Search results for: financial services
4546 Clinicians’ Perspectives on Child Language Brokering
Authors: Carmen Pena-Díaz
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Linguistic and cultural difficulties regarding the access and use of public services, as well as facilitating communication at all levels, are problems which have not yet been tackled by authorities in Spain. In fact, linguistic and cultural issues are often not recognised as an integral part of migratory movements or social integration. While professionals of interlinguistic and intercultural communication (translators, interpreters, mediators) know that language and culture are key components to achieve immigrant integration and consolidate a truly multilingual society, policymakers at local, national, or supranational levels do not always seem aware of the risks and costs of not providing interpreting and translation services, particularly those affecting the health of users. Regarding the services currently used to cover the communication-related needs between the non-Spanish speaking population and healthcare professionals, evidence proves that there are no effective provisions for communication problems at present in Spanish hospitals. An example that suggests the poor management of the situation in relation to the migrants’ access to public healthcare is the fact that relying on a family member (often a minor) in medical consultations is one of the main practices that affects communication. At present, most medical professionals will explain that in their consultations with migrants who do not speak Spanish, they ask them to bring along a family member or friend who speaks Spanish. In fact, an abundant body of literature describes situations in which family members, children, friends, or anyone who speaks or understands a language helps to break language barriers in hospitals, not only in Spain. It is not difficult to see the problems this may cause, from ethical issues to comprehension problems and misunderstandings. This paper will present the results of Narrative Inquiry from a sample of eight clinicians about their perceptions and experiences using child language brokers in their appointments with non-Spanish speaking families. The main aim is to collect information about child language brokering as recalled and perceived by clinicians who present CLB as a routine practice and express their concerns and worries about using children to convey negative news to their parents or family members.Keywords: child language brokering, community interpreting, healthcare, PSIT
Procedia PDF Downloads 794545 Impact of Capital Structure, Dividend Policy and Sustainability on Value of Firm: A Case Study of Spinning Textile Sector of Pakistan
Authors: Zahid Ahmad, Samia Yousaf
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The main purpose of this study is to evaluate and assess the financial position, operating performance, and recent outlook of the companies. This study investigates the impact of capital structure, dividend policy and sustainability on the value of firms of textile spinning sector of Pakistan which is listed on Pakistan stock exchange. The panel data technique has been applied to this group of textile sector which is textile spinning. This study covers the last ten years of time period. All the data related to the variables have been collected from the annual reports and financial statements of the textile sector firms. There are differently related determinants to measure the capital structure which are fixed assets turnover ratio, debt ratio, equity ratio, debt to equity ratio, assets tangibility, and shareholder’s equity. Dividend policy is being measured by two determinants which are earning per share (EPS) and dividend payout ratio. Sustainability is being measured by three suitable factors which are sales growth, gross profit margin ratio and firm size. These are three independent variables and their determinants of this study. Value of firm is measured through the return on asset (ROA). Capital structure is at the top of the list among all the three variables. According to the results of this research work, somewhere all the three variables generates positive and significant effect on the firm’s performance and its growth.Keywords: capital structure, dividend policy, panel data, sustainability
Procedia PDF Downloads 2314544 Factors Influencing the Logistics Services Providers' Performance: A Literature Overview
Authors: A. Aguezzoul
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The Logistics Services Providers (LSPs) selection and performance is a strategic decision that affects the overall performance of any company as well as its supply chain. It is a complex process, which takes into account various conflicting quantitative and qualitative factors, as well as outsourced logistics activities. This article focuses on the evolution of the weights associated to these factors over the last years in order to better understand the change in the importance that logistics professionals place on them criteria when choosing their LSPs. For that, an analysis of 17 main studies published during 2014-2017 period was carried out and the results are compared to those of a previous literature review on this subject. Our analysis allowed us to deduce the following observations: 1) the LSPs selection is a multi-criteria process; 2) the empirical character of the majority of studies, conducted particularly in Asian countries; 3) the criteria importance has undergone significant changes following the emergence of information technologies that have favored the work in close collaboration and in partnership between the LSPs and their customers, even on a worldwide scale; 4) the cost criterion is relatively less important than in the past; and finally 5) with the development of sustainable supply chains, the factors associated with the logistic activities of return and waste processing (reverse logistics) are becoming increasingly important in this multi-criteria process of selection and evaluation of LSPs performance.Keywords: logistics outsourcing, logistics providers, multi-criteria decision making, performance
Procedia PDF Downloads 1544543 Assessing Psycho-Social Stressors for Chronically Infected Hepatitis C Virus Patients in Egypt
Authors: Ammal M. Metwally, Dalia M. Elmosalami, Walaa A. Fouad, Abla G. Khalifa, Lobna A. El Etreby, Mohamed AbdelRahman
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People with hepatitis C are likely to experience psychological distress related to adjustment issues following diagnosis. Objective: The study was conducted to determine the psycho-social stressors accompanying Hepatitis C virus (HCV) chronic infection. The study focused on immediate and later on reactions to being diagnosed as infected HCV patients. Effect of HCV on disruption of patients’ relationships in term of family relationship and friendship, employment and financial status was assessed. The magnitude and causes of the social stigma and its relation to awareness about illness, level of education were also assessed. Methods: During this study the subjective experiences of people having HCV was explored through a designed questionnaire targeted 540 cases; 359 males and 181 females from ten out of 21 National Treatment Reference Centers of National Hepatology and Tropical Medicine Research Institutes of Ministry of Health (MOH) hospitals. The study was conducted along a period of six months from September 2011 to March 2012. Results: The study revealed that the financial problems are the commonest problems faced by 75.5 % of the cases. More than 70% of the cases suffered from immediate sadness versus 67.4% suffered from worry. Social stigma was reported by 13 % of HCV +patients, the majority of which were females. Conclusions: Exploring the psychosocial consequences of HCV infection can act as pressing motivators for behavior change needed for limiting HCV endemicity in Egypt.Keywords: Egypt, HCV infection, psycho-social adjustment, stigma
Procedia PDF Downloads 3674542 A Mixed Integer Programming Model for Optimizing the Layout of an Emergency Department
Authors: Farhood Rismanchian, Seong Hyeon Park, Young Hoon Lee
