WorldWideScience

Sample records for countries lack access

  1. Millions of cancer victims in developing countries lack access to life-saving radiotherapy

    International Nuclear Information System (INIS)

    2003-01-01

    The number of cancer patients in the developing world will double to 10 million new cases annually by 2015 (World Cancer Report, World Health Organization, 2003), most of whom will have no access to the radiation therapy that could save or prolong their lives, and decrease their pain and suffering, the International Atomic Energy Agency (IAEA) says. Radiotherapy ranks with surgery as the most important methods of curing local cancer, according to the World Health Organization (WHO). 'A silent crisis in cancer treatment exists in developing countries and is intensifying every year,' says Mohamed ElBaradei, IAEA Director General. Over the next decade, the IAEA estimates that at least $2.5 billion is needed to provide adequate treatment facilities in the developing world, half to purchase machines, and half to train the physicians and physicists required to ensure safe and effective treatment. The IAEA works in partnership with the WHO on most of its cancer projects. The WHO works to address the full spectrum of the health-disease continuum from prevention to end-of-life care. The role of the IAEA in cancer control programs has grown rapidly as radiotherapy and nuclear imaging become increasingly important for the management of cancer. IAEA programmes in some 80 countries around the world demonstrate the value of radiation therapy. The four main IAEA goals are: Mobilizing the required funding to bring machines and training for local specialists in the 15 African countries that do not have any and where the technology is sustainable; Increasing the number of machines to enable people to access radiation therapy when they need it - to a far higher proportion than the present one machine for one million people; Increasing the utilization of existing machines by training more doctors and other health professionals in their safe and effective use; Establishing good clinical and safety practices in radiotherapy institutions. With help from the IAEA, modern radiotherapy

  2. Psychosocial impacts of the lack of access to water and sanitation in low- and middle-income countries: a scoping review.

    Science.gov (United States)

    Bisung, Elijah; Elliott, Susan J

    2017-02-01

    The lack of access to safe water and adequate sanitation has implications for the psychosocial well-being of individuals and households. To review the literature on psychosocial impacts, we completed a scoping review of the published literature using Medline, Embase, and Scopus. Fifteen studies met the inclusion criteria and were reviewed in detail. Of the included studies, six were conducted in India, one in Nepal, one in Mexico, one in Bolivia, two in Ethiopia, one in Zimbabwe, one in South Africa, and two in Kenya. Four interrelated groups of stressors emerged from the review: physical stressors, financial stressors, social stressors, and stressors related to (perceived) inequities. Further, gender differences were observed, with women carrying a disproportionate psychosocial burden. We argue that failure to incorporate psychosocial stressors when estimating the burden or benefits of safe water and sanitation may mask an important driver of health and well-being for many households in low- and middle-income countries. We propose further research on water-related stressors with particular attention to unique cultural norms around water and sanitation, short and long term psychosocial outcomes, and individual and collective coping strategies. These may help practitioners better understand cumulative impacts and mechanisms for addressing water and sanitation challenges.

  3. Improving access to transport in developing countries

    CSIR Research Space (South Africa)

    Savill, T

    2003-06-01

    Full Text Available Improving access and mobility of people with disabilities is an essential component of the alleviation of poverty in developing countries. Disabled people are among the most socially excluded members of society and poorly designed and inaccessible...

  4. Access to Information in the Nordic Countries

    DEFF Research Database (Denmark)

    Jørgensen, Oluf

    Access to Information in the Nordic Countries explains and compares the legal rules determining public access to documents and data in Sweden, Finland, Denmark, Norway, and Iceland. In addition, international rules emanating from the United Nations, the Council of Europe and the European Union...

  5. Lack of research-based standards for accessible housing

    DEFF Research Database (Denmark)

    Helle, Tina; Brandt, Åse; Slaug, Bjørn

    2011-01-01

    openings at the entrance (defined ≥75cm) implied that the proportion of dwellings not meeting it was 11.3% compared to 64.4%, if the standard was set to ≥83cm. The proportion of individuals defined as having accessibility problems for profiles not using of mobility devices was 4-5%, 57% for profiles using...

  6. Undocumented migrants lack access to pregnancy care and prevention

    Directory of Open Access Journals (Sweden)

    Andreoli Nicole

    2008-03-01

    Full Text Available Abstract Background Illegal migration is an increasing problem worldwide and the so-called undocumented migrants encounter major problems in access to prevention and health care. The objective of the study was to compare the use of preventive measures and pregnancy care of undocumented pregnant migrants with those of women from the general population of Geneva, Switzerland. Methods Prospective cohort study including pregnant undocumented migrants presenting to the University hospital from February 2005 to October 2006. The control group consisted of a systematic sample of pregnant women with legal residency permit wishing to deliver at the same public hospital during the same time period. Results 161 undocumented and 233 control women were included in the study. Mean ages were 29.4 y (SD 5.8 and 31.1 y (SD 4.8 (p Conclusion Compared to women who are legal residents of Geneva, undocumented migrants have more unintended pregnancies and delayed prenatal care, use fewer preventive measures and are exposed to more violence during pregnancy. Not having a legal residency permit therefore suggests a particular vulnerability for pregnant women. This study underscores the need for better access to prenatal care and routine screening for violence exposure during pregnancy for undocumented migrants. Furthermore, health care systems should provide language- and culturally-appropriate education on contraception, family planning and cervical cancer screening.

  7. Open Access in Turkey and Comparison with Other Countries

    Directory of Open Access Journals (Sweden)

    Bülent Karasözen

    2010-06-01

    Full Text Available The number of open access journals and institutional repositories, as a product of open access movement has grown rapidly in recent years. Open access research articles remove the barriers in accessing scientific research results and accelerate the communication among the scientist worldwide. In many countries the number of institutional archives and open access journal are increasing. In this article, the recent developments in open access journals, institutional repositories and open courseware in Turkey are summarized and compared with some countries. A sample mandatory institutional repository policy document is given with some suggestion for establishing open access in Turkey.

  8. Access to parks and physical activity: an eight country comparison

    DEFF Research Database (Denmark)

    Schipperijn, Jasper; Cerin, Ester; Adams, Marc A

    2017-01-01

    Abstract Several systematic reviews have reported mixed associations between access to parks and physical activity, and suggest that this is due to inconsistencies in the study methods or differences across countries. An international study using consistent methods is needed to investigate...... the association between access to parks and physical activity. The International Physical Activity and Environment Network (IPEN) Adult Study is a multi-country cross-sectional study using a common design and consistent methods Accelerometer, survey and Geographic Information Systems (GIS) data for 6......,181 participants from 12 cities in 8 countries (Belgium, Brazil, Czech Republic, Denmark, Mexico, New Zealand, UK, USA) were used to estimate the strength and shape of associations of 11 measures of park access (1 perceived and 10 GIS-based measures) with accelerometer-based moderate-to-vigorous physical activity...

  9. A Conceptual Framework of Mapping Access to Health Care across EU Countries: The Patient Access Initiative.

    Science.gov (United States)

    Souliotis, Kyriakos; Hasardzhiev, Stanimir; Agapidaki, Eirini

    Research evidence suggests that access to health care is the key influential factor for improved population health outcomes and health care system sustainability. Although the importance of addressing barriers in access to health care across European countries is well documented, little has been done to improve the situation. This is due to different definitions, approaches and policies, and partly due to persisting disparities in access within and between European countries. To bridge this gap, the Patient Access Partnership (PACT) developed (a) the '5As' definition of access, which details the five critical elements (adequacy, accessibility, affordability, appropriateness, and availability) of access to health care, (b) a multi-stakeholders' approach for mapping access, and (c) a 13-item questionnaire based on the 5As definition in an effort to address these obstacles and to identify best practices. These tools are expected to contribute effectively to addressing access barriers in practice, by suggesting a common framework and facilitating the exchange of knowledge and expertise, in order to improve access to health care between and within European countries. © 2016 S. Karger AG, Basel.

  10. Does lack of resources impair access to breast and cervical cancer screening in Japan?

    Science.gov (United States)

    Sano, Hiroshi; Goto, Rei; Hamashima, Chisato

    2017-01-01

    To assess the impact of the quantity of resources for breast and cervical cancer screening on the participation rates in screening in clinical settings in municipalities, as well as to clarify whether lack of resources impairs access to cancer screening in Japan. Of the 1,746 municipalities in 2010, 1,443 (82.6%) and 1,469 (84.1%) were included in the analyses for breast and cervical cancer screening, respectively. In order to estimate the effects of the number of mammography units and of gynecologists on the participation rates in breast and cervical cancer screening in clinical settings, multiple regression analyses were performed using the interaction term for urban municipalities. The average participation rate in screening in clinical settings was 6.01% for breast cancer, and was 8.93% for cervical cancer. The marginal effect of the number of mammography units per 1,000 women was significantly positive in urban municipalities (8.20 percent point). The marginal effect of the number of gynecologists per 1,000 women was significantly positive in all municipalities (2.54 percent point) and rural municipalities (3.68 percent point). Lack of mammography units in urban areas and of gynecologists particularly in rural areas impaired access to breast and cervical cancer screening. Strategies are required that quickly improve access for the residents and increase their participation rates in cancer screening.

  11. Access to Orphan Drugs: A Comprehensive Review of Legislations, Regulations and Policies in 35 Countries.

    Science.gov (United States)

    Gammie, Todd; Lu, Christine Y; Babar, Zaheer Ud-Din

    2015-01-01

    To review existing regulations and policies utilised by countries to enable patient access to orphan drugs. A review of the literature (1998 to 2014) was performed to identify relevant, peer-reviewed articles. Using content analysis, we synthesised regulations and policies for access to orphan drugs by type and by country. Fifty seven articles and 35 countries were included in this review. Six broad categories of regulation and policy instruments were identified: national orphan drug policies, orphan drug designation, marketing authorization, incentives, marketing exclusivity, and pricing and reimbursement. The availability of orphan drugs depends on individual country's legislation and regulations including national orphan drug policies, orphan drug designation, marketing authorization, marketing exclusivity and incentives such as tax credits to ensure research, development and marketing. The majority of countries (27/35) had in place orphan drug legislation. Access to orphan drugs depends on individual country's pricing and reimbursement policies, which varied widely between countries. High prices and insufficient evidence often limit orphan drugs from meeting the traditional health technology assessment criteria, especially cost-effectiveness, which may influence access. Overall many countries have implemented a combination of legislations, regulations and policies for orphan drugs in the last two decades. While these may enable the availability and access to orphan drugs, there are critical differences between countries in terms of range and types of legislations, regulations and policies implemented. Importantly, China and India, two of the largest countries by population size, both lack national legislation for orphan medicines and rare diseases, which could have substantial negative impacts on their patient populations with rare diseases.

  12. Access to Orphan Drugs: A Comprehensive Review of Legislations, Regulations and Policies in 35 Countries.

    Directory of Open Access Journals (Sweden)

    Todd Gammie

    Full Text Available To review existing regulations and policies utilised by countries to enable patient access to orphan drugs.A review of the literature (1998 to 2014 was performed to identify relevant, peer-reviewed articles. Using content analysis, we synthesised regulations and policies for access to orphan drugs by type and by country.Fifty seven articles and 35 countries were included in this review. Six broad categories of regulation and policy instruments were identified: national orphan drug policies, orphan drug designation, marketing authorization, incentives, marketing exclusivity, and pricing and reimbursement. The availability of orphan drugs depends on individual country's legislation and regulations including national orphan drug policies, orphan drug designation, marketing authorization, marketing exclusivity and incentives such as tax credits to ensure research, development and marketing. The majority of countries (27/35 had in place orphan drug legislation. Access to orphan drugs depends on individual country's pricing and reimbursement policies, which varied widely between countries. High prices and insufficient evidence often limit orphan drugs from meeting the traditional health technology assessment criteria, especially cost-effectiveness, which may influence access.Overall many countries have implemented a combination of legislations, regulations and policies for orphan drugs in the last two decades. While these may enable the availability and access to orphan drugs, there are critical differences between countries in terms of range and types of legislations, regulations and policies implemented. Importantly, China and India, two of the largest countries by population size, both lack national legislation for orphan medicines and rare diseases, which could have substantial negative impacts on their patient populations with rare diseases.

  13. The Political Business Cycles of EU Accession Countries

    NARCIS (Netherlands)

    M. Hallerberg; L. Vinhas de Souza

    2000-01-01

    textabstractThis paper considers whether political business cycles exist in Eastern European accession countries. Section I introduces the overall objectives of the work. Section II provides a short introduction to the political business cycle literature. It also considers the role of exchange

  14. Patient Access to Medicines for Rare Diseases in European Countries.

    Science.gov (United States)

    Detiček, Andreja; Locatelli, Igor; Kos, Mitja

    2018-05-01

    The number of authorized orphan and non-orphan medicines for rare diseases has increased in Europe. Patient access to these medicines is affected by high costs, weak efficacy/safety evidence, and societal value. European health care systems must determine whether paying for expensive treatments for only a few patients is sustainable. This study aimed to evaluate patient access to orphan and non-orphan medicines for rare diseases in 22 European countries during 2005 to 2014. Medicines for rare diseases from the Orphanet list, authorized during 2005 to 2014, were searched for in the IMS MIDAS Quarterly Sales Data, January 2005 - December 2014 (IQVIA, Danbury, CT). The following three measures were determined for each country: number of available medicines, median time to continuous use, and medicine expenditure. A medicine was considered available if uninterrupted sales within a 1-year period were detected. From 2005 to 2014, 125 medicines were authorized and 112 were found in the search. Of those, between 70 (63%) and 102 (91%) were available in Germany, the United Kingdom, Italy, France, and the Scandinavian countries. These countries were also the fastest to enable continuous use (3-9 mo). Only 27% to 38% of authorized medicines were available in Greece, Ireland, Bulgaria, Romania, and Croatia, which took 1 to 2.6 years to begin continuous use. A country's expenditure on medicines for rare diseases in 2014 ranged between €0.2 and €31.9/inhabitant. Patient access to medicines for rare diseases varies largely across Europe. Patients in Germany, Scandinavian countries, Switzerland, France, and the United Kingdom can access larger numbers of medicines in shorter time. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  15. Understanding access to medicines in low- and middle-income countries through the use of price and availability indicators

    NARCIS (Netherlands)

    Cameron, A.M.

    2013-01-01

    Objectives: While it is generally understood that large sections of the population in low- and middle-income countries (LMICs) lack access to medicines, the concept of access is difficult to define and measure.Data on medicine prices and availability obtained through national facility-based surveys

  16. Access to Orphan Drugs: A Comprehensive Review of Legislations, Regulations and Policies in 35 Countries

    Science.gov (United States)

    Gammie, Todd

    2015-01-01

    Objective To review existing regulations and policies utilised by countries to enable patient access to orphan drugs. Methods A review of the literature (1998 to 2014) was performed to identify relevant, peer-reviewed articles. Using content analysis, we synthesised regulations and policies for access to orphan drugs by type and by country. Results Fifty seven articles and 35 countries were included in this review. Six broad categories of regulation and policy instruments were identified: national orphan drug policies, orphan drug designation, marketing authorization, incentives, marketing exclusivity, and pricing and reimbursement. The availability of orphan drugs depends on individual country’s legislation and regulations including national orphan drug policies, orphan drug designation, marketing authorization, marketing exclusivity and incentives such as tax credits to ensure research, development and marketing. The majority of countries (27/35) had in place orphan drug legislation. Access to orphan drugs depends on individual country’s pricing and reimbursement policies, which varied widely between countries. High prices and insufficient evidence often limit orphan drugs from meeting the traditional health technology assessment criteria, especially cost-effectiveness, which may influence access. Conclusions Overall many countries have implemented a combination of legislations, regulations and policies for orphan drugs in the last two decades. While these may enable the availability and access to orphan drugs, there are critical differences between countries in terms of range and types of legislations, regulations and policies implemented. Importantly, China and India, two of the largest countries by population size, both lack national legislation for orphan medicines and rare diseases, which could have substantial negative impacts on their patient populations with rare diseases. PMID:26451948

  17. Telecommunications (Interception and Access) and Its Regulation in Arab Countries

    OpenAIRE

    Kiswani, Nazzal

    2010-01-01

    Telecommunication has been a necessity in all countries this century. Communication has always been an essential part of our lives, education, family relations, business, government and other organizational activities. As telecommunication technology has advanced, so has the need for the interception of telecommunications and access by law enforcement authorities. In addition, lawful interception and the way it is performed have played an important role in the effectiveness of the monitoring ...

  18. Innovative Approaches to Increase Access to Medicines in Developing Countries

    Directory of Open Access Journals (Sweden)

    Hilde Stevens

    2017-12-01

    Full Text Available Access to essential medicines is problematic for one third of all persons worldwide. The price of many medicines (i.e., drugs, vaccines, and diagnostics is unaffordable to the majority of the population in need, especially in least-developed countries, but also increasingly in middle-income countries. Several innovative approaches, based on partnerships, intellectual property, and pricing, are used to stimulate innovation, promote healthcare delivery, and reduce global health disparities. No single approach suffices, and therefore stakeholders need to further engage in partnerships promoting knowledge and technology transfer in assuring essential medicines to be manufactured, authorized, and distributed in low- and middle-income countries (LMICs in an effort of making them available at affordable and acceptable conditions.

  19. Public opinion towards castration without anaesthesia and lack of access to pasture in beef cattle production.

    Science.gov (United States)

    Lemos Teixeira, Dayane; Larraín, Rafael; Melo, Oscar; Hötzel, María José

    2018-01-01

    Recent publications have shown that citizens in developing nations are gaining interest in farm animal welfare. The aims of this study were to assess the opinion of Chilean citizens about surgical castration without anaesthesia and lack of access to pasture in beef cattle production, to investigate how involvement in livestock production influences opinions, and to evaluate if different types of information would affect their opinion towards these management practices. The study was carried out in the Metropolitan Region of Santiago, Chile, and consisted of two surveys with 400 participants in each study. The first one used an online, self-administered questionnaire and the second one used a face to face questionnaire. The second questionnaire had four information treatments assigned randomly to survey participants (no information; negative information; negative and positive information; positive information). Most participants were aware that the two management practices are common in beef production systems and were opposed to them. Involvement in animal production was associated with greater acceptance of both management practices and participants that had visited a beef production farm before the study were more likely to support castration without anaesthesia in Survey 1. Belonging to any socioeconomic group and providing negative or positive information had no impact on participants' opinion. The results show a disconnection between the views of participants recruited for this study and beef production systems that do not provide pain control for male cattle surgical castration or provide little or no access to pasture.

  20. Improving access to medicines in low and middle income countries: corporate responsibilities in context.

    Science.gov (United States)

    Leisinger, Klaus Michael; Garabedian, Laura Faden; Wagner, Anita Katharina

    2012-12-01

    More than two billion people in low- and middle-income countries (LMIC) lack adequate access to essential medicines. In this paper, we make strong public health, human rights and economic arguments for improving access to medicines in LMIC and discuss the different roles and responsibilities of key stakeholders, including national governments, the international community, and non-governmental organizations (NGOs). We then establish a framework of pharmaceutical firms' corporate responsibilities - the "must," the "ought to," and the "can" dimensions - and make recommendations for actionable business strategies for improving access to medicines. We discuss controversial topics, such as pharmaceutical profits and patents, with the goal of building consensus around facts and working towards a solution. We conclude that partnerships and collaboration among multiple stakeholders are urgently needed to improve equitable access to medicines in LMIC.

  1. Girls' Access to Education in a Developing Country

    Science.gov (United States)

    Geissinger, Helen

    1997-09-01

    Papua New Guinea is a developing country which gained its independence from Australia in 1975. Many of its educational structures inherited from the time of the early missions and the colonial administration influence the practices of today. Women have not advanced in the new country as far as was prophesied in the early 1970s leading up to Independence. Although the current poor economic conditions have some effect on women's advancement, the difficulties they face in even obtaining a basic education form one of the major factors which hinder their progress. This paper describes a number of the barriers which prevent girls from accessing education at every level, from gaining enrolment in the first year of school to positioning themselves for university entry. Distance education provides one of the few "second chances" that young Papua New Guineans can gain, provided they can afford the fees and engage with the somewhat independent study required for success.

  2. Availability, accessibility, and affordability of neurodiagnostic tests in 37 countries.

    Science.gov (United States)

    McLane, Hannah C; Berkowitz, Aaron L; Patenaude, Bryan N; McKenzie, Erica D; Wolper, Emma; Wahlster, Sarah; Fink, Günther; Mateen, Farrah J

    2015-11-03

    To determine the availability, accessibility, and affordability of EEG, EMG, CSF analysis, head CT, and brain MRI for neurologic disorders across countries. An online, 60-question survey was distributed to neurology practitioners in 2014 to assess the presence, wait time, and cost of each test in private and public health sectors. Data were stratified by World Bank country income group. Affordability was calculated with reference to the World Health Organization's definition of catastrophic health expenditure as health-related out-of-pocket expenditure of >40% of disposable household income, and assessment of providers' perceptions of affordability to the patient. Availability of EEG and EMG is correlated with higher World Bank income group (correlation coefficient 0.38, test for trend p = 0.046; 0.376, p = 0.043); CSF, CT, and MRI did not show statistically significant associations with income groups. Patients in public systems wait longer for neurodiagnostic tests, especially MRI, EEG, and urgent CT (p private sector (US $55.25 vs $214.62, p income group is associated with a 29% decrease in the estimated share of the population who can afford a given test (95% confidence interval -33.4, 25.2; p income countries surveyed, only the top 10% or 20% of the population was able to afford tests below catastrophic levels. In surveyed lower-middle-income countries, >40% of the population, on average, could not afford neurodiagnostic tests. Neurodiagnostic tests are least affordable in the lowest income settings. Closing this "diagnostic gap" for countries with the lowest incomes is essential. © 2015 American Academy of Neurology.

  3. Household food access and child malnutrition: results from the eight-country MAL-ED study.

    Science.gov (United States)

    Psaki, Stephanie; Bhutta, Zulfiqar A; Ahmed, Tahmeed; Ahmed, Shamsir; Bessong, Pascal; Islam, Munirul; John, Sushil; Kosek, Margaret; Lima, Aldo; Nesamvuni, Cebisa; Shrestha, Prakash; Svensen, Erling; McGrath, Monica; Richard, Stephanie; Seidman, Jessica; Caulfield, Laura; Miller, Mark; Checkley, William

    2012-12-13

    Stunting results from decreased food intake, poor diet quality, and a high burden of early childhood infections, and contributes to significant morbidity and mortality worldwide. Although food insecurity is an important determinant of child nutrition, including stunting, development of universal measures has been challenging due to cumbersome nutritional questionnaires and concerns about lack of comparability across populations. We investigate the relationship between household food access, one component of food security, and indicators of nutritional status in early childhood across eight country sites. We administered a socioeconomic survey to 800 households in research sites in eight countries, including a recently validated nine-item food access insecurity questionnaire, and obtained anthropometric measurements from children aged 24 to 60 months. We used multivariable regression models to assess the relationship between household food access insecurity and anthropometry in children, and we assessed the invariance of that relationship across country sites. Average age of study children was 41 months. Mean food access insecurity score (range: 0-27) was 5.8, and varied from 2.4 in Nepal to 8.3 in Pakistan. Across sites, the prevalence of stunting (42%) was much higher than the prevalence of wasting (6%). In pooled regression analyses, a 10-point increase in food access insecurity score was associated with a 0.20 SD decrease in height-for-age Z score (95% CI 0.05 to 0.34 SD; p = 0.008). A likelihood ratio test for heterogeneity revealed that this relationship was consistent across countries (p = 0.17). Our study provides evidence of the validity of using a simple household food access insecurity score to investigate the etiology of childhood growth faltering across diverse geographic settings. Such a measure could be used to direct interventions by identifying children at risk of illness and death related to malnutrition.

  4. Household food access and child malnutrition: results from the eight-country MAL-ED study

    Directory of Open Access Journals (Sweden)

    Psaki Stephanie

    2012-12-01

    Full Text Available Abstract Background Stunting results from decreased food intake, poor diet quality, and a high burden of early childhood infections, and contributes to significant morbidity and mortality worldwide. Although food insecurity is an important determinant of child nutrition, including stunting, development of universal measures has been challenging due to cumbersome nutritional questionnaires and concerns about lack of comparability across populations. We investigate the relationship between household food access, one component of food security, and indicators of nutritional status in early childhood across eight country sites. Methods We administered a socioeconomic survey to 800 households in research sites in eight countries, including a recently validated nine-item food access insecurity questionnaire, and obtained anthropometric measurements from children aged 24 to 60 months. We used multivariable regression models to assess the relationship between household food access insecurity and anthropometry in children, and we assessed the invariance of that relationship across country sites. Results Average age of study children was 41 months. Mean food access insecurity score (range: 0–27 was 5.8, and varied from 2.4 in Nepal to 8.3 in Pakistan. Across sites, the prevalence of stunting (42% was much higher than the prevalence of wasting (6%. In pooled regression analyses, a 10-point increase in food access insecurity score was associated with a 0.20 SD decrease in height-for-age Z score (95% CI 0.05 to 0.34 SD; p = 0.008. A likelihood ratio test for heterogeneity revealed that this relationship was consistent across countries (p = 0.17. Conclusions Our study provides evidence of the validity of using a simple household food access insecurity score to investigate the etiology of childhood growth faltering across diverse geographic settings. Such a measure could be used to direct interventions by identifying children at risk of illness and

  5. Access to sustainable energy in emerging and developing countries: exploring multi-stakeholder partnerships and emerging business models on an international-to-local scale

    NARCIS (Netherlands)

    van den Buuse, D.; Kolk, A.; Pinkse, J.

    2012-01-01

    The critical role of access to energy in developing countries is widely recognized as a condition for sustainable development, given that at present an estimated 1.4 billion people in developing countries still lack access to electricity, while the Millennium Development Goals (MDGs) stipulate that

  6. Young peoples’ access to working life in three Nordic countries

    DEFF Research Database (Denmark)

    Jørgensen, Christian Helms

    2018-01-01

    While working life in the Nordic countries generally has a high quality, the question examined in this chapter is how accessible working life is for young people. The chapter examines how upper secondary vocational education (VET) is connected to working life and how it supports young peoples......’ transitions to the labour market in Norway, Denmark and Sweden. The examination includes a conceptual discussion of the links between education and working life in comparative research on VET and transition systems. It explores how the VET systems match the educational demand of young people with the skills...... requirements in working life. In addition, it examines young peoples’ transitions to working life in two selected industries, health care and construction. Also, three new, innovative institutions to mediate between VET and working life are investigat-ed....

  7. Erupted frothy xenoliths may explain lack of country-rock fragments in plutons

    Science.gov (United States)

    Burchardt, Steffi; Troll, Valentin R.; Schmeling, Harro; Koyi, Hemin; Blythe, Lara

    2016-01-01

    Magmatic stoping is discussed to be a main mechanism of magma emplacement. As a consequence of stoping, abundant country-rock fragments should occur within, and at the bottom of, magma reservoirs as “xenolith graveyards”, or become assimilated. However, the common absence of sufficient amounts of both xenoliths and crustal contamination have led to intense controversy about the efficiency of stoping. Here, we present new evidence that may explain the absence of abundant country-rock fragments in plutons. We report on vesiculated crustal xenoliths in volcanic rocks that experienced devolatilisation during heating and partial melting when entrained in magma. We hypothesise that the consequential inflation and density decrease of the xenoliths allowed them to rise and become erupted instead of being preserved in the plutonic record. Our thermomechanical simulations of this process demonstrate that early-stage xenolith sinking can be followed by the rise of a heated, partially-molten xenolith towards the top of the reservoir. There, remnants may disintegrate and mix with resident magma or erupt. Shallow-crustal plutons emplaced into hydrous country rocks may therefore not necessarily contain evidence of the true amount of magmatic stoping during their emplacement. Further studies are needed to quantify the importance of frothy xenolith in removing stoped material. PMID:27804996

  8. How Can Pricing and Reimbursement Policies Improve Affordable Access to Medicines? Lessons Learned from European Countries.

    Science.gov (United States)

    Vogler, Sabine; Paris, Valérie; Ferrario, Alessandra; Wirtz, Veronika J; de Joncheere, Kees; Schneider, Peter; Pedersen, Hanne Bak; Dedet, Guillaume; Babar, Zaheer-Ud-Din

    2017-06-01

    This article discusses pharmaceutical pricing and reimbursement policies in European countries with regard to their ability to ensure affordable access to medicines. A frequently applied pricing policy is external price referencing. While it provides some benchmark for policy-makers and has been shown to be able to generate savings, it may also contribute to delay in product launch in countries where medicine prices are low. Value-based pricing has been proposed as a policy that promotes access while rewarding useful innovation; however, implementing it has proven quite challenging. For high-priced medicines, managed-entry agreements are increasingly used. These agreements allow policy-makers to manage uncertainty and obtain lower prices. They can also facilitate earlier market access in case of limited evidence about added therapeutic value of the medicine. However, these agreements raise transparency concerns due to the confidentiality clause. Tendering as used in the hospital and offpatent outpatient sectors has been proven to reduce medicine prices but it requires a robust framework and appropriate design with clear strategic goals in order to prevent shortages. These pricing and reimbursement policies are supplemented by the widespread use of Health Technology Assessment to inform decision-making, and by strategies to improve the uptake of generics, and also biosimilars. While European countries have been implementing a set of policy options, there is a lack of thorough impact assessments of several pricing and reimbursement policies on affordable access. Increased cooperation between authorities, experience sharing and improving transparency on price information, including the disclosure of confidential discounts, are opportunities to address current challenges.

  9. The Schizotypal Personality Questionnaire-Brief lacks measurement invariance across three countries.

    Science.gov (United States)

    Liu, Shujuan; Mellor, David; Ling, Mathew; Saiz, José L; Vinet, Eugenia V; Xu, Xiaoyan; Renati, Solomon; Byrne, Linda K

    2017-12-01

    The Schizotypal Personality Questionnaire-Brief (SPQ-B) is a commonly-used tool for measuring schizotypal personality traits and due to its wide application, its cross-cultural validity is of interest. Previous studies suggest that the SPQ-B either has a three- or four-factor structure, but the majority of studies have been conducted in Western contexts and little is known about the psychometric properties of the scale in other populations. In this study factorial invariance testing across three cultural contexts-Australia, China and Chile was conducted. In total, 729 young adults (Mean age = 23.99 years, SD = 9.87 years) participated. Invariance testing did not support the four-factor model across three countries. Confirmatory Factor Analyses revealed that neither the four- nor three-factor model had strong fit in any of the settings. However, in comparison with other competing models, the four-factor model showed the best for the Australian sample, while the three-factor model was the most reasonable for both Chinese and Chilean samples. The reliability of the SPQ-B scores, estimated with Omega, ranged from 0.86 to 0.91. These findings suggest that the SPQ-B factors are not consistent across different cultural groups. We suggest that these differences could be attributed to potential confounding cultural and translation issues. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. WTO ACCESSION OF BRICS COUNTRIES: THE CHINESE EXPERIENCE

    Directory of Open Access Journals (Sweden)

    I. Mikheeva

    2017-01-01

    Full Text Available The stages of reforms under the influence of requirements of the World Trade Organization are considered on the basis of an analysis of Chinese legislation. Four stages of preparation by the People’s Republic of China for accession to the WTO within which there was a transformation of the legal system of China from 1982 to 2001 are described. The sources of Chinese lawmaking are presented and systematized as the basis of the economic legislation of the PRC at the stage of preparation for inclusion of China in the WTO. Attention is drawn to the particularities of the power organization of the Chinese state, in which there is no separation of powers into three branches: legislative, executive and judicial. This, in turn, allows to mark the feature in the economic sphere of legal regulation in China connected with the existence of the rules established by the Supreme National Court as a source of law. To represent the dynamics of normativelegal regulation of foreign trade activities, China has used the system of dialectical and universal methods of knowledge; general scientific methods (induction and deduction and techniques (analysis and synthesis; as well as a special method – formally-legal. The identified course and direction of changes in legal support of domestic and foreign economic processes in China suggests the possibility to consider the experience of China in the promotion of Russia in the international trading community.The authors propose that the entry of China into the WTO is of interest to the BRICS countries as long as China achieves optimal utilization of the WTO’s external economic opportunities. In addition, China has established a legally solid basis for the development of market relations in the state.

  11. Mapping actions to improve access to medicines for mental disorders in low and middle income countries.

    Science.gov (United States)

    Barbui, C; Dua, T; Kolappa, K; Saraceno, B; Saxena, S

    2017-10-01

    In recent years a number of intergovernmental initiatives have been activated in order to enhance the capacity of countries to improve access to essential medicines, particularly for mental disorders. In May 2013 the 66th World Health Assembly adopted the World Health Organization (WHO) Comprehensive Mental Health Action Plan 2013-2020, which builds upon the work of WHO's Mental Health Gap Action Programme. Within this programme, evidence-based guidelines for mental disorders were developed, including recommendations on appropriate use of medicines. Subsequently, the 67th World Health Assembly adopted a resolution on access to essential medicines, which urged Member States to improve national policies for the selection of essential medicines and to promote their availability, affordability and appropriate use. Following the precedent set by these important initiatives, this article presents eleven actions for improving access and appropriate use of psychotropic medicines. A 4 × 4 framework mapping actions as a function of the four components of access - selection, availability, affordability and appropriate use - and across four different health care levels, three of which belong to the supply side and one to the demand side, was developed. The actions are: developing a medicine selection process; promoting information and education activities for staff and end-users; developing a medicine regulation process; implementing a reliable supply system; implementing a reliable quality-control system; developing a community-based system of mental health care and promoting help-seeking behaviours; developing international agreements on medicine affordability; developing pricing policies and a sustainable financing system; developing or adopting evidence-based guidelines; monitoring the use of psychotropic medicines; promoting training initiatives for staff and end-users on critical appraisal of scientific evidence and appropriate use of psychotropic medicines. Activating

  12. Cancer Deaths due to Lack of Universal Access to Radiotherapy in the Brazilian Public Health System.

    Science.gov (United States)

    Mendez, L C; Moraes, F Y; Fernandes, G Dos S; Weltman, E

    2018-01-01

    Radiotherapy plays a fundamental role in the treatment of cancer. Currently, the Brazilian public health system cannot match the national radiotherapy demand and many patients requiring radiotherapy are never exposed to this treatment. This study estimated the number of preventable deaths in the public health system if access to radiotherapy was universal. Incidence rates for the year 2016 provided by Instituto Nacional de Cancer were used in this analysis. The number of untreated patients requiring radiotherapy was obtained through the difference between the total number of patients requiring radiotherapy and the total amount of delivered radiotherapy treatments in the public health system. The number of deaths for the three most common cancers in each gender due to radiotherapy shortage was calculated. Initially, the total number of patients per cancer type was divided in stages using Brazilian epidemiological data. Subsequently, previously published tree arm diagrams were used to define the rate of patients requiring radiotherapy in each specific clinical setting. Finally, the clinical benefit of radiotherapy in overall survival was extracted from studies with level 1 evidence. Over 596 000 cancer cases were expected in Brazil in 2016. The public health system covers more than 75% of the Brazilian population and an estimated 111 432 patients who required radiotherapy in 2016 did not receive this treatment. Breast, colorectal and cervix cancers are the most frequent malignant tumours in women and prostate, lung and colorectal in men. The number of deaths due to a radiotherapy shortage in the year 2016 for these types of cancer were: (i) breast: 1011 deaths in 10 years; (ii) cervix: 2006 deaths in 2 years; (iii) lung: 1206 deaths in 2 years; (iv) prostate, intermediate risk: 562 deaths in 13 years; high risk: 298 deaths in 10 years; (v) colorectal: 0 deaths, as radiotherapy has no proven benefit in overall survival. Thousands of cancer patients requiring

  13. [Similarities between disaster areas and developing countries in terms of the lack of facilities for clinical examinations].

    Science.gov (United States)

    Suganami, Shigeru

    2012-03-01

    From the experience of more than 130 emergency medical relief missions in over 50 countries/areas, the AMDA would like to propose a system of mobile clinical examinations to prepare for possible natural disasters in Japan. Such a system will require the development of vehicles equipped with a full range of laboratory equipment, which I believe will become a public property in the world, and contribute to the enhancement of medical services in disaster areas as well as in areas with less developed medical technologies. AMDA's recent medical relief activities include the support of the victims of the earthquakes in Haiti (2010) and Turkey (2011), and the flood in Thailand (2012). In these countries, the AMDA faced the lack of a clinical examination system which resulted in a huge number of patients who could not receive proper treatment after injury, or those who suffered from infectious diseases. Domestically, when the AMDA sent medical teams to the affected areas of the Great East Japan Earthquake and tsunami (2011), their activities took place mainly in evacuation shelters, where survivors needed treatment for chronic diseases and preventive care. All of these experiences highlight the importance of clinical examination in disaster areas, as well as in developing countries/areas similarly lacking basic medical services. The Japanese Society of Laboratory Medicine will surely play an important role in the development of the proposed system of mobile clinical examinations. The AMDA would like to collaborate with the JSLM in emergency relief activities and medical aid projects in areas affected by disasters or lack basic medical services.

  14. Access to healthcare for undocumented migrants in 11 European countries

    OpenAIRE

    Chauvin , Pierre; Parizot , Isabelle; Simonnot , Nathalie

    2009-01-01

    Through our national programmes we meet people in Europe who have fled extreme poverty, violent armies and police forces, conflict areas and disasters. A tiny minority of the children, women and men whom we try to support when we work in their countries end up coming here. After migration journeys which are very often long, dangerous and exhausting, many find themselves without permission to stay in the country, forced into the shadows of our towns and cities. At home, as abroad, Médecins du ...

  15. Securing Access to Medicines for Least Developed Countries

    African Journals Online (AJOL)

    Since Doha, more than sixty low and middle income countries have ... of Human Rights (1948).2 The binding International Covenant on Economic,. Social ... protection and came into effect in 1995.3 The growth of global trade led to ... The rise and spread of ..... The United Kingdom, for example, spends approximately 6 per.

  16. European Union's public fishing access agreements in developing countries

    OpenAIRE

    Le Manach, F.; Chaboud, Christian; Copeland, D.; Cury, Philippe; Gascuel, D.; Kleisner, K.M.; Standing, A.; Sumaila, U.R.; Zeller, D.; Pauly, D.

    2013-01-01

    The imperative to increase seafood supply while dealing with its overfished local stocks has pushed the European Union (EU) and its Member States to fish in the Exclusive Economic Zones of other countries through various types of fishing agreements for decades. Although European public fishing agreements are commented on regularly and considered to be transparent, this is the first global and historical study on the fee regime that governs them. We find that the EU has subsidized these agreem...

  17. FDI in small accession countries: The Baltic states

    OpenAIRE

    Hunya, Gábor

    2004-01-01

    Analysing the evolution and determinants of foreign direct investment (FDI) in Estonia, Latvia and Lithuania, this paper argues that sound economic policies have created an environment conducive for FDI. Overall, FDI has contributed to economic growth in the Baltic economies, having financed around one-fifth of fixed investment. However, their small size makes the Baltic countries relatively less attractive for market-seeking FDI in manufacturing. Moreover, at the outset of transition, their ...

  18. Open access for operational research publications from low- and middle-income countries: who pays?

    Science.gov (United States)

    Zachariah, R; Kumar, A M V; Reid, A J; Van den Bergh, R; Isaakidis, P; Draguez, B; Delaunois, P; Nagaraja, S B; Ramsay, A; Reeder, J C; Denisiuk, O; Ali, E; Khogali, M; Hinderaker, S G; Kosgei, R J; van Griensven, J; Quaglio, G L; Maher, D; Billo, N E; Terry, R F; Harries, A D

    2014-09-21

    Open-access journal publications aim to ensure that new knowledge is widely disseminated and made freely accessible in a timely manner so that it can be used to improve people's health, particularly those in low- and middle-income countries. In this paper, we briefly explain the differences between closed- and open-access journals, including the evolving idea of the 'open-access spectrum'. We highlight the potential benefits of supporting open access for operational research, and discuss the conundrum and ways forward as regards who pays for open access.

  19. Girls' access to education in a developing country.

    Science.gov (United States)

    Geissinger, H

    1997-10-01

    This article provides an overview of girls' access to education in Papua New Guinea (PNG). PNG is a nation state formed by groups speaking over 800 languages. In 1990, population, except in the North Solomons, numbered about 3.5 million. Life expectancy is about 56.1 years. 43% are aged under 15 years. PNG has one of the highest rates of subsistence living in the world. Most live in villages. Fees are charged for schooling. European style education was brought by the missionaries and was directed mainly to boys. Girls could be included in Bible studies. In 1906, Australia began building schools for boys to work in colony administrative jobs. Colonial control was expanded through development of schools. PNG is mountainous and has few roads, bus routes, or trains. Secondary schools must offer dormitories. In 1988, at least 50% of children were in primary school in all 19 provinces and the area comprising the National Capital District. The government became independent in 1975. Statistical data were unreliably collected. North Solomons was known for having high female primary school enrollments, high status for women, and limited data. Physical location of schools depends on availability of land and resources. Tribal fighting interferes with access. Lotteries determine entrance to secondary school. There are bottlenecks in advancing from one grade to the next. Girls in remote villages may not see women role models and have little desire to obtain any education. Parents may prevent female schooling. Cultural and historical factors are key obstacles to female schooling. Female schooling may not equate with job options.

  20. European Union's public fishing access agreements in developing countries.

    Science.gov (United States)

    Le Manach, Frédéric; Chaboud, Christian; Copeland, Duncan; Cury, Philippe; Gascuel, Didier; Kleisner, Kristin M; Standing, André; Sumaila, U Rashid; Zeller, Dirk; Pauly, Daniel

    2013-01-01

    The imperative to increase seafood supply while dealing with its overfished local stocks has pushed the European Union (EU) and its Member States to fish in the Exclusive Economic Zones of other countries through various types of fishing agreements for decades. Although European public fishing agreements are commented on regularly and considered to be transparent, this is the first global and historical study on the fee regime that governs them. We find that the EU has subsidized these agreements at an average of 75% of their cost (financial contribution agreed upon in the agreements), while private European business interests paid the equivalent of 1.5% of the value of the fish that was eventually landed. This raises questions of fisheries benefit-sharing and resource-use equity that the EU has the potential to address during the nearly completed reform of its Common Fisheries Policy.

  1. European Union's public fishing access agreements in developing countries.

    Directory of Open Access Journals (Sweden)

    Frédéric Le Manach

    Full Text Available The imperative to increase seafood supply while dealing with its overfished local stocks has pushed the European Union (EU and its Member States to fish in the Exclusive Economic Zones of other countries through various types of fishing agreements for decades. Although European public fishing agreements are commented on regularly and considered to be transparent, this is the first global and historical study on the fee regime that governs them. We find that the EU has subsidized these agreements at an average of 75% of their cost (financial contribution agreed upon in the agreements, while private European business interests paid the equivalent of 1.5% of the value of the fish that was eventually landed. This raises questions of fisheries benefit-sharing and resource-use equity that the EU has the potential to address during the nearly completed reform of its Common Fisheries Policy.

  2. Competition among Cohesion and Accession Countries: Comparative Analysis of Specialization Within the EU Market

    OpenAIRE

    Dora Borbély

    2004-01-01

    European integration brings about major impulses for structural change. Analyzing the new competitive structure of countries and industries within the enlarged European Union is a great challenge for economic research. Focusing on the four cohesion countries, Spain, Portugal, Ireland and Greece, this paper presents the key shifts in sectoral developments and changing RCA indicators in exports to the EU15. Comparing the results with the according indicators for selected accession countries ind...

  3. Benefits of global partnerships to facilitate access to medicines in developing countries: a multi-country analysis of patients and patient outcomes in GIPAP

    Directory of Open Access Journals (Sweden)

    Vandoros Sotiris

    2009-12-01

    Full Text Available Abstract Background Access to medicines in developing countries continues to be a significant problem due to lack of insurance and lack of affordability. Chronic Myeloid Leukemia (CML, a rare disease, can be treated effectively, but the pharmaceutical treatment available (imatinib is costly and unaffordable by most patients. GIPAP, is a programme set up between a manufacturer and an NGO to provide free treatment to eligible CML patients in 80 countries worldwide. Objectives To discuss the socio-economic and demographic characteristics of patients participating in GIPAP; to research the impact GIPAP is having on health outcomes (survival of assistance-eligible CML patients; and to discuss the determinants of such outcomes and whether there are any variations according to socio-economic, demographic, or geographical criteria. Methods Data for 13,568 patients across 15 countries, available quarterly, were analysed over the 2005-2007 period. Ordered Probit panel data analysis was used to analyze the determinants of a patient's progress in terms of participation in the programme. Four waves of patients entering quarterly in 2005 were used to evaluate patient survival over the sample period. Results All patients in the sample are eligible to receive treatment provided they report to a facility quarterly. 62.3% of patients were male and 37.7% female. The majority (84.4% entered during the chronic phase of the disease and their average age was 38.4 years. Having controlled for age, location and occupation, the analysis showed that patients were significantly much more likely to move towards a better health state after receiving treatment irrespective of their disease stage at the point of entry to the program (OR = 30.5, α = 1%; and that the larger the gap between diagnosis and approval for participation in the program, the more likely it is that patients' condition deteriorates (OR = 0.995, α = 1%, due to absence of treatment. Regressions to account

  4. Benefits of global partnerships to facilitate access to medicines in developing countries: a multi-country analysis of patients and patient outcomes in GIPAP.

    Science.gov (United States)

    Kanavos, Panos; Vandoros, Sotiris; Garcia-Gonzalez, Pat

    2009-12-31

    Access to medicines in developing countries continues to be a significant problem due to lack of insurance and lack of affordability. Chronic Myeloid Leukemia (CML), a rare disease, can be treated effectively, but the pharmaceutical treatment available (imatinib) is costly and unaffordable by most patients. GIPAP, is a programme set up between a manufacturer and an NGO to provide free treatment to eligible CML patients in 80 countries worldwide. To discuss the socio-economic and demographic characteristics of patients participating in GIPAP; to research the impact GIPAP is having on health outcomes (survival) of assistance-eligible CML patients; and to discuss the determinants of such outcomes and whether there are any variations according to socio-economic, demographic, or geographical criteria. Data for 13,568 patients across 15 countries, available quarterly, were analysed over the 2005-2007 period. Ordered Probit panel data analysis was used to analyze the determinants of a patient's progress in terms of participation in the programme. Four waves of patients entering quarterly in 2005 were used to evaluate patient survival over the sample period. All patients in the sample are eligible to receive treatment provided they report to a facility quarterly. 62.3% of patients were male and 37.7% female. The majority (84.4%) entered during the chronic phase of the disease and their average age was 38.4 years. Having controlled for age, location and occupation, the analysis showed that patients were significantly much more likely to move towards a better health state after receiving treatment irrespective of their disease stage at the point of entry to the program (OR = 30.5, alpha = 1%); and that the larger the gap between diagnosis and approval for participation in the program, the more likely it is that patients' condition deteriorates (OR = 0.995, alpha = 1%), due to absence of treatment. Regressions to account for the effect of large countries (India, China

  5. Estimating rural populations without access to electricity in developing countries through night-time light satellite imagery

    International Nuclear Information System (INIS)

    Doll, Christopher N.H.; Pachauri, Shonali

    2010-01-01

    A lack of access to energy and, in particular, electricity is a less obvious manifestation of poverty but arguably one of the most important. This paper investigates the extent to which electricity access can be investigated using night-time light satellite data and spatially explicit population datasets to compare electricity access between 1990 and 2000. We present here the first satellite derived estimates of rural population without access to electricity in developing countries to draw insights on issues surrounding the delivery of electricity to populations in rural areas. The paper provides additional evidence of the slow progress in expansion of energy access to households in Sub-Saharan Africa and shows how this might be ascribed in part due to the low population densities in rural areas. The fact that this is a continent with some of the lowest per-capita income levels aggravates the intrinsic difficulties associated with making the investments needed to supply electricity in areas with low population density and high dispersion. Clearly, these spatial dimensions of the distributions of the remaining unelectrified populations in the world have an impact on what options are considered the most appropriate in expanding access to these households and the relative attractiveness of decentralized options.

  6. Differences and inequalities in relation to access to renal replacement therapy in the BRICS countries.

    Science.gov (United States)

    Ferraz, Fábio Humberto Ribeiro Paes; Rodrigues, Cibele Isaac Saad; Gatto, Giuseppe Cesare; Sá, Natan Monsores de

    2017-07-01

    End-stage renal disease (ESRD) is an important public health problem, especially in developing countries due to the high level of economic resources needed to maintain patients in the different programs that make up renal replacement therapy (RRT). To analyze the differences and inequalities involved in access to RRT in the BRICS countries (Brazil, Russian Federation, India, China and South Africa). This is an applied, descriptive, cross-sectional, quantitative and qualitative study, with documentary analysis and a literature review. The sources of data were from national censuses and scientific publications regarding access to RRT in the BRICS countries. There is unequal access to RRT in all the BRICS countries, as well as the absence of information regarding dialysis and transplants (India), the absence of effective legislation to inhibit the trafficking of organs (India and South Africa) and the use of deceased prisoners as donors for renal transplants (China). The construction of mechanisms to promote the sharing of benefits and solidarity in the field of international cooperation in the area of renal health involves the recognition of bioethical issues related to access to RRT in the BRICS countries.

  7. Towards accessible integrated palliative care: Perspectives of leaders from seven European countries on facilitators, barriers and recommendations for improvement.

    Science.gov (United States)

    den Herder-van der Eerden, Marlieke; Ewert, Benjamin; Hodiamont, Farina; Hesse, Michaela; Hasselaar, Jeroen; Radbruch, Lukas

    2017-01-01

    Literature suggests that integrated palliative care (IPC) increases the quality of care for palliative patients at lower costs. However, knowledge on models encompassing all integration levels for successfully implementing IPC is scarce. The purpose of this paper is to describe the experiences of IPC leaders in seven European countries regarding core elements, facilitators and barriers of IPC implementation and provides recommendations for future policy and practice. A qualitative interview study was conducted between December 2013 and May 2014. In total, 34 IPC leaders in primary and secondary palliative care or public health in Belgium, Germany, Hungary, Ireland, the Netherlands, Spain and the UK were interviewed. Transcripts were analysed using thematic data analysis. IPC implementation efforts involved a multidisciplinary team approach and cross-sectional coordination. Informal professional relationships, basic medical education and general awareness were regarded as facilitators of IPC. Identified barriers included lack of knowledge about when to start palliative care, lack of collaboration and financial structures. Recommendations for improvement included access, patient-centeredness, coordination and cooperation, financing and ICT systems. Although IPC is becoming more common, action has been uneven at different levels. IPC implementation largely remains provisional and informal due to the lack of standardised treatment pathways, legal frameworks and financial incentives to support multilevel integration. In order to make IPC more accessible, palliative care education as well as legal and financial support within national healthcare systems needs to be enhanced.

  8. Mini-grid based off-grid electrification to enhance electricity access in developing countries: What policies may be required?

    International Nuclear Information System (INIS)

    Bhattacharyya, Subhes C.; Palit, Debajit

    2016-01-01

    With 1.2 billion people still lacking electricity access by 2013, electricity access remains a major global challenge. Although mini-grid based electrification has received attention in recent times, their full exploitation requires policy support covering a range of areas. Distilling the experience from a five year research project, OASYS South Asia, this paper presents the summary of research findings and shares the experience from four demonstration activities. It suggests that cost-effective universal electricity service remains a challenge and reaching the universal electrification target by 2030 will remain a challenge for the less developed countries. The financial, organisational and governance weaknesses hinder successful implementation of projects in many countries. The paper then provides 10 policy recommendations to promote mini-grids as a complementary route to grid extension to promote electricity access for successful outcomes. - Highlights: •The academic and action research activities undertaken through OASYS South Asia Project are reported. •Evidence produced through a multi-dimensional participatory framework supplemented by four demonstration projects. •Funding and regulatory challenges militate against universal electrification objectives by 2030. •Innovative business approaches linking local mini-grids and livelihood opportunities exist. •Enabling policies are suggested to exploit such options.

  9. A win-win solution?: A critical analysis of tiered pricing to improve access to medicines in developing countries.

    Science.gov (United States)

    Moon, Suerie; Jambert, Elodie; Childs, Michelle; von Schoen-Angerer, Tido

    2011-10-12

    Tiered pricing - the concept of selling drugs and vaccines in developing countries at prices systematically lower than in industrialized countries - has received widespread support from industry, policymakers, civil society, and academics as a way to improve access to medicines for the poor. We carried out case studies based on a review of international drug price developments for antiretrovirals, artemisinin combination therapies, drug-resistant tuberculosis medicines, liposomal amphotericin B (for visceral leishmaniasis), and pneumococcal vaccines. We found several critical shortcomings to tiered pricing: it is inferior to competition for achieving the lowest sustainable prices; it often involves arbitrary divisions between markets and/or countries, which can lead to very high prices for middle-income markets; and it leaves a disproportionate amount of decision-making power in the hands of sellers vis-à-vis consumers. In many developing countries, resources are often stretched so tight that affordability can only be approached by selling medicines at or near the cost of production. Policies that "de-link" the financing of R&D from the price of medicines merit further attention, since they can reward innovation while exploiting robust competition in production to generate the lowest sustainable prices. However, in special cases - such as when market volumes are very small or multi-source production capacity is lacking - tiered pricing may offer the only practical option to meet short-term needs for access to a product. In such cases, steps should be taken to ensure affordability and availability in the longer-term. To ensure access to medicines for populations in need, alternate strategies should be explored that harness the power of competition, avoid arbitrary market segmentation, and/or recognize government responsibilities. Competition should generally be the default option for achieving affordability, as it has proven superior to tiered pricing for reliably

  10. A win-win solution?: A critical analysis of tiered pricing to improve access to medicines in developing countries

    Directory of Open Access Journals (Sweden)

    Childs Michelle

    2011-10-01

    Full Text Available Abstract Background Tiered pricing - the concept of selling drugs and vaccines in developing countries at prices systematically lower than in industrialized countries - has received widespread support from industry, policymakers, civil society, and academics as a way to improve access to medicines for the poor. We carried out case studies based on a review of international drug price developments for antiretrovirals, artemisinin combination therapies, drug-resistant tuberculosis medicines, liposomal amphotericin B (for visceral leishmaniasis, and pneumococcal vaccines. Discussion We found several critical shortcomings to tiered pricing: it is inferior to competition for achieving the lowest sustainable prices; it often involves arbitrary divisions between markets and/or countries, which can lead to very high prices for middle-income markets; and it leaves a disproportionate amount of decision-making power in the hands of sellers vis-à-vis consumers. In many developing countries, resources are often stretched so tight that affordability can only be approached by selling medicines at or near the cost of production. Policies that "de-link" the financing of R&D from the price of medicines merit further attention, since they can reward innovation while exploiting robust competition in production to generate the lowest sustainable prices. However, in special cases - such as when market volumes are very small or multi-source production capacity is lacking - tiered pricing may offer the only practical option to meet short-term needs for access to a product. In such cases, steps should be taken to ensure affordability and availability in the longer-term. Summary To ensure access to medicines for populations in need, alternate strategies should be explored that harness the power of competition, avoid arbitrary market segmentation, and/or recognize government responsibilities. Competition should generally be the default option for achieving affordability

  11. A win-win solution?: A critical analysis of tiered pricing to improve access to medicines in developing countries

    Science.gov (United States)

    2011-01-01

    Background Tiered pricing - the concept of selling drugs and vaccines in developing countries at prices systematically lower than in industrialized countries - has received widespread support from industry, policymakers, civil society, and academics as a way to improve access to medicines for the poor. We carried out case studies based on a review of international drug price developments for antiretrovirals, artemisinin combination therapies, drug-resistant tuberculosis medicines, liposomal amphotericin B (for visceral leishmaniasis), and pneumococcal vaccines. Discussion We found several critical shortcomings to tiered pricing: it is inferior to competition for achieving the lowest sustainable prices; it often involves arbitrary divisions between markets and/or countries, which can lead to very high prices for middle-income markets; and it leaves a disproportionate amount of decision-making power in the hands of sellers vis-à-vis consumers. In many developing countries, resources are often stretched so tight that affordability can only be approached by selling medicines at or near the cost of production. Policies that "de-link" the financing of R&D from the price of medicines merit further attention, since they can reward innovation while exploiting robust competition in production to generate the lowest sustainable prices. However, in special cases - such as when market volumes are very small or multi-source production capacity is lacking - tiered pricing may offer the only practical option to meet short-term needs for access to a product. In such cases, steps should be taken to ensure affordability and availability in the longer-term. Summary To ensure access to medicines for populations in need, alternate strategies should be explored that harness the power of competition, avoid arbitrary market segmentation, and/or recognize government responsibilities. Competition should generally be the default option for achieving affordability, as it has proven superior

  12. Promoting Access to Finance by Empowering Consumers--Financial Literacy in Developing Countries

    Science.gov (United States)

    Kefela, Ghirmai T.

    2010-01-01

    This paper is an effort to establish the financial sector in developing countries to promote financial literacy of their customers. This could have access to finance and savings, which in turn support livelihoods, economic growth, sound financial systems, and participate in the economy. The main objectives of this paper is to enhance a bank's…

  13. Unesco's Activities to Facilitate Access of Developing Countries to Protected Works.

    Science.gov (United States)

    Alam, A. M. N.

    1979-01-01

    Describes the operational activities of UNESCO to facilitate easy access of developing countries to works protected by copyright. Particular reference is made to collection of data, economic situation, formation of national copyright information centers, copyright data bank services, reprographic reproduction, preparation of model contracts,and…

  14. [How do immigrant women access health services in the Basque Country? Perceptions of health professionals].

    Science.gov (United States)

    Pérez-Urdiales, Iratxe; Goicolea, Isabel

    2017-09-12

    To determine the perception of health professionals working in alternative health centres on the barriers and facilitators in the access by immigrant women to general public health services and sexual and reproductive health in the Basque Country. Basque Country. Analysis of qualitative content based on 11 individual interviews. Health professionals working in alternative health centres of Primary Care and sexual and reproductive health. Data collection was performed between September and December 2015 in four alternative health centres. After transcription, the units of meaning, codes and categories were identified. Four categories emerged from the analysis, which represented how the characteristics of immigrant women (Tell me how you are and I will tell you how to access), the attitude of the administrative and health staff ("When they are already taken care of"), the functioning of the health system (Inflexible, passive and needs-responsive health system), and health policies ("If you do not meet the requirements, you do not go in. The law is the law") influence access to health services of immigrant women. This study shows that there are a considerable number of barriers and few facilitators to the access by immigrant women to public health and sexual and reproductive health services in the Basque Country. The alternative health centres were presented as favouring the improvement of the health of the immigrant population and in their access. Copyright © 2017. Publicado por Elsevier España, S.L.U.

  15. Access to electronic health knowledge in five countries in Africa: a descriptive study

    Directory of Open Access Journals (Sweden)

    Honorati Masanja

    2007-05-01

    Full Text Available Abstract Background Access to medical literature in developing countries is helped by open access publishing and initiatives to allow free access to subscription only journals. The effectiveness of these initiatives in Africa has not been assessed. This study describes awareness, reported use and factors influencing use of on-line medical literature via free access initiatives. Methods Descriptive study in four teaching hospitals in Cameroon, Nigeria, Tanzania and Uganda plus one externally funded research institution in The Gambia. Survey with postgraduate doctors and research scientists to determine Internet access patterns, reported awareness of on-line medical information and free access initiatives; semi structured interviews with a sub-sample of survey participants to explore factors influencing use. Results In the four African teaching hospitals, 70% of the 305 postgraduate doctors reported textbooks as their main source of information; 66% had used the Internet for health information in the last week. In two hospitals, Internet cafés were the main Internet access point. For researchers at the externally-funded research institution, electronic resources were their main source, and almost all had used the Internet in the last week. Across all 333 respondents, 90% had heard of PubMed, 78% of BMJ on line, 49% the Cochrane Library, 47% HINARI, and 19% BioMedCentral. HINARI use correlates with accessing the Internet on computers located in institutions. Qualitative data suggested there are difficulties logging into HINARI and that sometimes it is librarians that limit access to passwords. Conclusion Text books remain an important resource for postgraduate doctors in training. Internet use is common, but awareness of free-access initiatives is limited. HINARI and other initiatives could be more effective with strong institutional endorsement and management to promote and ensure access.

  16. Electricity (in)accessibility to the urban poor in developing countries

    DEFF Research Database (Denmark)

    Singh, Rozita; Wang, Xiao; Mendoza, Juan Carlos

    2015-01-01

    More than half of the world’s population now lives in urban areas. The difficulties involved in providing new urban residents with a wide variety of services reveals a new face of poverty, one in which urban communities cannot access or afford basic modern energy services for their development...... and empowerment. As an enabler of development processes, access to electricity in urban and peri-urban contexts plays a key role in providing possibilities and solutions to the urban poor. Energy poverty is no longer a rural-only phenomenon, and a concerted effort is needed to find solutions. Taking...... this into account, the Global Network on Energy for Sustainable Development (GNESD) initiated the Urban Peri-Urban Energy Access (UPEA) project in 2006. The objective was to understand the barriers to energy access in the context of the urban poor in seven countries. Barriers from both the supply and demand sides...

  17. Policies of access to healthcare services for accompanied asylum-seeking children in the Nordic countries.

    Science.gov (United States)

    Sandahl, Hinuga; Norredam, Marie; Hjern, Anders; Asher, Henry; Nielsen, Signe Smith

    2013-08-01

    Asylum-seeking children constitute a vulnerable group with high prevalence and risk for mental health problems. The aim of this study was to compare policies of access to healthcare services, including physical examination and screening for mental health problems on arrival, for accompanied asylum-seeking children in the Nordic countries. This study was based on the national reports "Reception of refugee children in the Nordic countries" written by independent national experts for the Nordic Network for Research on Refugee Children, supplemented by information from relevant authorities. In Sweden, Norway and Iceland, asylum-seeking children had access to healthcare services equal to children in the general population. On a policy level, Denmark imposed restrictions on non-acute hospitalisations and prolonged specialist treatments. Regarding health examinations, Sweden deviated from the Nordic pattern by not performing these systematically. In Denmark, Iceland, and some counties in Sweden, but not in Norway, screening for mental health problems was offered to asylum-seeking children. Access to healthcare services for asylum-seeking children differs in the Nordic countries; the consequences of these systematic differences for the individual asylum-seeking child are unknown. For asylum-seeking children, access to healthcare has to be considered in a wider context that includes the core conditions of being an asylum-seeker. A comparative study at policy level needs to be supplemented with empirical follow-up studies of the well-being of the study population to document potential consequences of policies in practice.

  18. The association between insured male expatriates' knowledge of health insurance benefits and lack of access to health care in Saudi Arabia.

