Health is important to economic development, and economic development has an important impact on health outcomes. Health Expenditure makes up a substantial part of the global economy. In the world, the costs of health...Health is important to economic development, and economic development has an important impact on health outcomes. Health Expenditure makes up a substantial part of the global economy. In the world, the costs of healthcare are increasing;patients are compelled to pay more for treatment, and that makes a lot of people faced to Catastrophic Health Expenditures (CHE) and in long run fall below the poverty line. One of the most urgent and vexing challenges faced by many low- and middle-income countries is how to provide health care for the more than two billion poor people who live in these areas (developing countries). As much as more than 65% (in 2014) of total private health care expenditure in low-income countries comes from out-of-pocket payment by patients. In addition, according to World Bank report (2007), in low and lower middle-income countries was speared nearly 13% of global health spending with 87% the global disease burden. The WHO considers health financing models with high risk pooled, such as health insurance and prepaid schemes, a promising means for achieving universal health-care coverage and promotion health care. A crucial concept in health financing is that of pooling. The WHO defines risk-pooling as the “accumulation and management of revenues in such a way as to ensure that the risk of having to pay for health care is borne by all members of the pool and not by each contributor individually”. The larger degree of pooling, the less people will have to bear the health financial risks. Furthermore, adopting and operating financing policies based on greeter risk pooling/sharing (prepayments) are recommended to all countries (especially in low and lower-middle income countries). It means risk sharing/pooling plays a key role in all financing systems for achieving effectiveness and efficiency health systems.展开更多
Liver disease in human immunodeficiency virus(HIV)-infected individuals encompasses the spectrum from abnormal liver function tests,liver decompensation,with and without evidence of cirrhosis on biopsy,to non-alcoholi...Liver disease in human immunodeficiency virus(HIV)-infected individuals encompasses the spectrum from abnormal liver function tests,liver decompensation,with and without evidence of cirrhosis on biopsy,to non-alcoholic liver disease and its more severe form,non-alcoholic steatohepatitis and hepatocellular cancer.HIV can infect multiple cells in the liver,leading to enhanced intrahepatic apoptosis,activation and fibrosis.HIV can also alter gastro-intestinal tract permeability,leading to increased levels of circulating lipopolysaccharide that may have an impact on liver function.This review focuses on recent changes in the epidemiology,pathogenesis and clinical presentation of liver disease in HIV-infected patients,in the absence of co-infection with hepatitis B virus or hepatitis C virus,with a specific focus on issues relevant to low and middle income countries.展开更多
Nosocomial or hospital acquired infections are a major challenge for low and middle income countries (LMICs) which have limited healthcare resources. Risk factors include the lack of appropriate hospital facilities su...Nosocomial or hospital acquired infections are a major challenge for low and middle income countries (LMICs) which have limited healthcare resources. Risk factors include the lack of appropriate hospital facilities such as isolation units, bed space, and sinks;inadequate waste management, contaminated equipment, inappropriate use of antibiotics and transmission of infection from the hands of healthcare workers and family caretakers due to inadequate hand washing. Nosocomial infections increase the costs of healthcare due to added antimicrobial treatment and prolonged hospitalization. Since the prevalence of nosocomial infections is generally higher in developing countries with limited resources, the socio-economic burden is even more severe in these countries. This review summarizes the current knowledge on the risks of hospital acquired infections and summarizes current recommendations for the development of hospital infrastructure and the institution of protocols to reduce these infections in LMICs such as Bangladesh.展开更多
<strong><em>Background</em>:</strong> The purpose of this paper is to report the perceptions of continuous professional development by the nurses and midwives in a low resource country. These f...<strong><em>Background</em>:</strong> The purpose of this paper is to report the perceptions of continuous professional development by the nurses and midwives in a low resource country. These findings are part of a larger study on the experiences of nurses and midwives providing postpartum care in rural areas of Kenya. Besides being the main healthcare providers in rural areas, nurses in low resource countries have limited access to continuous professional development. <strong><em>Research design</em>:</strong> This is a qualitative research guided by critical theory and Foucault’s concepts of power and knowledge. Focused ethnography provided the framework of data collection and analysis. 23 in-depth interviews were contacted, and thematic analysis was used for data analysis. Reflexive memos kept throughout the research process helped to ensure the trustworthiness of data. <strong><em>Findings</em>:</strong> This paper will focus on the theme of continuing professional development (CPD) as a resource for a healthy work environment. While the knowledge of the nurses and midwives allowed them to provide care to the mothers and their infants adequately, personal and structural barriers prevented them from participating in continuing professional development. <strong><em>Discussion and Conclusion</em>:</strong> A well-prepared nursing and midwifery workforce could have the capacity to transform the health outcomes of their clients through the application of evidence-based practices. Therefore, courses that are context-appropriate and meet the needs of different learners should be available to support the nurses’ and midwives’ professional growth. There is a need for more research on the nurses’ and midwives’ participation in CPD in Kenya, and the effect of CPD on specific health outcomes.展开更多