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During the recent years, demand for healthcare services has dramatically increased. As the demand for healthcare services increases, so does the necessity of constructing new healthcare buildings and redesigning and renovating existing ones. Increasing demands necessitate the use of optimization techniques to improve the overall service efficiency in healthcare settings. However, high complexity of care processes remains the major challenge to accomplish this goal. This study proposes a method based on process mining results to address the high complexity of care processes and to find the optimal layout of the various medical centers in an emergency department. ProM framework is used to discover clinical pathway patterns and relationship between activities. Sequence clustering plug-in is used to remove infrequent events and to derive the process model in the form of Markov chain. The process mining results served as an input for the next phase which consists of the development of the optimization model. Comparison of the current ED design with the one obtained from the proposed method indicated that a carefully designed layout can significantly decrease the distances that patients must travel.Keywords: Mixed Integer programming, Facility layout problem, Process Mining, Healthcare Operation Management
Procedia PDF Downloads 3394541 Interprofessional School-Based Mental Health Services for Rural Adolescents in South Australia
Authors: Garreth Kestell, Lukah Dykes, Danielle Zerk, Kyla Trewartha, Rhianon Marshall, Elena Rudnik
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Adolescent mental health is an international priority and the impact of innovative service models must be evaluated. Secondary school-based mental health services (SBMHS) involving private general practitioners and psychologists are a model of care being trialed in South Australia. Measures of depression, anxiety, and stress are routinely collected throughout psychotherapy sessions. This research set out to quantify the impact of psychotherapy for rural adolescents in a school setting and explore the importance of session frequency. Methods: Demographics, session date and DASS21 scores from students (n=65) seen in 2016 by three psychologists working at the SBMHS were recorded. Students were aged 13-18 years (M=15.43, SD= 1.24), mostly female (F=51, M=14), attended between 1 and 23 sessions with a median of 6 sessions (MAD 5.93) in one-year. The treating psychologist collected self-administered DASS21 scores. A mixed model analysis was used with age, sex, treating psychologist, months from first session, and session number as fixed effects, with response variables of DASS depression, anxiety, and stress scores. Results: 71.5% were classified as having extreme or severe anxiety and half had extreme or severe depression and/or stress scores. On average males had a greater increase in DASS scores over time but males attending more sessions benefited most from therapy. Discussion: Psychologists are treating rural adolescents in schools for severe anxiety, depression, and stress. This pilot study indicates that a predictive model combining demographics, session frequency, and DASS scores may help identify who is most likely to benefit from individual psychotherapy. Variations in DAS scores of individuals over time indicate the need for the collection of information such as living situation and exposure to alcohol. A larger sample size and additional data are currently being collected to allow for a more robust analysis.Keywords: adolescent health, psychotherapy, school based mental health services, DAS21
Procedia PDF Downloads 1664540 Resolving Urban Mobility Issues through Network Restructuring of Urban Mass Transport
Authors: Aditya Purohit, Neha Bansal
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Unplanned urbanization and multidirectional sprawl of the cities have resulted in increased motorization and deteriorating transport conditions like traffic congestion, longer commuting, pollution, increased carbon footprint, and above all increased fatalities. In order to overcome these problems, various practices have been adopted including– promoting and implementing mass transport; traffic junction channelization; smart transport etc. However, these methods are found to be primarily focusing on vehicular mobility rather than people accessibility. With this research gap, this paper tries to resolve the mobility issues for Ahmedabad city in India, which being the economic capital Gujarat state has a huge commuter and visitor inflow. This research aims to resolve the traffic congestion and urban mobility issues focusing on Gujarat State Regional Transport Corporation (GSRTC) for the city of Ahmadabad by analyzing the existing operations and network structure of GSRTC followed by finding possibilities of integrating it with other modes of urban transport. The network restructuring (NR) methodology is used with appropriate variations, based on commuter demand and growth pattern of the city. To do these ‘scenarios’ based on priority issues (using 12 parameters) and their best possible solution, are established after route network analysis for 2700 population sample of 20 traffic junctions/nodes across the city. Approximately 5% sample (of passenger inflow) at each node is considered using random stratified sampling technique two scenarios are – Scenario 1: Resolving mobility issues by use of Special Purpose Vehicle (SPV) in joint venture to GSRTC and Private Operators for establishing feeder service, which shall provide a transfer service for passenger for movement from inner city area to identified peripheral terminals; and Scenario 2: Augmenting existing mass transport services such as BRTS and AMTS for using them as feeder service to the identified peripheral terminals. Each of these has now been analyzed for the best suitability/feasibility in network restructuring. A desire-line diagram is constructed using this analysis which indicated that on an average 62% of designated GSRTC routes are overlapping with mass transportation service routes of BRTS and AMTS in the city. This has resulted in duplication of bus services causing traffic congestion especially in the Central Bus Station (CBS). Terminating GSRTC services on the periphery of the city is found to be the best restructuring network proposal. This limits the GSRTC buses at city fringe area and prevents them from entering into the city core areas. These end-terminals of GSRTC are integrated with BRTS and AMTS services which help in segregating intra-state and inter-state bus services. The research concludes that absence of integrated multimodal transport network resulted in complexity of transport access to the commuters. As a further scope of research comparing and understanding of value of access time in total travel time and its implication on generalized cost on trip and how it varies city wise may be taken up.Keywords: mass transportation, multi-modal integration, network restructuring, travel behavior, urban transport
Procedia PDF Downloads 1984539 Commerce and Islamic Banking System
Authors: Rahmoune Abdelhaq
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Systemic Islamic banking has been in practice for long but started receiving due attention and high popularity since last decade. It has received a warm welcome from all over the world and these banks operating on Islamic principles have been able to get a sizeable business not only in Islamic countries but in non-Islamic countries too. Despite exemplary advancements and achievements, there remains number of controversies over various underlying concepts and practices. This paper basically explores and highlights all those controversies and challenges which are in minds of different school of thoughts and are needed to be addressed and overcome if Islamic banking continues flourishing the way it is at present. The authors have also tried to suggest suitable remedies to overcome these challenges where appropriate. As well, This paper makes an attempt to review major principles surrounding the working of Islamic banking and its historical growth. A brief overview of main differences between the Islamic banking and the conventional banking. In addition, references are particularly made to implications arising from the emergence of e-commerce and the realities that the Islamic Shari’ah law has to consider in adopting the new phenomenon into its banking system. This paper shows, whilst the conventional banking and financial system is based on the principle of rationality and interest, the Islamic financial system is based on morality and social justice which prohibits interest as a means of speculation and injustice. The concepts of e-business such as e-commerce and e-banking are acceptable in Islam as since in Islam anything is halal unless prohibited by Shari’ah, dealing with business by internet is considered as Shari’ah compliant. This paper, therefore, provides the latest thinking of e-business from an Islamic viewpoint, thus creating a reference point and valued information for a future research.Keywords: Islamic Finance, principles of Islamic banking, Islamic commerce, Shari’ah compliant