    Science.gov (United States)

    Alkhamis, Abdulwahab A

    2018-03-15

    Insufficient knowledge of health insurance benefits could be associated with lack of access to health care, particularly for minority populations. This study aims to assess the association between expatriates' knowledge of health insurance benefits and lack of access to health care. A cross-sectional study design was conducted from March 2015 to February 2016 among 3398 insured male expatriates in Riyadh, Saudi Arabia. The dependent variable was binary and expresses access or lack of access to health care. Independent variables included perceived and validated knowledge of health insurance benefits and other variables. Data were summarized by computing frequencies and percentage of all quantities of variables. To evaluate variations in knowledge, personal and job characteristics with lack of access to health care, the Chi square test was used. Odds ratio (OR) and 95% confidence interval (CI) were recorded for each independent variable. Multiple logistic regression and stepwise logistic regression were performed and adjusted ORs were extracted. Descriptive analysis showed that 15% of participants lacked access to health care. The majority of these were unskilled laborers, usually with no education (17.5%), who had been working for less than 3 years (28.1%) in Saudi Arabia. A total of 23.3% worked for companies with less than 50 employees and 16.5% earned less than 4500 Saudi Riyals monthly ($1200). Many (20.3%) were young (English (16.7%) and lacked previous knowledge of health insurance (18%). For perceived knowledge of health insurance, 55.2% scored 1 or 0 from total of 3. For validated knowledge, 16.9% scored 1 or 0 from total score of 4. Multiple logistic regression analysis showed that only perceived knowledge of health insurance had significant associations with lack of access to health care ((OR) = 0.393, (CI) = 0.335-0.461), but the result was insignificant for validated knowledge. Stepwise logistic regression gave similar findings. Our results

  19. Energy access: Lessons learned in Brazil and perspectives for replication in other developing countries

    International Nuclear Information System (INIS)

    Coelho, Suani T.; Goldemberg, José

    2013-01-01

    Energy access has been singled out by the AGECC in 2010 as one of the important problems to be tackled in the next few decades in a world where 1.3 billion people do not have access to electricity and 2.7 use primitive fuels – mainly fuel wood – for cooking and heating. To solve such problems, innumerous small scale projects have been implemented around the world either on the improvement of cooking stoves, biogas and others, as well as in generating electricity in decentralized systems. We discuss here the “large scale approach” to solve these problems in Brazil through the introduction of LPG (liquid petroleum gas) in Brazil 70 years ago, all over the country, as a cooking fuel that replaced significantly the use of fuel wood in rural areas. In addition to that, we describe the governmental program (Luz para Todos – LPT – Light for all) introduced more recently to extend the electricity grid to around 10 million people, reducing considerably the number of people without access to electricity in the rural areas of the country. Such experiences and the corresponding lessons learned could be replicated in other developing countries, contributing significantly to poverty alleviation. - Highlights: • Energy access is one important problem for 1.3 billion people not having access to electricity and 2.7 billion using primitive fuels for cooking-heating. • We discuss the approach introduced in Brazil through the introduction of LPG as a cooking fuel that replaced significantly the use of fuel wood in rural areas. • We describe the program introduced to supply electricity, reducing the number of people without access to electricity in rural areas. • Lessons learned could be replicated in other DCs, contributing to poverty alleviation

  20. STI Services for Adolescents and Youth in Low and Middle Income Countries: Perceived and Experienced Barriers to Accessing Care

    Science.gov (United States)

    Newton-Levinson, Anna; Leichliter, Jami S.; Chandra-Mouli, Venkatraman

    2017-01-01

    Access to sexual and reproductive health services (SRH) is vital for sexually active adolescents; yet, their SRH care needs are often unmet. We conducted a qualitative systematic review of mixed methods studies to assess adolescent and provider views of barriers to seeking appropriate medical care for sexually transmitted infection (STI) services for adolescents. We searched peer-reviewed literature for studies published between 2001–2014 with a study population of youth (aged 10–24 years) and/or health service providers. Nineteen studies were identified for inclusion from fifteen countries. Thematic analyses identified key themes across the studies. Findings suggest that youth lacked knowledge about STIs and services. Additionally, youth experienced barriers related to service availability and a lack of integration of services. The most reported barriers were related to acceptability of services. Youth reported avoiding services or having confidentiality concerns based on provider demographics and some behaviors. Finally, experiences of shame and stigma were common barriers to seeking care. Adolescents in low and middle income countries experience significant barriers in obtaining STI and SRH services. Improving uptake may require efforts to address clinic systems and provider attitudes, including confidentiality issues. Moreover, addressing barriers to STI services may require addressing cultural norms related to adolescent sexuality. PMID:27338664

  1. Secret Shoppers Find Access To Providers And Network Accuracy Lacking For Those In Marketplace And Commercial Plans.

    Science.gov (United States)

    Haeder, Simon F; Weimer, David L; Mukamel, Dana B

    2016-07-01

    The adequacy of provider networks for plans sold through insurance Marketplaces established under the Affordable Care Act has received much scrutiny recently. Various studies have established that networks are generally narrow. To learn more about network adequacy and access to care, we investigated two questions. First, no matter the nominal size of a network, can patients gain access to primary care services from providers of their choice in a timely manner? Second, how does access compare to plans sold outside insurance Marketplaces? We conducted a "secret shopper" survey of 743 primary care providers from five of California's nineteen insurance Marketplace pricing regions in the summer of 2015. Our findings indicate that obtaining access to primary care providers was generally equally challenging both inside and outside insurance Marketplaces. In less than 30 percent of cases were consumers able to schedule an appointment with an initially selected physician provider. Information about provider networks was often inaccurate. Problems accessing services for patients with acute conditions were particularly troubling. Effectively addressing issues of network adequacy requires more accurate provider information. Project HOPE—The People-to-People Health Foundation, Inc.

  2. FAO's role in facilitating access to the scientific and technical literature in Agriculture in developing countries

    OpenAIRE

    Katz, Stephen

    2007-01-01

    Research generated in developing and emerging countries is currently “missing” from the international knowledge bases because of financial consequences affecting its publication and distribution. Much of the scientific research output from Africa for example, is in form of grey literature and hardly accessible. FAO is the specialized United Nation agency that leads international efforts to defeat hunger and emphasizes on knowledge management for food and agriculture. FAO more than an extensiv...

  3. Framing access to medicines in developing countries: an analysis of media coverage of Canada's Access to Medicines Regime.

    Science.gov (United States)

    Esmail, Laura C; Phillips, Kaye; Kuek, Victoria; Cosio, Andrea Perez; Kohler, Jillian Clare

    2010-01-04

    In September 2003, the Canadian government committed to developing legislation that would facilitate greater access to affordable medicines for developing countries. Over the course of eight months, the legislation, now known as Canada's Access to Medicines Regime (CAMR), went through a controversial policy development process and the newspaper media was one of the major venues in which the policy debates took place. The purpose of this study was to examine how the media framed CAMR to determine how policy goals were conceptualized, which stakeholder interests controlled the public debate and how these variables related to the public policy process. We conducted a qualitative content analysis of newspaper coverage of the CAMR policy and implementation process from 2003-2008. The primary theoretical framework for this study was framing theory. A total of 90 articles from 11 Canadian newspapers were selected for inclusion in our analysis. A team of four researchers coded the articles for themes relating to access to medicines and which stakeholders' voice figured more prominently on each issue. Stakeholders examined included: the research-based industry, the generic industry, civil society, the Canadian government, and developing country representatives. The most frequently mentioned themes across all documents were the issues of drug affordability, intellectual property, trade agreements and obligations, and development. Issues such as human rights, pharmaceutical innovation, and economic competitiveness got little media representation. Civil society dominated the media contents, followed far behind by the Canadian government, the research-based and generic pharmaceutical industries. Developing country representatives were hardly represented in the media. Media framing obscured the discussion of some of the underlying policy goals in this case and failed to highlight issues which are now significant barriers to the use of the legislation. Using the media to engage

  4. [Lack of access to information on oral health problems among adults: an approach based on the theoretical model for literacy in health].

    Science.gov (United States)

    Roberto, Luana Leal; Noronha, Daniele Durães; Souza, Taiane Oliveira; Miranda, Ellen Janayne Primo; Martins, Andréa Maria Eleutério de Barros Lima; Paula, Alfredo Maurício Batista De; Ferreira, Efigênia Ferreira E; Haikal, Desirée Sant'ana

    2018-03-01

    This study sought to investigate factors associated with the lack of access to information on oral health among adults. It is a cross-sectional study, carried out among 831 adults (35-44 years of age). The dependent variable was access to information on how to avoid oral problems, and the independent variables were gathered into subgroups according to the theoretical model for literacy in health. Binary logistic regression was carried out, and results were corrected by the design effect. It was observed that 37.5% had no access to information about dental problems. The lack of access was higher among adults who had lower per capita income, were dissatisfied with the dental services provided, did not use dental floss, had unsatisfactory physical control of the quality of life, and self-perceived their oral health as fair/poor/very poor. The likelihood of not having access to information about dental problems among those dissatisfied with the dental services used was 3.28 times higher than for those satisfied with the dental services used. Thus, decreased access to information was related to unfavorable conditions among adults. Health services should ensure appropriate information to their users in order to increase health literacy levels and improve satisfaction and equity.

  5. FDIs and investment policy in some European countries after their EU accession. Challenges during the crisis

    Directory of Open Access Journals (Sweden)

    Magdalena RADULESCU

    2011-12-01

    Full Text Available The aim of this paper is to find out to what extent the accession countries will be able to benefit from an increase in the quality of foreign direct investments (FDIs that they receive due to EU membership. Although there will be some investment in new affiliates resulting in greenfield subsidiaries, transnational companies (TNCs may divest their operations in response to better location advantages elsewhere in the EU (as Spain and Portugal are experiencing because their low-cost advantages are eroded. In many Central and Eastern European (CEE countries, the share of foreign ownership in total capital stock is already typically much higher than in older EU member states, but we can already observe a trend of relocating TNCs’ subsidiaries to other emerging countries in order to diminish the costs, in the context of the present crisis and we believe that this trend will continue in the future, especially in the crisis context when the inceptive burden is heavy for governments. The conclusion of this paper is that the CEE countries haven’t faced quite similar conditions as the Southern European countries that acceded to the EU in the ‘80s. So, their benefits have considerably diminished and the present crisis didn’t help them at all to reduce their economic gaps comparing to the developed European countries.

  6. Sea-change or change challenge? Health information access in developing countries: The U.S. National Library of Medicine experience.

    Science.gov (United States)

    Royall, J; Lyon, B

    2011-09-01

    Health professionals in developing countries want access to information to help them make changes in health care and contribute to medical research. However, they face challenges of technology limitations, lack of training, and, on the village level, culture and language. This report focuses on the U.S. National Library of Medicine experience with access: for the international medical/scientific community to health information which has been published by researchers in developing countries; for scientists and clinicians in developing countries to their own literature and to that of their colleagues around the world; for medical librarians who are a critical conduit for students, faculty, researchers, and, increasingly, the general public; and for the front line workers at the health center in the village at the end of the line. The fundamental question of whether or not information communication technology can make a difference in access and subsequently in health is illustrated by an anecdote regarding an early intervention in Africa in 1992. From that point, we examine programs to improve access involving malaria researchers, medical journal editors, librarians, and medical students working with local health center staff in the village. Although access is a reality, the positive change in health that the information technology intervention might produce often remains a mirage. Information and technology are not static elements in the equation for better access. They must function together, creating a dialectic in which they transform and inform one another and those whom their combination touches.

  7. Anchor, float or abandon ship: exchange rate regimes for the accession countries

    Directory of Open Access Journals (Sweden)

    Willem H. Buiter

    2002-06-01

    Full Text Available The paper considers alternative exchange rate regimes for the East Europeanaccession candidates, both prior to EU accession and following EU accession but prior to EMU membership. We conclude that, from an economic point of view, EMU membership should be as early as possible. There is, however, a risk that prevailing interpretations of the inflation and exchange rate criteria for EMU membership could lead to unnecessary delays in EMU membership for the accession countries. Theexchange rate criterion for EMU membership requires that the candidate "has respected the normal fluctuation margins provided for by the exchange ratemechanism of the European Monetary System without severe tensions for at least the last two yeas before the examination." Both this text and the precedents of Finland, Italy and Greece, support the view that the exchange rate criterion can be satisfied without two years of formal ERMII membership. Insistence on at least two years of formal ERMII membership for the accession countries, would result in an unnecessary, costly and potentially risky stay in EMU purgatory.

  8. Towards comprehensive early abortion service delivery in high income countries: insights for improving universal access to abortion in Australia

    Directory of Open Access Journals (Sweden)

    Angela Dawson

    2016-10-01

    Full Text Available Abstract Background Improving access to safe abortion is an essential strategy in the provision of universal access to reproductive health care. Australians are largely supportive of the provision of abortion and its decriminalization. However, the lack of data and the complex legal and service delivery situation impacts upon access for women seeking an early termination of pregnancy. There are no systematic reviews from a health services perspective to help direct health planners and policy makers to improve access comprehensive medical and early surgical abortion in high income countries. This review therefore aims to identify quality studies of abortion services to provide insight into how access to services can be improved in Australia. Methods We undertook a structured search of six bibliographic databases and hand-searching to ascertain peer reviewed primary research in English between 2005 and 2015. Qualitative and quantitative study designs were deemed suitable for inclusion. A deductive content analysis methodology was employed to analyse selected manuscripts based upon a framework we developed to examine access to early abortion services. Results This review identified the dimensions of access to surgical and medical abortion at clinic or hospital-outpatient based abortion services, as well as new service delivery approaches utilising a remote telemedicine approach. A range of factors, mostly from studies in the United Kingdom and United States of America were found to facilitate improved access to abortion, in particular, flexible service delivery approaches that provide women with cost effective options and technology based services. Standards, recommendations and targets were also identified that provided services and providers with guidance regarding the quality of abortion care. Conclusions Key insights for service delivery in Australia include the: establishment of standards, provision of choice of procedure, improved provider

  9. Legal Barriers in Accessing Opioid Medicines : Results of the ATOME Quick Scan of National Legislation of Eastern European Countries

    NARCIS (Netherlands)

    Vranken, Marjolein J M; Mantel-Teeuwisse, Aukje K; Jünger, Saskia; Radbruch, Lukas; Lisman, John; Scholten, Willem; Payne, Sheila; Lynch, Tom; Schutjens, Marie-Hélène D B

    2014-01-01

    CONTEXT: Overregulation of controlled medicines is one of the factors contributing to limited access to opioid medicines. OBJECTIVES: The purpose of this study was to identify legal barriers to access to opioid medicines in 12 Eastern European countries participating in the Access to Opioid

  10. Improving access to surgery in a developing country: experience from a surgical collaboration in Sierra Leone.

    Science.gov (United States)

    Kushner, Adam L; Kamara, Thaim B; Groen, Reinou S; Fadlu-Deen, Betsy D; Doah, Kisito S; Kingham, T Peter

    2010-01-01

    Although surgery is increasingly recognized as an essential component of primary health care, there has been little documentation of surgical programs in low- and middle-income countries. Surgeons OverSeas (SOS) is a New York-based organization with a mission to save lives in developing countries by improving surgical care. This article highlights the surgical program in Sierra Leone as a possible model to improve access to surgery. An SOS team conducted a needs assessment of surgical capacity in Sierra Leone in February 2008. Interventions were then developed and programs were implemented. A follow-up assessment was conducted in December 2009, which included interviews of key Sierra Leone hospital personnel and a review of operating room log books. Based on an initial needs assessment, a program was developed that included training, salary support, and the provision of surgical supplies and equipment. Two 3-day workshops were conducted for a total of 44 health workers, salary support given to over 100 staff, and 2 containers of supplies and equipment were donated. Access to surgery, as measured by the number of major operations at Connaught Hospital, increased from 460 cases in 2007 to 768 cases in 2009. The SOS program in Sierra Leone highlights a method for improving access to surgery that incorporates an initial needs assessment with minimal external support and local staff collaboration. The program functions as a catalyst by providing training, salary support, and supplies. The beneficial results of the program can then be used to advocate for additional resources for surgery from policy makers. This model could be beneficial in other resource-poor countries in which improved access to surgery is desired. Copyright 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  11. Efforts to secure universal access to HIV/AIDS treatment: a comparison of BRICS countries.

    Science.gov (United States)

    Sun, Jing; Boing, Alexandra Crispim; Silveira, Marysabel P T; Bertoldi, Andréa D; Ziganshina, Liliya E; Khaziakhmetova, Veronica N; Khamidulina, Rashida M; Chokshi, Maulik R; McGee, Shelley; Suleman, Fatima

    2014-02-01

    This article illustrates how the BRICS countries have been building their focused leadership, making important high level commitment and national policy changes, and improving their health systems, in addressing the HIV/AIDS epidemics in respective settings. Specific aspects are focused on efforts of creating public provisions to secure universal access to ARVs from the aspects of active responsive system and national program, health system strengthening, fostering local production of ARVs, supply chain management, and information system strengthening. Challenges in each BRICS country are analyzed respectively. The most important contributors to the success of response to HIV/AIDS include: creating legal basis for healthcare as a fundamental human right; political commitment to necessary funding for universal access and concrete actions to secure equal quality care; comprehensive system to secure demands that all people in need are capable of accessing prevention, treatment and care; active community involvement; decentralization of the management system considering the local settings; integration of treatment and prevention; taking horizontal approach to strengthen health systems; fully use of the TRIPS flexibility; and regular monitoring and evaluation to serve evidence based decision making. © 2013 Chinese Cochrane Center, West China Hospital of Sichuan University and Wiley Publishing Asia Pty Ltd.

  12. Access to medicines for acute illness in middle income countries in Central America

    Directory of Open Access Journals (Sweden)

    Isabel Cristina Martins Emmerick

    2013-12-01

    Full Text Available OBJECTIVE : To analyze the main predictors of access to medicines for persons who experienced acute health conditions. METHODS : This was a cross-sectional analytic study, based on data from household surveys. We examined the predictors of: (1 seeking care for acute illness in the formal health care system and (2 obtaining all medicines sought for the acute condition. RESULTS : The significant predictors of seeking health care for acute illnesses were urban geographic location, head of household with secondary school education or above, age under 15, severity of illness perceived by the respondent, and having health insurance. The most important predictor of obtaining full access to medicines was seeking care in the formal health care system. People who sought care in the formal system were three times more likely to receive all the medicines sought (OR 3.0, 95%CI 2.3;4.0. For those who sought care in the formal health system, the strongest predictors of full access to medicines were seeking care in the private sector, having secondary school education or above, and positive perceptions of quality of health care and medicines in public sector health facilities. For patients who did not seek care in the formal health system, full access to medicines was more likely in Honduras or Nicaragua than in Guatemala. Urban geographic location, higher economic status, and male gender were also significant predictors. CONCLUSIONS : A substantial part of the population in these three countries sought and obtained medicines outside of the formal health care system, which may compromise quality of care and pose a risk to patients. Determinants of full access to medicines inside and outside the formal health care system differ, and thus may require different strategies to improve access to medicines.

  13. Contraception for adolescents in low and middle income countries: needs, barriers, and access.

    Science.gov (United States)

    Chandra-Mouli, Venkatraman; McCarraher, Donna R; Phillips, Sharon J; Williamson, Nancy E; Hainsworth, Gwyn

    2014-01-02

    Substantial numbers of adolescents experience the negative health consequences of early, unprotected sexual activity - unintended pregnancy, unsafe abortions, pregnancy-related mortality and morbidity and Sexually Transmitted Infections including Human Immunodeficiency Virus; as well as its social and economic costs. Improving access to and use of contraceptives - including condoms - needs to be a key component of an overall strategy to preventing these problems. This paper contains a review of research evidence and programmatic experiences on needs, barriers, and approaches to access and use of contraception by adolescents in low and middle income countries (LMIC). Although the sexual activity of adolescents (ages 10-19) varies markedly for boys versus girls and by region, a significant number of adolescents are sexually active; and this increases steadily from mid-to-late adolescence. Sexually active adolescents - both married and unmarried - need contraception. All adolescents in LMIC - especially unmarried ones - face a number of barriers in obtaining contraception and in using them correctly and consistently. Effective interventions to improve access and use of contraception include enacting and implementing laws and policies requiring the provision of sexuality education and contraceptive services for adolescents; building community support for the provision of contraception to adolescents, providing sexuality education within and outside school settings, and increasing the access to and use of contraception by making health services adolescent-friendly, integrating contraceptive services with other health services, and providing contraception through a variety of outlets. Emerging data suggest mobile phones and social media are promising means of increasing contraceptive use among adolescents.

  14. The introduction of new vaccines into developing countries. IV: Global Access Strategies.

    Science.gov (United States)

    Mahoney, Richard T; Krattiger, Anatole; Clemens, John D; Curtiss, Roy

    2007-05-16

    This paper offers a framework for managing a comprehensive Global Access Strategy for new vaccines in developing countries. It is aimed at strengthening the ability of public-sector entities to reach their goals. The Bill and Melinda Gates Foundation and The Rockefeller Foundation have been leaders in stimulating the creation of new organizations - public/private product development partnerships (PDPs) - that seek to accelerate vaccine development and distribution to meet the health needs of the world's poor. Case studies of two of these PDPs - the Salmonella Anti-pneumococcal Vaccine Program and the Pediatric Dengue Vaccine Initiative - examine development of such strategies. Relying on the application of innovation theory, the strategy leads to the identification of six Components of Innovation which cover all aspects of the vaccine innovation process. Appropriately modified, the proposed framework can be applied to the development and introduction of other products in developing countries including drugs, and nutritional and agricultural products.

  15. Access to Strong Opioid Analgesics in the Context of Legal and Regulatory Barriers in Eleven Central and Eastern European Countries.

    Science.gov (United States)

    Vranken, Marjolein J M; Mantel-Teeuwisse, Aukje K; Schutjens, Marie-Hélène D B; Scholten, Willem K; Jünger, Saskia; Medic, Dr Rer; Leufkens, Hubert G M

    2018-04-06

    In 2011-2013, >95% of the global opioid analgesics consumption occurred in three regions, accounting for 15% of the world population. Despite abundant literature on barriers to access, little is known on the correlation between actual access to opioid analgesics and barriers to access, including legal and regulatory barriers. This study aimed to evaluate the correlation between access to strong opioid analgesics and barriers to access in national legislation and regulations in 11 central and eastern European countries that participated in the Access to Opioid Medication in Europe (ATOME) project. Two variables were contrasted to assess their correlation: the country level of access to strong opioid analgesics indicated by the Adequacy of Consumption Measure (ACM) and the number of potential legal and regulatory barriers identified by an external review of legislation and regulations. A linear correlation was evaluated using a squared linear correlation coefficient. Evaluation of the correlation between the ACM and the number of potential barriers produces an R 2 value of 0.023 and a correlation plot trend line gradient of -0.075, indicating no correlation between access to strong opioid analgesics and the number of potential barriers in national legislation and regulations in the countries studied. No correlation was found, which indicates that other factors besides potential legal and regulatory barriers play a critical role in withholding prescribers and patients essential pain medication in the studied countries. More research is needed toward better understanding of the complex interplay of factors that determine access to strong opioid analgesics.

  16. The impact of access to immunization information on vaccine acceptance in three countries.

    Directory of Open Access Journals (Sweden)

    Lori K Handy

    Full Text Available Vaccine acceptance is a critical component of sustainable immunization programs, yet rates of vaccine hesitancy are rising. Increased access to misinformation through media and anti-vaccine advocacy is an important contributor to hesitancy in the United States and other high-income nations with robust immunization programs. Little is known about the content and effect of information sources on attitudes toward vaccination in settings with rapidly changing or unstable immunization programs.The objective of this study was to explore knowledge and attitudes regarding vaccines and vaccine-preventable diseases among caregivers and immunization providers in Botswana, the Dominican Republic, and Greece and examine how access to information impacts reported vaccine acceptance.We conducted 37 focus groups and 14 semi-structured interviews with 96 providers and 153 caregivers in Botswana, the Dominican Republic, and Greece. Focus groups were conducted in Setswana, English, Spanish, or Greek; digitally recorded; and transcribed. Transcripts were translated into English, coded in qualitative data analysis software (NVivo 10, QSR International, Melbourne, Australia, and analyzed for common themes.Dominant themes in all three countries included identification of health care providers or medical literature as the primary source of vaccine information, yet participants reported insufficient communication about vaccines was available. Comments about level of trust in the health care system and government contrasted between sites, with the highest level of trust reported in Botswana but lower levels of trust in Greece.In Botswana, the Dominican Republic, and Greece, participants expressed reliance on health care providers for information and demonstrated a need for more communication about vaccines. Trust in the government and health care system influenced vaccine acceptance differently in each country, demonstrating the need for country-specific data that focus

  17. Prospects for Vascular Access Education in Developing Countries: Current Situation in Cambodia.

    Science.gov (United States)

    Naganuma, Toshihide; Takemoto, Yoshiaki

    2017-01-01

    We report our activities training doctors on vascular access procedures at International University (IU) Hospital in Cambodia through a program facilitated by Ubiquitous Blood Purification International, a nonprofit organization that provides medical support to developing countries in the field of dialysis medicine. Six doctors from Japan have been involved in the education of medical personnel at IU, and we have collectively visited Cambodia about 15 times from 2010 to 2016. In these visits, we have performed many operations, including 42 for arteriovenous fistula, 1 arteriovenous graft, and 1 percutaneous transluminal angioplasty. Stable development and management of vascular access is increasingly required in Cambodia due to increased use of dialysis therapy, and training of doctors in this technique is urgently required. However, we have encountered several difficulties that need to be addressed, including (1) the situation of personnel receiving this training, (2) problems with facilities, including medical equipment and drugs, (3) financial limitations, and (4) problems with management of vascular access. © 2017 S. Karger AG, Basel.

  18. Patents and access to drugs in developing countries: an ethical analysis.

    Science.gov (United States)

    Sterckx, Sigrid

    2004-05-01

    More than a third of the world's population has no access to essential drugs. More than half of this group of people live in the poorest regions of Africa and Asia. Several factors determine the accessibility of drugs in developing countries. Hardly any medicines for tropical diseases are being developed, but even existing drugs are often not available to the patients who need them. One of the important determinants of access to drugs is the working of the patent system. This paper first maps out some facts about the global patent regime that has emerged as a consequence of the conclusion of the WTO-TRIPs Agreement in 1994. Attempts to construct a moral justification of the patent system have been based on three grounds: natural rights, distributive justice, and utilitarian arguments. This paper examines to what extent and on which grounds drug patents can be justified. The final section looks at the so-called 'Doha Declaration on the TRIPs Agreement and Public Health', which was adopted by the WTO Ministerial Conference two years ago, recognising the primacy of public health over the interests of patent proprietors.

  19. Free Open Access Medical Education resource knowledge and utilisation amongst Emergency Medicine trainees: A survey in four countries

    Directory of Open Access Journals (Sweden)

    Natalie Thurtle

    2016-03-01

    The Emergency Medicine trainees in both developed and low resource settings studied were aware that Free Open Access Medical Education resources exist, but trainees in lower income settings were generally less aware of specific resources. Lack of internet and device access was not a barrier to use in this group.

  20. The Cervix Cancer Research Network (CCRN: Increasing access to cancer clinical trials in low- and middle-income countries

    Directory of Open Access Journals (Sweden)

    Gita eSuneja

    2015-02-01

    Full Text Available Introduction: The burden of cervical cancer is large and growing in developing countries, due in large part to limited access to screening services and lack of human papillomavirus (HPV vaccination. In spite of modern advances in diagnostic and therapeutic modalities, outcomes from cervical cancer have not markedly improved in recent years. Novel clinical trials are urgently needed to improve outcomes from cervical cancer worldwide. Methods: The Cervix Cancer Research Network (CCRN, a subsidiary of the Gynecologic Cancer InterGroup (GCIG, is a multi-national, multi-institutional consortium of physicians and scientists focused on improving cervical cancer outcomes worldwide by making cancer clinical trials available in low-, middle-, and high-income countries. Standard operating procedures for participation in CCRN include a pre-qualifying questionnaire to evaluate clinical activities and research infrastructure, followed by a site visit. Once a site is approved, they may choose to participate in one of four currently accruing clinical trials.Results: To date, 13 different CCRN site visits have been performed. Of these 13 sites visited, 10 have been approved as CCRN sites including Tata Memorial Hospital, India; Bangalore, India; Trivandrum, India; Ramathibodi, Thailand; Siriaj, Thailand; Pramongkutklao, Thailand; Ho Chi Minh, Vietnam; Blokhin Russian Cancer Research Center; the Hertzen Moscow Cancer Research Institute; and the Russian Scientific Center of Roentgenoradiology. The four currently accruing clinical trials are TACO, OUTBACK, INTERLACE, and SHAPE.Discussion: The CCRN has successfully enrolled 10 sites in developing countries to participate in four randomized clinical trials. The primary objectives are to provide novel therapeutics to regions with the greatest need and to improve the validity and generalizability of clinical trial results by enrolling a diverse sample of patients.

  1. Matching Up to the Information Society: An Evaluation of the EU, the EU Accession Countries, Switzerland and the United States

    Science.gov (United States)

    Graafland-Essers, Irma; Cremonini, Leon; Ettedgui, Emile; Botterman, Maarten

    2003-01-01

    This report presents the current understanding of the advancement of the Information Society within the European Union and countries that are up for accession in 2004, and is based on the SIBIS (Statistical Indicators Benchmarking the Information Society) surveys and analyses per SIBIS theme and country. The report is unique in its coherent and…

  2. Lack of proportionality. Seven specifications of public interest that override post-approval commercial interests on limited access to clinical data

    Directory of Open Access Journals (Sweden)

    Strech Daniel

    2012-07-01

    Full Text Available Abstract For the protection of commercial interests, licensing bodies such as the EMA and health technology assessment institutions such as NICE restrict full access to unpublished evidence. Their respective policies on data transparency, however, lack a systematic account of (1 what kinds of commercial interests remain relevant after market approval has been granted, (2 what the specific types of public interest are that may override these commercial interests post approval, and, most importantly, (3 what criteria guide the trade-off between public interest and legitimate measures for the protection of commercial interest. Comparing potential commercial interests with seven specifications of relevant public interest reveals the lack of proportionality inherent in the current practices of EMA and NICE.

  3. European union water policy--tasks for implementing "Water Framework Directive" in pre-accession countries.

    Science.gov (United States)

    Sözen, Seval; Avcioglu, Ebru; Ozabali, Asli; Görgun, Erdem; Orhon, Derin

    2003-08-01

    Water Framework Directive aiming to maintain and improve the aquatic environment in the EU was launched by the European Parliament in 2000. According to this directive, control of quantity is an ancillary element in securing good water quality and therefore measures on quantity, serving the objective of ensuring good quality should also be established. Accordingly, it is a comprehensive and coordinated package that will ensure all European waters to be protected according to a common standard. Therefore, it refers to all other Directives related to water resources management such as Urban Wastewater Treatment Directive Nitrates Directive, Drinking Water Directive, Integrated Pollution Prevention Control etc. Turkey, as a candidate state targeting full-membership, should comply the necessary preparations for the implementation of the "Water Framework Directive" as soon as possible. In this study, the necessary legislative, political, institutional, and technical attempts of the pre-accession countries have been discussed and effective recommendations have been offered for future activities in Turkey.

  4. Accessing international financing for climate change mitigation - A guidebook for developing countries

    Energy Technology Data Exchange (ETDEWEB)

    Limaye, D.R.; Zhu, X.

    2012-08-15

    This guidebook has been prepared by the UNEP Risoe Centre (URC) as part of its Technology Needs Assessment (TNA) project. The TNA project assists developing countries to identify national mitigation and adaptation technology priorities and to develop Technology Action Plans (TAPs) for mitigation of greenhouse gas (GHG) emissions and climate change adaptation. This guidebook provides information to help TNA countries better identify and access financial resources for the mitigation activities included in their national TAPs. This guidebook covers both mitigation 'projects' (such as a wind farm or a solar PV generation facility) and 'programmes' (such as a credit line for financing energy efficiency projects in small and medium-sized enterprises (SMEs), or bulk procurement and distribution of compact fluorescent lamps to households). The primary emphasis is on multilateral and bilateral sources of financing but the guidebook also includes an overview of private funding sources and public-private partnerships (PPPs). This guidebook only covers international financing for mitigation actions in developing countries. For example, EU funding for EU member countries and Chinese funding for mitigation in China are not covered in this guidebook. However, the EU funding for mitigation in developing countries and Chinese funding supporting mitigation in other developing countries are included. Special funds established in some developing countries by pooling financing support from developed countries are also covered in this guidebook. Information on the financing sources was compiled in a standard format and reviewed and analysed to categorise the financing sources. For the multilateral and bilateral financing sources, the available information was used to define their major characteristics (such as geographic coverage, technology/sector focus, funding sources, financing objectives, financing mechanisms, and management and governance). In addition, the

  5. Are social franchises contributing to universal access to reproductive health services in low-income countries?

    Science.gov (United States)

    Sundari Ravindran, T K; Fonn, Sharon

    2011-11-01

    A social franchise in health is a network of for-profit private health practitioners linked through contracts to provide socially beneficial services under a common brand. The early 21st century has seen considerable donor enthusiasm for promoting social franchises for the provision of reproductive health services. Based on a compendium of descriptive information on 45 clinical social franchises, located in 27 countries of Africa, Asia and Latin America, this paper examines their contribution to universal access to comprehensive reproductive health services. It finds that these franchises have not widened the range of reproductive health services, but have mainly focused on contraceptive services, and to a lesser extent, maternal health care and abortion. In many instances, coverage had not been extended to new areas. Measures taken to ensure sustainability ran counter to the objective of access for low-income groups. In almost two-thirds of the franchises, the full cost of all services had to be paid out of pocket and was unaffordable for low-income women. While standards and protocols for quality assurance were in place in all franchises, evidence on adherence to these was limited. Informal interviews with patients indicated satisfaction with services. However, factors such as difficulties in recruiting franchisees and significant attrition, franchisees' inability to attend training programmes, use of lay health workers to deliver services without support or supervision, and logistical problems with applying quality assurance tools, all raise concerns. The contribution of social franchises to universal access to reproductive health services appears to be uncertain. Continued investment in them for the provision of reproductive health services does not appear to be justified until and unless further evidence of their value is forthcoming. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  6. Burnout syndrome among psychiatric trainees in 22 countries: Risk increased by long working hours, lack of supervision, and psychiatry not being first career choice.

    Science.gov (United States)

    Jovanović, N; Podlesek, A; Volpe, U; Barrett, E; Ferrari, S; Rojnic Kuzman, M; Wuyts, P; Papp, S; Nawka, A; Vaida, A; Moscoso, A; Andlauer, O; Tateno, M; Lydall, G; Wong, V; Rujevic, J; Platz Clausen, N; Psaras, R; Delic, A; Losevich, M A; Flegar, S; Crépin, P; Shmunk, E; Kuvshinov, I; Loibl-Weiß, E; Beezhold, J

    2016-02-01

    Postgraduate medical trainees experience high rates of burnout, but evidence regarding psychiatric trainees is missing. We aim to determine burnout rates among psychiatric trainees, and identify individual, educational and work-related factors associated with severe burnout. In an online survey psychiatric trainees from 22 countries were asked to complete the Maslach Burnout Inventory (MBI-GS) and provide information on individual, educational and work-related parameters. Linear mixed models were used to predict the MBI-GS scores, and a generalized linear mixed model to predict severe burnout. This is the largest study on burnout and training conditions among psychiatric trainees to date. Complete data were obtained from 1980 out of 7625 approached trainees (26%; range 17.8-65.6%). Participants were 31.9 (SD 5.3) years old with 2.8 (SD 1.9) years of training. Severe burnout was found in 726 (36.7%) trainees. The risk was higher for trainees who were younger (Pcareer choice (P=0.043). After adjustment for socio-demographic characteristics, years in training and country differences in burnout, severe burnout remained associated with long working hours (Pworking hours and younger age, this is the first evidence of negative influence of lack of supervision and not opting for psychiatry as a first career choice on trainees' burnout. Copyright © 2016. Published by Elsevier Masson SAS.

  7. Health inequalities by gradients of access to water and sanitation between countries in the Americas, 1990 and 2010.

    Science.gov (United States)

    Mújica, Oscar J; Haeberer, Mariana; Teague, Jordan; Santos-Burgoa, Carlos; Galvão, Luiz Augusto Cassanha

    2015-11-01

    To explore distributional inequality of key health outcomes as determined by access coverage to water and sanitation (WS) between countries in the Region of the Americas. An ecological study was designed to explore the magnitude and change-over-time of standard gap and gradient metrics of environmental inequalities in health at the country level in 1990 and 2010 among the 35 countries of the Americas. Access to drinking water and access to improved sanitation facilities were selected as equity stratifiers. Five dependent variables were: total and healthy life expectancies at birth, and infant, under-5, and maternal mortality. Access to WS correlated with survival and mortality, and strong gradients were seen in both 1990 and 2010. Higher WS access corresponded to higher life expectancy and healthy life expectancy and lower infant, under-5, and maternal mortality risks. Burden of life lost was unequally distributed, steadily concentrated among the most environmentally disadvantaged, who carried up to twice the burden than they would if WS were fairly distributed. Population averages in life expectancy and specific mortality improved, but whereas absolute inequalities decreased, relative inequalities remained mostly invariant. Even with the Region on track to meet MDG 7 on water and sanitation, large environmental gradients and health inequities among countries remain hidden by Regional averages. As the post-2015 development agenda unfolds, policies and actions focused on health equity-mainly on the most socially and environmentally deprived-will be needed in order to secure the right for universal access to water and sanitation.

  8. Spatial Access to Emergency Services in Low- and Middle-Income Countries: A GIS-Based Analysis.

    Directory of Open Access Journals (Sweden)

    Gavin Tansley

    Full Text Available Injury is a leading cause of the global disease burden, accounting for 10 percent of all deaths worldwide. Despite 90 percent of these deaths occurring in low and middle-income countries (LMICs, the majority of trauma research and infrastructure development has taken place in high-income settings. Furthermore, although accessible services are of central importance to a mature trauma system, there remains a paucity of literature describing the spatial accessibility of emergency services in LMICs. Using data from the Service Provision Assessment component of the Demographic and Health Surveys of Namibia and Haiti we defined the capabilities of healthcare facilities in each country in terms of their preparedness to provide emergency services. A Geographic Information System-based network analysis method was used to define 5- 10- and 50-kilometer catchment areas for all facilities capable of providing 24-hour care, higher-level resuscitative services or tertiary care. The proportion of a country's population with access to each level of service was obtained by amalgamating the catchment areas with a population layer. A significant proportion of the population of both countries had poor spatial access to lower level services with 25% of the population of Haiti and 51% of the population of Namibia living further than 50 kilometers from a facility capable of providing 24-hour care. Spatial access to tertiary care was considerably lower with 51% of Haitians and 72% of Namibians having no access to these higher-level services within 50 kilometers. These results demonstrate a significant disparity in potential spatial access to emergency services in two LMICs compared to analogous estimates from high-income settings, and suggest that strengthening the capabilities of existing facilities may improve the equity of emergency services in these countries. Routine collection of georeferenced patient and facility data in LMICs will be important to understanding

  9. Improving access to malaria medicine through private-sector subsidies in seven African countries.

    Science.gov (United States)

    Tougher, Sarah; Mann, Andrea G; Ye, Yazoume; Kourgueni, Idrissa A; Thomson, Rebecca; Amuasi, John H; Ren, Ruilin; Willey, Barbara A; Ansong, Daniel; Bruxvoort, Katia; Diap, Graciela; Festo, Charles; Johanes, Boniface; Kalolella, Admirabilis; Mallam, Oumarou; Mberu, Blessing; Ndiaye, Salif; Nguah, Samual Blay; Seydou, Moctar; Taylor, Mark; Wamukoya, Marilyn; Arnold, Fred; Hanson, Kara; Goodman, Catherine

    2014-09-01

    Improving access to quality-assured artemisinin combination therapies (ACTs) is an important component of malaria control in low- and middle-income countries. In 2010 the Global Fund to Fight AIDS, Tuberculosis, and Malaria launched the Affordable Medicines Facility--malaria (AMFm) program in seven African countries. The goal of the program was to decrease malaria morbidity and delay drug resistance by increasing the use of ACTs, primarily through subsidies intended to reduce costs. We collected data on price and retail markups on antimalarial medicines from 19,625 private for-profit retail outlets before and 6-15 months after the program's implementation. We found that in six of the AMFm pilot programs, prices for quality-assured ACTs decreased by US$1.28-$4.34, and absolute retail markups on these therapies decreased by US$0.31-$1.03. Prices and markups on other classes of antimalarials also changed during the evaluation period, but not to the same extent. In all but two of the pilot programs, we found evidence that prices could fall further without suppliers' losing money. Thus, concerns may be warranted that wholesalers and retailers are capturing subsidies instead of passing them on to consumers. These findings demonstrate that supranational subsidies can dramatically reduce retail prices of health commodities and that recommended retail prices communicated to a wide audience may be an effective mechanism for controlling the market power of private-sector antimalarial retailers and wholesalers. Project HOPE—The People-to-People Health Foundation, Inc.

  10. A simple and low-cost Internet-based teleconsultation system that could effectively solve the health care access problems in underserved areas of developing countries.

    Science.gov (United States)

    Kuntalp, Mehmet; Akar, Orkun

    2004-08-01

    In many developing countries including Turkey, telemedicine systems are not in wide use due to the high cost and complexity of the required technology. Lack of these systems however has serious implications on patients who live in rural areas. The objective of this paper is to present a simple and economically affordable alternative to the current systems that would allow experts to easily access the medical data of their remote patients over the Internet. The system is developed in client-server architecture with a user-friendly graphical interface and various services are implemented as dynamic web pages based on PHP. The other key features of the system are its powerful security features and platform independency. An academic prototype is implemented and presented to the evaluation of a group of physicians. The results reveal that the system could find acceptance from the medical community and it could be an effective means of providing quality health care in developing countries.

  11. Improving access to emergency contraception pills through strengthening service delivery and demand generation: a systematic review of current evidence in low and middle-income countries.

    Directory of Open Access Journals (Sweden)

    Angela Dawson

    Full Text Available Emergency contraception pills (ECP are among the 13 essential commodities in the framework for action established by the UN Commission on Life-Saving Commodities for Women and Children. Despite having been on the market for nearly 20 years, a number of barriers still limit women's access to ECP in low- and middle-income countries (LMIC including limited consumer knowledge and poor availability. This paper reports the results of a review to synthesise the current evidence on service delivery strategies to improve access to ECP.A narrative synthesis methodology was used to examine peer reviewed research literature (2003 to 2013 from diverse methodological traditions to provide critical insights into strategies to improve access from a service delivery perspective. The studies were appraised using established scoring systems and the findings of included papers thematically analysed and patterns mapped across all findings using concept mapping.Ten papers were included in the review. Despite limited research of adequate quality, promising strategies to improve access were identified including: advance provision of ECP; task shifting and sharing; intersectoral collaboration for sexual assault; m-health for information provision; and scale up through national family planning programs.There are a number of gaps in the research concerning service delivery and ECP in LMIC. These include a lack of knowledge concerning private/commercial sector contributions to improving access, the needs of vulnerable groups of women, approaches to enhancing intersectoral collaboration, evidence for social marketing models and investment cases for ECP.

  12. Improving Access to Emergency Contraception Pills through Strengthening Service Delivery and Demand Generation: A Systematic Review of Current Evidence in Low and Middle-Income Countries

    Science.gov (United States)

    Dawson, Angela; Tran, Nguyen-Toan; Westley, Elizabeth; Mangiaterra, Viviana; Festin, Mario

    2014-01-01

    Objectives Emergency contraception pills (ECP) are among the 13 essential commodities in the framework for action established by the UN Commission on Life-Saving Commodities for Women and Children. Despite having been on the market for nearly 20 years, a number of barriers still limit women's access to ECP in low- and middle-income countries (LMIC) including limited consumer knowledge and poor availability. This paper reports the results of a review to synthesise the current evidence on service delivery strategies to improve access to ECP. Methods A narrative synthesis methodology was used to examine peer reviewed research literature (2003 to 2013) from diverse methodological traditions to provide critical insights into strategies to improve access from a service delivery perspective. The studies were appraised using established scoring systems and the findings of included papers thematically analysed and patterns mapped across all findings using concept mapping. Findings Ten papers were included in the review. Despite limited research of adequate quality, promising strategies to improve access were identified including: advance provision of ECP; task shifting and sharing; intersectoral collaboration for sexual assault; m-health for information provision; and scale up through national family planning programs. Conclusion There are a number of gaps in the research concerning service delivery and ECP in LMIC. These include a lack of knowledge concerning private/commercial sector contributions to improving access, the needs of vulnerable groups of women, approaches to enhancing intersectoral collaboration, evidence for social marketing models and investment cases for ECP. PMID:25285438

  13. Access to Archives in Post-Communist Countries: The Victim’s Perspective

    Directory of Open Access Journals (Sweden)

    Gruodytė Edita

    2015-10-01

    Full Text Available The collapse of the communist regime at the end of the twentieth century resulted in a wave of democratization in Central and Eastern Europe. While trying to establish democracy, many states in this region had to demonstrate their ability to protect human rights and to deal with the past of the repressive regime. As these states decided to join various human rights instruments they also became subject to certain obligations towards their people. One of these obligations is the requirement to provide remedies in case of human rights abuses, and the right to know the truth is recognized as part of it. Therefore the goal of this article is to identify the abilities of the victim of the communist regime to access the files of former secret services in post-communist countries in the light of the right to know the truth. The answer is provided using an analysis of international documents, historic, comparative and systemic methods, providing and evaluating the practice of different states dealing with the files of former secret services or government files of the repressive past and academic literature.

  14. An Internationally Competitive Economy: a Comparison of Poland and the Visegrad Group Countries in the Post‑Accession Period

    Directory of Open Access Journals (Sweden)

    Molendowski Edward

    2017-12-01

    Full Text Available This article presents the results of an analysis comparing the competitive position of Poland and other countries of the Visegrad Group (V4 in the post‑accession period (2004-2015. The assumption is that among the V4 countries, Poland has joined those countries where the diverse effects of EU membership are clearly visible. In the study, analysis was applied to secondary data pertaining to pillars of economic competitiveness, as determined by the ‘Global Competitiveness Reports’ prepared by the World Economic Forum. The article ends with a list of vital conclusions based on the presented analysis.

  15. Identification of Challenges to the Availability and Accessibility of Opioids in Twelve European Countries: Conclusions from Two ATOME Six-Country Workshops.

    Science.gov (United States)

    Linge-Dahl, Lisa; Vranken, Marjolein; Juenger, Saskia; North, Kate; Scholten, Willem; Payne, Sheila; Radbruch, Lukas

    2015-12-01

    Access to many controlled medicines is inadequate in a number of European countries. This leads to deficits in the treatment of moderate to severe pain as well as in opioid agonist therapy. The study objective was to elaborate the reasons for this inadequacy. The work plan of the Access to Opioid Medication in Europe (ATOME) project included two six-country workshops. These workshops comprised a national situational analysis, drafting tailor-made recommendations for improvement and developing action plans for their implementation. In total, 84 representatives of the national Ministries of Health, national controlled substances authorities, experts representing regulatory and law enforcement authorities, leading health care professionals, and patient representatives from 13 European countries participated in either one of the workshops. The delegates used breakout sessions to identify key common challenges. Content analysis was used for the evaluation of protocols and field notes. A number of challenges to opioid accessibility in the countries was identified in the domains of knowledge and educational, regulatory, legislative, as well as public awareness and training barriers that limit opioid prescription. In addition, short validity of prescriptions and bureaucratic practices resulting in overregulation impeded availability of some essential medicines. Stigmatization and criminalisation of people who use drugs remained the major impediment to increasing opioid agonist program coverage. The challenges identified during outcomes of the workshops were used as the basis for subsequent dissemination and implementation activities in the ATOME project, and in some countries the workshop proceedings already served as a stepping-stone for the first changes in regulations and legislation.

  16. The CAP Mid Term Review and the WTO Doha Round; Analyses for the Netherlands, EU and accession countries

    NARCIS (Netherlands)

    Lips, M.

    2004-01-01

    This report analyses the potential impact of the EU CAP reforms that follow the Mid Term Review and the Harbinson Proposal for negotiation modalities in the WTO Doha Round on the Netherlands, EU14 and the accession countries. In welfare terms, the MTR has a rela-tively small impact on the

  17. Addiction treatment in deprived urban areas in EU countries: Accessibility of care for people from socially marginalized groups

    NARCIS (Netherlands)

    Welbel, Marta; Matanov, Aleksandra; Moskalewicz, Jacek; Barros, Henrique; Canavan, Reamonn; Gabor, Edina; Gaddini, Andrea; Greacen, Tim; Kluge, Ulrike; Lorant, Vincent; Esteban Pena, Mercedes; Schene, Aart H.; Soares, Joaquim J. F.; Strassmayr, Christa; Vondrackova, Petra; Priebe, Stefan

    2013-01-01

    Aim: This study examines the accessibility of addiction treatment within services providing mental health care and support for people from socially marginalized groups in deprived urban areas across EU countries. Methods: Services providing mental health care and support in deprived areas of 14 EU

  18. Health inequalities by gradients of access to water and sanitation between countries in the Americas, 1990 and 2010

    Directory of Open Access Journals (Sweden)

    Oscar J. Mújica

    Full Text Available OBJECTIVE: To explore distributional inequality of key health outcomes as determined by access coverage to water and sanitation (WS between countries in the Region of the Americas. METHODS: An ecological study was designed to explore the magnitude and change-over-time of standard gap and gradient metrics of environmental inequalities in health at the country level in 1990 and 2010 among the 35 countries of the Americas. Access to drinking water and access to improved sanitation facilities were selected as equity stratifiers. Five dependent variables were: total and healthy life expectancies at birth, and infant, under-5, and maternal mortality. RESULTS: Access to WS correlated with survival and mortality, and strong gradients were seen in both 1990 and 2010. Higher WS access corresponded to higher life expectancy and healthy life expectancy and lower infant, under-5, and maternal mortality risks. Burden of life lost was unequally distributed, steadily concentrated among the most environmentally disadvantaged, who carried up to twice the burden than they would if WS were fairly distributed. Population averages in life expectancy and specific mortality improved, but whereas absolute inequalities decreased, relative inequalities remained mostly invariant. CONCLUSIONS: Even with the Region on track to meet MDG 7 on water and sanitation, large environmental gradients and health inequities among countries remain hidden by Regional averages. As the post-2015 development agenda unfolds, policies and actions focused on health equity-mainly on the most socially and environmentally deprived-will be needed in order to secure the right for universal access to water and sanitation.

  19. Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency

    Directory of Open Access Journals (Sweden)

    Kangolle Alfred CT

    2010-10-01

    Full Text Available Abstract Background Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. Discussion This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1 Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2 Process: enabling follow-up, knowledge translation, patient safety and quality assurance. (3 Outcome: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes. Summary There is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1 Capacity building in oncology health services research, policy and planning relevant to developing countries. (2 Development of high-quality health data sources. (3 More oncology-related economic evaluations in developing countries. (4 Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and

  20. Cancer control in developing countries: using health data and health services research to measure and improve access, quality and efficiency.

    Science.gov (United States)

    Hanna, Timothy P; Kangolle, Alfred C T

    2010-10-13

    Cancer is a rapidly increasing problem in developing countries. Access, quality and efficiency of cancer services in developing countries must be understood to advance effective cancer control programs. Health services research can provide insights into these areas. This article provides an overview of oncology health services in developing countries. We use selected examples from peer-reviewed literature in health services research and relevant publicly available documents. In spite of significant limitations in the available data, it is clear there are substantial barriers to access to cancer control in developing countries. This includes prevention, early detection, diagnosis/treatment and palliation. There are also substantial limitations in the quality of cancer control and a great need to improve economic efficiency. We describe how the application of health data may assist in optimizing (1) Structure: strengthening planning, collaboration, transparency, research development, education and capacity building. (2) PROCESS: enabling follow-up, knowledge translation, patient safety and quality assurance. (3) OUTCOME: facilitating evaluation, monitoring and improvement of national cancer control efforts. There is currently limited data and capacity to use this data in developing countries for these purposes. There is an urgent need to improve health services for cancer control in developing countries. Current resources and much-needed investments must be optimally managed. To achieve this, we would recommend investment in four key priorities: (1) Capacity building in oncology health services research, policy and planning relevant to developing countries. (2) Development of high-quality health data sources. (3) More oncology-related economic evaluations in developing countries. (4) Exploration of high-quality models of cancer control in developing countries. Meeting these needs will require national, regional and international collaboration as well as political

  1. "It makes us really look inferior to outsiders": Coping with psychosocial experiences associated with the lack of access to safe water and sanitation.

    Science.gov (United States)

    Bisung, Elijah; Elliott, Susan J

    2017-11-09

    This paper explores daily experiences and coping resources related to the lack of access to safe water and adequate sanitation in Usoma, a lakeshore community in Western Kenya. A qualitative approach that involved 10 focus group discussions and 9 key informant interviews with community leaders, volunteers and professionals was used to explore the research objectives. Data were collected from June to August 2013. Daily practices and experiences around water and sanitation, such as water collection, open defecation and shared toilets, were a major concern to residents. In the absence of safe water, residents used social networks and support, financial resources and the nearby Lake Victoria as coping resources. Findings from this study are important for mobilizing resources in vulnerable settings as a first step towards designing community-based interventions. For public health practice, practitioners must work with - and collaborate across - sectors to enhance and strengthen social networks and cohesion, and protect the natural environment while working toward addressing water-related challenges in deprived settings.

  2. Legal barriers in accessing opioid medicines: results of the ATOME quick scan of national legislation of eastern European countries.

    Science.gov (United States)

    Vranken, Marjolein J M; Mantel-Teeuwisse, Aukje K; Jünger, Saskia; Radbruch, Lukas; Lisman, John; Scholten, Willem; Payne, Sheila; Lynch, Tom; Schutjens, Marie-Hélène D B

    2014-12-01

    Overregulation of controlled medicines is one of the factors contributing to limited access to opioid medicines. The purpose of this study was to identify legal barriers to access to opioid medicines in 12 Eastern European countries participating in the Access to Opioid Medication in Europa project, using a quick scan method. A quick scan method to identify legal barriers was developed focusing on eight different categories of barriers. Key experts in 12 European countries were requested to send relevant legislation. Legislation was quick scanned using World Health Organization guidelines. Overly restrictive provisions and provisions that contain stigmatizing language and incorrect definitions were identified. The selected provisions were scored into two categories: 1) barrier and 2) uncertain, and reviewed by two authors. A barrier was recorded if both authors agreed the selected provision to be a barrier (Category 1). National legislation was obtained from 11 of 12 countries. All 11 countries showed legal barriers in the areas of prescribing (most frequently observed barrier). Ten countries showed barriers in the areas of dispensing and showed stigmatizing language and incorrect use of definitions in their legislation. Most barriers were identified in the legislation of Bulgaria, Greece, Lithuania, Serbia, and Slovenia. The Cypriot legislation showed the fewest total number of barriers. The selected countries have in common as main barriers prescribing and dispensing restrictions, the use of stigmatizing language, and incorrect use of definitions. The practical impact of these barriers identified using a quick scan method needs to be validated by other means. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  3. Housing Quality and Access to Material and Learning Resources within the Home Environment in Developing Countries

    Science.gov (United States)

    Bradley, Robert H.; Putnick, Diane L.

    2012-01-01

    This study examined home environment conditions (housing quality, material resources, formal and informal learning materials) and their relations with the Human Development Index (HDI) in 28 developing countries. Home environment conditions in these countries varied widely. The quality of housing and availability of material resources at home were…

  4. THE DETERMINANTS OF DEVELOPING-COUNTRIES ACCESS TO THE INTERNATIONAL CAPITAL-MARKET

    NARCIS (Netherlands)

    LENSINK, R; VANBERGEIJK, PAG

    1991-01-01

    The traditional analysis of Western credit relations with Developing Countries mainly focuses on the possibilities of debtor countries' meeting their debt obligations and tries to find factors behind possible default. The present study explicitly considers flows of funds between creditors and

  5. Sexually Transmitted Infection Services for Adolescents and Youth in Low- and Middle-Income Countries: Perceived and Experienced Barriers to Accessing Care.

    Science.gov (United States)

    Newton-Levinson, Anna; Leichliter, Jami S; Chandra-Mouli, Venkatraman

    2016-07-01

    Access to sexual and reproductive health (SRH) services is vital for sexually active adolescents; yet, their SRH care needs are often unmet. We conducted a qualitative systematic review of mixed methods studies to assess adolescent and provider views of barriers to seeking appropriate medical care for sexually transmitted infection (STI) services for adolescents. We searched peer-reviewed literature for studies published between 2001 and 2014 with a study population of youth (aged 10-24 years) and/or health service providers. Nineteen studies were identified for inclusion from 15 countries. Thematic analyses identified key themes across the studies. Findings suggest that youth lacked knowledge about STIs and services. In addition, youth experienced barriers related to service availability and a lack of integration of services. The most reported barriers were related to acceptability of services. Youth reported avoiding services or having confidentiality concerns based on provider demographics and some behaviors. Finally, experiences of shame and stigma were common barriers to seeking care. Adolescents in low- and middle-income countries experience significant barriers in obtaining STI and SRH services. Improving uptake may require efforts to address clinic systems and provider attitudes, including confidentiality issues. Moreover, addressing barriers to STI services may require addressing cultural norms related to adolescent sexuality. Copyright © 2016 Society for Adolescent Health and Medicine. All rights reserved.

  6. Access to information on nuclear safety in some Western countries. Additional expertise commissioned by the Public Debate National Commission

    International Nuclear Information System (INIS)

    Marignac, Y.; Schneider, Th.; Drouet, F.

    2006-01-01

    The authors report the analysis of procedures implemented in different western countries (Switzerland, Finland, United Kingdom, Germany, Sweden and United States) about the access to information on nuclear safety in the broad sense, i.e. as far as population protection against accidental or malevolent situations is concerned. They aimed at analysing how these procedures conciliate pluralism and comprehensive debate while preserving national and industrial interests as well as population's confidence. For each country, they present the different pubic bodies or agencies in charge of nuclear installations and nuclear safety, the existing legal framework related to information on government and nuclear activities, and give examples of information related to nuclear safety (incident or accident concerning nuclear power station or radioactive wastes). The comparative analysis considers different issues: access to information, and pluralist expertise

  7. National and Regional Impacts of Increasing Non-Agricultural Market Access by Developing Countries – the Case of Pakistan

    OpenAIRE

    Butt, Muhammad Shoaib; Bandara, Jayatilleke S.

    2008-01-01

    The US, the EU, Brazil and India met in Germany in June 2007 with a view to bridging differences between developed and developing countries on the Doha Round of trade negotiations. However, the talks broke down because of disagreement on the intertwined issues of agricultural protection and Non-Agricultural Market Access (NAMA). This study uses the first regional computable general equilibrium (CGE) model of Pakistan to evaluate the national and regional impacts of increasing NAMA as per two ...

  8. The Paris-Nairobi climate initiative. Access to clean energy for all in Africa and countries vulnerable to climate change. Access to energy, sustainable development and climate change

    International Nuclear Information System (INIS)

    2011-01-01

    The first part of this report highlights the importance of a universal access to energy, the role of public policies and renewable energies, the need to implement sustainable economic models for energy services, and indicates the major objectives and essential actions for these purposes. The second part outlines the weakness of electricity production in Africa, the degradation of the energy mix balance, the vulnerability to climate change, and the fact that Africa, like other countries vulnerable to climate change, possess huge and unexploited renewable energy resources (biomass, hydroelectricity, geothermal, solar, wind). The third part proposes an approach to energy services by developing sustainable cooking, supplying energy to support rural development and to poles of economic growth, by developing sustainable cities (notably in transports and buildings), and by developing national and regional electricity grids. The last part addresses the issue of energy financing in developing countries

  9. Perspectives of policy and political decision makers on access to formal dementia care: expert interviews in eight European countries.

    Science.gov (United States)

    Broda, Anja; Bieber, Anja; Meyer, Gabriele; Hopper, Louise; Joyce, Rachael; Irving, Kate; Zanetti, Orazio; Portolani, Elisa; Kerpershoek, Liselot; Verhey, Frans; Vugt, Marjolein de; Wolfs, Claire; Eriksen, Siren; Røsvik, Janne; Marques, Maria J; Gonçalves-Pereira, Manuel; Sjölund, Britt-Marie; Woods, Bob; Jelley, Hannah; Orrell, Martin; Stephan, Astrid

    2017-08-03

    As part of the ActifCare (ACcess to Timely Formal Care) project, we conducted expert interviews in eight European countries with policy and political decision makers, or representatives of relevant institutions, to determine their perspectives on access to formal care for people with dementia and their carers. Each ActifCare country (Germany, Ireland, Italy, The Netherlands, Norway, Portugal, Sweden, United Kingdom) conducted semi-structured interviews with 4-7 experts (total N = 38). The interview guide addressed the topics "Complexity and Continuity of Care", "Formal Services", and "Public Awareness". Country-specific analysis of interview transcripts used an inductive qualitative content analysis. Cross-national synthesis focused on similarities in themes across the ActifCare countries. The analysis revealed ten common themes and two additional sub-themes across countries. Among others, the experts highlighted the need for a coordinating role and the necessity of information to address issues of complexity and continuity of care, demanded person-centred, tailored, and multidisciplinary formal services, and referred to education, mass media and campaigns as means to raise public awareness. Policy and political decision makers appear well acquainted with current discussions among both researchers and practitioners of possible approaches to improve access to dementia care. Experts described pragmatic, realistic strategies to influence dementia care. Suggested innovations concerned how to achieve improved dementia care, rather than transforming the nature of the services provided. Knowledge gained in these expert interviews may be useful to national decision makers when they consider reshaping the organisation of dementia care, and may thus help to develop best-practice strategies and recommendations.

  10. Tobacco taxation policy in three Baltic countries after the EU accession

    Directory of Open Access Journals (Sweden)

    Konstantin Krasovsky

    2012-11-01

    Full Text Available BACKGROUND: Estonia, Latvia and Lithuania joined the EU in 2004 and had to increase tobacco excise rates. The aim of the paper is to explore the impact of tax policies on tobacco consumption, revenue and tobacco market in the Baltic countries.METHODS: Data on tobacco sales, tax rates, prices, revenues, and smoking prevalence were taken from databases and reports. Tobacco affordability index was calculated using data on prices and GDP. RESULTS: Tobacco taxation policy had three similar stages in Baltic countries: (1 In 2004-2007, tax rates increased slowly and cigarettes became more affordable in years of economic boom. Tobacco consumption and smuggling out of Baltic countries was on the rise, which caused increase of sales and revenues. (2 In 2008-2009, Baltic countries had to hike excise and VAT rates in years of economic recession, which caused sharp decline of cigarette affordability and resulted in large decline of consumption and sales and some excise revenue downfall in 2009-2010; however, all countries had higher revenues in 2010 than in 2007. (3 In 2011, economic situation improved and tobacco sales and revenue increased. The tobacco taxation policy in Baltic countries in 2004-2011 resulted in: (1 decline of total (licit + illicit annual cigarette consumption by 30% both in Latvia and Lithuania, and by 10% in Estonia; (2 decline of daily smoking prevalence by 10-20%; (3 decline of the out-of-country smuggling; (4 almost no changes in volumes of smuggling into Lithuania and Estonia; (5 three-fold increase of the annual tobacco revenues in three countries combined.CONCLUSIONS: Decrease of tobacco affordability caused by tax hikes and economic recession was the key factor of tobacco consumption decline. Tobacco tax hike is a win-win policy, while in years of economic boom it has more fiscal benefits and in years of economic recession it has more public health benefits.

  11. Approximation of the energy acquis communautaire. Review of energy markets and policies of seven accession countries

    International Nuclear Information System (INIS)

    Van Oostvoorn, F.; Voogt, M.H.; Uyterlinde, M.A.; Van Wees, M.T.

    1999-12-01

    This report is a compilation of the country reviews conducted by ECN in the framework of the Phare Multi-country programme project 'Approximation of CEEC to EU legislation'. The project was conducted and co-ordinated by DEM (Denmark), with contributions of ERM (UK) and ECN. The project's main objective was to assist the CEECs to approximate their energy legislation with EU energy legislation. A secondary objective was to review the current situation of the energy markets and policies in the thirteen CEECs with respect to their progress in approximation towards the EU energy acquis and policy practices. For this second objective ECN assessed the current situation in seven countries, on the basis of a survey organised by the project co-ordinator DEM and filled in by the counterparts in the seven CEECs. Those seven countries are: the Czech Republic, the Slovak Republic, Hungary, Latvia, Estonia, Lithuania, and Poland. These country reviews, which were sent to DEM for inclusion in their final report, are compiled here. In addition, ECN drafted an introduction and formulated a few final comments

  12. An investigation and an accessment of organic cotton production and processing in developing countries (VB)

    DEFF Research Database (Denmark)

    Persson, Frida; Andersen, Lasse Kragh; Looms, Majken

    1999-01-01

    as important is that the locals participate on all levels of the project, so they feel responsible for the project and are able to run it themselves when the donor withdraws from the project after some time.Our conclusion is that implementing organic cotton production and organic cotton processing in Zimbabwe...... and Mozambique is a difficult but not impossible task, but a challenging way of improving the environmental impacts of todays conventional cotton production. Completing the manufacturing of cotton in the developing countries will enhance the economy of the country and thus the living standards of the population....

  13. Tools for healthy tribes: improving access to healthy foods in Indian country.

    Science.gov (United States)

    Fleischhacker, Sheila; Byrd, Randi R; Ramachandran, Gowri; Vu, Maihan; Ries, Amy; Bell, Ronny A; Evenson, Kelly R

    2012-09-01

    There is growing recognition that policymakers can promote access to healthy, affordable foods within neighborhoods, schools, childcare centers, and workplaces. Despite the disproportionate risk of obesity and type 2 diabetes among American Indian children and adults, comparatively little attention has been focused on the opportunities tribal policymakers have to implement policies or resolutions to promote access to healthy, affordable foods. This paper presents an approach for integrating formative research into an action-oriented strategy of developing and disseminating tribally led environmental and policy strategies to promote access to and consumption of healthy, affordable foods. This paper explains how the American Indian Healthy Eating Project evolved through five phases and discusses each phase's essential steps involved, outcomes derived, and lessons learned. Using community-based participatory research and informed by the Social Cognitive Theory and ecologic frameworks, the American Indian Healthy Eating Project was started in fall 2008 and has evolved through five phases: (1) starting the conversation; (2) conducting multidisciplinary formative research; (3) strengthening partnerships and tailoring policy options; (4) disseminating community-generated ideas; and (5) accelerating action while fostering sustainability. Collectively, these phases helped develop and disseminate Tools for Healthy Tribes-a toolkit used to raise awareness among participating tribal policymakers of their opportunities to improve access to healthy, affordable foods. Formal and informal strategies can engage tribal leaders in the development of culturally appropriate and tribe-specific sustainable strategies to improve such access, as well as empower tribal leaders to leverage their authority toward raising a healthier generation of American Indian children. Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  14. Each-One-Teach-One Mobile Networks: An Innovative Strategy for Knowledge Access in Asian Countries

    Science.gov (United States)

    Misra, P. K.

    2012-01-01

    The changing landscape of learning is helping Asian countries to emerge as technology-driven knowledge-based societies. The success of these societies depends on promoting the acquisition of key competences and broadening opportunities for innovative and more flexible forms of learning for every citizen. Considering that in Asia almost everyone…

  15. Financial accessibility and user fee reforms for maternal healthcare in five sub-Saharan countries: a quasi-experimental analysis.

