WorldWideScience

Sample records for buck health sector

  1. Suriname: Health Sector Assessment

    OpenAIRE

    Rena Eichler

    1999-01-01

    This study assesses the health sector in Suriname, with the goal of assisting policy makers to develop a better understanding of problems and to propose a range of solutions. This study presents the analytical framework used to assess the health sector, reviews the major findings, and presents key recommendations. The focus is on the complex inter-relationships between the major actors in the health sector: policy leaders, consumers, providers, and payers. This market-oriented framework was c...

  2. Health: Sector Strategy (2004)

    OpenAIRE

    Inter-American Development Bank (IDB)

    2004-01-01

    The objective of this Health Strategy (GN-2321) is to help Latin American and the Caribbean countries improve the health of their populations, attaining national health objectives and tailoring Millennium Development Goals to conditions in each country. The priorities areas of Bank Actions include: 1) Supporting the establishment and scope of strategic national health objectives adapted to the conditions in each country that seek to satisfy the needs of the very poor and to promote inclusion ...

  3. Private Health Sector Assessment in Kenya

    OpenAIRE

    Barnes, Jeff; O'Hanlon, Barbara; Feeley, Frank III; McKeon, Kimberly; Gitonga, Nelson; Decker, Caytie

    2010-01-01

    Kenya private sector is one of the most developed and dynamic in Sub Saharan Africa. In this context, USAID/Kenya requested that the Private Sector Partnerships-One project (PSP One) conduct an assessment of the private health sector in Kenya. The scope of work involved assessing the role of the private sector in the overall health system, considering the potential of the private sector to...

  4. Egypt : Health Sector Reform and Financing Review

    OpenAIRE

    World Bank

    2004-01-01

    In 1997, the Ministry of Health and Population (MOHP) of the Government of Egypt (GOE) launched a comprehensive Health Sector Reform Program (HSRP) aiming to develop a national health system, based on social insurance that would address existing problems in equity, access, efficiency, quality and financial sustainability. The purpose of the Health Sector Reform and Financing Review is to p...

  5. Public health assessment for Revere Chemical Company, Nockamixon, Bucks County, Pennsylvania, Region 3. Cerclis No. PAD051395499. Final report

    Energy Technology Data Exchange (ETDEWEB)

    1994-01-06

    The Revere Chemical National Priorities List (NPL) site is located on the southeast side of Pennsylvania State Route 611, approximately three quarters of a mile south of the town of Revere in Nockamixon Township, Bucks County, Pennsylvania. Operations at the Revere Chemical site were initiated in 1963 and reportedly involved the recycling of spent chromic acid solutions, the recovery of copper from electric plating solution, and the reclamation of metals from printed circuit boards. The process area soils are contaminated with volatile organic compounds and metals. Soil contamination decreases markedly with distance from the process area. Trichloroethene (TCE) and 1,2,4-trichlorobenzene (TCB) were detected in on-site monitoring well MW-4 at concentrations of 110 micrograms per liter and 41 micrograms/liter, respectively. The Revere Chemical site currently represents an indeterminate public health hazard since groundwater flow direction has not been fully characterized and not all residential wells near the site have been sampled.

  6. Occupational health scenario of Indian informal sector.

    Science.gov (United States)

    Nag, Anjali; Vyas, Heer; Nag, Pranab

    2016-08-01

    Workers in the Indian informal sector are engaged with different occupations. These occupations involve varied work related hazards. These occupational hazards are a consequent risk to health. The study aimed to determine occupational health scenario in the Indian Informal sector. One thousand eleven hundred twenty two workers from five different occupations namely weaving (handloom and power loom), construction, transportation, tobacco processing and fish processing were assessed by interviewer administered health questionnaire. Workers suffered from musculo-skeletal complaints, respiratory health hazards, eye problems and skin related complaints. There was a high prevalence of self-reported occupational health problems in the selected sectors. The study finds that workers have occupational exposures to multiple hazards. The absence of protective guards aggrevate their health condition. The study attempts to draws an immediate attention on the existing health scenario of the Indian Informal sector.

  7. Implementing TQM in the health care sector.

    Science.gov (United States)

    Motwani, J; Sower, V E; Brashier, L W

    1996-01-01

    This article examines the issue of implementing TQM/CQI programs in the health care industry by grouping the prescriptive literature into four research streams. Based on the literature, a strategic programming model for implementing TQM/CQI in the health care industry is suggested. Finally, issues relating to TQM in the health care sector, which need to be addressed within each research stream in the future, are provided.

  8. Private Health Sector Assessment in Tanzania

    OpenAIRE

    White, James; O’Hanlon, Barbara; Chee, Grace; Malangalila, Emmanuel; Kimambo, Adeline; Coarasa, Jorge; Callahan, Sean; Levey, Ilana Ron; McKeon, Kim

    2013-01-01

    Tanzania exemplifies the developing world's struggle to achieve 'middle-income' country status while confronting widespread poverty and substantial health challenges-such as persistently high child and maternal mortality, human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), tuberculosis (TB), and malaria. In this context, Tanzania's National Public Private Partnership (PPP) policy and second Health Sector Strategic Plan (HSSP) included a call for a private health secto...

  9. Gender Issues in Health Sector

    OpenAIRE

    Prakash Prabhakarrao Doke

    2015-01-01

    Gender wise analysis of data brings out biological, behavioural and social variables which indicate inequality in the health parameters in male and female sex. There is discrimination against women. Right to birth is denied by sex selective elimination, right to survival is denied by the neglect of girl child resulting in declining trend of child sex ratio which has reached an alarming low level of 914 in 2011 in spite of the fact that the female sex is biologically st...

  10. Strengthening health systems by health sector reforms

    OpenAIRE

    Senkubuge, Flavia; Modisenyane, Moeketsi; Bishaw, Tewabech

    2014-01-01

    Background: The rising burden of disease and weak health systems are being compounded by the persistent economic downturn, re-emerging diseases, and violent conflicts. There is a growing recognition that the global health agenda needs to shift from an emphasis on disease-specific approaches to strengthening of health systems, including dealing with social, environmental, and economic determinants through multisectoral responses.Methods: A review and analysis of data on strengthening health se...

  11. Gender Issues in Health Sector

    Directory of Open Access Journals (Sweden)

    Prakash Prabhakarrao Doke

    2015-04-01

    Full Text Available Gender wise analysis of data brings out biological, behavioural and social variables which indicate inequality in the health parameters in male and female sex. There is discrimination against women. Right to birth is denied by sex selective elimination, right to survival is denied by the neglect of girl child resulting in declining trend of child sex ratio which has reached an alarming low level of 914 in 2011 in spite of the fact that the female sex is biologically stronger. The mortality and morbidity indicators are unfavourable to the females. Maternal mortality in developing countries including India is unacceptably high. There is a failure of achievement of Millennium Development Goals in relation to maternal mortality and gender equality and empowerment of women. Crime against women is increasing. Violence is domestic or at workplace or occurring in public places. Social factors like male dominance and subordinate status of women make them vulnerable to unfair treatment, discrimination, denial of basic human rights to survival, education, health, inheritance, etc. The preventive measures in the form of education of masses for effective change in behaviour against gender discrimination, provision of facilities for achieving gender equality, and legislative measures for controlling violence against women at domestic and public level need intensification to achieve social justice of gender equality.

  12. Abnormal economics in the health sector.

    Science.gov (United States)

    Hsaio, W C

    1995-01-01

    The implosion of centrally-planned economies has led to a widespread and uncritical belief that a free market is the best mechanism for structuring the economic and social sectors. Many international agencies have pushed this belief on the developing nations. This paper offers a critical analysis of the effectiveness of using free market principles to structure the health sector. We try to answer two questions: in what spheres can the market operate freely? In what spheres is government action required? According to economic theory, the market is only appropriate for producing and distributing private goods. This study analyzed health care and subdivides it into three categories (public, merit, and private goods) to clarify where the market has a legitimate role. Next, we analyze two of the five markets in the health sector--financing and delivery--and assess the respective roles of the market and government Competitive markets have certain prerequisites. We identify the major market failures by evaluating where these conditions are not satisfied. Next, we draw on international experience to ascertain the seriousness of those failures and the capacity of government action to correct them. Lessons are drawn for developing nations about the appropriateness of market strategies to finance and deliver health care. PMID:10156633

  13. [Health, hospitality sector and tobacco industry].

    Science.gov (United States)

    Abella Pons, Francesc; Córdoba Garcia, Rodrigo; Suárez Bonel, Maria Pilar

    2012-11-01

    To present the strategies used by the tobacco industry to meet government regulatory measures of its products. To demonstrate the relationship between tobacco industry and the hospitality sector. Note that the arguments and strategies used routinely by the hospitality industry have been previously provided by the tobacco industry. Location of key documents by meta-search, links to declassified documents, specific websites of the tobacco and hospitality industry, news sources and published articles in health journals. This review reveals the close relationship between tobacco industry and hospitality sector. It highlights the strategies carried out by the tobacco industry, including strategic hoarding of information, public relations, lobbying, consultation program, smoker defence groups, building partnerships, intimidation and patronage. The arguments and strategies used by the hospitality industry to match point by point that used by the tobacco industry. These arguments are refutable from the point of view of public health as it is scientifically proven that totally smoke-free environments are the only way to protect non-smokers from tobacco smoke exposure and its harmful effects on health.

  14. [Health, hospitality sector and tobacco industry].

    Science.gov (United States)

    Abella Pons, Francesc; Córdoba Garcia, Rodrigo; Suárez Bonel, Maria Pilar

    2012-11-01

    To present the strategies used by the tobacco industry to meet government regulatory measures of its products. To demonstrate the relationship between tobacco industry and the hospitality sector. Note that the arguments and strategies used routinely by the hospitality industry have been previously provided by the tobacco industry. Location of key documents by meta-search, links to declassified documents, specific websites of the tobacco and hospitality industry, news sources and published articles in health journals. This review reveals the close relationship between tobacco industry and hospitality sector. It highlights the strategies carried out by the tobacco industry, including strategic hoarding of information, public relations, lobbying, consultation program, smoker defence groups, building partnerships, intimidation and patronage. The arguments and strategies used by the hospitality industry to match point by point that used by the tobacco industry. These arguments are refutable from the point of view of public health as it is scientifically proven that totally smoke-free environments are the only way to protect non-smokers from tobacco smoke exposure and its harmful effects on health. PMID:22257526

  15. Health sector reform and public sector health worker motivation: a conceptual framework.

    Science.gov (United States)

    Franco, Lynne Miller; Bennett, Sara; Kanfer, Ruth

    2002-04-01

    Motivation in the work context can be defined as an individual's degree of willingness to exert and maintain an effort towards organizational goals. Health sector performance is critically dependent on worker motivation, with service quality, efficiency, and equity, all directly mediated by workers' willingness to apply themselves to their tasks. Resource availability and worker competence are essential but not sufficient to ensure desired worker performance. While financial incentives may be important determinants of worker motivation, they alone cannot and have not resolved all worker motivation problems. Worker motivation is a complex process and crosses many disciplinary boundaries, including economics, psychology, organizational development, human resource management, and sociology. This paper discusses the many layers of influences upon health worker motivation: the internal individual-level determinants, determinants that operate at organizational (work context) level, and determinants stemming from interactions with the broader societal culture. Worker motivation will be affected by health sector reforms which potentially affect organizational culture, reporting structures, human resource management, channels of accountability, types of interactions with clients and communities, etc. The conceptual model described in this paper clarifies ways in which worker motivation is influenced and how health sector reform can positively affect worker motivation. Among others, health sector policy makers can better facilitate goal congruence (between workers and the organizations they work for) and improved worker motivation by considering the following in their design and implementation of health sector reforms: addressing multiple channels for worker motivation, recognizing the importance of communication and leadership for reforms, identifying organizational and cultural values that might facilitate or impede implementation of reforms, and understanding that reforms

  16. [Cost effectiveness and health sector reform].

    Science.gov (United States)

    Musgrove, P

    1995-01-01

    The cost-effectiveness of a health intervention is an estimate of the relation between what it costs to be provided, and the improvement in health which results from such intervention. Health may improve because the incidence of illness or injury is reduced, because death is avoided or delayed, or because the duration or severity of disability is limited. The calculation of this health benefit combines objective factors, such as the age at incidence and whether or not the outcome is death, with subjective factors such as the severity of disability, the judgement as to the value of life lived at different ages, and the rate at which the future is discounted. The construction and interpretation of the estimate are explained. Also, the paper examines whether the concept of cost-effectiveness is consistent with ethical norms such as equity, and concludes that they are not in conflict. Finally, it addresses the question of how to incorporate cost-effectiveness into a health sector reform, and possible ways to implement it.

  17. The Health Sector in the Slovak Republic; Efficiency and Reform

    OpenAIRE

    Victoria Gunnarsson; Sergio Lugaresi; Marijn Verhoeven

    2007-01-01

    The paper assesses the financial situation of the health sector in the Slovak Republic. It also evaluates the efficiency of health expenditures and service delivery in comparison to the OECD and other new EU member states and suggests avenues for cost recovery and reform. The health sector of the Slovak Republic is plagued by financial problems. To turn around health system finances and achieve larger gains in health outcomes, the efficiency of health spending needs to increase and the mix an...

  18. Working in the health sector: implementation of workplace health promotion

    Directory of Open Access Journals (Sweden)

    Eliana Castro S

    2011-11-01

    Full Text Available Objective: to discuss issues that are relevant to the implementation of workplace health promotion (whp in organization processes of the health sector as a strategic tool to manage health and safety at the workplace. Methods: after a conceptual review of whp in 2009, a qualitative case study on the development of this strategy in third level hospitals of Bogotá was carried out. This descriptive and cross-sectional study was approved by the Ethics Committee of the Faculty of Nursing at the National University of Colombia. Results: although there are occupational health programs that convey the spirit of whp in their content, its level of development is not consistently linked to it. The following criteria were analyzed: strategy and commitment, human resources and organization, social responsibility, planning, and development and results, all of which were not well valued by workers. Final considerations: the traditional approach to occupational health and the poor integration of the WHP principles into organizational processes are reflected in the actions taken and the expectations regarding the subject. Therefore, actions should be taken in terms of public policies to strengthen the institutional capacity to ensure the feasibility of whp in the health sector.

  19. Has the Swap Influenced Aid Flows in the Health Sector?

    Science.gov (United States)

    Sweeney, Rohan; Mortimer, Duncan

    2016-05-01

    The sector wide approach (SWAp) emerged during the 1990s as a mechanism for managing aid from the multiplicity of development partners that operate in the recipient country's health, education or agricultural sectors. Health SWAps aim to give increased control to recipient governments, allowing greater domestic influence over how health aid is allocated and facilitating allocative efficiency gains. This paper assesses whether health SWAps have increased recipient control of health aid via increased general sector-support and have facilitated (re)allocations of health aid across disease areas. Using a uniquely compiled panel data set of countries receiving development assistance for health over the period 1990-2010, we employ fixed effects and dynamic panel models to assess the impact of introducing a health SWAp on levels of general sector-support for health and allocations of health-sector aid across key funding silos (including HIV, 'maternal and child health' and 'sector-support'). Our results suggest that health SWAps have influenced health-sector aid flows in a manner consistent with increased recipient control and improvements in allocative efficiency.

  20. Using climate information in the health sector

    Directory of Open Access Journals (Sweden)

    T. A. Ghebreyesus

    2010-09-01

    Full Text Available Many infectious and chronic diseases are either directly or indirectly sensitive to the climate. Managing this climate sensitivity more effectively requires new working relationships between the health sector and the providers of climate data and information. In Africa, where communities are particularly vulnerable, Ministries of Health and National Meteorological Services need to collaborate to reduce the burden of climate related ill health. The Ministry of Health and the National Meteorological Agency of Ethiopia have made significant progress towards the development of a climate-informed early warning and response system for diseases such as malaria and other climate-sensitive diseases. An important enabling mechanism is a Climate and Health Working Group, which is a multi-sectoral partnership created to spearhead the use of climate information for health interventions. While this is a work in progress, the key ingredients necessary to sustain such a joint venture are described to encourage similar activities in other countries faced with a growing climate-sensitive disease burden, to facilitate networking and to increase the return from the investment.De nombreuses infections et maladies chroniques sont sensibles, directement ou indirectement, au climat. Une gestion plus efficace de cette sensibilité au climat passe par l’instauration d’une coopération entre le secteur de la santé et les fournisseurs de données et d’informations sur le climat. En Afrique, où les communautés sont particulièrement vulnérables, le ministère de la Santé et les Services de météorologie nationale doivent collaborer pour réduire le fardeau des maladies liées au climat.Le ministère de la Santé et l’Agence de météorologie nationale d’Ethiopie ont fait des progrès considérables dans le développement d’un système d’alerte et de réponse précoces basé sur les informations climatiques pour des maladies comme le paludisme et d

  1. Tribute to Paul Buck

    Directory of Open Access Journals (Sweden)

    Constance Murray

    2008-12-01

    Full Text Available Paul Buck passed away on January 16, 2008. Respected and admired by his colleagues and friends, he left a legacy of lifelong commitment to ecology and botany. Paul was a founding member of the Board of Directors of the Oklahoma Native Plant Society in 1987, and, after serving on its board for several subsequent terms, he was the second recipient of the ONPS Service Award.

  2. Tribute to Paul Buck

    OpenAIRE

    Constance Murray

    2008-01-01

    Paul Buck passed away on January 16, 2008. Respected and admired by his colleagues and friends, he left a legacy of lifelong commitment to ecology and botany. Paul was a founding member of the Board of Directors of the Oklahoma Native Plant Society in 1987, and, after serving on its board for several subsequent terms, he was the second recipient of the ONPS Service Award.

  3. Market Orientation in the Public Health Sector of Mutare, Zimbabwe

    OpenAIRE

    Noah Ariel Mutongoreni; Nelson Jagero

    2014-01-01

    This study undertook an assessment of market orientation in the Public Health Sector of Mutare, Zimbabwe. This study focused on five health centers in Mutare which are Mutare General Hospital, Sakubva Hospital, Dangamvura Clinic, Chikanga clinic and Mutare Infectious Disease Hospital. A total of 50 questionnaires were sent out and 35 questionnaires were returned. This represented a total return of 70%.The principal finding of the research is that the Public Health Sector in Mutare, Zimbabwe e...

  4. Health Sector:Public Expenditure Review 2010/11

    OpenAIRE

    Kikuli, Regina; Ally, Mariam

    2012-01-01

    The main objective of Health Sector Public Expenditure Review for fiscal year (FY) 2011 (PER FY11) was to assess the budgetary allocations and expenditures to inform stakeholders about progress made in key health financing milestones over the 2006/07–2011/12 period. Specifically, the Health Sector PER sets out to provide: A review of PER FY10 findings and actions taken by the sector in response to those findings, indicating unaccomplished/pending actions, and identifying follow-up actions fo...

  5. Competition in the Dutch Health Care Sector

    OpenAIRE

    Schut, Erik

    1995-01-01

    textabstractFor more than two decades, Dutch health policy has been marked by a search for a suitable market order in health care. Suitable in the sense of maintaining universal access, containing the growth of health care expenditure and improving the technical and allocative efficiency of health care delivery. This search was spurred by the seemingly uncontrollable escalation of health care expenditure during the early 1970s. The solution initially put forward to control health care cost in...

  6. On The Anthropomorphization of Buck

    Institute of Scientific and Technical Information of China (English)

    杨凡

    2009-01-01

    As the protagonist in The Call of the Wild, the dog Buck is personified in a muiti-hyered way, at levels of mental activities, hu- man disposition and emotions, morality and even spirit. The anthropomotphization of Buck is aided by its unique narrative method. The novel is a powerful allegory for human nature and successfully appeals to readers.

  7. Competition in the Dutch Health Care Sector

    NARCIS (Netherlands)

    F.T. Schut (Erik)

    1995-01-01

    textabstractFor more than two decades, Dutch health policy has been marked by a search for a suitable market order in health care. Suitable in the sense of maintaining universal access, containing the growth of health care expenditure and improving the technical and allocative efficiency of health c

  8. COMMENTARY: GLOBALIZATION, HEALTH SECTOR REFORM, AND THE HUMAN RIGHT TO HEALTH: IMPLICATIONS FOR FUTURE HEALTH POLICY.

    Science.gov (United States)

    Schuftan, Claudio

    2015-01-01

    The author here distills his long-time personal experience with the deleterious effects of globalization on health and on the health sector reforms embarked on in many of the more than 50 countries where he has worked in the last 25 years. He highlights the role that the "human right to health" framework can and should play in countering globalization's negative effects on health and in shaping future health policy. This is a testimonial article.

  9. Ideologies in the Swedish health sector today

    DEFF Research Database (Denmark)

    Diderichsen, Finn

    1982-01-01

    , the state has proposed a new health reform emphasizing the responsibility of the public health service to prevent disease and provide equal access to care. It is claimed that improved health planning, based on epidemiological knowledge on inequalities, can solve the crisis in medicine within an improved...... system of primary care and prevention. However, in the context of the current economic crisis, the struggle against health hazards and cuts in public spending has intensified and the gap between the ideology of technological rationalism and reality has widened....

  10. How Does Retiree Health Insurance Influence Public Sector Employee Saving?

    OpenAIRE

    Clark, Robert L.; Mitchell, Olivia S.

    2013-01-01

    Economic theory predicts that employer-provided retiree health insurance benefits crowd-out household wealth accumulation. Nevertheless, there is little research on the impacts of retiree health insurance on wealth accruals, so this paper utilizes a unique data file on three baseline cohorts from the Health and Retirement Study to explore how employer-provided retiree health insurance may influence net household wealth among public sector employees, where retiree healthcare benefits are still...

  11. Organizing the health sector for response to disasters

    Directory of Open Access Journals (Sweden)

    Kimberley Shoaf

    2014-09-01

    Full Text Available Each year millions of people around the world are affected by natural and manmade disasters. The consequences of natural disasters in terms of health are complex. Disasters directly impact the health of the population resulting in physical trauma, acute disease, and emotional trauma. Furthermore, disasters may increase the morbidity and mortality associated with chronic and infectious diseases due to the impact on the health system. The health sector must be organized for adequate preparedness, mitigation, response and recuperation from a plethora of potential disasters. This paper examines the various potential impacts of disasters on health, the components of the health sector and their roles in emergency medical care and disaster situations, as well as the coordination and organization necessary within the system to best meet the health needs of a population in the aftermath of a disaster.

  12. Kosovo : Report on Management Accountability in the Health Sector

    OpenAIRE

    Gaumer, Gary

    2007-01-01

    This report assesses the opportunities for improving the performance of the government health sector in Kosovo through better management and improved information for managers. Specifically, it concerns the kinds of information used by managers in the health system, and indications of demand for additional data and performance measures. Overall, we try to assess the need for new investments...

  13. Exploring corruption in the South African health sector.

    Science.gov (United States)

    Rispel, Laetitia C; de Jager, Pieter; Fonn, Sharon

    2016-03-01

    Recent scholarly attention has focused on weak governance and the negative effects of corruption on the provision of health services. Employing agency theory, this article discusses corruption in the South African health sector. We used a combination of research methods and triangulated data from three sources: Auditor-General of South Africa reports for each province covering a 9-year period; 13 semi-structured interviews with health sector key informants and a content analysis of print media reports covering a 3-year period. Findings from the Auditor-General reports showed a worsening trend in audit outcomes with marked variation across the nine provinces. Key-informants indicated that corruption has a negative effect on patient care and the morale of healthcare workers. The majority of the print media reports on corruption concerned the public health sector (63%) and involved provincial health departments (45%). Characteristics and complexity of the public health sector may increase its vulnerability to corruption, but the private-public binary constitutes a false dichotomy as corruption often involves agents from both sectors. Notwithstanding the lack of global validated indicators to measure corruption, our findings suggest that corruption is a problem in the South African healthcare sector. Corruption is influenced by adverse agent selection, lack of mechanisms to detect corruption and a failure to sanction those involved in corrupt activities. We conclude that appropriate legislation is a necessary, but not sufficient intervention to reduce corruption. We propose that mechanisms to reduce corruption must include the political will to run corruption-free health services, effective government to enforce laws, appropriate systems, and citizen involvement and advocacy to hold public officials accountable. Importantly, the institutionalization of a functional bureaucracy and public servants with the right skills, competencies, ethics and value systems and whose

  14. Exploring corruption in the South African health sector.

    Science.gov (United States)

    Rispel, Laetitia C; de Jager, Pieter; Fonn, Sharon

    2016-03-01

    Recent scholarly attention has focused on weak governance and the negative effects of corruption on the provision of health services. Employing agency theory, this article discusses corruption in the South African health sector. We used a combination of research methods and triangulated data from three sources: Auditor-General of South Africa reports for each province covering a 9-year period; 13 semi-structured interviews with health sector key informants and a content analysis of print media reports covering a 3-year period. Findings from the Auditor-General reports showed a worsening trend in audit outcomes with marked variation across the nine provinces. Key-informants indicated that corruption has a negative effect on patient care and the morale of healthcare workers. The majority of the print media reports on corruption concerned the public health sector (63%) and involved provincial health departments (45%). Characteristics and complexity of the public health sector may increase its vulnerability to corruption, but the private-public binary constitutes a false dichotomy as corruption often involves agents from both sectors. Notwithstanding the lack of global validated indicators to measure corruption, our findings suggest that corruption is a problem in the South African healthcare sector. Corruption is influenced by adverse agent selection, lack of mechanisms to detect corruption and a failure to sanction those involved in corrupt activities. We conclude that appropriate legislation is a necessary, but not sufficient intervention to reduce corruption. We propose that mechanisms to reduce corruption must include the political will to run corruption-free health services, effective government to enforce laws, appropriate systems, and citizen involvement and advocacy to hold public officials accountable. Importantly, the institutionalization of a functional bureaucracy and public servants with the right skills, competencies, ethics and value systems and whose

  15. Strategic Planning in a Health Leadership Sector: A Report from UNESCO Chair in Health Education, Iran

    Directory of Open Access Journals (Sweden)

    K Bidad

    2009-12-01

    Full Text Available "nStrategic planning defines the formal decision of a company for its future. Like all organizations, health care sectors need to prepare their strategic planning and act according to it. UNESCO chair in health edu­cation as a leader health sector, describes the course and steps for preparing its strategic planning based on SWOT analysis technique. 

  16. Strategic Planning in a Health Leadership Sector: A Report from UNESCO Chair in Health Education, Iran

    OpenAIRE

    K Bidad; F Farzadi; Z. Pourpak; M. Moin

    2009-01-01

    "nStrategic planning defines the formal decision of a company for its future. Like all organizations, health care sectors need to prepare their strategic planning and act according to it. UNESCO chair in health edu­cation as a leader health sector, describes the course and steps for preparing its strategic planning based on SWOT analysis technique. 

  17. Health sector employment growth calls for improvements in labor productivity.

    Science.gov (United States)

    Hofmarcher, Maria M; Festl, Eva; Bishop-Tarver, Leslie

    2016-08-01

    While rising costs of healthcare have put increased fiscal pressure on public finance, job growth in the health sector has had a stabilizing force on overall employment levels - not least in times of economic crises. In 2014 EU-15 countries employed 21 million people in the health and social care sector. Between 2000 and 2014 the share of employed persons in this sector rose from 9.5% to 12.5% of the total labor force in EU-15 countries. Over time labor input growth has shifted towards residential care activities and social work while labor in human health activities including hospitals and ambulatory care still comprises the major share. About half of the human health labor force works in hospital. Variation of health and social care employment is large even in countries with generally comparable institutional structures. While standard measures of productivity in health and social care are not yet comparable across countries, we argue that labor productivity of a growing health work force needs more attention. The long-term stability of the health system will require care delivery models that better utilize a growing health work force in concert with smart investments in digital infrastructure to support this transition. In light of this, more research is needed to explain variations in health and social care labor endowments, to identify effective policy measures of labor productivity enhancement including enhanced efforts to develop comparable productivity indicators in these areas. PMID:27370916

  18. Performance of private sector health care: implications for universal health coverage.

    Science.gov (United States)

    Morgan, Rosemary; Ensor, Tim; Waters, Hugh

    2016-08-01

    Although the private sector is an important health-care provider in many low-income and middle-income countries, its role in progress towards universal health coverage varies. Studies of the performance of the private sector have focused on three main dimensions: quality, equity of access, and efficiency. The characteristics of patients, the structures of both the public and private sectors, and the regulation of the sector influence the types of health services delivered, and outcomes. Combined with characteristics of private providers-including their size, objectives, and technical competence-the interaction of these factors affects how the sector performs in different contexts. Changing the performance of the private sector will require interventions that target the sector as a whole, rather than individual providers alone. In particular, the performance of the private sector seems to be intrinsically linked to the structure and performance of the public sector, which suggests that deriving population benefit from the private health-care sector requires a regulatory response focused on the health-care sector as a whole. PMID:27358251

  19. Interdependence of the health and education sectors in meeting health human resource needs.

    Science.gov (United States)

    Duckett, Stephen

    2009-01-01

    The health sector is dynamic with change endemic. But role assignment in the workplace is varying little by little because of the rigidities associated with professional demarcations, the long training times for many health professions and the pace and ability of educational institutions to respond to changes in the health workforce. In their article, Tzountzouris and Gilbert identify a number of issues that could inform educational institutions' response to emerging health human resource needs. This commentary discusses limitations on our thinking, the intertwined relationships between the educational and health sectors and three critical steps to take in health sector human resource planning. PMID:19521150

  20. Adaptation to climate change in the Ontario public health sector

    Directory of Open Access Journals (Sweden)

    Paterson Jaclyn A

    2012-06-01

    Full Text Available Abstract Background Climate change is among the major challenges for health this century, and adaptation to manage adverse health outcomes will be unavoidable. The risks in Ontario – Canada’s most populous province – include increasing temperatures, more frequent and intense extreme weather events, and alterations to precipitation regimes. Socio-economic-demographic patterns could magnify the implications climate change has for Ontario, including the presence of rapidly growing vulnerable populations, exacerbation of warming trends by heat-islands in large urban areas, and connectedness to global transportation networks. This study examines climate change adaptation in the public health sector in Ontario using information from interviews with government officials. Methods Fifty-three semi-structured interviews were conducted, four with provincial and federal health officials and 49 with actors in public health and health relevant sectors at the municipal level. We identify adaptation efforts, barriers and opportunities for current and future intervention. Results Results indicate recognition that climate change will affect the health of Ontarians. Health officials are concerned about how a changing climate could exacerbate existing health issues or create new health burdens, specifically extreme heat (71%, severe weather (68% and poor air-quality (57%. Adaptation is currently taking the form of mainstreaming climate change into existing public health programs. While adaptive progress has relied on local leadership, federal support, political will, and inter-agency efforts, a lack of resources constrains the sustainability of long-term adaptation programs and the acquisition of data necessary to support effective policies. Conclusions This study provides a snapshot of climate change adaptation and needs in the public health sector in Ontario. Public health departments will need to capitalize on opportunities to integrate climate change into

  1. How to improve collaboration between the public health sector and other policy sectors to reduce health inequalities? – A study in sixteen municipalities in the Netherlands

    OpenAIRE

    Storm, Ilse; den Hertog, Frank; van Oers, Hans; Schuit, Albertine J

    2016-01-01

    Background The causes of health inequalities are complex. For the reduction of health inequalities, intersectoral collaboration between the public health sector and both social policy sectors (e.g. youth affairs, education) and physical policy sectors (e.g. housing, spatial planning) is essential, but in local practice difficult to realize. The aim of this study was to examine the collaboration between the sectors in question more closely and to identify opportunities for improvement. Method ...

  2. Promoting Occupational Safety and Health for Cambodian Entertainment Sector Workers.

    Science.gov (United States)

    Hsu, Lee-Nah; Howard, Richard; Torriente, Anna Maria; Por, Chuong

    2016-08-01

    Cambodia has developed booming textile, garment, tourism, and entertainment service industries since the mid-1990s. The 2007 global financial crisis pushed many garment workers, who lost their jobs, into the entertainment sector. Entertainment workers are typically engaged informally by their employers and are subjected to long working hours, sexual harassment, and violence. Many who sell beverages are forced into excessive alcohol consumption as part of their work. Many are also expected by their employers and clients to provide sexual services. To address unsafe and unhealthy working conditions for these workers, an innovative occupational safety and health regulation was adopted in 2014. This first-of-its-kind occupational safety and health regulation was developed jointly by the Cambodian Ministry of Labour and Vocational Training and employers' and workers' organizations in the entertainment sector. The implementation of this regulation can also be a viable contribution of occupational safety and health to HIV interventions for these workers. PMID:27242184

  3. Guidelines for Analysis of Health Sector Financing in Developing Countries. Volume 8: Health Sector Financing in Developing Countries. International Health Planning Methods Series.

    Science.gov (United States)

    Robertson, Robert L.; And Others

    Intended to assist Agency for International Development officers, advisors, and health officials in incorporating health planning into national plans for economic development, this eighth of ten manuals in the International Health Planning Methods series provides a methodology for conducting a study of health sector financing. It presents an…

  4. Climate change and eHealth: a promising strategy for health sector mitigation and adaptation

    OpenAIRE

    Holmner, Åsa; Ng, Nawi; Nilsson, Maria; Rocklöv, Joacim

    2012-01-01

    Climate change is one of today’s most pressing global issues. Policies to guide mitigation and adaptation are needed to avoid the devastating impacts of climate change. The health sector is a significant contributor to greenhouse gas emissions in developed countries, and its climate impact in low-income countries is growing steadily. This paper reviews and discusses the literature regarding health sector mitigation potential, known and hypothetical co-benefits, and the potential of health inf...

  5. Health sector reform in Brazil: a case study of inequity.

    Science.gov (United States)

    Almeida, C; Travassos, C; Porto, S; Labra, M E

    2000-01-01

    Health sector reform in Brazil built the Unified Health System according to a dense body of administrative instruments for organizing decentralized service networks and institutionalizing a complex decision-making arena. This article focuses on the equity in health care services. Equity is defined as a principle governing distributive functions designed to reduce or offset socially unjust inequalities, and it is applied to evaluate the distribution of financial resources and the use of health services. Even though in the Constitution the term "equity" refers to equal opportunity of access for equal needs, the implemented policies have not guaranteed these rights. Underfunding, fiscal stress, and lack of priorities for the sector have contributed to a progressive deterioration of health care services, with continuing regressive tax collection and unequal distribution of financial resources among regions. The data suggest that despite regulatory measures to increase efficiency and reduce inequalities, delivery of health care services remains extremely unequal across the country. People in lower income groups experience more difficulties in getting access to health services. Utilization rates vary greatly by type of service among income groups, positions in the labor market, and levels of education.

  6. Co-operative bidding of SMEs in health care sector.

    Science.gov (United States)

    Mezgár, István; Kovács, György; Bonfatti, Fabio

    2002-01-01

    Tendering become an important process for customers in the health care sector to select products and services from the market for the lowest price, with the highest quality and with the shortest delivery time. The number of SMEs (Small and Medium-sized Enterprises) delivering products or services for the health care sector is increasing, but they have usually limited capital and expertise to participate in tenders. The paper introduces a possible solution for this problem, when SMEs form special groups, so called Smart Bidding Organisations (SBO), to prepare a bid for the tender jointly. The SBO appears for the customer (tender issuer) as a single enterprise and the bidding procedure will be faster and less expensive in this way. PMID:15460809

  7. Financial health of agricultural enterprises in the organic sector

    OpenAIRE

    Brozova, Ivana

    2011-01-01

    The present research was aimed at evaluating the economic performance of organic farm enterprises (legal entities) in the Czech Republic on the basis of their production base and financial health. The evaluation was carried out by means of specific financial indicators. The results recorded in the organic farming sector were confronted with those of the conventional agriculture. It stemmed from the analysis that conventionally farming legal entities, as opposed to the organically farming ones...

  8. Patient Satisfaction Before and After Executing Health Sector Evolution Plan

    OpenAIRE

    Behrouz Hashemi; Alireza Baratloo; Mohammad Mehdi Forouzafar; Maryam Motamedi; Mohammadreza Tarkhorani

    2015-01-01

    Introduction: After long discussions, carrying out health sector evolution (HSE) plan began on May 5, 2014 throughout Iran. Shohadaye Tajrish Hospital, Tehran, was also included in this plan. This study aimed to evaluate the level of emergency department patient satisfaction, before and after running this plan. Methods: This cross-sectional study analyzed the data extracted from a standard questionnaire filled out by the patients presented to the emergency department of Shohadaye Tajrish Hosp...

  9. New patterns in health sector aid to India.

    Science.gov (United States)

    Jeffery, R

    1986-01-01

    Criticisms of health aid have largely been derived from African and Latin American experiences. It is suggested that such analyses, while valuable, cannot be applied wholesale to India without detailed examination of the patterns of health sector aid which have actually characterized the period since 1947. This article brings together material on the scale and form that this assistance has taken, and demonstrates that its focus has been preventive in emphasis and oriented towards the primary care sector. In some periods it has contributed a substantial share of total public sector expenditures, and in some spheres, it has played a major role, particularly the control of communicable diseases. However, the impact of less substantial sums going to prestige medical colleges or to population control programs should not be ignored; and several of the aid categories have been of dubious origin (PL-480 counterpart funds and U.S. food surpluses as the prime examples). However, the "new" health aid programs do not deserve the ready dismissal they have received in some quarters. PMID:3957509

  10. [Role of the health sector in climate change].

    Science.gov (United States)

    Roda, Tania Burstein

    2016-03-01

    This article compiles the conclusions and results of several studies conducted by global and intergovernmental organizations involved in the research and promotion of policies and strategies for a successful and efficient management of the negative effects of climate change in public health. It is also a call for awareness the health community regarding their protagonist and strategic role to be assumed in relation to this global phenomenon which requires the coordinated cross-sectoral and inter-institution collaboration to achieve true social and environmental resilience. PMID:27384633

  11. Data Hemorrhages in the Health-Care Sector

    Science.gov (United States)

    Johnson, M. Eric

    Confidential data hemorrhaging from health-care providers pose financial risks to firms and medical risks to patients. We examine the consequences of data hemorrhages including privacy violations, medical fraud, financial identity theft, and medical identity theft. We also examine the types and sources of data hemorrhages, focusing on inadvertent disclosures. Through an analysis of leaked files, we examine data hemorrhages stemming from inadvertent disclosures on internet-based file sharing networks. We characterize the security risk for a group of health-care organizations using a direct analysis of leaked files. These files contained highly sensitive medical and personal information that could be maliciously exploited by criminals seeking to commit medical and financial identity theft. We also present evidence of the threat by examining user-issued searches. Our analysis demonstrates both the substantial threat and vulnerability for the health-care sector and the unique complexity exhibited by the US health-care system.

  12. Beyond trade: taking globalization to the health sector.

    Science.gov (United States)

    Daulaire, Nils

    2003-01-01

    The pace of globalization has brought the world to the brink of a new era in international relations. While the world has outgrown traditional mechanisms for addressing global issues, it has not yet developed new forms of effective governance. This temporary void poses threats and enormous opportunities. The public health sector will play a crucial "formal" role--that is, carried out by existing bodies such as WHO and the UN. But WHO does not necessarily represent the full spectrum of views and its members necessarily work, to some degree, for separate national interests. The formal dimension must be supplemented. Globalization is not synonymous with lack of regulation. Many responsible businesses would welcome a transparent and universally applied regulatory regime to prevent a race to the lowest standards. The economic benefits of globalization may hit a glass ceiling if societies outside the global economy become progressively poorer and less healthy. The business community is recognizing that good health is essential for economic growth and social stability. Globalization may cause millions to migrate for economic opportunity. The private sector's forward-thinkers recognize the health threats of migration and are beginning to view global health promotion as a means to ensure optimal market access.

  13. Club Goods in the Health and Wellness Sector

    Directory of Open Access Journals (Sweden)

    Roger Lee Mendoza

    2012-04-01

    Full Text Available This study applies club theory to privately-provided and publicly-funded services within the health and wellness sector. Specifically, it examines the theoretical and practical premises and dilemmas of club provision, production, distribution and regulation using illustrations derived from cross-cultural settings. Because health and wellness contain public or merit good aspects and the quality of services in this sector is difficult to systematically evaluate even from a regulatory standpoint, tensions inevitably and constantly arise between efficiency and equity objectives. These tensions often have broader and longer-term policy implications, for excludability is both the cardinal virtue and vice of health and wellness clubs offering vital social resources rather than durable or non-durable goods and their complimentary goods. Although many of the club issues we explore in health care present opportunities for public policy intervention, the study sounds a cautious note. It proposes a set of efficiency and accountability criteria to establish, or at least gauge, the necessity, extent and consequences of such intervention. To the famous idiom, “if it ain’t broke, don’t fix it,” we therefore hasten to add “and, if it’s broke, think more than twice before you even try to fix it.”

  14. Health sector responses to intiate partner violence: A literature review

    Directory of Open Access Journals (Sweden)

    Kate Rees

    2014-01-01

    Full Text Available Background: Intimate partner violence (IPV is a common and serious public health concern, particularly in South Africa, but it is not well managed in primary care.Aim: This review aims to summarise the current state of knowledge regarding health sector-based interventions for IPV, their integration into health systems and services and the perspectives of service users and healthcare workers on IPV care, focusing on the South African context.Method: PubMed, CINAHL, PsycINFO and Google Scholar were searched betweenJanuary 2012 and May 2014. All types of study design were included, critically appraised and summarised.Results: Exposure to IPV leads to wide-ranging and serious health effects. There is suffiient evidence that intervening in IPV in primary care can improve outcomes. Women who have experienced IPV have described an appropriate response by healthcare providers to be non-judgmental, understanding and empathetic. IPV interventions that are complex, comprehensive and utilise systems-wide approaches have been most effective, but system- andsociety-level barriers hamper implementation. Gender inequities should not be overlooked when responding to IPV.Conclusion: Further evaluations of health sector responses to IPV are needed, in order to assist health services to determine the most appropriate models of care, how these can be integrated into current systems and how they can be supported in managing IPV. The need for this research should not prevent health services and healthcare providers from implementing IPV care, but rather should guide the development of rigorous contextually-appropriate evaluations.

  15. Buck-Buck- Boost Regulatr (B3R)

    Science.gov (United States)

    Mourra, Olivier; Fernandez, Arturo; Landstroem, Sven; Tonicello, Ferdinando

    2011-10-01

    In a satellite, the main function of a Power Conditioning Unit (PCU) is to manage the energy coming from several power sources (usually solar arrays and battery) and to deliver it continuously to the users in an appropriate form during the overall mission. The objective of this paper is to present an electronic switching DC-DC converter called Buck-Buck-Boost Regulator (B3R) that could be used as a modular and recurrent solution in a PCU for regulated or un- regulated 28Vsatellite power bus classes. The power conversion stages of the B3R topology are first described. Then theoretical equations and practical tests illustrate how the converter operates in term of power conversion, control loops performances and efficiency. The paper finally provides some examples of single point failure tolerant implementation using the B3R.

  16. Pesticide Vendors in the Informal Sector: Trading Health for Income.

    Science.gov (United States)

    Rother, Hanna-Andrea

    2016-08-01

    South African low-income communities face many challenges (e.g., insufficient housing, poor service delivery, and abject poverty); additionally, a silent challenge of pest infestation plagues these areas resulting in disease risks, nuisances, and stigma. Consequently, an enterprising urban informal sector business has emerged providing residents with highly toxic, effective, cheap, and illegal "street pesticides." These pesticides pose acute and chronic health risks for vendors and residents. The economic opportunity provided by the high demand for effective and cheap pest control results in the high risk of health effects being traded for income. Current measures to control and "regulate" the massive street pesticide sales result in toxic stockpiles and government's "turning a blind eye." Solutions will only be achieved through open dialog identifying and developing non-toxic pest control strategies while ensuring vendors' income; and relevant stakeholder recognition that pest infestation is a social and environmental health determinant needing acknowledgement in different government policies. PMID:27235997

  17. The problem of wastes in the health sector

    International Nuclear Information System (INIS)

    The article presents the management of hospital wastes in Lebanon. Hospital wastes considered as solid wastes, are divided into three main categories: radioactive wastes, contaminated wastes and chemical wastes. The treatment of wastes in the health sector in Lebanon is reduced to the incinerators. This method causes the major air pollution by emitting toxic substances as Dioxin. Advantages and disadvantages of alternate methods of wastes treatment are discussed such as: steam sterilization, bio-conversion, coal-burning, electronic radiation sterilization and chemical sterilization

  18. Just How Big is the Schism Between the Health Sector and the Water and Sanitation Sector in Developing Countries?

    Directory of Open Access Journals (Sweden)

    A. A. Cronin

    2008-01-01

    Full Text Available Water, sanitation and hygiene are all key aspects to a healthy environment but often they suffer from a lack of coherence within the sector itself and also a lack of synergy with the health sector. This is not acceptable given one quarter of all child deaths are directly attributable to water-borne disease. This lack of synergy is evident at many different layers including planning, resource allocation and donor commitment. Developing countries must, in consultation with their communities, examine their biggest health risks and allocate resources accordingly. Sustained dialogue and increased in-depth analysis are needed to find consensus and an improved synergy across these vital sectors.

  19. Climate change and eHealth: a promising strategy for health sector mitigation and adaptation

    Directory of Open Access Journals (Sweden)

    Åsa Holmner

    2012-06-01

    Full Text Available Climate change is one of today's most pressing global issues. Policies to guide mitigation and adaptation are needed to avoid the devastating impacts of climate change. The health sector is a significant contributor to greenhouse gas emissions in developed countries, and its climate impact in low-income countries is growing steadily. This paper reviews and discusses the literature regarding health sector mitigation potential, known and hypothetical co-benefits, and the potential of health information technology, such as eHealth, in climate change mitigation and adaptation. The promising role of eHealth as an adaptation strategy to reduce societal vulnerability to climate change, and the link's between mitigation and adaptation, are also discussed. The topic of environmental eHealth has gained little attention to date, despite its potential to contribute to more sustainable and green health care. A growing number of local and global initiatives on ‘green information and communication technology (ICT’ are now mentioning eHealth as a promising technology with the potential to reduce emission rates from ICT use. However, the embracing of eHealth is slow because of limitations in technological infrastructure, capacity and political will. Further research on potential emissions reductions and co-benefits with green ICT, in terms of health outcomes and economic effectiveness, would be valuable to guide development and implementation of eHealth in health sector mitigation and adaptation policies.

  20. Health sector reforms for 21(st) century healthcare.

    Science.gov (United States)

    Shankar, Darshan

    2015-01-01

    The form of the public health system in India is a three tiered pyramid-like structure consisting primary, secondary, and tertiary healthcare services. The content of India's health system is mono-cultural and based on western bio-medicine. Authors discuss need for health sector reforms in the wake of the fact that despite huge investment, the public health system is not delivering. Today, 70% of the population pays out of pocket for even primary healthcare. Innovation is the need of the hour. The Indian government has recognized eight systems of healthcare viz., Allopathy, Ayurveda, Siddha, Swa-rigpa, Unani, Naturopathy, Homeopathy, and Yoga. Allopathy receives 97% of the national health budget, and 3% is divided amongst the remaining seven systems. At present, skewed funding and poor integration denies the public of advantage of synergy and innovations arising out of the richness of India's Medical Heritage. Health seeking behavior studies reveal that 40-70% of the population exercise pluralistic choices and seek health services for different needs, from different systems. For emergency and surgery, Allopathy is the first choice but for chronic and common ailments and for prevention and wellness help from the other seven systems is sought. Integrative healthcare appears to be the future framework for healthcare in the 21(st) century. A long-term strategy involving radical changes in medical education, research, clinical practice, public health and the legal and regulatory framework is needed, to innovate India's public health system and make it both integrative and participatory. India can be a world leader in the new emerging field of "integrative healthcare" because we have over the last century or so assimilated and achieved a reasonable degree of competence in bio-medical and life sciences and we possess an incredibly rich and varied medical heritage of our own. PMID:25878456

  1. Health sector reforms for 21 st century healthcare

    Directory of Open Access Journals (Sweden)

    Darshan Shankar

    2015-01-01

    Full Text Available The form of the public health system in India is a three tiered pyramid-like structure consisting primary, secondary, and tertiary healthcare services. The content of India′s health system is mono-cultural and based on western bio-medicine. Authors discuss need for health sector reforms in the wake of the fact that despite huge investment, the public health system is not delivering. Today, 70% of the population pays out of pocket for even primary healthcare. Innovation is the need of the hour. The Indian government has recognized eight systems of healthcare viz., Allopathy, Ayurveda, Siddha, Swa-rigpa, Unani, Naturopathy, Homeopathy, and Yoga. Allopathy receives 97% of the national health budget, and 3% is divided amongst the remaining seven systems. At present, skewed funding and poor integration denies the public of advantage of synergy and innovations arising out of the richness of India′s Medical Heritage. Health seeking behavior studies reveal that 40-70% of the population exercise pluralistic choices and seek health services for different needs, from different systems. For emergency and surgery, Allopathy is the first choice but for chronic and common ailments and for prevention and wellness help from the other seven systems is sought. Integrative healthcare appears to be the future framework for healthcare in the 21 st century. A long-term strategy involving radical changes in medical education, research, clinical practice, public health and the legal and regulatory framework is needed, to innovate India′s public health system and make it both integrative and participatory. India can be a world leader in the new emerging field of "integrative healthcare" because we have over the last century or so assimilated and achieved a reasonable degree of competence in bio-medical and life sciences and we possess an incredibly rich and varied medical heritage of our own.

  2. Interventions to reduce corruption in the health sector

    Science.gov (United States)

    Gaitonde, Rakhal; Oxman, Andrew D; Okebukola, Peter O; Rada, Gabriel

    2016-01-01

    Background Corruption is the abuse or complicity in abuse, of public or private position, power or authority to benefit oneself, a group, an organisation or others close to oneself; where the benefits may be financial, material or non-material. It is wide-spread in the health sector and represents a major problem. Objectives Our primary objective was to systematically summarise empirical evidence of the effects of strategies to reduce corruption in the health sector. Our secondary objective was to describe the range of strategies that have been tried and to guide future evaluations of promising strategies for which there is insufficient evidence. Search methods We searched 14 electronic databases up to January 2014, including: CENTRAL; MEDLINE; EMBASE; sociological, economic, political and other health databases; Human Resources Abstracts up to November 2010; Euroethics up to August 2015; and PubMed alerts from January 2014 to June 2016. We searched another 23 websites and online databases for grey literature up to August 2015, including the World Bank, the International Monetary Fund, the U4 Anti-Corruption Resource Centre, Transparency International, healthcare anti-fraud association websites and trial registries. We conducted citation searches in Science Citation Index and Google Scholar, and searched PubMed for related articles up to August 2015. We contacted corruption researchers in December 2015, and screened reference lists of articles up to May 2016. Selection criteria For the primary analysis, we included randomised trials, non-randomised trials, interrupted time series studies and controlled before-after studies that evaluated the effects of an intervention to reduce corruption in the health sector. For the secondary analysis, we included case studies that clearly described an intervention to reduce corruption in the health sector, addressed either our primary or secondary objective, and stated the methods that the study authors used to collect and

  3. Health Information Management System for Elderly Health Sector: A Qualitative Study in Iran

    Science.gov (United States)

    Sadoughi, Farahnaz; Shahi, Mehraban; Ahmadi, Maryam; Davaridolatabadi, Nasrin

    2016-01-01

    Background: There are increasing change and development of information in healthcare systems. Given the increase in aging population, managers are in need of true and timely information when making decision. Objectives: The aim of this study was to investigate the current status of the health information management system for the elderly health sector in Iran. Materials and Methods: This qualitative study was conducted in two steps. In the first step, required documents for administrative managers were collected using the data gathering form and observed and reviewed by the researcher. In the second step, using an interview guide, the required information was gathered through interviewing experts and faculty members. The convenience, purposeful and snowball sampling methods were applied to select interviewees and the sampling continued until reaching the data saturation point. Finally, notes and interviews were transcribed and content analysis was used to analyze them. Results: The results of the study showed that there was a health information management system for the elderly health sector in Iran. However, in all primary health care centers the documentation of data was done manually; the data flow was not automated; and the analysis and reporting of data are also manually. Eventually, decision makers are provided with delayed information. Conclusions: It is suggested that the steward of health in Iran, the ministry of health, develops an appropriate infrastructure and finally puts a high priority on the implementation of the health information management system for elderly health sector in Iran. PMID:27186383

  4. Facilitating health and education sector collaboration in support of comprehensive school health.

    Science.gov (United States)

    2010-01-01

    Comprehensive school health (CSH) is embraced internationally as the most effective way of promoting the health of students and the school community. It is a framework for supporting improvements in students' educational outcomes while addressing their well-being in a planned, holistic way. While many successful CSH initiatives are brought about by passionate individuals at the grassroots level, these initiatives benefit greatly from effective cross-sector collaborations within and among governments to coordinate policy and funding from the health and education sectors. Governments represent just one group of professionals within the myriad of players involved in implementing CSH in Canada. To be effective contributors to the model, all levels of government need to work together to reduce duplication while at the same time minimizing gaps in the policies and practices that support school health promotion. Collaboration between the health and education sectors within and across governmental boundaries is proving to be an effective mechanism for achieving this. In its first five-year mandate, the Pan Canadian Joint Consortium for School Health has broken new ground in horizontal integration and, as a result, has identified a set of key factors necessary for successful cross-sector collaboration.

  5. The Role of Branding in the Health Sector

    Directory of Open Access Journals (Sweden)

    Shahriar Shafiee

    2010-05-01

    Full Text Available A services brand is essentially a promise about the nature of a future experience with an organization or individual service provider. A strong services brand is built and sustained primarily by customers' interactions with the provider. From the inter relationships among the presented brand, external communications, and customers' experiences emerge brand awareness, meaning, and, ultimately, equity. Customers' experience-based perceptions prevail if external information and personal experience are conflicting. Great services brands are built on excellent customer experiences. Building a strong identity in the health care category comes with a unique set of branding challenges. Consider that a successful branding strategy must address how to:"n•Re-shape the consumers' perceptions of the health care organization by signaling a new future-focused strategy"n•Consolidate and coordinate existing identities"n•Preserve the equity residing with keystone health care identities and lever those equities to build trust and equity in the new identity"n•Incorporate the values of the organization to reinforce "living the brand""nBrand building in health services insures the patients (clients with the quality of treatment they receive via creating, extending, and protecting value under the name of powerful brands. This cannot be achieved without an unwavering commitment to the customers' well-being. Today's health care environment requires a branding process that goes beyond the traditional, corporate identity process. It is a process that focuses on building brand equity with health care consumers. Managers in the healthcare sector may benefit from branding through:"n•Enrichment of organizational values"n•Manifesting the brand core values in each and every effective contact point"n•Amplifying patients' word-of-mouth (turning customers into marketers

  6. Health Sector Evolution Plan in Iran; Equity and Sustainability Concerns.

    Science.gov (United States)

    Moradi-Lakeh, Maziar; Vosoogh-Moghaddam, Abbas

    2015-10-01

    In 2014, a series of reforms, called as the Health Sector Evolution Plan (HSEP), was launched in the health system of Iran in a stepwise process. HSEP was mainly based on the fifth 5-year health development national strategies (2011-2016). It included different interventions to: increase population coverage of basic health insurance, increase quality of care in the Ministry of Health and Medical Education (MoHME) affiliated hospitals, reduce out-of-pocket (OOP) payments for inpatient services, increase quality of primary healthcare, launch updated relative value units (RVUs) of clinical services, and update tariffs to more realistic values. The reforms resulted in extensive social reaction and different professional feedback. The official monitoring program shows general public satisfaction. However, there are some concerns for sustainability of the programs and equity of financing. Securing financial sources and fairness of the financial contribution to the new programs are the main concerns of policy-makers. Healthcare providers' concerns (as powerful and influential stakeholders) potentially threat the sustainability and efficiency of HSEP. Previous experiences on extending health insurance coverage show that they can lead to a regressive healthcare financing and threat financial equity. To secure financial sources and to increase fairness, the contributions of people to new interventions should be progressive by their income and wealth. A specific progressive tax would be the best source, however, since it is not immediately feasible, a stepwise increase in the progressivity of financing must be followed. Technical concerns of healthcare providers (such as nonplausible RVUs for specific procedures or nonefficient insurance-provider processes) should be addressed through proper revision(s) while nontechnical concerns (which are derived from conflicting interests) must be responded through clarification and providing transparent information. The requirements of

  7. Health Sector Evolution Plan in Iran; Equity and Sustainability Concerns

    Directory of Open Access Journals (Sweden)

    Maziar Moradi-Lakeh

    2015-10-01

    Full Text Available In 2014, a series of reforms, called as the Health Sector Evolution Plan (HSEP, was launched in the health system of Iran in a stepwise process. HSEP was mainly based on the fifth 5-year health development national strategies (2011-2016. It included different interventions to: increase population coverage of basic health insurance, increase quality of care in the Ministry of Health and Medical Education (MoHME affiliated hospitals, reduce out-of-pocket (OOP payments for inpatient services, increase quality of primary healthcare, launch updated relative value units (RVUs of clinical services, and update tariffs to more realistic values. The reforms resulted in extensive social reaction and different professional feedback. The official monitoring program shows general public satisfaction. However, there are some concerns for sustainability of the programs and equity of financing. Securing financial sources and fairness of the financial contribution to the new programs are the main concerns of policy-makers. Healthcare providers’ concerns (as powerful and influential stakeholders potentially threat the sustainability and efficiency of HSEP. Previous experiences on extending health insurance coverage show that they can lead to a regressive healthcare financing and threat financial equity. To secure financial sources and to increase fairness, the contributions of people to new interventions should be progressive by their income and wealth. A specific progressive tax would be the best source, however, since it is not immediately feasible, a stepwise increase in the progressivity of financing must be followed. Technical concerns of healthcare providers (such as nonplausible RVUs for specific procedures or nonefficient insurance-provider processes should be addressed through proper revision(s while nontechnical concerns (which are derived from conflicting interests must be responded through clarification and providing transparent information. The

  8. Health Sector Evolution Plan in Iran; Equity and Sustainability Concerns.

    Science.gov (United States)

    Moradi-Lakeh, Maziar; Vosoogh-Moghaddam, Abbas

    2015-08-31

    In 2014, a series of reforms, called as the Health Sector Evolution Plan (HSEP), was launched in the health system of Iran in a stepwise process. HSEP was mainly based on the fifth 5-year health development national strategies (2011-2016). It included different interventions to: increase population coverage of basic health insurance, increase quality of care in the Ministry of Health and Medical Education (MoHME) affiliated hospitals, reduce out-of-pocket (OOP) payments for inpatient services, increase quality of primary healthcare, launch updated relative value units (RVUs) of clinical services, and update tariffs to more realistic values. The reforms resulted in extensive social reaction and different professional feedback. The official monitoring program shows general public satisfaction. However, there are some concerns for sustainability of the programs and equity of financing. Securing financial sources and fairness of the financial contribution to the new programs are the main concerns of policy-makers. Healthcare providers' concerns (as powerful and influential stakeholders) potentially threat the sustainability and efficiency of HSEP. Previous experiences on extending health insurance coverage show that they can lead to a regressive healthcare financing and threat financial equity. To secure financial sources and to increase fairness, the contributions of people to new interventions should be progressive by their income and wealth. A specific progressive tax would be the best source, however, since it is not immediately feasible, a stepwise increase in the progressivity of financing must be followed. Technical concerns of healthcare providers (such as nonplausible RVUs for specific procedures or nonefficient insurance-provider processes) should be addressed through proper revision(s) while nontechnical concerns (which are derived from conflicting interests) must be responded through clarification and providing transparent information. The requirements of

  9. Interventions to reduce corruption in the health sector

    Science.gov (United States)

    Gaitonde, Rakhal; Oxman, Andrew D; Okebukola, Peter O; Rada, Gabriel

    2016-01-01

    Background Corruption is the abuse or complicity in abuse, of public or private position, power or authority to benefit oneself, a group, an organisation or others close to oneself; where the benefits may be financial, material or non-material. It is wide-spread in the health sector and represents a major problem. Objectives Our primary objective was to systematically summarise empirical evidence of the effects of strategies to reduce corruption in the health sector. Our secondary objective was to describe the range of strategies that have been tried and to guide future evaluations of promising strategies for which there is insufficient evidence. Search methods We searched 14 electronic databases up to January 2014, including: CENTRAL; MEDLINE; EMBASE; sociological, economic, political and other health databases; Human Resources Abstracts up to November 2010; Euroethics up to August 2015; and PubMed alerts from January 2014 to June 2016. We searched another 23 websites and online databases for grey literature up to August 2015, including the World Bank, the International Monetary Fund, the U4 Anti-Corruption Resource Centre, Transparency International, healthcare anti-fraud association websites and trial registries. We conducted citation searches in Science Citation Index and Google Scholar, and searched PubMed for related articles up to August 2015. We contacted corruption researchers in December 2015, and screened reference lists of articles up to May 2016. Selection criteria For the primary analysis, we included randomised trials, non-randomised trials, interrupted time series studies and controlled before-after studies that evaluated the effects of an intervention to reduce corruption in the health sector. For the secondary analysis, we included case studies that clearly described an intervention to reduce corruption in the health sector, addressed either our primary or secondary objective, and stated the methods that the study authors used to collect and

  10. Diagnostic evaluation of dementia in the secondary health care sector

    DEFF Research Database (Denmark)

    Phung, Thien Kieu Thi; Andersen, Birgitte Bo; Kessing, Lars Vedel;

    2009-01-01

    BACKGROUND: We conducted a nationwide registry-based study of the quality of diagnostic evaluation for dementia in the secondary health care sector. METHOD: Two hundred patients were randomly selected from the patient population (4,682 patients) registered for the first time with a dementia...... diagnosis in the nationwide hospital registries during the last 6 months of 2003. Through medical record review, we evaluated the completeness of the work-up on which the dementia diagnosis was based, using evidence-based dementia guidelines as reference standards. RESULTS: Satisfactory or acceptable...... completion of the basic dementia work-up was documented in 51.3% of the patients. Only 11.5% of those with unsatisfactory work-up were referred to follow-up investigations. Dementia syndrome was confirmed in 88.5% of the cases, but correct subtypes were diagnosed in only 35.1%. CONCLUSION: The adherence...

