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1 – 10 of over 1000Health is a human right and a fundamental building block of sustainable development, economic prosperity and poverty reduction. To realize people’s right to health, evaluating the…
Abstract
Purpose
Health is a human right and a fundamental building block of sustainable development, economic prosperity and poverty reduction. To realize people’s right to health, evaluating the situation of the right and its determinants is necessary. This paper aims to analyze Iran’s conduct in realizing its population’s right to health.
Design/methodology/approach
A qualitative case study design involving a structured review of relevant laws, policy documents, reports and academic literature was undertaken. The data were collected from electronic databases and the official Web pages of the United Nations (UN) and Iran’s Government and analyzed by a framework suggested by the UN.
Findings
Iran’s law and policies intend to combat health inequalities and to provide an adequate standard of living for everyone, particularly disadvantaged groups and individuals. However, not all laws and policies protecting disadvantaged groups are adequately implemented. There are disparities in health status and access to health care among different socio-economic groups. International economic sanctions and government policies decreased people’s ability to access the necessities of life including health care. Moreover, social determinants of health, such as cultural beliefs regarding women’s rights have not been addressed sufficiently in the country’s laws.
Research limitations/implications
This study includes a broad range of subjects and provides an overview of the health-care system of Iran. However, more detail is needed to describe every aspect of the right to health. It was not feasible to address them all in this paper and needs more research. In addition, as with the majority of qualitative studies, the design of the current study is subject to limitations. Firstly, the research quality of narrative reviews is dependent on the researcher’ skills and more easily can be influenced by his/her personal biases. Second, the rigor is more difficult to maintain, assess and demonstrate. Nevertheless, narrative studies often complement quantitative studies and are informative.
Originality/value
To fulfill the right to health, Iran should improve affordability and quality of care and the situation of the determinants of health. The gaps in people’s access to health care need to be identified, and all necessary means and scarce resources be allocated to remove access barriers and to improve the situation of disadvantaged people. The adoption of relatively low-cost targeted programs, the proper management of resources and the prevention of unnecessary costs are suggested.
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Athanasios Michalis, Demosthenes B. Panagiotakos, Apostolos Papadopoulos and Vassiliki Costarelli
The study aims to have adults discuss experiences, practices needs and feelings related to health management, diet and food security.
Abstract
Purpose
The study aims to have adults discuss experiences, practices needs and feelings related to health management, diet and food security.
Design/methodology/approach
A total of 22 immigrants were recruited from the Open School of Immigrants in Piraeus, Attica, Greece, to participate in focus group discussions. The discussions were audio recorded and thematically analyzed. Three major themes were developed: pathways to health care, nutrition management and experiences related to food shortages.
Findings
Most of the participants identified internet as the most commonly used way to obtain health advice; they also stated that unexpected ill-health is usually accompanied by feelings of fear, anxiety and loneliness. Immigrants, who had visited a public hospital in Greece, identified the language barrier as the most challenging issue, followed by the long waiting lists. Fear and anxiety of hospital visits was an important factor in their decision to vaccinate against COVID-19. Lack of time, high cost of healthy food and lack of knowledge were the most common obstacles to a healthy diet. One in two immigrants reported that they have faced food insecurity issues in the past. Stress, psychological distress and irritation were reported, due to food shortages, especially during the first few years of arriving in Greece. The exclusion of some foods, reduced portion sizes and buying cheaper foods were among the coping strategies to address food shortages.
Originality/value
The study offers an insight into immigrant’s experiences, practices and feelings about managing health issues and could be useful for health-care practitioners, researchers and policymakers.
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Reza Salehzadeh and Mehran Ziaeian
This study aims to advance the understanding of humble leadership (HL) in health care.
Abstract
Purpose
This study aims to advance the understanding of humble leadership (HL) in health care.
Design/methodology/approach
This study presents a scoping review to explore and synthesize the existing knowledge in the literature. The search process encompassed three main online databases, PubMed, Scopus and Web of Science. Due to the novelty of the topic of HL in health care and the lack of research in this area, all articles published until the end of February 2023 were considered in this study.