Procedia PDF Downloads 4114538 An Investigation of the Relationship Between Privacy Crisis, Public Discourse on Privacy, and Key Performance Indicators at Facebook (2004–2021)
Authors: Prajwal Eachempati, Laurent Muzellec, Ashish Kumar Jha
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We use Facebook as a case study to investigate the complex relationship between the firm’s public discourse (and actions) surrounding data privacy and the performance of a business model based on monetizing user’s data. We do so by looking at the evolution of public discourse over time (2004–2021) and relate topics to revenue and stock market evolution Drawing from archival sources like Zuckerberg We use LDA topic modelling algorithm to reveal 19 topics regrouped in 6 major themes. We first show how, by using persuasive and convincing language that promises better protection of consumer data usage, but also emphasizes greater user control over their own data, the privacy issue is being reframed as one of greater user control and responsibility. Second, we aim to understand and put a value on the extent to which privacy disclosures have a potential impact on the financial performance of social media firms. There we found significant relationship between the topics pertaining to privacy and social media/technology, sentiment score and stock market prices. Revenue is found to be impacted by topics pertaining to politics and new product and service innovations while number of active users is not impacted by the topics unless moderated by external control variables like Return on Assets and Brand Equity.Keywords: public discourses, data protection, social media, privacy, topic modeling, business models, financial performance
Procedia PDF Downloads 924537 Business and Psychological Principles Integrated into Automated Capital Investment Systems through Mathematical Algorithms
Authors: Cristian Pauna
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With few steps away from the 2020, investments in financial markets is a common activity nowadays. In the electronic trading environment, the automated investment software has become a major part in the business intelligence system of any modern financial company. The investment decisions are assisted and/or made automatically by computers using mathematical algorithms today. The complexity of these algorithms requires computer assistance in the investment process. This paper will present several investment strategies that can be automated with algorithmic trading for Deutscher Aktienindex DAX30. It was found that, based on several price action mathematical models used for high-frequency trading some investment strategies can be optimized and improved for automated investments with good results. This paper will present the way to automate these investment decisions. Automated signals will be built using all of these strategies. Three major types of investment strategies were found in this study. The types are separated by the target length and by the exit strategy used. The exit decisions will be also automated and the paper will present the specificity for each investment type. A comparative study will be also included in this paper in order to reveal the differences between strategies. Based on these results, the profit and the capital exposure will be compared and analyzed in order to qualify the investment methodologies presented and to compare them with any other investment system. As conclusion, some major investment strategies will be revealed and compared in order to be considered for inclusion in any automated investment system.Keywords: Algorithmic trading, automated investment systems, limit conditions, trading principles, trading strategies
Procedia PDF Downloads 1944536 Examining Three Psychosocial Factors of Tax Compliance in Self-Employed Individuals using the Mindspace Framework - Evidence from Australia and Pakistan
Authors: Amna Tariq Shah
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Amid the pandemic, the contemporary landscape has experienced accelerated growth in small business activities and an expanding digital marketplace, further exacerbating the issue of non-compliance among self-employed individuals through aggressive tax planning and evasion. This research seeks to address these challenges by developing strategic tax policies that promote voluntary compliance and improve taxpayer facilitation. The study employs the innovative MINDSPACE framework to examine three psychosocial factors—tax communication, tax literacy, and shaming—to optimize policy responses, address administrative shortcomings, and ensure adequate revenue collection for public goods and services. Preliminary findings suggest that incomprehensible communication from tax authorities drives individuals to seek alternative, potentially biased sources of tax information, thereby exacerbating non-compliance. Furthermore, the study reveals low tax literacy among Australian and Pakistani respondents, with many struggling to navigate complex tax processes and comprehend tax laws. Consequently, policy recommendations include simplifying tax return filing and enhancing pre-populated tax returns. In terms of shaming, the research indicates that Australians, being an individualistic society, may not respond well to shaming techniques due to privacy concerns. In contrast, Pakistanis, as a collectivistic society, may be more receptive to naming and shaming approaches. The study employs a mixed-method approach, utilizing interviews and surveys to analyze the issue in both jurisdictions. The use of mixed methods allows for a more comprehensive understanding of tax compliance behavior, combining the depth of qualitative insights with the generalizability of quantitative data, ultimately leading to more robust and well-informed policy recommendations. By examining evidence from opposite jurisdictions, namely a developed country (Australia) and a developing country (Pakistan), the study's applicability is enhanced, providing perspectives from two disparate contexts that offer insights from opposite ends of the economic, cultural, and social spectra. The non-comparative case study methodology offers valuable insights into human behavior, which can be applied to other jurisdictions as well. The application of the MINDSPACE framework in this research is particularly significant, as it introduces a novel approach to tax compliance behavior analysis. By integrating insights from behavioral economics, the framework enables a comprehensive understanding of the psychological and social factors influencing taxpayer decision-making, facilitating the development of targeted and effective policy interventions. This research carries substantial importance as it addresses critical challenges in tax compliance and administration, with far-reaching implications for revenue collection and the provision of public goods and services. By investigating the psychosocial factors that influence taxpayer behavior and utilizing the MINDSPACE framework, the study contributes invaluable insights to the field of tax policy. These insights can inform policymakers and tax administrators in developing more effective tax policies that enhance taxpayer facilitation, address administrative obstacles, promote a more equitable and efficient tax system, and foster voluntary compliance, ultimately strengthening the financial foundation of governments and communities.Keywords: individual tax compliance behavior, psychosocial factors, tax non-compliance, tax policy
Procedia PDF Downloads 754535 Cognitive Models of Health Marketing Communication in the Digital Era: Psychological Factors, Challenges, and Implications
Authors: Panas Gerasimos, Kotidou Varvara, Halkiopoulos Constantinos, Gkintoni Evgenia