  11. Mobility and health sector development in China and India.

    Science.gov (United States)

    Holdaway, Jennifer; Levitt, Peggy; Fang, Jing; Rajaram, Narasimhan

    2015-04-01

    China and India are both attempting to create comprehensive healthcare systems in the context of rapid but uneven economic growth and rapidly changing burdens of disease. While in each country the referencing of international policies and work experience abroad have been part of this process, research has yet to examine the kind of knowledge that is exchanged or the various actors involved in knowledge circulation. Based on a study of two sub-national contexts, this article focuses on the role Chinese and Indian health professionals who have studied and worked overseas play in introducing ideas and practices about healthcare provision and health education. We found that experience abroad influenced individuals, institutions, and each society differently and with some contradictory effects. International experience clearly contributed to personal growth and led individuals to support the adoption of new institutional practices, such as more egalitarian relations between doctors and patients and between students and teachers. However, the content of what individuals learned overseas and the mechanisms through which this knowledge was introduced back into homeland settings often reinforced rather than ameliorated institutional hierarchies and social inequalities. While the scope of this research was limited, we suggest that more explicit analysis of the role professional migrants play in transferring ideas and practices within the health sector would be valuable for policymakers and funders seeking to support a more productive interaction between local and global knowledge. PMID:25734612

  12. Public sector reform and demand for human resources for health (HRH

    Directory of Open Access Journals (Sweden)

    Lethbridge Jane

    2004-11-01

    Full Text Available Abstract This article considers some of the effects of health sector reform on human resources for health (HRH in developing countries and countries in transition by examining the effect of fiscal reform and the introduction of decentralisation and market mechanisms to the health sector. Fiscal reform results in pressure to measure the staff outputs of the health sector. Financial decentralisation often leads to hospitals becoming "corporatised" institutions, operating with business principles but remaining in the public sector. The introduction of market mechanisms often involves the formation of an internal market within the health sector and market testing of different functions with the private sector. This has immediate implications for the employment of health workers in the public sector, because the public sector may reduce its workforce if services are purchased from other sectors or may introduce more short-term and temporary employment contracts. Decentralisation of budgets and administrative functions can affect the health sector, often in negative ways, by reducing resources available and confusing lines of accountability for health workers. Governance and regulation of health care, when delivered by both public and private providers, require new systems of regulation. The increase in private sector provision has led health workers to move to the private sector. For those remaining in the public sector, there are often worsening working conditions, a lack of employment security and dismantling of collective bargaining agreements. Human resource development is gradually being recognised as crucial to future reforms and the formulation of health policy. New information systems at local and regional level will be needed to collect data on human resources. New employment arrangements, strengthening organisational culture, training and continuing education will also be needed.

  13. Chiropractic practice in the Danish public health care sector

    DEFF Research Database (Denmark)

    Myburgh, Corrie

    2009-01-01

    This commentary offers preliminary considerations around a phenomenological investigation of chiropractic services in a Danish public sector setting. In this narrative description, the main venue for chiropractic public (secondary) sector practice in the Danish context is briefly described...

  14. Implementing performance management in the Irish Health Sector.

    Science.gov (United States)

    Byrne, Michael

    2006-01-01

    To realize the goals of successive health strategies, managers in the Irish Health Sector will have to proactively facilitate optimal employee performance in line with policy objectives. Along with developing employee and teams' capabilities, these managers have begun to implement performance management to achieve the latter. However, there typically are a variety of foundational organizational characteristics required for the successful implementation of performance management. These include providing top-down support for line management buy-in, providing ongoing managerial and performance management training so that trusting relationships and a culture of consensus and cooperation are developed, and appropriately managing expectations. Agreement on employee role definitions and provision of team-based conflict resolution training is also needed to facilitate performance management. There is a need for negotiated performance indicators that are of various types, specific, measurable, and aligned with strategy objectives. Associated reward systems need to be holistic and imaginative, and personal development plans need to have a broader focus than merely improving current job skills and performance. Performance review needs to be ongoing, conducted in a transparent manner, and allocated sufficient discussion time. Managers also need to be mindful of managing overperformance. PMID:16699325

  15. Improving Cross-Sector Comparisons: Going Beyond the Health-Related QALY.

    Science.gov (United States)

    Brazier, John; Tsuchiya, Aki

    2015-12-01

    The quality-adjusted life-year (QALY) has become a widely used measure of health outcomes for use in informing decision making in health technology assessment. However, there is growing recognition of outcomes beyond health within the health sector and in related sectors such as social care and public health. This paper presents the advantages and disadvantages of ten possible approaches covering extending the health-related QALY and using well-being and monetary-based methods, in order to address the problem of using multiple outcome measures to inform resource allocation within and between sectors. PMID:26324402

  16. Returns to Treatment in the Formal Health Care Sector: Evidence from Tanzania*

    OpenAIRE

    Achyuta Adhvaryu; Anant Nyshadham

    2014-01-01

    Improving access to the formal health care sector is a primary public health goal in many low-income countries. But the returns to this access are unclear, given that the quality of care at public health facilities is often considered inadequate. We exploit temporal and geographic variation in the cost of traveling to formal sector health facilities to show that treatment at these facilities improves short-term health outcomes for acutely ill children in Tanzania. Our results suggest that the...

  17. The roles of the health sector and health workers before, during and after violent conflict

    DEFF Research Database (Denmark)

    Buhmann, Caecilie; Barbara, Joanna Santa; Arya, Neil;

    2010-01-01

    Starting with a view of war as a significant population health problem, this article explores the roles of health workers in relation to violent conflict. Four different roles are identified, defined by goals and values--military, development, humanitarian and peace. In addition, four dimensions...... of health work are seen as cross-cutting factors influencing health work in violent conflict-- whether the health worker is an insider or outsider to the conflict, whether they are oriented to primary, secondary or tertiary prevention of the mortality and morbidity of war, whether they take an individual...... clinical or a population health approach, and whether they are oriented to policy and whole-sector change or not. This article explores the nature of these roles, the influence of these cross-cutting dimensions, the challenges of each role and finally commonalities and possibilities for cooperation between...

  18. Climate change and adaptation of the health sector: The case of infectious diseases.

    Science.gov (United States)

    Confalonieri, Ulisses E C; Menezes, Júlia Alves; Margonari de Souza, Carina

    2015-01-01

    Infectious diseases form a group of health problems highly susceptible to the influences of climate. Adaptation to protect human population health from the changes in infectious disease epidemiology expected to occur as a consequence of climate change involve actions in the health systems as well as in other non-health sectors. In the health sector strategies such as enhanced and targeted epidemiological and entomological surveillance and the development of epidemic early warning systems informed by climate scenarios are needed. Measures in other sectors such as meteorology, civil defense and environmental sanitation will also contribute to a reduction in the risk of infection under climate change.

  19. Health behaviour and safety in the construction sector.

    Science.gov (United States)

    Meliá, José L; Becerril, Marta

    2009-08-01

    Workers' health behaviour includes habits or actions related to physical exercise, nutrition, smoking, and drug or alcohol consumption. Unhealthy behaviour, and especially alcohol consumption, has been considered a source of accidents and injuries among construction workers. However, unhealthy behaviour can also be seen as a result of the safety and risk conditions of these jobs. The purpose of this paper is to contrast the role of unhealthy behaviour as a source or as an outcome of safety and risk in the construction sector. Data was collected from 180 workers belonging to a Spanish construction company. Two path models representing these two hypotheses were tested. The model in which unhealthy behaviour is an antecedent of injuries did not fit the data (Chi square=73.798, df=3, p<0.001). Results support the hypothesis of unhealthy behaviour as a result of safety and risk factors through the mediating effect of the experience of tension (Chi-square=4.507, df=2, p=.212). This model not only corroborates the stressful nature of exposure to risk and the absence of supervisors' safety response, but it also makes it possible to consider injuries as a cause of tension that, in turn, affects the employees' unhealthy behaviour. PMID:19622324

  20. Management of the human resources in the health sector

    Directory of Open Access Journals (Sweden)

    Matina Stavropoulou

    2010-07-01

    Full Text Available There are many common points between the theory of the management of human resources and other general fields such as the business theory and the management theory. Especially, the management of nurses includes all the procedures which are involved in order to hire the right people for the job. The necessary procedures are in chronicle sequence the attraction of employees, the choice between the most skilful of them, their control and certification, the proper delegation of duties and the preservation of this personnel or its promotion to the next level.The aim the present study is the analysis of the parameters relative to management strategies in nurse departments.Method: This study was based on a search which was carried out through relative bibliographical references both from international and Greek textbooks and also through the Internet in recognized databases.Conclusions: The foundation stone in the theory of nursing management is the idea that the employees have to meet a double challenge. This challenge is the maximization of their productivity and at the same time the fulfillment of the organization purposes. The efficiency of human resources at the health sector is resultant of many powers. These are the hierarchical promotion, the motives, the employee’s satisfaction, the working conditions and the in-service training which should be provided for life.

  1. Patient Satisfaction Before and After Executing Health Sector Evolution Plan

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    Behrouz Hashemi

    2015-02-01

    Full Text Available Introduction: After long discussions, carrying out health sector evolution (HSE plan began on May 5, 2014 throughout Iran. Shohadaye Tajrish Hospital, Tehran, was also included in this plan. This study aimed to evaluate the level of emergency department patient satisfaction, before and after running this plan. Methods: This cross-sectional study analyzed the data extracted from a standard questionnaire filled out by the patients presented to the emergency department of Shohadaye Tajrish Hospital over 6-month periods before and after the beginning of HSE. Results: 3665 patients were surveyed. After the execution of the plan, satisfaction decreased significantly regarding pre-discharge training (p = 0.03, hospitalization room condition (p = 0.0002, restroom sanitation (p = 0.007, waiting time to be visited by the physician (p = 0.04, accuracy and duration of physical examination (p = 0.007, feeling confident and desirable outcome (p = 0.03, commitment to religious and moral principles (p = 0.01, and handling financial affairs (p = 0.03. Conclusion: Based on the results of the present study, after execution of HSE plan, patient satisfaction has decreased significantly regarding pre-discharge training, hospitalization room condition, restroom sanitation, timely visit of the physicians, accuracy and duration of physical examination, suggestions for wellbeing of the patient, handling financial affairs, and commitment to religious and moral principles.

  2. People Management Practices in the Public Health Sector: Developments from Victoria, Australia

    Science.gov (United States)

    Stanton, Pauline; Bartram, Timothy; Harbridge, Raymond

    2004-01-01

    This study investigates the impact on human resource management (HRM) practices in the public health sector in Victoria, Australia of two different government policy environments. First, it explores the Liberal Coalition Government's decentralisation of public health sector management, from 1992-1999 and second, the Labor Government's…

  3. THE EXPECTANCIES OF THE HEALTH SECTOR FROM ACCOUNTING EDUCATION AND THE IMPLEMENTATION OF ANKARA PUBLIC HOSPITALS

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    Seyhan ÇİL KOÇYİĞİT

    2016-01-01

    Full Text Available Health sector requires qualified accounting personnel and demands qualified accounting personnel who knows the sector and who has the vocational knowledge and the ability. Education and training activities designed to meet the expectencies and the requirements of the sector are very important. These requirements can be met by the good quality of accounting education designed by the demands of the health sector. In this research, a survey has been administered to the managers of Ankara public hospitals in order to reveal the expectencies of the health sector from accounting education. The results of the survey show the follwings; accounting education should include practical information, The Uniform Chart Of Accounts should be developed in order to meet the expectencies of the health sector, there should be an internship opportunity at the health sector for accounting students, the content of the accounting courses should be determined by a cooperation between the sector and the academia and the demands of the health sector should be taken into consideration more.

  4. Strengthening Intersectoral Collaboration for Primary Health Care in Developing Countries: Can the Health Sector Play Broader Roles?

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    Omokhoa Adedayo Adeleye

    2010-01-01

    Full Text Available Many strategic challenges impeding the success of primary health care are rooted in weak strategic inputs, including intersectoral collaboration. Some encouraging evidence from programmes, projects, and studies suggests that intersectoral collaboration is feasible and useful. The strategy has the potential to fast-track the attainment of Millenium Development Goals. However, the strategy is not commonly utilised in developing countries. The health sector expects inputs from other sectors which may not necessarily subscribe to a shared responsibility for health improvement, whereas the public expects ‘‘health’’ from the health sector. Yet, the health sector rarely takes on initiatives in that direction. The sector is challenged to mobilise all stakeholders for intersectoral collaboration through advocacy and programming. Pilot projects are advised in order to allow for cumulative experience, incremental lessons and more supportive evidence.

  5. Lessons from the business sector for successful knowledge management in health care: A systematic review

    OpenAIRE

    Sibbald Shannon; Hastie Robyn; Hovanec Nina; Kothari Anita

    2011-01-01

    Abstract Background The concept of knowledge management has been prevalent in the business sector for decades. Only recently has knowledge management been receiving attention by the health care sector, in part due to the ever growing amount of information that health care practitioners must handle. It has become essential to develop a way to manage the information coming in to and going out of a health care organization. The purpose of this paper was to summarize previous studies from the bus...

  6. Catastrophic Health Expenditure After the Implementation of Health Sector Evolution Plan: A Case Study in the West of Iran

    OpenAIRE

    Bakhtiar Piroozi; Ghobad Moradi; Bijan Nouri; Amjad Mohamadi Bolbanabad; Hossein Safari

    2016-01-01

    Background: One of the main objectives of health systems is the financial protection against out-of-pocket (OOP) health expenditures. OOP health expenditures can lead to catastrophic payments, impoverishment or poverty among households. In Iran, health sector evolution plan (HSEP) has been implemented since 2014 in order to achieve universal health coverage and reduce the OOP health expenditures as a percentage of total health expenditures. This study aimed to explore the percenta...

  7. Population health improvement: a community health business model that engages partners in all sectors.

    Science.gov (United States)

    Kindig, David A; Isham, George

    2014-01-01

    Because population health improvement requires action on multiple determinants--including medical care, health behaviors, and the social and physical environments--no single entity can be held accountable for achieving improved outcomes. Medical organizations, government, schools, businesses, and community organizations all need to make substantial changes in how they approach health and how they allocate resources. To this end, we suggest the development of multisectoral community health business partnership models. Such collaborative efforts are needed by sectors and actors not accustomed to working together. Healthcare executives can play important leadership roles in fostering or supporting such partnerships in local and national arenas where they have influence. In this article, we develop the following components of this argument: defining a community health business model; defining population health and the Triple Aim concept; reaching beyond core mission to help create the model; discussing the shift for care delivery beyond healthcare organizations to other community sectors; examining who should lead in developing the community business model; discussing where the resources for a community business model might come from; identifying that better evidence is needed to inform where to make cost-effective investments; and proposing some next steps. The approach we have outlined is a departure from much current policy and management practice. But new models are needed as a road map to drive action--not just thinking--to address the enormous challenge of improving population health. While we applaud continuing calls to improve health and reduce disparities, progress will require more robust incentives, strategies, and action than have been in practice to date. Our hope is that ideas presented here will help to catalyze a collective, multisectoral response to this critical social and economic challenge.

  8. The creation of the health consumer: challenges on health sector regulation after managed care era

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    Merhy Emerson E

    2011-02-01

    Full Text Available Abstract Background We utilized our previous studies analyzing the reforms affecting the health sector developed in the 1990s by financial groups to frame the strategies implemented by the pharmaceutical industry to regain market positions and to understand the challenges that regulatory agencies are confronting. Methods We followed an analytical approach for analyzing the process generated by the disputes between the financial groups and the pharmaceutical corporations and the challenges created to governmental regulation. We analyzed primary and secondary sources using situational and discourse analyses. We introduced the concepts of biomedicalization and biopedagogy, which allowed us to analyze how medicalization was radicalized. Results In the 1990s, structural adjustment policies facilitated health reforms that allowed the entrance of multinational financial capital into publicly-financed and employer-based insurance. This model operated in contraposition to the interests of the medical industrial complex, which since the middle of the 1990s had developed silent reforms to regain authority in defining the health-ill-care model. These silent reforms radicalized the medicalization. Some reforms took place through deregulatory processes, such as allowing direct-to-consumer advertisements of prescription drugs in the United States. In other countries different strategies were facilitated by the lack of regulation of other media such as the internet. The pharmaceutical industry also has had a role in changing disease definitions, rebranding others, creating new ones, and pressuring for approval of treatments to be paid by public, employer, and private plans. In recent years in Brazil there has been a substantial increase in the number of judicial claims demanding that public administrations pay for new treatments. Conclusions We found that the dispute for the hegemony of the health sector between financial and pharmaceutical companies has deeply

  9. Health system responsiveness after health sector evolution plan (HSEP): An inpatient survey in Kermanshah in 2015

    Science.gov (United States)

    Najafi, Farid; Karami-Matin, Behzad; Rezaei, Satar; Rajabi-Gilan, Nader; Soofi, Moslem

    2016-01-01

    Background: Responsiveness is one of the three main goals of the health system introduced by World Health Organization. This study aimed at examining health system responsiveness after Health Sector Evolution Plan in Kermanshah, Western Iran. Methods: A sample of 335 hospitalized patients was selected using proportionate allocation to population size method in the city of Kermanshah (Iran) in 2015. World Health Survey (WHS) questionnaire was used to collect data. Data were analyzed using descriptive statistics and principal component analysis by STATA 12. Results: The overall health system responsiveness score was 72.6. The best and worst performance for domains of dignity and autonomy were 82.2 and 62.5, respectively. Socio-demographic variables of the patients had no significant effect on the total health system responsiveness score. The principal component analysis findings indicated that 68% of the variance of the overall responsiveness score was explained by four components. Conclusion: The overall responsiveness score of each of the domains was higher than that of other similar previous studies in Iran. Although it is difficult to reach a conclusion, our findings may show better responsiveness of the health system compared to the previous reports PMID:27493931

  10. What is the Meaning of Public Sector Health?

    DEFF Research Database (Denmark)

    Waldorff, Susanne Boch

    2013-01-01

    This study explores the dynamics involved in establishing discourses necessary for constructing organizational change within the public sector. Drawing upon critical discourse analysis, the study identifies two competing discourses – a ‘patient’ and a ‘healthy citizen’ discourse, which exist...... in the context of public sector change. First, the study shows that discourses not only provide different senses of meaning and warrant particular social actors a louder voice than others, but that these actors also develop discursive legitimizing strategies and translate particular meanings...

  11. Scaling up the health workforce in the public sector: the role of government fiscal policy.

    Science.gov (United States)

    Vujicic, Marko

    2010-01-01

    Health workers play a key role in increasing access to health care services. Global and country-level estimates show that staffing in many developing countries - particularly in Sub-Saharan Africa - is far leaner than needed to deliver essential health services to the population. One factor that can limit scaling up the health workforce in developing countries is the government's overall wage policy which sometimes creates restrictions on hiring in the health sector. But while there is considerable debate, the information base in this important area has been quite limited. This paper summarizes the process that determines the budget for health wages in the public sector, how it is linked to overall wage policies, and how this affects staffing in the health sector. The author draws mainly from a recent World Bank report. PMID:21155425

  12. Development of health biotechnology in developing countries: can private-sector players be the prime movers?

    Science.gov (United States)

    Abuduxike, Gulifeiya; Aljunid, Syed Mohamed

    2012-01-01

    Health biotechnology has rapidly become vital in helping healthcare systems meet the needs of the poor in developing countries. This key industry also generates revenue and creates employment opportunities in these countries. To successfully develop biotechnology industries in developing nations, it is critical to understand and improve the system of health innovation, as well as the role of each innovative sector and the linkages between the sectors. Countries' science and technology capacities can be strengthened only if there are non-linear linkages and strong interrelations among players throughout the innovation process; these relationships generate and transfer knowledge related to commercialization of the innovative health products. The private sector is one of the main actors in healthcare innovation, contributing significantly to the development of health biotechnology via knowledge, expertise, resources and relationships to translate basic research and development into new commercial products and innovative processes. The role of the private sector has been increasingly recognized and emphasized by governments, agencies and international organizations. Many partnerships between the public and private sector have been established to leverage the potential of the private sector to produce more affordable healthcare products. Several developing countries that have been actively involved in health biotechnology are becoming the main players in this industry. The aim of this paper is to discuss the role of the private sector in health biotechnology development and to study its impact on health and economic growth through case studies in South Korea, India and Brazil. The paper also discussed the approaches by which the private sector can improve the health and economic status of the poor. PMID:22617902

  13. SPECTRAL ANALYSIS OF BUCK AND SEPIC CONVERTERS

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    CHAKIB ALAOUI

    2011-02-01

    Full Text Available Switched mode power converters generate harmonic currents, which will be injected into the utility grid, causing distortion of the utility waveform. They also become a source for the generation of EMI, which may affect the communication systems. This work is about the design and evaluation of the two most frequently used SMPS used in step down mode of operation: the Buck converter and the Sepic converter working in step-down mode of operation. These converters were designed using optimized equations for their components ratings. Simulation results show that although the Buck output voltage is low in harmonics, it has high harmonic contents in currents circulating in its inductor and diode, and hence requires strong filtering. The Sepic converterhas lower harmonic contents than the Buck converter.

  14. Contemporary specificities of labour in the health care sector: introductory notes for discussion

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    Albuquerque Eduardo

    2005-08-01

    Full Text Available Abstract Background This paper combines the literature on public health, on economics of health and on economics of technological innovation to discuss the peculiarities of labour in the health care sector. Method and framework The starting point is the investigation of the economic peculiarities of medical care. Results and discussions This investigation leads to the identification of the prevalence of non-market forms of medical care in the countries of the Organisation for Economic Co-operation and Development (OECD. Furthermore, the health care system has a distinctive characteristic from other economic sectors: it is the intersection between social welfare and innovation systems. The relationship between technological innovation and cost in the health care sector is surveyed. Finally, the Brazilian case is discussed as an example of a developing country. Conclusion The peculiarities of labour in the health care sector suggest the need to recognize the worth of sectoral labour and to cease to treat it separately. This process should take into account the rapid development of the health innovation system and one important consequence: the obsolescence of the acquired knowledge. One way to dignify labour is to implement continued education and training of health professions personnel.

  15. Health sector reforms and human resources for health in Uganda and Bangladesh: mechanisms of effect

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    Kielmann Tara

    2007-02-01

    Full Text Available Abstract Background Despite the expanding literature on how reforms may affect health workers and which reactions they may provoke, little research has been conducted on the mechanisms of effect through which health sector reforms either promote or discourage health worker performance. This paper seeks to trace these mechanisms and examines the contextual framework of reform objectives in Uganda and Bangladesh, and health workers' responses to the changes in their working environments by taking a 'realistic evaluation' approach. Methods The study findings were generated by triangulating both qualitative and quantitative methods of data collection and analysis among policy technocrats, health managers and groups of health providers. Quantitative surveys were conducted with over 700 individual health workers in both Bangladesh and Uganda and supplemented with qualitative data obtained from focus group discussions and key interviews with professional cadres, health managers and key institutions involved in the design, implementation and evaluation of the reforms of interest. Results The reforms in both countries affected the workforce through various mechanisms. In Bangladesh, the effects of the unification efforts resulted in a power struggle and general mistrust between the two former workforce tracts, family planning and health. However positive effects of the reforms were felt regarding the changes in payment schemes. Ugandan findings show how the workforce responded to a strong and rapidly implemented system of decentralisation where the power of new local authorities was influenced by resource constraints and nepotism in recruitment. On the other hand, closer ties to local authorities provided the opportunity to gain insight into the operational constraints originating from higher levels that health staff were dealing with. Conclusion Findings from the study suggest that a reform planners should use the proposed dynamic responses model to

  16. FUNCTIONAL ANALYSIS OF THE HEALTH SECTOR IN ROMANIA

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    Bogdan Tatiana

    2015-07-01

    Full Text Available This paper comprises an assessment of the Romanian health financing policy and a detailed analysis of income and expenditure trends over the past seven years. The current situation of the health system is evaluated by reviewing the existing health legislation and documents on public health policies from Romania and from abroad, by analyzing the official statistics (the Romanian Yearbook of Health Statistics, Who database and by performing a healthcare system financial analysis. Although the financial efforts of the Romanian state to support the health system have increased, almost all the incomes and expenditures of the health care system having recorded significant increases, the population perception on health services worsened. Financing the health system continues to be inadequate and used in an ineffective way. Health is an essential component of well-being with major socio-economic implications. The organization and functioning of the health system depends on ensuring adequate funding. Romania must develop its health strategy in the context of European Union policies. These policies are based on values and principles such as promoting universal protection against financial risk, promoting a more equitable distribution of the financing burden, promoting equitable provision and use of services relative to need, improving the transparency and accountability of the system to the public, promoting quality and efficiency in service delivery, improving administrative efficiency, while ensuring the financial sustainability of the health system. In this context, in order to support a financially sustainable and high performing health system, the paper includes recommendations for increasing the public incomes in the health insurance system and options to streamline the healthcare services and expenses in the future.

  17. Designing New Financial Management System in Health Sector of Islamic Republic of Iran

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    R Hafezi

    2009-03-01

    Full Text Available "nBackground: In health system of any country, securing financial resources and management of the same is one of the most vital apprehensions in regards policy makers. This article expresses a part of the obstacles and threats present in the man­agement of the government financial resources of health sector and in assimilating this, the requirement for amendments in the financial system and designing new financial management system of health sector in Iran."nMethods: The authors conducted a case study based on interviews with government, and academic participants. Two meth­ods of data collection were used: retrospective analysis of official documents and in-depth interview."nResults: The root of the obstacles relevant to the management of financial resources in health sector in four intricate and fundamental modes of executing cash accounts in contrary to accrual accounts, where there is an intense weakness in the internal controls due to the lack of periodic reports, so as to define the source of deviations, the lack of a mechanized system and ultimately, the absence of a comprehensive monetary plan in the Country. Based on these obstacles, the new financial management system of health sector in Iran was designed including mission, objectives, structure, human resources and duties, processes and procedures, external environment."nConclusion: Designing new financial system in health sector of country is a way to effective and efficient management of financial resources and aid health system to achieve ultimate goals.

  18. Health sector reforms in Central and Eastern Europe

    Directory of Open Access Journals (Sweden)

    2004-04-01

    Full Text Available The political and economic transition of the 1990s in the countries of central and eastern Europe has been accompanied by wide ranging health care reform. The initial Soviet model has given way to a variety of forms of health insurance. Yet, as this paper argues, reform has too often been preoccupied with ideological imperatives, such as provider autonomy and the creation of funds separate from government, and has given much less thought to the contribution that health care can make to population health. The paper begins by examining the changing nature of health care. It recalls how the Soviet model was able to provide basic care to dispersed populations at low cost but notes how this is no longer sufficient in the face of an increasingly complex health care environment. This complexity reflects several factors, such as the growth in chronic disease, the emergence of new forms of infectious disease, and the introduction of new treatments requiring integrated delivery systems. It reviews evidence on how the former communist countries failed to keep up with developments in the west from the 1970s onwards, at a time when the complexity of health care was becoming apparent. It continues by setting out a framework for the organisation of health care based on the goal of health gain. This involves a series of activities that can be summarised as active purchasing, and which include assessment of health needs, designing effective packages of care, and monitoring outcomes. It concludes by arguing that a new relationship is needed between the state and the organisations involved in funding and delivering health care, to design a system that will tackle the considerable health needs of the people who live in this region.

  19. Free-Market Illusions: Health Sector Reforms In Uganda 1987–2007

    OpenAIRE

    Okuonzi, Sam Agatre

    2009-01-01

    Introduction: By the late 1980s, Uganda’s health system had been devastated by two decades of conflict and mismanagement. At the same time, public-funded and run health systems had begun to be viewed as inefficient and undesirable. Uganda’s attempt to rehabilitate its destroyed health infrastructure was blocked by donors in favour of reform. Introduced as pre-conditions of aid, market-based health sector reforms (HSRs) were eventually embraced by the government of Uganda as par...

  20. Human resources: the Cinderella of health sector reform in Latin America

    OpenAIRE

    Ugalde Antonio; Homedes Núria

    2005-01-01

    Abstract Human resources are the most important assets of any health system, and health workforce problems have for decades limited the efficiency and quality of Latin America health systems. World Bank-led reforms aimed at increasing equity, efficiency, quality of care and user satisfaction did not attempt to resolve the human resources problems that had been identified in multiple health sector assessments. However, the two most important reform policies – decentralization and privatization...

  1. Lessons learned from health sector reform: a four-country comparison.

    Science.gov (United States)

    Talukder, Md Noorunnabi; Rob, Ubaidur; Mahabub-Ul-Anwar, Md

    Various reforms have been undertaken to improve the functioning of health systems in developing countries, but there is limited comparative analysis of reform initiatives. This article discusses health sector reform experiences of four developing countries and identifies the lessons learned. The article is based on the review of background papers on Bangladesh, Pakistan, Indonesia, and Tanzania prepared as part of a multi-country study on health sector reform. Findings suggest that decentralization works effectively while implementing primary and secondary health programs. Decentralization of power and authority to local authorities requires strengthening and supporting these units. Along with the public sector, the private sector plays an effective role in institutional and human resources development as well as in improving service delivery. Community participation facilitates recruitment and development of field workers, facility improvement, and service delivery. For providing financial protection to the poor, there is a need to review user fees and develop affordable health insurance with an exemption mechanism. There is no uniform health sector reform approach; therefore, the experiences of other countries will help countries undertake appropriate reforms. Here, it is important to examine the context and determine the reform measures that constitute the best means in terms of equity, efficiency, and sustainability. PMID:19131306

  2. Health assessment for Revere Chemical Company National Priorities List (NPL) Site, Revere, Bucks County, Pennsylvania, Region 3. CERCLIS No. PAD051395499. Preliminary report

    Energy Technology Data Exchange (ETDEWEB)

    1989-04-20

    The Revere Chemical Company site was operated from the late 1960s until 1972 as an acid, metal, and plating waste processing facility. It is suspected of also accepting organic solvent waste. The environmental contamination on-site consists of chromium, mercury, lead, arsenic, and cadmium in the surface water of tributaries on the site boundaries; benzoic acid in the sediment; diethylhexylphthalate in the fire pond; trans-1,2-dichloroethylene and 2-butanone in a production well; chromium, nickel, diethylhexylphthalate, and arsenic in soil. Off-site environmental contamination consists of chromium, lead, arsenic, and nickel in the surface water of the tributaries; chromium, lead, hexachlorobenzene, benzoic acid, di-n-octylphthalate, diethylhexylphthalate, and total polynuclear aromatic hydrocarbons in sediment; and diethylhexylphthalate, nickel, lead, and arsenic in residential well water. Even though removal operations were carried out in 1984, subsequent data collections have shown significant contamination present in surface water, soil, and sediment both on- and off-site. Arsenic and nickel levels exceed water quality criteria. Soil and sediment off-site are contaminated with lead and chromium and would be considered a public health concern should they be in areas where children come in contact with them. In addition, the levels of contamination in surface water and sediment may adversely impact edible aquatic organisms making them unfit for human consumption.

  3. Integration: the firm and the health care sector.

    Science.gov (United States)

    Laugesen, Miriam J; France, George

    2014-07-01

    Integration in health care is a key goal of health reform in United States and England. Yet past efforts in the 1990s to better integrate the delivery system were of limited success. Building on work by Bevan and Janus on delivery integration, this article explores integration through the lens of economic theories of integration. Firms generally integrate to increase efficiency through economies of scale, to improve their market power, and resolve the transaction costs involved with multiple external suppliers. Using the United States and England as laboratories, we apply concepts of economic integration to understand why integration does or does not occur in health care, and whether expectations of integrating different kinds of providers (hospital, primary care) and health and social services are realistic. Current enthusiasm for a more integrated health care system expands the scope of integration to include social services in England, but retains the focus on health care in the United States. We find mixed applicability of economic theories of integration. Economies of scale have not played a significant role in stimulating integration in both countries. Managerial incentives for monopoly or oligopoly may be more compelling in the United States, since hospitals seek higher prices and more leverage over payers. In both countries the concept of transaction costs could explain the success of new payment and budgeting methods, since health care integration ultimately requires resolving transaction costs across different delivery organizations. PMID:24759287

  4. Public health sector unions and deregulation in Europe.

    Science.gov (United States)

    Lethbridge, Jane

    2004-01-01

    Deregulation and liberalization of health services take several forms in Europe: public-private partnerships; contracting out of services; and corporatization of health care institutions. The impact on health workers includes changes in terms and conditions of employment, breakup of collective bargaining agreements, and often more stressful working conditions. The author examines four types of trade union responses to deregulation. National health trade union action has used campaigning, awareness raising, and judicial review. Health workers' unions in alliance with other trade unions have taken part in wider campaigns against privatization and in promoting public services. Health workers' unions joining with social movements have become involved in wider alliances that link with broader public policy issues such as poverty reduction and urban/regional regeneration. European-wide action, seen through the work of the European Federation of Public Service Unions, has concentrated on the development of an alternative health policy, and the promotion of social dialogue at a European level. Trade unions must adopt a range of approaches to challenge the effects of deregulation. Increasingly, trade union members need to be aware of how to take action at both the national and European levels. PMID:15346679

  5. Evaluating digital libraries in the health sector. Part 1: measuring inputs and outputs.

    Science.gov (United States)

    Cullen, Rowena

    2003-12-01

    This is the first part of a two-part paper which explores methods that can be used to evaluate digital libraries in the health sector. In this first part, some approaches to evaluation that have been proposed for mainstream digital information services are examined for their suitability to provide models for the health sector. The paper summarizes some major national and collaborative initiatives to develop measures for digital libraries, and analyses these approaches in terms of their relationship to traditional measures of library performance, which are focused on inputs and outputs, and their relevance to current debates among health information specialists. The second part* looks more specifically at evaluative models based on outcomes, and models being developed in the health sector.

  6. The skills gap in hospital management in the South African public health sector.

    Science.gov (United States)

    Pillay, Rubin

    2008-01-01

    A lack of management capacity has been identified as the key stumbling block to the transformation and reconceptualization of the public sector in South Africa into a more effective, efficient, and responsive system of health delivery. As part of the overall management development process, this research aimed to identify the skills important for public sector health management and to evaluate managers' self-assessed proficiency in each of these skills. A cross-sectional survey using a self-administered questionnaire was conducted among hospital managers in the South African public health sector. Respondents were asked to rate the level of importance that each proposed competency had in their job and to indicate their proficiency in each skill. Self-assessment of levels of competency showed that managers felt most competent in strategic planning, people management, and self-management, and relatively less competent in the task-related skills and their ability to deliver healthcare. People management, self-management, and task-related skills were rated as being most important, followed by strategic management and health delivery skills, respectively. The largest differences between mean importance rating and mean skill rating were for people management skills, task-related and self-management skills. These findings reflect the reality of the local health service environment and the needs of health managers and will be useful in the conceptualization, design, and delivery of health management programs aimed at enhancing current and future management and leadership capacity in the public health sector in South Africa. PMID:18708881

  7. The Brain Drain Potential of Students in the African Health and Nonhealth Sectors

    Directory of Open Access Journals (Sweden)

    Jonathan Crush

    2012-01-01

    Full Text Available The departure of health professionals to Europe and North America is placing an intolerable burden on public health systems in many African countries. Various retention, recall, and replacement policies to ameliorate the impact of this brain drain have been suggested, none of which have been particularly successful to date. The key question for the future is whether the brain drain of health sector skills is likely to continue and whether the investment of African countries in training health professionals will continue to be lost through emigration. This paper examines the emigration intentions of trainee health professionals in six Southern African countries. The data was collected by the Southern African Migration Program (SAMP in a survey of final-year students across the region which included 651 students training for the health professions. The data also allows for the comparison of health sector with other students. The analysis presented in this paper shows very high emigration potential amongst all final-year students. Health sector students do show a slightly higher inclination to leave than those training to work in other sectors. These findings present a considerable challenge for policy makers seeking to encourage students to stay at home and work after graduation.

  8. Integrating Health and Sustainability: The Higher Education Sector as a Timely Catalyst

    Science.gov (United States)

    Orme, J.; Dooris, M.

    2010-01-01

    Higher education is an influential sector with enormous potential to impact positively on health and sustainability. The purpose of this paper was to explore its emergent role as a key setting for promoting health and sustainability and for addressing their challenges in an integrated and coherent way. Acknowledging both the relative narrowness of…

  9. Cross-sector Service Provision in Health and Social Care: An Umbrella Review

    Directory of Open Access Journals (Sweden)

    Shannon Winters

    2016-04-01

    Full Text Available Introduction: Meeting the complex health needs of people often requires interaction among numerous different sectors. No one service can adequately respond to the diverse care needs of consumers. Providers working more effectively together is frequently touted as the solution. Cross-sector service provision is defined as independent, yet interconnected sectors working together to better meet the needs of consumers and improve the quality and effectiveness of service provision. Cross-sector service provision is expected, yet much remains unknown about how it is conceptualised or its impact on health status. This umbrella review aims to clarify the critical attributes that shape cross-sector service provision by presenting the current state of the literature and building on the findings of the 2004 review by Sloper. Methods: Literature related to cross-sector service provision is immense, which poses a challenge for decision makers wishing to make evidence-informed decisions. An umbrella review was conducted to articulate the overall state of cross-sector service provision literature and examine the evidence to allow for the discovery of consistencies and discrepancies across the published knowledge base. Findings: Sixteen reviews met the inclusion criteria. Seven themes emerged: Focusing on the consumer, developing a shared vision of care, leadership involvement, service provision across the boundaries, adequately resourcing the arrangement, developing novel arrangements or aligning with existing relationships, and strengthening connections between sectors. Future research from a cross-organisational, rather than individual provider, perspective is needed to better understand what shapes cross-sector service provision at the boundaries. Conclusion: Findings aligned closely with the work done by Sloper and raise red flags related to reinventing what is already known. Future researchers should look to explore novel areas rather than looking into

  10. Accreditation and Participatory Design in the Health-Care Sector

    DEFF Research Database (Denmark)

    Simonsen, Jesper; Scheuer, John Damm; Hertzum, Morten

    2015-01-01

    We reconsider the role of participatory design approaches emphasizing the current context of the accreditation regime imposed on the Danish healthcare sector. We describe effects-driven IT development as an instrument supporting sustained participatory design. Effects-driven IT development includes...... specifying, realizing, and measuring effects from using an information technology. This approach aligns with much of the logic inherent in accreditation and it supports challenging parts of the accreditation process. Effects-driven IT development furthermore might support effects related to clinical evidence......-based thinking. We describe and compare effects- driven IT development with accreditation and discuss the prospects and challenges for this approach to participatory design within the healthcare domain....

  11. Medicare and Medicaid Trends in Health Care Sectors

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Centers for Medicare and Medicaid Services (CMS) provides monthly and fiscal-year-to-date income and expenditure trends for Medicare Hospital Insurance (HI) and...

  12. Consensus and contention in the priority setting process: examining the health sector in Uganda.

    Science.gov (United States)

    Colenbrander, Sarah; Birungi, Charles; Mbonye, Anthony K

    2015-06-01

    Health priority setting is a critical and contentious issue in low-income countries because of the high burden of disease relative to the limited resource envelope. Many sophisticated quantitative tools and policy frameworks have been developed to promote transparent priority setting processes and allocative efficiency. However, low-income countries frequently lack effective governance systems or implementation capacity, so high-level priorities are not determined through evidence-based decision-making processes. This study uses qualitative research methods to explore how key actors' priorities differ in low-income countries, using Uganda as a case study. Human resources for health, disease prevention and family planning emerge as the common priorities among actors in the health sector (although the last of these is particularly emphasized by international agencies) because of their contribution to the long-term sustainability of health-care provision. Financing health-care services is the most disputed issue. Participants from the Ugandan Ministry of Health preferentially sought to increase net health expenditure and government ownership of the health sector, while non-state actors prioritized improving the efficiency of resource use. Ultimately it is apparent that the power to influence national health outcomes lies with only a handful of decision-makers within key institutions in the health sector, such as the Ministries of Health, the largest bilateral donors and the multilateral development agencies. These power relations reinforce the need for ongoing research into the paradigms and strategic interests of these actors.

  13. Local communities and health disaster management in the mining sector

    Directory of Open Access Journals (Sweden)

    Freek Cronjé

    2013-01-01

    Full Text Available Mining activities throughout the Southern African Development Community (SADC have impacted on the health and safety of mining communities for many decades. Despite the economic contribution of mining to surrounding communities, a huge amount of social and environmental harm is associated with the industry. In this regard, mining companies have, on the one hand, contributed toward improved social development by providing jobs, paying taxes and earning foreign exchange. On the other hand, they have been linked publicly to poor labour conditions, corruption, pollution incidents, health and safety failings, as well as disrespect of human rights. The objectives of this study are to give an overview of social and natural factors relating to health disasters in selected communities in the mining environment. Regarding the findings, this paper focuses on the social and natural factors involved in the creation of health disasters. The social factors include poverty, unemployment, poor housing and infrastructure, prostitution and a high influx of unaccompanied migrant labour. Major health issues in this regard, which will be highlighted, are the extraordinary high incidence rate of HIV and STIs (sexually transmitted infections, addiction and mental illness. The environmental (natural threats to health that will be discussed in the study are harmful particles in the air and water, excessive noise and overcrowded and unhygienic living conditions. In conclusion, the paper also finds that communities need to be ‘fenced in’ in terms of health disaster management instead of being excluded. Specific recommendations to mining companies to reduce health and safety disasters will be made to conclude the paper.

  14. Contracting private sector providers for public sector health services in Jalisco, Mexico: perspectives of system actors

    Directory of Open Access Journals (Sweden)

    González Luz

    2009-10-01

    Full Text Available Abstract Introduction Contracting out health services is a strategy that many health systems in the developing world are following, despite the lack of decisive evidence that this is the best way to improve quality, increase efficiency and expand coverage. A large body of literature has appeared in recent years focusing on the results of several contracting strategies, but very few papers have addressed aspects of the managerial process and how this can affect results. Case description This paper describes and analyses the perceptions and opinions of managers and workers about the benefits and challenges of the contracting model that has been in place for almost 10 years in the State of Jalisco, Mexico. Both qualitative and quantitative information was collected. An open-ended questionnaire was used to obtain information from a group of managers, while information provided by a self-selected group of workers was collected via a closed-ended questionnaire. The analysis contrasted the information obtained from each source. Discussion and Evaluation Findings show that perceptions of managers and workers vary for most of the items studied. For managers the model has been a success, as it has allowed for expansion of coverage based on a cost-effective strategy, while for workers the model also possesses positive elements but fails to provide fair labour relationships, which negatively affects their performance. Conclusion Perspectives of the two main groups of actors in Jalisco's contracting model are important in the design and adjustment of an adequate contracting model that includes managerial elements to give incentives to worker performance, a key element necessary to achieve the model's ultimate objectives. Lessons learnt from this study could be relevant for the experience of contracting models in other developing countries.

  15. Final report:Health sector Public Expenditure Review (PER) update Financial Year (FY) 05

    OpenAIRE

    Ministry of Health,Tanzania, (MHT)

    2008-01-01

    In contrast to recent years, the health sector Public Expenditure Review update for FY05 is presented largely as an internal sectoral document for reviewing trends in budget and expenditure rather than as a detailed input to the budget process due to its delayed timing and a change in the focus of the overall government poverty reduction strategy with the development of the MKUKUTA (the Kiswahili acronym for the National Strategy for Growth and Poverty Reduction, the second Poverty Reduction ...

  16. Independent sector mental health care: a 1-day census of private and voluntary sector placements in seven Strategic Health Authority areas in England.

    Science.gov (United States)

    Hatfield, Barbara; Ryan, Tony; Simpson, Victoria; Sharma, Indhu

    2007-09-01

    The aims of this study were (i) to map the extent of all mental health placements in the independent sector, for adults of working age, and elderly people (excluding those with a diagnosis of dementia placed in Local Authority care homes), on a census date, across the areas in which the study was commissioned; (ii) to identify the characteristics of the population in placements; (iii) to explore some of the characteristics of the placements and the patterns of use within the private and voluntary sectors; and (iv) to identify the funding source of placements, and cost differences between the private and voluntary sector. The study took place in seven Strategic Health Authority areas, and information was sought from all Primary Care Trust and Social Services commissioners of mental health services, including regional secure commissioning teams, within those areas. A cross-sectional sample was used. Information was requested in relation to every individual meeting the inclusion criteria, placed in independent (private or voluntary) psychiatric hospitals, registered mental nursing homes and care homes on a specified study 'census date' of 28 June 2004 in six of the Strategic Health Authority areas, and 7 October 2004 in the seventh. Information was recorded on a standard questionnaire specifically designed for the study. Information was obtained on 3535 adults and 1623 elderly people in private or voluntary facilities. The largest groups of adults and elderly people had diagnoses of severe mental illnesses (42.1% and 30.5%, respectively), and placements were described as 'continuing care' or rehabilitation, with a 'niche' in specialist forensic care. Around four-fifths of units were in the private sector, which for adults was significantly more expensive than the voluntary sector. A large proportion of units (47.2% of adult placements and 59.3% of placements for elderly people) had only single placements from particular commissioning authorities, whilst others had

  17. Regulating the for-profit private health sector: lessons from East and Southern Africa.

    Science.gov (United States)

    Doherty, Jane E

    2015-03-01

    International evidence shows that, if poorly regulated, the private health sector may lead to distortions in the type, quantity, distribution, quality and price of health services, as well as anti-competitive behaviour. This article provides an overview of legislation governing the for-profit private health sector in East and Southern Africa. It identifies major implementation problems and suggests strategies Ministries of Health could adopt to regulate the private sector more effectively and in line with key public health objectives. This qualitative study was based on a document review of existing legislation in the region, and seven semi-structured interviews with individuals selected purposively on the basis of their experience in policymaking and legislation. Legislation was categorized according to its objectives and the level at which it operates. A thematic content analysis was conducted on interview transcripts. Most legislation focuses on controlling the entry of health professionals and organizations into the market. Most countries have not developed adequate legislation around behaviour following entry. Generally the type and quality of services provided by private practitioners and facilities are not well-regulated or monitored. Even where there is specific health insurance regulation, provisions seldom address open enrolment, community rating and comprehensive benefit packages (except in South Africa). There is minimal control of prices. Several countries are updating and improving legislation although, in most cases, this is without the benefit of an overarching policy on the private sector, or reference to wider public health objectives. Policymakers in the East and Southern African region need to embark on a programme of action to strengthen regulatory frameworks and instruments in relation to private health care provision and insurance. They should not underestimate the power of the private health sector to undermine efforts for increased

  18. The use of geographical information system in health sector.

    Science.gov (United States)

    Mechili, Aggelos; Zimeras, Stelios; Al-Fantel, Konstantina; Diomidous, Marianna

    2014-01-01

    The provision of health care has undergone radical changes during the last years. Geography plays an important role in understanding the dynamics of health, as well as the reasons why a disease is spreading. In general, a Geographic Information System (GIS) is based on the same principals with a traditional relational database. The main idea behind this study is the methodological approach as far as the implementation of a real- time electronic healthcare record is concerned, for the descriptive statistical analysis that uses geographical information to identify spatial data related to accidents. The purpose of developing such a health care record is to record the patients who were injured in accidents. The database that will be used for the development of the EHR is based on Microsoft Office 2007, which is considered to be one of the best tools for developing databases. The main table of the database includes the fields with demographics, ie name, surname, age, sex, address and place of birth. The primary key of the table Demographics is Patient_ID. The demographics from the table are connected to the table Admission with a relationship type one- to- many. The combination of these features in a graphic representation can be used to display the health problems on the map, so that the proper health policies can be applied. The results of the monitoring could be used as pilot instructions for spatial epidemiological analysis. PMID:25000047

  19. The public sector and mental health parity: time for inclusion.

    Science.gov (United States)

    Hogan, Michael F.

    1998-12-01

    BACKGROUND: In the United States, there is an uneasy division of responsibility for financing mental health care. For most illnesses, employer-sponsored health insurance and the large federal health insurance programs (Medicare, Medicaid) cover the costs of care. However, most employer-sponsored plans and Medicare provide only limited coverage for treatment of mental illness. A possible cause and result of this limited coverage in mental health is that states, and in some cases local (county) governments, finance a separate system of mental health care. This separate "public mental health system" provides a "safety net" of care for indigent individuals needing mental health care. However, there are potential negative consequences of maintaining separate systems. Continuity of treatment between systems may be impaired, and costs may be higher due to duplicate administrative costs. Maintaining a separate system managed by government may exacerbate the stigma associated with mental illness treatment. Most significantly, since eligibility for care may be linked to poverty status, and since having a serious mental illness may preclude regaining private coverage, maintaining a separate system may contribute to the poverty rate among persons with mental illnesses. AIMS OF THE PAPER: These potential problems have not been widely considered, perhaps because other problems and controversies in mental health care have captured our attention. In particular, controversies over deinstitutionalization in mental health have dominated the policy debate, especially when linked to related problems. These have included conflicts over authority and financial responsibility among federal, state and local governments, sensationalized media coverage of incidents involving people with mental illness, problems with siting community facilities, concern about mental illness among prisoners and the like. However, with the substantial reform of public mental health care in some states and

  20. The use of geographical information system in health sector.

    Science.gov (United States)

    Mechili, Aggelos; Zimeras, Stelios; Al-Fantel, Konstantina; Diomidous, Marianna

    2014-01-01

    The provision of health care has undergone radical changes during the last years. Geography plays an important role in understanding the dynamics of health, as well as the reasons why a disease is spreading. In general, a Geographic Information System (GIS) is based on the same principals with a traditional relational database. The main idea behind this study is the methodological approach as far as the implementation of a real- time electronic healthcare record is concerned, for the descriptive statistical analysis that uses geographical information to identify spatial data related to accidents. The purpose of developing such a health care record is to record the patients who were injured in accidents. The database that will be used for the development of the EHR is based on Microsoft Office 2007, which is considered to be one of the best tools for developing databases. The main table of the database includes the fields with demographics, ie name, surname, age, sex, address and place of birth. The primary key of the table Demographics is Patient_ID. The demographics from the table are connected to the table Admission with a relationship type one- to- many. The combination of these features in a graphic representation can be used to display the health problems on the map, so that the proper health policies can be applied. The results of the monitoring could be used as pilot instructions for spatial epidemiological analysis.

  1. [Neoliberal health sector reforms in Latin America: unprepared managers and unhappy workers].

    Science.gov (United States)

    Ugalde, Antonio; Homedes, Nuria

    2005-03-01

    This work analyzes the neoliberal health sector reforms that have taken place in Latin America, the preparation of health care workers for the reforms, the reforms' impacts on the workers, and the consequences that the reforms have had on efficiency and quality in the health sector. The piece also looks at the process of formulating and implementing the reforms. The piece utilizes secondary sources and in-depth interviews with health sector managers in Bolivia, Colombia, Costa Rica, the Dominican Republic, Ecuador, El Salvador, and Mexico. Neoliberal reforms have not solved the human resources problems that health sector evaluations and academic studies had identified as the leading causes of health system inefficiency and low-quality services that existed before the reforms. The reforms worsened the situation by putting new pressures on health personnel, in terms of both the lack of necessary training to face the challenges that came with the reforms and efforts to take away from workers the rights and benefits that they had gained during years of struggles by unions, and to replace them with temporary contracts, reduced job security, and lower benefits. The secrecy with which the reforms were developed and applied made workers even more unified. In response, unions opposed the reforms, and in some countries they were able to delay the reforms. The neoliberal reforms have not improved the efficiency or quality of health systems in Latin America despite the resources that have been invested. Nor have the neoliberal reforms supported specific changes that have been applied in the public sector and that have demonstrated their ability to solve important health problems. These specific changes have produced better results than the neoliberal reforms, and at a lower cost.

  2. Women in History--Pearl Buck: An Advocate for Women and Children

    Science.gov (United States)

    Watts, Lynette

    2008-01-01

    This article profiles Pearl Buck, an advocate for women's rights and minority children, an author of Chinese history, and a pioneer in many ways. Buck established the Welcome House in 1949 in order to help unadoptable children find families (Conn, 1996). In 1964, Buck founded the Pearl S. Buck Foundation, now Pearl S. Buck International, which…

  3. The Impact of Electricity Sector Privatization on Public Health

    DEFF Research Database (Denmark)

    Gonzalez-Eiras, Martin; Rossi, Martín

    2008-01-01

    We use province-level data for Argentina to test for the causal relation between electricity distribution and health. We are interested in the impact of privatization on two output measures, incidence of low birth weight and child mortality rates caused by food poisoning. Privatization improves...

  4. Contemporary specificities of labour in the health care sector: introductory notes for discussion

    OpenAIRE

    Albuquerque Eduardo; Campos Francisco

    2005-01-01

    Abstract Background This paper combines the literature on public health, on economics of health and on economics of technological innovation to discuss the peculiarities of labour in the health care sector. Method and framework The starting point is the investigation of the economic peculiarities of medical care. Results and discussions This investigation leads to the identification of the prevalence of non-market forms of medical care in the countries of the Organisation for Economic Co-oper...

  5. Corporate governance of public health services: lessons from New Zealand for the state sector.

    Science.gov (United States)

    Perkins, R; Barnett, P; Powell, M

    2000-01-01

    New Zealand public hospitals and related services were grouped into 23 Crown Health Enterprises and registered as companies in 1993. Integral to this change was the introduction of corporate governance. New directors, largely from the business sector, were appointed to govern these organisations as efficient and effective businesses. This article presents the results of a survey of directors of New Zealand publicly-owned health provider organisations. Although directors thought they performed well in business systems development, they acknowledged their shortcomings in meeting government expectations in respect to financial performance and social responsibility. Changes in public health sector provider performance indicators have resulted in a mixed report card for the sector six years after corporate governance was instituted.

  6. Indiana's Health Care Sector and Insurance Market: Summary Report.

    OpenAIRE

    Deborah Chollet; Fabrice Smieliauskas; Rebecca Nyman; Andrea Staiti

    2004-01-01

    This report summarizes a series of reports investigating Indiana’s health care economy and markets. The findings suggest the need for policymakers in Indiana to address important challenges on multiple fronts. Important areas for immediate attention include greater efficiency in the delivery of hospital care, reducing the spending for hospital care that appears to be crowding out spending for other medical services. However, equally critical is attention to three problems that are more closel...

  7. Indianas Health Care Sector and Insurance Market Summary Report

    OpenAIRE

    Deborah Chollet; Fabrice Smieliauskas; Rebecca Nyman; Andrea Staiti

    2004-01-01

    This report summarizes a series of reports investigating Indiana’s health care economy and markets. The findings suggest the need for policymakers in Indiana to address important challenges on multiple fronts. Important areas for immediate attention include greater efficiency in the delivery of hospital care, reducing the spending for hospital care that appears to be crowding out spending for other medical services. However, equally critical is attention to three problems that are more clos...

  8. Analysis of Developing Public Health Service Sector with Private Finance Initiative in Guangxi

    Institute of Scientific and Technical Information of China (English)

    王宇

    2006-01-01

    In Guangxi Public Health Service Sector (GPHSS), because lack of budget, it has caused a number of problems, such as weakened public health service in rural areas, poor professional quality of medical personnel in public health units at village and township levels, current urban public health service could not meet the health demand for urban residents. This paper is a secondary research. Through analysis of the financial problem and both of the advantages and disadvantages of using the Private Finance Initiative (PFI), it intend to demonstrate that using the PFI could be considered as a good way for the Guangxi government.

  9. The World Health Organization's mechanisms for increasing the health sector budget: The South African context.

    Science.gov (United States)

    Venter, Fouche Hendrik Johannes; Wolfaardt, Jaqueline Elizabeth

    2016-08-01

    South Africa (SA) has limited scope for raising income taxes, and the proposed National Health Insurance (NHI) scheme will necessitate growth in the health sector budget. The NHI White Paper suggests five funding scenarios to meet the expected shortfall. These scenarios are a mixture of a surcharge on taxable income, an increase in value-added tax and a payroll tax. Five alternative options, suggested by the World Health Organization, are interrogated as ways to decrease the general taxation proposed in the White Paper. The five mechanisms (corporate tax, financial transaction levy, and taxes on tobacco, alcohol and unhealthy foods) were chosen based on their fund-raising potential and their mandatory element. A literature review provides the information for a discussion of the potential costs of each mechanism. Within specific assumptions, potential budgetary contribution is compared with the requirement. First, raising corporate tax rates could raise enough funds, but the losses due to capital flight might be too much for the local economy to bear. Second, a levy on currency transactions is unlikely to raise the required resources, even without a probable decrease in the number of transactions. Third, the increase in the tax on tobacco and alcohol would need to be very large, even assuming that consumption patterns would remain unchanged. Lastly, a tax on unhealthy food products is a new idea and could be explored as an option - especially as the SA Treasury has announced its future implementation. Implementing only one of the mechanisms is unlikely to increase available funding sufficiently, but if they are implemented together the welfare-maximising tax rate for each mechanism may be high enough to fulfil the NHI scheme's budgetary requirement, moderating the increases in the tax burden of the SA population. PMID:27499398

  10. The World Health Organization's mechanisms for increasing the health sector budget: The South African context.

    Science.gov (United States)

    Venter, Fouche Hendrik Johannes; Wolfaardt, Jaqueline Elizabeth

    2016-07-04

    South Africa (SA) has limited scope for raising income taxes, and the proposed National Health Insurance (NHI) scheme will necessitate growth in the health sector budget. The NHI White Paper suggests five funding scenarios to meet the expected shortfall. These scenarios are a mixture of a surcharge on taxable income, an increase in value-added tax and a payroll tax. Five alternative options, suggested by the World Health Organization, are interrogated as ways to decrease the general taxation proposed in the White Paper. The five mechanisms (corporate tax, financial transaction levy, and taxes on tobacco, alcohol and unhealthy foods) were chosen based on their fund-raising potential and their mandatory element. A literature review provides the information for a discussion of the potential costs of each mechanism. Within specific assumptions, potential budgetary contribution is compared with the requirement. First, raising corporate tax rates could raise enough funds, but the losses due to capital flight might be too much for the local economy to bear. Second, a levy on currency transactions is unlikely to raise the required resources, even without a probable decrease in the number of transactions. Third, the increase in the tax on tobacco and alcohol would need to be very large, even assuming that consumption patterns would remain unchanged. Lastly, a tax on unhealthy food products is a new idea and could be explored as an option - especially as the SA Treasury has announced its future implementation. Implementing only one of the mechanisms is unlikely to increase available funding sufficiently, but if they are implemented together the welfare-maximising tax rate for each mechanism may be high enough to fulfil the NHI scheme's budgetary requirement, moderating the increases in the tax burden of the SA population.

  11. Waiting Time Policies in the Health Care Sector. What Works?

    DEFF Research Database (Denmark)

    Christiansen, Terkel; Bech, Mickael

    2013-01-01

    choice of hospital for somatic and psychiatric patients, short maximum waiting time guarantee for life-threatening diseases coupled with care packages for cancer and heart diseases and extra-activity targeted hospital grants. There are good reasons to believe that these policies have reduced waiting...... times. In addition, a range of other measures may indirectly have affected waiting times, such as a general increase in spending on health care, the general practitioners’ role as gate-keepers, increased use of activity-based hospital reimbursement, increasing use of private heath insurance and private...

  12. Increased fairness in priority setting processes within the health sector

    DEFF Research Database (Denmark)

    Zulu, Joseph M.; Michelo, Charles; Msoni, Carol;

    2014-01-01

    level in Kapiri-Mposhi District in Zambia. METHODS: Data was collected using in depth interviews (IDIs), focus group discussions (FGDs) and review of documents from national to district level. The study population for this paper consisted of health related stakeholders employed in the district...... devolution of PS and decision making procedures. However, important gaps were identified in terms of experiences of stakeholder involvement and fairness in PS processes in practice. The evaluation study revealed that a transformation of the views and methods regarding fairness in PS processes was ongoing...

