4,456 research outputs found

    How do patients and providers navigate the “corruption complex” in mixed health systems? The case of Abuja, Nigeria.

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    INTRODUCTION: Over the last decades, scholars have sought to investigate the causes, manifestations, and impacts of corruption in healthcare. Most of this scholarship has focused on corruption as it occurs in public health facilities. However, in Nigeria, in which most residents attend private health facilities for at least some of their care needs, this focus is incomplete. In such contexts, it is important to understand corruption as it occurs across both public and private settings, and in the interactions between them. This study seeks to address this gap. It aims to examine how corruption is experienced by, and impacts upon, patients and providers as they navigate the “corruption complex” in the mixed health system of Abuja, Nigeria. OBJECTIVES: This over-arching aim is addressed via three interrelated objectives, as follows: 1.To investigate the experiences of patients and providers concerning the causes, manifestations, and impacts of corruption in public health facilities, in Abuja, Nigeria. 2.To investigate patients / provider experiences of corruption as they relate to private health facilities in Abuja, Nigeria. 3.To investigate how, and the extent to which, corruption is enabled by the co-existence of and interactions between public and private health facilities in the context of the mixed health system of Nigeria – and of Abuja in particular. METHODS: All three objectives are addressed via a qualitative exploratory study. Data was collected in Abuja, Nigeria’s Federal Capital Territory (between October 2021 to May 2022) through: (i) in-depth interviews with 53 key informants, representing a range of patient and provider types, and policymakers; and (ii) participant observation over eight months of fieldwork. The research took place in three secondary-level public health facilities (Gwarinpa, Kubwa, and Wuse General hospital) and three equivalent-sized private health facilities (Nissa, Garki, and King's Care Hospital) in Abuja. The empirical data was analysed using Braun and Clarke's (2006) reflexive thematic analysis approach and presented in a narrative form. Abuja was selected as the research setting, as the city is representative of the mixed health system structures that exist in Nigeria, especially in the country’s larger urban areas. RESULTS: Objective 1: Corruption in public health facilities is driven by a shortage of resources, low salaries, commercialisation of health and relationships between patients and providers, and weak accountability structures. Corruption takes various forms which include: bribery, informal payments, theft, influence- activities associated with nepotism, and pressure from informal rules. Impacts include erosion of the right to health care and patient dignity, alongside increased barriers to access, including financial barriers, especially for poorer patients. Objective 2: Corruption in private health facilities is driven by incentives aimed at profit maximisation, poor regulation, and lack of oversight. Corruption takes various forms which include: inappropriate or unnecessary prescriptions (often driven by the potential for kickbacks), forging of medical reports, over-invoicing, and other related types of fraud, and under/over-treatment of patients. Impacts include reductions to the quality of care provided and exacerbation of financial risks to patients. Objective 3: The nature of public-private sector interactions creates scope for several forms of corruption. For example, these interactions contribute to the causes of corruption in the public sector - especially the problem of scarcity of resources. Related manifestations include dual practice, absenteeism, and theft (e.g., diversion of patients, medical supplies, and equipment from public to private facilities). The impacts of such practices include inequities of access, for example, due to delays in and denials of needed services and additional financial barriers encountered in public facilities, alongside reductions to quality of care, pricing transparency and financial protection in private facilities. CONCLUSION: Patients experience corruption in both public and private health facilities in Abuja, Nigeria. The causes, manifestations and impacts of corruption differ across these settings. In the public sector, corruption creates financial and non-financial barriers to care – aggravating inequities of access. In the private health sector, corruption undermines quality of care and exacerbates financial risks. The public-private mix is itself implicated in the problem – giving rise to new opportunities for corruption, to the detriment of patients’ health and welfare. For policymakers in Nigeria to address the problem of corruption, a cross-sectoral approach - inclusive of the full range of providers within the mixed health system – will be required

    Unleashing the power of artificial intelligence for climate action in industrial markets

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    Artificial Intelligence (AI) is a game-changing capability in industrial markets that can accelerate humanity's race against climate change. Positioned in a resource-hungry and pollution-intensive industry, this study explores AI-powered climate service innovation capabilities and their overall effects. The study develops and validates an AI model, identifying three primary dimensions and nine subdimensions. Based on a dataset in the fast fashion industry, the findings show that the AI-powered climate service innovation capabilities significantly influence both environmental and market performance, in which environmental performance acts as a partial mediator. Specifically, the results identify the key elements of an AI-informed framework for climate action and show how this can be used to develop a range of mitigation, adaptation and resilience initiatives in response to climate change

    Distributed Ledger Technology (DLT) Applications in Payment, Clearing, and Settlement Systems:A Study of Blockchain-Based Payment Barriers and Potential Solutions, and DLT Application in Central Bank Payment System Functions