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As a result of growing technology and briefing by the internet, users resort to the internet and subsequently to the opinion of an expert. In many cases, they take control of their health in their hand and make a decision without the contribution of a doctor. According to that, this essay intends to analyze the confidence of searching health issues on the internet. For the fulfillment of this study, there has been a survey among doctors in order to find out the reasons a patient uses the internet about their health problems and the consequences that health information could lead by searching on the internet, as well. Specifically, the results regarding the research of the users demonstrate: a) the majority of users make use of the internet about health issues once or twice a month, b) individuals that possess chronic disease make health search on the internet more frequently, c) the most important topics that the majority of users usually search are pathological, dietary issues and the search of issues that are associated with doctors and hospitals. However, it observed that topic search varies depending on the users’ age, d) the most common sources of information concern the direct contact with doctors, as there is a huge preference from the majority of users over the use of the electronic form for their briefing and e) it has been observed that there is large lack of knowledge about e-health services. From the doctor's point of view, the following conclusions occur: a) almost all doctors use the internet as their main source of information, b) the internet has great influence over doctors’ relationship with the patients, c) in many cases a patient first makes a visit to the internet and then to the doctor, d) the internet significantly has a psychological impact on patients in order to for them to reach a decision, e) the most important reason users choose the internet instead of the health professional is economic, f) the negative consequence that emerges is inaccurate information, g) and the positive consequences are about the possibility of online contact with the doctor and contributes to the easy comprehension of the doctor, as well. Generally, it’s observed from both sides that the use of the internet in health issues is intense, which declares that the new means the doctors have at their disposal, produce the conditions for radical changes in the way of providing services and in the doctor-patient relationship.Keywords: cognitive models, health marketing, e-health, psychological factors, digital marketing, e-health services
Procedia PDF Downloads 2064534 The Effect of Tax Evasion and Avoidance on Somalia’s Economy
Authors: Mohamed Salad Ahmed
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This study explores the impact of tax evasion and avoidance on the economy of Somalia. Somalia's economy is largely informal and cash-based, making it challenging to accurately assess the extent of tax evasion and avoidance. However, it is widely recognized that these practices have significant negative effects on the economy, including reduced government revenue, an uneven playing field for businesses, corruption, and a lack of access to international aid and investment. The study focuses on identifying strategies and solutions to reduce tax evasion and avoidance and increase revenue collection. This includes improving the government's capacity to enforce tax laws and regulations, creating a more transparent and accountable tax system, and increasing public awareness of the importance of paying taxes. By addressing these issues, Somalia can improve its economic stability and enhance its ability to provide essential public services, reduce poverty, and promote growth and development. Tax evasion and avoidance have a significant negative impact on the economy of Somalia. The informal nature of the country's economy and the difficulty in accurately assessing the extent of tax evasion and avoidance make it challenging to address these issues effectively. The lack of government revenue resulting from tax evasion and avoidance makes it difficult for the government to fund essential services, leading to a decline in the quality of public services and hindering economic growth. Tax evasion and avoidance also create an uneven playing field for businesses, discourage investment, contribute to corruption, and undermine the rule of law. Additionally, tax evasion and avoidance can make it more difficult for Somalia to access international aid and investment. Addressing these issues will require a concerted effort by the government to strengthen tax collection and enforcement, as well as by the international community to provide technical assistance and support. This abstract highlights the importance of addressing tax evasion and avoidance in Somalia and the potential benefits of doing so.Keywords: tax evasion, tax avoidance, Somalia economy, revenue collection, informal economy, corruption economic growth, investment, tax policy, tax administration, governance, private sector
Procedia PDF Downloads 124533 Shari'ah Governance in Islamic Banking and Finance - A Comparison Between Malaysia and Other Selected Countries, Current Challenges and Potential Solution
Authors: Muhamad Badri Bin Othman
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As a role model and leading country in the world that establishes and promotes Islamic banking and finance, Malaysia has set up and come up with a set of standards and frameworks to govern its Shari’ah function towards implementing the desired outcome of Islamic banking and finance as new source of wealth creation. This paper, examines and highlights, at the very minimum, the importance and application of Shari’ah governance in Islamic banking and finance in Malaysia as a leading country in Islamic banking and finance. This paper also, compares on Shari’ah governance, which is being adopted between Malaysia and other selected countries namely, Pakistan, Bahrain, Kuwait, United Arab Emirates (UAE) and Qatar. This paper also, aims at highlighting the current challenges and issues faced by the scholars in Shari’ah Supervisory Board (SSB) in deliberating their opinions and fatwa towards the implementation of new products in Islamic banking industry to promote innovation among the industry players. The author of this paper will highlight the major challenges and issues faced by the SSB members of Islamic banks in Malaysia, taking into account the complexity of the operation wise and products of Islamic banking, and how they overcome those challenges and issues identified. This will be done through a series of face-to-face interview sessions which will be conducted with a few prominent figures of Islamic banking and finance scholars in Malaysia to highlight the issues and challenges they are facing towards Islamic financial innovation and subsequently finding solutions for the identified issues and challenges.Keywords: Shari’ah governance, Shari’ah supervisory board (SSB), Issues and challenges, Islamic financial innovation
Procedia PDF Downloads 4214532 Case Study: Institutionalization of CSR Activities of MRGC through an NGO (OSDI)
Authors: Aasim Siddiqui
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In a country where 45.6 per cent of the total population lives below the poverty line, according to the Human Development Report 2014 by UNDP, an increasing number of private companies are now dedicating their resources to remedy this situation of chronic poverty. Most corporations in Pakistan now have a separate and dedicated department for Corporate Social Responsibility (CSR), albeit with varying goals and hence different strategies for achieving those goals. Similarly, Marine Group of Companies (MRGC) also has a robust CSR policy which the group implements through a Non-Government Organization (NGO) called Organization for Social Development Initiatives (OSDI). This organization, which operates under the ambit of MRGC’s CSR division, has a concentrated focus on helping the poorest communities in the rural areas of Pakistan to break out of intergenerational poverty. This paper maps the theoretical strategies as well as practical activities undertaken by OSDI for poverty alleviation via rural development in Pakistan. To obtain in-depth information of demographics, livelihood and socio-economic indicators in OSDI’s focused districts; a combination of quantitative and qualitative research methodologies was used during the course of this research. The paper highlights and explains OSDI’s unique three-pronged approach which aims at reducing poverty through income generation via the livelihood assistance program and through the provision of access to the most basic services (including health and education) via the community development and food security programs. Modeled on the concept of capacity building, OSDI’s modus operandi is centered on disbursing timely microcredit facilities to farmers who can benefit from these funds by investing in productive assets to foster financial capability for the future. With a focus on increasing the income of poor farmers, OSDI’s approach is to integrate all the socio-economic facets: education, health and sanitation and food security, to induce a sustained positive impact on their living standards.Keywords: CSR, poverty, rural, sustainability
Procedia PDF Downloads 2464531 Barriers and Opportunities for Implementing Electronic Prescription Software in Public Libyan Hospitals