Findings
A total of 18 studies were included. The results showed that in the period of 2019–2023 more attention was paid to HL in health care than in previous years. The research design used in these articles included quantitative (n = 13) and qualitative (n = 5) methods and the statistical population included nurses, hospital employees and health-care department managers. Based on the results obtained, the definition of HL can be divided into two general approaches, including self-evaluation and the way one treats others. In addition, humble leaders in the health-care sector should exhibit certain behavioral characteristics and finally, the results indicated that HL has several positive consequences; however, little attention has been paid to the factors influencing HL in health care.
Practical implications
This research will help practitioners gain a deeper understanding of the various applications of HL in health care.
Originality/value
To the best of the authors’ knowledge, no comprehensive research review has yet been conducted on the application of HL in health care.
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Sujeet Jaydeokar, Mahesh Odiyoor, Faye Bohen, Trixie Motterhead and Daniel James Acton
People with intellectual disability die prematurely and from avoidable causes. Innovative solutions and proactive strategies have been limited in addressing this disparity. This…
Abstract
Purpose
People with intellectual disability die prematurely and from avoidable causes. Innovative solutions and proactive strategies have been limited in addressing this disparity. This paper aims to detail the process of developing a risk stratification tool to identify those individuals who are higher risk of premature mortality.
Design/methodology/approach
This study used population health management principles to conceptualise a risk stratification tool for avoidable deaths in people with intellectual disability. A review of the literature examined the existing evidence of causes of death in people with intellectual disability. A qualitative methodology using focused groups of specialist clinicians was used to understand the factors that contributed towards avoidable deaths in people with intellectual disability. Delphi groups were used for consensus on the variables for inclusion in the risk stratification tool (Decision Support Tool for Physical Health).
Findings
A pilot of the Decision Support Tool for Physical Health within specialist intellectual disability service demonstrated effective utility and acceptability in clinical practice. The tool has also demonstrated good face and construct validity. A further study is currently being completed to examine concurrent and predictive validity of the tool.
Originality/value
To the best of the authors’ knowledge, this is the only study that has used a systematic approach to designing a risk stratification tool for identifying premature mortality in people with intellectual disability. The Decision Support Tool for Physical Health in clinical practice aims to guide clinical responses and prioritise those identified as at higher risk of avoidable deaths.
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Sundeep Sahay and Esther N. Landen
The purpose of this paper is to understand how digital interventions are mediating the identity work of community health workers (CHWs) in the context of two African countries.
Abstract
Purpose
The purpose of this paper is to understand how digital interventions are mediating the identity work of community health workers (CHWs) in the context of two African countries.
Design/methodology/approach
This paper analyzes the everyday work of CHWs in two low- and middle-income country (LMIC) contexts (Uganda and Malawi) and seeks to understand changes in collective identity and the role of Information and Communication Technologies (ICTs) in mediating this “identity work”. As CHWs conduct their everyday tasks of care giving, data reporting and maintaining social interactions, they play two primary roles. One is the care giving role oriented towards the community, and two, is reporting and administrative work by virtue of them being affiliated with the Ministry of Health, either in formal or voluntary capacity. The ambivalence which they experience as they move back and forth between these two worlds of work is significantly now mediated through ICTs. The paper analyzes these dynamics and identifies three key sets of ambivalence in identity work: (1) role embracing-institutional distancing; (2) conformist-resistant and (3) dramaturgical-transformative. The paper makes unique contributions to information systems (IS) and ICT for development (ICT4D) studies in that it focuses on a nonprofessional group, which plays a fundamental role in providing care to underserved populations and also conducts data work which provides the foundation of the national health information system. This contrasts with dominant research in the field which focuses on professional groups, largely based in Western business organizations.
Findings
The paper identifies identity related tensions that emerge with the mediation of digital technologies in the work world of CHWs. These include tensions of conformist-resistant; and (3) dramaturgical-transformative. These findings are relevant and unique to the field of IS and ICT4D studies in that it focuses on a nonprofessional group, which plays a fundamental role in providing care to underserved populations and also conducts data work which provides the foundation of the national health information system.
Research limitations/implications
While acknowledging identity construction and negotiation is a function of both work and social lives, in this paper we could only focus on the work lives.
Practical implications
As digital interventions in the health sector of low and middle income countries is becoming increasingly widespread, often the focus is more on the supply side (the supply of the technology) rather than on the demand side (users experiences and aspirations). Identity becomes a lens to understand these demand side dynamics, which helps provides practical guidance on implementation approaches to ensure that the technology adds value to user work processes and there is a seamless and not a disruptive transition.