  13. Microbial diseases of the genital system of rams or bucks.

    Science.gov (United States)

    Gouletsou, P G; Fthenakis, G C

    2015-12-14

    Objective of the present paper is to review microbial diseases of the genital system of male small ruminants. The paper reviews the infections and the diseases by taking an organ approach within the genital system, whilst relevant health management actions are also discussed. Diseases of the genital organs of male small ruminants include orchitis, of bacterial or viral aetiology, epididymitis, primarily caused by Brucella ovis, by other bacteria as well (e.g., Actinobacillus seminis, Haemophilus somni), infections of the accessory glands, orf, other infections of the penis or prepuce and infections of the scrotum. The health management of rams/bucks include the appropriate diagnostic investigations, the relevant therapeutic approaches and, finally, the preventive measures. PMID:26209019

  14. Improving child health promotion practices in multiple sectors – outcomes of the Swedish Salut Programme

    Directory of Open Access Journals (Sweden)

    Edvardsson Kristina

    2012-10-01

    Full Text Available Abstract Background To improve health in the population, public health interventions must be successfully implemented within organisations, requiring behaviour change in health service providers as well as in the target population group. Such behavioural change is seldom easily achieved. The purpose of this study was to examine the outcomes of a child health promotion programme (The Salut Programme on professionals’ self-reported health promotion practices, and to investigate perceived facilitators and barriers for programme implementation. Methods A before-and-after design was used to measure programme outcomes, and qualitative data on implementation facilitators and barriers were collected on two occasions during the implementation process. The sample included professionals in antenatal care, child health care, dental services and open pre-schools (n=144 pre-implementation in 13 out of 15 municipalities in a Swedish county. Response rates ranged between 81% and 96% at the four measurement points. Results Self-reported health promotion practices and collaboration were improved in all sectors at follow up. Significant changes included: 1 an increase in the extent to which midwives in antenatal care raised issues related to men’s violence against women, 2 an increase in the extent to which several lifestyle topics were raised with parents/clients in child health care and dental services, 3 an increased use of motivational interviewing (MI and separate ‘fathers visits’ in child health care 4 improvements in the supply of healthy snacks and beverages in open pre-schools and 5 increased collaboration between sectors. Main facilitators for programme implementation included cross-sectoral collaboration and sector-specific work manuals/questionnaires for use as support in everyday practice. Main barriers included high workload, and shortage of time and staff. Conclusion This multisectoral programme for health promotion, based on sector

  15. Use of communities of practice in business and health care sectors: A systematic review

    Directory of Open Access Journals (Sweden)

    Coyte Peter C

    2009-05-01

    Full Text Available Abstract Background Since being identified as a concept for understanding knowledge sharing, management, and creation, communities of practice (CoPs have become increasingly popular within the health sector. The CoP concept has been used in the business sector for over 20 years, but the use of CoPs in the health sector has been limited in comparison. Objectives First, we examined how CoPs were defined and used in these two sectors. Second, we evaluated the evidence of effectiveness on the health sector CoPs for improving the uptake of best practices and mentoring new practitioners. Methods We conducted a search of electronic databases in the business, health, and education sectors, and a hand search of key journals for primary studies on CoP groups. Our research synthesis for the first objective focused on three areas: the authors' interpretations of the CoP concept, the key characteristics of CoP groups, and the common elements of CoP groups. To examine the evidence on the effectiveness of CoPs in the health sector, we identified articles that evaluated CoPs for improving health professional performance, health care organizational performance, professional mentoring, and/or patient outcome; and used experimental, quasi-experimental, or observational designs. Results The structure of CoP groups varied greatly, ranging from voluntary informal networks to work-supported formal education sessions, and from apprentice training to multidisciplinary, multi-site project teams. Four characteristics were identified from CoP groups: social interaction among members, knowledge sharing, knowledge creation, and identity building; however, these were not consistently present in all CoPs. There was also a lack of clarity in the responsibilities of CoP facilitators and how power dynamics should be handled within a CoP group. We did not find any paper in the health sector that met the eligibility criteria for the quantitative analysis, and so the effectiveness

  16. Colombia and Cuba, contrasting models in Latin America's health sector reform.

    Science.gov (United States)

    De Vos, Pol; De Ceukelaire, Wim; Van der Stuyft, Patrick

    2006-10-01

    Latin American national health systems were drastically overhauled by the health sector reforms the 1990s. Governments were urged by donors and by the international financial institutions to make major institutional changes, including the separation of purchaser and provider functions and privatization. This article first analyses a striking paradox of the far-reaching reform measures: contrary to what is imposed on public health services, after privatization purchaser and provider functions are reunited. Then we compare two contrasting examples: Colombia, which is internationally promoted as a successful--and radical--example of 'market-oriented' health care reform, and Cuba, which followed a highly 'conservative' path to adapt its public system to the new conditions since the 1990s, going against the model of the international institutions. The Colombian reform has not been able to materialize its promises of universality, improved equity, efficiency and better quality, while Cuban health care remains free, accessible for everybody and of good quality. Finally, we argue that the basic premises of the ongoing health sector reforms in Latin America are not based on the people's needs, but are strongly influenced by the needs of foreign--especially North American--corporations. However, an alternative model of health sector reform, such as the Cuban one, can probably not be pursued without fundamental changes in the economic and political foundations of Latin American societies. PMID:17002735

  17. Analysis of health sector gender equality and social inclusion strategy 2009 of Nepal.

    Science.gov (United States)

    Mahara, G B; Dhital, S R

    2014-01-01

    The policy on gender equality and social inclusion (GESI) in health sector of Nepal is formulated in 2009 targeting toward poor, vulnerable, marginalized social and ethnic groups. Gender inequality and social discrimination are a social problem that affect on individual health finally. The main objective of this paper is to critically analysis and evaluates the Government's strategy on health sector gender equality and social inclusion in Nepal. We collected published and unpublished information assessing the public health, policy analysis and research needs from different sources. A different policy approaches for the analysis and evaluation of GESI strategies is applied in this paper. Universal education, community participation, individual, group and mass communication approaches, and social capital are the key aspects of effective implementation of policy at target levels.

  18. Review of corruption in the health sector: theory, methods and interventions.

    Science.gov (United States)

    Vian, Taryn

    2008-03-01

    There is increasing interest among health policymakers, planners and donors in how corruption affects health care access and outcomes, and what can be done to combat corruption in the health sector. Efforts to explain the risk of abuse of entrusted power for private gain have examined the links between corruption and various aspects of management, financing and governance. Behavioural scientists and anthropologists also point to individual and social characteristics which influence the behaviour of government agents and clients. This article presents a comprehensive framework and a set of methodologies for describing and measuring how opportunities, pressures and rationalizations influence corruption in the health sector. The article discusses implications for intervention, and presents examples of how theory has been applied in research and practice. Challenges of tailoring anti-corruption strategies to particular contexts, and future directions for research, are addressed.

  19. Lighting in the health care sector; Verlichting in de zorg

    Energy Technology Data Exchange (ETDEWEB)

    Visser, R. [Grontmij, Amersfoort (Netherlands)

    2009-02-15

    The importance of light for people's health and welfare attracts frequent attention, not only the professional press but also in countless articles in newspapers and news magazines. Insufficient illumination can upset the biological clock and may even cause depression. In principle this applies to anyone who has to stay indoors all day or nearly all day; in the case of care homes it affects residents who have no regular opportunity to sit at a window, for example those who are bedridden. Research indicates that we need a minimum daily portion of daylight or of artificial light with similar qualities as daylight. This is also of great importance to night workers. [Dutch] Niet alleen in de vakpers, maar ook in tal van dag- en weekbladen, wordt regelmatig het belang van licht voor het welzijn en de gezondheid van de mens aan de orde gesteld. Gebrek aan voldoende licht kan het bioritme verstoren en zelfs leiden tot depressie. Dat geldt in principe voor alle mensen die om wat voor redenen dan ook de hele dag of nagenoeg de hele dag binnen moeten blijven. In zorginstellingen is dit vooral van toepassing voor degenen die zich niet regelmatig direct achter het ream kunnen bevinden, zoals mensen die bedlegering zijn. Want door onderzoek is gebleken dat we elke dag een voldoende portie daglicht nodig hebben of licht met overeenkomstige kwaliteiten als daglicht. Voor mensen die 's nachts moeten werken is het laatstgenoemde ook van groot belang.

  20. Reforming the health sector in Thailand: the role of policy actors on the policy stage.

    Science.gov (United States)

    Green, A

    2000-01-01

    This paper reports on exploratory research carried out into the processes of policy-making, and in particular health sector reform, in the health sector of Thailand. It is one of a set of studies examining health sector reform processes in a number of countries. Though in the period under study (1970-1996) there had been no single health sector reform package in Thailand, there was interest in a number of quarters in the development of such an initiative. It is clear, however, that despite recognition of the need for reform such a policy was far from being formulated, let alone implemented. The research, based on both documentary analysis and interviews, explores the reasons underpinning the failure of the policy process to respond to such a perceived need. The research findings suggest that the policy formation process in Thailand successfully occurs when there is a critical mass of support from strategic interest groups. The relative power of these interest groups is constantly changing. In particular the last two decades has seen a decline in the power of the bureaucratic élites (military and civilian) and a related rise in the power of the economic élites either directly or through their influence on political parties and government. Other critical groups include the media, NGOs and the professions. Informal policy groups are also significant. A number of implications for policy makers operating under such circumstances are drawn.

  1. Lumbar spinal fusion patients' demands to the primary health sector: evaluation of three rehabilitation protocols

    DEFF Research Database (Denmark)

    Soegaard, Rikke; Christensen, Finn B; Lauerberg, Ida;

    2006-01-01

    Very few studies have investigated the effects or costs of rehabilitation regimens following lumbar spinal fusion. The effectiveness of in-hospital rehabilitation regimens has substantial impact on patients' demands in the primary health care sector. The aim of this study was to investigate patie...... service utilization in the primary health care sector as compared to the usual regimen and a training exercise regimen. The results stress the importance of a cognitive element of coping in a rehabilitation program.......Very few studies have investigated the effects or costs of rehabilitation regimens following lumbar spinal fusion. The effectiveness of in-hospital rehabilitation regimens has substantial impact on patients' demands in the primary health care sector. The aim of this study was to investigate patient......-articulated demands to the primary health care sector following lumbar spinal fusion and three different in-hospital rehabilitation regimens in a prospective, randomized study with a 2-year follow-up. Ninety patients were randomized 3 months post lumbar spinal fusion to either a 'video' group (one-time oral...

  2. High performance work practices in the health care sector: A dutch case study

    NARCIS (Netherlands)

    Boselie, J.P.P.E.F.

    2010-01-01

    Purpose – This paper aims to present an empirical study of the effect of high performance work practices on commitment and citizenship behaviour in the health care sector. The theory suggests that individual employees are willing “to go the extra mile” when they are given the opportunity to develop

  3. Cross-sector cooperation in health-enhancing physical activity policymaking

    DEFF Research Database (Denmark)

    Hämäläinen, Riitta-Maija; Aro, Arja R; Lau, Cathrine Juel;

    2016-01-01

    in health-enhancing physical activity (HEPA) policies in six European Union (EU) member states. METHODS: Qualitative content analysis of HEPA policies and semi-structured interviews with key policymakers in six European countries. RESULTS: Cross-sector cooperation varied between EU member states within HEPA...

  4. Health Sector Initiatives for Disaster Risk Management in Ethiopia: A Narrative Review

    OpenAIRE

    Tadesse, Luche; Ardalan, Ali

    2014-01-01

    Background: Natural and man-made disasters are prevailing in Ethiopia mainly due to drought, floods, landslides, earthquake, volcanic eruptions, and disease epidemics. Few studies so far have critically reviewed about medical responses to disasters and little information exists pertaining to the initiatives being undertaken by health sector from the perspective of basic disaster management cycle. This article aimed to review emergency health responses to disasters and other related interventi...

  5. IT capabilities within the Dutch SME first line health care sector

    OpenAIRE

    Maris, Arjen; Ravesteijn, Pascal; Versendaal, Johan; Smit, Kobus

    2015-01-01

    The complexity of Information Technology (IT) is increasing; so are customer expectations. Consequently it is not easy for especially small and medium enterprises (SMEs) to keep track of all IT-developments, let alone leverage them in business operations with the aim to satisfy increasingly demanding customers. This also holds for the health care sector. This research is focussed on first line health care, and deals with the following research question; ‘which IT capabilities do SMEs within t...

  6. Can media relations promote public health? The pharmaceutical sector in the Portuguese press

    OpenAIRE

    Ruão, Teresa; Lopes, Felisbela; Marinho, Sandra; Araújo, Rita Alexandra Manso; Fernandes, Luciana Gabriela Moura

    2013-01-01

    The research project "Disease in the news" (FCT) has been constituted as an observatory of media information on health, produced in Portugal since 2008. In this context, we have undertaken a systematic study of the work of the institutional sources of the health sector, the promotion of information to citizen by the media. This study includes an examination of journalistic texts produced by three national newspapers - Expresso, Público e Jornal de Notícias - and a direct contact with healthca...

  7. Health System Reform and Organisational Culture: An Exploratory Study in Abu Dhabi Public Healthcare Sector

    OpenAIRE

    Jammoul, Nada Youssef

    2015-01-01

    The Health system in Abu Dhabi has undergone a series of far reaching reforms during the past six years, yet in spite of the structural transformations, public confidence in the performance of this vital sector is still skeptical at best and employee engagement is still low. The thesis was underpinned by the aim to reveal the challenges in public health system reform outside the context of western administration. This thesis is an attempt to analyse the intricate, multidimensional concept of ...

  8. Assessing the impact of a new health sector pay system upon NHS staff in England

    OpenAIRE

    Buchan James; Evans David

    2008-01-01

    Abstract Background Pay and pay systems are a critical element in any health sector human resource strategy. Changing a pay system can be one strategy to achieve or sustain organizational change. This paper reports on the design and implementation of a completely new pay system in the National Health Service (NHS) in England. 'Agenda for Change' constituted the largest-ever attempt to introduce a new pay system in the UK public services, covering more than one million staff. Its objectives we...

  9. [Evaluation in the health sector: concepts and methods].

    Science.gov (United States)

    Contandriopoulos, A P; Champagne, F; Denis, J L; Avargues, M C

    2000-12-01

    The practice of evaluation has existed in one form or another for as long as one can remember and is central to all processes of learning. Today, evaluation is a popular concept grouping together multiple and diverse realities. This article aims to propose a conceptual framework for evaluation that is broad and universal enough to allow all those concerned with evaluation of health services (regardless of their disciplines and interests) to better understand each other, to perform better evaluations, and to use them in a more pertinent manner. We will begin by defining evaluation as the process which consists of making a judgement on the value of an intervention by implementing a system which can provide scientifically valid and socially legitimate information on regarding this particular intervention (or any of its components) to the different stakeholders concerned, such that they can form an opinion from their perspective on the intervention and reach a judgement which can translate into action. We define "intervention" as any organized system of action (a structure, actors and their practices, processes of action, one or many finalities and an environment) aiming to, in a given environment, during a given time period, modify the foreseeable course of a phenomenon to correct a problematic situation. An intervention can be a technique, a medication, a treatment, an organisation, a program, a policy or even a complex system like the health care system. Various interventions, regardless of their nature, can be the object of two types of evaluation. Normative evaluation is based on appreciation of each component of the intervention according to criteria and standards. This type of evaluation is defined as an activity which consists of making a judgement regarding an intervention by comparing the resources utilized and their organisation (structure); services and goods produced (process) and results obtained to criteria and standards (in other words, summaries of

  10. Health sector planning led by management of recurrent expenditure: an agenda for action-research.

    Science.gov (United States)

    Segall, M

    1991-01-01

    Health services in developing countries face a crisis of recurrent costs. Far from being able to fund primary health care (PHC) developments, governments now have difficulty in keeping existing health services in operation. This article proposes an approach to the problem based on the proactive planning and management of recurrent health expenditure. The system addresses existing services as well as future plans and allows explicit trade-offs to be made in resource allocation. This may be termed 'recurrent-expenditureled planning'. The article describes a diagnostic health sector review, which incorporates a recurrent expenditure profile in four planes: by type of provider, source of finance, level of care and recipient population group. A fifth dimension of time trends for certain expenditure categories can be added. The steps of a strategic planning cycle for health services resources are then described, which allows health service strategies to be tested for broad economic feasibility. It also results in the establishment of resource targets that can act as benchmarks against which actual levels of funding can be compared. The targets help to maintain sectoral priorities in resource allocation even in times of economic constraint and to channel funds preferentially to localities and facilities in greatest need. The system calls for innovations in the methods of health planning and financial management in the health sector. Implementation will require health systems action-research at the country level. The essential purpose is to promote PHC policy-led resource allocation and use. No amount of planning can substitute for political action to realize 'health for all', but this system provides technical support to the political forces in favour of distributive PHC policies.

  11. Psychosocial safety climate: a multilevel theory of work stress in the health and community service sector.

    Science.gov (United States)

    Dollard, M F; McTernan, W

    2011-12-01

    Work stress is widely thought to be a significant problem in the health and community services sector. We reviewed evidence from a range of different data sources that confirms this belief. High levels of psychosocial risk factors, psychological health problems and workers compensation claims for stress are found in the sector. We propose a multilevel theoretical model of work stress to account for the results. Psychosocial safety climate (PSC) refers to a climate for psychological health and safety. It reflects the balance of concern by management about psychological health v. productivity. By extending the health erosion and motivational paths of the Job Demands-Resources model we propose that PSC within work organisations predicts work conditions and in turn psychological health and engagement. Over and above this, however, we expect that the external environment of the sector particularly government policies, driven by economic rationalist ideology, is increasing work pressure and exhaustion. These conditions are likely to lead to a reduced quality of service, errors and mistakes.

  12. Strategies for engaging the private sector in sexual and reproductive health: how effective are they?

    Science.gov (United States)

    Peters, David H; Mirchandani, Gita G; Hansen, Peter M

    2004-10-01

    The private health sector provides a significant portion of sexual and reproductive health (SRH) services in developing countries. Yet little is known about which strategies for intervening with private providers can improve quality or coverage of services. We conducted a systematic review of the literature through PubMed from 1980 to 2003 to assess the effectiveness of private sector strategies for SRH services in developing countries. The strategies examined were regulating, contracting, financing, franchising, social marketing, training and collaborating. Over 700 studies were examined, though most were descriptive papers, with only 71 meeting our inclusion criteria of having a private sector strategy for one or more SRH services and the measurement of an outcome in the provider or the beneficiary. Nearly all studies (96%) had at least one positive association between SRH and the private sector strategy. About three-quarters of the studies involved training private providers, though combinations of strategies tended to give better results. Maternity services were most commonly addressed (55% of studies), followed by prevention and treatment of sexually transmitted diseases (32%). Using study design to rate the strength of evidence, we found that the evidence about effectiveness of private sector strategies on SRH services is weak. Most studies did not use comparison groups, or they relied on cross-sectional designs. Nearly all studies examined short-term effects, largely measuring changes in providers rather than changes in health status or other effects on beneficiaries. Five studies with more robust designs (randomized controlled trials) demonstrated that contraceptive use could be increased through supporting private providers, and showed cases where the knowledge and practices of private providers could be improved through training, regulation and incentives. Although tools to work with the private sector offer considerable promise, without stronger research

  13. Good governance and corruption in the health sector: lessons from the Karnataka experience.

    Science.gov (United States)

    Huss, R; Green, A; Sudarshan, H; Karpagam, Ss; Ramani, Kv; Tomson, G; Gerein, N

    2011-11-01

    Strengthening good governance and preventing corruption in health care are universal challenges. The Karnataka Lokayukta (KLA), a public complaints agency in Karnataka state (India), was created in 1986 but played a prominent role controlling systemic corruption only after a change of leadership in 2001 with a new Lokayukta (ombudsman) and Vigilance Director for Health (VDH). This case study of the KLA (2001-06) analysed the:Scope and level of poor governance in the health sector; KLA objectives and its strategy; Factors which affected public health sector governance and the operation of the KLA. We used a participatory and opportunistic evaluation design, examined documents about KLA activities, conducted three site visits, two key informant and 44 semi-structured interviews and used a force field model to analyse the governance findings. The Lokayukta and his VDH were both proactive and economically independent with an extended social network, technical expertise in both jurisdiction and health care, and were widely perceived to be acting for the common good. They mobilized media and the public about governance issues which were affected by factors at the individual, organizational and societal levels. Their investigations revealed systemic corruption within the public health sector at all levels as well as in public/private collaborations and the political and justice systems. However, wider contextual issues limited their effectiveness in intervening. The departure of the Lokayukta, upon completing his term, was due to a lack of continued political support for controlling corruption. Governance in the health sector is affected by positive and negative forces. A key positive factor was the combined social, cultural and symbolic capital of the two leaders which empowered them to challenge corrupt behaviour and promote good governance. Although change was possible, it was precarious and requires continuous political support to be sustained.

  14. [Gender equity in health sector reform policies in Latin America and the Caribbean].

    Science.gov (United States)

    Gómez, Elsa Gómez

    2002-01-01

    Gender equity is increasingly being acknowledged as an essential aspect of sustainable development and more specifically, of health development. The Pan American Health Organization's Program for Women, Health, and Development has been piloting for a year now a project known as Equidad de género en las políticas de reforma del sector de salud, whose objective is to promote gender equity in the health sector reform efforts in the Region. The first stage of the project is being conducted in Chile and Peru, along with some activities throughout the Region. The core of the project is the production and use of information as a tool for introducing changes geared toward achieving greater gender equity in health, particularly in connection with malefemale disparities that are unnecessary, avoidable, and unfair in health status, access to health care, and participation in decision-making within the health system. We expect that in three years the project will have brought about changes in the production of information and knowledge, advocacy, and information dissemination, as well as in the development, appropriation, and identification of intersectoral mechanisms that will make it possible for key figures in government and civil society to work together in setting and surveying policy on gender equity in health.

  15. [Plansalud: Decentralized and agreed sector plan for the capacity development in health, Peru 2010-2014].

    Science.gov (United States)

    Huamán-Angulo, Lizardo; Liendo-Lucano, Lindaura; Nuñez-Vergara, Manuel

    2011-06-01

    Human resources are the backbone of health sector actions; however, they are not necessarily the area with the greatest attention, therefore, the Ministry of Health of Peru (MINSA) together with regional governments, led the Decentralized and Agreed Sector Plan for the Capacity Development in Health 2010-2014 (PLANSALUD) with the aim of strengthening the capacities of Human Resources for Health (HRH) and contribute to health care efficient development, quality, relevance, equity and multiculturalism, in the context of descentralization, the Universal Health Insurance (AUS) and health policies. To achieve this goal, they have proposed three components (technical assistance, joint training and education - health articulation) that bring together an important set of interventions, which are planned and defined according to the national, regional and local levels, thus contributing to improve the government capacity, capability management and delivery of health services. This paper presents a first approach of PLANSALUD, including aspects related to planning, management, financing, structure and functioning, as well as monitoring and evaluation measures. PMID:21845319

  16. Nutrition Beyond the Health Sector : A Profile of World Bank Lending in Nutrition from 2000 to 2006

    OpenAIRE

    Garrett, James; El Hag El Tahir, Safinaz

    2008-01-01

    The World Bank report Repositioning Nutrition as Central to Development (2006) explicitly recommended improving nutrition by not only working through the health sector, but also in non-health sectors such as agriculture and education. This report provides descriptive and financial profiles of the Bank's recent portfolio in nutrition (from FY2000 to late FY2006) to note the extent to which ...

  17. Implementation and quality monitoring of e-communication across health care sectors

    DEFF Research Database (Denmark)

    Nicolaisen, Anne; Qvist, Peter

    Background: There has been an increased focus on how to improve the quality of care for patients that receives services from more than one sector in the health care system. Continuity in and coordination of patient pathways in the health care system are included in accreditation standards both...... for general practice and hospitals. An important factor for patient-perceived quality of care is the cooperation between the health care sectors that provides services for the patient. In 2009 the Region of Southern Denmark launched a collaboration agreement called Sam:Bo between general practice, hospitals...... monitoring of specified quality standards. Objective: To monitor the implementation and quality of the Sam:Bo e-communication Method: An explicit audit performed in all local municipalities and at selected hospital departments from all hospital units in the Region of Southern Denmark. The audit was conducted...

  18. Evaluating digital libraries in the health sector. Part 2: measuring impacts and outcomes.

    Science.gov (United States)

    Cullen, Rowena

    2004-03-01

    This is the second part of a two-part paper which explores methods that can be used to evaluate digital libraries in the health sector. Part 1 focuses on approaches to evaluation that have been proposed for mainstream digital information services. This paper investigates evaluative models developed for some innovative digital library projects, and some major national and international electronic health information projects. The value of ethnographic methods to provide qualitative data to explore outcomes, adding to quantitative approaches based on inputs and outputs is discussed. The paper concludes that new 'post-positivist' models of evaluation are needed to cover all the dimensions of the digital library in the health sector, and some ways of doing this are outlined.

  19. Role of health sector contingency plan in emergency preparedness and response: Orissa experiences.

    Science.gov (United States)

    Biswas, R; Dasgupta, A

    2009-01-01

    A study was organized to orient the district level health sector disaster managers to review, revise and update the health sector contingency plan (HSCP) against common natural calamities, followed by its execution and evaluation. An inter-state 3 days workshop was organized at Kolkata during the month of October 2004 to review the district level HSCP and its execution in 5 (five) worst affected districts. The District Health Officers, in consultation with the investigators, revised and updated the HSCP. Thereafter, status survey was conducted to examine the implementation of the contingency plan. During flood, the HSCP was found to be followed in the districts. Control room, construction/identification of flood shelter, sanitation and other preventive measures were taken care of, with an exception of Kendra Para, where lack of man power was noted. Technical support, trained manpower, relief materials, ambulance, Communication and information system were present in all the 5 (five) districts. PMID:20108889

  20. Health workforce attrition in the public sector in Kenya: a look at the reasons

    Directory of Open Access Journals (Sweden)

    Muchiri Stephen

    2009-07-01

    Full Text Available Abstract Background Kenya, like many other countries in sub-Saharan Africa, has been affected by shortages of health workers in the public sector. Data on the rates and leading reasons for health workers attrition in the public sector are key in developing effective, evidence-based planning and policy on human resources for health. Methods This study analysed data from a human resources health facility survey conducted in 2005 in 52 health centres and 22 public hospitals (including all provincial hospitals across all eight provinces in Kenya. The study looked into the status of attrition rates and the proportion of attrition due to retirement, resignation or death among doctors, clinical officers, nurses and laboratory and pharmacy specialists in surveyed facilities. Results Overall health workers attrition rates from 2004 to 2005 were similar across type of health facility: provincial hospitals lost on average 4% of their health workers, compared to 3% for district hospitals and 5% for health centres. However, there are differences in the patterns of attrition rates by cadre. Attrition among doctors and registered nurses was much higher at the provincial hospitals than at district hospitals or health centres, whereas the opposite pattern was observed for laboratory and pharmacy staff (lost at a higher rate in lower-level facilities. In provincial hospitals, doctors had higher attrition rates than clinical officers, and registered nurses had higher attrition rates than enrolled nurses. In contrast, attrition of enrolled and registered nurses in district hospitals and health centres was similar. The main reason for health worker attrition (all cadres combined at each level of facility was retirement, followed by resignation and death. However, resignation drives attrition among doctors and clinical officers; retirement accounts for the main share of attrition among nurses and pharmacy staff; and death is the primary reason for attrition among

  1. The Impact of Health Sector Reform on State and Society in Bangladesh, 1995-2005

    OpenAIRE

    Islam, Kazi Maruful

    2007-01-01

    Despite the fact that in recent years the Government of Bangladesh has invested substantially and initiated numbers of multi-sector and multilevel institutional and programmatic reforms to improve the health of the poor and women, the health status of the poor in Bangladesh is one of the worst in the world. In this context this thesis aims to answer do health reform policies benefit the poor? In order to address the central research question, from a bottom-up critical perspective, it aims to...

  2. How the health and community development sectors are combining forces to improve health and well-being.

    Science.gov (United States)

    Braunstein, Sandra; Lavizzo-Mourey, Risa

    2011-11-01

    The root causes of poor health experienced by many who live in low-income neighborhoods-such as the lack of access to health care, limited food choices, and exposure to environmental hazards-are well documented, but often go beyond the scope of the health care delivery system. But that is beginning to change. The health sector has begun to collaborate with the community development sector, which for decades has been working in low-income neighborhoods. Encouraging local and national examples of these new partnerships abound. They include an effort in Seattle, Washington, to reduce exposure to allergens and irritants among low-income asthmatic children, and a $500 million federal program to finance the operation of grocery stores in what have previously been urban "food deserts." To nurture such efforts, the Robert Wood Johnson Foundation, the Federal Reserve System, and others have sponsored a series of "healthy community" forums in US cities. In this article we explore the growing partnerships between the health and community development sectors as well as the challenges they face, and we offer policy recommendations that might help them succeed. PMID:22068394

  3. Research priorities for the health sector for the 8th Malaysia Plan

    International Nuclear Information System (INIS)

    At the inter-institutional meeting to identify, the research priorities for the sector for the 7MP (7th Malaysian Plan), held in mid-1994, priorities were determined according to the hierarchy of socioeconomic groups, target areas, programmes and scopes. The more detailed projects under these were to be determined by the researchers they embark on the projects themselves. The most useful level for reference is the target area. There were 7 target areas identified at the deliberations, and an eighth one (medical biotechnology) was added later on by the IRPA Secretariat in the Ministry of Science Technology and Environment. These 8 target areas are: 1)Health problems associated with lifestyles 2) Health problems related to demographic changes, 3) Vector borne and other communicable diseases, 4 ) Epidemiological databases, 5) Technologies in health, 6)The health system and health care industry, 7) Environmental and occupational health, 8) Medical biotechnology. (author)

  4. Public-private sector interactions and the demand for supplementary health insurance in the United Kingdom.

    Science.gov (United States)

    Bíró, Anikó; Hellowell, Mark

    2016-07-01

    We examine the demand for private health insurance (PHI) in the United Kingdom and relate this to changes in the supply of public and private healthcare. Using a novel collection of administrative, private sector and survey data, we re-assess the relationships between the quality and availability of public and private sector inpatient care, and the demand for PHI. We find that PHI coverage in the United Kingdom is positively related to the median of the region- and year-specific public sector waiting times. We find that PHI prevalence ceteris paribus increases with being self-employed and employed, while it decreases with having financial difficulties. In addition, we highlight the complexities of inter-sectoral relations and their impact on PHI demand. Within a region, we find that an increase in private healthcare supply is associated with a decrease in public sector waiting times, implying lower PHI demand. This may be explained by the usage of private facilities by NHS commissioners. These results have important implications for policymakers interested in the role of private healthcare supply in enhancing the availability of and equitable access to acute inpatient care. PMID:27234967

  5. Private Sector An Important But Not Dominant Provider Of Key Health Services In Low- And Middle-Income Countries.

    Science.gov (United States)

    Grépin, Karen A

    2016-07-01

    There is debate about the role of the private sector in providing services in the health systems of low- and middle-income countries and about how the private sector could help achieve the goal of universal health coverage. Yet the role that the private sector plays in the delivery of health services is poorly understood. Using data for the period 1990-2013 from 205 Demographic and Health Surveys in seventy low- and middle-income countries, I analyzed the use of the private sector for the treatment of diarrhea and of fever or cough in children, for antenatal care, for institutional deliveries, and as a source of modern contraception for women. I found that private providers were the dominant source of treatment for childhood illnesses but not for the other services. I also found no evidence of increased use of the private sector over time. There is tremendous variation in use of the private sector across countries and health services. Urban and wealthier women disproportionately use the private sector, compared to rural and poorer women. The private sector plays an important role in providing coverage, but strategies to further engage the sector, if they are to be effective, will need to take into consideration the variation in its use. PMID:27385236

  6. Organization and Finance of China's Health Sector: Historical Antecedents for Macroeconomic Structural Adjustment.

    Science.gov (United States)

    Li, Hui; Hilsenrath, Peter

    2016-01-01

    China has exploded onto the world economy over the past few decades and is undergoing rapid transformation toward relatively more services. The health sector is an important part of this transition. This article provides a historical account of the development of health care in China since 1949. It also focuses on health insurance and macroeconomic structural adjustment to less saving and more consumption. In particular, the question of how health insurance impacts precautionary savings is considered. Multivariate analysis using data from 1990 to 2012 is employed. The household savings rate is the dependent variable in 3 models segmented for rural and urban populations. Independent variables include out-of-pocket health expenditures, health insurance payouts, housing expenditure, education expenditure, and consumption as a share of gross domestic product (GDP). Out-of-pocket health expenditures were positively correlated with household savings rates. But health insurance remains weak, and increased payouts by health insurers have not been associated with lower levels of household savings so far. Housing was positively correlated, whereas education had a negative association with savings rates. This latter finding was unexpected. Perhaps education is perceived as investment and a substitute for savings. China's shift toward a more service-oriented economy includes growing dependence on the health sector. Better health insurance is an important part of this evolution. The organization and finance of health care is integrally linked with macroeconomic policy in an environment constrained by prevailing institutional convention. Problems of agency relationships, professional hegemony, and special interest politics feature prominently, as they do elsewhere. China also has a dual approach to medicine relying heavily on providers of traditional Chinese medicine. Both of these segments will take part in China's evolution, adding another layer of complexity to policy. PMID

  7. Organization and Finance of China's Health Sector: Historical Antecedents for Macroeconomic Structural Adjustment.

    Science.gov (United States)

    Li, Hui; Hilsenrath, Peter

    2016-01-01

    China has exploded onto the world economy over the past few decades and is undergoing rapid transformation toward relatively more services. The health sector is an important part of this transition. This article provides a historical account of the development of health care in China since 1949. It also focuses on health insurance and macroeconomic structural adjustment to less saving and more consumption. In particular, the question of how health insurance impacts precautionary savings is considered. Multivariate analysis using data from 1990 to 2012 is employed. The household savings rate is the dependent variable in 3 models segmented for rural and urban populations. Independent variables include out-of-pocket health expenditures, health insurance payouts, housing expenditure, education expenditure, and consumption as a share of gross domestic product (GDP). Out-of-pocket health expenditures were positively correlated with household savings rates. But health insurance remains weak, and increased payouts by health insurers have not been associated with lower levels of household savings so far. Housing was positively correlated, whereas education had a negative association with savings rates. This latter finding was unexpected. Perhaps education is perceived as investment and a substitute for savings. China's shift toward a more service-oriented economy includes growing dependence on the health sector. Better health insurance is an important part of this evolution. The organization and finance of health care is integrally linked with macroeconomic policy in an environment constrained by prevailing institutional convention. Problems of agency relationships, professional hegemony, and special interest politics feature prominently, as they do elsewhere. China also has a dual approach to medicine relying heavily on providers of traditional Chinese medicine. Both of these segments will take part in China's evolution, adding another layer of complexity to policy.

  8. Sector wide approaches for health in small island states: lessons learned from the Solomon Islands.

    Science.gov (United States)

    Negin, Joel; Martiniuk, Alexandra

    2012-01-01

    Sector Wide Approaches (SWAps) have increasingly been implemented in countries around the world as a mechanism for effective delivery of health sector funding from various sources. Despite the global focus on aid effectiveness, SWAps have been under-examined. In 2007, the Solomon Islands and development partners began discussing a health SWAp making the Solomon Islands one of the first fragile states globally to adopt a SWAp. This paper explores the establishment and implementation of a health SWAp in the Solomon Islands as a specific case study with lessons learned for the region as well as for aid architecture in fragile states more generally. Tensions between donors and the government impeded agreement and early implementation and country ownership of the SWAp idea was muted. Since mid-2009, however, the Solomon Islands SWAp has made strong progress with greater government ownership and with more focus on partnership and harmonisation rather than on funding mechanisms. The SWAp mechanism has been a challenge for the capacity-constrained Solomon Islands health sector and for development partners familiar with other aid modalities, but current momentum suggests that the SWAp will have a positive impact on adherence to agreed aid effectiveness principles. PMID:21736517

  9. Developing a composite index of spatial accessibility across different health care sectors: A German example.

    Science.gov (United States)

    Siegel, Martin; Koller, Daniela; Vogt, Verena; Sundmacher, Leonie

    2016-02-01

    The evolving lack of ambulatory care providers especially in rural areas increasingly challenges the strict separation between ambulatory and inpatient care in Germany. Some consider allowing hospitals to treat ambulatory patients to tackle potential shortages of ambulatory care in underserved areas. In this paper, we develop an integrated index of spatial accessibility covering multiple dimensions of health care. This index may contribute to the empirical evidence concerning potential risks and benefits of integrating the currently separated health care sectors. Accessibility is measured separately for each type of care based on official data at the district level. Applying an Improved Gravity Model allows us to factor in potential cross-border utilization. We combine the accessibilities for each type of care into a univariate index by adapting the concept of regional multiple deprivation measurement to allow for a limited substitutability between health care sectors. The results suggest that better health care accessibility in urban areas persists when taking a holistic view. We believe that this new index may provide an empirical basis for an inter-sectoral capacity planning.

  10. Lessons from the business sector for successful knowledge management in health care: A systematic review

    Directory of Open Access Journals (Sweden)

    Sibbald Shannon

    2011-07-01

    Full Text Available Abstract Background The concept of knowledge management has been prevalent in the business sector for decades. Only recently has knowledge management been receiving attention by the health care sector, in part due to the ever growing amount of information that health care practitioners must handle. It has become essential to develop a way to manage the information coming in to and going out of a health care organization. The purpose of this paper was to summarize previous studies from the business literature that explored specific knowledge management tools, with the aim of extracting lessons that could be applied in the health domain. Methods We searched seven databases using keywords such as "knowledge management", "organizational knowledge", and "business performance". We included articles published between 2000-2009; we excluded non-English articles. Results 83 articles were reviewed and data were extracted to: (1 uncover reasons for initiating knowledge management strategies, (2 identify potential knowledge management strategies/solutions, and (3 describe facilitators and barriers to knowledge management. Conclusions KM strategies include such things as training sessions, communication technologies, process mapping and communities of practice. Common facilitators and barriers to implementing these strategies are discussed in the business literature, but rigorous studies about the effectiveness of such initiatives are lacking. The health care sector is at a pinnacle place, with incredible opportunities to design, implement (and evaluate knowledge management systems. While more research needs to be done on how best to do this in healthcare, the lessons learned from the business sector can provide a foundation on which to build.

  11. Prohibit, constrain, encourage, or purchase: how should we engage with the private health-care sector?

    Science.gov (United States)

    Montagu, Dominic; Goodman, Catherine

    2016-08-01

    The private for-profit sector's prominence in health-care delivery, and concern about its failures to deliver social benefit, has driven a search for interventions to improve the sector's functioning. We review evidence for the effectiveness and limitations of such private sector interventions in low-income and middle-income countries. Few robust assessments are available, but some conclusions are possible. Prohibiting the private sector is very unlikely to succeed, and regulatory approaches face persistent challenges in many low-income and middle-income countries. Attention is therefore turning to interventions that encourage private providers to improve quality and coverage (while advancing their financial interests) such as social marketing, social franchising, vouchers, and contracting. However, evidence about the effect on clinical quality, coverage, equity, and cost-effectiveness is inadequate. Other challenges concern scalability and scope, indicating the limitations of such interventions as a basis for universal health coverage, though interventions can address focused problems on a restricted scale. PMID:27358250

  12. Achieving universal health care coverage: Current debates in Ghana on covering those outside the formal sector

    Directory of Open Access Journals (Sweden)

    Abiiro Gilbert

    2012-10-01

    Full Text Available Abstract Background Globally, extending financial protection and equitable access to health services to those outside the formal sector employment is a major challenge for achieving universal coverage. While some favour contributory schemes, others have embraced tax-funded health service cover for those outside the formal sector. This paper critically examines the issue of how to cover those outside the formal sector through the lens of stakeholder views on the proposed one-time premium payment (OTPP policy in Ghana. Discussion Ghana in 2004 implemented a National Health Insurance Scheme, based on a contributory model where service benefits are restricted to those who contribute (with some groups exempted from contributing, as the policy direction for moving towards universal coverage. In 2008, the OTPP system was proposed as an alternative way of ensuring coverage for those outside formal sector employment. There are divergent stakeholder views with regard to the meaning of the one-time premium and how it will be financed and sustained. Our stakeholder interviews indicate that the underlying issue being debated is whether the current contributory NHIS model for those outside the formal employment sector should be maintained or whether services for this group should be tax funded. However, the advantages and disadvantages of these alternatives are not being explored in an explicit or systematic way and are obscured by the considerable confusion about the likely design of the OTPP policy. We attempt to contribute to the broader debate about how best to fund coverage for those outside the formal sector by unpacking some of these issues and pointing to the empirical evidence needed to shed even further light on appropriate funding mechanisms for universal health systems. Summary The Ghanaian debate on OTPP is related to one of the most important challenges facing low- and middle-income countries seeking to achieve a universal health care system. It

  13. A realistic theory of health sector management. The case for critical realism.

    Science.gov (United States)

    Connelly, J

    2000-01-01

    To date the practice of health sector management has not been sufficiently theorised. An adequate theory should be able to answer the pre-eminent critique of managerial rationality and ethics mounted by Alasdair MacIntyre in After Virtue and should also offer robust analytical and ethical resources to identify and engage with the social, political, economic and moral issues underlying health sector management. Critical realism with its ontology of generative mechanisms, agency-structure relationships, valorisation of activity and ideology critique offers such resources in an empirically orientated but adequately theorised realist framework. Rather than negate MacIntyre, critical realism incorporates and transcends his key arguments regarding the rationality and ethics of management. This article introduces the main elements of critical realism and clears a conceptual space for the cumulation of critical realist case-studies and managerial craft knowledge.

  14. An integrated health sector response to violence against women in Malaysia: lessons for supporting scale up.

    OpenAIRE

    Colombini Manuela; Mayhew Susannah H; Ali Siti; Shuib Rashidah; Watts Charlotte

    2012-01-01

    Abstract Background Malaysia has been at the forefront of the development and scale up of One-Stop Crisis Centres (OSCC) - an integrated health sector model that provides comprehensive care to women and children experiencing physical, emotional and sexual abuse. This study explored the strengths and challenges faced during the scaling up of the OSCC model to two States in Malaysia in order to identify lessons for supporting successful scale-up. Methods In-depth interviews were conducted with ...

  15. Ethical Competence and Moral Distress in the Health Care Sector : A Prospective Evaluation of Ethics Rounds

    OpenAIRE

    Kälvemark Sporrong, Sofia

    2007-01-01

    Ongoing structural and financial changes in the health care sector have resulted in increased risks for ethical dilemmas and moral distress. It is purported that increased ethical competence will help staff manage ethical dilemmas and hence decrease moral distress. To enhance ethical competence several approaches may be used – theoretical education, and methods focusing on reflection and decision-making abilities. Ethics rounds are a widespread systematic method hypothesized to improve ethica...

  16. The sustainability of donor funded projects in the health sector / T. Mitchell

    OpenAIRE

    Mitchell, Therese

    2013-01-01

    The need for donor funding has increased significantly over the last decade. Without donor funding millions of people wouldn’t be alive today. Thanks either to research finding a cure, successful treatment, funds donated for food, aid toward building infrastructure, or giving people the opportunity to further their education. Donor funding thus facilitates a better future. A literature review was conducted to give background on the health sector and how these funds were distributed, ethical c...

  17. Stress in the Health Sector and Effect of Optimism on the Job Satisfaction

    OpenAIRE

    Songul Yigı

    2015-01-01

    Job is an indispensable part of life. All employees face stress. The health sector has many properties that may lead to stress stemming from its characteristic structure. Due to the fact that the slightest mistake may lead to loss of human life, satisfaction or dissatisfaction of employees has an importance not only in terms of individuals but also in terms of the society.Optimism is a viewpoint. An optimistic person can cope with any difficulties of life and survive dangerous situations with...

  18. Is the Water Sector Lagging behind Education and Health on Aid Effectiveness? Lessons from Bangladesh, Ethiopia and Uganda

    Directory of Open Access Journals (Sweden)

    Katharina Welle

    2009-10-01

    Full Text Available A study in three countries (Bangladesh, Ethiopia and Uganda assessed progress against the Paris Principles for Aid Effectiveness (AE in three sectors – water, health and education – to test the assumption that the water sector is lagging behind. The findings show that it is too simplistic to say that the water sector is lagging, although this may well be the case in some countries. The study found that wider governance issues are more important for AE than having in place sector-specific mechanics such as Sector-Wide Approaches alone. National political leadership and governance are central drivers of sector AE, while national financial and procurement systems and the behaviour of actors who have not signed up to the Paris Principles – at both national and global levels – have implications for progress that cut across sectors. Sectors and sub-sectors do nonetheless have distinct features that must be considered in attempting to improve sector-level AE. In light of these findings, using political economy approaches to better understand and address governance and strengthening sector-level monitoring is recommended as part of efforts to improve AE and development results in the water sector.

  19. Community mental health in two sectors: County Caroni and St. George East--an evaluation.

    Science.gov (United States)

    James, V

    1986-01-01

    An evaluation of the community mental health program in Trinidad in two sectors with differing sociological backgrounds is made. Results showed that both sectors had regular outpatient clinics, outpatient group psychotherapy, and mental health officers partly community based. County Caroni had a low admission rate to St. Ann's Hospital, an ongoing education programme, an outpatient club, and an Extended Care Centre with Day Care Centre. The predominant illnesses seen in County Caroni were Alcoholism in the males and Depression and Anxiety States in the females. In St. George East, there was a higher admission rate to St. Ann's Hospital. The education program was irregular. There was an Extended Care Centre in Tacarigua half of which was allocated to psychiatric patients and a Day Care Centre at the Tumpuna Rehabilitation Centre. The most frequent illnesses in St. George East were Schizophrenia and Alcoholism in the males, and Schizophrenia and Depression with equal frequency in the females. The results indicated that the specific needs of each sector were different--hence the need for different approaches. The difficulties of implementing the Community Mental Health programme are discussed.

  20. Partnerships between the faith-based and medical sectors: Implications for preventive medicine and public health.

    Science.gov (United States)

    Levin, Jeff

    2016-12-01

    Interconnections between the faith-based and medical sectors are multifaceted and have existed for centuries, including partnerships that have evolved over the past several decades in the U.S. This paper outlines ten points of intersection that have engaged medical and healthcare professionals and institutions across specialties, focusing especially on primary care, global health, and community-based outreach to underserved populations. In a time of healthcare resource scarcity, such partnerships-involving religious congregations, denominations, and communal and philanthropic agencies-are useful complements to the work of private-sector medical care providers and of federal, state, and local public health institutions in their efforts to protect and maintain the health of the population. At the same time, challenges and obstacles remain, mostly related to negotiating the complex and contentious relations between these two sectors. This paper identifies pressing legal/constitutional, political/policy, professional/jurisdictional, ethical, and research and evaluation issues that need to be better addressed before this work can realize its full potential. PMID:27512649

  1. Diabetes, HIV and other health determinants associated with absenteeism among formal sector workers in Namibia

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    Guariguata Leonor

    2012-01-01

    Full Text Available Abstract Background As countries in sub-Saharan Africa develop their economies, it is important to understand the health of employees and its impact on productivity and absenteeism. While previous studies have assessed the impact of single conditions on absenteeism, the current study evaluates multiple health factors associated with absenteeism in a large worker population across several sectors in Namibia. Methods From March 2009 to June 2010, PharmAccess Namibia conducted a series of cross-sectional surveys of 7,666 employees in 7 sectors of industry in Namibia. These included a self-reported health questionnaire and biomedical screenings for certain infectious diseases and non-communicable disease (NCD risk factors. Data were collected on demographics, absenteeism over a 90-day period, smoking behavior, alcohol use, hemoglobin, blood pressure, blood glucose, cholesterol, waist circumference, body mass index (BMI, HIV status, and presence of hepatitis B antigens and syphilis antibodies. The associations of these factors to absenteeism were ascertained using negative binomial regression. Results Controlling for demographic and job-related factors, high blood glucose and diabetes had the largest effect on absenteeism (IRR: 3.67, 95%CI: 2.06-6.55. This was followed by anemia (IRR: 1.59, 95%CI: 1.17-2.18 and being HIV positive (IRR: 1.47; 95%CI: 1.12-1.95. In addition, working in the fishing or services sectors was associated with an increased incidence of sick days (IRR: 1.53, 95%CI: 1.23-1.90; and IRR: 1.70, 95%CI: 1.32-2.20 respectively. The highest prevalence of diabetes was in the services sector (3.6%, 95%CI:-2.5-4.7. The highest prevalence of HIV was found in the fishing sector (14.3%, 95%CI: 10.1-18.5. Conclusion Both NCD risk factors and infectious diseases are associated with increased rates of short-term absenteeism of formal sector employees in Namibia. Programs to manage these conditions could help employers avoid costs associated

  2. Health sector operational planning and budgeting processes in Kenya-"never the twain shall meet".

    Science.gov (United States)

    Tsofa, Benjamin; Molyneux, Sassy; Goodman, Catherine

    2016-07-01

    Operational planning is considered an important tool for translating government policies and strategic objectives into day-to-day management activities. However, developing countries suffer from persistent misalignment between policy, planning and budgeting. The Medium Term Expenditure Framework (MTEF) was introduced to address this misalignment. Kenya adopted the MTEF in the early 2000s, and in 2005, the Ministry of Health adopted the Annual Operational Plan process to adapt the MTEF to the health sector. This study assessed the degree to which the health sector Annual Operational Plan process in Kenya has achieved alignment between planning and budgeting at the national level, using document reviews, participant observation and key informant interviews. We found that the Kenyan health sector was far from achieving planning and budgeting alignment. Several factors contributed to this problem including weak Ministry of Health stewardship and institutionalized separation between planning and budgeting processes; a rapidly changing planning and budgeting environment; lack of reliable data to inform target setting and poor participation by key stakeholders in the process including a top-down approach to target setting. We conclude that alignment is unlikely to be achieved without consideration of the specific institutional contexts and the power relationships between stakeholders. In particular, there is a need for institutional integration of the planning and budgeting processes into a common cycle and framework with common reporting lines and for improved data and local-level input to inform appropriate and realistic target setting. © 2015 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd.

  3. Older lesbians and work in the Australian health and aged care sector.

    Science.gov (United States)

    Hughes, Mark; Kentlyn, Sujay

    2015-01-01

    While research has identified challenges lesbians face in the workplace, there is limited understanding of the particular experiences of older lesbians, especially those working in the health and aged care sector. This article draws on the stories of four women who participated in a narrative research project on lesbian and gay people's experiences of health and aged care. It highlights the need for future research to examine the complexity of identity expression and community affiliation, how people negotiate "coming out" in the workplace, the impact of discrimination, and the resources (such as friends) available to lesbians in the workplace. PMID:25575323

  4. Integrating human health into environmental impact assessment: case studies of Canada's Northern mining resource sector

    International Nuclear Information System (INIS)

    This paper examines the integration of human health considerations into environmental impact assessment (EIA) in the Canadian North. Emphasis is placed on the northern mining sector, where more land has been staked in the past decade than in the previous 50 years combined. Using information from interviews with northern EIA and health practitioners and reviews of selected project documents, we examined three principal mining case studies, northern Saskatchewan uranium mining operations, the Ekati diamond project, and the Voisey's Bay mine/mill project, to determine whether and how health considerations in EIA have evolved and the current nature and scope of health integration. Results suggest that despite the recognized link between environment and health and the number of high-profile megaprojects in Canada's North, human health, particularly social health, has not been given adequate treatment in northern EIA. Health considerations in EIA have typically been limited to physical health impacts triggered directly by project-induced environmental change, while social and other health determinants have been either not considered at all, or limited to those aspects of health and well-being that the project proponent directly controlled, namely employment opportunities and worker health and safety. In recent years, we have been seeing improvements in the scope of health in EIA to reflect a broader range of health determinants, including traditional land use and culture. However, there is still a need to adopt impact mitigation and enhancement measures that are sensitive to northern society, to monitor and follow up actual health impacts after project approval, and to ensure that mitigation and enhancement measures are effective. (author)

  5. Health resources in a 200,000 urban Indian population argues the need for a policy on private sector health services

    Directory of Open Access Journals (Sweden)

    Kheya Melo Furtado

    2014-01-01

    Full Text Available Background: There are limited primary data on the number of urban health care providers in private practice in developing countries like India. These data are needed to construct and test models that measure the efficacy of public stewardship of private sector health services. Objective: This study reports the number and characteristics of health resources in a 200 000 urban population in Pune. Materials and Methods: Data on health providers were collected by walking through the 15.46 sq km study area. Enumerated data were compared with existing data sources. Mapping was carried out using a Global Positioning System device. Metrics and characteristics of health resources were analyzed using ArcGIS 10.0 and Statistical Package for the Social Sciences, Version 16.0 software. Results: Private sector health facilities constituted the majority (424/426, 99.5% of health care services. Official data sources were only 39% complete. Doctor to population ratios were 2.8 and 0.03 per 1000 persons respectively in the private and public sector, and the nurse to doctor ratio was 0.24 and 0.71, respectively. There was an uneven distribution of private sector health services across the area (2-118 clinics per square kilometre. Bed strength was forty-fold higher in the private sector. Conclusions: Mandatory registration of private sector health services needs to be implemented which will provide an opportunity for public health planners to utilize these health resources to achieve urban health goals.

  6. Healthy firms: constraints to growth among private health sector facilities in Ghana and Kenya.

    Directory of Open Access Journals (Sweden)

    Nicholas E Burger

    Full Text Available BACKGROUND: Health outcomes in developing countries continue to lag the developed world, and many countries are not on target to meet the Millennium Development Goals. The private health sector provides much of the care in many developing countries (e.g., approximately 50 percent in Sub-Saharan Africa, but private providers are often poorly integrated into the health system. Efforts to improve health systems performance will need to include the private sector and increase its contributions to national health goals. However, the literature on constraints private health care providers face is limited. METHODOLOGY/PRINCIPAL FINDINGS: We analyze data from a survey of private health facilities in Kenya and Ghana to evaluate growth constraints facing private providers. A significant portion of facilities (Ghana: 62 percent; Kenya: 40 percent report limited access to finance as the most significant barrier they face; only a small minority of facilities report using formal credit institutions to finance day to day operations (Ghana: 6 percent; Kenya: 11 percent. Other important barriers include corruption, crime, limited demand for goods and services, and poor public infrastructure. Most facilities have paper-based rather than electronic systems for patient records (Ghana: 30 percent; Kenya: 22 percent, accounting (Ghana: 45 percent; Kenya: 27 percent, and inventory control (Ghana: 41 percent; Kenya: 24 percent. A majority of clinics in both countries report undertaking activities to improve provider skills and to monitor the level and quality of care they provide. However, only a minority of pharmacies report undertaking such activities. CONCLUSIONS/SIGNIFICANCE: The results suggest that improved access to finance and improving business processes especially among pharmacies would support improved contributions by private health facilities. These strategies might be complementary if providers are more able to take advantage of increased access to

  7. Decentralization and decision space in the health sector: a case study from Karnataka, India.

    Science.gov (United States)

    Seshadri, Shreelata Rao; Parab, Suraj; Kotte, Sandesh; Latha, N; Subbiah, Kalyani

    2016-03-01

    Various attempts have been made in India with respect to decentralization, most significantly the 73rd Amendment to the Constitution of India (1993) which provided the necessary legal framework for decentralization to take place. However, the outcome has been mixed: an evaluation of the impact of decentralization in the health sector found virtually no change in health system performance and access to health services in terms of availability of health personnel or improvement in various health indicators, such as Infant Mortality Rates or Maternal Mortality Ratio. Subsequently, there has been a conscious effort under the National Rural Health Mission (NRHM)-launched in 2005-to promote decentralization of funds, functions and functionaries to lower levels of government; and Karnataka had a head-start since devolution of all 29 functions prescribed by the 73rd Amendment had already taken place in the state by the late 1990s. This study presents the findings of an on-going research effort to build empirical evidence on decentralization in the health sector and its impact on system performance. The focus here is on analyzing the responses of health personnel at the district level and below on their perceived 'Decision Space'-the range of choice or autonomy they see themselves as having along a series of functional dimensions. Overall, the data indicate that there is a substantial gap between the spirit of the NRHM guidelines on decentralization and the actual implementation on the ground. There is a need for substantial capacity building at all levels of the health system to genuinely empower functionaries, particularly at the district level, in order to translate the benefits of decentralization into reality. PMID:25967105

  8. The Gateway Paper--stewardship and governance in the health sector in Pakistan.

    Science.gov (United States)

    Nishtar, Sania

    2006-12-01

    As an opening for a dialogue on health reforms in the country, the Gateway Paper places emphasis on strengthening the stewardship function of mandated State agencies in Pakistan with particular attention to two key areas. Firstly, greater emphasis on a stewardship role for the Ministry and departments of health in the context of inter-sectoral scope of health and secondly, a stronger role for the State agencies as regulators of healthcare within the country. The Gateway Paper envisages that the role of State agencies will become more critical as new models of financing health and delivering services are structured given that these entail regulation of private sector providers, providing oversight for ensuring a system for ongoing education and implementation of frameworks for public-private partnerships. The Gateway Paper refers to stewardship with reference to analysis and overview of health policies within the country, their relationship with evidence, their follow-up into planning and finally their implementation. The Paper also provides an insight into policies from a process-related as well as content and program related perspectives. In doing so a number of questions relating to the evidence and policy disconnect; issues at strategic and operational levels of planning, and governance-related impediments to program implementation have been discussed and a viewpoint articulated on an approach to addressing these challenges.

  9. Pro-social preferences and self-selection into the public health sector: evidence from an economic experiment.

    Science.gov (United States)

    Kolstad, Julie Riise; Lindkvist, Ida

    2013-05-01

    Motivational crowding-out theory establishes that the effectiveness of financial incentive schemes, like pay-for-performance, crucially depends on the underlying social preferences of health workers. In this paper we study the extent to which heterogeneity in the strength and structure of social preferences is related to career choices by testing whether preferences vary systematically between Tanzanian health worker students who prefer to work in the private for-profit health sector and those who prefer to work in the public health sector. Despite its important policy implications, this issue has received little attention to date. By combining data from a questionnaire and an economic experiment, we find that students who prefer to work in the public health sector have stronger pro-social preferences than those who prefer to work in the private for-profit sector. PMID:22763126

  10. The changing locus of decision making in the health care sector.

    Science.gov (United States)

    Havighurst, C C

    1986-01-01

    In the 1970s, the health policy debate focused on whether government or the medical profession should control the health care system. This article asserts that that struggle between two forms of centralized control was both less promising and less consequential than the devolution of decision-making authority upon consumers and their agents that is occurring today and that seems likely to continue as competitive forces become stronger and opportunities for meaningful consumer choice increases. What we are witnessing is the simultaneous deprofessionalization and depoliticization of important decisions affecting health care, a decentralization and diversification of the system that is opening new possibilities for translating diverse consumer desires into provider performance. Although covering much familiar ground, this article links a variety of seemingly discrete issues under the sterility of the competition-versus-regulation debate and to show the historical and ethical significance of the major changes that are under way in the health care sector today. PMID:3571884

  11. Health care inequities in north India: Role of public sector in universalizing health care

    OpenAIRE

    Prinja, Shankar; Kanavos, Panos; Kumar, Rajesh

    2012-01-01

    Background & objectives: Income inequality is associated with poor health. Inequities exist in service utilization and financing for health care. Health care costs push high number of households into poverty in India. We undertook this study to ascertain inequities in health status, service utilization and out-of-pocket (OOP) health expenditures in two States in north India namely, Haryana and Punjab, and Union Territory of Chandigarh. Methods: Data from National Sample Survey 60th Round on M...

  12. How stem defects affect the capability of optimum bucking method?

    Directory of Open Access Journals (Sweden)

    Abdullah Emin Akay

    2015-07-01

    Full Text Available In forest harvesting activities, computer-assisted optimum bucking method increases the economic value of harvested trees. The bucking decision highly depends on the log quality grades which mainly vary with the surface characteristics such as stem defects and form of the stems. In this study, the effects of stem defects on optimum bucking method was investigated by comparing bucking applications which were conducted during the logging operations in two different Brutian Pine (Pinus brutia Ten stands. In the applications, the first stand contained the stems with relatively more stem defects than that of the stems in the second stand. The average number of defects per log for sample trees in the first and the second stand was recorded as 3.64 and 2.70, respectively. The results indicated that optimum bucking method increased the average economic value of harvested trees by 15.45% and 8.26 % in the stands, respectively. Therefore, the computer-assisted optimum bucking method potentially provides better results than that of traditional bucking method especially for the harvested trees with more stem defects.

  13. Violencia contra las mujeres: el papel del sector salud en la legislación internacional Violence against women: the role of the health sector in international legislation

    Directory of Open Access Journals (Sweden)

    Gaby Ortiz-Barreda

    2012-10-01

    Full Text Available Objetivos: Identificar y describir las responsabilidades que se atribuyen a las administraciones sanitarias en materia de prevención y atención de la violencia contra las mujeres en la legislación internacional sobre este tema. Métodos: Análisis de contenido de las leyes de violencia contra las mujeres recopiladas en The Annual Review of Law of Harvard University, UN Secretary-General's database on Violence against Women, International Digest of Health Legislation y Stop Violence against Women. Se identificaron y seleccionaron las leyes que hacían mención explícita a la participación del sector salud en intervenciones de violencia contra las mujeres. Se clasificaron las intervenciones según los niveles de prevención primaria, secundaria y terciaria definidos por la Organización Mundial de la Salud en su Informe Mundial sobre Violencia y Salud (2002. Resultados: De 115 países analizados, 55 disponen de leyes sobre la violencia contra las mujeres que contemplan la participación del sector salud en sus intervenciones. En la mayoría, esta participación se centra en la denuncia de casos detectados y la atención de casos derivados de servicios policiales. Se identificaron 24 leyes que hacían mención a intervenciones específicamente desarrolladas por el sector salud, sobre todo de prevención terciaria. Las leyes de México, Colombia, Argentina, El Salvador, España y Filipinas integran intervenciones relacionadas con los tres niveles de prevención. Conclusiones: Una cuarta parte de las leyes sobre la violencia contra las mujeres estudiadas incorporan intervenciones específicas del sector salud. Esto sugiere que todavía es incipiente el abordaje integral del problema. Se requiere un mayor aprovechamiento de las potencialidades de este sector en intervenciones previas a las consecuencias de la violencia contra las mujeres.Objectives: To identify and describe the responsibilities attributed to health administrations in preventing

  14. The voluntary sector and health policy: the role of national level health consumer and patients' organisations in the UK.

