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Africa has been identified as an area where higher mortality happens due to un-accessibility to health care, drugs and other health facilities. Nigeria, as one of the African countries, is not excluded from such difficulties. This study aims to examine the determinants of efficient last-mile delivery at selected health facilities and the Kaduna State Health Supplies Management Agency (KADSHMA).

The study sourced data from KADSHMA and the health facilities’ staff, with a total of 261 observations used. Likewise, the respondents were picked from warehouses of each health facility and KADSHMA. The data was analysed using the partial least square structural equation modelling analysis to estimate the relationship among the variables of the study.

The study’s findings revealed that all five variables of the study (i.e. determinants) were significantly affecting the efficient last-mile delivery. Four constructs (delivery cost [DC], delivery time [DT], mode of delivery [MD] and facilities technology [FT]) have shown a positive and significant association with efficient last-mile delivery, whereas one variable (product mix [PM]) indicated a negative and significant association with efficient last-mile delivery. The study concludes that DC, DT, MD, FT and PM played significant roles in efficient last-mile delivery.

The study provides that specific means of transportation should always be on standby to transport health supplies. Time schedules should always be prepared and adhered to when transporting health supplies to the facilities, and each facility should network with robust technology to ease communication in terms of order and order planning. Additionally, facilities should try as much as possible to reduce the varieties of products when ordering health supplies, as it will increase the efficiency of the delivery.

To the best of the authors’ knowledge, this study is the first of its kind that considered these five variables (DC, DT, MD, FT and PM) with impact on the last-mile delivery in one model, especially in the Nigerian case. This is a great contribution to knowledge, more importantly, to the last-mile delivery of the health sector. The result confirmed the importance of these determinants (DC, DT, FT and PM) of last-mile delivery efficiency in saving lives.

A quick search of the headlines of major newspapers reveals a treasure trove of technology procurement gone wrong. While the private sector seems to adopt and implement new technology seamlessly and quickly to deliver for customers, the government struggles to accomplish technology purchases and integrations with the same ease. As governments in the United States are looking to retain their current workforce and attract the next generation of workers, the technological capabilities and ethos of governments will be paramount. With nearly every industry being transformed by technology and Generation T being the first generation to have an ingrained “technology first” mindset, the ability of governments to attract these workers depends, in large part, on the ability to transform their government technology culture, policies, and practices.

In this chapter, the authors examine the administrative branch and observe two key components at the root of most technology failures: poor organizational structure in the bureaucracy and the lack of an empowered Chief Information/Technology Officer. Building upon case studies from Massachusetts and California, this chapter looks at the factors related to failure or success to understand the technology procurement culture. The chapter concludes by presenting four key “best practice” principles of public policy and administration that can be implemented by almost any governmental entity to improve their acquisition and implementation of technology.

We present the results of one of the only in-depth studies of a police agency’s internal and external response to the coronavirus pandemic of 2020 (COVID-19). This study emphasizes the importance of law enforcement agencies conducting comprehensive case studies and after-action assessments to prepare, prevent and respond to prolonged public health crises and showcases the profound (and lingering) effects of COVID-19 on police organizations.

This multi-method case study combines document analysis, a workforce survey, a community survey, interviews and analysis of administrative data to detail and assess the agency’s internal and operational responses to the pandemic and the reactions of employees and community members to those responses.

Despite agency strategies to mitigate the pandemic’s effects, employees cited very high stress levels one year after the pandemic and a third of sworn officers considered leaving the policing profession altogether during the first two years of the COVID-19 pandemic. Several policies intended by the agency to protect employee health and maintain staffing needs kept workforce levels steady but may have increased feelings of organizational injustice in both sworn and non-sworn individuals, with variation across racial and gender groups. A jurisdiction-wide community survey indicated general support for the police department’s responses but a preference for in-person rather than telephone-based responses to service calls. Officers, however, preferred continuing remote responses even after the pandemic subsided.

To the best of our knowledge, this is one of the only in-depth case studies that examine a police agency’s internal and external responses to COVID-19 and the sworn, non-sworn and community reactions to those responses.

