Lessons for Vietnam on the Use of Digital Technologies to Support Patient-Centered Care in Low- and Middle-Income Countries in the Asia-Pacific Region: Scoping Review.

BACKGROUND: A rapidly aging population, a shifting disease burden and the ongoing threat of infectious disease outbreaks pose major concerns for Vietnam's health care system. Health disparities are evident in many parts of the country, especially in rural areas, and the population faces inequitable access to patient-centered health care. Vietnam must therefore explore and implement advanced solutions to the provision of patient-centered care, with a view to reducing pressures on the health care system simultaneously. The use of digital health technologies (DHTs) may be one of these solutions. OBJECTIVE: This study aimed to identify the application of DHTs to support the provision of patient-centered care in low- and middle-income countries in the Asia-Pacific region (APR) and to draw lessons for Vietnam. METHODS: A scoping review was undertaken. Systematic searches of 7 databases were conducted in January 2022 to identify publications on DHTs and patient-centered care in the APR. Thematic analysis was conducted, and DHTs were classified using the National Institute for Health and Care Excellence evidence standards framework for DHTs (tiers A, B, and C). Reporting was in line with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. RESULTS: Of the 264 publications identified, 45 (17%) met the inclusion criteria. The majority of the DHTs were classified as tier C (15/33, 45%), followed by tier B (14/33, 42%) and tier A (4/33, 12%). At an individual level, DHTs increased accessibility of health care and health-related information, supported individuals in self-management, and led to improvements in clinical and quality-of-life outcomes. At a systems level, DHTs supported patient-centered outcomes by increasing efficiency, reducing strain on health care resources, and supporting patient-centered clinical practice. The most frequently reported enablers for the use of DHTs for patient-centered care included alignment of DHTs with users' individual needs, ease of use, availability of direct support from health care professionals, provision of technical support as well as user education and training, appropriate governance of privacy and security, and cross-sectorial collaboration. Common barriers included low user literacy and digital literacy, limited user access to DHT infrastructure, and a lack of policies and protocols to guide the implementation and use of DHTs. CONCLUSIONS: The use of DHTs is a viable option to increase equitable access to quality, patient-centered care across Vietnam and simultaneously reduce pressures on the health care system. Vietnam can take advantage of the lessons learned by other low- and middle-income countries in the APR when developing a national road map to digital health transformation. Recommendations that Vietnamese policy makers may consider include emphasizing stakeholder engagement, strengthening digital literacy, supporting the improvement of DHT infrastructure, increasing cross-sectorial collaboration, strengthening governance of cybersecurity, and leading the way in DHT uptake.

Women and the Justice Divide in Asia Pacific: How can Informal and Formal Institutions Bridge the Gap?

Across Asia and the Pacific, legal pluralist systems meet both cultural norms and address injustices at the local level. What is the capacity of these pluralist systems to provide justice and mitigate discrimination against women? This article examines women's experiences across five countries to identify the factors that enable and constrain women's engagement with legal pluralist justice systems in the Asia-Pacific region. Drawing on examples of women's individual and collective attempts to access justice specifically concerning custody, land, and violence, this article identifies three persistent conditions that perpetuate women's inability to access justice: the absence of gender mainstreaming resources in pluralist legal systems, most notably in rural, remote, and impoverished communities;cultural and religious preference for women's underrepresentation in decision-making;and women's low representation in justice-related civil service positions.

"Patriarchal reset" in the asia pacific during COVID-19: the impacts on women's security and rights

COVID-19 has disrupted social, economic and political life across the Asia Pacific region, with particularly deleterious impacts on women. Rather than equitably affecting all, COVID-19 has brought about a "patriarchal reset", exacerbating women's health and care labour burdens and heightening the physical violence against women and other threats to women's human rights. This paper examines global health governance in the region from a feminist political economy perspective. We ask how has the pandemic and associated lockdowns affected women's safety and access to economic resources and services on the one hand, and 'women, peace and security' (WPS) practitioners' capacity to safeguard women's rights in fragile settings on the other hand? We examine the gendered impacts of COVID-19 based on two surveys of WPS practitioners during 2020. Significant rises in domestic and gender-based violence, reduced access to reproductive health services, and increased income insecurity were all perceived and/or experienced during COVID-19 restrictions. WPS practitioners delivered services to mitigate these effects of COVID-19 despite overall less funding than before COVID-19. With the benefit of primary data, we explore how a more radical approach is needed to understand and transform gender relations in light of gender-based violence and depletion of women's labour. [ FROM AUTHOR] Copyright of Pacific Review is the property of Routledge 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 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 . (Copyright applies to all s.)

