BACKGROUND: Existing models to increase TB case notifications from the private sector in Pakistan are financially unsustainable and have achieved modest success due to limited coverage.
OBJECTIVE: To evaluate the impact of a social enterprise model (SEM) intervention on TB case detection in Karachi, Pakistan, and to assess its financial sustainability.
METHODS: Purpose-built centres were established within the private sector that integrated TB screening, diagnostics and treatment and operated 12 hours per day with convenient locations to improve access. TB services were offered free of cost, and revenue generation took place through user fees from other diagnostics. Private providers with a focus on the informal sector were engaged through community workers to generate screening referrals.
RESULTS: Overall 171,488 people were screened and 18,683 cases were notified, including 197 individuals with drug-resistant TB. Annual TB notifications in Karachi increased from 18,105 in 2014 to a maximum of 25,840 (40% increase). The proportion of cases in Karachi notified by the centres grew to 27% in 2020. Commercial revenue reached USD288,065 and enabled operating cost recovery of 15%. Average cost per TB case notified was USD203.
CONCLUSIONS: The SEM intervention contributed a large proportion of notifications in Karachi and achieved modest cost recovery.
BACKGROUND: Les modèles existants visant à augmenter les notifications de cas de TB par le secteur privé au Pakistan ne sont pas viables financièrement et n\'ont obtenu qu\'un succès modeste en raison d\'une couverture limitée.
OBJECTIVE: Évaluer l\'impact d\'un modèle déntreprise sociale (SEM, pour l’anglais « social entreprise model ») sur la détection des cas de TB à Karachi, au Pakistan, et évaluer sa viabilité financière.
UNASSIGNED: Des centres spécialisés ont été créés dans le secteur privé. Ils intègrent le dépistage, le diagnostic et le traitement de la TB et fonctionnent 12 heures par jour dans des lieux adaptés afin dén faciliter l\'accès. Les services de lutte contre la TB étaient gratuits et les recettes provenaient des frais d\'utilisation des autres diagnostics. Des prestataires privés, axés sur le secteur informel, ont été engagés par l\'intermédiaire d\'agents communautaires pour orienter les patients vers les services de dépistage.
UNASSIGNED: Au total, 171 488 personnes ont été dépistées et 18 683 cas ont été notifiés, dont 197 personnes atteintes de TB résistante aux médicaments. Les notifications annuelles de TB à Karachi sont passées de 18 105 en 2014 à un maximum de 25 840 (augmentation de 40%). La proportion de cas à Karachi notifiés par les centres est passée à 27% en 2020. Les recettes commerciales ont atteint 288 065 USD et ont permis un recouvrement des coûts déxploitation de 15%. Le coût moyen par cas de TB notifié était de 203 USD.
CONCLUSIONS: L\'intervention SEM a contribué à une grande proportion de notifications à Karachi et a permis un modeste recouvrement des coûts.

This paper examined the learning experiences of a group of undergraduate business students from a Thai business school in a social business course. The key point to examine in this study is learning and teaching approaches for social business education that can promote understanding of gender diversity. To understand the experiences of stakeholders in social business education, a qualitative approach was adopted wherein students, teaching staff and social entrepreneurs engaged with the researcher in a real-time, hands-on social business environment. We collected secondary data from assignments, feedback, and presentations from students and their social business coaches. We also collected primary data in the form of personal interviews with two social entrepreneurs who coached students in this course. The results suggest that the development of pedagogy for social business requires multidisciplinary collaboration and codesign among course coordinators, teachers, social business, and students. We also summarized four appropriate learning approaches, LGBTIQ + social business, in the Thai higher education context: advocacy, problem-based, research-based and practical-operational approaches. We suggest that social business should also be taught by academic staff and industry representatives to help students in the learning process. This study also suggests that a student-centered approach can help students synergize social impacts with the financial returns of social business by adopting inquiry-based activities, role plays, and talking with LGBTIQ + social entrepreneurs.

To achieve Universal Health Coverage and the United Nations\' (UN) Sustainable Development Goals (SDGs) agenda for 2030, the World Health Organisation (WHO) recommended the use of social enterprise, digital technology, and citizen engagement in the delivery of Integrated People-Centred Health Services (IPCHS) as part of its strategic vision for 21st century primary care.
We conducted a hermeneutic review of frameworks, models and theories on social enterprise, digital health, citizen engagement and IPCHS. This involved multiple iterative cycles of (i) searching and acquisition, followed by (ii) critical analysis and interpretation of literature to assemble arguments and evidence for conceptual relationships until information saturation was reached. This process identified a set of constructs which we synthesised into a testable framework.
Several interdisciplinary frameworks, models and theories explain how social enterprises could use digital technology, and citizen engagement to enable the technical and social integration required to facilitate people-centred primary care. Innovative approaches can be used to maintain financial sustainability while delivering IPCHS at lower cost to vulnerable and marginalised populations in both developed and developing countries.
This framework provides a theoretical grounding to guide empirical inquiry into how social enterprises use digital technology to engage citizens in co-producing IPCHS.

The rapid rise in microbiome and probiotic science has led to estimates of product creation and sales exceeding $50 billion within five years. However, many people do not have access to affordable products, and regulatory agencies have stifled progress. The objective of a discussion group at the 2017 meeting of the International Scientific Association for Probiotics and Prebiotics was to identify mechanisms to confer the benefits of probiotics to a larger portion of the world\'s population. Three initiatives, built around fermented food, were discussed with different methods of targeting populations that face enormous challenges of malnutrition, infectious disease, poverty and violent conflict. As new candidate probiotic strains emerge, and the market diversifies towards more personalised interventions, manufacturing processes will need to evolve. Information dissemination through scientific channels and social media is projected to provide consumers and healthcare providers with rapid access to clinical results, and to identify the nearest location of sites making new and affordable probiotic food and supplements. This rapid translation of science to individual well-being will not only expand the beneficiaries of probiotics, but also fuel new social enterprises and economic business models.

