BMC Health Services Research最新文献

{"title":"Factors influencing attrition of health professionals in the Upper East Region of Northern Ghana.","authors":"Samuel T Chatio, Irene Kuwolamo, Nana Akosua Ansah, Lucy O Ababio, Mathilda Aku Tsifodze, James Akazili, Boakye Boateng, Patrick Ansah","doi":"10.1186/s12913-025-13210-w","DOIUrl":"https://doi.org/10.1186/s12913-025-13210-w","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the high healthcare needs in rural regions in Ghana, it is a challenge for health managers to attract and retain healthcare professionals in these regions including the Upper East Region, which negatively affects health service delivery. This study investigated factors contributing to attrition of health professionals in the Upper East Region of Northern Ghana.</p><p><strong>Methodology: </strong>The study used a qualitative research approach where 92 in-depth interviews were conducted with participants between June and August, 2023. The interviews were recorded, transcribed and coded into themes using QSR Nvivo 12 software before thematic content analysis.</p><p><strong>Results: </strong>Participants agreed that health worker attrition in the Upper East Region was a problem. Difficulty for health workers to obtain study leave for further studies, administrative lapses, linked with lack of respect and appreciation, family issues and poor working conditions were the main factors contributing to health worker attrition. However, health worker motivation, approval of study leave for qualified health staff, provision of medical equipment/ logistics and health managers showing respect and appreciation to frontline healthcare workers were strategies recommended by participants to address health worker attrition.</p><p><strong>Conclusion: </strong>Views shared by stakeholders in our study suggest that health worker attrition is a serious issue affecting service delivery in the Upper East Region. Thus, it is important for health managers to implement appropriate strategies including those recommended in this study towards addressing the issue, to improve healthcare.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1018"},"PeriodicalIF":3.0,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Who's got the infants in mind?\" A qualitative exploration of the barriers and enablers to commissioning parent-infant relationship services in England.","authors":"Lorraine McSweeney, Karen Bateson, Wook Hamilton, Bronia Arnott","doi":"10.1186/s12913-025-13215-5","DOIUrl":"https://doi.org/10.1186/s12913-025-13215-5","url":null,"abstract":"<p><strong>Background: </strong>The earliest relationships between babies and their caregivers can act as a risk factor for social and emotional wellbeing in infancy and impact on later development. Difficulties in parent-infant relationships (PAIR) are characterised by inequalities, with families experiencing adversity at greater risk. In the absence of support, these relationship problems may require later, more expensive services. Interventions exist to address PAIR difficulties but are not widely commissioned, with regional disparities, and infants being under-served. This project qualitatively explored barriers and enablers to commissioning PAIR services.</p><p><strong>Methods: </strong>Individuals with commissioning responsibilities relating to PAIR working in Clinical Commissioning Groups or Local Authorities in the North East North Cumbria (NENC) region were invited to participate. Qualitative semi-structured interviews were informed by a topic guide developed through practitioner involvement. Nine interviews were completed online between February and April 2022. Anonymised transcripts were analysed using Framework Analysis.</p><p><strong>Results: </strong>Barriers and enablers to commissioning were general, specific to PAIR services, or related to the pandemic context. General factors included the nature of the commissioning process, the importance of taking a collaborative approach to commissioning and the constraints of funding processes. Commissioners valued being able to demonstrate impact and value for money through service evaluation but faced challenges in doing so. Specific barriers relating to PAIR commissioning included a lack of awareness of the importance of infant mental health although there was an acknowledgement of the importance of maternal and parent-infant services/support during the early years. Factors amenable to change were mapped on to the Behaviour Change Wheel to inform the future co-development of a resource to address barriers and enablers.</p><p><strong>Conclusions: </strong>This paper is the first to report a pragmatic, applied qualitative exploration of barriers and enablers to commissioning parent-infant relationship services. Insights from commissioners with a wide range of portfolios identified key factors operating at the individual level which were amenable to change. In addition, there were barriers beyond the individual level, such as funding. Using a pragmatic approach, we identified best-fit behaviour change initiatives to develop a commissioning support toolkit to increase access to support, improve outcomes, and decrease inequalities, addressing infants as an under-served group.