International Journal of Health Planning and Management最新文献

{"title":"The Impact of Prolonged Emergency Department Waiting Time on Elective Surgical Activities: A Cross-Sectional Observational Study in National Health Service (NHS) Scotland.","authors":"Jia Jin Kwong, Kawan Shalli","doi":"10.1002/hpm.70124","DOIUrl":"https://doi.org/10.1002/hpm.70124","url":null,"abstract":"<p><strong>Introduction: </strong>The NHS is now facing serious challenges from acute care pressure, reflecting on the emergency department (ED) national waiting time target compliance. Concerns about cancelling elective operations to cope with emergency services have also arisen. However, there is a lack of existing evidence to prove a direct relationship between ED episodes and planned hospital services. Thus, the objective of this study is to investigate the impact of high ED attendances on elective surgical activities.</p><p><strong>Methods: </strong>Retrospective cross-sectional observational study which includes the five largest health boards in NHS Scotland. All patients who presented to the ED in 2021 are included. Univariate and multivariate regression analysis were used to show relationship between ED attendances and elective surgical services including in- and out-patient waiting lists and clinic activities. Explanatory variables include total ED attendances and attendances that exceeded the national waiting time target.</p><p><strong>Results: </strong>The five health boards recoded a higher patient visit to ED on second and third quarter. Non-compliances to 4 hours waiting time ranges between 6% and 20%. Both Univariate and multivariate regression analysis showed a positive correlation between long ED waiting time (> 8 and 12 hours) and increased patient waiting time for elective surgical service as well as delay in clinic review.</p><p><strong>Discussion: </strong>Prolonged ED waiting times were consistently associated with delay in in- and out-patient elective service. To ensure timely and adequate treatment of patients, policymakers should invest in resources to improve the efficiency of both emergency and elective services and introduce management plans that balance the needs of both services.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907550","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":"Framing the Canadian Health Technology Assessment as an Organisational Process: A Bibliometric Analysis.","authors":"Salvatore Tallarico, Simone Lazzini, Luisa Pellegrini, Harindra C Wijeysundera","doi":"10.1002/hpm.70132","DOIUrl":"https://doi.org/10.1002/hpm.70132","url":null,"abstract":"<p><p>Health Technology Assessment (HTA) is an organizational process used to determine the value of health-technologies. There is considerable variation in how HTA is developed globally, with Canada at the forefront of this field, having pioneered the use of HTA and implemented it extensively across healthcare organisations at all levels. This study is relevant for its unique focus on citation networks and author keywords regarding HTA in Canada, providing a holistic view by analysing HTA as an organizational process. By identifying fundamental process elements and differentiating research streams (RSs), it addresses a notable gap in the literature, offering fresh insights and informing policy recommendations to enhance HTA practices. While referring to the Canadian HTA, this study conducts a Systematic Literature Network Analysis to identify the RSs that will be analysed according to a process perspective. This analysis allows highlighting the process components-like stakeholders, phases, and methods-that have played a role in the success of Canada's HTA, as well as pinpointing the ongoing challenges that need to be tackled to create greater value. Analysing documents published in peer-reviewed English-language journals from the Scopus-Elsevier database, we identified seven RSs, including macro-HTA, meso-HTA, micro-HTA, ethical considerations, and patient involvement. For each stream, this study delineates the process elements, that is, the involved stakeholders, process phases, methodologies, and evaluation criteria. It is evident that while expert panels and specialist groups are crucial for technical HTA activities, patients and caregivers play a pivotal role in social and ethical evaluations. The study also highlights future challenges for HTA procedures: integrating qualitative and quantitative considerations, assessing the real impact of macro-HTA outputs, and overcoming barriers to patient involvement. Theoretically, this paper clarifies the differences between streams in terms of HTA process elements, and practically, it assists practitioners in tailoring the HTA process to their specific needs. Policymaking recommendations include considerations regarding the number and intensity of stakeholder engagement.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898125","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":"The Efficiency of the German Healthcare System: Some Puzzling Findings.","authors":"Afschin Gandjour","doi":"10.1002/hpm.70108","DOIUrl":"10.1002/hpm.70108","url":null,"abstract":"<p><p>This article examines the cost-effectiveness of the German healthcare system from the perspective of statutory health insurance (SHI). Using data for 2011-2014-the most recent period for which consistent national inputs are available-we compare a marginal, system-wide cost-effectiveness ratio with the cost-effectiveness of newly approved cancer drugs. The analysis indicates that the German healthcare system incurred costs per life-year gained that were broadly comparable to the incremental cost-effectiveness ratios reported for many new cancer drugs. Sensitivity analyses varying the attribution of mortality reduction to healthcare do not materially