Blockchain Papers

Ezinne Victory Kanu, Charles Chibuisi Ehiemere, Ishaku Adamu Akyala, Eric Terkuma Chia · 5 authors

Despite global commitments under SDG-3, maternal mortality rates remain disproportionately high in Sub-Saharan Africa. This review examines how health policies have shaped outcomes between 2014 and 2024 in Nigeria, Rwanda, South Africa, and Gabon. A comparative narrative review was conducted using WHO, World Bank, UNFPA, DHS, and national policy documents. Guided by the Walt & Gilson Policy Triangle and the WHO Health System Building Blocks, policies were assessed for context, content, actors, process, and health system capacity. Data were synthesized thematically to compare implementation and outcomes. Rwanda achieved substantial declines through decentralized financing, performance-based funding, and community health worker integration. South Africa reduced deaths via integration of HIV and maternal services but still faces equity gaps. Gabon improved financial access but rural infrastructure and workforce limitations constrain outcomes. Nigeria’s fragmented governance and weak PHC financing explain stagnation despite multiple reforms. Implementation quality, not policy presence, drives progress. Strengthening governance, financing transparency, workforce readiness, and community engagement remains crucial for achieving SDG-3. This study highlights cross-country lessons transferable to similar contexts.

Adah Patrick Eneojo, Olorunmaiye Theophilus, Dr Emmanuel Bola Jonah K, Adah William Arome · 7 authors

Uptake of the Basic Minimum Package of Health Services (BMPHS) in Kogi State has been limited by supply‑side constraints, demand‑side barriers, and place‑based vulnerabilities concentrated in riverine and rural LGAs. The IMPACT rollout (2022–2025) combined Decentralized Facility Financing (DFF) with bundled Continuous Quality Improvement (CQI) supports to strengthen facility responsiveness, stabilize commodities, and expand outreach. We used a quasi‑experimental, mixed‑methods design on a facility‑month DHIS2 panel (2019–2025; n = 96 PHCs). Quantitative inference triangulated three counterfactual generators: augmented two‑way fixed‑effects Difference‑in‑Differences (DiD) for average effects, Interrupted Time Series (ITS) segmented regression to decompose immediate (level) and sustained (slope) impacts, and facility‑level counterfactuals via synthetic control and matrix completion for robustness. Multilevel mixed‑effects models estimated heterogeneity; causal mediation (bootstrap, 5,000 sims) quantified pathways (cold‑chain uptime, outreach frequency, commodity availability). Qualitative interviews and supervision records explained fidelity and contextual moderators. Costing used activity‑based methods with probabilistic sensitivity analysis. DFF plus CQI produced both rapid operational gains and durable system strengthening. Primary policy‑relevant estimates: DiD DPT3 +6.2 percentage points, ITS immediate level change α₂ = +3.7pp, and ITS slope α₃ = +0.12 pp/month. Mediation attributed ~41% of the DPT3 gain to improved cold‑chain uptime; outreach and commodity availability explained large shares of ANC1 and IPTp3 gains. Results are robust across lagged‑outcome DiD, matrix completion, generalized synthetic control, event‑study checks, and autocorrelation corrections. Cost‑effectiveness benchmarks show program‑level ICERs consistent with high probability of value for money for composite BMPHS gains. To maximize equitable BMPHS gains, prioritize cold‑chain resilience, predictable and timely disbursements, and earmarked outreach financing for high‑environmental‑risk LGAs. Embed both the ITS level (α₂) and slope (α₃) as complementary KPIs in routine dashboards: α₂ signals rapid operational fixes; α₃ signals durable system strengthening. Scale‑up should pair DFF with CQI, protected commodity lines, and context‑sensitive outreach modalities to sustain and equitably distribute gains.

David Olpengs, Jennifer Mamwa

Introduction Over the past two decades, Sub-Saharan Africa has achieved remarkable progress toward the UNAIDS 95-95-95 targets through sustained donor investment, community leadership, and political commitment. However, in early 2025, abrupt funding contractions including the suspension of PEPFAR disbursements by the United States and significant cuts by other major donors, threaten to reverse gains in HIV diagnosis, treatment initiation, and viral suppression. This study examines the potential impact of these funding shifts on the HIV response and explores strategies to sustain progress in a changing financing landscape. Methodology This review employed a structured narrative synthesis approach. A comprehensive search was conducted across peer-reviewed journals, grey literature, and institutional reports published between 2020 and 2025. Databases searched were PubMed, Google Scholar, and institutional repositories of UNAIDS, PEPFAR, USAID, and the Global Fund, using terms such as “HIV/AIDS,” “Sub-Saharan Africa,” “95-95-95 targets,” “donor funding cuts,” and “health system resilience.” Of 99 records identified, 15 articles and reports met inclusion criteria. Data were thematically analyzed along the three pillars of the 95-95-95 framework, emphasizing health system resilience, equity, and sustainability. Findings Funding cuts have led to immediate service delivery challenges. HIV testing programs in East and Southern Africa report supply chain interruptions, staff shortages, and reduced outreach, particularly in marginalized communities. ART initiation has slowed due to clinic budget constraints and inadequate safety nets, leading to declines in patient retention and treatment uptake. Viral load monitoring systems are increasingly strained, with insufficient resources for reagents, equipment, and logistics. These disruptions are projected to cause a sixfold increase in new infections and a surge in AIDS-related mortality by 2029 if unaddressed. Furthermore, funding disparities are exacerbating inequities, with countries like Botswana and Eswatini maintaining progress due to better ability to absorb shocks, while conflict-affected and resource-poor regions face greater setbacks. Discussion The donor funding shortfall presents both a crisis and an opportunity. Immediate mitigation requires tapping emergency funds, reprogramming health budgets, and negotiating bridge financing with bilateral and multilateral partners. Long-term sustainability hinges on strengthening domestic resource mobilization through health levies, sin taxes, and diaspora bonds, integrating HIV services into primary healthcare, and scaling digital and community-led service delivery platforms for decentralized adherence support. Geospatial targeting and real-time data systems can optimize resource allocation to emerging hotspots. By fostering regional solidarity and community-driven financing, Sub-Saharan Africa can convert this funding crisis into an opportunity for resilient, locally owned HIV responses that keep the path to ending AIDS within reach.