Authors: Abdelbaset M. Elghriani, Abdelsalam M. Maatuk, Isam Denna, Amira Abdulla Werfalli
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Electronic prescription software (e-prescribing) benefits patients and physicians by preventing handwriting errors and giving accurate prescriptions. E-prescribing allows prescriptions to be written and sent to pharmacies electronically instead of using handwritten notes. Significant factors that may affect the adoption of e-prescription systems include lacking technical support, financial resources to operate the systems, and change resistance from some clinicians, which have been identified as barriers to the implementation of e-prescription systems. This study aims to explore the trends and opinions of physicians and pharmacists about e-prescriptions and to identify the obstacles and benefits of the application of e-prescriptions in the health care system. A cross-sectional descriptive study was conducted at three Libyan public hospitals. Data were collected through a self-constructed questionnaire to assess the opinions regarding potential constraining factors and benefits of implementing an e-prescribing system in hospitals. Data presented as mean, frequency distribution table, cross-tabulation, and bar charts. Data analysis was performed, and the results show that technical, financial, and organizational obstacles are the most important obstacles that prevent the application of e-prescribing systems in Libyan hospitals. In addition, there was awareness of the benefits of e-prescribing, especially reducing medication dispensing errors, and a desire of physicians and pharmacists to use electronic prescriptions.Keywords: physicians, e-prescribing, health care system, pharmacists
Procedia PDF Downloads 1264530 The Influence of Neighborhood Centers of Tehran Municipality in Living Style of the Residents of Each Neighborhood
Authors: Fahimeh Rafiezade, Fatemeh Kakoyi Dinaki, Maryam Soufi
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This research studies and identifies the important elements of the living style of the residents of one of the neighborhoods of Tehran. The study will also study the role, the degree, and extent of the influence of neighborhood trainings in the lives of these people. Saraymahaleh is one of the centers established by Tehran municipality in various neighborhoods of Tehran in order to provide educational, cultural, etc. services. We carried out our study according to demography, field study, observation, 30 interviews, and 2 focus group discussions (FGD) at Sahebalzaman neighborhood in district 18 of Tehran municipality. We interpreted our observations and interviews with the neighborhoods’ supervisors and city council assistants (Shorayar), supervisor of Saraymahaleh and people who refer to them. We used this information to study the citizens’ lifestyle, values, behavioral, motivational, and attitude preferences in their religious and environmental orientations, cultural consumptions, and spare times, and the influence of Saraymahaleh on these aspects according to specific economic, cultural, and ethnic characteristics. Sahebalzaman neighborhood is considered an underprivileged district in terms of economy, high illiteracy, and low but structured migration of young people. The interviews we made helped us classify the people referring to Saraymahaleh based on their demographic attributes and attitudes and the reason of referring and finally the influence of the rendered services on their lifestyles. The studies indicate that women made the most part of people referring to Saraymahaleh Sahebalzaman. They were mostly young, in their midlives, and generally unemployed without a specialized skill. People referred to Saraymahaleh Sahebalzaman mostly to receive services or for entertainment and recreation purposes, i.e. they did not take part actively. In addition to creating welfare and cultural facilities, Saraymahaleh increases the level of skill training, empowerment, innovation and creativity, and issues skill certificates and documents that helps to increase job and income producing opportunities for the neighborhood residents, improve the quality of their live, and increase their hope for life.Keywords: lifestyle, living in neighborhood, Saraymahaleh, Tehran municipality, urban life, demography
Procedia PDF Downloads 3774529 A Conceptual Model of Preparing School Counseling Students as Related Service Providers in the Transition Process
Authors: LaRon A. Scott, Donna M. Gibson
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Data indicate that counselor education programs in the United States do not prepare their students adequately to serve students with disabilities nor provide counseling as a related service. There is a need to train more school counselors to provide related services to students with disabilities, for many reasons, but specifically, school counselors are participating in Individualized Education Programs (IEP) and transition planning meetings for students with disabilities where important academic, mental health and post-secondary education decisions are made. While school counselors input is perceived very important to the process, they may not have the knowledge or training in this area to feel confident in offering required input in these meetings. Using a conceptual research design, a model that can be used to prepare school counseling students as related service providers and effective supports to address transition for students with disabilities was developed as a component of this research. The authors developed the Collaborative Model of Preparing School Counseling Students as Related Service Providers to Students with Disabilities, based on a conceptual framework that involves an integration of Social Cognitive Career Theory (SCCT) and evidenced-based practices based on Self-Determination Theory (SDT) to provide related and transition services and planning with students with disabilities. The authors’ conclude that with five overarching competencies, (1) knowledge and understanding of disabilities, (2) knowledge and expertise in group counseling to students with disabilities, (3), knowledge and experience in specific related service components, (4) knowledge and experience in evidence-based counseling interventions, (5) knowledge and experiencing in evidenced-based transition and career planning services, that school counselors can enter the field with the necessary expertise to adequately serve all students. Other examples and strategies are suggested, and recommendations for preparation programs seeking to integrate a model to prepare school counselors to implement evidenced-based transition strategies in supporting students with disabilities are includedKeywords: transition education, social cognitive career theory, self-determination, counseling
Procedia PDF Downloads 2434528 Consumption Culture of Rural Youth: A Study of the Conspicuous Consumption Pattern of a Youth Sample in an Egyptian Village
Authors: Marwa H. Salah
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Modern consumption culture represents a widespread phenomenon that affects young people, as it affects all age groups in both urban and rural societies. It has been helped by globalization, specifically cultural globalization, also internal and external migration, and the immense development in information technology as well, these factors have led to the appearance of the conspicuous consumption pattern among young people. This research firstly interested in identifying the nature of this pattern of consumption among young people in the countryside, which represents a society with a special nature, was characterized by the pattern of traditional consumption. Secondly to find out whether the rural character has an impact on the conspicuous consumption of youth. Finally to identify the reasons for the rural youth's tendency to such type of consumption and if it contributes in satisfying certain social needs. The research used the anthropological method. Observation and open-ended interviews were used as tools to collect data and an interview guide was applied on a selective youth sample (40:20 male and 20 female) aged between 17to 34 in an Egyptian village located in Dakahlia governorate. The research showed that rural youth has impacted with the modern consumption culture and not isolated from it despite the lack of financial abilities. The conspicuous consumption is a dominant pattern of consumption among the Egyptian rural youth and it has been practicing by rural youth regardless of their educational & financial levels. Also, the wish to show the social and economic status, bragging and show off is the main reason for the rural youth to adopt the conspicuous consumption, moreover to face the inferior view from their counterparts’ urban youth.Keywords: consumption culture, youth, conspicuous consumption, rural society
