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Migrants face some unique health-care challenges, which often remain unaddressed by the health system. The purpose of this study is to determine health-care access among migrants in Chhattisgarh, from a lens of health equity.

This study was conducted in a government-built tenement under the Integrated Housing and Slum Development program in Bilaspur district of Chhattisgarh state of India. It is a mixed-methods study which used a survey method, focus group discussion, in depth-interviews, semi-structured interviews and non-participant observations of health facilities in the area. Respondents included residents (migrants) and other local stakeholders like the Chief Medical Officer of the district, elected representatives of the local government and frontline health workers. This paper focuses on the findings from the qualitative component of the study.

The move to resettle the people living in the slums to the periphery of the city had a negative impact on their health-care access. They find it difficult to access public health services, given the services are concentrated in the city. Women, elderly people and disabled people grapple with additional challenges in being able to access basic reproductive health services and care for chronic illnesses. Equity in health-care access is linked to various social determinants of health including access to housing and social security. However, the authors found that the migrant community is being deprived of appropriate housing facilities and social security.

This paper explores the health-care access of internal migrants in Chhattisgarh state of India in the larger context of urban development with a focus on health equity.

The primary objective of this article is to examine current procurement, inventory control and management practices in modern healthcare, with a particular focus on the procurement and management of surgical supplies in a prominent public, highly specialized healthcare sector.

This study was conducted in three phases. In Phase 1, the study team interacted with various hospital management stakeholders, including the surgical hospital store, examined the current procurement process and identified challenges. Phase 2 focused on selecting items for a detailed study and collected the qualitative and quantitative details of the store department of the healthcare sector chosen. A detailed study analyzed revenue, output/demand, inventory levels, etc. In Phase 3, a decision-making framework is proposed, and inventory control systems are redesigned and demonstrated for the selected items.

It was observed that the demand for many surgical items had increased significantly over the years due to an increase in disposable/disposable items, while inventories fluctuated widely. Maximum inventory levels varied between 50 and 75%. Storage and availability were important issues for the hospital. It is assumed the hospital adopts the proposed inventory control system. In this case, the benefits can be a saving of 62% of the maximum inventory, 20% of the average stock in the system and optimal use of storage space, improving the performance and productivity of the hospital.

This study can help the healthcare sector administration to develop better systems for the procurement and delivery of common surgical items and efficient resource allocation. It can help provide adequate training to store staff. This study can help improve management/procurement policies, ordering and delivery systems, better service levels, and inventory control of items in the hospital business context. This study can serve as a pilot study to further investigate the overall hospital operations.

This study can help the healthcare sector administration develop better systems for procuring and delivering common surgical items and efficient resource allocation. It can help provide adequate training to store staff. This study can help improve management/procurement policies, ordering and delivery systems, better service levels and inventory control of items in the hospital business context. This study can serve as a pilot study to further investigate the overall hospital operations.

This study is an early attempt to develop a decision framework and inventory control system from the perspective of healthcare inventory management. The gaps identified in real hospital scenarios are investigated, and theoretically based-inventory management strategies are applied and proposed.

The primary study purpose is to examine whether managerial support triggers job crafting and sustainable employability, and to what extent work uncertainty moderates the managerial support and sustainable employability relationships mediated by job crafting using a moderated mediation approach. Thus, this study aims to uncover new antecedent and outcomes of job crafting using job demands and resources (JD–R) theory as no such research has yet examined these relationships.

The structural equation modeling (SEM) technique was employed to test the proposed relationships based on survey data that include a final 483 knowledge workers of the services sector. The authors tested the structural model using self-developed estimates for AMOS 24.0 to examine the moderated mediation process models (process models 7, 14 and 58) rather than using a conventional process macro through SPSS.

Consistent with the formulated hypothesis, the results of this study indicate that managerial support directly stimulates job crafting and sustainable employability. Further, job crafting mediates the relationships between managerial support and sustainable employability. This validates the JD–R theory assumption that managerial support as job resources initiates a motivational process through job crafting, leading to sustainable employability as the outcome of the motivational process. Additionally, the moderated mediation results show that in the presence of high work uncertainty, employees are more engaged in job crafting to boost their sustainable employability.

Organizations may incorporate these findings while developing human resources (HR) management policies and practices to align top-down and bottom-up job re(design) approaches. For example, by designing line managers’ role in implementation of supportive HR practices, their supportive leadership behavior towards employees will successfully trigger job crafting and nurture their sustainable employability.