    Science.gov (United States)

    Leone, Tiziana; Cetorelli, Valeria; Neal, Sarah; Matthews, Zoë

    2016-01-28

    Evidence on whether removing fees benefits the poorest is patchy and weak. The aim of this paper is to measure the impact of user fee reforms on the probability of giving birth in an institution or undergoing a caesarean section (CS) in Ghana, Burkina Faso, Zambia, Cameroon and Nigeria for the poorest strata of the population. Women's experience of user fees in 5 African countries. Using quasi-experimental regression analysis we tested the impact of user fee reforms on facilities' births and CS differentiated by wealth, education and residence in Burkina Faso and Ghana. Mapping of the literature followed by key informant interviews are used to verify details of reform implementation and to confirm and support our countries' choice. We analysed data from consecutive surveys in 5 countries: 2 case countries that experienced reforms (Ghana and Burkina Faso) by contrast with 3 that did not experience reforms (Zambia, Cameroon, Nigeria). User fee reforms are associated with a significant percentage of the increase in access to facility births (27 percentage points) and to a much lesser extent to CS (0.7 percentage points). Poor (but not the poorest), and non-educated women, and those in rural areas benefitted the most from the reforms. User fees reforms have had a higher impact in Burkina Faso compared with Ghana. Findings show a clear positive impact on access when user fees are removed, but limited evidence for improved availability of CS for those most in need. More women from rural areas and from lower socioeconomic backgrounds give birth in health facilities after fee reform. Speed and quality of implementation might be the key reason behind the differences between the 2 case countries. This calls for more research into the impact of reforms on quality of care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  16. Access to HIV/AIDS care: a systematic review of socio-cultural determinants in low and high income countries.

    Science.gov (United States)

    Gari, Sara; Doig-Acuña, Camilo; Smail, Tino; Malungo, Jacob R S; Martin-Hilber, Adriane; Merten, Sonja

    2013-05-28

    The role of socio-cultural factors in influencing access to HIV/AIDS treatment, care and support is increasingly recognized by researchers, international donors and policy makers. Although many of them have been identified through qualitative studies, the evidence gathered by quantitative studies has not been systematically analysed. To fill this knowledge gap, we did a systematic review of quantitative studies comparing surveys done in high and low income countries to assess the extent to which socio-cultural determinants of access, identified through qualitative studies, have been addressed in epidemiological survey studies. Ten electronic databases were searched (Cinahl, EMBASE, ISI Web of Science, IBSS, JSTOR, MedLine, Psyinfo, Psyindex and Cochrane). Two independent reviewers selected eligible publications based on the inclusion/exclusion criteria. Meta-analysis was used to synthesize data comparing studies between low and high income countries. Thirty-four studies were included in the final review, 21 (62%) done in high income countries and 13 (38%) in low income countries. In low income settings, epidemiological research on access to HIV/AIDS services focused on socio-economic and health system factors while in high income countries the focus was on medical and psychosocial factors. These differences depict the perceived different barriers in the two regions. Common factors between the two regions were also found to affect HIV testing, including stigma, high risk sexual behaviours such as multiple sexual partners and not using condoms, and alcohol abuse. On the other hand, having experienced previous illness or other health conditions and good family communication was associated with adherence to ART uptake. Due to insufficient consistent data, a meta-analysis was only possible on adherence to treatment. This review offers evidence of the current challenges for interdisciplinary work in epidemiology and public health. Quantitative studies did not

  17. Systematic review of strategies to increase access to health services among children over five in low- and middle-income countries.

    Science.gov (United States)

    Bright, Tess; Felix, Lambert; Kuper, Hannah; Polack, Sarah

    2018-05-01

    The populations of many low- and middle-income countries (LMIC) are young. Despite progress made towards achieving Universal Health Coverage and remarkable health gains, evidence suggests that many children in LMIC are still not accessing needed healthcare services. Delayed or lack of access to health services can lead to a worsening of health and can in turn negatively impact a child's ability to attend school, and future employment opportunities. We conducted a systematic review to assess the effectiveness of interventions aimed at increasing access to health services for children over 5 years in LMIC settings. Four electronic databases were searched in March 2017. Studies were included if they evaluated interventions that aimed to increase: healthcare utilisation, immunisation uptake and compliance with medication/referral. Randomised controlled trials and non-randomised study designs were included in the review. Data extraction included study characteristics, intervention type and measures of access to health services for children above 5 years of age. Study outcomes were classified as positive, negative, mixed or null in terms of their impact on access outcomes. Ten studies met the criteria for inclusion in the review. Interventions were evaluated in Nicaragua (1), Brazil (1), Turkey (1), India (1), China (1), Uganda (1), Ghana (1), Nigeria (1), South Africa (1) and Swaziland (1). Intervention types included education (2), incentives (1), outreach (1), SMS/phone call reminders (2) and multicomponent interventions (4). All evaluations reported positive findings on measured health access outcomes; however, the quality and strength of evidence were mixed. This review provides evidence of the range of interventions that were used to increase healthcare access for children above 5 years old in LMIC. Nevertheless, further research is needed to examine each of the identified intervention types and the influence of contextual factors, with robust study designs. There

  18. An economic justification for open access to essential medicine patents in developing countries.

    Science.gov (United States)

    Flynn, Sean; Hollis, Aidan; Palmedo, Mike

    2009-01-01

    This paper offers an economic rationale for compulsory licensing of needed medicines in developing countries. The patent system is based on a trade-off between the "deadweight losses" caused by market power and the incentive to innovate created by increased profits from monopoly pricing during the period of the patent. However, markets for essential medicines under patent in developing countries with high income inequality are characterized by highly convex demand curves, producing large deadweight losses relative to potential profits when monopoly firms exercise profit-maximizing pricing strategies. As a result, these markets are systematically ill-suited to exclusive marketing rights, a problem which can be corrected through compulsory licensing. Open licenses that permit any qualified firm to supply the market on the same terms, such as may be available under licenses of right or essential facility legal standards, can be used to mitigate the negative effects of government-granted patents, thereby increasing overall social welfare.

  19. THE IMPACT OF CHINA´S ACCESSION TO WTO ON THE EXPORTS OF DEVELOPING COUNTRIES

    OpenAIRE

    S.M. Shafaeddin

    2002-01-01

    Using the "revealed competitive advantage indices" for exports and imports, the paper is devoted to the analyses of the vulnerability of selected developing countries if China´s competitive position is improved due to its entry to WTO. In contrast to the existing literature which concentrates on labour-intensive products as a group, this paper considers products at a disaggregate level since products in the same group are not often homogeneous. In labour-intensive manufactured goods, China co...

  20. Effective vaccine safety systems in all countries: a challenge for more equitable access to immunization.

    Science.gov (United States)

    Amarasinghe, Ananda; Black, Steve; Bonhoeffer, Jan; Carvalho, Sandra M Deotti; Dodoo, Alexander; Eskola, Juhani; Larson, Heidi; Shin, Sunheang; Olsson, Sten; Balakrishnan, Madhava Ram; Bellah, Ahmed; Lambach, Philipp; Maure, Christine; Wood, David; Zuber, Patrick; Akanmori, Bartholomew; Bravo, Pamela; Pombo, María; Langar, Houda; Pfeifer, Dina; Guichard, Stéphane; Diorditsa, Sergey; Hossain, Md Shafiqul; Sato, Yoshikuni

    2013-04-18

    Serious vaccine-associated adverse events are rare. To further minimize their occurrence and to provide adequate care to those affected, careful monitoring of immunization programs and case management is required. Unfounded vaccine safety concerns have the potential of seriously derailing effective immunization activities. To address these issues, vaccine pharmacovigilance systems have been developed in many industrialized countries. As new vaccine products become available to prevent new diseases in various parts of the world, the demand for effective pharmacovigilance systems in low- and middle-income countries (LMIC) is increasing. To help establish such systems in all countries, WHO developed the Global Vaccine Safety Blueprint in 2011. This strategic plan is based on an in-depth analysis of the vaccine safety landscape that involved many stakeholders. This analysis reviewed existing systems and international vaccine safety activities and assessed the financial resources required to operate them. The Blueprint sets three main strategic goals to optimize the safety of vaccines through effective use of pharmacovigilance principles and methods: to ensure minimal vaccine safety capacity in all countries; to provide enhanced capacity for specific circumstances; and to establish a global support network to assist national authorities with capacity building and crisis management. In early 2012, the Global Vaccine Safety Initiative (GVSI) was launched to bring together and explore synergies among on-going vaccine safety activities. The Global Vaccine Action Plan has identified the Blueprint as its vaccine safety strategy. There is an enormous opportunity to raise awareness for vaccine safety in LMIC and to garner support from a large number of stakeholders for the GVSI between now and 2020. Synergies and resource mobilization opportunities presented by the Decade of Vaccines can enhance monitoring and response to vaccine safety issues, thereby leading to more equitable

  1. Russia's accession to the WTO as an important factor of the country's integration into the world economy

    Directory of Open Access Journals (Sweden)

    Linetsky Alexander

    2011-12-01

    Full Text Available Russia's accession to the WTO is an efficient instrument of the country's integration into the globalized world economy. However, it can adversely affect a number of enterprises and industries within the national economy. Thus, there is a need to develop a methodology for the assessment of the preparedness for operating under WTO membership conditions, which can be practically applied in the development of measures aimed at increasing the competitiveness of economic entities. This determines the objective of the research. This article offers the author's assessment of the reasonability of Russia's accession to the WTO and suggests methodological approaches to the assessment of preparedness of the constituent entities of the Russian Federation for functioning in the new economic conditions based on the algorithm of choosing a system of indicators, as well as the organisation of enterprise monitoring according to this system, which makes it possible to formulate rational administrative decisions in order to minimise the adverse effects of Russia's accession to the WTO. The major result of the research is the conclusion that, although the objective of identifying the start position of the constituent entities before the accession to the WTO and its possible implications is quite difficult to attain, it is both theoretically and practically feasible.

  2. Access to non-pecuniary benefits: does gender matter? Evidence from six low- and middle-income countries.

    Science.gov (United States)

    Gupta, Neeru; Alfano, Marco

    2011-10-19

    Gender issues remain a neglected area in most approaches to health workforce policy, planning and research. There is an accumulating body of evidence on gender differences in health workers' employment patterns and pay, but inequalities in access to non-pecuniary benefits between men and women have received little attention. This study investigates empirically whether gender differences can be observed in health workers' access to non-pecuniary benefits across six low- and middle-income countries. The analysis draws on cross-nationally comparable data from health facility surveys conducted in Chad, Côte d'Ivoire, Jamaica, Mozambique, Sri Lanka and Zimbabwe. Probit regression models are used to investigate whether female and male physicians, nurses and midwives enjoy the same access to housing allowance, paid vacations, in-service training and other benefits, controlling for other individual and facility-level characteristics. While the analysis did not uncover any consistent pattern of gender imbalance in access to non-monetary benefits, some important differences were revealed. Notably, female nursing and midwifery personnel (the majority of the sample) are found significantly less likely than their male counterparts to have accessed in-service training, identified not only as an incentive to attract and retain workers but also essential for strengthening workforce quality. This study sought to mainstream gender considerations by exploring and documenting sex differences in selected employment indicators across health labour markets. Strengthening the global evidence base about the extent to which gender is independently associated with health workforce performance requires improved generation and dissemination of sex-disaggregated data and research with particular attention to gender dimensions.

  3. Access to non-pecuniary benefits: does gender matter? Evidence from six low- and middle-income countries

    Directory of Open Access Journals (Sweden)

    Alfano Marco

    2011-10-01

    Full Text Available Abstract Background Gender issues remain a neglected area in most approaches to health workforce policy, planning and research. There is an accumulating body of evidence on gender differences in health workers' employment patterns and pay, but inequalities in access to non-pecuniary benefits between men and women have received little attention. This study investigates empirically whether gender differences can be observed in health workers' access to non-pecuniary benefits across six low- and middle-income countries. Methods The analysis draws on cross-nationally comparable data from health facility surveys conducted in Chad, Côte d'Ivoire, Jamaica, Mozambique, Sri Lanka and Zimbabwe. Probit regression models are used to investigate whether female and male physicians, nurses and midwives enjoy the same access to housing allowance, paid vacations, in-service training and other benefits, controlling for other individual and facility-level characteristics. Results While the analysis did not uncover any consistent pattern of gender imbalance in access to non-monetary benefits, some important differences were revealed. Notably, female nursing and midwifery personnel (the majority of the sample are found significantly less likely than their male counterparts to have accessed in-service training, identified not only as an incentive to attract and retain workers but also essential for strengthening workforce quality. Conclusion This study sought to mainstream gender considerations by exploring and documenting sex differences in selected employment indicators across health labour markets. Strengthening the global evidence base about the extent to which gender is independently associated with health workforce performance requires improved generation and dissemination of sex-disaggregated data and research with particular attention to gender dimensions.

  4. IMPLICATIONS OF GLOBAL PRICING POLICIES ON ACCESS TO INNOVATIVE DRUGS: THE CASE OF TRASTUZUMAB IN SEVEN LATIN AMERICAN COUNTRIES.

    Science.gov (United States)

    Pichon-Riviere, Andres; Garay, Osvaldo Ulises; Augustovski, Federico; Vallejos, Carlos; Huayanay, Leandro; Bueno, Maria del Pilar Navia; Rodriguez, Alarico; de Andrade, Carlos José Coelho; Buendía, Jefferson Antonio; Drummond, Michael

    2015-01-01

    Differential pricing, based on countries' purchasing power, is recommended by the World Health Organization to secure affordable medicines. However, in developing countries innovative drugs often have similar or even higher prices than in high-income countries. We evaluated the potential implications of trastuzumab global pricing policies in terms of cost-effectiveness (CE), coverage, and accessibility for patients with breast cancer in Latin America (LA). A Markov model was designed to estimate life-years (LYs), quality-adjusted life-years (QALYs), and costs from a healthcare perspective. To better fit local cancer prognosis, a base case scenario using transition probabilities from clinical trials was complemented with two alternative scenarios with transition probabilities adjusted to reflect breast cancer epidemiology in each country. Incremental discounted benefits ranged from 0.87 to 1.00 LY and 0.51 to 0.60 QALY and incremental CE ratios from USD 42,104 to USD 110,283 per QALY (2012 U.S. dollars), equivalent to 3.6 gross domestic product per capita (GDPPC) per QALY in Uruguay and to 35.5 GDPPC in Bolivia. Probabilistic sensitivity analysis showed 0 percent probability that trastuzumab is CE if the willingness-to-pay threshold is one GDPPC per QALY, and remained so at three GDPPC threshold except for Chile and Uruguay (4.3 percent and 26.6 percent, respectively). Trastuzumab price would need to decrease between 69.6 percent to 94.9 percent to became CE in LA. Although CE in other settings, trastuzumab was not CE in LA. The use of health technology assessment to prioritize resource allocation and support price negotiations is critical to making innovative drugs available and affordable in developing countries.

  5. Accessibility

    DEFF Research Database (Denmark)

    Brooks, Anthony Lewis

    2017-01-01

    This contribution is timely as it addresses accessibility in regards system hardware and software aligned with introduction of the Twenty-First Century Communications and Video Accessibility Act (CVAA) and adjoined game industry waiver that comes into force January 2017. This is an act created...... by the USA Federal Communications Commission (FCC) to increase the access of persons with disabilities to modern communications, and for other purposes. The act impacts advanced communications services and products including text messaging; e-mail; instant messaging; video communications; browsers; game...... platforms; and games software. However, the CVAA has no legal status in the EU. This text succinctly introduces and questions implications, impact, and wider adoption. By presenting the full CVAA and game industry waiver the text targets to motivate discussions and further publications on the subject...

  6. Instruments and options for environmental policy during the accession process of EU associated countries in the area of environment and energy. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Cames, M.; Matthes, F.C.; Baer, S.; Oberthuer, S.; Krug, M.; Mez, L.; Tempel, S.

    2001-07-01

    With regard to the leading role of the EU in climate protection policies, it is important to consider the impact of the accession process on EU climate policy. This study includes the analysis of the most important issues related to environment and energy within the accession process, namely: 1) status quo and development of the energy sector and structural CO{sub 2} mitigation options; 2) legal gap assessment and analysis of performance in the accession process; 3) identification of implementation patterns through detailed policy analysis; 4) evaluation of co-operation projects in the field of environment and energy in order to develop new projects that promote the accession process. This volume includes comparative analysis of the five Accession Countries. The detailed analysis of each country is documented in five country reports, each in a separate volume available only on the attached CD. (orig.)

  7. The effect of social franchising on access to and quality of health services in low- and middle-income countries.

    Science.gov (United States)

    Koehlmoos, Tracey Perez; Gazi, Rukhsana; Hossain, S Shahed; Zaman, K

    2009-01-21

    Social franchising has developed as a possible means of improving provision of health services through engaging the non-state sector in low- and middle-income countries. To examine the evidence that social franchising has on access to and quality of health services in low- and middle-income countries. We searched the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register (up to October 2007), Cochrane Central Register of Controlled Trials (The Cochrane Library 2007, Issue 3), MEDLINE, Ovid (1950 to September Week 3 2007), EMBASE, Ovid (1980 to 2007 Week 38), CINAHL, Ovid (1982 to September Week 3 2007), EconLit, WebSPIRS (1969 to Sept 2007), LILACS, Science Citation Index Expanded and Social Sciences Citation Index (1975 to March 2008), Sociological Abstracts, CSA Illumnia (1952 September 2007), WHOLIS (1948 November 2007). Randomized controlled trials, non-randomized controlled trials, controlled before and after studies and interrupted time series comparing social franchising models with other models of health service delivery, other social franchising models or absence of health services. Two review authors independently applied the criteria for inclusion and exclusion of studies to scan titles and abstracts. The same two review authors independently screened full reports of selected citations . At each stage, results were compared and discrepancies settled through discussion. No studies were found which were eligible for inclusion in this review. There is a need to develop rigorous studies to evaluate the effects of social franchising on access to and quality of health services in low- and middle-income countries. Such studies should be informed by the wider literature to identify models of social franchising that have a sound theoretical basis and empirical research addressing their reach, acceptability, feasibility, maintenance and measurability.

  8. Use of the 'Accountability for Reasonableness' Approach to Improve Fairness in Accessing Dialysis in a Middle-Income Country.

    Directory of Open Access Journals (Sweden)

    Mohammed Rafique Moosa

    Full Text Available Universal access to renal replacement therapy is beyond the economic capability of most low and middle-income countries due to large patient numbers and the high recurrent cost of treating end stage kidney disease. In countries where limited access is available, no systems exist that allow for optimal use of the scarce dialysis facilities. We previously reported that using national guidelines to select patients for renal replacement therapy resulted in biased allocation. We reengineered selection guidelines using the 'Accountability for Reasonableness' (procedural fairness framework in collaboration with relevant stakeholders, applying these in a novel way to categorize and prioritize patients in a unique hierarchical fashion. The guidelines were primarily premised on patients being transplantable. We examined whether the revised guidelines enhanced fairness of dialysis resource allocation. This is a descriptive study of 1101 end stage kidney failure patients presenting to a tertiary renal unit in a middle-income country, evaluated for dialysis treatment over a seven-year period. The Assessment Committee used the accountability for reasonableness-based guidelines to allocate patients to one of three assessment groups. Category 1 patients were guaranteed renal replacement therapy, Category 3 patients were palliated, and Category 2 were offered treatment if resources allowed. Only 25.2% of all end stage kidney disease patients assessed were accepted for renal replacement treatment. The majority of patients (48% were allocated to Category 2. Of 134 Category 1 patients, 98% were accepted for treatment while 438 (99.5% Category 3 patients were excluded. Compared with those palliated, patients accepted for dialysis treatment were almost 10 years younger, employed, married with children and not diabetic. Compared with our previous selection process our current method of priority setting based on procedural fairness arguably resulted in more equitable

  9. Nutrient composition of premixed and packaged complementary foods for sale in low- and middle-income countries: Lack of standards threatens infant growth.

    Science.gov (United States)

    Masters, William A; Nene, Marc D; Bell, Winnie

    2017-10-01

    Premixed flours for infant porridge are increasingly produced and sold in developing countries to complement continued breastfeeding. Such complementary food (CF) products have known efficacy against malnutrition in children from 6 to 24 months of age, but ingredient ratios and production processes may vary. This study provides the first systematic measurement of their actual nutrient composition. We purchased samples of 108 premixed CF products in 22 low- and middle-income countries, and commissioned blind laboratory measurement of each product's macronutrients and micronutrients. We compared measured contents to nutrient claims on their packaging and to CF standards from the Codex Alimentarius, the Super Cereal Plus product used in nutrition assistance programs, and the Lutter and Dewey (2003) recommendations, as well as our own modeled nutrient requirements for a healthy breastfed child. Actual densities are significantly different from nutrient claims for protein (p = .013) and fat (p = .000). Only 15% of samples met two of the three benchmarks for fat, 32% met the most stringent protein standard, while only 22% met them for iron, and 21% for zinc. The median healthy child consuming breast milk plus enough of these solid foods to meet energy needs would experience deficits of zinc at 6 months, iron at 6 and 9 months, and dietary fat from 12 months of age. In summary, premixed CF products can provide adequate nutrient density but usually do not, revealing the need and opportunity for independent monitoring and quality assurance to help grain millers making premixed foods maintain uniform ingredient ratios and production practices. © 2016 John Wiley & Sons Ltd.

  10. Matching Up to the Information Society: An Evaluation of the EU, the EU Accession Countries, Switzerland and the United States. Summary

    Science.gov (United States)

    Graafland-Essers, Irma; Cremonini, Leon; Ettedgui, Emile; Botterman, Maarten

    2003-01-01

    This report presents the current understanding of the advancement of the Information Society within the European Union and countries that are up for accession in 2004, and is based on the SIBIS (Statistical Indicators Benchmarking the Information Society) surveys and analyses per SIBIS theme and country. The report is unique in its coherent and…

  11. Analysis of the network capacities and possible congestion of the electricity transmission networks within the accession countries

    International Nuclear Information System (INIS)

    Kristiansen, Tarjei; Hewicker, Cristian

    2005-01-01

    Since the passage of the first Electricity Directive, the gradual establishment of the Internal Electricity Market (IEM) of the European Union has resulted in a remarkable growth of cross-border trade in electricity that have made trading and flow patterns more dynamic and less predictable. Simultaneously, market actors are increasingly facing congestion on several cross-border lines, limiting their opportunities to exploit the existing economic export and import potential between different markets to the benefit of European consumers. Ten new countries joined the European Union in May 2004 and thus became part of the IEM. In addition, Bulgaria, Romania and Turkey have been granted the status of Candidate Countries and may join the EU in the future. This paper describes a study commissioned by the European Commission (Directorate-General Energy and Transport) about the electricity market modelling of the these countries and their neighbour countries with respect to transmission congestion and investments. Our focus is on the following objectives: 1) Determining the economic export and import potential for the new parts of the Internal Electricity Market, covering exchanges between the Accession Countries, and between the Accession Countries and those countries that had already been part of the IEM before May 2004. 2) Developing a methodology for assessing transmission projects based on the market simulations and an assessment of investment costs. We have chosen to simulate market behaviour through a production simulation tool that allows us to determine the least-cost dispatch of power plants, while simultaneously taking account of limited cross-border capacities. Based on existing data and information and the expertise of our specialists, we have thus built a European market model in the well-known production simulation tool PROSYM. This tool is based on a minimum cost dispatch where the underlying power system is described with power plant characteristics and

  12. Assessment of access to electricity and the socio-economic impacts in rural areas of developing countries

    Energy Technology Data Exchange (ETDEWEB)

    Kanagawa, Makoto; Nakata, Toshihiko [Department of Management Science and Technology, Graduate School of Engineering, Tohoku University, Aoba-Yama 6-6-11-815, Sendai 980-8579 (Japan)

    2008-06-15

    The purpose of this study is to reveal relations between access to electricity and advancement in a socio-economic condition in rural areas of developing countries. Recently, multi-dimensional aspects of poverty, for example, economy, education, and health, has been increasingly focused on, and access to modern energy such as electricity is one possible solution. As a case study, we have analyzed unelectrified rural areas in Assam state, India. We have developed an energy-economic model in order to analyze the possibility of electrification through dissemination of electric lighting appliances as well as applied multiple regression analysis to estimate the socio-economic condition, a literacy rate above 6 years old, in the areas. As a result of the case study, the household electrification rate, the 1000 km{sup 2} road density, and sex ratio have been chosen as the explanatory variables of the literacy rate. Moreover, the model analysis shows that complete household electrification will be achieved by the year 2012. In combination with the multiple regression and model analysis, the literacy rate in Assam may increase to 74.4% from 63.3%. (author)

  13. Assessment of access to electricity and the socio-economic impacts in rural areas of developing countries

    International Nuclear Information System (INIS)

    Kanagawa, Makoto; Nakata, Toshihiko

    2008-01-01

    The purpose of this study is to reveal relations between access to electricity and advancement in a socio-economic condition in rural areas of developing countries. Recently, multi-dimensional aspects of poverty, for example, economy, education, and health, has been increasingly focused on, and access to modern energy such as electricity is one possible solution. As a case study, we have analyzed unelectrified rural areas in Assam state, India. We have developed an energy-economic model in order to analyze the possibility of electrification through dissemination of electric lighting appliances as well as applied multiple regression analysis to estimate the socio-economic condition, a literacy rate above 6 years old, in the areas. As a result of the case study, the household electrification rate, the 1000 km 2 road density, and sex ratio have been chosen as the explanatory variables of the literacy rate. Moreover, the model analysis shows that complete household electrification will be achieved by the year 2012. In combination with the multiple regression and model analysis, the literacy rate in Assam may increase to 74.4% from 63.3%

  14. Access to Specialized Care Through Telemedicine in Limited-Resource Country: Initial 1,065 Teleconsultations in Albania.

    Science.gov (United States)

    Latifi, Rifat; Gunn, Jayleen K L; Bakiu, Evis; Boci, Arian; Dasho, Erion; Olldashi, Fatos; Pipero, Pellumb; Stroster, John A; Qesteri, Orland; Kucani, Julian; Sulo, Ardi; Oshafi, Manjola; Osmani, Kalterina L; Dogjani, Agron; Doarn, Charles R; Shatri, Zhaneta; Kociraj, Agim; Merrell, Ronald C

    2016-12-01

    To analyze the initial experience of the nationwide clinical telemedicine program of Albania, as a model of implementation of telemedicine using "Initiate-Build-Operate-Transfer" strategy. This was a retrospective study of prospectively collected data from teleconsultations in Albania between January 1, 2014 and August 26, 2015, delivered synchronously, asynchronously, or a combination of both methods. Patient's demographics, mode of consultation, clinical specialty, hospitals providing referral and consultation, time from initial call to completion of consultation, and patient disposition following teleconsultation were analyzed. Challenges of the newly created program have been identified and analyzed as well. There were 1,065 teleconsultations performed altogether during the study period. Ninety-one patients with autism managed via telemedicine were not included in this analysis and will be reported separately. Of 974 teleconsults, the majority were for radiology, neurotrauma, and stroke (55%, 16%, and 10% respectively). Asynchronous technology accounted for nearly two-thirds of all teleconsultations (63.7%), followed by combined (24.3%), and then synchronous (12.0%). Of 974 cases, only 20.0% of patients in 2014 and 22.72% of patients in 2015 were transferred to a tertiary hospital. A majority (98.5%) of all teleconsultations were conducted within the country itself. The Integrated Telemedicine and e-Health program of Albania has become a useful tool to improve access to high-quality healthcare, particularly in high demanding specialty disciplines. A number of challenges were identified and these should serve as lessons for other countries in their quest to establish nationwide telemedicine programs.

  15. Current use of ultrasound for central vascular access in children and infants in the Nordic countries--a cross-sectional study

    DEFF Research Database (Denmark)

    Olsen, Thomas C Risom; Rimstad, Ivan Jonassen; Tarpgaard, Mona

    2015-01-01

    . METHODS: A cross-sectional survey using an online questionnaire was distributed to one anaesthesiologist at every hospital in the Nordic countries; a total of 177 anaesthesiologists were contacted from July till August 2012. RESULTS: The use of US for placing central venous catheters (CVCs) seems......PURPOSE: The use of ultrasound (US) guidance for central vascular access in children has been advocated as a safer approach compared to traditional landmark techniques. We therefore collected data on the current use of US for central vascular access in children and infants in the Nordic countries...

  16. Increasing access to kidney transplantation in countries with limited resources: the Indian experience with kidney paired donation.

    Science.gov (United States)

    Kute, Vivek B; Vanikar, Aruna V; Shah, Pankaj R; Gumber, Manoj R; Patel, Himanshu V; Engineer, Divyesh P; Modi, Pranjal R; Shah, Veena R; Trivedi, Hargovind L

    2014-10-01

    According to the Indian chronic kidney disease registry, in 2010 only 2% of end stage kidney disease patients were managed with kidney transplantation, 37% were managed with dialysis and 61% were treated conservatively without renal replacement therapy. In countries like India, where a well-organized deceased donor kidney transplantation program is not available, living donor kidney transplantation is the major source of organs for kidney transplantation. The most common reason to decline a donor for directed living donation is ABO incompatibility, which eliminates up to one third of the potential living donor pool. Because access to transplantation with human leukocyte antigen (HLA)-desensitization protocols and ABO incompatible transplantation is very limited due to high costs and increased risk of infections from more intense immunosuppression, kidney paired donation (KPD) promises hope to a growing number of end stage kidney disease patients. KPD is a rapidly growing and cost-effective living donor kidney transplantation strategy for patients who are incompatible with their healthy, willing living donor. In principle, KPD is feasible for any centre that performs living donor kidney transplantation. In transplant centres with a large living donor kidney transplantation program KPD does not require extra infrastructure, decreases waiting time, avoids transplant tourism and prevents commercial trafficking. Although KPD is still underutilized in India, it has been performed more frequently in recent times. To substantially increase donor pool and transplant rates, transplant centres should work together towards a national KPD program and frame a uniform acceptable allocation policy. © 2014 Asian Pacific Society of Nephrology.

  17. THE CHOICE OF THE EXCHANGE RATE REGIMES OF THE EUROPEAN UNION ACCESSION COUNTRIES INFLUENCED BY THE WORLD CURRENCY CONSOLIDATION

    Directory of Open Access Journals (Sweden)

    Marin Frâncu

    2004-05-01

    Full Text Available The pressure of the currency consolidation increased in the years 1990 as the world currency system became obviously too complicated and too costly. There are too many national currencies that generate artificial barriers and avoidable transaction costs, both for the domestic economies and for the world economy. The high costs and great vulnerability of the national currencies determined the financial and economic business of small open economies to move into the major currencies of the world. The world needs fewer national currencies, but does it need fewer central banks too? Or it needs central banks capable to pursuit sound monetary policies? What kind of institutional arrangements and international financial architecture are most suitable for the prospective environment of a greatly reduced multiplicity of currencies? A regional currency consolidation may be a good answer but a regional currency union is a better answer. Though, until membership of the Euro zone, what kind of the exchange rate regime is more suitable for Romania and other European Union accession countries? The hard peg regimes seem not to be a good solution. The best solution lays probable between managed floating regimes and intermediate regimes. This may be because emerging markets have both “fear of floating” and “fear of fixing”. But there is no ideal exchange rate regime”to suit everybody”. Once the exchange rate regime chosen, it evolves in time. So is the case with the exchange rate benchmarks for the national currency.

  18. Development tendencies in the energy industries of the EU accession candidate countries of Central and Eastern Europe

    International Nuclear Information System (INIS)

    Riesner, W.

    2000-01-01

    The present work considers development problems of energy facilities in Central and Eastern European Countries being in transition in the period from 1990 to 1999 and outline the changes in their economic situation. The paper also shows the development dynamics for economic indicators in 11 countries and analyses them for each country of the Central and Eastern European countries taken separately. (author)

  19. Barriers to access to opioid medicines for patients with opioid dependence: a review of legislation and regulations in eleven central and eastern European countries.

    Science.gov (United States)

    Vranken, Marjolein J M; Mantel-Teeuwisse, Aukje K; Jünger, Saskia; Radbruch, Lukas; Scholten, Willem; Lisman, John A; Subataite, Marija; Schutjens, Marie-Hélène D B

    2017-06-01

    Barriers linked to drug control systems are considered to contribute to inequitable access to controlled medicines, leaving millions of people in pain and suffering. Most studies focus on access to opioids for the treatment of severe (cancer) pain. This study aims to identify specific access barriers for patients with opioid dependence in legislation and regulations of 11 central and eastern European countries. This study builds on a previous analysis of legislation and regulations as part of the EU 7th Framework Access To Opioid Medication in Europe (ATOME) project. An in-depth analysis was undertaken to determine specific barriers for patients with opioid dependence in need of opioid analgesics or opioid agonist therapy (OAT). For each country, the number and nature of specific potential barriers for these patients were assessed according to eight categories: prescribing; dispensing; manufacturing; usage; trade and distribution; affordability; penalties; and other. An additional keyword search was conducted to minimize the omission of barriers. Barriers in an additional category, language, were recorded qualitatively. Countries included Bulgaria, Cyprus, Estonia, Greece, Hungary, Latvia, Lithuania, Serbia, Slovakia, Slovenia and Turkey. Ten of the 11 countries (all except Estonia) showed specific potential barriers in their legislation and regulations. The total number of barriers varied from two (Slovenia) to 46 (Lithuania); the number of categories varied from one (Slovenia) to five (Lithuania). Most specific potential barriers were shown in the categories 'prescribing', 'usage' and 'other'. The total number in a single category varied from one to 18 (Lithuania, prescribing). Individual differences between countries in the same specific potential barrier were shown; for example, variation in minimum age criteria for admission to OAT ranging from 15 (Lithuania, in special cases) to 20 years (Greece). All countries had stigmatizing language in their legislation

  20. Genetic diversity and genetic structure of Persian walnut (Juglans regia) accessions from 14 European, African, and Asian countries using SSR markers

    Science.gov (United States)

    Aziz Ebrahimi; Abdolkarim Zarei; Shaneka Lawson; Keith E. Woeste; M. J. M. Smulders

    2016-01-01

    Persian walnut (Juglans regia L.) is the world's most widely grown nut crop, but large-scale assessments and comparisons of the genetic diversity of the crop are notably lacking. To guide the conservation and utilization of Persian walnut genetic resources, genotypes (n = 189) from 25 different regions in 14 countries on...

  1. Patient Access, Unmet Medical Need, Expected Benefits, and Concerns Related to the Utilisation of Biosimilars in Eastern European Countries: A Survey of Experts

    Directory of Open Access Journals (Sweden)

    Andras Inotai

    2018-01-01

    Full Text Available This policy research aims to map patient access barriers to biologic treatments, to explore how increased uptake of biosimilars may lower these hurdles and to identify factors limiting the increased utilisation of biosimilars. A policy survey was developed to review these questions in 10 Central and Eastern European (CEE and Commonwealth of Independent States (CIS countries. Two experts (one public and one private sector representative from each country completed the survey. Questions were related to patient access, purchasing, clinical practice, and real-world data collection on both original biologics and biosimilars. Restrictions on the number of patients that can be treated and related waiting lists were reported as key patient access barriers. According to respondents, for both clinicians and payers the primary benefit of switching patients to biosimilars would be to treat more patients. However, concerns with therapeutic equivalence and fear of immunogenicity may reduce utilisation of biosimilars. Similar limitations in patient access to both original biologics and biosimilars raise concerns about the appropriateness and success of current biosimilar policies in CEE and CIS countries. The conceptual framework for additional real-world data collection exists in all countries which may provide a basis for future risk-management activities including vigorous pharmacovigilance data collection.

  2. Overall satisfaction of health care users with the quality of and access to health care services: a cross-sectional study in six Central and Eastern European countries.

    Science.gov (United States)

    Stepurko, Tetiana; Pavlova, Milena; Groot, Wim

    2016-08-02

    The measurement of consumer satisfaction is an essential part of the assessment of health care services in terms of service quality and health care system responsiveness. Studies across Europe have described various strategies health care users employ to secure services with good quality and quick access. In Central and Eastern European countries, such strategies also include informal payments to health care providers. This paper analyzes the satisfaction of health care users with the quality of and access to health care services. The study focuses on six Central and Eastern European countries (Bulgaria, Hungary, Lithuania, Poland, Romania and Ukraine). We use data on past experience with health care use collected in 2010 through uniform national surveys in these countries. Based on these data, we carry out a multi-country analysis to investigate factors associated with the satisfaction of health care users in the six countries. The results indicate that about 10-14 % of the service users are not satisfied with the quality of, or access to health care services they used in the preceding year. However, significant differences across countries and services are observed, e.g. the highest level of dissatisfaction with access to outpatient services (16.4 %) is observed among patients in Lithuania, while in Poland, the level of dissatisfaction with quality of outpatient and inpatient services are much lower than dissatisfaction with access. The study also analyses the association of users' satisfaction with factors such as making informal payments, inability to pay and relative importance of service attributes stated by the service users. These multi-country findings provide evidence for health policy making in the Central and Eastern European countries. Although the average rates of satisfactions per country are relatively high, the results suggest that there is ample room for improvements. Specifically, many service-users still report dissatisfaction especially those

  3. Pensamentos, Emoções de um Grupo de Cadeirantes frente aos Problemas causados pela Falta de Acessibilidade nas Universidades Thoughts, Emotions of a Group of College Wheelchair facing the Problems Caused by Lack of Accessibility in the Universities

    Directory of Open Access Journals (Sweden)

    Maria Cecília Prado

    2011-09-01

    researcher, at home and via the Internet. Results: All wheelchair users alleged that universities didn't offer adequated access and 71,5% said that, in front a lack of physical access, they felt dependent to do some activities. About the interaction with colleagues, 14,2% attach the lack of accessibility as a factor that impede the interaction, 42,9% said that it happens only in some situations. The feelings related by the wheelchair users in front the obstacles were 'exclusion and anger' (42,9%, 'embarrassment' (28,6% and 'revolt' (28,6%. Conclusion: Wheelchair students were unanimous to respond that the lack of access don't influence on school performance. It was not observed significant relations with lack of accessibility, school performance, interaction and depression incidence.

  4. Treatment of infections in young infants in low- and middle-income countries: a systematic review and meta-analysis of frontline health worker diagnosis and antibiotic access.

    Directory of Open Access Journals (Sweden)

    Anne C C Lee

    2014-10-01

    Full Text Available BACKGROUND: Inadequate illness recognition and access to antibiotics contribute to high case fatality from infections in young infants (<2 months in low- and middle-income countries (LMICs. We aimed to address three questions regarding access to treatment for young infant infections in LMICs: (1 Can frontline health workers accurately diagnose possible bacterial infection (pBI?; (2 How available and affordable are antibiotics?; (3 How often are antibiotics procured without a prescription? METHODS AND FINDINGS: We searched PubMed, Embase, WHO/Health Action International (HAI, databases, service provision assessments (SPAs, Demographic and Health Surveys, Multiple Indicator Cluster Surveys, and grey literature with no date restriction until May 2014. Data were identified from 37 published studies, 46 HAI national surveys, and eight SPAs. For study question 1, meta-analysis showed that clinical sign-based algorithms predicted bacterial infection in young infants with high sensitivity (87%, 95% CI 82%-91% and lower specificity (62%, 95% CI 48%-75% (six studies, n = 14,254. Frontline health workers diagnosed pBI in young infants with an average sensitivity of 82% (95% CI 76%-88% and specificity of 69% (95% CI 54%-83% (eight studies, n = 11,857 compared to physicians. For question 2, first-line injectable agents (ampicillin, gentamicin, and penicillin had low variable availability in first-level health facilities in Africa and South Asia. Oral amoxicillin and cotrimoxazole were widely available at low cost in most regions. For question 3, no studies on young infants were identified, however 25% of pediatric antibiotic purchases in LMICs were obtained without a prescription (11 studies, 95% CI 18%-34%, with lower rates among infants <1 year. Study limitations included potential selection bias and lack of neonatal-specific data. CONCLUSIONS: Trained frontline health workers may screen for pBI in young infants with relatively high sensitivity and lower

  5. Improving the Accessibility and Efficiency of Point-of-Care Diagnostics Services in Low- and Middle-Income Countries: Lean and Agile Supply Chain Management.

    Science.gov (United States)

    Kuupiel, Desmond; Bawontuo, Vitalis; Mashamba-Thompson, Tivani P

    2017-11-29

    Access to point-of-care (POC) diagnostics services is essential for ensuring rapid disease diagnosis, management, control, and surveillance. POC testing services can improve access to healthcare especially where healthcare infrastructure is weak and access to quality and timely medical care is a challenge. Improving the accessibility and efficiency of POC diagnostics services, particularly in resource-limited settings, may be a promising route to improving healthcare outcomes. In this review, the accessibility of POC testing is defined as the distance/proximity to the nearest healthcare facility for POC diagnostics service. This review provides an overview of the impact of POC diagnostics on healthcare outcomes in low- and middle-income countries (LMICs) and factors contributing to the accessibility of POC testing services in LMICs, focusing on characteristics of the supply chain management and quality systems management, characteristics of the geographical location, health infrastructure, and an enabling policy framework for POC diagnostics services. Barriers and challenges related to the accessibility of POC diagnostics in LMICs were also discussed. Bearing in mind the reported barriers and challenges as well as the disease epidemiology in LMICs, we propose a lean and agile supply chain management framework for improving the accessibility and efficiency of POC diagnostics services in these settings.

  6. Improving the Accessibility and Efficiency of Point-of-Care Diagnostics Services in Low- and Middle-Income Countries: Lean and Agile Supply Chain Management

    Directory of Open Access Journals (Sweden)

    Desmond Kuupiel

    2017-11-01

    Full Text Available Access to point-of-care (POC diagnostics services is essential for ensuring rapid disease diagnosis, management, control, and surveillance. POC testing services can improve access to healthcare especially where healthcare infrastructure is weak and access to quality and timely medical care is a challenge. Improving the accessibility and efficiency of POC diagnostics services, particularly in resource-limited settings, may be a promising route to improving healthcare outcomes. In this review, the accessibility of POC testing is defined as the distance/proximity to the nearest healthcare facility for POC diagnostics service. This review provides an overview of the impact of POC diagnostics on healthcare outcomes in low- and middle-income countries (LMICs and factors contributing to the accessibility of POC testing services in LMICs, focusing on characteristics of the supply chain management and quality systems management, characteristics of the geographical location, health infrastructure, and an enabling policy framework for POC diagnostics services. Barriers and challenges related to the accessibility of POC diagnostics in LMICs were also discussed. Bearing in mind the reported barriers and challenges as well as the disease epidemiology in LMICs, we propose a lean and agile supply chain management framework for improving the accessibility and efficiency of POC diagnostics services in these settings.

  7. Demand and supply for psychological help in general practice in different European countries: access to primary mental health care in six European countries.

    NARCIS (Netherlands)

    Verhaak, P.F.M.; Brink-Muinen, A. van den; Bensing, J.M.; Gask, L.

    2004-01-01

    The general practitioner is usually the first health care contact for mental problems. The position of a general practitioner may vary between health care systems, depending on the referral system (gatekeepers versus directly accessible specialists), presence of fixed lists and the payment system.

  8. Sanitation planning in developing countries

    NARCIS (Netherlands)

    Kerstens, S.M.

    2016-01-01

    Sanitation planning in developing countries: Added value of resource recovery

    Worldwide 2.5 billion people lack access to sanitation. This impacts human live, the environment and represents a loss of valuable resources that can be regained from wastewater. This study

  9. Interventions to improve access to cataract surgical services and their impact on equity in low- and middle-income countries.

    Science.gov (United States)

    Ramke, Jacqueline; Petkovic, Jennifer; Welch, Vivian; Blignault, Ilse; Gilbert, Clare; Blanchet, Karl; Christensen, Robin; Zwi, Anthony B; Tugwell, Peter

    2017-11-09

    Cataract is the leading cause of blindness in low- and middle-income countries (LMICs), and the prevalence is inequitably distributed between and within countries. Interventions have been undertaken to improve cataract surgical services, however, the effectiveness of these interventions on promoting equity is not known. To assess the effects on equity of interventions to improve access to cataract services for populations with cataract blindness (and visual impairment) in LMICs. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2017, Issue 3), MEDLINE Ovid (1946 to 12 April 2017), Embase Ovid (1980 to 12 April 2017), LILACS (Latin American and Caribbean Health Sciences Literature Database) (1982 to 12 April 2017), the ISRCTN registry (www.isrctn.com/editAdvancedSearch); searched 12 April 2017, ClinicalTrials.gov (www.clinicaltrials.gov); searched 12 April 2017 and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en); searched 12 April 2017. We did not use any date or language restrictions in the electronic searches for trials. We included studies that reported on strategies to improve access to cataract services in LMICs using the following study designs: randomised and quasi-randomised controlled trials (RCTs), controlled before-and-after studies, and interrupted time series studies. Included studies were conducted in LMICs, and were targeted at disadvantaged populations, or disaggregated outcome data by 'PROGRESS-Plus' factors (Place of residence; Race/ethnicity/ culture/ language; Occupation; Gender/sex; Religion; Education; Socio-economic status; Social capital/networks. The 'Plus' component includes disability, sexual orientation and age). Two authors (JR and JP) independently selected studies, extracted data and assessed them for risk of bias. Meta-analysis was not possible, so included studies were

  10. Access to hepatitis C treatment for people who inject drugs in low and middle income settings: Evidence from 5 countries in Eastern Europe and Asia.

    Science.gov (United States)

    Luhmann, Niklas; Champagnat, Julie; Golovin, Sergey; Maistat, Ludmila; Agustian, Edo; Inaridze, Ina; Myint, Wai Moe; Butsashvili, Maia; Bouscaillou, Julie

    2015-11-01

    People who inject drugs (PWID) are disproportionately affected by the hepatitis C (HCV) epidemic. Of the estimated 16 million PWID worldwide, approximately 8 million live with chronic HCV, and around 26% and 23% of the global HCV infections among PWID occur in East/Southeast Asia and Eastern Europe respectively. Globally, few PWID have access to treatment for HCV. We conducted a systematic literature review and internet survey in 2014 to document the burden of disease, access to diagnosis and treatment and the existence of national policy and treatment guidelines for HCV. We included Georgia, Russia, Ukraine, Myanmar and Indonesia as countries with injection drug use epidemics. HCV antibody prevalence among the general population ranged from 0.80% in Indonesia to 5% in Georgia, and among PWID from 48.1% in Myanmar to 92% in Georgia. PWID carried a significant burden of disease, ranging from 2.7% in Indonesia to 40.4% in Russia. Yearly treatment uptake was under 1% for the general population and PWID in all countries. Diagnostic tools and disease staging investigations as well as pegylated interferon/ribavirin treatment were available at a range of prices. Despite policy and treatment protocols for HCV in the majority of countries, strategies focusing on PWID were largely absent. PWID are a priority group for treatment, and access to treatment should be based on sound national policy, accessible public treatment programmes and functional surveillance systems. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. The fragile environments of inexpensive CD4+ T-cell enumeration in the least developed countries: strategies for accessible support.

    Science.gov (United States)

    Larsen, Christoph H

    2008-01-01

    With the advent of affordable antiretroviral treatment (ART), flow cytometry has ventured out of the exclusive realms of First World research to the resource-strapped clinical environment of developing countries (DCs). Flow cytometric instrumentation for ART has become more cost-efficient, thanks to simplified, yet accurate protocols and smart technologies. These positive developments have, however, not taken shape without problems, as health care in DCs remains weak due to chronic underfunding of their primary health systems. In addition, the multiplicity of donors has created parallel infrastructures that are difficult to manage and may undermine the responsibilities of public services. Hence, there is a prevailing lack of attention to maintenance, support, and human resource development. Not uncommonly, the procurement of high-value equipment is guided by nontechnical interests with mixed results. As conventional service contracts are unpopular, the sustainability of equipment is under serious threat after warranty periods, with environmental factors such as dust and unreliable power supplies being well-known culprits. Reagent supplies and servicing constitute further challenges, where a combination of short reagent shelf life, cold-box shipping, huge distances across poor infrastructures, rigid accounting procedures, and erratic customs requirements cause significant delays and extra costs. Although excellent, highly trained or trainable local staff is available, it is frequently diverted by brain drain from the government sector to privately funded hospitals, research facilities, and overseas postings. Despite these challenges, corporate service management has commonly remained loyal to its roots in the developed world.A number of propositions address the current situation: "Reagent-rental" agreements represent an attractive alternative to service contracts, while smart instrument design has started to make inroads into more robust device concepts. To avoid

  12. Accounting for water quality in monitoring access to safe drinking-water as part of the Millennium Development Goals: lessons from five countries

    Science.gov (United States)

    Bain, Rob ES; Wright, Jim A; Yang, Hong; Pedley, Steve; Bartram, Jamie K

    2012-01-01

    Abstract Objective To determine how data on water source quality affect assessments of progress towards the 2015 Millennium Development Goal (MDG) target on access to safe drinking-water. Methods Data from five countries on whether drinking-water sources complied with World Health Organization water quality guidelines on contamination with thermotolerant coliform bacteria, arsenic, fluoride and nitrates in 2004 and 2005 were obtained from the Rapid Assessment of Drinking-Water Quality project. These data were used to adjust estimates of the proportion of the population with access to safe drinking-water at the MDG baseline in 1990 and in 2008 made by the Joint Monitoring Programme for Water Supply and Sanitation, which classified all improved sources as safe. Findings Taking account of data on water source quality resulted in substantially lower estimates of the percentage of the population with access to safe drinking-water in 2008 in four of the five study countries: the absolute reduction was 11% in Ethiopia, 16% in Nicaragua, 15% in Nigeria and 7% in Tajikistan. There was only a slight reduction in Jordan. Microbial contamination was more common than chemical contamination. Conclusion The criterion used by the MDG indicator to determine whether a water source is safe can lead to substantial overestimates of the population with access to safe drinking-water and, consequently, also overestimates the progress made towards the 2015 MDG target. Monitoring drinking-water supplies by recording both access to water sources and their safety would be a substantial improvement. PMID:22461718

  13. Accounting for water quality in monitoring access to safe drinking-water as part of the Millennium Development Goals: lessons from five countries.

    Science.gov (United States)

    Bain, Rob E S; Gundry, Stephen W; Wright, Jim A; Yang, Hong; Pedley, Steve; Bartram, Jamie K

    2012-03-01

    To determine how data on water source quality affect assessments of progress towards the 2015 Millennium Development Goal (MDG) target on access to safe drinking-water. Data from five countries on whether drinking-water sources complied with World Health Organization water quality guidelines on contamination with thermotolerant coliform bacteria, arsenic, fluoride and nitrates in 2004 and 2005 were obtained from the Rapid Assessment of Drinking-Water Quality project. These data were used to adjust estimates of the proportion of the population with access to safe drinking-water at the MDG baseline in 1990 and in 2008 made by the Joint Monitoring Programme for Water Supply and Sanitation, which classified all improved sources as safe. Taking account of data on water source quality resulted in substantially lower estimates of the percentage of the population with access to safe drinking-water in 2008 in four of the five study countries: the absolute reduction was 11% in Ethiopia, 16% in Nicaragua, 15% in Nigeria and 7% in Tajikistan. There was only a slight reduction in Jordan. Microbial contamination was more common than chemical contamination. The criterion used by the MDG indicator to determine whether a water source is safe can lead to substantial overestimates of the population with access to safe drinking-water and, consequently, also overestimates the progress made towards the 2015 MDG target. Monitoring drinking-water supplies by recording both access to water sources and their safety would be a substantial improvement.

  14. From market access to patient access: overview of evidence-based approaches for the reimbursement and pricing of pharmaceuticals in 36 European countries.

    Science.gov (United States)

    Panteli, Dimitra; Eckhardt, Helene; Nolting, Alexandra; Busse, Reinhard; Kulig, Michael

    2015-09-25

    Coverage decisions determining the benefit baskets of health systems have been increasingly relying on evidence regarding patient benefit and costs. Relevant structures, methodologies, and processes have especially been established for pharmaceuticals but approaches differ. The objective of this work was thus to identify institutions in a broad range of European countries (n = 36) in charge of determining the value of pharmaceuticals for pricing and reimbursement purposes and to map their decision-making process; to examine the different approaches and consider national and supranational possibilities for best practice. Institutions were identified through websites of international networks, ministries, and published literature. Details on institutional practices were supplemented with information from institution websites and linked online sources. The type and extent of information available varied considerably across countries. Different types of public regulatory bodies are involved in pharmaceutical coverage decisions, assuming a range of responsibilities. As a rule, the assessment of scientific evidence is kept structurally separate from its appraisal. Recommendations on value are uniformly issued by specific committees within or commissioned by responsible institutions; these institutions often also act as decision-makers on reimbursement status and level or market price. While effectiveness and costs are important criteria in all countries, the latter are often considered on a case-by-case basis. In all countries, manufacturer applications, including relevant evidence, are used as one of the main sources of information for the assessment. Transparency of evidence-based coverage decisions should be enhanced. International collaboration can facilitate knowledge exchange, improve efficiency of information production, and strengthen new or developing systems.

  15. Barriers in access to healthcare in countries with different health systems. A cross-sectional study in municipalities of central Colombia and north-eastern Brazil.

    Science.gov (United States)

    Garcia-Subirats, Irene; Vargas, Ingrid; Mogollón-Pérez, Amparo Susana; De Paepe, Pierre; da Silva, Maria Rejane Ferreira; Unger, Jean Pierre; Vázquez, María Luisa

    2014-04-01

    There are few comprehensive studies available on barriers encountered from the initial seeking of healthcare through to the resolution of the health problem; in other words, on access in its broad domain. For Colombia and Brazil, countries with different healthcare systems but common stated principles, there have been no such analyses to date. This paper compares factors that influence access in its broad domain in two municipalities of each country, by means of a cross-sectional study based on a survey of a multistage probability sample of people who had had at least one health problem within the last three months (2163 in Colombia and 2155 in Brazil). The results reveal important barriers to healthcare access in both samples, with notable differences between and within countries, once differences in sociodemographic characteristics and health needs are accounted for. In the Colombian study areas, the greatest barriers were encountered in initial access to healthcare and in resolving the problem, and similarly when entering the health service in the Brazilian study areas. Differences can also be detected in the use of services: in Colombia greater geographical and economic barriers and the need for authorization from insurers are more relevant, whereas in Brazil, it is the limited availability of health centres, doctors and drugs that leads to longer waiting times. There are also differences according to enrolment status and insurance scheme in Colombia, and between areas in Brazil. The barriers appear to be related to the Colombian system's segmented, non-universal nature, and to the involvement of insurance companies, and to chronic underfunding of the public system in Brazil. Further research is required, but the results obtained reveal critical points to be tackled by health policies in both countries. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. A cross-sectional study of parental awareness of and reasons for lack of health insurance among minority children, and the impact on health, access to care, and unmet needs.

    Science.gov (United States)

    Flores, Glenn; Lin, Hua; Walker, Candy; Lee, Michael; Portillo, Alberto; Henry, Monica; Fierro, Marco; Massey, Kenneth

    2016-03-22

    Minority children have the highest US uninsurance rates; Latino and African-American children account for 53 % of uninsured American children, despite comprising only 48 % of the total US child population. The study aim was to examine parental awareness of and the reasons for lacking health insurance in Medicaid/CHIP-eligible minority children, and the impact of the children's uninsurance on health, access to care, unmet needs, and family financial burden. For this cross-sectional study, a consecutive series of uninsured, Medicaid/CHIP-eligible Latino and African-American children was recruited at 97 urban Texas community sites, including supermarkets, health fairs, and schools. Measures/outcomes were assessed using validated instruments, and included sociodemographic characteristics, uninsurance duration, reasons for the child being uninsured, health status, special healthcare needs, access to medical and dental care, unmet needs, use of health services, quality of care, satisfaction with care, out-of-pocket costs of care, and financial burden. The mean time uninsured for the 267 participants was 14 months; 5 % had never been insured. The most common reason for insurance loss was expired and never reapplied (30 %), and for never being insured, high insurance costs. Only 49 % of parents were aware that their uninsured child was Medicaid/CHIP eligible. Thirty-eight percent of children had suboptimal health, and 2/3 had special healthcare needs, but 64 % have no primary-care provider; 83 % of parents worry about their child's health more than others. Unmet healthcare needs include: healthcare, 73 %; mental healthcare, 70 %; mobility aids/devices, 67 %; dental, 61 %; specialty care, 57 %; and vision, 46 %. Due to the child's health, 35 % of parents had financial problems, 23 % cut work hours, and 10 % ceased work. Higher proportions of Latinos lack primary-care providers, and higher proportions of African-Americans experience family financial burden. Half of parents

  17. Presence, characteristics and equity of access to breast cancer screening programmes in 27 European countries in 2010 and 2014. Results from an international survey.

    Science.gov (United States)

    Deandrea, S; Molina-Barceló, A; Uluturk, A; Moreno, J; Neamtiu, L; Peiró-Pérez, R; Saz-Parkinson, Z; Lopez-Alcalde, J; Lerda, D; Salas, D

    2016-10-01

    The European Union Council Recommendation of 2 December 2003 on cancer screening suggests the implementation of organised, population-based breast cancer screening programmes based on mammography every other year for women aged 50 to 69years, ensuring equal access to screening, taking into account potential needs for targeting particular socioeconomic groups. A European survey on coverage and participation, and key organisational and policy characteristics of the programmes, targeting years 2010 and 2014, was undertaken in 2014. Overall, 27 countries contributed to this survey, 26 of the 28 European Union member states (92.9%) plus Norway. In 2014, 25 countries reported an ongoing population-based programme, one country reported a pilot programme and another was planning a pilot. In eight countries, the target age range was broader than that proposed by the Council Recommendation, and in three countries the full range was not covered. Fifteen countries reported not reaching some vulnerable populations, such as immigrants, prisoners and people without health insurance, while 22 reported that participation was periodically monitored by socioeconomic variables (e.g. age and territory). Organised, population-based breast cancer screening programmes based on routine mammograms are in place in most EU member states. However, there are still differences in the way screening programmes are implemented, and participation by vulnerable populations should be encouraged. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  18. Controversies and consensus in the innovation access for cancer therapy in the European countries: on the subject of metastatic prostate cancer.

    Science.gov (United States)

    Oudard, S; Courbon, F

    2017-02-01

    Innovative cancer therapies and advances in drug development have created new hopes for patients and health providers. The purpose of this article was to evaluate the discrepancies in the assessment of the magnitude of benefit of four new drugs (abiraterone acetate, enzalutamide, cabazitaxel, radium-223 dichloride) for the treatment of metastatic castration-resistant prostate cancer (mCRPC). The comparison was done among three European countries (UK, Germany and France) and Canada, according to the statement of each country and to the European Society of Medical Oncology (ESMO) Magnitude of Clinical Benefit Scale. Whereas those drugs are authorized by the European Medical Agency, one can observed that clear discrepancies in the magnitude of benefit assessment exist between selected countries, as well as between national pricing evaluation agencies and ESMO. However, price setting and reimbursement decisions remain national responsibility with differences in assessment of the medical value of new treatment across countries, leading to a heterogeneous accessibility to cancer treatments. In conclusion, several procedures have to be implemented to overcome the patchwork of administrative assessments. Among them, the assessment of medical value should be based on independent statements of learned societies, and the harmonization of access to cancer therapy in Europe has to be driven by a common European reimbursement and pricing policy. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. Patient access to medicines in two countries with similar health systems and differing medicines policies: Implications from a comprehensive literature review.

    Science.gov (United States)

    Babar, Zaheer-Ud-Din; Gammie, Todd; Seyfoddin, Ali; Hasan, Syed Shahzad; Curley, Louise E

    2018-04-13

    Countries with similar health systems but different medicines policies might result in substantial medicines usage differences and resultant outcomes. The literature is sparse in this area. To review pharmaceutical policy research in New Zealand and Australia and discuss differences between the two countries and the impact these differences may have on subsequent medicine access. A review of the literature (2008-2016) was performed to identify relevant, peer-reviewed articles. Systematic searches were conducted across the six databases MEDLINE, PubMed, Science Direct, Springer Links, Scopus and Google Scholar. A further search of journals of high relevance was also conducted. Using content analysis, a narrative synthesis of pharmaceutical policy research influencing access to medicines in Australia and New Zealand was conducted. The results were critically assessed in the context of policy material available via grey literature from the respective countries. Key elements regarding pharmaceutical policy were identified from the 35 research papers identified for this review. Through a content analysis, three broad categories of pharmaceutical policy were found, which potentially could influence patient access to medicines in each country; the national health system, pricing and reimbursement. Within these three categories, 9 subcategories were identified: national health policy, pharmacy system, marketing authorization and regulation, prescription to non-prescription medicine switch, orphan drug policies, generic medicine substitution, national pharmaceutical schedule and health technology assessment, patient co-payment and managed entry agreements. This review systematically evaluated the current literature and identified key areas of difference in policy between Australia and NZ. Australia appears to cover and reimburse a greater number of medicines, while New Zealand achieves much lower prices for medicines than their Australian counterparts and has been more

  20. Access to direct-acting antivirals for the treatment of hepatitis C in a country with limited resources.

    Science.gov (United States)

    Marciano, S; Haddad, L; Borzi, S M; D'Amico, C; Gaite, L A; Aubone, M V; Sirotinsky, M E; Ratusnu, N; Frola, M S; Aparicio, M C; Ríos, B; Anselmo, M N; Hansen, R; De Filippi, S; Dans, C García; de Labra, L; Peche, M A; Strella, T M; Ibáñez Duran, M; García Rosales, M B; Dirchwolf, M; Galdame, O A; Gadano, A C

    2018-04-12

    To estimate the proportion of patients who access to direct-acting antivirals agents (DAAs) for the treatment of hepatitisC in Argentina and to evaluate factors associated with failure to access to treatment. We performed a cross-sectional study of DAAs prescriptions written by centers participating in the telemedicine project ECHO TM -Hospital Italiano of Buenos Aires between January 2016 and February 2017. A total of 143 consecutive prescriptions were evaluated; the global access was 70% (95% CI: 62%-77%). The only factor independently associated with failure to access to treatment was belonging to the public healthcare system [OR 4.98 (95% CI: 2.05- 12.09)] in comparison to belonging to private insurance or HMOs. Patients with hepatitisC who belong to the public healthcare system are 4 times more likely to fail to access to treatment of hepatitisC than patients with private insurance or other kind of insurance. Copyright © 2018 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

  1. Gold Open Access Publishing in Mega-Journals: Developing Countries Pay the Price of Western Premium Academic Output

    NARCIS (Netherlands)

    Ellers, Jacintha; Crowther, Thomas W.; Harvey, Jeffrey A.

    2017-01-01

    Open access publishing (OAP) makes research output freely available, and several national governments have now made OAP mandatory for all publicly funded research. Gold OAP is a common form of OAP where the author pays an article processing charge (APC) to make the article freely available to

  2. Access to What? Creating a Composite Measure of Educational Quantity and Educational Quality for 11 African Countries

    Science.gov (United States)

    Spaull, Nicholas; Taylor, Stephen

    2015-01-01

    The aim of the current study is to create a composite statistic of educational quantity and educational quality by combining household data (Demographic and Health Survey) on grade completion and survey data (Southern and Eastern African Consortium for Monitoring Educational Quality) on cognitive outcomes for 11 African countries: Kenya, Lesotho,…

  3. Access: A Directory of Contacts, Environmental Data Bases, and Scientific Infrastructure on 175 Biosphere Reserves in 32 Countries.

    Science.gov (United States)

    Department of State, Washington, DC. Bureau of Oceans and International Environmental and Scientific Affairs.

    Following the EuroMAB meeting in Strasbourg, France (September 1991) and on an initiative of the Man and the Biosphere National Committee of the United States, a decision was made to create a research network from information available in biosphere reserves in 30 European countries, Canada and the United States. This Directory of EuroMAB Biosphere…

  4. Where are we now? A multi country qualitative study on access to pre-antiretroviral care services

    DEFF Research Database (Denmark)

    Bukenya, Dominic; Wringe, Alison; Moshabela, Mosa

    2017-01-01

    and acceptability of care.- Results: Affordability: Transport and treatment costs were a barrier to HIV care, although some participants travelled to distant clinics to avoid being seen by people who knew them or for specific services. Broken equipment and drug stock-outs in local clinics could also necessitate...... travel to other facilities. Availability: Some facilities did not offer full HIV care, or only offered all services intermittently. PLHIV who frequently travelled complained that care was seldom available to them in places they visited. Acceptability: Severe pain or sickness was a key driver...... care. PLHIV reported that healthcare workers’ knowledge, attitudes and behaviours, and their ability to impart health education, also influenced whether they accessed HIV care. Conclusion: Despite efforts to decentralise services over the past decade, many barriers to accessing HIV care persist...

  5. STI Services for Adolescents and Youth in Low and Middle Income Countries: Perceived and Experienced Barriers to Accessing Care

    OpenAIRE

    Newton-Levinson, Anna; Leichliter, Jami S.; Chandra-Mouli, Venkatraman

    2016-01-01

    Access to sexual and reproductive health services (SRH) is vital for sexually active adolescents; yet, their SRH care needs are often unmet. We conducted a qualitative systematic review of mixed methods studies to assess adolescent and provider views of barriers to seeking appropriate medical care for sexually transmitted infection (STI) services for adolescents. We searched peer-reviewed literature for studies published between 2001?2014 with a study population of youth (aged 10?24 years) an...