YOON SUK-YEOL ADMINISTRATION'S FOREIGN POLICY STRATEGY AND THE U.S.–ROK ALLIANCE

The article studies new foreign policy of South Korea after the administration change in Seoul in May 2022. Over the last period, the external environment for the country has become more complex. That was due to the growth of rivalry between the USA and China, COVID-19 pandemic implications as well as the Ukrainian crisis, which resulted in increased global and regional instability and disruption of previously established supply chains. Along with that, the confrontation on the Korean Peninsula has become deeper and more protracted with no way forward to break that impasse. All previous attempts to engage North Korea into the dialogue, made by the Moon Jae-in administration, have failed. Those factors affected the priorities chosen by the new administration in foreign affairs. The author concentrates on the concept of the "global pivotal state” announced by the Yoon Suk-yeol's government. With the criticism of the previous government's approach that was narrowly focused on Inter-Korean agendas, the new foreign policy team is going to pursue the brand of a "value diplomacy”, emphasizing South Korea's role in promoting "liberal democracy” and "rules-based regional order”. As for North Korea, Yoon Suk-yeol has shifted his strategy to a hard-line approach which implied strengthening deterrence and raising credibility of the U.S. assurances to provide a nuclear umbrella to defend its ally. The article highlights Seoul's new policy aimed at rebuilding and strengthening the "comprehensive global alliance” between the ROK and the USA that presupposes cooperation on a wide range of international and regional agendas beyond the Korean Peninsula. The paper explores some emerging political dimensions of South Korea in the Indo-Pacific region. It is shown that Seoul wishes to be an active participant of the U.S. – led minilateral arrangements to ensure its expanded economic and security interests in the region. © The Authors.

YOON SUK-YEOL ADMINISTRATION'S FOREIGN POLICY STRATEGY AND THE U.S.–ROK ALLIANCE

The article studies new foreign policy of South Korea after the administration change in Seoul in May 2022. Over the last period, the external environment for the country has become more complex. That was due to the growth of rivalry between the USA and China, COVID-19 pandemic implications as well as the Ukrainian crisis, which resulted in increased global and regional instability and disruption of previously established supply chains. Along with that, the confrontation on the Korean Peninsula has become deeper and more protracted with no way forward to break that impasse. All previous attempts to engage North Korea into the dialogue, made by the Moon Jae-in administration, have failed. Those factors affected the priorities chosen by the new administration in foreign affairs. The author concentrates on the concept of the "global pivotal state” announced by the Yoon Suk-yeol's government. With the criticism of the previous government's approach that was narrowly focused on Inter-Korean agendas, the new foreign policy team is going to pursue the brand of a "value diplomacy”, emphasizing South Korea's role in promoting "liberal democracy” and "rules-based regional order”. As for North Korea, Yoon Suk-yeol has shifted his strategy to a hard-line approach which implied strengthening deterrence and raising credibility of the U.S. assurances to provide a nuclear umbrella to defend its ally. The article highlights Seoul's new policy aimed at rebuilding and strengthening the "comprehensive global alliance” between the ROK and the USA that presupposes cooperation on a wide range of international and regional agendas beyond the Korean Peninsula. The paper explores some emerging political dimensions of South Korea in the Indo-Pacific region. It is shown that Seoul wishes to be an active participant of the U.S. – led minilateral arrangements to ensure its expanded economic and security interests in the region. © The Authors.

YOON SUK-YEOL ADMINISTRATION'S FOREIGN POLICY STRATEGY AND THE U.S.–ROK ALLIANCE

The article studies new foreign policy of South Korea after the administration change in Seoul in May 2022. Over the last period, the external environment for the country has become more complex. That was due to the growth of rivalry between the USA and China, COVID-19 pandemic implications as well as the Ukrainian crisis, which resulted in increased global and regional instability and disruption of previously established supply chains. Along with that, the confrontation on the Korean Peninsula has become deeper and more protracted with no way forward to break that impasse. All previous attempts to engage North Korea into the dialogue, made by the Moon Jae-in administration, have failed. Those factors affected the priorities chosen by the new administration in foreign affairs. The author concentrates on the concept of the "global pivotal state” announced by the Yoon Suk-yeol's government. With the criticism of the previous government's approach that was narrowly focused on Inter-Korean agendas, the new foreign policy team is going to pursue the brand of a "value diplomacy”, emphasizing South Korea's role in promoting "liberal democracy” and "rules-based regional order”. As for North Korea, Yoon Suk-yeol has shifted his strategy to a hard-line approach which implied strengthening deterrence and raising credibility of the U.S. assurances to provide a nuclear umbrella to defend its ally. The article highlights Seoul's new policy aimed at rebuilding and strengthening the "comprehensive global alliance” between the ROK and the USA that presupposes cooperation on a wide range of international and regional agendas beyond the Korean Peninsula. The paper explores some emerging political dimensions of South Korea in the Indo-Pacific region. It is shown that Seoul wishes to be an active participant of the U.S. – led minilateral arrangements to ensure its expanded economic and security interests in the region. © The Authors.

