Reclaiming the Authority to Plan: Recentralization of COVID-19 Response in Ghana

The paper examines the implications of COVID-19 pandemic on multi-level governance (MLG) in Ghana. Adopting a qualitative document analysis approach supported by 18 key informant interviews, the findings revealed four enablers of recentralization: COVID-19-induced legislations for centralized decision, centralized distribution of relief packages and medical supplies, centralized institutional response, and centralized government communication strategies. Despite the use of centralized policy making, the management of pandemic is fraught with institutional inefficiencies, rigidities, and ambiguities. The paper argues that the recentralization of COVID-19 management is symptomatic of a long period of neglect of MLG in Ghana. Since, local governments are perceived as inept and ill-equipped, there is a mistaken believe that recentralized decisions are more effective during emergencies. To ensure an effective response to public emergencies, its mitigation and post-crisis recovery in developing countries, a MLG approach - where central, local, and other non-state actors work together in equal partnership is crucial.

Shocks, resilience and regional industry policy: Brexit and the automotive sector in two Midlands regions

This article draws upon novel survey evidence to examine the possible regional impacts of Brexit as a ‘disruptive process' to manufacturing operations and logistics in the automotive industry, in the context of the regional resilience literature. The current Brexit (and Covid-19) context, along with the sector's need to re-orientate towards electrification, provides renewed urgency to reconsider industrial policy in spatial terms. The findings have salience not only in the context of anticipating and reacting to Brexit-induced economic shocks at a regional level, but also over the role of decentralized regional bodies. In this regard, the UK government's agenda of ‘levelling up' will be challenging, especially in the context of the place-based shocks likely to arise from Brexit as well as the impact of Covid-19. The article concludes that a more place-based regional industrial policy is required both to anticipate and to respond to shocks and also to reposition the sector in the region going forward.

Exploring tourism business model importance with the emergence of blockchain system: directions for tourism industry of China.

The study aims to explore the importance of the tourism business model with the emergence of the blockchain platform in China. The study focused on the importance of the tourism business model of china, studied the need to improve the tourism business infrastructure, and traced the value of the blockchain system in the tourism industry of china. For this, the researchers used a semi-structured interview approach to conduct a qualitative research design. About nine Chinese tourism and travel industry experts were interwar after initial screening using purposive sampling techniques. The respondents' responses were analyzed by applying a thematic analysis approach, and by this, the researchers extracted the main themes on study topicality to fill the gap in the literature. The study's novelty is in its topicality and context, for which it also provides viable, practical directions for stakeholders.

Conceptual Principles of Accounting and Control of the Local Budgets during the War and Post-War Periods

External threats (Russian-Ukrainian war, climate change on the planet, consequences of the COVID-19 pandemic) and internal factors (lack of funding, inefficient use of funds, inconsistency of powers of the executive power at different levels) lead to unbalanced adoption of budget decisions at the local level in Ukraine. A major role in overcoming such bottlenecks lies in rethinking the functions of accounting and control. The purpose of the article is to find new conceptual approaches that will improve the efficiency of municipalities based on providing the management of the territorial community with complete, accurate and operational data. The authors analyze the publications for 1946-2022 from SCOPUS by computer program VOSviewer, using methods of content analysis and clustering. In addition, the authors use a number of scientific methods: analysis and synthesis, induction and deduction, the system method, analogies, etc. The study deals with a number of problems and solutions implemented by municipalities during wartime, related to local budgets. The influence of natural factors, sustainable development, accounting and control on ensuring the manageability of budgets of territorial communities has been clarified. The authors propose a new conceptual approach to the organization of the budgetary process of territorial communities, which is based on the concept of STEM. For its practical implementation, it is recommended to apply the smart city concept. The study identifies the main advantages and caveats regarding its implementation in Ukraine. The practical significance of the obtained results lies in the possibility of improving accounting and control of local budgets.

