Vol 14 Issue 2 October 2026-March 2027

Abstract: Digital health transformation is seen as a strategic way forward to safer, more efficient and patient-centred care in hospitals; however, it is not well understood how the organisational mechanisms can facilitate the transformation of digital investments into quality performance. The integrated model proposed and validated in this study suggests that digital health transformation positively influences quality performance both directly and indirectly through the variable of employee engagement, while quality governance (safety culture) positively influences the relationship between digital health transformation and employee engagement, and directly influences quality performance. The framework is based on the theories of sociotechnical systems, high-reliability organisations, resource-based view, dynamic capabilities and Donabedian's structure-process-outcome logic. A cross sectional explanatory design was designed with 612 doctors, nurses, allied health professionals, administrators, quality professionals and digitally enabled healthcare professionals of 12 NABH accredited multi-specialty hospitals in India. Constructs were thought of as multi-dimensional organisational capabilities and were measured using multi-item scales which were established and/or derived from the literature. Partial least squares structural equation modelling with 10,000 bootstrap subsamples was used to assess the measurement and structural models. The relationships between digital health transformation and employee engagement (β = .428, p < .001), and between digital health transformation and quality performance (β = .276, p < .001), and between employee engagement and quality performance (β = .357, p < .001) were all positive. In addition to the direct path, a significant indirect path via employee engagement was found (β = .153, p < .001) consistent with complementary partial mediation. Safety culture governance had a positive direct relationship with quality performance (β = .241, p < .001), and a positive relationship between transformation and engagement (interaction β = .124, p = .002). The model explains 41.2% of the variance of engagement and 62.8% of the variance of quality performance. The study contributes an employee-centered perspective of the digital value creation in hospitals and shows that digital capability is related to better quality performance in the context of accountable safety governance. Practical implications are provided for boards of hospitals, quality leaders, digital transformation teams, accreditation and policy makers who would like to leverage technology to align workforce engagement and safety governance.

Keywords: Digital health transformation, employee engagement, safety culture governance, quality performance, multi-specialty hospitals, PLS-SEM, India, patient safety.

Title: Digital Health Transformation, Safety Culture Governance, and Quality Performance: The Mediating Role of Employee Engagement in Multi-Specialty Hospitals

Author: Anita David, Dr. Sapna S Rathore

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 2, October 2026 - March 2027

Page No: 83-98

Research Publish Journals

Website: www.researchpublish.com

Published Date: 10-November-2026

Abstract: Thunderstorms pose significant public health and disaster risks in Rwanda, making community knowledge, attitudes, and protective practices essential for effective risk reduction. This study assessed community members’ knowledge, attitudes, and practices regarding thunderstorm risk reduction in Boneza and Gihango Sectors of Rutsiro District, Western Province, Rwanda. A quantitative descriptive cross-sectional design was employed among 394 community members aged 18 years and above. The sample was proportionally distributed between the two sectors, and participants were recruited through randomly selected community cooperatives and associations. Data were collected using a structured questionnaire in Kinyarwanda, which respondents completed independently where possible, with assistance provided to those who required support due to literacy limitations. Data were analyzed using descriptive statistics in IBM SPSS Statistics Version 25.0. Based on a predetermined operational cut-off of 80%, the findings showed that 55.6% of respondents had good knowledge, 67.3% demonstrated positive attitudes, and 63.7% reported good protective practices. However, important knowledge gaps persisted. More than half of the respondents (53.3%) did not know that all thunderstorms produce lightning, while 44.2% were unaware that lightning can strike the same location more than once. Additionally, 30.7% considered bathing during lightning safe. Access to preparedness information was also limited: 78.7% had not received lightning-warning messages, and only 12.7% had participated in lightning-safety training. These findings indicate that relatively favorable overall attitudes and protective practices coexisted with specific misconceptions and limited exposure to safety information. The study recommends strengthening community-based thunderstorm risk-reduction initiatives in Boneza and Gihango Sectors through targeted safety education, timely and accessible warning messages, and practical training on lightning protection. Community cooperatives and associations could serve as effective channels for disseminating safety information and promoting preparedness. These measures may help address existing knowledge gaps and strengthen community capacity to respond safely to thunderstorms.

Keywords: Community Knowledge; Attitudes; Risk Reduction Practices; Thunderstorm Preparedness; Rutsiro District, Rwanda.