  6. Insufficient access to harm reduction measures in prisons in 5 countries (PRIDE Europe): a shared European public health concern

    OpenAIRE

    Michel, Laurent; Lions, Caroline; Van Malderen, Sara; Schiltz, Julie; Vanderplasschen, Wouter; Holm, Karina; Kolind, Torsten; Nava, Felice; Weltzien, Nadja; Moser, Andrea; Jauffret-Roustide, Marie; Maguet, Olivier; Carrieri, Patrizia M; Brentari, Cinzia; St?ver, Heino

    2015-01-01

    International audience; AbstractBackgroundPrisoners constitute a high-risk population, particularly for infectious diseases. The aim of this study was to estimate the level of infectious risk in the prisons of five different European countries by measuring to what extent the prison system adheres to WHO/UNODC recommendations.MethodsFollowing the methodology used in a previous French survey, a postal/electronic questionnaire was sent to all prisons in Austria, Belgium, Denmark and Italy to col...

  7. Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015

    DEFF Research Database (Denmark)

    2017-01-01

    Background National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high......-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care...... the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks...

  8. Internet access is NOT restricted globally to high income countries: so why are evidenced based prevention and treatment programs for mental disorders so rare?

    Science.gov (United States)

    Watts, Sarah E; Andrews, Gavin

    2014-08-01

    Mental disorders are widespread and universal. They are frequently accompanied by considerable harmful consequences for the individual and come at a significant economic cost to a community. Yet while effective evidence based prevention and treatment exists, there are a number of barriers to access, implement and disseminate. Cognitive behavior therapy programs, such as those available at www.thiswayup.com.au are widely available using the Internet in high income countries, such as Australia. With the ubiquitous uptake of Internet users globally, it is suggested that low and middle income countries should consider ways to embrace and scale up these cost effective programs. An explanation of why and some suggestions as to how this can be done are presented. Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.

  9. Geographic analysis of the variation in the incidence of ADHD in a country with free access to healthcare

    DEFF Research Database (Denmark)

    Madsen, Kathrine Bang; Ersbøll, Annette Kjær; Olsen, Jørn

    2015-01-01

    and individual tracking based on unique personal identification may in particular contribute to our understanding of the reasons for this increase. Based on Danish registers we aimed to examine the geographical patterns of the distribution of ADHD diagnosis and medication use and explore the association...... between neighbouring municipalities, no significant associations were found between ADHD and access to diagnostic services, different diagnostic culture, socioeconomic status at municipality level or the municipal spending on health care for children. CONCLUSIONS: A large geographical variation of ADHD...

  10. Scaling-up access to family planning may improve linear growth and child development in low and middle income countries.

    Science.gov (United States)

    Fink, Günther; Sudfeld, Christopher R; Danaei, Goodarz; Ezzati, Majid; Fawzi, Wafaie W

    2014-01-01

    A large literature has indicated a robust association between birth spacing and child survival, but evidence on the association of birth timing with physical growth in low and middle income countries (LMICs) remains limited. Data from 153 cross-sectional Demographic and Health Surveys (DHS) across 61 LMICs conducted between 1990 and 2011 were combined to assess the association of birth timing with child stunting (height-for-age z-score Middle East and North Africa sample. Postponing the age of first birth and increasing inter-pregnancy intervals has the potential to significantly reduce the prevalence of stunting and improve child development in LMICs.

  11. Speeding Access to Vaccines and Medicines in Low- and Middle-Income Countries: A Case for Change and a Framework for Optimized Product Market Authorization.

    Directory of Open Access Journals (Sweden)

    Vincent Ahonkhai

    Full Text Available The United Nations Millennium Development Goals galvanized global efforts to alleviate suffering of the world's poorest people through unprecedented public-private partnerships. Donor aid agencies have demonstrably saved millions of lives that might otherwise have been lost to disease through increased access to quality-assured vaccines and medicines. Yet, the introduction of these health interventions in low- and middle-income countries (LMICs continues to face a time lag due to factors which remain poorly understood.A recurring theme from our partnership engagements was that an optimized regulatory process would contribute to improved access to quality health products. Therefore, we investigated the current system for medicine and vaccine registration in LMICs as part of our comprehensive regulatory strategy. Here, we report a fact base of the registration timelines for vaccines and drugs used to treat certain communicable diseases in LMICs. We worked with a broad set of stakeholders, including the World Health Organization's prequalification team, national regulatory authorities, manufacturers, procurers, and other experts, and collected data on the timelines between first submission and last approval of applications for product registration sub-Saharan Africa. We focused on countries with the highest burden of communicable disease and the greatest need for the products studied. The data showed a typical lag of 4 to 7 years between the first regulatory submission which was usually to a regulatory agency in a high-income country, and the final approval in Sub-Saharan Africa. Two of the three typical registration steps which products undergo before delivery in the countries involve lengthy timelines. Failure to leverage or rely on the findings from reviews already performed by competent regulatory authorities, disparate requirements for product approval by the countries, and lengthy timelines by manufacturers to respond to regulatory queries

  12. A narrative synthesis of the impact of primary health care delivery models for refugees in resettlement countries on access, quality and coordination.

    Science.gov (United States)

    Joshi, Chandni; Russell, Grant; Cheng, I-Hao; Kay, Margaret; Pottie, Kevin; Alston, Margaret; Smith, Mitchell; Chan, Bibiana; Vasi, Shiva; Lo, Winston; Wahidi, Sayed Shukrullah; Harris, Mark F

    2013-11-07

    Refugees have many complex health care needs which should be addressed by the primary health care services, both on their arrival in resettlement countries and in their transition to long-term care. The aim of this narrative synthesis is to identify the components of primary health care service delivery models for such populations which have been effective in improving access, quality and coordination of care. A systematic review of the literature, including published systematic reviews, was undertaken. Studies between 1990 and 2011 were identified by searching Medline, CINAHL, EMBASE, Cochrane Library, Scopus, Australian Public Affairs Information Service - Health, Health and Society Database, Multicultural Australian and Immigration Studies and Google Scholar. A limited snowballing search of the reference lists of all included studies was also undertaken. A stakeholder advisory committee and international advisers provided papers from grey literature. Only English language studies of evaluated primary health care models of care for refugees in developed countries of resettlement were included. Twenty-five studies met the inclusion criteria for this review of which 15 were Australian and 10 overseas models. These could be categorised into six themes: service context, clinical model, workforce capacity, cost to clients, health and non-health services. Access was improved by multidisciplinary staff, use of interpreters and bilingual staff, no-cost or low-cost services, outreach services, free transport to and from appointments, longer clinic opening hours, patient advocacy, and use of gender-concordant providers. These services were affordable, appropriate and acceptable to the target groups. Coordination between the different health care services and services responding to the social needs of clients was improved through case management by specialist workers. Quality of care was improved by training in cultural sensitivity and appropriate use of interpreters. The

  13. Current Cigarette Smoking, Access, and Purchases from Retail Outlets Among Students Aged 13-15 Years - Global Youth Tobacco Survey, 45 Countries, 2013 and 2014.

    Science.gov (United States)

    D'Angelo, Denise; Ahluwalia, Indu B; Pun, Eugene; Yin, Shaoman; Palipudi, Krishna; Mbulo, Lazarous

    2016-09-02

    Tobacco use is a leading preventable cause of morbidity and mortality, with nearly 6 million deaths caused by tobacco use worldwide every year (1). Cigarette smoking is the most common form of tobacco use in most countries, and the majority of adult smokers initiate smoking before age 18 years (2,3). Limiting access to cigarettes among youths is an effective strategy to curb the tobacco epidemic by preventing smoking initiation and reducing the number of new smokers (3,4). CDC used the Global Youth Tobacco Survey (GYTS) data from 45 countries to examine the prevalence of current cigarette smoking, purchase of cigarettes from retail outlets, and type of cigarette purchases made among school students aged 13-15 years. The results are presented by the six World Health Organization (WHO) regions: African Region (AFR); Eastern Mediterranean Region (EMR); European Region (EUR); Region of the Americas (AMR); South-East Asian Region (SEAR); and Western Pacific Region (WPR). Across all 45 countries, the median overall current cigarette smoking prevalence among students aged 13-15 years was 6.8% (range = 1.7% [Kazakhstan]-28.9% [Timor-Leste]); the median prevalence among boys was 9.7% (2.0% [Kazakhstan]-53.5% [Timor-Leste]), and among girls was 3.5% (0.0% [Bangladesh]-26.3% [Italy]). The proportion of current cigarette smokers aged 13-15 years who reported purchasing cigarettes from a retail outlet such as a store, street vendor, or kiosk during the past 30 days ranged from 14.9% [Latvia] to 95.1% [Montenegro], and in approximately half the countries, exceeded 50%. In the majority of countries assessed in AFR and SEAR, approximately 40% of cigarette smokers aged 13-15 years reported purchasing individual cigarettes. Approximately half of smokers in all but one country assessed in EUR reported purchasing cigarettes in packs. These findings could be used by countries to inform tobacco control strategies in the retail environment to reduce and prevent marketing and sales of

  14. Sanitation planning in developing countries

    OpenAIRE

    Kerstens, S.M.

    2016-01-01

    Sanitation planning in developing countries: Added value of resource recovery Worldwide 2.5 billion people lack access to sanitation. This impacts human live, the environment and represents a loss of valuable resources that can be regained from wastewater. This study shows that resource recovery can be a potential driver to accelerate sanitation. A new sanitation decision framework for policy makers was created and tested in Indonesia. The variety of advantages and disadvantages of sanitatio...

  15. Do new Access and Benefit Sharing procedures under the Convention on Biological Diversity threaten the future of biological control? Supplemental material (case studies, natural enemy releases, country views concerning ABS)

    NARCIS (Netherlands)

    Cock, M.J.W.; Lenteren, van J.C.; Brodeur, J.; Barratt, I.P.; Bigler, F.; Bolckmans, K.; Cônsoli, F.L.; Haas, F.; Mason, P.G.; Parra, J.R.P.

    2010-01-01

    Under the Convention on Biological Diversity (CBD) countries have sovereign rights over their genetic resources. Agreements governing the access to these resources and the sharing of the benefits arising from their use need to be established between involved parties [i.e. Access and Benefit Sharing

  16. Monitoring fever treatment behaviour and equitable access to effective medicines in the context of initiatives to improve ACT access: baseline results and implications for programming in six African countries

    Directory of Open Access Journals (Sweden)

    Littrell Megan

    2011-10-01

    Full Text Available Abstract Background Access to artemisinin-based combination therapy (ACT remains limited in high malaria-burden countries, and there are concerns that the poorest people are particularly disadvantaged. This paper presents new evidence on household treatment-seeking behaviour in six African countries. These data provide a baseline for monitoring interventions to increase ACT coverage, such as the Affordable Medicines Facility for malaria (AMFm. Methods Nationally representative household surveys were conducted in Benin, the Democratic Republic of Congo (DRC, Madagascar, Nigeria, Uganda and Zambia between 2008 and 2010. Caregivers responded to questions about management of recent fevers in children under five. Treatment indicators were tabulated across countries, and differences in case management provided by the public versus private sector were examined using chi-square tests. Logistic regression was used to test for association between socioeconomic status and 1 malaria blood testing, and 2 ACT treatment. Results Fever treatment with an ACT is low in Benin (10%, the DRC (5%, Madagascar (3% and Nigeria (5%, but higher in Uganda (21% and Zambia (21%. The wealthiest children are significantly more likely to receive ACT compared to the poorest children in Benin (OR = 2.68, 95% CI = 1.12-6.42; the DRC (OR = 2.18, 95% CI = 1.12-4.24; Madagascar (OR = 5.37, 95% CI = 1.58-18.24; and Nigeria (OR = 6.59, 95% CI = 2.73-15.89. Most caregivers seek treatment outside of the home, and private sector outlets are commonly the sole external source of treatment (except in Zambia. However, children treated in the public sector are significantly more likely to receive ACT treatment than those treated in the private sector (except in Madagascar. Nonetheless, levels of testing and ACT treatment in the public sector are low. Few caregivers name the national first-line drug as most effective for treating malaria in Madagascar (2%, the DRC (2%, Nigeria (4% and Benin (10

  17. Scaling-up access to family planning may improve linear growth and child development in low and middle income countries.

    Directory of Open Access Journals (Sweden)

    Günther Fink

    Full Text Available A large literature has indicated a robust association between birth spacing and child survival, but evidence on the association of birth timing with physical growth in low and middle income countries (LMICs remains limited.Data from 153 cross-sectional Demographic and Health Surveys (DHS across 61 LMICs conducted between 1990 and 2011 were combined to assess the association of birth timing with child stunting (height-for-age z-score <-2. A total of 623,789 children of birth order 1-5 contributed to the maternal age analysis, while the birth spacing dataset consisted of 584,226 children of birth order 2 and higher. Compared to 27-34 year old mothers, maternal age under 18 years was associated with a relative stunting risk of 1.35 (95% CI: 1.29-1.40 for firstborn children, whereas the relative risk was 1.24 (95% CI: 1.19-1.29 for mothers aged 18-19 years. The association of young maternal age with stunting was significantly greater for urban residents and those in the top 50% of household wealth. Birth intervals less than 12 months and 12-23 months had relative risks for stunting of 1.09 (95% CI: 1.06-1.12 and 1.06 (95% CI: 1.05-1.06 as compared to a 24-35 month inter-pregnancy interval, respectively. The strength of both teenage pregnancy and short birth interval associations showed substantial variation across WHO region. We estimate that 8.6% (6.9-10.3% of stunted cases in the South Asian DHS sample would have been averted by jointly eliminating teen pregnancies and birth intervals less than 24 months, while only 3.6% (1.5-5.7% of stunting cases would have prevented in the Middle East and North Africa sample.Postponing the age of first birth and increasing inter-pregnancy intervals has the potential to significantly reduce the prevalence of stunting and improve child development in LMICs.

  18. How social policies can improve financial accessibility of healthcare: a multi-level analysis of unmet medical need in European countries.

    Science.gov (United States)

    Israel, Sabine

    2016-03-05

    The article explores in how far financial accessibility of healthcare (FAH) is restricted for low-income groups and identifies social protection policies that can supplement health policies in guaranteeing universal access to healthcare. The article is aimed to advance the literature on comparative European social epidemiology by focussing on income-related barriers of healthcare take-up. The research is carried out on the basis of multi-level cross-sectional analyses using 2012 EU-SILC data for 30 European countries. The social policy data stems from EU-SILC beneficiary information. It is argued that unmet medical needs are a reality for many individuals within Europe - not only due to direct user fees but also due to indirect costs such as waiting time, travel costs, time not spent working. Moreover, low FAH affects not only the lowest income quintile but also the lower middle income class. The study observes that social allowance increases the purchasing power of both household types, thereby helping them to overcome financial barriers to healthcare uptake. Alongside healthcare system reform aimed at improving the pro-poor availability of healthcare facilities and financing, policies directed at improving FAH should aim at providing a minimum income base to the low-income quintile. Moreover, categorical policies should address households exposed to debt which form the key vulnerable group within the low-income classes.

  19. Open access

    African Journals Online (AJOL)

    Prof. Dennis Ocholla

    The argument that access to information is an instrumental and individual as well as ... and Dean School of Information Studies, University of Wisconsin, Milwaukee, USA. ... to scholarly publications and can be in any digital format, including text, movies and ... language barriers, censorship, lack of access to the Internet and ...

  20. Use and Access of Grey Literature in Special Libraries may be Hindered by Lack of Visibility and Cataloguing. A review of: Ranger, Sara L. “Grey Literature in Special Libraries: Access in Use.” Publishing Research Quarterly 21.1 (Spring 2005: 53-63.

    Directory of Open Access Journals (Sweden)

    David Hook

    2006-03-01

    the interviews was that most of the users of grey literature are also producers of grey literature. The librarians surveyed reported that some of the reasons for using grey literature included use in research, to write (often more grey literature, interest in the topic, for class assignments, as records of previous practices, for localized studies, and for creating models and practices. Results found that for the libraries surveyed, much of the grey literature remains uncatalogued and what has been catalogued was done using a variety of methods. Over half of the libraries surveyed had their grey literature accessible online. Conclusion – Two main reasons were cited as explanations for why grey literature was not used as much as it should be: lack of cataloguing and visibility. In many of the libraries surveyed, much of the grey literature had not been catalogued, making it difficult to find and use the resources. Reasons cited for not cataloguing grey literature include lack of time, funds and/or knowledge. As well, in many of the libraries surveyed, it was found that the holdings of grey literature were not readily visible to the users, so users were not even aware that it existed. To improve the awareness and accessibility of grey literature, the author recommends regional depositories for grey literature, international standards for cataloguing and more cooperation between special libraries.

  1. Reconciling uncertainty of costs and outcomes with the need for access to orphan medicinal products: a comparative study of managed entry agreements across seven European countries.

    Science.gov (United States)

    Morel, Thomas; Arickx, Francis; Befrits, Gustaf; Siviero, Paolo; van der Meijden, Caroline; Xoxi, Entela; Simoens, Steven

    2013-12-24

    National payers across Europe have been increasingly looking into innovative reimbursement approaches - called managed entry agreements (MEAs) - to balance the need to provide rapid access to potentially beneficial orphan medicinal products (OMPs) with the requirements to circumscribe uncertainty, obtain best value for money or to ensure affordability. This study aimed to identify, describe and classify MEAs applied to OMPs by national payers and to analyse their practice in Europe. To identify and describe MEAs, national health technology assessments and reimbursement decisions on OMPs across seven European countries were reviewed and their main characteristics extracted. To fill data gaps and validate the accuracy of the extraction, collaboration was sought from national payers. To classify MEAs, a bespoke taxonomy was implemented. Identified MEAs were analysed and compared by focusing on five key themes, namely by describing the MEAs in relation to: drug targets and therapeutic classes, geographical spread, type of MEA applied, declared rationale for setting-up of MEAs, and evolution over time. 42 MEAs for 26 OMPs, implemented between 2006 and 2012 and representing a variety of MEA designs, were identified. Italy was the country with the highest number of schemes (n=15), followed by the Netherlands (n=10), England and Wales (n=8), Sweden (n=5) and Belgium (n=4). No MEA was identified for France and Germany due to data unavailability. Antineoplastic agents were the primary targets of MEAs. 55% of the identified MEAs were performance-based risk-sharing arrangements; the other 45% were financial-based. Nine of these 26 OMPs were subject to MEAs in two or three different countries, resulting in 24 MEAs. 60% of identified MEAs focused on conditions whose prevalence is less than 1 per 10,000. This study confirmed that a variety of MEAs were increasingly used by European payers to manage aspects of uncertainty associated with the introduction of OMPs in the healthcare

  2. Barriers and Opportunities in Consent and Access Procedures in Low- and Middle-Income Country Biobanks: Meeting Notes from the BCNet Training and General Assembly.

    Science.gov (United States)

    Zawati, Ma'n H; Tassé, Anne Marie; Mendy, Maimuna; Caboux, Elodie; Lang, Michael

    2018-04-18

    As biobanking research in low- and middle-income countries (LMICs) continues to grow, novel legal and policy considerations have arisen. Also, while an expansive literature has developed around these issues, the views and concerns of individual researchers in these contexts have been less actively studied. These meeting notes aim to contribute to the growing literature on biobanking in LMICs by communicating a number of challenges and opportunities identified by biobank researchers themselves. Specifically, we describe concerns that emerge in consent and access policy domains. First, we present a review of the literature on distinct policy and legal concerns faced in LMICs, giving special attention to the general absence of practitioner perspectives. From there, we outline and discuss considerations that were raised by meeting participants at a Biobank and Cohort Building Network (BCNet) Ethical, Legal, and Social Issues training program. We conclude by proposing that the unique perspectives of biobank researchers in LMICs should be given serious attention and further research on these perspectives should be conducted.

  3. Worldwide access to evidence-based mental health literature: how useful is PubMed in Anglo-Saxon and non-Anglo-Saxon countries?

    Science.gov (United States)

    Morlino, Massimo; Polese, Daniela; Bruni, Andrea; Renato, Bellinello

    2005-10-01

    The aim of this study was to verify the presence of cultural variety among the psychiatric journals available on PubMed, the major online tool for accessing literature. Data for analysis were taken from a survey of the world psychiatric journals indexed in Index Medicus 1999 (IM), the alphabetical list used by PubMed, and from the mean impact factor (IF) values of the journals. Approximately 80% of international psychiatric literature available on PubMed is published in Anglo-Saxon countries, especially in the USA (59.8% of the total). The widespread use of the English language (94.9% of all the journals) further stresses the dominance of the Anglo-Saxon cultural model, as do the mean IF values of Anglo-Saxon journals compared to non-Anglo-Saxon publications (3.252 vs. 1.693; P=0.0079). The under-representation of non-Anglo-Saxon cultural models on PubMed plays a negative role for bringing about a truly multicultural literature in psychiatry.

  4. 'It's risky to walk in the city with syringes': understanding access to HIV/AIDS services for injecting drug users in the former Soviet Union countries of Ukraine and Kyrgyzstan

    Directory of Open Access Journals (Sweden)

    Harmer Andrew

    2011-07-01

    Full Text Available Abstract Background Despite massive scale up of funds from global health initiatives including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund and other donors, the ambitious target agreed by G8 leaders in 2005 in Gleneagles to achieve universal access to HIV/AIDS treatment by 2010 has not been reached. Significant barriers to access remain in former Soviet Union (FSU countries, a region now recognised as a priority area by policymakers. There have been few empirical studies of access to HIV/AIDS services in FSU countries, resulting in limited understanding and implementation of accessible HIV/AIDS interventions. This paper explores the multiple access barriers to HIV/AIDS services experienced by a key risk group-injecting drug users (IDUs. Methods Semi-structured interviews were conducted in two FSU countries-Ukraine and Kyrgyzstan-with clients receiving Global Fund-supported services (Ukraine n = 118, Kyrgyzstan n = 84, service providers (Ukraine n = 138, Kyrgyzstan n = 58 and a purposive sample of national and subnational stakeholders (Ukraine n = 135, Kyrgyzstan n = 86. Systematic thematic analysis of these qualitative data was conducted by country teams, and a comparative synthesis of findings undertaken by the authors. Results Stigmatisation of HIV/AIDS and drug use was an important barrier to IDUs accessing HIV/AIDS services in both countries. Other connected barriers included: criminalisation of drug use; discriminatory practices among government service providers; limited knowledge of HIV/AIDS, services and entitlements; shortages of commodities and human resources; and organisational, economic and geographical barriers. Conclusions Approaches to thinking about universal access frequently assume increased availability of services means increased accessibility of services. Our study demonstrates that while there is greater availability of HIV/AIDS services in Ukraine and Kyrgyzstan, this does not equate with greater

  5. 'It's risky to walk in the city with syringes': understanding access to HIV/AIDS services for injecting drug users in the former Soviet Union countries of Ukraine and Kyrgyzstan

    LENUS (Irish Health Repository)

    Spicer, Neil

    2011-07-13

    Abstract Background Despite massive scale up of funds from global health initiatives including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and other donors, the ambitious target agreed by G8 leaders in 2005 in Gleneagles to achieve universal access to HIV\\/AIDS treatment by 2010 has not been reached. Significant barriers to access remain in former Soviet Union (FSU) countries, a region now recognised as a priority area by policymakers. There have been few empirical studies of access to HIV\\/AIDS services in FSU countries, resulting in limited understanding and implementation of accessible HIV\\/AIDS interventions. This paper explores the multiple access barriers to HIV\\/AIDS services experienced by a key risk group-injecting drug users (IDUs). Methods Semi-structured interviews were conducted in two FSU countries-Ukraine and Kyrgyzstan-with clients receiving Global Fund-supported services (Ukraine n = 118, Kyrgyzstan n = 84), service providers (Ukraine n = 138, Kyrgyzstan n = 58) and a purposive sample of national and subnational stakeholders (Ukraine n = 135, Kyrgyzstan n = 86). Systematic thematic analysis of these qualitative data was conducted by country teams, and a comparative synthesis of findings undertaken by the authors. Results Stigmatisation of HIV\\/AIDS and drug use was an important barrier to IDUs accessing HIV\\/AIDS services in both countries. Other connected barriers included: criminalisation of drug use; discriminatory practices among government service providers; limited knowledge of HIV\\/AIDS, services and entitlements; shortages of commodities and human resources; and organisational, economic and geographical barriers. Conclusions Approaches to thinking about universal access frequently assume increased availability of services means increased accessibility of services. Our study demonstrates that while there is greater availability of HIV\\/AIDS services in Ukraine and Kyrgyzstan, this does not equate with

  6. Energy brands lack vitality

    International Nuclear Information System (INIS)

    Godri, S.; Wilders, E.

    2004-01-01

    The three Dutch energy companies (Nuon, Essent and Eneco Energie) have relatively little brand strength. The brands are not perceived to be sufficiently different from one another and are not valued by consumers. With liberalisation imminent, this is hardly a strong starting point. How can you win over consumers if it is not clear what is on offer? In the business market, decision-makers are better placed to distinguish between brands. However, the brands lack vitality in this sector of the market too. The only consolation is that the situation is by no means exclusive to the Netherlands [nl

  7. Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations : a systematic analysis from the Global Burden of Disease Study 2016

    NARCIS (Netherlands)

    Fullman, Nancy; Yearwood, Jamal; Abay, Solomon M.; Abbafati, Cristiana; Abd-Allah, Foad; Abdela, Jemal; Abdelalim, Ahmed; Abebe, Zegeye; Abebo, Teshome Abuka; Aboyans, Victor; Abraha, Haftom Niguse; Abreu, Daisy M.X.; Abu-Raddad, Laith J.; Adane, Akilew Awoke; Adedoyin, Rufus Adesoji; Adetokunboh, Olatunji; Adhikari, Tara Ballav; Afarideh, Mohsen; Afshin, Ashkan; Agarwal, Gina; Agius, Dominic; Agrawal, Anurag; Agrawal, Sutapa; Ahmad Kiadaliri, Aliasghar; Aichour, Miloud Taki Eddine; Akibu, Mohammed; Akinyemi, Rufus Olusola; Akinyemiju, Tomi F.; Akseer, Nadia; Al Lami, Faris Hasan; Alahdab, Fares; Al-Aly, Ziyad; Alam, Khurshid; Alam, Tahiya; Alasfoor, Deena; Albittar, Mohammed I.; Alene, Kefyalew Addis; Al-Eyadhy, Ayman; Ali, Syed Danish; Alijanzadeh, Mehran; Aljunid, Syed M.; Alkerwi, Ala'a; Alla, François; Amare, Azmeraw T.; Berhe, Derbew Fikadu; Hoek, Hans W.; Khan, Muhammad Ali; Leigh, James; Postma, Maarten J.; van Boven, Job F.M.

    2018-01-01

    Background: A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We

  8. Innovative Approaches for Pharmaceutical Policy Research in Developing Countries: The View Through a Market Lens

    NARCIS (Netherlands)

    Waning, B.

    2011-01-01

    Despite one-third of the world lacking access to essential medicines, a dearth of pharmaceutical policy research in developing countries has resulted in policy decisions based upon opinion and conventional wisdom rather than evidence. While historical approaches to improve access to medicines

  9. A systematic review of the status of children's school access in low- and middle-income countries between 1998 and 2013: using the INDEPTH Network platform to fill the research gaps.

    Science.gov (United States)

    Kamanda, Mamusu; Sankoh, Osman

    2015-01-01

    The framework for expanding children's school access in low- and middle-income countries (LMICs) has been directed by universal education policies as part of Education for All since 1990. In measuring progress to universal education, a narrow conceptualisation of access which dichotomises children's participation as being in or out of school has often been assumed. Yet, the actual promise of universal education goes beyond this simple definition to include retention, progression, completion, and learning. Our first objective was to identify gaps in the literature on children's school access using the zones of exclusion of the Consortium for Research on Educational Access, Transition, and Equity as a framework. Second, we gave consideration to how these gaps can be met by using longitudinal and cross-country data from Health and Demographic Surveillance System (HDSS) sites within the International Network for the Demographic Evaluation of Population and Their Health (INDEPTH) in LMICs. Using Web of Science, we conducted a literature search of studies published in international peer-reviewed journals between 1998 and 2013 in LMICs. The phrases we searched included six school outcomes: school enrolment, school attendance, grade progression, school dropout, primary to secondary school transition, and school completion. From our search, we recorded studies according to: 1) school outcomes; 2) whether longitudinal data were used; and 3) whether data from more than one country were analysed. The area of school access most published is enrolment followed by attendance and dropout. Primary to secondary school transition and grade progression had the least number of publications. Of 132 publications which we found to be relevant to school access, 33 made use of longitudinal data and 17 performed cross-country analyses. The majority of studies published in international peer-reviewed journals on children's school access between 1998 and 2013 were focused on three outcomes

  10. A systematic review of the status of children's school access in low- and middle-income countries between 1998 and 2013: using the INDEPTH Network platform to fill the research gaps

    Directory of Open Access Journals (Sweden)

    Mamusu Kamanda

    2015-11-01

    Full Text Available Background: The framework for expanding children's school access in low- and middle-income countries (LMICs has been directed by universal education policies as part of Education for All since 1990. In measuring progress to universal education, a narrow conceptualisation of access which dichotomises children's participation as being in or out of school has often been assumed. Yet, the actual promise of universal education goes beyond this simple definition to include retention, progression, completion, and learning. Objective: Our first objective was to identify gaps in the literature on children's school access using the zones of exclusion of the Consortium for Research on Educational Access, Transition, and Equity as a framework. Second, we gave consideration to how these gaps can be met by using longitudinal and cross-country data from Health and Demographic Surveillance System (HDSS sites within the International Network for the Demographic Evaluation of Population and Their Health (INDEPTH in LMICs. Design: Using Web of Science, we conducted a literature search of studies published in international peer-reviewed journals between 1998 and 2013 in LMICs. The phrases we searched included six school outcomes: school enrolment, school attendance, grade progression, school dropout, primary to secondary school transition, and school completion. From our search, we recorded studies according to: 1 school outcomes; 2 whether longitudinal data were used; and 3 whether data from more than one country were analysed. Results: The area of school access most published is enrolment followed by attendance and dropout. Primary to secondary school transition and grade progression had the least number of publications. Of 132 publications which we found to be relevant to school access, 33 made use of longitudinal data and 17 performed cross-country analyses. Conclusions: The majority of studies published in international peer-reviewed journals on children

  11. IMPROVING ACCESS TO DRUGS

    Directory of Open Access Journals (Sweden)

    Max Joseph Herman

    2012-11-01

    Full Text Available Although essentially not all therapies need drug intervention, drugs is still an important components in health sector, either in preventive, curative, rehabilitative or promotion efforts. Hence the access to drugs is a main problem, either in international or national scale even to the smallest unit. The problem on access to drugs is very complicated and cannot be separated especially from pharmacy management problems; moreover in general from the overall lack of policy development and effective of health policy, and also the implementation process. With the policy development and effective health policy, rational drug uses, sufficient health service budget so a country can overcome the health problems. Besides infrastructures, regulations, distribution and cultural influences; the main obstacles for drug access is drugs affordability if the price of drugs is an important part and determined by many factors, especially the drug status whether is still patent orgenerics that significantly decrease cost of health cares and enhance the drugs affordability. The determination of essential drug prices in developing countries should based on equity principal so that poor people pay cheaper and could afford the essential drugs. WHO predicts two third of world population can not afford the essential drugs in which in developing countries, some are because of in efficient budget allocation in consequence of drug distribution management, including incorrect selection and allocation and also irrational uses. In part these could be overcome by enhancing performances on the allocation pharmacy needs, including the management of information system, inventory management, stock management and the distribution. Key words: access, drugs, essential drugs, generic drugs

  12. Open Access to essential health care information

    Directory of Open Access Journals (Sweden)

    Pandey Manoj

    2004-12-01

    Full Text Available Abstract Open Access publishing is a valuable resource for the synthesis and distribution of essential health care information. This article discusses the potential benefits of Open Access, specifically in terms of Low and Middle Income (LAMI countries in which there is currently a lack of informed health care providers – mainly a consequence of poor availability to information. We propose that without copyright restrictions, Open Access facilitates distribution of the most relevant research and health care information. Furthermore, we suggest that the technology and infrastructure that has been put in place for Open Access could be used to publish download-able manuals, guides or basic handbooks created by healthcare providers in LAMI countries.

  13. Agricultural Value Chains in Developing Countries; a Framework for Analysis

    NARCIS (Netherlands)

    Trienekens, J.H.

    2011-01-01

    The paper presents a framework for developing country value chain analysis made up of three components. The first consists of identifying major constraints for value chain upgrading: market access restrictions, weak infrastructures, lacking resources and institutional voids. In the second component

  14. Digital Muslimas: ICT Skills of Females in Middle Eastern Countries

    Science.gov (United States)

    Primo, L. Heidi

    2010-01-01

    This article examines women in Islamic countries with regard to sustainable futures, equity, and social justice. Some barriers to ICT use for women in the Middle East include access to computers, gender discrimination by employers, marginalized political participation, high rates of illiteracy, and lack of independence. Distance education offers a…

  15. Ancorare, fluttuare o abbandonare la nave:i regimi valutari dei paesi candidati all’Unione Europea (Anchor, Float or Abandon Ship: Exchange Rate Regimes for the Accession Countries

    Directory of Open Access Journals (Sweden)

    Willem H. Buiter

    2012-04-01

    Full Text Available The paper considers alternative exchange rate regimes for the East European accession candidates, both prior to EU accession and following EU accession but prior to EMU membership. We conclude that, from an economic point of view, EMU membership should be as early as possible. There is, however, a risk that prevailing interpretations of the inflation and exchange rate criteria for EMU membership could lead to unnecessary delays in EMU membership for the accession countries. The exchange rate criterion for EMU membership requires that the candidate "has respected the normal fluctuation margins provided for by the exchange rate mechanism of the European Monetary System without severe tensions for at least the last two years before the examination." Both this text and the precedents of Finland, Italy and Greece, support the view that the exchange rate criterion can be satisfied without two years of formal ERM II membership. Insistence on at least two years of formal ERM II membership for the accession countries would result in an unnecessary, costly and potentially risky stay in EMU purgatory.           JEL Codes: F33, P33, F15Keywords: EMU, EU, Exchange Rates

  16. Ancorare, fluttuare o abbandonare la nave:i regimi valutari dei paesi candidati all’Unione Europea (Anchor, Float or Abandon Ship: Exchange Rate Regimes for the Accession Countries

    Directory of Open Access Journals (Sweden)

    Willem H. Buiter

    2002-06-01

    Full Text Available The paper considers alternative exchange rate regimes for the East European accession candidates, both prior to EU accession and following EU accession but prior to EMU membership. We conclude that, from an economic point of view, EMU membership should be as early as possible. There is, however, a risk that prevailing interpretations of the inflation and exchange rate criteria for EMU membership could lead to unnecessary delays in EMU membership for the accession countries. The exchange rate criterion for EMU membership requires that the candidate "has respected the normal fluctuation margins provided for by the exchange rate mechanism of the European Monetary System without severe tensions for at least the last two years before the examination." Both this text and the precedents of Finland, Italy and Greece, support the view that the exchange rate criterion can be satisfied without two years of formal ERM II membership. Insistence on at least two years of formal ERM II membership for the accession countries would result in an unnecessary, costly and potentially risky stay in EMU purgatory.

  17. Barriers to access to opioid medicines for patients with opioid dependence : a review of legislation and regulations in eleven central and eastern European countries

    NARCIS (Netherlands)

    Vranken, Marjolein J M; Mantel-Teeuwisse, Aukje K; Jünger, Saskia; Radbruch, Lukas; Scholten, Willem; Lisman, John A; Subataite, Marija; Schutjens, Marie-Hélène D B

    BACKGROUND AND AIMS: Barriers linked to drug control systems are considered to contribute to inequitable access to controlled medicines, leaving millions of people in pain and suffering. Most studies focus on access to opioids for the treatment of severe (cancer) pain. This study aims to identify

  18. Community-level antibiotic access and use (ABACUS in low- and middle-income countries: Finding targets for social interventions to improve appropriate antimicrobial use – an observational multi-centre study [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Heiman F.L. Wertheim

    2017-07-01

    Full Text Available In many low- and middle-income countries (LMICs, a poor link between antibiotic policies and practices exists. Numerous contextual factors may influence the degree of antibiotic access, appropriateness of antibiotic provision, and actual use in communities. Therefore, improving appropriateness of antibiotic use in different communities in LMICs probably requires interventions tailored to the setting of interest, accounting for cultural context. Here we present the ABACUS study (AntiBiotic ACcess and USe, which employs a unique approach and infrastructure, enabling quantitative validation, contextualization of determinants, and cross-continent comparisons of antibiotic access and use. The community infrastructure for this study is the INDEPTH-Network (International Network for the Demographic Evaluation of Populations and Their Health in Developing Countries, which facilitates health and population research through an established health and demographic surveillance system. After an initial round of formative qualitative research with community members and antibiotic suppliers in three African and three Asian countries, household surveys will assess the appropriateness of antibiotic access, provision and use. Results from this sample will be validated against a systematically conducted inventory of suppliers. All potential antibiotic suppliers will be mapped and characterized. Subsequently, their supply of antibiotics to the community will be measured through customer exit interviews, which tend to be more reliable than bulk purchase or sales data. Discrepancies identified between reported and observed antibiotic practices will be investigated in further qualitative interviews. Amartya Sen’s Capability Approach will be employed to identify the conversion factors that determine whether or not, and the extent to which appropriate provision of antibiotics may lead to appropriate access and use of antibiotics. Currently, the study is ongoing and

  19. Community-level antibiotic access and use (ABACUS) in low- and middle-income countries: Finding targets for social interventions to improve appropriate antimicrobial use – an observational multi-centre study

    Science.gov (United States)

    Wertheim, Heiman F.L.; Chuc, Nguyen Thi Kim; Punpuing, Sureeporn; Khan, Wasif Ali; Gyapong, Margaret; Asante, Kwaku Poku; Munguambe, Khatia; Gómez-Olivé, F. Xavier; Ariana, Proochista; John-Langba, Johannes; Sigauque, Betuel; Toan, Tran Khanh; Tollman, Stephen; Cremers, Amelieke J.H.; Do, Nga T.T.; Nadjm, Behzad; van Doorn, H. Rogier; Kinsman, John; Sankoh, Osman

    2017-01-01

    In many low- and middle-income countries (LMICs), a poor link between antibiotic policies and practices exists. Numerous contextual factors may influence the degree of antibiotic access, appropriateness of antibiotic provision, and actual use in communities. Therefore, improving appropriateness of antibiotic use in different communities in LMICs probably requires interventions tailored to the setting of interest, accounting for cultural context. Here we present the ABACUS study (AntiBiotic ACcess and USe), which employs a unique approach and infrastructure, enabling quantitative validation, contextualization of determinants, and cross-continent comparisons of antibiotic access and use. The community infrastructure for this study is the INDEPTH-Network (International Network for the Demographic Evaluation of Populations and Their Health in Developing Countries), which facilitates health and population research through an established health and demographic surveillance system. After an initial round of formative qualitative research with community members and antibiotic suppliers in three African and three Asian countries, household surveys will assess the appropriateness of antibiotic access, provision and use. Results from this sample will be validated against a systematically conducted inventory of suppliers. All potential antibiotic suppliers will be mapped and characterized. Subsequently, their supply of antibiotics to the community will be measured through customer exit interviews, which tend to be more reliable than bulk purchase or sales data. Discrepancies identified between reported and observed antibiotic practices will be investigated in further qualitative interviews. Amartya Sen’s Capability Approach will be employed to identify the conversion factors that determine whether or not, and the extent to which appropriate provision of antibiotics may lead to appropriate access and use of antibiotics. Currently, the study is ongoing and expected to conclude

  20. Information Accessibility and Utilization as Correlate of Quality Of ...

    African Journals Online (AJOL)

    The quality of life of people in developing countries, including Nigeria, is often adjudged to be lower than the expected standard. This is worse with women living in the rural areas whose lives are characterised by inadequate access and use of basic amenities of life. The situation is compounded by the women's lack of ...

  1. Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016

    DEFF Research Database (Denmark)

    Moesgaard Iburg, Kim

    2018-01-01

    used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods...... and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used......·0 (14·3–23·7) in Somalia, and 23·4 (20·2–26·8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America...

  2. Greenhouse gas emissions trading among Pacific Rim countries: An analysis of policies to bring developing countries to the bargaining table

    International Nuclear Information System (INIS)

    Rose, Adam; Wei Dan

    2008-01-01

    This paper examines the aggregate net costs and individual country cost savings of greenhouse gas emissions trading among Pacific Rim countries. We propose emission permit allocation rules designed to entice developing countries to participate. Absence of developing country involvement has served as an excuse for the lack by participation by the United States in the first compliance period of the Kyoto Protocol and may serve as a disincentive to even more countries in subsequent periods. Our analysis specifies permit allocation rules that could result in no net costs, and even cost-savings, to developing countries for their involvement in the emissions trading market, while at the same time providing extensive benefits to industrialized countries through access to lower-cost mitigation alternatives

  3. The financial burden of out-of-pocket patient payments in the European Union and accession countries: Results of a systematic literature review

    NARCIS (Netherlands)

    Moser, K.; Pavlova, M.; Groot, W.

    2014-01-01

    A major issue for public health policy is to reduce the poverty and catastrophic effects of out-of-pocket payments. This paper reviews empirical studies that analyze the financial burden of out-of-pocket payments and factors that are associated with this burden for households in the EU and accession

  4. Presence, characteristics and equity of access to breast cancer screening programmes in 27 European countries in 2010 and 2014. Results from an international survey

    DEFF Research Database (Denmark)

    Deandrea, S; Molina-Barceló, A; Uluturk, A

    2016-01-01

    The European Union Council Recommendation of 2 December 2003 on cancer screening suggests the implementation of organised, population-based breast cancer screening programmes based on mammography every other year for women aged 50 to 69years, ensuring equal access to screening, taking into accoun...

  5. Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990-2015: a novel analysis from the Global Burden of Disease Study 2015.

    Science.gov (United States)

    2017-07-15

    National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure-the Healthcare Quality and Access (HAQ) Index-on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This

  6. Wheelchair accessibility to public buildings in Istanbul.

    Science.gov (United States)

    Evcil, A Nilay

    2009-03-01

    Accessibility to public environment is the human right and basic need of each citizen and is one of the fundamental considerations for urban planning. The aim of this study is to determine the compliance of public buildings in central business districts (CBD) of Istanbul, Turkey, to wheelchair accessibility to the guidelines of the instrument and identify architectural barriers faced by wheelchair users. This is a descriptive study of 26 public buildings in CBD of Istanbul. The instrument used is the adapted Useh, Moyo and Munyonga questionnaire to collect the data from direct observation and measurement. Descriptive statistics of simple percentages and means are used to explain the compliance to the guidelines of the instrument and wheelchair accessibility. The descriptive survey results indicate that wheelchair users experience many accessibility problems in public environment of the most urbanised city (cultural capital of Europe in 2010) in a developing country. It is found that the major architectural barrier is the public transportation items with the lowest mean compliance (25%). Beside this, the most compliant to the instrument is entrance to building items with 79% as mean percentage. It is also found that there is an intention to improve accessibility when building construction period is investigated. This article describes the example of the compliance of public buildings accessibility when the country has legislation, but lacking regulations about accessibility for the wheelchair users.

  7. Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990-2015

    DEFF Research Database (Denmark)

    Barber, Ryan M; Fullman, Nancy; Sorensen, Reed J D

    2017-01-01

    and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ...... Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle...

  8. Evaluation of Trends in Foreign Trade Development in the Post-Communist Countries of Europe in the Years 2000–2012 Following their Accession to the EU

    Directory of Open Access Journals (Sweden)

    Cieślik Ewa

    2016-12-01

    Full Text Available This paper seeks to analyse directions in foreign trade in the post-communist countries of Europe over the years 2000-2012 in the context of changes observed in other EU states. It was assumed that changes in the directions of foreign trade in post-communist states would be similar to those noted in Western Europe. On the basis of data derived from the OECD, EUROSTAT and OECD-WTO we show that the trading rules used by the old EU-15 adopted by those countries have brought them measurable benefits. As a result, the post-communist economies have become similar to those of the EU-15. Considering the structure of their trade and links with the EU-15, it is apparent that they have become the main trading and investment partners for the European Union. Hence, their integration with the EU structures made their development faster, but also made them more sensitive to industrial and demand shocks coming from the eurozone. It is predicted that the present model is not going to change, especially in the context of the participation in production networks.

  9. Medical tourism's impact on health care equity and access in low- and middle-income countries: making the case for regulation.

    Science.gov (United States)

    Chen, Y Y Brandon; Flood, Colleen M

    2013-01-01

    There is currently an evidentiary gap in the scholarship concerning medical tourism's impact on low- and middle-income destination countries (LMICs). This article reviews relevant evidence that exists and concludes that there are signs of correlation between medical tourism and the expansion of private, technology- intensive health care in LMICs, which has largely remained out of reach for the majority of the local patients. In light of this health care inequity between local residents and medical tourists in LMICs, we argue that the presumption should not be in favor of medical tourism and that governments have a legitimate interest in seeking to regulate this industry to ensure that the net effects for their citizens is positive. Moreover, sending countries, particularly those in the developed world, have the responsibility to adopt public policies to diminish demand on the part of their citizens for medical tourism and to work with LMICs to ensure that the growth of medical tourism does not occur at the expense of the poorest of the poor. © 2013 American Society of Law, Medicine & Ethics, Inc.

  10. A Roadmap and Cost Implications of Establishing Comprehensive Cancer Care Using a Teleradiotherapy Network in a Group of Sub-Saharan African Countries With No Access to Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Datta, Niloy R., E-mail: niloyranjan.datta@ksa.ch [Center for Radiation Oncology, KSA-KSB, Kantonsspital Aarau, Aarau (Switzerland); Heuser, Michael [Center for Radiation Oncology, KSA-KSB, Kantonsspital Aarau, Aarau (Switzerland); Bodis, Stephan [Center for Radiation Oncology, KSA-KSB, Kantonsspital Aarau, Aarau (Switzerland); Department of Radiation Oncology, University Hospital Zurich, Zurich (Switzerland)

    2016-08-01

    Purpose: To propose a roadmap and explore the cost implications of establishing a teleradiotherapy network to provide comprehensive cancer care and capacity building in countries without access to radiation therapy. Methods and Materials: Ten low-income sub-Saharan countries with no current radiation therapy facilities were evaluated. A basic/secondary radiation therapy center (SRTC) with 2 teletherapy, 1 brachytherapy, 1 simulator, and a treatment planning facility was envisaged at a cost of 5 million US dollars (USD 5M). This could be networked with 1 to 4 primary radiation therapy centers (PRTC) with 1 teletherapy unit, each costing USD 2M. The numbers of PRTCs and SRTCs for each country were computed on the basis of cancer incidence, assuming that a PRTC and SRTC could respectively treat 450 and 900 patients annually. Results: An estimated 71,215 patients in these countries will need radiation therapy in 2020. Stepwise establishment of a network with 99 PRTCs and 28 SRTCs would result in 155 teletherapy units and 96% access to radiation therapy. A total of 310 radiation oncologists, 155 medical physicists, and 465 radiation therapy technologists would be needed. Capacity building could be undertaken through telementoring by networking to various international institutions and professional societies. Total infrastructure costs would be approximately USD 860.88M, only 0.94% of the average annual gross domestic product of these 10 countries. A total of 1.04 million patients could receive radiation therapy during the 15-year lifespan of a teletherapy unit for an investment of USD 826.69 per patient. For the entire population of 218.32 million, this equates to USD 4.11 per inhabitant. Conclusion: A teleradiotherapy network could be a cost-contained innovative health care strategy to provide effective comprehensive cancer care through resource sharing and capacity building. The network could also be expanded to include other allied specialties. The proposal calls for

  11. Inmigrants from a country of the european union: Romanian inmigrants´social network, irregular inmigration and access to the labour market

    Directory of Open Access Journals (Sweden)

    Miguel Pajares

    2014-11-01

    Full Text Available Romanian immigration to Spain has been high in number and has taken place in a relatively short period of time, during which it has become the third most important immigrant group in statistical terms. The reasons behind this phenomenon stem from the living conditions in Romania as well as the particular characteristics of the Spanish labor market in recent years. It should be noted,however, that a side from these factors, it is the strong social network that has truly made possible such an intense migration dynamic.The social network constructed by the Romanians has some unique characteristics: there are few inner relationships, limited primarily to close family and friends, and it is weak in some aspects(except in the case of those belonging to religious minorities and the Roma people. Nonetheless, it is a useful network for labor insertion.Access to the labor market is produced via the «network»to the extent to which Romanians bring others into businesses or make initial contacts for them. In case studies, it has been observed that those Romanians arriving without a social network have a hard time finding work. The primary reason for this is that Romanian immigration has been channeled primarily through illegal means, thus initially entering the labour market in the submerged economy.Since January 1, 2007, the date marking the entry of Romaniain to the European Union, the Romanian community is the contingency with one of the highest rates of irregular immigration. Upon gaining recognition as EU community members, those immigrants who had previously found themselves in an irregular legal situation have been experiencing a change contradictory to their true legal status.

  12. Economic Evaluation of Family Planning Interventions in Low and Middle Income Countries : A Systematic Review

    NARCIS (Netherlands)

    Zakiyah, Neily; van Asselt, Antoinette D. I.; Roijmans, Frank; Postma, Maarten J.

    2016-01-01

    Background A significant number of women in low and middle income countries (L-MICs) who need any family planning, experience a lack in access to modern effective methods. This study was conducted to review potential cost effectiveness of scaling up family planning interventions in these regions

  13. Three-dimensional Printing in Developing Countries.

    Science.gov (United States)

    Ibrahim, Ahmed M S; Jose, Rod R; Rabie, Amr N; Gerstle, Theodore L; Lee, Bernard T; Lin, Samuel J

    2015-07-01

    The advent of 3-dimensional (3D) printing technology has facilitated the creation of customized objects. The lack of regulation in developing countries renders conventional means of addressing various healthcare issues challenging. 3D printing may provide a venue for addressing many of these concerns in an inexpensive and easily accessible fashion. These may potentially include the production of basic medical supplies, vaccination beads, laboratory equipment, and prosthetic limbs. As this technology continues to improve and prices are reduced, 3D printing has the potential ability to promote initiatives across the entire developing world, resulting in improved surgical care and providing a higher quality of healthcare to its residents.

  14. The role of population on economic growth and development: evidence from developing countries

    OpenAIRE

    Atanda, Akinwande A.; Aminu, Salaudeen B.; Alimi, Olorunfemi Y.

    2012-01-01

    The precise relationship between population growth and per capita income has been inconclusive in the literature and the nexus has been found not clearly explain the determinants of rapid population growth in developing countries that lacks fertility control and management framework. This forms the rationale for this study to access the trend of factors that influence rapid population growth in developing countries between 1980 and 2010. This paper examined the comparative trend review of pop...

  15. Radiotherapy in small countries.

    Science.gov (United States)

    Barton, Michael B; Zubizarreta, Eduardo H; Polo Rubio, J Alfredo

    2017-10-01

    To examine the availability of radiotherapy in small countries. A small country was defined as a country with a population less than one million persons. The economic status of each country was defined using the World Bank Classification. The number of cancers in each country was obtained from GLOBOCAN 2012. The number of cancer cases with an indication or radiotherapy was calculated using the CCORE model. There were 41 countries with a population of under 1 million; 15 were classified as High Income, 15 Upper Middle Income, 10 Lower Middle Income and one Low Income. 28 countries were islands. Populations ranged from 799 (Holy See) to 886450 (Fiji) and the total number of cancer cases occurring in small countries was 21,043 (range by country from 4 to 2476). Overall the total number of radiotherapy cases in small countries was 10982 (range by country from 2 to 1239). Radiotherapy was available in all HIC islands with 80 or more new cases of cancer in 2012 but was not available in any LMIC island. Fiji was the only LMIC island with a large radiotherapy caseload. Similar caseloads in non-island LMIC all had radiotherapy services. Most non-island HIC did not have radiotherapy services presumably because of the easy access to radiotherapy in neighbouring countries. There are no radiotherapy services in any LMIC islands. Copyright © 2017. Published by Elsevier Ltd.

  16. Understanding the political economy and key drivers of energy access in addressing national energy access priorities and policies

    International Nuclear Information System (INIS)

    Rehman, I.H.; Kar, Abhishek; Banerjee, Manjushree; Kumar, Preeth; Shardul, Martand; Mohanty, Jeevan; Hossain, Ijaz

    2012-01-01

    Globally, 1.5 billion people lack access to electricity and nearly 3 billion lack access to modern cooking energy options. Of the world’s “energy poor”, 95% are in Asia and Sub-Saharan Africa. Within Asia, almost 80% of electricity-deprived and 86% of biomass-dependent populations are in the “Big 5” countries: Bangladesh, China, India, Indonesia, and Pakistan. In this paper, we discuss the broad contours of the political economy of energy access in these countries. The political economy is assessed through an examination of three sustainability objectives: accessibility of physical infrastructure; energy service delivery; and conformance to social goals. The key areas of concern include emphasis on supply-driven grid electricity; vested power dynamics favouring affluent and urban areas; unreliability of energy service provision; and misdirected and misappropriated subsidies. The above-mentioned issues are responsible for limiting accelerated achievement of universal energy access in the “Big 5” countries and need to be addressed through innovative approaches. The paper emphasizes the need for firm commitments, policy convergence, and the implementation of 'pro-poor' equitable energy policies through a broad-based energy framework of bench-marked, technology-neutral energy provisioning that ensures reliability and equity. It highlights the need for reorienting of the subsidy regime and incorporating energy service delivery indicators in monitoring and reporting mechanisms. - Highlights: ► Limited emphasis on improved cooking programmes relative to electrification schemes. ► Strong disparity between rural and urban electrification and LPG access. ► Grid extension and subsidy on cooking fuels has limited success. ► Electricity access does not indicate transition to better cooking options. ► Technology neutrality in choosing suitable alternatives may led to improved access. ► There is need to re-orient energy subsidies and incentives.

  17. Less educated and older patients have reduced access to biologic DMARDs even in a country with highly developed social welfare (Norway): results from Norwegian cohort study NOR-DMARD.

    Science.gov (United States)

    Putrik, Polina; Ramiro, Sofia; Lie, Elisabeth; Keszei, Andras P; Kvien, Tore K; van der Heijde, Désirée; Landewé, Robert; Uhlig, Till; Boonen, Annelies

    2016-07-01

    To explore whether age, gender or education influence the time until initiation of the first bDMARD in patients with RA. Data from the Norwegian Register of DMARDs collected between 2000 and 2012 were used. Only DMARD-naïve patients with RA starting their first conventional synthetic DMARD were included in the analyses. The start of the first bDMARD was the main outcome of interest. Cox regression analyses were used to explore the impact of education, age and gender on the start of a first bDMARD, adjusting for confounders, either at baseline or varying over time (time-varying model). Of 1946 eligible patients [mean (s.d.) age: 55 (14) years, 68% females], 368 (19%) received a bDMARD during follow-up (mean 2.6 years). In the baseline prediction model, older age [Hazard Ratio (HR) 0.97, 95% CI: 0.96, 0.98], lower education [HR = 0.76 and 0.68 for low and intermediate education levels vs college/university education, respectively (P = 0.01)] and female gender [only in the period 2000-03, HR = 0.61 (95% CI: 0.41, 0.91)] were associated with a lower hazard ratio to start a bDMARD. The time-varying model provided overall consistent results, but the effect of education was only relevant for older patients (>57 years) and became more pronounced by the end of the decade. Less educated and older patients have disadvantages with regard to access to costly treatments, even in a country with highly developed welfare like Norway. Females had lower access in the beginning of the 2000s, but access had improved by the end of the decade. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. Air pollution: a tale of two countries.

    Science.gov (United States)

    Haryanto, Budi; Franklin, Peter

    2011-01-01

    The fast growing economies and continued urbanization in Asian countries have increased the demand for mobility and energy in the region, resulting in high levels of air pollution in cities from mobile and stationary sources. In contrast, low level of urbanization in Australia produces low level of urban air pollution. The World Health Organization estimates that about 500,000 premature deaths per year are caused by air pollution, leaving the urban poor particularly vulnerable since they live in air pollution hotspots, have low respiratory resistance due to bad nutrition, and lack access to quality health care. Identifying the differences and similarities of air pollution levels and its impacts, between Indonesia and Australia, will provide best lesson learned to tackle air pollution problems for Pacific Basin Rim countries.

  19. Reduced alcohol consumption in mice lacking preprodynorphin.

    Science.gov (United States)

    Blednov, Yuri A; Walker, Danielle; Martinez, Marni; Harris, R Adron

    2006-10-01

    Many studies suggest a role for endogenous opioid peptides and their receptors in regulation of ethanol intake. It is commonly accepted that the kappa-opioid receptors and their endogenous ligands, dynorphins, produce a dysphoric state and therefore may be responsible for avoidance of alcohol. We used mutant mice lacking preprodynorphin in a variety of behavioral tests of alcohol actions. Null mutant female, but not male, mice showed significantly lower preference for alcohol and consumed lower amounts of alcohol in a two-bottle choice test as compared with wild-type littermates. In the same test, knockout mice of both sexes showed a strong reduction of preference for saccharin compared to control mice. In contrast, under conditions of limited (4 h) access (light phase of the light/dark cycle), null mutant mice did not show any differences in consumption of saccharin, but they showed significantly reduced intake of sucrose. To determine the possible cause for reduction of ethanol preference and intake, we studied other ethanol-related behaviors in mice lacking the preprodynorphin gene. There were no differences between null mutant and wild-type mice in ethanol-induced loss of righting reflex, acute ethanol withdrawal, ethanol-induced conditioned place preference, or conditioned taste aversion to ethanol. These results indicate that deletion of preprodynorphin leads to substantial reduction of alcohol intake in female mice, and suggest that this is caused by decreased orosensory reward of alcohol (sweet taste and/or palatability).

  20. [Deficient information in developing countries: Internet alone is no solution].

    Science.gov (United States)

    Sluijs, M B; Veeken, H; Overbeke, A J P M

    2006-06-17

    Health-care personnel in developing countries have poor access to information, partly because the books are out of date and journals and Internet access are lacking, and partly because the information that is available is not appropriate for the local situation. There is too little research aimed at the problems of the Third World. This is due to a lack of interest in Western countries and because local scientists have done too little research. Internet solves the problem of access to information for health-care personnel in large hospitals and institutes, but there is still a shortage of relevant information for them as well. The editorial boards of professional journals could make a contribution by facilitating the publication of relevant research. Health-care personnel in rural areas will remain dependent upon basic books. This basic component of the provision of information should continue to receive attention. For the time being, Internet will remain inaccessible for rural health-care personnel. One of the initiatives being undertaken in order to improve the provision of information to health-care personnel in developing countries is the distribution of the 'blue trunk library' of the WHO with a selection of more than 100 basic books in every trunk. A number of journals have also taken action: the BMJ Publishing Group offers access to its journals free of charge to the 118 poorest countries and the Canadian Medical Association Journal provides free copies to libraries in developing countries. Moreover, a number ofwebsites have been started with a view to enlarging the information for health-care personnel in the Third World.

  1. in a Developing Country

    African Journals Online (AJOL)

    GB

    This could have contributed to the refusal for readmission. In conclusion, identification and management of mucopolysaccharidosis type II in affected patients pose a problem in resource-constrained countries due to late identification and presentation, lack of facilities for diagnosis and treatment, as well as the cost and the.

  2. Cancer Pain Management in Developing Countries.

    Science.gov (United States)

    Saini, Shalini; Bhatnagar, Sushma

    2016-01-01

    The World Health Organization estimated that more than 60% of the 14 million new cancer cases worldwide in 2012 were reported in the developing part of the world, including Asia, Africa, Central and South America. Cancer survival rate is poorer in developing countries due to diagnosis at late stage and limited access to timely treatment. Since the disease per se cannot be treated even with the best available treatment modalities, what remains important is symptom management and providing comfort care to these patients. The incidence of pain in advanced stages of cancer approaches 70-80%. Lack of preventive strategies, poverty, illiteracy, and social stigma are the biggest cause of pain suffering and patient presenting in advance stage of their disease. The need for palliative care is expanding due to aging of world's population and increase in the rate of cancer in developed and developing countries. A huge gap remains between demand and current palliative care services. Overcoming barriers to palliative care is a major global health agenda that need immediate attention. Main causes of inadequate pain relief remain lack of knowledge among physician and patients, lack of adequate supply of opioids and other drugs for pain relief, strong bureaucracy involved in terms of procurement, and dispensing of opioids. Beside this, poverty and illiteracy remain the most important factors of increased suffering.

  3. Peer-Reviewed Veterinary Journals From Arabic-Speaking Countries: A Systematic Review.

    Science.gov (United States)

    Robertson, Kristen M; Bowser, Jacquelyn E; Bernstein, Joshua; Aboul-Enein, Basil H

    The prevalence of diseases of foodborne and zoonotic origin in Arabic-speaking countries highlights the importance of collaboration between human and animal health professionals. However, accessibility of research and evidence-based practices in these countries is not well characterized. This brief report determines the availability of professional veterinary journals within the Arabic-speaking region. An electronic search using 6 databases assessed for publication period, activity status, and available languages incorporated all aspects of veterinary medicine and specialties. Among 29 veterinary journals identified, the oldest current publication originated 63 years ago, with 10 journals currently interrupted or ceased. All 19 currently active journals are available electronically as open access, with 8 also offered in paper format. Veterinary journals published within Arabic-speaking countries are predominantly produced in Egypt, Iraq, and Sudan. Electronic access is lacking compared with English-speaking countries, and there is a lack of journals with an Arabic-language option. The reasons associated with language options in veterinary publications are not immediately apparent, yet may highlight differences among public health, health education, and zoonotic professionals and the populations they serve. Veterinary journals in Arabic-speaking countries do not adequately represent the overall region and are limited in access. Further evaluation of regional culture and publisher preferences is indicated to identify new collaboration opportunities among health professionals and local stakeholders. Copyright © 2017 Icahn School of Medicine at Mount Sinai. Published by Elsevier Inc. All rights reserved.

  4. Head and Neck Cancers in Developing Countries

    Directory of Open Access Journals (Sweden)

    Poonam Joshi

    2014-04-01

    Full Text Available Head and neck cancers are the most common cancers in developing countries, especially in Southeast Asia. Head and neck cancers are more common in males compared to females. This is mainly attributed to tobacco, areca nut, alcohol, etc. Oral cancers are most common amongst all head and neck squamous cell cancers (HNSCC. HNSCC in the developing world differ from those in the Western world in terms of age, site of disease, etiology, and molecular biology. Poverty, illiteracy, advanced stage at presentation, lack of access to health care, and poor treatment infrastructure pose a major challenge in management of these cancers. The annual GDP (gross domestic product spent on health care is very low in developing countries compared to the developed countries. Cancer treatment leads to a significant financial burden on the cancer patients and their families. Several health programs have been implemented to curb this rising burden of disease. The main aims of these health programs are to increase awareness among people regarding tobacco and to improve access to health care facilities, early diagnosis, treatment, and palliative care.

  5. Chronic kidney disease hotspots in developing countries in South Asia.

    Science.gov (United States)

    Abraham, Georgi; Varughese, Santosh; Thandavan, Thiagarajan; Iyengar, Arpana; Fernando, Edwin; Naqvi, S A Jaffar; Sheriff, Rezvi; Ur-Rashid, Harun; Gopalakrishnan, Natarajan; Kafle, Rishi Kumar

    2016-02-01

    In many developing countries in the South Asian region, screening for chronic diseases in the community has shown a widely varying prevalence. However, certain geographical regions have shown a high prevalence of chronic kidney disease (CKD) of unknown etiology. This predominantly affects the young and middle-aged population with a lower socioeconomic status. Here, we describe the hotspots of CKD of undiagnosed etiology in South Asian countries including the North, Central and Eastern provinces of Sri Lanka and the coastal region of the state of Andhra Pradesh in India. Screening of these populations has revealed cases of CKD in various stages. Race has also been shown to be a factor, with a much lower prevalence of CKD in whites compared to Asians, which could be related to the known influence of ethnicity on CKD development as well as environmental factors. The difference between developed and developing nations is most stark in the realm of healthcare, which translates into CKD hotspots in many regions of South Asian countries. Additionally, the burden of CKD stage G5 remains unknown due to the lack of registry reports, poor access to healthcare and lack of an organized chronic disease management program. The population receiving various forms of renal replacement therapy has dramatically increased in the last decade due to better access to point of care, despite the disproportionate increase in nephrology manpower. In this article we will discuss the nephrology care provided in various countries in South Asia, including India, Bangladesh, Pakistan, Nepal, Bhutan, Sri Lanka and Afghanistan.

  6. Broadband Access

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Broadband Access. Worldwide market for broadband access $30 Billion! Over 200 million broadband subscribers worldwide! Various Competing Broadband access. Digital Subscriber line; Wireless; Optical Fiber.