An Integrated Assessment of the Horticulture Sector in Northern Australia to Inform Future Development

The horticulture sector in northern Australia, covering north of Western Australia (WA), Northern Territory (NT), and north Queensland (QLD), contributes $1.6 billion/year to the Australian economy by supplying diverse food commodities to meet domestic and international demand. To date, the Australian Government has funded several studies on developing the north’s agriculture sector, but these primarily focused on land and water resources and omitted an integrated, on-ground feasibility analysis for including farmers’/growers’ perspectives. This study is the first of its kind in the north for offering a detailed integrated assessment, highlighting farmers’ perspectives on the current state of the north’s horticulture sector, and related challenges and opportunities. For this, we applied a bottom-up approach to inform future agriculture development in the region, involving a detailed literature review and conducting several focus group workshops with growers and experts from government organisations, growers’ associations, and regional development agencies. We identified several key local issues pertaining to crop production, availability of, and secure access to, land and water resources, and workforce and marketing arrangements (i.e., transport or processing facilities, export opportunities, biosecurity protocols, and the role of the retailers/supermarkets) that affect the economic viability and future expansion of the sector across the region. For example, the availability of the workforce (skilled and general) has been a challenge across the north since the start of the COVID-19 pandemic in 2020. Similarly, long-distance travel for farm produce due to a lack of processing and export facilities in the north restricts future farm developments. Any major investment should be aligned with growers’ interests. This research highlights the importance of understanding and incorporating local growers’ and researchers’ perspectives, applying a bottom-up approach, when planning policies and programs for future development, especially for the horticulture sector in northern Australia and other similar regions across the globe where policy makers’ perspectives may differ from farmers.

The China Alternative. Changing Regional Order in the Pacific Islands

The presence of China poses a challenge to the dominance of Western powers and their allies, who have set the agenda in the Pacific since the end of the Second World War. [...]today, the region has been characterised by (post-)colonial power structures. In her opening remarks, Dame Meg Taylor clearly states that the Pacific Island states regard the presence of China in the region as a positive development because it gives PIF countries access to markets, technology, financing and infrastructure. The Boe Declaration of the PIF meeting in 2018, which states that "climate change remains the single greatest threat to the livelihoods, security and wellbeing of the peoples of the Pacific" (ix) - is the principal element of efforts by Pacific Island state leaders to implement the "Blue Pacific" concept and stands in stark contrast to the environmental and security policy of PIF member country Australia as well as that of the previous Trump administration. In Australia alone, economic damage caused each year by Beijing's punitive actions in response to bans on Huawei equipment (Australia excludes the Chinese company from the country's 5G roll-out) and COVID-19 demands (Canberra's call for an independent investigation into the origins of the virus) runs into the billions annually.

Stock market volatility from the Covid-19 pandemic: New evidence from the Asia-Pacific region.

Responses from stock markets to the Covid-19 pandemic appear to change over time. Recent responses might differ as herd mentality in stock markets tends to become herd immunity to the pandemic. This study revisits the pandemic's effects on the Asia-Pacific countries' market volatility over the past 25 months. Primarily, we examine the changes of the impacts of the pandemic on volatility between the first pandemic period (2020) and the second period (January 2021-January 2022). Our findings indicate that implementing pandemic control measures helps reduce market volatility at the country and region levels. The effects of new Covid-19 cases and pandemic control measures on market volatility have been dramatically fading since 2021. The Toda-Yamamoto causality test and the panel impulse response functions from panel VAR estimation are also used for robustness analysis. Based on our findings, it appears that the current pandemic may no longer be blamed for stock market volatility in the Asia-Pacific region.

