International Journal of Health Planning and Management最新文献

{"title":"Leveraging Community Drug Outlets for Vaccination Delivery in Tanzania: A Qualitative Study to Inform Future Implementation.","authors":"George Msema Bwire, Goodluck G Nyondo, Tusaligwe Mbilinyi, Renatus B Magati, Mathew Mganga, Arapha B Nshau","doi":"10.1002/hpm.70065","DOIUrl":"10.1002/hpm.70065","url":null,"abstract":"<p><strong>Objective: </strong>A prior pre-implementation survey in Tanzania identified moderate feasibility and low acceptability of integrating vaccination services into community drug outlets (CDOs). The qualitative review was conducted to gain deeper insight into the factors influencing the feasibility and acceptability of integrating vaccination services into CDOs, such as community pharmacies and Accredited Drug Dispensing Outlets (ADDOs).</p><p><strong>Methods: </strong>A descriptive qualitative design was employed as part of an explanatory sequential mixed-methods approach. Interviews were conducted with purposively sampled stakeholders, guided by findings from the prior survey. Interviews were audio-recorded and transcribed verbatim, then thematically analysed using implementation science frameworks, with coding supported by Nvivo software.</p><p><strong>Results: </strong>A total of 17 qualitative interviews were conducted with 46 participants across Dar es Salaam, Pwani, and Dodoma, including community members, health providers, regulators, and supply chain personnel. Six themes emerged: feasibility, acceptability, training, policy, infrastructure, and economics. Community pharmacies were viewed as more feasible and better equipped than ADDOs, which face more severe challenges related to limited space, inadequate cold chain capacity, and insufficient staffing. Acceptability was higher for pharmacies, though both settings (pharmacy and ADDO) require policy, training, and infrastructure improvements.</p><p><strong>Conclusion: </strong>Community pharmacies show greater readiness than ADDOs for vaccine delivery due to better infrastructure, professional staffing, and regulatory alignment. However, both face challenges requiring policy reform, training, and support systems. Future studies should assess operational readiness and develop national standards to guide safe, equitable, and sustainable pharmacy-based immunisation services.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":"440-449"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social and Health Services in the Platform: Developing a Concession Pricing Model for Eldercare Service Platforms.","authors":"Rui Liu, Zeyuan Huang, Jingfeng Yuan, Jianfeng Zhao, Yinhua Shen, Lingzhi Li","doi":"10.1002/hpm.70059","DOIUrl":"10.1002/hpm.70059","url":null,"abstract":"<p><p>As eldercare service platforms (ECSPs) are becoming increasingly popular due to the rapidly ageing population, using only a single pricing strategy has resulted in a mismatch between bilateral users (providers and consumers) in these platforms. To address these challenges, multiple innovative pricing strategies, considering the characteristics of the consumers, service providers, governments, and the private sector should be formulated by governments. Therefore, based on social welfare maximisation, this study develops a concession pricing model for ECSPs that combines different government subsidy methods, platforms' service quality, network externalities, and price elasticity. The results suggest that ECSPs should set a higher price for the group with more significant network externalities and a lower price for the group with more negligible network externalities. The optimal concession price decreases with service quality, while the size of bilateral users increases with service quality. It is further found out that governments should prioritise subsidising eldercare services with a low price elasticity of demand to improve subsidy efficiency, and that their subsidies can expand the size of bilateral users, decrease the concession prices, and improve social welfare. This study contributes to the body of knowledge of public services by proposing a concession pricing model for ECSPs, adding further evidence to the discussion about social and health services in platform. In practice, the findings would be of utmost interest to governments and the private sector that need to make more informed pricing decisions to improve the efficiency of eldercare services provision and maximise platform profit.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":"521-544"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internationally Educated Nurse (IEN) Integration in Nova Scotia: A Provincial Realist Evaluation.","authors":"Alyssa Indar, Meaghan Sim, Ruth Martin-Misener, Annette Elliott-Rose","doi":"10.1002/hpm.70080","DOIUrl":"https://doi.org/10.1002/hpm.70080","url":null,"abstract":"<p><strong>Background: </strong>Canada is committed to supporting internationally educated nurse (IEN) integration into the healthcare system, as a strategy to address post-pandemic nursing shortages. The province of Nova Scotia has emerged as a Canadian exemplar with the development of NICHE (Nova Scotia's International Community of Healthcare Workers Engagement) programme, which anchors intersectoral collaboration between the government, the nursing regulator and healthcare systems in service of streamlining IEN integration.