  7. Health problems of Nepalese migrants working in three Gulf countries

    Directory of Open Access Journals (Sweden)

    Prescott Gordon J

    2011-03-01

    Full Text Available Abstract Background Nepal is one of the largest suppliers of labour to countries where there is a demand for cheap and low skilled workers. In the recent years the Gulf countries have collectively become the main destinations for international migration. This paper aims to explore the health problems and accidents experienced by a sample of Nepalese migrant in three Gulf countries. Methods A cross-sectional survey was conducted among 408 Nepalese migrants who had at least one period of work experience of at least six months in any of three Gulf countries: Qatar, Saudi Arabia and United Arab Emirates (UAE. Face to face questionnaire interviews were conducted applying a convenience technique to select the study participants. Results Nepalese migrants in these Gulf countries were generally young men between 26-35 years of age. Unskilled construction jobs including labourer, scaffolder, plumber and carpenter were the most common jobs. Health problems were widespread and one quarter of study participants reported experiencing injuries or accidents at work within the last 12 months. The rates of health problems and accidents reported were very similar in the three countries. Only one third of the respondents were provided with insurance for health services by their employer. Lack of leave for illness, cost and fear of losing their job were the barriers to accessing health care services. The study found that construction and agricultural workers were more likely to experience accidents at their workplace and health problems than other workers. Conclusion The findings suggest important messages for the migration policy makers in Nepal. There is a lack of adequate information for the migrants making them aware of their health risks and rights in relation to health services in the destination countries and we suggest that the government of Nepal should be responsible for providing this information. Employers should provide orientation on possible health

  8. Joint default probabilities and country risk

    NARCIS (Netherlands)

    Scholtens, Bert; Hameeteman, Daphne

    2003-01-01

    The assessment of country risk is of crucial importance for both developing countries and international lenders and investors. Many existing country risk approaches are opaque and heavily rely on subjective choices. In general, they lack a theoretical basis. To assess country risk, we use the Merton

  9. Beyond Wage Bill Ceilings : The Impact of Government Fiscal and Human Resource Management Policies on the Health Workforce in Developing Countries, Background Country Study for Rwanda

    OpenAIRE

    World Bank

    2008-01-01

    One of the main explanations put forth on why access to health workers is so low in developing countries is that there are insufficient resources within the public sector to pay the wage bill - the salary and allowance payments - of an expanded health workforce. In turn, the lack of wage bill resources for the health sector is thought to be a direct result of restrictive macroeconomic poli...

  10. Access 2010 for dummies

    CERN Document Server

    Ulrich Fuller, Laurie

    2010-01-01

    A friendly, step-by-step guide to the Microsoft Office database application Access may be the least understood and most challenging application in the Microsoft Office suite. This guide is designed to help anyone who lacks experience in creating and managing a database learn to use Access 2010 quickly and easily. In the classic For Dummies tradition, the book provides an education in Access, the interface, and the architecture of a database. It explains the process of building a database, linking information, sharing data, generating reports, and much more.As the Micr

  11. [Costly drugs: analysis and proposals for the Mercosur countries].

    Science.gov (United States)

    Marín, Gustavo H; Polach, María Andrea

    2011-08-01

    Determine how the Mercosur countries access, regulate, and finance costly drugs and propose joint selection and financing strategies at the subregional level. Qualitative design, using content analyses of primary and secondary sources, document reviews, interviews, focus groups, and case studies. The variables selected included: selection criteria, access, financing, and regulations in the various countries. Costly drugs were divided into those that do not alter the natural course of the disease and those with demonstrated efficacy, using the defined daily dose to compare the costs of classical treatments and those involving costly drugs. The Mercosur countries generally lack formal strategies for dealing with the demand for costly drugs, and governments and insurers wind up financing them by court order. The case studies show that there are costly drugs whose efficacy has not been established but that nonetheless generate demand. The fragmentation of procurement, international commitments with regard to intellectual property, and low negotiating power exponentially increase the price of costly drugs, putting health system finances in jeopardy. Costly drugs must be regulated and rationally selected so that only those that substantively benefit people are accepted. To finance the drugs so selected, common country strategies are needed that include such options as flexible in trade agreements, the creation of national resource funds, or joint procurement by countries to enhance their negotiating power.

  12. Demystifying Open Access

    International Nuclear Information System (INIS)

    Mele, Salvatore

    2007-01-01

    The tenets of Open Access are to grant anyone, anywhere and anytime free access to the results of scientific research. HEP spearheaded the Open Access dissemination of scientific results with the mass mailing of preprints in the pre-WWW era and with the launch of the arXiv preprint system at the dawn of the '90s. The HEP community is now ready for a further push to Open Access while retaining all the advantages of the peer-review system and, at the same time, bring the spiralling cost of journal subscriptions under control. I will present a possible plan for the conversion to Open Access of HEP peer-reviewed journals, through a consortium of HEP funding agencies, laboratories and libraries: SCOAP3 (Sponsoring Consortium for Open Access Publishing in Particle Physics). SCOAP3 will engage with scientific publishers towards building a sustainable model for Open Access publishing, which is as transparent as possible for HEP authors. The current system in which journals income comes from subscription fees is replaced with a scheme where SCOAP3 compensates publishers for the costs incurred to organise the peer-review service and give Open Access to the final version of articles. SCOAP3 will be funded by all countries active in HEP under a 'fair share' scenario, according to their production of HEP articles. In this talk I will present a short overview of the history of Open Access in HEP, the details of the SCOAP3 model and the outlook for its implementation.

  13. Peritoneal Dialysis in Western Countries.

    Science.gov (United States)

    Struijk, Dirk G

    2015-12-01

    Peritoneal dialysis (PD) for the treatment of end-stage renal failure was introduced in the 1960s. Nowadays it has evolved to an established therapy that is complementary to hemodialysis (HD), representing 11% of all patients treated worldwide with dialysis. Despite good clinical outcomes and similar results in patient survival between PD and HD, the penetration of PD is decreasing in the Western world. First the major events in the history of the development of PD are described. Then important insights into the physiology of peritoneal transport are discussed and linked to the changes in time observed in biopsies of the peritoneal membrane. Furthermore, the developments in peritoneal access, more biocompatible dialysate solutions, automated PD at home, the establishment of parameters for dialysis adequacy and strategies to prevent infectious complications are mentioned. Finally non-medical issues responsible for the declining penetration in the Western world are analyzed. Only after introduction of the concept of continuous ambulatory PD by Moncrief and Popovich has this treatment evolved in time to a renal replacement therapy. Of all structures present in the peritoneal membrane, the capillary endothelium offers the rate-limiting hindrance for solute and water transport for the diffusive and convective transport of solutes and osmosis. The functional and anatomical changes in the peritoneal membrane in time can be monitored by the peritoneal equilibrium test. Peritonitis incidence decreased by introduction of the Y-set and prophylaxis using mupirocin on the exit site. The decrease in the proportion of patients treated with PD in the Western world can be explained by non-medical issues such as inadequate predialysis patient education, physician experience and training, ease of HD initiation, overcapacity of in-center HD, lack of adequate infrastructure for PD treatment, costs and reimbursement issues of the treatment. (1) PD is cheaper than HD and provides a

  14. Nuclear information access system

    International Nuclear Information System (INIS)

    Ham, C. H.; Yang, M. H.; Yoon, S. W.

    1998-01-01

    The energy supply in the countries, which have abundant energy resources, may not be affected by accepting the assertion of anti-nuclear and environment groups. Anti-nuclear movements in the countries which have little energy resources may cause serious problem in securing energy supply. Especially, it is distinct in Korea because she heavily depends on nuclear energy in electricity supply(nuclear share in total electricity supply is about 40%).The cause of social trouble surrounding nuclear energy is being involved with various circumstances. However, it is very important that we are not aware of the importance of information access and prepared for such a situation from the early stage of nuclear energy's development. In those matter, this paper analyzes the contents of nuclear information access system in France and Japan which have dynamic nuclear development program and presents the direction of the nuclear access regime through comparing Korean status and referring to progresses of the regime

  15. Wireless Access

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Wireless Access. Wireless connect to the Base station. Easy and Convenient access. Costlier as compared to the wired technology. Reliability challenges. We see it as a complementary technology to the DSL.

  16. Open access

    NARCIS (Netherlands)

    Valkenburg, P.M.

    2015-01-01

    Open access week Van 19 tot en met 25 oktober 2015 vond wereldwijd de Open Access Week plaats. Tijdens deze week werden er over de hele wereld evenementen georganiseerd waar open access een rol speelt. Ook in Nederland zijn er diverse symposia, workshops en debatten georganiseerd zoals het debat in

  17. Biomarker Testing for Personalized Therapy in Lung Cancer in Low- and Middle-Income Countries.

    Science.gov (United States)

    Hirsch, Fred R; Zaric, Bojan; Rabea, Ahmed; Thongprasert, Sumitra; Lertprasertsuke, Nirush; Dalurzo, Mercedes Liliana; Varella-Garcia, Marileila

    2017-01-01

    There have been many important advances in personalized therapy for patients with lung cancer, particularly for those with advanced disease. Molecular testing is crucial for implementation of personalized therapy. Although the United States and many Western countries have come far in the implementation of personalized therapy for lung cancer, there are substantial challenges for low- and middle-income countries (LMICs). Globally, the LMICs display great heterogeneity in the pattern of implementation of molecular testing and targeted therapy. The current review presents an attempt to identify the challenges and obstacles for the implementation of molecular testing and the use of targeted therapies in these areas. Lack of infrastructure, lack of technical expertise, economic factors, and lack of access to new drugs are among the substantial barriers.

  18. Historical temperature, salinity, oxygen, nutrients and meteorological data collected in the Arctic Ocean and Atlantic Ocean by various countries from 20 Jul 1870 to 17 Jul 1995 (NODC Accession 0085914)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Historical temperature, salinity, oxygen, nutrients and meteorological data collected in the Arctic Ocean and Atlantic Ocean by various countries from 1870 to 1995,...

  19. African Journals Online: Browse by Country

    African Journals Online (AJOL)

    African Journals Online: Browse by Country. Home > African Journals Online: Browse by Country. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Browse By Category · Browse Alphabetically · Browse By Country · List All Titles · Free to read Titles This Journal is ...

  20. Country nuclear power profiles

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-03-01

    The preparation of Country Nuclear Power Profiles was initiated within the framework of the IAEA`s programme for nuclear power plant performance assessment and feedback. It responded to a need for a database and a technical document containing a description of the energy and economic situation and the primary organizations involved in nuclear power in IAEA Member States. The task was included in the IAEA`s programmes for 1993/1994 and 1995/1996. In March 1993, the IAEA organized a Technical Committee meeting to discuss the establishment of country data ``profiles``, to define the information to be included in the profiles and to review the information already available in the IAEA. Two expert meetings were convened in November 1994 to provide guidance to the IAEA on the establishment of the country nuclear profiles, on the structure and content of the profiles, and on the preparation of the publication and the electronic database. In June 1995, an Advisory Group meeting provided the IAEA with comprehensive guidance on the establishment and dissemination of an information package on industrial and organizational aspects of nuclear power to be included in the profiles. The group of experts recommended that the profiles focus on the overall economic, energy and electricity situation in the country and on its nuclear power industrial structure and organizational framework. In its first release, the compilation would cover all countries with operating power plants by the end of 1995. It was also recommended to further promote information exchange on the lessons learned from the countries engaged in nuclear programmes. For the preparation of this publication, the IAEA received contributions from the 29 countries operating nuclear power plants and Italy. A database has been implemented and the profiles are supporting programmatic needs within the IAEA; it is expected that the database will be publicly accessible in the future. Refs, figs, tabs.

  1. Country nuclear power profiles

    International Nuclear Information System (INIS)

    1998-03-01

    The preparation of Country Nuclear Power Profiles was initiated within the framework of the IAEA's programme for nuclear power plant performance assessment and feedback. It responded to a need for a database and a technical document containing a description of the energy and economic situation and the primary organizations involved in nuclear power in IAEA Member States. The task was included in the IAEA's programmes for 1993/1994 and 1995/1996. In March 1993, the IAEA organized a Technical Committee meeting to discuss the establishment of country data ''profiles'', to define the information to be included in the profiles and to review the information already available in the IAEA. Two expert meetings were convened in November 1994 to provide guidance to the IAEA on the establishment of the country nuclear profiles, on the structure and content of the profiles, and on the preparation of the publication and the electronic database. In June 1995, an Advisory Group meeting provided the IAEA with comprehensive guidance on the establishment and dissemination of an information package on industrial and organizational aspects of nuclear power to be included in the profiles. The group of experts recommended that the profiles focus on the overall economic, energy and electricity situation in the country and on its nuclear power industrial structure and organizational framework. In its first release, the compilation would cover all countries with operating power plants by the end of 1995. It was also recommended to further promote information exchange on the lessons learned from the countries engaged in nuclear programmes. For the preparation of this publication, the IAEA received contributions from the 29 countries operating nuclear power plants and Italy. A database has been implemented and the profiles are supporting programmatic needs within the IAEA; it is expected that the database will be publicly accessible in the future

  2. Reciprocity in the FTAA: The Roles of Market Access, Institutions and Negotiating Capacity

    OpenAIRE

    Julio J. Nogués

    2003-01-01

    The benefits of the FTAA to Latin American countries will materialize through two channels: improved access to the region's markets, and enhanced growth prospects through the strengthening of basic economic institutions. Furthermore, the importance of these negotiations is heightened by the fact that they are taking place against the failure of the Uruguay Round to liberalize agricultural trade, and the lack of progress in the ongoing negotiations of the Doha round. Under these conditions for...

  3. Open Access

    Science.gov (United States)

    Suber, Peter

    2012-01-01

    The Internet lets us share perfect copies of our work with a worldwide audience at virtually no cost. We take advantage of this revolutionary opportunity when we make our work "open access": digital, online, free of charge, and free of most copyright and licensing restrictions. Open access is made possible by the Internet and copyright-holder…

  4. The Paradox of Nutrition-Related Diseases in the Arab Countries: The Need for Action

    Science.gov (United States)

    Musaiger, Abdulrahman O.; Hassan, Abdelmonem S.; Obeid, Omar

    2011-01-01

    The aim of this review was to highlight the current situation of nutrition-related diseases in the Arab countries, and factors associated with prevalence of these diseases. PubMed and Google Scholar were searched for data relating to such nutrition-related diseases published between January 1990 and May 2011. The picture of nutritional status in the Arab countries has changed drastically over the past 30 years as a result of changes in the social and economic situation. Two contrasting nutrition-related diseases exist, those associated with inadequate intake of nutrients and unhealthy dietary habits such as growth retardation among young children and micronutrient deficiencies; and those associated with changes in lifestyle such as cardiovascular disease, cancer, osteoporosis, diabetes and obesity (diet-related non-communicable diseases). Factors contributing to nutritional problems vary from country to country, depending on socio-economic status. In general, unsound dietary habits, poor sanitation, poverty, ignorance and lack of access to safe water and health services are mainly responsible for under-nutrition. Changes in lifestyle and dietary habits as well as inactivity are associated with the occurrence of diet-related non-communicable diseases. Programs to prevent and control nutrition-related diseases are insufficient and ineffective, due mainly to a focus on curative care at the expense of preventive health care services, lack of epidemiological studies, lack of nutritional surveillance, inadequate nutrition information and lack of assessment of the cost-effectiveness of nutrition intervention programs. PMID:22016708

  5. HIV/AIDS programmes should focus on improved access.

    Science.gov (United States)

    Manning, A

    2000-10-14

    This paper discusses the need for HIV/AIDS programs in sub-Saharan countries to focus more on improved access to information to empower poor people living in remote areas. It is noted that despite Glaxo Wellcome's move to reduce the cost of antiretroviral therapy, it is unlikely to have an impact on most of those infected with or affected by HIV/AIDS, since concerns regarding lack of sustainability, bureaucratic administration, and communication difficulties predominate in the country. In this regard, it is therefore recommended that national HIV/AIDS programs be balanced with the needs of both the community and the individual and in prevention and care. Health workers should be explicit in confronting traditional beliefs, such as those about gender roles and traditional medicine, in prevention campaigns. Moreover, there is also an urgent need to improve access to condoms; strengthen health programs such as directly observed treatment short-term (DOTS) courses for tuberculosis and the syndromic approach to sexually transmitted disease treatment; and improve practical support to communities caring for those who are sick and the orphans. Lastly, all partners working with prevention programs should use the more positive community attitudes towards HIV/AIDS issues seen in many sub-Saharan countries to develop evidence-based programs that focus more on improved access and less on sustainability.

  6. Enabling Equal Access to Molecular Diagnostics: What Are the Implications for Policy and Health Technology Assessment?

    Science.gov (United States)

    Plun-Favreau, Juliette; Immonen-Charalambous, Kaisa; Steuten, Lotte; Strootker, Anja; Rouzier, Roman; Horgan, Denis; Lawler, Mark

    2016-01-01

    Molecular diagnostics can offer important benefits to patients and are a key enabler of the integration of personalised medicine into health care systems. However, despite their promise, few molecular diagnostics are embedded into clinical practice (especially in Europe) and access to these technologies remains unequal across countries and sometimes even within individual countries. If research translation and the regulatory environments have proven to be more challenging than expected, reimbursement and value assessment remain the main barriers to providing patients with equal access to molecular diagnostics. Unclear or non-existent reimbursement pathways, together with the lack of clear evidence requirements, have led to significant delays in the assessment of molecular diagnostics technologies in certain countries. Additionally, the lack of dedicated diagnostics budgets and the siloed nature of resource allocation within certain health care systems have significantly delayed diagnostics commissioning. This article will consider the perspectives of different stakeholders (patients, health care payers, health care professionals, and manufacturers) on the provision of a research-enabled, patient-focused molecular diagnostics platform that supports optimal patient care. Through the discussion of specific case studies, and building on the experience from countries that have successfully integrated molecular diagnostics into clinical practice, this article will discuss the necessary evolutions in policy and health technology assessment to ensure that patients can have equal access to appropriate molecular diagnostics. © 2016 S. Karger AG, Basel.

  7. Perceptions of Nongovernmental Organization (NGO Staff about Water Privatization in Developing Countries

    Directory of Open Access Journals (Sweden)

    Ellis A. Adams

    2014-11-01

    Full Text Available Almost a billion people globally lack access to potable water. In the early 1990’s, attempts to improve potable water access in the global south included a massive push for water services privatization, often involving the transfer of public water services to private companies. Critics of water privatization claim it rarely improves access to water, and in most cases, unfairly affect poor people. Proponents on the other hand argue that it is necessary for efficient management and capital investment in the water sector. Although development NGOs play an important role in developing country water provision, hardly any studies have sought to understand their perceptions about the potential role of water privatization towards improving access to potable water in developing countries. We interviewed the key staff among 28 international and national NGO staff about water privatization, its opportunities and constraints. Their perceptions were mixed. While most criticized water privatization as increasing water costs to the poor, some noted that privatization is necessary for improving water access through increased capital investment. We present the findings and discuss larger implications for water policies and reforms in developing countries.

  8. Absenteeism in the Nordic countries

    DEFF Research Database (Denmark)

    Løkke Nielsen, Ann-Kristina; Eskildsen, Jacob Kjær; Jensen, Troels Wendelboe

    2007-01-01

    and Sweden. Employees working in the public sector, more specific the municipalities, have a higher level of absence compared to the private sector. According to the personal characteristics, women are more absent than men in all Nordic countries, but the effect of age differs according to the country...... in question. If the manager however is a woman and the employee likewise, then the level of absence is higher in Denmark, Norway and Finland compared to the other gender constellations. Originality/value - Because of the lack of international comparative studies of absenteeism in the Nordic countries...

  9. Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015 : a novel analysis from the Global Burden of Disease Study 2015

    NARCIS (Netherlands)

    Barber, Ryan M.; Fullman, Nancy; Sorensen, Reed JD; Bollyky, Thomas; McKee, Martin; Nolte, Ellen; van Boven, Job; Murray, Christopher J L

    2017-01-01

    Background National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on

  10. Mitigating Negative Externalities Affecting Access and Equity of Education in Low-Resource Countries: A Study Exploring Social Marketing as a Potential Strategy for Planning School Food Programs in Malawi

    Science.gov (United States)

    Magreta-Nyongani, Martha

    2012-01-01

    School feeding programs enhance the efficiency of the education system by improving enrollment, reducing dropouts and increasing perseverance. They also have the potential to reach the poor, directly making them an effective social safety net. In many low-resource countries, school feeding programs are designed to protect children from the effects…

  11. Lack of diversity in behavioral healthcare leadership reflected in services.

    Science.gov (United States)

    Rosenberg, Linda

    2008-04-01

    America's rapidly changing demographics present an enormous challenge for today's healthcare leaders to redesign the organization and delivery of care to accommodate people who now represent every language, culture and religious belief in the world. So will mental health and addictions services in this country be ready to address the unique needs of these multicultural patients? A survey of the present landscape in 2008 tells us that we have a long, long way to go. Not only are mental health and addictions fields lacking in cultural competency, but there is little diversity in our leadership ranks. Top administrators and executives in behavioral health today are overwhelmingly non-Hispanic whites. This lack of cultural diversity among our leaders will lead to an ever-widening gap in the current chasm of racial and ethnic disparities in healthcare.

  12. Access Contested

    International Development Research Centre (IDRC) Digital Library (Canada)

    Transforming Global Information and Communication Markets: The Political Economy of ... 8 Control and Resistance: Attacks on Burmese Opposition Media 153 ...... “Reluctant Gatekeepers: Corporate Ethics on a Filtered Internet,” in Access ...

  13. Accessing memory

    Science.gov (United States)

    Yoon, Doe Hyun; Muralimanohar, Naveen; Chang, Jichuan; Ranganthan, Parthasarathy

    2017-09-26

    A disclosed example method involves performing simultaneous data accesses on at least first and second independently selectable logical sub-ranks to access first data via a wide internal data bus in a memory device. The memory device includes a translation buffer chip, memory chips in independently selectable logical sub-ranks, a narrow external data bus to connect the translation buffer chip to a memory controller, and the wide internal data bus between the translation buffer chip and the memory chips. A data access is performed on only the first independently selectable logical sub-rank to access second data via the wide internal data bus. The example method also involves locating a first portion of the first data, a second portion of the first data, and the second data on the narrow external data bus during separate data transfers.

  14. Uzbekistan : Country Procurement Assessment Report

    OpenAIRE

    World Bank

    2003-01-01

    Uzbekistan inherited the Soviet system for the procurement of goods, works and services for State needs. This system was suitable for a command economy but lacks the essential elements of competitiveness, transparency and accountability, which are the hallmarks of a market-based approach to government contracting. This Country Procurement Assessment Report (CPAR) comes at a time when a num...

  15. Forbidden Access

    CERN Multimedia

    C. Colloca TS/FM

    2004-01-01

    TS/FM group informs you that, for the replacement of the door of the main entrance at bldg. 500, the access will be closed to the public between 19 and 30 July 2004. Access to the Main Building complex will be assured at any time through both of the side doors and from bldg. 64. For more information, please contact 73273. C. Colloca TS/FM

  16. Country Immunization Information System Assessments - Kenya, 2015 and Ghana, 2016.

    Science.gov (United States)

    Scott, Colleen; Clarke, Kristie E N; Grevendonk, Jan; Dolan, Samantha B; Ahmed, Hussein Osman; Kamau, Peter; Ademba, Peter Aswani; Osadebe, Lynda; Bonsu, George; Opare, Joseph; Diamenu, Stanley; Amenuvegbe, Gregory; Quaye, Pamela; Osei-Sarpong, Fred; Abotsi, Francis; Ankrah, Joseph Dwomor; MacNeil, Adam

    2017-11-10

    The collection, analysis, and use of data to measure and improve immunization program performance are priorities for the World Health Organization (WHO), global partners, and national immunization programs (NIPs). High quality data are essential for evidence-based decision-making to support successful NIPs. Consistent recording and reporting practices, optimal access to and use of health information systems, and rigorous interpretation and use of data for decision-making are characteristics of high-quality immunization information systems. In 2015 and 2016, immunization information system assessments (IISAs) were conducted in Kenya and Ghana using a new WHO and CDC assessment methodology designed to identify root causes of immunization data quality problems and facilitate development of plans for improvement. Data quality challenges common to both countries included low confidence in facility-level target population data (Kenya = 50%, Ghana = 53%) and poor data concordance between child registers and facility tally sheets (Kenya = 0%, Ghana = 3%). In Kenya, systemic challenges included limited supportive supervision and lack of resources to access electronic reporting systems; in Ghana, challenges included a poorly defined subdistrict administrative level. Data quality improvement plans (DQIPs) based on assessment findings are being implemented in both countries. IISAs can help countries identify and address root causes of poor immunization data to provide a stronger evidence base for future investments in immunization programs.

  17. Strategies to improve smallholders' market access

    NARCIS (Netherlands)

    Tilburg, van A.; Schalkwyk, van H.D.

    2011-01-01

    Smallholders, especially in less developed countries, have encountered several challenges in gaining access to markets. Market access includes the ability to obtain necessary farm inputs and farm services, and the ability to deliver farm products to buyers. Market access was less of a problem in the

  18. Renewable Energy Country Profiles. Caribbean

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-09-15

    IRENA Renewable Energy Country Profiles take stock of the latest developments in the field of renewables at country level around the world. Each profile combines analysis by IRENA's specialists with the latest available country data and additional information from a wide array of sources. The resulting reports provide a brief yet comprehensive picture of the situation with regard to renewable energy, including energy supply, electrical generation and grid capacity, and access. Energy policies, targets and projects are also considered, along with each country's investment climate and endowment with renewable energy resources. The energy statistics presented here span the period from 2009 until 2012, reflecting varying timelines in the source material. Since data availability differs from country to country, wider regional comparisons are possible only for the latest year with figures available for every country included. Despite the time lag in some cases, the evident differences and disparities between countries and regions around the world remain striking. The current package of country profiles is just a starting point. The geographic scope will continue to expand, and existing profiles will be enhanced with new indicators, with the whole series maintained as a live product on the IRENA website (www.irena.org)

  19. Sizable variations in circulatory disease mortality by region and country of birth in six European countries

    DEFF Research Database (Denmark)

    Rafnsson, Snorri B; Bhopal, Raj S; Agyemang, Charles

    2013-01-01

    BACKGROUND: Circulatory disease mortality inequalities by country of birth (COB) have been demonstrated for some EU countries but pan-European analyses are lacking. We examine inequalities in circulatory mortality by geographical region/COB for six EU countries. METHODS: We obtained national deat...

  20. Nuclear Medicine in a developing country

    International Nuclear Information System (INIS)

    Wenzel, K.S. von; Rubow, S.M.; Ellmann, A.; Ghoorun, S.

    2002-01-01

    Namibia is a country with 1,8 million inhabitants, of whom the majority has limited access to first world facilities. Nevertheless, medical services of high standard are offered. A Nuclear Medicine Department was established at Windhoek Central Hospital in 1982. A nuclear physician, two nuclear medicine radiographers and a nursing sister staff the department. Equipment includes a Siemens Orbiter and an Elscint Apex SPX Helix gamma camera. Radiopharmaceuticals are obtained from suppliers in South Africa. Investigations performed include musculoskeletal, liver, hepatobiliary, thyroid, renal studies, ventilation perfusion lung scans as well as the following Nuclear Cardiology studies: Gated blood pool scans, Tc-99m pyrophosphate hot spot scans, Tl-201 myocardial perfusion studies, Tc-99m MIBI myocardial perfusion studies and Tl-201 rest-redistribution studies. Problems experienced at the Windhoek Nuclear Medicine department include: Lack of funding and high cost of equipment and radiopharmaceuticals, lack of understanding of Nuclear Medicine by the hospital management and health administrators, and difficulties in procuring short-lived radiopharmaceuticals. Furthermore, the absence of company representatives and spare parts in Namibia leads to loss of time whenever equipment needs to be repaired. Working as the only nuclear medicine physician in a country also poses major problems. Careful management of resources and information drives have helped to sustain the Nuclear Medicine service despite economic problems in the country. Installation of a tele-link between the department in Windhoek Hospital and Tygerberg Hospital in South Africa has greatly assisted to overcome the problem of isolation and lack of back up from fellow specialists. The IAEA has equipped both departments with Hermes workstations (Nuclear Diagnostics) and a tele-link is maintained via modem. The current software provided with the Hermes system is ideally suited to processing of data such as gated

  1. Accessible Knowledge - Knowledge on Accessibility

    DEFF Research Database (Denmark)

    Kirkeby, Inge Mette

    2015-01-01

    Although serious efforts are made internationally and nationally, it is a slow process to make our physical environment accessible. In the actual design process, architects play a major role. But what kinds of knowledge, including research-based knowledge, do practicing architects make use of when...... designing accessible environments? The answer to the question is crucially important since it affects how knowledge is distributed and how accessibility can be ensured. In order to get first-hand knowledge about the design process and the sources from which they gain knowledge, 11 qualitative interviews...... were conducted with architects with experience of designing for accessibility. The analysis draws on two theoretical distinctions. The first is research-based knowledge versus knowledge used by architects. The second is context-independent knowledge versus context-dependent knowledge. The practitioners...

  2. Open access

    CERN Document Server

    Suber, Peter

    2012-01-01

    The Internet lets us share perfect copies of our work with a worldwide audience at virtually no cost. We take advantage of this revolutionary opportunity when we make our work "open access": digital, online, free of charge, and free of most copyright and licensing restrictions. Open access is made possible by the Internet and copyright-holder consent, and many authors, musicians, filmmakers, and other creators who depend on royalties are understandably unwilling to give their consent. But for 350 years, scholars have written peer-reviewed journal articles for impact, not for money, and are free to consent to open access without losing revenue. In this concise introduction, Peter Suber tells us what open access is and isn't, how it benefits authors and readers of research, how we pay for it, how it avoids copyright problems, how it has moved from the periphery to the mainstream, and what its future may hold. Distilling a decade of Suber's influential writing and thinking about open access, this is the indispe...

  3. [Illegitimate patients: Undocumented immigrants' access to health care in Chile].

    Science.gov (United States)

    Concha, Nanette Liberona; Mansilla, Miguel Ángel

    2017-01-01

    In recent decades, Chile has become a destination for immigrants from other South American countries, which has significantly impacted public services - particularly the public health system - at the economic, social, and cultural levels. The aim of this paper is to provide substantiated information on issues concerning undocumented immigrants' access to health care in Chile. A qualitative methodology, fundamentally an ethnography of the clinical setting, was used. Results were then analyzed in relation to theories of power asymmetries and interethnic relations. The research results highlight the lack of compliance with existing regulations and the exercise of discretionary personal judgment as barriers to access. It is concluded that in Chile immigrants in general, and undocumented immigrants in particular, are considered to be illegitimate patients.

  4. Illegitimate patients: Undocumented immigrants’ access to health care in Chile

    Directory of Open Access Journals (Sweden)

    Nanette Paz Liberona Concha

    2017-10-01

    Full Text Available In recent decades, Chile has become a destination for immigrants from other South American countries, which has significantly impacted public services – particularly the public health system – at the economic, social, and cultural levels. The aim of this paper is to provide substantiated information on issues concerning undocumented immigrants’ access to health care in Chile. A qualitative methodology, fundamentally an ethnography of the clinical setting, was used. Results were then analyzed in relation to theories of power asymmetries and interethnic relations. The research results highlight the lack of compliance with existing regulations and the exercise of discretionary personal judgment as barriers to access. It is concluded that in Chile immigrants in general, and undocumented immigrants in particular, are considered to be illegitimate patients.

  5. SMES' SECTOR ACCESS TO FINANCE: AN OVERVIEW

    Directory of Open Access Journals (Sweden)

    Roman Angela

    2011-07-01

    Full Text Available Through their contribution to the creation of added value and new jobs, the small and medium enterprises (SMEs have a significant role in the economic and social development of a country. However, these enterprises are facing numerous obstacles that limit their performance, growth and development. Among the difficulties faced by SMEs, the access to finance is often reported as a major obstacle to the deployment and expansion of their activity. The access to finance is crucial for efficient allocation of financial resources and entrepreneurial development, which explains the major interest given to this subject both by the academic literature and the policy makers. The paper aims to highlight the difficulties faced by SMEs in securing financing resources, emphasizing the differences between countries and also between SMEs and large enterprises. Knowing the difficulties in SMEs financing is essential for policy makers in order to design and implement appropriate measures, which will help to improve the access to financing for these enterprises. Thus, another issue addressed, synthetically, in this paper aims the measures taken by public authorities in order to support the access to financing for SMEs. The research methodology used in this paper starts with a literature review in order to highlight the importance of the subject addressed in our research. The analysis conducted in this paper is based on data and statistics provided mainly by the World Bank surveys, by certain empirical studies and by the National Council of Small and Medium Sized Private Enterprises in Romania. Based on the methodology used, the paper indicates the difficulties in SMEs financing and the crucial importance of enhancing the public authorities concerns regarding their alleviation, especially by adopting measures focused on increasing financial development, which would ensure greater availability of financing for businesses and thus economic growth. The limited

  6. How to implement and organize the universal access to energy.

    Energy Technology Data Exchange (ETDEWEB)

    Perez, S.; Clerc, M.

    2007-07-01

    In a world where energy is going to become a rare and strategic commodity for developed countries, it is becoming extremely important to implement and organise universal access to energy for those populations of developing countries who lack it. This is a fundamental issue if we want to avoid the large migrations, tensions and conflicts that will most definitely occur in a world where some have everything and others nothing. In the field of access to energy, as in many others relating to development, financial problems could be reduced, for example by publi-private partnership. In fact, the amounts spent on aid and assisting with the conesquences of a lack of energy are much greater than the amounts necessary to take energy to those without it. This is a political problem, one of organisation and governance at an international level. As representatives of society, and having observed in the field - in the very midst of these populations - the sometimes disastrous consequences of decisions taken without these factors, we have drawn up this plan of action and these proposals in which companies have a key role to play. (auth)

  7. Access French

    CERN Document Server

    Grosz, Bernard

    2014-01-01

    Access is the major new language series designed with the needs of today's generation of students firmly in mind. Whether learning for leisure or business purposes or working towards a curriculum qualification, Access French is specially designed for adults of all ages and gives students a thorough grounding in all the skills required to understand, speak, read and write contemporary French from scratch. The coursebook consists of 10 units covering different topic areas, each of which includes Language Focus panels explaining the structures covered and a comprehensive glossary. Learning tips

  8. Electric Energy Access in Bangladesh

    Directory of Open Access Journals (Sweden)

    Muhammad Taheruzzaman

    2016-07-01

    Full Text Available This paper represents the overall electrical energy profile and access in Bangladesh. In the recent past Bangladesh has been experiencing shortage of electricity, and about 42 % of population no access to the electricity. The electricity consumption has rapidly increased over last decade. The demand and consumption will intensify in the remote future as overall development and future growth. To set “vision 2021” of Bangladesh; government of Bangladesh has devoted to ensuring access of affordable and reliable electricity for all by 2021. In the modern time, energy is the vital ingredient for socioeconomic growth in the developing country i.e., alleviating poverty. Along with electricity access in Bangladesh strived to become middle income country by 2021. Bangladesh has experienced that energy consumption inclines to increase rapidly when per capita income researches between US$ 1,000 and US$ 10,000, and a country’s

  9. A Phenomenological Study on Lack of Motivation

    Science.gov (United States)

    Educational Research and Reviews, 2013

    2013-01-01

    The aim of this research is to point out the underlying reasons about the lack of motivation at academic activities concerning Attribution Theory. Attribution Theory trys to understand how the people answer "why" question and how they do casual explanations. This research is a qualitative based research. It used the phenomenological…

  10. STRATEGIC MANAGEMENT ANALYSIS IN THE EU COUNTRIES

    Directory of Open Access Journals (Sweden)

    Antonina Verhun

    2017-12-01

    Full Text Available The concept of national and regional development strategies for small and medium-sized enterprises (SMEs are studied for a long time, as small and medium businesses are the foundation of the economy and the basis for effective country functioning. The business development program of the European Union countries is particularly interesting because there are several levels that correspond to each other and give full effect on the SMEs development. The EU standards are higher than in non-EU countries; therefore, it is worth considering legislative documents, as well as statistics showing the indicators of openness and access to the development of small and medium-sized enterprises (SMEs. The complexity and comparative novelty of studying such a problem in Ukraine led to the need to explore sources of information in the original language due to the lack of information in Ukrainian or Russian. All these suggest that the problem of creating strategies at the national and regional level is more relevant and important to study in the West that demonstrates the current state. The subject of the study is to analyse the effectiveness of implementing strategies for the development of small and medium-sized enterprises as well as the impact of national and regional policies on their functioning and development in the European Union countries. Methodology. The authors highlighted the peculiarities and main features of the development strategies implementation for small and medium-sized enterprises in the EU countries through a comparative analysis of the legislative framework, statistical and other data that help assess the performance and effectiveness of the implemented strategies. The content analysis helps to identify peculiarities of the implemented strategies in quantitative and qualitative forms. The thorough analysis using the above-mentioned methods allowed doing a qualitative study of national and regional strategies in the context of the

  11. Gaining Access.

    Science.gov (United States)

    Wand, Sean; Thermos, Adam C.

    1998-01-01

    Explains the issues to consider before a college decides to purchase a card-access system. The benefits of automation, questions involving implementation, the criteria for technology selection, what typical card technology involves, privacy concerns, and the placement of card readers are discussed. (GR)

  12. Cyclotrons in developing countries

    International Nuclear Information System (INIS)

    Vera Ruiz, Hernan

    2004-01-01

    Cyclotron accelerators are prolific sources of charged particle for the production of radionuclides and have become an essential tool in the practice of modern nuclear medicine by providing reliable radiotracers for SPECT and PET studies. In a recent survey conducted by the IAEA in 2001, the growth in the number of cyclotron facilities installed in laboratories and hospitals in developed as well as developing countries was recorded. This trend, which started in the late 70's, continues in the present time also and all indications are that it will continue in the next five to ten years. The reasons for this growth are several: technology involved has become more user or 'hospital friendly', third party reimbursement for several clinical studies based on F-18 PET radiopharmaceuticals at least in some of the advanced countries started in 1998 and above all, the clear irrefutable and demonstrable conclusion of the positive cost/benefit outcomes of PET studies in the field of oncology to a lesser degree, thus far, for cardiology and neurology. It is however recognizable that the overall financial cost of the technology, which comprises the premises to house the facility, the cyclotron accelerator, the corresponding radiochemistry and quality control equipment and the PET cameras can be nevertheless an expensive proposition that requires careful advance planning. This fact is even more relevant when the facility is planned for installation in a developing country, which, frequently, in addition to having a lack of sufficient financial resources, do have shortage of qualified human resources to efficiently run the facility. In spite of the above, it is fact that more and more public as well as private organizations in the developing countries are setting up cyclotron/PET programmes or are seriously considering the installation of such a facility

  13. Managing nuclear knowledge in developing countries. A view from Pakistan

    International Nuclear Information System (INIS)

    Ahmad, I.

    2002-01-01

    Full text: For the developing countries, managing nuclear knowledge requires both acquiring know-how from the developed countries as well as building and conserving their own knowledge resource. The rapid growth of information technology culture has made vast amounts of information and database universally accessible although some bars do indeed apply. The challenge, therefore, lies in having a continuous supply of different tiers of trained and competent professionals who can benefit from what is available and can carry on developing the indigenous capability. This presentation focuses on the issues and problems faced in meeting the above challenge. Steps taken in a developing country like Pakistan to manage nuclear knowledge will be discussed. These measures include developing an interface between the universities and the industry as well as concentrating on meeting the specific infrastructure requirements. The task is, however, becoming increasingly difficult for the developing countries because of the fall out of the lack of proper growth in the nuclear industry at the global level, and the large and long-term financial commitments associated with nuclear energy which leave the entire burden of the nuclear power program development on the public sector. (author)

  14. The male-taller norm: Lack of evidence from a developing country.

    Science.gov (United States)

    Sohn, K

    2015-08-01

    In general, women prefer men taller than themselves; this is referred to as the male-taller norm. However, since women are shorter than men on average, it is difficult to determine whether the fact that married women are on average shorter than their husbands results from the norm or is a simple artifact generated by the shorter stature of women. This study addresses the question by comparing the rate of adherence to the male-taller norm between actual mating and hypothetical random mating. A total of 7954 actually married couples are drawn from the last follow-up of the Indonesian Family Life Survey, a nationally representative survey. Their heights were measured by trained nurses. About 10,000 individuals are randomly sampled from the actual couples and randomly matched. An alternative random mating of about 100,000 couples is also performed, taking into account an age difference of 5 years within a couple. The rate of adherence to the male-taller norm is 93.4% for actual couples and 88.8% for random couples. The difference between the two figures is statistically significant, but it is emphasized that it is very small. The alternative random mating produces a rate of 91.4%. The male-taller norm exists in Indonesia, but only in a statistical sense. The small difference suggests that the norm is mostly explained by the fact that women are shorter than men on average. Copyright © 2015 Elsevier GmbH. All rights reserved.

  15. Timor-Leste : Country Environmental Analysis

    OpenAIRE

    World Bank

    2009-01-01

    The Country Environmental Analysis (CEA) for Timor-Leste identifies environmental priorities through a systematic review of environmental issues in natural resources management and environmental health in the context of the country's economic development and environmental institutions. Lack of data has been the main limitation in presenting a more rigorous analysis. Nevertheless, the repor...

  16. Entrepreneurship Education: Experiences in Selected Countries

    Science.gov (United States)

    Bakar, Rosni; Islam, Md Aminul; Lee, Jocelyne

    2015-01-01

    Entrepreneurship and education play a role in enhancing the country's economic state. Entrepreneurship helps the economy by providing job opportunities. The lack of job opportunities has caused unemployment rates to increase tremendously throughout the years making the development rate of a country slow down. One way for the economy to improve is…

  17. Conceptualising the lack of health insurance coverage.

    Science.gov (United States)

    Davis, J B

    2000-01-01

    This paper examines the lack of health insurance coverage in the US as a public policy issue. It first compares the problem of health insurance coverage to the problem of unemployment to show that in terms of the numbers of individuals affected lack of health insurance is a problem comparable in importance to the problem of unemployment. Secondly, the paper discusses the methodology involved in measuring health insurance coverage, and argues that the current method of estimation of the uninsured underestimates the extent that individuals go without health insurance. Third, the paper briefly introduces Amartya Sen's functioning and capabilities framework to suggest a way of representing the extent to which individuals are uninsured. Fourth, the paper sketches a means of operationalizing the Sen representation of the uninsured in terms of the disability-adjusted life year (DALY) measure.

  18. Laura: Soybean variety lacking Kunitz trypsin inhibitor

    Directory of Open Access Journals (Sweden)

    Srebrić Mirjana

    2010-01-01

    Full Text Available Grain of conventional soybean varieties requires heat processing to break down trypsin inhibitor's activity before using as food or animal feed. At the same time, protein denaturation and other qualitative changes occur in soybean grain, especially if the temperature of heating is not controlled. Two types of trypsin inhibitor were found in soybean grain the Kunitz trypsin inhibitor and the Bowman-Birk inhibitor. Mature grain of soybean Laura is lacking Kunitz trypsin inhibitor. Grain yield of variety Laura is equal to high yielding varieties from the maturity group I, where it belongs. Lacking of Kunitz-trypsin inhibitor makes soybean grain suitable for direct feeding in adult non ruminant animals without previous thermal processing. Grain of variety Laura can be processed for a shorter period of time than conventional soybeans. This way we save energy, and preserve valuable nutritional composition of soybean grain, which is of interest in industrial processing.

  19. Accessing diabetes care in rural Uganda: Economic and social resources.

    Science.gov (United States)

    Nielsen, Jannie; Bahendeka, Silver K; Bygbjerg, Ib C; Meyrowitsch, Dan W; Whyte, Susan R

    2017-07-01

    Non-communicable diseases including type 2 diabetes (T2D) are increasing rapidly in most Sub-Saharan African (SSA) countries like Uganda. Little attention has been given to how patients with T2D try to achieve treatment when the availability of public health care for their disease is limited, as is the case in most SSA countries. In this paper we focus on the landscape of availability of care and the therapeutic journeys of patients within that landscape. Based on fieldwork in south-western Uganda including 10 case studies, we explore the diabetes treatment options in the area and what it takes to access the available treatment. We analyse the resources patients need to use the available treatment options, and demonstrate that the patients' journeys to access and maintain treatment are facilitated by the knowledge and support of their therapy management groups. Patients access treatment more effectively, if they and their family have money, useful social relations, and knowledge, together with the capacity to communicate with health staff. Patients coming from households with high socio-economic status (SES) are more likely to have all of these resources, while for patients with low or medium SES, lack of economic resources increases the importance of connections within the health system.

  20. Innovative farmers and regulatory gatekeepers: Genetically modified crops regulation and adoption in developing countries.

    Science.gov (United States)

    Sinebo, Woldeyesus; Maredia, Karim

    2016-01-02

    The regulation of genetically modified (GM) crops is a topical issue in agriculture and environment over the past 2 decades. The objective of this paper is to recount regulatory and adoption practices in some developing countries that have successfully adopted GM crops so that aspiring countries may draw useful lessons and best practices for their biosafatey regulatory regimes. The first 11 mega-GM crops growing countries each with an area of more than one million hectares in 2014 were examined. Only five out of the 11 countries had smooth and orderly adoption of these crops as per the regulatory requirement of each country. In the remaining 6 countries (all developing countries), GM crops were either introduced across borders without official authorization, released prior to regulatory approval or unapproved seeds were sold along with the approved ones in violation to the existing regulations. Rapid expansion of transgenic crops over the past 2 decades in the developing world was a result of an intense desire by farmers to adopt these crops irrespective of regulatory roadblocks. Lack of workable biosafety regulatory system and political will to support GM crops encouraged unauthorized access to GM crop varieties. In certain cases, unregulated access in turn appeared to result in the adoption of substandard or spurious technology which undermined performance and productivity. An optimal interaction among the national agricultural innovation systems, biosafety regulatory bodies, biotech companies and high level policy makers is vital in making a workable regulated progress in the adoption of GM crops. Factoring forgone opportunities to farmers to benefit from GM crops arising from overregulation into biosafety risk analysis and decision making is suggested. Building functional biosafety regulatory systems that balances the needs of farmers to access and utilize the GM technology with the regulatory imperatives to ensure adequate safety to the environment and human

  1. Export opportunities in developing countries

    International Nuclear Information System (INIS)

    Sullivan, J.

    1992-01-01

    Developing countries will offer major opportunities to US exporters of energy and related environmental equipment in the next ten years. These opportunities arise because the markets in developing countries will be growing much faster than those in the developed countries during this period, and because these countries will not in most cases have strong domestic manufacturers to compete against. US technologies will help these countries solve their energy, environmental, and economic development problems, and help the US solve its serious trade balance problems. This market will represent over $200 billion between now and 2000. There are, however, many potential problems. These include a lack of focus and coordination among US government trade assistance organizations, a lack of interest on the part of US firms in exporting and an unwillingness to make the needed investments, barriers put up by the governments of potential foreign customers, and strong international competition. This paper describes how the United States Agency for International Development's (A.I.D.) Office of Energy and other US agencies are helping US firms resolve these problems with a comprehensive program of information, trade promotion assistance, and co-funding of feasibility studies. In addition, there are monies available to match unfair concessionary financing offered by our major competitors

  2. KAUST Open Access policy

    KAUST Repository

    Baessa, Mohamed A.

    2017-03-07

    The transition to open access (OA) is being driven by funders, libraries, researchers and publishers around the world, and is having an impact on us all. It is inevitable that different countries, organisations and disciplines are moving at different rates towards an OA model, and it is this that we will focus on in this session. Drawing on experiences from across Europe and the Middle East we will provide perspectives from both a global publisher and institutions based in the region. Taylor & Francis take a flexible, evidence-based approach to open access, providing a choice of publication routes for our authors, and a choice of agreements for our library customers. Carolyn will outline some of the open access developments, opportunities and challenges at Taylor & Francis. The library plays a critical role in facilitating open access for their researchers, from managing a repository to providing support and information on the OA publication process to their authors. Janis Tyhurst and Dr Imad Bachir will each give an overview of how this is being managed by their institution. There will be an opportunity for questions and discussion with the panel.

  3. Country Presentation. Central African Republic

    International Nuclear Information System (INIS)

    Paulin Poussoumandji-Ouinga, P.

    2010-01-01

    No incident related to the illicit trafficking of nuclear and other radioactive materials has been yet reported in the country. However, rumors relating to the orphaned sources exist due to buried radioactive waste and former radiotherapy activities. Illicit trafficking of nuclear materials and radioactive materials is a new threat for the law enforcement agents.This is contributed by absence of dedicated equipment for radiation detection either at the border or within the country, lack of awareness of agents in charge of enforcement control, porosity of the border, absence of a protocol for exchanging information between Customs, intelligence and Police Service

  4. What Makes MNCs Succeed in Developing countries?

    DEFF Research Database (Denmark)

    Hansen, Michael W.; Gwozdz, Wencke

    MNCs are increasingly investing in developing countries to be part of rapid market growth, to enhance the efficiency of their value chains, and to access abundant resources and talent. The potential gains are high, however so are the risks. Some developing country subsidiaries become top performers...... regardless of location and industry. The findings of the study have important implications for the IB literature, for managers and for policy aimed at promoting FDI in developing countries....

  5. The Paradox of Nutrition-Related Diseases in the Arab Countries: The Need for Action

    Directory of Open Access Journals (Sweden)

    Omar Obeid

    2011-09-01

    Full Text Available The aim of this review was to highlight the current situation of nutrition-related diseases in the Arab countries, and factors associated with prevalence of these diseases. PubMed and Google Scholar were searched for data relating to such nutrition-related diseases published between January 1990 and May 2011. The picture of nutritional status in the Arab countries has changed drastically over the past 30 years as a result of changes in the social and economic situation. Two contrasting nutrition-related diseases exist, those associated with inadequate intake of nutrients and unhealthy dietary habits such as growth retardation among young children and micronutrient deficiencies; and those associated with changes in lifestyle such as cardiovascular disease, cancer, osteoporosis, diabetes and obesity (diet-related non-communicable diseases. Factors contributing to nutritional problems vary from country to country, depending on socio-economic status. In general, unsound dietary habits, poor sanitation, poverty, ignorance and lack of access to safe water and health services are mainly responsible for under-nutrition. Changes in lifestyle and dietary habits as well as inactivity are associated with the occurrence of diet-related non-communicable diseases. Programs to prevent and control nutrition-related diseases are insufficient and ineffective, due mainly to a focus on curative care at the expense of preventive health care services, lack of epidemiological studies, lack of nutritional surveillance, inadequate nutrition information and lack of assessment of the cost-effectiveness of nutrition intervention programs.

  6. A prospective international cooperative information technology platform built using open-source tools for improving the access to and safety of bone marrow transplantation in low- and middle-income countries.

    Science.gov (United States)

    Agarwal, Rajat Kumar; Sedai, Amit; Dhimal, Sunil; Ankita, Kumari; Clemente, Luigi; Siddique, Sulman; Yaqub, Naila; Khalid, Sadaf; Itrat, Fatima; Khan, Anwar; Gilani, Sarah Khan; Marwah, Priya; Soni, Rajpreet; Missiry, Mohamed El; Hussain, Mohamed Hamed; Uderzo, Cornelio; Faulkner, Lawrence

    2014-01-01

    Jagriti Innovations developed a collaboration tool in partnership with the Cure2Children Foundation that has been used by health professionals in Italy, Pakistan, and India for the collaborative management of patients undergoing bone marrow transplantation (BMT) for thalassemia major since August 2008. This online open-access database covers data recording, analyzing, and reporting besides enabling knowledge exchange, telemedicine, capacity building, and quality assurance. As of February 2014, over 2400 patients have been registered and 112 BMTs have been performed with outcomes comparable to international standards, but at a fraction of the cost. This approach avoids medical emigration and contributes to local healthcare strengthening and competitiveness. This paper presents the experience and clinical outcomes associated with the use of this platform built using open-source tools and focusing on a locally pertinent tertiary care procedure-BMT. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  7. Medicamentos y transnacionales farmacéuticas: impacto en el acceso a los medicamentos para los países subdesarrollados The drugs and the pharmaceutical transnationals: impact on the drugs access for developing countries

    Directory of Open Access Journals (Sweden)

    Amarilys Torres Domínguez

    2010-03-01

    Full Text Available Este trabajo tiene como objetivo realizar una presentación general acerca de la situación de salud a nivel mundial, relacionar esta con la problemática del acceso a los medicamentos y vincular ambos factores a las características que tipifican la diversidad de intereses alrededor de las empresas farmacéuticas transnacionales. La explosión en la producción y comercialización de los medicamentos durante los últimos años han convertido al sector farmacéutico en líder mundial. No obstante, actualmente ¾ partes de la población mundial tienen poca o ninguna posibilidad de adquirir los medicamentos esenciales. La situación actual es insostenible y, por lo tanto, se trata de ir a alternativas diferentes de las que hoy existen.The aim of present paper is to perform a general presentation about the worldwide health situation, to relates it with the problem of drugs access ant to link both factors with features typifying the diversity of interests around the transnational pharmaceutical enterprises. The boom in drugs production and marketing over past years becomes the pharmaceutical sector in the world leader. However, nowadays the ¾ of world population has not much or neither possibility to acquires the essential drugs. Present situation is untenable and therefore, it is necessary tolook for alternatives difeferent to available nowadays.

  8. Accidents in radiotherapy: Lack of quality assurance?

    International Nuclear Information System (INIS)

    Novotny, J.

    1997-01-01

    About 150 radiological accidents, involving more than 3000 patients with adverse effects, 15 patient's fatalities and about 5000 staff and public exposures have been collected and analysed. Out of 67 analysed accidents in external beam therapy 22% has been caused by wrong calculation of the exposure time or monitor units, 13% by inadequate review of patient's chart, 12% by mistakes in the anatomical area to be treated. The remaining 35% can be attributed to 17 different causes. The most common mistakes in brachytherapy were wrong activities of sources used for treatment (20%), inadequate procedures for placement of sources applicators (14%), mistakes in calculating the treatment time (12%), etc. The direct and contributing causes of radiological accidents have been deduced from each event, when it was possible and categorized into 9 categories: mistakes in procedures (30%), professional mistakes (17%), communication mistakes (15%), lack of training (8.5%), interpretation mistakes (7%), lack of supervision (6%), mistakes in judgement (6%), hardware failures (5%), software and other mistakes (5.5%). Three types of direct and contributing causes responsible for almost 62% of all accidents are directly connected to the quality assurance of treatment. The lessons learnt from the accidents are related to frequencies of direct and contributing factors and show that most of the accident are caused by lack, non-application of quality assurance (QA) procedures or by underestimating of QA procedures. The international system for collection of accidents and dissemination of lessons learnt from the different accidents, proposed by IAEA, can contribute to better practice in many radiotherapy departments. Most of the accidents could have been avoided, had a comprehensive QA programme been established and properly applied in all radiotherapy departments, whatever the size. (author)

  9. Why does Colombia lack agricultural commodity futures?

    Directory of Open Access Journals (Sweden)

    Pablo Moreno-Alemay

    2015-11-01

    Full Text Available This article explores the reasons why futures contracts are not traded as an alternative to price hedging for agricultural goods in Colombia. Based on surveys, interviews and statistical analysis, this study identified that conceptual gaps in contract negotiation, lack of consensus in the agricultural sector regarding the use of financial mechanisms and the sector’s infrequent contact with Colombia’s financial institutions, are the main reasons why a futures contracts market has not emerged.

  10. Publishing in Open Access Journals

    International Development Research Centre (IDRC) Digital Library (Canada)

    mbrunet

    While most open access journals are peer‐reviewed and high quality, there are a number of ... Publisher has a negative reputation (e.g., documented examples in Chronicle of Higher Education, ... A key part of Canada's aid program, IDRC supports research in developing countries to promote growth and development.

  11. Public Access ICT across Cultures

    International Development Research Centre (IDRC) Digital Library (Canada)

    3 Impact of Public Access to ICT Skills on Job Prospects in Rwanda ... reform and information and communication technology (ICT) policies, particularly in developing countries. ... (From internal memoranda prepared by Amy Mahan, 2008) ..... little decision-making autonomy, power, or financial control within the household.

  12. Country Presentation Congo

    International Nuclear Information System (INIS)

    Mwata, P.K.; SAKI, A.; KAZADI, J.

    2010-01-01

    Illicit trafficking of radioactive minerals, precious metals and nuclear materials is generally expanded practice in some parts of the Democratic Republic of Congo. The phenomenon took place early in 1990 and amplified from 1998. The main causes of this practice are political instability that led to general poverty among population and the lack of legal framework governing the exploitation of minerals. Nuclear Illicit trafficking in Congo concerns radioactive mineral sand precious metals in eastern and southern parts of the country. The unfavorable political environment that took place in Congo in the 1990s resulted in local manpower and mine workers immigrating to neighboring countries. A great fraction of these new jobless started exploiting abandoned mines residues searching for Cu, Co and Au for survival. First cases of illicit exploitation of uranium minerals were reported very soon after rock sliding that occurred in 2004 on Shinkolobwe site in Katanga region. This uncontrolled mineral exploitation got worse when several mining companies were licensed by GECAMINES company to explore, exploit, purchase minerals from individuals and export raw materials and concentrates.

  13. A systematic review of radiotherapy capacity in low and middle income countries

    Directory of Open Access Journals (Sweden)

    Surbhi eGrover

    2015-01-01

    Full Text Available Objectives: The cancer burden in Low and Middle Income Countries (LMIC is substantial. The purpose of this study was to identify and describe country and region-specific patterns of radiotherapy (RT facilities in LMIC. Methods: A systematic review of the literature was undertaken. A search strategy was developed to include articles on radiation capacity in LMIC from the following databases: PubMed, Embase, CINAHL Plus, Global Health and the Latin-American and Caribbean System on Health Sciences Information. Searches included all literature up to April 2013. Results: A total of 49 articles were included in the review. Studies reviewed were divided into one of four regions: Africa, Asia, Eastern Europe, and South America. The African continent has the least amount of resources for RT. Furthermore, a wide disparity exists, as 60% of all machines on the continent are concentrated in Egypt and South Africa while 29 countries in Africa are still lacking any RT resource. A significant heterogeneity also exists across Southeast Asia despite a three-fold increase in megavoltage teletherapy machines from 1976 to 1999, which corresponds with a rise in economic status. In LMIC of the Americas, only Uruguay met the International Atomic Energy Agency (IAEA recommendations of 4 MV/million population, whereas Bolivia and Venezuela had the most radiation oncologists (>1 per 1000 new cancer cases. The main concern with the review of RT resources in Eastern Europe was the lack of data.Conclusions: There is a dearth of publications on RT therapy infrastructure in LMIC. However, based on limited published data, availability of RT resources reflects the economic status of the countries. The challenges to delivering radiation in the discussed regions are multidimensional and include: lack of physical resources, lack of human personnel, and lack of data. Furthermore, access to existing radiotherapy and affordability of care remains a large problem.

  14. Lack of production sharing laws slows joint ventures in Russia

    International Nuclear Information System (INIS)

    Knott, D.

    1995-01-01

    When Russia opened its doors to foreign oil companies in 1990, there was a rush to secure a piece of the country's potentially vast oil wealth. Since then, many of the ventures between Russian and non-Russian partners have become bogged down with operational problems and an ever changing tax and legal regime. There is a stockpile of massive developments building, while government grinds with seeming reluctance toward passing laws that will allow outside firms to do big business. For major development projects the main stumbling block is the lack of production sharing contract legislation. The paper describes the problems, the current legislation, and operating problems, then highlights several joint ventures that have been successful and several that have ended in pullouts of the foreign investor

  15. Editorial - Open Access and accessing openness

    Directory of Open Access Journals (Sweden)

    Yngve Nordkvelle

    2008-12-01

    Full Text Available Seminar.net enters it’s fourth year, and has reached a state of maturity in a number of meanings: it receives manuscripts from all continents, the articles are read from 134 countries, of which India represents the highest number of readers, a number of articles have been read by more than 10 000 interested persons, and the frequency of issues is now three per year, and will reach four by next year. Interested parties now approach us in order to learn about our policies and practices.It takes time to become established and influential in the sense that articles are cited and referred to in prestigious publications. Still, the most prestigious publications are on paper. Many countries now embark on a policy that rewards researchers that publish in international journals, preferably in English. National languages are rendered less significant. In the UK, the research assessment exercise (RAE, and several other countries with a publication or citation based reward system in research, tend to favour quantitative dimensions at the expense of the quality of the publication. International publishing houses are huge profit-making companies that over years have increased their profit rates, charging increasingly economically pressured higher education institution with high subscription rates. With the advent of electronic publishing their position is severely challenged. It has been noted that the most significant publication of the last couple of decades was an electronic publication: Tim Berners Lee published the protocol for the World Wide Web in 1990. It was never refereed, nor was controlled by appointed gatekeepers of the “establishment”. The number of Open Access publications is rising every day, and the number of e-journals for academic publishing is reaching higher and higher numbers. In a recent case The Faculty of Arts and Sciences at Harvard University decided, that Harvard employees must publish all their material simultaneously on the

  16. Improving children's access to health care: the role of decategorization.

    Science.gov (United States)

    Hughes, D C; Halfon, N; Brindis, C D; Newacheck, P W

    1996-01-01

    Far too many children in this country are unable to obtain the health care they need because of barriers that prohibit easy access. Among the most significant obstacles are financial barriers, including lack of adequate health insurance and inadequate funding of programs for low-income children and those with special health-care needs. Another set of "non-financial" barriers are related to the categorical nature of addressing children's health-care needs, which impedes access by increasing the complexity and burden of seeking care and discourages providers from providing care. Decategorization represents an appealing partial remedy to these problems because it can lead to fundamental and lasting changes in financing and delivering health services. The greatest appeal of decategorization is its potential to improve access to care with the expenditure of little or no new funds. Decategorization also holds considerable risk. Depending on how it is designed and implemented, decategorization may lead to diminished access to care by serving as a foil for budget cuts or by undermining essential standards of care. However, these risks do not negate the value of exploring decategorization as an approach that can be taken today to better organize services and ensure that existing resources adequately meet children's needs. In this report we examine the role of decategorization as a mechanism for removing the barriers to care that are created by categorical funding of health programs.

  17. FINANCIAL DEPTH AND FINANCIAL ACCESS IN INDONESIA

    OpenAIRE

    Sigit Setiawan

    2015-01-01

    This study is intended to analyze the current levels of financial depth and financial access in Indonesia and to analyze the factors affecting them. The analysis method used was a combination of descriptive quantitative, benchmarking, and literature reviews. The conclusion is that the financial depth in Indonesia has not shown a satisfactory level since it was the lowest, or the second lowest ranked country among the sampled countries. Meanwhile, the financial access in Indonesia is relativel...

  18. Lack of consensus in social systems

    Science.gov (United States)

    Benczik, I. J.; Benczik, S. Z.; Schmittmann, B.; Zia, R. K. P.

    2008-05-01

    We propose an exactly solvable model for the dynamics of voters in a two-party system. The opinion formation process is modeled on a random network of agents. The dynamical nature of interpersonal relations is also reflected in the model, as the connections in the network evolve with the dynamics of the voters. In the infinite time limit, an exact solution predicts the emergence of consensus, for arbitrary initial conditions. However, before consensus is reached, two different metastable states can persist for exponentially long times. One state reflects a perfect balancing of opinions, the other reflects a completely static situation. An estimate of the associated lifetimes suggests that lack of consensus is typical for large systems.

  19. Renewable Energy Country Profiles. Pacific

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-09-15

    The IRENA Renewable Energy Country Profiles take stock of the latest development of renewable energy in two regions where renewable energy can make a significant contribution to combat climate change and bring modern energy services to everyone: Africa and the Pacific. These two regions are presented separately in this volume and its sister publication. The country profiles combine elements of IRENA analysis with the latest information available from a vast array of sources in order to give a brief yet comprehensive and up-to-date picture of the situation of renewable energy that includes energy supply, electrical capacity, energy access, policies, targets, investment climate, projects and endowment in renewable energy resources. Because of the different timelines of these sources, data presented here refer to years between 2008 and 2012. Data availability also differs from country to country, which makes comparison with a wider regional group possible only for the year for which figures are available for all the members of the group; while this may not be the most recent year, the differences between countries, regions and the world remain striking. The current country profiles are just a starting point; they will be extended upon with new indicators to make them more informative, and maintained as a live product on the IRENA website as a key source of information on renewable energy.

  20. Renewable Energy Country Profiles. Africa

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-02-15

    The IRENA Renewable Energy Country Profiles take stock of the latest development of renewable energy in two regions where renewable energy can make a significant contribution to combat climate change and bring modern energy services to everyone: Africa and the Pacific. These two regions are presented separately in this volume and its sister publication. The country profiles combine elements of IRENA analysis with the latest information available from a vast array of sources in order to give a brief yet comprehensive and up-to-date picture of the situation of renewable energy that includes energy supply, electrical capacity, energy access, policies, targets, investment climate, projects and endowment in renewable energy resources. Because of the different timelines of these sources, data presented here refer to years between 2008 and 2012. Data availability also differs from country to country, which makes comparison with a wider regional group possible only for the year for which figures are available for all the members of the group; while this may not be the most recent year, the differences between countries, regions and the world remain striking. The current country profiles are just a starting point; they will be extended upon with new indicators to make them more informative, and maintained as a live product on the IRENA website as a key source of information on renewable energy.