    Science.gov (United States)

    Baggott, Rob; Jones, Kathryn

    2014-12-01

    This article explores the policy role of health consumer and patients' organisations (HCPOs), an important subset of the UK voluntary health sector. Based on research findings from two surveys, the article examines the activities, resources and contacts of HCPOs. It also assesses their impact on health policy and reform. There is some evidence that HCPOs can influence policy and reform. However, much depends on the alliances they build with other policy actors (including other HCPOs), their resources and leadership. HCPOs seem to have more impact on the detail of policy than on the direction of travel. In addition, there are potentially adverse consequences for HCPOs that do engage with the policy process, which may partly explain why some are wary of such involvement. For example, it is possible that HCPOs can be manipulated by government and other powerful policy actors such as health professionals and the drugs industry.

  15. Health worker (internal customer) satisfaction and motivation in the public sector in Ghana.

    Science.gov (United States)

    Agyepong, Irene Akua; Anafi, Patricia; Asiamah, Ebenezer; Ansah, Evelyn K; Ashon, Daniel A; Narh-Dometey, Christiana

    2004-01-01

    This paper describes factors affecting health worker motivation and satisfaction in the public sector in Ghana. The data are from a survey of public sector health care providers carried out in January 2002 and repeated in August 2003 using an interviewer administered structured questionnaire. It is part of a continuous quality improvement (CQI) effort in the health sector in the Greater Accra region of Ghana. Workplace obstacles identified that caused dissatisfaction and de-motivated staff in order of the most frequently mentioned were low salaries such that obtaining basic necessities of daily living becomes a problem; lack of essential equipment, tools and supplies to work with; delayed promotions; difficulties and inconveniences with transportation to work; staff shortages; housing, additional duty allowances and in-service (continuous) training. Others included children's education, vehicles to work with such as ambulances and pickups, staff transfer procedures, staff pre-service education inadequate for job requirements, and the effect of the job on family and other social factors. There were some differences in the percentages of staff selecting a given workplace obstacle between the purely rural districts, the highly urbanized Accra metropolis and the districts that were a mixture of urbanized and rural. It is unlikely that the Ghana Health Service can provide high quality of care to its end users (external customers) if workplace obstacles that de-motivate staff (internal customers) and negatively influence their performance are not properly recognized and addressed as a complex of inter-related problems producing a common result--dissatisfied poorly motivated staff and resulting poor quality services. PMID:15688876

  16. Diode-assisted buck-boost voltage source inverters

    DEFF Research Database (Denmark)

    Gao, F.; Loh, P.C.; Teodorescu, Remus;

    2007-01-01

    This paper proposes buck-boost voltage source inverters with a unique X-shape diode-capacitor network inserted between inverter circuitry and dc source for producing a large voltage boost gain. Comparing with other voltage buck-boost techniques, the presented topologies with only a little more...... passive components can significantly enhance voltage boost capability for dc-ac inversion. With different front-end circuitries, the diode-assisted buck-boost inverters can show different operational principle and voltage boost ratio. Carefully analyzing the operational principle for the inherent energy...

  17. Job satisfaction and motivation of health workers in public and private sectors: cross-sectional analysis from two Indian states

    Directory of Open Access Journals (Sweden)

    Mahapatra Prasanta

    2010-11-01

    Full Text Available Abstract Background Ensuring health worker job satisfaction and motivation are important if health workers are to be retained and effectively deliver health services in many developing countries, whether they work in the public or private sector. The objectives of the paper are to identify important aspects of health worker satisfaction and motivation in two Indian states working in public and private sectors. Methods Cross-sectional surveys of 1916 public and private sector health workers in Andhra Pradesh and Uttar Pradesh, India, were conducted using a standardized instrument to identify health workers' satisfaction with key work factors related to motivation. Ratings were compared with how important health workers consider these factors. Results There was high variability in the ratings for areas of satisfaction and motivation across the different practice settings, but there were also commonalities. Four groups of factors were identified, with those relating to job content and work environment viewed as the most important characteristics of the ideal job, and rated higher than a good income. In both states, public sector health workers rated "good employment benefits" as significantly more important than private sector workers, as well as a "superior who recognizes work". There were large differences in whether these factors were considered present on the job, particularly between public and private sector health workers in Uttar Pradesh, where the public sector fared consistently lower (P P Conclusion There are common areas of health worker motivation that should be considered by managers and policy makers, particularly the importance of non-financial motivators such as working environment and skill development opportunities. But managers also need to focus on the importance of locally assessing conditions and managing incentives to ensure health workers are motivated in their work.

  18. Catastrophic Health Expenditure After the Implementation of Health Sector Evolution Plan: A Case Study in the West of Iran

    Science.gov (United States)

    Piroozi, Bakhtiar; Moradi, Ghobad; Nouri, Bijan; Mohamadi Bolbanabad, Amjad; Safari, Hossein

    2016-01-01

    Background: One of the main objectives of health systems is the financial protection against out-of-pocket (OOP) health expenditures. OOP health expenditures can lead to catastrophic payments, impoverishment or poverty among households. In Iran, health sector evolution plan (HSEP) has been implemented since 2014 in order to achieve universal health coverage and reduce the OOP health expenditures as a percentage of total health expenditures. This study aimed to explore the percentage of households facing catastrophic health expenditures (CHE) after the implementation of HSEP and the factors that determine CHE. Methods: A total of 663 households were selected through a cluster sampling based on the census framework of Sanandaj Health Center in July 2015. Data were gathered using face-to-face interviews based on the household section of the World Health Survey questionnaire. In this study, according to the World Health Organization (WHO) definition, if household health expenditures were equal to or more than 40% of the household capacity to pay, household was considered to be facing CHE. The determinants of CHE were analyzed using logistic regression model. Results: The rates of households facing CHE were 4.8%. The key determinants of CHE were household economic status, presence of elderly or disabled members in the household and utilization of inpatient or rehabilitation services. Conclusion: The comparison of our findings and those of other studies carried out using a methodology comparable with ours in different parts of Iran before the implementation of HSEP suggests that the implementation of recent reforms has reduced CHE at the household level. Utilization of inpatient and rehabilitation services, the presence of elderly or disabled members in the household and the low economic status of the household would increase the likelihood of facing CHE. These variables should be considered by health policy-makers in order to review and revise content of recent reform

  19. Catastrophic Health Expenditure After the Implementation of Health Sector Evolution Plan: A Case Study in the West of Iran

    Directory of Open Access Journals (Sweden)

    Bakhtiar Piroozi

    2016-07-01

    Full Text Available Background: One of the main objectives of health systems is the financial protection against out-of-pocket (OOP health expenditures. OOP health expenditures can lead to catastrophic payments, impoverishment or poverty among households. In Iran, health sector evolution plan (HSEP has been implemented since 2014 in order to achieve universal health coverage and reduce the OOP health expenditures as a percentage of total health expenditures. This study aimed to explore the percentage of households facing catastrophic health expenditures (CHE after the implementation of HSEP and the factors that determine CHE. Methods: A total of 663 households were selected through a cluster sampling based on the census framework of Sanandaj Health Center in July 2015. Data were gathered using face-to-face interviews based on the household section of the World Health Survey questionnaire. In this study, according to the World Health Organization (WHO definition, if household health expenditures were equal to or more than 40% of the household capacity to pay, household was considered to be facing CHE. The determinants of CHE were analyzed using logistic regression model. Results: The rates of households facing CHE were 4.8%. The key determinants of CHE were household economic status, presence of elderly or disabled members in the household and utilization of inpatient or rehabilitation services. Conclusion: The comparison of our findings and those of other studies carried out using a methodology comparable with ours in different parts of Iran before the implementation of HSEP suggests that the implementation of recent reforms has reduced CHE at the household level. Utilization of inpatient and rehabilitation services, the presence of elderly or disabled members in the household and the low economic status of the household would increase the likelihood of facing CHE. These variables should be considered by health policy-makers in order to review and revise content of

  20. PUBLIC PRIVATE PARTNERSHIP IN HEALTH SECTOR IN KARNATAKA: WITH SPECIAL REFERENCE TO WOMEN'S HEALTH

    OpenAIRE

    PRASANNA B JOSHI; GURUPRASAD GANESHKAR

    2013-01-01

    Good Health of people is one of the important indicators of a country'sprosperity. Every country has witnessed a deterioration in the health of its people due tochanges in the life styles, food habits, growing consumerism and also pollution that hasresulted in health problems. Therefore health is a prime concern in the task of nationbuilding. To earn good will of the community by providing quality services is one of theobjectives of the Governments both at the national and state levels is to ...

  1. The adoption of Health Impact Assessments in the Mongolian mining sector: A case study of the diffusion of policy innovation

    OpenAIRE

    Byambaa, Tsogtbaatar

    2014-01-01

    Mongolia’s rapid economic growth, propelled by rapid development of the extractives sector requires that the country be better prepared for potential negative impacts to the health of the people and the country. People are both excited for the remarkable development opportunities that mining promises and are concerned with the potential social, environmental and health risks it could bring. As a country highly dependent on the mining sector, Mongolia has realized that it needs to develop a st...

  2. Treatment and prevention of malaria in pregnancy in the private health sector in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony K; Buregyeya, Esther; Rutebemberwa, Elizeus;

    2016-01-01

    BACKGROUND: Malaria in pregnancy is a major public health problem in Uganda; and it is the leading cause of anaemia among pregnant women and low birth weight in infants. Previous studies have noted poor quality of care in the private sector. Thus there is need to explore ways of improving quality.......03 were the factors that most influenced correct treatment of fever in pregnancy. CONCLUSION: Treatment of fever during pregnancy was poor in this study setting. These data highlight the need to develop interventions to improve patient safety and quality of care for pregnant women in the private health......, pharmacy or private clinic. Data was collected using a structured questionnaire targeting one provider who was found on duty in each selected private health facility and consented to the study. The main variables were: provider characteristics, previous training received, type of drugs stocked, treatment...

  3. Treatment and prevention of malaria in pregnancy in the private health sector in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony K; Buregyeya, Esther; Rutebemberwa, Elizeus;

    2016-01-01

    and prevention practices for malaria among pregnant women. The main study outcome was the proportion of private health facilities who prescribe treatment of fever among pregnant women as recommended in the guidelines. RESULTS: A total of 241 private health facilities were surveyed; 70.5 % were registered drug...... clinics and pharmacies for prevention of malaria in pregnancy. Few facilities had malaria treatment guidelines; (44.1 % of private clinics, 17.9 % of drug shops, and 41.7 % at pharmacies. Knowledge of people at risk of malaria, P = 0.02 and availability of malaria treatment guidelines, P = 0.03 were......BACKGROUND: Malaria in pregnancy is a major public health problem in Uganda; and it is the leading cause of anaemia among pregnant women and low birth weight in infants. Previous studies have noted poor quality of care in the private sector. Thus there is need to explore ways of improving quality...

  4. The promotion of children's health and wellbeing: the contributions of England's charity sector

    Directory of Open Access Journals (Sweden)

    Persaud Albert

    2010-07-01

    Full Text Available Abstract Background Sports and arts based services for children have positive impacts on their mental and physical health. The charity sector provides such services, often set up in response to local communities expressing a need. The present study maps resilience promoting services provided by children's charities in England. Specifically, the prominence of sports and arts activities, and types of mental health provisions including telephone help-lines, are investigated. Findings The study was a cross-sectional web-based survey of chief executives, senior mangers, directors and chairs of charities providing services for children under the age of 16. The aims, objectives and activities of participating children's charities and those providing mental health services were described overall. In total 167 chief executives, senior managers, directors and chairs of charities in England agreed to complete the survey. From our sample of charities, arts activities were the most frequently provided services (58/167, 35%, followed by counselling (55/167, 33% and sports activities (36/167, 22%. Only 13% (22/167 of charities expected their work to contribute to the health legacy of the 2012 London Olympics. Telephone help lines were provided by 16% of the charities that promote mental health. Conclusions Counselling and arts activities were relatively common. Sports activities were limited despite the evidence base that sport and physical activity are effective interventions for well-being and health gain. Few of the charities we surveyed expected a health legacy from the 2012 London Olympics.

  5. Financial Management Reforms in the Health Sector: A Comparative Study Between Cash-based and Accrual-based Accounting Systems

    OpenAIRE

    ABOLHALLAJE, Masoud; Jafari, Mehdi; Seyedin, Hesam; Salehi, Masoud

    2014-01-01

    Background: Financial management and accounting reform in the public sectors was started in 2000. Moving from cash-based to accrual-based is considered as the key component of these reforms and adjustments in the public sector. Performing this reform in the health system is a part of a bigger reform under the new public management. Objectives: The current study aimed to analyze the movement from cash-based to accrual-based accounting in the health sector in Iran. Patients and Methods: This co...

  6. Health Status of the Female Workers in the Garment Sector of Bangladesh

    Directory of Open Access Journals (Sweden)

    Shaheen AHMED

    2014-06-01

    Full Text Available Readymade Garment (RMG Sector in Bangladesh has been playing a vital role in creating employment opportunity for the rural marginal people for the last two decades. At present 5,100 garment factories are operating in this country and 3.6 million workers are working there in which more than 80 percent of them are female. From the beginning it is largely apparent that the health status of the female garment workers is not well enough to do their work properly. Keeping this in mind, the study was conducted to find out the health status of the female workers. In this study, 200 female workers of Bangladesh were interviewed to identify the major diseases they experienced. The study reveals that the majority of the female workers in the garment sector suffer from the diseases like problems in bones, abortion complexity, dermatitis, back pain, eye stain, pruritus, malnutrition, respiratory problems, hepatitis (Jandice, gastric pain, fatigue, fever, abdomen pain, common cold, and helminthiasis. The policy makers and other concern bodies should take necessary measures to ensure good health of the garment workers. It will help female workers to be more productive and their contribution to the country will be enhanced.

  7. [Mobile applications for the health sector: apps to support scientific information and medical practice].

    Science.gov (United States)

    Poltronieri, Elisabetta; Barbaro, Annarita; Gentili, Donatella; Napolitani, Federica

    2013-01-01

    The market of mobile applications (apps) and wireless technology infrastructures is rapidly widening and diversifying to better meet users' needs. Over the last few years, the use of mobile technologies and applications has been increasingly expanding in many professional fields. Research and academic institutions, hospitals, and drug companies are heavily investing in this sector, also in Italy, even though the offer seems to be still limited at the moment. As far as the industry of scientific publishing is concerned, the main Italian publishing groups show an increasing interest in developing apps aiming at spreading their own products, following the example of international publishing companies. The purpose of this paper is to provide a general overview of the mobile applications and services available in the domain of scientific information relating to health disciplines and medical practice, especially within the Italian context. This study intends to inform professionals and users in the health sector about the benefits offered by the mobile technology, and to help them to become familiar with these tools. The two main online markets (iTunes and Google Play) have been analysed; search engines for apps and Italian STM publishers' websites have also been considered. Within this fast moving scenery, innovation is supported by the pressing demand for mobile access technology which has increased enormously. Not surprisingly, the most promising target of mobile technology is represented by scientific information tools relating to health. PMID:23585438

  8. Incorporation of environmental and health impacts into policy, planning and decision making for the electricity sector

    International Nuclear Information System (INIS)

    This paper summarizes the report of an international expert group on ways to incorporate considerations of environmental and health impacts into policy, planning and decision making in the electricity sector. The problems addressed are very complex, and a comprehensive approach is needed. Both economic efficiency and the efficient use of resources are of key importance. The report does not attempt to present solutions to the problems, but seeks instead to describe a series of options and a mechanism for making trade-offs between them so that different countries and different decision-making bodies can be guided to make choices in a rational way

  9. The Challenges and Issues Regarding E-Health and Health Information Technology Trends in the Healthcare Sector

    Science.gov (United States)

    Esmaeilzadeh, Pouyan; Sambasivan, Murali; Kumar, Naresh

    Like other industries, the utilization of the internet and Information Technology (IT) has increased in the health sector. Different applications attributed to the internet and IT in healthcare practice. It includes a range of services that intersect the edge of medicine, computer and information science. The presence of the internet helps healthcare practice with the use of electronic processes and communication. Also, health IT (HIT) deals with the devices, clinical guidelines and methods required to improve the management of information in healthcare. Although the internet and HIT has been considered as an influential means to enhance health care delivery, it is completely naive to imagine all new tools and mechanisms supported by the internet and HIT systems are simply adopted and used by all organizational members. As healthcare professionals play an important role in the healthcare sector, there is no doubt that mechanism of newly introduced HIT and new application of the internet in medical practice should be coupled with healthcare professionals' acceptance. Therefore, with great resistance by healthcare professionals new mechanism and tools supported by IT and the internet cannot be used properly and subsequently may not improve the quality of medical care services. However, factors affecting the healthcare professionals' adoption behavior concerning new e-health and HIT mechanism are still not conclusively identified. This research (as a theoretical study) tries to propose the source of resistance in order to handle the challenges over new e-technology in the health industry. This study uses the involved concepts and develops a conceptual framework to improve overall acceptance of e-health and HIT by healthcare professionals.

  10. Efficiency of social sector expenditure in India: a case of health and education in selected Indian states

    Directory of Open Access Journals (Sweden)

    Brijesh C. Purohit

    2014-07-01

    Full Text Available Social sector expenditure in India captures a number of important aspects including health, nutrition, education, water supply, sanitation, housing and welfare, among others. Over a period of time, besides budgetary outlay on this sector, private sector has also played a considerable role. Thus, efficiency of expenditure in this sector by state government has to be reckoned both in terms of relative levels of various aspects across the states and in terms of comparable benchmarks for different aspects of the sector. This paper attempts an analysis of social sector efficiency focusing on two major aspects: health and education. Unlike other studies on the Indian context, this analysis focusing on major states in India uses both non-parametric and parametric approaches. Although both approaches provide benchmarks to judge relative efficiency across states, the former provides a yardstick more at an aggregative level without parametric restrictions, whereas the latter is used for major focus on health care aspects. Results of free disposal hull analysis are suggestive of a considerably more scope for improvement in efficiency of public expenditure in health relative to education. Our results of stochastic frontier analysis indicate considerable state level disparities which could be reduced through a mix of strategies involving reallocation of factors (namely, manpower and supply of consumables within the sector, mobilizing additional resources possibly through enhanced budgetary emphasis, or encouraging more private sector participation. Based on our results, this may enhance efficiency by nearly 20% in health care sector and increase availability and equity across low performing and poorer states like Madhya Pradesh and Uttar Pradesh.

  11. Research on a Novel Soft-Switching Buck Converter

    OpenAIRE

    Peng Ge; Ben Niu; Yuanbin Li

    2013-01-01

    Based on classical zero voltage transition buck pwm converter, an ideal buck converter with pwm-controlled soft-switching circuit is proposed. The proposed auxiliary circuit allows the main switch to operate with zero-voltage switching. Besides, all of the semiconductor devices operate under soft-switching conditions. Thus, losses were reduced. It was analyzed in detail to demonstrate the operating principle of the novel circuit. Finally, simulation results are given analysis and the simulati...

  12. Design & Implementation of Zero Voltage Switching Buck Converter

    OpenAIRE

    A.Suresh Kumar; P.Krishna Reddy

    2014-01-01

    Zero voltage switching (ZVS) buck converter is more preferable over hard switched buck converter for low power, high frequency DC-DC conversion applications. In Zero voltage switching converter, turn on & turn off of a switch occurs at zero voltage that results in lower switching losses. In this converter soft switching is achieved by using resonant components. The optimal values of resonant components are determined by using electric functions derived from circuit configurati...

  13. Instantaneous Current Feedback Control Strategy on Buck Mode Inverter

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Control strategies for Buck mode inverter have important effect on static and dynamic characteristics, reliability, load capacity, and short-circuit resistance. Instantaneous current feedback control strategies include instantaneous inductor current feedback control and instantaneous capacitor current feedback control, both of which have essential difference. When the Buck mode inverter respectively adopts instantaneous inductor current and capacitor current feedback control strategies, characteristics of stability, output voltage and power, short circuit, nonlinear load and dynamic are fully investigated in this paper.

  14. Accurate Sliding-Mode Control System Modeling for Buck Converters

    DEFF Research Database (Denmark)

    Høyerby, Mikkel Christian Wendelboe; Andersen, Michael Andreas E.

    2007-01-01

    This paper shows that classical sliding mode theory fails to correctly predict the output impedance of the highly useful sliding mode PID compensated buck converter. The reason for this is identified as the assumption of the sliding variable being held at zero during sliding mode, effectively...... approach also predicts the self-oscillating switching action of the sliding-mode control system correctly. Analytical findings are verified by simulation as well as experimentally in a 10-30V/3A buck converter....

  15. [Decentralization of the health sector in Mexico. Scope and limitations of local health systems].

    Science.gov (United States)

    González-Block, M A

    1992-01-01

    This paper is a product of the reflection on the decentralization and sectorization experiences in Mexico since 1917 with particular emphasis on the 1980s. The historical analysis included the creation of an analytical model designed to identify the relationship between the distinct sanitary policies implemented in Mexico and the tendencies towards decentralization and integration. This analysis is combined with a critical review of the recent decentralization experiences undertaken in the states of Guerrero, Oaxaca and Nuevo León. While comparing Guerrero and Oaxaca, restitution and deconcentration under similar socio-economic conditions were discussed. The comparison between Guerrero and Nuevo Leon allowed the discussion of the benefits and limits of restitution under different socio-economic conditions. In addition, with this model the author discusses a few generalizations regarding the possible future of decentralization.

  16. Health co-benefits of climate change mitigation policies in the transport sector

    Science.gov (United States)

    Shaw, Caroline; Hales, Simon; Howden-Chapman, Philippa; Edwards, Richard

    2014-06-01

    Theory, common sense and modelling studies suggest that some interventions to mitigate carbon emissions in the transport sector can also have substantial short-term benefits for population health. Policies that encourage active modes of transportation such as cycling may, for example, increase population physical activity and decrease air pollution, thus reducing the burden of conditions such as some cancers, diabetes, heart disease and dementia. In this Perspective we systematically review the evidence from 'real life' transport policies and their impacts on health and CO2 emissions. We identified a few studies that mostly involved personalized travel planning and showed modest increases in active transport such as walking, and reductions in vehicle use and CO2 emissions. Given the poor quality of the studies identified, urgent action is needed to provide more robust evidence for policies.

  17. Colombian public policies contributing to the achievement of Millennium Development Goals in the health sector, 2006

    Directory of Open Access Journals (Sweden)

    Lina M. Grisales

    2008-02-01

    Full Text Available During the General Assembly of the United Nations, in September 2000,189 countries (including Colombia committed to eight objectives leading to a more human and fairer world. Such objectives are called the Millennium Development Goals (mdg and to achieve them it is crucial to incorporate them in the action agendas of each country. The purpose of this monograph is to recognize current public policies in Colombia and Antioquia leading the achievement of the Millennium Development Goals, specifically those related to the reduction of mortality among children less than 5 years of age, improvement of maternal health and fighting against hiv/aids, malaria and dengue.In Colombia, Conpes 91 of 2005 is the only guideline given by the Government establishing goals and strategies to achieve the Millennium Development Goals in 2015. Nevertheless, other policies, programs and projects before and even after the Millennium Statement (but without explicit purpose contribute to achieving such goals. Revision of those policies is an effort for the research project “Degree of contribution of public policies to the achievement of the Millennium Development Goals related to the health sector, Antioquia, 2006”, which will evaluate the impact these guidelines have had in the achievement of the development goals in that particular sector.

  18. Human resources: the Cinderella of health sector reform in Latin America

    Directory of Open Access Journals (Sweden)

    Ugalde Antonio

    2005-01-01

    Full Text Available Abstract Human resources are the most important assets of any health system, and health workforce problems have for decades limited the efficiency and quality of Latin America health systems. World Bank-led reforms aimed at increasing equity, efficiency, quality of care and user satisfaction did not attempt to resolve the human resources problems that had been identified in multiple health sector assessments. However, the two most important reform policies – decentralization and privatization – have had a negative impact on the conditions of employment and prompted opposition from organized professionals and unions. In several countries of the region, the workforce became the most important obstacle to successful reform. This article is based on fieldwork and a review of the literature. It discusses the reasons that led health workers to oppose reform; the institutional and legal constraints to implementing reform as originally designed; the mismatch between the types of personnel needed for reform and the availability of professionals; the deficiencies of the reform implementation process; and the regulatory weaknesses of the region. The discussion presents workforce strategies that the reforms could have included to achieve the intended goals, and the need to take into account the values and political realities of the countries. The authors suggest that autochthonous solutions are more likely to succeed than solutions imported from the outside.

  19. A case for increased private sector involvement in Ireland's national animal health services.

    Science.gov (United States)

    More, Simon J

    2008-01-01

    Non-regulatory animal health issues, such as Johne's disease, infectious bovine rhinotracheitis (IBR) and mastitis will become increasing important, with ongoing globalisation of markets in animals and animal products. In response, Ireland may need to broaden the scope of its national animal health services. However, there have been concerns about the respective roles and responsibilities (both financial and otherwise) of government and industry in any such moves. This paper argues the case for increased private sector involvement in Ireland's national animal health services, based both on theoretical considerations and country case studies (the Netherlands and Australia). The Dutch and Australian case studies present examples of successful partnerships between government and industry, including systems and processes to address non-regulatory animal health issues. In each case, the roles and responsibilities of government are clear, as are the principles underpinning government involvement. Furthermore, the roles and responsibilities (financial and otherwise) of the Dutch and Australian industry are determined through enabling legislation, providing both legitimacy and accountability. There are constraints on the use of EU and national government funds to support non-regulatory animal health services in EU member states (such as Ireland and the Netherlands). PMID:21851708

  20. A case for increased private sector involvement in ireland's national animal health services

    Directory of Open Access Journals (Sweden)

    More Simon J

    2008-02-01

    Full Text Available Abstract Non-regulatory animal health issues, such as Johne's disease, infectious bovine rhinotracheitis (IBR and mastitis will become increasing important, with ongoing globalisation of markets in animals and animal products. In response, Ireland may need to broaden the scope of its national animal health services. However, there have been concerns about the respective roles and responsibilities (both financial and otherwise of government and industry in any such moves. This paper argues the case for increased private sector involvement in Ireland's national animal health services, based both on theoretical considerations and country case studies (the Netherlands and Australia. The Dutch and Australian case studies present examples of successful partnerships between government and industry, including systems and processes to address non-regulatory animal health issues. In each case, the roles and responsibilities of government are clear, as are the principles underpinning government involvement. Furthermore, the roles and responsibilities (financial and otherwise of the Dutch and Australian industry are determined through enabling legislation, providing both legitimacy and accountability. There are constraints on the use of EU and national government funds to support non-regulatory animal health services in EU member states (such as Ireland and the Netherlands.

  1. The Impact of Robotics on Employment and Motivation of Employees in the Service Sector, with Special Reference to Health Care

    Science.gov (United States)

    Qureshi, Mohammed Owais; Syed, Rumaiya Sajjad

    2014-01-01

    Background The economy is being lifted by the new concept of robotics, but we cannot be sure of all the possible benefits. At this early stage, it therefore becomes important to find out the possible benefits/limitations associated with robotics, so that the positives can be capitalized, established, and developed further for the employment and motivation of employees in the health care sector, for overall economic development. The negatives should also be further studied and mitigated. Methods This study is an exploratory research, based on secondary data, such as books on topics related to robotics, websites, public websites of concerned departments for data and statistics, journals, newspapers and magazines, websites of health care providers, and different printed materials (brochures, etc). Results The impact of robotics has both positive and negative impacts on the employment and motivation of employees in the retail sector. So far, there has been no substantial research done into robotics, especially in the health care sector. Conclusion Replacing employees with robots is an inevitable choice for organizations in the service sector, more so in the health care sector because of the challenging and sometimes unhealthy working environments, but, at the same time, the researchers propose that it should be done in a manner that helps in improving the employment and motivation of employees in this sector. PMID:25516812

  2. [Telematics in the public health sector. Where is the protection of health data?].

    Science.gov (United States)

    Voßhoff, Andrea; Raum, Bertram; Ernestus, Walter

    2015-10-01

    There is a long history of telematics in the German health system. Apart from the growing technical possibilities in the field, it is important to concentrate on the protection of health data in telematics applications. Health data in the hands of service providers or other third parties entails certain risks for the patient's personality rights, because these institutions may not be bound by the practice of medical confidentiality. In addition, big data processing risks make the individual lives of patients and insured persons totally transparent. Measures to reduce these risks have to be taken by the providers as well as by the users of telematics infrastructure; they are the ones who should explicitly address the relevant risks and dangers in a data protection and IT-security concept and develop adequate strategies to cope with these dangers. Additionally, the German legislator remains obliged to create a regulatory framework for the protection of patients' rights. PMID:26285650

  3. Conceptual framework of public health surveillance and action and its application in health sector reform

    Directory of Open Access Journals (Sweden)

    Alemu Wondi

    2002-01-01

    Full Text Available Abstract Background Because both public health surveillance and action are crucial, the authors initiated meetings at regional and national levels to assess and reform surveillance and action systems. These meetings emphasized improved epidemic preparedness, epidemic response, and highlighted standardized assessment and reform. Methods To standardize assessments, the authors designed a conceptual framework for surveillance and action that categorized the framework into eight core and four support activities, measured with indicators. Results In application, country-level reformers measure both the presence and performance of the six core activities comprising public health surveillance (detection, registration, reporting, confirmation, analyses, and feedback and acute (epidemic-type and planned (management-type responses composing the two core activities of public health action. Four support activities – communications, supervision, training, and resource provision – enable these eight core processes. National, multiple systems can then be concurrently assessed at each level for effectiveness, technical efficiency, and cost. Conclusions This approach permits a cost analysis, highlights areas amenable to integration, and provides focused intervention. The final public health model becomes a district-focused, action-oriented integration of core and support activities with enhanced effectiveness, technical efficiency, and cost savings. This reform approach leads to sustained capacity development by an empowerment strategy defined as facilitated, process-oriented action steps transforming staff and the system.

  4. Health technology assessment and its role in the future development of the Indian healthcare sector.

    Science.gov (United States)

    Hass, Bastian; Pooley, Jayne; Feuring, Martin; Suvarna, Viraj; Harrington, Adrian E

    2012-04-01

    Public expenditure on healthcare in India is low by international comparison, and access to essential treatment pushes many uninsured citizens below the poverty line. In many countries, policymakers utilize health technology assessment (HTA) methodologies to direct investments in healthcare, to obtain the maximum benefit for the population as a whole. With rising incomes and a commitment from the Government of India to increase the proportion of gross domestic product spent on health, this is an opportune moment to consider how HTA might help to allocate healthcare spending in India, in an equitable and efficient manner. Despite the predominance of out-of-pocket payments in the Indian healthcare sector, payers of all types are increasingly demanding value for money from expenditure on healthcare. In this review we demonstrate how HTA can be used to inform several aspects of healthcare provision. Areas in which HTA could be applied in the Indian context include, drug pricing, development of clinical practice guidelines, and prioritizing interventions that represent the greatest value within a limited budget. To illustrate the potential benefits of using the HTA approach, we present an example from a mature HTA market (Canada) that demonstrates how a new treatment for patients with atrial fibrillation - although more expensive than the current standard of care - improves clinical outcomes and represents a cost-effective use of public health resources. If aligned with the prevailing cultural and ethical considerations, and with the necessary investment in expert staff and resources, HTA promises to be a valuable tool for development of the Indian healthcare sector. PMID:22701823

  5. Health technology assessment and its role in the future development of the Indian healthcare sector

    Directory of Open Access Journals (Sweden)

    Bastian Hass

    2012-01-01

    Full Text Available Public expenditure on healthcare in India is low by international comparison, and access to essential treatment pushes many uninsured citizens below the poverty line. In many countries, policymakers utilize health technology assessment (HTA methodologies to direct investments in healthcare, to obtain the maximum benefit for the population as a whole. With rising incomes and a commitment from the Government of India to increase the proportion of gross domestic product spent on health, this is an opportune moment to consider how HTA might help to allocate healthcare spending in India, in an equitable and efficient manner. Despite the predominance of out-of-pocket payments in the Indian healthcare sector, payers of all types are increasingly demanding value for money from expenditure on healthcare. In this review we demonstrate how HTA can be used to inform several aspects of healthcare provision. Areas in which HTA could be applied in the Indian context include, drug pricing, development of clinical practice guidelines, and prioritizing interventions that represent the greatest value within a limited budget. To illustrate the potential benefits of using the HTA approach, we present an example from a mature HTA market (Canada that demonstrates how a new treatment for patients with atrial fibrillation - although more expensive than the current standard of care - improves clinical outcomes and represents a cost-effective use of public health resources. If aligned with the prevailing cultural and ethical considerations, and with the necessary investment in expert staff and resources, HTA promises to be a valuable tool for development of the Indian healthcare sector.

  6. Encouraging Health Insurance for the Informal Sector: A Cluster Randomized Experiment in Vietnam.

    Science.gov (United States)

    Wagstaff, Adam; Nguyen, Ha Thi Hong; Dao, Huyen; Bales, Sarah

    2016-06-01

    Subsidized voluntary enrollment in government-run health insurance schemes is often proposed as a way of increasing coverage among informal sector workers and their families. We report the results of a cluster randomized experiment, in which 3000 households in 20 communes in Vietnam were randomly assigned at baseline to a control group or one of three treatments: an information leaflet about Vietnam's government-run scheme and the benefits of health insurance, a voucher entitling eligible household members to 25% off their annual premium, and both. At baseline, the four groups had similar enrollment rates (4%) and were balanced on plausible enrollment determinants. The interventions all had small and insignificant effects (around 1 percentage point or ppt). Among those reporting sickness in the 12 months prior to the baseline survey the subsidy-only intervention raised enrollment by 3.5 ppts (p = 0.08) while the combined intervention raised enrollment by 4.5 ppts (p = 0.02); however, the differences in the effect sizes between the sick and non-sick were just shy of being significant. Our results suggest that information campaigns and subsidies may have limited effects on voluntary health insurance enrollment in Vietnam and that such interventions might exacerbate adverse selection. Copyright © The World Bank Health Economics © 2015 John Wiley & Sons, Ltd. PMID:26666771

  7. Cost of Delivering Health Care Services in Public Sector Primary and Community Health Centres in North India

    Science.gov (United States)

    Gupta, Aditi; Verma, Ramesh; Bahuguna, Pankaj; Kumar, Dinesh; Kaur, Manmeet; Kumar, Rajesh

    2016-01-01

    Background With the commitment of the national government to provide universal healthcare at cheap and affordable prices in India, public healthcare services are being strengthened in India. However, there is dearth of cost data for provision of health services through public system like primary & community health centres. In this study, we aim to bridge this gap in evidence by assessing the total annual and per capita cost of delivering the package of health services at PHC and CHC level. Secondly, we determined the per capita cost of delivering specific health services like cost per antenatal care visit, per institutional delivery, per outpatient consultation, per bed-day hospitalization etc. Methods We undertook economic costing of fourteen public health facilities (seven PHCs and CHCs each) in three North-Indian states viz., Haryana, Himachal Pradesh and Punjab. Bottom-up costing method was adopted for collection of data on all resources spent on delivery of health services in selected health facilities. Analysis was undertaken using a health system perspective. The joint costs like human resource, capital, and equipment were apportioned as per the time value spent on a particular service. Capital costs were discounted and annualized over the estimated life of the item. Mean annual costs and unit costs were estimated along with their 95% confidence intervals using bootstrap methodology. Results The overall annual cost of delivering services through public sector primary and community health facilities in three states of north India were INR 8.8 million (95% CI: 7,365,630–10,294,065) and INR 26.9 million (95% CI: 22,225,159.3–32,290,099.6), respectively. Human resources accounted for more than 50% of the overall costs at both the level of PHCs and CHCs. Per capita per year costs for provision of complete package of preventive, curative and promotive services at PHC and CHC were INR 170.8 (95% CI: 131.6–208.3) and INR162.1 (95% CI: 112–219

  8. An integrated health sector response to violence against women in Malaysia: lessons for supporting scale up

    Directory of Open Access Journals (Sweden)

    Colombini Manuela

    2012-07-01

    Full Text Available Abstract Background Malaysia has been at the forefront of the development and scale up of One-Stop Crisis Centres (OSCC - an integrated health sector model that provides comprehensive care to women and children experiencing physical, emotional and sexual abuse. This study explored the strengths and challenges faced during the scaling up of the OSCC model to two States in Malaysia in order to identify lessons for supporting successful scale-up. Methods In-depth interviews were conducted with health care providers, policy makers and key informants in 7 hospital facilities. This was complemented by a document analysis of hospital records and protocols. Data were coded and analysed using NVivo 7. Results The implementation of the OSCC model differed between hospital settings, with practise being influenced by organisational systems and constraints. Health providers generally tried to offer care to abused women, but they are not fully supported within their facility due to lack of training, time constraints, limited allocated budget, or lack of referral system to external support services. Non-specialised hospitals in both States struggled with a scarcity of specialised staff and limited referral options for abused women. Despite these challenges, even in more resource-constrained settings staff who took the initiative found it was possible to adapt to provide some level of OSCC services, such as referring women to local NGOs or community support groups, or training nurses to offer basic counselling. Conclusions The national implementation of OSCC provides a potentially important source of support for women experiencing violence. Our findings confirm that pilot interventions for health sector responses to gender based violence can be scaled up only when there is a sound health infrastructure in place – in other words a supportive health system. Furthermore, the successful replication of the OSCC model in other similar settings requires that the

  9. Community-based organizations in the health sector: A scoping review

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    Wilson Michael G

    2012-11-01

    Full Text Available Abstract Community-based organizations are important health system stakeholders as they provide numerous, often highly valued programs and services to the members of their community. However, community-based organizations are described using diverse terminology and concepts from across a range of disciplines. To better understand the literature related to community-based organizations in the health sector (i.e., those working in health systems or more broadly to address population or public health issues, we conducted a scoping review by using an iterative process to identify existing literature, conceptually map it, and identify gaps and areas for future inquiry. We searched 18 databases and conducted citation searches using 15 articles to identify relevant literature. All search results were reviewed in duplicate and were included if they addressed the key characteristics of community-based organizations or networks of community-based organizations. We then coded all included articles based on the country focus, type of literature, source of literature, academic discipline, disease sector, terminology used to describe organizations and topics discussed. We identified 186 articles addressing topics related to the key characteristics of community-based organizations and/or networks of community-based organizations. The literature is largely focused on high-income countries and on mental health and addictions, HIV/AIDS or general/unspecified populations. A large number of different terms have been used in the literature to describe community-based organizations and the literature addresses a range of topics about them (mandate, structure, revenue sources and type and skills or skill mix of staff, the involvement of community members in organizations, how organizations contribute to community organizing and development and how they function in networks with each other and with government (e.g., in policy networks. Given the range of terms used to

  10. Cross-sector cooperation in health-enhancing physical activity policymaking: more potential than achievements?

    OpenAIRE

    Hämäläinen, Riitta-Maija; Aro, Arja R; Lau, Cathrine Juel; Rus, Diana; Cori, Liliana; Syed, Ahmed M.; ,

    2016-01-01

    Background The cooperation of actors across policy fields and the need for cross-sector cooperation as well as recommendations on how to implement cross-sector cooperation have been addressed in many national and international policies that seek to solve complex issues within societies. For such a purpose, the relevant governance structure between policy sectors is cross-sector cooperation. Therefore, cross-sector cooperation and its structures need to be better understood for improved implem...

  11. Bridging the gaps in the Health Management Information System in the context of a changing health sector

    Science.gov (United States)

    2010-01-01

    Background The Health Management Information System (HMIS) is crucial for evidence-based policy-making, informed decision-making during planning, implementation and evaluation of health programs; and for appropriate use of resources at all levels of the health system. This study explored the gaps and factors influencing HMIS in the context of a changing health sector in Tanzania. Methods A cross sectional descriptive study was conducted in 11 heath facilities in Kilombero district between January and February 2008. A semi-structured questionnaire was used to interview 43 health workers on their knowledge, attitude, practice and factors for change on HMIS and HMIS booklets from these facilities were reviewed for completeness. Results Of all respondents, 81% had never been trained on HMIS, 65% did not properly define this system, 54% didn't know who is supposed to use the information collected and 42% did not use the collected data for planning, budgeting and evaluation of services provision. Although the attitude towards the system was positive among 91%, the reviewed HMIS booklets were never completed in 25% - 55% of the facilities. There were no significant differences in knowledge, attitude and practice on HMIS between clinicians and nurses. The most common type of HMIS booklets which were never filled were those for deliveries (55%). The gaps in the current HMIS were linked to lack of training, inactive supervision, staff workload pressure and the lengthy and laborious nature of the system. Conclusions This research has revealed a state of poor health data collection, lack of informed decision-making at the facility level and the factors for change in the country's HMIS. It suggests need for new innovations including incorporation of HMIS in the ongoing reviews of the curricula for all cadres of health care providers, development of more user-friendly system and use of evidence-based John Kotter's eight-step process for implementing successful changes in this

  12. Bridging the gaps in the Health Management Information System in the context of a changing health sector

    Directory of Open Access Journals (Sweden)

    Nyamtema Angelo S

    2010-06-01

    Full Text Available Abstract Background The Health Management Information System (HMIS is crucial for evidence-based policy-making, informed decision-making during planning, implementation and evaluation of health programs; and for appropriate use of resources at all levels of the health system. This study explored the gaps and factors influencing HMIS in the context of a changing health sector in Tanzania. Methods A cross sectional descriptive study was conducted in 11 heath facilities in Kilombero district between January and February 2008. A semi-structured questionnaire was used to interview 43 health workers on their knowledge, attitude, practice and factors for change on HMIS and HMIS booklets from these facilities were reviewed for completeness. Results Of all respondents, 81% had never been trained on HMIS, 65% did not properly define this system, 54% didn't know who is supposed to use the information collected and 42% did not use the collected data for planning, budgeting and evaluation of services provision. Although the attitude towards the system was positive among 91%, the reviewed HMIS booklets were never completed in 25% - 55% of the facilities. There were no significant differences in knowledge, attitude and practice on HMIS between clinicians and nurses. The most common type of HMIS booklets which were never filled were those for deliveries (55%. The gaps in the current HMIS were linked to lack of training, inactive supervision, staff workload pressure and the lengthy and laborious nature of the system. Conclusions This research has revealed a state of poor health data collection, lack of informed decision-making at the facility level and the factors for change in the country's HMIS. It suggests need for new innovations including incorporation of HMIS in the ongoing reviews of the curricula for all cadres of health care providers, development of more user-friendly system and use of evidence-based John Kotter's eight-step process for implementing

  13. Ethics in public health research: masters of marketing: bringing private sector skills to public health partnerships.

    Science.gov (United States)

    Curtis, Valerie A; Garbrah-Aidoo, Nana; Scott, Beth

    2007-04-01

    Skill in marketing is a scarce resource in public health, especially in developing countries. The Global Public-Private Partnership for Handwashing with Soap set out to tap the consumer marketing skills of industry for national handwashing programs. Lessons learned from commercial marketers included how to (1) understand consumer motivation, (2) employ 1 single unifying idea, (3) plan for effective reach, and (4) ensure effectiveness before national launch. After the first marketing program, 71% of Ghanaian mothers knew the television ad and the reported rates of handwashing with soap increased. Conditions for the expansion of such partnerships include a wider appreciation of what consumer marketing is, what it can do for public health, and the potential benefits to industry. Although there are practical and philosophical difficulties, there are many opportunities for such partnerships.

  14. The health sector and nursing work El sector salud y el trabajo en enfermería

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    MORALES CORREA ESPERANZA

    2007-12-01

    Full Text Available AEn el sector de la salud y la seguridad social, la aplicación de las políticas del actual gobierno, encaminadas a la privatización y a su adecuación a las reglas del Acuerdo General de Comercialización de Servicios de la Organización Mundial del Comercio (OMC, se viene impulsando con especial empeño y rapidez, lo que se ha traducido en la adopción de reformas que han dado lugar a la liquidación, privatización o transformación de las entidades estatales de la seguridad social, con énfasis en aquellas que prestan servicios de salud y las que administran los distintos regímenes de pensiones, lo que ha incidido gravemente sobre la estabilidad y los derechos laborales de los trabajadores y profesionales vinculados a esta rama de los servicios y, naturalmente, ha significado un deterioro de la calidad y reducción de cobertura en la prestación de los servicios de la salud. Hoy el mundo del trabajo para el conjunto de los trabajadores del sector comporta los elementos de un modelo de salud que se opuso diametralmente al fundamento del sistema de salud que operaba en Colombia desde la década de los setenta, y antes de la Ley 100 de 1993; como se evidencia en la actualidad, este modelo alejó la salud como un derecho social, e incorporó la competencia entre lo público y lo privado, el concepto de mercado de servicios, la selección adversa e intermediación en el sistema de salud, la calificación de enfermedades como ruinosas catastróficas costosas, la flexibilización laboral y la polivalencia de los trabajadores: "Hacer más y de todo por un menor costo".

  15. Effectively engaging the private sector through vouchers and contracting - A case for analysing health governance and context.

    Science.gov (United States)

    Nachtnebel, Matthias; O'Mahony, Ashleigh; Pillai, Nandini; Hort, Kris

    2015-11-01

    Health systems of low and middle income countries in the Asia Pacific have been described as mixed, where public and private sector operate in parallel. Gaps in the provision of primary health care (PHC) services have been picked up by the private sector and led to its growth; as can an enabling regulatory environment. The question whether governments should purchase services from the private sector to address gaps in service provision has been fiercely debated. This purposive review draws evidence from systematic reviews, and additional published and grey literature, for input into a policy brief on purchasing PHC-services from the private sector for underserved areas in the Asia Pacific region. Additional published and grey literature on vouchers and contracting as mechanisms to engage the private sector was used to supplement the conclusions from systematic reviews. We analysed the literature through a policy lens, or alternatively, a 'bottom-up' approach which incorporates components of a realist review. Evidence indicates that both vouchers and contracting can improve health service outcomes in underserved areas. These outcomes however are strongly influenced by (1) contextual factors, such as roles and functions attributable to a shared set of key actors (2) the type of delivered services and community demand (3) design of the intervention, notably provider autonomy and trust (4) governance capacity and provision of stewardship. Examining the experience of vouchers and contracting to expand health services through engagement with private sector providers in the Asia Pacific found positive effects with regards to access and utilisation of health services, but more importantly, highlighted the significance of contextual factors, appropriate selection of mechanism for services provided, and governance arrangements and stewardship capacity. In fact, for governments seeking to engage the private sector, analysis of context and capacities are potentially a more

  16. Developing a decision aid to guide public sector health policy decisions: A study protocol

    Directory of Open Access Journals (Sweden)

    Brouwers Melissa

    2011-05-01

    Full Text Available Abstract Background Decision aids have been developed in a number of health disciplines to support evidence-informed decision making, including patient decision aids and clinical practice guidelines. However, policy contexts differ from clinical contexts in terms of complexity and uncertainty, requiring different approaches for identifying, interpreting, and applying many different types of evidence to support decisions. With few studies in the literature offering decision guidance specifically to health policymakers, the present study aims to facilitate the structured and systematic incorporation of research evidence and, where there is currently very little guidance, values and other non-research-based evidence, into the policy making process. The resulting decision aid is intended to help public sector health policy decision makers who are tasked with making evidence-informed decisions on behalf of populations. The intent is not to develop a decision aid that will yield uniform recommendations across jurisdictions, but rather to facilitate more transparent policy decisions that reflect a balanced consideration of all relevant factors. Methods/design The study comprises three phases: a modified meta-narrative review, the use of focus groups, and the application of a Delphi method. The modified meta-narrative review will inform the initial development of the decision aid by identifying as many policy decision factors as possible and other features of methodological guidance deemed to be desirable in the literatures of all relevant disciplines. The first of two focus groups will then seek to marry these findings with focus group members' own experience and expertise in public sector population-based health policy making and screening decisions. The second focus group will examine issues surrounding the application of the decision aid and act as a sounding board for initial feedback and refinement of the draft decision aid. Finally, the Delphi

  17. ICTs and the health sector towards smarter health and wellness models

    CERN Document Server

    2013-01-01

    The future sustainability of health systems will depend on how well governments are able to anticipate and respond to efficiency and quality of care challenges. Bold action is required, as well as willingness to test innovative care delivery approaches. The greatest promise for transformational change is in applications that encourage new, ubiquitous, participatory preventive and personalised smart models of care. A whole new world of possibilities in using mobiles and the Internet to address healthcare challenges has opened up. The potential of mobile devices, services and applications to sup

  18. A Development of an ISG Framework for Mosul’s Health Sector

    Directory of Open Access Journals (Sweden)

    Mohammad Salim

    2012-06-01

    Full Text Available The world has started to appreciate more and more the value ofinformation and its impact on the community. This paper sharesthe findings of a study done on information securityimplementation at Mosul’s health sector. The study wasconducted via a self-administrated questionnaire and interview.The respondents are the IT managers and personnel withfunctions related to IT in selected hospitals in the city of Mosul.The findings reveal an ISG status that is in dire need forimprovement to maintain suitable level of security ofinformation which can be achieved through having goodgovernance practices in place. However there are variousdegrees of implementation by the hospitals. It is recommendedthat these findings be used as basis for developing a secureinformation-based system for the respective hospitals.

  19. Concrete core activation in the public health sector [in the Netherlands]; Betonkernactivering in de gezondheidszorg

    Energy Technology Data Exchange (ETDEWEB)

    Nicolaas, H.J. [College bouw zorginstellingen, Utrecht (Netherlands)

    2006-03-15

    Nursing homes, hospitals and residential care centres are all developing plans to take advantage of concrete core activation. Starting from the requirements for interior climate and HVAC technology in the health care sector, this article examines points that merit additional attention in the use of concrete core activation. The subjects touched on include the need for supplementary heating, how to deal with the ventilation, the influence of the building process, the consequences for acoustics, and the cost considerations of these systems. [Dutch] Zowel verpleeghuizen, ziekenhuizen en woonzorgcentra ontwikkelen plannen om van BetonKernActivering gebruik te maken. Uitgaande van de eisen die aan her binnenklimaat en de installatietechniek in de zorgsector worden gesteld, gaat dit artikel in op de punten die extra aandacht verdienen bij het toepassen van BKA. Onderwerpen zijn: noodzaak tot aanvullende verwarming, hoe om te gaan met ventilatie, de invloed op bet bouwproces, gevolgen voor de akoestiek en meer en minder kosten van dergelijke installaties.

  20. The public health sector supply of modern contraceptives in rural Nigeria: an analysis of selection, forecasting and inventory control

    OpenAIRE

    Asa Auta; Banwat, Samuel B

    2011-01-01

    Public health facilities in rural Nigeria have been experiencing a long period of stock-outs and unavailability of modern contraceptives. This work was carried out to review the public health sector supply of modern contraceptives in rural Nigeria in order to make recommendations on how to improve the supply of modern contraceptives in this area. The study reviewed secondary data from country documents and literature obtained from Pubmed, Popline, and Global Health databases; as well as websi...

  1. Dual Buck Hybrid Cascaded Multilevel Inverter%复合型级联多电平双buck式逆变器

    Institute of Scientific and Technical Information of China (English)

    嵇保健; 洪峰; 张广明

    2011-01-01

    采用不同级联单元构建的复合型结构成为级联多电平逆变器电路重要的研究与发展方向。为此,提出了一种新颖的复合型级联多电平双buck逆变器结构。该逆变器引入双buck电路作为基本组成单元,由双buck电路和桥式电路级联构成,发挥各自优点;并采用开环工频控制和滞环电流脉宽调制(PWM)控制相结合的控制方案。其中,双buck电路采用PWM控制,完成输出波形闭环控制,充分利用双buck电路无桥臂直通、无开关器件体二极管反向恢复、适宜高频化的特点;而桥式电路单元开关管在整个工频周期仅开关一次,输出阶梯合成波(三电平时为%A dual buck hybrid cascaded multilevel inverter is presented, and a novel dual buck circuit is introduced into this inverter as the basic cascaded cell. Then, the inverter is made of one dual buck cell and several bridge cells. The merits of dual buck circuit and bridge circuit are remained in this hybrid inverter. And a simple control method composed of low working-frequency switch control and hysteretic current pulse width modulate (PWM) control is adopted. This method is easy to be accomplished. The main cascaded part of the inverter which is modulated by hysteretic current PWM close-loop control method is the dual buck cell. Dual buck circuit is a highly efficient and reliable topology which overcomes the shoot-through problem in traditional bridge inverter, and its switches and diodes can be designed respectively. The other cascaded parts of inverter are all bridge cells, working in a working-frequency switch mode and providing main sector of output voltage. Low frequency and high voltage pressure components can be used as switches of bridge cell. This inverter remains the merits of cascaded multilevel inverter that the harmonic content of output voltage is low, so the filter can be simplified, and its reliability and efficiency are improved.

  2. Pesticide Health and Safety Challenges Facing Informal Sector Workers: A Case of Small-scale Agricultural Workers in Tanzania.

    Science.gov (United States)

    Ngowi, Aiwerasia; Mrema, Ezra; Kishinhi, Stephen

    2016-08-01

    The Tanzania informal sector is growing fast, with precarious working conditions and particular hazards for women and children in agriculture. Hazardous agricultural chemicals including pesticides are mostly imported and have been used for many years. Despite the role played by pesticides in food security and vector control, these chemicals are responsible for acute and chronic illnesses among communities. The availability of obsolete persistent organic pesticides on the open market indicates existence of an inadequate regulatory system. People who get injured or ill in the agriculture sector in Tanzania receive health services in primary health care facilities where professionals have little or no knowledge of pesticides. We are presenting the pesticide health and safety challenges faced by small-scale farmers who fall in the informal sector. Achievements that have been made by the government and other players to reduce and prevent pesticide exposures and poisoning are also outlined.

  3. Pesticide Health and Safety Challenges Facing Informal Sector Workers: A Case of Small-scale Agricultural Workers in Tanzania.

    Science.gov (United States)

    Ngowi, Aiwerasia; Mrema, Ezra; Kishinhi, Stephen

    2016-08-01

    The Tanzania informal sector is growing fast, with precarious working conditions and particular hazards for women and children in agriculture. Hazardous agricultural chemicals including pesticides are mostly imported and have been used for many years. Despite the role played by pesticides in food security and vector control, these chemicals are responsible for acute and chronic illnesses among communities. The availability of obsolete persistent organic pesticides on the open market indicates existence of an inadequate regulatory system. People who get injured or ill in the agriculture sector in Tanzania receive health services in primary health care facilities where professionals have little or no knowledge of pesticides. We are presenting the pesticide health and safety challenges faced by small-scale farmers who fall in the informal sector. Achievements that have been made by the government and other players to reduce and prevent pesticide exposures and poisoning are also outlined. PMID:27406110

  4. Field Plot Points for Buck Island Reef National Monument Vegetation Mapping Project

    Data.gov (United States)

    National Park Service, Department of the Interior — This shapefile represents all the field plots visited on Buck Island. To fully comprehend this feature class, please refer to the full "Buck Island Reef National...

  5. Applications of the balanced scorecard for strategic management and performance measurement in the health sector.

    Science.gov (United States)

    Behrouzi, Farshad; Shaharoun, Awaluddin Mohamed; Ma'aram, Azanizawati

    2014-05-01

    In order to attain a useful balanced scorecard (BSC), appropriate performance perspectives and indicators are crucial to reflect all strategies of the organisation. The objectives of this survey were to give an insight regarding the situation of the BSC in the health sector over the past decade, and to afford a generic approach of the BSC development for health settings with specific focus on performance perspectives, performance indicators and BSC generation. After an extensive search based on publication date and research content, 29 articles published since 2002 were identified, categorised and analysed. Four critical attributes of each article were analysed, including BSC generation, performance perspectives, performance indicators and auxiliary tools. The results showed that 'internal business process' was the most notable BSC perspective as it was included in all reviewed articles. After investigating the literature, it was concluded that its comprehensiveness is the reason for the importance and high usage of this perspective. The findings showed that 12 cases out of 29 reviewed articles (41%) exceeded the maximum number of key performance indicators (KPI) suggested in a previous study. It was found that all 12 cases were large organisations with numerous departments (e.g. national health organisations). Such organisations require numerous KPI to cover all of their strategic objectives. It was recommended to utilise the cascaded BSC within such organisations to avoid complexity and difficulty in gathering, analysing and interpreting performance data. Meanwhile it requires more medical staff to contribute in BSC development, which will result in greater reliability of the BSC. PMID:24589328

  6. Applications of the balanced scorecard for strategic management and performance measurement in the health sector.

    Science.gov (United States)

    Behrouzi, Farshad; Shaharoun, Awaluddin Mohamed; Ma'aram, Azanizawati

    2014-05-01

    In order to attain a useful balanced scorecard (BSC), appropriate performance perspectives and indicators are crucial to reflect all strategies of the organisation. The objectives of this survey were to give an insight regarding the situation of the BSC in the health sector over the past decade, and to afford a generic approach of the BSC development for health settings with specific focus on performance perspectives, performance indicators and BSC generation. After an extensive search based on publication date and research content, 29 articles published since 2002 were identified, categorised and analysed. Four critical attributes of each article were analysed, including BSC generation, performance perspectives, performance indicators and auxiliary tools. The results showed that 'internal business process' was the most notable BSC perspective as it was included in all reviewed articles. After investigating the literature, it was concluded that its comprehensiveness is the reason for the importance and high usage of this perspective. The findings showed that 12 cases out of 29 reviewed articles (41%) exceeded the maximum number of key performance indicators (KPI) suggested in a previous study. It was found that all 12 cases were large organisations with numerous departments (e.g. national health organisations). Such organisations require numerous KPI to cover all of their strategic objectives. It was recommended to utilise the cascaded BSC within such organisations to avoid complexity and difficulty in gathering, analysing and interpreting performance data. Meanwhile it requires more medical staff to contribute in BSC development, which will result in greater reliability of the BSC.

  7. Creating an integrated public sector? Labour's plans for the modernisation of the English health care system

    Directory of Open Access Journals (Sweden)

    Nick Goodwin

    2002-03-01

    Full Text Available The current Labour Government has embarked on radical public sector reform in England. A so-called ‘Modernisation Agenda’ has been developed that is encapsulated in the NHS Plan—a document that details a long-term vision for health care. This plan involves a five-fold strategy: investment through greater public funding; quality assurance; improving access; service integration and inter-professional working; and providing a public health focus. The principles of Labour's vision have been broadly supported. However, achieving its aims appears reliant on two key factors. First, appropriate resources are required to create capacity, particularly management capacity, to enable new functions to develop. Second, promoting access and service integration requires the development of significant co-ordination, collaboration and networking between agencies and individuals. This is particularly important for health and social care professionals. Their historically separate professions suggest that a significant period of change management is required to allow new roles and partnerships to evolve. In an attempt to secure delivery of its goals, however, the Government has placed the emphasis on further organisational restructuring. In doing so, the Government may have missed the key challenges faced in delivering its NHS Plan. As this paper argues, cultural and behavioural change is probably a far more appropriate and important requirement for success than a centrally directed approach that emphasises the rearrangement of structural furniture.

  8. The financial crisis and health care systems in Europe: universal care under threat? Trends in health sector reforms in Germany, the United Kingdom, and Spain

    OpenAIRE

    Lígia Giovanella; Klaus Stegmüller

    2014-01-01

    The paper analyzes trends in contemporary health sector reforms in three European countries with Bismarckian and Beveridgean models of national health systems within the context of strong financial pressure resulting from the economic crisis (2008-date), and proceeds to discuss the implications for universal care. The authors examine recent health system reforms in Spain, Germany, and the United Kingdom. Health systems are described using a matrix to compare state intervention in financing, r...