Prosper Mandela Amaltinga Awuni, James Mbinta

The withdrawal of the USA from the World Health Organization and the freeze on USAID are among the major events in the realm of U.S. foreign policy under the U.S. president. Within his broader “America First” policy, aimed at reducing the U.S.‘s international commitments and rethinking its role in global organizations and foreign aid, this review attempts to make a case for Africa by examining the implications of recent reductions in U.S. funding. We conducted a comparative case study of Nigeria, Ghana, Zambia, and Rwanda, selected for their aid volume, exposure to disruption events, and availability of outcome data. Using process tracing and critical narrative synthesis, we analyzed policy documents, expenditure reports and peer-reviewed studies to assess how each country responded to aid disruptions and what structural factors shaped their resilience or fragility. Three dominant patterns emerged: acute service interruptions (Nigeria, Zambia), structural fragmentation (Ghana), and resilient adaptation (Rwanda). Key drivers of vulnerability included overreliance on tied aid, SAP-era health system legacies, and underdeveloped domestic financing mechanisms. Rwanda’s ability to maintain high ART coverage and reduce malaria deaths by 88% during funding cuts reflects a deliberate break from aid dependency through community-based insurance, decentralized governance, and regional procurement strategies. Donor transitions are not neutral events; they expose and exacerbate pre-existing structural weaknesses. Current models that frame aid withdrawal as empowerment risk, replicating past harm unless coupled with institutional reform and reciprocal accountability. This study suggests assessing transition readiness and reorienting global health partnerships toward equitable, resilient, and sovereign systems.

Christian Ehiobuche

In an era of rising nationalistic populism and shifting global power dynamics, African healthcare systems remain precariously dependent on Western aid frameworks and, increasingly, China’s profit-driven digital health expansions. This dependency perpetuates structural inequities, leaving nations vulnerable to external agendas while stifling local innovation. This qualitative, exploratory study interrogates the potential of blockchain technology to reconfigure healthcare financing from a paradigm of donor reliance to one of autonomous, equitable resource mobilization. Focusing on Africa, the research critically examines emerging models—such as tokenized health bonds and blockchain-based aid tracking—that could decentralize financial sovereignty, enhance transparency, and foster self-sustaining health ecosystems. The study contrasts Western philanthropic approaches, often entangled with conditionalities and bureaucratic inefficiencies, against China’s strategic, commercialized health infrastructure investments, probing how blockchain might offer a third way—leveraging decentralized finance (DeFi) to reclaim agency. Key questions include: How can blockchain mitigate the politicization of aid in an age of populist retrenchment? Can smart contracts and tokenization democratize health financing while ensuring accountability? Drawing on stakeholder interviews and policy analysis, the presentation argues that blockchain’s disruptive potential lies not merely in technological innovation but in its capacity to recalibrate power dynamics—positioning African nations as architects, rather than beneficiaries, of their health futures. By centering African perspectives, this research challenges deterministic narratives of technological solutionism, instead framing blockchain as a contested but potent tool for decolonizing health financing. The findings aim to provoke debate on the intersection of decentralized technologies, post-colonial autonomy, and the urgent need for equitable health sovereignty in a fragmenting global order.

Mohammed Al Ghafari, Badar Al Alawi, Idris Aal Jumaa, Salah Al Awaidy

Background/Objectives: Oman Vision 2040, the national blueprint for socio-economic transformation, aims to elevate the Sultanate to developed nation status, with the “Health” priority committed to building a “Leading Healthcare System with International Standards” via a Health in All Policies (HiAP) approach. This paper critically reviews Oman’s strategic health directions and implementation frameworks under Vision 2040, assessing their alignment with global Sustainable Development Goals (SDGs) and serving as a case model for health system transformation. Methods: This study employs a critical narrative synthesis based on a comprehensive literature search that included academic, official government reports, and international organization sources. The analysis is guided by the World Health Organization’s (WHO) Health Systems Framework, providing a structured interpretation of progress across its six building blocks. Results: Key interventions implemented include integrated governance (e.g., Committee for Managing and Regulating Healthcare), diversified health financing (e.g., public private partnership (PPPs), Health Endowment Foundation), and strategic digital transformation (e.g., Al-Shifa system, AI diagnostics). Performance metrics show progress, with a rise in the Legatum Prosperity Index ranking and an increase in the Community Satisfaction Rate. However, critical challenges persist, including resistance to change during governance restructuring, cybersecurity risks from digital adoption, and system fragmentation that complicates a unified Non-Communicable Disease (NCD) response. Conclusions: Oman’s integrated approach, emphasizing decentralization, quality improvement, and investment in preventive health and human capital, positions it for sustained progress. The transformation offers generalizable insights. Successfully realizing Vision 2040 demands rigorous, evidence-informed policymaking to effectively address equity implications and optimize resource allocation.

