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The Covid-19 pandemic is still current but has been particularly well addressed, so far, in the Australian context. This article presents an analysis of management practice to describe the experience of one Primary Health Network (PHN) and its approach and response to the pandemic within its geographical region in accordance with Federal government directives. The PHN is a large geographic area that includes the Central Coast, just north of the Sydney basin, the Newcastle and Hunter Valley region and the Northwest/New England region that extends from Tamworth to the Queensland Border. The article describes the PHN function within its primary healthcare role (PHC) in respect to responding to national initiatives to address and reduce the impact Of the Covid-19 event. The article recounts the Federal Governments directive described through the ‘National Cabinet’ and the Federal Health Department and the PHN response to those directives and initiatives. The article also recounts the actual cases of Covid-19 over the period of the epidemic. The article describes the governance, leadership, and management initiatives. The article then describes the PHN approach to evaluation of its approach from the perspective of general practice and other PHC providers as well as providing perspectives from governance, management, and staff. The evaluation process identified significant impacts on providers and strong support for the continuation of telehealth measures. There were positive responses to the PHN activity and as a strong sense of trusted information, ongoing education, and general engagement.

This issue is the fourth and final issue of the Journal for 2021. It reflects a widespread interest in the Asia Pacific with 30 articles from 11 countries. These countries include Australia, India, Iran, Indonesia, the Philippines, Saudi Arabia, Bangladesh. Vietnam, Thailand, Turkey and Hong Kong, China. This represents a significant collaboration of healthcare managers, leaders, academics, students, and health professionals from diverse health systems. This is a credit to them all and our reviewers. The topics addressed within the issue continue to be dominated by Covid_19 but are also more extensive than that topic. The topics include leadership, engagement, health literacy, employee performance, job satisfaction, mentoring, , artificial intelligence, big data to name many but not all. This is extensive collection of health management topics that should be of interest. Another continuing feature of this issue is the interest in publishing articles from international conferences. There are articles from four recent conferences. These included the 2021 Shape Symposium conducted from Australia and online, “Shaping the future for health management education and research in a time of flux and uncertainty”, held online in July and available at http://shape.org.au/. The Hong Kong Polytechnic University’s College of Professional and Continuing Education (CPCE) Conference “Post-pandemic health and long-term care: A new paradigm”. September 2021 with online and ‘in presence’ attendance. Two conferences highlighted in this issue are recognised from India with some eight articles published from these conferences. The conferences were the AICTE sponsored International Conference on Circular Economy, Management and Industry Leading towards Sustainability, October 2021 and the 2nd Conference on Business Data Analytics, November 2021 We wish to specifically mention these conferences and recognise the conference organisers and our guest co -editors on this occasion, who assisted us with the 8 selected articles. The guest co-editors are Mr. Anuj Kumar, Assistant Professor, Apeejay School of Management, Dwarka, Delhi, India https://www.apeejay.edu/asm/?utm_source=google&utm_medium=google+business+listing&utm_campaign=organic. (Top PGDM Colleges Delhi NCR) and Dr. Nimit Gupta, Professor, School of Management, The NorthCap University, Gurugram, India https://www.ncuindia.edu/educate-india- society/.

In writing an editorial it is difficult to ignore the impact and ramifications of addressing the Covid Pandemic. In Australia, there is emerging political and media signals that are saying we must start to move on and get people back to work and living normally. At the same time our health bureaucracies are pointing to higher vaccination rates, new variants, the need for ‘booster shots’ and continued reticence in some about opening state and national borders....

It is a privilege to be asked to present this Oration. Like many similar events, it pays tribute to a well-respected, revered, and past leader in our profession, in education, economics and life in general. Someone, who most of us would not have known personally nor about his involvement in the health system, particularly, SHAPE.

This issue is a special issue of the Journal based on the proceedings of a Health Management conference held earlier this year in India. Please read the editorial and the preface to discover how this eventuated. Most articles, 15 in total come from the proceedings of that conference but there are also a significant number of additional articles from our colleagues from India. Our thanks to Professor Prema Basargekar and his colleagues from K. J. Somaiya Institute of Management (K J SIM), Mumbai, India for working to make this issue significant There are some 30 articles in total In the issue. This is a record issue for APJHM.

This special issue has its focus on the nation-state of India, its healthcare system and health services. You may well ask why a special issue on India and the simple response would be that our colleagues from the K. J. Somaiya Institute of Management (K J SIM), Mumbai, India approached the Journal to see if we would publish a special issue base on articles that were presented at the 1st Annual Conference on Healthcare Management conducted earlier this year by them......

Since the last issue when we first spoke of the impact of Covid-19 we continue to be focused on addressing the challenges this virus has on health systems, nation states, communities, and people. The approach of countries and health systems has been variable as has the political interventions and interpretations of policy with some unfortunately placing parochial populism ahead of evidence and common sense......