The role of digital skill in mitigating digital divide: evidences from Asia-Pacific region

Purpose>This paper aims to make a modest attempt to classify the Asia-Pacific countries in terms of the access to information and communication technology (ICT) to unearth the prevalence of digital divide (if any) in the Asia-Pacific region. In addition to that, this paper also examines the role played by the digital skill in bridging the digital divide in the context of Asia–Pacific countries.Design/methodology/approach>Secondary data on 43 Asia-Pacific countries for the period from 2012 to 2017 was collected from International Telecommunication Union (ITU) database and World Development Indicators, World Bank. K-means clustering technique was applied to explore the natural grouping of the Asia-Pacific countries based on ICT access. The role of digital/ICT skill in narrowing the access-based digital divide was investigated using panel data regression technique.Findings>Clustering of countries suggested a significant difference amongst the Asia-Pacific countries in terms of ICT access, signifying the prevalence of access based digital divide. Digital skill played pivotal role in promoting ICT access and thereby reducing the digital divide during the period of the study. Per capita income level, level of education, openness of the economy and urbanisation were observed to be the determining factors in reducing the digital divide during the period of study in the Asia-Pacific region.Originality/value>The study makes an unique attempt to explore the role of digital/ICT skill in tapering the access-based digital divide in the context of Asia-Pacific region.

NEW TRADE AND ECONOMIC REGIONALISM: A SPACE OF OPPORTUNITIES IN GREATER EURASIA

The article is devoted to the issues of trade and economic integration in the Greater Eurasia region. The trends of regionalization in the Asia-Pacific region based on multilateral trade deals are studied. The analysis of the Regional Comprehensive Economic Partnership Agreement, the prerequisites for its conclusion, and the effects of implementation has been carried out. These issues were considered in conjunction with the implementation of the Comprehensive and Progressive Agreement for Trans-Pacific Partnership, including considering the current prerequisites for its expansion. The authors investigate the issues of conjugation of the EAEU and integration processes in the Asia-Pacific region within the framework of the idea of the Greater Eurasian Partnership. Specific proposals for the organization of work, based on the mechanisms for implementing the EAEU’s international legal personality, have been formulated. An overview of the possible results of the conclusion of the Agreement in Greater Eurasia in the economic and geopolitical context is presented.

The Trump Administration's Policy Changes on China and Their Destructive Ramifications for US-China Relations

This article analyzes the change in policy discourse of the Trump administration and its destructive effects on US-China relations. It begins with a retrospective look at the China policies of two prior US administrations, those of President George W. Bush and President Barack Obama, in order to show just how significant the shift is. Following the review are analyses of the new policy discourse on China and how China has responded to it, especially in the context of the coronavirus pandemic. The last section of this article discusses a popular theme in recent academic circles: Is a new Cold War inevitable?

COVID-19: Asia Pacific sees drop in bottled water sales

Speed read Bottled water sales fell during lockdowns in the Asia Pacific Sales began to rise again after COVID-19 restrictions eased Plastic pollution from bottled water is a growing concern [MANILA] Measures to contain the spread of COVID-19 caused a decline in the sales of bottled water across the Asia Pacific region during 2020, according to a study by the global market research firm, Euromonitor International. The region has historically accounted for the largest share of bottled water sales, driven by rising health and wellness awareness and a lack of access to safe water, Euromonitor said in a report. [The] presence of diseases other than COVID-19 will be counted as comorbidity that will complicate the health of the persons with COVID-19,” he told SciDev.Net. [...]the early 1990s Filipinos relied on drinking water from the tap but that changed as consumers started to observe deteriorating water quality, Magtibay said.

Students’ future on hold as govts put malls before schools

Speed read Foundational years of schooling vital for overall development Lack of digital infrastructure impedes remote learning Children’s education a priority for most parents in the region A “generational catastrophe” looms as governments prioritise opening of malls over schools, resulting in huge learning losses with some 117 million children globally still affected by full school closures due to COVID-19 lockdowns, according to the UN Educational, Scientific and Cultural Organization (UNESCO). Lost formative years Children have missed the hands-on experience of learning and face-to-face engagement with teachers. Since the onset of the pandemic, schools have been completely closed for an average of 16 weeks in the Asia Pacific region comprising 47 countries. If partial closures by locality or educational level are factored in, the average duration of closures represents 29 weeks across the regions, according to the latest data from UNESCO’s HQ’s Global monitoring of school closures. A UNESCO study shows that over 100 million children will fall below the minimum proficiency level in reading due to the impact of COVID-19 school closures.

Barriers to integrating diagnostic services for febrile illness to support surveillance and patient management in Asia‐Pacific

As malaria cases continue to decline in Asia, an integrated service delivery approach is ever more urgent to ensure that no malaria and fever cases are missed, and that malaria health workers continue contributing to broader infectious disease control efforts. However, despite its perceived merit, translating integrated surveillance into practice poses several systemic challenges. This article aims to identify what is hindering improved processes for integrating diagnostic and surveillance services for febrile illnesses. Data from peer‐reviewed and grey literature were reviewed using a systems approach based on the World Health Organisation health systems building blocks to fully understand the connections between different elements and system implications of integration. We include snippets from Sri Lanka, Myanmar, Malaysia and Nepal, highlighting expanded diagnostic integration best practices. This review provides a foundation for ‘integration roadmaps’ that can be adapted to different contexts and guide national stakeholders on the operational and political steps for a successful integration model. Such a model can support malaria elimination efforts and serve as a public health tool in the context of disease surveillance and regional health security.