This research adds to the work design and employability literature. No such study has yet examined whether managerial support triggers job crafting and sustainable employability. Prior studies examine personality traits, some individual difference variable, job characteristics, or leadership influence as antecedents of job crafting. Utilizing the JD–R theory, we empirically validate that job crafting plays a vital role in the motivational process initiated by the job resources (managerial support), leading to sustainable employability as an outcome of the motivational process. The authors further show that in the presence of high job demands (work uncertainty), employees are more engaged in job crafting and more conscious to boost their sustainable employability.

The COVID-19 pandemic has had a disruptive effect on the health system. Health facility leaders were at the forefront of maintaining service delivery and were exposed to varied stressors in the early phase of the pandemic. This study aims to explore the leadership experiences of health facility leaders during the early phase of the COVID-19 pandemic in Nigeria’s epicentre.

This study conducted an exploratory descriptive qualitative study. To achieve this, 33 health facility leaders of different cadres across primary, secondary, and tertiary levels of the public health care system in Lagos, Nigeria, were remotely interviewed. The key informant interviews were transcribed verbatim and were analysed by using thematic analysis.

The health facility leaders experienced heightened levels of fear, anxiety and stressors during the early phase of the pandemic. They also had genuine concerns about exposing their family members to the virus and had to manage some health-care workers who were afraid for their lives and reluctant. Coping mechanisms included psychological and social support, innovative hygiene measures at health facility and at home, training and staff welfare in more ways than usual. They were motivated to continue rendering services during the crisis because of their passion, their calling, the Hippocratic oath and support from the State government.

The experiences of health facility leaders from different parts of the world have been documented. However, to the best of the authors’ knowledge, this is one of the first studies that specifically report multi-layer leadership experiences of health facility leaders during the early phase of the COVID-19 pandemic in sub-Saharan Africa.

The purpose of this paper is to report on the implementation of the World Health Organization (WHO) trauma care checklist (TCC) (WHO, 2016) in an emergency department in a tertiary hospital in Nepal. This research was undertaken as part of a Hybrid International Emergency Medicine Fellowship programme (Subedi et al., 2020) across UK and Nepal, incorporating a two-year rotation through the UK National Health Service, via the Medical Training Initiative (MTI) (AoMRC, 2017). The WHO TCC can improve outcomes for trauma patients (Lashoher et al., 2016); however, significant barriers affect its implementation worldwide (Nolan et al., 2014; Wild et al., 2020). This article reports on the implementation, barriers and recommendations of WHO TCC implementation in the context of Nepal and argues for Transformational Leadership (TL) to support its implementation.

Explanatory mixed methods research (Creswell, 2014), comprising quasi-experimental research and a qualitative online survey, were selected methods for this research. A training module was designed and implemented for 10 doctors and 15 nurses from a total of 76 (33%) of clinicians to aid in the introduction of the WHO TCC in an emergency department in a hospital in Nepal. The quasi-experimental research involved a pre- and post-training survey aimed to assess participant’s knowledge of the WHO TCC before and after training and before the implementation of the WHO TCC in the emergency department. Post-training, 219 patients were reviewed after four weeks to identify if process measures had improved the quality of care to trauma patients. Subsequently six months later, a qualitative online survey was sent to all clinical staff in the department to identify barriers to implementation, with a response rate of 26 (n = 26) (34%) (20 doctors and 6 nurses). Descriptive statistics were used to evaluate quantitative data and the qualitative data were analysed using the five stepped approach of thematic analysis (Braun and Clarke, 2006).

The evaluation of the implementation of the WHO TCC showed an improvement in care for trauma patients in an emergency setting in a tertiary hospital in Nepal. There were improvements in the documentation in trauma management, showing the training had a direct impact on the quality of care of trauma patients. Notably, there was an improvement in cervical spine examination from 56.1% before training to 78.1%; chest examination 125 (57.07%) before training and 170 (77.62%) post-training; abdominal examination 121 (55.25%) before training and 169 (77.16%) post-training; gross motor examination 13 (5.93%) before training and 131 (59.82%) post-training; sensory examination 4 (1.82%) before training and 115 (52.51%) post-training; distal pulse examination 6 (2.73%) before training and 122 (55.7%) post-training. However, while the quality of documentation for trauma patients improved from the baseline of 56%, it only reached 78% when the percentage improvement target agreed for this research project was 90%. The 10 (n = 10) doctors and 15 (n = 15) nurses in the Emergency Department (ED) all improved their baseline knowledge from 72.2% to 87% (p = 0.00006), by 14.8% and 67% to 85%) (p = 0.006), respectively. Nurses started with lower scores (mean 67) in the baseline when compared to doctors, but they made significant gains in their learning post-training. The qualitative data reported barriers, such as the busyness of the department, with residents and medical officers, suggesting a shortened version of the checklist to support greater protocol compliance. Embedding this research within TL provided a steer for successful innovation and change, identifying action for sustaining change over time.

