The Mixed-Method 5W2D Approach for Health System Stakeholders Analysis in Quality of Care: An Application to the Moroccan Context

The human milk microbiome: who, what, when, where, why, and how?

Human milk (HM) contains an incredible array of microorganisms. These likely contribute to the seeding of the infant gastrointestinal microbiome, thereby influencing infant immune and metabolic development and later-life health. Given the importance of the HM microbiota in this context, there has been an increase in research efforts to characterize this in different populations and in relation to different maternal and infant characteristics. However, despite a decade of intensive research, there remain several unanswered questions in this field. In this review, the "5 W+H" approach (who, what, when, where, why, and how) is used to comprehensively describe the composition, function, and origin of the HM microbiome. Here, existing evidence will be drawn together and critically appraised to highlight avenues for further research, both basic and applied. Perhaps the most interesting of these is the potential to modulate the HM microbiome using pre/probiotics or dietary interventions. Another exciting possibility is the personalization of donor milk for women with insufficient supply. By gaining a deeper understanding of the HM microbiome, opportunities to intervene to optimize infant and lifelong health may be identified.

Designing a Transportation-Strategy Decision-Making Process for a Supply Chain: Case of a Pharmaceutical Supply Chain

Including an active participation of stakeholders along the transportation decision-making process is increasingly recognized as a necessary condition for reaching successful and high-quality decisions. This paper presents a framework for deciding on the appropriate transportation strategy for a supply chain from a multistakeholder perspective. It consists of three steps: (1) defining the transportation-strategy decision-making context and the objectives that must be achieved; (2) analyzing the actual transportation strategy regarding its three components: transportation network; transportation mode; and transportation insource/outsource, as well as identifying the stakeholders interested in the study; and (3) conducting a group decision making regarding each transportation strategy’s component, while involving the key stakeholders and taking into account the specificities of transported products. The proposed framework is then applied to a real case of the Moroccan public pharmaceutical supply chain, which has different features that distinguish it from other supply chains including its importance, urgency, and regulation. We employed the DELPHI method to determine the key stakeholders that should be involved in the decisional process. After that, we applied the group AHP method for selecting the appropriate transport-network design option while involving the identified key stakeholders.