文摘Health is important to economic development, and economic development has an important impact on health outcomes. Health Expenditure makes up a substantial part of the global economy. In the world, the costs of healthcare are increasing;patients are compelled to pay more for treatment, and that makes a lot of people faced to Catastrophic Health Expenditures (CHE) and in long run fall below the poverty line. One of the most urgent and vexing challenges faced by many low- and middle-income countries is how to provide health care for the more than two billion poor people who live in these areas (developing countries). As much as more than 65% (in 2014) of total private health care expenditure in low-income countries comes from out-of-pocket payment by patients. In addition, according to World Bank report (2007), in low and lower middle-income countries was speared nearly 13% of global health spending with 87% the global disease burden. The WHO considers health financing models with high risk pooled, such as health insurance and prepaid schemes, a promising means for achieving universal health-care coverage and promotion health care. A crucial concept in health financing is that of pooling. The WHO defines risk-pooling as the “accumulation and management of revenues in such a way as to ensure that the risk of having to pay for health care is borne by all members of the pool and not by each contributor individually”. The larger degree of pooling, the less people will have to bear the health financial risks. Furthermore, adopting and operating financing policies based on greeter risk pooling/sharing (prepayments) are recommended to all countries (especially in low and lower-middle income countries). It means risk sharing/pooling plays a key role in all financing systems for achieving effectiveness and efficiency health systems.
基金Supported by An NHMRC Practitioner Fellowship to Lewin SRan am FAR Mathilde Krim Fellowship in Basic Biomedical Science to Crane Man NHMRC postgraduate scholarship to Iser D
文摘Liver disease in human immunodeficiency virus(HIV)-infected individuals encompasses the spectrum from abnormal liver function tests,liver decompensation,with and without evidence of cirrhosis on biopsy,to non-alcoholic liver disease and its more severe form,non-alcoholic steatohepatitis and hepatocellular cancer.HIV can infect multiple cells in the liver,leading to enhanced intrahepatic apoptosis,activation and fibrosis.HIV can also alter gastro-intestinal tract permeability,leading to increased levels of circulating lipopolysaccharide that may have an impact on liver function.This review focuses on recent changes in the epidemiology,pathogenesis and clinical presentation of liver disease in HIV-infected patients,in the absence of co-infection with hepatitis B virus or hepatitis C virus,with a specific focus on issues relevant to low and middle income countries.
文摘Nosocomial or hospital acquired infections are a major challenge for low and middle income countries (LMICs) which have limited healthcare resources. Risk factors include the lack of appropriate hospital facilities such as isolation units, bed space, and sinks;inadequate waste management, contaminated equipment, inappropriate use of antibiotics and transmission of infection from the hands of healthcare workers and family caretakers due to inadequate hand washing. Nosocomial infections increase the costs of healthcare due to added antimicrobial treatment and prolonged hospitalization. Since the prevalence of nosocomial infections is generally higher in developing countries with limited resources, the socio-economic burden is even more severe in these countries. This review summarizes the current knowledge on the risks of hospital acquired infections and summarizes current recommendations for the development of hospital infrastructure and the institution of protocols to reduce these infections in LMICs such as Bangladesh.
文摘<strong><em>Background</em>:</strong> The purpose of this paper is to report the perceptions of continuous professional development by the nurses and midwives in a low resource country. These findings are part of a larger study on the experiences of nurses and midwives providing postpartum care in rural areas of Kenya. Besides being the main healthcare providers in rural areas, nurses in low resource countries have limited access to continuous professional development. <strong><em>Research design</em>:</strong> This is a qualitative research guided by critical theory and Foucault’s concepts of power and knowledge. Focused ethnography provided the framework of data collection and analysis. 23 in-depth interviews were contacted, and thematic analysis was used for data analysis. Reflexive memos kept throughout the research process helped to ensure the trustworthiness of data. <strong><em>Findings</em>:</strong> This paper will focus on the theme of continuing professional development (CPD) as a resource for a healthy work environment. While the knowledge of the nurses and midwives allowed them to provide care to the mothers and their infants adequately, personal and structural barriers prevented them from participating in continuing professional development. <strong><em>Discussion and Conclusion</em>:</strong> A well-prepared nursing and midwifery workforce could have the capacity to transform the health outcomes of their clients through the application of evidence-based practices. Therefore, courses that are context-appropriate and meet the needs of different learners should be available to support the nurses’ and midwives’ professional growth. There is a need for more research on the nurses’ and midwives’ participation in CPD in Kenya, and the effect of CPD on specific health outcomes.