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Sample records for achieve universal coverage

  1. Assessing Latin America's Progress Toward Achieving Universal Health Coverage.

    PubMed

    Wagstaff, Adam; Dmytraczenko, Tania; Almeida, Gisele; Buisman, Leander; Hoang-Vu Eozenou, Patrick; Bredenkamp, Caryn; Cercone, James A; Diaz, Yadira; Maceira, Daniel; Molina, Silvia; Paraje, Guillermo; Ruiz, Fernando; Sarti, Flavia; Scott, John; Valdivia, Martin; Werneck, Heitor

    2015-10-01

    Two commonly used metrics for assessing progress toward universal health coverage involve assessing citizens' rights to health care and counting the number of people who are in a financial protection scheme that safeguards them from high health care payments. On these metrics most countries in Latin America have already "reached" universal health coverage. Neither metric indicates, however, whether a country has achieved universal health coverage in the now commonly accepted sense of the term: that everyone--irrespective of their ability to pay--gets the health services they need without suffering undue financial hardship. We operationalized a framework proposed by the World Bank and the World Health Organization to monitor progress under this definition and then constructed an overall index of universal health coverage achievement. We applied the approach using data from 112 household surveys from 1990 to 2013 for all twenty Latin American countries. No country has achieved a perfect universal health coverage score, but some countries (including those with more integrated health systems) fare better than others. All countries except one improved in overall universal health coverage over the time period analyzed.

  2. Morocco's policy choices to achieve Universal health coverage

    PubMed Central

    Tinasti, Khalid

    2015-01-01

    Morocco's health system remains weak in spite of the improvement of other development indicators in the last ten years. Health remains one of the major challenges to lower the social disparities that are the priority for the authorities. Despite the goodwill of all stakeholders, significant reforms implemented respond only partially to the needs of the population. Morocco established several public insurance schemes, of which one focuses on the poorest, to achieve financial-risk protection for its population. Nevertheless, achieving universal health coverage through one of its dimensions is not sufficient, and all the effort being concentrated in one area has shown the deterioration of equity in access to and quality of health services. Moreover, the insurance schemes did not reach their objectives of protecting a majority of Moroccans from financial hardship. PMID:26405489

  3. Priority-setting for achieving universal health coverage.

    PubMed

    Chalkidou, Kalipso; Glassman, Amanda; Marten, Robert; Vega, Jeanette; Teerawattananon, Yot; Tritasavit, Nattha; Gyansa-Lutterodt, Martha; Seiter, Andreas; Kieny, Marie Paule; Hofman, Karen; Culyer, Anthony J

    2016-06-01

    Governments in low- and middle-income countries are legitimizing the implementation of universal health coverage (UHC), following a United Nation's resolution on UHC in 2012 and its reinforcement in the sustainable development goals set in 2015. UHC will differ in each country depending on country contexts and needs, as well as demand and supply in health care. Therefore, fundamental issues such as objectives, users and cost-effectiveness of UHC have been raised by policy-makers and stakeholders. While priority-setting is done on a daily basis by health authorities - implicitly or explicitly - it has not been made clear how priority-setting for UHC should be conducted. We provide justification for explicit health priority-setting and guidance to countries on how to set priorities for UHC.

  4. Achieving effective universal health coverage with equity: evidence from Chile.

    PubMed

    Frenz, Patricia; Delgado, Iris; Kaufman, Jay S; Harper, Sam

    2014-09-01

    Chile's 'health guarantees' approach to providing universal and equitable coverage for quality healthcare in a dual public-private health system has generated global interest. The programme, called AUGE, defines legally enforceable rights to explicit healthcare benefits for priority health conditions, which incrementally covered 56 problems representing 75% of the disease burden between 2005 and 2009. It was accompanied by other health reform measures to increase public financing and public sector planning to secure the guarantees nationwide, as well as the state's stewardship role. We analysed data from household surveys conducted before and after the AUGE reform to estimate changes in levels of unmet health need, defined as the lack of a healthcare visit for a health problem occurring in the last 30 days, by age, sex, income, education, health insurance, residence and ethnicity; fitting logistic regression models and using predictive margins. The overall prevalence of unmet health need was much lower in 2009 (17.6%, 95% CI: 16.5%, 18.6%) than in 2000 (30.0%, 95% CI: 28.3%, 31.7%). Differences by income and education extremes and rural-urban residence disappeared. In 2009, people who had been in treatment for a condition covered by AUGE in the past year had a lower adjusted prevalence of unmet need for their recent problem (11.7%, 95% CI: 10.5%, 13.2%) than who had not (21.0%, 95% CI: 19.6%, 22.4%). Despite limitations including cross-sectional and self-reported data, our findings suggest that the Chilean health system has become more equitable and responsive to need. While these changes cannot be directly attributed to AUGE, they were coincident with the AUGE reforms. However, healthcare equity concerns are still present, relating to quality of care, health system barriers and differential access for health conditions that are not covered by AUGE.