  9. Digital technology for health sector governance in low and middle income countries: a scoping review

    Science.gov (United States)

    Holeman, Isaac; Cookson, Tara Patricia; Pagliari, Claudia

    2016-01-01

    Background Poor governance impedes the provision of equitable and cost–effective health care in many low– and middle–income countries (LMICs). Although systemic problems such as corruption and inefficiency have been characterized as intractable, “good governance” interventions that promote transparency, accountability and public participation have yielded encouraging results. Mobile phones and other Information and Communication Technologies (ICTs) are beginning to play a role in these interventions, but little is known about their use and effects in the context of LMIC health care. Methods Multi–stage scoping review: Research questions and scope were refined through a landscape scan of relevant implementation activities and by analyzing related concepts in the literature. Relevant studies were identified through iterative Internet searches (Google, Google Scholar), a systematic search of academic databases (PubMed, Web of Science), social media crowdsourcing (targeted LinkedIn and Twitter appeals) and reading reference lists and websites of relevant organizations. Parallel expert interviews helped to verify concepts and emerging findings and identified additional studies for inclusion. Results were charted, analyzed thematically and summarized. Results We identified 34 articles from a wide range of disciplines and sectors, including 17 published research articles and 17 grey literature reports. Analysis of these articles revealed 15 distinct ways of using ICTs for good governance activities in LMIC health care. These use cases clustered into four conceptual categories: 1) gathering and verifying information on services to improve transparency and auditability 2) aggregating and visualizing data to aid communication and decision making 3) mobilizing citizens in reporting poor practices to improve accountability and quality and 4) automating and auditing processes to prevent fraud. Despite a considerable amount of implementation activity, we identified

  10. Occupational and Environmental Health Risks Associated with Informal Sector Activities-Selected Case Studies from West Africa.

    Science.gov (United States)

    Basu, Niladri; Ayelo, Paul Ahoumènou; Djogbénou, Luc S; Kedoté, Marius; Lawin, Herve; Tohon, Honesty; Oloruntoba, Elizabeth O; Adebisi, Nurudeen A; Cazabon, Danielle; Fobil, Julius; Robins, Thomas; Fayomi, Benjamin

    2016-08-01

    Most in the Economic Community of West African States region are employed in the informal sector. While the informal sector plays a significant role in the region's economy, policymakers and the scientific community have long neglected it. To better understand informal-sector work conditions, the goal here is to bring together researchers to exchange findings and catalyze dialogue. The article showcases research studies on several economic systems, namely agriculture, resource extraction, transportation, and trade/commerce. Site-specific cases are provided concerning occupational health risks within artisanal and small-scale gold mining, aggregate mining, gasoline trade, farming and pesticide applications, and electronic waste recycling. These cases emphasize the vastness of the informal sector and that the majority of work activities across the region remain poorly documented, and thus no data or knowledge is available to help improve conditions and formulate policies and programs to promote and ensure decent work conditions. PMID:27231011

  11. Occupational and Environmental Health Risks Associated with Informal Sector Activities-Selected Case Studies from West Africa.

    Science.gov (United States)

    Basu, Niladri; Ayelo, Paul Ahoumènou; Djogbénou, Luc S; Kedoté, Marius; Lawin, Herve; Tohon, Honesty; Oloruntoba, Elizabeth O; Adebisi, Nurudeen A; Cazabon, Danielle; Fobil, Julius; Robins, Thomas; Fayomi, Benjamin

    2016-08-01

    Most in the Economic Community of West African States region are employed in the informal sector. While the informal sector plays a significant role in the region's economy, policymakers and the scientific community have long neglected it. To better understand informal-sector work conditions, the goal here is to bring together researchers to exchange findings and catalyze dialogue. The article showcases research studies on several economic systems, namely agriculture, resource extraction, transportation, and trade/commerce. Site-specific cases are provided concerning occupational health risks within artisanal and small-scale gold mining, aggregate mining, gasoline trade, farming and pesticide applications, and electronic waste recycling. These cases emphasize the vastness of the informal sector and that the majority of work activities across the region remain poorly documented, and thus no data or knowledge is available to help improve conditions and formulate policies and programs to promote and ensure decent work conditions.

  12. Design and Control for the Buck-Boost Converter Combining 1-Plus-D Converter and Synchronous Rectified Buck Converters

    Directory of Open Access Journals (Sweden)

    Jeevan Naik

    2015-06-01

    Full Text Available In this paper, a design and control for the buck-boost converter, i.e., 1-plus-D converter with a positive output voltage, is presented, which combines the 1-plus-D converter and the synchronous rectified (SR buck converter. By doing so, the problem in voltage bucking of the 1-plus-D converter can be solved, thereby increasing the application capability of the 1-plus-D converter. Since such a converter operates in continuous conduction mode inherently, it possesses the nonpulsating output current, thereby not only decreasing the current stress on the output capacitor but also reducing the output voltage ripple. Above all, both the 1-plus-D converter and the SR buck converter, combined into a buck–boost converter with no right-half plane zero, use the same power switches, thereby causing the required circuit to be compact and the corresponding cost to be down. Furthermore, during the magnetization period, the input voltage of the 1-plus-D converter comes from the input voltage source, whereas during the demagnetization period, the input voltage of the 1-plus-D converter comes from the output voltage of the SR buck converter.

  13. Solar Photovoltaic Powered Sailing Boat Using Buck Converter

    Directory of Open Access Journals (Sweden)

    Soumya Das

    2015-03-01

    Full Text Available The main objective of this paper is to establish technical and economical aspects of the application of stand-alone photovoltaic (PV system in sailing boat using a buck converter in order to enhance the power generation and also to minimize the cost. Performance and control of dc-dc converter, suitable for photovoltaic (PV applications, is presented here. A buck converter is employed here which extracts complete power from the PV source and feeds into the dc load. The power, which is fed into the load, is sufficient to drive a boat . With the help of matlab simulink software PV module and buck model has been designed and simulated and also compared with theoretical predictions.

  14. Accurate Modeling of Buck Converters with Magnetic-Core Inductors

    DEFF Research Database (Denmark)

    Astorino, Antonio; Antonini, Giulio; Swaminathan, Madhavan

    2015-01-01

    In this paper, a modeling approach for buck converters with magnetic-core inductors is presented. Due to the high nonlinearity of magnetic materials, the frequency domain analysis of such circuits is not suitable for an accurate description of their behaviour. Hence, in this work, a timedomain...... model of buck converters with magnetic-core inductors in a SimulinkR environment is proposed. As an example, the presented approach is used to simulate an eight-phase buck converter. The simulation results show that an unexpected system behaviour in terms of current ripple amplitude needs the inductor core...

  15. Social security health insurance for the informal sector in Nicaragua: a randomized evaluation.

    Science.gov (United States)

    Thornton, Rebecca L; Hatt, Laurel E; Field, Erica M; Islam, Mursaleena; Diaz, Freddy Solís; González, Martha Azucena

    2010-09-01

    This article presents the results from an experimental evaluation of a voluntary health insurance program for informal sector workers in Nicaragua. Costs of the premiums as well as enrollment location were randomly allocated. Overall, take-up of the program was low, with only 20% enrollment. Program costs and streamlined bureaucratic procedures were important determinants of enrollment. Participation of local microfinance institutions had a slight negative effect on enrollment. One year later, those who received insurance substituted toward services at covered facilities and total out-of-pocket expenditures fell. However, total expenditures fell by less than the insurance premiums. We find no evidence of an increase in health-care utilization among the newly insured. We also find very low retention rates after the expiration of the subsidy, with less than 10% of enrollees still enrolled after one year. To shed light on the findings from the experimental results, we present qualitative evidence of institutional and contextual factors that limited the success of this program. PMID:20593433

  16. Diode-Assisted Buck-Boost Voltage-Source Inverters

    DEFF Research Database (Denmark)

    Gao, Feng; Loh, Poh Chiang; Teodorescu, Remus;

    2009-01-01

    This paper proposes a number of diode-assisted buck-boost voltage-source inverters with a unique X-shaped diode-capacitor network inserted between the inverter circuitry and dc source for producing a voltage gain that is comparatively higher than those of other buck-boost conversion techniques....... Using the diode-assisted network, the proposed inverters can naturally configure themselves to perform capacitive charging in parallel and discharging in series to give a higher voltage multiplication factor without compromising waveform quality. In addition, by adopting different front-end circuitries...

  17. Human health-related externalities in energy system modelling the case of the Danish heat and power sector

    DEFF Research Database (Denmark)

    Zvingilaite, Erika

    2011-01-01

    and power sector verifies that it is cheaper for the society to include externalities in the planning of an energy system than to pay for the resulting damages later. Total health costs decrease by around 18% and total system costs decrease by nearly 4% when health externalities are included...... in the optimisation. Furthermore, including localisation aspects can reduce health costs of the heat and power sector in Denmark by additional 7%.......This paper discusses methodology of energy system modelling when reduction of local externalities, such as damage to the human health from energy production-related air pollution, is in focus. Ideally, the local energy externalities should be analysed by adopting the impact pathway approach...

  18. Tool, weapon, or white elephant? A realist analysis of the five phases of a twenty-year programme of occupational health information system implementation in the health sector

    OpenAIRE

    Spiegel Jerry M; Lockhart Karen; Dyck Carmen; Wilson Andrea; O’Hara Lyndsay; Yassi Annalee

    2012-01-01

    Abstract Background Although information systems (IS) have been extensively applied in the health sector worldwide, few initiatives have addressed the health and safety of health workers, a group acknowledged to be at high risk of injury and illness, as well as in great shortage globally, particularly in low and middle-income countries. Methods Adapting a context-mechanism-outcome case study design, we analyze our team’s own experience over two decades to address this gap: in two different Ca...

  19. How does the health sector benefit from trade openness? Evidence form panel data across sub-Saharan Africa countries.

    OpenAIRE

    Novignon, Jacob; Atakorah, Yaw Boateng

    2016-01-01

    The linkages between international trade integration and economic performance has received significant attention from both policy makers and researchers. There seem to be consensus in the literature to suggest that improved trade openness corresponds to improved economic growth. A missing link in the literature is how trade openness affects specific sectors of the economy. Here we argue that trade openness has significant impact on population health and health financing. The study employed pa...

  20. Climate change and its effect on agriculture, water resources and human health sectors in Poland

    Science.gov (United States)

    Szwed, M.; Karg, G.; Pińskwar, I.; Radziejewski, M.; Graczyk, D.; Kedziora, A.; Kundzewicz, Z. W.

    2010-08-01

    Multi-model ensemble climate projections in the ENSEMBLES Project of the EU allowed the authors to quantify selected extreme-weather indices for Poland, of importance to climate impacts on systems and sectors. Among indices were: number of days in a year with high value of the heat index; with high maximum and minimum temperatures; length of vegetation period; and number of consecutive dry days. Agricultural, hydrological, and human health indices were applied to evaluate the changing risk of weather extremes in Poland in three sectors. To achieve this, model-based simulations were compared for two time horizons, a century apart, i.e., 1961-1990 and 2061-2090. Climate changes, and in particular increases in temperature and changes in rainfall, have strong impacts on agriculture via weather extremes - droughts and heat waves. The crop yield depends particularly on water availability in the plant development phase. To estimate the changes in present and future yield of two crops important for Polish agriculture i.e., potatoes and wheat, some simple empirical models were used. For these crops, decrease of yield is projected for most of the country, with national means of yield change being: -2.175 t/ha for potatoes and -0.539 t/ha for wheat. Already now, in most of Poland, evapotranspiration exceeds precipitation during summer, hence the water storage (in surface water bodies, soil and ground) decreases. Summer precipitation deficit is projected to increase considerably in the future. The additional water supplies (above precipitation) needed to use the agro-potential of the environment would increase by half. Analysis of water balance components (now and in the projected future) can corroborate such conclusions. As regards climate and health, a composite index, proposed in this paper, is a product of the number of senior discomfort days and the number of seniors (aged 65+). The value of this index is projected to increase over 8-fold during 100 years. This is an

  1. Climate change and its effect on agriculture, water resources and human health sectors in Poland

    Directory of Open Access Journals (Sweden)

    M. Szwed

    2010-08-01

    Full Text Available Multi-model ensemble climate projections in the ENSEMBLES Project of the EU allowed the authors to quantify selected extreme-weather indices for Poland, of importance to climate impacts on systems and sectors. Among indices were: number of days in a year with high value of the heat index; with high maximum and minimum temperatures; length of vegetation period; and number of consecutive dry days. Agricultural, hydrological, and human health indices were applied to evaluate the changing risk of weather extremes in Poland in three sectors. To achieve this, model-based simulations were compared for two time horizons, a century apart, i.e., 1961–1990 and 2061–2090. Climate changes, and in particular increases in temperature and changes in rainfall, have strong impacts on agriculture via weather extremes – droughts and heat waves. The crop yield depends particularly on water availability in the plant development phase. To estimate the changes in present and future yield of two crops important for Polish agriculture i.e., potatoes and wheat, some simple empirical models were used. For these crops, decrease of yield is projected for most of the country, with national means of yield change being: –2.175 t/ha for potatoes and –0.539 t/ha for wheat. Already now, in most of Poland, evapotranspiration exceeds precipitation during summer, hence the water storage (in surface water bodies, soil and ground decreases. Summer precipitation deficit is projected to increase considerably in the future. The additional water supplies (above precipitation needed to use the agro-potential of the environment would increase by half. Analysis of water balance components (now and in the projected future can corroborate such conclusions. As regards climate and health, a composite index, proposed in this paper, is a product of the number of senior discomfort days and the number of seniors (aged 65+. The value of this index is projected to increase over 8-fold during

  2. District decision-making for health in low-income settings: a case study of the potential of public and private sector data in India and Ethiopia.

    Science.gov (United States)

    Bhattacharyya, Sanghita; Berhanu, Della; Taddesse, Nolawi; Srivastava, Aradhana; Wickremasinghe, Deepthi; Schellenberg, Joanna; Iqbal Avan, Bilal

    2016-09-01

    Many low- and middle-income countries have pluralistic health systems where private for-profit and not-for-profit sectors complement the public sector: data shared across sectors can provide information for local decision-making. The third article in a series of four on district decision-making for health in low-income settings, this study shows the untapped potential of existing data through documenting the nature and type of data collected by the public and private health systems, data flow and sharing, use and inter-sectoral linkages in India and Ethiopia. In two districts in each country, semi-structured interviews were conducted with administrators and data managers to understand the type of data maintained and linkages with other sectors in terms of data sharing, flow and use. We created a database of all data elements maintained at district level, categorized by form and according to the six World Health Organization health system blocks. We used content analysis to capture the type of data available for different health system levels. Data flow in the public health sectors of both counties is sequential, formal and systematic. Although multiple sources of data exist outside the public health system, there is little formal sharing of data between sectors. Though not fully operational, Ethiopia has better developed formal structures for data sharing than India. In the private and public sectors, health data in both countries are collected in all six health system categories, with greatest focus on service delivery data and limited focus on supplies, health workforce, governance and contextual information. In the Indian private sector, there is a better balance than in the public sector of data across the six categories. In both India and Ethiopia the majority of data collected relate to maternal and child health. Both countries have huge potential for increased use of health data to guide district decision-making.

  3. District decision-making for health in low-income settings: a case study of the potential of public and private sector data in India and Ethiopia.

    Science.gov (United States)

    Bhattacharyya, Sanghita; Berhanu, Della; Taddesse, Nolawi; Srivastava, Aradhana; Wickremasinghe, Deepthi; Schellenberg, Joanna; Iqbal Avan, Bilal

    2016-09-01

    Many low- and middle-income countries have pluralistic health systems where private for-profit and not-for-profit sectors complement the public sector: data shared across sectors can provide information for local decision-making. The third article in a series of four on district decision-making for health in low-income settings, this study shows the untapped potential of existing data through documenting the nature and type of data collected by the public and private health systems, data flow and sharing, use and inter-sectoral linkages in India and Ethiopia. In two districts in each country, semi-structured interviews were conducted with administrators and data managers to understand the type of data maintained and linkages with other sectors in terms of data sharing, flow and use. We created a database of all data elements maintained at district level, categorized by form and according to the six World Health Organization health system blocks. We used content analysis to capture the type of data available for different health system levels. Data flow in the public health sectors of both counties is sequential, formal and systematic. Although multiple sources of data exist outside the public health system, there is little formal sharing of data between sectors. Though not fully operational, Ethiopia has better developed formal structures for data sharing than India. In the private and public sectors, health data in both countries are collected in all six health system categories, with greatest focus on service delivery data and limited focus on supplies, health workforce, governance and contextual information. In the Indian private sector, there is a better balance than in the public sector of data across the six categories. In both India and Ethiopia the majority of data collected relate to maternal and child health. Both countries have huge potential for increased use of health data to guide district decision-making. PMID:27591203

  4. District decision-making for health in low-income settings: a case study of the potential of public and private sector data in India and Ethiopia

    Science.gov (United States)

    Bhattacharyya, Sanghita; Berhanu, Della; Taddesse, Nolawi; Srivastava, Aradhana; Wickremasinghe, Deepthi; Schellenberg, Joanna

    2016-01-01

    Many low- and middle-income countries have pluralistic health systems where private for-profit and not-for-profit sectors complement the public sector: data shared across sectors can provide information for local decision-making. The third article in a series of four on district decision-making for health in low-income settings, this study shows the untapped potential of existing data through documenting the nature and type of data collected by the public and private health systems, data flow and sharing, use and inter-sectoral linkages in India and Ethiopia. In two districts in each country, semi-structured interviews were conducted with administrators and data managers to understand the type of data maintained and linkages with other sectors in terms of data sharing, flow and use. We created a database of all data elements maintained at district level, categorized by form and according to the six World Health Organization health system blocks. We used content analysis to capture the type of data available for different health system levels. Data flow in the public health sectors of both counties is sequential, formal and systematic. Although multiple sources of data exist outside the public health system, there is little formal sharing of data between sectors. Though not fully operational, Ethiopia has better developed formal structures for data sharing than India. In the private and public sectors, health data in both countries are collected in all six health system categories, with greatest focus on service delivery data and limited focus on supplies, health workforce, governance and contextual information. In the Indian private sector, there is a better balance than in the public sector of data across the six categories. In both India and Ethiopia the majority of data collected relate to maternal and child health. Both countries have huge potential for increased use of health data to guide district decision-making. PMID:27591203

  5. Willingness to pay for social health insurance among informal sector workers in Wuhan, China: a contingent valuation study

    Directory of Open Access Journals (Sweden)

    Zhang Xinping

    2007-07-01

    Full Text Available Abstract Background Most of the about 140 million informal sector workers in urban China do not have health insurance. A 1998 central government policy leaves it to the discretion of municipal governments to offer informal sector workers in cities voluntary participation in a social health insurance for formal sector workers, the so-called 'basic health insurance' (BHI. Methods We used the contingent valuation method to assess the maximum willingness to pay (WTP for BHI among informal sector workers, including unregistered rural-to-urban migrants, in Wuhan City, China. We selected respondents in a two-stage self-weighted cluster sampling scheme. Results On average, informal sector workers were willing to pay substantial amounts for BHI (30 Renminbi (RMB, 95% confidence interval (CI 27-33 as well as substantial proportions of their incomes (4.6%, 95% CI 4.1-5.1%. Average WTP increased significantly when any one of the copayments of the BHI was removed in the valuation: to 51 RMB (95% CI 46-56 without reimbursement ceiling; to 43 RMB (95% CI 37-49 without deductible; and to 47 RMB (95% CI 40-54 without coinsurance. WTP was higher than estimates of the cost of BHI based on past health expenditure or on premium contributions of formal sector workers. Predicted coverage with BHI declined steeply with the premium contribution at low contribution levels. When we applied equity weighting in the aggregation of individual WTP values in order to adjust for inequity in the distribution of income, mean WTP for BHI increased with inequality aversion over a plausible range of the aversion parameter. Holding other factors constant in multiple regression analysis, for a 1% increase in income WTP for BHI with different copayments increased by 0.434-0.499% (all p Conclusion Our results suggest that Chinese municipal governments should allow informal sector workers to participate in the BHI. From a normative perspective, BHI for informal sector workers is likely to

  6. Public Health England survey of eye lens doses in the UK medical sector

    International Nuclear Information System (INIS)

    The ICRP has recently recommended that the occupational exposure limit for the lens of the eye be reduced to 20 mSv in a year, averaged over defined periods of 5 years, with no single year exceeding 50 mSv. There has been concern amongst some groups of individuals, particularly interventional cardiologists and radiologists as well as relevant professional bodies, that implementation of these recommendations into UK law will adversely affect working patterns. However, despite a number of informative European studies, there is currently little UK dosimetry data available upon which judgements can effectively be based. In order to address this knowledge gap, Public Health England has carried out a small, targeted survey of UK lens doses to medical staff undertaking procedures likely to involve the highest levels of radiation exposure. Two out of a total of 61 individuals surveyed had projected annual doses which could be close to 20 mSv, measured outside lead glasses. Use of protective equipment was generally good; however, lead glasses were only used by 9 participants. The results of this survey suggest that compliance with the ICRP recommendations is likely to be possible for most individuals in the UK medical sector. (paper)

  7. Eugenics Past and Present: Remembering Buck v. Bell.

    Science.gov (United States)

    Berson, Michael J.; Cruz, Barbara

    2001-01-01

    Provides background information about the eugenics movement. Focuses on eugenics in the United States detailing the case, Buck v. Bell, and eugenics in Germany. Explores the present eugenic movement, focusing on "The Bell Curve," China's one child policy, and the use of eugenic sterilizations in the United States and Canada. Includes strategies…

  8. "The Bell Curve" and Carrie Buck: Eugenics Revisited.

    Science.gov (United States)

    Smith, J. David

    1995-01-01

    The 1994 publication of "The Bell Curve" by R. Herrnstein and C. Murray is compared to other examples of eugenic principles, including the sterilization of "feebleminded" Carrie Buck, family degeneracy studies focusing on lower class Caucasian families, and other works that view the poorest and least educated members of society as problems for…

  9. BUCKS LAKE AND CHIPS CREEK ROADLESS AREAS, CALIFORNIA.

    Science.gov (United States)

    Sorensen, Martin L.; Linne, J. Mitchell

    1984-01-01

    The results of a mineral-resource assessment of the Bucks Lake and Chips Creek Roadless Areas, California indicate several areas with mineral-resource potential. The presence or absence of these potentially auriferous deposits can best be determined by drilling through the relatively thin cover of volcanic rocks.

  10. Developing and testing an instrument for identifying performance incentives in the Greek health care sector

    Directory of Open Access Journals (Sweden)

    Paleologou Victoria

    2006-09-01

    Full Text Available Abstract Background In the era of cost containment, managers are constantly pursuing increased organizational performance and productivity by aiming at the obvious target, i.e. the workforce. The health care sector, in which production processes are more complicated compared to other industries, is not an exception. In light of recent legislation in Greece in which efficiency improvement and achievement of specific performance targets are identified as undisputable health system goals, the purpose of this study was to develop a reliable and valid instrument for investigating the attitudes of Greek physicians, nurses and administrative personnel towards job-related aspects, and the extent to which these motivate them to improve performance and increase productivity. Methods A methodological exploratory design was employed in three phases: a content development and assessment, which resulted in a 28-item instrument, b pilot testing (N = 74 and c field testing (N = 353. Internal consistency reliability was tested via Cronbach's alpha coefficient and factor analysis was used to identify the underlying constructs. Tests of scaling assumptions, according to the Multitrait-Multimethod Matrix, were used to confirm the hypothesized component structure. Results Four components, referring to intrinsic individual needs and external job-related aspects, were revealed and explain 59.61% of the variability. They were subsequently labeled: job attributes, remuneration, co-workers and achievement. Nine items not meeting item-scale criteria were removed, resulting in a 19-item instrument. Scale reliability ranged from 0.782 to 0.901 and internal item consistency and discriminant validity criteria were satisfied. Conclusion Overall, the instrument appears to be a promising tool for hospital administrations in their attempt to identify job-related factors, which motivate their employees. The psychometric properties were good and warrant administration to a larger

  11. THE ANALYSIS OF TRAINING NEEDS IN PUBLIC INSTITUTIONS OPERATING IN HEALTH CARE SECTOR IN THE PODKARPACIE PROVINCE

    Directory of Open Access Journals (Sweden)

    Tomasz Skica

    2012-04-01

    Full Text Available The article is an attempt at diagnosing training needs of the employees of units operating in health care sector in the Podkarpacie Province. In times of permanent changes affecting each sphere of economy, providers of health care services cannot afford to remain outside this trend. Improving qualifications, adaptability of the offer, influencing its quality, and above all, the awareness of the necessity of these changes, have become an element which is fully integrated also with this sphere of public sector operations. Taking into account the above, the article verifies not only training needs articulated by employees of Health Care Centers (HCC operating in the Podkarpacie Province, but also the way they are perceived by the managers of these centers, the ability to define training needs and their compatibility with characteristic features of analyzed HCCs. Therefore special emphasis has been placed on demonstrating the variety of diagnosed training needs with reference to such criteria as the size of analyzed centers, the market serviced by them, and their location. These determinants allowed us to conduct a complex analysis of conditions and structure of voiced need for subject training, and as a consequence, contributed to diagnosing the expectations of the health care sector concerning initiatives improving the quality of public services in the health care services area.

  12. Place-Based Initiatives to Improve Health in Disadvantaged Communities: Cross-Sector Characteristics and Networks of Local Actors in North Carolina

    Science.gov (United States)

    Moody, James; Nelson, Alicia; Willis, Janese M.; Fuller, Lori; Smart, Allen J.; Easterling, Doug; Silberberg, Mina

    2016-01-01

    Objectives. To examine the leadership attributes and collaborative connections of local actors from the health sector and those outside the health sector in a major place-based health initiative. Methods. We used survey data from 340 individuals in 4 Healthy Places North Carolina counties from 2014 to assess the leadership attributes (awareness, attitudes, and capacity) and network connections of local actors by their organizational sector. Results. Respondents’ leadership attributes—scored on 5-point Likert scales—were similar across Healthy Places North Carolina counties. Although local actors reported high levels of awareness and collaboration around community health improvement, we found lower levels of capacity for connecting diversity, identifying barriers, and using resources in new ways to improve community health. Actors outside the health sector had generally lower levels of capacity than actors in the health sector. Those in the health sector exhibited the majority of network ties in their community; however, they were also the most segregated from actors in other sectors. Conclusions. More capacity building around strategic action—particularly in nonhealth sectors—is needed to support efforts in making widespread changes to community health. PMID:27459443

  13. Assessing the impact of a new health sector pay system upon NHS staff in England

    Directory of Open Access Journals (Sweden)

    Buchan James

    2008-06-01

    Full Text Available Abstract Background Pay and pay systems are a critical element in any health sector human resource strategy. Changing a pay system can be one strategy to achieve or sustain organizational change. This paper reports on the design and implementation of a completely new pay system in the National Health Service (NHS in England. 'Agenda for Change' constituted the largest-ever attempt to introduce a new pay system in the UK public services, covering more than one million staff. Its objectives were to improve the delivery of patient care as well as enhance staff recruitment, retention and motivation, and to facilitate new ways of working. Methods This study was the first independent assessment of the impact of Agenda for Change at a local and national level. The methods used in the research were a literature review; review of 'grey' unpublished documentation provided by key stakeholders in the process; analysis of available data; interviews with key national informants (representing government, employers and trade unions, and case studies conducted with senior human resource managers in ten NHS hospitals in England Results Most of the NHS trust managers interviewed were in favour of Agenda for Change, believing it would assist in delivering improvements in patient care and staff experience. The main benefits highlighted were: 'fairness', moving different staff groups on to harmonized conditions; equal pay claim 'protection'; and scope to introduce new roles and working practices. Conclusion Agenda for Change took several years to design, and has only recently been implemented. Its very scale and central importance to NHS costs and delivery of care argues for a full assessment at an early stage so that lessons can be learned and any necessary changes made. This paper highlights weaknesses in evaluation and limitations in progress. The absence of systematically derived and applied impact indicators makes it difficult to assess impact and impact

  14. Sources of satisfaction and dissatisfaction among specialists within the public and private health sectors

    DEFF Research Database (Denmark)

    Ashton, Toni; Brown, Paul M.; Sopina, Elizaveta (Liza);

    2013-01-01

    sectors. Such information can assist workforce planning, management and policy and may inform the wider debate about the relationship between the two sectors. Method A postal survey was conducted of 1983 registered specialists throughout New Zealand. Respondents were asked to assess 14 sources...... of satisfaction and 9 sources of dissatisfaction according to a 5-point Likert scale. Means and standard deviations were calculated for the total sample, and for procedural and non-procedural specialties. Differences between the means of each source of satisfaction and dissatisfaction were also calculated....... Results Completed surveys were received from 943 specialists (47% response rate). Overall mean levels of satisfaction were higher in the private sector than the public sector while levels of dissatisfaction were lower. While the public system is valued for its opportunities for further education...

  15. The precariousness of the franchise state: Voluntary sector health services and international NGOs in Tanzania, 1960s - mid-1980s.

    Science.gov (United States)

    Jennings, Michael

    2015-09-01

    This paper challenges conventional narratives on the role of international non-governmental organisations (INGOs) in the delivery of health services in Tanzania. Adopting an historical gaze which focuses on the 1960s to mid-1980s the paper argues that the 'franchise state' in the Tanzanian health system was not created by collusion between international donors and INGOs, underpinned by a set of health sector reforms that advocated the use of non-state actors; but was rather the legacy of the colonial health system bequeathed to the post-independence state. It was a system in which voluntary non-state actors (but, importantly, not INGOs) were already entrenched as key providers; and in which many of the features of the franchise state - fragmentation, structural weaknesses, lack of accountability to users - were already long established. But if INGOs did not create these features, as their critics attest, they did contribute to the maintenance and extension of these features. The short-term perspectives of NGOs, their small-scale piecemeal engagement, and the extra demands they placed upon their voluntary actor partners, left little scope for the development of sustainable, national and accountable solutions to the health needs of the country. In exploring these ideas, the paper contributes to a more nuanced understanding of the path dependency that created Tanzania's health system. The analysis also contributes to a deepening of the understanding of the make-up of the voluntary sector beyond a narrow gaze on the institution of the INGO. PMID:26233295

  16. 卫生部门治理:战略与机制%Health sector governance:Strategies and mechanisms

    Institute of Scientific and Technical Information of China (English)

    刘丽杭

    2014-01-01

    在将健康作为一个要素融入所有政府部门与社会团体政策制定中的大健康整合战略下,政府各部门及社会团体在共识基础上形成广泛性治理目标,由政府主导卫生系统的运行,通过加强政府各部门间及与社会组织的协调与合作,统筹卫生系统的服务及管理功能,建立社会参与的绩效问责机制,实现提升卫生部门治理水平,改善社会健康结果的目标。%Under the health integration strategies of public policy to health in all policies of all sectors and so-cial areas, government departments and social organizations form a broad consensus on the basis of the goals of gov-ernance, led by government health system operations, through the strengthening of coordination and cooperation a-mong government departments and social organizations as well as overall planning of the service functions of the health system, and the establishment of community participation in the performance accountability mechanism, in order to enhance the level of health sector governance and improve community health outcomes.

  17. Consequences of local variations in social care on the performance of the acute health care sector

    OpenAIRE

    Fernandez, Jose-Luis; Forder, Julien

    2008-01-01

    Abstract The paper uses two-years worth of data from 150 English local authorities to quantify the extent to which local variations in social care resources are associated with variations in performance in the acute sector, and particularly on the rates of hospital delayed discharges and hospital emergency readmissions. Results indicate social care services play a significant role in explaining local variations in acute sector performance. (Fernandez, Jose...

  18. Common Health, Safety and Environmental Concerns in Upstream Oil and Gas Sector: Implications for HSE Management in Ghana

    OpenAIRE

    Seth Oppong

    2014-01-01

    This paper explores the literature to identify common occupational injuries, diseases, and psychological wellbeing on oil rigs as well as the negative environmental impacts of the upstream oil and gas sector. It ends by making recommendations for effective health, safety, and environmental (HSE) management. Review of the literature showed that contusion (bruise), cuts, and laceration are the commonest occupational injuries that workers on the oil rig suffer and that the injuries mostly affect...

  19. Motivational conditions of successful corporate social responsibility (CSR) actions in form of cross sector collaborations in international health

    OpenAIRE

    Erat, Anna Margareta

    2013-01-01

    It is clearly of paramount importance to secure both short-term and long-term provision and access to drugs and healthcare services in order to accomplish a substantial impact on public health in any country. Nevertheless, there are millions of people, especially in the developing world, that have no or limited access to such pharmaceutics and services. Faced with the situation, some important cross-sector efforts that make drugs and services available through the engagement of private for pr...

  20. The Impact of Robotics on Employment and Motivation of Employees in the Service Sector, with Special Reference to Health Care

    OpenAIRE

    Qureshi, Mohammed Owais; Syed, Rumaiya Sajjad

    2014-01-01

    Background The economy is being lifted by the new concept of robotics, but we cannot be sure of all the possible benefits. At this early stage, it therefore becomes important to find out the possible benefits/limitations associated with robotics, so that the positives can be capitalized, established, and developed further for the employment and motivation of employees in the health care sector, for overall economic development. The negatives should also be further studied and mitigated. Metho...

  1. Closed Loop Control of Soft Switched Interleaved Buck Converter

    Directory of Open Access Journals (Sweden)

    R. Shenbagalakshmi

    2012-06-01

    Full Text Available Design, Modeling and Simulation of a closed loop control is presented for Interleaved Buck Converter with Soft Switching. The features of the closed loop system are to reduce the switching losses and load current sharing among the parallel connected converters. The control system of the converter is designed using PWM technique. In order to improve the transient response and dynamic stability of the converters, the controller parameters are designed based on current mode control. Resonant components thus designed enable the application of zero current switching for both the converters connected in parallel thereby maintaining greater efficiency and minimizing voltage and current oscillations. The system analysis, design and performance are verified through simulation using MATLAB/Simulink environment. The simulation approach reveals the high speed dynamic performance of the closed loop system designed using robust PID controller. The laboratory prototype of the Buck converter is developed to verify the controller platform using PIC16F877A microcontroller.

  2. Human health-related externalities in energy system modelling the case of the Danish heat and power sector

    International Nuclear Information System (INIS)

    This paper discusses methodology of energy system modelling when reduction of local externalities, such as damage to the human health from energy production-related air pollution, is in focus. Ideally, the local energy externalities should be analysed by adopting the impact pathway approach of ExternE study, and following the pollutants from their release to the personal uptake and resulting health effects. This would require inclusion of air pollution modelling and monetary valuation of the impacts into an energy system optimisation process. However, this approach involves a complex study and generalisations are needed. The way local externalities are included in the existing energy system models is identified and discussed in the paper. Only a few studies include localisation aspects when internalising local externalities in an energy system optimisation. The performed analysis of the Danish heat and power sector verifies that it is cheaper for the society to include externalities in the planning of an energy system than to pay for the resulting damages later. Total health costs decrease by around 18% and total system costs decrease by nearly 4% when health externalities are included in the optimisation. Furthermore, including localisation aspects can reduce health costs of the heat and power sector in Denmark by additional 7%. (author)

  3. The financial crisis and health care systems in Europe: universal care under threat? Trends in health sector reforms in Germany, the United Kingdom, and Spain.

    Science.gov (United States)

    Giovanella, Lígia; Stegmüller, Klaus

    2014-11-01

    The paper analyzes trends in contemporary health sector reforms in three European countries with Bismarckian and Beveridgean models of national health systems within the context of strong financial pressure resulting from the economic crisis (2008-date), and proceeds to discuss the implications for universal care. The authors examine recent health system reforms in Spain, Germany, and the United Kingdom. Health systems are described using a matrix to compare state intervention in financing, regulation, organization, and services delivery. The reforms' impacts on universal care are examined in three dimensions: breadth of population coverage, depth of the services package, and height of coverage by public financing. Models of health protection, institutionality, stakeholder constellations, and differing positions in the European economy are factors that condition the repercussions of restrictive policies that have undermined universality to different degrees in the three dimensions specified above and have extended policies for regulated competition as well as commercialization in health care systems. PMID:25493982

  4. The financial crisis and health care systems in Europe: universal care under threat? Trends in health sector reforms in Germany, the United Kingdom, and Spain

    Directory of Open Access Journals (Sweden)

    Lígia Giovanella

    2014-11-01

    Full Text Available The paper analyzes trends in contemporary health sector reforms in three European countries with Bismarckian and Beveridgean models of national health systems within the context of strong financial pressure resulting from the economic crisis (2008-date, and proceeds to discuss the implications for universal care. The authors examine recent health system reforms in Spain, Germany, and the United Kingdom. Health systems are described using a matrix to compare state intervention in financing, regulation, organization, and services delivery. The reforms’ impacts on universal care are examined in three dimensions: breadth of population coverage, depth of the services package, and height of coverage by public financing. Models of health protection, institutionality, stakeholder constellations, and differing positions in the European economy are factors that condition the repercussions of restrictive policies that have undermined universality to different degrees in the three dimensions specified above and have extended policies for regulated competition as well as commercialization in health care systems.

  5. The "aid contract" and its compensation scheme: a case study of the performance of the Ugandan health sector.

    Science.gov (United States)

    Oliveira Cruz, Valeria; McPake, Barbara

    2010-10-01

    Current literature on aid effectiveness describes increasing use of a more contractual approach to the relationship between donor and recipient government in which a system of rewards and penalties for good and bad performance operates. The purpose of this case study of the Ugandan health sector was to understand the extent to which this approach is influencing processes and effectiveness. This qualitative study used a conceptual framework based on agency theory and 'realistic evaluation'. Our results showed that the main official mechanism to assess and reward performance established through the Sector Wide Approach lacked objective criteria and was based on an unstructured system of discussions and agreements among donors. The achievement of a satisfactory performance rating was facilitated by the agreeing to undertakings that were under-demanding, vaguely formulated and lacking quantitative benchmarks against which progress could be measured. However, even when poor performance was readily observable, penalties failed to be applied by donors. This was always the case in relation to health sector performance and mostly so in relation to general governance and accountability. Funds continued to be disbursed despite the lack of progress made in achieving targets and undertakings and other evident performance problems (e.g. in the area of governance). A series of explanations of the failure to penalise were put forward by donor representatives in relation to this behaviour including the need to maintain long-term relationships based on trust and not to undermine health sector performance by withdrawing aid. Thus there are likely to be incentives to disburse funds and report success, irrespective of the realities of aid programmes in the context of large foreign aid volumes associated with increased political visibility of aid in donor countries.

  6. A comparative study of internal customer management practices within service sector firms and the National Health Service.

    Science.gov (United States)

    Chaston, I

    1994-02-01

    In responding to the UK government's market forces model, some National Health Service (NHS) managers have introduced private sector concepts such as 'customer care' and 'total quality management' (TQM). Private sector firms find that success of these techniques is dependent upon creating an internal marketing orientation across the entire organization. To determine how internal marketing is being applied, a comparative survey of UK service sector firms and NHS units was undertaken using a modified version of Parasuraman's SERVQUAL model. All respondents indicated existence of type 1, 2, 3 and 4 gaps in the internal customer management process within their organizations. Major influencers of service gaps include departments placing internal efficiency ahead of internal customers and insufficient understanding of internal customer requirements. The survey indicated that, in certain areas of managing service quality, the NHS is performing better than its private sector counterparts. Nevertheless, opportunity for enhancing service quality in the NHS is possible through improving the flow of information between departments, stronger orientation towards meeting customer needs, upgrading provision systems and changing intradepartmental culture. The constraint facing the NHS manager is the limited availability of resources. One solution is to allocate resources in relation to service priorities. A directional planning matrix is presented as a tool for developing an optimum internal customer management strategy within an NHS unit.

  7. Two phase interleaved buck converter for driving high power LEDs

    OpenAIRE

    Beczkowski, Szymon; Munk-Nielsen, Stig

    2011-01-01

    The goal of this paper is to evaluate an interleaved buck topology for driving high current light-emitting diodes. Low output capacitor value allows the use of non-electrolytic capacitors extending the lifetime of the converter. Converter is operated as a constant, regulated current source which increases luminous efficacy of LED compared to PWM dimmed system. Because of the low dynamic resistance of LEDs the duty cycle of the converter does not change greatly with controlled current. By sett...

  8. Hybrid posicast controller for a DC-DC buck converter

    OpenAIRE

    Kaithamalai Udhayakumar; Ponnusamy Lakshmi; Kandasamy Boobal

    2008-01-01

    A new Posicast compensated hybrid controller for the DC-DC Buck converter is investigated. Posicast is a feed forward compensator, which eliminates the overshoot in the step response of a lightly damped system. However, the traditional method is sensitive to variations in natural frequency. The new method described here reduces this undesirable sensitivity by using Posicast within the feedback loop. Design of the Posicast function is independent of computational delay. The new controller resu...

  9. Two phase interleaved buck converter for driving high power LEDs

    DEFF Research Database (Denmark)

    Beczkowski, Szymon; Munk-Nielsen, Stig

    2011-01-01

    increases luminous efficacy of LED compared to PWM dimmed system. Because of the low dynamic resistance of LEDs the duty cycle of the converter does not change greatly with controlled current. By setting the input voltage of the buck converter to around twice the voltage of diode strings, converter can...... be operated close to the 50% duty cycle, where the ripple attenuation is the highest....

  10. THE HUMANISM OF PEARL S. BUCK: THE THREADS OF SORROW

    OpenAIRE

    Augustine, Jonathan

    2014-01-01

    There are few women in the history of literature who have been more active in humanitarian projects than Pearl S. Buck. After spending the first four decades of her life in China, she moved to the United States and became an outspoken figure in the civil rights, movement contributing articles regularly to the Crisis, the Monthly Magazine of the NAACP. She also spoke out against British colonialism, the wartime internment of Japanese Americans and the development of nuclear weapons, just to ...

  11. Prevalence and health correlates of work-life conflict among blue- and white-collar workers from different economic sectors

    Directory of Open Access Journals (Sweden)

    Oliver eHämmig

    2014-11-01

    Full Text Available The research on work-life conflict (WLC is largely neglected in occupational medicine and public health and typically limited to white-collar workers and public servants. This study therefore aims to explore possible differences in the prevalence of WLC and its association with health outcomes between white- and blue-collar workers from different work environments in Switzerland. Cross-sectional survey data collected in 2007 in the service sector and in 2010 in the industrial sector were used for statistical analyses. A subsample of university graduates employed by large service companies (N=1,170 from the first survey’s population was taken and compared with a subsample of low or unskilled industrial and construction workers with no or only compulsory education (N=489 from the second survey’s population. The results show almost consistently, and particularly in women, a lower prevalence of time- and strain-based forms and both causal directions of WLC in blue-collar workers. However, associations between different WLC measures and general, physical and mental health outcomes were found to be equally strong or even stronger among blue-collar workers compared to white-collar workers. Low or unskilled industrial and construction workers are less frequently affected by higher degrees of WLC but are then at no lower risk of suffering poor self-rated health or severe backaches and sleep disorders than university graduates working in the service sector with comparable exposure to WLC. In conclusion it can be stated that WLC turned out to be much less prevalent but equally or even more detrimental to health in blue-collar workers, who therefore need to be considered in future studies.

  12. What is the private sector? Understanding private provision in the health systems of low-income and middle-income countries.

    Science.gov (United States)

    Mackintosh, Maureen; Channon, Amos; Karan, Anup; Selvaraj, Sakthivel; Cavagnero, Eleonora; Zhao, Hongwen

    2016-08-01

    Private health care in low-income and middle-income countries is very extensive and very heterogeneous, ranging from itinerant medicine sellers, through millions of independent practitioners-both unlicensed and licensed-to corporate hospital chains and large private insurers. Policies for universal health coverage (UHC) must address this complex private sector. However, no agreed measures exist to assess the scale and scope of the private health sector in these countries, and policy makers tasked with managing and regulating mixed health systems struggle to identify the key features of their private sectors. In this report, we propose a set of metrics, drawn from existing data that can form a starting point for policy makers to identify the structure and dynamics of private provision in their particular mixed health systems; that is, to identify the consequences of specific structures, the drivers of change, and levers available to improve efficiency and outcomes. The central message is that private sectors cannot be understood except within their context of mixed health systems since private and public sectors interact. We develop an illustrative and partial country typology, using the metrics and other country information, to illustrate how the scale and operation of the public sector can shape the private sector's structure and behaviour, and vice versa. PMID:27358253

  13. Authentic leadership as a source of optimism, trust in the organisation and work engagement in the public health care sector

    Directory of Open Access Journals (Sweden)

    Frederick W. Stander

    2015-03-01

    Full Text Available Orientation: The orientation of this study is towards authentic leadership (AL and its influence on optimism, trust in the organisation and work engagement of employees in the public health care sector.Research purpose: The objectives of this study were to determine whether the leadership style of AL could predict optimism, trust in the organisation and work engagement amongst a large sample of employees from various functions in public hospitals and clinics in Gauteng and to establish whether optimism and trust in the organisation could mediate the relationship between AL and work engagement.Research approach, design and method: A convenience sample of 633 public health employees from various functions within 27 public hospitals and clinics in the province was used in this research. A cross-sectional research design was implemented. Structural equation modelling was utilised to investigate the Authentic Leadership Inventory (ALI, and the validity and fit of the measurement model, to position AL as a job resource within the nomological net and to test its mediating effects.Main findings: The statistical analysis revealed that AL was a significant predictor of optimism and trust in the organisation and that optimism and trust in the organisation mediated the relationship between AL and work engagement.Practical/managerial implications: The research results suggested that organisations in the public health care sector should encourage their managers to adopt a more authentic leadership style. This will lead to higher levels of optimism, trust in the organisation and eventually work engagement. This will greatly assist employees in the domain of public health care to manage their demanding working environment.Contribution: This study provides evidence that the ALI can be used reliably within the South African context and specifically within the public health care sector. It further substantiates for the implementation of AL as a leadership style in

  14. Modeling and Simulation of Buck-Boost Converter with Voltage Feedback Control

    OpenAIRE

    Zhou Xuelian; He Qiang

    2015-01-01

    In order to design the control system, it is necessary to have an exact model of buck-boost converter. This paper put forward the transfer function model of buck-boost converter by the state-space average method. The open-loop transfer function model of uncompensated system is deduced according to the mathematic model of the buck-boost converter, the controller is designed according to frequency domain. The phase and magnitude margin of the open-loop system of the buck-boost converter with co...

  15. Health and wellness trends in the oil and gas sector : insights from the Shepell-fgi Research Group

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-07-01

    This report discussed health and wellness trends in the oil and gas sector in relation to employee assistance program (EAP) data. The data were derived from oil and gas client organizations across Canada for 2008, and represented a population base of 14,685 employees. The data demonstrated that EAP utilization in the petroleum industry increased by approximately 5 per cent from 2006 to 2008. The sector's utilization was 34 per cent higher than the Canadian norm in 2006, and 40 per cent higher than in 2007 and 2008. Females used the EAP to a greater extent than males. A higher proportion of the spouses of workers accessed EAP than the national norm. Employees accessed EAP for assistance with work-life issues; family support services; and substance abuse interventions. Weight management and dietary consultations in relation to disease control were also of concern within the sector. A 66 per cent increase in childcare issues was noted, as well as a 148 per cent increase in eldercare issues, and a 112 per cent increase in addiction issues. The findings indicated that the EAP is being effectively communicated as a relevant and accessible tool. As the industry continues to develop in remote regions, new services and resources will be required to retain existing workforces and attract new employees. Prevention-focused training and services and program for at-risk groups are needed to ensure that employee health and productivity is maintained. 1 tab., 4 figs.

  16. The relevance of a coproductive capacity framework to climate change adaptation: investigating the health and water sectors in Cambodia

    Directory of Open Access Journals (Sweden)

    Kathryn J. Bowen

    2015-03-01

    Full Text Available Multiple active partnerships in the health and water sectors in Cambodia exist to address climate change adaptation, operating beyond typical sectoral and organizational divides. Decisions around national adaptation policy are made predominantly by the relevant lead ministry, contrasting with where funding originates from (i.e., major donors, multilaterals, United Nation agencies. Adaptation policy is thus the result of a process of coproduction by state and nonstate actors. The research we present sought to understand the relationships that exist between knowledge- and decision-makers with respect to climate change adaptation in the health and water sectors in Cambodia, and the factors that enabled or constrained these relationships. Forty-four interviews were conducted with representatives of 32 organizations. We found that coproductive relationships were most effective when there were clearly defined roles and responsibilities, coordination of technical and financial resources, and trust. The two key factors of coproductive capacity that enabled and supported these partnerships were scientific resources and governance capability. Ultimately, the roles and responsibilities given to various actors requires commensurate funding and greater consideration of existing relationships and power dynamics. The reliance on international scientific expertise also needs to be challenged so that local research capabilities can be developed and locally relevant, problem-specific information can be provided. The ongoing funding, codevelopment, and sharing of such knowledge would significantly enhance trust and cooperation.

  17. Aalborg Inverter - A new type of “Buck in Buck, Boost in Boost” Grid-tied Inverter

    DEFF Research Database (Denmark)

    Wu, Weimin; Blaabjerg, Frede

    2013-01-01

    This paper presents a new family of high efficiency DC/AC grid-tied inverter with a wide variation of input DC voltage. It is a kind of “Boost in Boost, Buck in Buck” inverter, meaning that only one power stage works at the high frequency to achieve the minimum switching loss. Furthermore, the mi...... the analysis on the equivalent circuits of a “three-level” single-phase inverter. Simulations show it has good control performance.......This paper presents a new family of high efficiency DC/AC grid-tied inverter with a wide variation of input DC voltage. It is a kind of “Boost in Boost, Buck in Buck” inverter, meaning that only one power stage works at the high frequency to achieve the minimum switching loss. Furthermore...

  18. [The climate change policy of the city of São Paulo, Brazil: reflexivity and permeability of the health sector].

    Science.gov (United States)

    Landin, Rubens; Giatti, Leandro Luiz

    2014-10-01

    São Paulo is today an unsustainable city in which social and environmental vulnerabilities are obliged to tackle the uncertainties of climate change. To face up to this situation, in 2009 the city unveiled its Climate Change Policy. The scope of this paper is to analyze how the health sector is preparing to contribute to the implementation of this policy by 2012. Content analysis was the method adopted by examining official documents and conducting semi-structured interviews. In a context of social transformation affected by environmental degradation and socio-environmental consequences there is a need for the cessation of inertia and a demand for new knowledge systems. The outcomes of the study showed a positive intersectorial dialectic relationship, since the research hypothesis was that the health sector would be called upon to back actions on air quality monitoring. Its verification showed a broad scope introducing health promotion and preventive actions as the determinant focus, especially influencing other public policies. Thus, the process under scrutiny acquired reflexivity when evolving with interactive measures breaking with the traditional sectorial and reductionist policy model. It shows an intersectorial perspective based on the importance of issues related to local public health.

  19. Prevention of childhood obesity in Spain: a focus on policies outside the health sector. SESPAS report 2010.

    Science.gov (United States)

    Franco, Manuel; Sanz, Belén; Otero, Laura; Domínguez-Vila, Adrián; Caballero, Benjamín

    2010-12-01

    Obesity is currently a global public health problem. Obesity in early life increases the risk of long-term energy imbalance and adult obesity and its comorbidities, type 2 diabetes, and cardiovascular disease. Since infancy and childhood are critical periods for the adoption of food preferences and physical activity, prevention strategies must intervene in these early periods to promote healthy habits and reduce risk behaviors. Trends in the prevalence of childhood obesity and overweight in Spain have continuously increased in the last three decades. Obesity and overweight currently affect 15 and 20% of Spanish children, respectively, and these percentages are among the highest in Europe. Childhood obesity is determined by social and economic factors pertaining to sectors other than the health system, such as advertising, the built environment, education and the school environment, transportation and the food environment. Following the Health in All Policies (HiAP) approach, the authors identified a series of multisector policy changes that may help to prevent and control the current rising trend of childhood obesity in Spain. The HiAP approach acknowledges that social factors including socioeconomic status, gender differences and the work-life balance are important to develop effective policy changes in the prevention of childhood obesity. A key to success in the prevention of childhood obesity in Spain through policy changes will depend on the ability to establish a policy with the explicit and primary goal of improving health outcomes, despite the anticipated resistance from various sectors and stakeholders. PMID:21074906

  20. An Implication of Health Sector Reform for Disadvantaged Women's Struggle for Birth Control: A Case of Kurdish Rural-Urban Migrant Women in Van, Turkey.

    Science.gov (United States)

    Him, Miki Suzuki; Hoşgör, Ayşe Gündüz

    2015-09-01

    In this article, we examine how socioeconomically disadvantaged women are affected by health sector reform and family planning policy changes in Turkey through a case study of Kurdish women's struggles for birth control. In Turkey, a family planning program became relatively marginalized in primary health care services as a result of health sector reform as well as a shift of population policy toward a moderately pronatal approach. We argue that an emerging health care system would leave disadvantaged women unable to benefit from contraceptives and would perpetuate reproductive health inequalities between women in the country. PMID:24134209

  1. Assessing public and private sector contributions in reproductive health financing and utilization for six sub-Saharan African countries.

    Science.gov (United States)

    Nguyen, Ha; Snider, Jeremy; Ravishankar, Nirmala; Magvanjav, Oyunbileg

    2011-05-01

    The present study provides evidence to support enhanced attention to reproductive health and comprehensive measures to increase access to quality reproductive health services. We compare and contrast the financing and utilization of reproductive health services in six sub-Saharan African countries using data from National Health Accounts and Demographic and Health Surveys. Spending on reproductive health in 2006 ranged from US$4 per woman of reproductive age in Ethiopia to US$17 in Uganda. These are below the necessary level for assuring adequate services given that an internationally recommended spending level for family planning alone was US$16 for 2006. Moreover, reproductive health spending shows signs of decline in tandem with insufficient improvement in service utilization. Public providers played a predominant role in antenatal and delivery care for institutional births, but home deliveries with unqualified attendants dominated. The private sector was a major supplier of condoms, oral pills and IUDs. Private clinics, pharmacies and drug vendors were important sources of STI treatment. The findings highlight the need to commit greatly increased funding for reproductive health services as well as more policy attention to the contribution of public, private and informal providers and the role of collaboration among them to expand access to services for under-served populations. PMID:21555087

  2. Climate variability and change and their potential health effects in small island states: information for adaptation planning in the health sector.

    Science.gov (United States)

    Ebi, Kristie L; Lewis, Nancy D; Corvalan, Carlos

    2006-12-01

    Small island states are likely the countries most vulnerable to climate variability and longterm climate change. Climate models suggest that small island states will experience warmer temperatures and changes in rainfall, soil moisture budgets, prevailing winds (speed and direction), and patterns of wave action. El Niño events likely will strengthen shortterm and interannual climate variations. In addition, global mean sea level is projected to increase by 0.09-0.88 m by 2100, with variable effects on regional and local sea level. To better understand the potential human health consequences of these projected changes, a series of workshops and a conference organized by the World Health Organization, in partnership with the World Meteorological Organization and the United Nations Environment Programme, addressed the following issues: the current distribution and burden of climate-sensitive diseases in small island states, the potential future health impacts of climate variability and change, the interventions currently used to reduce the burden of climate-sensitive diseases, additional interventions that are needed to adapt to current and future health impacts, and the health implications of climate variability and change in other sectors. Information on these issues is synthesized and key recommendations are identified for improving the capacity of the health sector to anticipate and prepare for climate variability and change in small island states.

  3. Resource allocation in Pakistan's health sector: a critical appraisal and a path toward the Millennium Development Goals.

    Science.gov (United States)

    Shaikh, Babar Tasneem; Ejaz, Irum; Mazhar, Arslan; Hafeez, Assad

    2013-01-01

    Pakistan is trying hard to sustain its progress toward the Millennium Development Goals. However, because of a lack of political commitment to innovative solutions to improve its financing mechanism, the health system is unable to provide even essential and basic services to the people. The country, with more than 70% of the population living on less than two US dollars a day, largely depends on direct taxes for its revenue. Because of inadequate financing, the quality of government services is inexcusably poor; therefore, a majority of people seek healthcare in the private sector. This has led to a horde of issues pertaining to equity, accessibility and fairness. High out-of-pocket expenses on health jeopardize a family's livelihood, pushing it into a vicious circle of poverty. In the wake of recent devolution, this paper presents options for future health financing that enables the provinces to exert their autonomy to safeguard the health of the most vulnerable in the country. Our recommendations follow the vision of the World Health Organization and the Commission on Macroeconomics and Health, to achieve universal health coverage and social protection for the poor. PMID:23803492

  4. Innovative health service delivery models in low and middle income countries - what can we learn from the private sector?

    Directory of Open Access Journals (Sweden)

    Daar Abdallah S

    2010-07-01

    Full Text Available Abstract Background The poor in low and middle income countries have limited access to health services due to limited purchasing power, residence in underserved areas, and inadequate health literacy. This produces significant gaps in health care delivery among a population that has a disproportionately large burden of disease. They frequently use the private health sector, due to perceived or actual gaps in public services. A subset of private health organizations, some called social enterprises, have developed novel approaches to increase the availability, affordability and quality of health care services to the poor through innovative health service delivery models. This study aims to characterize these models and identify areas of innovation that have led to effective provision of care for the poor. Methods An environmental scan of peer-reviewed and grey literature was conducted to select exemplars of innovation. A case series of organizations was then purposively sampled to maximize variation. These cases were examined using content analysis and constant comparison to characterize their strategies, focusing on business processes. Results After an initial sample of 46 studies, 10 case studies of exemplars were developed spanning different geography, disease areas and health service delivery models. These ten organizations had innovations in their marketing, financing, and operating strategies. These included approaches such a social marketing, cross-subsidy, high-volume, low cost models, and process reengineering. They tended to have a narrow clinical focus, which facilitates standardizing processes of care, and experimentation with novel delivery models. Despite being well-known, information on the social impact of these organizations was variable, with more data on availability and affordability and less on quality of care. Conclusions These private sector organizations demonstrate a range of innovations in health service delivery that have

  5. Factors influencing decision-making by social care and health sector professionals in cases of elder financial abuse.

    Science.gov (United States)

    Davies, Miranda L; Gilhooly, Mary L M; Gilhooly, Kenneth J; Harries, Priscilla A; Cairns, Deborah

    2013-01-01

    This study aimed to identify the factors that have the greatest influence on UK social care and health sector professionals' certainty that an older person is being financially abused, their likelihood of intervention, and the type of action most likely to be taken. A factorial survey approach, applying a fractional factorial design, was used. Health and social care professionals (n = 152) viewed a single sample of 50 elder financial abuse case vignettes; the vignettes contained seven pieces of information (factors). Following multiple regression analysis, incremental F tests were used to compare the impact of each factor on judgements. Factors that had a significant influence on judgements of certainty that financial abuse was occurring included the older person's mental capacity and the nature of the financial problem suspected. Mental capacity accounted for more than twice the variance in likelihood of action than the type of financial problem. Participants from social care were more likely to act and chose more actions compared to health sector participants. The results are discussed in relation to a bystander intervention model. The impact of the older person's mental capacity on decision-making suggests the need for training to ensure action is also taken in cases where older people have full mental capacity and are being abused. Training also needs to highlight the more subtle types of financial abuse, the types that appear not to lead to certainty or action.

  6. An assessment of health sector guidelines and services for treatment of sexual violence in El Salvador, Guatemala, Honduras and Nicaragua.

    Science.gov (United States)

    McNaughton Reyes, H Luz; Billings, Deborah L; Paredes-Gaitan, Yolanda; Padilla Zuniga, Karen

    2012-12-01

    In Central America, approximately 12% of women report ever having been forced to have sex by an intimate male partner, and sexual violence by others is also a frequent experience. All Central American countries are signatories to human rights agreements that oblige States to ensure access to comprehensive health services for victims of sexual violence, but there is limited information as to whether these agreements have been translated into policy and practice. This article critically examines health sector guidelines for the treatment of sexual violence in El Salvador, Guatemala, Honduras and Nicaragua, and reports on an assessment of services in 34 private- and public-sector facilities in the four countries. Overall, policies were consistent with international agreements and included guidance on detection and documentation of violence, forensic examination, treatment, referral and follow-up care. However, only a small proportion of women who experience sexual violence actually seek care. The challenge facing all four countries is to turn policy into practice. Screening practices were inconsistent, and policies needed to indicate more clearly the roles and responsibilities of health care providers and forensic specialists. Finally, women's right to privacy and confidentiality in reports of cases to legal authorities needed further consideration, as well as the importance of providing all services at a single location.

  7. National survey of paediatric audiological services for diagnosis and intervention in the South African private health care sector

    Directory of Open Access Journals (Sweden)

    Miriam E. Meyer

    2014-06-01

    Full Text Available Objective: A national survey of early hearing detection and intervention services was undertaken to describe the current status of diagnostic and intervention services in the South African private health care sector.Methods: All private hospitals with obstetric units (n = 166 were surveyed telephonically. The data was integrated with data collected from self-administered questionnaires subsequently distributed nationally to private audiology practices providing hearing screening at the respective hospitals reporting hearing screening services (n = 87. Data was analysed descriptively to yield national percentages and frequency distributions.Results: Average reported age at diagnosis was 11 months. Most participants (74% indicated that less than 20% of infants fitted with hearing aids received amplification before the age of 6 months. Most (64% participants indicated that the average period between confirmed diagnosis and hearing aid fitting was 1 month, on par with international benchmarks. Only 16%–23% of participants included all diagnostic procedures recommended by the Health Professions Council of South Africa’s 2007 position statement for minimum diagnostic test batteries for infants and young children.Conclusions: Diagnosis of hearing loss, hearing aid fitting and audiological intervention is delayed significantly in the South African private health care sector. Improved services should include integrated systematic hospital-based screening as part of birthing packages with diagnostic referral to specialist paediatric audiologists for accurate assessment and management of patients in a timely manner.