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    Payment, clearing, and settlement systems are essential components of the financial markets and exert considerable influence on the overall economy. While there have been considerable technological advancements in payment systems, the conventional systems still depend on centralized architecture, with inherent limitations and risks. The emergence of Distributed ledger technology (DLT) is being regarded as a potential solution to transform payment and settlement processes and address certain challenges posed by the centralized architecture of traditional payment systems (Bank for International Settlements, 2017). While proof-of-concept projects have demonstrated the technical feasibility of DLT, significant barriers still hinder its adoption and implementation. The overarching objective of this thesis is to contribute to the developing area of DLT application in payment, clearing and settlement systems, which is still in its initial stages of applications development and lacks a substantial body of scholarly literature and empirical research. This is achieved by identifying the socio-technical barriers to adoption and diffusion of blockchain-based payment systems and the solutions proposed to address them. Furthermore, the thesis examines and classifies various applications of DLT in central bank payment system functions, offering valuable insights into the motivations, DLT platforms used, and consensus algorithms for applicable use cases. To achieve these objectives, the methodology employed involved a systematic literature review (SLR) of academic literature on blockchain-based payment systems. Furthermore, we utilized a thematic analysis approach to examine data collected from various sources regarding the use of DLT applications in central bank payment system functions, such as central bank white papers, industry reports, and policy documents. The study's findings on blockchain-based payment systems barriers and proposed solutions; challenge the prevailing emphasis on technological and regulatory barriers in the literature and industry discourse regarding the adoption and implementation of blockchain-based payment systems. It highlights the importance of considering the broader socio-technical context and identifying barriers across all five dimensions of the social technical framework, including technological, infrastructural, user practices/market, regulatory, and cultural dimensions. Furthermore, the research identified seven DLT applications in central bank payment system functions. These are grouped into three overarching themes: central banks' operational responsibilities in payment and settlement systems, issuance of central bank digital money, and regulatory oversight/supervisory functions, along with other ancillary functions. Each of these applications has unique motivations or value proposition, which is the underlying reason for utilizing in that particular use case

    UMSL Bulletin 2023-2024

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    The 2023-2024 Bulletin and Course Catalog for the University of Missouri St. Louis.https://irl.umsl.edu/bulletin/1088/thumbnail.jp

    Multidisciplinary perspectives on Artificial Intelligence and the law

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    This open access book presents an interdisciplinary, multi-authored, edited collection of chapters on Artificial Intelligence (‘AI’) and the Law. AI technology has come to play a central role in the modern data economy. Through a combination of increased computing power, the growing availability of data and the advancement of algorithms, AI has now become an umbrella term for some of the most transformational technological breakthroughs of this age. The importance of AI stems from both the opportunities that it offers and the challenges that it entails. While AI applications hold the promise of economic growth and efficiency gains, they also create significant risks and uncertainty. The potential and perils of AI have thus come to dominate modern discussions of technology and ethics – and although AI was initially allowed to largely develop without guidelines or rules, few would deny that the law is set to play a fundamental role in shaping the future of AI. As the debate over AI is far from over, the need for rigorous analysis has never been greater. This book thus brings together contributors from different fields and backgrounds to explore how the law might provide answers to some of the most pressing questions raised by AI. An outcome of the Católica Research Centre for the Future of Law and its interdisciplinary working group on Law and Artificial Intelligence, it includes contributions by leading scholars in the fields of technology, ethics and the law.info:eu-repo/semantics/publishedVersio

    Digitalization and Development

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    This book examines the diffusion of digitalization and Industry 4.0 technologies in Malaysia by focusing on the ecosystem critical for its expansion. The chapters examine the digital proliferation in major sectors of agriculture, manufacturing, e-commerce and services, as well as the intermediary organizations essential for the orderly performance of socioeconomic agents. The book incisively reviews policy instruments critical for the effective and orderly development of the embedding organizations, and the regulatory framework needed to quicken the appropriation of socioeconomic synergies from digitalization and Industry 4.0 technologies. It highlights the importance of collaboration between government, academic and industry partners, as well as makes key recommendations on how to encourage adoption of IR4.0 technologies in the short- and long-term. This book bridges the concepts and applications of digitalization and Industry 4.0 and will be a must-read for policy makers seeking to quicken the adoption of its technologies

    Security Aspects in Web of Data Based on Trust Principles. A brief of Literature Review

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    Within scientific community, there is a certain consensus to define "Big Data" as a global set, through a complex integration that embraces several dimensions from using of research data, Open Data, Linked Data, Social Network Data, etc. These data are scattered in different sources, which suppose a mix that respond to diverse philosophies, great diversity of structures, different denominations, etc. Its management faces great technological and methodological challenges: The discovery and selection of data, its extraction and final processing, preservation, visualization, access possibility, greater or lesser structuring, between other aspects, which allow showing a huge domain of study at the level of analysis and implementation in different knowledge domains. However, given the data availability and its possible opening: What problems do the data opening face? This paper shows a literature review about these security aspects

    UMSL Bulletin 2022-2023

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    The 2022-2023 Bulletin and Course Catalog for the University of Missouri St. Louis.https://irl.umsl.edu/bulletin/1087/thumbnail.jp
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