Social implications
CHWs are the most neglected cadre in the health system of low and middle income countries, even though they provide the cutting edge in care provision work to the most marginalized populations, living in rural and underserved areas. By focusing on how technologies can be more effectively implemented to support these care processes, the paper provides important social implications both for practice and research.
Originality/value
Analysis of identity construction and negotiation of informal groups in the unorganized sector of low and middle income countries has not received adequate attention in IS research. The paper seeks to fill this important gap.
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Yixin Liang, Xuejie Ren and Lindu Zhao
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…
Abstract
Purpose
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.
Design/methodology/approach
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.
Findings
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.
Originality/value
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.
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Angela Crocker, Jill Titterington and Michelle Tennyson
This study aims to evaluate the quality of a speech and language therapy (SLT) swallow service provided to adults with intellectual disability (ID) by exploring the process and…
Abstract
Purpose
This study aims to evaluate the quality of a speech and language therapy (SLT) swallow service provided to adults with intellectual disability (ID) by exploring the process and outcome factors; to explore the process of what is done to and for the patient including identifying dysphagia, choking and pneumonia risk, typical interventions and management; examine clinical outcomes; and explore the relationship of outcomes with risk factors, satisfaction with the service and the impact of the service on the number of choking incidents and admissions to acute hospital with swallow concerns.
Design/methodology/approach
There were three specific work packages: (1) collecting and scrutinising patient data from the clinical record for adults with ID referred to the SLT swallow service over a six-month period. The researcher created aims, defined the limits to achieve the aims, designed a standardised data collection form, set out where data was in the clinical record, piloted, set limits for collection and trained reviewers; (2) gathering experience and satisfaction surveys from patients, caregivers and referrers over the six-month study period; and (3) monitoring choking adverse incident reports and hospital admission with swallow concerns for the whole ID population.
Findings
Choking and hospital admission were the main reasons for referral, and pneumonia risk significantly predicted dysphagia impairment. The research highlighted common dysphagia risk factors, interventions and recommendations for this population. The SLT swallow service is a quality service that is highly valued by patients, their caregivers and referrers. The service achieves significant clinical improvements, helps identify dysphagia and provides management to reduce associated risks.
Research limitations/implications
This study found common dysphagia risk factors, interventions and recommendations; it also found that the therapy outcome measures/Royal College of Speech and Language Therapy online outcome tool was a meaningful outcome measure, and that pneumonia risk significantly predicted dysphagia impairment, all of which could inform the identified dysphagia research priorities for this population.
Practical implications
Naming usual care in treatment and recommendations could help ensure a fair service and could help form quality indicators. People with ID, their caregivers and staff generated valuable ideas for improvement, and further involvement work could create a logic model for the service. Other future work could explore the use of screening tools, increase multidisciplinary team working, improve access to instrumental assessments, raise awareness of swallowing and promote important oral health and medication reviews. By using this information to shape quality improvement work and policies, one can work toward addressing high health-related inequalities and preventable deaths associated with dysphagia in this vulnerable population.
Social implications
It may be useful to raise awareness that adults with ID age earlier and that one should not exclude them from older people’s services because of an age threshold, often set higher than their life expectancy. This study highlighted a possible inequality of access issue for adults with ID who do not have direct care or day care staff. There is a need to increase access to awareness training so caregivers and general practitioners can recognise swallow difficulties and know how to make a referral for a swallow assessment.
Originality/value
Overall, the evaluation of the swallow service to adults with ID suggests that SLT have a quality service for adults with ID that is highly valued and provides significant clinical improvements. By building on these strengths, SLT could extend the reach, influence and impact of their services to help those adults with ID who have emerging swallow difficulties or who do not access the service.
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Due to its ability to support well-informed decision-making, business intelligence (BI) has grown in popularity among executives across a range of industries. However, given the…
Abstract
Purpose
Due to its ability to support well-informed decision-making, business intelligence (BI) has grown in popularity among executives across a range of industries. However, given the volume of data collected in health-care organizations, there is a lack of exploration concerning its implementation. Consequently, this research paper aims to investigate the key factors affecting the acceptance and use of BI in healthcare organizations.