The study is a single-centre study that involved trauma patients in an emergency department in one hospital in Nepal. There is a lack of internationally recognised trauma training in Nepal and very few specialist trauma centres; hence, it was challenging to teach trauma to clinicians in a single 1-h session. High levels of transformation of health services are required in Nepal, but the sample for this research was small to test out and pilot the protocol to gain wider stakeholder buy in. The rapid turnover of doctors and nurses in the emergency department, creates an additional challenge but encouraging a multi-disciplinary approach through TL creates a greater chance of sustainability of the WHO TCC.

International protocols are required in Nepal to support the transformation of health care. This explanatory mixed methods research, which is part of an International Fellowship programme, provides evidence of direct improvements in the quality of patient care and demonstrates how TL can drive improvement in a low- to medium-income country.

The Nepal/UK Hybrid International Emergency Medicine Fellowships have an opportunity to implement changes to the health system in Nepal through research, by bringing international level standards and protocols to the hospital to improve the quality of care provided to patients.

To the best of the authors’ knowledge, this research paper is one of the first studies of its kind to demonstrate direct patient level improvements as an outcome of the two-year MTI scheme.

Coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented mental health repercussions in the lives of every individual including university students. Therefore, study on students’ psychological state and its associated factors during the pandemic are of importance. This study aims to discuss the aforementioned issue.

An online survey was done on a total of 207 university students of Pakistan to collect information on socio-demographic characteristics, concerns or fears amidst COVID-19 and mental distress. Validated tools; Perceived Stress Scale (PSS), Generalized Anxiety Disorder Scale (GAD-7) and Patient Health Questionnaire (PHQ-9)-Depression were used to assess stress, anxiety and depression, respectively.

Around 14% of the university students were experiencing severe stress and anxiety, while 8.2% had severe depression. The authors found that stress among university students was related to psychiatric illness or symptoms (OR = 5.1: 1.1, 22.9) and unpredictability due to the pandemic (OR = 3.7: 1.2, 11.2). The significant determinants of anxiety were psychiatric illness/symptoms (OR = 6.6: 3.4, 12.9), implementation of public health measures (OR = 3.7: 1.1, 11.6), employed mothers (OR = 2.4: 1.1, 5.0) and lack of support from university administration (OR = 2.2: 1.0, 5.0). While the factors associated with depression included psychiatric illness or symptoms (OR = 8.4: 3.3, 21.5), unpredictability due to pandemic (OR = 6.8: 2.2, 20.7), impaired social support system (OR = 3.7: 1.3, 10.4) and studying without a scholarship (OR = 2.1: 1.0, 4.4).

These findings call for an urgent need to develop appropriate interventions and educational programs that could address the psychological needs of students.

The study directs the role of university and faculty in dealing the mental health needs of the student in COVID-19 pandemic time.

Educational programs are important that could address the psychological needs of students in COVID-19 pandemic.

University students reported mental distress during COVID-19 pandemic which shows that younger people are at risk of COVID-19 repercussions. Moreover, several stressors (i.e. impaired social support system and lack of support from universities) were revealed that could be mitigated by implementing appropriate strategies.

This study aimed to compare mortality rate, length of stay (LOS) and hospitalization costs at different priority levels for a patient admitted to an intensive care unit (ICU) at a public tertiary hospital in Qazvin, Iran. This study also aimed to predict influencing factors on patients’ mortality, ICU LOS and hospitalization costs in different admission groups.

The authors conducted a retrospective cohort study among patients who mainly suffered from internal diseases admitted to an ICU of a public hospital. This study was conducted among 127 patients admitted to ICU from July to September 2019. The authors categorized patients into four groups based on two crucial hemodynamic and respiratory status criteria. The authors used a logistic regression model to predict the likelihood of mortality in ICU admitted patients during hospitalizations for the four prioritization groups. Furthermore, the authors conducted a multivariate analysis using the “enter” method to identify risk factors for LOS.

Results showed a statistically significant relationship between the priority of being admitted to ICU and hospitalization costs. The authors’ findings revealed that age, LOS and levels of consciousness had a predictability role in determining in-hospital mortality. Besides, age, gender, consciousness level of patients and type of the disease were mentioned as affecting factors of LOS.