  1. Examination of accessibility for disabled people at metro stations

    Directory of Open Access Journals (Sweden)

    Evren Burak Enginöz

    2016-07-01

    Full Text Available According to World Health Organization (WHO, 10% of the population in developed countries and 12% of the population in developing countries are disabled people. And also researches by TUİK, in 2003, 12% of the population in our country are disabled. The problems that are faced in daily life, do not only affect disabled people but also their family. Therefore, it is said to be that half of our population have a disabled life. According to Scherrer, “Anyone, who has handicaps, is not a disabled person in an accessible place. But healthy person will become disabled in a place without accessibility.” (Scherrer 2001. Accessibility can be provided through the continuity of interrelated daily activities without any interruption. When the connection between the activities breaks off, we cannot mention about accessibility. Accessibility is not only plays an important role on disabled people by providing daily activities and physical requirements without any interruption but also by sustaining to live as independent individuals in society. Therefore, we have to re-design our urban accessibility to achieve uninterruptible and independent daily life in cities. In our country, disabled people also have difficulties to access indoors and outdoors and also have to face significant problems to be included in daily life despite the current regulations and laws. However, disabled people are entitled to have all social and cultural benefits independently as healthy people do. Realization of this act can be possible, if we re-design our buildings, transportation systems and the city life to achieve the accessibility requirements of disabled people. All around the world and also in our country, various laws, design rules and standards are tried to level the playing field on accessibility for public transportation systems with their service stations. However, despite of ensuring laws, regulations and standards on accessibility, lack of reglementation and

  2. Traditional Medicine in Developing Countries

    DEFF Research Database (Denmark)

    Thorsen, Rikke Stamp

    or spiritual healer and self-treatment with herbal medicine or medicinal plants. Reliance on traditional medicine varies between countries and rural and urban areas, but is reported to be as high as 80% in some developing countries. Increased realization of the continued importance of traditional medicine has......People use traditional medicine to meet their health care needs in developing countries and medical pluralism persists worldwide despite increased access to allopathic medicine. Traditional medicine includes a variety of treatment opportunities, among others, consultation with a traditional healer...... led to the formulation of policies on the integration of traditional medicine into public health care. Local level integration is already taking place as people use multiple treatments when experiencing illness. Research on local level use of traditional medicine for health care, in particular the use...

  3. Population growth, accessibility spillovers and persistent borders: Historical growth in West-European municipalities.

    Science.gov (United States)

    Jacobs-Crisioni, Chris; Koomen, Eric

    2017-06-01

    Lack of cross-border transport supply has repeatedly been blamed for the fact that national borders limit spatial interaction and, consequently, the growth of border regions. This study applies an accessibility approach to investigate for most municipalities in ten countries in mainland West Europe if foreign transport supply is lagging behind, and if population growth in these municipalities has been affected by the limits that national borders have imposed on market access. To do so, data describing historical population changes and road networks between 1961 and 2011 have been used. The results show that in the study area, cross-border transport accessibility was not at a disadvantage in 1961 and has since then grown even more than domestic accessibility. However, municipal population growth has depended almost exclusively on domestic market access. Processes of economic international integration in the study area are found to coincide with the growth of cross-border accessibility, but do not have a clear coincidence with the effects of cross-border accessibility on population growth.

  4. Problems and prospects of globalization in developing countries ...

    African Journals Online (AJOL)

    for Researchers · for Journals · for Authors · for Policy Makers · about Open Access · Journal Quality. 521 African Journals. Browse By Category · Browse Alphabetically · Browse By Country · List All Titles · Free To Read Titles This Journal is Open Access. Featuring journals from 32 Countries: Algeria (5); Benin (2); Botswana ...

  5. Perceived barriers in the use of ultrasound in developing countries.

    Science.gov (United States)

    Shah, Sachita; Bellows, Blaise A; Adedipe, Adeyinka A; Totten, Jodie E; Backlund, Brandon H; Sajed, Dana

    2015-12-01

    Access to ultrasound has increased significantly in resource-limited settings, including the developing world; however, there remains a lack of sonography education and ultrasound-trained physician support in developing countries. To further investigate this potential knowledge gap, our primary objective was to assess perceived barriers to ultrasound use in resource-limited settings by surveying care providers who practice in low- and middle-income settings. A 25-question online survey was made available to health care providers who work with an ultrasound machine in low- and middle-income countries (LMICs), including doctors, nurses, technicians, and clinical officers. This was a convenience sample obtained from list-serves of ultrasound and radiologic societies. The survey was analyzed, and descriptive results were obtained. One hundred and thirty-eight respondents representing 44 LMICs including countries from the continents of Africa, South America, and Asia completed the survey, with a response rate of 9.6 %. Ninety-one percent of the respondents were doctors, and 9 % were nurses or other providers. Applications for ultrasound were diverse, including obstetrics (75 %), DVT evaluation (51 %), abscess evaluation (54 %), cardiac evaluation (64 %), inferior vena cava (IVC) assessment (49 %), Focused Assessment Sonography for Trauma (FAST) exam (64 %), biliary tree assessment (54 %), and other applications. The respondents identified the following barriers to use of ultrasound: lack of training (60 %), lack of equipment (45 %), ultrasound machine malfunction (37 %), and lack of ultrasound maintenance capability (47 %). Seventy-four percent of the respondents wished to have further training in ultrasound, and 82 % were open to receiving distance learning or telesonography training. Subjects used communication tools including Skype, Dropbox, emailed photos, and picture archiving and communication system (PACS) as ways to communicate and receive feedback

  6. Is astronomical research appropriate for developing countries?

    Science.gov (United States)

    Snowden, Michael S.

    An unproductive 45-cm astronomical telescope, given by JICA (Japan) to Sri Lanka, raises general questions as to the reasons for unproductive pure science in developing countries. Before installation, site, maintenance, and scientific objectives were discussed. The facility was launched with a conference organised by the UN Office for Outer Space Affairs. Unfortunately, no research or significant education has resulted after four years. The annual operating cost is U.S. $5000 per year, including salary for a trainee, maintenance, and a modest promotional programme. Comparison with a similar installation in Auckland suggests lack of funding or technical competence do not explain the failure in Sri Lanka. The facility in New Zealand, on the roof of Auckland University's Physics Department, has a slightly smaller budget but has led to modest but useful research and teaching. Lack of financial backing and expertise are often blamed for weak science in developing countries, but examination shows most of these countries have adequately skilled people, and plenty of resources for religion and military. General lack of motivation for science appears to be the principal reason. This lack of interest and highly inefficient bureaucracies are common to scientifically unproductive countries. They mostly lack the cultural and philosophical base of the European Renaissance that motivate the pursuit of modern science, an activity that violates human preferences. There are excellent facilities (ESO, SAAO, Cerro Tololo, and GONG) in some of these same countries, when administered from the West.

  7. Expanding global access to radiotherapy.

    Science.gov (United States)

    Atun, Rifat; Jaffray, David A; Barton, Michael B; Bray, Freddie; Baumann, Michael; Vikram, Bhadrasain; Hanna, Timothy P; Knaul, Felicia M; Lievens, Yolande; Lui, Tracey Y M; Milosevic, Michael; O'Sullivan, Brian; Rodin, Danielle L; Rosenblatt, Eduardo; Van Dyk, Jacob; Yap, Mei Ling; Zubizarreta, Eduardo; Gospodarowicz, Mary

    2015-09-01

    Radiotherapy is a critical and inseparable component of comprehensive cancer treatment and care. For many of the most common cancers in low-income and middle-income countries, radiotherapy is essential for effective treatment. In high-income countries, radiotherapy is used in more than half of all cases of cancer to cure localised disease, palliate symptoms, and control disease in incurable cancers. Yet, in planning and building treatment capacity for cancer, radiotherapy is frequently the last resource to be considered. Consequently, worldwide access to radiotherapy is unacceptably low. We present a new body of evidence that quantifies the worldwide coverage of radiotherapy services by country. We show the shortfall in access to radiotherapy by country and globally for 2015-35 based on current and projected need, and show substantial health and economic benefits to investing in radiotherapy. The cost of scaling up radiotherapy in the nominal model in 2015-35 is US$26·6 billion in low-income countries, $62·6 billion in lower-middle-income countries, and $94·8 billion in upper-middle-income countries, which amounts to $184·0 billion across all low-income and middle-income countries. In the efficiency model the costs were lower: $14·1 billion in low-income, $33·3 billion in lower-middle-income, and $49·4 billion in upper-middle-income countries-a total of $96·8 billion. Scale-up of radiotherapy capacity in 2015-35 from current levels could lead to saving of 26·9 million life-years in low-income and middle-income countries over the lifetime of the patients who received treatment. The economic benefits of investment in radiotherapy are very substantial. Using the nominal cost model could produce a net benefit of $278·1 billion in 2015-35 ($265·2 million in low-income countries, $38·5 billion in lower-middle-income countries, and $239·3 billion in upper-middle-income countries). Investment in the efficiency model would produce in the same period an even

  8. Access to finance - An unfinished agenda

    NARCIS (Netherlands)

    Beck, T.H.L.; Demirgüc-Kunt, A.

    2008-01-01

    Recent data compilations show that many poor and nonpoor people in many developing countries face a high degree of financial exclusion and high barriers in access to finance. Theory and empirical evidence point to the critical role that improved access to finance has in promoting growth and reducing

  9. Development of voluntary private health insurance in Nordic countries - An exploratory study on country-specific contextual factors.

    Science.gov (United States)

    Tynkkynen, Liina-Kaisa; Alexandersen, Nina; Kaarbøe, Oddvar; Anell, Anders; Lehto, Juhani; Vrangbӕk, Karsten

    2018-03-16

    The Nordic countries are healthcare systems with tax-based financing and ambitions for universal access to comprehensive services. This implies that distribution of healthcare resources should be based on individual needs, not on the ability to pay. Despite this ideological orientation, significant expansion in voluntary private health insurance (VPHI) contracts has occurred in recent decades. The development and role of VPHIs are different across the Nordic countries. Complementary VPHI plays a significant role in Denmark and in Finland. Supplementary VPHI is prominent in Norway and Sweden. The aim of this paper is to explore drivers behind the developments of the VPHI markets in the Nordic countries. We analyze the developments in terms of the following aspects: the performance of the statutory system (real or perceived), lack of coverage in certain areas of healthcare, governmental interventions or inability to reform the system, policy trends and the general socio-cultural environment, and policy responses to voting behavior or lobbying by certain interest groups. It seems that the early developments in VPHI markets have been an answer to the gaps in the national health systems created by institutional contexts, political decisions, and cultural interpretations on the functioning of the system. However, once the market is created it introduces new dynamics that have less to do with gaps and inflexibilities and more with cultural factors. Copyright © 2018. Published by Elsevier B.V.

  10. ROMANIA'S EU ACCESSION. GAINS AND LOSSES (I

    Directory of Open Access Journals (Sweden)

    Caba Stefan

    2012-07-01

    Full Text Available EU accession has brought, as expected, many changes in economic, social and cultural domains. An important chapter is the trade dynamics and how this dynamic has been modified over time by changes in the legal status of Romania's relations with certain trading partners. In this paper we present data on trade with countries with which Romania has concluded trade agreements before accession. Data presentation and analysis continues in "Romania's EU accession. Gains and losses (II".

  11. Application of ICT in strengthening health information systems in developing countries in the wake of globalisation.

    Science.gov (United States)

    Simba, Daudi O; Mwangu, Mughwira

    2004-12-01

    Information Communication Technology (ICT) revolution brought opportunities and challenges to developing countries in their efforts to strengthen the Health Management Information Systems (HMIS). In the wake of globalisation, developing countries have no choice but to take advantage of the opportunities and face the challenges. The last decades saw developing countries taking action to strengthen and modernise their HMIS using the existing ICT. Due to poor economic and communication infrastructure, the process has been limited to national and provincial/region levels leaving behind majority of health workers living in remote/rural areas. Even those with access do not get maximum benefit from ICT advancements due to inadequacies in data quality and lack of data utilisation. Therefore, developing countries need to make deliberate efforts to address constraints threatening to increase technology gap between urban minority and rural majority by setting up favourable policies and appropriate strategies. Concurrently, strategies to improve data quality and utilisation should be instituted to ensure that HMIS has positive impact on people's health. Potential strength from private sector and opportunities for sharing experiences among developing countries should be utilised. Short of this, advancement in ICT will continue to marginalise health workers in developing countries especially those living in remote areas.

  12. Widening energy access in Africa: Towards energy transition

    International Nuclear Information System (INIS)

    Sokona, Youba; Mulugetta, Yacob; Gujba, Haruna

    2012-01-01

    The discussion to widen access to modern energy services has been influential in shaping some of the discussions on energy at the international level. The practice of widening modern energy services access to the poor in Africa is complex, and exacerbated by the dual nature of the energy system across Sub-Saharan Africa where traditional and modern energy systems and practices co-exist. This presents major challenges for policy makers who have to contend with a fragmented energy system, which requires the mobilisation of an array of actors at cross-sectoral levels in order to develop effective institutions and implement innovative policy frameworks. This paper further argues that, the ‘energy access’ discussion needs to take place in the context of energy transitions, giving due consideration to the productive sector as an important vehicle for change. As the link between energy and development is context specific, each African country needs to chart its own energy transition pathway into the future, and there are ample lessons that they can draw from previous energy transitions. - Highlights: ► Lack of access to modern energy services in Africa is an impediment to socio-economic development. ► Widening modern energy services access to the poor in Africa is complex. ► A broader approach to address the ‘energy access’ discourse is required. ► Each African country needs to chart its own energy transition pathway. ► Both fossil and renewable energy systems would be needed for a transition to modern energy sources.

  13. Disintegrated care: the Achilles heel of international health policies in low and middle-income countries

    Directory of Open Access Journals (Sweden)

    Jean-Pierre Unger

    2006-09-01

    Full Text Available Purpose: To review the evidence basis of international aid and health policy. Context of case: Current international aid policy is largely neoliberal in its promotion of commoditization and privatisation. We review this policy's responsibility for the lack of effectiveness in disease control and poor access to care in low and middle-income countries. Data sources: National policies, international programmes and pilot experiments are examined in both scientific and grey literature. Conclusions and discussion: We document how health care privatisation has led to the pool of patients being cut off from public disease control interventions—causing health care disintegration—which in turn resulted in substandard performance of disease control. Privatisation of health care also resulted in poor access. Our analysis consists of three steps. Pilot local contracting-out experiments are scrutinized; national health care records of Colombia and Chile, two countries having adopted contracting-out as a basis for health care delivery, are critically examined against Costa Rica; and specific failure mechanisms of the policy in low and middle-income countries are explored. We conclude by arguing that the negative impact of neoliberal health policy on disease control and health care in low and middle-income countries justifies an alternative aid policy to improve both disease control and health care.

  14. ENHANCED IMMUNIZATION COVERAGE THROUGH INTERVENTIONS FOR CHILDHOOD CLUSTER DISEASES IN DEVELOPING COUNTRIES.

    Science.gov (United States)

    Mureed, Sheh; Somronghtong, Ratana; Kumar, Ramesh; Ghaffar, Abdul; Chapman, Robert S

    2015-01-01

    Globally immunisation has to be considered as a most effective and efficient public health intervention to reduce morbidity and mortality among children. Most of the children from developing countries are still not fully immunized due to multiple factors including lack of interventions, awareness, and financial constraints and due to limited resource. Conversely, this review has identified the effectiveness of interventions to increase the immunisation coverage among children of developing countries. Systematic review by using PRISMA statement ("preferred reporting items for systematic reviews and meta-analyses") has been conducted in English. published articles on Pub Med, Scopus, Cochrane, Medline and ISI by searching keywords like immunizations, childhood vaccination and developing countries has been accessed. Only randomised controlled trial and quasi-experimental studies designs were included in the final analysis based on quality assessment by adopting the Down and Black checklist and finally pooled analysis was done by random effect model. This systematic review has been approved and registered by University of York. A total of 16,570 published articles were accessed and finally 10 fulfilled our criteria that were analysed and interpreted. It demonstrated that the interventions has shown significantly increase vaccine coverage for childhood cluster diseases (OR 2.136 and p 0.05) and full vaccination schedule (OR 1.342 and p>0.05). Systematic review has concluded that the professional interventions are an effective while in improving the child immunisation coverage for cluster diseases in developing countries, major effect on DTP an.d measles.

  15. Glaucoma in developing countries

    Directory of Open Access Journals (Sweden)

    Ravi Thomas

    2012-01-01

    Full Text Available Objective: To describe the background and strategy required for the prevention of blindness from glaucoma in developing countries. Materials and Methods: Extrapolation of existing data and experience in eye care delivery and teaching models in an unequally developed country (India are used to make recommendations. Results: Parameters like population attributable risk percentage indicate that glaucoma is a public health problem but lack of simple diagnostic techniques and therapeutic interventions are barriers to any effective plan. Case detection rather than population-based screening is the recommended strategy for detection. Population awareness of the disease is low and most patients attending eye clinics do not receive a routine comprehensive eye examination that is required to detect glaucoma (and other potentially blinding eye diseases. Such a routine is not taught or practiced by the majority of training institutions either. Angle closure can be detected clinically and relatively simple interventions (including well performed cataract surgery can prevent blindness from this condition. The strategy for open angle glaucoma should focus on those with established functional loss. Outcomes of this proposed strategy are not yet available. Conclusions: Glaucoma cannot be managed in isolation. The objective should be to detect and manage all potential causes of blindness and prevention of blindness from glaucoma should be integrated into existing programs. The original pyramidal model of eye care delivery incorporates this principle and provides an initial starting point. The routine of comprehensive eye examination in every clinic and its teaching (and use in residency programs is mandatory for the detection and management of potentially preventable blinding pathology from any cause, including glaucoma. Programs for detection of glaucoma should not be initiated unless adequate facilities for diagnosis and surgical intervention are in place and

  16. A Comparison between Administration of First Nations Education in Canada and Peru: Divestments, Losses and Lacks.

    Science.gov (United States)

    Young-Ing, Greg

    1988-01-01

    Points out similarities in the histories of Canadian and Peruvian government policies on the formal schooling of Native peoples. Discusses the divestment of Native cultural capital, loss of human potential, and lack of recognition of a fundamental Aboriginal right in both countries. Contains 20 references. (SV)

  17. Lack of RNase L attenuates macrophage functions.

    Directory of Open Access Journals (Sweden)

    Xin Yi

    Full Text Available Macrophages are one of the major cell types in innate immunity against microbial infection. It is believed that the expression of proinflammatory genes such as tumor necrosis factor-α (TNF-α, interleukin (IL-1β, IL-6, and cyclooxygenase-2 (Cox-2 by macrophages is also crucial for activation of both innate and adaptive immunities. RNase L is an interferon (IFN inducible enzyme which is highly expressed in macrophages. It has been demonstrated that RNase L regulates the expression of certain inflammatory genes. However, its role in macrophage function is largely unknown.Bone marrow-derived macrophages (BMMs were generated from RNase L(+/+and (-/- mice. The migration of BMMs was analyzed by using Transwell migration assays. Endocytosis and phagocytosis of macrophages were assessed by using fluorescein isothiocyanate (FITC-Dextran 40,000 and FITC-E. coli bacteria, respectively. The expression of inflammatory genes was determined by Western Blot and ELISA. The promoter activity of Cox-2 was measured by luciferase reporter assays.Lack of RNase L significantly decreased the migration of BMMs induced by M-CSF, but at a less extent by GM-CSF and chemokine C-C motif ligand-2 (CCL2. Interestingly, RNase L deficient BMMs showed a significant reduction of endocytic activity to FITC-Dextran 40,000, but no any obvious effect on their phagocytic activity to FITC-bacteria under the same condition. RNase L impacts the expression of certain genes related to cell migration and inflammation such as transforming growth factor (TGF-β, IL-1β, IL-10, CCL2 and Cox-2. Furthermore, the functional analysis of the Cox-2 promoter revealed that RNase L regulated the expression of Cox-2 in macrophages at its transcriptional level. Taken together, our findings provide direct evidence showing that RNase L contributes to innate immunity through regulating macrophage functions.

  18. Global Surgery 2030: a roadmap for high income country actors

    Science.gov (United States)

    Greenberg, Sarah L M; Abdullah, Fizan; Amado, Vanda; Anderson, Geoffrey A; Cossa, Matchecane; Costas-Chavarri, Ainhoa; Davies, Justine; Debas, Haile T; Dyer, George S M; Erdene, Sarnai; Farmer, Paul E; Gaumnitz, Amber; Hagander, Lars; Haider, Adil; Leather, Andrew J M; Lin, Yihan; Marten, Robert; Marvin, Jeffrey T; McClain, Craig D; Meara, John G; Meheš, Mira; Mock, Charles; Mukhopadhyay, Swagoto; Orgoi, Sergelen; Prestero, Timothy; Price, Raymond R; Raykar, Nakul P; Riesel, Johanna N; Riviello, Robert; Rudy, Stephen M; Saluja, Saurabh; Sullivan, Richard; Tarpley, John L; Taylor, Robert H; Telemaque, Louis-Franck; Toma, Gabriel; Varghese, Asha; Walker, Melanie; Yamey, Gavin; Shrime, Mark G

    2016-01-01

    The Millennium Development Goals have ended and the Sustainable Development Goals have begun, marking a shift in the global health landscape. The frame of reference has changed from a focus on 8 development priorities to an expansive set of 17 interrelated goals intended to improve the well-being of all people. In this time of change, several groups, including the Lancet Commission on Global Surgery, have brought a critical problem to the fore: 5 billion people lack access to safe, affordable surgical and anaesthesia care when needed. The magnitude of this problem and the world's new focus on strengthening health systems mandate reimagined roles for and renewed commitments from high income country actors in global surgery. To discuss the way forward, on 6 May 2015, the Commission held its North American launch event in Boston, Massachusetts. Panels of experts outlined the current state of knowledge and agreed on the roles of surgical colleges and academic medical centres; trainees and training programmes; academia; global health funders; the biomedical devices industry, and news media and advocacy organisations in building sustainable, resilient surgical systems. This paper summarises these discussions and serves as a consensus statement providing practical advice to these groups. It traces a common policy agenda between major actors and provides a roadmap for maximising benefit to surgical patients worldwide. To close the access gap by 2030, individuals and organisations must work collectively, interprofessionally and globally. High income country actors must abandon colonial narratives and work alongside low and middle income country partners to build the surgical systems of the future. PMID:28588908

  19. Developing countries and the global science Web

    CERN Document Server

    Cerdeira, Hilda; Fonda, Carlo; Cottrell, R L A

    2003-01-01

    Enabling scientists from developing countries to bridge the gap between rich and poor depends on closing another gap - the "digital divide". Now the technology exists to monitor this divide, and it reveals some alarming results. Most developing countries experience great difficulties because of adverse economic conditions and political instability, which means they lag behind in scientific and technological development. With the advent of the World Wide Web and the rapid exchange of information via the Internet, one might naively have thought that much of the gap between developed and developing nations would disappear, even if problems still persisted for those areas of science that need expensive facilities. However, access to information, peer reviewed or not, depends on having the appropriate hardware, i.e. a computer, and Internet connectivity, and there is a serious problem with access to the Internet in developing countries. Gaining access to a computer is more of a question of economics, and one that ...

  20. Rural women and violence situation: access and accessibility limits to the healthcare network.

    Science.gov (United States)

    Costa, Marta Cocco da; Silva, Ethel Bastos da; Soares, Joannie Dos Santos Fachinelli; Borth, Luana Cristina; Honnef, Fernanda

    2017-07-13

    To analyze the access and accessibility to the healthcare network of women dwelling in rural contexts undergoing violence situation, as seen from the professionals' speeches. A qualitative, exploratory, descriptive study with professionals from the healthcare network services about coping with violence in four municipalities in the northern region of Rio Grande do Sul. The information derived from interviews, which have been analyzed by thematic modality. (Lack of) information of women, distance, restricted access to transportation, dependence on the partner and (lack of) attention by professionals to welcome women undergoing violence situation and (non)-articulation of the network are factors that limit the access and, as a consequence, they result in the lack of confrontation of this problem. To bring closer the services which integrate the confrontation network of violence against women and to qualify professionals to welcome these situations are factors that can facilitate the access and adhesion of rural women to the services.

  1. Lack of efficacy of ergocalciferol repletion

    Directory of Open Access Journals (Sweden)

    Thomas Wasser

    2012-04-01

    Full Text Available Introduction: Vitamin D has become an area of intensive scrutiny, both in medical and lay literature. However, there are limited data to suggest proper repletion regimens for those patients who have hypovitaminosis D. Consequently, various methods are used in clinical practice. The aim of this study was to assess the efficacy of various treatment strategies for hypovitaminosis D in an ambulatory internal medicine practice. Methods: A retrospective chart review between October 2005 and June 2010 of a suburban internal medicine practice was performed via query of the electronic medical record (Centricity, General Electric Healthcare, UK. Patients with a 25-hydroxyvitamin D concentration less than 32 mg/dl were identified and treated. Treatment success was defined as 25-hydroxyvitamin D concentrations greater than 32 mg/dl. Statistical analysis to assess changes in vitamin D level controlling for season, comorbidities, and demographics were used. Results: A total of 607 treatment episodes were identified, with 395 excluded due to lack of follow-up vitamin D level within 16 weeks, no treatment documented, topical treatment, doxercalciferol treatment, or non-compliance. Of the remaining patients, there were 212 treatment instances on 178 patients. Ergocalciferol 50,000 international units (IU was used most frequently (71.4% of the time.. A higher initial vitamin D level was positively associated with treatment success (adjusted odds ratio = 1.11, p=0.002. Increased doses of ergocalciferol increased the likelihood of treatment success (p=0.0011. Seasonal variation was related to posttreatment 25-hydroxyvitamin D concentration as was body mass index (BMI (p=0.003 and p=0.044. Conclusion: Pretreatment levels of 25-hydroxyvitamin D, BMI, season, and vitamin D dose are predictors of successful hypovitaminosis D treatment. Our data suggest that patients with initial 25-hydroxyvitamin D concentrations of <20 should be treated with a higher total dose of

  2. Continuing Professional Education in Open Access - a French-German Survey

    Directory of Open Access Journals (Sweden)

    Achim Oßwald

    2016-08-01

    Full Text Available While open access (OA has become a significant part of scientific communication and academic publishing, qualification issues have been out of focus in the OA community until recent years. Based on findings about the qualification for OA within university-based programs in France and Germany the authors surveyed continuing professional education activities regarding OA in both countries in the years 2012-2015. The results indicate that there are different types of events qualifying for OA and reveal a lack of coherent concepts for different target groups. Until now traditional presentation formats have been dominant. Formats for distance learning, like MOOCs or webinars, might serve different needs and interests.

  3. Role of the private sector in the provision of immunization services in low- and middle-income countries.

    Science.gov (United States)

    Levin, Ann; Kaddar, Miloud

    2011-07-01

    The authors conducted a literature review on the role of the private sector in low- and middle-income countries. The review indicated that relatively few studies have researched the role of the private sector in immunization service delivery in these countries. The studies suggest that the private sector is playing different roles and functions according to economic development levels, the governance structure and the general presence of the private sector in the health sector. In some countries, generally low-income countries, the private for-profit sector is contributing to immunization service delivery and helping to improve access to traditional EPI vaccines. In other countries, particularly middle-income countries, the private for-profit sector often acts to facilitate early adoption of new vaccines and technologies before introduction and generalization by the public sector. The not-for-profit sector plays an important role in extending access to traditional EPI vaccines, particularly in low-income countries. Not-for-profit facilities are situated in rural as well as urban areas and are more likely to be coordinated with public services than the private for-profit sector. Although numerous studies on non-governmental organizations (NGOs) suggest that the extent of NGO provision of immunization services in low- and middle-income countries is substantial, the contribution of this sector is poorly documented, leading to a lack of recognition of its role at national and global levels. Studies on quality of immunization service provision at private health facilities suggest that it is sometimes inadequate and needs to be monitored. Although some articles on public-private collaboration exist, little was found on the extent to which governments are effectively interacting with and regulating the private sector. The review revealed many geographical and thematic gaps in the literature on the role and regulation of the private sector in the delivery of immunization

  4. Rethinking burns for low & middle-income countries: Differing patterns of burn epidemiology, care seeking behavior, and outcomes across four countries.

    Science.gov (United States)

    Davé, Dattesh R; Nagarjan, Neeraja; Canner, Joseph K; Kushner, Adam L; Stewart, Barclay T

    2018-02-20

    Low-and middle-income (LMIC) countries account for 90% of all reported burns, nevertheless there is a paucity of providers to treat burns. Current studies on burns in LMICs have not evaluated the gap between care seeking and receiving. This study explores this gap across socioeconomically similar populations in a multi-country population based assessment to inform burn care strategies. The Surgeons OverSeas Assessment of Surgical Need (SOSAS) instrument is a cross sectional national, cluster random sampling survey administered in Nepal, Rwanda, Sierra Leone, and Uganda from 2011 to 2014. The survey identifies burn etiology, demographics, timing, disability, and barriers to receiving care. Among 13,763 individuals surveyed, 896 burns were identified. Rwanda had the highest proportion of individuals seeking and receiving care (91.6% vs 88.5%) while Sierra Leone reported the fewest (79.3% vs 70.3%). Rwanda reported the largest disability while Nepal reported the highest proportion with no disability (47.5% vs 76.2%). Lack of money, healthcare providers, and rural living reduce the odds of receiving care by 68% and 85% respectively. Despite similar country socioeconomic characteristics there was significant variability in burn demographics, timing, and disability. Nevertheless, being geographically and economically disadvantaged predict lack of access to burn care. Copyright © 2018 Elsevier Ltd and ISBI. All rights reserved.

  5. Energy technology transfer to developing countries

    International Nuclear Information System (INIS)

    Goldemberg, J.

    1991-01-01

    This paper gives some examples of how technology transfer can successfully be given to third world countries to allow them to benefit in their quest for economic growth and better standards of living through reduced energy consumption and environmental pollution. It also suggests methods by which obstacles such as high investment costs, lack of information, market demand, etc., can be overcome in order to motivate technological transfer by industrialized countries

  6. Accessibility and inclusion informational

    Directory of Open Access Journals (Sweden)

    Mônica Sena de Souza

    2013-06-01

    Full Text Available Introduction: Discusses the role of information professionals in meeting the informational demands of people with disabilities in the information society. The librarian is crucial for the effectiveness and success in the informational inclusion of people with disabilities, considering also continuing education for their professional qualification.Objective: To provide reflections on the role of the librarian in serving users with disabilities, highlighting the need for improvement in information units, identified in the scientific literature with regard to accessibility.Methodology: Literature search, based on a review of literature in books and scientific papers, highlighting the main authors: Adams (2000, Mazzoni (2001 and Sassaki (1997, 2002, 2005.Results: The lack of informational access for people with disabilities hampers their social and political participation, hence, reduces its condition of citizenship.Conclusion: The librarian responsible for seeking continuing education, greater involvement in the events of the area and the constant search for job training, which will reflect on the best service the information needs of users with disabilities.

  7. Advanced Practice Nursing: A Strategy for Achieving Universal Health Coverage and Universal Access to Health

    Directory of Open Access Journals (Sweden)

    Denise Bryant-Lukosius

    Full Text Available ABSTRACT Objective: to examine advanced practice nursing (APN roles internationally to inform role development in Latin America and the Caribbean to support universal health coverage and universal access to health. Method: we examined literature related to APN roles, their global deployment, and APN effectiveness in relation to universal health coverage and access to health. Results: given evidence of their effectiveness in many countries, APN roles are ideally suited as part of a primary health care workforce strategy in Latin America to enhance universal health coverage and access to health. Brazil, Chile, Colombia, and Mexico are well positioned to build this workforce. Role implementation barriers include lack of role clarity, legislation/regulation, education, funding, and physician resistance. Strong nursing leadership to align APN roles with policy priorities, and to work in partnership with primary care providers and policy makers is needed for successful role implementation. Conclusions: given the diversity of contexts across nations, it is important to systematically assess country and population health needs to introduce the most appropriate complement and mix of APN roles and inform implementation. Successful APN role introduction in Latin America and the Caribbean could provide a roadmap for similar roles in other low/middle income countries.

  8. Female labor force participation in developing countries

    OpenAIRE

    Verick, Sher

    2014-01-01

    While women’s labor force participation tends to increase with economic development, the relationship is not straightforward or consistent at the country level. There is considerably more variation across developing countries in labor force participation by women than by men. This variation is driven by a wide variety of economic and social factors, which include economic growth, education, and social norms. Looking more broadly at improving women’s access to quality employment, a critica...

  9. Environmental Policy of Serbia and Challenges of Accession to Europe

    Directory of Open Access Journals (Sweden)

    Darko Nadić

    2012-01-01

    Full Text Available This article analyzes the environmental policy of the Republic of Serbia within the context of accession conditions to the European Union. The main challenges of environmental integration of the environmental policies of Serbia are: economic challenges, the sustainable development challenge, administrative challenges, democratic deficiency challenges, and political challenges. These challenges, while flaws of the environmental policy in Serbia, are no different than the challenges faced by other Central Eastern European countries during the accession process. However, the influence of the global economic crisis, the constant political crisis and unclear definition of the political scene in Serbia, an incomplete vision of environmental education, as well as too much "green" marketing activities and a lack of true law implementation, are additional factors that make the process of environmental accession of Serbia to the EU even more difficult. Therefore, the harmonization of the Serbian environmental legal frame with the European one must be followed by the harmonization of actions of political institutions, social groups and individual citizens, and the overall democratization of society.

  10. Using information technology for an improved pharmaceutical care delivery in developing countries. Study case: Benin.

    Science.gov (United States)

    Edoh, Thierry Oscar; Teege, Gunnar

    2011-10-01

    One of the problems in health care in developing countries is the bad accessibility of medicine in pharmacies for patients. Since this is mainly due to a lack of organization and information, it should be possible to improve the situation by introducing information and communication technology. However, for several reasons, standard solutions are not applicable here. In this paper, we describe a case study in Benin, a West African developing country. We identify the problem and the existing obstacles for applying standard ECommerce solutions. We develop an adapted system approach and describe a practical test which has shown that the approach has the potential of actually improving the pharmaceutical care delivery. Finally, we consider the security aspects of the system and propose an organizational solution for some specific security problems.

  11. Lack of international consensus in low-risk drinking guidelines.

    Science.gov (United States)

    Furtwaengler, Nina A F F; de Visser, Richard O

    2013-01-01

    To encourage moderate alcohol consumption, many governments have developed guidelines for alcohol intake, guidelines for alcohol consumption during pregnancy and legislation relating to blood alcohol limits when driving. The aim of this study was to determine the degree of international consensus within such guidelines. Official definitions of standard drinks and consumption guidelines were searched for on government websites, including all 27 European Union Member States and countries from all global geographic regions. There was a remarkable lack of agreement about what constitutes harmful or excessive alcohol consumption on a daily basis, a weekly basis and when driving, with no consensus about the ratios of consumption guidelines for men and women. International consensus in low-risk drinking guidelines is an important--and achievable--goal. Such agreement would facilitate consistent labelling of packaged products and could help to promote moderate alcohol consumption. However, there are some paradoxes related to alcohol content labelling and people's use of such information: although clearer information could increase people's capacity to monitor and regulate their alcohol consumption, not all drinkers are motivated to drink moderately or sensibly, and drinkers who intend to get drunk may use alcohol content labelling to select more alcoholic products. © 2012 Australasian Professional Society on Alcohol and other Drugs.

  12. A cross-sectional ecological study of spatial scale and geographic inequality in access to drinking-water and sanitation.

    Science.gov (United States)

    Yu, Weiyu; Bain, Robert E S; Mansour, Shawky; Wright, Jim A

    2014-11-26

    Measuring inequality in access to safe drinking-water and sanitation is proposed as a component of international monitoring following the expiry of the Millennium Development Goals. This study aims to evaluate the utility of census data in measuring geographic inequality in access to drinking-water and sanitation. Spatially referenced census data were acquired for Colombia, South Africa, Egypt, and Uganda, whilst non-spatially referenced census data were acquired for Kenya. Four variants of the dissimilarity index were used to estimate geographic inequality in access to both services using large and small area units in each country through a cross-sectional, ecological study. Inequality was greatest for piped water in South Africa in 2001 (based on 53 areas (N) with a median population (MP) of 657,015; D = 0.5599) and lowest for access to an improved water source in Uganda in 2008 (N = 56; MP = 419,399; D = 0.2801). For sanitation, inequality was greatest for those lacking any facility in Kenya in 2009 (N = 158; MP = 216,992; D = 0.6981), and lowest for access to an improved facility in Uganda in 2002 (N = 56; MP = 341,954; D = 0.3403). Although dissimilarity index values were greater for smaller areal units, when study countries were ranked in terms of inequality, these ranks remained unaffected by the choice of large or small areal units. International comparability was limited due to definitional and temporal differences between censuses. This five-country study suggests that patterns of inequality for broad regional units do often reflect inequality in service access at a more local scale. This implies household surveys designed to estimate province-level service coverage can provide valuable insights into geographic inequality at lower levels. In comparison with household surveys, censuses facilitate inequality assessment at different spatial scales, but pose challenges in harmonising water and sanitation typologies across countries.

  13. Preferential Market Access, Foreign Aid and Economic Development

    DEFF Research Database (Denmark)

    Afesorgbor, Sylvanus Kwaku; Abreha, Kaleb Girma

    contributed to the economic development of the beneficiary countries. Focusing on the ACP countries over the period 1970-2009, we show that only the EU preferential scheme is effective in promoting exports and that market access plays a significant and economically large role in the development of beneficiary......Several studies highlight that exporters in developing countries face substantial trade costs. To reduce these costs, a few developed countries mainly Canada, the EU, Japan and the USA granted preferential market access to these exporters. We assess whether these preferential accesses have...

  14. A metasynthesis of qualitative studies regarding opinions and perceptions about barriers and determinants of health services’ accessibility in economic migrants

    Directory of Open Access Journals (Sweden)

    Agudelo-Suárez Andrés A

    2012-12-01

    Full Text Available Abstract Background Access to health services is an important health determinant. New research in health equity is required, especially amongst economic migrants from developing countries. Studies conducted on the use of health services by migrant populations highlight existing gaps in understanding which factors affect access to these services from a qualitative perspective. We aim to describe the views of the migrants regarding barriers and determinants of access to health services in the international literature (1997–2011. Methods A systematic review was conducted for Qualitative research papers (English/Spanish published in 13 electronic databases. A selection of articles that accomplished the inclusion criteria and a quality evaluation of the studies were carried out. The findings of the selected studies were synthesised by means of metasynthesis using different analysis categories according to Andersen’s conceptual framework of access and use of health services and by incorporating other emergent categories. Results We located 3,025 titles, 36 studies achieved the inclusion criteria. After quality evaluation, 28 articles were definitively synthesised. 12 studies (46.2% were carried out in the U.S and 11 studies (42.3% dealt with primary care services. The participating population varied depending mainly on type of host country. Barriers were described, such as the lack of communication between health services providers and migrants, due to idiomatic difficulties and cultural differences. Other barriers were linked to the economic system, the health service characteristics and the legislation in each country. This situation has consequences for the lack of health control by migrants and their social vulnerability. Conclusions Economic migrants faced individual and structural barriers to the health services in host countries, especially those with undocumented situation and those experimented idiomatic difficulties. Strategies to

  15. Challenges Women with Disability Face in Accessing and Using Maternal Healthcare Services in Ghana: A Qualitative Study

    Science.gov (United States)

    Ganle, John Kuumuori; Otupiri, Easmon; Obeng, Bernard; Edusie, Anthony Kwaku; Ankomah, Augustine; Adanu, Richard

    2016-01-01

    Background While a number of studies have examined the factors affecting accessibility to and utilisation of healthcare services by persons with disability in general, there is little evidence about disabled women's access to maternal health services in low-income countries and few studies consult disabled women themselves to understand their experience of care and the challenges they face in accessing skilled maternal health services. The objective of this paper is to explore the challenges women with disabilities encounter in accessing and using institutional maternal healthcare services in Ghana. Methods and Findings A qualitative study was conducted in 27 rural and urban communities in the Bosomtwe and Central Gonja districts of Ghana with a total of 72 purposively sampled women with different physical, visual, and hearing impairments who were either lactating or pregnant at the time of this research. Semi-structured in-depth interviews were used to gather data. Attride-Stirling’s thematic network framework was used to analyse the data. Findings suggest that although women with disability do want to receive institutional maternal healthcare, their disability often made it difficult for such women to travel to access skilled care, as well as gain access to unfriendly physical health infrastructure. Other related access challenges include: healthcare providers’ insensitivity and lack of knowledge about the maternity care needs of women with disability, negative attitudes of service providers, the perception from able-bodied persons that women with disability should be asexual, and health information that lacks specificity in terms of addressing the special maternity care needs of women with disability. Conclusions Maternal healthcare services that are designed to address the needs of able-bodied women might lack the flexibility and responsiveness to meet the special maternity care needs of women with disability. More disability-related cultural competence and

  16. The WTO and the Poorest Countries; The Stark Reality

    OpenAIRE

    Aaditya Mattoo; Arvind Subramanian

    2004-01-01

    Small and poor countries pose a challenge for the World Trade Organization (WTO). These countries have acquired a significant say in WTO decision-making. However, they have limited ability to engage in the reciprocity game that is at the heart of the WTO, and have limited interests in the broader liberalization agenda because of their preferential access to industrial country markets. Accommodating the interests of the small and poor countries is desirable in itself, but would also facilitate...

  17. Inequity of access to ACE inhibitors in Swedish heart failure patients: a register-based study

    Science.gov (United States)

    Lindahl, Bertil; Hanning, Marianne; Westerling, Ragnar

    2016-01-01

    Background Several international studies suggest inequity in access to evidence-based heart failure (HF) care. Specifically, studies of ACE inhibitors (ACEIs) point to reduced ACEI access related to female sex, old age and socioeconomic position. Thus far, most studies have either been rather small, lacking diagnostic data, or lacking the possibility to account for several individual-based sociodemographic factors. Our aim was to investigate differences, which could reflect inequity in access to ACEIs based on sex, age, socioeconomic status or immigration status in Swedish patients with HF. Methods Individually linked register data for all Swedish adults hospitalised for HF in 2005–2010 (n=93 258) were analysed by multivariate regression models to assess the independent risk of female sex, high age, low employment status, low income level, low educational level or foreign country of birth, associated with lack of an ACEI dispensation within 1 year of hospitalisation. Adjustment for possible confounding was made for age, comorbidity, Angiotensin receptor blocker therapy, period and follow-up time. Results Analysis revealed an adjusted OR for no ACEI dispensation for women of 1.31 (95% CI 1.27 to 1.35); for the oldest patients of 2.71 (95% CI 2.53 to 2.91); and for unemployed patients of 1.59 (95% CI 1.46 to 1.73). Conclusions Access to ACEI treatment was reduced in women, older patients and unemployed patients. We conclude that access to ACEIs is inequitable among Swedish patients with HF. Future studies should include clinical data, as well as mortality outcomes in different groups. PMID:26261264

  18. Building country image process

    Directory of Open Access Journals (Sweden)

    Zubović Jovan

    2005-01-01

    Full Text Available The same branding principles are used for countries as they are used for the products, only the methods are different. Countries are competing among themselves in tourism, foreign investments and exports. Country turnover is at the level that the country's reputation is. The countries that begin as unknown or with a bad image will have limits in operations or they will be marginalized. As a result they will be at the bottom of the international influence scale. On the other hand, countries with a good image, like Germany (despite two world wars will have their products covered with a special "aura".

  19. Trading electricity outside the Nordic countries

    International Nuclear Information System (INIS)

    1994-01-01

    The subject of transborder trade of electricity between the Nordic countries and other North-European countries is dealt with. A detailed comparison of generating capacity, generating costs as well as electricity prices, market structure and national and international regulations is given. This shows that generating costs in the Nordic countries in general are lower than those in other North-European countries. This indicates a potential for transborder trade. Norway has a potential for exporting power while Denmark and Sweden have a potential for energy exports due to current excess capacity. Transmission capacity from the Nordic countries to Germany is limited. As access to the German transmission network is restricted, conditions for trade depend on differences between marginal cost. After transmission cost, those differences do not finance larger investments in further capacity. A change in the market structure in Germany with third party access to the transmission network will allow major consumers to buy directly from producers in the Nordic countries. An opening up of the market should reduce the price load in Germany. This could cause price increases in the Nordic countries. (AB)

  20. Usability Evaluation in a Digitally Emerging Country

    DEFF Research Database (Denmark)

    Lizano, Fulvio; Sandoval, Maria Marta; Bruun, Anders

    2013-01-01

    Several emerging countries experience increasing software development activities. With the purpose of provide useful feedback on possible courses of action for increasing application of usability evaluation in such countries, this paper explores the status of usability evaluation in a digitally...... emerging country. Our aim is to identifying common characteristics or behavioral patterns that could be compared with digitally advanced countries. We used an online survey answered by 26 software development organizations, which gave a snapshot of the application of usability evaluation...... in these organizations. We found many similarities with advanced countries, several completely new obstacles more connected with software development matters and a relatively positive improvement in the lack of “usability culture”. These findings suggest good conditions to improve conduction of usability evaluations...

  1. Country-Specific Effects of Climate Variability on Human Migration

    Science.gov (United States)

    Gray, Clark; Wise, Erika

    2016-01-01

    Involuntary human migration is among the social outcomes of greatest concern in the current era of global climate change. Responding to this concern, a growing number of studies have investigated the consequences of short to medium-term climate variability for human migration using demographic and econometric approaches. These studies have provided important insights, but at the same time have been significantly limited by lack of expertise in the use of climate data, access to cross-national data on migration, and attention to model specification. To address these limitations, we link data on internal and international migration over a 6-year period from 9,812 origin households in Kenya, Uganda, Nigeria, Burkina Faso and Senegal to high-resolution gridded climate data from both station and satellite sources. Analyses of these data using several plausible specifications reveal that climate variability has country-specific effects on migration: Migration tends to increase with temperature anomalies in Uganda, tends to decrease with temperature anomalies in Kenya and Burkina Faso, and shows no consistent relationship with temperature in Nigeria and Senegal. Consistent with previous studies, precipitation shows weak and inconsistent relationships with migration across countries. These results challenge generalizing narratives that foresee a consistent migratory response to climate change across the globe. PMID:27092012

  2. Country-Specific Effects of Climate Variability on Human Migration.

    Science.gov (United States)

    Gray, Clark; Wise, Erika

    2016-04-01

    Involuntary human migration is among the social outcomes of greatest concern in the current era of global climate change. Responding to this concern, a growing number of studies have investigated the consequences of short to medium-term climate variability for human migration using demographic and econometric approaches. These studies have provided important insights, but at the same time have been significantly limited by lack of expertise in the use of climate data, access to cross-national data on migration, and attention to model specification. To address these limitations, we link data on internal and international migration over a 6-year period from 9,812 origin households in Kenya, Uganda, Nigeria, Burkina Faso and Senegal to high-resolution gridded climate data from both station and satellite sources. Analyses of these data using several plausible specifications reveal that climate variability has country-specific effects on migration: Migration tends to increase with temperature anomalies in Uganda, tends to decrease with temperature anomalies in Kenya and Burkina Faso, and shows no consistent relationship with temperature in Nigeria and Senegal. Consistent with previous studies, precipitation shows weak and inconsistent relationships with migration across countries. These results challenge generalizing narratives that foresee a consistent migratory response to climate change across the globe.

  3. Proposed Special Issue: Progress of cancer research in developing countries

    Directory of Open Access Journals (Sweden)

    T.S. Jong

    2016-10-01

    Full Text Available As developing economies[1] around the world become more socially affluent in the coming decades, the incidence of cancer-related mortality is expected rise significantly owing to a combination of lifestyle changes and multiple environmental factors (Figure 1. Based on statistics from the World Health Organization, developing countries accounted for nearly 72% of cancer mortality in 2008 even though the average disease incidence in these countries is lower compared to that of high-income nations[3]It has been projected that up to 60% (ca. 15–20 million of new cancer cases will occur in developing countries by the year 2020[4-6], causing more deaths than AIDS, malaria, and tuberculosis combined. In the past, cancer management in developing countries has focused heavily on disease prevention, general awareness improvement, and early detection, while deprioritizing treatment and research efforts as a result of limited resources[7]. However, given the severity of the situation, it is now necessary to recalibrate our focus and reprioritize the investment of valuable resources in the fight against cancer.With respect to cancer research in developing countries, a major challenge faced by international researchers is the lack of reliable data[6], along with a limited research output from the developing world, which hampers our general understanding of the capability of these countries in dealing with the cancer pandemic. From 2011 to 2015, the average combined research output from developing countries constituted only 20% of the total publication output of the world’s top 100 most published countries in the field of oncology (Figure 2. Nonetheless, developing countries have recorded an impressive 20% average year-on-year increase in terms of their publication output during this period, and five of these countries contributed to more than three quarter of the total number of papers published (Figure 3.In contrast, developed nations only registered a 4

  4. The first safe country

    Directory of Open Access Journals (Sweden)

    Raffaela Puggioni

    2012-06-01

    Full Text Available The Dublin II Regulation makes the first safe country of refuge solelyresponsible for refugees and asylum seekers. In the case of Italy, thefirst responsible country has not been acting responsibly.

  5. Housing policies in developing countries: Microfinance

    NARCIS (Netherlands)

    Smets, P.G.S.M.; Smith, S.J.; Elsinga, M.; O’Mahony, L.H.; Ong, S.E.; Wachter, S.; Wood, G.

    2012-01-01

    Shelter is a basic human need for which financial means are required. Poorer sections of society face difficulties in accessing and coping with conventional mortgage finance and are better assisted with housing microfinance. This enables the poor, especially in 'developing' countries to build their

  6. Household Water Treatments in Developing Countries

    Science.gov (United States)

    Smieja, Joanne A.

    2011-01-01

    Household water treatments (HWT) can help provide clean water to millions of people worldwide who do not have access to safe water. This article describes four common HWT used in developing countries and the pertinent chemistry involved. The intent of this article is to inform both high school and college chemical educators and chemistry students…

  7. Assessing trade in health services in countries of the Eastern Mediterranean from a public health perspective.

    Science.gov (United States)

    Siddiqi, Sameen; Shennawy, Azza; Mirza, Zafer; Drager, Nick; Sabri, Belgacem

    2010-01-01

    Assessing trade in health services (TiHS) in developing countries is challenging since the sources of information are diverse, information is not accessible and professionals lack grasp of issues. A multi-country study was conducted in the Eastern Mediterranean Region (EMR)--Egypt, Jordan, Lebanon, Morocco, Oman, Pakistan, Sudan, Syrian Arab Republic, Tunisia, and Yemen. The objective was to estimate the direction, volume, and value of TiHS; analyze country commitments; and assess the challenges and opportunities for health services.Trade liberalization favored an open trade regime and encouraged foreign direct investment. Consumption abroad and movement of natural persons were the two prevalent modes. Yemen and Sudan are net importers, while Jordan promotes health tourism. In 2002, Yemenis spent US$ 80 million out of pocket for treatment abroad, while Jordan generated US$ 620 million. Egypt, Pakistan, Sudan and Tunisia export health workers, while Oman relies on import and 40% of its workforce is non-Omani. There is a general lack of coherence between Ministries of Trade and Health in formulating policies on TiHS.This is the first organized attempt to look at TiHS in the EMR. The systematic approach has helped create greater awareness, and a move towards better policy coherence in the area of trade in health services. Copyright (c) 2009 John Wiley & Sons, Ltd.

  8. Pediatric anesthesia in developing countries.

    Science.gov (United States)

    Bösenberg, Adrian T

    2007-06-01

    To highlight the problems faced in developing countries where healthcare resources are limited, with particular emphasis on pediatric anesthesia. The fact that very few publications address pediatric anesthesia in the developing world is not surprising given that most anesthetics are provided by nonphysicians, nurses or unqualified personnel. In compiling this article information is drawn from pediatric surgical, anesthetic and related texts. In a recent survey more than 80% of anesthesia providers in a poor country acknowledged that with the limited resources available they could not provide basic anesthesia for children less than 5 years. Although many publications could be regarded as anecdotal, the similarities to this survey suggest that the lack of facilities is more generalized than we would like to believe. The real risk of anesthesia in comparison to other major health risks such as human immunodeficiency virus, malaria, tuberculosis and trauma remains undetermined. The critical shortage of manpower remains a barrier to progress. Despite erratic electrical supplies, inconsistent oxygen delivery, paucity of drugs or equipment and on occasion even lack of running water, many provide life-saving anesthesia. Perioperative morbidity and mortality is, however, understandably high by developed world standards.

  9. FINANCIAL INCLUSION STRATEGIES IN DEVELOPING COUNTRIES WITH SPECIAL REFERENCE TO INDIA

    Directory of Open Access Journals (Sweden)

    DIN SANGMI MOHI - UD

    2013-12-01

    Full Text Available Day in and day out, the gap between the haves and have-nots is widening, not only at inter- country level but also at the intra – country level. In this process, a large chunk of population does not have access to the formal financial markets, institutions and instruments. It is estimated that as many as eighty seven percent of marginal households in the world lack access to formal finance, and to fulfill their credit needs, they are resorting to the means of informal and unregulated finance, through money lenders, who charge them as much as hundred percent rate of interest. Thus, this stratum of population, in midst of financial exclusion, has been pushed to the vicious circle of poverty and, therefore, remain outside the growth parameters always. However, recently, the governments in about one hundred and forty two countries have become serious to overcome this menace and decided to design strategies to make formal finance available to the un-bankable at cheaper (price interest. In this way, Financial Inclusion became a buzzword of these strategies. Financial inclusion, as a pre-condition to inclusive development, refers to the process of ensuring the accessibility, availability and usage of formal financial system for all members of an economy. In this paper, an attempt has been made to examine the financial inclusion efforts made at the global level and highlight the progress made on the subject in SAARC countries, and what strategies were designed and implemented in the fast developing economy like India in the past two decades have been discussed in detail.

  10. Delivering affordable cancer care in high-income countries.

    Science.gov (United States)

    Sullivan, Richard; Peppercorn, Jeffrey; Sikora, Karol; Zalcberg, John; Meropol, Neal J; Amir, Eitan; Khayat, David; Boyle, Peter; Autier, Philippe; Tannock, Ian F; Fojo, Tito; Siderov, Jim; Williamson, Steve; Camporesi, Silvia; McVie, J Gordon; Purushotham, Arnie D; Naredi, Peter; Eggermont, Alexander; Brennan, Murray F; Steinberg, Michael L; De Ridder, Mark; McCloskey, Susan A; Verellen, Dirk; Roberts, Terence; Storme, Guy; Hicks, Rodney J; Ell, Peter J; Hirsch, Bradford R; Carbone, David P; Schulman, Kevin A; Catchpole, Paul; Taylor, David; Geissler, Jan; Brinker, Nancy G; Meltzer, David; Kerr, David; Aapro, Matti

    2011-09-01

    The burden of cancer is growing, and the disease is becoming a major economic expenditure for all developed countries. In 2008, the worldwide cost of cancer due to premature death and disability (not including direct medical costs) was estimated to be US$895 billion. This is not simply due to an increase in absolute numbers, but also the rate of increase of expenditure on cancer. What are the drivers and solutions to the so-called cancer-cost curve in developed countries? How are we going to afford to deliver high quality and equitable care? Here, expert opinion from health-care professionals, policy makers, and cancer survivors has been gathered to address the barriers and solutions to delivering affordable cancer care. Although many of the drivers and themes are specific to a particular field-eg, the huge development costs for cancer medicines-there is strong concordance running through each contribution. Several drivers of cost, such as over-use, rapid expansion, and shortening life cycles of cancer technologies (such as medicines and imaging modalities), and the lack of suitable clinical research and integrated health economic studies, have converged with more defensive medical practice, a less informed regulatory system, a lack of evidence-based sociopolitical debate, and a declining degree of fairness for all patients with cancer. Urgent solutions range from re-engineering of the macroeconomic basis of cancer costs (eg, value-based approaches to bend the cost curve and allow cost-saving technologies), greater education of policy makers, and an informed and transparent regulatory system. A radical shift in cancer policy is also required. Political toleration of unfairness in access to affordable cancer treatment is unacceptable. The cancer profession and industry should take responsibility and not accept a substandard evidence base and an ethos of very small benefit at whatever cost; rather, we need delivery of fair prices and real value from new technologies

  11. Surviving spinal cord injury in low income countries

    Directory of Open Access Journals (Sweden)

    Tone Øderud

    2014-08-01

    Objectives: The aims of this study were to explore life expectancy (life expectancy is the average remaining years of life of an individual and the situation of persons living with SCI in low income settings. Method: Literature studies and qualitative methods were used. Qualitative data was collected through semi-structured interviews with 23 informants from four study sites in Zimbabwe representing persons with SCI, their relatives and rehabilitation professionals. Results: There are few publications available about life expectancy and the daily life of persons with SCI in low income countries. Those few publications identified and the study findings confirm that individuals with SCI are experiencing a high occurrence of pressure sores and urinary tract infections leading to unnecessary suffering, often causing premature death. Pain and depression are frequently reported and stigma and negative attitudes are experienced in society. Lack of appropriate wheelchairs and services, limited knowledge about SCI amongst health care staff, limited access to health care and rehabilitation services, loss of employment and lack of financial resources worsen the daily challenges. Conclusion: The study indicates that life expectancy for individuals with SCI in low income settings is shorter than for the average population and also with respect to individuals with SCI in high income countries. Poverty worsened the situation for individuals with SCI, creating barriers that increase the risk of contracting harmful pressure sores and infections leading to premature death. Further explorations on mortality and how individuals with SCI and their families in low income settings are coping in their daily life are required to provide comprehensive evidences.

  12. The pharmaceutical sector, patents and access to medicines in the South

    Directory of Open Access Journals (Sweden)

    Xabier Barrutia Etxebarría

    2003-12-01

    Full Text Available This article deals with the lack of access to drug treatments experienced by the poor in the economic South. First, it studies the extraordinarily profitable pharmaceutical industry, whose research forgets about the illnesses typical of the South, given its greatbusiness and market concentration in the countries of the North, where marketing is decisive. Then, it deals with the relationship between the high prices of medicines and a patent system which is greatly strengthened by the rules of the WTO and which clasheswith people’s right to health, as revealed by the case of HIV-AIDS treatment in the countries of the South. The paper concludes by underscoring the need for an active intervention by the public sector, both at a national and international level, which wouldlimit the patents on drugs and promote research on the forgotten diseases.

  13. E-Government Maturity Model for Sustainable E-Government Services from the Perspective of Developing Countries

    Directory of Open Access Journals (Sweden)

    Pusp Raj Joshi

    2018-06-01

    Full Text Available Electric government (e-government projects in developing countries are facing many challenges to deliver sustainable e-government services. From the existing literature, we found that most of the studies considered lack of technology, and limitations in budgets and human resources as the main hurdles in effective implementation of e-government services. Along with these limitations, we found that the e-government maturity models adopted by developing countries are failing to provide an appropriate strategic plan to deploy sustainable e-government services. While assessing the existing e-government maturity model, we made several observations on the lack of detail, the technology-centric nature, the emphasis on implementation, and the lack of an adoption strategy. This work contributes toward the proposition of a new e-government maturity model that would address the limitations of exiting e-government maturity models, and would support governments in developing countries to achieve sustainable e-government services. To achieve this goal, we considered five determinants—a detailed process, streamlined services, agile accessibility, use of state-of-the-art technology, and trust and awareness. The proposed model was validated by employing an empirical investigation through case-study and survey methods. We found that both the implementers (government and adopters (users of the e-government services benefited from the proposed model, resulting in an increased sustainability of e-government services.

  14. Fishing Access Areas

    Data.gov (United States)

    Vermont Center for Geographic Information — The Vermont Fish & Wildlife Department maintains developed fishing access areas. These sites provide public access to waters in Vermont for shore fishing...

  15. Accessibility and sensory experiences

    DEFF Research Database (Denmark)

    Ryhl, Camilla

    2010-01-01

    and accessibility. Sensory accessibility accommodates aspects of a sensory disability and describes architectural design requirements needed to ensure access to architectural experiences. In the context of architecture accessibility has become a design concept of its own. It is generally described as ensuring...... physical access to the built environment by accommodating physical disabilities. While the existing concept of accessibility ensures the physical access of everyone to a given space, sensory accessibility ensures the choice of everyone to stay and be able to participate and experience....

  16. Black Edens, country Eves: Listening, performance, and black queer longing in country music.

    Science.gov (United States)

    Royster, Francesca T

    2017-07-03

    This article explores Black queer country music listening, performance, and fandom as a source of pleasure, nostalgia, and longing for Black listeners. Country music can be a space for alliance and community, as well as a way of accessing sometimes repressed cultural and personal histories of violence: lynching and other forms of racial terror, gender surveillance and disciplining, and continued racial and economic segregation. For many Black country music listeners and performers, the experience of being a closeted fan also fosters an experience of ideological hailing, as well as queer world-making. Royster suggests that through Black queer country music fandom and performance, fans construct risky and soulful identities. The article uses Tina Turner's solo album, Tina Turns the Country On! (1974) as an example of country music's power as a tool for resistance to racial, sexual, and class disciplining.

  17. Controlling Access to Suicide Means

    Directory of Open Access Journals (Sweden)

    Miriam Iosue

    2011-12-01

    Full Text Available Background: Restricting access to common means of suicide, such as firearms, toxic gas, pesticides and other, has been shown to be effective in reducing rates of death in suicide. In the present review we aimed to summarize the empirical and clinical literature on controlling the access to means of suicide. Methods: This review made use of both MEDLINE, ISI Web of Science and the Cochrane library databases, identifying all English articles with the keywords “suicide means”, “suicide method”, “suicide prediction” or “suicide prevention” and other relevant keywords. Results: A number of factors may influence an individual’s decision regarding method in a suicide act, but there is substantial support that easy access influences the choice of method. In many countries, restrictions of access to common means of suicide has lead to lower overall suicide rates, particularly regarding suicide by firearms in USA, detoxification of domestic and motor vehicle gas in England and other countries, toxic pesticides in rural areas, barriers at jumping sites and hanging, by introducing “safe rooms” in prisons and hospitals. Moreover, decline in prescription of barbiturates and tricyclic antidepressants (TCAs, as well as limitation of drugs pack size for paracetamol and salicylate has reduced suicides by overdose, while increased prescription of SSRIs seems to have lowered suicidal rates. Conclusions: Restriction to means of suicide may be particularly effective in contexts where the method is popular, highly lethal, widely available, and/or not easily substituted by other similar methods. However, since there is some risk of means substitution, restriction of access should be implemented in conjunction with other suicide prevention strategies.

  18. A Systematic Content Analysis of Policy Barriers Impeding Access to Opioid Medication in Central and Eastern Europe: Results of ATOME.

    Science.gov (United States)

    Larjow, Eugenia; Papavasiliou, Evangelia; Payne, Sheila; Scholten, Willem; Radbruch, Lukas

    2016-01-01

    Reliable access to opioid medication is critical to delivering effective pain management, adequate treatment of opioid dependence, and quality palliative care. However, more than 80% of the world population is estimated to be inadequately treated for pain because of difficulties in accessing opioids. Although barriers to opioid access are primarily associated with restrictive laws, regulations, and licensing requirements, a key problem that significantly limits opioid access relates to policy constraints. To identify and explore policy barriers to opioid access in 12 Eastern and Central European countries involved in the Access to Opioid Medication in Europe project, funded by the European Community's Seventh Framework (FP7/2007-2013, no. 222994) Programme. A systematic content analysis of texts retrieved from documents (e.g., protocols of national problem analyses, strategic planning worksheets, and executive summaries) compiled, reviewed, approved, and submitted by either the Access to Opioid Medication in Europe consortium or the national country teams (comprising experts in pain management, harm reduction, and palliative care) between September 2011 and April 2014 was performed. Twenty-five policy barriers were identified (e.g., economic crisis, bureaucratic issues, lack of training initiatives, stigma, and discrimination), classified under four predetermined categories (financial/economic aspects and governmental support, formularies, education and training, and societal attitudes). Key barriers related to issues of funding allocation, affordability, knowledge, and fears associated with opioids. Reducing barriers and improving access to opioids require policy reform at the governmental level with a set of action plans being formulated and concurrently implemented and aimed at different levels of social, education, and economic policy change. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  19. 'Predatory' open access: a longitudinal study of article volumes and market characteristics.