INTEGRATION OF SARS-CoV-2 RAPID ANTIGEN TEST IN HEALTH SERVICES IN KENYA AND CAMEROON

Background: Early diagnosis of COVID-19 is key to prevent severe cases and poor outcomes in vulnerable populations, including pregnant women and people living with HIV or infected with tuberculosis (TB). The feasibility of integration of SARS-CoV-2 antigen rapid diagnostic testing (Ag-RDT) into maternal neonatal, and child Health (MNCH);HIV;and TB clinics is unknown. Method(s): We analyzed data from a SARS-CoV-2 screen and test program implemented in 50 health facilities (25 in Kenya and 25 in Cameroon), integrating SARS-CoV-2 Ag-RDT in MNCH, HIV, and TB clinics between May and October 2022. Clients aged two and older attending MNCH, HIV, and TB clinics were offered SARS-CoV-2 screening, and those eligible were tested using SARS-CoV-2 Ag-RDT. Routine SARS-CoV-2 program data were captured through dedicated paper forms in Cameroon or an electronic medical record (EMR) interface in Kenya and transferred to a database for analysis. We estimated the proportion of clients screened and tested and the SARS-CoV-2 positivity rates. Result(s): Overall, 527,184 attendee visits were reported in Cameroon (282,404) and Kenya (244,780), with screening for COVID-19 symptoms and exposure performed in 256,033 (48.5%) with substantive variations between countries (62.6% in Cameroon and 32.4% in Kenya). Among the 256,033 screened, 19,058 (7.4%) were eligible for testing (9.0% in Cameroon and 3.9% in Kenya), of whom 12,925 (67.8%) were tested for SARS-CoV-2 with substantial variation in testing rates between countries (61.9% in Cameroon and 97.9% in Kenya) and clinics (59.9% in MNCH, 68.7% in HIV, and 92.8% in TB clinics). A total of 390 (3.0%) positive tests were identified (329 (3.3%) in Cameroon and 61 (2.0%) in Kenya). The estimated case detection rate was 1.26 (95% CI=0.76-1.75) per 1,000 attendee visits in Cameroon and 0.49 (95% CI=0.12-0.86) per 1,000 attendee visits in Kenya. Country integration strategy, facility level, setting, and clinic were independently associated with screening (Table 1) and testing. Conclusion(s): Integration of SARS-CoV-2 Ag-RDT in HIV, TB, and MNCH clinics was feasible in both countries despite challenges with low screening rates in Kenya and low testing rates in Cameroon. Decentralization of SARS-CoV-2 testing at different facility clinics allowed detection of SARS-CoV-2 cases among vulnerable populations. Integration strategies should consider facility settings (rural compared to urban) and additional human resources in high volume facilities to improve screening and testing rates.

The effect of a physical exercise package on the motor proficiency of students with down syndrome

Objectives: The purpose of this study was to evaluate the feasibility and potential effect of a physical exercise package on the motor proficiency of children and adolescents with Down syndrome. Methods: In this research, an experimental design was conducted in two special schools to evaluate the effectiveness of this package and identify its strengths and weaknesses. Forty students with Down syndrome were selected and randomly divided into intervention and control groups. A total of 36 (22 male and 14 female) students out of 50 at two special schools for children with special needs between October 2020 and March 2021 were recruited for the study. Participants were aged 12.888 +or- 2.375 (12.954 +or- 2.609 for boys and 12.785 +or- 2.044 for girls) years. The 18 students in the intervention group participated in the exercise sessions, 2 or 3 sessions per week for 12 weeks. Pre- and post-tests were performed on both groups. The Physical Exercise Package included the principles of exercise, the preferred exercise methods, and the details of exercise planning for Down syndrome individuals (FITT-VP) based on the etiology of Down syndrome and the characteristics of people with this syndrome. Motor proficiency was measured using the Bruininks Oseretsky Test of Motor Proficiency (BOT-2). Results: The results of the study showed that the designed exercise package was adhered to with all the participants attending 93.2% of the sessions, and participants significantly improved their total motor proficiency score, manual dexterity, upper-limb coordination, strength, balance, upper-limb coordination, running speed and agility and fine motor Integration (P < 0.05). However, the exercises did not significantly change the bilateral coordination and fine motor precision (P > 0.05). Conclusions: the current study result shows that developing and implementing the individualized exercise package and observing the principles set out in the program could have significant positive impacts on the motor proficiency of students with Down syndrome.

