Search Results (65)

Background: In Canada, despite universal healthcare coverage, dental care remains predominantly privately financed, creating financial barriers that prevent many from accessing essential services. This case study is part of a larger initiative, the One Smile Research program, which evaluates the impact of cost-free dental care on the oral health and overall well-being of individuals who have been unable to access dental services in the past two years due to financial constraints. Participants in the program receive necessary dental care and attend follow-up appointments to assess the long-term effects of continuous cost-free care. Clinical Case: This mixed-methods case report focuses on a 26-year-old male participant and integrates a qualitative semi-structured interview with clinical and self-reported data, providing an in-depth understanding of his experiences. Results: Clinical outcomes demonstrated the effectiveness of the provided dental treatments, while self-reported measures indicated improved oral health, satisfaction with dental appearance, enhanced psychosocial well-being, increased self-esteem, reduced dental anxiety, and better oral hygiene habits. The qualitative interview identified three key themes reflecting positive experiences with the program: ease of admission, staff kindness, and overall well-being improvement. The integration of both quantitative and qualitative analyses revealed significant advancements in both objective and subjective measures, particularly regarding overall well-being. Conclusions: The continuity of cost-free dental care effectively addressed the participant’s oral health and overall well-being, with most benefits sustained even at the two-year follow-up. These individual-level outcomes offer preliminary insight into the potential advantages of universal dental coverage within the Canadian healthcare system. Full article

This study examines the integration and sustainability of solar energy technologies as a tool for rural electrification in Ghana, using the Lofetsume community as a case study. Persistent electricity access deficits in rural areas, coupled with unreliable grid systems and high energy costs, underscore the need for alternative energy solutions. Through semi-structured interviews and surveys, the study explores community perspectives and expert views on the viability of solar energy in rural Ghana. Findings reveal strong grassroots support for solar energy due to its reliability and environmental benefits, despite barriers such as high upfront installation costs and maintenance challenges. The study recommends multi-stakeholder partnerships, innovative financing models, and capacity-building initiatives to enhance solar energy adoption. By prioritizing solar energy technologies, the government, private sector, and local communities can collaborate to develop sustainable and affordable electrification solutions, ultimately improving living standards in remote areas and contributing to Ghana’s broader energy sustainability goals. Full article

The private healthcare sector in Romania, led by prominent players such as Medlife, Regina Maria, Medicover and Sanador, has become a cornerstone of the country’s healthcare system. However, achieving sustainability in this sector remains a challenge. This study evaluates sustainability practices in Romania’s private medical sector using the Triple Bottom Line (TBL) framework, comparing them to those of the EU, USA and Japan. Using statistical methods and benchmarking, we identify correlations between healthcare expenditures, financing schemes and sustainability metrics. A bibliographic review highlights global trends in sustainable healthcare management, including environmental, social and economic strategies and provides insights into the cost-effectiveness of green initiatives. Special focus is given to the role of technology in driving sustainability through innovations in telemedicine, digital health records and operational optimization. Using statistical methods (Pearson and Spearman correlation coefficients), we have performed an analysis of health expenditure data for EU countries, the USA and Japan. The dataset was extracted from the Organisation for Economic Co-operation and Development (OECD) data portal and included various health expenditure indicators, financing schemes and administrative data for all EU countries, the USA and Japan for the period 2018–2023. We have performed a structured analysis that explores correlations between these indicators, with a focus on financial schemes, expenditures and management sustainability. The analysis shows strong correlations between healthcare expenditures, financing schemes and administrative costs. Countries with efficient governance, balanced financing and proactive population health strategies (e.g., Japan and Nordic countries) demonstrate better management sustainability. However, countries like the USA and Eastern EU nations face challenges due to high administrative costs and inefficient financing models, respectively. Addressing these issues is critical to sustaining healthcare systems in the long term. The findings reveal that while Romanian providers excel in patient satisfaction and technological innovation, they lag behind their European counterparts in environmental sustainability and equitable access. Recommendations are proposed to address these gaps, drawing on successful strategies implemented in other European healthcare systems. This study fills a gap in the literature by providing a structured analysis of sustainability practices in Romania’s private healthcare sector, contextualized within a global comparative framework. Full article

Subsidized, decent, and durable housing is a persistent issue for South Africa’s urban areas. Social housing is one of the most important instruments for addressing the situation, yet structural barriers such as land prices, bureaucracy, and governance pose a challenge to forward momentum. This study provides a qualitative examination of social housing in Durban, Cape Town, and Johannesburg on the basis of three dimensions: effectiveness of governance, land accessibility, and practice of sustainability. It is evident that land acquisition is still a great hindrance due to private stakeholder opposition, complex rezoning processes, and speculative ownership of land. Institutional systems within the three cities are characterized by poor intergovernmental coordination, a lack of transparency in land disposition, and lengthy project approval. Johannesburg has seen extensive transit-oriented development, while Cape Town is more advanced in sustainability initiatives, albeit with a resource constraint, and Durban’s human-scale housing types suffer from finance and technical capacity challenges. This study underscores the need for interlinked policy changes to bridge the inefficiencies in governance, facilitate land accessibility, and enhance the incentives of sustainability. An across-the-board data-driven process involving government authorities, private builders, and civil society stakeholders is indispensable in advocating effective and sustainable urban housing strategies for South Africa. Full article

