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The COVID-19 pandemic exposed and reinforced the structural crisis in paid and unpaid care work. On the one hand, pandemic-related closures of schools and childcare facilities increased the fragility of unpaid care arrangements, which are mainly organised by women. On the other hand, high infection and hospitalisation rates exacerbated the difficult working conditions in health-care professions, ranging from low wages and long working hours to high levels of mental and physical stress. Drawing on interviews conducted in an ongoing project in the German and Austrian health-care sector, this article investigates, from a gender perspective, how employees in health-care professions, who are at the very centre of both the unpaid and paid care crises, experienced this precarious situation during the pandemic. We suggest that the female-dominated sectors of paid and unpaid care work experienced further devaluation during the COVID-19 pandemic, while attempts to valorise their work were rather short-lived. We further argue that the structural crisis in paid care work is threatening the functionality of the health-care sector.

Purpose – This study aims to examine the impact of workplace safety (WPS) on employee retention (ER) in the health-care sector in Azad Jammu and Kashmir (AJ&K), Pakistan. At the same time, a mediation relationship through job satisfaction (JS) and employee loyalty (EL) was also tested. Design/methodology/approach – Structured questionnaires were used to collect the data from 300 doctors, using purposive sampling technique analysed using partial least squares (Smart-PLS 3). Findings – This study’s findings supported all hypotheses, such as WPS has a significant positive relationship with ER. In addition, a mediation relationship between JS and EL was also confirmed. Furthermore, a serial mediation effect of JS and EL between WPS and ER was also confirmed in this study. Research limitations/implications – This study might not fit organisations from other regions due to regional norms. In the future, this study’s model may be tested on other regions and segments of the health-care sector, such as nurses, management staff and support staff. Practical implications – The present study is unique because it is based on a newly formulated framework, WPS → JS → EL → ER, under the social exchange theory, which has not been tested before. Social implications – In a safe environment, doctors will feel relaxed, stay longer and provide better services; resultantly, patients will get better treatment. Originality/value – This study tested the sequential mediation effect through JS and EL for the first time in ER, which was missing previously, to the best of the authors’ knowledge. This will add more insights to the safety-retention literature in health-care settings. Furthermore, this study is also the first attempt to explore the relationship between WPS and ER in the health-care sector in AJ&K.

Purpose: This study aims to examine the relationships between organizational culture, employee loyalty, trust and job satisfaction within the Lebanese health-care sector. It addresses the critical need to improve employee retention and organizational performance in a context marked by economic instability and political uncertainty. By analyzing data from 270 health-care professionals, the study aims to explore how different aspects of organizational culture - such as transparency, supportiveness and ethical leadership - affect employee trust and satisfaction. These factors, in turn, play a significant role in enhancing employee loyalty, which is crucial for reducing turnover and ensuring the stability of health-care services., Design/methodology/approach: The research used a quantitative methodology, gathering data from 270 health-care professionals across various private health-care institutions in Lebanon. A structured survey was used, and responses were analyzed using structural equation modeling (SEM) to test the proposed hypotheses. The SEM approach was chosen for its ability to evaluate both measurement and structural models, ensuring robust validation of the theoretical framework. Partial least squares (PLS-SEM) was specifically applied, given its suitability for smaller sample sizes and complex models. After screening and cleaning the data, the final sample size was 270, ensuring a representative and accurate analysis., Findings: The research findings reveal that a strong organizational culture significantly enhances employee loyalty, mediated by higher levels of trust and job satisfaction. Cultures characterized by transparency, supportiveness and ethical leadership are shown to build trust among employees, which directly contributes to greater job satisfaction. This satisfaction, in turn, plays a crucial role in strengthening employee loyalty, helping to reduce turnover rates and maintain organizational stability. The study underscores the importance of fostering a positive corporate culture as a strategic tool in health-care settings, particularly in challenging environments like Lebanon, to improve both employee engagement and overall performance., Originality/value: This study offers originality by focusing on the underexplored Lebanese health-care sector, particularly in the context of organizational culture's impact on employee loyalty, trust and job satisfaction. While much research has been conducted in more stable economies, this study addresses the unique socio-economic challenges faced by health-care institutions in Lebanon, including political instability and economic volatility. By using SEM, the research provides new insights into the critical role of transparent, supportive and ethically driven organizational cultures in enhancing employee engagement and retention. These findings offer both theoretical contributions and practical applications for similar sectors globally., (© Emerald Publishing Limited.)