Henry Komakech, Lynn Atuyambe, Fadi El‐Jardali, Christopher Garimoi Orach

BACKGROUND: Low- and middle-income countries face several challenges in providing health services, particularly to displaced populations, during all phases of emergencies. However, little is known about how health services are organized to displaced populations following repatriation. This study examined the organization of health services following the repatriation of South Sudanese refugees from the three West Nile districts of Arua, Adjumani, and Moyo in Uganda. METHODS: We conducted a qualitative case study in three West Nile refugee hosting districts, Arua, Moyo, and Adjumani. We used the World Health Organization Health System Framework, focusing on four blocks: health services, financing, medicines and supplies, and human resources. We conducted in-depth interviews with 32 purposefully selected respondents, including health service providers, district civil leaders, local government staff, and non-government organization staff. The data were analyzed using content analysis. RESULTS: Following repatriation, the district health teams in the three districts assumed overall responsibility for planning, managing, and providing health services. Health services followed an integrated model within a decentralized framework in all three districts. Health services were available in most areas except for former refugee settlements where facilities were either closed or relocated. After repatriation, funding for health services was provided through the government's primary health care grant with minimal support from aid agencies. Districts, however, face several challenges, including shortages of medicines and essential supplies, inadequate health workers, and poor infrastructure. CONCLUSION: Refugee repatriation disrupted health service delivery in the refugee hosting districts, leading to a reduction in funding; inadequate skilled health workers and equipment; and the closure of some facilities. To ensure the continuity of health services, government and aid agencies should plan for repatriation and establish strategies to sustain health services in refugee-hosting areas.