</p><p><strong>Methods: </strong>We conducted a province-wide realist evaluation of the integration of IENs into the Nova Scotia healthcare system and community. We collected data from interviews with 24 participants, comprised of IENs and stakeholders at meso- and micro-healthcare system levels. We used a theory-driven approach to data analysis which utilised elements of content analysis, reflective dialogue and the construction of CMOCs (context-mechanism-outcome configurations).</p><p><strong>Results: </strong>We constructed three main CMOCs which highlight facilitators for IEN integration related to (1) the development of adaptive programme pathways for IENs, (2) the critical role of IEN allies and advocates within healthcare systems, and (3) the shift in focus from recruitment to retention.</p><p><strong>Conclusions: </strong>The study findings describe the contextual factors and key mechanisms that promote 'successful' IEN integration which may be useful for leaders and policymakers integrating IENs into their local health human workforce. The findings raise important questions about supporting IEN retention, consistent with the vision for a healthy and sustainable nursing workforce. The findings from this study underscore the need for further evaluation research in on the topic of IENs.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Inequalities in Access to Sexual and Reproductive Healthcare Services for Indigenous Women in Three Latin American Countries.","authors":"Gustavo Nigenda, Clara Juárez-Ramírez, Daniel Maceira, Oswaldo Lazo","doi":"10.1002/hpm.70063","DOIUrl":"10.1002/hpm.70063","url":null,"abstract":"<p><strong>Introduction: </strong>In Latin America, indigenous populations' access to sexual and reproductive health services is burdened by ideological neocolonial practices.</p><p><strong>Methods: </strong>Qualitative information was collected in three Latin American countries regarding barriers to sexual and reproductive healthcare access for indigenous populations. Three types of informants were interviewed: pregnant women, health care providers, and key actors.</p><p><strong>Results: </strong>In the three countries studied, we found some similarities in the social and cultural context of indigenous communities that represent the greatest barriers to guarantee their access to sexual and reproductive healthcare. The similarities revolve around three main themes: roots of inequalities, access to health services, and interculturality.</p><p><strong>Discussion: </strong>The determinants of indigenous women's access to public sexual and reproductive healthcare services in the three countries are articulated in a complex set of factors. Traditional beliefs about pregnancy, delivery care practices, and newborn care differ significantly from the biomedical perspective of healthcare workers. The latter can be understood as a historical mechanism of colonization and allows understanding the conflictive relationship of indigenous groups towards institutional care practices.</p><p><strong>Conclusion: </strong>The knowledge and beliefs of indigenous cultures bolster their own ways of understanding and caring for sexual and reproductive health and need to be respected to provide them with appropriate healthcare suited to their needs.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":"477-489"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146097593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ireland's Future Health and Social Care Workforce Strategy: Technical Maturity, Unfinished Agenda.","authors":"Jim Campbell, Tiago Correia","doi":"10.1002/hpm.70064","DOIUrl":"10.1002/hpm.70064","url":null,"abstract":"","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":"423-425"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Local Responses to Limits on U.S. Public Health Authority During the COVID-19 Emergency.","authors":"Genevive R Meredith, Xue Zhang, Zachary M Batterman, Hannah M Morris, Zhiwei Chen, Mah Liqa, Mildred E Warner","doi":"10.1002/hpm.70062","DOIUrl":"10.1002/hpm.70062","url":null,"abstract":"<p><p>Public health has become politicized in the U.S. Though research shows that limiting public health authority during emergency response puts community wellbeing and health outcomes at risk, during the COVID-19 emergency (2020-2021), some U.S. state policymakers limited the disease-preventing actions local public health agencies could take. This conflicts with public health agencies' mandate to protect lives. Using COVID-19 as a case study, we explored