Federated Learning for Healthcare Domain - Pipeline, Applications and Challenges

Federated learning is the process of developing machine learning models over datasets distributed across data centers such as hospitals, clinical research labs, and mobile devices while preventing data leakage. This survey examines previous research and studies on federated learning in the healthcare sector across a range of use cases and applications. Our survey shows what challenges, methods, and applications a practitioner should be aware of in the topic of federated learning. This paper aims to lay out existing research and list the possibilities of federated learning for healthcare industries.© 2022 Copyright held by the owner/author(s).

Resources curse hypothesis and COP26 target: Mineral and oil resources economies COVID-19 perspective.

In recent times, industrialized economies have focused more on achieving a sustainable environment while maintaining economic prosperity. However, it is clear from the current research that natural resource exploitation and decentralization substantially affect environmental quality. To experimentally validate such data, the current study examines decentralized economies during the previous three decades (1990-2020). This study discovered the existence of long-term cointegration between carbon emissions, economic growth, revenue decentralization, spending decentralization, natural resources, and human capital using panel data econometric techniques. The findings are based on non-parametric techniques, indicating that economic growth and revenue decentralization are the primary barriers to meeting the COP26 objective. Human capital drives down carbon emissions and contributes to meeting the COP26 objective. On the contrary, decentralization of spending and natural resources has a mixed influence on carbon emissions across quantiles. This report recommends investing in human capital, education, and research & development to speed up COP26's target accomplishment.

Health Passport: A blockchain-based PHR-integrated self-sovereign identity system

During the COVID-19 pandemic, it was necessary to validate a person's health status along with their identity to permit travel. This was facilitated via paper-based certificates and centralized digital apps. Even after COVID-19, it is anticipated that such health status verifications will be required for travel and other purposes. As a result, there needs to be an additional credential, a "Health Passport," that establishes whether a person satisfies the health requirements for various purposes. Digital credentials so prepared should be trustable, unforgeable, and verifiable. The Health Passport should be designed to protect the end-users' privacy and give people control over the data they use to confirm their credentials. This article explores the requirements for a generalized Health Passport system and uses agent-oriented modeling (AOM) to design a blockchain-based self-sovereign identity (SSI) system integrated with the Personal Health Record (PHR) to address this requirement. The article demonstrates the feasibility of the solution by implementing a proof of concept on Hyperledger Indy and Aries, integrated with the PHR - MediTrans. Credential issuance and verification time were calculated, and it was observed that the time overhead was minimal. This solution allows users to verify their credentials with the verifier without revealing any significant personal information. Our solution can be integrated into any PHR solution as the SSI solution is added as a plugin to the PHR accessible via a mobile/web app.

Human Development in the Context of Socio-Political Crisis (on the Example of Modeling the Coordination Mechanism for Regulating Agricultural and Construction Policies)