Title: Community Members’ Knowledge, Attitudes and Practices Regarding Thunderstorm Risk Reduction in Rutsiro District Rwanda

Author: Umulisa Florence, Dr. Japheths OGENDI

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 2, October 2026 - March 2027

Page No: 69-82

Research Publish Journals

Website: www.researchpublish.com

Published Date: 09-November-2026

Abstract: Postnatal maternal mental health is an important public health concern, particularly among single mothers who may face economic hardship, social stigma, and limited support. This study assessed the determinants of integrated community-based counselling for improving postnatal maternal mental health among single mothers in Ruhango District, Rwanda. Specifically, it examined the availability of counselling services, associated socioeconomic and sociocultural factors, and the relationship between counselling and maternal mental health. The study was guided by Social Ecological Theory and Interpersonal Theory of Depression. A descriptive research design using a mixed-methods approach was adopted. The study involved 130 participants, selected through a census approach, comprising 84 single mothers, 40 community-based counselling facilitators, and six healthcare counsellors. Purposive sampling was used to select healthcare counsellors and community-based counselling facilitators, while simple random sampling was applied to select single mothers. Data were collected using questionnaires and interview guides. Instrument reliability was assessed using Cronbach’s alpha, with a threshold of 0.70, while validity was established through expert judgement. Quantitative data were analyzed using the Statistical Package for the Social Sciences (SPSS), employing descriptive statistics and regression analysis, while qualitative data were analyzed thematically. The findings indicated that integrated community-based counselling was generally available to single mothers in Ruhango District, although barriers related to rural accessibility and inflexible scheduling persisted. Socioeconomic factors were positively associated with improved postnatal maternal mental health, while sociocultural factors demonstrated a slightly stronger relationship. The findings also revealed a close relationship between socioeconomic and sociocultural conditions, suggesting that both influence access to counselling and maternal mental health outcomes. The study concludes that integrated community-based counselling can provide valuable support for single mothers, particularly when services are accessible, affordable, culturally appropriate, and supported by regular follow-up and strong community networks. It recommends that the Ministry of Health, district authorities, healthcare providers, and community health workers strengthen mental health screening, counselling, referral services, and stigma-reduction initiatives. Further research should investigate the long-term effectiveness, sustainability, and cost-effectiveness of community-based counselling interventions among single mothers in Rwanda.

Keywords: Integrated community-based counselling; Postnatal maternal mental health; Single mothers; Determinants; Ruhango District, Rwanda.

Title: Determinants of Integrated Community Based Counselling  To Improve  Postnatal Maternal Mental Health  Among Single Mothers In Ruhango District, Rwanda, 2026

Author: Benimana Francine Fridaus, Dr. Maurice Silali

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 2, October 2026 - March 2027

Page No: 57-68

Research Publish Journals

Website: www.researchpublish.com

Published Date: 09-November-2026

Abstract: Handwashing with soap is an effective and affordable public health intervention for preventing communicable diseases, including diarrheal and respiratory infections. Practicing handwashing at critical moments is particularly important among school-aged children and adolescents because it helps reduce the transmission of infectious diseases. This study assessed handwashing practices among primary and secondary school students in relation to handwashing critical moments in Gicumbi District, Rwanda. A cross-sectional study design employing a mixed-methods approach was used. The study was conducted in ten selected schools, comprising five primary schools and five secondary schools. A minimum sample size of 384 students was determined using William G. Cochran’s formula for large or unknown populations, and students were selected through simple random sampling. Purposive sampling was used to select key informants, including head teachers, teachers responsible for school health programs, and student representatives. Data were collected using structured questionnaires, observation checklists, focus group discussions, and key informant interviews. Quantitative data were double-entered in Microsoft Excel and exported to IBM SPSS Statistics version 25 for analysis. Descriptive statistics were used to summarize students’ handwashing practices at critical moments. The Pearson chi-square test was used to examine associations between categorical variables and handwashing practices, with statistical significance set at p < 0.05. Logistic regression analysis was conducted to estimate crude and adjusted odds ratios with 95% confidence intervals. Qualitative data were analyzed thematically to complement the quantitative findings. The study findings provide evidence on students’ handwashing practices at critical moments in the selected schools in Gicumbi District. The results can inform the development and strengthening of school-based hygiene promotion interventions to improve handwashing practices and reduce the risk of communicable diseases among primary and secondary school students.

