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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.

This paper aims to examine lean thinking in medical commodities supply chains by considering its applications and success factors. It determines the drivers and wastes of medical commodity supply chain, and the existing lean tools and practices together with their application in the supply chain processes. The paper also examined the challenges and success factors for effective lean application in the medical commodities supply chains.

The study used qualitative approaches, in-depth interviews and focus group discussions with key informants to form the basis for data collection. Through thematic analysis, the collected data were analyzed by developing themes reflecting the objectives of the study.

The main drivers for waste associated with the supply chain were demand management, supplier development, institutional framework and governance. The wastes were observed at the level of inventory, operation costs, transaction costs, delays in terms of service, commodity delivery time and quality. Digitalization, information technology and standardization were the tools for medical supply chain. Poor infrastructure, unreliable internet supply, environmental uncertainty and poor management support were challenges to realizing an effective supply chain.

Although the qualitative approach used in the study provides detailed information, a quantitative study covers a larger sample for generalization.

Capacity building and professionalism should be given a priority because the philosophy of lean focuses on waste removal and continuous improvement, which highly depends on the quality of human resource (Brito et al., 2020). Limited human resource capabilities in supply chain management will, therefore, result into poor operational efficiency, which are wasted. Moreover, systems interoperability is key waste minimization and, therefore, demands interventions.

The government under the Ministry of Health and other key sector ministries such as local and regional governments should better understand the role of the waste drivers and adopt system-wide reforms to support improvements to remove waste in the medical supply chain. For example, the current institutional framework creates an administrative block and hence leads to wastes. This bureaucratic procedure should be removed to minimize wastes along the chain.

This study is among the first studies to determine applicability and implementation of lean in a resource-constrained context. The paper identifies contextual factors for lean implementation. This paper focused on a holistic view of the entire supply chains to enhance a well-functioning supply chain in delivering health commodities.

The calculation of buildings’ carbon footprint (CFP) is an important basis for formulating energy-saving and emission-reduction plans for building. As an important building type, there is currently no model that considers the time factor to accurately calculate the CFP of hospital building throughout their life cycle. This paper aims to establish a CFP calculation model that covers the life cycle of hospital building and considers time factor.

On the basis of field and literature research, the basic framework is built using dynamic life cycle assessment (DLCA), and the gray prediction model is used to predict the future value. Finally, a CFP model covering the whole life cycle has been constructed and applied to a hospital building in China.

The results applied to the case show that the CO₂ emission in the operation stage of the hospital building is much higher than that in other stages, and the total CO₂ emission in the dynamic and static analysis operation stage accounts for 83.66% and 79.03%, respectively; the difference of annual average emission of CO₂ reached 28.33%. The research results show that DLCA is more accurate than traditional static life cycle assessment (LCA) when measuring long-term objects such as carbon emissions in the whole life cycle of hospital building.

This research established a carbon emission calculation model that covers the life cycle of hospital building and considered time factor, which enriches the research on carbon emission of hospital building, a special and extensive public building, and dynamically quantifies the resource consumption of hospital building in the life cycle. This paper provided a certain reference for the green design, energy saving, emission reduction and efficient use of hospital building, obviously, the limitation is that this model is only applicable to hospital building.

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 research theoretically proposed and empirically validated a Customer-Based Brand Equity (CBBE) scale specifically for Medical Tourism for emerging economies including recent findings from tourism theories such as gravity model and signalling theory, but more specifically accommodating political, cultural, economic, legal and social influences.

In-depth literature reviews from tourism, medical tourism, healthcare and hospitality domains are used to propose the theoretical model. The authors have used the lavaan package in R for the empirical analysis and model verification.

The research included, tested and verified the established latent variables such as “brand awareness”, “brand association”, “perceived quality” and “loyalty”, along with new observed variables for the CBBE scale from the theoretical perspectives of this research. “Infrastructure” has emerged as a new scale construct and “culture” was found to be a moderating variable for “perceived quality” in the CBBE scale, which are novel additions to the literature.

The research contributed to scale refining, latent construct assessment, and fine-tuning of the observed variables for the mentioned theoretical gaps.

Customers today expect businesses to cater to their individual needs by tailoring the products they purchase to their own preferences. The term “Industry 5.0” refers to a new wave of manufacturing that aims to meet each customer's unique demands. Even while Industry 4.0 allowed for mass customization, that wasn't good enough before, customers today demand individualized products at scale, and Industry 5.0 is driving the transition from mass customization to mass personalization to meet these demands. It caters to the individual needs of each consumer by meeting their demands. More specialized components for use in medicine are made possible by the widespread customization made possible by Industry 5.0. These individualized parts are included into the medical care of the patient to meet their specific needs and preferences. In the current medical revolution, an enabling technology of Industry 5.0 can produce medical implants, artificial organs, bodily fluids, and transplants with pinpoint accuracy. With the advent of AI-enabled sensors, we now live in a world where data can be swiftly analyzed. Machines may be programmed to make complex choices on the fly. In the medical field, these innovations allow for exact measurement and monitoring of human body variables according to the individual's needs. They aid in monitoring the body's response to training for peak performance. It allows for the digital dissemination of accurate healthcare data networks. In order to collect and exchange relevant patient data, every equipment is online.

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.