    Science.gov (United States)

    Shen, Cenyu; Björk, Bo-Christer

    2015-10-01

    A negative consequence of the rapid growth of scholarly open access publishing funded by article processing charges is the emergence of publishers and journals with highly questionable marketing and peer review practices. These so-called predatory publishers are causing unfounded negative publicity for open access publishing in general. Reports about this branch of e-business have so far mainly concentrated on exposing lacking peer review and scandals involving publishers and journals. There is a lack of comprehensive studies about several aspects of this phenomenon, including extent and regional distribution. After an initial scan of all predatory publishers and journals included in the so-called Beall's list, a sample of 613 journals was constructed using a stratified sampling method from the total of over 11,000 journals identified. Information about the subject field, country of publisher, article processing charge and article volumes published between 2010 and 2014 were manually collected from the journal websites. For a subset of journals, individual articles were sampled in order to study the country affiliation of authors and the publication delays. Over the studied period, predatory journals have rapidly increased their publication volumes from 53,000 in 2010 to an estimated 420,000 articles in 2014, published by around 8,000 active journals. Early on, publishers with more than 100 journals dominated the market, but since 2012 publishers in the 10-99 journal size category have captured the largest market share. The regional distribution of both the publisher's country and authorship is highly skewed, in particular Asia and Africa contributed three quarters of authors. Authors paid an average article processing charge of 178 USD per article for articles typically published within 2 to 3 months of submission. Despite a total number of journals and publishing volumes comparable to respectable (indexed by the Directory of Open Access Journals) open access

  20. Developing countries and copyright in the information age The ...

    African Journals Online (AJOL)

    . Developing countries are especially disadvantaged by diminished access to works. In this article it is argued that adherence to the principle of functional equivalence in implementing the anti-circumvention provisions of the WCT will ensure ...

  1. FINANCIAL DEPTH AND FINANCIAL ACCESS IN INDONESIA

    OpenAIRE

    Sigit Setiawan

    2015-01-01

    This study is intended to analyse the current levels of financial depth and financial access in Indonesia and to analyse the factors affecting them. The analysis method used was a combination of descriptive quantitative, benchmarking, and literature reviews. The conclusion is that the financial depth in Indonesia has not shown a satisfactory level since it was the lowest, or the second lowest ranked country among the sampled countries. Meanwhile, the financial access in Indonesia is relativel...

  2. Financial Depth and Financial Access in Indonesia

    OpenAIRE

    Setiawan, Sigit

    2015-01-01

    This study is intended to analyse the current levels of financial depth and financial access in Indonesia and to analyse the factors affecting them. The analysis method used was a combination of descriptive quantitative, benchmarking, and literature reviews. The conclusion is that the financial depth in Indonesia has not shown a satisfactory level since it was the lowest, or the second lowest ranked country among the sampled countries. Meanwhile, the financial access in Indonesia is relativel...

  3. The academic, economic and societal impacts of Open Access: an evidence-based review.

    Science.gov (United States)

    Tennant, Jonathan P; Waldner, François; Jacques, Damien C; Masuzzo, Paola; Collister, Lauren B; Hartgerink, Chris H J

    2016-01-01

    Ongoing debates surrounding Open Access to the scholarly literature are multifaceted and complicated by disparate and often polarised viewpoints from engaged stakeholders. At the current stage, Open Access has become such a global issue that it is critical for all involved in scholarly publishing, including policymakers, publishers, research funders, governments, learned societies, librarians, and academic communities, to be well-informed on the history, benefits, and pitfalls of Open Access. In spite of this, there is a general lack of consensus regarding the potential pros and cons of Open Access at multiple levels. This review aims to be a resource for current knowledge on the impacts of Open Access by synthesizing important research in three major areas: academic, economic and societal. While there is clearly much scope for additional research, several key trends are identified, including a broad citation advantage for researchers who publish openly, as well as additional benefits to the non-academic dissemination of their work. The economic impact of Open Access is less well-understood, although it is clear that access to the research literature is key for innovative enterprises, and a range of governmental and non-governmental services. Furthermore, Open Access has the potential to save both publishers and research funders considerable amounts of financial resources, and can provide some economic benefits to traditionally subscription-based journals. The societal impact of Open Access is strong, in particular for advancing citizen science initiatives, and leveling the playing field for researchers in developing countries. Open Access supersedes all potential alternative modes of access to the scholarly literature through enabling unrestricted re-use, and long-term stability independent of financial constraints of traditional publishers that impede knowledge sharing. However, Open Access has the potential to become unsustainable for research communities if

  4. The academic, economic and societal impacts of Open Access: an evidence-based review

    Science.gov (United States)

    Tennant, Jonathan P.; Waldner, François; Jacques, Damien C.; Masuzzo, Paola; Collister, Lauren B.; Hartgerink, Chris. H. J.

    2016-01-01

    Ongoing debates surrounding Open Access to the scholarly literature are multifaceted and complicated by disparate and often polarised viewpoints from engaged stakeholders. At the current stage, Open Access has become such a global issue that it is critical for all involved in scholarly publishing, including policymakers, publishers, research funders, governments, learned societies, librarians, and academic communities, to be well-informed on the history, benefits, and pitfalls of Open Access. In spite of this, there is a general lack of consensus regarding the potential pros and cons of Open Access at multiple levels. This review aims to be a resource for current knowledge on the impacts of Open Access by synthesizing important research in three major areas: academic, economic and societal. While there is clearly much scope for additional research, several key trends are identified, including a broad citation advantage for researchers who publish openly, as well as additional benefits to the non-academic dissemination of their work. The economic impact of Open Access is less well-understood, although it is clear that access to the research literature is key for innovative enterprises, and a range of governmental and non-governmental services. Furthermore, Open Access has the potential to save both publishers and research funders considerable amounts of financial resources, and can provide some economic benefits to traditionally subscription-based journals. The societal impact of Open Access is strong, in particular for advancing citizen science initiatives, and leveling the playing field for researchers in developing countries. Open Access supersedes all potential alternative modes of access to the scholarly literature through enabling unrestricted re-use, and long-term stability independent of financial constraints of traditional publishers that impede knowledge sharing. However, Open Access has the potential to become unsustainable for research communities if

  5. Tariff-Tax Reforms and Market Access

    DEFF Research Database (Denmark)

    Kreickemeier, Udo; Raimondos-Møller, Pascalis

    2006-01-01

    Reducing tariffs and increasing consumption taxes is a standard IMF advice to countries that want to open up their economy without hurting government finances. Indeed, theoretical analysis of such a tariff-tax reform shows an unambiguous increase in welfare and government revenues. The present pa...... efficient proposal to follow both as far as it concerns market access and welfare.JEL code: F13, H20.Keywords: Market access; tariff reform, consumption tax reform....

  6. Attracted to open access journals: A bibliometric author analysis in the field of biology

    DEFF Research Database (Denmark)

    Faber Frandsen, Tove

    2009-01-01

    Purpose - Scholars from developing countries have limited access to research publications due to expensive subscription costs. However, the open access movement is challenging the constraint to access. Consequently, researchers in developing countries are often mentioned as major recipients...... of the benefits when advocating open access (OA). One of the implications of that argument is that authors from developing countries are more likely to perceive open access positively than authors from developed countries. The present study aims to investigate the use of open access by researchers from developing...... countries and is thus a supplement to the existing author surveys and interviews. Design/methodology/approach - Bibliometric analyses of both publishing behaviour and citing behaviour in relation to OA publishing provides evidence of the impact of open access on developing countries. Findings - The results...

  7. Palliative radiotherapy in developing countries

    International Nuclear Information System (INIS)

    Allen, B.J.

    2010-01-01

    Full text: The International Agency for Research on Cancer predicts that cancer incidence in developing countries will increase dramatically in the first two decades of this millennium. Already some 80% of cancer patients in developing countries present with incurable disease. [n many cases pain is a severe problem and palliation is needed to improve quality of life as well as extending survival. This paper will consider the physical and clinical aspects of palliative radiotherapy (PRT), choice of radiation modality, alternative approaches to imaging and therapy and cost-benefit considerations. The potential benefits of a dedicated palliative centre include lower cost and therefore more centres, enabling more patients access to regional palliative care. Whilst there is an obvious need for palliative radiotherapy, simple curative treatments could also be managed. C060 radiotherapy has important advantages in developing countries, because of the higher initial cost of a linear accelerator, as well as the need for reliable power supply and the level of skill required by linac technicians and physicists. The beam characteristics of both C060 units and low energy linacs are compared and both are found to be acceptable for palliation. The concept of telemedicine is also discussed, using mobile phones and internet communication to allow rural clinics to receive support from specialists based in the cities, to send images for remote diagnosis and remote dose planning for radiotherapy. (author)

  8. Developed country trade barriers and the least developed countries: The economic results of freeing trade

    OpenAIRE

    Haveman, Jon D.; Shatz, Howard J.

    2003-01-01

    The Doha Ministerial Declaration emphasized that priority should be given to improving market access for products originating in the Least Developed Countries (LDCs). In this paper, we analyze the importance of this proposition with respect to market access in the Triad economies. We first present a brief history of non-reciprocal preferences granted by the Triad. This covers Generalized System of Preference (GSP) programmes in each, and further preferences granted to African, Caribbean and P...

  9. Cross-cultural comparison of lack of regular physical activity among college students: Universal versus transversal.

    Science.gov (United States)

    Seo, Dong-Chul; Torabi, Mohammad R; Jiang, Nan; Fernandez-Rojas, Xinia; Park, Bock-Hee

    2009-01-01

    This study examined cultural influence on personal and behavioral correlates of lack of regular physical activity (PA) among college students in four countries, i.e., the United States, Costa Rica, India, and South Korea. Public universities were randomly chosen among the four countries. A total of 4,685 students participated in the study during the 2006-2007 academic year with a response rate of 90.1%. The vast majority of the questions on the instrument were adopted from the Youth Risk Behavior Survey and the Behavioral Risk Factor Surveillance System questionnaires. The instrument was translated into Spanish and Korean and then back-translated into English to check accuracy of the translation. Low fruit consumption was a culture-universal predictor of lack of regular PA. Gender, perceived body weight, vegetable consumption, and cigarette smoking were culture-specific predictors, indicating PA might be a transversal value. Body mass index, binge drinking, and TV/video watching were not associated with lack of regular PA in any of the four countries. While PA is valued across different segments of many cultures, given the several culture-specific predictors, PA appears to be more transversal than universal. Therefore, culturally sensitive interventions are necessary to promote PA among young adults.

  10. Lack of Population Structure in Coriander Populations Based on SDS (Seed Storage Protein Page Analysis

    Directory of Open Access Journals (Sweden)

    Gülsüm Yaldiz

    2016-08-01

    Full Text Available Genetic variation is prerequisite for plant breeding. Nothing information existed in the literature for available diversity of Coriander accession in Turkey. Plant breeding activities are negligible in Turkey. So in order to start effective plant breeding program in Turkey, information on the available genetic diversity is viable. Therefore we planned to study the genetic variation and population structure of 29 Coriander accessions by seed storage protein (SDS. SDS analysis elaborated the lack of population structure and genetic bottleneck in the Coriander accessions in Turkey. Based on the results of this study, it was clear that sampling strategy was not appropriate and plant introduction should be made from different sources and diverse genotypes should be used as parents to initialize the effective Turkish Coriander breeding program.

  11. Removing user fees in the health sector: a review of policy processes in six sub-Saharan African countries.

    Science.gov (United States)

    Meessen, Bruno; Hercot, David; Noirhomme, Mathieu; Ridde, Valéry; Tibouti, Abdelmajid; Tashobya, Christine Kirunga; Gilson, Lucy

    2011-11-01

    In recent years, governments of several low-income countries have taken decisive action by removing fully or partially user fees in the health sector. In this study, we review recent reforms in six sub-Saharan African countries: Burkina Faso, Burundi, Ghana, Liberia, Senegal and Uganda. The review describes the processes and strategies through which user fee removal reforms have been implemented and tries to assess them by referring to a good practice hypotheses framework. The analysis shows that African leaders are willing to take strong action to remove financial barriers met by vulnerable groups, especially pregnant women and children. However, due to a lack of consultation and the often unexpected timing of the decision taken by the political authorities, there was insufficient preparation for user fee removal in several countries. This lack of preparation resulted in poor design of the reform and weaknesses in the processes of policy formulation and implementation. Our assessment is that there is now a window of opportunity in many African countries for policy action to address barriers to accessing health care. Mobilizing sufficient financial resources and obtaining long-term commitment are obviously crucial requirements, but design details, the formulation process and implementation plan also need careful thought. We contend that national policy-makers and international agencies could better collaborate in this respect.

  12. Motor hypertonia and lack of locomotor coordination in mutant mice lacking DSCAM.

    Science.gov (United States)

    Lemieux, Maxime; Laflamme, Olivier D; Thiry, Louise; Boulanger-Piette, Antoine; Frenette, Jérôme; Bretzner, Frédéric

    2016-03-01

    Down syndrome cell adherence molecule (DSCAM) contributes to the normal establishment and maintenance of neural circuits. Whereas there is abundant literature regarding the role of DSCAM in the neural patterning of the mammalian retina, less is known about motor circuits. Recently, DSCAM mutation has been shown to impair bilateral motor coordination during respiration, thus causing death at birth. DSCAM mutants that survive through adulthood display a lack of locomotor endurance and coordination in the rotarod test, thus suggesting that the DSCAM mutation impairs motor control. We investigated the motor and locomotor functions of DSCAM(2J) mutant mice through a combination of anatomical, kinematic, force, and electromyographic recordings. With respect to wild-type mice, DSCAM(2J) mice displayed a longer swing phase with a limb hyperflexion at the expense of a shorter stance phase during locomotion. Furthermore, electromyographic activity in the flexor and extensor muscles was increased and coactivated over 20% of the step cycle over a wide range of walking speeds. In contrast to wild-type mice, which used lateral walk and trot at walking speed, DSCAM(2J) mice used preferentially less coordinated gaits, such as out-of-phase walk and pace. The neuromuscular junction and the contractile properties of muscles, as well as their muscle spindles, were normal, and no signs of motor rigidity or spasticity were observed during passive limb movements. Our study demonstrates that the DSCAM mutation induces dystonic hypertonia and a disruption of locomotor gaits. Copyright © 2016 the American Physiological Society.

  13. Senior citizens: Digital immigrants in their own country?

    OpenAIRE

    Loos, E.

    2012-01-01

    Populations are ageing at a rapid pace in the majority of western countries. At the same time, these countries are increasingly becoming more digitised and information is supplied to a growing extent in digital form. To what extent is there an actual problem for senior citizens who are looking for accessible information? Is age the deciding factor for the way they make use of old and new media to gain access to information or are there other explanations for their information search behaviour...

  14. JISC Open Access Briefing Paper

    OpenAIRE

    Swan, Alma

    2005-01-01

    What Open Access is. What Open Access is not. How is Open Access provided? Open Access archives or repositories. Open Access journals. Why should authors provide Open Access to their work? Further information and resources

  15. Evaluating palliative care needs in Middle Eastern countries.

    Science.gov (United States)

    Silbermann, Michael; Fink, Regina M; Min, Sung-Joon; Mancuso, Mary P; Brant, Jeannine; Hajjar, Ramzi; Al-Alfi, Nesreen; Baider, Lea; Turker, Ibrahim; ElShamy, Karima; Ghrayeb, Ibtisam; Al-Jadiry, Mazin; Khader, Khaled; Kav, Sultan; Charalambous, Haris; Uslu, Ruchan; Kebudi, Rejin; Barsela, Gil; Kuruku, Nilgün; Mutafoglu, Kamer; Ozalp-Senel, Gulsin; Oberman, Amitai; Kislev, Livia; Khleif, Mohammad; Keoppi, Neophyta; Nestoros, Sophia; Abdalla, Rasha Fahmi; Rassouli, Maryam; Morag, Amira; Sabar, Ron; Nimri, Omar; Al-Qadire, Mohammad; Al-Khalaileh, Murad; Tayyem, Mona; Doumit, Myrna; Punjwani, Rehana; Rasheed, Osaid; Fallatah, Fatimah; Can, Gulbeyaz; Ahmed, Jamila; Strode, Debbie

    2015-01-01

    Cancer incidence in Middle Eastern countries, most categorized as low- and middle-income, is predicted to double in the next 10 years, greater than in any other part of the world. While progress has been made in cancer diagnosis/treatment, much remains to be done to improve palliative care for the majority of patients with cancer who present with advanced disease. To determine knowledge, beliefs, barriers, and resources regarding palliative care services in Middle Eastern countries and use findings to inform future educational and training activities. Descriptive survey. Fifteen Middle Eastern countries; convenience sample of 776 nurses (44.3%), physicians (38.3%) and psychosocial, academic, and other health care professionals (17.4%) employed in varied settings. Palliative care needs assessment. Improved pain management services are key facilitators. Top barriers include lack of designated palliative care beds/services, community awareness, staff training, access to hospice services, and personnel/time. The nonexistence of functioning home-based and hospice services leaves families/providers unable to honor patient wishes. Respondents were least satisfied with discussions around advance directives and wish to learn more about palliative care focusing on communication techniques. Populations requiring special consideration comprise: patients with ethnic diversity, language barriers, and low literacy; pediatric and young adults; and the elderly. The majority of Middle Eastern patients with cancer are treated in outlying regions; the community is pivotal and must be incorporated into future plans for developing palliative care services. Promoting palliative care education and certification for physicians and nurses is crucial; home-based and hospice services must be sustained.

  16. Public Sector Education Institution's Analysis: A Way Forward to Curtail Rural-Regional Education Accessibility Problems

    Directory of Open Access Journals (Sweden)

    Mir Aftab Hussain Talpur

    2014-10-01

    Full Text Available The availability of accessible educational facilities is essential for the better rural education. However, because of the huge population, lack of resources and absence of proper policy plans; the distance between educational facilities and rural communities is mounting as time progresses. These sorts of problematic circumstances put damaging effects on education standards and become responsible for the declining literacy rate. Hence, the goal of this research is to investigate the lack of educational institutions with respect to indigenous standards. Therefore, in this study, the dearth of education institutions was determined for the one of the most deprived sub-regions of Pakistan, i.e. Badin. The data were collected through observations, questionnaire survey, and from secondary sources, like census report and other pertinent public sector documents. The outcome of this study can be taken as an input to develop policy plans, targeting the education accessibility issues of backward communities. This research could show a guiding-path to local planning agencies, as these can come-up with the policy plans to trounce the education accessibility issues from the bucolic sub-regions of developing countries

  17. Transportation Limitation Access to the Small Islands (Case Study: Banggai Laut Regency)

    Science.gov (United States)

    Sunarti, S.

    2018-02-01

    Indonesia is as an archipelago and maritime country, the large number of Islands owned and scattered in all directions makes a challenge for the Government in equitable development. Development in Indonesia has not been spread evenly and tends to focus on the big island, while the smaller islands are still far behind and lack of government attention. One of them is the lack of infrastructure especially the access to the small islands. Among the small islands in Indonesia with minimal maritime infrastructure or transportation is Banggai Laut Regency, Central Sulawesi Province. This Regency is a new regency that separate itself from its previous regency that is Banggai Kepulauan Regency in about 4 years ago. For the development of the Banggai Laut Regency, access to reach that regency is quite difficult. Therefore, the aim of this research is to find infrastructure development strategy to support the development of Banggai Laut Regency. The research method used was the concurrent model mixed method. Data collection method was done with primary data through field observation and interview, secondary data through literature and document review. Analytical techniques used are qualitative descriptive and Map Overlay techniques using GIS to describe the characteristics of study areas and spatial relationships between islands. The results of this research conclude that the Banggai Laut Regency requires infrastructure development particularly maritime transportation to enhance accessibility of the community headed to Banggi Laut Regency or headed to another island from the Banggai Laut Regency.

  18. Assessment of the Vaccine Industry in Iran in Context of Accession to WTO: a Survey Study

    Directory of Open Access Journals (Sweden)

    Amir Hashemi Meshkini

    2012-08-01

    Full Text Available Background :The vaccine industry is one of the most important health-related industries. It can be affected by accession to the World Trade Organization (WTO because of probable dramatic changes in the business environment. Iran has already initiated accession negotiations. Purpose of the study In this paper, we investigate the position of, challenges to, and opportunities for vaccine manufacturing in Iran with regard to accession to the WTO. Methods:This is a qualitative and cross sectional study. To collect information, we designed a questionnaire and interviewed some of the vaccine industry's key opinion leaders in Iran. Before the interviews were conducted, the questionnaires were sent to these individuals by email. Results:According to the interviewees, the country's main challenges with regard to accession to the WTO are the lack of firm internal intellectual property (IP rules, not being recognized as pre-qualified by the World Health Organization (WHO, the use of old equipment, and a lack of cooperation with global vaccine companies. Major conclusions Iran's local vaccine industry, with a long history and international reputation that could be used as an advantage, is faced with several challenges, such as problems with keeping up with Current Good Manufacturing Practice (cGMP, a lack of adequate and meaningful investment in research and development (R&D, and limitations on private sector participation in the production of vaccines. Gradual privatization of the industry, improved international relations, utilization of the R&D power of small hi-tech companies, consistent education of human resources, and modernization of infrastructures and equipment are among the suggested solutions.

  19. Assessment of the vaccine industry in Iran in context of accession to WTO: a survey study.

    Science.gov (United States)

    Hashemi Meshkini, Amir; Kebriaeezadeh, Abbas; Dinarvand, Rasoul; Nikfar, Shekoufeh; Habibzadeh, Mohammadgafar; Vazirian, Iman

    2012-08-30

    The vaccine industry is one of the most important health-related industries. It can be affected by accession to the World Trade Organization (WTO) because of probable dramatic changes in the business environment. Iran has already initiated accession negotiations. In this paper, we investigate the position of, challenges to, and opportunities for vaccine manufacturing in Iran with regard to accession to the WTO. This is a qualitative and cross sectional study. To collect information, we designed a questionnaire and interviewed some of the vaccine industry's key opinion leaders in Iran. Before the interviews were conducted, the questionnaires were sent to these individuals by email. According to the interviewees, the country's main challenges with regard to accession to the WTO are the lack of firm internal intellectual property (IP) rules, not being recognized as pre-qualified by the World Health Organization (WHO), the use of old equipment, and a lack of cooperation with global vaccine companies. Iran's local vaccine industry, with a long history and international reputation that could be used as an advantage, is faced with several challenges, such as problems with keeping up with Current Good Manufacturing Practice (cGMP), a lack of adequate and meaningful investment in research and development (R&D), and limitations on private sector participation in the production of vaccines.Gradual privatization of the industry, improved international relations, utilization of the R&D power of small hi-tech companies, consistent education of human resources, and modernization of infrastructures and equipment are among the suggested solutions.

  20. Nuclear oncology in a developing country: Namibia

    International Nuclear Information System (INIS)

    Wenzel, K.S. von; Rubow, S.M.; Ellmann, A.

    2004-01-01

    Full text: Namibia is a country with 1.8 million inhabitants of whom the majority have limited access to world-class medical facilities. On an average, 25% people in Namibia get cancer in their lifetime. Most cancers can be cured if detected early and treated more effectively when metastatic disease is localized or even excluded. Nuclear medicine techniques play an important role in the detection, staging and management of malignant disease. In Namibia, due to sun exposure, skin cancer (31%) tops the list of prevailing cancers. The next most common cancer is breast cancer (9%), followed by head and neck cancers (8%), prostate (7%), Kaposi sarcoma (7%) and cervical cancer (6%). AIDS is an ever growing problem in Namibia, and related cancers e.g. Kaposi sarcoma and lymphoma are on the rise. A Nuclear Medicine Department was established at Windhoek Central Hospital in 1982. A nuclear physician, two nuclear medicine radiographers and a nursing sister staff the department. Equipment includes a Siemens Orbiter and an Elscint Apex SPX Helix gamma camera. Radiopharmaceuticals are obtained from suppliers in South Africa. There is a good working relationship between the Nuclear Medicine department and the clinicians, including the oncologists and surgeons. Therefore oncology patients are regularly referred for Nuclear Medicine procedures. Approximately 50% of all studies performed in the department are referred from oncologists. Investigations performed for breast cancer patients include scintimammography, sentinel node mapping with gamma probe. Bone scans and liver scans are used for the detection of metastases in patients with breast carcinoma and other cancers. In thyroid cancer patients, whole body radioiodine scans are done post-thyroidectomy to confirm the presence of a thyroid remnant and to detect local or distant metastases. Thallium and Sestamibi scans are performed to localize metastatic disease in thyroid cancer patients with a rising thyroglobulin level but a

  1. Country Presentation Uganda

    International Nuclear Information System (INIS)

    Oriada, R.; Byakagaba, A.; Kiza, M.; Magembe, M.

    2010-01-01

    Like Many African countries, Uganda is not Immune to the problem of illicit trafficking of Nuclear and Radioactive materials. This has been worsened by the porosity of the Ugandan Borders. There is control on the few Entry points and much of the border line does not have adequate control on what enters and leaves the country. Uganda is also used as a transit route with the neighboring countries like Sudan, Democratic Republic of Congo, Kenya,Tanzania.

  2. Nuclear power in developing countries

    International Nuclear Information System (INIS)

    Lane, J.A.; Covarrubias, A.J.; Csik, B.J.; Fattah, A.; Woite, G.

    1977-01-01

    This paper is intended to be a companion to similar papers by OECD/NEA and CMEA and will summarize the nuclear power system plans of developing Member States most likely to have nuclear programmes before the year 2000. The information that is presented is derived from various sources such as the Agency 1974 study of the market for nuclear power in developing countries, the annual publication, ''Power Reactors in Member States - 1976 Edition'', various nuclear power planning studies carried out by the Agency during the period 1975 and 1976, direct correspondence with selected Member States and published information in the open literature. A preliminary survey of the prospects for nuclear power in Member States not belonging to the OECD or having centrally planned economies indicates that about 27 of these countries may have operating nuclear power plants by the end of the century. In the 1974 Edition of the ''Market Survey'' it was estimated that the installed nuclear capacity in these countries might reach 24 GW by 1980, 157 GW by 1190 and 490 GW by the year 2000. It now appears that these figures are too high for a number of reasons. These include 1) the diminished growth in electrical demand which has occurred in many Member States during the last several years, 2) the extremely high cost of nuclear plant construction which has placed financial burdens on countries with existing nuclear programmes, 3) the present lack of commercially available small and medium power reactors which many of the smaller Member States would need in order to expand their electric power systems and 4) the growing awareness of Member States that more attention should be paid to exploitation of indigenous energy sources such as hydroelectric power, coal and lignite

  3. [AIDS, developing countries and ethnopsychiatry].

    Science.gov (United States)

    Ehrhardt, N; Defourny, J; Bertrand, J

    1995-04-01

    This work briefly assesses the history of the AIDS epidemic in different geographic regions and examines factors that render developing countries particularly vulnerable. It reviews the three main techniques of traditional therapeutic systems and examines their implications for psychiatric treatment of AIDS patients from developing countries. Young age structures, low rates of condom usage, women's lack of education and of sexual bargaining power, and the deficiencies of health and educational facilities are among factors that increase risks of HIV in developing countries. Health education geared to specific audiences should encourage condom use and other preventive measures. Among factors to encourage condom use, group decision making appears to be of greatest potential influence on behavior in sub-Saharan Africa and among African immigrants to Europe. To encourage preventive measures and to understand reactions of non-Western populations to HIV, it is desirable to understand the deeper meanings of their cultures and of traditional therapies. It is difficult and misguided to pose a diagnosis according to the criteria of Western psychiatry. Western psychiatry has been proven incompetent in its attempts to treat members of traditional societies, whether immigrants or in their countries of origin. And attempts to integrate traditional healing into a western medical system have not been successful. Traditional systems accomplish therapeutic goals by three major techniques, possession, shamanism, and clairvoyance, or their numerous variants. It is recommended that group sessions be held with immigrants requiring treatment, in which the principal therapist is assisted by translators, who help create a space for the patient intermediate between the two cultures, where the therapies can coexist without conflict.

  4. Review: Sustainability of crossbreeding in developing countries; definitely not like crossing a meadow….

    Science.gov (United States)

    Leroy, G; Baumung, R; Boettcher, P; Scherf, B; Hoffmann, I

    2016-02-01

    Crossbreeding, considering either terminal or rotational crossing, synthetic breed creation or breed replacement, is often promoted as an efficient strategy to increase farmers' income through the improvement of productivity of local livestock in developing countries. Sustainability of crossbreeding is however frequently challenged by constraints such as poor adaptation to the local environment or lack of logistic support. In this review, we investigate factors that may influence the long-term success or the failure of crossbreeding programs, based on the scientific literature and country reports submitted for The Second Report on the State of the World's Animal Genetic Resources for Food and Agriculture. Crossbreeding activities vary widely across species and countries. Its sustainability is dependent on different prerequisites such as continual access to adequate breeding stock (especially after the end of externally funded crossbreeding projects), the opportunity of improved livestock to express their genetic potential (e.g. through providing proper inputs) and integration within a reliable market chain. As formal crossbreeding programs are often associated with adoption of other technologies, they can be a catalyst for innovation and development for smallholders. Given the increasing global demand for animal products, as well as the potential environmental consequences of climate change, there is a need for practical research to improve the implementation of long-term crossbreeding programs in developing countries.

  5. An intellectual property sharing initiative in agricultural biotechnology: development of broadly accessible technologies for plant transformation.

    Science.gov (United States)

    Chi-Ham, Cecilia L; Boettiger, Sara; Figueroa-Balderas, Rosa; Bird, Sara; Geoola, Josef N; Zamora, Pablo; Alandete-Saez, Monica; Bennett, Alan B

    2012-06-01

    The Public Intellectual Property Resource for Agriculture (PIPRA) was founded in 2004 by the Rockefeller Foundation in response to concerns that public investments in agricultural biotechnology benefiting developing countries were facing delays, high transaction costs and lack of access to important technologies due to intellectual property right (IPR) issues. From its inception, PIPRA has worked broadly to support a wide range of research in the public sector, in specialty and minor acreage crops as well as crops important to food security in developing countries. In this paper, we review PIPRA's work, discussing the failures, successes, and lessons learned during its years of operation. To address public sector's limited freedom-to-operate, or legal access to third-party rights, in the area of plant transformation, we describe PIPRA's patent 'pool' approach to develop open-access technologies for plant transformation which consolidate patent and tangible property rights in marker-free vector systems. The plant transformation system has been licensed and deployed for both commercial and humanitarian applications in the United States (US) and Africa, respectively. © 2012 The Authors. Plant Biotechnology Journal © 2012 Society for Experimental Biology, Association of Applied Biologists and Blackwell Publishing Ltd.

  6. What drives energy consumption in developing countries? The experience of selected African countries

    International Nuclear Information System (INIS)

    Keho, Yaya

    2016-01-01

    This study investigates the drivers of energy consumption in Sub-Saharan African countries. It applies the bounds testing approach to cointegration to time series data at individual country levels over the period from 1970 to 2011. The study finds that energy consumption is cointegrated with real GDP per capita, industrial output, imports, foreign direct investment, credit to private sector, urbanization and population. Furthermore, the sign and magnitude of long-run estimates vary significantly for a single country and across countries depending on the energy consumption variable used. Overall, the findings confirm the leading role of economic growth, industrial output, population and urbanization. Economic growth, industrial output and population have positive effects on energy consumption in the majority of countries. Given the urgent need to address climate change, African countries should adopt policies to improve energy efficiency and accelerate transition toward renewable energy. The African Renewable Energy Initiative launched at the 21st session of the United Nations Conference of the Parties (COP21) is an opportunity for African countries to provide and maintain widespread access to reliable and affordable environmentally cleaner energy to meet the requirements of rapid economic growth and improved living standards. - Highlights: •Key drivers of energy use in 12 African countries are examined. •Economic growth, industrial GDP, population and urbanization play a leading role in explaining energy use. •Urbanization has a positive effect on energy use in six countries and a negative effect in four countries. •The results obtained have useful policy implications.

  7. Barcelona 2002: law, ethics, and human rights. Using the law to improve access to treatments.

    Science.gov (United States)

    Elliott, Richard; Parmar, Sharan; Divan, Vivek; Berger, Jonathan

    2002-12-01

    The XIII International AIDS Conference in Durban, South Africa in July 2000 focused worldwide attention on the problem of accessing treatments in developing countries. In the interim, thanks to the work of activists - from demonstrations to court cases, and from acts of public courage by people living with HIV/AIDS to ongoing lobbying of politicians and trade negotiators - some very significant developments have occurred. But the reality is that the vast majority of people living with HIV/AIDS still lack access to affordable, quality medicines. This article, a summary of a paper presented at "Putting Third First: Vaccines, Access to Treatments and the Law," a satellite meeting held at Barcelona on 5 July 2002 and organized by the Canadian HIV/AIDS Legal Network, the AIDS Law Project, South Africa, and the Lawyers Collective HIV/AIDS Unit, India, explores three approaches for improving access. In the first part, Richard Elliott provides an overview of the state of the right to health as embodied in international human rights law; comments on the experience to date in litigating claims to the right to health; and identifies potential strategies activists can adopt to advance recognition of the right to health. In the second part, Sharan Parmar and Vivek Divan describe price-control and drug-financing mechanisms used by industrialized countries to increase the affordability of medicines; and discuss how some of these mechanisms could be adapted for use in developing countries. Finally, Jonathan Berger describes the use of litigation in the courts by the Treatment Action Campaign in South Africa.

  8. Cervical cancer screening and practice in low resource countries ...

    African Journals Online (AJOL)

    While developed countries have recorded significant reduction in the incidence of cervical cancer owing to organizedscreening programs, treatment of premalignant cervical lesions, and follow‑up of treated cases, developing countries including Nigeria are yet to optimally utilize screening services due to lack of organized ...

  9. Accessing social rights in Denmark

    DEFF Research Database (Denmark)

    Jacqueson, Catherine

    2015-01-01

    are in decreasing order Polish, German and British nationals. Debates among politicians reflected in the media have since the enlargement of the EU to 10 new Member States in 2004 focused on and off on the issue of access by migrants to social benefits and the issue of social tourism. The debate and discussions...... 2014. The reason for that is the government’s change of practice in administrating family benefits, granting them to all Union citizens lawfully residing in Denmark without any requirement of prior residence in the country. This change was the result of a request from the European Commission...

  10. Children's active travel and independent mobility in four countries

    DEFF Research Database (Denmark)

    Fyhri, Aslak; Hjorthol, Randi; Mackett, Roger L.

    2011-01-01

    In many countries a decline in children's active and independent mobility, like walking and cycling is registered. In this paper the development of children's mobility in Denmark, Finland, Great Britain and Norway is compared to examine differences and similarities in these countries. Accessible ...

  11. Agronomic Challenges and Opportunities for Smallholder Terrace Agriculture in Developing Countries.

    Science.gov (United States)

    Chapagain, Tejendra; Raizada, Manish N

    2017-01-01

    Improving land productivity is essential to meet increasing food and forage demands in hillside and mountain communities. Tens of millions of smallholder terrace farmers in Asia, Africa, and Latin America who earn $1-2 per day do not have access to peer-reviewed knowledge of best agronomic practices, though they have considerable traditional ecological knowledge. Terrace farmers also lack access to affordable farm tools and inputs required to increase crop yields. The objectives of this review are to highlight the agronomic challenges of terrace farming, and offer innovative, low-cost solutions to intensify terrace agriculture while improving local livelihoods. The article focuses on smallholder farmers in developing nations, with particular reference to Nepal. The challenges of terrace agriculture in these regions include lack of quality land area for agriculture, erosion and loss of soil fertility, low yield, poor access to agricultural inputs and services, lack of mechanization, labor shortages, poverty, and illiteracy. Agronomic strategies that could help address these concerns include intensification of terraces using agro-ecological approaches along with introduction of light-weight, low-cost, and purchasable tools and affordable inputs that enhance productivity and reduce female drudgery. To package, deliver, and share these technologies with remote hillside communities, effective scaling up models are required. One opportunity to enable distribution of these products could be to "piggy-back" onto pre-existing snackfood/cigarette/alcohol distribution networks that are prevalent even in the most remote mountainous regions of the world. Such strategies, practices, and tools could be supported by formalized government policies dedicated to the well-being of terrace farmers and ecosystems, to maintain resiliency at a time of alarming climate change. We hope this review will inform governments, non-governmental organizations, and the private sector to draw

  12. Day Care: Other Countries.

    Science.gov (United States)

    Hjartarson, Freida; And Others

    This collection of 5 bilingual papers on day care programs in foreign countries (China, the Soviet Union, and 3 Scandinavian countries) is part of a series of papers on various aspects of day care published by the Canadian Department of Health and Welfare. Each paper is presented in both English and French. Paper I considers day care services in…

  13. Country Profiles, Malaysia.

    Science.gov (United States)

    Marzuki, Ariffin Bin; Peng, J. Y.

    A profile of Malaysia is sketched in this paper. Emphasis is placed on the nature, scope, and accomplishments of population activities in the country. Topics and sub-topics include: location and description of the country; population (size, growth patterns, age structure, urban/rural distribution, ethnic and religious composition, migration,…

  14. Serbia : Systematic Country Diagnostic

    OpenAIRE

    World Bank Group

    2015-01-01

    This Systematic Country Diagnostic (SCD) aims to identify the major constraints on and opportunities for sustaining poverty reduction and shared prosperity in Serbia. The SCD serves as the analytic foundation on which the World Bank Group and the Government of Serbia will define a new Country Partnership Framework for FY2016 to FY2020. It is based on the best possible analysis, drawing on ...

  15. Telemedicine for Developing Countries

    Science.gov (United States)

    Combi, Carlo; Pozzani, Gabriele

    2016-01-01

    Summary Background Developing countries need telemedicine applications that help in many situations, when physicians are a small number with respect to the population, when specialized physicians are not available, when patients and physicians in rural villages need assistance in the delivery of health care. Moreover, the requirements of telemedicine applications for developing countries are somewhat more demanding than for developed countries. Indeed, further social, organizational, and technical aspects need to be considered for successful telemedicine applications in developing countries. Objective We consider all the major projects in telemedicine, devoted to developing countries, as described by the proper scientific literature. On the basis of such literature, we want to define a specific taxonomy that allows a proper classification and a fast overview of telemedicine projects in developing countries. Moreover, by considering both the literature and some recent direct experiences, we want to complete such overview by discussing some design issues to be taken into consideration when developing telemedicine software systems. Methods We considered and reviewed the major conferences and journals in depth, and looked for reports on the telemedicine projects. Results We provide the reader with a survey of the main projects and systems, from which we derived a taxonomy of features of telemedicine systems for developing countries. We also propose and discuss some classification criteria for design issues, based on the lessons learned in this research area. Conclusions We highlight some challenges and recommendations to be considered when designing a telemedicine system for developing countries. PMID:27803948

  16. State of inequality in malaria intervention coverage in sub-Saharan African countries.

    Science.gov (United States)

    Galactionova, Katya; Smith, Thomas A; de Savigny, Don; Penny, Melissa A

    2017-10-18

    Scale-up of malaria interventions over the last decade have yielded a significant reduction in malaria transmission and disease burden in sub-Saharan Africa. We estimated economic gradients in the distribution of these efforts and of their impacts within and across endemic countries. Using Demographic and Health Surveys we computed equity metrics to characterize the distribution of malaria interventions in 30 endemic countries proxying economic position with an asset-wealth index. Gradients were summarized in a concentration index, tabulated against level of coverage, and compared among interventions, across countries, and against respective trends over the period 2005-2015. There remain broad differences in coverage of malaria interventions and their distribution by wealth within and across countries. In most, economic gradients are lacking or favor the poorest for vector control; malaria services delivered through the formal healthcare sector are much less equitable. Scale-up of interventions in many countries improved access across the wealth continuum; in some, these efforts consistently prioritized the poorest. Expansions in control programs generally narrowed coverage gaps between economic strata; gradients persist in countries where growth was slower in the poorest quintile or where baseline inequality was large. Despite progress, malaria is consistently concentrated in the poorest, with the degree of inequality in burden far surpassing that expected given gradients in the distribution of interventions. Economic gradients in the distribution of interventions persist over time, limiting progress toward equity in malaria control. We found that, in countries with large baseline inequality in the distribution of interventions, even a small bias in expansion favoring the least poor yielded large gradients in intervention coverage while pro-poor growth failed to close the gap between the poorest and least poor. We demonstrated that dimensions of disadvantage

  17. Financing low carbon energy access in Africa

    International Nuclear Information System (INIS)

    Gujba, Haruna; Thorne, Steve; Mulugetta, Yacob; Rai, Kavita; Sokona, Youba

    2012-01-01

    Modern energy access in Africa is critical to meeting a wide range of developmental challenges including poverty reduction and the Millennium Development Goals (MDGs). Despite having a huge amount and variety of energy resources, modern energy access in the continent is abysmal, especially Sub-Saharan Africa. Only about 31% of the Sub-Saharan African population have access to electricity while traditional biomass energy accounts for over 80% of energy consumption in many Sub-Saharan African countries. With energy use per capita among the lowest in the world, there is no doubt that Africa will need to increase its energy consumption to drive economic growth and human development. Africa also faces a severe threat from global climate change with vulnerabilities in several key areas or sectors in the continent including agriculture, water supply, energy, etc. Low carbon development provides opportunities for African countries to improve and expand access to modern energy services while also building low-emission and climate-resilient economies. However, access to finance from different sources will be critical in achieving these objectives. This paper sets out to explore the financial instruments available for low carbon energy access in Africa including the opportunities, markets and risks in low carbon energy investments in the continent. - Highlights: ► Access to finance will be critical to achieving low carbon energy access in Africa. ► Domestic finance will be important in leveraging private finance. ► Private sector participation in modern and clean energy in Africa is still low. ► Many financing mechanisms exist for low carbon energy access in Africa. ► The right institutional frameworks are critical to achieving low carbon energy access in Africa.

  18. ERAWATCH Country Reports 2012

    DEFF Research Database (Denmark)

    Grimpe, Christoph

    between the national priorities and the structural challenges, highlighting the latest developments, their dynamics and impact in the overall national context. They further analyse and assess the ability of the policy mix in place to consistently and efficiently tackle these challenges. These reports were......This analytical country report is one of a series of annual ERAWATCH reports produced for EU Member States and Countries Associated to the Seventh Framework Programme for Research of the European Union (FP7). The main objective of the ERAWATCH Annual Country Reports is to characterise and assess...... the performance of national research systems and related policies in a structured manner that is comparable across countries. The Country Report 2012 builds on and updates the 2011 edition. The report identifies the structural challenges of the national research and innovation system and assesses the match...

  19. Information systems for mental health in six low and middle income countries : Cross country situation analysis

    NARCIS (Netherlands)

    Upadhaya, Nawaraj; Jordans, Mark J D; Abdulmalik, Jibril; Ahuja, Shalini; Alem, Atalay; Hanlon, Charlotte; Kigozi, Fred; Kizza, Dorothy; Lund, Crick; Semrau, Maya; Shidhaye, Rahul; Thornicroft, Graham; Komproe, Ivan H.; Gureje, Oye

    2016-01-01

    Background: Research on information systems for mental health in low and middle income countries (LMICs) is scarce. As a result, there is a lack of reliable information on mental health service needs, treatment coverage and the quality of services provided. Methods: With the aim of informing the

  20. Initiating a Human Variome Project Country Node.

    Science.gov (United States)

    AlAama, Jumana; Smith, Timothy D; Lo, Alan; Howard, Heather; Kline, Alexandria A; Lange, Matthew; Kaput, Jim; Cotton, Richard G H

    2011-05-01

    Genetic diseases are a pressing global health problem that requires comprehensive access to basic clinical and genetic data to counter. The creation of regional and international databases that can be easily accessed by clinicians and diagnostic labs will greatly improve our ability to accurately diagnose and treat patients with genetic disorders. The Human Variome Project is currently working in conjunction with human genetics societies to achieve this by establishing systems to collect every mutation reported by a diagnostic laboratory, clinic, or research laboratory in a country and store these within a national repository, or HVP Country Node. Nodes have already been initiated in Australia, Belgium, China, Egypt, Malaysia, and Kuwait. Each is examining how to systematically collect and share genetic, clinical, and biochemical information in a country-specific manner that is sensitive to local ethical and cultural issues. This article gathers cases of genetic data collection within countries and takes recommendations from the global community to develop a procedure for countries wishing to establish their own collection system as part of the Human Variome Project. We hope this may lead to standard practices to facilitate global collection of data and allow efficient use in clinical practice, research and therapy. © 2011 Wiley-Liss, Inc.

  1. WTO negotiations on agriculture and developing countries:

    OpenAIRE

    Hoda, Anwarul; Gulati, Ashok

    2008-01-01

    The World Trade Organization’s Doha Round of trade talks has been plagued by a lack of concrete progress toward establishing a fair and harmonious agricultural trading system. Because the results of the Doha Round could have far-reaching implications for the trade and economic prospects of developing countries in the twenty-first century, it is critical for these countries to fully understand the issues involved in the negotiations on agriculture. However, there has been no authoritative an...

  2. Problems of radiation therapy in developing countries

    Energy Technology Data Exchange (ETDEWEB)

    Lyimo, R; Neumeister, K

    1988-01-01

    Poverty as well as lack of proper cancer programmes has prevented the early detection of cancer in developing countries. Radiotherapy is applied mostly in advanced cases only. To change the situation comprehensive programmes must be introduced with particular attention to the importance of cancer control. The establishment of cancer societies as well as the introduction of centres for training of radiological personnel will really improve the situation. A realistic method for the optimization of radiotherapy in developing countries should be the use of radiomodification such as hypoxyradiotherapy.

  3. MULTI-NATIONAL COMPANIES AND TRANSITION COUNTRIES: A MACEDONIAN EXPERIENCE

    OpenAIRE

    Aleksandra Patoska; Branko Dimeski

    2015-01-01

    The process of globalization and liberalization is further accelerated by the growing expansion of multinational companies in post-communist transition countries. Transition countries improve their technological development, increase the exports and gain better access to global markets. On other hand, global companies maximize their profits by employing cheaper resources, paying lower taxes and using a number of benefits that the transition countries offer to them. The main purpose of the pap...

  4. Country branding: an imperative for developing countries | Akotia ...

    African Journals Online (AJOL)

    Clarifying what a country brand and country branding encompasses, this paper examines the competitive advantage a country brand engenders for developing countries. Furthermore, emphasising country branding as a social construction, this paper argues that for developing countries entrenched in the poverty cycle there ...

  5. Professional Access 2013 programming

    CERN Document Server

    Hennig, Teresa; Hepworth, George; Yudovich, Dagi (Doug)

    2013-01-01

    Authoritative and comprehensive coverage for building Access 2013 Solutions Access, the most popular database system in the world, just opened a new frontier in the Cloud. Access 2013 provides significant new features for building robust line-of-business solutions for web, client and integrated environments.  This book was written by a team of Microsoft Access MVPs, with consulting and editing by Access experts, MVPs and members of the Microsoft Access team. It gives you the information and examples to expand your areas of expertise and immediately start to develop and upgrade projects. Exp

  6. Access 2010 Programmer's Reference

    CERN Document Server

    Hennig, Teresa; Griffith, Geoffrey L

    2010-01-01

    A comprehensive guide to programming for Access 2010 and 2007. Millions of people use the Access database applications, and hundreds of thousands of developers work with Access daily. Access 2010 brings better integration with SQL Server and enhanced XML support; this Wrox guide shows developers how to take advantage of these and other improvements. With in-depth coverage of VBA, macros, and other programming methods for building Access applications, this book also provides real-world code examples to demonstrate each topic.: Access is the leading database that is used worldwide; While VBA rem

  7. Open Access for International Criminal Lawyers

    NARCIS (Netherlands)

    van Laer, Coen

    2016-01-01

    This study investigates to what extent Open Access is useful for international criminal lawyers. Free reuse and distribution may be particularly advantageous for the audience in less resourceful countries. And individual authors need visibility to promote their academic reputation. However, many

  8. What are the biggest obstacles to growth of SMEs in developing countries? – An empirical evidence from an enterprise survey

    Directory of Open Access Journals (Sweden)

    Yao Wang

    2016-09-01

    Full Text Available SMEs are drivers of economic growth and job creation in developing countries. It is paramount to determine the factors that hinder their growth. This paper uses the Enterprise Survey from the World Bank which covers data from 119 developing countries to investigate the biggest obstacles SMEs are confronting and the determinants that influence the obstacles as perceived by enterprise managers. The results show that SMEs perceive access to finance as the most significant obstacle which hinders their growth. The key determinants among firms' characteristics are size, age and growth rate of firms as well as the ownership of the firm. The latter – the role of the state in financing SME – is particularly intriguing. External reasons for the financing dilemma are also examined. It is shown that the main barriers to external financing are high costs of borrowing and a lack of consultant support.

  9. A review of formal institutions affecting water supply and access in Botswana

    Science.gov (United States)

    Mogomotsi, Patricia K.; Mogomotsi, Goemeone E. J.; Matlhola, Dimpho M.

    2018-06-01

    Over the years, many countries across the world have increasingly experienced the collapse of their ecosystems, leading to an elevated increase on the demand for freshwater resources. Botswana is not an exception. The problem of disrupted potable water supply is widespread across the country. However, the physical shortage of water in the country is arguably coupled by lack of effective and efficient water supply and management institutions and water infrastructure. Most of the research on water scarcity in Botswana is mostly inclined towards physical water scarcity, while little is investigated on how the design of institutions for water management in developing countries leads to water scarcity. Furthermore, the premises of most research is neoclassical economics ideas, thereby offering solutions as developing and/or reforming water markets and water pricing mechanisms, among other findings. This paper analyses potable water supply and access in Botswana within a new institutional economics paradigm. The study examines key features of water institutions in Botswana on how they affect water supply and access, applying new institutional economics fundamentals. The study extensively uses various secondary data sources including weather and climate reports, policy documents, maps and charts and survey data, among others. The paper argues that to achieve effective water allocation in Botswana, there is a need to balance social and environmental water resource needs through water policies and other statutory enactments, as well as the crafting of practical management strategies. The country, therefore, requires not only a swift institutional transformation in the water sector, but also needs practical governance structure necessary for implementing integrated water resources management and driving water resources towards sustainability.

  10. Paediatric Palliative Care in Resource-Poor Countries

    Directory of Open Access Journals (Sweden)

    Julia Downing

    2018-02-01

    Full Text Available There is a great need for paediatric palliative care (PPC services globally, but access to services is lacking in many parts of the world, particularly in resource-poor settings. Globally it is estimated that 21.6 million children need access to palliative care, with 8.2 needing specialist services. PC has been identified as important within the global health agenda e.g., within universal health coverage, and a recent Lancet commission report recognised the need for PPC. However, a variety of challenges have been identified to PPC development globally such as: access to treatment, access to medications such as oral morphine, opiophobia, a lack of trained health and social care professionals, a lack of PPC policies and a lack of awareness about PPC. These challenges can be overcome utilising a variety of strategies including advocacy and public awareness, education, access to medications, implementation and research. Examples will be discussed impacting on the provision of PPC in resource-poor settings. High-quality PPC service provision can be provided with resource-poor settings, and there is an urgent need to scale up affordable, accessible, and quality PPC services globally to ensure that all children needing palliative care can access it.

  11. 10 CFR 503.21 - Lack of alternate fuel supply.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Lack of alternate fuel supply. 503.21 Section 503.21 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS NEW FACILITIES Temporary Exemptions for New Facilities § 503.21 Lack of alternate fuel supply. (a) Eligibility. Section 211(a)(1) of the Act provides for...

  12. Treatment of AKI in developing and developed countries: An international survey of pediatric dialysis modalities.

    Directory of Open Access Journals (Sweden)

    Rupesh Raina

    Full Text Available Acute kidney injury (AKI is a common cause of morbidity and mortality worldwide, with a pediatric incidence ranging from 19.3% to 24.1%. Treatment of pediatric AKI is a source of debate in varying geographical regions. Currently CRRT is the treatment for pediatric AKI, but limitations due to cost and accessibility force use of adult equipment and other therapeutic options such as peritoneal dialysis (PD and hemodialysis (HD. It was hypothesized that more cost-effective measures would likely be used in developing countries due to lesser resource availability.A 26-question internet-based survey was distributed to 650 pediatric Nephrologists. There was a response rate of 34.3% (223 responses. The survey was distributed via pedneph and pcrrt email servers, inquiring about demographics, technology, resources, pediatric-specific supplies, and preference in renal replacement therapy (RRT in pediatric AKI. The main method of analysis was to compare responses about treatments between nephrologists in developed countries and nephrologists in developing countries using difference-of-proportions tests.PD was available in all centers surveyed, while HD was available in 85.1% and 54.1% (p = 0.00, CRRT was available in 60% and 33.3% (p = 0.001, and SLED was available in 20% and 25% (p = 0.45 centers of developed and developing world respectively. In developing countries, 68.5% (p = 0.000 of physicians preferred PD to costlier therapies, while in developed countries it was found that physicians favored HD (72%, p = 0.00 or CRRT (24%, p = 0.041 in infants.Lack of availability of resources, trained physicians and funds often preclude standards of care in developing countries, and there is much development needed in terms of meeting higher global standards for treating pediatric AKI patients. PD remains the main modality of choice for treatment of AKI in infants in developing world.

  13. The global burden of visual difficulty in low, middle, and high income countries.

    Directory of Open Access Journals (Sweden)

    Ellen E Freeman

    Full Text Available Using a world-wide, population-based dataset of adults, we sought to determine the frequency of far visual difficulty and its associated risk factors.The World Health Survey (WHS was conducted in 70 countries throughout the world in 2003 using a random, multi-stage, stratified, cluster sampling design of adults ages 18 years and older. Far vision was assessed by asking "In the last 30 days, how much difficulty did you have in seeing and recognizing a person you know across the road (i.e. from a distance of about 20 meters?". Responses included none, mild, moderate, severe, or extreme/unable. The income status of countries was estimated using gross national income per capita data from 2003 from the World Bank. Prevalence and regression estimates were adjusted to account for the complex sample design.21% of adults reported any visual difficulty. The rate varied by the income status of the country with the percentage who had any visual difficulty being 24%, 23%, and 13% in low, middle, and high income countries, respectively. Five percent of people reported severe or extreme visual difficulty with rates in low, middle, and high income countries of 6%, 5%, and 2% respectively. Risk factors for visual difficulty included older age, female sex, poorer socioeconomic status, little to no formal education, and diabetes (P<0.05.One out of five adults in the WHS reported some degree of far visual difficulty. Given the importance of vision to living an independent life, better access to quality eye care services and life course factors affecting vision health (e.g. repeated eye infections, diet lacking vitamin A must receive adequate attention and resources, especially in low and middle income countries.

  14. Radiation-sparing managements for cervical cancer: a developing countries perspective

    Directory of Open Access Journals (Sweden)

    de la Garza Jaime

    2006-11-01

    Full Text Available Abstract Cervical cancer is the seventh most frequent cancer worldwide but more than 80% of cases occur in developing countries. Till date, radiation therapy with external beam and brachytherapy remains as the core treatment for most stages of cervical cancer. However, radiation treatment protocols and equipment modelled on the best developed countries can be seldom applied directly to developing countries owing to financial constraints and lack of qualified personnel, thus, a substantial proportion of patients do not have access to even palliative radiation therapy. Treatment options when the standard therapy is either not available or difficult to reproduce in particular settings is highly desirable with the potential to save lives that otherwise could be lost by the lack of adequate treatment. These options of treatment ideally had to have show, 1 that these are not inferior to the "standard" in terms of either survival or quality of life; 2 that these can be delivered in settings were the "standard" is not available or if available its quality is poor; and 3 that the treatment option be accepted by the population to be treated. Based on these considerations, it is obvious that cervical cancer patients, particularly those who live in countries with limited resources and therefore may not have sufficient radiation therapy resources are in need of newer therapeutical options. There is now a considerable amount of information emanating from clinical studies where surgery has a major role in treating this disease. These forms of "radiation-sparing" treatments include total mesometrial resection that could make unnecessary the use of adjuvant radiation; neoadjuvant chemotherapy that could avoid the use of adjuvant radiation in around 85% of patients and preoperative chemoradiation that could make brachytherapy dispensable. The feasibility and therapeutical value of these potential forms of management need to be prospectively evaluated.

  15. Accessing diabetes care in rural Uganda

    DEFF Research Database (Denmark)

    Nielsen, Jannie; Bahendeka, Silver K.; Bygbjerg, Ib C.

    2017-01-01

    Non-communicable diseases including type 2 diabetes (T2D) are increasing rapidly in most Sub-Saharan African (SSA) countries like Uganda. Little attention has been given to how patients with T2D try to achieve treatment when the availability of public health care for their disease is limited......, as is the case in most SSA countries. In this paper we focus on the landscape of availability of care and the therapeutic journeys of patients within that landscape. Based on fieldwork in south-western Uganda including 10 case studies, we explore the diabetes treatment options in the area and what it takes...... to access the available treatment. We analyse the resources patients need to use the available treatment options, and demonstrate that the patients’ journeys to access and maintain treatment are facilitated by the knowledge and support of their therapy management groups. Patients access treatment more...

  16. FINANCIAL DEPTH AND FINANCIAL ACCESS IN INDONESIA

    Directory of Open Access Journals (Sweden)

    Sigit Setiawan

    2015-05-01

    Full Text Available This study is intended to analyze the current levels of financial depth and financial access in Indonesia and to analyze the factors affecting them. The analysis method used was a combination of descriptive quantitative, benchmarking, and literature reviews. The conclusion is that the financial depth in Indonesia has not shown a satisfactory level since it was the lowest, or the second lowest ranked country among the sampled countries. Meanwhile, the financial access in Indonesia is relatively better than its financial depth, especially for financial markets, in which Indonesia ranks in the lower average group. From literature reviews, it can be inferred that the main factor driving the poor financial depth in Indonesia is non-competitiveness of the institutions; whereas the driving force of poor financial access in Indonesia are geographical constraints, poverty, a high income gap, and a less than effective national financial development policy.

  17. Overview: Routes to Open Access

    OpenAIRE

    Tullney, Marco; van Wezenbeek, Wilma

    2017-01-01

    Slides of an overview presentation given at a CESAER workshop on Open Access, February 2nd, 2017, in Brussels Cover major routes to more open access as discussed in the Task Force Open Science of CESAER: (national) open access strategies open access mandates open access incentives open access awareness open access publishing open access infrastructure

  18. Achieving open access to conservation science.

    Science.gov (United States)

    Fuller, Richard A; Lee, Jasmine R; Watson, James E M

    2014-12-01

    Conservation science is a crisis discipline in which the results of scientific enquiry must be made available quickly to those implementing management. We assessed the extent to which scientific research published since the year 2000 in 20 conservation science journals is publicly available. Of the 19,207 papers published, 1,667 (8.68%) are freely downloadable from an official repository. Moreover, only 938 papers (4.88%) meet the standard definition of open access in which material can be freely reused providing attribution to the authors is given. This compares poorly with a comparable set of 20 evolutionary biology journals, where 31.93% of papers are freely downloadable and 7.49% are open access. Seventeen of the 20 conservation journals offer an open access option, but fewer than 5% of the papers are available through open access. The cost of accessing the full body of conservation science runs into tens of thousands of dollars per year for institutional subscribers, and many conservation practitioners cannot access pay-per-view science through their workplace. However, important initiatives such as Research4Life are making science available to organizations in developing countries. We urge authors of conservation science to pay for open access on a per-article basis or to choose publication in open access journals, taking care to ensure the license allows reuse for any purpose providing attribution is given. Currently, it would cost $51 million to make all conservation science published since 2000 freely available by paying the open access fees currently levied to authors. Publishers of conservation journals might consider more cost effective models for open access and conservation-oriented organizations running journals could consider a broader range of options for open access to nonmembers such as sponsorship of open access via membership fees. © 2014 The Authors. Conservation Biology published by Wiley Periodicals, Inc., on behalf of the Society for

  19. Enhanced immunization coverage through interventions for childhood cluster diseases in developing countries

    International Nuclear Information System (INIS)

    Mureed, S.; Somronghtong, R.; Kumar, R.

    2015-01-01

    Globally immunisation has to be considered as a most effective and efficient public health intervention to reduce morbidity and mortality among children. Most of the children from developing countries are still not fully immunized due to multiple factors including lack of interventions, awareness, and financial constraints and due to limited resource. Conversely, this review has identified the effectiveness of interventions to increase the immunisation coverage among children of developing countries. Methods: Systematic review by using PRISMA statement (preferred reporting items for systematic reviews and meta-analyses) has been conducted in English published articles on Pub Med, Scopus, Cochrane, Medline and ISI by searching keywords like immunizations, childhood vaccination and developing countries has been accessed. Only randomised controlled trial and quasi-experimental studies designs were included in the final analysis based on quality assessment by adopting the Down and Black checklist and finally pooled analysis was done by random effect model. This systematic review has been approved and registered by University of York. Results: A total of 16,570 published articles were accessed and finally 10 fulfilled our criteria that were analysed and interpreted. It demonstrated that the interventions has shown significantly increase vaccine coverage for childhood cluster diseases (OR 2.136 and p <0.05).Furthermore, it has been proved that an effect was more prominent for DTP (OR 2.397 and p<0.05) and measles (OR 2.628 and p<0.05), not as much for polio (OR 2.284 and p>0.05) and full vaccination schedule (OR 1.342 and p>0.05). Conclusions: Systematic review has concluded that the professional interventions are an effective while in improving the child immunisation coverage for cluster diseases in developing countries, major effect on DTP and measles. (author)

  20. Neurology training in sub-Saharan Africa: A survey of people in training from 19 countries.

    Science.gov (United States)

    Mateen, Farrah J; Clark, Sarah J; Borzello, Mia; Kabore, Jean; Seidi, Osheik

    2016-06-01

    To provide a comprehensive understanding of neurology training from the sub-Saharan African perspective. A 40-question survey was distributed to attendees of the 7th annual sub-Saharan African neurology teaching course in Khartoum, Sudan (2015). Themes included the student body, faculty, curriculum, assessment and examinations, technology, and work hours and compensation. Of 19 responding countries, 10 had no formal neurology training programs; Burkina Faso, Cameroon, Republic of the Congo, and Mozambique had an adult neurology program; Ethiopia, Madagascar, Nigeria, Senegal, and South Africa had adult and pediatric neurology programs (training duration range = 3-6 years). There was a median of 2.5 full-time neurologists on the teaching faculty at the respondents' training institutions (neurologists on-faculty:in-country ratio = 0.48), with the lowest ratios in Sudan and Nigeria. Neurology was perceived to be a competitive specialty for entrance in 57% of countries, with 78% of respondents reporting a requisite entrance examination. Ninety-five percent had access to a personal smartphone, 62% used the Internet more than occasionally, and 60% had access to online neurology journals. The average number of weekly work hours was 51 (range = 40-75), and average monthly salary among those earning income was 1,191 USD (range = 285-3,560). Twenty percent of respondents reported paying for training. The most common barriers to neurology postgraduate education were few training programs and lack of training in neurodiagnostic tests. Among 17 reporting countries, there is an estimated average of 0.6 neurologists per million people. Neurology training programs in sub-Saharan Africa are relatively limited in number and have several unmet needs including a small cadre of faculty and an opportunity to standardize curricula and financing of programs. Ann Neurol 2016;79:871-881. © 2016 American Neurological Association.

  1. Physical Access Control Database -

    Data.gov (United States)

    Department of Transportation — This data set contains the personnel access card data (photo, name, activation/expiration dates, card number, and access level) as well as data about turnstiles and...

  2. Design for Accessibility

    DEFF Research Database (Denmark)

    Herriott, Richard

    2012-01-01

    A report on how nine rail builder, operators and transport designers deal with design for accessibility......A report on how nine rail builder, operators and transport designers deal with design for accessibility...

  3. Information on Open Access

    African Journals Online (AJOL)

    Open Access (OA), defined most simply, means free full text online. There are over 130 Open Access journals hosted on the AJOL website. You can find a full list of these journals here: OA journals on AJOL ...

  4. Gender, International Law and Justice : Access to Gender Equality ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Gender, International Law and Justice : Access to Gender Equality. Countries that have ratified or acceded to the Convention on the Elimination of All Forms of Discrimination against ... Centre for International Sustainable Development Law.

  5. Editorial Challenging barriers to surgical access in lower and middle ...

    African Journals Online (AJOL)

    unmet surgical needs globally.2 Barriers to surgical access lead to delayed presentation of ... educational constraints (First Delay). Once the decision to ... Day of surgery cancellations have implications in both high- and low- income countries.

  6. Access to water: Technical and social solutions help communities ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2010-12-08

    Dec 8, 2010 ... English · Français ... Access to water: Technical and social solutions help communities make the most of ... IDRC-supported research engages communities, and countries, in developing durable solutions to water problems.

  7. Shadow Libraries: Access to Knowledge in Global Higher Education ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2018-05-04

    May 4, 2018 ... Shadow Libraries: Access to Knowledge in Global Higher Education ... that are emerging in middle- and low-income countries as opportunities for higher education expand but funding for materials shrinks. ... Innovation.