The UNSW WHO Collaborating Centre (WHOCC) in eHealth was established in 2013. Its designated activities are: mHealth and evidence-based evaluation, including use case analyses. The UNSW Yunus Social Business Health Hub (YSBHH), established in 2015 to build on the Yunus Centre/Grameen Bank eHealth initiatives, added social business and community participation dimensions to the UNSW global eHealth program. The Grameen Bank is a social business built around microcredit, which are small loans to poor people to enable them to \"produce something, sell something, earn something to develop self-reliance and a life of dignity\". The vision revolves around global partnerships for development, Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs). The scope includes mHealth implementation and evaluation in the context of the Internet of Things (IoT), with a growing focus on social business and citizen engagement approaches. This paper summarises a critical case study of the UNSW WHOCC (eHealth) designated activities in collaboration with Bangladesh institutions (International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDRB) and Yunus Centre). Issues and challenges are highlighted.

A persistent challenge facing global health actors is ensuring that time-bound interventions are ultimately adopted and integrated into local health systems for long term health system strengthening and capacity building. This level of sustainability is rarely achieved with current models of global health intervention that rely on continuous injection of resources or persistent external presence on the ground. Presented here is a case study of a flipped approach to creating capacity and adoption through an engagement strategy centered around an innovative mHealth device and connected service. Through an impact-oriented business model, this mHealth solution engages stakeholders in a cohesive and interdependent network by appealing to the pain points for each actor throughout the health system. This particular intervention centers around the MobileODT, Inc. Enhanced Visual Assessment (EVA) System for enhanced visualization. While focused on challenges to cervical cancer screening and treatment services, the lessons learned are offered as a model for lateral translation into adjacent health condition verticals.

Little is known about the types of work accommodations and natural supports that are useful for people experiencing severe mental illness working in social businesses. We conducted an exploratory, descriptive and cross-sectional investigation in Australia, Canada and Italy to study the nature of work accommodations and natural supports available in social businesses. Study findings are drawn from survey responses of a convenience sample of 90 employees with self-reported psychiatric disabilities. Results showed that, regardless of the country, social businesses provide many work accommodations and natural supports, especially those linked to schedule flexibility and support, while work accommodations related to training and schedule flexibility were linked to longer job tenure. Overall, this study advances our knowledge about the spectrum of work accommodations and natural supports that are available in social businesses for people with severe mental illness. Also, it highlights the type of work accommodations that are likely to support this population to sustain employment.

BACKGROUND: Social enterprises are often seen as a source of new and innovative solutions to persistent societal problems and a means for better inclusion of employees and customers. Because social enterprises combine business logic and social goals, they have vast potential to renew business and social life; therefore, it is vital to understand how their creation can be initiated and supported.
OBJECTIVE: This study provides an overview of the participatory design process for a new social enterprise as it appears in practice.
METHODS: The methods used in this case study guided the participants - mental health and substance abuse rehabilitees - in the co-creation and refinement of a business idea. The methods used enabled participants to acknowledge their own strengths or preferences for their potential future work, which was a unique means of establishing a new social enterprise.
CONCLUSIONS: Social empowerment of the participants/future employees of the social enterprise formed the important, intangible capital in this case. By definition, the core of social enterprises is the customer- and employee-driven nature. This study clarifies how a social enterprise functions as a laboratory of social innovation at the local and community levels.

OBJECTIVE: The aim of this project was to develop a quality nurse education programme in Bangladesh. A sustainable social business financial model was used. The project is a collaboration between Glasgow Caledonian University and the Grameen Health Care Trust. It contributes to the UN development agenda, eradication of poverty, sustainability and the development of global partnerships.
BACKGROUND: There is an acute shortage of nurses in Bangladesh but many young women who wish to become nurses are unable to do so. Women are discriminated against, have few leadership opportunities and poverty affects large proportions of rural society.
METHODS: The collaboration between the University and the Trust provides the necessary input to ensure a quality nursing programme. A business plan was developed, competency-based teaching introduced, infrastructure and financial management processes were set-up and an evaluation framework was put in place.
RESULTS: The systems evaluation framework monitors the financial status of the College and the effects of the programme on students. The social business model, providing access to educational loans, has enabled 118 students to graduate into employment. The College is currently on target to be financially sustainable by 2016.
CONCLUSIONS: This project outlines a business model that tackles poverty, gender equality and contributes to the human resource deficit. Young women are equipped as change agents and leaders.
UNASSIGNED: The social business model provides a mechanism for releasing funds for education to those who are impoverished. It provides a viable option for increasing the number of well-educated nurse leaders in developing countries.

This study evaluated the long-term effects of a therapeutic workplace social business on drug abstinence and employment. Pregnant and postpartum women (N = 40) enrolled in methadone treatment were randomly assigned to a therapeutic workplace or usual care control group. Therapeutic workplace participants could work weekdays in training and then as employees of a social business, but were required to provide drug-free urine samples to work and maintain maximum pay. Three-year outcomes were reported previously. This paper reports 4- to 8-year outcomes. During year 4 when the business was open, therapeutic workplace participants provided significantly more cocaine- and opiate-negative urine samples than controls; reported more days employed, higher employment income, and less money spent on drugs. During the 3 years after the business closed, therapeutic workplace participants only reported higher income than controls. A therapeutic workplace social business can maintain long-term abstinence and employment, but additional intervention may be required to sustain effects.