Miroslav Mateev

Background The SARS-Cov-2 pandemic (COVID-19) sudden onset disrupted the direct access to face-to-face nutrition consultation fostering the rapid adoption of Telehealth by dietitians. Objective This study investigates Telehealth use among Lebanese Licensed Dietitians (LDs) amid COVID-19, in the absence of national Telehealth practical guidelines (TPG), and offers insights on Telehealth application under uncertainties of pandemic event, economic crisis, and destructed infrastructure occurring simultaneously in Lebanon. Design A cross-sectional study during March 2023, using an anonymous online survey (44 questions), diffused through the Lebanese Order of Dietitians and social media platforms. Participants The sample (n=94) consisted mostly of females (98.9%) and young dietitians (mean(SD) age: 30.54(6.41) years) having a mean(SD) of 7.89(5.7) years of experience. Most respondents identified clinical nutrition as their primary practice area (87.2%), mostly in weight management (84%). Main outcome measures Telehealth experience amid COVID-19 including tools utilized in remote consultations, barriers, facilitators, and perspectives of Telehealth use. Statistical analyses Descriptive analysis (counts, frequencies) using SPSS version 28. Results Although 48.4% of LDs reported using Telehealth prior COVID-19, this proportion increased to 97.8% during the pandemic. The most common tools used were WhatsApp (90.3%), Zoom (72.0%), and E-mails (41.9%). Reported barriers included bad internet connection (74.2%), patients preferring face-to-face consultation (61.3%), and patients lacking technical literacy (33.3%); benefits included scheduling and time flexibility (83.9%), decrease in practice-related costs (77.4%), and compliance with social distancing measures (53.8%). The majority agreed that Telehealth is needed (78.5%) and applicable in the Lebanese context (64.6%) and expressed the need for Telehealth trainings (78.5%) and TPG for nutrition care (74.2%). Conclusions This study recognizes increasing use of Telehealth in Lebanon, warranting the development of Telehealth nutrition care infrastructure comprising national regulations and evidence-based practical guidelines to respond to the innovation in the healthcare industry, and to assure Telehealth sustainability in LDs’ routine practice.

Purpose: This empirical research investigates the impact of board nationality diversity on the efficiency of banks. Additionally, our analysis examines the interacting impact of women's representation on bank boards in the correlation between nationality diversity on board and bank efficiency. Design/methodology/approach: This research utilizes a dataset comprising banks operating in the MENA countries over an eight-year period. We apply diverse statistical methodologies, with Ordinary Least Squares (OLS) being the primary econometric analysis, alongside several robustness tests. Findings: The research results offer important insights into the importance of board nationality diversity, as well as its interaction with the inclusion of women on boards. The findings indicate that having foreign directors on bank boards enhances efficiency. Furthermore, they suggest that increased women representation on boards improves the positive correlation between presence of foreign directors in boardrooms and efficiency of banks, thereby mitigating agency problems and enhancing governance practices. Practical implications: These results carry substantial implications for legislators across the MENA countries. Advocating for diversity policies within banks to encourage the inclusion of foreign directors on their boards could lead to efficiency enhancements. Furthermore, policymakers might explore the implementation of quotas or directives to bolster gender heterogeneity within board appointments, ultimately fostering improved bank efficiency and bolstering competitiveness within the region. Originality/value: This study breaks new ground by investigating how board nationality diversity affects efficiency of banking sector in the MENA countries. It stands out for examining the moderating role of women representation on boards, offering novel insights into how these factors interact.

Purpose: This study investigates the role of market concentration and efficiency in banking system stability during the COVID-19 pandemic. We empirically test the hypothesis that market concentration and efficiency are significant determinants of bank performance and stability during the time of crises, using a sample of 575 banks in 20 countries in the Middle East and North Africa (MENA). Design/methodology/approach: The main sources of bank data are the BankScope and BankFocus (Bureau van Dijk) databases, World Bank development indicators, and official websites of banks in MENA countries. This study combined descriptive and analytical approaches. We utilize a panel dataset and adopt panel data econometric techniques such as fixed/random effects and the Generalized Method of Moments (GMM) estimator. Findings: The results reveal that market concentration negatively affects bank profitability, whereas improved efficiency further enhances bank performance and contributes to the banking sector’s overall stability. Furthermore, our analysis indicates that during the COVID-19 pandemic, bank stability strongly depended on the level of market concentration, but not on bank efficiency. However, more efficient banks are more profitable and stable if the banking institutions are Islamic. Similarly, Islamic banks with the same level of efficiency demonstrated better overall financial performance during the pandemic than their conventional peers did. Research limitations/implications: The main limitation is related to the period of COVID-19 pandemic that was covered in this paper (2020–2021). Therefore, further investigation of the COVID-19 effects on bank profitability and risk will require an extended period of the pandemic crisis, including 2022. Practical implications: This study provides information that will enable bank managers and policymakers in MENA countries to assess the growing impact of market concentration and efficiency on the banking sector stability. It also helps them in formulating suitable strategies to mitigate the adverse consequences of the COVID-19 pandemic. Our recommendations are useful guides for policymakers and regulators in countries where Islamic and conventional banking systems co-exist and compete, based on different business models and risk management practices. Originality/value: The authors contribute to the banking stability literature by investigating the role of market concentration and efficiency as the main determinants of bank performance and stability during the COVID-19 pandemic. This study is the first to analyze banking sector stability in the MENA region, using both individual and risk-adjusted aggregated performance measures.