  8. Barriers to accessing urethroplasty.

    Science.gov (United States)

    Consolo, Michael J; Syed, Kirin K; Robison, Christopher; McFadden, Jacob; Shalowitz, David I; Brown, Gordon A; Sussman, David O; Figler, Bradley D

    2016-01-01

    Urethroplasty is an effective treatment for men with anterior urethral strictures, but is utilized less frequently than ineffective treatments such as internal urethrotomy. We sought to identify provider-level barriers to urethroplasty. An anonymous online survey was emailed to all Mid-Atlantic American Urological Association members. Six scenarios in which urethroplasty was the most appropriate treatment were presented. Primary outcome was recommendation for urethroplasty in ≥ three clinical scenarios. Other factors measured include practice zip code, urethroplasty training, and proximity to a urethroplasty surgeon. Multivariate logistic regression identified factors associated with increased likelihood of urethroplasty recommendation. Of 670 members emailed, 109 (16%) completed the survey. Final analysis included 88 respondents. Mean years in practice was 17.2. Most respondents received formal training in urethroplasty: 43 (49%) in residency, 5 (6%) in fellowship, and 10 (11%) in both; 48 respondents (55%) had a urethroplasty surgeon in their practice, whereas 18 (20%) had a urethroplasty surgeon within 45 minutes of his or her primary practice location. The only covariate that was associated with an increased likelihood of recommending urethroplasty in ≥ three scenarios was formal urethroplasty training. Most members (68%) reported no barriers to referring patients for urethroplasty; the most common barriers cited were long distance to urethroplasty surgeon (n 5 13, 15%) and concern about complications (n 5 8, 9%). Urethroplasty continues to be underutilized in men with anterior urethral strictures, potentially due to lack of knowledge dissemination and access to a urethroplasty surgeon. Appropriate urethroplasty utilization may increase with greater exposure to urethroplasty in training.

  9. Access to essential medicines for sexual and reproductive health care: the role of the pharmaceutical industry and international regulation.

    Science.gov (United States)

    Cottingham, Jane; Berer, Marge

    2011-11-01

    The range of medicines and technologies that are essential for sexual and reproductive health care is well established, but access to them is far from universally assured, particularly in less developed countries. This paper shows how the pharmaceutical industry plays a major role in the lack of access to essential medicines for sexual and reproductive health care, by a) investing in products for profit-making reasons despite their negative health impact (e.g. hormone replacement therapy), b) marketing new essential medicines at prices beyond the reach of countries that most need them (e.g. HPV vaccines), and c) failing to invest in the development of new products (e.g. microbicides and medical abortion pills). Small companies, some of them non-profit-making, struggle to fill some of that demand (e.g. for female condoms). International patent protection contributes to high prices of medicines, and while international agreements such as compulsory licensing under TRIPS and the Medicines Patent Pool allow for mechanisms to enable poorer countries to get access to essential medicines, the obstacles created by "big pharma" are daunting. All these barriers have fostered a market in sub-standard medicines (e.g. fake medical abortion pills sold over the internet). An agenda driven by sexual and reproductive health needs, based on the right to health, must focus on universal access to essential medicines at prices developing countries can afford. We call for greater public investment in essential medicines, expanded production of affordable generic drugs, and the development of broad strategic plans, that include affordable medicines and technologies, for addressing identified public health problems, such as cervical cancer. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  10. The status of Bosnia and Herzegovina in the process of accession to the European Union

    Directory of Open Access Journals (Sweden)

    Lakić Danijela

    2015-01-01

    Full Text Available The paper analyzes the level that Bosnia and Herzegovina has reached in the process of accession to the European union. Since year 2000, it has been included in Stabilization and Accession process, politico-legal framework of the European union for the integration in the Western Balkans. Among the countries in this region, Bosnia and Herzegovina has the slowest advancement on its way to the EU. It has not yet submitted the application for EU membership nor has the Stabilization and Accession Agreement come into force. The EU requires that Bosnia and Herzegovina meet two conditions in order to move forward. The first condition is the implementation of the Sejdić and Finci ruling of The European Court of Human Rights, from 2009, and the second is to create an efficient coordination mechanism on EU issues ( with one voice on EU issues. until the second condition is met, the EU has postponed making the decision on pre-accession assistance to Bosnia and Herzegovina until further notice. According to the assessment of the European Commission, the main cause of this stagnation of Bosnia and Herzegovina is the lack of political will, and its specific constitution that does not present the obstacle to succession in the process of European integration.

  11. European countries in transition

    International Nuclear Information System (INIS)

    Gautier, Celia; Pescia, Dimitri; Ferreira, Francisco; Antunes, Rita; Claustre, Raphael; Priesner, Goerg C.; Pidous, Blandine; Dufour, Manon; Zuloaga, Francisco

    2014-01-01

    From the Atlantic Ocean to the Baltic Sea, from Portugal to Poland through UK, Germany or Austria, energy transition is in progress everywhere in Europe, but at different rhythms and in various conditions from one country to the other. How does the European framework promote the energy transition at the local and regional scales? What advantages the most advanced countries are relying on? How do citizens and local projects take over slow or retrograde governmental policies? This dossier gives some elements of answer through an overview of some energy policy scenarios under implementation in some European countries (Germany, Portugal, Denmark, Austria, UK, Spain)

  12. The opportunities and obstacles to collaboration between the developing and developed countries in the field of occupational health

    International Nuclear Information System (INIS)

    Rantanen, Jorma; Lehtinen, Suvi; Savolainen, Kai

    2004-01-01

    The 2.4 billion working people in the developing countries often have to endure employment conditions, which do not meet even basic occupational safety and health (OSH) standards. The lack of work safety, excessive work loads, and occupational physical, chemical and biological exposures result in occupational diseases, injuries and as many as 1.2 million fatalities each year. Furthermore, as little as 15% of workers in the developing countries have access to occupational health and safety services. Some collaboration between the industrialized and developing countries in the field of OSH has been practiced for 30 years but its volume has been modest compared to other sectors of development assistance. The lessons learned from 30 years of experience are that the most important OSH improving factors in developing countries include legal and policy instruments, national OSH programs, infrastructure for OSH implementation, and OSH services. The establishment of OSH expert human resources, centers serving as engines for research, training, as well as information and registration systems can also be considered as key factors in any such collaboration. A convincing government OSH policy, and close cooperation between social partners and the government are also critical factors that guarantee sustainable OSH programs in a developing country over a long-term basis

  13. Access Customized Forms

    OpenAIRE

    Cosma Emil; Jeflea Victor

    2010-01-01

    By using Word, Excel or PowerPoint one can automate routine operations using the VBA language (Visual Basic for Applications). This language is also used in Access, allowing access to data stored in tables or queries. Thus, Access and VBA resources can be used together. Access is designed for programming forms and reports (among other things), so there won’t be found any of the VBA editor’s specific forms.

  14. Assessing the impact of fisheries co-management interventions in developing countries: a meta-analysis.

    Science.gov (United States)

    Evans, Louisa; Cherrett, Nia; Pemsl, Diemuth

    2011-08-01

    Co-management is now established as a mainstream approach to small-scale fisheries management across the developing world. A comprehensive review of 204 potential cases reveals a lack of impact assessments of fisheries co-management. This study reports on a meta-analysis of the impact of fisheries co-management in developing countries in 90 sites across 29 case-studies. The top five most frequently measured process indicators are participation, influence, rule compliance, control over resources, and conflict. The top five most frequently measured outcome indicators are access to resources, resource well-being, fishery yield, household well-being, and household income. To deal with the diversity of the 52 indicators measured and the different ways these data are collected and analysed, we apply a coding system to capture change over time. The results of the meta-analysis suggest that, overall fisheries co-management delivers benefits to end-users through improvements in key process and outcome indicators. However, the dataset as a whole is constituted primarily of data from the Philippines. When we exclude this body of work, few generalisations can be made about the impact of fisheries co-management. The lack of comparative data suitable for impact assessment and the difficulties in comparing data and generalising across countries and regions reiterates calls in other fields for more systematic approaches to understanding and evaluating governance frameworks. Copyright © 2011 Elsevier Ltd. All rights reserved.

  15. Financing Renewable Energy Projects in Developing Countries: A Critical Review

    Science.gov (United States)

    Donastorg, A.; Renukappa, S.; Suresh, S.

    2017-08-01

    Access to clean and stable energy, meeting sustainable development goals, the fossil fuel dependency and depletion are some of the reasons that have impacted developing countries to transform the business as usual economy to a more sustainable economy. However, access and availability of finance is a major challenge for many developing countries. Financing renewable energy projects require access to significant resources, by multiple parties, at varying points in the project life cycles. This research aims to investigate sources and new trends in financing RE projects in developing countries. For this purpose, a detail and in-depth literature review have been conducted to explore the sources and trends of current RE financial investment and projects, to understand the gaps and limitations. This paper concludes that there are various internal and external sources of finance available for RE projects in developing countries.

  16. Area Handbook Series. Albania: A Country Study

    Science.gov (United States)

    1992-04-01

    inadequa prenal cue, tbe proportion of preature births increse •d from 7 to 11 perent between 197 amd early 1992. Hospits lacked es- sen"h mecidmund erp...were urgently needed to deal with the multiplying number of privately owned cars. Albanian entrepreneurs also 151 Albania: A Country Study imported... entrepreneurs from the reta marketplace. At first, peasants began setting up road- side fruit and vegetables stands or carrying their produce to mar- kets in

  17. Accessibility Guidelines for Astronomy and Astrophysics Meetings

    Science.gov (United States)

    Monkiewicz, Jacqueline; Murphy, Nicholas; Diaz-Merced, Wanda Liz; Aarnio, Alicia; Knierman, Karen; AAS Working Group for Accessibility and Disability

    2018-01-01

    Attendance at meetings and conferences is a critical component of an astronomer's professional life, providing opportunities for presenting one's work, staying current in the field, career networking, and scientific collaboration. Exclusion from these gatherings due to lack of accessibility and accommodation failure is a reality for disabled astronomers, and contributes substantially to low levels of representation in the senior-most levels of the field. We present a preview of the AAS Working Group for Accessibility and Disability's best practice recommendations for meetings accessibility. Applying the principles of universal access and barrier-free design, we model a paradigm of anticipating and removing accessibility barriers in advance, rather than putting the burden of requesting accommodation solely on disabled astronomers and students. We cite several professional and nonprofessional societies identified as meetings accessibility exemplars, and model our guidelines on their best practices. We establish standards for accessibility budgeting, venue choice, publication of policies online, designating point persons, and identifying barriers. We make recommendations for oral and poster presentations, event registration, receptions and banquets, excursions, and other typical conference activities. For meetings which are constrained by fixed budgets and venue choice, we identify a number of low cost/high reward accessibility steps which might still have a large beneficial impact. We likewise provide adapted recommendations for low budget meetings. THIS IS A POSTER LOCATED IN THE AAS BOOTH

  18. Accessing Electronic Journals.

    Science.gov (United States)

    McKay, Sharon Cline

    1999-01-01

    Discusses issues librarians need to consider when providing access to electronic journals. Topics include gateways; index and abstract services; validation and pay-per-view; title selection; integration with OPACs (online public access catalogs)or Web sites; paper availability; ownership versus access; usage restrictions; and services offered…

  19. Open access and beyond

    Directory of Open Access Journals (Sweden)

    Das Chhaya

    2006-09-01

    Full Text Available Abstract Uncensored exchange of scientific results hastens progress. Open Access does not stop at the removal of price and permission barriers; still, censorship and reading disabilities, to name a few, hamper access to information. Here, we invite the scientific community and the public to discuss new methods to distribute, store and manage literature in order to achieve unfettered access to literature.

  20. Lack of concordance in parapneumonic effusion management in children in central Europe.

    Science.gov (United States)

    Hafen, Gaudenz M; Grenzbach, Andrea-Claudia; Moeller, Alexander; Rochat, Mascha K

    2016-04-01

    Treatment of parapneumonic effusion in children remains controversial in the literature and in clinical practice. The aim of this study was to determine whether mutual consensus exists in the diagnosis and treatment of parapneumonic effusion in Central European countries. A questionnaire was sent to all directors of pediatric respiratory units in four adjacent Central European countries (Austria, France, Germany, Switzerland). The response rate was 61.8%. Responses reflected acceptable agreement regarding initial diagnostic procedures, as most centers performed chest X-ray and biological exams, followed by ultrasound, thoracocentesis, or computed tomography. However, antibiotic regimens were very heterogeneous, and the survey revealed complete lack of agreement on the indications and effusion volume threshold for invasive procedures, such as fibrinolytic instillation and thoracoscopy. In conclusion, apart from initial diagnostic procedures, this study showed a lack of mutual consensus among the four countries regarding the management of pediatric parapneumonic effusion. Multicenter prospective trials are clearly needed to acquire more evidence on the management of childhood parapneumonic effusion, enabling the development of evidence-based algorithms that could help to avoid unnecessary examinations with potential long-term side effects, such as radiation exposure at a young age. © 2015 Wiley Periodicals, Inc.

  1. Youth Entrepreneurship in Visegrad Countries

    Directory of Open Access Journals (Sweden)

    Marian Holienka

    2016-12-01

    Full Text Available Objective: The aim of our paper is to analyse the entrepreneurial activity drivers of youth and young adults in Visegrad countries, considering the opportunity/necessity motivation dichotomy. Research Design & Methods: We employ the Global Entrepreneurship Monitor data for young individuals (18 to 34 years from V4 countries for years 2011 to 2013. We use the binomial logistic regression modelling with logit transformation. Separate models are constructed for youth and young adults, as well as for opportunity- and necessity-driven entrepreneurial activity. Findings: We found common drivers and distinctive attributes affecting involvement of young people in business start-up according to its motivation. Self-confidence and access to networks are universally important factors. In most examined cases, fear of failure and being a female reduces chance of business start-up. Especially among youth, being a student significantly inhibits involvement in enterprising efforts. Implications & Recommendations: In order to support youth entrepreneurship, an emphasis should be put on education and training to build skills and knowledge required to business start-up, together with capacity to spot opportunities, and reduce fear of failure.  Also, formal and informal networking plays an important role. Contribution & Value Added: Based on empirical analysis, our findings point out the key drivers of entrepreneurial activity among young people in V4 countries. We show directions for policy makers aiming to foster entrepreneurship within young generation as both way to exploit available business opportunities, as well as reaction to necessity situations.

  2. The SciELO Open Access: A Gold Way from the South

    Science.gov (United States)

    Packer, Abel L.

    2009-01-01

    Open access has long emphasized access to scholarly materials. However, open access can also mean access to the means of producing visible and recognized journals. This issue is particularly important in developing and emergent countries. The SciELO (Scientific Electronic Library On-line) project, first started in Brazil and, shortly afterward, in…

  3. Public opinion: Country comparisons

    Science.gov (United States)

    Hopkins, Debbie

    2015-11-01

    Climate change awareness, risk perception and policy support vary between and within countries. National-scale comparisons can help to explain this variability and be used to develop targeted interventions.

  4. Investment in Developing Countries

    Science.gov (United States)

    Motooka, Takeshi

    1973-01-01

    The fundamental problems of investment in rural education in the present developing countries are analyzed. Needs of rural education are outlined and financial considerations related to investment in the improvement of rural educational programs are discussed. (SM)

  5. Evaluating the relative environmental impact of countries.

    Science.gov (United States)

    Bradshaw, Corey J A; Giam, Xingli; Sodhi, Navjot S

    2010-05-03

    Environmental protection is critical to maintain ecosystem services essential for human well-being. It is important to be able to rank countries by their environmental impact so that poor performers as well as policy 'models' can be identified. We provide novel metrics of country-specific environmental impact ranks - one proportional to total resource availability per country and an absolute (total) measure of impact - that explicitly avoid incorporating confounding human health or economic indicators. Our rankings are based on natural forest loss, habitat conversion, marine captures, fertilizer use, water pollution, carbon emissions and species threat, although many other variables were excluded due to a lack of country-specific data. Of 228 countries considered, 179 (proportional) and 171 (absolute) had sufficient data for correlations. The proportional index ranked Singapore, Korea, Qatar, Kuwait, Japan, Thailand, Bahrain, Malaysia, Philippines and Netherlands as having the highest proportional environmental impact, whereas Brazil, USA, China, Indonesia, Japan, Mexico, India, Russia, Australia and Peru had the highest absolute impact (i.e., total resource use, emissions and species threatened). Proportional and absolute environmental impact ranks were correlated, with mainly Asian countries having both high proportional and absolute impact. Despite weak concordance among the drivers of environmental impact, countries often perform poorly for different reasons. We found no evidence to support the environmental Kuznets curve hypothesis of a non-linear relationship between impact and per capita wealth, although there was a weak reduction in environmental impact as per capita wealth increases. Using structural equation models to account for cross-correlation, we found that increasing wealth was the most important driver of environmental impact. Our results show that the global community not only has to encourage better environmental performance in less

  6. Evaluating the Relative Environmental Impact of Countries

    Science.gov (United States)

    Bradshaw, Corey J. A.; Giam, Xingli; Sodhi, Navjot S.

    2010-01-01

    Environmental protection is critical to maintain ecosystem services essential for human well-being. It is important to be able to rank countries by their environmental impact so that poor performers as well as policy ‘models’ can be identified. We provide novel metrics of country-specific environmental impact ranks – one proportional to total resource availability per country and an absolute (total) measure of impact – that explicitly avoid incorporating confounding human health or economic indicators. Our rankings are based on natural forest loss, habitat conversion, marine captures, fertilizer use, water pollution, carbon emissions and species threat, although many other variables were excluded due to a lack of country-specific data. Of 228 countries considered, 179 (proportional) and 171 (absolute) had sufficient data for correlations. The proportional index ranked Singapore, Korea, Qatar, Kuwait, Japan, Thailand, Bahrain, Malaysia, Philippines and Netherlands as having the highest proportional environmental impact, whereas Brazil, USA, China, Indonesia, Japan, Mexico, India, Russia, Australia and Peru had the highest absolute impact (i.e., total resource use, emissions and species threatened). Proportional and absolute environmental impact ranks were correlated, with mainly Asian countries having both high proportional and absolute impact. Despite weak concordance among the drivers of environmental impact, countries often perform poorly for different reasons. We found no evidence to support the environmental Kuznets curve hypothesis of a non-linear relationship between impact and per capita wealth, although there was a weak reduction in environmental impact as per capita wealth increases. Using structural equation models to account for cross-correlation, we found that increasing wealth was the most important driver of environmental impact. Our results show that the global community not only has to encourage better environmental performance in less

  7. Evaluating the relative environmental impact of countries.

    Directory of Open Access Journals (Sweden)

    Corey J A Bradshaw

    Full Text Available Environmental protection is critical to maintain ecosystem services essential for human well-being. It is important to be able to rank countries by their environmental impact so that poor performers as well as policy 'models' can be identified. We provide novel metrics of country-specific environmental impact ranks - one proportional to total resource availability per country and an absolute (total measure of impact - that explicitly avoid incorporating confounding human health or economic indicators. Our rankings are based on natural forest loss, habitat conversion, marine captures, fertilizer use, water pollution, carbon emissions and species threat, although many other variables were excluded due to a lack of country-specific data. Of 228 countries considered, 179 (proportional and 171 (absolute had sufficient data for correlations. The proportional index ranked Singapore, Korea, Qatar, Kuwait, Japan, Thailand, Bahrain, Malaysia, Philippines and Netherlands as having the highest proportional environmental impact, whereas Brazil, USA, China, Indonesia, Japan, Mexico, India, Russia, Australia and Peru had the highest absolute impact (i.e., total resource use, emissions and species threatened. Proportional and absolute environmental impact ranks were correlated, with mainly Asian countries having both high proportional and absolute impact. Despite weak concordance among the drivers of environmental impact, countries often perform poorly for different reasons. We found no evidence to support the environmental Kuznets curve hypothesis of a non-linear relationship between impact and per capita wealth, although there was a weak reduction in environmental impact as per capita wealth increases. Using structural equation models to account for cross-correlation, we found that increasing wealth was the most important driver of environmental impact. Our results show that the global community not only has to encourage better environmental performance in

  8. Mauritius country study

    Energy Technology Data Exchange (ETDEWEB)

    Manraj, D D [Central Statistical Office (Mauritius)

    1998-10-01

    Mauritius has no known oil, gas or coal reserves but is only endowed with limited renewable energy resources namely hydropower and bagasse. Bagasse represents about one third of the country`s energy requirements and meets almost all of the sugar industries energy demand. Projects identified for mitigation options are: Energy Sector - Renewable Sources (Solar, Wind, Biomass); Transport Sector - Fuel switching and Mass transit transport; Manufacturing Sector - Increase efficiency of energy use in the manufacturing process. (EG)

  9. Inequality in OECD countries.

    Science.gov (United States)

    Thévenot, Celine

    2017-08-01

    This article recalls the state of play of inequality levels and trends in OECD countries, with a special focus on Nordic countries. It sheds light on explaining the drivers of the rise in inequality and its economic consequences. It addresses in particular the issue of redistribution through taxes and transfers. It concludes with an overview of policy packages that should be considered to address the issue of rising inequalities.

  10. Managing Water supply in Developing Countries

    Science.gov (United States)

    Rogers, P. P.

    2001-05-01

    If the estimates are correct that, in the large urban areas of the developing world 30 percent of the population lack access to safe water supply and 50 percent lack access to adequate sanitation, then we are currently faced with 510 million urban residents without access to domestic water and 850 million without access to sanitation. Looking to the year 2020, we will face an additional 1,900 million in need of water and sanitation services. The provision of water services to these billions of people over the next two decades is one of the greatest challenges facing the nations of the world. In addition to future supplies, major problems exist with the management of existing systems where water losses can account for a significant fraction of the water supplied. The entire governance of the water sector and the management of particular systems raise serious questions about the application of the best technologies and the appropriate economic incentive systems. The paper outlines a few feasible technical and economic solutions.

  11. Access and utilization of water and sanitation facilities and their ...

    African Journals Online (AJOL)

    Introduction: Lack of safe water, sanitation and hygiene remains one of the most pressing global health issues of our time. Water and sanitation-related improvements are crucial in meeting the Global Sustainable Development Goals. This study was conducted to determine the access, utilization, and determinants of access ...

  12. Analysis of Rural Farming Households' Access to Credit in Kwara ...

    African Journals Online (AJOL)

    The study showed that co-operative societies, personal savings and rotary loan scheme 'esusu' were the regularly accessible sources of credit. The study also showed that interest rate, type of agricultural enterprise and size of farm had significant relationship with the farmers' access to credit. Lack of collateral security was ...

  13. Access 2013 for dummies

    CERN Document Server

    Ulrich Fuller, Laurie

    2013-01-01

    The easy guide to Microsoft Access returns with updates on the latest version! Microsoft Access allows you to store, organize, view, analyze, and share data; the new Access 2013 release enables you to build even more powerful, custom database solutions that integrate with the web and enterprise data sources. Access 2013 For Dummies covers all the new features of the latest version of Accessand serves as an ideal reference, combining the latest Access features with the basics of building usable databases. You'll learn how to create an app from the Welcome screen, get support

  14. Pro Access 2010 Development

    CERN Document Server

    Collins, Mark

    2011-01-01

    Pro Access 2010 Development is a fundamental resource for developing business applications that take advantage of the features of Access 2010 and the many sources of data available to your business. In this book, you'll learn how to build database applications, create Web-based databases, develop macros and Visual Basic for Applications (VBA) tools for Access applications, integrate Access with SharePoint and other business systems, and much more. Using a practical, hands-on approach, this book will take you through all the facets of developing Access-based solutions, such as data modeling, co

  15. Android Access Control Extension

    Directory of Open Access Journals (Sweden)

    Anton Baláž

    2015-12-01

    Full Text Available The main objective of this work is to analyze and extend security model of mobile devices running on Android OS. Provided security extension is a Linux kernel security module that allows the system administrator to restrict program's capabilities with per-program profiles. Profiles can allow capabilities like network access, raw socket access, and the permission to read, write, or execute files on matching paths. Module supplements the traditional Android capability access control model by providing mandatory access control (MAC based on path. This extension increases security of access to system objects in a device and allows creating security sandboxes per application.

  16. Rail Access to Yucca Mountain: Critical Issues

    International Nuclear Information System (INIS)

    Halstead, R. J.; Dilger, F.; Moore, R. C.

    2003-01-01

    The proposed Yucca Mountain repository site currently lacks rail access. The nearest mainline railroad is almost 100 miles away. Absence of rail access could result in many thousands of truck shipments of spent nuclear fuel and high-level radioactive waste. Direct rail access to the repository could significantly reduce the number of truck shipments and total shipments. The U.S. Department of Energy (DOE) identified five potential rail access corridors, ranging in length from 98 miles to 323 miles, in the Final Environmental Impact Statement (FEIS) for Yucca Mountain. The FEIS also considers an alternative to rail spur construction, heavy-haul truck (HHT) delivery of rail casks from one of three potential intermodal transfer stations. The authors examine the feasibility and cost of the five rail corridors, and DOE's alternative proposal for HHT transport. The authors also address the potential for rail shipments through the Las Vegas metropolitan area

  17. Open Access @ DTU

    DEFF Research Database (Denmark)

    Ekstrøm, Jeannette

    Open Access is high on the agenda in Denmark and internationally. Denmark has announced a national strategy for Open Access that aims to achieve Open Access to 80% in 2017 and 100% in 2022 to peer review research articles. All public Danish funders as well as H2020 requires that all peer review...... articles that is an outcome of their funding will be Open Access. Uploading your full texts (your final author manuscript after review ) to DTU Orbit is a fundamental part of providing Open Access to your research. We are here to answer all your questions with regards to Open Access and related topics...... such as copyright, DTU Orbit, Open Access journals, APCs, Vouchers etc....

  18. Energy policies of IEA countries: 2006 review

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-07-01

    This compilation contains a broad analysis of recent trends and an easily accessible overview of energy policy of the 26 member countries of the International Energy Agency and other key non-member countries such as China, India and Russia, during the last 12 months. The overview section examines trends in energy markets, including an analysis of energy demand and supply, energy prices and energy related CO{sub 2} emissions. It highlights key policy trends across member and non-member countries on energy security, energy market reform, climate change mitigation, energy efficiency, renewables and energy R&D. The book contains a special chapter on energy efficiency, which compares the most successful efficiency policies of member countries on the basis of In-Depth Review findings of the past three years. It also presents the major findings of the World Energy Outlook 2006, key statistical information and brief summaries of major IEA publications released during the past year. In past years summaries of In-Depth Reviews conducted in the cycle covered by this book, as well as Standard Reviews, were published as part of the book. From this year they will only be available from the IEA's website on www.iea.org. Chapter headings are: Executive summary; Energy efficiency; World energy outlook 2006; Energy security; Energy market reform; Climate change; Renewable energy; Technology, research and development; Energy policies in key non-member countries; and Energy balances and key statistical data of IEA countries. 25 figs., 11 tabs., 4 annexes.

  19. Extending AAA operational model for profile-based access control in ethernet-based Neutral Access Networks

    NARCIS (Netherlands)

    Matias, J.; Jacob, E.; Demchenko, Y.; de Laat, C.; Gommans, L.; Macías López, E.M.; Bogliolo, A.; Perry, M.; Ran, M

    2010-01-01

    Neutral Access Networks (NAN) have appeared as a new model to overcome some restrictions and lack of flexibility that are present currently in broadband access networks. NAN brings new business opportunities by opening this market to new stakeholders. Although the NAN model is accepted, there are

  20. The Relationship between of Rural Accessibility and Development

    Directory of Open Access Journals (Sweden)

    Thomas Soseco

    2016-09-01

    Full Text Available Rural accessibility has been an important situation to enhance people living. Lack of access limiting people’s opportunity to not only economic choices but also educational and health aspects. Various studies found that there was a positive relationship between better accessibility and poverty, health, and educational measurements. One indicator to measure accessibility is Rural Access Index (RAI, which developed by The Worldbank. Eventhough Indonesia has quite high RAI, but in realty Indonesia still experience large disparity of road condition in its regions. Accessibility became big problems because it may cause worse effect on wider aspects, for instance health. Health, which proxied by infant mortality rate, is worse in villages with poor acessibility. Thus, government must do adequate efforts to enhance accessibility and at the same time make sure that more villages can gain better access.

  1. Lack of consent for mediation between companies and its reasons

    OpenAIRE

    Karpińska-Królikowska, Iwona

    2011-01-01

    This article discusses commercial mediation, presenting its principles and procedure. It shows the reason why I became interested in the topic of companies’ lack of willingness to solve problems through mediation. It presents empirical statistics from mediation in commercial cases, including those on lack of consents or settlements. The figures are shown against the background of court statistics. On the basis of research conducted in the form of case studies, it presents...

  2. System towards the touristic information sharing amongst portuguese speaking countries

    Directory of Open Access Journals (Sweden)

    M. M. M. Moura

    2008-12-01

    Full Text Available Global and efficient communication has always been a goal to expanding touristic destinations in order to potentiate the growth of the sector and the sustainable development of the regions concerned. With the emergence of the new information technologies, the creation of networks for information sharing became a reality. This facilitated the implementation of benchmarking actions and programs between touristic destinations involved in cooperation projects. The Internet development, as an inexpensive infrastructure, allowed breaking many access barriers faced by many touristic destinations, due to the lack of investment funds in these areas. The inherent cost of design, installation and maintenance of networked computer systems are currently a fraction of the initial implementation cost of a traditional system, even allowing for the standardization of all the technology applied. The article exposes the problematical issues concerning the creation of networks for information sharing and proposes a model for the development of a distributed information system as the support infrastructure to such a network. Thus, the organized exploitation of a decentralized information flow allows the creation of synergies amongst the agents involved and, at the same time, the maximization of the development of the emerging touristic destinations. Such s network towards the sustainable development of the touristic destinations of Portuguese speaking countries of enables the development of processes of continuous enhancement of the global performance, processes that are oriented to the pursuit of competitivity, sustainability and quality of touristic products.

  3. Access to scientific publications: the scientist's perspective.

    Directory of Open Access Journals (Sweden)

    Yegor Voronin

    Full Text Available BACKGROUND: Scientific publishing is undergoing significant changes due to the growth of online publications, increases in the number of open access journals, and policies of funders and universities requiring authors to ensure that their publications become publicly accessible. Most studies of the impact of these changes have focused on the growth of articles available through open access or the number of open-access journals. Here, we investigated access to publications at a number of institutes and universities around the world, focusing on publications in HIV vaccine research--an area of biomedical research with special importance to the developing world. METHODS AND FINDINGS: We selected research papers in HIV vaccine research field, creating: 1 a first set of 50 most recently published papers with keywords "HIV vaccine" and 2 a second set of 200 articles randomly selected from those cited in the first set. Access to the majority (80% of the recently published articles required subscription, while cited literature was much more accessible (67% freely available online. Subscriptions at a number of institutions around the world were assessed for providing access to subscription-only articles from the two sets. The access levels varied widely, ranging among institutions from 20% to 90%. Through the WHO-supported HINARI program, institutes in low-income countries had access comparable to that of institutes in the North. Finally, we examined the response rates for reprint requests sent to corresponding authors, a method commonly used before internet access became widespread. Contacting corresponding authors with requests for electronic copies of articles by email resulted in a 55-60% success rate, although in some cases it took up to 1.5 months to get a response. CONCLUSIONS: While research articles are increasingly available on the internet in open access format, institutional subscriptions continue to play an important role. However

  4. Nuclear Energy is the Answer to Cope with the Lack of Energy and Global Warming

    International Nuclear Information System (INIS)

    Wisnu Arya Wardhana

    2009-01-01

    This paper of nuclear energy is the answer to cope with the lack of energy and global warming based on the analysis of energy demand which is increasing rapidly, meanwhile the energy reserve is limited and decreased. Mostly world′s energy is generated by fossil fuel energy, mainly oil and coal. Fossil fuel energy and industrial activities produce green house gases (GHG) such as : COx, CH 4 , N 2 O, and CFC which cause of global warming. Global warming gives bad impact to environment and to human being. Every country in the world needs sufficient energy, but the energy resources is limited and decreased. The answer for this solution must be an energy source which does not produce green house gases. Why nuclear energy is chosen to cope with the lack of energy and global warming will be explained briefly in this paper. (author)

  5. Appetite and tuberculosis: is the lack of appetite an unidentified risk factor for tuberculosis?

    Science.gov (United States)

    Hernández-Garduño, Eduardo; Pérez-Guzmán, Carlos

    2007-01-01

    Different risk factors have been identified as associated with tuberculosis (TB), an important and common one is malnutrition, however, the causes of malnutrition have not been studied in detail, the lack of food and poverty are among the most frequent in developing countries but others are yet to be identified. We hypothesized that chronic lack of appetite can be one of the causes of malnutrition associated to TB and therefore be a potential independent risk factor for latent tuberculosis infection (LTBI) or TB disease. If this is true, contact subjects with LTBI who have poor appetite will be at higher risk for getting the disease and people with the disease will be at risk for poor treatment outcomes.

  6. Islamic vs Conventional Microfinance Institutions: Performance analysis in MENA countries

    Directory of Open Access Journals (Sweden)

    Ines Ben Abdelkader

    2013-07-01

    Full Text Available Microfinance has been identified as an important policy instrument that allows greater financial and social independence for women and poor by facilitating access to financial services for the poorest and destitute. Microfinance institutions (MFIs have mostly a high concentration of women beneficiaries and aim at alleviation of poverty in all its forms. Accordingly, the principal purpose of microfinance institutions is to be social performing by reducing poverty. However, they have to reconcile this objective with financial performance by trying to be profitable and sustainable. On other side, Islamic Microfinance has progressively growing in the world, particularly in poor countries, as credible alternative which allows poor populations to have access to basic financial services at low cost. The integration of Islamic finance concepts to microfinance was one of the valuable reasons in attracting poor to get advantage of these services. Whereas the complexity of these methods in microfinance and lack of transparency in profit distribution, there are some challenges about their efficiency. It is therefore of utmost interest to consider if the financial performance of Islamic microfinance institutions will be negatively correlated with the depth of outreach. The aim of this paper is to examine the performance of Islamic microfinance institutions in comparison with conventional institutions. This study focuses analysis on the MENA region, where a large proportion of the poor are practicing Muslims and are thus unable to take advantage of traditional microfinance contracts which are incompatible with Sharia’. Using a non parametric data envelopment analysis (DEA to estimate the efficiency of the microfinance institutions, our study provides the empirical evidence from Islamic and conventional microfinance institutions in MENA region.

  7. Ethiopia's accession to the world trade organisation: lessons from ...

    African Journals Online (AJOL)

    This article examines the experiences of least developing countries (LDCs) acceded to World Trade Organisation (WTO) in relation to their accession process, terms of accession and implementation of commitments with a view to drawing lessons which could be relevant to Ethiopia to devise successful strategies and avoid ...

  8. Expanding Access to Insurance by the Poor : Policy, Regulation and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Expanding Access to Insurance by the Poor : Policy, Regulation and Supervision of Micro Insurance. This project aims to facilitate poor people's access to insurance products and services as a means of addressing their vulnerability to risk. It will do so by carrying out case studies in five countries. Potential candidates ...

  9. Electronic resources access and usage among the postgraduates of ...

    African Journals Online (AJOL)

    ... and usage among the postgraduates of a Nigerian University of Technology. ... faced by postgraduates in using e-resources include takes too much time to find, ... Resources, Access, Use, Postgraduat, Students, University, Technology, Nigeria ... By Country · List All Titles · Free To Read Titles This Journal is Open Access.

  10. Planning of Efficient Wireless Access with IEEE 802.16 for Connecting Home Network to the Internet

    Directory of Open Access Journals (Sweden)

    Pichet Ritthisoonthorn

    2010-01-01

    Full Text Available The emergence of IEEE802.16 wireless standard technology (WiMAX has significantly increased the choice to operators for the provisioning of wireless broadband access network. WiMAX is being deployed to compliment with xDSL in underserved or lack of the broadband network area, in both developed and developing countries. Many incumbent operators in developing countries are considering the deployment of WiMAX as part of their broadband access strategy. This paper presents an efficient and simple method for planning of broadband fixed wireless access (BFWA with IEEE802.16 standard to support home connection to Internet. The study formulates the framework for planning both coverage and capacity designs. The relationship between coverage area and access rate from subscriber in each environment area is presented. The study also presents the throughput and channel capacity of IEEE802.16 in different access rates. An extensive analysis is performed and the results are applied to the real case study to demonstrate the practicality of using IEEE 802.16 for connecting home to Internet. Using empirical data and original subscriber traffic from measurement, it is shown that the BFWA with IEEE802.16 standard is a capacity limited system. The capacity of IEEE802.16 is related to different factors including frequency bandwidth, spectrum allocation, estimation of traffic per subscriber, and choice of adaptive modulation from subscriber terminal. The wireless access methods and procedures evolved in this research work and set out in this paper are shown to be well suited for planning BFWA system based on IEEE802.16 which supports broadband home to Internet connections.

  11. CDM Country Guides

    International Nuclear Information System (INIS)

    2005-01-01

    Under the Integrated Capacity Strengthening for the Clean Development Mechanism (ICS-CDM) programme, IGES presents the CDM Country Guides, a series of manuals on CDM project development for Cambodia, China, India, Indonesia, the Philippines, and Thailand. These guidebooks aim at facilitating CDM project developments in Asia by providing essential information to both project developers and potential investors. Chapter 1, Introduction, is a summary of issues that developers and investors in CDM projects should be aware of. Includes tips for readers to effectively use the guidebook to find specific information. Chapter 2, Country Profile, comprises a profile that provides a broad picture of the country, including social, economic, and political information, as well as an overview of the country's energy situation, which is important for project development and investment. Chapter 3, The CDM Project Cycle, gives an explanation of the general CDM project cycle, which includes identifying a project, issuance of carbon credits, requirements, and stakeholders for each process. Chapter 4, Possible CDM Projects in the Country, is an overview of the country's potential resources and sectoral or project type categories that hold potential for CDM projects. Chapter 5, Government Authorities, gives a comprehensive picture of the CDM-related institutional framework and its inter-organisational relationships. Chapter 6, CDM Project Approval Procedures and Requirements Steps, informs about obtaining project approval and its requirements (e.g., country-specific provisions on additionality, sustainable development criteria, and environmental impact assessment) in the host country. Chapter 7, Laws and Regulations, is an overview of basic investment-related laws, environmental and property law, and sector-specific regulations relevant to CDM project activities. Chapter 8, Fiscal and Financing Issues, gives practical information on the financial market in the host country (both

  12. FOREIGN AFFAIRS: Internally Displaced Persons Lack Effective Protection

    National Research Council Canada - National Science Library

    2001-01-01

    Internally displaced persons--those forced to flee their homes because of armed conflict and persecution but who remain within their own country are among the most at-risk, vulnerable populations in the world...

  13. Genetic Diversity of Cowpea (Vigna unguiculata (L.) Walp.) Accession in Kenya Gene Bank Based on Simple Sequence Repeat Markers.

    Science.gov (United States)

    Wamalwa, Emily N; Muoma, John; Wekesa, Clabe

    2016-01-01

    Increased agricultural production is an urgent issue. Projected global population is 9 million people by mid of this century. Estimation projects death of 1 million people for lack of food quality (micronutrient deficit) and quantity (protein deficit). Majority of these people will be living in developing countries. Other global challenges include shrinking cultivable lands, salinity, and flooding due to climate changes, new emerging pathogens, and pests. These affect crop production. Furthermore, they are major threats to crop genetic resources and food security. Genetic diversity in cultivated crops indicates gene pool richness. It is the greatest resource for plant breeders to select lines that enhance food security. This study was conducted by Masinde Muliro University to evaluate genetic diversity in 19 cowpea accessions from Kenya national gene bank. Accessions clustered into two major groups. High divergence was observed between accessions from Ethiopia and Australia and those from Western Kenya. Upper Volta accessions were closely related to those from Western Kenya. Low variation was observed between accessions from Eastern and Rift Valley than those from Western and Coastal regions of Kenya. Diversity obtained in this study can further be exploited for the improvement of cowpea in Kenya as a measure of food security.

  14. Genetic Diversity of Cowpea (Vigna unguiculata (L. Walp. Accession in Kenya Gene Bank Based on Simple Sequence Repeat Markers

    Directory of Open Access Journals (Sweden)

    Emily N. Wamalwa

    2016-01-01

    Full Text Available Increased agricultural production is an urgent issue. Projected global population is 9 million people by mid of this century. Estimation projects death of 1 million people for lack of food quality (micronutrient deficit and quantity (protein deficit. Majority of these people will be living in developing countries. Other global challenges include shrinking cultivable lands, salinity, and flooding due to climate changes, new emerging pathogens, and pests. These affect crop production. Furthermore, they are major threats to crop genetic resources and food security. Genetic diversity in cultivated crops indicates gene pool richness. It is the greatest resource for plant breeders to select lines that enhance food security. This study was conducted by Masinde Muliro University to evaluate genetic diversity in 19 cowpea accessions from Kenya national gene bank. Accessions clustered into two major groups. High divergence was observed between accessions from Ethiopia and Australia and those from Western Kenya. Upper Volta accessions were closely related to those from Western Kenya. Low variation was observed between accessions from Eastern and Rift Valley than those from Western and Coastal regions of Kenya. Diversity obtained in this study can further be exploited for the improvement of cowpea in Kenya as a measure of food security.

  15. The impact of mobile phones on knowledge access and transfer of small-scale horticultural farmers in Tanzania

    Directory of Open Access Journals (Sweden)

    Krone, Madlen

    2014-09-01

    Full Text Available Agriculture is the main economic activity in Tanzania and the country´s largest employer, providing livelihood for at least 80 % of the economically active population. Many studies have identified key challenges facing the sector for Africa in general – among these lack of access to knowledge. For agricultural producers, access to knowledge is important for an improved productivity and competitiveness. The fast diffusion of information and communication technologies (ICT such as mobile phones across Africa in the last years has resulted in an improved access and transfer of agricultural knowledge. Studies have shown that rural actors like farmers in remote areas even use mobile phones for their farming business. Based on qualitative interviews in the Mwanza Region in northwestern Tanzania, this study aims to identify and categorise the different types of knowledge which are transferred via mobile phones. Our results show that mobile phones enlarge the ability of farmers to access business-relevant knowledge at an increasing spatial scale. However, the effects of the use depend on the type of knowledge and other factors. The results add to existing studies by deepening the understanding of the benefits of ICT on knowledge access and transfer for the context of rural small-scale framers in Tanzania.

  16. WTO Accession: Tough love or a heavy hand? | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2011-01-31

    Jan 31, 2011 ... Thirty-one countries from war-torn Afghanistan to Yemen are ... the body created to consider would-be members' applications. .... For a poor country the size of Cambodia, market access is the key to attracting the foreign ...

  17. Socio-economic challenges of rural telecommunication access ...

    African Journals Online (AJOL)

    There has been growing interest on how to provide universal telecommunication access in developing countries. The trend in digital divide between the rural and urban areas for developing countries reveals a growing gap. In this paper, we discussed from a socioeconomic perspective, the various challenges facing the ...

  18. Poverty, Access to Health Care Services and Human Capital ...

    African Journals Online (AJOL)

    The paper is aimed at examining the poverty profile of Nigeria and its consequences on access to health care services and human capital development in the country. It is a startling paradox that about two – thirds of Nigerians are poor despite living in a country with vast potential wealth. Apart from looking at the theoretical ...

  19. Social and cultural issues in organ transplantation in Islamic countries.

    Science.gov (United States)

    Shaheen, Faissal A M; Al-Jondeby, Mohammad; Kurpad, Ramprasad; Al-Khader, Abdullah A

    2004-01-01

    The importance of religion In Islamic countries is undoubted. Fatwas (opinion from religious scholars) have been passed in most Islamic countries approving the concepts of brain death and organ transplantation. There are some specific points that have be considered while talking of organ transplantation in Islamic countries. They include public attitude, taking organ(s) from donors who have committed suicide, the influence of local Imams as well as feeding breast milk, concept of spousal donation, timing of death as well as soul departure and extended families that exist in these countries. Sound knowledge of these factors is mandatory to any transplant coordinator and lack of sensitivity to these issues could be disastrous.

  20. Non-agricultural Market Access: A South Asian Perspective

    OpenAIRE

    A. R. Kemal; Musleh-ud Din; Ejaz Ghani

    2005-01-01

    A key element of the Doha Round of trade negotiations is liberalisation of trade in industrial products, commonly known as non-agricultural market access (NAMA). These negotiations are important for developing countries as these will determine the market access opportunities through which they can improve their growth prospects. This paper examines the key issues of NAMA from the South Asian perspective, outlines a negotiating strategy for increased market access, and spells out some policy i...

  1. How Do Countries' Health Information Systems Perform in Assessing Asylum Seekers' Health Situation? Developing a Health Information Assessment Tool on Asylum Seekers (HIATUS) and Piloting It in Two European Countries.

    Science.gov (United States)

    Bozorgmehr, Kayvan; Goosen, Simone; Mohsenpour, Amir; Kuehne, Anna; Razum, Oliver; Kunst, Anton E

    2017-08-08

    Background: Accurate data on the health status, health behaviour and access to health care of asylum seekers is essential, but such data is lacking in many European countries. We hence aimed to: (a) develop and pilot-test an instrument that can be used to compare and benchmark the country health information systems (HIS) with respect to the ability to assess the health status and health care situation of asylum seekers and (b) present the results of that pilot for The Netherlands (NL) and Germany (DE). Materials and Methods : Reviewing and adapting existing tools, we developed a Health Information Assessment Tool on Asylum Seekers (HIATUS) with 50 items to assess HIS performance across three dimensions: (1) availability and detail of data across potential data sources; (2) HIS resources and monitoring capacity; (3) general coverage and timeliness of publications on selected indicators. We piloted HIATUS by applying the tool to the HIS in DE and NL. Two raters per country independently assessed the performance of country HIS and the inter-rater reliability was analysed by Pearson's rho and the intra-class correlation (ICC). We then applied a consensus-based group rating to obtain the final ratings which were transformed into a weighted summary score (range: 0-97). We assessed HIS performance by calculating total and domain-specific HIATUS scores by country as well as absolute and relative gaps in scores within and between countries. Results : In the independent rating, Pearson's rho was 0.14 (NL) and 0.30 (DE), the ICC yielded an estimated reliability of 0.29 (NL) and 0.83 (DE) respectively. In the final consensus-based rating, the total HIATUS score was 47 in NL and 15 in DE, translating into a relative gap in HIS capacity of 52% (NL) and 85% (DE) respectively. Shortfalls in HIS capacity in both countries relate to the areas of HIS coordination, planning and policies, and to limited coverage of specific indicators such as self-reported health, mental health, socio

  2. Establishing a baseline to measure change in political will and the use of data for decision-making in maternal and newborn health in six African countries.

    Science.gov (United States)

    Nove, Andrea; Hulton, Louise; Martin-Hilber, Adriane; Matthews, Zoe

    2014-10-01

    The Evidence for Action (E4A) program assumes that both resource allocation and quality of care can improve via a strategy that combines evidence and advocacy to stimulate accountability. The present paper explains the methods used to collect baseline monitoring data using two tools developed to inform program design in six focus countries. The first tool is designed to understand the extent to which decision-makers have access to the data they need, when they need it, and in meaningful formats, and then to use the data to prioritize, plan, and allocate resources. The second tool seeks the views of people working in the area of maternal and newborn health (MNH) about political will, including: quality of care, the political and financial priority accorded to MNH, and the extent to which MNH decision-makers are accountable to service users. Findings indicate significant potential to improve access to and use of data for decision-making, particularly at subnational levels. Respondents across all six program countries reported lack of access by ordinary citizens to information on the health and MNH budget, and data on MNH outcomes. In all six countries there was a perceived inequity in the distribution of resources and a perception that politicians do not fully understand the priorities of their constituents. Copyright © 2014. Published by Elsevier Ireland Ltd.

  3. Where do poor women in developing countries give birth? A multi-country analysis of demographic and health survey data.

    Science.gov (United States)

    Montagu, Dominic; Yamey, Gavin; Visconti, Adam; Harding, April; Yoong, Joanne

    2011-02-28

    In 2008, over 300,000 women died during pregnancy or childbirth, mostly in poor countries. While there are proven interventions to make childbirth safer, there is uncertainty about the best way to deliver these at large scale. In particular, there is currently a debate about whether maternal deaths are more likely to be prevented by delivering effective interventions through scaled up facilities or via community-based services. To inform this debate, we examined delivery location and attendance and the reasons women report for giving birth at home. We conducted a secondary analysis of maternal delivery data from Demographic and Health Surveys in 48 developing countries from 2003 to the present. We stratified reported delivery locations by wealth quintile for each country and created weighted regional summaries. For sub-Saharan Africa (SSA), where death rates are highest, we conducted a subsample analysis of motivations for giving birth at home. In SSA, South Asia, and Southeast Asia, more than 70% of all births in the lowest two wealth quintiles occurred at home. In SSA, 54.1% of the richest women reported using public facilities compared with only 17.7% of the poorest women. Among home births in SSA, 56% in the poorest quintile were unattended while 41% were attended by a traditional birth attendant (TBA); 40% in the wealthiest quintile were unattended, while 33% were attended by a TBA. Seven per cent of the poorest women reported cost as a reason for not delivering in a facility, while 27% reported lack of access as a reason. The most common reason given by both the poorest and richest women for not delivering in a facility was that it was deemed "not necessary" by a household decision maker. Among the poorest women, "not necessary" was given as a reason by 68% of women whose births were unattended and by 66% of women whose births were attended. In developing countries, most poor women deliver at home. This suggests that, at least in the near term, efforts to

  4. Where do poor women in developing countries give birth? A multi-country analysis of demographic and health survey data.

    Directory of Open Access Journals (Sweden)

    Dominic Montagu

    2011-02-01

    Full Text Available In 2008, over 300,000 women died during pregnancy or childbirth, mostly in poor countries. While there are proven interventions to make childbirth safer, there is uncertainty about the best way to deliver these at large scale. In particular, there is currently a debate about whether maternal deaths are more likely to be prevented by delivering effective interventions through scaled up facilities or via community-based services. To inform this debate, we examined delivery location and attendance and the reasons women report for giving birth at home.We conducted a secondary analysis of maternal delivery data from Demographic and Health Surveys in 48 developing countries from 2003 to the present. We stratified reported delivery locations by wealth quintile for each country and created weighted regional summaries. For sub-Saharan Africa (SSA, where death rates are highest, we conducted a subsample analysis of motivations for giving birth at home. In SSA, South Asia, and Southeast Asia, more than 70% of all births in the lowest two wealth quintiles occurred at home. In SSA, 54.1% of the richest women reported using public facilities compared with only 17.7% of the poorest women. Among home births in SSA, 56% in the poorest quintile were unattended while 41% were attended by a traditional birth attendant (TBA; 40% in the wealthiest quintile were unattended, while 33% were attended by a TBA. Seven per cent of the poorest women reported cost as a reason for not delivering in a facility, while 27% reported lack of access as a reason. The most common reason given by both the poorest and richest women for not delivering in a facility was that it was deemed "not necessary" by a household decision maker. Among the poorest women, "not necessary" was given as a reason by 68% of women whose births were unattended and by 66% of women whose births were attended.In developing countries, most poor women deliver at home. This suggests that, at least in the near term

  5. Where Do Poor Women in Developing Countries Give Birth? A Multi-Country Analysis of Demographic and Health Survey Data

    Science.gov (United States)

    Montagu, Dominic; Yamey, Gavin; Visconti, Adam; Harding, April; Yoong, Joanne

    2011-01-01

    Background In 2008, over 300,000 women died during pregnancy or childbirth, mostly in poor countries. While there are proven interventions to make childbirth safer, there is uncertainty about the best way to deliver these at large scale. In particular, there is currently a debate about whether maternal deaths are more likely to be prevented by delivering effective interventions through scaled up facilities or via community-based services. To inform this debate, we examined delivery location and attendance and the reasons women report for giving birth at home. Methodology/Principal Findings We conducted a secondary analysis of maternal delivery data from Demographic and Health Surveys in 48 developing countries from 2003 to the present. We stratified reported delivery locations by wealth quintile for each country and created weighted regional summaries. For sub-Saharan Africa (SSA), where death rates are highest, we conducted a subsample analysis of motivations for giving birth at home. In SSA, South Asia, and Southeast Asia, more than 70% of all births in the lowest two wealth quintiles occurred at home. In SSA, 54.1% of the richest women reported using public facilities compared with only 17.7% of the poorest women. Among home births in SSA, 56% in the poorest quintile were unattended while 41% were attended by a traditional birth attendant (TBA); 40% in the wealthiest quintile were unattended, while 33% were attended by a TBA. Seven per cent of the poorest women reported cost as a reason for not delivering in a facility, while 27% reported lack of access as a reason. The most common reason given by both the poorest and richest women for not delivering in a facility was that it was deemed “not necessary” by a household decision maker. Among the poorest women, “not necessary” was given as a reason by 68% of women whose births were unattended and by 66% of women whose births were attended. Conclusions In developing countries, most poor women deliver at home

  6. Country report: a methodology

    International Nuclear Information System (INIS)

    Colin, A.

    2013-01-01

    This paper describes a methodology which could be applicable to establish a country report. In the framework of nuclear non proliferation appraisal and IAEA safeguards implementation, it is important to be able to assess the potential existence of undeclared nuclear materials and activities as undeclared facilities in the country under review. In our views a country report should aim at providing detailed information on nuclear related activities for each country examined taken 'as a whole' such as nuclear development, scientific and technical capabilities, etc. In order to study a specific country, we need to know if there is already an operating nuclear civil programme or not. In the first case, we have to check carefully if it could divert nuclear material, if there are misused declared facilities or if they operate undeclared facilities and conduct undeclared activities aiming at manufacturing nuclear weapon. In the second case, we should pay attention to the development of a nuclear civil project. A country report is based on a wide span of information (most of the time coming from open sources but sometimes coming also from confidential or private ones). Therefore, it is important to carefully check the nature and the credibility (reliability?) of these sources through cross-check examination. Eventually, it is necessary to merge information from different sources and apply an expertise filter. We have at our disposal a lot of performing tools to help us to assess, understand and evaluate the situation (cartography, imagery, bibliometry, etc.). These tools allow us to offer the best conclusions as far as possible. The paper is followed by the slides of the presentation. (author)

  7. Migrants' access to healthcare

    DEFF Research Database (Denmark)

    Norredam, Marie

    2011-01-01

    There are strong pragmatic and moral reasons for receiving societies to address access to healthcare for migrants. Receiving societies have a pragmatic interest in sustaining migrants' health to facilitate integration; they also have a moral obligation to ensure migrants' access to healthcare...... according to international human rights principles. The intention of this thesis is to increase the understanding of migrants' access to healthcare by exploring two study aims: 1) Are there differences in migrants' access to healthcare compared to that of non-migrants? (substudy I and II); and 2) Why...... are there possible differences in migrants' access to healthcare compared to that of non-migrants? (substudy III and IV). The thesis builds on different methodological approaches using both register-based retrospective cohort design, cross-sectional design and survey methods. Two different measures of access were...

  8. Tales From Two Countries

    DEFF Research Database (Denmark)

    Ooi, Can-Seng

    2006-01-01

    Place branding has become popular. Places brand themselves to attract tourists, talented foreign workers, investments and businesses. The brand accentuates the positive characteristics of the place; it frames the society and sells its cultures. In the context of tourism, this paper examines...... to present a prevailing reality. To the Danes, the brand is descriptive and should portray the country in a positive and accurate manner. To the Singaporeans, the brand is normative and a vision of what Singaporean society ought to become. These countries share common goals when branding themselves...

  9. Country report Egypt 1993

    International Nuclear Information System (INIS)

    1993-07-01

    The 'Laenderberichte' (country reports), published at irregular intervals, give detailed information on the economic and social structure and development of the country discussed. Extensive tables with a highly specific classification contain data on population and economics, also for longer periods of time. The data appear in a detailed text part with maps, illustrations and tables. There are tables on: Territory and population, health services, social affairs, education and culture, employment, agriculture and forestry, fishery, manufacturing industry, civil engineering, inland trade, external trade, transportation, money and credits, investments, prices and wages, supply and consumption, total balance of national economy. (orig.) [de

  10. Country report Belgium 1993

    International Nuclear Information System (INIS)

    1993-09-01

    The 'Laenderberichte' (country reports), published at irregular intervals, give detailed information on the economic and social structure and development of the country discussed. Extensive tables with a highly specific classification contain data on population and economics, also for longer periods of time. The data appear in a detailed text part with maps, illustrations and tables. There are tables on: Territory and population, health services, social affairs, education and culture, employment, agriculture and forestry, fishery, manufacturing industry, civil engineering, inland trade, external trade, transportation, money and credits, investments, prices and wages, supply and consumption, total balance of national economy. (orig.) [de

  11. Country report Belarus 1994

    International Nuclear Information System (INIS)

    1994-09-01

    The 'Laenderberichte' (country reports), published at irregular intervals, give detailed information on the economic and social structure and development of the country discussed. Extensive tables with a highly specific classification contain data on population and economics, also for longer periods of time. The data appear in a detailed text part with maps, illustrations and tables. There are tables on: Territory and population, health services, social affairs, education and culture, employment, agriculture and forestry, fishery, manufacturing industry, civil engineering, inland trade, external trade, transportation, money and credits, investments, prices and wages, supply and consumption, total balance of national economy. (orig.) [de

  12. Country report Brazil 1994

    International Nuclear Information System (INIS)

    1994-09-01

    The 'Laenderberichte' (country reports), published at irregular intervals, give detailed information on the economic and social structure and development of the country discussed. Extensive tables with a highly specific classification contain data on population and economics, also for longer periods of time. The data appear in a detailed text part with maps, illustrations and tables. There are tables on: Territory and population, health services, social affairs, education and culture, employment, agriculture and forestry, fishery, manufacturing industry, civil engineering, inland trade, external trade, transportation, money and credits, investments, prices and wages, supply and consumption, total balance of national economy. (orig.) [de

  13. Mental health provision in schools: approaches and interventions in 10 European countries.

    Science.gov (United States)

    Patalay, P; Gondek, D; Moltrecht, B; Giese, L; Curtin, C; Stanković, M; Savka, N

    2017-01-01

    The role of schools in providing community-based support for children's mental health and well-being is widely accepted and encouraged. Research has mainly focused on designing and evaluating specific interventions and there is little data available regarding what provision is available, the focus and priorities of schools and the professionals involved in providing this support. The current study presents these data from schools in 10 European countries. Online survey of 1466 schools in France, Germany, Ireland, Netherlands, Poland, Serbia, Spain, Sweden, UK and Ukraine. The participating countries were chosen based on their geographical spread, diversity of political and economic systems, and convenience in terms of access to the research group and presence of collaborators. Schools reported having more universal provision than targeted provision and there was greater reported focus on children who already have difficulties compared with prevention of problems and promotion of student well-being. The most common interventions implemented related to social and emotional skills development and anti-bullying programmes. Learning and educational support professionals were present in many schools with fewer schools reporting involvement of a clinical specialist. Responses varied by country with 7.4-33.5% between-country variation across study outcomes. Secondary schools reported less support for parents and more for staff compared with primary schools, with private schools also indicating more staff support. Schools in rural locations reported less student support and professionals involved than schools in urban locations. The current study provides up-to-date and cross-country insight into the approaches, priorities and provision available for mental health support in schools; highlighting what schools prioritise in providing mental health support and where coverage of provision is lacking.

  14. Key policy considerations for facilitating low carbon technology transfer to developing countries

    International Nuclear Information System (INIS)

    Ockwell, David G.; Watson, Jim; MacKerron, Gordon; Pal, Prosanto; Yamin, Farhana

    2008-01-01

    Based on Phase I of a UK-India collaborative study, this paper analyses two case studies of low carbon technologies-hybrid vehicles and coal-fired power generation via integrated gasification combined cycle (IGCC). The analysis highlights the following six key considerations for the development of policy aimed at facilitating low carbon technology transfer to developing countries: (1) technology transfer needs to be seen as part of a broader process of sustained, low carbon technological capacity development in recipient countries; (2) the fact that low carbon technologies are at different stages of development means that low carbon technology transfer involves both vertical transfer (the transfer of technologies from the R and D stage through to commercialisation) and horizontal transfer (the transfer from one geographical location to another). Barriers to transfer and appropriate policy responses often vary according to the stage of technology development as well as the specific source and recipient country contexts; (3) less integrated technology transfer arrangements, involving, for example, acquisition of different items of plant from a range of host country equipment manufacturers, are more likely to involve knowledge exchange and diffusion through recipient country economies; (4) recipient firms that, as part of the transfer process, strategically aim to obtain technological know-how and knowledge necessary for innovation during the transfer process are more likely to be able to develop their capacity as a result; (5) whilst access to Intellectual Property Rights (IPRs) may sometimes be a necessary part of facilitating technology transfer, it is not likely to be sufficient in itself. Other factors such as absorptive capacity and risks associated with new technologies must also be addressed; (6) there is a central role for both national and international policy interventions in achieving low carbon technology transfer. The lack of available empirical analysis

  15. Access Data Analysis Cookbook

    CERN Document Server

    Bluttman, Ken

    2008-01-01

    This book offers practical recipes to solve a variety of common problems that users have with extracting Access data and performing calculations on it. Whether you use Access 2007 or an earlier version, this book will teach you new methods to query data, different ways to move data in and out of Access, how to calculate answers to financial and investment issues, how to jump beyond SQL by manipulating data with VBA, and more.

  16. Strategic Accessibility Competition

    OpenAIRE

    Bacchiega, Emanuele; Randon, Emanuela; Zirulia, Lorenzo

    2010-01-01

    We analyze the effect of competition in market-accessibility enhancement among quality-differentiated firms. Firms are located in regions with different ex-ante transport costs to reach the final market. We characterize the equilibrium of the two-stage game in which firms first invest to improve market accessibility and then compete in prices. Efforts in accessibility improvement crucially depend on the interplay between the willingness to pay for the quality premium of the median consumer an...

  17. Are PDF Documents Accessible?

    Directory of Open Access Journals (Sweden)

    Mireia Ribera Turró

    2008-09-01

    Full Text Available Adobe PDF is one of the most widely used formats in scientific communications and in administrative documents. In its latest versions it has incorporated structural tags and improvements that increase its level of accessibility. This article reviews the concept of accessibility in the reading of digital documents and evaluates the accessibility of PDF according to the most widely established standards.

  18. Open Access Monitor - DK

    DEFF Research Database (Denmark)

    Svendsen, Michael; Hansen, Lars Asger Juel; Andersen, Dorte

    2017-01-01

    Open Access Monitor - DK (OAM-DK) is a 2-year DEFF funded [DEFF.2016-0018] national project running in 2017-2018 with the aim of collecting, documenting and administrating Open Access publishing costs. OAM-DK is lead by Copenhagen University Library under the Royal Danish Library with participation...... of all Danish University Libraries. This poster presents the first results of Open Access costs related to 2015 publications at the The University of Copenhagen....

  19. [Risk sharing methods in middle income countries].

    Science.gov (United States)

    Inotai, András; Kaló, Zoltán

    2012-01-01

    The pricing strategy of innovative medicines is based on the therapeutic value in the largest pharmaceutical markets. The cost-effectiveness of new medicines with value based ex-factory price is justifiable. Due to the international price referencing and parallel trade the ex-factory price corridor of new medicines has been narrowed in recent years. Middle income countries have less negotiation power to change the narrow drug pricing corridor, although their fair intention is to buy pharmaceuticals at lower price from their scarce public resources compared to higher income countries. Therefore the reimbursement of new medicines at prices of Western-European countries may not be justifiable in Central-Eastern European countries. Confidential pricing agreements (i.e. confidential price discounts, claw-back or rebate) in lower income countries of the European Union can alleviate this problem, as prices of new medicines can be adjusted to local purchasing power without influencing the published ex-factory price and so the accessibility of patients to these drugs in other countries. In order to control the drug budget payers tend to apply financial risk sharing agreements for new medicines in more and more countries to shift the consequences of potential overspending to pharmaceutical manufacturers. The major paradox of financial risk-sharing schemes is that increased mortality, poor persistence of patients, reduced access to healthcare providers, and no treatment reduce pharmaceutical spending. Consequently, payers have started to apply outcome based risk sharing agreements for new medicines recently to improve the quality of health care provision. Our paper aims to review and assess the published financial and outcome based risk sharing methods. Introduction of outcome based risk-sharing schemes can be a major advancement in the drug reimbursement strategy of payers in middle income countries. These schemes can help to reduce the medical uncertainty in coverage

  20. Applying a Total Market Lens: Increased IUD Service Delivery Through Complementary Public- and Private-Sector Interventions in 4 Countries

    Science.gov (United States)

    White, Julia N; Corker, Jamaica

    2016-01-01

    ABSTRACT Increasing access to the intrauterine device (IUD), as part of a comprehensive method mix, is a key strategy for reducing unintended pregnancy and maternal mortality in low-income countries. To expand access to IUDs within the framework of informed choice, Population Services International (PSI) has historically supported increased IUD service delivery through private providers. In applying a total market lens to better understand the family planning market and address major market gaps, PSI identified a lack of high-quality public provision of IUDs. In 2013, PSI started a pilot in 4 countries (Guatemala, Laos, Mali, and Uganda) to grow public-provider IUD service delivery through increased public-sector engagement while maintaining its ongoing focus on private providers. In collaboration with country governments, PSI affiliates carried out family planning market analyses in the 4 pilot countries to identify gaps in IUD service delivery and create sustainable strategies for scaling up IUD services in the public sector. Country-specific interventions to increase service delivery were implemented across all levels of the public health system, including targeted advocacy at the national level to promote government ownership and program sustainability. Mechanisms to ensure government ownership were built into the program design, including a proof-of-concept approach to convince governments of the feasibility and value of taking over and scaling up interventions. In the first 2 years of the pilot (2013–2014), 102,055 IUD services were provided to women at 417 targeted public-sector facilities. These preliminary results suggest that there is untapped demand for IUD service delivery in the public sector that can be met in part through greater participation of the public sector in family planning and IUD provision. PMID:27540122