I proposed that I would start this editorial with the phrase ‘that we live in interesting times…’given the ongoing challenge to all is the Covid_19 pandemic. The alleged origin of the phrase is said to be from a Chinese curse ‘may you live in interesting times’ but is found not to be directly attributable to a Chinese source, but it does use irony to suggest we are living in difficult and challenging times. It was subsequently used by the likes of Joseph Chamberlain and more recently in the 1960s by the then USA President John F Kennedy. [1] Either way most of us know that pandemics, dissent, war, and environmental disasters are not new and recent, but have occurred throughout history and are repeated often enough for most of us to have some experience or memories of those events.......

At the time of writing, nation states globally are beginning the vaccination process in response to Covid-19. There is great expectation that it will deliver effective protection to most populations. The logistic of the production and delivery of the vaccines, and use are immense and, we are fortunate, in the Australian context that the extent of the virus spread, and impact has been relatively limited and mostly contained. While everyone is wanting rapid progress, our context does allow us the opportunity to ‘hasten slowly’ and have a positive outcome....

This special issue responds to publications arising from presentations at the 2020 CPCE Health Conference held in Hong Kong in January. The conference was conducted by the College of Professional and Continuing Education of the Hong Kong Polytechnic University in association with a number a number of organisations including the Centre for Ageing and Healthcare Management Research and our colleagues from the Hong Kong College of Health Service Executives. The theme of the conference was ‘Ageing with Health and Dignity – Implications for Public Policy, Service Delivery Workforce, Technology and Financing’.....

It is difficult while writing an editorial, at this time, to ignore the extensive impact of the Corona virus (COVID-19) and it is probably important for us, as health professionals to give it some considered thought, outside the immediacy of current activity. I say this as someone recently returned from work related overseas travel, with my travel not meeting the government-imposed return deadline by some seven hours. This required my quarantine and/or isolation for some two weeks. After my first week of exclusion from most of my family, friends and working remotely and online it seems that the rest of Australia has caught up with my circumstance, many stood down from work, many businesses closed, a massive effort by the health system and economic rescue or support packages being implemented by government. It seems that I will have little opportunity to relax and celebrate with others at the end of this week.....

In this issue continues to explore the theme of health reform by traversing some recent experiences of the Editor in rural health contexts that traverse big data, technology, the social capital of health professionals all currently operating in drought and fire ravaged circumstances. After we pass the current circumstances there will be a need to rebuild rural communities and sustainable health services and workforce should be part of the community building......

During the recent Australian Federal election held on the 18th May 2019 much was made by all sides of the political divide about health and health services, much was praised, and more was promised in the name of health policy and improved approaches to health care delivery. Given that the ‘quiet Australians’ have made their choice and the political angst and dust has diminished, it might be time to return the debate to determine what it was that we all agreed to and where do we go from here.....

The lead Editorial in this issue – a special issue, as it contains six articles presented at the College of Professional and Continuing Education (CPCE) of the Hong Kong Polytechnic University Health Conference of 2019 is provided by Professor Peter Yuen, Dean of that College and Professor, Department of Management and Marketing of the Hong Kong Polytechnic University......

Recently I was talking to a colleague of mine from Hong Kong and he reminded me that Hong Kong had had 28 years of health reform. A period just slightly longer than we had known each other. We are deeply imbued in the management and organisation of health services and health systems and, therefore public health policy. He suggested that there should be a lot of learning for us all from that period and, he was exploring how that might happen. I agreed with the idea and the need to think it through. I also recognised potential for the Journal to play some role in that suggestion. Most national health systems have undergone extensive reform so there should be a lot of learning for all of us from that reform.....

This is the third and final issue for 2018. We continue in transition from publishing three issues a year to the concept of publish as ready. This has resulted in delays to processing and publishing, so we extend our apologies to both authors and readers. We currently have some twenty articles in review and delays are also occurring in this area in finding willing and receptive reviewers. We would appreciate authors suggesting reviewers as they submit articles.....

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In recent years much has been made of the need to effectively translate knowledge developed through research into health systems practice. [1] Literature suggests that the acceptance of research findings would be more likely if the research were achieved and disseminated into practice where it occurs in a more collaborative alignment of researchers and practitioners.....

Introduction: Motivation and retention of village health workers (VHWs) are crucial for the continuity, sustainability, and success of health programs. VHWs are the first point of contact for rural communities, providing health services to improve access and health coverage which, for a variety of logistical reasons, cannot be reached by the district health care system. Thus VHWs are critical for ultimately ensuring universal health coverage. However, systematic review revealed that there are numerous factors that affects their motivation and retention, leading to high dropout rates and hampering the delivery of health services to the community. This review intends to examine contextual factors affecting motivation and retention of VHWs in their roles and identify recommendations and strategies to motivate and retain them in the systems. Method: Five electronic databases and two search engines were accessed. Nineteen studies met the inclusion criteria for the final review. An in-depth reading of all the articles was undertaken to gather and compile the relevant themes. Content analysis was done based on the list of specific categories that are relevant to motivation and retention. Result: Findings from the systematic review revealed different levels of factor affecting motivation and retention of village health workers. It was finally contextualized and categorized into four main domains such as individual, family, social or community and organizational or systems levels. Financial incentives under the organizational factors was highlighted for the demotivation and the discontentment for the VHWs. Conclusion: Financial factors under the organization were often key in the studies reviewed. However, there were also many other factors, sometimes surprising or unintuitive, influencing the motivation and retention of village health workers.