Gamification and older adults: Opportunities for gamification to support health promotion initiatives for older adults in the context of COVID-19.

The COVID-19 pandemic has increased reliance on digital service delivery, including the delivery of health promotion initiatives. Health promotion interventions need to carefully consider user engagement. Gamification is a strategy used to engage and motivate people, and evidence shows overall cautious positive results in the use of gamification for older people across a range of health areas although more evidence is needed. Gamification has been used as a strategy in COVID-19 related initiatives and there is potential to build on the evidence to further develop gamification initiatives for those living in the Western Pacific region to impact positively on healthy behaviours and health outcomes.

Lessons from the frontline: Leadership and governance experiences in the COVID-19 pandemic response across the Pacific region.

Background: Universal access to safe, effective emergency care (EC) during the COVID-19 pandemic has illustrated its centrality to healthcare systems. The 'Leadership and Governance' building block provides policy, accountability and stewardship to health systems, and is essential to determining effectiveness of pandemic response. This study aimed to explore the experience of leadership and governance during the COVID-19 pandemic from frontline clinicians and stakeholders across the Pacific region. Methods: Australian and Pacific researchers collaborated to conduct this large, qualitative research project in three phases between March 2020 and July 2021. Data was gathered from 116 Pacific regional participants through online support forums, in-depth interviews and focus groups. A phenomenological approach shaped inductive and deductive data analysis, within a previously identified Pacific EC systems building block framework. Findings: Politics profoundly influenced pandemic response effectiveness, even at the clinical coalface. Experienced clinicians spoke authoritatively to decision-makers; focusing on safety, quality and service duty. Rapid adaptability, past surge event experience, team-focus and systems-thinking enabled EC leadership. Transparent communication, collaboration, mutual respect and trust created unity between frontline clinicians and 'top-level' administrators. Pacific cultural assets of relationship-building and community cohesion strengthened responses. Interpretation: Effective governance occurs when political, administrative and clinical actors work collaboratively in relationships characterised by trust, transparency, altruism and evidence. Trained, supported EC leadership will enhance frontline service provision, health security preparedness and future Universal Health Coverage goals. Funding: Epidemic Ethics/World Health Organization (WHO), Foreign, Commonwealth and Development Office/Wellcome Grant 214711/Z/18/Z. Co-funding: Australasian College for Emergency Medicine Foundation, International Development Fund Grant.

Lessons from the frontline: The value of emergency care processes and data to pandemic responses across the Pacific region.

Background: Emergency care (EC) addresses the needs of patients with acute illness and injury, and has fulfilled a critical function during the COVID-19 pandemic. 'Processes' (e.g. triage) and 'data' (e.g. surveillance) have been nominated as essential building blocks for EC systems. This qualitative research sought to explore the impact of the pandemic on EC clinicians across the Pacific region, including the contribution of EC building blocks to effective responses. Methods: The study was conducted in three phases, with data obtained from online support forums, key informant interviews and focus group discussions. There were 116 participants from more than 14 Pacific Island Countries and Territories. A phenomenological approach was adopted, incorporating inductive and deductive methods. The deductive thematic analysis utilised previously identified building blocks for Pacific EC. This paper summarises findings for the building blocks of 'processes' and 'data'. Findings: Establishing triage and screening capacity, aimed at assessing urgency and transmission risk respectively, were priorities for EC clinicians. Enablers included support from senior hospital leaders, previous disaster experience and consistent guidelines. The introduction of efficient patient flow processes, such as streaming, proved valuable to emergency departments, and checklists and simulation were useful implementation strategies. Some response measures impacted negatively on non-COVID patients, and proactive approaches were required to maintain 'business as usual'. The pandemic also highlighted the value of surveillance and performance data. Interpretation: Developing effective processes for triage, screening and streaming, among other areas, was critical to an effective EC response. Beyond the pandemic, strengthening processes and data management capacity will build resilience in EC systems. Funding: Phases 1 and 2A of this study were part of an Epidemic Ethics/World Health Organization (WHO) initiative, supported by Foreign, Commonwealth and Development Office/Wellcome Grant 214711/Z/18/Z. Co-funding for this research was received from the Australasian College for Emergency Medicine Foundation via an International Development Fund Grant.