alter this comparison. Although evidence of overuse and inefficiency in the German healthcare system is documented across multiple sectors, the available evidence does not clearly identify a single domain sufficiently large to explain the aggregate pattern. This raises the hypothesis that inefficiency may be diffuse, or that structural features common to high-income health systems-such as diminishing marginal returns to health spending-play an important role. While the empirical estimates rely on data from roughly a decade ago, subsequent trends in treatment costs and life expectancy provide little indication that the underlying tension has dissipated. The findings highlight the need for more systematic cost-effectiveness analysis across sectors, alongside rigorous evaluation of reforms and consideration of institutional and political constraints affecting implementation.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":"1108-1115"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608665","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":"Experiences of Pain Among Indigenous Peoples Globally: A Qualitative Systematic Review.","authors":"Madison Cachagee, Annika Ramesh, Sneha Sethi, Dandara Haag, Joanne Hedges, Lisa Jamieson, Brianna Poirier","doi":"10.1002/hpm.70123","DOIUrl":"10.1002/hpm.70123","url":null,"abstract":"<p><strong>Background: </strong>Indigenous Peoples continue to face colonisation and oppressive policies that intentionally disrupt their ways of life and wellbeing. The increased experience of disease for Indigenous Peoples, due to colonial processes, is confounded by immense difficulties accessing culturally secure healthcare. The experience of pain for Indigenous Peoples within this unjust socio-political context encompasses physical, emotional, spiritual, and mental pain.</p><p><strong>Objective: </strong>This systematic review aims to explore factors related to the experience of pain for Indigenous Peoples globally.</p><p><strong>Search strategy: </strong>Four databases: PubMed, EMBASE, Scopus, and Web of Science were searched utilising a pre-established search strategy to identify qualitative papers that focused on experiences and understandings of pain among global Indigenous Communities.</p><p><strong>Data extraction and synthesis: </strong>Two independent reviewers performed title, abstract and full text screening, which resulted in the inclusion of 26 papers. Data extraction and synthesis was done in two stages which involved grouping illustrations from papers into categories, and then into four overarching synthesised findings.</p><p><strong>Main results: </strong>The synthesised findings aligned with social ecological theories and included: intrapersonal, interpersonal, institutional and cultural levels. For Indigenous Peoples, pain is situated within a complex network of social, historical, and political determinants of health.</p><p><strong>Discussion: </strong>The creation of a judgement-free space, accessibility of traditional healing practices and a greater inclusion of family and Community throughout treatment processes were identified as facilitators to care for Indigenous Peoples experiencing pain.</p><p><strong>Conclusion: </strong>By ascertaining and prioritising patient desires throughout the pain management experiences, practitioners can actualise self-determination of patient wellbeing and ensure provision of culturally respectful and comprehensive care.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":"1094-1107"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608627","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":"Understanding How Multisectoral Programs and Policies Across Systems Can Be Leveraged to Improve Maternal, Infant, and Child Nutrition in Guinea.","authors":"Teresa R Schwendler, Ramatou Hermine Sankhon, Leif Jensen, Mohamed L Fofana, Mamady Daffé, Facely Camara, Ramakwende Zoma, Ibrahima Balde, Stephen R Kodish","doi":"10.1002/hpm.70105","DOIUrl":"10.1002/hpm.70105","url":null,"abstract":"<p><strong>Objective: </strong>To understand how current programmes and policies can be leveraged to improve maternal, infant, and young child nutrition outcomes (MIYCN) in Guinea.</p><p><strong>Data collection methods: </strong>Study design. This study is part of a larger multiphase mixed methods study design.</p><p><strong>Theoretical framework: </strong>A systems framework developed by the United Nations Children's Fund (UNICEF) and an implementation science framework were used to guide this research. Phase 1. An in-depth literature review of current programme and policy documents (2019-2022) targeting MIYCN through the water, sanitation, and hygiene (WASH), health, food, and social protection systems in Guinea was conducted. Phase 2. Semi-structured interviews with stakeholders (n = 20) from each system were completed to explore stakeholders' knowledge related to pertinent programs and policies. Phase 3. Validation of findings was conducted using member checking.</p><p><strong>Data analysis methods: </strong>Grey literature documents and interview findings were analysed using content analysis guided by the systems framework and implementation science framework, respectively.</p><p><strong>Results: </strong>Policy documents across systems were all multisectoral and more than half (27/32) of evidence-based programme modalities across systems were included in policies. Most (28/32) evidence-based programme modalities were also being implemented in Guinea. Stakeholder interview findings revealed that programme implementation was the most salient barrier to operationalising evidence-based programme modalities.</p><p><strong>Conclusion: </strong>Findings from our study indicate that policy and programme frameworks are strong but improved financial planning and vertical and horizontal programme planning may create a stronger enabling environment to support MIYCN in Guinea.