Indexing

Abstract: In this article, we explore how crises affect the vast, heterogeneous informal economy. We have studied folk singers, artisans, retailers, petty manufacturing units, service providers, and construction workers across different zones of West Bengal through in-depth micro-case studies that focus on the severity of their vulnerability, their contexts, and their economic conditions. We have conducted a telephone survey at different time points during the COVID-19 pandemic. The findings clearly show that while the informal economy as a whole is highly vulnerable to external shocks, the nature and intensity of this vulnerability are far from uniform. Instead, they are shaped by the specific conditions under which different occupations operate. Vulnerability in the informal economy is structurally generated, not incidental, stemming from the interplay of significant market dependency, fragile asset bases, and insufficient institutional support, all of which are exacerbated during crises. Therefore, treating the informal sector as a homogeneous category obscures important differences and may lead to policy responses that fail to address the specific needs of different groups.

Keywords: Informal economy, Petty production, Crisis, Covid-19, India.

Title: Crisis and the Informal Economy: A Case Study of West Bengal, India

Author: Rahul Pal, Ushosi Chatterjee

International Journal of Recent Research in Commerce Economics and Management (IJRRCEM)

ISSN 2349-7807

Vol. 13, Issue 2, April 2026 - June 2026

Page No: 164-172

Paper Publications 

Website: www.paperpublications.org

Published Date: 30-May-2026

Abstract: Digital transformation and artificial intelligence adoption present both opportunities and challenges for enterprises seeking sustainable competitive advantage. Yet technology adoption alone does not guarantee superior performance. Through a structured review of several  studies identified via systematic search of the Web of Science and Scopus databases (2015–2024), this paper synthesizes research on strategic technology adoption through the lens of dynamic capabilities theory. We propose an integrated Strategic Technology Adoption Model (STAM) comprising five iterative stages: environmental scanning, strategic alignment assessment, capability development, technology integration, and continuous reconfiguration. The review identifies absorptive capacity, strategic alignment, and platform orchestration capabilities as critical mediators between technology adoption and competitive outcomes, while environmental dynamism, organizational agility, and governance structures moderate these effects. Drawing on micro-foundational analysis at individual, process, and structural levels, the paper derives twelve testable propositions specifying conditions under which enterprise AI enhances sensing, seizing, and reconfiguring capabilities. The STAM model advances existing frameworks, including those of Vial (2019) and Warner and Wäger (2019) by integrating AI-human substitution-complementarity dynamics and ecosystem-level orchestration mechanisms absent from prior models. Practical implications address capability-building priorities for enterprises navigating digital disruption.

Keywords: dynamic capabilities, strategic technology adoption, competitive advantage, enterprise AI, digital transformation.

Title: Strategic Technology Adoption and Competitive Advantage: A Dynamic Capabilities Framework for Enterprise AI and Digital Innovation

Author: Fiyinfoluwa Oyesola, Micheal Odunsi

International Journal of Recent Research in Commerce Economics and Management (IJRRCEM)

ISSN 2349-7807

Vol. 13, Issue 2, April 2026 - June 2026

Page No: 146-163

Paper Publications 

Website: www.paperpublications.org

Published Date: 19-May-2026

Abstract: The purpose of the study was to determine the strategic stakeholder engagement clarity and performance of County government of Kisii in Kenya. The study was guided by goal setting theory, contingency theory and modern organizational theory. The study utilized cross sectional research design and the target population for the study comprised of all middle level management in County. The study employed census since the target population was small. The study utilized primary data sources which was collected by use of structure questionnaires. The questionnaires for the research were structured based on the research objectives. Data analysis techniques used by the study was descriptive statistics and inferential statistics which was computed through multiple regression and correlation analysis. The data collection tool used by the researcher was Statistical Package for Social Sciences (SPSS) version 27. Analyzed data was presented in frequency distribution tables so as to make it easy for research results description and explanation. Based on the findings, the study concluded that strategic stakeholder engagement clarity has a significant effect on performance of County government of Kisii in Kenya. The study came up with the following recommendations; The county government should have procedural charts for all major stakeholder engagement and orient them on new processes before rolling out. The strategic decisions made by the organization should be communicated to all stakeholders.