Procedia PDF Downloads 1904527 Implementation of Stop Tuberculosis Strategy in High Burden Country like India and the Role of Ni-Kshay Mitra
Authors: Upvan Chobera
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India bears the highest burden of tuberculosis globally, facing a significant incidence rate. To combat this public health challenge, the Ministry of Health and Family Welfare in India has launched an ambitious national strategic plan with the aim of achieving END TB targets by 2025. Addressing tuberculosis requires a comprehensive, multi-sectoral approach that encompasses factors such as nutritional support, living and working conditions, and improved access to diagnostics and treatment services. This study delves into the burden of tuberculosis in India, examining the government's strategic plan to combat the disease. Additionally, it explores the role of Ni-Kshay Mitra (community support) in this fight, encompassing various entities such as cooperative societies, corporations, elected representatives, individuals, institutions, non-government organizations, and political parties or individual donors. These efforts aim to enhance the response against tuberculosis, complementing the government's initiatives and catering to district-specific requirements, all coordinated with the district administration. It is important to note that the support provided under the Ni-Kshay Mitra initiative is supplementary to the free services offered by the National TB Elimination Program (NTEP) available to all patients.Keywords: end TB targets, Ni-kshay Mitra, NTEP, tuberculosis burden in India
Procedia PDF Downloads 844526 An Ethnographic Study on Peer Support Work-Ers in a Peer Driven Non Governmental Organization: The Colorado Mental Wellness Network
Authors: Shawna M. Margesson
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This research study seeks to explore the lived experience of peer support workers (PSWs) in a peer-led non-governmental organization in Denver, Colorado, USA. The Colorado Mental Wellness Network offers supportive wellness recovery services such as wellness recovery action plans (WRAP), advocacy trainings for anti-stigma campaigns, and PSWs to work with and for consumers in the community. This study suggests that a peer-run environment is a unique community setting for PSWs to work given all employees are living in mental wellness recovery. Little has been documented about PSWs' personal accounts of working within a recovery-oriented organization and their first-person accounts to working with consumers. The importance of this study is to provide an ethnographic account of both subjects; the lived experiences of PSWs of both organizational and consumer-driven recovery. This study seeks to add to the literature and the social work profession the personal accounts of PSWs as they provide services to others like themselves. It also will provide an additional lens to view the peer-driven movement in mental health and wellness recovery.Keywords: peer to peer movement, mental health, ethnography, peer support workers
Procedia PDF Downloads 1644525 Co-Movement between Financial Assets: An Empirical Study on Effects of the Depreciation of Yen on Asia Markets
Authors: Yih-Wenn Laih
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In recent times, the dependence and co-movement among international financial markets have become stronger than in the past, as evidenced by commentaries in the news media and the financial sections of newspapers. Studying the co-movement between returns in financial markets is an important issue for portfolio management and risk management. The realization of co-movement helps investors to identify the opportunities for international portfolio management in terms of asset allocation and pricing. Since the election of the new Prime Minister, Shinzo Abe, in November 2012, the yen has weakened against the US dollar from the 80 to the 120 level. The policies, known as “Abenomics,” are to encourage private investment through a more aggressive mix of monetary and fiscal policy. Given the close economic relations and competitions among Asia markets, it is interesting to discover the co-movement relations, affected by the depreciation of yen, between stock market of Japan and 5 major Asia stock markets, including China, Hong Kong, Korea, Singapore, and Taiwan. Specifically, we devote ourselves to measure the co-movement of stock markets between Japan and each one of the 5 Asia stock markets in terms of rank correlation coefficients. To compute the coefficients, return series of each stock market is first fitted by a skewed-t GARCH (generalized autoregressive conditional heteroscedasticity) model. Secondly, to measure the dependence structure between matched stock markets, we employ the symmetrized Joe-Clayton (SJC) copula to calculate the probability density function of paired skewed-t distributions. The joint probability density function is then utilized as the scoring scheme to optimize the sequence alignment by dynamic programming method. Finally, we compute the rank correlation coefficients (Kendall's and Spearman's ) between matched stock markets based on their aligned sequences. We collect empirical data of 6 stock indexes from Taiwan Economic Journal. The data is sampled at a daily frequency covering the period from January 1, 2013 to July 31, 2015. The empirical distributions of returns indicate fatter tails than the normal distribution. Therefore, the skewed-t distribution and SJC copula are appropriate for characterizing the data. According to the computed Kendall’s τ, Korea has the strongest co-movement relation with Japan, followed by Taiwan, China, and Singapore; the weakest is Hong Kong. On the other hand, the Spearman’s ρ reveals that the strength of co-movement between markets with Japan in decreasing order are Korea, China, Taiwan, Singapore, and Hong Kong. We explore the effects of “Abenomics” on Asia stock markets by measuring the co-movement relation between Japan and five major Asia stock markets in terms of rank correlation coefficients. The matched markets are aligned by a hybrid method consisting of GARCH, copula and sequence alignment. Empirical experiments indicate that Korea has the strongest co-movement relation with Japan. The strength of China and Taiwan are better than Singapore. The Hong Kong market has the weakest co-movement relation with Japan.Keywords: co-movement, depreciation of Yen, rank correlation, stock market
Procedia PDF Downloads 2314524 Occupational Diseases in the Automotive Industry in Czechia
Authors: J. Jarolímek, P. Urban, P. Pavlínek, D. Dzúrová
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The industry constitutes a dominant economic sector in Czechia. The automotive industry represents the most important industrial sector in terms of gross value added and the number of employees. The objective of this study was to analyse the occurrence of occupational diseases (OD) in the automotive industry in Czechia during the 2001-2014 period. Whereas the occurrence of OD in other sectors has generally been decreasing, it has been increasing in the automotive industry, including growing spatial discrepancies. Data on OD cases were retrieved from the National Registry of Occupational Diseases. Further, we conducted a survey in automotive companies with a focus on occupational health services and positions of the companies in global production networks (GPNs). An analysis of OD distribution in the automotive industry was performed (age, gender, company size and its role in GPNs, regional distribution of studied companies, and regional unemployment rate), and was accompanied by an assessment of the quality and range of occupational health services. The employees older than 40 years had nearly 2.5 times higher probability of OD occurrence compared with employees younger than 40 years (OR 2.41; 95% CI: 2.05-2.85). The OD occurrence probability was 3 times higher for women than for men (OR 3.01; 95 % CI: 2.55-3.55). The OD incidence rate was increasing with the size of the company. An association between the OD incidence and the unemployment rate was not confirmed.Keywords: occupational diseases, automotive industry, health geography, unemployment
Procedia PDF Downloads 2504523 Finding the Theory of Riba Avoidance: A Scoping Review to Set the Research Agenda
Authors: Randa Ismail Sharafeddine
