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The purpose of this study is to explore and prioritize the factors that determine the social insurance contribution of unorganized workers.

A two-stage procedure was adopted to recognize and prioritize factors influencing the social insurance participation of unorganized workers: first, crucial factors influencing unorganized workers’ contribution towards social insurance were identified by employing exploratory factor analysis, and in the second phase, the fuzzy analytical hierarchal process was applied to rank the specified criteria and then sub-criteria by assigning weights.

Four broad factors were identified, namely, economic, political, operational and socio-psychological, that significantly influence unorganized workers’ contribution towards social insurance. Later findings revealed that the prime influencer of unorganized workers’ contribution is employment contracts followed by average earnings, delivery of quality services, eligibility and accessibility.

The research findings are feasible as the basic propositions are based on real-world scenario. The identification and ranking of factors have the potential to be used as a checklist for policymakers when designing pension and social insurance for unorganized workers. If it is not possible to consider all, the criteria and sub-criteria assigned upper rank can be given priority to extend pension coverage for a large group of working poor.

The key factors driving social insurance contributions have been highlighted by studying the stakeholders’ perceptions at a micro level. By comprehending the challenges, there is a possibility of covering a large section of the working poor into social insurance coverage.

This paper is believed to be one of its kinds to acknowledge a combination of factors that determine the contribution of unorganized workers to social insurance. This study is an empirical investigation to prioritize the essential drivers of social insurance participation by low-income cohorts in the context of emerging countries. The present approach of employing fuzzy logic has also very limited use in social insurance literature yet.

The study aims to address a critical gap in existing healthcare payment schemes and care service pricing by recognizing the influential role of patients' decisions on self-management efforts. These decisions not only impact health outcomes but also shape the demand for care, subsequently influencing care costs. Despite the significance of this interplay, current payment schemes often overlook these dynamics. The research focuses on investigating the implications of a novel behavior-based payment scheme, designed to align incentives and establish a direct connection between patients' decisions and care costs. The primary objective is to comprehensively understand whether and how this innovative payment scheme structure influences key stakeholders, including patients, care providers, insurers and overall social welfare.

In this paper, we propose a game-theoretical model to incorporate the performance of self-management with the demand for healthcare service, compare the patient's effort decision for self-management and provider's price decision for healthcare service under a behavior-based scheme with that under two implemented widely payment schemes, that is, co-payment scheme and co-insurance scheme.

Our findings confirm that the behavior-based scheme incentives patient self-management more than current schemes while reducing their possibility of seeking healthcare service, which indirectly induces the provider to lower the price of the service. The stakeholders' utility under various payment schemes is sensitive to the cost of treatment and the perceived health utility of patients. Especially, patient health awareness is not always benefited provider profit, as it motivates patient self-management while diminishing the demand for care.

We provide a novel framework for characterizing behavior-based payment schemes. Our results confirm the need for modification of the current payment scheme to incentivize patient self-management.

Beneficiary photos on charity appeals are believed to engender prosocial behavior. This study explores photo framing of healthy and unhealthy beneficiary photos in the context of photo-rich online medical crowdfunding. Based on framing theory, emphasis framing effect (i.e. unhealthy photos only vs both healthy and unhealthy photos) and equivalency framing effect (i.e. healthy photos prior to unhealthy photos vs unhealthy photos prior to healthy photos) are identified.

A scenario-based experiment with 135 participants was used to empirically test the proposed research hypotheses. The subjects were randomly assigned to three treatment groups, with 45 subjects in each group. ANOVA, linear regression, and multiple mediation analysis were used to analysis data.

The results reveal that disclosing both healthy and unhealthy photos can elicit stronger sympathy and perceived need than merely disclosing unhealthy photos. Moreover, the order of unhealthy photos prior to healthy photos leads to a higher level of sympathy than the order of healthy photos prior to unhealthy photos. Furthermore, sympathy and perceived need are positively related to donation intention.

First, this study extends the photo-related research limited to certain characteristics of a single photo to the sequence effect of multiple photos. Second, this study contributes to framing theory by introducing photo framing, particularly the equivalence and emphasis framing effect of beneficiary photos. Finally, this study reveals the emotional and cognitive routes through which beneficiary photos stimulate prosocial behavior. It also offers practical guidance in the aspects of the framing effect of beneficiary photos for crowdfunding management.