  8. Information technology systems in public sector health facilities in developing countries: the case of South Africa

    Directory of Open Access Journals (Sweden)

    Cline Gregory B

    2013-01-01

    Full Text Available Abstract Background The public healthcare sector in developing countries faces many challenges including weak healthcare systems and under-resourced facilities that deliver poor outcomes relative to total healthcare expenditure. Global references demonstrate that information technology has the ability to assist in this regard through the automation of processes, thus reducing the inefficiencies of manually driven processes and lowering transaction costs. This study examines the impact of hospital information systems implementation on service delivery, user adoption and organisational culture within two hospital settings in South Africa. Methods Ninety-four interviews with doctors, nurses and hospital administrators were conducted in two public sector tertiary healthcare facilities (in two provinces to record end-user perceptions. Structured questionnaires were used to conduct the interviews with both qualitative and quantitative information. Results Noteworthy differences were observed among the three sample groups of doctors, nurses and administrators as well as between our two hospital groups. The impact of automation in terms of cost and strategic value in public sector hospitals is shown to have yielded positive outcomes with regard to patient experience, hospital staff workflow enhancements, and overall morale in the workplace. Conclusion The research provides insight into the reasons for investing in system automation, the associated outcomes, and organisational factors that impact the successful adoption of IT systems. In addition, it finds that sustainable success in these initiatives is as much a function of the technology as it is of the change management function that must accompany the system implementation.

  9. From health services to medical markets: the commodity transformation of medical production and the nonprofit sector.

    Science.gov (United States)

    Imershein, A W; Estes, C L

    1996-01-01

    In recent years the language and logic of medical care have moved from providing medical services to marketing product lines. Analysis in this article examines this task transformation and its implications for transformation of the nonprofit sector and of the state. The authors argue that these transformations are essential explanatory elements to account for the origins of medical services in the nonprofit sector, the early exclusion of capitalist organizations from hospital care, and the changes that fostered corporate entry. To wit, medical care tasks have undergone a two-stage transformation. The first transformation changed open-ended, ill-defined services with uncertain funding into more highly organized and codified services with stable funding, attracting both capitalist enterprises and capitalist logic into the nonprofit sector. The second transformation standardized medical care tasks into product lines, a process that also challenged the status of the nonprofit organizations performing these tasks. In an analysis of the second transformation, the authors argue that this challenge is in the process of turning back upon itself, undermining the conditions that fostered capitalist entry into medical care delivery in the first place.

  10. Capacity building in the health sector to improve care for child nutrition and development.

    Science.gov (United States)

    Yousafzai, Aisha K; Rasheed, Muneera A; Daelmans, Bernadette; Manji, Sheila; Arnold, Caroline; Lingam, Raghu; Muskin, Joshua; Lucas, Jane E

    2014-01-01

    The effectiveness of interventions promoting healthy child growth and development depends upon the capacity of the health system to deliver a high-quality intervention. However, few health workers are trained in providing integrated early child-development services. Building capacity entails not only training the frontline worker, but also mobilizing knowledge and support to promote early child development across the health system. In this paper, we present the paradigm shift required to build effective partnerships between health workers and families in order to support children's health, growth, and development, the practical skills frontline health workers require to promote optimal caregiving, and the need for knowledge mobilization across multiple institutional levels to support frontline health workers. We present case studies illustrating challenges and success stories around capacity development. There is a need to galvanize increased commitment and resources to building capacity in health systems to deliver early child-development services.

  11. TECHNOLOGY MANAGEMENT IN THE PUBLIC HEALTH SECTOR: PROFESSIONAL VIEW FROM EQUIPMENT MAINTENANCE EXPERTS

    OpenAIRE

    M.O. Kachieng’a

    2012-01-01

    South Africa has tried various strategies to improve access, quality and cost-efficiency in the health care delivery systems. However it is clear that the optimal approach has yet to be found. It has been recognised that health technology is an important element of this transformation, and will continue to play a vital role.
    It is almost evident that the way health technology is managed in health care institutions directly affects the quality of treatment patients receive. Althoug...

  12. Problems and tendencies in management optimisation of hospital sector within health care system of Republic of Bulgaria

    Directory of Open Access Journals (Sweden)

    M.G. Stoycheva

    2013-03-01

    Full Text Available The aim of the article. The purpose of this article is to analyze the specifics, priorities and tendencies of the reforms in hospital sector management within the health care system of Republic of Bulgaria, the hospital care organization practices in relation to the National discussions on issues of hospital sector of the health care system.The results of the analysis. The accession of Republic of Bulgaria to the EU has created new conditions in defining the priorities in the area of public health care, including hospital medical aid. Summarizing, accumulation and transfer of experience in reforming of health care systems of the European Union member states, development of unified requirements, harmonization of legislation, financing, structure of functioning and management of hospital care within the health care system, lead to the need of deep analysis of situation, strategic priorities renewal, management optimization of whole health care system, and in particular the hospital care system in Republic of Bulgaria.In the article the author analyses the research and publications of some major materials, regulations and documents, which provided the basis for the reforms in the health care management system in Republic of Bulgaria in its continuing integration into the pan-European system. Illustrating current situation analysis, the author shares the opinion that the most important part in the organization of common management system in health care is the sector responsible for the development of hospital financing.The author pays special attention to the issues of economic activity of health care institutions.The author cites a number of documents of the National Centre for Medical Information (NCMI noting that leading specialists of the Centre: .Dikov, R.Kolarova, T.Hundurzhievhave prepared detailed reports on economics 2001-2008 and comparative analysis of the medical institutions operation as well as those for outpatient care in Republic of

  13. An ethnographic study of Latino preschool children's oral health in rural California: Intersections among family, community, provider and regulatory sectors

    Directory of Open Access Journals (Sweden)

    Horton Sarah B

    2008-03-01

    Full Text Available Abstract Background Latino children experience a higher prevalence of caries than do children in any other racial/ethnic group in the US. This paper examines the intersections among four societal sectors or contexts of care which contribute to oral health disparities for low-income, preschool Latino1 children in rural California. Methods Findings are reported from an ethnographic investigation, conducted in 2005–2006, of family, community, professional/dental and policy/regulatory sectors or contexts of care that play central roles in creating or sustaining low income, rural children's poor oral health status. The study community of around 9,000 people, predominantly of Mexican-American origin, was located in California's agricultural Central Valley. Observations in homes, community facilities, and dental offices within the region were supplemented by in-depth interviews with 30 key informants (such as dental professionals, health educators, child welfare agents, clinic administrators and regulatory agents and 47 primary caregivers (mothers of children at least one of whom was under 6 years of age. Results Caregivers did not always recognize visible signs of caries among their children, nor respond quickly unless children also complained of pain. Fluctuating seasonal eligibility for public health insurance intersected with limited community infrastructure and civic amenities, including lack of public transportation, to create difficulties in access to care. The non-fluoridated municipal water supply is not widely consumed because of fears about pesticide pollution. If the dentist brought children into the clinic for multiple visits, this caused the accompanying parent hardship and occasionally resulted in the loss of his or her job. Few general dentists had received specific training in how to handle young patients. Children's dental fear and poor provider-parent communication were exacerbated by a scarcity of dentists willing to serve rural

  14. Efficiency of Health Care Sector at Sub-State Level in India: A Case of Punjab

    Directory of Open Access Journals (Sweden)

    Brijesh C. Purohit

    2009-11-01

    Full Text Available In recent years, WHO and other individual researchers have advocated estimation of health system performance through stochastic frontier models. It provides an idealized yardstick to evaluate economic performance of health system. So far attempts in India have remained focused at state level analysis. This paper attempts a sub-state level analysis for an affluent Indian state, namely Punjab, by using stochastic frontier technique. Our results provide pertinent insight into state health system and facilitate health facility planning at the sub-state level. Carried out in two stages of estimation, our results suggest that life expectancy in the Indian state could be enhanced considerably by correcting the factors that are adversely influencing the sub-state level health system efficiency. A higher budgetary allocation for health manpower is recommended by us to improve efficiency in poorly performing districts. This may be supported by policy initiatives outside the health system by empowering women through better education and work participation.

  15. Single phase AC-DC power factor corrected converter with high frequency isolation using buck converter

    Directory of Open Access Journals (Sweden)

    R. Ramesh,

    2014-03-01

    Full Text Available Single phase ac-dc converters having high frequency isolation are implemented in buck, boost, buck-boost configuration with improving the power quality in terms of reducing the harmonics of input current. The paperpropose the circuit configuration, control mechanism, and simulation result for the single phase ac-dc converter.

  16. Buck-Boost Current-Source Inverters With Diode-Inductor Network

    DEFF Research Database (Denmark)

    Gao, Feng; Liang, Chao; Loh, Poh Chiang;

    2009-01-01

    compared with other recently reported buck-boost CSIs. For controlling the proposed CSIs, two modulation schemes are designed for achieving either optimized harmonic performance or minimized commutation count without influencing the inverter current buck-boost gain. These theoretical findings were...

  17. Mainstreaming Gender in the Health Sector : Prevention of Gender-Based Violence and Male Involvement in Reproductive Health

    OpenAIRE

    Betron, Myra; Fort, Lucía

    2006-01-01

    The Bank has hosted various conferences to address issues of male involvement in reproductive health and gender-based violence, yet no projects in the World Bank's portfolio have directly addressed either topic.1 Recent gender-related work in the World Bank's health projects in Latin America has made evident the limited capacity of health personnel and communities to integrate men into fam...

  18. Conceptual reflections about organizational and professional commitment in the health sector Reflexión conceptual sobre compromiso organizacional y profesional en el sector salud Reflexões conceituais sobre comprometimento organizacional e profissional no setor saúde

    OpenAIRE

    Eliana Ofelia LLapa-Rodríguez; Maria Auxiliadora Trevizan; Gilberto Tadeu Shinyashiki

    2008-01-01

    In the daily exercise of their functions, health professionals face a duality of systems, that is, the professional system and the organizational system, each of which has its own distinct values, principles and expectations. The authors aim to present organizational and professional commitment concepts and their relations in the context of the health sector. They consider that organizational and professional commitment are not incompatible, but can be reconciled in the organizational dynamic...

  19. Hybrid posicast controller for a DC-DC buck converter

    Directory of Open Access Journals (Sweden)

    Kaithamalai Udhayakumar

    2008-01-01

    Full Text Available A new Posicast compensated hybrid controller for the DC-DC Buck converter is investigated. Posicast is a feed forward compensator, which eliminates the overshoot in the step response of a lightly damped system. However, the traditional method is sensitive to variations in natural frequency. The new method described here reduces this undesirable sensitivity by using Posicast within the feedback loop. Design of the Posicast function is independent of computational delay. The new controller results in a lower noise in the control signal, when compared to a conventional PID controller.

  20. Nonlinear Phenomena in Buck-Boost Power Factor Correction Converter

    Directory of Open Access Journals (Sweden)

    Mehrnoosh Vatani

    2013-01-01

    Full Text Available Buck-Boost Power-Factor-Correction (PFC converter with Average-Current-Model (ACM control is a nonlinear circuit because of the multiplier using and large change in the duty cycle, so its stability analysis must be studied by nonlinear model. In this paper double averaging method is used for describing the model of this converter. By this model we would be able to explain the low frequency dynamics of the system and identify stability boundaries according to circuit parameters and also nonlinear phenomena of this converter are detected.

  1. Component-Minimized Buck-Boost Voltage Source Inverters

    DEFF Research Database (Denmark)

    Gao, F.; Loh, P.C.; Blaabjerg, Frede;

    2007-01-01

    order to form a distinct neutral potential in the corresponding voltage boost circuitry for correct B4 inverter operation, necessary modifications are derived step by step. The resulted dc networks with symmetrical placement of passive components allow complete charging and equal energy distribution...... between capacitors. Modulation wise, the proposed buck-boost B4 inverters can be controlled using a carefully designed carrier-based pulse-width modulation (PWM) scheme that will always ensure balanced threephase outputs as desired, while simultaneously achieving minimal voltage stress across...

  2. Notch filter feedback controlled chaos in buck converter

    Institute of Scientific and Technical Information of China (English)

    Lu Wei-Guo; Zhou Luo-Wei; Luo Quan-Ming

    2007-01-01

    A method of controlling chaos in the voltage-mode buck converter is presented by using an improved notch filter feedback control in this paper. The proposed control part comprises a notch filter and a low-pass filter. The discrepancy between the outputs of the two filters is introduced into the control prototype of the power converter. In this way, the system period-1 solution is kept unchanged. The harmonic balance method is applied to analysing the variation law of the system bifurcation point, and then the stable range of the feedback gain is ascertained. The results of simulation and experiment are also given finally.

  3. Patterns of perceptions of workplace violence in the Portuguese health care sector

    OpenAIRE

    Craveiro Isabel; Fronteira Inês; Biscaia André; Ferrinho Paulo; Antunes Ana; Conceição Claudia; Flores Isabel; Santos Osvaldo

    2003-01-01

    Abstract This article characterizes the problem of violence against health professionals in the workplace (VAHPITWP) in selected settings in Portugal. It addresses the questions of what types of violence are most frequent and who are the most affected health professionals. Three methodological approaches were followed: (i) documentary studies, (ii) a questionnaire-based hospital and health centre (HC) complex case study and (iii) semi-structured interviews with stakeholders. Of the different ...

  4. Exploring the influence of trust relationships on motivation in the health sector: a systematic review

    OpenAIRE

    Okello, DR; Gilson, L

    2015-01-01

    Background Dedicated and motivated health workers (HWs) play a major role in delivering efficient and effective health services that improve patients’ experience of health care. Growing interest in HW motivation has led to a global focus on pay for performance strategies, but less attention has been paid to nurturing intrinsic motivation. Workplace trust relationships involve fair treatment and respectful interactions between individuals. Such relationships enable cooperation among HWs and th...

  5. Common Health, Safety and Environmental Concerns in Upstream Oil and Gas Sector: Implications for HSE Management in Ghana

    Directory of Open Access Journals (Sweden)

    Seth Oppong

    2014-01-01

    Full Text Available This paper explores the literature to identify common occupational injuries, diseases, and psychological wellbeing on oil rigs as well as the negative environmental impacts of the upstream oil and gas sector. It ends by making recommendations for effective health, safety, and environmental (HSE management. Review of the literature showed that contusion (bruise, cuts, and laceration are the commonest occupational injuries that workers on the oil rig suffer and that the injuries mostly affect the hand and finger, leg, and eyes of the offshore workers. These injuries were found to be caused mostly by direct stroke, jamming and overstrain. Similarly, accidental poisoning, musculoskeletal disorders, respiratory disorders and diseases of the digestive system were also documented as the commonest occupational diseases among offshore workers. The literature also shows that working offshore is associated with poorer psychological wellbeing or health; this is to say that offshore workers tend to experience higher levels of stress, burnout, anxiety, depression, low job satisfaction (particularly with the environmental conditions associated with their work, and sleep disorders. Finally, the literature review indicated that land-use problems, air pollution, acid rain, climate change, habitat disruption, environmental degradation, oil spills and leakages are some of environmental impacts of upstream oil production. This review was concluded by recommending some measures for the management of the HSE hazards associated with the oil and gas sector.

  6. The Building Blocks Collaborative: advancing a life course approach to health equity through multi-sector collaboration.

    Science.gov (United States)

    Shrimali, Bina Patel; Luginbuhl, Jessica; Malin, Christina; Flournoy, Rebecca; Siegel, Anita

    2014-02-01

    Too many children are born into poverty, often living in disinvested communities without adequate opportunities to be healthy and thrive. Two complementary frameworks-health equity and life course-propose new approaches to these challenges. Health equity strategies seek to improve community conditions that influence health. The life course perspective focuses on key developmental periods that can shift a person's trajectory over the life course, and highlights the importance of ensuring that children have supports in place that set them up for long-term success and health. Applying these frameworks, the Alameda County Public Health Department launched the Building Blocks Collaborative (BBC), a countywide multi-sector initiative to engage community partners in improving neighborhood conditions in low-income communities, with a focus on young children. A broad cross-section of stakeholders, called to action by the state of racial and economic inequities in children's health, came together to launch the BBC and develop a Bill of Rights that highlights the diverse factors that contribute to children's health. BBC partners then began working together to improve community conditions by learning and sharing ideas and strategies, and incubating new collaborative projects. Supportive health department leadership; dedicated staff; shared vision and ownership; a flexible partnership structure; and broad collective goals that build on partners' strengths and priorities have been critical to the growth of the BBC. Next steps include institutionalizing BBC projects into existing infrastructure, ongoing partner engagement, and continued project innovation-to achieve a common vision that all babies have the best start in life. PMID:23807714

  7. Out of Place: Mediating Health and Social Care in Ontario's Long-Term Care Sector

    Science.gov (United States)

    Daly, Tamara

    2007-01-01

    The paper discusses two reforms in Ontario's long-term care. The first is the commercialization of home care as a result of the implementation of a "managed competition" delivery model. The second is the Ministry of Health and Long-Term Care's privileging of "health care" over "social care" through changes to which types of home care and home…

  8. Cost-effectiveness analysis for sector-wide priority setting in health

    NARCIS (Netherlands)

    R.C.W. Hutubessy (Raymond)

    2003-01-01

    textabstractCost-effectiveness analysis (CEA) provides one means by which decision-makers may assess and potentially improve the performance of health systems. The process can help to ensure that resources devoted to health systems are achieving the maximum possible benefit in terms of outcomes that

  9. An international comparative public health analysis of sex trafficking of women and girls in eight cities: achieving a more effective health sector response.

    Science.gov (United States)

    Macias Konstantopoulos, Wendy; Ahn, Roy; Alpert, Elaine J; Cafferty, Elizabeth; McGahan, Anita; Williams, Timothy P; Castor, Judith Palmer; Wolferstan, Nadya; Purcell, Genevieve; Burke, Thomas F

    2013-12-01

    Sex trafficking, trafficking for the purpose of forced sexual exploitation, is a widespread form of human trafficking that occurs in all regions of the world, affects mostly women and girls, and has far-reaching health implications. Studies suggest that up to 50 % of sex trafficking victims in the USA seek medical attention while in their trafficking situation, yet it is unclear how the healthcare system responds to the needs of victims of sex trafficking. To understand the intersection of sex trafficking and public health, we performed in-depth qualitative interviews among 277 antitrafficking stakeholders across eight metropolitan areas in five countries to examine the local context of sex trafficking. We sought to gain a new perspective on this form of gender-based violence from those who have a unique vantage point and intimate knowledge of push-and-pull factors, victim health needs, current available resources and practices in the health system, and barriers to care. Through comparative analysis across these contexts, we found that multiple sociocultural and economic factors facilitate sex trafficking, including child sexual abuse, the objectification of women and girls, and lack of income. Although there are numerous physical and psychological health problems associated with sex trafficking, health services for victims are patchy and poorly coordinated, particularly in the realm of mental health. Various factors function as barriers to a greater health response, including low awareness of sex trafficking and attitudinal biases among health workers. A more comprehensive and coordinated health system response to sex trafficking may help alleviate its devastating effects on vulnerable women and girls. There are numerous opportunities for local health systems to engage in antitrafficking efforts while partnering across sectors with relevant stakeholders. PMID:24151086

  10. An international comparative public health analysis of sex trafficking of women and girls in eight cities: achieving a more effective health sector response.

    Science.gov (United States)

    Macias Konstantopoulos, Wendy; Ahn, Roy; Alpert, Elaine J; Cafferty, Elizabeth; McGahan, Anita; Williams, Timothy P; Castor, Judith Palmer; Wolferstan, Nadya; Purcell, Genevieve; Burke, Thomas F

    2013-12-01

    Sex trafficking, trafficking for the purpose of forced sexual exploitation, is a widespread form of human trafficking that occurs in all regions of the world, affects mostly women and girls, and has far-reaching health implications. Studies suggest that up to 50 % of sex trafficking victims in the USA seek medical attention while in their trafficking situation, yet it is unclear how the healthcare system responds to the needs of victims of sex trafficking. To understand the intersection of sex trafficking and public health, we performed in-depth qualitative interviews among 277 antitrafficking stakeholders across eight metropolitan areas in five countries to examine the local context of sex trafficking. We sought to gain a new perspective on this form of gender-based violence from those who have a unique vantage point and intimate knowledge of push-and-pull factors, victim health needs, current available resources and practices in the health system, and barriers to care. Through comparative analysis across these contexts, we found that multiple sociocultural and economic factors facilitate sex trafficking, including child sexual abuse, the objectification of women and girls, and lack of income. Although there are numerous physical and psychological health problems associated with sex trafficking, health services for victims are patchy and poorly coordinated, particularly in the realm of mental health. Various factors function as barriers to a greater health response, including low awareness of sex trafficking and attitudinal biases among health workers. A more comprehensive and coordinated health system response to sex trafficking may help alleviate its devastating effects on vulnerable women and girls. There are numerous opportunities for local health systems to engage in antitrafficking efforts while partnering across sectors with relevant stakeholders.

  11. An informatics system to support knowledge management in the health sector--the South African National Health Knowledge Network.

    Science.gov (United States)

    Louw, J A; Seebregts, C J; Makgoba, W M; Fouché, B

    2001-01-01

    This paper discusses the planning and development of a South African national health knowledge network. The methodology is in essence based on the principles of knowledge management and the drivers of a system of innovation. The knowledge network, SA HealthInfo, aims to provide a one-stop interactive forum/resource, for quality-controlled and evidence-based health research information, to a wide spectrum of users, at various levels of aggregation, with the necessary security arrangements and facilities for interaction among users to promote explicit (codified) and tacit knowledge flow. It will therefore stimulate the process of innovation within the South African health system.

  12. Measuring and managing progress in the establishment of basic health services: the Afghanistan health sector balanced scorecard.

    Science.gov (United States)

    Hansen, Peter M; Peters, David H; Niayesh, Haseebullah; Singh, Lakhwinder P; Dwivedi, Vikas; Burnham, Gilbert

    2008-01-01

    The Ministry of Public Health (MOPH) of Afghanistan has adopted the Balanced Scorecard (BSC) as a tool to measure and manage performance in delivery of a Basic Package of Health Services. Based on results from the 2004 baseline round, the MOPH identified eight of the 29 indicators on the BSC as priority areas for improvement. Like the 2004 round, the 2005 and 2006 BSCs involved a random selection of more than 600 health facilities, 1700 health workers and 5800 patient-provider interactions. The 2005 and 2006 BSCs demonstrated substantial improvements in all eight of the priority areas compared to 2004 baseline levels, with increases in median provincial scores for presence of active village health councils, availability of essential drugs, functional laboratories, provider knowledge, health worker training, use of clinical guidelines, monitoring of tuberculosis treatment, and provision of delivery care. For three of the priority indicators-drug availability, health worker training and provider knowledge-scores remained unchanged or decreased between 2005 and 2006. This highlights the need to ensure that early gains achieved in establishment of health services in Afghanistan are maintained over time. The use of a coherent and balanced monitoring framework to identify priority areas for improvement and measure performance over time reflects an objectives-based approach to management of health services that is proving to be effective in a difficult environment.

  13. Public Service Agreement 2010-2014 - Health Sector Action Plan 2012

    OpenAIRE

    Department of Health

    2012-01-01

    This revised Action Plan is designed to support the delivery of the HSEâ?Ts 2012 National Service Plan by facilitating the fast-tracking of measures required to deliver essential health and personal social services across the country within the context of further reductions in funding and staff numbers. The implementation of the National Service Plan, approved by the Minister for Health on 13 January 2012, represents a major challenge to the health services and comes at a time of major refor...

  14. A TEG Efficiency Booster with Buck-Boost Conversion

    Science.gov (United States)

    Wu, Hongfei; Sun, Kai; Zhang, Junjun; Xing, Yan

    2013-07-01

    A thermoelectric generator (TEG) efficiency booster with buck-boost conversion and power management is proposed as a TEG battery power conditioner suitable for a wide TEG output voltage range. An inverse-coupled inductor is employed in the buck-boost converter, which is used to achieve smooth current with low ripple on both the TEG and battery sides. Furthermore, benefiting from the magnetic flux counteraction of the two windings on the coupled inductor, the core size and power losses of the filter inductor are reduced, which can achieve both high efficiency and high power density. A power management strategy is proposed for this power conditioning system, which involves maximum power point tracking (MPPT), battery voltage control, and battery current control. A control method is employed to ensure smooth switching among different working modes. A modified MPPT control algorithm with improved dynamic and steady-state characteristics is presented and applied to the TEG battery power conditioning system to maximize energy harvesting. A 500-W prototype has been built, and experimental tests carried out on it. The power efficiency of the prototype at full load is higher than 96%, and peak efficiency of 99% is attained.

  15. Feeding and reproductive behaviour in fallow bucks (Dama dama)

    Science.gov (United States)

    Apollonio, Marco; Vittorio, Irene

    2004-12-01

    Observations on individually marked fallow deer (Dama dama) in central Italy were performed over 2 years in order to analyse time budgets of four age and sex classes. The aim was to test whether feeding activity was influenced by mating activity, forage quality or physiological constraints during the rut. Only adult males (bucks) completely ceased feeding during the rutting season, well before the actual start of mating behaviour and concurrently with the phenomenon of scent-urination, and spending most of their daily time completely inactive. All other age and sex classes were unaffected in their feeding behaviour by the rutting season. Indeed, females and young males showed a marked increase in grazing in response to an improvement in forage quality from summer to autumn. These results seem to confirm the hypothesis that hypophagia, displayed only by bucks, may be of no adaptive value in itself. On the other hand, it may be a by-product of other physiological processes occurring during the rut, inducing scent-urination, which plays an important role in intraspecific recognition and sexual attraction.

  16. Patterns of perceptions of workplace violence in the Portuguese health care sector

    Directory of Open Access Journals (Sweden)

    Craveiro Isabel

    2003-11-01

    Full Text Available Abstract This article characterizes the problem of violence against health professionals in the workplace (VAHPITWP in selected settings in Portugal. It addresses the questions of what types of violence are most frequent and who are the most affected health professionals. Three methodological approaches were followed: (i documentary studies, (ii a questionnaire-based hospital and health centre (HC complex case study and (iii semi-structured interviews with stakeholders. Of the different types of violence, all our study approaches confirm that verbal violence is the most frequent. Discrimination, not infrequent in the hospital, seems to be underestimated by the stakeholders interviewed. Violence seems much more frequent in the HC than in the hospital. In the HC, all types of violence are also most frequently directed against female health workers and, in the hospital, against male workers. These studies allow us to conclude that violence is frequent but underreported.

  17. The public health sector supply of modern contraceptives in rural Nigeria: an analysis of selection, forecasting and inventory control

    Directory of Open Access Journals (Sweden)

    Asa Auta

    2011-07-01

    Full Text Available Public health facilities in rural Nigeria have been experiencing a long period of stock-outs and unavailability of modern contraceptives. This work was carried out to review the public health sector supply of modern contraceptives in rural Nigeria in order to make recommendations on how to improve the supply of modern contraceptives in this area. The study reviewed secondary data from country documents and literature obtained from Pubmed, Popline, and Global Health databases; as well as websites of USAID/DELIVER Project, Measure DHS and Federal Ministry of Health. The study revealed that a wide range of contraceptives are included in the essential drug list to be used in secondary facilities, while only a few ones are selected to be used in primary facilities which serve the majority of rural population. Forecasting is done using issue data from the central warehouse because facilities are not generating reliable consumption data. Inventory control is poor in rural facilities, and these facilities do not follow the established inventory control guidelines. The study therefore demonstrates that the current essential drug list should be reviewed in order to include injectables for use in primary facilities, strengthen the current forecasting, data reporting and inventory control system.

  18. [Equity in the health sector: evaluation of public policy in Belo Horizonte, Minas Gerais State, Brazil, 1993-1997].

    Science.gov (United States)

    Junqueira, Virginia; Pessoto, Umberto Catarino; Kayano, Jorge; Nascimento, Paulo Roberto; Castro, Iracema Ester do Nascimento; Rocha, Jucilene Leite da; Terence, Marcelo Fernando; Boaretto, Roberta Cristina; Ibanhes, Lauro Cesar; Cortizo, Carlos Tato; Heimann, Luiza Sterman

    2002-01-01

    This article evaluates government measures to reduce inequity in the health sector in Belo Horizonte from 1993 to 1997. Our hypothesis is that a municipal administration committed to equity can reduce disparities in health with the support of the Unified National Health System (SUS). The methodology used an urban quality of life index in Belo Horizonte to detect social inequalities in living conditions, as well as differences between the component indices in the infant mortality rate. Other municipal measures were assessed according to the investment resulting from the implementation of a participatory local budget and open planning process. The urban quality of life index appeared to be an appropriate measure for orienting municipal administration. The infant mortality rate proved to be a good indicator for measuring inequality in health. There was a reduction in IMR and mortality reducing gaps in the districts studied. We observed greater investment of physical and financial resources in the districts with the lowest urban quality of life index, and it can thus be stated that the municipal administration reduced the prevailing inequalities. PMID:12118313

  19. Stakeholder views on factors influencing the wellbeing and health sector engagement of young Asian New Zealanders.

    Science.gov (United States)

    Peiris-John, Roshini; Wong, Agnes; Sobrun-Maharaj, Amritha; Ameratunga, Shanthi

    2016-03-01

    INTRODUCTION In New Zealand, while the term 'Asians' in popular discourse means East and South-east Asian peoples, Statistics New Zealand's definition includes people of many nationalities from East, South and South-east Asia, all with quite different cultural norms, taboos and degrees of conservatism. In a context where 'Asian' youth data are typically presented in aggregate form, there are notable gaps in knowledge regarding the contextual determinants of health in this highly heterogeneous group. This qualitative study explored key stakeholder views on issues that would be most useful to explore on the health and wellbeing of Asian youth and processes that would foster engagement of Asian youth in health research. METHODS Interviews were conducted with six key stakeholders whose professional activities were largely focused on the wellbeing of Asian people. The general inductive approach was used to identify and analyse themes in the qualitative text data. FINDINGS Six broad themes were identified from the key stakeholder interviews framed as priority areas that need further exploration: cultural identity, integration and acculturation; barriers to help-seeking; aspects to consider when engaging Asian youth in research (youth voice, empowerment and participatory approach to research); parental influence and involvement in health research; confidentiality and anonymity; and capacity building and informing policy. CONCLUSION With stakeholders strongly advocating the engagement of Asian youth in the health research agenda this study highlights the importance of engaging youth alongside service providers to collaborate on research and co-design responsive primary health care services in a multicultural setting. KEYWORDS Asian youth; New Zealand; health research; minority health; Community and social participation.

  20. Neighbourhoods and self rated health: a comparison of public sector employees in London and Helsinki

    OpenAIRE

    Stafford, M; Martikainen, P; Lahelma, E; Marmot, M.

    2004-01-01

    Study objective: Mortality and morbidity vary across neighbourhoods and larger residential areas. Effects of area deprivation on health may vary across countries, because of greater spatial separation of people occupying high and low socioeconomic positions and differences in the provision of local services and facilities. Neighbourhood variations in health and the contribution of residents' characteristics and neighbourhood indicators were compared in London and Helsinki, two settings where ...

  1. Occupational Health and Safety Management and Turnover Intention in the Ghanaian Mining Sector

    OpenAIRE

    Amponsah-Tawiah, Kwesi; Ntow, Michael Akomeah Ofori; Mensah, Justice

    2015-01-01

    Background The mining industry is considered as one of the most dangerous and hazardous industries and the need for effective and efficient occupational health and safety management is critical to safeguard workers and the industry. Despite the dangers and hazards present in the mining industry, only few studies have focused on how occupational health and safety and turnover intentions in the mines. Method The study suing a cross-sectional survey design collected quantitative data from the 25...

  2. Stakeholder views on factors influencing the wellbeing and health sector engagement of young Asian New Zealanders.

    Science.gov (United States)

    Peiris-John, Roshini; Wong, Agnes; Sobrun-Maharaj, Amritha; Ameratunga, Shanthi

    2016-03-01

    INTRODUCTION In New Zealand, while the term 'Asians' in popular discourse means East and South-east Asian peoples, Statistics New Zealand's definition includes people of many nationalities from East, South and South-east Asia, all with quite different cultural norms, taboos and degrees of conservatism. In a context where 'Asian' youth data are typically presented in aggregate form, there are notable gaps in knowledge regarding the contextual determinants of health in this highly heterogeneous group. This qualitative study explored key stakeholder views on issues that would be most useful to explore on the health and wellbeing of Asian youth and processes that would foster engagement of Asian youth in health research. METHODS Interviews were conducted with six key stakeholders whose professional activities were largely focused on the wellbeing of Asian people. The general inductive approach was used to identify and analyse themes in the qualitative text data. FINDINGS Six broad themes were identified from the key stakeholder interviews framed as priority areas that need further exploration: cultural identity, integration and acculturation; barriers to help-seeking; aspects to consider when engaging Asian youth in research (youth voice, empowerment and participatory approach to research); parental influence and involvement in health research; confidentiality and anonymity; and capacity building and informing policy. CONCLUSION With stakeholders strongly advocating the engagement of Asian youth in the health research agenda this study highlights the importance of engaging youth alongside service providers to collaborate on research and co-design responsive primary health care services in a multicultural setting. KEYWORDS Asian youth; New Zealand; health research; minority health; Community and social participation. PMID:27477373

  3. A private sector view of health, surveillance, and communities of color.

    OpenAIRE

    Rabin, S A

    1994-01-01

    The U.S. population is fast evolving into a patchwork of health behaviors, incomes, and ethnic backgrounds. Simple cultural labeling will not do. A growing number of Americans, now numbering about 10 million, cannot or will not describe their race in any one of the Census Bureau's standard categories--white, black, American Indian, Eskimo, Aleut, Asian Pacific, or Hispanic. They group themselves as a multicultural population rather than a single racial or ethnic category. To guide health inte...

  4. Examining growth and internationalization within the health and well-being sector

    OpenAIRE

    Bergman, Maria

    2011-01-01

    HYVIS Pirkanmaa project, operating at Tampere Region Economic Development Agency Tredea, develops the health and well-being growth enterprises situated in Tampere region. I have conducted a survey for HYVIS Pirkanmaa project to provide it information about obstacles to growth, development challenges and internationalization of health and well-being growth enterprises in Tampere region. According to my survey results, market instability was considered as most significant obstacle to g...

  5. Improving health and education outcomes for children in remote communities: A cross-sector and developmental evaluation approach

    Directory of Open Access Journals (Sweden)

    Debra Maria Jones

    2015-09-01

    Full Text Available Early childhood is one of the most influential developmental life stages. Attainments at this stage will have implications for the quality of life children experience as they transition to adulthood. Children residing in remote Australia are exposed to socioeconomic disadvantage that can contribute to developmental delays and resultant poorer education and health outcomes. Complex contributing factors in far west New South Wales have resulted in children with speech and fine motor skill delays experiencing no to limited access to allied health services for a number of decades. More recently, growing awareness that no single policy, government agency, or program could effectively respond to these complexities or ensure appropriate allied health service access for children in these communities has led to the development of the Allied Health in Outback Schools Program, which has been operational since 2009. The program is underpinned by cross-sector partnerships and a shared aspirational aim to improve the developmental outcomes of children to enhance their later life opportunities. It was identified early that the initiative had the potential to deliver mutually beneficial outcomes for communities and participating partner organisations. Over the last five years the program has been the catalyst for partnership consolidation, expansion and diversification. The developmental evaluation approach to continuous program adaptation and refinement has provided valuable insights that have informed health and education policy and enabled the program to be responsive to changing community needs, emerging policy and funding reforms. This article explores the evolution of the program partnerships, their contribution to program success and longevity, and their capacity to respond to an emergent and dynamic environment. The authors propose that a community-centred and developmental approach to program innovation and implementation in remote locations is

  6. Efficiency of resource allocation in the hospital sector after global budgeting under National Health Insurance

    Institute of Scientific and Technical Information of China (English)

    Victor Kreng; YANG Shao-wei

    2013-01-01

    Background Taiwan has implemented a National Health Insurance (NHI) program to provide uniform comprehensive coverage since 1995.Forced by the severe financial deficit,global budgeting is introduced to replace the original payment system in Taiwan's NHI.Under global budgeting system,the total budget is distributed to six geographical regions in Taiwan.There is no pre-determined budget for each hospital.In order to investigate the longitudinal trend of how global budgeting influences health care resource,it is essential to estimate the efficiency of resource allocation in Taiwan's NHI.Methods Data Envelopment Analysis (DEA) and Malmquist index (MI) are used to investigate the 8-year panel data of 23 cities and counties which was collected from the annual report from the Department of Health,Taiwan,China.A value of MI greater than 1 indicates that total factor productivity progress has occurred,while a value of MI less than 1 indicates productivity loss.Results As a result,37 of the 184 DMUs in the analysis were found to be relatively efficient during the period,in which 14 of 23 DMUs are efficient in 2002 right after adopting globe budgeting.A trend of MI declines between 2002 and 2009implies the volume of health care services decrease after adopting global budgeting system.Production efficiency has been improved after global budgeting implies that behaviors of health providers control cost and avoid wasting resource at macro level.Conclusions The regressive MI indicates the hospitals redistribute health care resource to eliminate unnecessary treatment and to control the growth of service volume under global budgeting system.Hence,a trend of declining MI focuses on health care resource redistribution rather than efficiency improvement in this study.

  7. Politics, class actors, and health sector reform in Brazil and Venezuela.

    Science.gov (United States)

    Mahmood, Qamar; Muntaner, Carles

    2013-03-01

    Universal access to healthcare has assumed renewed importance in global health discourse, along with a focus on strengthening health systems. These developments are taking place in the backdrop of concerted efforts to advocate moving away from vertical, disease-based approaches to tackling health problems. While this approach to addressing public health problems is a step in the right direction, there is still insufficient emphasis on understanding the socio-political context of health systems. Reforms to strengthen health systems and achieve universal access to healthcare should be cognizant of the importance of the socio-political context, especially state-society relations. That context determines the nature and trajectory of reforms promoting universality or any pro-equity change. Brazil and Venezuela in recent years have made progress in developing healthcare systems that aim to achieve universal access. These achievements are noteworthy given that, historically, both countries had a long tradition of healthcare systems which were highly privatized and geared towards access to healthcare for a small segment of the population while the majority was excluded. These achievements are also remarkable since they took place in an era of neoliberalism when many states, even those with universally-based healthcare systems, were moving in the opposite direction. We analyze the socio-political context in each of these countries and look specifically at how the changing state-society relations resulted in health being constitutionally recognized as a social right. We describe the challenges that each faced in developing and implementing healthcare systems embracing universality. Our contention is that achieving the principle of universality in healthcare systems is less of a technical matter and more a political project. It involves opposition from the socially conservative elements in the society. Navigation to achieve this goal requires a political strategy that

  8. Estimating the number of paediatric fevers associated with malaria infection presenting to Africa's public health sector in 2007.

    Directory of Open Access Journals (Sweden)

    Peter W Gething

    2010-07-01

    Full Text Available BACKGROUND: As international efforts to increase the coverage of artemisinin-based combination therapy in public health sectors gather pace, concerns have been raised regarding their continued indiscriminate presumptive use for treating all childhood fevers. The availability of rapid-diagnostic tests to support practical and reliable parasitological diagnosis provides an opportunity to improve the rational treatment of febrile children across Africa. However, the cost effectiveness of diagnosis-based treatment polices will depend on the presumed numbers of fevers harbouring infection. Here we compute the number of fevers likely to present to public health facilities in Africa and the estimated number of these fevers likely to be infected with Plasmodium falciparum malaria parasites. METHODS AND FINDINGS: We assembled first administrative-unit level data on paediatric fever prevalence, treatment-seeking rates, and child populations. These data were combined in a geographical information system model that also incorporated an adjustment procedure for urban versus rural areas to produce spatially distributed estimates of fever burden amongst African children and the subset likely to present to public sector clinics. A second data assembly was used to estimate plausible ranges for the proportion of paediatric fevers seen at clinics positive for P. falciparum in different endemicity settings. We estimated that, of the 656 million fevers in African 0-4 y olds in 2007, 182 million (28% were likely to have sought treatment in a public sector clinic of which 78 million (43% were likely to have been infected with P. falciparum (range 60-103 million. CONCLUSIONS: Spatial estimates of childhood fevers and care-seeking rates can be combined with a relational risk model of infection prevalence in the community to estimate the degree of parasitemia in those fevers reaching public health facilities. This quantification provides an important baseline comparison

  9. Making governance work in the health care sector: evidence from a 'natural experiment' in Italy.

    Science.gov (United States)

    Nuti, Sabina; Vola, Federico; Bonini, Anna; Vainieri, Milena

    2016-01-01

    The Italian Health care System provides universal coverage for comprehensive health services and is mainly financed through general taxation. Since the early 1990s, a strong decentralization policy has been adopted in Italy and the state has gradually ceded its jurisdiction to regional governments, of which there are twenty. These regions now have political, administrative, fiscal and organizational responsibility for the provision of health care. This paper examines the different governance models that the regions have adopted and investigates the performance evaluation systems (PESs) associated with them, focusing on the experience of a network of ten regional governments that share the same PES. The article draws on the wide range of governance models and PESs in order to design a natural experiment. Through an analysis of 14 indicators measured in 2007 and in 2012 for all the regions, the study examines how different performance evaluation models are associated with different health care performances and whether the network-shared PES has made any difference to the results achieved by the regions involved. The initial results support the idea that systematic benchmarking and public disclosure of data are powerful tools to guarantee the balanced and sustained improvement of the health care systems, but only if they are integrated with the regional governance mechanisms. PMID:25819303

  10. Assessment of goat breed improvement through distribution of beetal bucks in rainfed pothwar, Punjab

    International Nuclear Information System (INIS)

    The present paper is based on the assessment of goat breed improvement intervention through supply of 65 Beetal bucks in rainfed Pothwar. To judge short term impact and assessment, a survey was carried out of both buck holder and non-holder beneficiaries in six project tehsils, after one year of buck distribution. Data were collected from a sample of 38 buck holders and 31 beneficiary farmers using a structured pretested questionnaire. The main influencing factor in keeping bucks was goat breed improvement. All the sample respondents were convinced of the benefits of crosses with Beetal buck and reported that the offsprings Beetal were of higher body weight (40% higher), good looking and well built. Regarding the suitability of Beetal with fodder and forage in the area, majority of the farmers (73%) considered it more suitable. There was a price difference of Rs. 1277 for male kids and Rs. 697 for female kids of the same age than the kids from local buck crosses. The farmers believed that the price difference was not only due to the higher weight but a better look and better structure of the Beetal goat. Farming community showed keen interest in using this intervention on a regular basis. (author)

  11. Implications for tertiary education: managerial competencies required of beginning practitioners in the health service sector.

    Science.gov (United States)

    Adamson, Barbara J.; Cant, Rosemary V.; Atyeo, John W.

    2001-03-01

    Five hundred and three experienced practitioners involved in management from four professional fields (medical radiation science, occupational therapy, speech pathology and physiotherapy) representing a range of health care settings participated in a survey. The survey examined the importance attached to managerial competencies for the beginning practitioner. The most important grouping related to management of future planning. Underlying competencies included decision making regarding time management and communication with other staff. The second most important grouping of managerial competencies related to organisational practices. These competencies included strategic and organisation-wide management processes associated with change, vision, organisational awareness and decision making. The third grouping of managerial competencies related to knowledge regarding legislation and in particular compliance with occupational health and safety regulations. Other competencies were seen as less important for the beginning practitioner. The implications of these findings are discussed in relation to health science curriculum development in higher education. PMID:11371299

  12. Relationship between morale and motivation in teamwork environments: A research in the health sector

    OpenAIRE

    Pınar Erdoğan; Adnan Çelik

    2016-01-01

    Hospitals in which wide variety of types of health care services are provided require the work of many professionals working together in a harmony. However, it is possible to provide the harmony by teamwork. For the quality health care, it is a must to keep the morale-motivation at high level of the hospital employees who serve 24-hour continuously. Teamwork, same in all other businesses, is considered as a factor that affects the morale and motivation of hospital employees in a positive mann...

  13. "In the driver's seat": the Health Sector Strategic Master Plan as an instrument for aid coordination in Mongolia.

    Science.gov (United States)

    Ulikpan, Anar; Narula, Indermohan; Malik, Asmat; Hill, Peter

    2014-04-03

    In 2005, the Ministry of Health (MoH) in Mongolia initiated the process of developing its Health Sector Strategic Master Plan (HSSMP), using a wide-ranging consultative process, driven by the MoH, and requiring participation from all levels of health facilities, other ministries, donor agencies and NGOs. Among other objectives, the MoH sought to coordinate the disparate inputs from key donors through the HSSMP, aligning them with the Plan's structure. This research explores the extent to which the HSSMP process served as a mechanism for effective aid coordination while promoting ownership and capacity building and the lessons learned for the wider international development community. The study is based on document review, key-informant interviews and authors' experience and participation in the MoH planning processes. The HSSMP process improved alignment and harmonisation. It enabled a better local understanding of the benefits of aid coordination, and the recognition that aid coordination as not only a mere administrative task, but a strategic step towards comprehensive management of both domestic and external resources. The process was not challenge free; the fractious political environment, the frequent turnover of key MoH staff, the resistance of some donors towards MoH scrutiny over their programmes and the dismantling of the central coordination and return of seconded staff following completion of the HSSMP, has slowed the pace of reform. Despite the challenges, the approach resulted in positive outcomes in the areas of ownership and better aid coordination, with HSSMP development emphasising ownership and capacity building. This contrasted with the usual outcomes focus, and neglect of the capacity building learning processes and structural and policy changes needed to ensure sustainable change. The largest and most influential programmes in the health sector are now largely aligned with HSSMP strategies, enabling the MoH to utilize these opportunities to

  14. District decision-making for health in low-income settings: a qualitative study in Uttar Pradesh, India, on engaging the private health sector in sharing health-related data.

    Science.gov (United States)

    Gautham, Meenakshi; Spicer, Neil; Subharwal, Manish; Gupta, Sanjay; Srivastava, Aradhana; Bhattacharyya, Sanghita; Avan, Bilal Iqbal; Schellenberg, Joanna

    2016-09-01

    Health information systems are an important planning and monitoring tool for public health services, but may lack information from the private health sector. In this fourth article in a series on district decision-making for health, we assessed the extent of maternal, newborn and child health (MNCH)-related data sharing between the private and public sectors in two districts of Uttar Pradesh, India; analysed barriers to data sharing; and identified key inputs required for data sharing. Between March 2013 and August 2014, we conducted 74 key informant interviews at national, state and district levels. Respondents were stakeholders from national, state and district health departments, professional associations, non-governmental programmes and private commercial health facilities with 3-200 beds. Qualitative data were analysed using a framework based on a priori and emerging themes. Private facilities registered for ultrasounds and abortions submitted standardized records on these services, which is compulsory under Indian laws. Data sharing for other services was weak, but most facilities maintained basic records related to institutional deliveries and newborns. Public health facilities in blocks collected these data from a few private facilities using different methods. The major barriers to data sharing included the public sector's non-standardized data collection and utilization systems for MNCH and lack of communication and follow up with private facilities. Private facilities feared information disclosure and the additional burden of reporting, but were willing to share data if asked officially, provided the process was simple and they were assured of confidentiality. Unregistered facilities, managed by providers without a biomedical qualification, also conducted institutional deliveries, but were outside any reporting loops. Our findings suggest that even without legislation, the public sector could set up an effective MNCH data sharing strategy with private

  15. District decision-making for health in low-income settings: a qualitative study in Uttar Pradesh, India, on engaging the private health sector in sharing health-related data.

    Science.gov (United States)

    Gautham, Meenakshi; Spicer, Neil; Subharwal, Manish; Gupta, Sanjay; Srivastava, Aradhana; Bhattacharyya, Sanghita; Avan, Bilal Iqbal; Schellenberg, Joanna

    2016-09-01

    Health information systems are an important planning and monitoring tool for public health services, but may lack information from the private health sector. In this fourth article in a series on district decision-making for health, we assessed the extent of maternal, newborn and child health (MNCH)-related data sharing between the private and public sectors in two districts of Uttar Pradesh, India; analysed barriers to data sharing; and identified key inputs required for data sharing. Between March 2013 and August 2014, we conducted 74 key informant interviews at national, state and district levels. Respondents were stakeholders from national, state and district health departments, professional associations, non-governmental programmes and private commercial health facilities with 3-200 beds. Qualitative data were analysed using a framework based on a priori and emerging themes. Private facilities registered for ultrasounds and abortions submitted standardized records on these services, which is compulsory under Indian laws. Data sharing for other services was weak, but most facilities maintained basic records related to institutional deliveries and newborns. Public health facilities in blocks collected these data from a few private facilities using different methods. The major barriers to data sharing included the public sector's non-standardized data collection and utilization systems for MNCH and lack of communication and follow up with private facilities. Private facilities feared information disclosure and the additional burden of reporting, but were willing to share data if asked officially, provided the process was simple and they were assured of confidentiality. Unregistered facilities, managed by providers without a biomedical qualification, also conducted institutional deliveries, but were outside any reporting loops. Our findings suggest that even without legislation, the public sector could set up an effective MNCH data sharing strategy with private

  16. Women's Use of Multi sector Mental Health Services in a Community-Based Perinatal Depression Program

    Science.gov (United States)

    Price, Sarah Kye

    2010-01-01

    Low-income and ethnic minority women have been described as at risk for experiencing depression during and around the time of pregnancy, a finding complicated by low levels of mental health service use within this population. This study retrospectively examined data from a community-based perinatal depression project targeting low-income women in…

  17. Improving the health care sector with a happiness-based approach

    NARCIS (Netherlands)

    Weiss, L.; Kedzia, S.; Francissen, A.A.; Westerhof, G.J.; Soraker, J. H.; Rijt, van der J.-W.; Boer, de J.; Brey, P.; Wong, P.-H.

    2015-01-01

    Traditionally, welfare states in Western Europe and their health care systems focused on the problems of individual citizens. Similarly, academic disciplines paid greater attention to what is going wrong than on what is going right. Nowadays the focus is shifting. It has been argued that it is impo

  18. Setting priorities for the health care sector in Zimbabwe using cost-effectiveness analysis and estimates of the burden of disease

    OpenAIRE

    Hansen Kristian; Chapman Glyn

    2008-01-01

    Abstract Background This study aimed at providing information for priority setting in the health care sector of Zimbabwe as well as assessing the efficiency of resource use. A general approach proposed by the World Bank involving the estimation of the burden of disease measured in Disability-Adjusted Life Years (DALYs) and calculation of cost-effectiveness ratios for a large number of health interventions was followed. Methods Costs per DALY for a total of 65 health interventions were estimat...

  19. A REFLECTION ON THE WAVE OF AMALGAMATIONS IN THE ROMANIAN HEALTH SECTOR

    Directory of Open Access Journals (Sweden)

    Ina MITU

    2014-12-01

    Full Text Available In the context of New Public Management (NPM and good governance, in the last decade the Romanian public health system has undergone a reform process. One of its consequences is the wave of public hospitals amalgamations that have occurred especially since the adoption of the new health law. Thus, in 2011 the Ministry of Health has made public a list of proposed amalgamations of hospitals (around 25% from total hospitals with beds that existed in that period. The aim of this research is to examine the wave of hospital mergers that occurred in Romania between 2011 and 2012. In particular, the study focuses on the drivers, social impact, typology and purpose of the analysed amalgamations. The study uses primary resources documents and it is based on a content analysis of 25 Government Decisions and Substantiation Notes from 2011 to 2012. An important generalization of the paper is that all the amalgamations from the analysed period are involuntary and are selected on territorial criteria and depending on the distance, the specific health services for the purpose of efficient use of human and material resources in order to enhance public health services. Additionally, the expected social impact of these events is materialized mainly in improving the quality of medical services provided to the population and providing unconditional access to medical services for policyholders. The expected changes include: reduction of staff costs; efficient use of public services; classifying the amalgamated hospitals in a higher category; reduction of management positions; optimizing medical activity in terms of economic efficiency; and achieving a management capable of the best use of existing financial resources.

  20. The match between motivation and performance management of health sector workers in Mali

    Directory of Open Access Journals (Sweden)

    Touré Hamadassalia

    2006-02-01

    Full Text Available Abstract Human resources for health (HRH play a central role in improving accessibility to services and quality of care. Their motivation influences this. In Mali, operational research was conducted to identify the match between motivation and the range and use of performance management activities. Objectives To describe the factors motivating and demotivating health workers in Mali and match the motivators with the implementation of performance management. Methods First an exploratory qualitative study was conducted: 28 interviews and eight group discussions were held. This was followed by a cross-sectional survey, during which 370 health workers were interviewed. The study population consisted of health workers of eight professional groups. The following issues were investigated: • motivating and demotivating factors; • experiences with performance management, including: job descriptions, continuous education, supervision, performance appraisal and career development. Findings The study showed that the main motivators of health workers were related to responsibility, training and recognition, next to salary. These can be influenced by performance management (job descriptions, supervisions, continuous education and performance appraisal. Performance management is not optimally implemented in Mali, as job descriptions were not present or were inappropriate; only 13% of interviewees received 4× per year supervision, and training needs were not analysed. Some 48% of the interviewees knew their performance had been appraised in the last two years; the appraisals were perceived as subjective. No other methods were in place to show recognition. The results enabled the research team to propose adaptations or improvements upon existing performance management. Conclusion The results showed the importance of adapting or improving upon performance management strategies to influence staff motivation. This can be done by matching performance management

  1. Private sector delivery of health services in developing countries: a mixed-methods study on quality assurance in social franchises

    Directory of Open Access Journals (Sweden)

    Schlein Karen

    2013-01-01

    Full Text Available Abstract Background Across the developing world health care services are most often delivered in the private sector and social franchising has emerged, over the past decade, as an increasingly popular method of private sector health care delivery. Social franchising aims to strengthen business practices through economies of scale: branding clinics and purchasing drugs in bulk at wholesale prices. While quality is one of the established goals of social franchising, there is no published documentation of how quality levels might be set in the context of franchised private providers, nor what quality assurance measures can or should exist within social franchises. The aim of this study was to better understand the quality assurance systems currently utilized in social franchises, and to determine if there are shared standards for practice or quality outcomes that exist across programs. Methods The study included three data sources and levels of investigation: 1 Self-reported program data; 2 Scoping telephone interviews; and 3 In-depth field interviews and clinic visits. Results Social Franchises conceive of quality assurance not as an independent activity, but rather as a goal that is incorporated into all areas of franchise operations, including recruitment, training, monitoring of provider performance, monitoring of client experience and the provision of feedback. Conclusions These findings are the first evidence to support the 2002 conceptual model of social franchising which proposed that the assurance of quality was one of the three core goals of all social franchises. However, while quality is important to franchise programs, quality assurance systems overall are not reflective of the evidence to-date on quality measurement or quality improvement best practices. Future research in this area is needed to better understand the details of quality assurance systems as applied in social franchise programs, the process by which quality assurance

  2. The Effects of Age, Breed, Sire, Body Weight and the Ejaculate Characteristics of Rabbit Bucks

    OpenAIRE

    G. N. Akpa; H.K. Yahaya; U.C. Martin

    2012-01-01

    The aim of this research is to analyse the semen of different breeds of rabbits and to determine the effects of age, breed, sire, generation and body weight on the ejaculate characteristics of rabbit bucks. Twenty rabbit bucks comprising of three breeds (New-Zealand White 8, Chinchilla 6 and Californian White 6) between the ages of 6-9 months were used to investigate the effect of age, breed, sire and generation on body weight and ejaculate characteristics of the bucks. The experiment was car...

  3. Topological Design and Modulation Strategy for Buck-Boost Three-Level Inverters

    DEFF Research Database (Denmark)

    Teodorescu, Remus; Gao, F.; Blaabjerg, Frede;

    2007-01-01

    buck-boost three-level inverters that can also support bidirectional power conversion. The proposed front-end circuitry is developed from the ¿uk-derived buck-boost two-level inverter, and by using the "alternative phase opposition disposition" (APOD) modulation scheme, the buck-boost three......-level inverters can perform distinct five-level line voltage and three-level phase voltage switching by simply controlling the active switches located in the designed voltage boost section of the circuits. As a cost saving option, one active switch can further be removed from the voltage-boost section...

  4. Modelling and Simulation of Variable Frequency Synchronous DC-DC Buck Converter

    Directory of Open Access Journals (Sweden)

    Jeya Selvan Renius

    2014-10-01

    Full Text Available In this paper, novel small-signal averaged models for dc–dc converter operating at variable switching frequency are derived. This is achieved by separately considering the on-time and the off-time of the switching period. The derivation is shown in detail for a synchronous buck converter. The Enhanced Small Signal (ESSA Model is derived for the synchronous buck converter. The equivalent series inductance (ESL is also considered in this modelling. The buck converter model is also simulated in MATLAB and the result is also presented.

  5. Role of GIS in social sector planning: can developing countries benefit from the examples of primary health care (PHC) planning in Britain?

    Science.gov (United States)

    Ishfaq, Mohammad; Lodhi, Bilal Khan

    2012-04-01

    Social sector planning requires rational approaches where community needs are identified by referring to relative deprivation among localities and resources are allocated to address inequalities. Geographical information system (GIS) has been widely argued and used as a base for rational planning for equal resource allocation in social sectors around the globe. Devolution of primary health care is global strategy that needs pains taking efforts to implement it. GIS is one of the most important tools used around the world in decentralization process of primary health care. This paper examines the scope of GIS in social sector planning by concentration on primary health care delivery system in Pakistan. The work is based on example of the UK's decentralization process and further evidence from US. This paper argues that to achieve benefits of well informed decision making to meet the communities' needs GIS is an essential tool to support social sector planning and can be used without any difficulty in any environment. There is increasing trend in the use of Health Management Information System (HMIS) in Pakistan with ample internet connectivity which provides well established infrastructure in Pakistan to implement GIS for health care, however there is need for change in attitude towards empowering localities especially with reference to decentralization of decision making. This paper provides GIS as a tool for primary health care planning in Pakistan as a starting point in defining localities and preparing locality profiles for need identification that could help developing countries in implementing the change.

  6. Perceptions of per diems in the health sector: evidence and implications.

    Science.gov (United States)

    Vian, Taryn; Miller, Candace; Themba, Zione; Bukuluki, Paul

    2013-05-01

    Per diems are used to pay work-related expenses and motivate employees, yet they also can distort incentives and may be abused. This study was designed to explore perceptions of per diems among 41 high-, mid- and low-level government officers and non-governmental organization (NGO) officials in Malawi and Uganda. Interviews explored attitudes about per diems, benefits and problems for organizations and individuals, and risks and patterns of abuse. The study found that per diems provide benefits such as encouraging training, increasing staff motivation and supplementing salary. Despite these advantages, respondents voiced many discontents about per diems, stating that they create conflict, contribute to a negative organizational culture where people expect to be paid for all activities, and lead to negative changes in work time allocation. Work practices are also manipulated in order to maximize financial gain by slowing work, scheduling unnecessary trainings, or exaggerating time needed for tasks. Officials may appropriate per diems meant for others or engage in various forms of fraud for personal financial gain. Abuse seemed more common in the government sector due to low pay and weaker controls. A striking finding was the distrust that lower-level workers felt toward their superiors: allowances were perceived to provide unfair financial advantages to already better-off and well-connected staff. To curb abuse of per diems, initiatives must reduce pressures and incentives to abuse, while controlling discretion and increasing transparency in policy implementation. Donors can play a role in reform by supporting development of policy analysis tools, design of control mechanisms and evaluation of reform strategies. PMID:22684639

  7. Policy entrepreneurship in the development of public sector strategy: the case of London health reform.

    Science.gov (United States)

    Oborn, Eivor; Barrett, Michael; Exworthy, Mark

    2011-01-01

    The development of health policy is recognized as complex; however, there has been little development of the role of agency in this process. Kingdon developed the concept of policy entrepreneur (PE) within his ‘windows’ model. He argued inter-related ‘policy streams' must coincide for important issues to become addressed. The conjoining of these streams may be aided by a policy entrepreneur. We contribute by clarifying the role of the policy entrepreneur and highlighting the translational processes of key actors in creating and aligning policy windows. We analyse the work in London of Professor Sir Ara Darzi as a policy entrepreneur. An important aspect of Darzi's approach was to align a number of important institutional networks to conjoin related problems. Our findings highlight how a policy entrepreneur not only opens policy windows but also yokes together a network to make policy agendas happen. Our contribution reveals the role of clinical leadership in health reform. PMID:22069793

  8. Policy entrepreneurship in the development of public sector strategy: the case of London health reform.

    Science.gov (United States)

    Oborn, Eivor; Barrett, Michael; Exworthy, Mark

    2011-01-01

    The development of health policy is recognized as complex; however, there has been little development of the role of agency in this process. Kingdon developed the concept of policy entrepreneur (PE) within his ‘windows’ model. He argued inter-related ‘policy streams' must coincide for important issues to become addressed. The conjoining of these streams may be aided by a policy entrepreneur. We contribute by clarifying the role of the policy entrepreneur and highlighting the translational processes of key actors in creating and aligning policy windows. We analyse the work in London of Professor Sir Ara Darzi as a policy entrepreneur. An important aspect of Darzi's approach was to align a number of important institutional networks to conjoin related problems. Our findings highlight how a policy entrepreneur not only opens policy windows but also yokes together a network to make policy agendas happen. Our contribution reveals the role of clinical leadership in health reform.