This study’s findings emphasize the necessity of categorizing patients according to specific criteria to efficiently use available resources to help health-care authorities reduce the costs and allocate the budget to different health sectors.

This paper aims to explore the antecedents and consequences of service chain flexibility (SCF) in healthcare service delivery.

A structural model was developed based on a literature review. A 29-indicator questionnaire was circulated among service providers in the healthcare system across India, and 253 valid responses were received, corresponding to a response rate of 46%. The research model was assessed using a cross-sectional research design, and the data were analyzed by structural equation modeling using analysis of moment structures (AMOS) software.

Service orientation (SO), technology integration (TI), knowledge sharing (KS) and supply chain integration (SCI) were identified as antecedents of SCF, the consequence of which is responsiveness in service delivery (RSD). Furthermore, patient-centered care moderates the relationship between SCF and RSD.

This paper highlights the impact of SCF on RSD in healthcare organizations. Consideration of the four constructs of SO, TI, KS and SCI as antecedents of SCF and, in turn, RSD may be one of the limitations. Future work may identify other theoretical constructs with potential impacts on SCF and RSD. Furthermore, eight months for data collection could have resulted in early-late response bias. This study was operationalized in India and may reflect political, economic, social, technological, environmental and legal factors unique to India.

The study provides suggestions to practitioners for building RSD by leveraging SO, TI, KS and SCI in flexibility-driven service chain processes. Recognizing the relationships among these constructs can aid in the timely formulation of corrective actions and patient-centric policies.

This paper highlights how focusing on a SCF can promote RSD. This understanding may aid the design of processes that develop patient-centricity and deliver health as a social good in an effective manner.

The empirical evidence from this study can help hospitals integrate and build flexibility in their functions, thus enabling them to deliver responsiveness in care.

This study aims to focus on the supply chain (SC) cost drivers of healthcare industries in the USA, as SC costs have increased 40% over the last decade. The second-most significant expense, the SC, accounts for 38% of total expenses in a typical hospital, while most other industries can operate within 10% of their operating cost. This makes healthcare centers supply-chain-sensitive organizations with limited facilities for high-quality healthcare services. As the cost drivers of healthcare SC are almost unknown to managers, their jobs become more complex.

Guided by pragmatism and positivism paradigms, a cross-sectional study has been designed using quantitative and deductive approaches. Both primary and secondary data were used. Primary data were collected from health centers across the country, and secondary data were from healthcare-related databases. This study examined the attributes that explain the most significant variation in each contributing factor. With multiple regression analysis for predicting cost and Student's t-tests for the significance of contributing factors, the authors of this study examined different theories, including the market-based view and five-forces, network and transaction cost analysis.

This study revealed that supply, materials and services represent the most significant expenses in primary care. Supply-chain cost breakdown results in four critical factors: facility, inventory, information and transportation.

This study examined the data from primary and secondary care institutions. Tertiary and quaternary care systems were not included. Although tertiary and quaternary care systems represent a small portion of the healthcare system, future research should address the supply chain costs of highly specialized organizations.

This study suggests methods that can help to improve supply chain operations in healthcare organizations worldwide.

This study presents an empirically proven methodology for testing the statistical significance of the primary factors contributing to healthcare supply chain costs. The results of this study may lead to positive policy changes to improve healthcare organizations' efficiency and increase access to high-quality healthcare.

Decree Law No. 663 introduced a decentralized organizational structure and administration pertaining to Turkish public hospitals in November 2011. This study aims to explore the effects of the public hospital unions (PHUs), which were a result of Decree Law No. 663, on the efficiency and productivity of public hospitals.

Data envelopment analysis (DEA) and DEA-based Malmquist total factor productivity (TFP) index were used from 2011 to 2016. Raw materials and supply expenses, salaries and fringe benefits, other service costs, general administrative expenses, total number of beds, number of specialists, number of residents, number of general practitioners, number of nurses and midwives and other medical officials were used as input variables. Working capital turnover, number of inpatients, number of outpatients and number of surgical operations for Groups A, B and C were used as output variables.

According to the DEA scores, the percentage of efficient hospitals showed a declining trend from 2011 to 2016. The TFP results also showed a decreasing trend from 2011 to 2016.

Providing administrative and financial autonomy to public hospital managers may cause efficiency and productivity losses, which is contrary to expectations.

This study is the first to reveal the impact of decentralization of public healthcare providers on their performance levels in Turkey.