Research has found a strong correlation between maternal healthcare and health insurance coverage. But, despite having one of the best health coverage systems in the developing world, Rwanda still faces formidable challenges in provision certain key maternal health services, leading to higher levels of maternal morbidity and mortality. To understand this paradox, this study will examine the association between maternal health services and insurance coverage, utilizing the latest data from the Rwanda Demographic Health Survey.

Using a sample of 6,167 childbearing women aged 15–49 years, a bivariate and multivariate analysis was conducted to examine the paradoxical relationship between health insurance and maternal health services, such as antenatal care, in Rwanda.

The results reveal significant differences in ANC4+ and the timing of the first ANC, which remain low in Rwanda. Despite significant improvements in delivery factors and skilled ANC providers, ANC4+ rates in the country remain the lowest. However, this study found a positive and significant association between ANC4+ and insurance coverage (AOR = 1.64, p < 0.001).

Rwanda has implemented an effective health insurance policy, but there has been minimal progress in the utilization of maternal health services. Therefore, there is a strong need for policy interventions to reduce barriers to healthcare utilization. Additionally, supply-side factors such as transportation, socio-cultural factors and other logistic barriers should be examined in greater detail. These factors may overshadow the impact of health insurance on the utilization of healthcare services in Rwanda.

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-01-2023-0059

Mainland Tanzania has seen two decades of significant social policy reforms and transformations in its social and economic structures, whilst the country continues to grapple with persisting gender inequalities. This article examines Tanzania's social policy developments from a gender perspective. The authors analyse the level, reach and quality of social policy delivery to working-age women across the areas of health policy, social protection and employment policy during 2000–2021.

The article draws on qualitative research deploying the scoping review method. The data consist of diverse secondary materials, including academic publications, government policy documents, relevant statistics and other types of “grey” literature.

Tanzania has made significant advancements in the legal frameworks around welfare provision and has instituted increasingly gender-responsive government policy plans. The health and social protection sectors, in particular, have witnessed the introduction of large-scale measures expanding social policy implementation. However, social policy delivery remains two-tiered, with differences in provisions for women in the formal and informal sectors.

Social policy delivery and implementation have increased and diversified in Sub-Saharan Africa (SSA) during the new millennium, with a growing integration of gender-specific policy objectives. However, limited social policy scholarship has focused on the gendered effects of broader social policy models in SSA. The article remedies the concomitant knowledge gaps by examining various social policies and their impacts on working-age women in Mainland Tanzania. The authors also engage with the theoretical welfare regime literature and present an analytical framework for gender-sensitive assessment of emerging social policy models in the Global South.

Wearable health devices (WHDs) have demonstrated significant potential in assisting elderly adults with proactive health management by utilizing sensors to record and monitor various aspects of their health, including physical activity, heart rate, etc. However, limited research has systematically explored older adults’ continued usage intention toward WHD. By utilizing the extended unified theory of acceptance and use of technology (UTAUT2), this paper aims to probe the precursors of elderly adults’ continuance intention to use WHD from an enabler–inhibitor perspective.

The research model was developed based on UTAUT2 and examined utilizing the partial least squares technique (PLS). The research data were collected through in-person meetings with older people (n = 272) in four cities in China.

Results reveal that performance expectancy, effort expectancy, social influence, facilitating conditions, hedonic values and perceived complexity are the positive predictors of elderly adults’ continuance intention to use WHDs. Technology-related anxiety and usage cost negatively influence the formation of older people’s continuance intention.

This work is an original empirical investigation that draws on several theories as guiding frameworks. It adds to the existing literature on the usage of wearable technologies and offers insights into how the elderly’s intentions to continue using WHDs can be developed. This study broadens the scope of the UTAUT2 application and presents an alternative theoretical framework that can be utilized in future research on the usage behavior of wearable devices by individuals.

Theory of Constraints (TOC), though a well-established process improvement methodology in manufacturing, is still a novel philosophy for healthcare and an exhaustive review of literature is needed to summarize the key findings of various researchers. Such a review can provide a direction to the researchers and academicians interested in exploring the application of TOC in the healthcare sector. This paper aims to review the existing literature of TOC tools and techniques applied to the healthcare environment, and to investigate motivating factors, benefits and key gaps for identifying directions for future research in the domain of healthcare.

In this paper, different electronic repositories were searched using multiple keywords. The current study identified 36 articles published between January 1999 to mid-2021 to conceptualize and summarize the research questions used in the study. Descriptive analysis along with pictorial representations have been used for better visualization of work.