Sahjid Mukhida, Nikunja Kumar Das, Sriram Kannuri, Shalini Bhaumik

Knowledge is power. Updates in any field are essential to know for one’s professional growth in life. In Medical science, scientist and clinicians have to be updated on recent developments. Continuing Medical Education (CME) is one of the ways to update. Different programs like CME, seminars, webinars, symposiums, Continuous Professional Development (CPD), etc., are conducted from time to time. When multiple people come to one platform for sharing their knowledge with experience with other delegates, it takes the form of a conference. After attending the conference, clinicians not only improve their knowledge but also get credit points. Various state medical councils in India have made mandatory requirements of credit points for medical registration renewal. Not only in India but also many other countries have made it mandatory.[1-3] Before the COVID-19 pandemic, many organizations and groups organized conferences in offline or physical modes but after the pandemic, most CMEs, seminars, and conferences are being conducted and converted from offline to online mode.[4] After around a 2 to 2.5 years of gap, the government has permitted offline conferences but now doctors incline to attend in online mode because online conference participation does not have distance, health issues, or cost like factors. They can attend their duties simultaneously and saves commuting times also.[5] Many of us attended the CME or conferences during the pre-pandemic and post-pandemic eras. We also thought of conducting a conference in a hybrid mode. We hence write what is required to arrange a basic conference successfully. Last year we organized one national level conference. We share our experience of how to arrange a conference, which can help all to understand the basics behind arranging one such event successfully. Concept: We discuss what you should have in your mind the thinking about organizing the Conference. Before going full throttle, better to conduct an all-India feedback among faculty members and post-graduate students to decide the theme of the conference and sessions for pre-conference workshops. Then, the organizers can shortlist the best theme. A reward also needs to be given to the winner who suggested the best theme during the conference because arranging a conference is a tedious thing. The planning takes a long-time and needs full concentration for many days to months.[6] Plan: Once you have a concept in mind, you can start planning for the conference. Finalizing the mode of the conference is a key thing nowadays (Online/Offline/Hybrid). Making a checklist serves a lot. Note down everything from beginning to end including the smallest to biggest things in your list. This list keeps on upgrading till the last day. We suggest that you have to think about what you expected as a delegate or participant from the organizer in any of the past conferences that you attended. Take advice from your senior faculties as well as juniors from the same as well as other departments to conduct the conference. The date of the conference is a separate entity. Choose the date after a minimum of 6 months, so you can get enough time for preparation. Most of the conferences are held on weekends and it is around 2-3 days. Select the date as per your convenience but weekends are suggested to get a good number of participants/delegates. Also, while finalizing a date, we check the availability of the auditoriums, clashing of any other programs, examinations, festivals, etc.[2] Committee: Organizing a conference is complete teamwork. Start preparing the team, which is known as the organizing team. The team should have a chairperson, organizing secretary, advisor, and other committee members. Chairperson and organizing secretary are key persons and to ease their work you have to appoint their deputy too. This will help in smoothening things during their absence of them. Choose the person in a particular committee based on the skills they are good at. Like good conversation, skilled in computer and internet work, good managerial skills, well in decorative things and many more. Arrangements of accommodation, travel, hospitality, etc., can be preferably given to the male members of the department. Scientific committee work should be given to the senior members of the team. The Finance committee looks after the financial aspects, audits, budgeting, etc., After the organizing committee builds up, the real work begins.[7,8] Funds: Whenever any event is organized, the first and biggest challenge is finance. Funds are needed for purchase, rent, gift/prize, mementos/honorarium for speakers, helpers/labor, travel costs, online platform costs, etc., You can get a sponsorship from the companies (who have a stake in the topic being discussed), from management, and also from registration of the delegates. Making a good budget for the conference goes a long way in the successful management of funds. Keep more than 15% or more funds for miscellaneous or contingency plans, because you will have things that you have not planned earlier.[8] Session and speaker finalization: For good participation and interest generation, a good theme (ideally a current topic) is essential. That will determine the topics for sessions. Selection of speakers, if possible, should have a mix of international, national, and local level speakers from that field. Avoid repeating or intersecting topics in the same type of session in your conference that you read or attend in the near past. Inviting the speakers on appropriate topics is also important. If the speakers are not comfortable with the topic, either you have to choose the topic or you have to shuffle the topics and speakers too. Sometimes all the speakers may not be available for all day or slot timings of conferences. Arrange the sessions as per the convenience of the speakers, but in a manner that the logical flow is maintained.[9] Registration fees and their category: Registration fee is one of the ways to decrease the requirements of external funds. This will support reducing the financial burden of a conference, but it also comes with its share of challenges. You have to set the fees, which are appropriate to cover a certain proportion of expenses but should not be too high to discourage participation. You can set the slab of the fees in three ways: early bird registration (least fees), normal registration (moderate), and spot registration (higher fees) as per the key dates. Another one is fees for consultant/faculty, student/resident, paramedical staff, and member/non-member category type. Variations in these fees structure will help you to get good enthusiastic delegates for the conference. Opening a new bank account in the name of the conference helps you to manage all the expense accountability records in one place. The GST bills, PAN cards of the bank account, etc., are necessary for smooth transactions and auditing purposes. Taking the help of a chartered accountant is necessary for financial guidance.[9] Applying for credit points in medical council: Many medical councils are encouraging associations to organize CME and CPD for clinician knowledge upgradation. They support CME by approving the credit points to delegates, which are also of interest to delegates. Appropriate efforts should be taken well beforehand to get your conference approved for credit points. You have to fulfill the criteria for the credit point as per the individual medical council requirements. For details, you have to visit and read the guidelines of the individual medical council’s website. The approval of credit points needs finance. The amount may vary based on credit points approved and also upon the number of delegates that have registered for the conference.[2] First announcement and brochure: Next step is information to the target delegates about the event. You can prepare the first announcement pamphlet if your complete brochure needs more time to design. The first announcement gives the first impression about the events. It is usually a teaser. So, reveal only a few interesting aspects of the conference here. It should be attractive, and informative as well as should make delegates eager to know full details of events. A new logo on the name/theme of the conference gives a unique identity. After finalizing the speakers, schedule, registration fees, and brochure design, distribution of the brochure to all stakeholders should be done. A unique e-mail ID with the name of the conference should be made which should be used for the conversation and queries related to conference matters. Give complete information regarding your key dates, registration methods, registration fees, and their categories, speakers, sessions, contact details (of organizing secretary), etc., in a brochure that can make delegates clear about your events. You can also keep details of some nearby tourist places to visit in the brochures.[7] It is worthwhile to conduct some quiz or online assignment for postgraduates and senior residents in online mode related to theme of the conference to keep them reminded of the upcoming conference. Advertisement with an invitation: First announcement or final brochure should be distributed to the medical fraternity and important dignitaries of the institute. You cannot get good numbers of delegates at your conference without reaching them. Before social networking platforms, it was difficult to reach the delegates personally but now it is relatively easy to reach people. Post a brochure on various social networking platforms and groups to spread information about your events in other medical fraternities. A humble invitation message with the brochure attracts the delegates to attend the events. Stationary printing: Apart from the information brochure, many more things are there you may have to print. Banners, delegates, speakers, and resource person’s badges with the string, each category certificates, various informative sign boards, note pads with the name of events, and many more things required to be printed. Venue arrangements: If you are organizing a virtual conference, not much worry about the venue is there, but if you are organizing a physical or hybrid conference, you have to take specific caution about the venue. The size of the hall or auditorium, registration area, welcome kit distribution area, a place for parking, stall for exhibition, poster/oral presentation hall, a dedicated area for breakfast/tea and lunch, dedicated seating arrangement for guests and speakers, and many other things have to be kept in mind. You have to manage all the things without making hurdles to other workplaces of the institute and also have to satisfy the delegates.