Keywords: strategic stakeholder engagement clarity, employed census, employed census, Statistical Package for Social Sciences (SPSS).

Title: Strategic Stakeholder Engagement Clarity and Performance of County Government of Kisii, Kenya

Author: HENRY BONVENTURE ASIBA, Dr. ELIZABETH NAMBUSWA

International Journal of Recent Research in Commerce Economics and Management (IJRRCEM)

ISSN 2349-7807

Vol. 13, Issue 2, April 2026 - June 2026

Page No: 135-145

Paper Publications 

Website: www.paperpublications.org

Published Date: 14-May-2026

Abstract: The study was guided by the following specific objective as to identify the influence of strategic evaluation on Performance of Kilifi County.  The study used the following theories as resource-based view, goal setting theory, system theory, results-based theory.  The study adopted a descriptive research design. The target Population was all county directors from all the 13 departments in of Kilifi County. Data collection instrument was structured questionnaire. Both primary and secondary data was collected. The researcher self-dropped and pick the duly filled questionnaires. Piloting was done to test the validity and reliability of data collection instrument. Data was organised, coded, edited to bring a meaning.  Data was analysed and presented using the statistical package for social science SPSS version 29. Both descriptive and inferential statistics was done. Multiple regression was done to test the significant levels of one variable over the other. Analysis of variance was also be done. The finding will be of significant to the researchers, academicians, stakeholders and to the entire economy as a whole.

Keywords: strategic evaluation, descriptive research design, Data collection instrument, researchers, academicians, stakeholders, entire economy.

Title: Strategic Evaluation on Performance of Kilifi County, Kenya

Author: Virginia Kathini Mutua, Dr. Elizabeth Nambuswa Makokha, Dr. Joyce Amuhaya

International Journal of Recent Research in Commerce Economics and Management (IJRRCEM)

ISSN 2349-7807

Vol. 13, Issue 2, April 2026 - June 2026

Page No: 110-122

Paper Publications 

Website: www.paperpublications.org

Published Date: 13-May-2026

Abstract: The performance of agribusiness small and medium enterprises (SMEs) is increasingly recognized as a critical driver of rural development, food security, and economic growth in Kenya. However, many SMEs in Wajir County face challenges such as limited access to finance, inadequate technical expertise, and inefficient deployment of available resources. This study investigated the influence of strategic resource allocation on the performance of agribusiness SMEs in Wajir County, Kenya, a semi-arid region characterized by climate vulnerability, infrastructural deficits, and limited financial inclusion. The general objective was to examine the influence of strategic resource allocation on SME performance, guided by specific objective: projects prioritization on SME performance. The study was anchored on four theoretical frameworks: the Analytic Network Process Theory, A mixed-methods research design was adopted, targeting 1,192 registered agribusiness SMEs, with a sample of 125 selected using stratified random sampling. The study achieved a response rate of 83.2%, with 104 completed questionnaires validated for analysis. Descriptive statistics revealed composite means of 3.22 for projects prioritization, 3.41 for resources alignment, 3.50 for capacity utilization, 3.35 for capital investment prioritization, and 3.36 for SME performance. Correlation analysis revealed strong positive relationships between all independent variables and SME performance, with capital investment prioritization demonstrating the strongest correlation. Multiple regression analysis showed that the predictor’ projects prioritization, explained 63.0% of the variance in SME performance (R² = 0.630, adjusted R² = 0.615). The regression model was significant (F = 42.067), The final regression equation was: Performance = 1.876 + 0.187 (Projects Prioritization). The study concludes that strategic resource allocation significantly influences the performance of agribusiness SMEs in Wajir County. For practitioners, the findings provide actionable insights for SME owner-managers to prioritize capital investments in productive assets, maintain optimal debt-to-equity balances, preserve adequate liquidity reserves, and implement structured project prioritization and resource alignment frameworks. For policymakers, the study offers evidence-based recommendations for designing accessible credit facilities, capacity-building programs, and shared infrastructure investments that enable SMEs to overcome resource constraints in Kenya's challenging arid and semi-arid lands.

Keywords:  agribusiness small, medium enterprises (SMEs), food security, economic growth.