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1020"},"PeriodicalIF":3.0,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding healthcare workers' risk perception and response to healthcare waste in Arba Minch town, Ethiopia: application of the extended parallel process model.","authors":"Kiros Muleta, Tsehaynew Kasse, Gistane Ayele, Desta Haftu, Yalemzer Agegnehu","doi":"10.1186/s12913-025-13142-5","DOIUrl":"https://doi.org/10.1186/s12913-025-13142-5","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1019"},"PeriodicalIF":3.0,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is South Africa ready for point-of-care, non-sputum tests for TB diagnosis? An assessment of end-user perceptions on a novel urine test and tongue swab for TB testing.","authors":"Nasiphi Mqedlana-Ntombela, Vanessa Fargnoli, Salome Charalambous, Kavindhran Velen, Sonjelle Shilton, Violet Chihota","doi":"10.1186/s12913-025-13165-y","DOIUrl":"https://doi.org/10.1186/s12913-025-13165-y","url":null,"abstract":"<p><strong>Background: </strong>Sputum collection continues to limit TB testing, resulting in undiagnosed TB. Innovative interventions are needed to expand point-of-care TB diagnosis particularly in low-to-middle income countries (LMICs). Novel non-sputum sample types currently under development can increase TB testing, however there is limited knowledge on end-user perceptions on these tests.</p><p><strong>Methods: </strong>Between March and June 2023, we conducted a mixed methods study to assess end-user insights on a tongue swab and urine test currently under development for TB diagnosis. To describe the sample types to respondents, we used visual information sheets. Surveys were conducted among TB care recipients, healthcare workers, public health experts and civil society stakeholders, while semi-structured interviews were with all groups except for TB care recipients. The surveys were analysed descriptively, and thematic analysis was used for the semi-structured interviews.</p><p><strong>Results: </strong>The median acceptability for the urine test and tongue swab were 94.85% and 96.8% respectively. While the acceptability of the novel tests was high, respondents identified potential barriers that would negatively impact effective implementation and utility if not addressed. The identified barriers included patient level factors such as collection of midstream urine for the urine test, clinic and healthcare provider factors such as the time required to process test results, and contextual factors such as power and water outages, as well as stock shortages common in South African health facilities.</p><p><strong>Conclusions: </strong>Both novel sample types were highly acceptable and preferred over sputum collection. There are however potential barriers identified by end-users that need that would affect effective implementation and utility if not addressed. Manufacturers need to consider patient, provider, gender, and context specific factors during the development of novel innovations for effective uptake and implementation.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1013"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing the effect of COVID-19 lockdown policy on the utilization of facility-based delivery in Kenya: a multi-method study.","authors":"MaryBennah N Kuloba, Christoph Strupat, Thit Thit Aye, Phidelis N Wamalwa, Judy Gichuki, Benjamin Tsofa, Manuela De Allergi","doi":"10.1186/s12913-025-13070-4","DOIUrl":"https://doi.org/10.1186/s12913-025-13070-4","url":null,"abstract":"<p><strong>Background: </strong>Amidst the COVID-19 pandemic, lockdown policies emerged as pivotal policies to contain viral transmission. Questions arise about whether their implementation challenged access to care, particularly in regions with fragile health systems, such as sub-Saharan Africa. Robust evidence on the effect of lockdown policies on access to healthcare services is sparse, also due to a lack of suitable data. We addressed this knowledge gap and assessed the effect of the COVID-19 lockdown policy on facility-based delivery during the first wave of the pandemic in Kenya.</p><p><strong>Methods: </strong>We triangulated results from two parallel yet independent quantitative analyses, exploiting the fact that COVID-19 lockdown policies in Kenya were implemented only in some counties. First, we relied on nationally representative repeated cross-sectional population-based surveys conducted in 2018 and 2020, with data being analyzed using a pre-post study with control. Second, we used monthly data from the Kenya Health Information System (from January 2019 to November 2020) to construct an interrupted time series (ITS) with independent controls, setting April 2020 as the interruption month (i.e., the onset of the lockdowns).</p><p><strong>Results: </strong>The controlled pre-post-analysis detected no significant effect of the lockdown policy on facility-based delivery in lockdown counties compared with non-lockdown counties. The ITSA model showed that the lockdown counties experienced an immediate increase of 4.97% (CI: 0.51%, 9.43%) in facility-based delivery compared with the non-lockdown counties during the first wave of the pandemic. This was followed by a significant monthly decrease of 0.97% (CI: -1.60%, -0.34%) compared with non-lockdown counties.</p><p><strong>Conclusion: </strong>We found no overall effect of the lockdown policy on facility-based deliveries. Our findings suggest that when managed effectively, lockdowns do not disrupt access to maternal health services. Our findings highlight the importance of implementing context-specific strategies to safeguard maternal healthcare during public health crises. Future research should explore localized and socioeconomic differences in how populations respond to public health interventions during pandemics.