[10] Food arrangement: Food variety and quality play one the major attractions for the delegates. A not too heavy breakfast, a working lunch, tea at least twice, and sometimes dinners or banquets needs to arranged in the conference. Food arrangements should be verified and confirmed at least before one day of events. Food items should reach to specific place a minimum of 30 minutes before the schedule which can give time to caterers to decorate and serve food on time. 2-3 designated persons should be moved around to take care of guests and speakers during the break and food time. A spread and portion size should be meticulously planned, taking into account the palate of all regions of people and also taking into account local flavors. Adequate time should be allotted to the dining time because a lot of interaction between people takes place at this time.[7] Audio/Visual planning: Audio-visual facility is one major area that needs to focus on properly, especially when you are organizing virtual or hybrid events. Good resolution of the speaker’s PowerPoint slides, clear voice with good audio transmission quality, good network connection for online delegates, and live interaction between online and offline delegates and speakers. A professional team needs to handle all these things. A dry run needs to be done a day or two before the actual event.[11] For virtual conference presentations, participants can be encouraged to share their recorded video presentations to address Internet-related issues and time management during presentation. Stage rehearsal: Stage etiquette and performance are also important. The selection of a master of ceremony, and script writing is an integral part. Coordination between anchors and other stage managers needs to be smoothened. Lamp lighting and inauguration ceremony should be rehearsed at least 2-3 times before the event which can make everyone confident on the event days. Welcoming the guest and speakers, anchoring the whole event, facilitating, and felicitation guests and speakers before and after sessions, delivering bouquets, mementos, and certificates to guests and speakers, and vote of thanks and the valedictory session should be finalized earlier. Rehearsals can make the whole event will go smoothly on the main day.[12] Abstract submission and result notification: One of the corollary events that take place in paper and poster presentations. The organizing team can call for papers and include them in competitions. Various institutes and places clinicians and students want to share their research work with others via conference. Organizers invite abstracts for the papers, posters, or both before the conference. Dates of submission, result notification, and paper/poster submission dates for presentation have to be announced well in advance with the brochure. The scientific committee and judges have to be decided beforehand for the abstract selection/rejection and judging the paper/poster presentation in the events. On the final day, the place/mode of presentation and AV aids need to be arranged. Format and criteria for judging need to be established well in advance.[11,13] Registration verification: In the information brochure, the link for registration and payment is given. But verification of the registration information with the account statement should be done to avoid financial problems in the future. You have to dedicate 1-2 persons for verifying those details and give confirmation to the delegates about registration via email, phone call, or message. You can set autoreply in the registration form or email but still you have to check it once to avoid any future problems. Miscellaneous: The day before the conference is usually very hectic. All last-moment preparations, checks, etc., go on. Preparing the delegates, speakers, and resource persons’ badges, welcome kit/folder preparation, sign board/banner sticking, stage arrangements, decoration of the venue, and other things going on. Have a good sleep at night.[6] On the day of the conference: On the day of the event all members have to do what they have been assigned. No work is small or less. Organizing committees have a big task to organize and all members have to fulfill their roles either in their work on stage or anywhere else. If each member does their best, no one can stop your event to be successful. Spot registration facility: People assigned to the registration counter should arrive early along with all delegate bags, batches, and signature/attendance forms. Turnout should be impressive as they are the face of the event. Some organizer keeps the spot registration facility. You can keep it but we suggest, don’t keep it unless a lot of spots are vacant because it is extra work, starting from registration to certificate distribution.[9] If you have in-house speakers, you do not have to worry about being on time session starting. If your speakers are coming only for session time, try to take confirmation and arrange transportation before the session time. They should reach the venue at least 30 minutes prior, so they can get time to ready for the sessions. You have to schedule the question–answer session at the end of each lecture or session. But try to manage the time limit to avoid delay for the next lecture or session.[7] Conducting an Oral/Poster session: If in your conference, you inviting the abstract for either paper, posters, or both, you have to arrange the time slot with the venue for the presentation. You also have to coordinate with the participants about their time slots and share links for presentations. You have to invite the judges for judging the presentation. After completion of the presentation, have to collect the scores from judges and compile them for prize announcements.[7] Last-moment hurdles: All events may have been completed without any hurdles. Even those hurdles will make our events more memorable for us. Some accidental events like speaker illness, late supply of material, electricity and Internet problems, some environmental/weather-related situations, and other things can create problems at the last moment, think about those during the event planning to avoid trouble on the event day.[7] Untoward incidents on the event day: Sometimes it may fail or fall even after perfect arrangements and rehearsal. Don’t panic on the event day, even after some mismanagement. Try to make it normal to maintain your team members’ morale for successful event completion. Collecting the attendance and feedback from offline and online delegates: To engage the delegates with sessions, speakers can ask the question to delegates during the session. Organizers can take attendance on a paper sheet for physical delegates while collecting online feedback responses from all delegates to be sure of attendance. You can improve your event management, after evaluating the delegates and guest feedback.[7] After the completion of all lectures and valedictory sessions, the conference is almost complete. Delegates will leave the venue, but this is not the end of your work. You also have a lot of work which is known as post-conference work. Post-conference work: The certificate is proof of attendance for delegates and participants. In a physical conference, you can distribute the certificate at the end of the last session but for the virtual or hybrid conference, you have to send the delegates, speakers, and participants certificates to their email id. If you don’t have good IT support, you will suffer to distribute them. you also have to announce the prize winners’ names and distribute certificates with prize gifts, if you had the slot for poster/paper presentations. You also have to return the material to the supplier in the same condition which you received. Complete the task as per your checklist to avoid any troubles in the future.[14] After completion of the above work, prepare the list and make the brief reports of the conference. You have to prepare the reports with the delegate list as per the requirement of institutional management, state medical council, National Medical council, and other regulatory body requirements with their suggested formats. You also have to send the thanks email/letter to the speakers, sponsors, and institutional management team to support you and your team in organizing the event. Keep all the reports records along with the event photographs, videos, speakers/delegates’ testimonials, presentations of lectures, feedback forms, etc. Future conference planning: After organizing one successful event, you can get a good experience for the future. You can plan the next event after a month, a year, or at your You can improve your work after evaluating feedback We that this will help all future event organizers to organize the conference. We are not to cover all the of organizing in one but we important things. from event is a new So, start from one day you will be successful in the future. support and sponsorship of interest are no of