  9. Financial Analysis of the Greek Private Health Sector over the Last Decade (2002-2012)

    OpenAIRE

    George Loukopoulos; Theodoros Roupas

    2014-01-01

    The purpose of this study is to perform a comprehensive financial statement analysis for Hygeia, the largest Private Health Organization in Greece. In this regard, we employ a variety of theoretically advanced approaches. For instance, DuPont analysis based on the decomposition scheme of Nissim and Penman (2001), shows that the capital structure decisions eroded shareholder profits, and specifically their impact was pronounced after the outbreak of the global financial crisis. Considering the...

  10. Inequity in a market-based health system: evidence from Canada's dental sector

    OpenAIRE

    Michel Grignon; Jeremiah Hurley; Li Wang; Sara Allin

    2008-01-01

    We study the extent and drivers of income-related inequity in utilization of dental services in Canada using the concentration-index approach that has been widely applied to study equity in physician and hospital services. Because dental care is almost wholly privately financed in Canada, our estimates provide a benchmark for income-related inequity of utilization in private health systems. Although a number of studies document a link between income and utilization, our study is one of the fe...

  11. Moderators between work context and psychological health in a public service sector / S. Williams

    OpenAIRE

    Wiliams, Shelley-Ann

    2009-01-01

    Work context has many consequences for the psychological outcomes of employees. These outcomes also have consequences for the employer through possible loss of productivity, impaired health of employees which may be associated with absenteeism and turnover intention, among others. The literature also shows that these outcomes are not always the same even under similar working conditions. Theorising in cognitive psychology indicates that the way in which an individual appraises a situation may...

  12. Measuring a Bank’s Financial Health: A Case Study for the Greek Banking Sector

    OpenAIRE

    John Thalassinos; Konstantinos Liapis

    2011-01-01

    The main aim of this article is to demonstrate a holistic framework for measuring a bank’s financial health by classifying its main responsibilities between conformance and performance. Responsibilities are classified into five categories as follows: First, Corporate Financial Reporting (CFR) that integrates General Accepted Accounting Principles (GAAP), Generally Accepted Auditing Standards (GAAS), Securities Exchange Commission (SEC), Financial Services Authority (FSA), and International Ac...

  13. Challenges to the implementation of health sector decentralization in Tanzania: experiences from Kongwa district council

    Directory of Open Access Journals (Sweden)

    Gasto Frumence

    2004-01-01

    Full Text Available Background: During the 1990s, the government of Tanzania introduced the decentralization by devolution (D by D approach involving the transfer of functions, power and authority from the centre to the local government authorities (LGAs to improve the delivery of public goods and services, including health services. Objective: This article examines and documents the experiences facing the implementation of decentralization of health services from the perspective of national and district officials. Design: The study adopted a qualitative approach, and data were collected using semi-structured interviews and were analysed for themes and patterns. Results: The results showed several benefits of decentralization, including increased autonomy in local resource mobilization and utilization, an enhanced bottom-up planning approach, increased health workers’ accountability and reduction of bureaucratic procedures in decision making. The findings also revealed several challenges which hinder the effective functioning of decentralization. These include inadequate funding, untimely disbursement of funds from the central government, insufficient and unqualified personnel, lack of community participation in planning and political interference. Conclusion: The article concludes that the central government needs to adhere to the principles that established the local authorities and grant more autonomy to them, offer special incentives to staff working in the rural areas and create the capacity for local key actors to participate effectively in the planning process.

  14. Contribution from the ten major emission sectors in Europe to the Health-Cost Externalities of Air Pollution using the EVA Model System - an integrated modelling approach

    Science.gov (United States)

    Brandt, Jørgen; Silver, Jeremy D.; Christensen, Jesper H.; Andersen, Mikael S.; Bønløkke, Jakob H.; Sigsgaard, Torben; Geels, Camilla; Gross, Allan; Hansen, Ayoe B.; Hansen, Kaj M.; Hedegaard, Gitte B.; Kaas, Eigil; Frohn, Lise M.

    2013-04-01

    We have developed an integrated model system, EVA (Economic Valuation of Air pollution), based on the impact-pathway chain, to assess the health-related economic externalities of air pollution resulting from specific emission sources or sectors, which can be used to support policy-making with respect to emission control. Central for the system is a tagging method capable of calculating the contribution from a specific emission source or sector to the overall air pollution levels, taking into account the non-linear atmospheric chemistry. The main objective of this work is to identify the anthropogenic emission sources in Europe and Denmark that contribute the most to human health impacts. In this study, we applied the EVA system to Europe and Denmark, with a detailed analysis of health-related external costs from the ten major emission sectors and their relative contributions. The paper contains a thorough description of the EVA system. The conclusions in the paper are sensitive to the toxicity of the different types of atmospheric particles, and therefore the existing knowledge of health impacts from particles is reviewed. We conclude that with our present knowledge we are not able to distinguish between the impacts from different particle types and therefore the toxicity of the particles is handled equally in the overall results. The main conclusion from the analysis of the ten major emission sectors in Europe and Denmark is that the major contributors to health-related external costs are major power production, agriculture, road traffic, and non-industrial domestic combustion, including wood combustion. The major power plants in Europe contribute with around 25% of the total health related external costs relative to all sources in Europe, while the Danish power plants only contribute with less than 10% relative to all Danish sources. Our results suggest that the agricultural sector contributes with 25% to health impacts and related external costs. We conclude

  15. Power decoupling method for single phase differential buck converter

    DEFF Research Database (Denmark)

    Yao, Wenli; Tang, Yi; Zhang, Xiaobin;

    2015-01-01

    The well-known inherent second-order ripple power in single phase converters imposes harmonic stress on the dc link, resulting in low efficiency and overheating issues. In order to avoid installing bulky electrolytic capacitors or LC filters in the dc-link, this paper presents a differential buck...... inverter to improve the dc link power quality, and an improved active power decoupling method is proposed to achieve ripple power reduction for both AC-DC and DC-AC conversions. The ripple energy storage is realized by the filter capacitors, which are connected between the output terminal and the negative...... dc bus. By properly controlling the differential mode voltage of the capacitors, it is possible to transfer desired energy between the DC port and AC port. The common mode voltage is controlled in such a way that the ripple power on the dc side will be reduced. Furthermore, an autonomous reference...

  16. Use of nuclear energy: the perception of public risk from radiation. Experience from health sector

    Directory of Open Access Journals (Sweden)

    Leopoldo Arranz y Carrillo de Albornoz

    2010-12-01

    Full Text Available Radiological risks are, probably by the fact that Hiroshima and Nagasaki bombs still are a part of the collective nightmares of the humankind, always with the sword of Damocles of a possible use of nuclear weapons, the paradigm of subjectivity. And their negative perception by the citizens has turned into a growing interest for people responsible of the management of any of the applications of the ionizing radiations. In this work the opinion of communication experts, some based on their experience in the health care system, with regard to radiological risks and what can be done in order to modify such negative perception are set out.

  17. Re-thinking global health sector efforts for HIV and tuberculosis epidemic control: promoting integration of programme activities within a strengthened health system

    Directory of Open Access Journals (Sweden)

    Maher Dermot

    2010-07-01

    development and scaling up interventions, and identify ways of joint planning and joint funding of integrated delivery as part of strengthened health systems. Summary As both a danger and an opportunity, the global financial crisis may entail disaster or recovery for global health sector efforts for HIV and tuberculosis epidemic control. Review of policies and progress in control paves the way for identification of synergies between the two programmes, within strengthened health services. The silver lining in the global economic crisis could be better control of the HIV and tuberculosis epidemics, better overall health system performance and outcomes, and better value for money.

  18. The implications of Herzberg's "motivation-hygiene" theory for management in the Irish health sector.

    Science.gov (United States)

    Byrne, Michael

    2006-01-01

    Given that they create what it sells, employees are the Irish Health service's most valuable asset. They are increasingly being asked to embrace change on many different levels. In order to facilitate this process, it behooves management to actively promote employee motivation. Herzberg et al's "motivation-hygiene" theory of motivation proposes that certain "motivator" and "hygiene" factors can respectively affect job satisfaction and dissatisfaction. Considering "motivators," better on-the-job performance may increase motivation. However, work overload can become a dissatisfier. Devolving equal levels of authority and responsibility and providing appropriate recognition may also serve to motivate. Likewise, providing opportunities for promotion and personal growth may maintain motivation, as might re-engineering of jobs so that work remains meaningful. Over time both salary and incentives may come to be viewed as entitlements and lose their ability to motivate. Other "hygiene" factors such as organizational policy and administrative structure, relations with others, job insecurity, physical working conditions, and quality of supervision can lead to job dissatisfaction. Hence, the theory of Herzberg et al usefully highlights many factors that may serve to motivate or demotivate employees. However, this theory does not reflect some of the realities of the modern health care work environment.

  19. The implications of Herzberg's "motivation-hygiene" theory for management in the Irish health sector.

    Science.gov (United States)

    Byrne, Michael

    2006-01-01

    Given that they create what it sells, employees are the Irish Health service's most valuable asset. They are increasingly being asked to embrace change on many different levels. In order to facilitate this process, it behooves management to actively promote employee motivation. Herzberg et al's "motivation-hygiene" theory of motivation proposes that certain "motivator" and "hygiene" factors can respectively affect job satisfaction and dissatisfaction. Considering "motivators," better on-the-job performance may increase motivation. However, work overload can become a dissatisfier. Devolving equal levels of authority and responsibility and providing appropriate recognition may also serve to motivate. Likewise, providing opportunities for promotion and personal growth may maintain motivation, as might re-engineering of jobs so that work remains meaningful. Over time both salary and incentives may come to be viewed as entitlements and lose their ability to motivate. Other "hygiene" factors such as organizational policy and administrative structure, relations with others, job insecurity, physical working conditions, and quality of supervision can lead to job dissatisfaction. Hence, the theory of Herzberg et al usefully highlights many factors that may serve to motivate or demotivate employees. However, this theory does not reflect some of the realities of the modern health care work environment. PMID:16501377

  20. Improvements in access to malaria treatment in Tanzania following community, retail sector and health facility interventions -- a user perspective

    Directory of Open Access Journals (Sweden)

    Obrist Brigit

    2010-06-01

    Full Text Available Abstract Background The ACCESS programme aims at understanding and improving access to prompt and effective malaria treatment. Between 2004 and 2008 the programme implemented a social marketing campaign for improved treatment-seeking. To improve access to treatment in the private retail sector a new class of outlets known as accredited drug dispensing outlets (ADDO was created in Tanzania in 2006. Tanzania changed its first-line treatment for malaria from sulphadoxine-pyrimethamine (SP to artemether-lumefantrine (ALu in 2007 and subsidized ALu was made available in both health facilities and ADDOs. The effect of these interventions on understanding and treatment of malaria was studied in rural Tanzania. The data also enabled an investigation of the determinants of access to treatment. Methods Three treatment-seeking surveys were conducted in 2004, 2006 and 2008 in the rural areas of the Ifakara demographic surveillance system (DSS and in Ifakara town. Each survey included approximately 150 people who had suffered a fever case in the previous 14 days. Results Treatment-seeking and awareness of malaria was already high at baseline, but various improvements were seen between 2004 and 2008, namely: better understanding causes of malaria (from 62% to 84%; an increase in health facility attendance as first treatment option for patients older than five years (27% to 52%; higher treatment coverage with anti-malarials (86% to 96% and more timely use of anti-malarials (80% to 93-97% treatments taken within 24 hrs. Unfortunately, the change of treatment policy led to a low availability of ALu in the private sector and, therefore, to a drop in the proportion of patients taking a recommended malaria treatment (85% to 53%. The availability of outlets (health facilities or drug shops is the most important determinant of whether patients receive prompt and effective treatment, whereas affordability and accessibility contribute to a lesser extent. Conclusions An

  1. Backscatter 0.5m TIFF Mosaic of St. Croix (Buck Island), US Virgin Islands, 2004

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This image represents a 0.5 meter resolution backscatter mosaic of the north shore of Buck Island, St. Croix, US Virgin Islands. NOAA's NOS/NCCOS/CCMA Biogeography...

  2. An Effective Wind Energy System based on Buck-boost Controller

    Directory of Open Access Journals (Sweden)

    N. Prakash

    2013-06-01

    Full Text Available In Domestic Wind Machines, if the wind speed is low, the output voltage is not sufficient to charge the battery as it is lower than the rated charging voltage of the battery. This limits the overall efficiency of the Wind Machine to 20%. This study proposed to design and develop a Buck Boost Controller for the effective utilization of the wind machine. By implementing a controller based Buck Boost converter, the voltage produced at the lower wind speeds can also be utilized effectively by boosting it to the rated charging voltage of the battery. Also if the wind speed is high (>14 m/s, the DC output voltage will increase to more than 65 V. The converter bucks this high voltage to the nominal battery charging voltage (52 V, thereby protecting the battery from over charging voltage. Thus the effective utilization of the wind machine has been achieved by the use of the proposed Buck Boost Controller.

  3. High Resolution Imagery of Buck Island Coral Reef Systems Prior to and During Suspected Bleaching Events

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This dataset is a collection of imagery of Buck Island coral reef systems. They are pairs of imagery where one image was acquired during a suspected bleaching...

  4. Modeling and Simulation of Buck-Boost Converter with Voltage Feedback Control

    Directory of Open Access Journals (Sweden)

    Zhou Xuelian

    2015-01-01

    Full Text Available In order to design the control system, it is necessary to have an exact model of buck-boost converter. This paper put forward the transfer function model of buck-boost converter by the state-space average method. The open-loop transfer function model of uncompensated system is deduced according to the mathematic model of the buck-boost converter, the controller is designed according to frequency domain. The phase and magnitude margin of the open-loop system of the buck-boost converter with compensator have both been increased. After compensating, this control system has the advantages of small overshoot and short settling time. It can also improve control system’s real time property and anti-interference ability.

  5. Quantum collapses and revivals from the k-photon Buck-Sukumar model

    International Nuclear Information System (INIS)

    The quantum collapses and revivals of the atomic inversion in the k-photon Buck-Sukumar model are shown by means of numerical and approximate methods for various photon transition processes. (author). 17 refs, 3 figs

  6. Milestones in Implementation of an Integrated Management System in the Health Sector. Case Study Radiologische Netzwerk Rheinland

    Directory of Open Access Journals (Sweden)

    Claus Nagel-Picioruş

    2016-05-01

    Full Text Available Healthcare organizations in Germany exploit the benefits of the ISO 9000 family of international standards as it became compulsory to implement a quality management system in accordance with ISO 9001 requirements. Until the innovative ISO 9001:2015 proposal it was no direct connection to the other management systems like risk management, knowledge management or environmental management. So far, only few bodies ensured interconnections between different systems of management or associated the quality management system with the strategic planning process. However, healthcare encapsulates supplementary requirements which affect a number of different systems. Additionally, the financial crisis has encouraged the trend to operate integrated reporting beyond financial aspects. This paper aims at presenting the experience on the development of integrated management and reporting system integrated in an organization belonging to the health sector. The work clarifies the steps towards merging distinctly regulated management systems (quality, health or environmental management with strategic planning and controlling, via a Balanced Dashboard (Balanced Scorecard - BSC as well as integrated reporting according to the model International Integrated Reporting Initiative (IIRI in a German medical company - Radiologische Netzwerk Rheinland - RNR AG. Using the case study method, the paper's purpose is to highlight approaches and results of the company that could support practitioners from medical area and bezound. The literature review clarified theoretical concepts while the case study allowed converging comprehensive information and knowledge accumulated by RNR AG, thus helping to bridge the gap between literature on total integrated management reporting and reporting system in healthcare.

  7. A retrospective content analysis of studies on factors constraining the implementation of health sector reform in Ghana.

    Science.gov (United States)

    Sakyi, E Kojo

    2008-01-01

    Ghana has undertaken many public service management reforms in the past two decades. But the implementation of the reforms has been constrained by many factors. This paper undertakes a retrospective study of research works on the challenges to the implementation of reforms in the public health sector. It points out that most of the studies identified: (1) centralised, weak and fragmented management system; (2) poor implementation strategy; (3) lack of motivation; (4) weak institutional framework; (5) lack of financial and human resources and (6) staff attitude and behaviour as the major causes of ineffective reform implementation. The analysis further revealed that quite a number of crucial factors obstructing reform implementation which are particularly internal to the health system have either not been thoroughly studied or overlooked. The analysis identified lack of leadership; weak communication and consultation; lack of stakeholder participation, corruption and unethical professional behaviour as some of the missing variables in the literature. The study, therefore, indicated that there are gaps in the literature that needed to be filled through rigorous reform evaluation based on empirical research particularly at district, sub-district and community levels. It further suggested that future research should be concerned with the effects of both systems and structures and behavioural factors on reform implementation.

  8. The third sector for supporting sustainability and innovation in health field

    Directory of Open Access Journals (Sweden)

    Ilaria Oberti

    2015-04-01

    Full Text Available In a precarious general framework, in which the quality of the Italian healthcare system is getting worse and worse, there are examples of excellence, such as the Maria Letizia Verga Center for the Study and Treatment of child leukemia. This is a new pavilion for the Pediatric Hematology of S. Gerardo Hospital in Monza, fourth center in the world to bring together in a single organization the medical care and the research/training activities. The building architectural design aimed at coordinating the efficiency of medical procedures together with the criteria of humanization of the spaces and the new partnership model, revolutionary within the Italian National Health Service, represent two of the aspects that contribute this Center to be a distinctive case.

  9. On professional and official requirements to physicians in radiation health by sectoral sanitary and epidemiological stations

    International Nuclear Information System (INIS)

    Professional and official requirements (POR) to sanitary physician, which deals with radiation hygiene at the sanitary and epidemiologic stations (SES), are considered. These requirements determine minimum of professional skills and abilities in the field of radiation hygiene. Physician should contribute to the improvement of radiation safety and health indices for personnel and population, and in this case, his activity should not impede the further usage of ionizing radiation sources in the national economy. Sanitary physician, dealing with a actain branch of industry, concerning the problems of radiation hygiene should know the principles of deontology, aims and functions of SES establishment and departments in the field of radiation hygiene, legal principles of radiation safety is basic tasks are as follows: 1) State sanitary inspection of sanitary-hygienic measures for the environmental protection and radiation protection of population; 2) organizational and methodological activity; 3) activity in medical civil defense

  10. Charger for NiMH batteries based on buck DC/DC converter

    OpenAIRE

    Lapčević Vladimir

    2014-01-01

    In this paper is presented charger for NiMH battery types AA. Charger is realized by Buck DC/DC converter and microcontroller. Microcontroller controls the work of Buck DC/DC converter by pulse width modulation and by measuring the current of battery charging. The current of charging is held constant by power electronics, and the time of charging is set by the user dependent of capacity of the battery. Standard battery chargers enable the recharge of NiMH b...

  11. A Novel Soft-Switching Synchronous Buck Converter for Portable Applications

    OpenAIRE

    Mohapatra, K. K.; Swapnajit Pattnaik; Anup Kumar Panda

    2008-01-01

    This paper proposes a zero-voltage-transition (ZVT) pulse-width-modulated (PWM) synchronous buck converter, which is designed to operate at low voltage and high efficiency typically required for portable systems. A new passive auxiliary circuit that allows the main switch to operate with zero-voltage switching has been incorporated in the conventional PWM synchronous buck converter. The operation principles and a detailed steady-state analysis of the ZVT-PWM synchronous converter implemented ...

  12. BUCK-BOOST变换器的输出能量分析及电感电容优化设计%Output Energy Analysis and Optimization Design of Inductance and Capacitance of BUCK-BOOST Converters

    Institute of Scientific and Technical Information of China (English)

    殷立; 王顺强

    2012-01-01

    The inner intrinsic safety of BUCK-BOOST convert is analyzed by minimum ignition curve. The worst-case energy of BUCK-BOOST is calculated. Comparing with the minimum ignition curve, the intrinsic safety of BUCK-BOOST convert is implemented. Through calculation, the maximum load capacitor and inductance are obtained.%从最小点燃曲线角度分析BUCK-BOOST变换器内部本质安全性能,推算出BUCK-BOOST最恶劣情况下的能量,与火花点燃曲线相比较,得到本安输出的BUCK-BOOST变换器,并通过计算得出最大负载电容及负载电感。

  13. District decision-making for health in low-income settings: a qualitative study in Uttar Pradesh, India, on engaging the private health sector in sharing health-related data

    Science.gov (United States)

    Gautham, Meenakshi; Spicer, Neil; Subharwal, Manish; Gupta, Sanjay; Srivastava, Aradhana; Bhattacharyya, Sanghita; Avan, Bilal Iqbal; Schellenberg, Joanna

    2016-01-01

    Health information systems are an important planning and monitoring tool for public health services, but may lack information from the private health sector. In this fourth article in a series on district decision-making for health, we assessed the extent of maternal, newborn and child health (MNCH)-related data sharing between the private and public sectors in two districts of Uttar Pradesh, India; analysed barriers to data sharing; and identified key inputs required for data sharing. Between March 2013 and August 2014, we conducted 74 key informant interviews at national, state and district levels. Respondents were stakeholders from national, state and district health departments, professional associations, non-governmental programmes and private commercial health facilities with 3–200 beds. Qualitative data were analysed using a framework based on a priori and emerging themes. Private facilities registered for ultrasounds and abortions submitted standardized records on these services, which is compulsory under Indian laws. Data sharing for other services was weak, but most facilities maintained basic records related to institutional deliveries and newborns. Public health facilities in blocks collected these data from a few private facilities using different methods. The major barriers to data sharing included the public sector’s non-standardized data collection and utilization systems for MNCH and lack of communication and follow up with private facilities. Private facilities feared information disclosure and the additional burden of reporting, but were willing to share data if asked officially, provided the process was simple and they were assured of confidentiality. Unregistered facilities, managed by providers without a biomedical qualification, also conducted institutional deliveries, but were outside any reporting loops. Our findings suggest that even without legislation, the public sector could set up an effective MNCH data sharing strategy with

  14. Buck Converter with Soft-Switching Cells for PV Panel Applications

    Directory of Open Access Journals (Sweden)

    Cheng-Tao Tsai

    2016-03-01

    Full Text Available In power conversion of photovoltaic (PV energy, a hard-switching buck converter always generates some disadvantages. For example, serious electromagnetic interference (EMI, high switching losses, and stresses on an active switch (metal-oxide-semiconductor-field-effect-transistor, MOSFET, and high reverse-recovery losses of a freewheeling diode result in low conversion efficiency. To release these disadvantages, a buck converter with soft-switching cells for PV panel applications is proposed. To create zero-voltage-switching (ZVS features of the active switches, a simple active soft-switching cell with an inductor, a capacitor, and a MOSFET is incorporated into the proposed buck converter. Therefore, the switching losses and stresses of the active switches and EMI can be reduced significantly. To reduce reverse-recovery losses of a freewheeling diode, a simple passive soft-switching cell with a capacitor and two diodes is implemented. To verify the performance and the feasibility of the proposed buck converter with soft-switching cells for PV panel applications, a prototype soft-switching buck converter is built and implemented by using a maximum-power-point-tracking (MPPT method. Simulated and experimental results are presented from a 100 W soft-switching buck converter for PV panel applications.

  15. Using Disability-Adjusted Life Years and Cost-Effectiveness Analysis to define Priorities for the Public Health Care Sector in Zimbabwe

    DEFF Research Database (Denmark)

    Hansen, Kristian Schultz

    calculated suggested that there was a good potential for improving the allocative efficiency in the health care sector. Possible strategies included a reallocation of resources from the interventions with high cost-effectiveness ratios to interventions with low cost-effectiveness ratios, ensuring......There is not much knowledge at present of the relative cost-effectiveness of health services offered in the Zimbabwean public health care sector. In addition, the information on the relative importance of diseases is less than complete. Such information may however be useful for assessing...... by estimates from epidemiological studies from other settings if no Zimbabwean sources were available. Disease and public health experts were consulted about the identification of the best possible sources of information, the quality of these sources and the data adjustments made. Epidemiological information...

  16. Resource based view of the firm: measures of reputation among health service-sector businesses.

    Science.gov (United States)

    Smith, Alan D

    2008-01-01

    Application of the strategic leverage of Resource Based View of the Firm (RBV) directly advocates that a company's competitive advantage is derived from its ability to assemble and exploit an appropriate combination of resources (both tangible and intangible assets). The three companies that were selected were Pittsburgh-based companies that were within relatively easy access, representing healthcare service-related industries, and can be reviewed for the principles of the RBV. The particular firms represented a variety of establishments and included Baptist Homes (a long-term care facility), University of Pittsburgh Medical Center (UPMC)(a provider of hospital and other health services), and GlaxoSmithKline, Consumer Healthcare, North America (GSK-CHNA)(a global provider of healthcare products and services). Through the case studies, it was found that not all intangible assets are strategic, and by extension, not all measures of reputation are strategic either. For an intangible asset to be considered strategic, in this case reputation, it must be valuable, rare, imperfectly imitable, and non-substitutable.

  17. Emerging aspects of nanotoxicology in health and disease: From agriculture and food sector to cancer therapeutics.

    Science.gov (United States)

    Piperigkou, Zoi; Karamanou, Konstantina; Engin, Ayse Basak; Gialeli, Chrysostomi; Docea, Anca Oana; Vynios, Demitrios H; Pavão, Mauro S G; Golokhvast, Kirill S; Shtilman, Mikhail I; Argiris, Athanassios; Shishatskaya, Ekaterina; Tsatsakis, Aristidis M

    2016-05-01

    Nanotechnology is an evolving scientific field that has allowed the manufacturing of materials with novel physicochemical and biological properties, offering a wide spectrum of potential applications. Properties of nanoparticles that contribute to their usefulness include their markedly increased surface area in relation to mass, surface reactivity and insolubility, ability to agglomerate or change size in different media and enhanced endurance over conventional-scale substance. Here, we review nanoparticle classification and their emerging applications in several fields; from active food packaging to drug delivery and cancer research. Nanotechnology has exciting therapeutic applications, including novel drug delivery for the treatment of cancer. Additionally, we discuss that exposure to nanostructures incorporated to polymer composites, may result in potential human health risks. Therefore, the knowledge of processes, including absorption, distribution, metabolism and excretion, as well as careful toxicological assessment is critical in order to determine the effects of nanomaterials in humans and other biological systems. Expanding the knowledge of nanoparticle toxicity will facilitate designing of safer nanocomposites and their application in a beneficial manner. PMID:26969113

  18. Advances in participatory occupational health aimed at good practices in small enterprises and the informal sector.

    Science.gov (United States)

    Kogi, Kazutaka

    2006-01-01

    Participatory programmes for occupational risk reduction are gaining importance particularly in small workplaces in both industrially developing and developed countries. To discuss the types of effective support, participatory steps commonly seen in our "work improvement-Asia" network are reviewed. The review covered training programmes for small enterprises, farmers, home workers and trade union members. Participatory steps commonly focusing on low-cost good practices locally achieved have led to concrete improvements in multiple technical areas including materials handling, workstation ergonomics, physical environment and work organization. These steps take advantage of positive features of small workplaces in two distinct ways. First, local key persons are ready to accept local good practices conveyed through personal, informal approaches. Second, workers and farmers are capable of understanding technical problems affecting routine work and taking flexible actions leading to solving them. This process is facilitated by the use of locally adjusted training tools such as local good examples, action checklists and group work methods. It is suggested that participatory occupational health programmes can work in small workplaces when they utilize low-cost good practices in a flexible manner. Networking of these positive experiences is essential.

  19. Advances in participatory occupational health aimed at good practices in small enterprises and the informal sector.

    Science.gov (United States)

    Kogi, Kazutaka

    2006-01-01

    Participatory programmes for occupational risk reduction are gaining importance particularly in small workplaces in both industrially developing and developed countries. To discuss the types of effective support, participatory steps commonly seen in our "work improvement-Asia" network are reviewed. The review covered training programmes for small enterprises, farmers, home workers and trade union members. Participatory steps commonly focusing on low-cost good practices locally achieved have led to concrete improvements in multiple technical areas including materials handling, workstation ergonomics, physical environment and work organization. These steps take advantage of positive features of small workplaces in two distinct ways. First, local key persons are ready to accept local good practices conveyed through personal, informal approaches. Second, workers and farmers are capable of understanding technical problems affecting routine work and taking flexible actions leading to solving them. This process is facilitated by the use of locally adjusted training tools such as local good examples, action checklists and group work methods. It is suggested that participatory occupational health programmes can work in small workplaces when they utilize low-cost good practices in a flexible manner. Networking of these positive experiences is essential. PMID:16610530

  20. Resource based view of the firm: measures of reputation among health service-sector businesses.

    Science.gov (United States)

    Smith, Alan D

    2008-01-01

    Application of the strategic leverage of Resource Based View of the Firm (RBV) directly advocates that a company's competitive advantage is derived from its ability to assemble and exploit an appropriate combination of resources (both tangible and intangible assets). The three companies that were selected were Pittsburgh-based companies that were within relatively easy access, representing healthcare service-related industries, and can be reviewed for the principles of the RBV. The particular firms represented a variety of establishments and included Baptist Homes (a long-term care facility), University of Pittsburgh Medical Center (UPMC)(a provider of hospital and other health services), and GlaxoSmithKline, Consumer Healthcare, North America (GSK-CHNA)(a global provider of healthcare products and services). Through the case studies, it was found that not all intangible assets are strategic, and by extension, not all measures of reputation are strategic either. For an intangible asset to be considered strategic, in this case reputation, it must be valuable, rare, imperfectly imitable, and non-substitutable. PMID:19064477

  1. [Governance and health: the rise of the managerialism in public sector reform].

    Science.gov (United States)

    Denis, Jean L; Lamothe, Lise; Langley, Ann; Stéphane, Guérard

    2010-01-01

    The article examines various healthcare systems reform projects in Canada and some Canadian provinces and reveals some tendencies in governance renewal. The analisis is based on the hypothesis that reform is an exercise aiming at the renewal of governance conception and practices. In renewing governance, reform leaders hope to use adequate and effective levers to attain announced reform objectives. The article shows that the conceptions and operational modalities of governance have changed over time and that they reveal tensions inherent to the transformation and legitimation process of public healthcare systems. The first section discusses the relationships between reform and change. The second section defines the conception of gouvernance used for the analisis. Based on a content analisis of the various reform reports, the third section reveals the evolution of the conception of governance in healthcare systems in Canada. In order to expose the new tendencies, ideologies and operational principles at the heart of the reform projects are analysed. Five ideologies are identified: the democratic ideology, the "population health" ideology, the business ideology, the managerial ideology and the ideology of equity and humanism. This leads to a discussion on the dominant influence of the managerial ideology in the current reform projects. PMID:20963305

  2. Measuring Use and Cost of Health Sector and Related Care in a Population of Girls and Young Women with Rett Syndrome

    Science.gov (United States)

    Hendrie, Delia; Bebbington, Ami; Bower, Carol; Leonard, Helen

    2011-01-01

    This study measured use and cost of health sector and related services in Rett syndrome and effects of socio-demographic, clinical severity and genetic factors on costs. The study population consisted of individuals with Rett syndrome registered with the Australian Rett Syndrome Database in 2004. Descriptive analysis was used to examine patterns…

  3. State-of-the-Art: Research Theoretical Framework of Information Systems Implementation Research in the Health Sector in Sub-Saharan Africa

    DEFF Research Database (Denmark)

    Tetteh, Godwin Kofi

    2014-01-01

    ) and Shaw & Jarvenpaa, (1997) is employed to examine reference theories employed in research conducted on information systems implementation in the health sector in the Sub-Saharan region and published between 2003 and 2013. Using a number of key words and searching on a number of databases, EBSCO, CSA...

  4. Setting priorities for the health care sector in Zimbabwe using cost-effectiveness analysis and estimates of the burden of disease

    DEFF Research Database (Denmark)

    Hansen, Kristian Schultz; Chapman, Glyn

    2008-01-01

    Years (DALYs) and calculation of cost-effectiveness ratios for a large number of health interventions was followed. Methods: Costs per DALY for a total of 65 health interventions were estimated. Costing data were collected through visits to health centres, hospitals and vertical programmes where....../98. In general, the analyses suggested that there was substantial potential for improving the efficiency of resource use in the public health care sector. Discussion: The proposed World Bank approach applied to Zimbabwe was extremely data demanding and required extensive data collection in the field...

  5. Introducing a model of cardiovascular prevention in Nairobi's slums by integrating a public health and private-sector approach: the SCALE-UP study

    Directory of Open Access Journals (Sweden)

    Steven van de Vijver

    2013-10-01

    Full Text Available Introduction: Cardiovascular disease (CVD is a leading cause of death in sub-Saharan Africa (SSA, with annual deaths expected to increase to 2 million by 2030. Currently, most national health systems in SSA are not adequately prepared for this epidemic. This is especially so in slum settlements where access to formal healthcare and resources is limited. Objective: To develop and introduce a model of cardiovascular prevention in the slums of Nairobi by integrating public health and private sector approaches. Study design: Two non-profit organizations that conduct public health research, Amsterdam Institute for Global Health and Development (AIGHD and African Population and Health Research Center (APHRC, collaborated with private-sector Boston Consulting Group (BCG to develop a service delivery package for CVD prevention in slum settings. A theoretic model was designed based on the integration of public and private sector approaches with the focus on costs and feasibility. Results: The final model includes components that aim to improve community awareness, a home-based screening service, patient and provider incentives to seek and deliver treatment specifically for hypertension, and adherence support. The expected outcomes projected by this model could prove potentially cost effective and affordable (1 USD/person/year. The model is currently being implemented in a Nairobi slum and is closely followed by key stakeholders in Kenya including the Ministry of Health, the World Health Organization (WHO, and leading non-governmental organizations (NGOs. Conclusion: Through the collaboration of public health and private sectors, a theoretically cost-effective model was developed for the prevention of CVD and is currently being implemented in the slums of Nairobi. If results are in line with the theoretical projections and first impressions on the ground, scale-up of the service delivery package could be planned in other poor urban areas in Kenya by

  6. Beyond bridging the know-do gap: a qualitative study of systemic interaction to foster knowledge exchange in the public health sector in The Netherlands

    OpenAIRE

    Driessen Mareeuw, F.A. van den; Vaandrager, L; Klerkx, L.; Naaldenberg, J.; Koelen, M

    2015-01-01

    BACKGROUND: Despite considerable attention currently being given to facilitating the use of research results in public health practice, several concerns remain, resulting in the so-called know-do gap. This article aims to identify the key tensions causing the know-do gap from a broad perspective by using a systemic approach and considering the public health sector as an innovation system. METHODS: An exploratory qualitative design including in-depth semi-structured interviews was used, with 3...

  7. The construction and legitimation of workplace bullying in the public sector: insight into power dynamics and organisational failures in health and social care.

    Science.gov (United States)

    Hutchinson, Marie; Jackson, Debra

    2015-03-01

    Health-care and public sector institutions are high-risk settings for workplace bullying. Despite growing acknowledgement of the scale and consequence of this pervasive problem, there has been little critical examination of the institutional power dynamics that enable bullying. In the aftermath of large-scale failures in care standards in public sector healthcare institutions, which were characterised by managerial bullying, attention to the nexus between bullying, power and institutional failures is warranted. In this study, employing Foucault's framework of power, we illuminate bullying as a feature of structures of power and knowledge in public sector institutions. Our analysis draws upon the experiences of a large sample (n = 3345) of workers in Australian public sector agencies - the type with which most nurses in the public setting will be familiar. In foregrounding these power dynamics, we provide further insight into how cultures that are antithetical to institutional missions can arise and seek to broaden the debate on the dynamics of care failures within public sector institutions. Understanding the practices of power in public sector institutions, particularly in the context of ongoing reform, has important implications for nursing. PMID:25131347

  8. The construction and legitimation of workplace bullying in the public sector: insight into power dynamics and organisational failures in health and social care.

    Science.gov (United States)

    Hutchinson, Marie; Jackson, Debra

    2015-03-01

    Health-care and public sector institutions are high-risk settings for workplace bullying. Despite growing acknowledgement of the scale and consequence of this pervasive problem, there has been little critical examination of the institutional power dynamics that enable bullying. In the aftermath of large-scale failures in care standards in public sector healthcare institutions, which were characterised by managerial bullying, attention to the nexus between bullying, power and institutional failures is warranted. In this study, employing Foucault's framework of power, we illuminate bullying as a feature of structures of power and knowledge in public sector institutions. Our analysis draws upon the experiences of a large sample (n = 3345) of workers in Australian public sector agencies - the type with which most nurses in the public setting will be familiar. In foregrounding these power dynamics, we provide further insight into how cultures that are antithetical to institutional missions can arise and seek to broaden the debate on the dynamics of care failures within public sector institutions. Understanding the practices of power in public sector institutions, particularly in the context of ongoing reform, has important implications for nursing.

  9. Li-Ion Battery Charging with a Buck-Boost Power Converter for a Solar Powered Battery Management System

    OpenAIRE

    Chien-Wei Ma; Jaw-Kuen Shiau

    2013-01-01

    This paper analyzes and simulates the Li-ion battery charging process for a solar powered battery management system. The battery is charged using a non-inverting synchronous buck-boost DC/DC power converter. The system operates in buck, buck-boost, or boost mode, according to the supply voltage conditions from the solar panels. Rapid changes in atmospheric conditions or sunlight incident angle cause supply voltage variations. This study develops an electrochemical-based equivalent circuit mod...

  10. Semen characteristics and sperm morphological studies of the West African Dwarf Buck treated with Aloe vera gel extract

    OpenAIRE

    Oyeyemi Matthew Olugbenga; Samuel Gbadebo Olukole; Ajayi Tolulope Adeoye

    2011-01-01

    Background: Aloe vera (Aloe barbadensis miller) is an evergreen perennial plant widely used in modern herbal practice and is often available in proprietary herbal preparations.Objective: This study was designed to investigate the semen picture and spermatozoa morphology of West African Dwarf (WAD) bucks treated with Aloe vera extract.Materials and Methods: Twelve sexually matured WAD bucks, weighing between 11 and 15 kg, were used for the study. The bucks were first used as control (pre-treat...

  11. Semen characteristics and sperm morphological studies of the West African Dwarf Buck treated with Aloe vera gel extract

    OpenAIRE

    Olugbenga, Oyeyemi Matthew; Olukole, Samuel Gbadebo; Adeoye, Ajayi Tolulope; Adejoke, Adeniji Deborah

    2011-01-01

    Background: Aloe vera (Aloe barbadensis miller) is an evergreen perennial plant widely used in modern herbal practice and is often available in proprietary herbal preparations. Objective: This study was designed to investigate the semen picture and spermatozoa morphology of West African Dwarf (WAD) bucks treated with Aloe vera extract. Materials and Methods: Twelve sexually matured WAD bucks, weighing between 11 and 15 kg, were used for the study. The bucks were first used as control (pre-tre...

  12. Prevention, control, and elimination of neglected diseases in the Americas: Pathways to integrated, inter-programmatic, inter-sectoral action for health and development

    Directory of Open Access Journals (Sweden)

    Genovese Miguel A

    2007-01-01

    Full Text Available Abstract Background In the Latin America and Caribbean region over 210 million people live below the poverty line. These impoverished and marginalized populations are heavily burdened with neglected communicable diseases. These diseases continue to enact a toll, not only on families and communities, but on the economically constrained countries themselves. Discussion As national public health priorities, neglected communicable diseases typically maintain a low profile and are often left out when public health agendas are formulated. While many of the neglected diseases do not directly cause high rates of mortality, they contribute to an enormous rate of morbidity and a drastic reduction in income for the most poverty-stricken families and communities. The persistence of this "vicious cycle" between poverty and poor health demonstrates the importance of linking the activities of the health sector with those of other sectors such as education, housing, water and sanitation, labor, public works, transportation, agriculture, industry, and economic development. Summary The purpose of this paper is three fold. First, it focuses on a need for integrated "pro-poor" approaches and policies to be developed in order to more adequately address the multi-faceted nature of neglected diseases. This represents a move away from traditional disease-centered approaches to a holistic approach that looks at the overarching causes and mechanisms that influence the health and well being of communities. The second objective of the paper outlines the need for a specific strategy for addressing these diseases and offers several programmatic entry points in the context of broad public health measures involving multiple sectors. Finally, the paper presents several current Pan American Health Organization and other institutional initiatives that already document the importance of integrated, inter-programmatic, and inter-sectoral approaches. They provide the framework for a

  13. Nexus between preventive policy inadequacies, workplace bullying, and mental health: Qualitative findings from the experiences of Australian public sector employees.

    Science.gov (United States)

    Hurley, John; Hutchinson, Marie; Bradbury, Joanne; Browne, Graeme

    2016-02-01

    Public sector organizations have been shown to have high levels of workplace bullying, despite widespread adoption of zero-tolerance policy. Given the level of harm that stems from bullying, it has been suggested that it might be one of the most serious problems facing modern organizations. The qualitative findings from a large cross sectional study of public servants in Australia are reported in the present study. The results highlight palpable mental distress and illness stemming from exposure to workplace bullying. This distress was exacerbated by failures in prohibitive workplace procedures. Reporting bullying through formal organization processes did not lead to resolution of the problem; it instead highlighted feelings of powerlessness and mistrust. In light of the findings, we suggest that an alternative discourse is required, one that gives attention to enhancing employee resilience and self-healing behaviours to the emotional trauma of workplaces. Organizations might be better placed investing resources in fostering the resilience and emotional intelligence of their workforce, rather than continuing to invest resources in prohibitive policies that fail to address the problem. Employees should be supported to prioritize responsibility for their own mental health, rather than an overreliance on organizational responses. PMID:26752457

  14. How can insulin initiation delivery in a dual-sector health system be optimised? A qualitative study on healthcare professionals’ views

    Directory of Open Access Journals (Sweden)

    Lee Ping Yein

    2012-04-01

    Full Text Available Abstract Background The prevalence of type 2 diabetes is increasing at an alarming rate in developing countries. However, glycaemia control remains suboptimal and insulin use is low. One important barrier is the lack of an efficient and effective insulin initiation delivery approach. This study aimed to document the strategies used and proposed by healthcare professionals to improve insulin initiation in the Malaysian dual-sector (public–private health system. Methods In depth interviews and focus group discussions were conducted in Klang Valley and Seremban, Malaysia in 2010–11. Healthcare professionals consisting of general practitioners (n = 11, medical officers (n = 8, diabetes educators (n = 3, government policy makers (n = 4, family medicine specialists (n = 10 and endocrinologists (n = 2 were interviewed. We used a topic guide to facilitate the interviews, which were audio recorded, transcribed verbatim and analysed using a thematic approach. Results Three main themes emerged from the interviews. Firstly, there was a lack of collaboration between the private and public sectors in diabetes care. The general practitioners in the private sector proposed an integrated system for them to refer patients to the public health services for insulin initiation programmes. There could be shared care between the two sectors and this would reduce the disproportionately heavy workload at the public sector. Secondly, besides the support from the government health authority, the healthcare professionals wanted greater involvement of non-government organisations, media and pharmaceutical industry in facilitating insulin initiation in both the public and private sectors. The support included: training of healthcare professionals; developing and disseminating patient education materials; service provision by diabetes education teams; organising programmes for patients’ peer group sessions; increasing awareness and demystifying

  15. Unemployment, public–sector health care expenditure and HIV mortality: An analysis of 74 countries, 1981–2009

    Directory of Open Access Journals (Sweden)

    Mahiben Maruthappu

    2015-06-01

    Full Text Available Background: The global economic downturn has been associated with increased unemployment and reduced public–sector expenditure on health care (PSEH. We determined the association between unemployment, PSEH and HIV mortality. Methods: Data were obtained from the World Bank and the World Health Organisation (1981–2009. Multivariate regression analysis was implemented, controlling for country–specific demographics and infrastructure. Time–lag analyses and robustness–checks were performed. Findings: Data were available for 74 countries (unemployment analysis and 75 countries (PSEH analysis, equating to 2.19 billion and 2.22 billion people, respectively, as of 2009. A 1% increase in unemployment was associated with a significant increase in HIV mortality (men: 0.1861, 95% CI: 0.0977 to 0.2744, P<0.0001, women: 0.0383, 95% CI: 0.0108 to 0.0657, P=0.0064. A 1% increase in PSEH was associated with a significant decrease in HIV mortality (men: –0.5015, 95% CI: –0.7432 to –0.2598, P=0.0001; women: –0.1562, 95% CI: –0.2404 to –0.0720, P=0.0003. Time–lag analysis showed that significant changes in HIV mortality continued for up to 5 years following variations in both unemployment and PSEH. Interpretation: Unemployment increases were associated with significant HIV mortality increases. PSEH increases were associated with reduced HIV mortality. The facilitation of access–to–care for the unemployed and policy interventions which aim to protect PSEH could contribute to improved HIV outcomes.

  16. La atención gerenciada en América Latina. Transnacionalización del sector salud en el contexto de la reforma Managed care in Latin America: transnationalization of the health sector in a context of reform

    Directory of Open Access Journals (Sweden)

    Celia Iriart

    2000-01-01

    Full Text Available Este artículo presenta resultados de la investigación comparativa "Atención Gerenciada en América Latina: Su Papel en la Reforma de los Sistemas de Salud", realizada por equipos de Argentina, Brasil, Chile, Ecuador y Estados Unidos. El objetivo del estudio fue analizar el proceso de exportación de la atención gerenciada, especialmente desde Estado Unidos, y su incorporación en los países latinoamericanos. Los métodos utilizados incluyeron técnicas cualitativas y cuantitativas. La adopción de la atención gerenciada muestra el proceso de transnacionalización del sector salud. Nuestros hallazgos demuestran el ingreso de los principales capitales financieros multinacionales en el sector privado de seguros y de prestadores de salud, y su intencionalidad de participar en la administración de las instituciones estatales y de los fondos de la seguridad social médica. Concluimos que este proceso de cambio sustancial, que implica la paulatina adopción de la atención gerenciada, es facilitado por las transformaciones operadas a nivel ideológico.This article presents the results of the comparative research project "Managed Care in Latin America: Its Role in Health Reform". The project was conducted by teams in Argentina, Brazil, Chile, Ecuador, and the United States. The study's objective was to analyze the process by which managed care is exported, especially from the United States, and how managed care is adopted in Latin American countries. Our research methods included qualitative and quantitative techniques. Adoption of managed care reflects transnationalization of the health sector. Our findings demonstrate the entrance of large multinational financial capital into the private insurance and health services sectors and their intention of participating in the administration of government institutions and medical/social security funds. We conclude that this basic change involving the slow adoption of managed care is facilitated by

  17. 50 MHz dual-mode buck DC—DC converter

    Science.gov (United States)

    Zhang, Zhang; Xing, Wang; Wencheng, Yu; Ye, Tan; Yizhong, Yang; Guangjun, Xie

    2016-08-01

    A 50 MHz 1.8/0.9 V dual-mode buck DC—DC converter is proposed in this paper. A dual-mode control for high-frequency DC—DC converter is presented to enhance the conversion efficiency of light-load in this paper. A novel zero-crossing detector is proposed to shut down synchronous rectification transistor NMOS when the inductor crosses zero, which can decrease the power loss caused by reverse current and the trip point is adjusted by regulating IBIAS (BIAS current). A new logic control for pulse-skipping modulation loop is also presented in this paper, which has advantages of simple structure and low power loss. The proposed converter is realized in SMIC 0.18 μm 1-poly 6-metal mixed signal CMOS process. With switching loss, conduction loss and reverse current related loss optimized, an efficiency of 57% is maintained at 10 mA, and a peak efficiency of 71% is measured at nominal operating conditions with a voltage conversion of 1.8 to 0.9 V. Project supported by the National Natural Science Foundation of China (Nos. 61404043, 61401137), the Key Laboratory of Infrared Imaging Material and Detectors, Shanghai Institute of Technical Physics, CAS (Nos. IIMDKFJJ-13-06, IIMDKFJJ-14-03), and the Fundamental Research Funds for the Central University (No. 2015HGZX0026).

  18. Advanced buck converter power supply ABCPS for APT

    Energy Technology Data Exchange (ETDEWEB)

    Street, R.; Overett, T.; Bowles, E. [General Atomics, San Diego, CA (United States)

    1998-12-31

    The United States Department of Energy (DOE) is planning to fabricate an Accelerator for the Production of Tritium (APT) at their Savannah River Site, to provide Tritium for national defense. The 1700 million electron volt (MeV) proton beam accelerator will be powered by radio frequency (RF) klystrons. A direct current (DC) power supply is required for each of the approximately two hundred and fifty 1-megawatt (MW) continuous wave klystrons in the RF power system. The requirements are that the power supply meet output performance specifications, provide fault protection for the klystron, have high efficiency, high reliability, good maintainability, and be readily manufacturable. As the power supplies are one of the largest cost elements in the accelerator, a technology review was made to determine the most economical approach to satisfy the requirements. A switch-mode power supply employing a buck-regulator was identified as being potentially the lowest cost approach. As the switch represents a certain development risk, a small-scale prototype has been constructed for evaluation, and has resulted in the decision to fabricate a full-scale prototype power supply. A description of the hardware will be presented.

  19. Thoracic aortic aneurysm in a buck associated with caseous lymphadenitis

    Directory of Open Access Journals (Sweden)

    R.R. Pinheiro

    2013-06-01

    Full Text Available This paper reports the clinical, bacteriological and pathological findings of a thoracic aortic aneurysm in a four-year-old Anglo-Nubian goat buck, related to a framework of visceral caseous lymphadenitis. General clinical examination showed heart rate of 75 beats per minute, respiratory rate of 20 movements per minute and ruminal movements of four movements per minute. Superficial lymph nodes were normal upon palpation. Rectal temperature was slightly high (40.5°C. Blood test showed an intense leukocytosis (54,000/µL, characterized by strong neutrophil shift to the left. At necropsy, a large blood clot was detected in the thoracic cavity. The thickening of the myocardium and dilatation of the aorta in the thoracic portion, presenting a saculiform format was also observed. A large number of abscesses were disseminated in the media and intima layers of aorta. The aorta lumen obstruction by arterial plaques consisting of inflammatory infiltrate, predominantly neutrophilic was also detected. Abscesses were found spread in turbinate, rumen, reticulum, kidneys, liver, spleen, testicles and aorta wall. The microbiological exam of exudate confirmed Corynebacterium pseudotuberculosis as the causal agent.

  20. Patterns of case management and chemoprevention for malaria-in-pregnancy by public and private sector health providers in Enugu state, Nigeria

    Directory of Open Access Journals (Sweden)

    Onwujekwe Ogochukwu C

    2012-07-01

    Full Text Available Abstract Background Malaria in pregnancy (MIP is a major disease burden in Nigeria and has adverse consequences on the health of the mother, the foetus and the newborn. Information is required on how to improve its prevention and treatment from both the providers’ and consumers’ perspectives. Methods The study sites were two public and two private hospitals in Enugu, southeast Nigeria. Data was collected using a pre-tested structured questionnaire. The respondents were healthcare providers (doctors, pharmacists and nurses providing ante-natal care (ANC services. They consisted of 32 respondents from the public facilities and 20 from the private facilities. The questionnaire elicited information on their: knowledge about malaria, attitude, chemotherapy and chemoprophylaxis using pyrimethamine, chloroquine proguanil as well as IPTp with sulphadoxine-pyrimethamine (SP. The data was collected from May to June 2010. Results Not many providers recognized maternal and neonatal deaths as potential consequences of MIP. The public sector providers provided more appropriate treatment for the pregnant women, but the private sector providers found IPTp more acceptable and provided it more rationally than public sector providers (p  Conclusions There is sub-optimal level of knowledge about current best practices for treatment and chemoprophylaxis for MIP especially in the private sector. Also, IPTp was hardly used in the public sector. Interventions are required to improve providers’ knowledge and practices with regards to management of MIP.

  1. Addressing the social determinants of health through health system strengthening and inter-sectoral convergence: the case of the Indian National Rural Health Mission

    Directory of Open Access Journals (Sweden)

    Amit Mohan Prasad

    2013-03-01

    Full Text Available Background: At the turn of the 21st century, India was plagued by significant rural–urban, inter-state and inter-district inequities in health. For example, in 2004, the infant mortality rate (IMR was 24 points higher in rural areas compared to urban areas. To address these inequities, to strengthen the rural health system (a major determinant of health in itself and to facilitate action on other determinants of health, India launched the National Rural Health Mission (NRHM in April 2005. Methods: Under the NRHM, Rs. 666 billion (US$12.1 billion was invested in rural areas from April 2005 to March 2012. There was also a substantially higher allocation for 18 high-focus states2 and 264 high-focus districts, identified on the basis of poor health and demographic indicators. Other determinants of health, especially nutrition and decentralized action, were addressed through mechanisms like State/District Health Missions, Village Health, Sanitation and Nutrition Committees, and Village Health and Nutrition Days. Results: Consequently, in bigger high-focus states, rural IMR fell by 15.6 points between 2004 and 2011, as compared to 9 points in urban areas. Similarly, the maternal mortality rate in high-focus states declined by 17.9% between 2004–2006 and 2007–2009 compared to 14.6% in other states. Conclusion: The article, on the basis of the above approaches employed under NRHM, proposes the NRHM model to ‘reduce health inequities and initiate action on SDH’.

  2. Change Theory for Accounting System Reform in Health Sector: A Case Study of Kerman University of Medical Sciences in Iran

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Mehrolhasani

    2013-11-01

    Full Text Available BackgroundChange theories provide an opportunity for organizational managers to plan, monitor and evaluate changes using a framework which enable them, among others, to show a fast response to environmental fluctuations and to predict the changing patterns of individuals and technology. The current study aimed to explore whether the change in the public accounting system of the Iranian health sector has followed Kurt Lewin’s change theory or not. MethodsThis study which adopted a mixed methodology approach, qualitative and quantitative methods, was conducted in 2012. In the first phase of the study, 41 participants using purposive sampling and in the second phase, 32 affiliated units of Kerman University of Medical Sciences (KUMS were selected as the study sample. Also, in phase one, we used face-to-face in-depth interviews (6 participants and the quote method (35 participants for data collection. We used a thematic framework analysis for analyzing data. In phase two, a questionnaire with a ten-point Likert scale was designed and then, data were analyzed using descriptive indicators, principal component and factorial analyses. ResultsThe results of phase one yielded a model consisting of four categories of superstructure, apparent infrastructure, hidden infrastructure and common factors. By linking all factors, totally, 12 components based on the quantitative results showed that the state of all components were not satisfactory at KUMS (5.06±2.16. Leadership and management; and technology components played the lowest and the greatest roles in implementing the accrual accounting system respectively. ConclusionThe results showed that the unfreezing stage did not occur well and the components were immature, mainly because the emphasis was placed on superstructure components rather than the components of hidden infrastructure. The study suggests that a road map should be developed in the financial system based on Kurt Lewin’s change theory and

  3. Introduction of EDI in the public sector

    DEFF Research Database (Denmark)

    Falch, Morten

    1997-01-01

    Reviews the status of EDI in the sectors of health, public transport and taxation and public administration. The impact of this on the diffusion of EDI in other sectors is analysed.......Reviews the status of EDI in the sectors of health, public transport and taxation and public administration. The impact of this on the diffusion of EDI in other sectors is analysed....

  4. Prescribing patterns of methylphenidate and atomoxetine containing products in a section of the private health care sector of South Africa / Stephan Rothmann

    OpenAIRE

    Rothmann, Stephan

    2009-01-01

    The general aim of this study was to investigate the prescribing patterns of products that contain methylphenidate or atomoxetine in a section of the private health care sector of South Africa. A quantitative, retrospective drug uitilisation review was performed according to data obtained from the database of a South African medicine claims pharmacy benefit management company's for three consecutive study years (Le. 2005 to 2007). The results indicated that a total of 7,990 patients had b...

  5. Differences in wage rates for males and females in the health sector: a consideration of unpaid overtime to decompose the gender wage gap

    Directory of Open Access Journals (Sweden)

    Vecchio Nerina

    2013-02-01

    Full Text Available Abstract Background In Australia a persistent and sizable gender wage gap exists. In recent years this gap has been steadily widening. The negative impact of gender wage differentials is the disincentive to work more hours. This implies a substantial cost on the Australian health sector. This study aimed to identify the magnitude of gender wage differentials within the health sector. The investigation accounts for unpaid overtime. Given the limited availability of information, little empirical evidence exists that accounts for unpaid overtime. Methods Information was collected from a sample of 10,066 Australian full-time employees within the health sector. Initially, ordinary least-squares regression was used to identify the gender wage gap when unpaid overtime was included and then excluded from the model. The sample was also stratified by gender and then by occupation to allow for comparisons. Later the Blinder–Oaxaca decomposition method was employed to identify and quantify the contribution of individual endowments to wage differentials between males and females. Results The analyses of data revealed a gender wage gap that varied across occupations. The inclusion of unpaid overtime in the analysis led to a slight reduction in the wage differential. The results showed an adjusted wage gap of 16.7%. Conclusions Unpaid overtime made a significant but small contribution to wage differentials. Being female remained the major contributing factor to the wage gap. Given that wage differentials provide a disincentive to work more hours, serious attempts to deal with the skilled labour shortage in the health sector need to address the gender wage gap.

  6. How can insulin initiation delivery in a dual-sector health system be optimised? A qualitative study on healthcare professionals’ views

    OpenAIRE

    Lee Ping Yein; Lee Yew Kong; Ng Chirk Jenn

    2012-01-01

    Abstract Background The prevalence of type 2 diabetes is increasing at an alarming rate in developing countries. However, glycaemia control remains suboptimal and insulin use is low. One important barrier is the lack of an efficient and effective insulin initiation delivery approach. This study aimed to document the strategies used and proposed by healthcare professionals to improve insulin initiation in the Malaysian dual-sector (public–private) health system. Methods In depth interviews and...

  7. Designing a Choice Modelling Survey to Value the Health and Environmental Impacts of Air Pollution from the Transport Sector in the Jakarta Metropolitan Area

    OpenAIRE

    Mia Amalia

    2010-01-01

    Poor air quality in Indonesia's capital city is having a significant impact on residents' health and there is an urgent need to introduce new initiatives to deal with the problem. To help justify investment in such new strategies, a recent EEPSEA study has looked at the value that citizens in the Jakarta Metropolitan Area (JMA) place on pollution reduction policies for the transportation sector. The study shows that, although many residents are mistrustful of the government's ability to clean...

  8. Research on Two-channel Interleaved Two-stage Paralleled Buck DC-DC Converter for Plasma Cutting Power Supply

    DEFF Research Database (Denmark)

    Yang, Xi-jun; Qu, Hao; Yao, Chen;

    2014-01-01

    As for high power plasma power supply, due to high efficiency and flexibility, multi-channel interleaved multi-stage paralleled Buck DC-DC Converter becomes the first choice. In the paper, two-channel interleaved two- stage paralleled Buck DC-DC Converter powered by three-phase AC power supply...

  9. Semen characteristics and sperm morphological studies of the West African Dwarf Buck treated with Aloe vera gel extract

    Directory of Open Access Journals (Sweden)

    Oyeyemi Matthew Olugbenga

    2011-01-01

    Full Text Available Background: Aloe vera (Aloe barbadensis miller is an evergreen perennial plant widely used in modern herbal practice and is often available in proprietary herbal preparations.Objective: This study was designed to investigate the semen picture and spermatozoa morphology of West African Dwarf (WAD bucks treated with Aloe vera extract.Materials and Methods: Twelve sexually matured WAD bucks, weighing between 11 and 15 kg, were used for the study. The bucks were first used as control (pre-treatment and later as two groups of six animals each. The first six bucks received 10 mls of the 3% extract while the other six received 10 mls of the 4% of the extract for a 7 day period. Semen was collected from both the 3 and 4% extract treated bucks for the control (pre-treatment, on days eight (first week post-treatment and fifteen (second week post-treatment in each case using the electroejaculation method. The spermiogram of the bucks were investigated using standard procedures. Data obtained were analyzed using two way ANOVA and significance reported at p<0.05.Results: The continuous administration of Aloe vera extract significantly (p<0.05 reduced sperm concentration, motility and percentage livability and resulted in increased sperm abnormalities in the WAD buck.Conclusion: Aloe vera adversely affected the spermiogram of bucks. The plant can reduce fertility in male animals and is therefore not recommended for medicinal purpose in male animals especially those used for breeding.

  10. On the Disillusionment of American Dream Through Buck in The Call of the Wild

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    The Call of the Wild,written by the famous American novelist Jack London,has attracted a large number of both readers and scholars ever since it came out.It provides the public with a fresh perspective through narrating the whole novel from the point of view of the protagonist Buck,a dog.Against the background of countless people flooding into the Alaska to search gold in order to fulfill their dream of becoming rich,which,to some extent,represents the American dream at that time,this novel vividly mirrored the then phenomenon,so illuminating and thought-provoking that it is of great value to analyze the disillusionment of American Dream through Buck.Therefore,this paper aims at exploring the disillusionment of American Dream through analyzing Buck and his rich life experiences.