This paper presents a thorough literature review of TOC in healthcare and identifies the evolution, current trends, tools used, nature of services chosen for application and research gaps and recommends future direction for research. A variety of motivating factors and benefits of TOC in healthcare are identified. Another key finding of this study is that almost all implementations listed in literature reported positive outcomes and substantial improvements in the performance of the healthcare unit chosen for study.

This paper provides valuable insight to researchers, practitioners and policymakers on the potential of TOC to improve quality of services, flow of patients, revenues, process efficiency and cost reduction in different health care settings. A number of findings and suggestions compiled in the paper from literature study can be used for diagnosing, learning and making substantial changes in healthcare. The methodologies used by different researchers were analysed and combined to propose a generic step by step procedure to apply TOC. This methodology will guide the practising managers about the appropriate tools of TOC for their specific need.

Good health is always the first desire of all men and women around the globe. The global aim of healthcare is to quickly cure more patients and ensure healthier population both today and in future. This article will work as a foundation for future applications of TOC in healthcare and guide upcoming applications in the booming healthcare sector. The paper will help the healthcare managers in serving a greater number of patients with limited available resources.

This paper provides original collaborative work compiled by the authors. Since no comprehensive systematic review of TOC in healthcare has been reported earlier, this study would be a valuable asset for researchers in this field. A model has been presented that links various benefits with one another and clarifies the need to focus on process improvement which naturally results in these benefits. Similarly, a model has been presented to guide the users in implementation of TOC in healthcare.

This paper aims to understand the maternal health vulnerabilities of migrant women in slums and explore their challenges during and after childbirth.

The study used a qualitative approach, including in-depth interviews through purposive and snowball sampling techniques. Thematic analysis was used for analysing data. The consolidated criteria for reporting qualitative studies (COREQ)-32 items were followed for reporting this study.

The study found that migrant women were highly susceptible to adverse birthing outcomes due to risks involved in birthing, lack of care and hygiene, lack of skilled care in dealing with complicated pregnancies and exposure to domestic and obstetric violence.

The study intends to highlight the narratives of female migrants’ birthing and maternal health challenges. The entire process of childbirth in slums with consequences can result in maternal and infant morbidities and mortalities.

This study aims to benchmark the operational efficiency of fifty-eight public hospitals across Mexico between 2015 and 2018 and identifies the most critical inputs affecting their efficiency. In doing so, the study analyzes the impact of policy changes in the Mexican healthcare system introduced in recent years.

To measure the operational efficiency of Mexican public hospitals, data envelopment analysis (DEA) window analysis variable returns to scale (VRS) methodology using longitudinal data collected from the National Institute for Transparency and Access to Information (IFAI). Hospital groups are developed and compared using a categorization approach according to their average and most recent efficiency.

Results show that most of the hospitals in the study fall in the moving ahead category. The hospitals in the losing momentum or falling behind categories are mostly large units. Hospitals with initially low efficiency scores have either increased their efficiency or at least maintained a steady improvement. Finally, the findings indicate that most hospitals classified as moving ahead focused on a single care area (cancer, orthopedic care, child care and trauma).

This study examined the technical efficiency of the Mexican healthcare system over a four-year period. Contrary to conventional belief, results indicate that most public Mexican hospitals are managed efficiently. However, recent changes in public and economic policies that came into effect in the current administration (2018) will likely have long-lasting effects on the hospitals' operational efficiency, which could impact the results of this study.

To the best of authors’ knowledge, this is the first study that examines the efficiency of the complex Mexican healthcare system using longitudinal data.

This study aims to evaluate how a community psychiatry model, referred to as the Mental Health Action Trust (MHAT) in India, provides decentralized care and comprehensive services to people with severe mental illness living in poverty. Using the complex adaptive system (CAS) framework, the authors aim to understand the factors that contribute to the diverse outcomes of the MHAT community mental health programme as observed in four different locations.

Four MHAT clinics were purposively chosen from two districts in Kerala. A comparative case study methodology was used to document each clinic’s MHAT services and activities, as found during field visits and interviews with staff members and volunteers.

The study shows that all four clinics met the basic aim of providing free, quality mental health care to the poorest populations, although not all aspects of the comprehensive model could be equally provided. Alignment with the MHAT vision, appropriate leadership, the relationship with partners and their level of community engagement determined the varied success between clinics.

The current study evaluation stresses that community ownership is crucial. Careful attention must be paid to the characteristics of selected partners, including their leadership styles and ability to garner resources.