  5. Achieving and Sustaining Universal Health Coverage: Fiscal Reform of the National Health Insurance in Taiwan.

    PubMed

    Lan, Jesse Yu-Chen

    2016-10-25

    The paper discusses the expansion of the universal health coverage (UHC) in Taiwan through the establishment of National Health Insurance (NHI), and the fiscal crisis it caused. Two key questions are addressed: How did the NHI gradually achieve universal coverage, and yet cause Taiwanese health spending to escalate to fiscal crisis? What measures have been taken to reform the NHI finance and achieve moderate success to date? The main argument of this paper is that the Taiwanese Government did try to implement various reforms to save costs and had moderate success, but the path-dependent process of reform does not allow increasing contribution rates significantly and thereby makes sustainability challenging.

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

    PubMed Central

    Bryant-Lukosius, Denise; Valaitis, Ruta; Martin-Misener, Ruth; Donald, Faith; Peña, Laura Morán; Brousseau, Linda

    2017-01-01

    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. PMID:28146177

  7. Achieving Effective Universal Health Coverage And Diagonal Approaches To Care For Chronic Illnesses.

    PubMed

    Knaul, Felicia Marie; Bhadelia, Afsan; Atun, Rifat; Frenk, Julio

    2015-09-01

    Health systems in low- and middle-income countries were designed to provide episodic care for acute conditions. However, the burden of disease has shifted to be overwhelmingly dominated by chronic conditions and illnesses that require health systems to function in an integrated manner across a spectrum of disease stages from prevention to palliation. Low- and middle-income countries are also aiming to ensure health care access for all through universal health coverage. This article proposes a framework of effective universal health coverage intended to meet the challenge of chronic illnesses. It outlines strategies to strengthen health systems through a "diagonal approach." We argue that the core challenge to health systems is chronicity of illness that requires ongoing and long-term health care. The example of breast cancer within the broader context of health system reform in Mexico is presented to illustrate effective universal health coverage along the chronic disease continuum and across health systems functions. The article concludes with recommendations to strengthen health systems in order to achieve effective universal health coverage.

  8. Health-financing reforms in southeast Asia: challenges in achieving universal coverage.

    PubMed

    Tangcharoensathien, Viroj; Patcharanarumol, Walaiporn; Ir, Por; Aljunid, Syed Mohamed; Mukti, Ali Ghufron; Akkhavong, Kongsap; Banzon, Eduardo; Huong, Dang Boi; Thabrany, Hasbullah; Mills, Anne

    2011-03-05

    In this sixth paper of the Series, we review health-financing reforms in seven countries in southeast Asia that have sought to reduce dependence on out-of-pocket payments, increase pooled health finance, and expand service use as steps towards universal coverage. Laos and Cambodia, both resource-poor countries, have mostly relied on donor-supported health equity funds to reach the poor, and reliable funding and appropriate identification of the eligible poor are two major challenges for nationwide expansion. For Thailand, the Philippines, Indonesia, and Vietnam, social health insurance financed by payroll tax is commonly used for formal sector employees (excluding Malaysia), with varying outcomes in terms of financial protection. Alternative payment methods have different implications for provider behaviour and financial protection. Two alternative approaches for financial protection of the non-poor outside the formal sector have emerged-contributory arrangements and tax-financed schemes-with different abilities to achieve high population coverage rapidly. Fiscal space and mobilisation of payroll contributions are both important in accelerating financial protection. Expanding coverage of good-quality services and ensuring adequate human resources are also important to achieve universal coverage. As health-financing reform is complex, institutional capacity to generate evidence and inform policy is essential and should be strengthened.

  9. The quest for universal health coverage: achieving social protection for all in Mexico.

    PubMed

    Knaul, Felicia Marie; González-Pier, Eduardo; Gómez-Dantés, Octavio; García-Junco, David; Arreola-Ornelas, Héctor; Barraza-Lloréns, Mariana; Sandoval, Rosa; Caballero, Francisco; Hernández-Avila, Mauricio; Juan, Mercedes; Kershenobich, David; Nigenda, Gustavo; Ruelas, Enrique; Sepúlveda, Jaime; Tapia, Roberto; Soberón, Guillermo; Chertorivski, Salomón; Frenk, Julio

    2012-10-06

    Mexico is reaching universal health coverage in 2012. A national health insurance programme called Seguro Popular, introduced in 2003, is providing access to a package of comprehensive health services with financial protection for more than 50 million Mexicans previously excluded from insurance. Universal coverage in Mexico is synonymous with social protection of health. This report analyses the road to universal coverage along three dimensions of protection: against health risks, for patients through quality assurance of health care, and against the financial consequences of disease and injury. We present a conceptual discussion of the transition from labour-based social security to social protection of health, which implies access to effective health care as a universal right based on citizenship, the ethical basis of the Mexican reform. We discuss the conditions that prompted the reform, as well as its design and inception, and we describe the 9-year, evidence-driven implementation process, including updates and improvements to the original programme. The core of the report concentrates on the effects and impacts of the reform, based on analysis of all published and publically available scientific literature and new data. Evidence indicates that Seguro Popular is improving access to health services and reducing the prevalence of catastrophic and impoverishing health expenditures, especially for the poor. Recent studies also show improvement in effective coverage. This research then addresses persistent challenges, including the need to translate financial resources into more effective, equitable and responsive health services. A next generation of reforms will be required and these include systemic measures to complete the reorganisation of the health system by functions. The paper concludes with a discussion of the implications of the Mexican quest to achieve universal health coverage and its relevance for other low-income and middle-income countries.

