Student loyalty is a critical measure in the success of higher education institutions that aim at retaining students until graduation and then attracting them back. This study examines the relative importance of relationship pathways among key factors affecting student loyalty in the following order: perceived service quality, satisfaction, trust, and commitment. The findings reveal that perceived service quality and student satisfaction do not translate directly into student loyalty, but, rather, indirectly through the mediation of trust and commitment. Implications of the findings are discussed.

The Global South nations and their statehoods have presented a driving force of economic and social development through most of the written history of humankind. China and India have been traditionally accounted as the economic powerhouses of the past. In recent decades, we have witnessed reestablishment of the traditional world economic structure as per Agnus Maddison Project data. These profound changes have led to accelerated real GDP growth across many LMICs and emerging countries of the Global South. This evolution had a profound impact on an evolving health financing landscape. This review revealed hidden patterns and explained the driving forces behind the political economy of health spending in these vast world regions. The medical device and pharmaceutical industry play a crucial role in addressing the unmet medical needs of rising middle class citizens across Asia, Latin America, and Africa. Domestic manufacturing has only been partially meeting this ever rising demand for medical services and medicines. The rest was complemented by the participation of multinational pharmaceutical industry, whose focus on investment into East Asia and ASEAN nations remains part of long-term market access strategies. Understanding of the past remains essential for the development of successful health strategies for the present. Political economy has been driving the evolution of health financing landscape since the establishment of early modern health systems in these countries. Fiscal gaps these governments face in diverse ways might be partially overcome with the spreading of cost-effectiveness based decision-making and health technology assessment capacities. The considerable remaining challenges ranging from insufficient reimbursement rates, large out-of-pocket spending, and lengthy lag in the introduction of cutting-edge technologies such as monoclonal antibodies, biosimilars, or targeted oncology agents, might be partially resolved only in the long run.

• There is a high rate of people willing to be vaccinated against COVID-19. • The finding confirmed positive willingness to pay individuals for a COVID-19 vaccine. • Adaptation to working under quarantine affects the probability of paying. • Government performance in managing the pandemic influences the vaccine valuation. • The social valuation is 1.09% of the per capita gross domestic product.

Background: The prevalence of COVID‐19 has a social and economic impact on people, leaving them distressed and fearful of getting infected.Objective: To determine the variables attributable to the fear of contracting COVID‐19.Design: This is a quantitative study based on an online cross‐sectional self‐administered survey in Chile between 10 July 2020 and 10 August 2020.Setting and participants: A sample of 531, comprising over 18‐year‐old participants from middle‐ and high‐income levels, was selected.Outcome measures: Estimations were obtained using a probit regression model with marginal effects.Results: Fear prevailed mainly in women. It has a positive relationship with variables such as chronic illnesses, infectious family or relatives, reduction in economic activity and perception of bad government response to a pandemic. Fear has a negative relationship with knowledge about COVID‐19, education level and ageing. Moreover, those who consider socioeconomic impact less important than health care do not fear a COVID‐19 infection.Discussionand conclusion: The socioeconomic and health aspects help predict fears. Thus, the government should prioritize these variables in implementing policies. The government's credibility and communication systems can also reduce fears of contracting COVID‐19.Patient or public contribution: A pilot focus group of COVID‐19–recuperated individuals and some members of our interest groups were consulted in the design stage of the study; this helped in constructing the survey questions. Additionally, three independent individuals volunteered to read and comment on the draft manuscript.

The historical legacy of Eastern European and the Balkans’ health systems was mutually interdependent and shaped by local socioeconomic circumstances. Three distinctive systems of risk sharing and health financing developed since the late XIX century were the Bismarck, Beveridge, and Semashko systems. Modern day healthcare systems in these countries are challenged by population aging, accelerated innovation in medical technology, growing purchasing power and rising demand for healthcare services. Supply-side changes contribute to demand-side efficiency bottlenecks in financing, driving up the costs of the already expensive medical care. All of the nations have a large share of citizens experiencing difficulty with affordability and access to medical care, particularly in rural and remote areas. Network of health technology assessment agencies have mushroomed over the past three decades. Principles of health economics theory and cost-effective resource allocation are slowly gaining ground in governing authorities’ mindset and decision-making processes. For many years to come, pharmaceuticals and medical services will remain dependent on out-of-pocket spending. Currently, accelerating and spreading 4.0 Industrial Revolution, together with the Belt and Road Initiative, are likely to substantially impact the further economic development of this vast region. Post-pandemic “green” recovery strategies adopted by many of the Eastern European governments shall also make this transition toward sustainable development more difficult and challenging, given the large dependency of all these economies on traditional carbon fuels.