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The management and exchange of electronic health records (EHRs) remain critical challenges in healthcare, with fragmented systems, varied standards, and security concerns hindering seamless interoperability. These challenges compromise patient care and operational efficiency. This paper proposes a novel solution to address these issues by leveraging distributed ledger technology (DLT), including blockchain, to enhance data security, integrity, and transparency in healthcare systems. The decentralized and immutable nature of DLT enables more efficient and secure information exchange across platforms, improving decision-making and coordination of care. This paper outlines a strategic implementation approach, detailing timelines, resource requirements, and stakeholder involvement while addressing crucial privacy and security concerns like encryption and access control. In addition, it explores standards and protocols necessary for achieving interoperability, offering case studies that demonstrate the framework's effectiveness. This work contributes by introducing a DLT-based solution to the persistent issue of EHR interoperability, providing a novel pathway to secure and efficient health data exchanges. It also identifies the standards and protocols essential for integrating DLT with existing health information systems, thereby facilitating a smoother transition toward enhanced interoperability. [ABSTRACT FROM AUTHOR]

Copyright of Humanities Journal of University of Zakho (HJUOZ) is the property of Humanities Journal of University of Zakho and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The Energy-Water-Food (EWF) nexus is a complex and multidimensional system, in which the energy, water and food resources are strongly interconnected. EWF nexus systems are seriously threatened by natural hazards (e.g., climate change and extreme weather events) along with other human-driven threats, including rapid population growth, urbanization, terrorism, and geopolitical uncertainty. As such, integrated analysis, as encouraged by the EWF nexus can facilitate the identification of essential connections and potential conflicts that may arise in the planning and operation of resource systems. Moreover, in order to consider immediate shocks and long-term pressures, it is imperative to prioritize the strengthening of EWF system resilience by incorporating robust and efficient resource management strategies, which consider various dimensions of sustainability and security such as technical, environmental, economic, and societal aspects. Decentralization is one concept that has the potential of improving the resilience of nexus systems faced to the multiple risks governing them through reducing single points of failure and enabling swifter responses to sudden shocks and continuous volatilities. However, in order to achieve a holistic system resilience through decentralization, the assessment of the different risks impacting each nexus sector is fundamental, yet it can be particularly challenging. Therefore, the objective of this study is to review the currently available resilience assessment methods for the EWF nexus system. The systematic literature review will connect various assessment methods used within decentralization studies that are applied to improve the resilience performance of the EWF nexus system. A total of 84 journal papers were evaluated. The review demonstrates that the deployment of multi-criteria decision-making framework based on composite indicators can be effective in addressing risks and uncertainties within EWF systems. Furthermore, findings of this review illustrate complementary connections between decentralization and resilience concepts, which when integrated with the EWF nexus approach, can be effectively utilized for integrated sustainable resource management. [ABSTRACT FROM AUTHOR]

To achieve Sustainable Development Goal 5 for gender equality by 2030, it is crucial for health and development professionals and governmental officials to understand how legal systems empower or oppress populations on the basis of gender worldwide, including opportunities and challenges of statutory provisions created by legal pluralism. Using Ethiopia as a case study, this paper examines how local laws applied in Sharia and Customary Dispute Resolution courts impact gender equality and the health of women and girls inspite of the inculcation of human rights statutes into national legislation, including the Constitution. We identify several key issues with the substantive law and its enforcement. First, laws which have been instituted at the national level to improve gender equally have been poorly enforced at the local level. Second, there is a sustained enforcement of laws that oppress women and that protect male perpetrators of gender-based violations. Third, local courts limit female representation and uphold patriarchy. To improve the health of women and girls, stakeholders must take into consideration the ways in which legal systems uphold harmful gender norms and obstruct and/or advance progress towards equal representation, opportunities, and constitutionally-mandated protections for all. [ABSTRACT FROM AUTHOR]

Aim: The centralization of Finnish maternity services can mean longer journeys when women are in labor. The aim of this study was to describe women's experiences of having an unplanned out-of-hospital delivery (OHD) and to produce a deeper understanding of how to support them when this happens. Design: Qualitative descriptive study design with narrative inquiry method. Methods: Individual interviews were carried out with 15 women who had an unplanned OHD and the data were analyzed using a narrative method. Results: Three narratives described the women's experiences of an unplanned OHD with a common plot being their sense of control. In the first narrative, a sense of control was maintained; in the second, the sense of control fluctuated; and the third narrative centered on a loss of control. All the narratives were related to the women's experiences of what was happening to their body, the people around them during delivery, and the situation after the childbirth. Conclusion: Having an unplanned OHD forced women to reconsider their preconceptions and expectations of childbirth and focus on how to handle the situation at hand. A key factor was the sense of control they felt while giving birth, which should be considered a core principle in maternity care practices, from antenatal care to delivery. [ABSTRACT FROM AUTHOR]

Background: Universal health coverage (UHC) improves national health outcomes while addressing social inequalities in access to quality healthcare services. The district health system (DHS) is critical to the success of UHC in South Africa through the National Health Insurance (NHI) scheme. Family physicians (FPs), as champions of primary care, are central to the DHS operation and implementation of NHI. Methods: This was a qualitative exploratory study that used semi-structured interviews to explore FPs views and engagement on NHI policy and implementation in their districts. Ten FPs were included through purposive sampling. Results: Most of the FPs interviewed were not engaged in either policy formulation or strategic planning. The NHI bill was seen as a theoretical ideology that lacked any clear plan. Family physicians expressed several concerns around corruption in governmental structures that could play out in NHI implementation. Family physicians felt unsupported within their district structures and disempowered to engage in rollout strategies. The FPs were able to provide useful solutions to health system challenges because of the design of their training programmes, as well as their experience at the primary care level. Conclusion: Healthcare governance in South Africa remains located in national and provincial structures. Devolution of governance to the DHS is required if NHI implementation is to succeed. The FPs need to be engaged in NHI strategies, to translate plans into actionable objectives at the primary care level. Contribution: This study highlights the need to involve FPs as key actors in implementing NHI strategies at a decentralised DHS governance level. [ABSTRACT FROM AUTHOR]

This research hinges upon the relationship between fiscal decentralization and life satisfaction. It contributes to the field by performing an empirical analysis focused on the case of Chile, by merging the national household survey (CASEN) with municipal level information. This analysis is based on a hierarchical empirical model, in which data from both sources are integrated. Our results show a significant positive effect of municipal level fiscal decentralization on individual subjective wellbeing. Nonetheless, we also show that said result is contingent upon residents' political representation, which is in line with the hypothesis that citizens' oversight of local authorities is a necessary condition for the effect of fiscal decentralization to emerge. From the viewpoint of how fiscally decentralized measures should be implemented in practice, above evidence suggests that said process should be accompanied by the strengthening of local residents' participation in community relevant matters. Further confirmation of this is presented in this research, by showing that residents' membership in organized groups further increases individual subjective well-being. [ABSTRACT FROM AUTHOR]

Copyright of Jurnal Wacana Politik is the property of Jurnal Wacana Politik (JWP) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)