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This study aims to develop an assessment scale for university service quality (university SQ) and examine University Service Quality assessment model (UNIQUAL) of higher education during the pandemic.

Two studies applied a mixed-method design to develop and validate the UNIQUAL scale. In-depth interviews and literature reviews were conducted to refine the initial dimensions and items of UNIQUAL in Study 1. Item analysis, EFA and CFA were then conducted to purify item refinement, scale refinement, purification and validation in Study 2. Finally, a confirmed UNIQUAL model was analyzed via partial least squares structural equation modeling (PLS-SEM) using Smart-PLS 4.0.

The research confirms the four-factor structure of UNIQUAL, with a total of 16 items, to be a valid and reliable scale for the assessment of the service quality (SQ) of universities. Having adopted the bias-corrected and accelerated (BCa) bootstrap approach to study 5,000 subsamples from 27 countries, the authors found “responsiveness” and “empathy” to be significantly associated and have positive relationships with students' satisfaction with university SQ. Furthermore, university SQ and satisfaction were mediated by “health and safety” concerns.

The newly developed UNIQUAL scale would be of value to educators and authorities of higher education to assess the SQ of their universities to enhance the effectiveness of student learning. The improvement in satisfaction with higher education's SQ ultimately helps in retaining both international and local students amidst concerns about traveling and studying during the pandemic.

COVID-19 has affected the private and public sectors worldwide. Millions of students have been affected by schools being shut down and substituted with distance-learning programs. Thus, the assessment of the quality of university services has become an important support mechanism for retaining the sustainability of higher education.

The UNIQUAL scale provides a conceptual model and validates an assessment tool. The research hypotheses confirm the relationship between university SQ and satisfaction from the perspective of international students.

With global migration, the number of ethnic minority and migrant women receiving maternity health care in dominantly Anglo-European societies has increased significantly but they consistently have among the worst pregnancy and maternal outcomes. This paper aims to analyse gaps in structural (migration-related inequalities) and cultural (responsiveness to ethno-cultural practices) competencies among maternal health practitioners in Aotearoa New Zealand (NZ).

Using a semi-structured interview guide, in-depth interviews were conducted with 13 maternal health practitioners in NZ. Data were analysed using a thematic analysis framework.

The results highlight significant barriers around language and communication, cultural stereotyping by professionals, ethnic women’s own constraints around family and cultural expectations and their lack of knowledge about reproductive health. In addition, practitioners’ own ethnic differences are inseparable from their approach to structural and cultural competencies; there were instances of ‘over-’ or ‘under-’ reading of culture, practitioner constructions of ideal pregnancies and anti-racism concerns that shaped maternal care practices that were sensitive to, but also marginalised, ethnic migrant women who attended maternity services.

To the best of the authors’ knowledge, this is the only study in NZ that examines the impact of complex dynamics of migration and culture on knowledge, beliefs and values of practitioners, in context of their own personal biographies. Identifying strategies to improve the way diversity is practiced in hospital settings can be transformational in improving maternal outcomes for ethnic migrant women in NZ.

The US prison population has recently reached an all-time high, with women representing the fastest growing subpopulation. Correctional health-care system in the USA remains fragmented and nonuniform in practice, particularly in women’s health care, with poor transitions between incarceration and release. This study aims to examine the qualitative health-care experiences of women while incarcerated and their transition into the community health-care setting. Additionally, this study also examined the experiences of a subset of women who were pregnant while incarcerated.

After obtaining institutional review board approval, adult, English-speaking women with a history of incarceration within the past 10 years were interviewed using a semi-structured interview tool. Interview transcripts were analyzed using inductive content analysis.

The authors completed 21 full interviews and identified six themes that were both the most significant and most novel: “feeling stigmatized and insignificant,” “care as punishment,” “delay in care,” “exceptions to the rule,” “fragmentation of care” and “obstetric trauma and resilience.”

Women face numerous barriers and hardships when accessing basic and reproductive health-care services while incarcerated. This hardship is particularly challenging for women with substance use disorders. The authors were able to describe for the first time, partially through their own words, novel challenges described by women interacting with incarceration health care. Community providers should understand these barriers and challenges so as to effectively reengage women in care upon release and improve the health-care status of this historically marginalized group.

Many refugees and asylum seekers in Germany experience a high disease burden and low health literacy. The current study aims to focus on assessing these issues among African refugees and asylum seekers in Bavaria, Germany. The authors evaluated their self-perceived health status and health literacy, and identified barriers and gaps in health care utilization, intending to improve health care services for this group.

The authors conducted a cross-sectional, questionnaire-based study involving 69 refugees and asylum seekers from Ethiopia, Eritrea and Nigeria. The authors performed descriptive and exploratory statistical analyses.

The authors found a substantial disease burden in the early stages of resettlement in Germany, particularly mental health symptoms (53.6%) and musculoskeletal problems (47.8%). Challenges in health literacy were observed, such as difficulties in understanding health information and managing emergency situations. Access to interpreters was limited, and understanding treatment certificates was more challenging than using electronic health cards, with 18.2% of participants reporting denial of medical treatment.