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1014"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of large-scale implementation of obstetric point of care ultrasound in eight counties in Kenya using RE-AIM framework.","authors":"Grace Githemo, Anthony Wanyoro, Jacob Masika, Lister Onsongo, Sarah Bett, Stephen Githuku, Grace Gachuiri, Dilys Walker, Nicole Santos, Rakesh Ghosh, George Otieno","doi":"10.1186/s12913-025-13212-8","DOIUrl":"https://doi.org/10.1186/s12913-025-13212-8","url":null,"abstract":"<p><strong>Background: </strong>Obstetric Point-of-Care Ultrasound (O-POCUS) holds promise for strengthening maternal health services particularly in low- and middle-income countries (LMICs). However, its widespread use is hindered by limited provider training and resource constraints within health facilities. To address this gap, a large-scale O-POCUS program was implemented across eight counties of Kenya whereby 468 healthcare providers (HCPs) from 224 facilities were trained in five basic O-POCUS parameters. This study evaluated the reach, effectiveness, adoption, implementation, and maintenance of this program using the RE-AIM framework.</p><p><strong>Methods: </strong>For this cross-sectional evaluation study, trained research staff conducted surveys and in-depth interviews with HCPs, stakeholders, and antenatal and postnatal care clients for one week from a random sample of about half of these facilities (n = 114) six months after O-POCUS introduction. A total of 249 HCPs, 2,292 antenatal and 1,704 postnatal clients were surveyed, and 96 HCPs/stakeholders and 114 clients were interviewed. Data were analyzed using descriptive and thematic methods and mapped onto the RE-AIM framework to assess program implementation.</p><p><strong>Results: </strong>The findings revealed that O-POCUS was implemented across all 114 health facilities and 1937 (49%) of surveyed clients received a scan (reach). Over 80% of trained HCPs reported moderate to high confidence in performing key obstetric assessments, and 72% reported that O-POCUS influenced clinical decision-making including referrals (effectiveness). 41% of HCPs conducted more than 20 scans per month and 89% of the clients reported that they were likely to recommend O-POCUS to others (adoption). Lack of resources such as gel and paper towels were identified as major challenges (implementation), while 60% of HCPs reported the need for further training and mentorship (maintenance).</p><p><strong>Conclusion: </strong>These findings demonstrate successful large-scale implementation of O-POCUS in Kenya and provide valuable insights for policymakers and healthcare organizations seeking to implement similar O-POCUS programs in resource-limited settings. Continuous strengthening through mentorship, supportive supervision and resource provision is recommended for sustained success of O-POCUS in improving maternal healthcare.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1016"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decolonizing global health: Africa's pursuit of pharmaceutical sovereignty.","authors":"Moses Mulumba, Jessica Oga, Nana Koomson, Tasha-Aliya Kara, Adanze Nge Cynthia, Lisa Forman","doi":"10.1186/s12913-025-13211-9","DOIUrl":"https://doi.org/10.1186/s12913-025-13211-9","url":null,"abstract":"<p><strong>Background: </strong>Africa's continued reliance on imported medicines, vaccines, and active pharmaceutical ingredients is the direct legacy of colonial extraction, intensified by the structural-adjustment era's dismantling of state-owned drug plants and cemented by intellectual-property regimes that keep critical know-how offshore. The COVID-19 vaccine scramble exposed the full cost of this vulnerability and has triggered a continent-wide push for pharmaceutical sovereignty-an explicit, decolonizing agenda to localize research, regulation, and production. This review distils the latest evidence on the barriers that still block that transition and maps the regulatory, financial, technological, and civic opportunities most likely to accelerate it.</p><p><strong>Methodology: </strong>A critical narrative literature review was conducted. Six databases (PubMed, Scopus, ProQuest, Google Scholar, BMJ Global Health and the Institute for Economic Justice repository) were searched for English-language records published January 2000-May 2025 using the terms Africa AND (pharmaceutic OR vaccine OR API) AND (sovereign OR manufactur OR decoloni). Grey literature from AU agencies, Africa CDC, WHO and UNIDO was added. Forty-five documents met inclusion criteria and were included in the article. Reflexive thematic analysis identified recurrent barriers and enabling pathways; intercoder reliability was ensured through independent coding and consensus meetings.</p><p><strong>Results: </strong>Four structurally reinforcing barriers dominate the evidence base: (i) TRIPS-based patent exclusivities that restrict technology transfer; (ii) fragmented and immature regulatory capacity (iii) chronic under-investment; and (iv) import-biased procurement. The countervailing opportunities center on (i) AMA-led regulatory harmonization, (ii) pooled-demand instruments (iii) technology-transfer partnerships and (iv) civic-sector mobilization.</p><p><strong>Conclusion: </strong>Africa now possesses the regulatory blueprint, pooled-demand incentives, and emerging technology platforms to localize production of medicines and vaccines. However, its realization is dependent on synchronizing these levers by easing IP constraints, completing AMA-led regulatory convergence, mobilizing concessional finance for API and bulk-drug capacity, and reforming procurement to reward local value. If pursued in concert, these steps can convert pharmaceutical sovereignty from a political slogan into a resilient, continent-wide industrial reality- anchoring Africa's wider agenda to decolonize global health.