The goal is to achieve human development through the printed media. Objectives - to study the socio-economic aspects of coordination of the activities of segmental components in the publishing industry;to find out and substantiate the strategic subjectivity of the state institutional regulation of the publishing industry of the national economy. Methodology. System-structural approach - in the study of theoretical and methodological aspects of ensuring the development strategy of the publishing industry of the national economy in transformational conditions;comparative analysis - for comparing objects and phenomena, identifying the general and special, for studying the causes of changes that have occurred, identifying development trends. For the implementation of the scientific topic: "Development of norms of consumption and norms of material waste in the production of textbooks and educational/teaching aids" 0122U002363. Results. The results of the latest pandemic caused by the COVID-19 virus and the active phase of the military confrontation have a decisive impact on the national economy and human development of our country. The current focus on agricultural development provides partial stabilization of the situation by maintaining an adequate level of food security and increasing food exports. In the long term, it is envisaged to use the existing advantages and revise the agrarian and construction policies, by coordinating them to create conditions for improving the human development situation in the country. To form the necessary theoretical basis for such changes, the definition of the term "state agricultural policy" was clarified and the list of strategic goals of the state agricultural policy was expanded. The current direction of construction policy is critically characterized. The essence of three dominants (continuation of land reform;decentralization;transformational changes in the development of agriculture), which should be taken into account when harmonizing agricultural and construction policies, is considered. The model of the coordination mechanism of agricultural and construction policy regulation was developed in order to create conditions for sustainable development of rural areas, which, accordingly, should contribute to the progress of human development.

Impact of Municipal Financial Resilience on Sustainable Economic Development: Case of Ukraine

Reform of fiscal decentralization is one of the most effective modern tools to improve the efficiency of public and local finances, as it involves the transfer of some powers from central to sub-central governments according to the principle of subsidiarity. Therefore, one of the top priorities in public finance development nowadays is to ensure municipal financial resilience (financial capacity). In the paper it is proposed to measure municipal financial resilience (financial capacity) as an integral indicator of fifth parameters (ratio of revenue / cost / tax revenue of local budgets (excluding transfers) to revenue / cost / tax revenue of the consolidated budget, "1" reduced by the ratio of net intergovernmental transfers to own revenue of local budgets;ratio of own revenue of local budgets to their own expenditure) aggregated based on Fishburn formula. It is proposed to chose as a proxies of municipal sustainable economic development such indicators as consumer price index, current account balance, volume of credits to the private sector, net foreign direct investment, GDP growth, GDP per capita, gross capital formation, business density, employment ratio, R&D expenditures, trade turnover. Testing the hypothesis on relationship between municipal financial resilience (financial capacity) and its economic development is realized on data for Ukraine for the period 2008–2021. Method of modelling – regression analysis in Stata software. Based on the empirical research results it might be concluded that there are national peculiarities of relationship between municipal financial resilience (financial capacity) and its sustainable economic development in Ukraine, which might be considered in terms of fiscal decentralization reform implementation, counteraction to negative consequence of coronavirus disease pandemic and municipality post-pandemic recovery strategy. Copyright © 2022– All Rights Reserved.

A Pandemic Instrument can Optimize the Regime Complex for AMR by Striking a Balance between Centralization and Decentralization.

Global antimicrobial resistance (AMR) is currently governed by a decentralized regime complex composed of multiple institutions with overlapping and sometimes conflicting principles, norms, rules, and procedures. Such a decentralized regime complex provides certain advantages and disadvantages when compared to a centralized regime. A pandemic instrument can optimize the regime complex for AMR by leveraging the strengths of both centralization and decentralization. Existing climate treaties under the UNFCCC offer lessons for achieving this hybrid approach.

Fiscal decentralization in Poland: 2004-2019 municipal and city dataset.

This dataset covers 2476-2479 Polish municipalities and cities (dependent on the year) over a period from 2004 when Poland joined the EU to the pre-COVID-19-pandemic 2019. The created 113 yearly panel variables include budgetary, electoral competitiveness, and European Union funded investment drive data. While the dataset has been created out of publicly available sources, their use requires advanced knowledge of budgetary data and their classification, as well as data gathering, merging, and clearing, which required many hours of work over a year. Fiscal variables were created out of raw data of over 25 million subcentral governments records. They were sourced from Rb27s (revenue), Rb28s (expenditure), RbNDS (balance), and RbZtd (debt) forms, which are reported quarterly by all subcentral governments to the Ministry of Finance. These data were aggregated according to the governmental budgetary classification keys into ready-to-use variables. Furthermore, these data were used to create original EU-financed local investment drives proxy variables based on large investments in general and in sports objects in particular. Moreover, subcentral electoral data from 2002, 2006, 2010, 2014, and 2018 were sourced from the National Electoral Commission, mapped, cleared, merged, and used to create original electoral competitiveness variables. This dataset can be used to model different aspects of fiscal decentralization, political budget cycles, and EU-funded investment in a large sample of local government units.