At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public health) and other industry sectors, began to recognize the limitations of the current fragmented healthcare system paradigm. Primary stakeholders, including employers, insurance companies, and healthcare professional organizations, also voiced dissatisfaction with unacceptable health outcomes and rising costs. Grand challenges and wicked problems threatened the viability of the health sector. American health systems responded with innovations and advances in healthcare delivery frameworks that encouraged shifts from intra- and inter-sector arrangements to multi-sector, lasting relationships that emphasized patient centrality along with long-term commitments to sustainability and accountability. This pathway, leading to a population health approach, also generated the need for transformative business models. The coproduction of health framework, with its emphasis on cross-sector alignments, nontraditional partner relationships, sustainable missions, and accountability capable of yielding return on investments, has emerged as a unique strategy for facing disruptive threats and challenges from nonhealth sector corporations. This chapter presents a coproduction of health framework, goals and criteria, examples of boundary spanning network alliance models, and operational (integrator, convener, aggregator) strategies. A comparison of important organizational science theories, including institutional theory, network/network analysis theory, and resource dependency theory, provides suggestions for future research directions necessary to validate the utility of the coproduction of health framework as a precursor for paradigm change.

The purpose of this paper was to examine law enforcement officers' perspectives on job stress and barriers to supportive resources when working child sexual abuse cases in a large southern state. It is well documented in the literature that professionals who work in healthcare, emergency services and law enforcement face tremendous amounts of stress and consequences to their physical and mental health. Little research has been done to examine how child sexual abuse investigations impact law enforcement, and how these specialized officers perceive access to supportive resources.

This qualitative study was part of a larger quantitative study and included 20 law enforcement officers who participated in anonymous, semi-structured phone interviews.

Findings included (1) child sexual abuse cases are difficult, specialized and disturbing (2) barriers to supportive resources include law enforcement culture, the stigma of asking for help, awareness and accessibility of resources and leadership as gatekeeper to the resources and (3) officers perceive both formal and informal resources to be helpful and at best should be proactively available to all officers in the state. A model of the findings was developed to illustrate the implications for practitioners and scholars.

This study was not without weaknesses, specifically the small number of participants, volunteer sampling does not represent the general population and the sampling technique means some demographics may have been missed by researchers.

This study adds to the literature on law enforcement mental health, occupational health and mental health resources. It confirms established research in the literature and provides insight into officer perspectives about barriers that prevent access to informal and formal supports that could improve their emotional well-being.

This study is the first of its kind, to our knowledge, that asks detectives and investigators of child abuse cases about mental health resources. These law enforcement officers are at high-risk for traumatic stress, compassion fatigue and burnout due to the specialized cases they investigate.

The institutional conditions of primary care provision remain understudied in low- and middle-income countries. This study analyzes how primary care doctors cope with medical uncertainty in municipal clinics in urban India. As street-level bureaucrats, the municipal doctors occupy two roles simultaneously: medical professional and state agent. They operate under conditions that characterize health systems in low-resource contexts globally: inadequate state investment, weak regulation and low societal trust. The study investigates how, in these conditions, the doctors respond to clinical risk, specifically related to noncommunicable diseases (NCDs).

The analysis draws on year-long ethnographic fieldwork in Pune (2013–14), a city of three million, including 30 semi-structured interviews with municipal doctors.

Interpreting their municipal mandate to exclude NCDs and reasoning their medical expertise as insufficient to treat NCDs, the doctors routinely referred NCD cases. They expressed concerns about violence from patients, negative media attention and unsupportive municipal authorities should anything go wrong clinically.

The study contextualizes street-level service-delivery in weak institutional conditions. Whereas street-level workers may commonly standardize practices to reduce workload, here the doctors routinized NCD care to avoid the sociopolitical consequences of clinical uncertainty. Modalities of the welfare state and medical care in India – manifest in weak municipal capacity and healthcare regulation – appear to compel restraint in service-delivery. The analysis highlights how norms and social relations may shape primary care provision and quality.

This study explored the effects of the coronavirus pandemic on rural municipal police in Pennsylvania.

The authors surveyed rural police chiefs and sworn officers to inquire about their intra-department organizational capabilities, police-community relations, well-being practices, and how these strategies may have developed since March 2020.

The pandemic affected rural police officers and rural policing strategies in many ways. Moreover, existing challenges to limited rural police budgets were exacerbated suggesting a need for more flexible budgetary capacities, access to wellness resources were limited suggesting better access to these resources and preparation for responding to public health emergencies was limited suggesting more complete training is warranted.

This study draws attention to the unique experiences of rural municipal police across one state by capturing specific areas of concern throughout the coronavirus pandemic.

This study explores the determinants of police officer support for pre-arrest/booking deflection programs that divert people presenting with substance use and/or mental health disorder symptoms out of the criminal justice system and connect them to supportive services.