AbuYusuf Aminu-Ibrahim, John Chinemerem Ogbete, Kazeem Babatunde Ambali

Expanding diagnostic access across underserved and rural healthcare regions remains a critical determinant of health equity, early disease detection, and system-wide resilience. Infrastructure-driven approaches offer a pragmatic pathway to closing persistent diagnostic gaps caused by geographic isolation, workforce shortages, fragmented referral networks, and underinvestment in health facilities. This paper examines how strategic development of physical, digital, and organizational infrastructure can enable scalable, sustainable diagnostic services in low-resource and rural settings. It synthesizes evidence from health systems strengthening, rural health planning, and diagnostic network design to identify core infrastructure enablers that improve access, quality, and continuity of care. Key infrastructure components include decentralized laboratory hubs, modular and prefabricated diagnostic facilities, reliable power and water systems, cold-chain and specimen transport logistics, and interoperable health information systems. When combined with digital connectivity, telepathology, and point-of-care diagnostics, these assets reduce turnaround times, minimize patient travel burdens, and support timely clinical decision-making. The paper further highlights the role of workforce-aligned infrastructure, emphasizing training-centered facility design, task-shifting support spaces, and remote supervision platforms that extend specialist expertise into rural contexts. From a policy and financing perspective, infrastructure-driven expansion requires coordinated investment models that align capital planning with service delivery objectives. Public–private partnerships, performance-based financing, and regional diagnostic networks are discussed as mechanisms to de-risk infrastructure investment while ensuring affordability and long-term operability. Governance frameworks that integrate maintenance planning, quality assurance, biosafety, and regulatory compliance are identified as essential to preventing infrastructure decay and service fragmentation. The papaer concludes that infrastructure is not merely a physical input but a systems-level enabler of equitable diagnostic access. By embedding diagnostics within resilient infrastructure ecosystems that integrate technology, logistics, workforce capacity, and governance, health systems can extend high-quality diagnostic services to underserved and rural populations. Such infrastructure-driven strategies are foundational to universal health coverage, pandemic preparedness, and the reduction of avoidable morbidity and mortality in marginalized regions. Importantly, infrastructure planning must be context-sensitive, data-informed, and community-engaged, ensuring that diagnostic expansion aligns with local disease burdens, cultural practices, referral pathways, and sustainability constraints while promoting trust, utilization, and long-term health system integration across diverse rural geographies globally and fragile health markets.

StanislawPeter Stawicki, SagarC Galwankar, Sebastian Clarke, Iain Craig · 11 authors