Title: STRATEGIC RESOURCE ALLOCATION AND PERFORMANCE OF AGRIBUSINESS SMALL AND MEDIUM ENTERPRISES IN WAJIR COUNTY, KENYA

Author: Jibril Omar Musa, Dr. Susan Naikuru

International Journal of Recent Research in Commerce Economics and Management (IJRRCEM)

ISSN 2349-7807

Vol. 13, Issue 2, April 2026 - June 2026

Page No: 96-109

Paper Publications 

Website: www.paperpublications.org

Published Date: 13-May-2026

Abstract: The constant inefficiencies in human resource management and payroll systems in the justice sector among the Semi-Autonomous Government Agencies (SAGAs) and bodies under the Office of the Attorney General in Kenya continue to affect employee morale, accountability and service delivery. Recent audits and reports indicate rampant payroll fraud such as discrepancies in the employee records, payments to dismissed staff, manual payments or disbursements despite the availability of digital systems such as GHRIS and IFMIS, etc., further compounding losses in the national exchequer and undermining the public confidence in legal institutions that are most vital for the rule of law and governance. This study examined digital human resource management (HRM) practices on the performance of employees in selected SAGAs under the Attorney General's Office operating in Nairobi City County. The specific objectives sought to determine the effect of e-recruitment on human resource performance in the justice sector institutions in Kenya. This study was anchored on the Technology Acceptance Model, Equity Theory, Reinforcement Theory and Social Exchange Theory. The study design was survey with quantitative approach. The target population were approximately 10,000 employees across these entities. A stratified random sampling technique was used to select 384 respondents using Yamane's formula. Data was collected using structured self-administered questionnaires and analysed using descriptive (frequencies, means, standard deviations) and inferential statistical techniques (Pearson correlation, multiple linear regression) in the statistical analysis package (SPSS version 27). The study found that the only statistically significant predictor of human resource performance was e-recruitment (β =.258, p =.001) and 75.6% of the respondents confirmed this fact. There was a notable positive relationship between e-recruitment and performance (r =.253, p < .01), meaning that it has a significant impact on employee efficiency, compliance, and productivity. On balance, the regression model accounted 6.5 percent of performance variation (R² =.065, p<.001), indicating that the e-recruitment is the main performance-enhancing digital practice whereas the payroll, biometric and communication systems serve as the hygiene factors that do not drive performance outcomes but ensure that operations remain stable in the justice sector institutions. Conclusion: E-recruitment plays a crucial role in the functioning of human resource performance, Recommendation: Justice sector institutions are advised to focus on e-recruitment investments as a key driver of performance.

Keywords: human resource management, justice sector, Semi-Autonomous Government Agencies (SAGAs), digital systems.

Title: DIGITAL HUMAN RESOURCE MANAGEMENT PRACTICES AND PERFORMANCE OF JUSTICE SECTOR INSTITUTIONS IN NAIROBI CITY COUNTY, KENYA

Author: Victor Omondi Oketch, Dr. Gor Kenneth, Dr. Clive Mukanzi

International Journal of Recent Research in Commerce Economics and Management (IJRRCEM)

ISSN 2349-7807

Vol. 13, Issue 2, April 2026 - June 2026

Page No: 85-95

Paper Publications 

Website: www.paperpublications.org

Published Date: 09-May-2026

Abstract: For many years Liberians have suffered from poverty and most of the challenges facing the country today can be attributed to the 14 years of devastating civil war that took the lives of over 300,000 Liberians. The war did not only destroyed infrastructures; it left thousands of Liberians living below the poverty line. This study adopts a quantitative research design to evaluate the effectiveness of microfinance on poverty alleviation in Liberia from 2015 to 2022 using the ordinary lease square method for estimations. The paper tends to answer the following question: what significant impact does microfinance has on the reduction of poverty in Liberia. In alignment with Smith, M. K. (2018), this paper used descriptive and Interpretive statistical techniques to explored the Relationship between GDP per capita and income inequality in poverty reduction. Contrary to expectations, the study finds a negative relationship between Domestic Credit to the Private Sector (DCPS) and Gross National Income per capita (PPP). This suggests that increased access to credit may not necessarily translate to poverty reduction in the Liberian context. Conversely, GDP per capita and educational attainment exhibit a strong positive influence on GNI per capita (PPP). The model demonstrates a high explanatory power, with an adjusted R-squared of 0.9893. The study concludes that while microfinance can play a role, fostering entrepreneurship and small business development through targeted support programs, including training, mentorship, and simplified business registration, is crucial. Additionally, expanding access to quality education at all levels is essential to enhance human capital and improve economic opportunities. Finally, the study emphasizes the need for policies that ensure equitable access to credit for low-income individuals and small businesses while preventing debt traps and promoting responsible lending practices.

