dilemma he faced and the various steps he would take both to extricate himself from his unsavory position and let the public know the full extent of the deception at Theranos.

Five optional handouts are available to instructors to further discussion after the case has been debriefed. The handouts serve as additional decision points for the students if your class time permits.

This paper aims to introduce a custom-designed integrated nucleic acid detection polymerase chain reaction (PCR) instrument for clinical detection applications.

The PCR instrument can make rapid, sensitive, low-cost and quantitative molecular diagnosis compared with the current routine test flow from the pipette, series reagent to RT-PCR by manual manipulation. By integrating the multichannel automatic pipetting module, heat amplification module and real-time fluorescence detection module for the first time, the custom-designed integrated nucleic acid detection PCR instrument can achieve sample collection, subpackage, mixing, extracting, measuring and result presentation.

The multichannel automatic pipetting module was assembled with an accuracy of 0.4% (2 microliters) for accuracy measurement. Besides, the accuracy and sensitivity of nucleic acid using integrated low-cost nucleic acid detection PCR instruments were checked with COV-2019 virus (staining method) and African swine fever virus (probe method) under different concentrations.

Because of its high cost, complex system and bulky laboratory settings, including sample subpackage, mixing, extracting, measuring and finally result in presentation, the current nucleic acid detection system is not suitable for field operation and disease diagnosis in remote areas. The group independently designed and assembled an integrated low-cost multichannel nucleic acid detection PCR instrument, including a multichannel automatic pipetting module, a heat amplification module and a real-time fluorescence detection module.

The above equipment showed better reliability compared with commercial qPCR. These results can lay the foundation for functional, fast and low-cost PCR equipment for trace measurements.

This study aims to explore the empirical correlation between patient flow issues, quality of green health services and patient satisfaction in specialist medical department factors from patients’ perspectives as service consumers.

This research is a type of nonintervention empirical research that uses an open survey to explore the views and experiences of users of specialist medical department services. The targeted population is hospital patients included in the top five national PERSI (Indonesian Hospital Association) Award 2022 Green Hospital Category, with a total number of respondents of 572 people. This study uses the partial least square-structural equation modeling analysis method with the SmartPLS application.

Patient flow problems generally affect the quality of eco-friendly health services, except for the waiting time problem, which affects service quality. It should be understood as a top priority for patients to receive services from medical specialists without risking time as a core service aspect from the patient’s perspective. In addition, all variables in eco-friendly hospital services affect patient satisfaction, except in the case of visits to specialist medical departments, which do not affect medical support services and hospital practices that are responsive to the delivery of care services resulting from medical support services that are inseparable in integrated services as well as health care following medical ethics.

This study has a novelty in understanding the implications of green practice in determining patient satisfaction in medical specialist department as the epicenter of hospital services and the main object of assessment for the quality of hospital services.

The paper develops a model for enhancing R&D productivity for Indian public funded laboratories. The paper utilizes the productivity data of five Council of Scientific and Industrial Research (CSIR) laboratories for analysis and to form the constructs of the model.

The weighted average method was employed for analyzing the rankings of survey respondents pertaining to the significant measures enhancing R&D involvement of researchers and significant non-R&D jobs. The authors have proposed a model of productivity. Various individual, organizational and environmental constructs related to the researchers working in the CSIR laboratories have been outlined that can enhance R&D productivity of researchers in Indian R&D laboratories. Partial Least Squares-Structural Equation Modeling (PLS-SEM) was used to find the predictability of the productivity model.

The organizational factors have a crucial role in enhancing the R&D outputs of CSIR laboratories. The R&D productivity of researchers can be improved through implementing the constructs of the proposed model of productivity.

The R&D productivity model can be adapted by the R&D laboratories to enhance researchers’ R&D involvement, increased R&D outputs and achieving self-sustenance in long run.

The R&D laboratories can initiate exercises to explore the most relevant factors and measures to enhance R&D productivity of their researchers. The constructs of the model can function as a guideline to introduce the most preferable research policies in the laboratory for overall mutual growth of laboratory and the researchers.

Hardly any studies have been found that have focused on finding the measures of enhancing R&D involvement of researchers and the influence of significant time-intensive jobs on researchers’ productivity.

This paper aims to establish an efficient maintenance management system tailored for healthcare facilities, recognizing the crucial role of medical equipment in providing timely and precise patient care.

The system is designed to function both as an information portal and a decision-support system. A knowledge-based approach is adopted centered on Semantic Web Technologies (SWTs), leveraging a customized ontology model for healthcare facilities’ knowledge capitalization. Semantic Web Rule Language (SWRL) is integrated to address decision-support aspects, including equipment criticality assessment, maintenance strategies selection and contracting policies assignment. Additionally, Semantic Query-enhanced Web Rule Language (SQWRL) is incorporated to streamline the retrieval of decision-support outcomes and other useful information from the system’s knowledge base. A real-life case study conducted at the University Hospital Center of Oran (Algeria) illustrates the applicability and effectiveness of the proposed approach.

Case study results reveal that 40% of processed equipment is highly critical, 40% is of medium criticality, and 20% is of negligible criticality. The system demonstrates significant efficacy in determining optimal maintenance strategies and contracting policies for the equipment, leveraging combined knowledge and data-driven inference. Overall, SWTs showcases substantial potential in addressing maintenance management challenges within healthcare facilities.

An innovative model for healthcare equipment maintenance management is introduced, incorporating ontology, SWRL and SQWRL, and providing efficient data integration, coordinated workflows and data-driven context-aware decisions, while maintaining optimal flexibility and cross-departmental interoperability, which gives it substantial potential for further development.

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.