Technological progress is reshaping multiple domains of human activity, from financial transactions to medical care.[1] This paradigm shift represents a global movement that will transform our lives for generations to come.[2] The democratization of decision-making capacity, including consensus-based mechanisms for transaction verification, will enable global implementation of projects that were previously not feasible because of the requirement for centralized control.[34] Blockchain represents a decentralized ledger technology that operates by consensus and serves to democratize decision-making processes and to disintermediate traditionally understood intermediaries.[1] According to Deutsche Bank forecasts, by mid-2020's, approximately 10% of the worldwide gross domestic product could be regulated by blockchain-based solutions.[5] It is estimated that more than $400 billion will be invested in this technology in 2019 to advance its capabilities.[6] Within this broader context, it is important to understand that cryptocurrencies and financial transactions constitute only one small aspect of the blockchain concept, which also incorporates areas like verification, transparency, encryption, and maintenance of data integrity.[378] Blockchain technology appears to be following a fairly typical pattern of adoption, with multiple early entrants into the increasingly crowded and competitive cryptocurrency space and the fast-growing sphere of blockchain-based applications.[91011] It is the latter that will help truly define, and be responsible for the societal impact of, “the era of distributed ledgers” that is under way.[1112] The primary goal of the strategic global partnership between Litecoin Cash Foundation (LCCF, https://litecoinca.sh/) and OPUS 12 Foundation, Inc. (O12FI, http://www.opus12.org/), is to leverage our collective resources to establish early leadership in the development and implementation of practical, real-life, blockchain-based solutions in academic and clinical medicine.[11314] The practicality of the dual blockchain utilization, featuring both currency and application layers, becomes apparent with the realization that the need for ongoing data processing relies on constant verification and encryption activity throughout the entire network of blockchain nodes.[113] Thus, the approach selected by the LCCF-O12FI consortium creates significantly more synergy than a single-track approach based on subcomponent strategy. Within this context, the technology provides not only a “digital wallet” functionality for currency exchange, but also different blockchain-based use cases incorporating academic and medical information. In one example, cell phones are ubiquitous in low- and middle-income countries (LMIC) whereas electronic health records are not. Older, less costly cell phone technology would suffice as only SMS capability is needed to utilize blockchain or cryptocurrency, enabling broad access to the populations of LMICs. Blockchain can support information exchange across disparate data types, while providing digital payments on a global scale and across borders. The functional dimension of introducing the primary currency feature of Litecoin Cash (LCC) cryptocurrency has the potential to bring tremendous benefits to the areas of the world where banking services (and infrastructure) are severely underdeveloped, yet basic components for the successful adoption of cryptocurrencies clearly exist (e.g., limited internet access and mobile devices capable of supporting blockchain transactions). Much like entire regions of the world that essentially “bypassed” landline-based telephony following the introduction of cellular networks, many localities stand to “bypass and leapfrog” traditional banking, and progress directly to distributed ledger technologies.[151617181920] There is growing recognition of the role of microeconomies and the critical need for efficient, dependable, accessible, safe, and scalable financial transactions and infrastructures, especially in low-resource regions, a topic that was recently recognized with a Nobel Prize in Economics.[2122] Of note, this does not necessarily preclude traditional banking firms from participation; however, they will need to adapt to new competitive pressures across economic realities for which high-resource environment models are not optimized. Ability to appropriately scale current blockchain capabilities will be critical to such implementations.[32324] Blockchain-based mechanisms also allow for crossover of monetary value from various loyalty cards and rewards programs, similar to currency exchange between different nations. Such reward points (mileage, car rental, and hotel stay) can then become an alternative subsidy for healthcare services. This can, for example, help establish a modernized barter system where a patient could use their “frequent flyer miles” to pay for medical costs, exchanging their reward points for “health care coins” through an intermediary exchange market. Institutions, such as nongovernmental organizations, could turn “flyer miles” used to shuttle staff between locations into vaccine and medical equipment purchases. Further, direct and real-time transparent payment for services in healthcare could lead to a reduction of both “intermediary” insurance companies and inefficiencies in the system. This streamlining would result in substantial healthcare savings, translating to lower costs, more access for patients, and decreased overhead with increased revenue for clinics, hospitals, and providers. Security of the blockchain (including various “side chains” and “layers”) is of paramount importance to ensuring trust and wider mainstream adoption of this technology.[252627] The inherent risk in the concept of distributed ledger “democratization” is the possibility of emerging inequality due to maldistribution of infrastructure responsible for the maintenance and ongoing operations of the blockchain.[2829] Within this broader topic area, our group previously described the risk of ill-intended, third-party actors to project massive bursts of “hashing power” and effectively take over the blockchain for a limited duration of time.[1] This, in turn, allows such destructive actors to “double spend” cryptocurrency output to the detriment of the broader populace.[114] To effectively prevent the risk of the blockchain being “hijacked,” the LCCF Developer Team devised an innovative paradigm of agent-based mining (e.g., the creation of new cryptocurrency) that helps ensure democratization of the LCC generation/transaction process while providing sustainable, long-term security of the distributed ledger.[14] Another significant advantage of this prototype mining technique is that it is not based on technologies that are becoming increasingly energy and resource inefficient, thus not requiring ever greater amounts of energy to generate diminishing amounts of block rewards (e.g., “coins”). The synergy between secure mining processes and the need for the highest possible levels of distributed ledger security creates a unique environment for the development of blockchain-based educational and medical applications. Our joint implementation framework of blockchain-based application layer includes clearly stated and reasonably achievable milestones, each defined within the broader contexts of adoption readiness and resource availability. Parallel to these developments will be the phased introduction of LCC as a voluntary medium of exchange for various international medical programs (IMPs) collaborating within our global network of institutions, providers, and clinical sites.[30] The initial step in the strategic LCCF-O12FI collaboration will be the development of a cryptography-based “Secure ID” (SID) that will serve as the foundation for the future developments. This SID will contain each user's unique identifying information, accessible only to the end-user (incorporating various best practices in cyber security such as 2-factor or multisource verification), and shareable for viewing and information verification only with end-user's designees. The SID will also serve as a “Secure Key” to access other, downstream blockchain-based applications including “Academic Activity Logger” (AAL) and “Credentialing Document Repository” (CDR). We will now discuss the development and implementation of AAL and CDR. The AAL will be the first step toward the integration of blockchain technology into real-life academic international medicine (AIM) applications. Powered by the global LCC network, the AAL will help record and track activities by faculty members, facilitating the categorization and quantification of academic efforts into the following subtypes: (a) teaching, (b) clinical medicine, (c) community/government interactions, (d) research, and (e) other/miscellaneous. Each entry will include the activity date/time/duration as well as basic description, with a number of generic entries available through a drop-down menu. Activities entered by academic faculty will then be analyzed periodically and will serve as a basis for resource mobilization and allocation. Access to the AAL will only be possible using the SID, thus making the AAL a logical extension and a springboard for subsequent LCC blockchain-based implementations. On this foundation, the CDR and ultimately a “basic electronic medical record” (BEMR, see below) will be constructed. Although the task of constructing a high-fidelity, immutable, and accurate ledger of academic activities will not be easy, certain steps can be taken to minimize the likelihood of “false claims.” Much like the blockchain-based cryptocurrency paradigm, a secure mechanism for consensus building and data verification can be constructed. Such a “network of trust” (NOT) is technically workable and analogous to how “pretty good privacy” keys were distributed at signing parties attended by people known to each other, and also similar to the way “secure socket layer” certificate authorities work.[3132] For example, if Party A's certificate is signed by some Party B who is trusted by Party C, Party C can trust Party A's certificate, etc. The next developmental step in our strategic plan will be the implementation of the CDR, where provider credentials will be securely uploaded and stored in decentralized fashion. These documents will follow predefined credentialing requirements by most institutions globally such as record of college education/graduation, professional school record/diploma, professional licensing/verification/certification, and any additional elements deemed important to the safe conduct of AIM efforts globally. Uploading of credentialing information will be voluntary, and access to this information will only be possible with the permission of the record owner, utilizing his or her unique SID. Optimally, this important credentialing instrument will help providers verify their identity, education, and qualifications, and ensure that appropriate standards are followed by all stakeholders. The end-result will be the provision of safe and efficient care to the patients worldwide. Similar to the academic activity verification process, there will be important challenges to consider before successfully implementing the global CDR. In principle, there will need to exist some form of “data onboarding” authority. This should be performed by a “verification agent” (e.g., independent organization/group) with equivalent authority to that which it takes to set up a legitimate record of specific type (e.g., a medical school diploma and medical board specialty certification). In terms of identity verification, for example, the level of diligence required is similar to that already present in “know your customer” legislation. The case for verifying professional credentials would be similar, including the process of independent data validation and certification. Again, this is technically possible with a NOT arrangement as mentioned above; however, there will be obvious limitations inherent to the workability of credential verification similar to traditional efforts already in place. If a practitioner is claiming to possess credentials from some credentialing provider, only that particular provider really has (and only should have) the authority to confirm that. At the same time, there must also be a mechanism to revoke trust and to hardwire time-defined recertification processes based on the expiry of records currently on file. The final step in the strategic LCCF-O12FI collaboration will be the development of a super secure, BEMR that could be deployed in low-resource environments, utilizing rudimentary portable device technology, and containing fundamental health information for each end-user. Much like the SID, information stored on the BEMR would be owned by the end-user and could be shared with healthcare providers only with the end-user's consent, requiring SID as the “Secure Key” to unlock information. We recognize the substantial challenges in the global implementation of this concept, especially with regards to the enormity of healthcare-related data (often from multiple systems and sources), the need for privacy, timely and accurate access, and verification of data. Other potential shortcomings, at this time, include the need for further development of the technology, limited availability of expert knowledge, significant gaps in public awareness, along with growth-related issues of scalability, security, and user adoption.[6] Nonetheless, it is our hope that the lessons learned from other blockchain application layers will serve as the foundation for successful development, evolution, and adoption of BEMR.[1] There are many other considerations related to blockchain technology implementations in healthcare. Although full discussion of such a broad topic is beyond the scope of this manuscript, certain key ramifications must be discussed in the context of the proposed O12FI-LCCF initiatives. Blockchain technology may be an important tool for increasing transparency of how charities collect and allocate funds, propelling a much leaner system that will benefit intended recipients to a much greater degree.[1] This application of the blockchain technology will help verify the integrity of an organization's operations such as the transparency regarding the proportion of contributions distributed to medical and educational causes versus the overhead. In turn, the public, philanthropic donors, and potential collaborators will be able to make more informed choices regarding where their contributions can be allocated most efficiently. Pharmaceutical companies may utilize blockchain to keep track of medications manufacturing and shipment, supply, expiration, and possible points of contamination.[33] By extension, similar technological approaches could be useful for tracking opiates in this age of epidemic prescription drug abuse.[34] In such cases, blockchain would make it easier to investigate and determine the source of access as the supply chain would become much more transparent. Various built-in data verification and safety features could also be used to prevent duplication of medications from different providers and other hazards that occur with polypharmacy. Furthermore, the same tracking approaches could be used to secure food supply chains and safeguard against disease outbreaks.[35] Contaminated food products could be quickly and more efficiently traced to specific farms, processing or packaging plants for immediate identification, and removal from circulation. When combined with potential applications for AIM and global health equity, blockchain-based applications could help catalyze further innovation. First, they can enable universal access to financial resources by removing third-party intermediaries and offering transparent, secure, and accountable means for AIM financing.[36] Next, they could help facilitate multilateral financing mechanisms dedicated to health system development and strengthening.[136] In addition, they could reduce fraud and corruption through the use of immutable, tamper-proof transaction ledgers.[136] Finally, entire new capital markets for healthcare data could be created, providing better access (and opportunities) to patients, institutions, governments, researchers, and other key stakeholders.[136] Additional benefit offered by any token with fixed or “capped” supply as a medium of international exchange – subject to harmonization with region-specific laws and regulations – is the noninflationary character of such cryptocurrency. This, in turn, may help provide end-users with a protective mechanism against inflation and loss of monetary value – a phenomenon experienced across many LMICs.[3738] In conclusion, the global partnership between OPUS 12 Foundation (including its allied partners and subsidiaries) and LCCF provides a unique platform for the parallel development of both global currency support framework and medical/educational application layer for the academic international medical community.