Keywords: Microfinance, Poverty Alleviation, Domestic Credit, Regression Analysis.

Title: Beyond Capital: The Critical Interplay of Financial Access and Educational Attainment for Entrepreneurial Success in Liberia

Author: Kollie Jovinah Naomi

International Journal of Recent Research in Commerce Economics and Management (IJRRCEM)

ISSN 2349-7807

Vol. 13, Issue 2, April 2026 - June 2026

Page No: 76-84

Paper Publications 

Website: www.paperpublications.org

Published Date: 07-May-2026

Abstract: The purpose of this study was to determine the effect of organisational structure on performance of commercial banks in Nakuru City County Kenya Higgins 8s Framework as presented by Higgins (2005), Resource Based View (RBV) and Institutional Theory, guided this study. This study adopted a descriptive research design. This study constituted a census survey of the 11banks in Nakuru City County respectively. Branch managers, Credit managers and customer care of the banks will be targeted. Once data is collected, it was crosschecked and verified for errors, completeness and consistency. It was coded, entered and analyzed descriptively using IBM Statistical Package for Social Sciences (SSPS 26). Pearson correlation analysis was used to test the relationship between variables in the study hypotheses. ANOVA multiple linear regression analysis was used to determine the statistical relationship between the independent variable and the dependent. Analyzed data was presented in the form of tables. The following conclusions were made from the study findings: organisational structure had a significant influence on performance of commercial banks in Nakuru County Kenya’, The management of the commercial banks should come up with an organizational structure that outlines how activities including task allocation, supervision and coordination are directed towards its individual aims.

Keywords: organisational structure, commercial banks, Resource Based View (RBV).

Title: Organisational Structure and Performance of Commercial Banks in Nakuru City County Kenya

Author: Geoffrey Rono, Dr. Elizabeth Nambuswa Makokha, Dr. Julius Miroga

International Journal of Recent Research in Commerce Economics and Management (IJRRCEM)

ISSN 2349-7807

Vol. 13, Issue 2, April 2026 - June 2026

Page No: 60-75

Paper Publications 

Website: www.paperpublications.org

Published Date: 29-April-2026

Abstract: The COVID-19 pandemic posed unprecedented challenges to healthcare systems worldwide, necessitating rapid restructuring of hospital services to ensure patient and staff safety while maintaining continuity of care. This article describes the development and implementation of a comprehensive COVID-19 preparedness and patient safety programme at District General Hospital Nawalapitiya during the early stages of the pandemic in Sri Lanka. The initiative involved establishing isolation units, intermediate care pathways, triage systems, infection control measures, patient education strategies, and communication networks. A multidisciplinary, system-level approach was adopted in alignment with national and international guidelines. The programme successfully enhanced infection control, improved patient flow, minimized hospital transmission risks, and ensured safe and efficient healthcare delivery during a critical period. This paper highlights the importance of proactive planning, coordinated teamwork, and adaptive system redesign in managing public health emergencies.

Keywords: COVID – 19 Preparedness, Intermediate Care Centre, Isolation, Triage System.