Design/methodology/approach
Leveraging the theoretical lens of the “unified theory of acceptance and use of technology” (UTAUT), a study framework was proposed and integrated with three context-related factors, including “rational decision-making culture” (RDC), “perceived threat to professional autonomy” (PTA) and “medical–legal risk” (MLR). The variables in the study framework were categorized as follows: information systems (IS) perspective; organizational perspective; and user perspective. In Jordan, 434 healthcare professionals participated in a cross-sectional online survey that was used to collect data.
Findings
The findings of the “structural equation modeling” revealed that professionals’ behavioral intentions toward using BI systems were significantly affected by performance expectancy, social influence, facilitating conditions, MLR, RDC and PTA. Also, an insignificant effect of PTA on PE was found based on the results of statistical analysis. These variables explained 68% of the variance (R2) in the individuals’ intentions to use BI-based health-care systems.
Practical implications
To promote the acceptance and use of BI technology in health-care settings, developers, designers, service providers and decision-makers will find this study to have a number of practical implications. Additionally, it will support the development of effective strategies and BI-based health-care systems based on these study results, attracting the interest of many users.
Originality/value
To the best of the author’s knowledge, this is one of the first studies that integrates the UTAUT model with three contextual factors (RDC, PTA and MLR) in addition to examining the suggested framework in a developing nation (Jordan). This study is one of the few in which the users’ acceptance behavior of BI systems was investigated in a health-care setting. More specifically, to the best of the author’s knowledge, this is the first study that reveals the critical antecedents of individuals’ intention to accept BI for health-care purposes in the Jordanian context.
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Nalan Gündüz, Selim Zaim and Yaman Ömer Erzurumlu
This paper aims to investigate the influence of health beliefs and trust by senior adults as associated with the perceived ease of use and perceived usefulness, for the acceptance…
Abstract
Purpose
This paper aims to investigate the influence of health beliefs and trust by senior adults as associated with the perceived ease of use and perceived usefulness, for the acceptance of smart technology with a focus on smartwatch technology.
Design/methodology/approach
Structural equation modeling is used to conceptualize the model using survey data collected from 243 randomly selected senior adults 60+ years of age.
Findings
This paper presents that perceived usefulness, perceived ease of use, trust and health belief are direct and indirect predictors of senior adults’ technology acceptance and intention to use smartwatch technology.
Research limitations/implications
The study reveals the moderator effect of social influence on relation between perceived usefulness, perceived ease of use and intention to use. The authors highlight the effect of health belief and trust on perceived usefulness and perceived ease of use and the role of intention to use smartwatch technology.
Practical implications
The authors contribute bridging developers of health technologists and senior adults as end-user perspectives. For marketing of health-care technology products, specifically smartwatch, to seniors, a focus on health beliefs and trust is essential to build, maintain and improve perceived usefulness and perceived ease of use.
Originality/value
The present study contributes empirical evidence to the literature on factors affecting the acceptance of the smartwatch technology by senior adults.
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Rashed Al Karim, Sakia Kawser, Md Karim Rabiul, Tabassum Chowdhury and Fathima Nabeelah Yoonoos Murtaza
This study aims to assess the effects of green supply chain management (GSCM) strategies on health-care organizations’ environmental performance (EP). It also assesses that green…
Abstract
Purpose
This study aims to assess the effects of green supply chain management (GSCM) strategies on health-care organizations’ environmental performance (EP). It also assesses that green innovation (GI), including green technology innovation (GTI) and green management innovation (GMI), plays mediating roles in the connection between GSCM and EP.
Design/methodology/approach
In total, 375 health-care sector employees in the Chattogram division of Bangladesh provided opinions in the questionnaire survey. PLS-SEM was used to verify the data’s validity and reliability and assess the hypotheses.
Findings
The findings reveal that GSCM practices significantly positively impact GI and EP. Moreover, GTI and GMI mediate the relationship between GSCM and EP in Bangladesh’s health-care sector.
Practical implications
The current findings could promote environmental sustainability in Bangladesh’s health-care industry by fostering environmental collaboration.
Originality/value
The detection of the mediation effect of GTI and GMI on GSCM and EP is a unique contribution of this study that enriches the present GSCM and GI literature, particularly in the Bangladeshi health-care sector.
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