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1 – 10 of over 1000Clair Reynolds Kueny, Alex Price and Casey Canfield
Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower…
Abstract
Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower health literacy, rural healthcare systems also experience significant resource shortages, as well as issues with recruitment and retention of healthcare providers, particularly specialists. These factors combined result in complex change management-focused challenges for rural healthcare systems. Change management initiatives are often resource intensive, and in rural health organizations already strapped for resources, it may be particularly risky to embark on change initiatives. One way to address these change management concerns is by leveraging socio-technical simulation models to estimate techno-economic feasibility (e.g., is it technologically feasible, and is it economical?) as well as socio-utility feasibility (e.g., how will the changes be utilized?). We present a framework for how healthcare systems can integrate modeling and simulation techniques from systems engineering into a change management process. Modeling and simulation are particularly useful for investigating the amount of uncertainty about potential outcomes, guiding decision-making that considers different scenarios, and validating theories to determine if they accurately reflect real-life processes. The results of these simulations can be integrated into critical change management recommendations related to developing readiness for change and addressing resistance to change. As part of our integration, we present a case study showcasing how simulation modeling has been used to determine feasibility and potential resistance to change considerations for implementing a mobile radiation oncology unit. Recommendations and implications are discussed.
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Zarjina Tarana Khalil and Samira Rahman
Although healthcare and healthy living are integral to the Sustainable Development Goals (SDGs) for 2030, the coronavirus epidemic has dealt a devastating blow to these efforts…
Abstract
Although healthcare and healthy living are integral to the Sustainable Development Goals (SDGs) for 2030, the coronavirus epidemic has dealt a devastating blow to these efforts. As governments and policymakers were compelled to shift their focus to lockdowns, sustenance, procurement, and distribution of vaccines, the momentum for health initiatives slowed, and the already fragile health systems of emerging markets were subjected to additional shocks. However, in many underserved regions of the globe, the introduction of technology has greatly facilitated the distribution and adoption of healthcare services.
This chapter highlights mini-cases from four emerging nations: Bangladesh, Nigeria, Vietnam, and the Philippines. Although the countries are emerging, each one of them are in a distinct stage of development and face a unique set of healthcare-related challenges. The chapter showcases how four different organizations based in these countries leveraged the use of technology to take healthcare services to underserved populations. In doing so, they addressed the key challenges of imparting healthcare: geographic accessibility, availability, financial accessibility, and acceptability.
This chapter concludes with a discussion of the implications of expanding healthcare industries leading to increased healthcare waste. To prevent mass population exposure to hazardous substances, the emergence of intelligent healthcare waste collection and disposal systems will be an absolute necessity. Hence, with the development of healthcare services, governments and policymakers need to mechanize smart waste management systems to safeguard humans, animals, and the environment.
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Anne Hendry, Donata Kurpas, Sarah-Anne Munoz and Helen Tucker
Fauster Agbenyo, Miller Williams Appau and Eunice Yorgri
This paper aims to examine landlords’ health support systems to tenants to control COVID-19 in selected informal settlement rental housing (ISRH) in Ghana, dwelling on landlords’…
Abstract
Purpose
This paper aims to examine landlords’ health support systems to tenants to control COVID-19 in selected informal settlement rental housing (ISRH) in Ghana, dwelling on landlords’ views.
Design/methodology/approach
The paper used the concurrent imbedded mixed-methods approach and grounded the findings in the socio-ecological theory. The authors collected both qualitative and quantitative data from 242 landlords in 13 informal settlements across Ghana using quotas. The authors undertook semi-structured face-to-face and telephone interviews. The authors conducted content and thematic qualitative data analysis and used simple descriptive statistical data analysis.
Findings
The paper discovered that tenants had limited knowledge on the transmission of the pandemic, forcing landlords to regulate their building services usage, ventilation and thermal control, entertainment, common areas and rent advancement for tenants to control the pandemic. Also, tenants found it difficult to comply with the rules on ventilation for fear of criminal attacks, while high social connection and interaction among renters and inadequate enforcement caused the non-adherence by renters to social gathering. Again, landlords had difficulty in contract-tracing visitors suspected to be infected with the virus.
Originality/value
The use of concurrent and imbedded mixed methods to investigate landlords’ viewpoints on their support in health needs of their tenants to regulate COVID-19. The prescriptions from the study provide practical applications to formulate a mix of housing and health policies to formalize the support of landlords to their tenants in ISRH in Ghana.
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Rosemarie Santa González, Marilène Cherkesly, Teodor Gabriel Crainic and Marie-Eve Rancourt
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…
Abstract
Purpose
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.
Design/methodology/approach
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).
Findings
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.
Originality/value
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.
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Jeffersson Santos, Amanda Acevedo-Morales, Lillian Jones, Tara Bautista, Carolyn Camplain, Chesleigh N. Keene and Julie Baldwin
Advancing behavioral health and primary care integration is a priority for helping clients overcome the complex health challenges impacting healthcare deserts like those in…
Abstract
Purpose
Advancing behavioral health and primary care integration is a priority for helping clients overcome the complex health challenges impacting healthcare deserts like those in Arizona, United States of America (USA). This study aimed to explore the perspectives of people with a substance use disorder (SUD) on accessing integrated primary care (IPC) services in a rural-serving behavioral healthcare organization in Arizona.