Political economy analysis of subnational health management in Kenya, Malawi and Uganda.

The need to bolster primary health care (PHC) to achieve the Sustainable Development Goal (SDG) targets for health is well recognized. In Eastern and Southern Africa, where governments have progressively decentralized health decision-making, health management is critical to PHC performance. While investments in health management capacity are important, so is improving the environment in which managers operate. Governance arrangements, management systems and power dynamics of actors can have a significant influence on health managers' ability to improve PHC access and quality. We conducted a problem-driven political economy analysis (PEA) in Kenya, Malawi and Uganda to explore local decision-making environments and how they affect management and governance practices for health. This PEA used document review and key informant interviews (N = 112) with government actors, development partners and civil societies in three districts or counties in each country (N = 9). We found that while decentralization should improve PHC by supporting better decisions in line with local priorities from community input, it has been accompanied by thick bureaucracy, path-dependent and underfunded budgets that result in trade-offs and unfulfilled plans, management support systems that are less aligned to local priorities, weak accountability between local government and development partners, uneven community engagement and insufficient public administration capacity to negotiate these challenges. Emergent findings suggest that coronavirus disease 2019 (COVID-19) not only resulted in greater pressures on health teams and budgets but also improved relations with central government related to better communication and flexible funding, offering some lessons. Without addressing the disconnection between the vision for decentralization and the reality of health managers mired in unhelpful processes and politics, delivering on PHC and universal health coverage goals and the SDG agenda will remain out of reach.

Lessons from Brazil's unsuccessful fiscal decentralization policy to fight COVID-19.

This manuscript investigates the unsuccessful case of the fiscal decentralization policy implemented by the Brazilian central government to help municipalities fight COVID-19. Based on quantitative analyses of data available on governmental websites, we identified that the transfer policy had ignored municipalities' risk patterns and income changes. It benefited municipalities regardless of their vulnerability and population infection risks, and many municipalities reduced healthcare expenditures funded by their revenues during the pandemic. Hence, some municipalities made a "pandemic surplus" in 2020 - a municipal electoral year. Indeed, COVID-19 killed 663,694 people in Brazil until 4 May 2022. Lessons from an unsuccessful case of response to COVID-19 help develop resilience for other crises by emerging market economies and developing countries. The findings have implications for policymakers and literature since they represent inadequate vertical coordination that followed a path dependence on traditional decentralization policies and took place in a year of municipal elections without clear spending and accountability rules.

Decentralization: A handicap in fighting the COVID-19 pandemic? The response of the regional governments in Spain.

The COVID-19 pandemic has provided an ultimate testing ground for evaluating the resilience and effectiveness of federal and decentralized systems. The article analyses how the Spanish asymmetrical system of decentralization has responded to the pandemic, focusing on the management developed by the sub-central governments (Autonomous Communities) during the first two waves of the pandemic in 2020. The research, which is both quantitative and qualitative, employs multidisciplinary tools and information sources, analyzing and linking fiscal and budgetary sources with the available statistics and information on health. Although the health, economic and social crisis caused by COVID-19 has highlighted appreciable shortcomings related to the decentralized model of territorial organization - in questions of both regional financing and health management - the research concludes that decentralization has not per se been a handicap when confronting the pandemic in Spain.

The Public Health Response to COVID-19 in Vietnam: Decentralization and Human Rights.

