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This article presents the summary and main recommendations for companies, local partnerships and networks, primary schools, education authorities and initial teacher education institutions, of the RSA project “Industry Matters”.

This paper aims to, invariably, critically look at primary records, their origins, categorization, uses and what the future holds for them, amid changing times. From the cradle of civilization, people have been using varied ways to record, store and distribute information. Years back, people kept their records on such materials as wax, papyrus, leather, clay, parchment, paper and wood. But recent technological developments have brought about different formats which in turn have influenced the choice of materials and methods used to write and circulate information.

This is a viewpoint paper on primary documents in library and information service institutions. The paper critically looks at the different types of primary documents, how they are collected, the challenges involved and their future amid changing technological times. Relevant literature was consulted, including the Internet.

The findings are that the future of primary documents will remain bleak if librarians, curators, records managers and archivists do not give serious thought to primary documents regardless of the fact that they are germane in library and information science.

This is a viewpoint paper on primary documents. Relevant information was drawn from varied readings in library and information service institutions as well as from the Internet.

The Models of Child Health Appraised (MOCHA) project identified the different models of primary care that exist for children, examined the particular attributes that might be different from those directed at adults and considered how these models might be appraised. The project took the multiple and interrelated dimensions of primary care and simplified them into a conceptual framework for appraisal. A general description of the models in existence in all 30 countries of the EU and EEA countries, focusing on lead practitioner, financial and regulatory and service provision classifications, was created. We then used the WHO ‘building blocks’ for high-performing health systems as a starting point for identifying a good system for children. The building blocks encompass safe and good quality services from an educated and empowered workforce, providing good data systems, access to all necessary medical products, prevention and treatments, and a service that is adequately financed and well led. An extensive search of the literature failed to identify a suitable appraisal framework for MOCHA, because none of the frameworks focused on child primary care in its own right. This led the research team to devise an alternative conceptualisation, at the heart of which is the core theme of child centricity and ecology, and the need to focus on delivery to the child through the life course. The MOCHA model also focuses on the primary care team and the societal and environmental context of the primary care system.

Sustainable Development Goal (SDG) Indicator 4.2 calls for all girls and boys to have access to high-quality early childhood education by 2030. This global mandate establishes a new framework of accountability to increase access to preprimary education in low- and middle-income countries through measurement and reporting. As with other global indicators, however, the measurement of preprimary education access is more complex and nuanced than may be supposed. This data-oriented chapter delves deeply into the measurement of SDG 4.2 and explores the accuracy of the indicator being used: the adjusted net enrollment ratio, one year before the official age of primary entry. The chapter analyzes data from both education management information systems (EMIS) and household surveys to triangulate information about children’s access to preprimary education before they begin primary school. The analysis concludes that the indicator used to measure SDG 4.2 is overestimating access to preprimary education, because it includes large numbers of children who enroll in primary school before the official age of entry. This suggests that parents “vote for preschool” by sending their under-age children to primary school when access to affordable preprimary is limited. Implications for SDG measurement and preprimary policy are discussed.

Purpose: While COVID-19 has upended lives, it has also catalyzed innovation with potential to advance health delivery. Yet, we know little about how the delivery system, and primary care in particular, has responded and how this has impacted vulnerable patients. We aimed to understand the impact of COVID-19 on primary care practice sites and their vulnerable patients and to identify explanations for variation. Approach: We developed and administered a survey to practice managers and physician leaders from 173 primary care practice sites, October-November 2020. We report and graphically depict results from univariate analysis and examine potential explanations for variation in practices' process innovations in response to COVID-19 by assessing bivariate relationships between seven dependent variables and four independent variables. Findings: Among 96 (55.5%) respondents, primary care practice sites on average took more safety (8.5 of 12) than financial (2.5 of 17) precautions in response to COVID-19. Practice sites varied in their efforts to protect patients with vulnerabilities, providing care initially postponed, and experience with virtual visits. Financial risk, practice size, practitioner age, and emergency preparedness explained variation in primary care practices' process innovations. Many practice sites plan to sustain virtual visits, dependent mostly on patient and provider preference and continued reimbursement. Value: While findings indicate rapid and substantial innovation, conditions must enable primary care practice sites to build on and sustain innovations, to support care for vulnerable populations, including those with multiple chronic conditions and socio-economic barriers to health, and to prepare primary care for future emergencies.