Keywords: Handwashing Practices, Primary and Secondary Students, Critical Moments, Gicumbi District.

Title: Assessing Handwashing Practices Among Primary and Secondary Students in Relation to Handwashing Critical Moments in Gicumbi District

Author: Nimukuze Hyacinthe, Dr.  NISHIMWE Clemence

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 2, October 2026 - March 2027

Page No: 47-56

Research Publish Journals

Website: www.researchpublish.com

Published Date: 29-October-2026

Abstract: Background & Objectives: Ocular inflammatory and ulcerative disorders, including keratoconjunctivitis sicca (KCS) and infectious conjunctivitis, represent prevalent clinical challenges in companion animal medicine. Conventional synthetic therapies present long-term safety risks. This study aimed to isolate high-purity plant-derived polydeoxyribonucleotide (Phyto-PDRN) from Houttuynia cordata using an Adsorption-Elution-Based Purification (ABT) system and enzymatic fragment processing, formulate a biocompatible ophthalmic complex (0.075% w/v Phyto-PDRN), and evaluate its preclinical therapeutic efficacy, corneal/conjunctival regeneration mechanisms, and safety profile.

Methods: Phyto-PDRN was purified from H. cordata via cellulase/pectinase hydrolysis, probe ultrasonication, DEAE-Sepharose ABT column chromatography, and controlled DNase I restriction cleavage. The target formulation was prepared with hyaluronic acid, isotonic buffering salts, sodium benzoate, and disodium edetate, followed by terminal gamma irradiation (25 kGy). Preclinical evaluations encompassed UV/SEC-MALS physicochemical characterization, HPLC phytochemical quantification, DPPH antioxidant assays, H2O2/cisplatin-induced epithelial cell (CRFK/HK-2) toxicity mitigation, TUNEL apoptosis assays, ZM241385-antagonized adenosine A2A receptor (A2AR) proliferation and scratch wound healing assays, NF-κB/MMP pathway western blotting, and HET-CAM ocular irritation and USP <51> antimicrobial effectiveness tests.

Results: The ABT process yielded 0.38 ± 0.04% Phyto-PDRN with A260/A280 purity of 1.88 ± 0.03 (≥95.5% purity), optimal fragment length of 50–1,500 bp, and endotoxin levels <0.012 EU/mL. The optimized formulation established physiological equivalence (pH 7.2 ± 0.1, 300 mOsm/kg, 0.9% NaCl isotonicity) and total non-irritation (HET-CAM score 0.0). The formulation exhibited 96.0% DPPH radical scavenging, restored CRFK survival to 94.1%, and reduced TUNEL-positive apoptosis from 68.4% to 8.2%. Phyto-PDRN stimulated epithelial cell proliferation by 215.4% (completely abolished by A2AR antagonist ZM241385 to 112.1%) and achieved 94.8% wound closure within 24 h. Furthermore, it attenuated p-p65 NF-κB phosphorylation by 72%, downregulating MMP-1, MMP-3 (76%), MMP-13 (68%), TNF-α, and IL-1β while normalizing Type II Collagen expression (0.89-fold).

Conclusions: The H. cordata Phyto-PDRN ophthalmic complex provides a highly effective, animal-origin-free, allergen-free therapeutic strategy for companion animal ocular diseases, demonstrating robust tissue regeneration, anti-inflammatory activity, and regulatory feasibility.

Keywords: Houttuynia cordata; Phyto-PDRN; Companion animal ocular diseases; Adenosine A2A receptor; Corneal epithelial regeneration; Isotonic ophthalmic formulation; Veterinary quasi-drugs.