how local public health agencies upheld their mandate when faced with limited public health authority. We conducted qualitative semi-structured focus groups (October 2023) with a purposive sample of U.S. public health officials (n = 14) from seven U.S. states which experienced four types of restrictions on local public health actions (limits on the emergency authority of governor, chief executive, state health officer, and local government health officers). Participants discussed barriers and challenges faced, adaptations made, actions taken, and perspectives for the future. Emergent themes suggest that while limited resources and restricted public health authority caused strain, public health efforts were upheld through cross agency collaboration at the local level which supported innovation. To achieve this, trust-building and communication were vital. Limitations on local public health authority may increase in the U.S. in the coming years. To mitigate risks amidst future public health emergencies, public health leaders must focus on building trust, clear and consistent communication, and bolstering collaborative networks at the local level. The politicization of health policy at the state and federal level also needs to be addressed, as local action can only go so far.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":"450-460"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146067617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges for the Implementation of Artificial Intelligence in Healthcare in Developing Countries: Structural, Ethical and Technological Barriers.","authors":"Adriana Kelly Santana Correa, Lucas Vinícius Souza Santos, Marina Dos Santos Barreto, Allec Yuri Santos Martins, Eloia Emanuelly Dias Silva, Deise Maria Rego Rodrigues Silva, Pedro Henrique Macedo Moura, Ronaldy Santana Santos, Lucas Alves da Mota Santana, Rajiv Gandhi Gopalsamy, Adriana Gibara Guimarães, Lysandro Pinto Borges","doi":"10.1002/hpm.70067","DOIUrl":"10.1002/hpm.70067","url":null,"abstract":"<p><p>Artificial intelligence (AI) has been widely used in the health sector for diagnostic, assistance and guidance purposes. However, its expansion has come up against applicability barriers in underdeveloped countries due to structural, financial and technological limitations encountered within a specific context. With this letter, we draw attention to the challenges of implementing AI in developing countries, suggesting strategies for scientific studies to optimise this.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":"554-556"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146195924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upholding the Principles of Development Effectiveness for Health System Strengthening in the Eastern Mediterranean Region (EMR)-Why It Is Important Now More than Ever.","authors":"John Grundy, Chaudhri Irtaza Ahmad, Arshad Altaf, Thomas S O'Connell, Awad Mataria","doi":"10.1002/hpm.70066","DOIUrl":"10.1002/hpm.70066","url":null,"abstract":"<p><p>The Eastern Mediterranean Region (EMR) of the World Health Organisation (WHO) consists of 22 countries and territories which are exposed to high levels of natural and man-made emergencies, and which have significant gaps in coverage of essential health services. Narrow fiscal space, economic distress, periodic shocks of conflicts, pandemics and natural disasters, and sharp declines in development assistance, are factors contributing to gaps in access to essential health services. The region receives development assistance from a range of development partnerships, which, although contributing to improved programme coverage and disease prevention, has been limited in developing and sustaining longer term health system capabilities. The increasing threats of conflict, pandemics and climate-related natural disasters, as well as the recent sharp downturns in development assistance, builds the case for more effective, efficient and equitable development assistance programming. Development assistance principles of alignment of health partnerships with sector priorities and building of country systems provide opportunities to sustainably address chronic health coverage and equity challenges, improve the capability of health systems to withstand periodic shocks, and sustain health programme improvements over longer time frames. In this paper, we describe how these principles are being applied in the region through country health compacts for universal health coverage, country and regional coordination models, and implementation of monitoring and evaluation of development effectiveness. Given the rapidly changing development landscape, application of development effectiveness principles provides opportunities to strengthen health systems, safeguard health security, and progress towards universal health coverage.