Purpose: The purpose of this paper is to reveal the impact of dynamic managerial innovative capabilities on the competitive advantage (CA), financial performance (FP) and non-financial performance (NFP) of the health-care sector during the very turbulent Covid-19 pandemic period. The focus is on human behavior and personnel interaction in the hospitals that receive Covid-19 cases. Design/methodology/approach: Data for this research was collected from the medical sector in Lebanon. The authors approached 14 public hospitals and 60 private hospitals for the study and only 48 hospitals (total of 284 respondents) accepted to complete the survey and provide data using a structured questionnaire. Findings: This study reveals the moderating impact of CA on the relationship between dynamic managerial innovative capabilities and the performance of the health-care sector. Based on 48 Lebanese health-care centers during the Covid-19 pandemic, the results of the structural equation modeling model indicate that dynamic managerial innovative practices positively impact on CA and NFP. The results also reveal that CA has a moderating effect on the relationship between dynamic managerial innovative practices and NFP. Practical implications: This study does not reveal any direct or indirect relationship between managerial capabilities and FP during the pandemic. Originality/value: As the world deals with the Covid-19 pandemic, the health-care sector needs new approaches and methods for confronting the constantly evolving and turbulent environment. This study examines how health-care leaders are dealing with these dynamic challenges and tests a three-dimensional SEM model of dynamic managerial capabilities (sensing, seizing and reconfiguration) that impact CA. [ABSTRACT FROM AUTHOR]

BACKGROUND: Nongovernmental organizations (NGOs) as entities out of the health sector can play various roles and functions at different levels of the health systems. The present study was conducted to investigate NGOs' potential and actual functions in Iran's health system. MATERIALS AND METHODS: This exploratory study was carried out in two parts from April 2020 to December 2020 in Tehran, Iran. For the first part, the statute of 65 NGOs was used for document review, and in the second part, the required data were collected using semi-structured interviews with 26 key informants from the governmental sector and NGOs. Data were analyzed using the framework analysis method and MAXQDA software. RESULTS: According to data analysis, the results of this study were classified into two sections of NGOs' current functions and expected functions in Iran's health system. The current functions of NGOs in Iran's health system include service delivery, educational, research, and information activities, financing, supportive and facilitation activities, and advocacy. Other functions in which NGOs could play a role include health system management, education, and service providing and support activities. CONCLUSION: In this study, the various roles of NGOs in Iran's health system were explained. NGOs can act actively as the consulting and executive hand alongside the public sector in the lowest to the highest levels of Iran's health system. Hence, health sector managers and policymakers must facilitate NGOs' involvement in the health sector and use their capacities and capabilities to improve health and increase public access to health-care services.

BACKGROUND AND OBJECTIVES: Because the performance assessment of the health system is used as the basis for decision-making and demonstrates progress or failure in achieving the goals of the health system, promoting the health system performance assessment can play a major role in improving and enhancing the health system. Therefore, the main aim of the study was to identify and prioritize the challenges of promoting the health system performance assessment. MATERIALS AND METHODS: There were two approaches in both qualitative and cross-sectional studies. At first, using semi-structured interviews with 52 performance appraisers, data related to the challenges of promoting the health system performance assessment were collected and thematically analyzed. Then, in cross-sectional terms, the performance appraisers were provided with researcher-made checklists which contained a list of challenges to determine the priority of challenges by scoring. The data were handled and analyzed using MAXQDA Plus version 12 and Microsoft Excel. RESULTS: Our results revealed five themes and ten subthemes on the challenges of promoting the health system performance assessment. Themes (subthemes) included infrastructures (cultural and technological), implementation (organizational support, process, and responsibilities), human resources (motivation and training), assessment (performance monitoring), and content of measures (reliability and validity). We also prioritized 31 listed challenges in three priority groups, including below average, average, and above average. CONCLUSION: Our findings suggest that promoting the health system performance assessment in Iran can be accomplished by allocating financial and nonfinancial motives to the performance assessment staffs, using performance assessment results in policymaking, clarifying tasks of assessment process executors, and reviewing and adapting the performance assessment indices according to contingencies in the health system.