Prudence Ditlopo

No abstract is available for this record.

James Kiarie, Carey Farquhar, Robert Redfield, Kefa O Bosire · 8 authors

Background: Lack and inequitable distribution of human resources for health (HRH) is a major health systems challenge in Sub-Saharan Africa.1,2 The Partnership for Innovative Medical Education for Kenya (PRIME-Kenya) is an innovative approach that seeks to strengthen health systems by increasing linkages and collaborations in health care, health education, and health research. This approach was informed by concerns of inadequate clinical exposure with increasing undergraduate student enrollment at a tertiary hospital; increasing demand for locally relevant health research; and the desire to retain health workers at nontertiary facilities during and after training. Intervention: We focused on three interventions as part of the PRIME-Kenya initiative: decentralized training of undergraduate students, building research capacity at 14 nontertiary health facilities, and a nurse training program based on an eLearning platform. Decentralized Training. We sought to improve medical education capacity at selected nontertiary health facilities by training facility staff that already had postgraduate clinical training by using e-resources (textbooks, guidelines, and online lectures). Staff that completed the training were appointed as adjunct faculty at the University of Nairobi (UoN). Building Research Capacity. We conducted two phases of implementation science research training. First, between December 2012 and August 2013, 354 staff (30–60 per facility) received three days of instruction at their facilities on how to develop research questions, write research proposals, and collect data. Second, in October and November 2013, 35 adjunct faculty (3–5 per facility) received two additional days of training during which they developed research proposals based on research questions developed during the first phase. These adjunct faculty will be mentored by UoN faculty to help them submit their proposals for ethics review, collect and analyze data, and disseminate results. eLearning. In 2012, the School of Nursing Sciences introduced an eLearning Bachelor of Nursing (eBScN) upgrading course for diploma-level nurses. Training is conducted in accredited county hospitals where students are supervised by UoN adjunct faculty. Outcomes: At 14 nontertiary health facilities, 182 adjunct faculty have been trained and 306 students have rotated. Adjunct faculty at 9 health facilities have developed draft research proposals covering various areas including the impact of national health financing policies, staff retention, and quality of services. At 28 county hospitals, 148 students are enrolled in the eBScN program, and initial exam results indicate that trainees are gaining expected knowledge and skills. Comment: According to the interviews, the students felt they had more opportunities to practice clinical skills, closer mentoring, and closer interactions with patients at the nontertiary facilities than at the tertiary hospital. Health workers at the nontertiary hospitals also reported improved quality of patient care, increased job satisfaction, and greater interest in research. Those working in the nontertiary health facilities prioritized research that was highly relevant to local practice and policy. In the eBScN training program, county hospitals have retained employees, and the nurses are upgrading their skills without losing income. This innovative approach is successfully addressing some of the HRH challenges in medical education, health care, and research. Acknowledgments: PRIME-Kenya Secretariat staff members included Collins Owek, Francis Njiri, Raphael Kinuthia, Samuel Runo, James Macharia, Wycliffe Ndege, Juliet Mwangi, Minnie Kibore, Linda Nyaga, Wycliffe Khaemba, Susan Wanja, and Luke D. Davies.