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":"1071-1084"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593928","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":"Frameworks for Action: A Scoping Review of Organisational Patient Engagement Models in Healthcare.","authors":"Titus A Chan, Queena Cheong, Brydne Edwards","doi":"10.1002/hpm.70090","DOIUrl":"10.1002/hpm.70090","url":null,"abstract":"<p><strong>Objective: </strong>Patient engagement (PE) is recognised as a key pillar of healthcare planning and delivery. However, there is a limited understanding of recent evidence-based organisational frameworks supporting PE; this gap can impact the uptake, implementation, and spread of PE efforts across healthcare organisations. Our study aims to identify and describe frameworks for PE applicable at an organisational level in academic literature.</p><p><strong>Methods: </strong>Our scoping review applied Arksey and O'Malley's five-stage methodology and included an optional sixth stage of community consultation. Four databases (MEDLINE, CINAHL, Cochrane Library, and Embase) were searched between 2014 and 2024. Included articles were double-extracted and coded for synthesis using data tables.</p><p><strong>Results: </strong>Out of 7870 total studies yielded by the search, 13 studies from North America, Europe, and Australia met inclusion criteria. Our study identified 11 organisational PE frameworks with varying structure and complexity. While no unifying PE model emerged, many frameworks conceptualised engagement on a continuum. Frameworks were predominantly hospital-based, and many did not provide in-depth theoretical underpinnings nor reported patient contributions towards development.</p><p><strong>Conclusions: </strong>By synthesising the available evidence, this review provides insights for healthcare organisations seeking tools to systematically strengthen their PE initiatives. Conceptualising engagement on a continuum may offer a pragmatic approach to scaling PE institution-wide. Future framework development should focus on tailoring evidence-based frameworks to their organisational context, and integrate vital components such as health equity, theoretical foundations, and impact indicators. Emerging organisational frameworks should aim to be adaptable, inclusive, and reflective of diverse patient experiences.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":"1054-1070"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148035648","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":"Economic Impact of Dengue Virus in Mexico Over One Decade: A Systematic Literature Review (2010-2020).","authors":"Gilberto Sánchez-González, Luz Del C Hernández-Hernández, Elaine Gallagher","doi":"10.1002/hpm.70096","DOIUrl":"10.1002/hpm.70096","url":null,"abstract":"<p><strong>Background: </strong>Dengue is a major mosquito-borne viral disease worldwide, imposing significant healthcare burden on governments in countries where it is endemic, such as Mexico. This systematic review focused on studies reporting the cost of dengue in Mexico during 2010-2020. To the best of our knowledge, this is the first review discussing this topic in Mexico. We analysed all published direct costs associated with care, prevention, and surveillance, as well as indirect costs.</p><p><strong>Methods: </strong>A comprehensive online search was conducted using Embase, MEDLINE, Evidence-Based Medicine Reviews, SciELO, and LILACS. Articles reporting cost data published during 2010-2020 in English and Spanish were included. Reports from the National Ministry of Health and grey literature during the same period were also reviewed. Following the PICOS (Population, Intervention, Comparison, Outcome and Study design) framework, articles reporting direct and indirect costs were included. The National Health Service Wales tool was used to assess the quality of the studies included.</p><p><strong>Results: </strong>Seven articles fulfiled the inclusion criteria. All articles reported the nationwide cost of dengue, and three focused on specific Mexican states. The dengue-related economic burden was substantial, peaking in 2013, with annual costs of $176.82 million (adjusted present value, $281.60 million). All the searches were verified in January 2023.</p><p><strong>Conclusions: </strong>The economic burden of dengue in Mexico is high and is further impacted by outbreaks, resulting in significant costs to the healthcare system and productivity losses. The heterogeneity of the methodological approaches in the cost studies reviewed makes it a challenge to compare them.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":"1085-1093"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608668","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":"Finding Space for Traditional Medicine in the National Health Insurance Scheme in Ghana: Insights From Stakeholders.","authors":"Maximillian Kolbe Domapielle","doi":"10.1002/hpm.70131","DOIUrl":"https://doi.org/10.1002/hpm.70131","url":null,"abstract":"<p><p>This article analyses the practicability of integrating the products and services of traditional medicine practitioners into the benefits package of the National Health Insurance Scheme (NHIS) in Ghana. There appears to be a consensus among scholars that the integration of traditional medicine into health systems in low-and middle-income countries (LMICs) can improve access to primary healthcare for populations in underserved communities, yet the perspective of key actors on the practicality of including the services of traditional medicine practitioners in the benefits package of the NHIS has not been explored. A qualitative approach was deployed to