Title: Development and Preclinical Validation of a Houttuynia cordata-Derived Phyto-PDRN Ophthalmic Complex Formulation for Companion Animal Ocular Diseases

Author: Dong-Myong Kim, Jun-Ku Lee, Won-Kyu Lee, Hyun-Ah Moon, Youn-Joo Cho, Ji-Young Bae, Jin-Woo Kim, Yeon-Mae Choi

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 2, October 2026 - March 2027

Page No: 39-46

Research Publish Journals

Website: www.researchpublish.com

Published Date: 28-October-2026

Abstract:  Background and Objectives: Antiretroviral therapy (ART) is the cornerstone of HIV management, yet ART default, defined as missing scheduled doses or clinic visits for 30 days or more, remains a significant public health challenge in resource-limited settings. Despite the expansion of ART services in Ghana, adherence rates remain suboptimal in many communities, including Kwaebibirem Municipality. This study aimed to determine the prevalence and factors influencing ART default among patients living with HIV attending an ART clinic in Kwaebibirem Municipality, Eastern Region, Ghana.

Methods: A facility-based cross-sectional study was conducted at Kade Government Hospital, the primary ART service centre in Kwaebibirem Municipality. A total of 253 patients living with HIV, aged 18 years and above, who had been on ART for a minimum of six months and were actively registered at the facility, were selected using purposive sampling. Data were collected through structured interviewer-administered questionnaires, complemented by 8–10 key informant interviews with healthcare providers. Predictors of ART default were identified using multivariable logistic regression.

Results: The prevalence of ART default was 27.7% (95% CI: 22.5–33.5%). The most commonly reported reasons for missing doses were forgetfulness (57.1%) and perceived clinical improvement (54.3%). In the adjusted analysis, experiencing ART side effects (aOR=3.13; 95% CI: 1.64–5.98; p=0.001) and difficulty taking medication in the presence of others (aOR=2.91; 95% CI: 1.10–7.73; p=0.032) were significantly associated with higher odds of default, while higher monthly income was independently protective against default.

Conclusions: ART default in Kwaebibirem Municipality is a significant concern. Economic hardship, medication side effects, and HIV-related stigma are key drivers of non-adherence. Targeted interventions including side-effect management, stigma-reduction programmes, and economic support for patients are urgently needed to improve ART retention and treatment outcomes.

Keywords:  ART default; HIV; antiretroviral therapy adherence; Ghana.

Title: Factors Influencing Antiretroviral Therapy (ART) Default among Patients Living with HIV in Kwaebibirem Municipality: A Facility-Based Study

Author: Ameyaw Patrick, Brainard Ayisi Asare, Stephen Quarcoo, Samuel Bortier Borlabi, Punguyire Damien, Moses Barima Djimatey, Kennedy T.C Brightson

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 2, October 2026 - March 2027

Page No: 13-23

Research Publish Journals

Website: www.researchpublish.com

Published Date: 08-October-2026

Abstract: Artificial intelligence (AI) is reshaping healthcare through prediction, classification, and automation, and Indian hospitals are beginning to adopt machine learning (ML), natural language processing (NLP), computer vision (CV), and robotic process automation (RPA) across both clinical and administrative functions. This narrative review synthesises the emerging evidence on AI-led governance and hospital management in India, tracing how these techniques are being used to strengthen diagnostic accuracy, forecast patient demand, and optimise bed and staff allocation in real time. The evidence points to genuine but uneven progress: national instruments such as NITI Aayog’s #AIforAll strategy and the Digital Personal Data Protection (DPDP) Act, 2023 establish a policy direction, yet institutional readiness, workforce capacity, and enforcement mechanisms remain inconsistent across public, private, and charitable providers. Persistent concerns include diffuse accountability, uneven data protection, and the black-boxing of clinical algorithms whose reasoning administrators and clinicians cannot easily inspect. To address these gaps, this review proposes a five-layer governance framework, built so that each layer’s functions are mutually exclusive and, together, collectively exhaustive of the governance task, spanning data infrastructure, analytical intelligence, operational application, governance and safeguards, and measured outcomes. A situated-ethics approach, one that treats India’s geographic disparity and uneven infrastructure as starting conditions rather than afterthoughts, runs through the analysis. Good AI governance, this review argues, treats AI as a monitored and accountable partner in hospital administration rather than a self-sufficient solution.

Keywords: Artificial intelligence; healthcare governance; hospital management; digital health; algorithmic governance; India.

Title: AI-Led Governance in Hospital & Healthcare Management in India: A narrative review of applications, frameworks and regulatory considerations

Author: Meghna Mishra, Bincy Pothen

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 2, October 2026 - March 2027

Page No: 1-12

Research Publish Journals

Website: www.researchpublish.com

Published Date: 03-October-2026