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The Islamic economic system is distinctive in that it implicitly recognizes money as a separate, independent component of production capable of assuming risk and so entitled to the same reward as other Entrepreneurial Factors of Production (EFP). Conventional theory does not identify money capital explicitly as a component of production; rather, interest is recognized as a reward for capital, the interest rate is the cost of money capital, and it is also seen as a cost of physical capital. The conventional theory of production examines how diverse non-entrepreneurial resources (Land, Labor, and Capital) are selected; however, the economic theory community is largely unaware of the reasons why these resources choose to remain as non-entrepreneurial resources as opposed to becoming entrepreneurial resources. Should land, labor, and financial asset owners choose to work for others in return for rent, income, or interest, or should they engage in entrepreneurial risk-taking in order to profit. This is a decision made often in the actual world, but it has never been effectively treated in economic theory. This article will conduct a critical analysis of the conventional classification of factors of production and propose a classification for resource allocation and income distribution (Rent, Wages, Interest, and Profits) that is more rational, even within the conventional theoretical framework for evaluating and developing production and distribution theories. Money is an essential component of production in an Islamic economy, and it must be used to sustain economic activity.Keywords: financial capital, production theory, distribution theory, economic activity, riba avoidance, institution of participation
Procedia PDF Downloads 914522 E-Government Development in Nigeria, 'Bank Verification No': An Anti-Corruption Tool
Authors: Ernest C. Nwadinobi, Amanda Peart, Carl Adams
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The leading countries like the USA, UK and some of the European countries have moved their focus away from just developing the e-government platform towards just the electronic services which aim at providing access to information to its citizens or customers, but they have gone to make significant backroom changes that can accommodate this electronic service being provided to its customers or citizens. E-government has moved from just providing electronic information to citizens and customers alike to serving their needs. In developing countries like Nigeria, the enablement of e-government is being used as an anti-corruption tool. The introduction of the Bank verification number (BVN) scheme by the Central Bank of Nigeria, has helped the government in not just saving money but also protecting customer’s transaction and enhancing confidence in the banking sector. This has helped curtail the high rate of cyber and financial crime that has been part of the system. The use of BVN as an anti-corruption tool in Nigeria came at a time there was need for openness, accountability, and discipline, after years of robbing the treasury and recklessness in handling finances. As there has not been a defined method for measuring the strength or success of e-government development, in this case BVN, in Nigeria, progress will remain at the same level. The implementation strategy of the BVN in Nigeria has mostly been a quick fix, quick win solution. In fact, there is little or no indication to show evidence of a framework for e-government. Like other leading countries, there is the need for proper implementation of strategy and framework especially towards a customer orientated process, which will accommodate every administrative body of the government institution including private business rather than focusing on a non-flexible organisational structure. The development of e-government must have a strategy and framework for it to work, and this strategy must enclose every public administration and will not be limited to any individual bodies or organization. A defined framework or monitoring method must be put in place to help evaluate and benchmark government development in e-government. This framework must follow the same concept or principles. In censorious analyses of the existing methods, this paper will denote areas that must be included in the existing approach to be able to channel e-government development towards its defined strategic objectives.Keywords: Bank Verification No (BVN), quick-fix, anti-corruption, quick-win
Procedia PDF Downloads 1604521 Measuring Enterprise Growth: Pitfalls and Implications
Authors: N. Šarlija, S. Pfeifer, M. Jeger, A. Bilandžić
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Enterprise growth is generally considered as a key driver of competitiveness, employment, economic development and social inclusion. As such, it is perceived to be a highly desirable outcome of entrepreneurship for scholars and decision makers. The huge academic debate resulted in the multitude of theoretical frameworks focused on explaining growth stages, determinants and future prospects. It has been widely accepted that enterprise growth is most likely nonlinear, temporal and related to the variety of factors which reflect the individual, firm, organizational, industry or environmental determinants of growth. However, factors that affect growth are not easily captured, instruments to measure those factors are often arbitrary, causality between variables and growth is elusive, indicating that growth is not easily modeled. Furthermore, in line with heterogeneous nature of the growth phenomenon, there is a vast number of measurement constructs assessing growth which are used interchangeably. Differences among various growth measures, at conceptual as well as at operationalization level, can hinder theory development which emphasizes the need for more empirically robust studies. In line with these highlights, the main purpose of this paper is twofold. Firstly, to compare structure and performance of three growth prediction models based on the main growth measures: Revenues, employment and assets growth. Secondly, to explore the prospects of financial indicators, set as exact, visible, standardized and accessible variables, to serve as determinants of enterprise growth. Finally, to contribute to the understanding of the implications on research results and recommendations for growth caused by different growth measures. The models include a range of financial indicators as lag determinants of the enterprises’ performances during the 2008-2013, extracted from the national register of the financial statements of SMEs in Croatia. The design and testing stage of the modeling used the logistic regression procedures. Findings confirm that growth prediction models based on different measures of growth have different set of predictors. Moreover, the relationship between particular predictors and growth measure is inconsistent, namely the same predictor positively related to one growth measure may exert negative effect on a different growth measure. Overall, financial indicators alone can serve as good proxy of growth and yield adequate predictive power of the models. The paper sheds light on both methodology and conceptual framework of enterprise growth by using a range of variables which serve as a proxy for the multitude of internal and external determinants, but are unlike them, accessible, available, exact and free of perceptual nuances in building up the model. Selection of the growth measure seems to have significant impact on the implications and recommendations related to growth. Furthermore, the paper points out to potential pitfalls of measuring and predicting growth. Overall, the results and the implications of the study are relevant for advancing academic debates on growth-related methodology, and can contribute to evidence-based decisions of policy makers.Keywords: growth measurement constructs, logistic regression, prediction of growth potential, small and medium-sized enterprises
Procedia PDF Downloads 2524520 The Basin Management Methodology for Integrated Water Resources Management and Development
Authors: Julio Jesus Salazar, Max Jesus De Lama