collect and analyse the data. In specific terms, semi-structured in-depth interviews, and Focused Group Discussions (FGDs) were employed to explore stakeholders' views on the prospects and potential barriers of including traditional medicine into the operations of the NHIS. The study found that despite the general acceptance of the view that traditional medicine plays an important part in providing primary health care to health care clients, there is scepticism about the viability of including the products and services of Traditional Medicine Practitioners (TMPs) in the benefits package of the NHIS. They argue that in spite of the existence of regulatory frameworks and guidelines for the use of traditional herbal products in modern health facilities, the criteria for including the products and services of traditional medicine practitioners in the benefits package of the NHIS are restrictive and are likely to exclude the majority of TMPs from participating in the NHIS. The study advocates further research to inform the development and implementation of an inclusive regulatory framework for an integrated healthcare system in the country.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820028","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":"Political Transition, Health System Reform and Trust in Childhood Vaccination in Ukraine: A Qualitative Case Study.","authors":"Harriet Dwyer, Jennifer Palmer, Luisa Enria, Anton Grushetskyi, Olya Fokaf, Kateryna Gatsenko, Hanna Yahorava, Nadine Beckmann","doi":"10.1002/hpm.70128","DOIUrl":"https://doi.org/10.1002/hpm.70128","url":null,"abstract":"<p><p>Trust in childhood vaccination is a concern for health policy, particularly in settings of political transition and conflict, where governance, institutional legitimacy and service delivery are often under strain. It is against this backdrop that this study aims to describe evolving interactions between health system governance, trust and childhood vaccination in Ukraine across periods of reform and conflict, and the implications for health policy in fragile settings. Drawing on qualitative interviews with key informants and Ukrainian parents, findings show that trust in the health system, with implications for vaccine confidence, has been intertwined with broader perceptions of the legitimacy of state institutions and quality of services. Trust was undermined by corruption and weak governance but reconfigured through reforms that increased accountability and patient choice. The 2022 full-scale invasion disrupted services but also strengthened forms of civic responsibility and engagement with public health. This study contributes to broader scholarship on health system trust and vaccine confidence by situating them within the historical and political evolution of Ukraine. It offers considerations relevant for Ukraine's post-conflict recovery and health governance and illustrates links between vaccine confidence and state-society relations in contexts of political transition and crisis.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820064","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":"Planning and Sustaining Breast Cancer Patient Navigation Programs: A CFIR-Informed Scoping Review of Implementation Determinants.","authors":"Siti Nurhafizah Saharudin, Nazirul Munir Abu Hassan, Mohd Fittri Fahmi Fauzi, Ahmad Zulfahmi Sha'ari, Mohd Faiz Mohd Ghazali, Afiq Izzudin A Rahim","doi":"10.1002/hpm.70129","DOIUrl":"https://doi.org/10.1002/hpm.70129","url":null,"abstract":"<p><strong>Background: </strong>Patient Navigation Programs (PNPs) address fragmentation and socioeconomic barriers in breast cancer care, but sustainable implementation is complex and context dependent. This scoping review systematically maps and synthesises multilevel determinants of breast cancer PNPs to inform strategic planning and health system management for sustainable service delivery across diverse public health contexts.</p><p><strong>Methods: </strong>Guided by the Arksey and O'Malley methodology framework and reported in accordance with PRISMA-ScR, we conducted a comprehensive search across five databases, covering studies published between January 2000 and December 2025. Implementation determinants were retrospectively mapped using the Consolidated Framework for Implementation Research (CFIR v1.0) as an analytic lens. Dual independent screening and multi-reviewer construct coding were performed, with discrepancies resolved through consensus.</p><p><strong>Results: </strong>Twenty-six studies met the inclusion criteria. Determinants were identified across all five CFIR domains. Outer-setting pressures (e.g., financial and transportation barriers) frequently intersect with inner-setting constraints (e.g., workforce shortages, fragmented service structures). Process-related strategies, particularly stakeholder engagement and structured navigator training, were consistently described as enabling mechanisms that buffered contextual strain-intervention characteristics, including cost, complexity, and adaptability, moderated integration trajectories. Sustainability improved when navigation functions were embedded within routine service structures rather than maintained as externally funded add-ons.</p><p><strong>Conclusion: </strong>The implementation of breast cancer PNPs appears to be shaped by dynamic cross-domain interactions. This synthesis suggests that sustainability may be strengthened through alignment of financing arrangements, workforce configuration, service integration mechanisms, and deliberate implementation strategies. A proposed phased implementation pathway offers a practical planning guide for resource-constrained systems.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799480","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}