Achieving the Sustainable Development Goals (SDGs) is crucial for addressing global environmental challenges. SDG 13 calls for urgent climate action, while SDG 7 promotes sustainable energy. These objectives are particularly relevant to China, where transport-related CO₂ emissions continue to rise due to urbanization, industrial growth, and increasing energy demand. This study examines the impact of economic governance, population aging, human capital, financial innovation, GDP growth, and energy transition on China’s transport-related CO₂ emissions, using quarterly data from 2006Q1 to 2018Q4. The Method of Moments Quantile Regression (MMQR) is applied to analyze heterogeneous effects across different emission levels. The findings reveal that economic governance (ECOG), energy transition (ENT), and human capital (HI) significantly reduce transport CO₂ emissions (TCO_2E) by enhancing institutional effectiveness and promoting clean energy adoption. In contrast, population aging (POPAGE), financial innovation (FI), and GDP contribute to higher emissions by increasing energy consumption and private transport dependency. These insights highlight the need for stronger governance frameworks, sustainable financial policies, and increased investment in renewable energy. Policymakers should strengthen environmental regulations, expand green financing initiatives, and enhance public transport infrastructure to align with SDGs 7 and 13. By implementing these strategies, China can make significant progress toward reducing transport emissions, achieving carbon neutrality, and ensuring long-term sustainability. Full article

Achieving the European Union’s (EU) energy efficiency targets is essential for reducing greenhouse gas emissions, enhancing energy security, and ensuring sustainable investments in the building and small and medium-sized enterprises (SMEs) sectors. However, stagnant investments hinder progress towards these goals. This study examines successful sustainable financing practices for energy efficiency projects, with a focus on replicable financing schemes and models across EU countries. By examining long-term, replicable initiatives, the paper identifies best practices that can be adapted across various EU Member States, despite differing regulatory frameworks. Key selection criteria include project scale, duration, results, and private financing attraction. The study also provides market updates, evaluates financial schemes and models, assesses barriers to private fund leveraging, and shares lessons learned in overcoming these challenges. This research contributes to understanding effective strategies for encouraging investments in energy efficiency and renewable energy across the EU by promoting large-scale communication campaigns and fostering greater public-private cooperation. Full article

In April 2024, a hybrid meeting organized by the WHO, PAHO, and MPP during the World Bank Spring Meetings focused on financing mRNA-based technologies in Low- and Middle-Income Countries (LMICs). This meeting sought to engage multilateral development banks (MDBs) and stakeholders in financing the expansion of vaccine production and enhancing pandemic preparedness. The COVID-19 pandemic underscored the disparities in vaccine production and distribution, highlighting the need for localized production to improve global health equity. The WHO’s mRNA Technology Transfer Programme, initiated in 2021, aims to build local capacity for mRNA vaccine development and manufacturing. Key sessions covered during the meeting include innovative investment models, with MDBs discussing funding instruments and the necessity of an integrated ecosystem for sustainable vaccine manufacturing. Challenges such as technological risks and the need for higher risk appetite were addressed, along with innovative financing mechanisms like blended financing. An analysis of capital and operational expenditures for mRNA vaccine facilities was presented, projecting significant production capacity in LMICs within a decade. Panelists emphasized the need for sustainable R&D investment and shared experiences in securing funding for mRNA technology. The meeting underscored the importance of collaboration, innovative financing, ecosystem development, and public–private partnerships, marking a pivotal step towards advancing mRNA technology in LMICs to tackle global health challenges. Full article

Innovation and productivity improvements are essential drivers of economic growth, social stability, and sustainable development. As a high-risk, long-term activity, innovation requires external support, especially from the financial sector. In response, governments have introduced various financial support policies, yet their effectiveness remains debatable. Using panel data from Chinese listed firms between 2006 and 2022, we examined the impact of an innovation-oriented financial support initiative in China—the Technology and Finance Integration (TFI) pilot—on firm innovation and total factor productivity (TFP). This quasi-natural experiment effectively alleviated endogeneity and helped us establish the causality. Our results show that TFI significantly enhances both the quantity and quality of firms’ innovation, as well as TFP. Furthermore, we found that the policy effects are more pronounced in firms with higher perceived uncertainty, in private firms, and in those located in regions with advanced financial development. Improved liquidity conditions, increased R&D investment, and better asset allocation constitute plausible mechanisms for interpreting our results. Theoretically, this paper complements the research on the nexus between financial support and innovation activity, shedding light on the underlying mechanisms. Practically, our findings provide valuable insights for the formulation of financial policies to promote innovation, particularly in developing countries that lack sufficient R&D incentives and effective market mechanisms to drive technical upgrading and productivity growth. Full article