Title: Hospital COVID-19 Preparedness and Patient Safety Programme: A System-Level Quality Improvement Initiative at District General Hospital Nawalapitiya

Author: Somaratne CJK, Weraduwage K, Raqeeb A, Pathiranage KPWC

International Journal of Recent Research in Commerce Economics and Management (IJRRCEM)

ISSN 2349-7807

Vol. 13, Issue 2, April 2026 - June 2026

Page No: 55-59

Paper Publications 

Website: www.paperpublications.org

Published Date: 16-April-2026

Abstract: Effective planning, policy making, and decision making depend on the availability of accurate hospital information. Hospital information storage is done though international accepted International Classification of Disease 10^threvision. Accurate diagnosis is vital for accurate coding. Ministry of Health has issued a circular (No-01 05/99) for the documentation of Bed Head Ticket (BHT) including writing the correct diagnosis. Objective of the study was to assess the quality of documentation in Bed Head Ticket in a ward of the District General Hospital Sri Lanka. One of the medical wards randomly selected for the study. Descriptive cross-sectional study was done to achieve objective. Three hundred eighty-four BHTs of selected ward belonged to the last quarter of 2025, were assessed by using data extraction sheet to check that diagnosis are according to the circular No-01-05/99. Out of 384 BHTs diagnosis was available in 350(91%) BHTs meanwhile legibility to read was 339 among available BHTs. In 32(9.5%) BHTs were written block capital letters as in circular 01-05/99 of 26/02/1999. Abbreviations were used to write diagnosis in 130 BHTs (38.3%).  As current activities and future developments of the hospital are based on accurate information. Therefore, priority should be given to appropriate hospital information management process. Accurate coding is dependent on comprehensive and accurately written diagnosis. Therefore, it is essential to enter comprehensive and accurate diagnosis in the BHTs. An interventional package to improve documentation of diagnosis   and further comprehensive studies on improving quality of diagnosis documentation are recommended.

Keywords: Bed Head Ticket, Diagnosis, Availability, Legibility, Adequacy).

Title: Assessment of the Quality of Diagnosis Documentation in Bed Head Ticket in a Selected Ward of a District General Hospital in Sri Lanka

Author: Indika Wanninayake, Jayani Marasinghe, Sucharitha Dharmasena

International Journal of Recent Research in Commerce Economics and Management (IJRRCEM)

ISSN 2349-7807

Vol. 13, Issue 2, April 2026 - June 2026

Page No: 52-54

Paper Publications 

Website: www.paperpublications.org

Published Date: 14-April-2026

Abstract: This study examines the influence of financial literacy on the growth of Small and Medium Enterprises (SMEs) in Nairobi City County, where limited financial knowledge and constrained access to financial services continue to hinder business performance and sustainability. Adopting a cross-sectional explanatory design, primary data were collected from 384 SMEs using structured questionnaires and analyzed through descriptive, correlation, and multiple regression techniques. The findings reveal that financial literacy significantly and positively influences SME growth, with financial product knowledge emerging as the most influential predictor, followed by budgeting skills and debt and liability management. These results indicate that financially literate SMEs are better equipped to make informed decisions, efficiently allocate resources, and sustain long-term growth. The study concludes that financial literacy is a critical strategic capability for enhancing SME competitiveness. It recommends strengthening financial education programs, promoting access to tailored financial products, and supporting SME capacity-building initiatives, while future research should adopt longitudinal designs and advanced analytical models.

Keywords: Budgeting Skills; Debt Management; Financial Literacy; Financial Product Knowledge; Nairobi City County; SME Growth.

Title: Financial Literacy on SMEs Growth in Nairobi City County

Author: Omiti Collins Odiwuor, Kariuki Grace Muthoni

International Journal of Recent Research in Commerce Economics and Management (IJRRCEM)

ISSN 2349-7807

Vol. 13, Issue 2, April 2026 - June 2026

Page No: 43-51

Paper Publications 

Website: www.paperpublications.org

Published Date: 13-April-2026

Abstract: The rapid integration of artificial intelligence into K–12 educational platforms has generated unprecedented volumes of learner interaction data, yet many schools lack structured mechanisms to translate these data into actionable strategic insights. This review paper proposes a comprehensive Business Intelligence framework designed to bridge learning analytics and institutional decision-making in primary and secondary education systems. The study synthesizes contemporary research on AI-powered adaptive learning systems, predictive analytics, dashboard architectures, and data governance models to construct a multi-layered framework that aligns operational analytics with school-level strategic objectives.

