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Strong leadership in primary care is necessary to coordinate an effective pandemic response; however, descriptions of leadership roles for family physicians are absent from previous pandemic plans. This study aims to describe the leadership roles and functions family physicians played during the COVID-19 pandemic in Canada and identify supports and barriers to formalizing these roles in future pandemic plans.

This study conducted semi-structured qualitative interviews with family physicians across four regions in Canada as part of a multiple case study. During the interviews, participants were asked about their roles during each pandemic stage and the facilitators and barriers they experienced. Interviews were transcribed and a thematic analysis approach was used to identify recurring themes.

Sixty-eight family physicians completed interviews. Three key functions of family physician leadership during the pandemic were identified: conveying knowledge, developing and adapting protocols for primary care practices and advocacy. Each function involved curating and synthesizing information, tailoring communications based on individual needs and building upon established relationships.

Findings demonstrate the need for future pandemic plans to incorporate formal family physician leadership appointments, as well as supports such as training, communication aides and compensation to allow family physicians to enact these key roles.

The COVID-19 pandemic presents a unique opportunity to examine the leadership roles of family physicians, which have been largely overlooked in past pandemic plans. This study’s findings highlight the importance of these roles toward delivering an effective and coordinated pandemic response with uninterrupted and safe access to primary care.

This paper aims to report on a case in which encouraging climate-smart agriculture in the form of better irrigation techniques in India can contribute to both climate change mitigation and adaptation goals by improving resource-use efficiency. It provides grounded institutional analysis on how these transformations can occur.

The authors based their research on three complementary approaches: institutional, sociological and technical. The institutional approach analyzed actors and interests in the water-energy nexus in India via over 25 semi-structured key informant interviews. The sociological approach surveyed over 50 farmers and equipment suppliers for insight into technology adoption. The technical component analyzed water and energy consumption data to calculate potential benefits from transitioning to more efficient techniques.

Because policymakers have a preference for voluntary policy instruments over coercive reforms, distortions in policy and market arenas can provide opportunities for embedded actors to leverage technology and craft policy bargains which facilitate Pareto superior reforms and, thereby, avoid stalemates in addressing climate change. Enlarging the solution space to include more actors and interests can facilitate such bargains more than traditional bilateral exchanges.

The analysis provides insights into crafting successful climate action policies in an inhospitable institutional terrain.

Studies about climate change politics generally focus on stalemates and portray the private sector as resistant and a barrier to climate action. This paper analyzes a contrary phenomenon, showing how reforms can be packaged in Pareto superior formats to overcome policy stalemates and generate technology-based climate and environmental co-benefits in even unpromising terrain such as technologically laggard and economically constrained populations.