This study analyzes responses from 254 surveys fielded to police officers in Delaware. Questionnaires asked about views on leadership, approaches toward crime, training, occupational experience and officer’s personal characteristics. The study applies a new machine learning method called kernel-based regularized least squares (KRLS) for non-linearities and interactions among independent variables. Estimates from a KRLS model are compared with those from an ordinary least square regression (OLS) model.

Support for diversion is positively associated with leadership endorsing diversion and thinking of new ways to solve problems. Tough-on-crime attitudes diminish programmatic support. Tenure becomes less predictive of police attitudes in the KRLS model, suggesting interactions with other factors. The KRLS model explains a larger proportion of the variance in officer attitudes than the traditional OLS model.

The study demonstrates the usefulness of the KRLS method for practitioners and scholars seeking to illuminate patterns in police attitudes. It further underscores the importance of agency leadership in legitimizing deflection as a pathway to addressing behavioral health challenges in communities.

The study aimed to listen to refugee survivors of sexual and gender-based violence (SGBV) and/or torture and explore what justice meant to them in exile. This study argues that what the survivors who participated in this research wanted was “viable justice”. The research was funded by the British Academy and Leverhulme Trust.

Using a survivor-focussed justice lens combined with a trauma-informed approach, narrative interviews were held with 41 women and 20 men refugee survivors living in refugee settlements in Northern Uganda. The researchers also conducted semi-structured interviews with 37 key informants including refugee welfare councils, the UN, civil society, non-government and government organisations. Thematic analysis of the data resulted in the following themes being identified: no hope of formal justice for atrocities that occurred in South Sudan; insecurity; lack of confidence in transitional justice processes in Ugandan refugee settlements; abuse and loss of freedom in refugee settlements; and lack of access to health and justice services in refugee settlements.

This study argues that what the survivors who participated in this research wanted was “viable justice”. That is justice that is survivor-centred and includes elements of traditional and transitional justice, underpinned by social justice. By including the voices of both men and women survivors of SGBV and/or torture and getting the views of service providers and other stakeholders, this paper offers an alternative form of justice to the internationally accepted types of justice, which offer little relevance or restitution to refugees, particularly where the crime has been committed in a different country and where there is little chance that perpetrators will be prosecuted in a formal court of law.

The research findings are based on a small sample of South Sudanese refugees living in three refugee settlements in Northern Uganda. Thus, wider conclusions should not be drawn. However, the research does suggest that a “viable justice” approach should be implemented that is gender and culturally sensitive and which could also be trialled in different refugee contexts.

Improvements in refugee survivors’ dignity, resilience and recovery are dependent upon the active engagement of refugees themselves using a “survivor-focussed approach” which combines formal and community-based health services with traditional and transitional justice responses.

The provision of a “viable justice approach” ensures those who have experienced SGBV and/or torture, and their families, feel validated. It will assist them to use their internal, cultural and traditional resilience and agency in the process of recovery.

The research findings are original in that data was collected from men and women survivors of SGBV and/or torture and service providers. The empirical evidence supports this study’s recommendation for an approach that combines both formal and survivor-focussed approaches towards health and viable justice services to meet the needs of refugees living in refugee settlements. This is a response that listens to and responds to the needs of refugee survivors in a way that continues to build their resilience and agency and restores their dignity.

The years following the 9/11/2001 terrorists attacks saw a marked increase in community and hospital emergency preparedness, from communications across community networks, development of policies and procedures, to attainment and training in the use of biological warfare resources. Regular drills ensured emergency and health care personnel were trained and prepared to address the next large-scale crisis, especially from terrorist and bioterrorist attacks. This chapter looks at some of the more familiar global health issues over the past two decades and the lessons learned from hospital responses to inform hospital management in preparation for future incidents.

This study is a narrative review of the literature related to lessons learned from four major events in the time period from 2002 to 2023 – SARS, MERS, Ebola, and COVID-19.

The initial search yielded 25,913 articles; 57 articles were selected for inclusion in the study.

Comparison of key issues and lessons learned among the four major events described in this article – SARS, MERS, Ebola, and COVID-19 – highlight that several lessons are “relearned” with each event. Other key issues, such as supply shortages, staffing availability, and hospital capacity to simultaneously provide care to noninfectious patients came to the forefront during the COVID-19 pandemic. A primary, ongoing concern for hospitals is how to maintain their preparedness given competing priorities, resources, and staff time. This concern remains post-COVID-19.