Design/methodology/approach
Clients from a behavioral health facility in Arizona (n = 10) diagnosed with SUDs who also accessed IPC participated in a 45-min semi-structured interview.
Findings
The authors identified six overarching themes: (1) importance of IPC for clients being treated for SUDs, (2) client low level of awareness of IPC availability at the facility, (3) strategies to increase awareness of IPC availability at the behavioral health facility, (4) cultural practices providers should consider in care integration, (5) attitudes and perceptions about the experience of accessing IPC and (6) challenges to attending IPC appointments. The authors also identified subthemes for most of the main themes.
Originality/value
This is the first study in rural Arizona to identify valuable insights into the experiences of people with SUDs accessing IPC, providing a foundation for future research in the region on care integration.
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Salehin Ahmadi, Ubada Aqeel and Shikha Gera
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…
Abstract
Learning outcomes
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).
Case overview/synopsis
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.
Complexity academic level
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.
Supplementary materials
Teaching notes are available for educators only.
Subject code
CSS3: Entrepreneurship.
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Ashok Dalwai, Ritambhara Singh, Vishita Khanna and S. Rutuparna
According to Global Healthcare Security Index 2021, India ranked 66 out of 195 countries, indicating the need and scope for improvement. The Cooperative healthcare system which…
Abstract
According to Global Healthcare Security Index 2021, India ranked 66 out of 195 countries, indicating the need and scope for improvement. The Cooperative healthcare system which has been rendering exemplary services is yet to gain visible recognition in India. Given the need for upgrading the health infrastructure in India and providing more affordable health services to the country’s growing population, it would help appreciate the large role that cooperative healthcare can play along with others. This study explores the structure, conduct, and performance of healthcare co-operatives in India, the factors contributing to their success and failure, and the challenges they face. The Health Cooperatives have a strong presence in Kerala and Karnataka and are also coming up in other parts of the country. However, a detailed database of them for public awareness is very limited. The cooperative hospitals can meet the basic requirements of curative treatment in rural and poorly-endowed urban areas. The democratic way in which they function makes them a destination for a financially weaker section. They must retain this feature. The study covers two successful cases which reveal that India needs a more dense healthcare cooperative network. Since cooperative hospitals in tune with the spirit of service run on the principle of being ‘Not-for-Profit’ they need to be supported by the governments more liberally, without however interfering with their governance and administration.
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Samaya Pillai, Manik Kadam, Madhavi Damle and Pankaj Pathak
Healthcare is indispensable for any civilisation to attain a good quality of life and well-being on both mental and physical levels. The healthcare domain primarily falls under…
Abstract
Healthcare is indispensable for any civilisation to attain a good quality of life and well-being on both mental and physical levels. The healthcare domain primarily falls under pharma, medical, biotechnology, and nursing. Also, other fields may be aligned with these primary fields. Healthcare amasses the contemporary trends and knowledge of upcoming techniques to improve healthcare processes. The practitioners are primarily doctors, nurses, specialists and health professionals, hospital administrators, and health insurance.
It is a fundamental attribute needed for any society to attain good quality of life and well-being in mental and physical health. It is a fundamental right of people to receive good healthcare where drug treatment and hospitalization are available at a nominal cost, as a requirement of today’s modern era. There appears to be a significant disparity in the availability of good healthcare in rural areas compared to urban in India. Even though we enter the digital era with the facilities offered in Industry 4.0 and other advanced technologies brings about a significant change of overall processing within healthcare systems. During the pandemic of COVID-19, there has been digital transformation with success globally. Healthcare cooperatives are a new norm to support the healthcare systems globally. The chapter discusses Gampaha healthcare cooperative and reviews Ayushman Sahakar scheme in India. The reforms require time to evolve.
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Maria Teresa Ferazzoli and Lily Kpobi
This paper aims to provide new insights into and offer potential solutions to the challenges encountered by mental health services working with remote, rural or underserved…
Abstract
Purpose
This paper aims to provide new insights into and offer potential solutions to the challenges encountered by mental health services working with remote, rural or underserved communities in the UK.
Design/methodology/approach
In this paper, the authors reflect on the utility of integrating conventional clinical approaches, with preventive care and empowering work within the community, to provide culturally sensitive and accessible mental health services. The authors describe an example of community intervention from a mental health service in Ghana designed to enhance reach within remote and rural communities and identify potential lessons for practice in the UK.
Findings
The partnership between community mental health services and the rural communities, including families and existing social frameworks, applies collaborative care to overcome the lack of resources and facilitate the acceptability of mental health services to the local population. There are a series of important lessons from this experience including the importance of understanding the culture of a community to optimise reach and the importance of working IN the community and WITH the community.
Originality/value
This paper is novel because it provides learning from a model of care applied in the global south that has potential for implementation with underserved populations in the UK. The authors suggest a reframing of the notion of community care to encompass existing frameworks of community, not merely a biomedical conceptualisation.
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