The proposed framework integrates data ingestion pipelines, AI-driven analytics engines, performance visualization dashboards, and executive-level reporting systems to support evidence-based planning in curriculum design, student support interventions, teacher performance evaluation, and resource allocation. Particular emphasis is placed on predictive modeling for early identification of at-risk students, prescriptive analytics for intervention planning, and KPI alignment with institutional performance benchmarks. The review further examines interoperability standards, ethical AI implementation, explainability requirements, and data privacy considerations specific to minors in educational environments.

By conceptualizing educational analytics within a Business Intelligence architecture rather than isolated reporting tools, this paper advances a strategic lens through which K–12 institutions can transform raw learner data into sustainable academic performance improvements, operational efficiency gains, and equitable learning outcomes. The framework offers a scalable model suitable for public school districts, private institutions, and hybrid digital learning ecosystems seeking data-driven transformation.

Keywords: Business Intelligence; Learning Analytics; AI-Powered Education; K–12 Strategic Decision-Making; Educational Data Governance.

Title: A Business Intelligence Framework for AI-Powered Educational Platforms Linking Learning Analytics to Strategic Decision-Making in K-12 Schools

Author: Maduabuchukwu Augustine Onwuzurike, Joy Onma Enyejo

International Journal of Recent Research in Commerce Economics and Management (IJRRCEM)

ISSN 2349-7807

Vol. 13, Issue 2, April 2026 - June 2026

Page No: 21-42

Paper Publications 

Website: www.paperpublications.org

Published Date: 11-April-2026

Abstract: Overcrowding in general medical wards, increasing patient complexity, and rising demand for subspecialty care present significant challenges to healthcare delivery in resource-limited settings. Traditional ward structures often result in delayed diagnoses, prolonged hospital stays, and inefficient resource utilization.

To establish a model medical subspecialty ward to deliver focused, multidisciplinary, and efficient specialist care while reducing overcrowding in general medical wards and improving patient outcomes.

A quality improvement initiative was implemented at District General Hospital Nawalapitiya beginning in 2023. The intervention involved creating a dedicated medical subspecialty ward with structured multidisciplinary teams, standardized care pathways, and fast-track admission systems. Data sources included patient feedback, ward-level discussions, and transfer records to tertiary care centres.

The implementation of the subspecialty ward resulted in improved patient flow, reduced overcrowding in general medical wards, enhanced multidisciplinary collaboration, and improved staff satisfaction. The results of the project were tangible and significant. From August 2023 to August 2025, Haematology admissions increased from 321 to 403, Dermatology from 131 to 155, Pulmonology from 158 to 208, and Cardiology from 88 to 233, indicating an overall rising trend across these specialties. Average length of stay decreased to 2.3 days from 4.5 days, reflecting earlier subspecialty input and more coordinated care. Bed occupancy rate decreased from 67% to 52% after the establishment of Medical Subspecialty Ward, easing congestion in general medical wards and improving access for acute admissions. Nurses and allied health professionals reported greater role clarity and professional recognition, while doctors benefitted from embedded subspecialty learning. The hospital also reduced unnecessary referrals to tertiary centres strengthening system integration at regional level.

Establishing a dedicated medical subspecialty ward significantly improves efficiency, patient-centred care, and healthcare delivery outcomes. This model demonstrates a scalable approach for optimizing hospital services and strengthening health systems.

Keywords:  Hospital efficiency, Medical Subspeciality Ward, Multidisciplinary care, Patient-centred care, Quality improvement, Subspecialty care.

Title: Establishment of a Model Medical Subspecialty Ward to Deliver Specialist Care Productively: A Quality Improvement Initiative at District General Hospital Nawalapitiya - Sri Lanka

Author: Somaratne CJK, Weraduwage K, Raqeeb A

International Journal of Recent Research in Commerce Economics and Management (IJRRCEM)

ISSN 2349-7807

Vol. 13, Issue 2, April 2026 - June 2026

Page No: 15-20

Paper Publications 

Website: www.paperpublications.org

Published Date: 10-April-2026

Abstract: Delays in receiving laboratory investigation reports and inappropriate utilization of on-call laboratory services can compromise patient care, increase institutional costs, and burden healthcare systems. Efficient laboratory workflows are essential for timely diagnosis, treatment decisions, and overall service quality.