This chapter examines the context for the implementation of the global commitment to early childhood education (ECE) within the framing of the sustainable development goals (SDGs) under SDG 4.2. We first define the concept of ECE as broadly understood in the field of education and in practice related to a focus on education of children. The essay adopts chronological age of children served outside of the formal school system, which has traditionally been recognized as basic education, to represent the population captured under ECE in both pre-school and pre-primary settings. UNICEF identifies those ages 3–6 to fall into this category. We present an exploration of the challenges and opportunities presented by multiplicity in multilateral agencies and other agencies driving the international initiatives around advancing ECE and the means by which they promote education opportunities for children. We offer a comparative perspective on the delivery, types, and funding mechanisms of ECE services in both developing and developed country contexts, which informs the possibilities for the realization of the SDG goal of inclusive quality education for all. An examination of the socio-cultural and economic context of accessibility to inclusive and equitable quality ECE is also presented. An overview of settings within which ECE is provided is interrogated within differing national contexts. We conclude with challenges and opportunities for sustained accountability, monitoring and evaluation of SDG 4.2 interventions from a comparative perspective.

To examine a local primary health care infrastructure and the reality of primary health care from the perspective of residents of a small, urban community in the southern United States.

Data were derived from 13 semistructured focus groups, plus three semistructured interviews, and were analyzed inductively consistent with a grounded theory approach.

Structural barriers to the local primary health care infrastructure include transportation, clinic and appointment wait time, and co-payments and health insurance. Hidden barriers consist of knowledge about local health care services, nonphysician gatekeepers, and fear of medical care. Community residents have used home remedies and the emergency department at the local academic medical center to manage these structural and hidden barriers.

Findings might not generalize to primary health care infrastructures in other communities, respondent perspectives can be biased, and the data are subject to various interpretations and conceptual and thematic frameworks. Nevertheless, the structural and hidden barriers to the local primary health care infrastructure have considerably diminished the autonomy community residents have been able to exercise over their decisions about primary health care, ultimately suggesting that efforts concerned with increasing the access of medically underserved groups to primary health care in local communities should recognize the centrality and significance of power.

This study addresses a gap in the sociological literature regarding the impact of specific barriers to primary health care among medically underserved groups.

There is considerable heterogeneity between primary care systems that have evolved in individual national cultural environments. Models of Child Health Appraised (MOCHA) studied how the transfer of models or their individual components can be achieved across nations, using examples of combinations of settings, functions, target groups and tracer conditions. There are many factors that determine the feasibility of successful transfer of these from one setting to another, which must be recognised and taken into account. These include the environment of the care system, national policy-making and contextual means of directing population behaviour – in the form of penalties and incentives, which cannot be assessed or expected to work by means of rational actions alone. MOCHA developed a list of criteria to assess transferability, summarised in a population characteristics, intervention content, environment and transfer (PIET-T) process. To explore the process and means of transferability, we obtained consensus statements from the researchers on optimum model scenarios and conducted a survey of stakeholders, professionals and users of children’s primary care services that involved three specific health topics: vaccination coverage in infants, monitoring of a chronic or complex condition and early recognition of mental health problems. The results give insight into features of transferability – such as the availability and the use of guidelines and formal procedures; the barriers and facilitators of implementation and similarities and differences between model practices and the existing model of child primary care in the country. We found that successful transfer of an optimal model is impossible without tailoring the model to a specific country setting. It is vital to be aware of the sensitivity of the population and environmental characteristics of a country before starting to change the system of primary care.

This chapter explores how primary care physicians deliver mental health treatment for Medicaid patients in one county in the United States, and how treatment may have changed after HMO enrollment with a mental health carve-out. We utilize Lipsky's theory of street-level bureaucracy to better understand how primary care physicians treat Medicaid patients for depression and what types of insurance arrangements support or inhibit that treatment. Exploratory interviews with 20 physicians revealed that the patient's status as a non-voluntary client, service system barriers and physicians’ commitment to treatment caused them to bear primary responsibility for the majority of depression care. Physicians were willing to act as advocates for their clients and viewed such advocacy as ethical given the lack of mental health parity. In general, primary care physicians were not familiar with new policies dictating mental health carve-outs for Medicaid patients, nor were they concerned with how mental health care was reimbursed for their patients. However, they were willing to provide mental health care even if they were not reimbursed. Physicians rely upon medication management to treat depression, and reimbursement plays a role in the amount of time spent with patients and in the coding used for the visit. Lipsky's (1980) theory of street-level bureaucracy provides a useful framework for understanding how physicians will act as advocates for their clients in the face of structural as well as resource constraints on health care.