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1015"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategic planning and organizational performance in public health sector: a scoping review.","authors":"Utoomporn Wongsin, Tanavij Pannoi, Chardsumon Prutipinyo, Mohammad Ainul Maruf, Dichapong Pongpattrachai, Orawan Quansri, Youwanuch Sattayasomboon","doi":"10.1186/s12913-025-13206-6","DOIUrl":"https://doi.org/10.1186/s12913-025-13206-6","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1017"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of tool to assess respectful maternity care practices among healthcare providers.","authors":"Radha Devi Dhakal, Regidor Iii Poblete Dioso, Kalpana Sharma, Govinda Prasad Dhungana","doi":"10.1186/s12913-025-13155-0","DOIUrl":"10.1186/s12913-025-13155-0","url":null,"abstract":"<p><strong>Background: </strong>Respectful maternity care in healthcare facilities during childbirth is a growing concern around the world. It is more than just an important component of care quality; it is also a human right. The aim of this study was to develop and validate a tool to assess respectful maternity care practices among healthcare providers in Nepal.</p><p><strong>Methods: </strong>This is a cross-sectional study as part of an explanatory sequential mixed-method research design. The tool was developed using 9 steps in three phases: item development, scale development, and scale evaluation. Tool is a five-point Likert scale containing 36 items. Each item was rated on a 1-5 scale ranging from 1 (strongly disagree) to 5 (strongly agree). The participants were healthcare providers working in maternity units of various healthcare centers of Madhesh Province. The items were analyzed for validity and reliability with exploratory factor analysis. The data were analyzed via the Statistical Package for Social Science version 22.</p><p><strong>Results: </strong>The content validity index (CVI = 0.895), kappa index and content validity ratio (CVR) were calculated for each item and they were within an acceptable range. Analysis of internal consistency revealed an acceptable Cronbach's alpha value (0.925) for the 36 item RMCP scale, and seven subscales. The suitability of the data for factor analysis was confirmed by Kaiser-Meyer-Olkin (0.801), and Bartlett's test of sphericity was significant (0.000). Principal component analysis with varimax with Kaiser normalization rotation identified 7 factors with eigenvalues greater than one, accounting for 74.55% of the observed variance.</p><p><strong>Conclusion: </strong>A new tool for respectful maternity care practices has been developed through a rigorous process of item generation and validity-reliability assessment in addition to confirmatory factor analysis to assess the respectful maternity care practices of healthcare providers in Nepal which is statistically proven to be valid and reliable, with an appropriate range of confirmatory factor analysis results. Assessing the RMC practices of health care providers during facility-based maternity care may be relevant.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1007"},"PeriodicalIF":3.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12312277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing a hospital-based case management intervention for people experiencing homelessness: the navigator program.","authors":"Jesse I R Jenkinson, Dinesh Moro, Oluwagbenga Dada, Kate Francombe Pridham, Jeremy Cygler, Stephen W Hwang","doi":"10.1186/s12913-025-13170-1","DOIUrl":"10.1186/s12913-025-13170-1","url":null,"abstract":"<p><strong>Background: </strong>People experiencing homelessness (PEH) have worse health than the general population, and higher rates of hospitalization. The transition period after discharge from hospital is often challenging for PEH, in part due to loss to follow-up, competing priorities, housing instability, and the absence of a primary care provider. In-patient hospital stays represent a window of opportunity to intervene and connect with patients, supporting them to stay in hospital and complete their treatment plan, identify and address their social needs, and support their transition of care into the community. This qualitative study explores supports and challenges to the implementation of the Navigator Program, a hospital-based critical time intervention that supports PEH during their hospital stay and after discharge into the community.</p><p><strong>Methods: </strong>We interviewed 35 participants (homeless outreach counsellors working on the program, hospital physicians and staff in the implementation setting, community service providers, and the implementation team) and conducted 130 h of non-participant observation. Analysis used the Framework Method and the Consolidated Framework for Implementation Research to highlight the barriers and facilitators to implementation.</p><p><strong>Results: </strong>A core aspect of successful implementation and program uptake was that all participants saw a need for the program. The flexible approach to model design and implementation was an essential approach to program development that adjusted to the implementation setting, while leaving room to create more systems and structures as the program progresses. Implementation also relied on clear approaches to attaining buy-in from all stakeholders, done through a mix of formal and informal approaches. Operating as a hospital-based program was essential for successful implementation, supporting team-building among care providers in both the healthcare and social service sectors, which can lead to improved patient care coordination.</p><p><strong>Conclusion: </strong>The implementation of programs addressing complex social and health issues can contribute to its success or failure. In this study, we discuss the effective implementation approaches of the Navigator Program, as well as lessons learned. This study provides practical and helpful strategies for implementing similar programs in hospitals across Canada, and in countries with similar healthcare system structures.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1006"},"PeriodicalIF":3.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12312349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}