To optimize laboratory investigation processes by improving workflow efficiency, ensuring appropriate prioritization of investigations, reducing unnecessary on-call testing, and enhancing timely report delivery.

 A quality improvement initiative was conducted at District General Hospital Nawalapitiya beginning in early 2024, following problem identification in late 2023. Retrospective audits, registry data analysis, and key informant interviews were used to assess workflow inefficiencies. A color-coded investigation system (routine–white, urgent–red, on-call–yellow), separate registries, and staff awareness programs were implemented. A re-audit was conducted regularly up until three months to evaluate outcomes.

Post-intervention analysis demonstrated significant improvement in workflow efficiency. Routine investigations were consistently processed within standard working hours, while on-call investigations were appropriately restricted to after-hours. Urgent investigations received prioritization. [Insert numerical data: % improvement, turnaround times, cost reduction].

A simple, low-cost, process-driven intervention significantly improved laboratory efficiency, reduced unnecessary expenditure, and enhanced patient care. This model demonstrates a scalable and sustainable approach to healthcare quality improvement in resource-limited settings.

Keywords: Laboratory optimization, Quality improvement, Workflow efficiency, Healthcare management, Diagnostic services.

Title: Optimizing Laboratory Investigations through Process Innovation: A Quality Improvement Initiative at District General Hospital Nawalapitiya – Sri Lanka

Author: Somaratne CJK, Weraduwage K, Raqeeb A, Pathiranage KPWC

International Journal of Recent Research in Commerce Economics and Management (IJRRCEM)

ISSN 2349-7807

Vol. 13, Issue 2, April 2026 - June 2026

Page No: 8-14

Paper Publications  

Website: www.paperpublications.org

Published Date: 10-April-2026

Abstract: Breastfeeding difficulties and low maternal confidence are major contributors to postnatal readmissions and high referrals to Lactation Management Centres (LMCs). These place avoidable strain on healthcare services. The structured, interactive antenatal education may enhance maternal preparedness, improve breastfeeding outcomes, and reduce postnatal healthcare burden.

The project objective was to evaluate the effectiveness of a multidisciplinary, interactive antenatal education program in improving maternal knowledge, confidence, and newborn care outcomes, while reducing lactation-related referrals and readmissions.

This quality improvement project was conducted at District General Hospital Nawalapitiya from April–July 2025, targeting mothers ≥36 weeks’ gestation. Exclusions included mothers <36 weeks, emergency admissions, and conditions requiring continuous monitoring. Interactive sessions were delivered by a multidisciplinary team, including medical officers, midwives, nursing officers from the LMC, and Quality Management Unit staff. Pre and post-session questionnaires assessed maternal knowledge and confidence, and monthly referral and readmission data were compared between pre- (Jan–Mar) and post-intervention (Apr–Jul) periods.

LMC referrals decreased from 54–70% pre-intervention to 35–49% post-intervention. Lactation-related readmissions dropped from 10 per month pre-intervention to 3–4 per month post-intervention (~60% reduction). Maternal knowledge and confidence improved significantly, and staff reported smoother postnatal workflow and enhanced maternal engagement.

Early, interactive, multidisciplinary antenatal education strengthens maternal confidence, improves breastfeeding outcomes, and reduces postnatal healthcare utilization. The Cradle with Care model provides a scalable framework for improving maternal-newborn care in hospital and community settings.

Keywords: Breastfeeding, Antenatal Education, Quality Improvement, Maternal Confidence, Lactation Management, Postnatal Readmissions.

Title: Cradle with Care – Building Safer Futures for Newborns: A Quality Improvement Initiative to Enhance Maternal Confidence and Reduce Lactation-Related Readmissions

Author: Somaratne CJK, Weraduwage K, Raqeeb A, Pathiranage KPWC, Nidharshani KWC

International Journal of Recent Research in Commerce Economics and Management (IJRRCEM)

ISSN 2349-7807

Vol. 13, Issue 2, April 2026 - June 2026

Page No: 1-7

Paper Publications 

Website: www.paperpublications.org

Published Date: 09-April-2026