Saudi Vision 2030 is a game-changer for all aspects of the economy, including healthcare. This article provides a comprehensive overview of healthcare financing in the Kingdom of Saudi Arabia (KSA). It identifies key healthcare financing challenges that must be addressed to achieve the initiative’s envisioned health system goals. The review also examines and demonstrates how healthcare funds in the KSA are allocated among different healthcare services, to offer a perspective on resource use efficiency at various healthcare levels. This research used a mixed-method design which includes a literature review and secondary data analysis. A literature review was conducted aligned with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. The secondary data were gathered from the reports and websites of government agencies, international organizations, and non-governmental organizations. Despite implementing significant reforms in its healthcare system, the share of private healthcare expenditure in total healthcare spending has seen only marginal growth. The current healthcare financing system appears insufficient to adequately support the chronically ill and the poor. There is a significant imbalance in the allocation of government budgets between hospitals and primary care, with four-fifths of financial resources directed towards hospital services. The Ministry of Health’s budget allocation prioritizes personnel compensation, potentially reducing the available budget for medicines and other essential healthcare supplies. Ongoing reforms in the health sector, including privatization, public–private partnership initiatives, and the government’s commitment to developing a robust primary healthcare network, are expected to play a significant role in controlling rapidly increasing public healthcare expenditures in Saudi Arabia. Full article

Developing countries, including Small Island Developing States (SIDSs) and Least Developed Countries (LDCs), are exceptionally vulnerable to climate change due to their distinct geographical and environmental characteristics. Escalating sea levels and heightened salinity levels imperil freshwater reserves, while warmer ocean temperatures and acidification disrupt water demand, tourism, health services, and fisheries. Concurrently, these countries bear the brunt of water shortages, flooding, and declining water quality. However, significant barriers such as limited financing capacities to fund water security initiatives, exacerbated by a growing debt crisis marked by escalating interest rates and inflation, hinder developmental progress and investments in climate adaptation and mitigation endeavors. Consequently, there arises a critical necessity to harness innovative financial mechanisms to transform these debts into opportunities that support effective climate action. This paper explores the potential of debt-for-climate swaps as a catalyst for advancing transformative wastewater projects, focusing on their strategic deployment to underpin critical initiatives. Through case studies and empirical evidence, the paper elucidates how debt-for-climate swaps can enhance sustainable wastewater management systems in developing countries and delineates best practices for leveraging these mechanisms and the roles and responsibilities of key stakeholders, including governments, policymakers, the private sector, communities, and climate financial institutions. Combining theoretical insights with tangible examples, this paper furnishes a comprehensive framework for harnessing debt-for-climate swaps to enhance water security and resilience in developing countries. It offers actionable strategies for policymakers, practitioners, and stakeholders to navigate the complex terrain of climate change and engender sustainable development. Full article

The value of construction projects in Indonesia is significantly enhanced by partnering, leading to the adoption of the model by the government. The Indonesian government, through the Ministry of Finance, is developing the partnering model based on Public–Private Partnerships (PPPs) projects to further accelerate extensive infrastructure development. By leveraging PPPs, these projects intend to bridge the funding gap experienced by the government to facilitate swift infrastructure development and enhance the value of construction projects even further. Therefore, this study aimed to examine PPPs, such as the solicited projects occurring in Indonesia. Solicited projects were government-initiated PPPs based on long-term development plans. A qualitative method was adopted, conducting in-depth analyses at three locations with solicited PPP projects. Using Soft System Methodology (SSM) and expert Focus Group Discussion (FGD) through the Delphi method, this study investigated the interactions and depth of partnering in PPP projects. The obtained results emphasized the positive impact of solicited projects on Indonesian infrastructure development, addressing the funding gap experienced by the government. This study further contributed new insights for stakeholders and academics in the development of the projects in Indonesia, emphasizing the necessity of extensive development to support the implementation. Full article