These findings highlight the need for early and tailored health support for refugees, with a particular focus on mental health. Efforts should be made to reduce language barriers and improve navigational skills within the health-care system, particularly in emergency situations. Addressing the restricted access to health care and bureaucratic obstacles is crucial for improved health outcomes among refugees.

To the best of the authors’ knowledge, this research is the first to specifically explore the self-reported health status and health literacy of African refugees and asylum seekers in Bavaria, Germany, providing valuable insights into the unique healthcare challenges of this often underrepresented and overlooked population.

The purpose of this paper was to explore the health of trafficking survivors in Spain, which is relatively unstudied (Sweileh, 2018). Therefore, the objectives of this study are to describe the health conditions, access to health-care facilities, COVID-19 protection and health challenges in relation to the COVID-19 pandemic reported by women survivors of human trafficking in Spain.

Due to the pandemic situation, limited research and the complexity of the issue, the authors took a qualitative approach. A cross-sectional study was carried out through interviews with women survivors of human trafficking for sexual exploitation in Spain. Prior to the interviews, the researchers conducted written interviews with social workers to understand the most important challenges that the women survivors were experiencing during confinement. As a result of these written interviews, the interview script for the survivors was modified.

To sum up, the COVID-19 situation poses several challenges, including social difficulties (food insecurity; violence; terrible housing conditions; working pressure; poor sleeping habits; and cultural, linguistic and religious challenges), medical insecurity (due to lockdowns, negative experiences in care, lack of official documents, collapse of hospitals, telephone monitoring and fear of contagion), great emotional distress reported by women (anxiety, fear, sadness, post-traumatic stress disorder, stigma and substance use) and physical health problems (serious weight loss, muscle pains, dental problems and sexual and reproductive health-care limitations).

As is usual in qualitative research, rather than obtain generalizable results, the main objective was to delve deeper into under-researched or complex issues (Polit and Beck, 2010). While this report provides a timely overview marked by COVID-19 of an important population, there are some limitations. The major limitation of this research was the sample representativity, because the sample was conducted with only one non-governmental organization and only individuals who voluntarily agreed to make the interview; as such, other victim profiles may not be represented.

The findings can provide information for detecting victims of human trafficking for sexual exploitation and contribute to understanding the pandemic’s impact. Furthermore, the paper emphasizes the need to adopt measures for the recovery of victims, such as medical and psychological assistance, in accordance with the Palermo Protocol. As people transition out of the pandemic, it is crucial for Spain, along with other European countries, to guarantee that all residents, particularly the victims of human trafficking, have access to social and health-care protections during times of crisis.

As already mentioned, further investigation should be done to fill the gaps on health of human trafficking (Sweileh, 2018) and improve the recovery of victims of trafficking (García-Vázquez and Meneses-Falcón, 2023 0; Sweileh, 2018). The paper acknowledges the existing research gap in the field and emphasizes the importance of future studies to delve deeper into the challenges faced by victims, calling for a more nuanced understanding of health.

The Coronavirus pandemic has increased and reinforced the vulnerability of sex-trafficked victims, especially creating different mental health problems. One of the biggest concerns for this group has been the difficulty of access to basic goods such as food. Furthermore, psychological distress impacted the well-being of trafficking victims, and many suffered from eating disorders. Less than half of the women who were forced to continue in prostitution did not have the means to protect themselves against COVID-19 and did not have easy situations to overcome illness.

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.

In a world teeming with concurrent processes and associated chaos, organizational working procedures have adapted to new trends; employees must keep up with everything while maintaining their mental health. Spirituality lends a person's life significance. Spirituality in the workplace can both physically and psychologically engage employees. Spirituality in the workplace is reflected in the organizational culture, which is founded on fundamental values such as trust, honesty, appreciation, innovation, care, respect, and loyalty. Workplace spirituality encompasses the pursuit of one's ultimate purpose in life, the development of a solid connection to colleagues and other people associated with work, and the consistency or alignment between one's fundamental beliefs and the organization's values. To have a competitive advantage and attract the best personnel, an organization's working environment must be based on strong ethical and spiritual values such as compassion, integrity, respect, harmony, trust, teamwork, and forgiveness, among others.

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.

The purpose of this study is to describe the design and validation of a three-dimensional (3D)-printed phantom of a uterus to support the development of uterine balloon tamponade devices conceived to stop post-partum haemorrhages (PPHs).

The phantom 3D model is generated by analysing the main requirements for validating uterine balloon tamponade devices. A modular approach is implemented to guarantee that the phantom allows testing these devices under multiple working conditions. Once finalised the design, the phantom effectiveness is validated experimentally.

The modular phantom allows performing the required measurements for testing the performance of devices designed to stop PPH.

PPH is the leading obstetric cause of maternal death worldwide, mainly in low- and middle-income countries. The proposed phantom could speed up and optimise the design and validation of devices for PPH treatment, reducing the maternal mortality ratio.

To the best of the authors’ knowledge, the 3D-printed phantom represents the first example of a modular, flexible and transparent uterus model. It can be used to validate and perform usability tests of medical devices.