A model for sustainable, partnership-based telehealth services in rural India: An early process evaluation from Tuver village, Gujarat

Background Telehealth can improve access to high-quality healthcare for rural populations in India. However, rural communities often have other needs, such as sanitation or employment, to benefit fully from telehealth offerings, highlighting a need for systems-level solutions. A Business of Humanity approach argues that innovative solutions to wicked problems like these require strategic decision-making that attends to a) humaneness, e.g., equity and safety and b) humankind, or the needs and potential of large and growing markets comprised of marginalized and low-income individuals. The approach is expected to improve economic performance and long-term value creation for partners, thus supporting sustainability. Methods A demonstration project was conducted in Tuver, a rural and tribal village in Gujarat, India. The project included seven components: a partnership that emphasized power-sharing and complementary contributions; telehealth services; health promotion; digital services; power infrastructure; water and sanitation; and agribusiness. Core partners included the academic partner, local village leadership, a local development foundation, a telehealth provider, and a design-build contractor. This early process evaluation relies on administrative data, field notes, and project documentation and was analyzed using a case study approach. Results Findings highlight the importance of taking a systems perspective and engaging inter-sectoral partners through alignment of values and goals. Additionally, the creation of a synergistic, health-promoting ecosystem offers potential to support telehealth services in the long-term. At the same time, engaging rural, tribal communities in the use of technological advances posed a challenge, though local staff and intermediaries were effective in bridging disconnects. Conclusion Overall, this early process evaluation highlights the promise and challenges of using a Business of Humanity approach for coordinated, sustainable community-level action to improve the health and well-being of marginalized communities.

Understanding role conflict and role ambiguity of school principals in Nepal

In the context of developed countries, a lot of research has been done to uncover and identify the problems school leaders face in their work but little is known about the school leadership of underdeveloped countries. In a quest to discover contextual problems in terms of role conflict and role ambiguity of school leaders, this qualitative study tries to capture the experiences of principals in Nepal through in-depth interviews of six community school principals. The findings reveal that the major sources of role conflict and ambiguity for principals from Nepal are problematic power-sharing, low job autonomy, dual role conflict, limited professional development training, and lack of leadership knowledge. The study has several policy-level implications such as importance of hiring principals with proven leadership skills and increasing the leadership skills of current principals to ensure that they can tackle these challenges.

The Problem of State Violence

When violence occurs, the state has an obligation to respond to and reduce the impacts of it; yet often the state originates, or at least contributes to, the violence. This may occur in a variety of ways, including through the use of force by police, pretrial incarceration at local jails, long periods of incarceration in prisons, or abuse and neglect of people who are incarcerated. This essay explores the role of the state in responding to violence and how it should contribute to reducing violence in communities, as well as in its own operations. Finally, it explores what the future of collaboration between state actors and the community looks like and offers examples of successful power-sharing and co-producing of safety between the state and the public.

Kazakh president hemmed in by his predecessor

Significance Since resigning as president in 2019, Nazarbayev wields considerable power thanks to the concentration of political levers in his hands. On November 23, he announced his intention to step down as chairman of the ruling Nur Otan party in favour of President Kassym Zhomart Tokayev. Impacts The Kazakh leadership will offer Russia sympathy but no more in its confrontation with the West. Daily COVID-19 cases and deaths have fallen significantly since an August peak but the Omicron variant presents new threats. The current power-sharing model weakens the authorities' ability to deal with the root causes of economic stagnation.