  11. Pulse width modulated buck-boost five-level current source inverters

    DEFF Research Database (Denmark)

    Blaabjerg, Frede; Gao, F.; Loh, P.C.;

    2008-01-01

    This paper presents new five-level current source inverters (CSIs) with voltage/current buck-boost capability. Being different from the existing multilevel CSI, the proposed CSIs were first designed to regulate the flowing path of dc input current by controlling two additional active switches......, resulting in the natural balance of input current. For maintaining the normalized volt-sec average unchanged, the alternative phase opposition disposition (APOD) modulation scheme with typical gating signal mapping technique from voltage source inverter (VSI) to CSI can be assumed to control the five-level...... buck-boost CSIs. Next by observing the hidden current charging path during inductive charging interval under APOD modulation, it is noted that the buck-boost five-level CSI can then be further modified with lesser active component without degrading output performance. To verify the theoretical findings...

  12. Nonlinear Phenomena and Resonant Parametric Perturbation Control in QR-ZCS Buck DC-DC Converters

    Science.gov (United States)

    Hsieh, Fei-Hu; Liu, Feng-Shao; Hsieh, Hui-Chang

    The purpose of this study is to investigate the chaotic phenomena and to control in current-mode controlled quasi-resonant zero-current-switching (QR-ZCS) DC-DC buck converters, and to present control of chaos by resonant parametric perturbation control methods. First of all, MATLAB/SIMULINK is used to derive a mathematical model for QR-ZCS DC-DC buck converters, and to simulate the converters to observe the waveform of output voltages, inductance currents and phase-plane portraits from the period-doubling bifurcation to chaos by changing the load resistances. Secondly, using resonant parametric perturbation control in QR-ZCS buck DC-DC converters, the simulation results of the chaotic converter form chaos state turn into stable state period 1, and improve ripple amplitudes of converters under the chaos, to verify the validity of the proposes method.

  13. Analysis of Discharge Spark Energy in Buck Converter of a Continuous Mode of Inductive Current

    Institute of Scientific and Technical Information of China (English)

    CUI Bao-chun; CHENG Hong; WANG Cong; LU Huan-yu; SHI Yun

    2006-01-01

    The basic idea of intrinsically safe circuit and the discharge spark in the Buck converter in the explosive atmospheres were introduced. The Buck converter is the main topological structure of the switch type of intrinsically safe circuit, which has two working modes: continuous inductive current (CCM - continuous conduction mode) and discrete inductance current (DCM - discontinuous conduction mode). The operating state of the continuous inductive current mode is analyzed in detail and the energy of discharge spark in various operating modes is discussed. The total energy will decrease with the increase of switch frequency, in a switching cycle; the discharge spark energy has a maximum and a minimum value. Therefore, the Buck converter has smaller discharge spark energy than the linear power circuit and the switch type of intrinsically safe circuit can enhance the output power and the conversion efficiency of the intrinsically safe power.

  14. High Power Efficiency Buck Converter Design for Standalone Wind Generation System

    Directory of Open Access Journals (Sweden)

    Yigeng Huangfu

    2015-01-01

    Full Text Available In wind generation system, the power converter efficiency is one of the key factors for the performance of the system. In those systems, DC/DC Buck converter is widely used for high power system. Considering the converter’s cost and efficiency, this paper mainly focuses on the design of an improved topology Buck converter adopted for high power standalone wind generation system. The designed converter uses multi-MOSFETs in parallel instead of the IGBTs, in order to increase the conductive current as well as the converter switch frequency. From the experimental tests results, the maximum efficiency of the designed 2 kW Buck converter is up to 96% based on maximum power point tracking (MPPT method.

  15. Non-Inverting Buck-Boost Converter for Fuel Cell Applications

    DEFF Research Database (Denmark)

    Schaltz, Erik; Rasmussen, Peter Omand; Khaligh, Alireza

    2008-01-01

    Fuel cell DC/DC converters often have to be able to both step-up and step-down the input voltage, and provide a high efficiency in the whole range of output power. Conventional negative output buck-boost and non-inverting buck-boost converters provide both step-up and step-down characteristics....... In this paper the non-inverting buck-boost with either diodes or synchronous rectifiers is investigated for fuel cell applications. Most of previous research does not consider  the parasitic in the evaluation of the converters. In this study, detailed analytical expressions of the efficiencies for the system...... composed of fuel cell system and interfacing converter, considering the parasitics, are presented. It is concluded that the implementation with synchronous rectifiers provides the highest efficiency in the whole range of the fuel cell power, and its efficiency characteristic is more suitable for fuel cell...

  16. Application of Theory of Hybrid Systems to Control the Switching of Buck Converter

    KAUST Repository

    Benmiloud, Mohammed

    2013-08-01

    The field of power electronics poses challenging control problems that can’t be treated in a complete manner using traditional modeling. In this paper, the buck converter operating in Continuous Conduction Mode (CCM) is represented analytically by hybrid automaton model and graphically representation is also given. The hybrid trajectory and the model behavior are presented. The control problem of buck switching converters is transformed to a guard selection problem. The guard selection calculation formulas of buck converter are derived from the basic circuit laws. The stability of the switching is established analytically by the use of multiple Lyapunov functions to ensure the convergence and Poincare map to assess the local stability of the limit cycle. Numerical results clearly bring out the advantages and effectiveness of the proposed control law under varying line voltage and load conditions. Simulation studies are carried out in Matlab/Simulink/Stateflow.

  17. Descentralización del sector de salud y conflictos con el gremio médico en México Health sector decentralization and divergences with the medical society in Mexico

    Directory of Open Access Journals (Sweden)

    Raquel Abrantes Pêgo

    2002-06-01

    Full Text Available OBJETIVO: Investigar la percepción y acción del gremio médico en el marco de la descentralización del Sector de Salud en dos estados de México, Guanajuato y Sonora. MÉTODOS: Se han utilizado técnicas cualitativas de investigación. Fueron realizadas 35 entrevistas, semiestructuradas, en total entre los dos estados, a médicos colegiados, Guanajuato y Sonora, tanto de instituciones públicas como privadas y representantes de las asociaciones gremiales y sindicales. RESULTADOS: Para el gremio médico de los dos estados investigados, la descentralización ha implicado en inseguridad, como resultado de la falta de claridad en la regulación del Sector de Salud. La acción de los Colegios de Médicos de ambos estados, se tradujo en una mayor politización de los Colegios de Médicos estatales, en la elaboración de propuestas con el objetivo de incidir en el control del mercado laboral médico de dichos estados y participación en la estructura de poder regional. CONCLUSIONES: La investigación comprueba una readaptación del gremio médico en el ámbito regional, indicando su permanencia como grupo de poder. Contrariamente a lo que informa la literatura estadounidense en México, los médicos han logrado influenciar en la regulación, con la finalidad de no perder su status privilegiado dentro de la competencia existente.OBJECTIVE: To evaluate the medical society's perception and actions in the context of health sector decentralization in the states of Guanajuato and Sonora, Mexico. METHODS: Qualitative research techniques were applied. Thirty-five semi-structured interviews were conducted with medical college members of both public and private institutions, and collegiate and union representatives of both states studied. RESULTS: Members of medical society in both states acknowledged that decentralization implied in insecurity due to the lack of clarity of health sector regulations. As a result of actions of the medical college in both

  18. The Effects of Age, Breed, Sire, Body Weight and the Ejaculate Characteristics of Rabbit Bucks

    Directory of Open Access Journals (Sweden)

    G.N. Akpa

    2012-06-01

    Full Text Available The aim of this research is to analyse the semen of different breeds of rabbits and to determine the effects of age, breed, sire, generation and body weight on the ejaculate characteristics of rabbit bucks. Twenty rabbit bucks comprising of three breeds (New-Zealand White 8, Chinchilla 6 and Californian White 6 between the ages of 6-9 months were used to investigate the effect of age, breed, sire and generation on body weight and ejaculate characteristics of the bucks. The experiment was carried out at the Animal Science departmental farm, Ahmadu Bello University, Zaria. Parameters considered include semen colour, semen volume, semen ejaculate volume, semen concentration, semen pH, sperm motility, body weight and age. The mean for semen ejaculate volume, semen concentration, pH, sperm motility, body weight and age were 0.5 mL, 325.5x106 sperm cells/mL, 7.5, 86.6, 2.0 and 7.6% months, respectively. Age, breed and sire had (p≤0.05 effect on ejaculate characteristics but breed and sire had higher significant (p<0.01 effect on body weight. However, generation had no significant effect on the body weight and ejaculate characteristics except on semen pH (p<0.05. The ejaculate characteristics of the rabbit bucks were influenced by age, breed and sire. The values obtained were within the normal standards for rabbits-bucks. New Zealand White bucks proved superior in terms of ejaculate characteristics.

  19. Modeling and Analysis of Transformerless High Gain Buck-boost DC-DC Converters

    Directory of Open Access Journals (Sweden)

    Vu Tran

    2014-12-01

    Full Text Available This paper proposes a transfomerless switched capacitor buck boost converter model, which provides higher voltage gain and higher efficiency when compared to the conventional buck boost converter. The averaged model based on state-space description is analyzed in the paper. The simulation results are presented to confirm the capability of the converter to generate high voltage ratios. The comparison between the proposed model and the traditional model is also provided to reveal the improvement. The proposed converter is suitable for for a wide application which requires high step-up DC-DC converters such as DC micro-grids and solar electrical energy.

  20. Development of TMS320F2810 DSP Based Bidirectional buck-boost Chopper

    OpenAIRE

    Mr. K.S. Chakradhar*1,; M.Ayesha siddiqa2; T.Vandhana3

    2014-01-01

    A DC - DC converter is an electronic circuit which converts a source of direct current (DC) from one voltage level to another. It is a class of power converter. One common application of DC - DC converters is DC motor control. The Buck - Boost Chopper is a type of DC - DC converter. They are static devices which are used to obtain variable DC voltage from the source of constant DC voltage. Besides the saving in power, Buck-Boost choppers offer greater efficiency, faster respon...

  1. Finite-time control of DC-DC buck converters via integral terminal sliding modes

    Science.gov (United States)

    Chiu, Chian-Song; Shen, Chih-Teng

    2012-05-01

    This article presents novel terminal sliding modes for finite-time output tracking control of DC-DC buck converters. Instead of using traditional singular terminal sliding mode, two integral terminal sliding modes are introduced for robust output voltage tracking of uncertain buck converters. Different from traditional sliding mode control (SMC), the proposed controller assures finite convergence time for the tracking error and integral tracking error. Furthermore, the singular problem in traditional terminal SMC is removed from this article. When considering worse modelling, adaptive integral terminal SMC is derived to guarantee finite-time convergence under more relaxed stability conditions. In addition, several experiments show better start-up performance and robustness.

  2. Buck-Boost Control of Four Quadrant Chopper using Symmetrical Impedance Network for Adjustable Speed Drive

    OpenAIRE

    Saswati Swapna Dash; Byamakesh Nayak

    2015-01-01

    This paper proposes buck-boost capabilities of four quadrant chopper for wide range speed control of DC motor drives using symmetrical impedance network called Z-source network. By controlling the shoot through duty ratio from 0 to 0.5 and non-shoot through techniques, the Z-source four quadrant choppers can produce any desired DC voltage across the DC motor. The switching patterns for both buck and boost operations are presented to achieve four modes of operation of DC motor. As a result, th...

  3. Bifurcation and Chaos in a Pulse Width modulation controlled Buck Converter

    DEFF Research Database (Denmark)

    Kocewiak, Lukasz; Bak, Claus Leth; Munk-Nielsen, Stig

    2007-01-01

    Power electronic system with pulse width modulation (PWM) control is studied. Behaviour characteristic for a nonlinear dynamical system is observed and theoretically explained. A DC-DC buck converter controlled by a voltage feedback is taken as an example. The studied system is described by a...... bifurcations as a complex behaviour in power electronic system evidence are also described. In order to verify theoretical study the experimental DC-DC buck converter was build. The results obtained from three sources were presented and compared. A very good agreement between theory and experiment was observed....

  4. Descentralización del sector salud en América Latina Descentralization of the health sector in Latin America

    Directory of Open Access Journals (Sweden)

    A. Ugalde

    2002-02-01

    Full Text Available Este trabajo analiza la experiencia latinoamericana con la descentralización de servicios de salud. Los autores examinan el significado de la descentralización: geográfica, institucional y de funciones. Se identifican los objetivos que según los promotores de la descentralización la justifican y se documenta que, en general, no se han conseguido. Una revisión de la bibliografía y los estudios llevados a cabo por los autores sugieren que con frecuencia la descentralización ha producido resultados opuestos a los buscados, es decir, ha incrementado la inequidad, ha disminuido la eficiencia y calidad de los servicios, y ha aumentado los costes. Se señala que la información existente no permite determinar con seguridad si el fracaso de la descentralización se debe a la selección de políticas inadecuadas o a fallos en el proceso de implementación. Se reconoce que la descentralización es un proceso político complejo que no se puede diseñar ni imponer desde fuera y que antes de tomar la decisión de descentralizar es necesario identificar cuál de las muchas modalidades de descentralización se quiere implementar, estimar los costes, anticipar los problemas que se pueden presentar en su proceso de implementación y buscar soluciones a los mismos. Los autores concluyen sugiriendo que los bancos multilaterales han errado al forzar a los países a descentralizar de una manera improvisada sin tener en cuenta los diferentes contextos históricos, políticos y socioeconómicos.This paper analyzes the Latin American experience of decentralizing health services within the context of health reform. We examine the meaning of the term decentralization and discuss the various modalities of this concept: geographical, institutional and functional. The objectives that, in general, these objectives have not been achieved. After reviewing the literature and drawing on our own fieldwork, we conclude that in many instances the Latin American

  5. A case study on tuberculosis treatment defaulters in Delhi: Weak health links of the community with the public sector, unsupported migrants and some misconceptions

    Directory of Open Access Journals (Sweden)

    Vinitha Jayachandran

    2014-01-01

    Full Text Available Background: Defaulters are producing the challenging, daunting category of drug resistant cases. It is important to examine and understand the patient′s notions and terms to manage them effectively. Objective: To study the reasons behind failure of adherence to treatment and to assess the health care seeking behaviour with awareness of these patients regarding the public sector provisions. Materials and Methods: In depth interviews with ten patients who had defaulted and were undergoing CAT-II treatment which included both retreatment defaulters and new defaulters, were conducted by repeated contacts in Fatehpur Beri PHC DOTS centre. Results: People refuse to seek treatment from a government health centre when they fall sick seriously as they are ready to get treated at any expense and seek private health care facility for the prompt treatment. There is a notion that free service from public sector is not as effective as private corporate hospitals. In the public sector patients defaulted because of side effects of drugs, fear of getting admitted in big tuberculosis (TB hospitals, incompatible timing, neglect, long waiting time, TB deaths in the family and lack of family support. Among migrants, lack of employers support, family support forced them to return home. Ignorance about existence of DOTS centre with free treatment was observed. Most of the patients were unaware that incomplete treatment could lead to disease. Misconceptions observed were that treatment was futile (talk in the community about drugs being useless and most of the patients were afraid of the disease and thought they could die because of it. Conclusion: Proposed measures include: Recognition of traditional medicine/complementary alternative medicine practitioners for universal access to TB diagnosis and care, Public sector should be made attractive to the middle class society through enhancement of services and user fees and empowerment initiatives for lack of social

  6. 基于改善关联性 Buck 变换器的混沌控制*%Chaotic control of the Buck converter based on improving the correlation∗

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

      由于 Buck 变换器具有非线性特性,在一定参数条件下,它会处于混沌状态,此时 Buck 变换器不能正常工作。为了抑制 Buck 变换器的混沌现象,本文首先建立了 Buck 变换器的精确状态方程模型,然后通过分析可控范围图、开关逻辑图、相图、电感电流波形、输出电压波形,研究了基于改善 Buck 变换器的电感电流与输出电压之间关联性的混沌控制策略。研究结果表明:该控制策略能够将处于混沌状态的 Buck 变换器稳定在周期1,2,4,8轨道,且该控制策略不需要预先确定期望的目标轨道,不依赖于 Buck 变换器的电路参数,只取决于一个外部参数即耦合强度,所以该控制策略同样适用于其他拓扑结构的功率变换器。%Due to the strong nonlinearity of the Buck converter, it can be in the chaotic state under certain parameters and the chaotic Buck converter does not work normally. In order to suppress the chaotic phenomena in the Buck converter, a chaotic control scheme is demonstrated by establishing the accurate state equation models, and then analyzing the controllable range diagrams, the switching logic diagrams, the phase portrait, the inductor current waveforms and the output voltage waveforms. Also this scheme can be im-plemented by improving the correlation between the inductor current and the output voltage of the Buck converter. Research results show that this scheme can stabilize the chaotic Buck converter to the period-1, period-2, period-4, period-8 orbits, without determining the desired targeting orbits in advance. Moreover, this scheme does not depend on circuit parameters of the Buck converter, it only depends on an external parameter named the coupling strength, so this scheme can be applied to the other power converters.

  7. Artemisinin combination therapies price disparity between government and private health sectors and its implication on antimalarial drug consumption pattern in Morogoro Urban District, Tanzania

    Directory of Open Access Journals (Sweden)

    Malisa Allen

    2012-03-01

    Full Text Available Abstract Background Universal access to effective treatments is a goal of the Roll Back Malaria Partnership. However, despite official commitments and substantial increases in financing, this objective remains elusive, as development assistance continue to be routed largely through government channels, leaving the much needed highly effective treatments inaccessible or unaffordable to those seeking services in the private sector. Methods To quantify the effect of price disparity between the government and private health systems, this study have audited 92 government and private Drug Selling Units (DSUs in Morogoro urban district in Tanzania to determine the levels, trend and consumption pattern of antimalarial drugs in the two health systems. A combination of observation, interviews and questionnaire administered to the service providers of the randomly selected DSUs were used to collect data. Results ALU was the most selling antimalarial drug in the government health system at a subsidized price of 300 TShs (0.18 US$. By contrast, ALU that was available in the private sector (coartem was being sold at a price of about 10,000 TShs (5.9 US$, the price that was by far unaffordable, prompting people to resort to cheap but failed drugs. As a result, metakelfin (the phased out drug was the most selling drug in the private health system at a price ranging from 500 to 2,000 TShs (0.29–1.18 US$. Conclusions In order for the prompt diagnosis and treatment with effective drugs intervention to have big impact on malaria in mostly low socioeconomic malaria-endemic areas of Africa, inequities in affordability and access to effective treatment must be eliminated. For this to be ensued, subsidized drugs should be made available in both government and private health sectors to promote a universal access to effective safe and affordable life saving antimalarial drugs.

  8. Tool, weapon, or white elephant? A realist analysis of the five phases of a twenty-year programme of occupational health information system implementation in the health sector

    Directory of Open Access Journals (Sweden)

    Spiegel Jerry M

    2012-08-01

    Full Text Available Abstract Background Although information systems (IS have been extensively applied in the health sector worldwide, few initiatives have addressed the health and safety of health workers, a group acknowledged to be at high risk of injury and illness, as well as in great shortage globally, particularly in low and middle-income countries. Methods Adapting a context-mechanism-outcome case study design, we analyze our team’s own experience over two decades to address this gap: in two different Canadian provinces; and two distinct South African settings. Applying a realist analysis within an adapted structuration theory framing sensitive to power relations, we explore contextual (socio-political and technological characteristics and mechanisms affecting outcomes at micro, meso and macro levels. Results Technological limitations hindered IS usefulness in the initial Canadian locale, while staffing inadequacies amid pronounced power imbalances affecting governance restricted IS usefulness in the subsequent Canadian application. Implementation in South Africa highlighted the special care needed to address power dynamics regarding both worker-employer relations (relevant to all occupational health settings and North–south imbalances (common to all international interactions. Researchers, managers and front-line workers all view IS implementation differently; relationships amongst the workplace parties and between community and academic partners have been pivotal in determining outcome in all circumstances. Capacity building and applying creative commons and open source solutions are showing promise, as is international collaboration. Conclusions There is worldwide consensus on the need for IS use to protect the health workforce. However, IS implementation is a resource-intensive undertaking; regardless of how carefully designed the software, contextual factors and the mechanisms adopted to address these are critical to mitigate threats and achieve

  9. Impacts of NMVOC emissions on human health in European countries for 2000-2010: Use of sector-specific substance profiles

    DEFF Research Database (Denmark)

    Laurent, Alexis; Hauschild, Michael Zwicky

    2014-01-01

    assess the damages at national level and thus define adequate air pollution abatement policies, substance breakdowns are needed. However, these are not readily available as total NMVOC emissions are only reported at sector level. In this study, we developed a reproducible methodology that combines...... for 31 European countries within the period 2000e2010. Using life cycle impact assessment methods for POF and human toxicity, impacts on human health were quantified. The results indicated that a strong linear correlation exists between POF impacts and the total NMVOC emissions, suggesting that air...... impacts (i) are caused by few substances, such as formaldehyde, acrolein and furan, (ii) primarily stem from transportation sectors and from residential sources, and (iii) are found not to correlate with total NMVOC emissions. Our findings therefore suggest the need for supporting air pollution abatement...

  10. Experiences and attitudes towards evidence-informed policy-making among research and policy stakeholders in the Canadian agri-food public health sector.

    Science.gov (United States)

    Young, I; Gropp, K; Pintar, K; Waddell, L; Marshall, B; Thomas, K; McEwen, S A; Rajić, A

    2014-12-01

    Policy-makers working at the interface of agri-food and public health often deal with complex and cross-cutting issues that have broad health impacts and socio-economic implications. They have a responsibility to ensure that policy-making based on these issues is accountable and informed by the best available scientific evidence. We conducted a qualitative descriptive study of agri-food public health policy-makers and research and policy analysts in Ontario, Canada, to understand their perspectives on how the policy-making process is currently informed by scientific evidence and how to facilitate this process. Five focus groups of 3-7 participants and five-one-to-one interviews were held in 2012 with participants from federal and provincial government departments and industry organizations in the agri-food public health sector. We conducted a thematic analysis of the focus group and interview transcripts to identify overarching themes. Participants indicated that the following six key principles are necessary to enable and demonstrate evidence-informed policy-making (EIPM) in this sector: (i) establish and clarify the policy objectives and context; (ii) support policy-making with credible scientific evidence from different sources; (iii) integrate scientific evidence with other diverse policy inputs (e.g. economics, local applicability and stakeholder interests); (iv) ensure that scientific evidence is communicated by research and policy stakeholders in relevant and user-friendly formats; (V) create and foster interdisciplinary relationships and networks across research and policy communities; and (VI) enhance organizational capacity and individual skills for EIPM. Ongoing and planned efforts in these areas, a supportive culture, and additional education and training in both research and policy realms are important to facilitate evidence-informed policy-making in this sector. Future research should explore these findings further in other countries and contexts.

  11. Three Phase Six-Switch PWM Buck Rectifier with Power Factor Improvement

    DEFF Research Database (Denmark)

    Zafar Ullah Khan, M; Mohsin Naveed, M.; Hussain, Dil Muhammad Akbar

    2013-01-01

    Conventional Phase Controlled Rectifier injects low order current harmonics into the AC mains. Large size filtering components are required to attenuate these harmonics. In this paper, Three Phase Six-Switch PWM Buck Rectifier[1] is presented which operates at nearly unity power factor and provid...

  12. 1 GHz GaAs Buck Converter for High Power Amplifier Modulation Applications

    NARCIS (Netherlands)

    Busking, E.B.; Hek, A.P. de; Vliet, F.E. van

    2012-01-01

    A fully integrated 1 GHz buck converter output stage, including on-chip inductor and DC output filtering has been realized, in a standard high-voltage breakdown GaAs MMIC technology. This is a significant step forward in designing highspeed power control of supply-modulated HPAs (high power amplifie

  13. Dinucleotide repeat microsatellite markers for buck's-horn plantain (Plantago coronopus)

    NARCIS (Netherlands)

    Koorevaar, G.N.; Ivanovic, S.; Van Damme, J.M.M.; Koelewijn, H.P.; Van 't Westende, W.P.C.; Smulders, M.J.M.; Vosman, B.

    2002-01-01

    Eleven polymorphic microsatellite loci were obtained from a GA enriched genomic library, constructed from DNA of buck's-horn plantain (Plantago coronopus). The microsatellite loci were tested on 24 genotypes. These plants were collected from meadows along the coast, located on 11 sites ranging from

  14. Circuit Simulation for Solar Power Maximum Power Point Tracking with Different Buck-Boost Converter Topologies

    Directory of Open Access Journals (Sweden)

    Jaw-Kuen Shiau

    2014-08-01

    Full Text Available The power converter is one of the essential elements for effective use of renewable power sources. This paper focuses on the development of a circuit simulation model for maximum power point tracking (MPPT evaluation of solar power that involves using different buck-boost power converter topologies; including SEPIC, Zeta, and four-switch type buck-boost DC/DC converters. The circuit simulation model mainly includes three subsystems: a PV model; a buck-boost converter-based MPPT system; and a fuzzy logic MPPT controller. Dynamic analyses of the current-fed buck-boost converter systems are conducted and results are presented in the paper. The maximum power point tracking function is achieved through appropriate control of the power switches of the power converter. A fuzzy logic controller is developed to perform the MPPT function for obtaining maximum power from the PV panel. The MATLAB-based Simulink piecewise linear electric circuit simulation tool is used to verify the complete circuit simulation model.

  15. "Class-Bucks": A Motivational Tool to Encourage Active Student Participation during Lectures

    Science.gov (United States)

    de Jager, T.

    2013-01-01

    The purpose of this study was to ascertain the influence of an extrinsic motivational tool, "class-bucks," on the possibility of improving first year student-teachers' participation in active learning at Tshwane University of Technology in South Africa. Research participants (n=289) were divided into four classes and engaged in this…

  16. Novel Family of modified qZS buck-boost multilevel inverters with reduced switch count

    DEFF Research Database (Denmark)

    Husev, Oleksandr; Strzelecki, Ryszard; Blaabjerg, Frede;

    2015-01-01

    This paper describes a novel family of modified quasi-Z-source buck-boost multilevel inverters with reduced switch count. The inverters are derived by means of the modified inverter configuration with quasi-Z-source networks. The main benefits of the proposed solutions lie in the increased amount...

  17. Transfer function modeling and analysis of the open-loop Buck converter using the fractional calculus

    International Nuclear Information System (INIS)

    Based on the fact that the real inductor and the real capacitor are fractional order in nature and the fractional calculus, the transfer function modeling and analysis of the open-loop Buck converter in a continuous conduction mode (CCM) operation are carried out in this paper. The fractional order small signal model and the corresponding equivalent circuit of the open-loop Buck converter in a CCM operation are presented. The transfer functions from the input voltage to the output voltage, from the input voltage to the inductor current, from the duty cycle to the output voltage, from the duty cycle to the inductor current, and the output impedance of the open-loop Buck converter in CCM operation are derived, and their bode diagrams and step responses are calculated, respectively. It is found that all the derived fractional order transfer functions of the system are influenced by the fractional orders of the inductor and the capacitor. Finally, the realization of the fractional order inductor and the fractional order capacitor is designed, and the corresponding PSIM circuit simulation results of the open-loop Buck converter in CCM operation are given to confirm the correctness of the derivations and the theoretical analysis

  18. Transfer function modeling and analysis of the open-loop Buck converter using the fractional calculus

    Institute of Scientific and Technical Information of China (English)

    Wang Fa-Qiang; Ma Xi-Kui

    2013-01-01

    Based on the fact that the real inductor and the real capacitor are fractional order in nature and the fractional calculus,the transfer function modeling and analysis of the open-loop Buck converter in a continuous conduction mode (CCM) operation are carried out in this paper.The fractional order small signal model and the corresponding equivalent circuit of the open-loop Buck converter in a CCM operation are presented.The transfer functions from the input voltage to the output voltage,from the input voltage to the inductor current,from the duty cycle to the output voltage,from the duty cycle to the inductor current,and the output impedance of the open-loop Buck converter in CCM operation are derived,and their bode diagrams and step responses are calculated,respectively.It is found that all the derived fractional order transfer functions of the system are influenced by the fractional orders of the inductor and the capacitor.Finally,the realization of the fractional order inductor and the fractional order capacitor is designed,and the corresponding PSIM circuit simulation results of the open-loop Buck converter in CCM operation are given to confirm the correctness of the derivations and the theoretical analysis.

  19. Analisys of Current-Bidirectional Buck-Boost Based Automotive Switch-Mode Audio Amplifier

    DEFF Research Database (Denmark)

    Bolten Maizonave, Gert; Andersen, Michael A. E.; Kjærgaard, Claus;

    2011-01-01

    The following study was carried out in order to assess quantitatively the performance of the buck-boost converter when used as switch-mode audio amplifier. It comprises of, to begin with, the delimitation of design criteria based on the state-ofthe- art solution, which is based in a differential ...

  20. Optimized diffusion of buck semen for saving genetic variability in selected dairy goat populations

    Directory of Open Access Journals (Sweden)

    Martin Pierre

    2011-02-01

    Full Text Available Abstract Background Current research on quantitative genetics has provided efficient guidelines for the sustainable management of selected populations: genetic gain is maximized while the loss of genetic diversity is maintained at a reasonable rate. However, actual selection schemes are complex, especially for large domestic species, and they have to take into account many operational constraints. This paper deals with the actual selection of dairy goats where the challenge is to optimize diffusion of buck semen on the field. Three objectives are considered simultaneously: i natural service buck replacement (NSR; ii goat replacement (GR; iii semen distribution of young bucks to be progeny-tested. An appropriate optimization method is developed, which involves five analytical steps. Solutions are obtained by simulated annealing and the corresponding algorithms are presented in detail. Results The whole procedure was tested on two French goat populations (Alpine and Saanen breeds and the results presented in the abstract were based on the average of the two breeds. The procedure induced an immediate acceleration of genetic gain in comparison with the current annual genetic gain (0.15 genetic standard deviation unit, as shown by two facts. First, the genetic level of replacement natural service (NS bucks was predicted, 1.5 years ahead at the moment of reproduction, to be equivalent to that of the progeny-tested bucks in service, born from the current breeding scheme. Second, the genetic level of replacement goats was much higher than that of their dams (0.86 unit, which represented 6 years of selection, although dams were only 3 years older than their replacement daughters. This improved genetic gain could be achieved while decreasing inbreeding coefficients substantially. Inbreeding coefficients (% of NS bucks was lower than that of the progeny-tested bucks (-0.17. Goats were also less inbred than their dams (-0.67. Conclusions It was possible to

  1. Governance processes and change within organizational participants of multi-sectoral community health care alliances: the mediating role of vision, mission, strategy agreement and perceived alliance value.

    Science.gov (United States)

    Hearld, Larry R; Alexander, Jeffrey A

    2014-03-01

    Multi-sectoral community health care alliances are organizations that bring together individuals and organizations from different industry sectors to work collaboratively on improving the health and health care in local communities. Long-term success and sustainability of alliances are dependent on their ability to galvanize participants to take action within their 'home' organizations and institutionalize the vision, goals, and programs within participating organizations and the broader community. The purpose of this study was to investigate two mechanisms by which alliance leadership and management processes may promote such changes within organizations participating in alliances. The findings of the study suggest that, despite modest levels of change undertaken by participating organizations, more positive perceptions of alliance leadership, decision making, and conflict management were associated with a greater likelihood of participating organizations making changes as a result of their participation in the alliance, in part by promoting greater vision, mission, and strategy agreement and higher levels of perceived value. Leadership processes had a stronger relationship with change within participating organizations than decision-making style and conflict management processes. Open-ended responses by participants indicated that participating organizations most often incorporated new measures or goals into their existing portfolio of strategic plans and activities in response to alliance participation.

  2. Contribution analysis as an evaluation strategy in the context of a sector-wide approach: Performance-based health financing in Rwanda

    Directory of Open Access Journals (Sweden)

    Martin Noltze

    2014-12-01

    Full Text Available Sector-wide approaches (SWAps emerged as a response to donor fragmentation and non-adjusted and parallel programming. In the health sector, SWAps have received considerable support by the international donor community due to their potential to reduce inefficiencies through alignment to common procedures and hence to increase development effectiveness. Evaluating development cooperation in the context of a SWAp, however, translates into methodological challenges for evaluators who have to disentangle the cumulative effects in strongly donor-aligned, complex sector environments. In this article the authors discussed the application of a methodological strategy for evaluating development interventions in complex settings – for example in the context of a SWAp –and reflected the suitability of the approach. The authors conducted a contribution analysis, a theory-based approach to evaluation, and exemplified the approach for an intervention of performance-based financing for Rwandan health workers supported by the Rwanda-German cooperation. The findings suggested that the Rwandan system of performance based financing increased service orientation and outputs of health professionals, but also indicated that negative motivational side effects and resource constraints are real. With regard to the methodological approach, the authors conclude that contribution analysis has a high potential to evaluate development cooperation in the context of a SWAp dueto its high flexibility to use different data collection tools and its capability to assess risks and rival explanations. Challenges can be identified with regard to the efficiency of the evaluation strategy and a remaining trade-off between scope and causal strength ofevidence.

  3. Design and manufacturing of sensors and of their interrogation technique for applications in the health and environmental sectors

    OpenAIRE

    Sanogo, Yacouba

    2012-01-01

    The increasing need for compact, selective, ultrasensitive, fast and affordable optical biosensors in the medical and environmental sectors gave rise to new technological solutions, especially regarding sensors based on optical microresonators. If their surfaces are functionalized, these biosensors can provide a selective detection of low concentrations of biomolecules. However, two common optical interrogation methods – spectral scanning and intensity variation – cannot provide the same sens...

  4. Does haute couture become Prêt à Porter? A paper on the fashion industry of the Swedish health care sector

    OpenAIRE

    Erlingsdottir, Gudbjörg; Jonnergård, Karin

    2004-01-01

    Using the metaphores of Haute Couture and Prêt à porter we would like to examine some of the fashions that have been spread in the Swedish health care sector the past two decades. Who are the fashion makers? Who dicides what to import and why? Who are the models demonstrating the last fashion? most of all we wonder if the Haute Couture gets transformd into Prêt à Porter so that it suites and becomes useful to the broad masses. And if not what do people do with fashion?

  5. Regional Disparity in Physical Resources in the Health Sector in Iran: A Comparison of Two Time Periods

    OpenAIRE

    Akbari-Sari, Ali; Rezaei, Satar; Enayatollah HOMAIE-RAD; DEHGHANIAN, Nasim; CHAVEHPOUR, Yousef

    2015-01-01

    Background: One of the major health policy issues, in the both developed and developing countries, is the equality in the distribution of health resources. The aim of this study was to investigate the disparity in the distribution of health physical resources across the provinces of Iran in 2001 and 2011.Methods: This was a cross-sectional retrospective study which investigated inequality in the distribution of health physical resources by three indexes of Gini Coefficient, Gaswirth index and...

  6. Towards a decision support tool for real estate management in the health sector using real options and scenario planning

    NARCIS (Netherlands)

    Reedt Dortland, van M.W.J.; Voordijk, J.T.; Dewulf, G.P.M.R.

    2012-01-01

    Purpose – Uncertainties affecting health organizations inevitably influence real estate decisions since real estate is required to facilitate the primary health process. The purpose of this study is to develop a decision support tool that supports health organisations in defining what flexibility th

  7. Health sector costs of self-reported food allergy in Europe : A patient-based cost of illness study

    NARCIS (Netherlands)

    Fox, Margaret; Mugford, Miranda; Voordouw, Jantine; Cornelisse-Vermaat, Judith; Antonides, Gerrit; de la Hoz Caballer, Belen; Cerecedo, Inma; Zamora, Javier; Rokicka, Ewa; Jewczak, Maciej; Clark, Allan B; Kowalski, Marek L; Papadopoulos, Nikos; Knulst, Anna C; Seneviratne, Suranjith; Belohlavkova, Simona; Asero, Roberto; de Blay, Frederic; Purohit, Ashok; Clausen, Michael; Flokstra de Blok, Bertine; Dubois, Anthony E; Fernandez-Rivas, Montserrat; Burney, Peter; Frewer, Lynn J; Mills, Clare E N

    2013-01-01

    Introduction: Food allergy is a recognized health problem, but little has been reported on its cost for health services. The EuroPrevall project was a European study investigating the patterns, prevalence and socio-economic cost of food allergy. Aims: To investigate the health service cost for food-

  8. Health sector costs of self-reported food allergy in Europe : a patient-based cost of illness study

    NARCIS (Netherlands)

    Fox, Margaret; Mugford, Miranda; Voordouw, Jantine; Cornelisse-Vermaat, Judith; Antonides, Gerrit; de la Hoz Caballer, Belen; Cerecedo, Inma; Zamora, Javier; Rokicka, Ewa; Jewczak, Maciej; Clark, Allan B; Kowalski, Marek L; Papadopoulos, Nikos; Knulst, Anna C; Seneviratne, Suranjith; Belohlavkova, Simona; Asero, Roberto; de Blay, Frederic; Purohit, Ashok; Clausen, Michael; Flokstra de Blok, Bertine; Dubois, Anthony E; Fernandez-Rivas, Montserrat; Burney, Peter; Frewer, Lynn J; Mills, Clare E N

    2013-01-01

    INTRODUCTION: Food allergy is a recognized health problem, but little has been reported on its cost for health services. The EuroPrevall project was a European study investigating the patterns, prevalence and socio-economic cost of food allergy. AIMS: To investigate the health service cost for food-

  9. A prospective, multi-method, multi-disciplinary, multi-level, collaborative, social-organisational design for researching health sector accreditation [LP0560737

    Directory of Open Access Journals (Sweden)

    Braithwaite Jeffrey

    2006-09-01

    Full Text Available Abstract Background Accreditation has become ubiquitous across the international health care landscape. Award of full accreditation status in health care is viewed, as it is in other sectors, as a valid indicator of high quality organisational performance. However, few studies have empirically demonstrated this assertion. The value of accreditation, therefore, remains uncertain, and this persists as a central legitimacy problem for accreditation providers, policymakers and researchers. The question arises as to how best to research the validity, impact and value of accreditation processes in health care. Most health care organisations participate in some sort of accreditation process and thus it is not possible to study its merits using a randomised controlled strategy. Further, tools and processes for accreditation and organisational performance are multifaceted. Methods/design To understand the relationship between them a multi-method research approach is required which incorporates both quantitative and qualitative data. The generic nature of accreditation standard development and inspection within different sectors enhances the extent to which the findings of in-depth study of accreditation process in one industry can be generalised to other industries. This paper presents a research design which comprises a prospective, multi-method, multi-level, multi-disciplinary approach to assess the validity, impact and value of accreditation. Discussion The accreditation program which assesses over 1,000 health services in Australia is used as an exemplar for testing this design. The paper proposes this design as a framework suitable for application to future international research into accreditation. Our aim is to stimulate debate on the role of accreditation and how to research it.

  10. Humanism in War—Analysis on Pearl S. Buck's War Outlook in Dragon Seed%Humanism in War—Analysis on Pearl S.Buck's War Outlook in Dragon Seed

    Institute of Scientific and Technical Information of China (English)

    张婷

    2015-01-01

    Pearl S.Buck is a controversial American writer.Dragon Seed is one of her war novels and arouses some readers'mis-understanding because of the vivid description of human loss.This research will focus on the analysis of the characters'person-ality change before and during the enemies'invasion.And then explore Pearl S.Buck's real attitude towards Chinese Anti-Japa-nese War and her buried war outlook.

  11. NOAA TIFF Graphic- 0.5m Backscatter Mosaic of St. Croix (Buck Island), US Virgin Islands, 2004

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This image represents a 1 meter resolution backscatter mosaic of the north shore of Buck Island, St. Croix, US Virgin Islands.NOAA's NOS/NCCOS/CCMA Biogeography...

  12. GeoTIFF of 3x3 m Bathymetry for Buck Island, St. Croix, 2011, UTM 20N NAD83

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This image represents a LiDAR (Light Detection & Ranging) 3x3 meter resolution bathymetric surface for an area including and surrounding Buck Island Reef...

  13. NOAA ESRI Geotiff- 1m Bathymetry of St. Croix (Buck Island), US Virgin Islands, 2004, UTM 20 WGS84

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This dataset contains an ESRI Geotiff with 1 meter cell size representing the bathymetry of the north shore of Buck Island St. Croix, US Virgin Islands.NOAA's...

  14. NOAA TIFF Graphic- 0.5m Backscatter Mosaic of St. Croix (Buck Island), US Virgin Islands, 2004

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This geotiff represents a 0.5 meter resolution backscatter mosaic of the north shore of Buck Island, St. Croix, US Virgin Islands.NOAA's NOS/NCCOS/CCMA Biogeography...

  15. Avoidance High-Frequency Chattering Second-Order Sliding Mode Controller Design: Buck Converter in Wind Power System

    Directory of Open Access Journals (Sweden)

    Yigeng Huangfu

    2012-01-01

    Full Text Available This paper mainly discussed a method of high-frequency second-order sliding mode control for Buck converter in wind power systems. Because the wind energy of nature is always unpredictable and intermittent, the robust control such as sliding mode control is adopted in past literatures. In order to remove the high frequency chattering problem when the traditional sliding mode achieves convergence, the second order sliding mode algorithm is reviewed firstly. Meanwhile, the Buck converter taken as a step-down converter is usually adopted in wind power system, because of its simple structure and good linearity. Under those conditions, the second order sliding mode controller is designed based on Buck converter, especially in high-power wind generation system. The experimental results illustrate that the theory of second order sliding mode can be used in high-power Buck converter. It provides one novel avoidance high frequency chattering method for the technology development of new energy generation system.

  16. Bathymetry 1M GRID of St. Croix (Buck Island), US Virgin Islands, 2004, UTM 20 WGS84

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This dataset contains an ESRI Grid with 1 meter cell size representing the bathymetry of the north shore of Buck Island St. Croix, US Virgin Islands. NOAA's...

  17. An Evaluation of the Persistence of Blat in Post-Soviet Societies: a Case Study of Ukraine’s Health Services Sector

    Directory of Open Access Journals (Sweden)

    Colin C Williams

    2015-12-01

    Full Text Available The use of personal connections to gain preferential access to goods and services and circumvent formal procedures exists in all countries to varying degrees. In this paper, the aim is to evaluate critically the continuing widespread positive depiction of this practice as a form of friendly help. Studying the health services sector in the city of Mykolayiv in Ukraine, this practice known as blat, widely used in Soviet societies to gain access to goods and services, is shown to persist in post-Soviet market societies but to have transformed. Those possessing connections and access to health services now increasingly view such access-assets as commodities to sell rather than provide them as non-monetised friendly favours. The outcome is a call for blat to be re-theorised more negatively as an exemplar of the darker side of social capital, and for a policy shift from doing nothing to seeking its eradication.

  18. Public Sector Performance

    NARCIS (Netherlands)

    B. Kuhry

    2004-01-01

    The performance of the public sector of national economies is a crucial factor in the race to achieve the goals in the Lisbon Agenda. It is therefore useful to relate differences in performance in education, health care, law and order, and public administration to differences in resource use and nat

  19. Barriers and Potential Improvements for Needle and Syringe Exchange Programs (NSPs) in China: A Qualitative Study from Perspectives of Both Health and Public Security Sectors.

    Science.gov (United States)

    Koo, Fung Kuen; Chen, Xi; Chow, Eric P F; Jing, Jun; Zheng, Jun; Zhao, Junshi; Zhang, Lei

    2015-01-01

    This study explores the acceptability, the barriers to the implementation of needle and syringe exchange programs (NSPs) and the potential improvement strategies in China from the perspectives of governmental health and public security officials. Purposive sampling was used for recruitment of participants who had been involved in NSPs implementation. Semi-Structured individual interviews were conducted in Mandarin to address three aspects of NSPs: (1) participants' attitudes towards NSPs, (2) participants' opinions on the effectiveness and barriers of NSPs, and (3) suggestions for improving the program. Content analysis was used to analyse the translated interview data. A total of 68 participants from 12 Hunan counties were interviewed (34 from each of the Bureau of Health and the Narcotic Division). Both groups recognised the importance and effectiveness of NSPs in HIV prevention, but public security officials regarded NSPs as a temporary intervention in place of punitive measures. Most health officials (32/34) regarded the main barriers to its implementation as administrative and structural, whereas participants from Narcotics Division (n=24) questioned the legitimacy of NSPs and concerned about the poor management of drug users' risk behaviours. Close cooperation between the health and public security sectors, engagement of the drug user community and an enabling policy environment were reportedly to be critical for potential improvements of NSPs in China. Misconceptions about NSPs encourage drug users' addictive behaviour, and an unclear leadership and insufficient support de-motivate the participants from the Bureau of Health and the Narcotics Division to actively support the program implementation.

  20. Oral glucose supplementation improved semen quality and constituents of seminal and blood plasma of NZW buck rabbits in the subtropics

    OpenAIRE

    Attia, Youssef

    2010-01-01

    Youssef A Attia1, A E Abd El Hamid1, Fulvia Bovera2, Mohamed El-Sayed11Department of Animal and Poultry Production, Faculty of Agriculture, Damanhour University, Egypt; 2Department of Scienze Zootecniche e Ispezione degli Alimenti, University of Naples Federico II, Napoli, ItalyAbstract: The effect of different levels of oral glucose supplementation on reproductive performance of New Zealand white buck rabbits was studied on 12 bucks aged 6–7 months, randomly divided among four grou...

  1. The Impact of Occupational Hazard Information on Employee Health and Safety: An Analysis by Professional Sectors in Spain

    Science.gov (United States)

    Saldaria, Miguel Angel Mariscal; Herrero, Susana Garcia; Rodriguez, Javier Garcia; Ritzel, Dale

    2012-01-01

    All workers have the right to perform their job duties under the best possible conditions, safeguarded from the harm which the execution of their duties may entail. In addition, employers have the obligation to guarantee this right to health, implementing a preventive system which assures the safety and health of the workers under their charge.…

  2. Situation analysis of health care waste management in private sector hospitals in federal capital territory, islamabad, pakistan

    International Nuclear Information System (INIS)

    The deleterious and harmful effects of hospital waste on environment and human health is well documented in Pakistan. The hospital waste that may be produced as a result of patient care in hospitals, clinical settings including the diagnostic laboratories is one of the potential health hazards. It significantly contributes to the transfusion transmitted diseases and ever increasing incidence of HBV, HCV and HIV. (author)

  3. Occupational stress and health-related quality of life among public sector bank employees: A cross-sectional study in Mysore, Karnataka, India

    Directory of Open Access Journals (Sweden)

    Sowmya N Malamardi

    2015-01-01

    Full Text Available Background: Occupational morbidities have been estimated to cause an economic loss up to 10–20% of the gross national product of a country. It is an important cause of occupational morbidity and decreased quality of life (QOL for the workers. Aim: The aim of the present study is to assess the level of occupational stress and its association with the QOL among the public sector bank employees. Materials and Methods: The present study was conducted among employees of public sector banks in Mysore district, Karnataka, India. A cross-sectional study design was used for the study. Job stress was measured by using occupational stress index (OSI scale questionnaire and health-related QOL was measured using the short form 12 (SF-12 questionnaire. The sample size estimated for the study was 526 and cluster random sampling technique was used. Chi-square test was used to find the association between the study variables and level of stress. Multiple linear regression model was used to find the determinants of health-related QOL among the study subjects. Results: The total number of the study subjects was 546 out of which 57% were males and 43% were females. The proportion of study subjects reporting to be current smokers was 4.2% and almost all study subjects reported occasional alcohol consumption. The mean physical component summary (PCS score and mental component summary (MCS using the original United States standardization were 47.90 and 48.30, respectively. The individuals with mild stress scored higher in both PCS and MCS than the individuals who had moderate to severe stress levels. There was significant association of health related quality of life with the age of the respondent,presence of at least one morbidity and level of stress with health-related QOL. Conclusion: This study has shown an association of occupational stress with the QOL. There is a need for interventions aimed at mitigating the occupational stress among employees of the banking

  4. A Novel Soft-Switching Synchronous Buck Converter for Portable Applications

    Directory of Open Access Journals (Sweden)

    Anup Kumar Panda

    2008-01-01

    Full Text Available This paper proposes a zero-voltage-transition (ZVT pulse-width-modulated (PWM synchronous buck converter, which is designed to operate at low voltage and high efficiency typically required for portable systems. A new passive auxiliary circuit that allows the main switch to operate with zero-voltage switching has been incorporated in the conventional PWM synchronous buck converter. The operation principles and a detailed steady-state analysis of the ZVT-PWM synchronous converter implemented with the auxiliary circuit are presented. Besides, the main switch and all of the semiconductor devices operate under soft-switching conditions. Thus, the auxiliary circuit provides a larger overall efficiency. The feasibility of the auxiliary circuit is confirmed by simulation and experimental results.

  5. Modelling and Simulation of Closed Loop Controlled Buck Converter Fed Pmbldc Drive System

    Directory of Open Access Journals (Sweden)

    R. Dhanasekaran

    2011-04-01

    Full Text Available Permanent Magnet Brushless DC Motor (PMBLDC is one of the best electrical drives that has increasing popularity, due to their high efficiency, reliability, good dynamic response and very low maintenance. This makes the interest of modeling an ideal PMBLDC motor and it’s associated Drive System in simple and lucid manner. In this paper the drive system is proposed with a buck converter topology. It has the advantages of reduced switching losses, low inductor power loss, reduced ripple by using a pi-filter, which in turn makes the DC link voltage to be stable. The modeling and simulation of the PMBLDC motor is done using the software package MATLAB/SIMULINK. The operation principle of the buck converter is analyzed and the simulation results are presented in this paper to verify the theoretical analysis.

  6. Buck-Boost Control of Four Quadrant Chopper using Symmetrical Impedance Network for Adjustable Speed Drive

    Directory of Open Access Journals (Sweden)

    Saswati Swapna Dash

    2015-02-01

    Full Text Available This paper proposes buck-boost capabilities of four quadrant chopper for wide range speed control of DC motor drives using symmetrical impedance network called Z-source network. By controlling the shoot through duty ratio from 0 to 0.5 and non-shoot through techniques, the Z-source four quadrant choppers can produce any desired DC voltage across the DC motor. The switching patterns for both buck and boost operations are presented to achieve four modes of operation of DC motor. As a result, the proposed model will have ride through capability during voltage sags, manage during voltage swells, used in any types of DC voltage sources such as fuel cell and solar cell and improve the reliability by reducing EMI noise. Analysis and simulation results are presented to demonstrate these new findings.

  7. Reliability-Oriented Design of LC Filter in Buck DC-DC Converter

    DEFF Research Database (Denmark)

    Liu, Yi; Huang, Meng; Wang, Huai;

    2015-01-01

    State-of-the-art LC filter design of buck DC-DC converter is based on the specifications of voltage and current ripples and constrains in power density and cost. Since lifetime is an important performance factor in reliability critical applications, this digest proposes a method to optimize...... the design of the LC filters from a reliability perspective, among other considerations. It investigates the design freedom between the values of inductor and capacitors, the physical formation of the LC network, and the corresponding electro-thermal stresses of the selected capacitors. The outcome enables...... an optimized LC filter design to fulfill the required lifetime. The theoretical analysis and simulation study are presented which are verified by the experimental results from a buck converter prototype....

  8. Incremental Conductance MPPT Algorithm for PV System Implemented Using DC-DC Buck and Boost Converter

    Directory of Open Access Journals (Sweden)

    Dhananjay Choudhary

    2014-08-01

    Full Text Available The two basic topologies of switch mode DC-DC converters (Buck and Boost are analyzed with a view of their use in PV (photovoltaic systems, as the photovoltaic generator exhibits non-linear characteristics due to the change in environmental condition and load variation. As the efficiency of PV panels is low it becomes mandatory to extract maximum power from the PV panel at a given period of time. Several MPPT algorithms with different types of converters are being proposed for extracting maximum power from the PV panel. It is found that the nature of load plays an important role in the choice of topology. This paper investigates the implementation issues of Incremental Conductance method with Buck and Boost Converters. Mathematical analysis and desirable steady-state operating point of the converters are derived to give satisfactory maximum power point tracking operation.

  9. Dynamics and stabilization of peak current-mode controlled buck converter with constant current load

    Institute of Scientific and Technical Information of China (English)

    冷敏瑞; 周国华; 张凯暾; 李振华

    2015-01-01

    The discrete iterative map model of peak current-mode controlled buck converter with constant current load (CCL), containing the output voltage feedback and ramp compensation, is established in this paper. Based on this model the com-plex dynamics of this converter is investigated by analyzing bifurcation diagrams and the Lyapunov exponent spectrum. The effects of ramp compensation and output voltage feedback on the stability of the converter are investigated. Experimental results verify the simulation and theoretical analysis. The stability boundary and chaos boundary are obtained under the theoretical conditions of period-doubling bifurcation and border collision. It is found that there are four operation regions in the peak current-mode controlled buck converter with CCL due to period-doubling bifurcation and border-collision bifur-cation. Research results indicate that ramp compensation can extend the stable operation range and transfer the operating mode, and output voltage feedback can eventually eliminate the coexisting fast-slow scale instability.

  10. Exploring the possibility of a common structural model measuring associations between safety climate factors and safety behaviour in health care and the petroleum sectors.

    Science.gov (United States)

    Olsen, Espen

    2010-09-01

    The aim of the present study was to explore the possibility of identifying general safety climate concepts in health care and petroleum sectors, as well as develop and test the possibility of a common cross-industrial structural model. Self-completion questionnaire surveys were administered in two organisations and sectors: (1) a large regional hospital in Norway that offers a wide range of hospital services, and (2) a large petroleum company that produces oil and gas worldwide. In total, 1919 and 1806 questionnaires were returned from the hospital and petroleum organisation, with response rates of 55 percent and 52 percent, respectively. Using a split sample procedure principal factor analysis and confirmatory factor analysis revealed six identical cross-industrial measurement concepts in independent samples-five measures of safety climate and one of safety behaviour. The factors' psychometric properties were explored with satisfactory internal consistency and concept validity. Thus, a common cross-industrial structural model was developed and tested using structural equation modelling (SEM). SEM revealed that a cross-industrial structural model could be identified among health care workers and offshore workers in the North Sea. The most significant contributing variables in the model testing stemmed from organisational management support for safety and supervisor/manager expectations and actions promoting safety. These variables indirectly enhanced safety behaviour (stop working in dangerous situations) through transitions and teamwork across units, and teamwork within units as well as learning, feedback, and improvement. Two new safety climate instruments were validated as part of the study: (1) Short Safety Climate Survey (SSCS) and (2) Hospital Survey on Patient Safety Culture-short (HSOPSC-short). Based on development of measurements and structural model assessment, this study supports the possibility of a common safety climate structural model across health

  11. Regional Disparity in Physical Resources in the Health Sector in Iran: A Comparison of Two Time Periods

    Directory of Open Access Journals (Sweden)

    Ali AKBARI-SARI

    2015-10-01

    Full Text Available Background: One of the major health policy issues, in the both developed and developing countries, is the equality in the distribution of health resources. The aim of this study was to investigate the disparity in the distribution of health physical resources across the provinces of Iran in 2001 and 2011.Methods: This was a cross-sectional retrospective study which investigated inequality in the distribution of health physical resources by three indexes of Gini Coefficient, Gaswirth index and Index of Dissimilarity. The data on prov-inces were obtained from the yearbook statistics and Ministry of Health, and Medical Education. The Excel software was used to calculated indexes.Results: The finding showed the mean Gini Coefficient for all variables was 0.178 in 2001 and 0.158 in 2011. Besides, the mean Gaswirth index and index of dissimilarity were 11.5 and 1.5% in 2001 and 11 and 1.4% in 2011, respectively.Conclusion: There was slightly inequality in distribution of physical health resources in Iran. According to the results of three indexes, this study showed when Tehran province excluding from total sample, the inequality was decreased.

  12. Regional Disparity in Physical Resources in the Health Sector in Iran: A Comparison of Two Time Periods

    Science.gov (United States)

    AKBARI SARI, Ali; REZAEI, Satar; HOMAIE RAD, Enayatollah; DEHGHANIAN, Nasim; CHAVEHPOUR, Yousef

    2015-01-01

    Background: One of the major health policy issues, in the both developed and developing countries, is the equality in the distribution of health resources. The aim of this study was to investigate the disparity in the distribution of health physical resources across the provinces of Iran in 2001 and 2011. Methods: This was a cross-sectional retrospective study which investigated inequality in the distribution of health physical resources by three indexes of Gini Coefficient, Gaswirth index and Index of Dissimilarity. The data on provinces were obtained from the yearbook statistics and Ministry of Health, and Medical Education. The Excel software was used to calculated indexes. Results: The finding showed the mean Gini Coefficient for all variables was 0.178 in 2001 and 0.158 in 2011. Besides, the mean Gaswirth index and index of dissimilarity were 11.5 and 1.5% in 2001 and 11 and 1.4% in 2011, respectively. Conclusion: There was slightly inequality in distribution of physical health resources in Iran. According to the results of three indexes, this study showed when Tehran province excluding from total sample, the inequality was decreased. PMID:26258098

  13. Two-Phase Interleaved Buck Converter with a new Digital Self-Oscillating Modulkator

    OpenAIRE

    Jakobsen, Lars Tønnes; Andersen, Michael Andreas E.

    2007-01-01

    This paper presents a new Digital Self-Oscillating Modulator (DiSOM) for DC/DC converters. The DiSOM modulator alllows the digital control algorithm to sample the output voltage at a sampling frequency higher than the converter switching frequency. This enables higher control loop bandwidth than for traditional digital PWM modulators given a certain switching frequency. A synchronised version of the DiSOM modulator is derived for interleaved converters. A prototype interleaved Buck converter ...

  14. Adaptive prediction in digitally controlled buck converter with fast load transient response

    OpenAIRE

    Lee, TLA; Chan, PCH

    2012-01-01

    An adaptive prediction scheme based on linear extrapolation for digitally controlled voltage-mode buck-type switching converter is presented. A major drawback of conventional digitally controlled switching converters is bandwidth limitation due to the additional phase lag in the digital feedback control loop. By predicting the future error voltage, the ADC sampling time delay is compensated in order to achieve a higher bandwidth even with a modest sampling rate. Both simulation and measuremen...

  15. Adaptive High-Bandwidth Digitally Controlled Buck Converter with Improved Line and Load Transient Response

    OpenAIRE

    Lee, ATL; Sin, JKO; Chan, PCH

    2014-01-01

    Digitally controlled switching converter suffers from bandwidth limitation because of the additional phase delay in the digital feedback control loop. In order to overcome the bandwidth limitation without using a high sampling rate, this paper presents an adaptive third-order digital controller for regulating a voltage-mode buck converter with a modest 2x oversampling ratio. The phase lag due to the ADC conversion time delay is virtually compensated by providing an early estimation of the err...

  16. Design and implementation of an observer controller for a buck converter

    OpenAIRE

    LAKSHMI, Shenbaga; RAJA, T. Sree Renga

    2014-01-01

    An observer controller for a buck converter is presented. A state feedback gain matrix is derived in order to achieve the stability of the converter and to ensure the robustness of the controller. A load estimator is designed to estimate the unmeasurable variables and to obtain the zero output voltage error. A pulse-width modulation scheme is adopted to obtain the output voltage regulation. In order to improve the transitory response and dynamic constancy of the converter, the controlle...

  17. Buck-Boost/Forward Hybrid Converter for PV Energy Conversion Applications

    OpenAIRE

    Sheng-Yu Tseng; Chien-Chih Chen; Hung-Yuan Wang

    2014-01-01

    This paper presents a charger and LED lighting (discharger) hybrid system with a PV array as its power source for electronic sign indicator applications. The charger adopts buck-boost converter which is operated in constant current mode to charge lead-acid battery and with the perturb and observe method to extract maximum power of PV arrays. Their control algorithms are implemented by microcontroller. Moreover, forward converter with active clamp circuit is operated in voltage regulation cond...

  18. 1 GHz GaAs Buck Converter for High Power Amplifier Modulation Applications

    OpenAIRE

    Busking, E.B.; Hek, A.P. de; Vliet, F.E. van

    2012-01-01

    A fully integrated 1 GHz buck converter output stage, including on-chip inductor and DC output filtering has been realized, in a standard high-voltage breakdown GaAs MMIC technology. This is a significant step forward in designing highspeed power control of supply-modulated HPAs (high power amplifiers). Agile power controlled HPAs are intended to find application in high-efficiency transmitters for both radio communication and radar applications, especially in which phased array transmit chai...

  19. Simulation and Implementation a Non-Isolated Buck Converter at ZCS Condition

    Directory of Open Access Journals (Sweden)

    Nahid Hematian

    2013-10-01

    Full Text Available A new soft-switching resonant inverting-buck converter with high efficiency is presented. The proposed converter steps down and inverts the input voltage. The zero-current-switching (ZCS technique is employed to reduce switching losses and Electromagnetic Interferences (EMI. An LLC resonant network is utilized to provide soft-switching conditions for all semiconductor devices. Experimental results verify the integrity of the proposed converter operation and the presented theoretical analysis.

  20. Optimization of Power MOSFET for High-Frequency Synchronous Buck Converter

    OpenAIRE

    Bai, Yuming

    2003-01-01

    Evolutions in microprocessor technology require the use of a high-frequency synchronous buck converter (SBC) in order to achieve low cost, low profile, fast transient response and high power density. However, high frequency also causes more power loss on MOSFETs. Optimization of the MOSFETs plays an important role in the system performance. Circuit and device modeling is important in understanding the relationship between the device parameters and the power loss. The gate-to-drain charge ...