The term ‘publish or perish’ is familiar to most of us engaged in some way in academia and reflects the mantra that to have a successful career as a teacher, researcher and all-round academic wanting to be recognised as an expert in your discipline requires you to be well and regularly published. This directive also has added implications to not publish in ‘any journal’ but in ones that have high impact factors. This suggests that they have recognised quality articles that have been peer reviewed, have rigour in the editorial process and, therefore are difficult to obtain publication in, particularly for students and emerging researchers. Progression of careers are dependant on this mantra and, we all want to ensure that the quality of our research, our science is of the best standard.....

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Book review of "Sociology of Health and Illness Monograph" series

Commentary and published research on the value of healthcare has become more evident in recent times. There has been a noticeable shift from the focus on efficiency of health systems and practice to a greater focus on what effectively works, or more so, what doesn’t work. Health delivery systems struggle with increased demand on existing services and other health priorities remain underserviced. What do we need to do to better examine and understand what delivers value to people, communities, the health system and at the same time improves health outcomes? ........

Thailand has performed admirably in its health reform over the last few decades. Healthcare is provided at a relatively low cost and healthcare needs have transitioned to begin to address diseases and mortality of developed countries. The challenges now faced by Thailand are similar to most developed countries reflecting adult mortality and risk factors of an uppermiddle income population and the need to modify institutional structures to reflect these changing circumstances. The approach to these challenges has focused on the ‘implementation of knowledge based health development’ and critically identifies ‘the triangle that moves the mountain’ (health reform) as a movement that mobilises; the creation of relevant knowledge, social movement and political involvement’ to address ‘inter-connected, complex and extremely difficult to solve’ problems. The move to District Health Systems as the access point to healthcare and the service delivery structure demands competent qualified leadership and management. It requires an understanding of the differences in managing professionally dominated complex adaptive systems compared to traditional approaches of managing within bureaucratic structures. This can be best described as managing connected, integrated care focused both on individuals as patients and communities with a strong emphasis on primary healthcare, prevention and evidence-based practice. It also requires an understanding of how distributed networks of practice (DNOP) provide the potential for researchers, practitioners and other agencies and communities to collaborate, learn and improve healthcare across geographic, jurisdictional and organisational boundaries. This approach provides recognition of the need to build the capacity and capability of health professionals in the management and leadership of health systems and Thailand is moving towards this goal in implementing specific health systems management curriculum which focuses on action-based research and learning together at the District health level augurs well for continued ability to address current health challenges and to achieve SDGs. Abbreviations: DHS – District Health System; DNOP – Distributed Networks of Practice; HSRI – Health Systems Research Institute; MoPH – Ministry of Public Health; NHSO – National Health Security Office; SDG – Strategic Development Goal; UHC – Universal Health Coverage.

Health reform has been a constant feature of most health systems for a number of decades and has often focused on structural change. The lexicon of health reform and health management has also become intertwined with managers reporting that reform has become a constant and that rather than influencing that change they are in fact influenced by it and by its impact on their role, professional development and career. There is a challenge for health service managers to return to a leadership role in enabling health reform. In doing so will this challenge us to think differently about management? This article addresses the significant body of research into health reform and health management through the lens of language used in reporting the context and the significant impact that it has had on the management role. It describes what directions that role might take, the qualities required in selecting capable managers and questions the current status quo in the education, training and development of this significant sector of the health system workforce. It concludes by proposing a way forward that acknowledges that contemporary health reform is shifting the paradigm of healthcare delivery in a way that requires the dominant view of health management to be challenged. This might be achieved by the use of a critical lens on the language of management, a focus on a grounded approach about what managers need to do and an acceptance of variability in that role in adaptive complex contexts. Abbreviations: DNOP – Distributed Networks of Practice; MDG – Millennium Development Goals; PHC – Primary Healthcare; PHN – Primary Health Network; SDG – Sustainable Development Goals; SEDOH – Social Economic Determinants of Health; SHAPE – Society for Health Administration Programs in Education.

In a recent online open forum of the Association of University Programs in Health Administration (AUPHA) two of our American colleagues were discussing the need for a greater focus in health management curricula on ‘transformation’. [1] They indicated that some time ago the American College of Healthcare Executives identified key skill areas for healthcare leaders as ‘operational, people, and transformation’, suggesting that good progress and focus on the first two had been achieved while more focus on the third was required. The discussion suggested that ‘the area of transformation’ needed to ‘specifically include skills in intrapreneurship and also innovation’. ....