The global momentum towards hydrogen has led to various initiatives aimed at harnessing hydrogen’s potential. In particular, low-carbon hydrogen is recognized for its crucial role in reducing greenhouse gas emissions across hard-to-abate sectors such as steel, cement and heavy-duty transport. This study focuses on the presentation of all hydrogen-related financing initiatives in Italy, providing a comprehensive overview of the various activities and their geographical locations. The examined funding comes from the National Recovery and Resilience Plan (PNRR), from projects directly funded through the Important Projects of Common European Interest (IPCEI) and from several initiatives supported by private companies or other funding sources (hydrogen valleys). Specific calls for proposals within the PNRR initiative outline the allocation of funds, focusing on hydrogen production in brownfield areas (52 expected hydrogen production plants by 2026), hydrogen use in hard-to-abate sectors and the establishment of hydrogen refuelling stations for both road (48 refuelling stations by 2026) and railway transport (10 hydrogen-based railway lines). A detailed description of the funded initiatives (150 in total) is presented, encompassing their geographical location, typology and size (when available), as well as the funding they have received. This overview sheds light on regions prioritising decarbonisation efforts in heavy-duty transport, especially along cross-border commercial routes, as evident in northern Italy. Conversely, some regions concentrate more on local transport, typically buses, or on the industrial sector, primarily steel and chemical industries. Additionally, the study presents initiatives aimed at strengthening the national manufacturing capacity for hydrogen-related technologies, alongside new regulatory and incentive schemes for hydrogen. The ultimate goal of this analysis is to foster connections among existing and planned projects, stimulate new initiatives along the entire hydrogen value chain, raise an awareness of hydrogen among stakeholders and promote cooperation and international competitiveness. Full article

Government efforts and reforms in health financing systems in various countries are aimed at achieving universal health coverage. Household spending on healthcare plays a very important role in achieving this goal. The aim of this systematic review was to assess out-of-pocket health expenditure inequalities measured by the FIA across different territories, in the context of achieving UHC by 2030. A comprehensive systematic search was conducted in the PubMed, Scopus, and Web of Science databases to identify original quantitative and mixed-method studies published in the English language between 2016 and 2022. A total of 336 articles were initially identified, and after the screening process, 15 articles were included in the systematic review, following the removal of duplicates and articles not meeting the inclusion criteria. Despite the overall regressivity, insurance systems have generally improved population coverage and reduced inequality in out-of-pocket health expenditures among the employed population, but regional studies highlight the importance of examining the situation at a micro level. The results of the study provide further evidence supporting the notion that healthcare financing systems relying less on public funding and direct tax financing and more on private payments are associated with a higher prevalence of catastrophic health expenditures and demonstrate a more regressive pattern in terms of healthcare financing, highlighting the need for policy interventions to address these inequities. Governments face significant challenges in achieving universal health coverage due to inequalities experienced by financially vulnerable populations, including high out-of-pocket payments for pharmaceutical goods, informal charges, and regional disparities in healthcare financing administration. Full article

This article analyzes the implementation of the National Financial Inclusion Strategy (NFIS) and its alignment with Sustainable Development Goal (SDG) I: Eradicate poverty. Despite the progress achieved, structural gaps persist and substantially limit the NFIS’s contribution to poverty reduction, especially among rural, indigenous, extreme poverty, and other vulnerable groups. The article employs a mixed methods approach combining qualitative and quantitative techniques. On the qualitative side, a hermeneutic documentary analysis of the NFIS and related regulations was carried out, with a critical textual interpretation supported by specialized software. Quantitatively, descriptive statistical techniques were applied to analyze official financial inclusion indicators—methodological integration was achieved through analytical triangulation under a concurrent mixed methods approach. The progress of initiatives under the NFIS was evaluated, identifying limitations such as the digital divide in rural areas, limited financing for Micro and Small Enterprises, gaps in financial education, and growing exposure to digital fraud. Although the NFIS promotes greater access to financial services, it does not explicitly focus on the poorest and most excluded populations. Therefore, it is recommended that the objectives and indicators of the NFIS be reformulated to focus on universal access and effective use of financial services by the population in extreme poverty and chronic exclusion. In addition, a strategic articulation with social protection policies is necessary, as well as promoting culturally relevant microfinance and inclusive finance models, strengthening consumer protection, and consolidating public–private alliances in high-poverty areas. Finally, strong monitoring and accountability are also key. Full article

When build–operate–transfer (BOT) roads are transferred back to the government upon the expiry of their contract, they are typically considered to be public roads and are no longer subject to tolls. However, in China, BOT roads, after being transferred to the government, remain tolled by the government in order to maintain efficiency. Therefore, such roads are termed public toll roads (PTRs). During the operational phase of PTRs, ongoing operating costs become a significant financial burden compared to the initial investment made for their construction. Against the backdrop of global carbon emission efforts, this paper studies the operational strategy of PTRs in terms of car emission costs, which constitute a portion of PTRs’ operation costs. This paper explores the operational strategy of PTRs, including whether the government should operate the road independently or outsource their operation to a competent private firm. Our analysis concludes that the operator should manage PTRs for the entire duration of their operation by maintaining self-financing while also accounting for operation costs. In this study, governmental regulations for the cost of carbon emissions are also studied. Full article