Human rights constitute a universal concern in different countries' responses to COVID-19. Vietnam is internationally praised for its success in containing the pandemic; nevertheless, human rights issues are a key area that needs to be assessed and improved. Little legal and ethical research is available on human rights in Vietnam, particularly in its response to COVID-19, however. In Vietnam, decentralization took place during the pandemic: higher authorities delegated power to lower ones to make and implement public health measures. Unfortunately, many measures made and implemented decentrally caused human rights concerns or breaches. This article aims to study what makes such measures cause human rights concerns or breaches. It argues that several social, legal, and political factors, including an inadequate understanding of human rights, the undefined breadth of discretion, and lack of supervision, are underlying factors for such problematic decentralized measures. Accordingly, this paper proposes two solutions (i) improving the supervision of the decentralization process, and (ii) improving the understanding of human rights. While Vietnam should learn from the international community to improve its measures, lessons and experience from Vietnam can also contribute to a richer dialogue and better protection of human rights globally.

Emerging digital citizenship regimes: Pandemic, algorithmic, liquid, metropolitan, and stateless citizenships

This article develops a conceptual taxonomy of five emerging digital citizenship regimes: (i) the globalised and generalisable regime called pandemic citizenship that clarifies how post-COVID-19 datafication processes have amplified the emergence of four intertwined, non-mutually exclusive, and non-generalisable new techno-politicalised and city-regionalised digital citizenship regimes in certain European nation-states' urban areas;(ii) algorithmic citizenship, which is driven by blockchain and has allowed the implementation of an e-Residency programme in Tallinn;(iii) liquid citizenship, driven by dataism – the deterministic ideology of Big Data – and contested through claims for digital rights in Barcelona and Amsterdam;(iv) metropolitan citizenship, as revindicated in reaction to Brexit and reshuffled through data co-operatives in Cardiff;and (v) stateless citizenship, driven by devolution and reinvigorated through data sovereignty in Barcelona, Glasgow, and Bilbao. This article challenges the existing interpretation of how these emerging digital citizenship regimes together are ubiquitously rescaling the associated spaces/practices of European nation-states.

Use of Blockchain Technology to Protect Privacy in Electronic Health Records- A Review

Patients' medical files are electronically preserved and accessible through a network such as Electronic Health Records (EHRs). Numerous opportunities exist for EHRs to enhance patient care, clinical practice performance indicators, and potential future clinical research contributions. The techniques used to preserve EHRs have proved incredibly unsafe in the contemporary era of smart homes and urban areas. Data can be easily accessed by hackers and unauthorized third parties. Furthermore, the data is not accessible to patients or healthcare practitioners. These plans cannot balance the accessibility and security of the data. But with blockchain, these issues can be resolved. Any application created utilizing blockchain technology is secure and inaccessible to unauthorized parties thanks to the three critical characteristics of the technology: Security, Decentralization, and Transparency. In a blockchain network, it is nearly difficult to manipulate data. This research work utilizes blockchain technology to deploy EHRs and improve their security and privacy. With its decentralized structure and cryptographic techniques, blockchain technology will maintain control over who gets access to information. Furthermore, it will maintain a balance between accessing data and privacy. The advanced aspects of the EHR system are handled by this research using smart contracts. The comprehensive healthcare management solution across a network can incorporate several sectors, such as billing and transportation. A website program can be combined with it to increase interactivity. By adding pharmacists to the system as a participant, EHRs can help them track medical sales. © 2023 IEEE.

Sustainable development:a new agenda for high-quality development of tourism

The COVID-19 pandemic has lasted for three years, social mobility has been greatly reduced, and the tourism industry has basically come to a standstill. With the adjustment of epidemic prevention policies and the refinement of governance, the restart and reshaping of the tourism industry is just around the corner. But the tourism industry, after the restart, is very different from that of three years ago, full of uncertainty and unpredictability. The global political and economic situation, geopolitics and international trade have undergone irreversible changes. The global industrial chain and supply chain have been restructured and the process of globalization has been interrupted and replaced by block cooperation characterized by regionalization.