Purpose: This paper aims to examine how the diversity of educational levels within bank boards influences the efficiency and stability of banks operating in the Middle East and North Africa (MENA) region. Unlike previous studies, this analysis also investigates the role of board gender diversity in moderating the relationship between board educational level diversity and bank efficiency and financial stability in MENA. Design/methodology/approach: In this study, a sample of 77 banks in the MENA region spanning the years 2011 to 2018 is used. The relationship between the presence of highly educated directors on the board, bank efficiency and stability is assessed using the ordinary least squares method. Additionally, the authors use the Generalized Method of Moments technique to correct endogeneity problem. Findings: This study establishes a positive association between the presence of directors with advanced educational backgrounds on bank boards and bank efficiency and stability. Furthermore, the inclusion of women on the board strengthens this relationship. Practical implications: These findings have important implications for policymakers and regulators in the MENA region, suggesting that promoting diversity policies that encourage the participation of highly educated directors on bank boards can contribute to enhanced efficiency and financial stability. Policymakers may also consider implementing quotas or guidelines to improve gender diversity in board appointments, thereby fostering bank performance in the region. Originality/value: This study stands out for its innovation and distinctiveness, as it delves into the connection between board educational level diversity and bank efficiency in the MENA region. Notably, it surpasses previous research by investigating the moderating role of board gender diversity, thus offering valuable insights into the complex interplay between these two facets of board diversity. This contribution enriches the existing literature by providing novel perspectives on board composition dynamics and its influence on bank efficiency and stability.

This study aims to contribute to the existing literature that explores the impact of market concentration on bank efficiency in emerging economies. Using a sample of 225 banks in 18 countries in the Middle East and North Africa (MENA) region over the period 2006–2020, we empirically investigate the significance of this relationship. Since the evidence of concentration effect on efficiency during the COVID-19 outbreak is ambiguous, we test the hypothesis that the efficiency is positively affected by the level of banking market concentration in the MENA region. We adopt fixed effect model specifications and test the robustness of our results with the two-step Generalized Method of Moments (GMM) estimation technique. Our analysis finds a strong positive association between market concentration and bank efficiency. The analysis of different types of banking systems that co-existing in the MENA region (Islamic and conventional) indicates the market concentration effect is more pronounced when the banking institution is Islamic and during the COVID-19 outbreak. Moreover, the better economic performance of Islamic banks during the initial stage of pandemic further increases their efficiency. Our analysis indicated that the impact of market competitive conditions on bank efficiency varies significantly across banks with different ownership structures and is more pronounced for government-owned banks. The results are robust using different model specifications and alternative estimation techniques.

This study aims to evaluate the effect of efficiency and banking market structure on bank performance in the Middle East and North Africa (MENA) region. The relationship between efficiency and bank performance in the countries in the MENA region during the COVID-19 outbreak has not been examined. We use data for 225 banks in 18 MENA countries and find that bank performance strongly depends on the efficiency level and market power of banks. Furthermore, we investigate whether efficiency and market competition effects are significantly different between the two banking systems (Islamic and conventional). Our results indicate that efficiency and competition have a greater influence on the profitability level of conventional than Islamic banks. However, the efficiency impact is only marginally significant during the COVID-19 outbreak. Overall, our results suggest that managing a higher efficiency level leads to improved financial stability but, at the same time, increases the bank's appetite for taking higher risks. These findings deepen the existing notion that efficient banks are more resilient during global financial crises and emphasize the importance of bank regulatory reforms that boost efficiency in standing against the negative consequences of the recent (COVID-19) crisis.