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":"545-553"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National and Subnational Models of Care That Support Primary Health Care: A Mixed-Methods Study.","authors":"Mary Louisa Plummer, Nuria Toro Polanco, Faraz Khalid, Fidan Talishinskaya, Hassan Salah, Teri Reynolds","doi":"10.1002/hpm.70057","DOIUrl":"10.1002/hpm.70057","url":null,"abstract":"<p><p>In 2020, the World Health Assembly called on countries to reorient their models of care (MOCs) toward primary health care (PHC). This study's objectives were to (a) describe common use of the concept of MOC; and (b) identify implemented MOCs and their components that support PHC at national and subnational levels. A scoping review charted data on national and subnational level MOCs from literature reviews in PubMed and Global Index Medicus databases and WHO publications. Qualitative interviews about current MOCs were conducted with national-level health planners in seven Eastern Mediterranean Region countries. 2189 abstracts were screened and 98 papers included. Few papers explicitly defined 'model of care'; most instead referred to particular models of care and their components, implicitly including processes of care, organization of providers and management of services. Seventy-eight papers described small subnational (e.g., district or municipal) MOCs focused on care groups or conditions. Twelve papers and all interviewees described national or large subnational (e.g., provincial or regional) MOCs intended to prioritize primary care services, service integration and people-centred service delivery. Key components included: strengthening primary care capacity to coordinate and deliver services; implementing multidisciplinary, team-based service delivery; building robust linkages (e.g., referral, communication and transportation) across all care levels; designing pathways to efficiently guide people's journeys through a health system; and ensuring longitudinal health care coordination. Findings suggest that reorienting a national MOC toward PHC is facilitated by explicit articulation of the intended MOC and practical, coordinated planning for its incremental implementation, financing and monitoring.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":"490-506"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conspiracy Beliefs, Institutional Mistrust, and Health-Related Behaviours During the COVID-19 Pandemic in Burkina Faso: A Mediation Analysis.","authors":"Gabin F Morillon, Marlène Guillon, Jacky Mathonnat","doi":"10.1002/hpm.70058","DOIUrl":"10.1002/hpm.70058","url":null,"abstract":"<p><strong>Background: </strong>No study has yet examined the conjoint role of institutional trust and COVID-19 conspiracy beliefs on compliance with COVID-19 preventive behaviours among populations of African countries. This study aims to deepen the understanding of the relationship between institutional mistrust, conspiracy beliefs, and health-related behaviours in the context of an African country during the COVID-19 pandemic.</p><p><strong>Methods: </strong>A cross-sectional research design was employed, and a paper-based survey using face-to-face interviews was conducted among the general adult population of Burkina Faso, collecting data on institutional mistrust, conspiracy beliefs, health-related behaviours (i.e., vaccination attitudes, agreement to sanitary measures, and containment-related behaviours), information-seeking behaviours (including traditional and digital sources of information), and negative sentiments. We defined a conceptual model according to the existing literature. A mediation analysis was employed to examine the direct effect of institutional mistrust on health-related behaviours and its indirect effect through conspiracy beliefs endorsement. Additionally, the effects of information-seeking behaviours and negative sentiments on mistrust and conspiracy beliefs were explored.</p><p><strong>Results: </strong>We find that institutional mistrust had a direct negative effect on all health-related behaviours and an indirect effect through conspiracy beliefs which themselves had a direct negative effect on protective behaviours. The partial mediation accounted for 12% (agreement with sanitary measures) to 34% (vaccination attitudes) of the total effect of institutional mistrust on health-related behaviours. Information seeking on traditional media and negative sentiments had positive effects on conspiracy beliefs and institutional mistrust, respectively.</p><p><strong>Conclusions: </strong>Our findings underscore the need for medium-to long-term policies aimed at restoring and perpetuating trust in institutions and curbing conspiracy beliefs for fighting future pandemics. In short term, health promotion campaigns should be channelled through the sources of information in which individuals have the greatest confidence such as religious and traditional leaders.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"41 3","pages":"461-476"},"PeriodicalIF":1.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}