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The challenges of water management are aggravated by global change, which implies high complexity and associated uncertainty; water management is difficult because water networks cross domains (natural, societal, and political), scales (space, time, jurisdictional, institutional, knowledge, etc.) and levels (area: patches to global; knowledge: a specific case to generalized principles). In this context, we need to apply natural and non-natural measures to manage water and soil. The Basin Management Methodology considers multifunctional measures of natural water retention and erosion control and soil formation to protect water resources and address the challenges related to the recovery or conservation of the ecosystem, as well as natural characteristics of water bodies, to improve the quantitative status of water bodies and reduce vulnerability to floods and droughts. This method of water management focuses on the positive impacts of the chemical and ecological status of water bodies, restoration of the functioning of the ecosystem and its natural services; thus, contributing to both adaptation and mitigation of climate change. This methodology was applied in 7 interventions in the sub-basin of the Shullcas River in Huancayo-Junín-Peru, obtaining great benefits in the framework of the participation of alliances of actors and integrated planning scenarios. To implement the methodology in the sub-basin of the Shullcas River, a process called Climate Smart Territories (CST) was used; with which the variables were characterized in a highly complex space. The diagnosis was then worked using risk management and adaptation to climate change. Finally, it was concluded with the selection of alternatives and projects of this type. Therefore, the CST approach and process face the challenges of climate change through integrated, systematic, interdisciplinary and collective responses at different scales that fit the needs of ecosystems and their services that are vital to human well-being. This methodology is now replicated at the level of the Mantaro river basin, improving with other initiatives that lead to the model of a resilient basin.Keywords: climate-smart territories, climate change, ecosystem services, natural measures, Climate Smart Territories (CST) approach
Procedia PDF Downloads 1514519 The Effectiveness of Men Who Have Sex with Men (MSM) Sensitivity Training for Nigerian Health Care Providers (HCPs)
Authors: Chiedu C. Ifekandu, Olusegun Sangowawa, Jean E. Njab
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Background: Health care providers (HCPs) in Nigeria receive little or no training of the healthcare needs of men who have sex with men (MSM) limiting the quality and effectiveness of comprehensive HIV prevention and treatment services. Consequently, most MSM disguise themselves to access services which limit the quality of care provided partly due to challenges related to stigma and discrimination, and breach of confidentiality. Objective: To assess the knowledge of healthcare providers on effective intervention for MSM. Methods: We trained 122 HIV focal persons drawn from 60 health facilities from twelve Nigerian states. , the participants were requested to complete a pre-training questionnaire to assess their level of working experience with key populations as a baseline. Participants included male and female doctors, nurses and counselors/testers. A test was administered to measure their knowledge on MSM sexual risk practices, HIV prevention and healthcare needs and also to assess their attitudes (including homophobia) and beliefs and how it affects service uptake by key populations particularly MSM prior and immediately after the training to ascertain the impact of the training. Results: The mean age of the HCP was 38 years +/- SD Of the 122 HCPs (45 % female, 55 % male; 85 % counsellor/testers; 15 % doctors and nurses; 92 % working in government facilities) from 42 health facilities were trained, of which 105 attempted the test questions. At the baseline, few HCPs reported any prior sensitivity training on MSM. Most of the HCPs had limited knowledge of MSM sexual health needs. Over 90% of the HCPs believed that homosexuality is a mental illness. 8 % do not consider MSM, FSW and PWID as key populations for HIV infection. 45 % lacked knowledge on MSM anal sexual practices. The post-test showed that homophobic attitudes had decreased significantly by the end of the training; the health care providers have acquired basic knowledge compared to the pre-test. Conclusions: Scaling up MSM sensitivity training for Nigerian HCPs is likely to be a timely and effective means to improve their understanding of MSM-related health issues, reduce homophobic sentiments and enhance their capacity to provide responsive HIV prevention, treatment and care services in a supportive and non-stigmatizing environment.Keywords: healthcare providers, key population, men who have sex with men, HCT
Procedia PDF Downloads 3554518 Analysis of the Relationship between the Old Days Hospitalized with Economic Lost Top Ten Age Productive Disease in Hospital Inpatient Inche Abdul Moeis Samarinda, Indonesia
Authors: Tri Murti Tugiman, Awalyya Fasha
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This research aims to analyze the magnitude of the economic losses incurred as a result of a person suffering from a particular disease of the ten highest in the productive age diseases in Hospitals Inche Abdul Moeis Samarinda. This research was a descriptive survey research and a secondary data analysis. For the analysis of economic losses populations used are all in patients who suffer from the 10 highest diseases in the productive age in hospitals IA Moeis Samarinda in 2011. Sampling was performed by using a stratified random sampling with samples of 77 people. Research results indicate that the direct cost community incurred to obtain medical services in hospitals IA Moeis is IDR 74437520. The amount of indirect costs incurred during service in a community hospital is IDR 10562000. The amount lost due to sickness fee is IDR 5377800. The amount of economic lost people to obtain medical services in hospitals IA Moeis is IDR 90377320. The number of days of hospitalization was as much as 171 respondents throughout the day. This study suggests the economic loss could be prevented by changes in the lifestyle of the people who clean and healthy along with the following insurance.Keywords: hospitalized, economic lost, productive age diseases, secondary data analysis
Procedia PDF Downloads 4804517 Participatory Action Research for Strengthening Health Systems: A Freirian Critique from a Community Based Study Conducted in the Northern Areas of Pakistan
Authors: Sohail Bawani, Kausar S. Khan, Rozina Karmaliani, Shehnaz Mir
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Action research (AR) is one of the types of health systems research (HSR), and participatory action research (PAR) is known for being effective in health systems strengthening (HSS). The current literature on PAR for HSS cites numerous examples and case studies that led to improve health services; build child health information system; increase knowledge and awareness of people about health problems, and identify pathways for institutional and policy change by engaging people in research. But examples of marginalized communities being agents of change in health governance are not common in health systems research (HSR). This approach to PAR is at the heart of Paolo Freire’s Social Transformation Theory and Critical Consciousness building, which was used to design a community-based PAR study in the Northern/mountainous areas of Pakistan. The purpose of the study was to understand the place and role of marginalized communities in strengthening existing health governance structure (health facility and village health committees and health boards) by taking marginalized communities as partners. Community meetings were carried out to identify who is living at the social, political, cultural and economic margins in 40 different villages. Participatory reflection and analysis (PRA) tools were used during the meeting to facilitate identification. Focus group discussions were conducted with marginalized groups using PRA tools and family ethnographies with marginalized families identified through group discussions. Findings of the study revealed that for the marginalized health systems constitute more than just delivery of health services, but it also embraces social determinants that surround systems and its governance. The paper argues that from Frerian perspective people’s participation should not only be limited to knowledge generation. People must be seen active users of the knowledge that they generate for achieving better health outcomes that they want to achieve in the time to come. PAR provides a pathway to the marginalized in playing a role in health governance. The study dissemination planned shall engage the marginalized in a dialogue with service providers so that together a role for the marginalized can be outlined.Keywords: participatory action research, health systems, marginalized, health services
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