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In parallel with most of the countries, our country is recently experiencing a transformation in the health-care as well. Information technology is in the center of this transformation. The importance of transforming all of the health-care processes with information technologies is continuously increasing, an large amounts of investments are done in these technologies. Therefore, it is of great importance to measure the success of information systems due to the high amounts of investments and to see whether these investments are on target. The objective of this study is to measure the success of the information systems that family physicians use. The findings reveal that both mandatory and voluntary use of information systems increase the user satisfaction, leading to an increase in the value created in the health-care system.

This study explores the implementation of the kanban system, which is a Lean technique, within the pharmaceutical supply chain (PSC). The case study provides insights on the benefits and challenges arising from the application of this technique, within a group of cooperative pharmacists, in Greece. The research questions developed from the review of the literature were tested using evidence from field-based, action research within a pharmaceutical organisation. The reported case study contributes to the longer term debate on assessing the Lean maturity level within the health-care sector. There are two primary findings: (i) that the adoption of kanban system provides a strategic benefit and improves the quality of services. (ii) It also provides a basis for a strategy of operational change; it gives the opportunity to the organisation to move away from the current push delivery and logistics systems towards improved logistics strategy models. [ABSTRACT FROM AUTHOR]

Introduction: Health-care organizations are facing a high burden of ergonomic occupational accidents, and prevention is a continuous point of interest. In this manuscript, we describe the characteristics of ergonomic accidents in a large Belgian university hospital and discuss the value of near misses., Methods: Combining databases, we identified the frequency [number of accidents × 10 6 hours worked per year], severity (number of days off work × 10 3 hours worked per year), and profile of the victims of occupational ergonomic accidents (with absence from work) or incidents or near-misses (without absence from work). Ergonomic accidents and incidents include slips, trips, falls, injurious body movements, overexertion, and handling heavy weights., Results: In a period of 23 years, we noticed a significant decrease in the frequency of ergonomic accidents (from about 7 to about 4 standard units), without changes in the severity. The decrease in the frequency of accidents is mirrored by an increase in the frequency of incidents (from about 4 to about 6 standard units). Female and older employees are more vulnerable to accidents, and the frequency was between two and four times higher for employees mostly involved in manual tasks compared to employees mostly involved in managerial tasks. The profile of the victims and the causes of accidents and incidents were identical., Conclusion: Although it is premature to assume a cause-consequence relationship between incidents and accidents, it is tempting to speculate that the increased ratio of the frequencies of incidents over accidents might be one of the variables reflecting the adequacy of preventive measures and the growth of safety behavior.

Policy-makers face pressures to improve lives and safeguard public finances sustainably. In this analysis, we estimate the economic importance of the health-care sector in 19 European national economies. We use input-output tables for the year 2010 and sectoral data to estimate a set of multipliers: simple, total, truncated, type I and type II multipliers for output, income, value-added, employment and import multiplier. The analysis reveals similarities in the economic importance of the health-care sector for the national economies of the observed countries. Results suggest prevailing positive effects on national economies (value-added, employment and household income) when spending on health-care sector products and services increases, especially in comparison to the effects of increases in spending in other sectors. The importance of the health-care sector is connected to countries' levels of development; the benefits are especially promising in countries with lower levels of gross domestic product (GDP) per capita, where changes in the health-care sector have a larger impact on employment in the national economy than similar changes in more developed countries. The health-care sector therefore can play an important role as an instrument of economic policy., Competing Interests: Declaration of Competing Interest All authors declare that they have no conflict of interest., (Copyright © 2020 World Health Organization. Published by Elsevier B.V. All rights reserved.)