  10. Moving towards universal coverage with malaria control interventions: achievements and challenges in rural Burkina Faso.

    PubMed

    De Allegri, Manuela; Louis, Valérie R; Tiendrébeogo, Justin; Souares, Aurelia; Yé, Maurice; Tozan, Yesim; Jahn, Albrecht; Mueller, Olaf

    2013-01-01

    This paper reports on a study, which assessed coverage with malaria control interventions in rural Burkina Faso, namely insecticide-treated mosquito nets (ITN) ownership, intermittent preventive treatment (IPTp) for pregnant women and artemisinin-based combination therapy (ACT) for under-five children. The study also addressed the distributional impact of such interventions, with specific reference to equity. The study used data from a representative household survey conducted on 1106 households in the Nouna Health District in 2010. Findings indicated that 59% of all households owned at least one ITN, 66% of all pregnant women received IPT at least once and 34% of under-five children reporting a malaria case were treated with ACT. Multivariate logistic regression revealed that higher socio-economic status, ownership of at least one radio and living in a village within a Health and Demographic Surveillance System were significantly positively associated with ITN, IPTp and ACT coverage. ITN coverage was higher among households in villages, which had previously hosted an ITN trial and/or the most favourable arm of a trial. Comparing current findings with previous estimates suggests that the country has made substantial progress towards scaling up malaria control interventions but that current coverage rates are still far from achieving the universal coverage targets set by the Roll Back Malaria Partnership. In addition, current coverage patterns reveal the existence of multiple inequities across groups, suggesting that current policies are inadequate to achieve equitable scaling up. Future planning of malaria control interventions ought to take into consideration current inadequacies and lead to programmes better designed to overcome them.

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

    PubMed Central

    2012-01-01

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

  12. Achieving universal health coverage goals in Thailand: the vital role of strategic purchasing.

    PubMed

    Tangcharoensathien, Viroj; Limwattananon, Supon; Patcharanarumol, Walaiporn; Thammatacharee, Jadej; Jongudomsuk, Pongpisut; Sirilak, Supakit

    2015-11-01

    Strategic purchasing is one of the key policy instruments to achieve the universal health coverage (UHC) goals of improved and equitable access and financial risk protection. Given favourable outcomes of Universal Coverage Scheme (UCS), this study synthesized strategic purchasing experiences in the National Health Security Office (NHSO) responsible for the UCS in contributing to achieving UHC goals. The UCS applied the purchaser-provider split concept where NHSO, as a purchaser, is in a good position to enforce accountability by public and private providers to the UCS beneficiaries, through active purchasing. A comprehensive benefit package resulted in high level of financial risk protection as reflected by low incidence of catastrophic health spending and impoverished households. The NHSO contracted the District Health System (DHS) network, to provide outpatient, health promotion and disease prevention services to the whole district population, based on an annual age-adjusted capitation payment. In most cases, the DHS was the only provider in a district without competitors. Geographical monopoly hampered the NHSO to introduce a competitive contractual agreement, but a durable, mutually dependent relationship based on trust was gradually evolved, while accreditation is an important channel for quality improvement. Strategic purchasing services from DHS achieved a pro-poor utilization due to geographical proximity, where travel time and costs were minimal. Inpatient services paid by Diagnostic Related Group within a global budget ceiling, which is estimated based on unit costs, admission rates and admission profiles, contained cost effectively. To prevent potential under-provisions of the services, some high cost interventions were unbundled from closed end payment and paid on an agreed fee schedule. Executing monopsonistic purchasing power by NHSO brought down price of services given assured quality. Cost saving resulted in more patients served within a finite

  13. Moving Toward Universal Health Coverage (UHC) to Achieve Inclusive and Sustainable Health Development: Three Essential Strategies Drawn From Asian Experience

    PubMed Central

    Xu, Ye; Huang, Cheng; Colón-Ramos, Uriyoán

    2015-01-01

    Binagwaho and colleagues’ perspective piece provided a timely reflection on the experience of Rwanda in achieving the Millennium Development Goals (MDGs) and a proposal of 5 principles to carry forward in post-2015 health development. This commentary echoes their viewpoints and offers three lessons for health policy reforms consistent with these principles beyond 2015. Specifically, we argue that universal health coverage (UHC) is an integrated solution to advance the global health development agenda, and the three essential strategies drawn from Asian countries’ health reforms toward UHC are: (1) Public financing support and sequencing health insurance expansion by first extending health insurance to the extremely poor, vulnerable, and marginalized population are critical for achieving UHC; (2) Improved quality of delivered care ensures supply-side readiness and effective coverage; (3) Strategic purchasing and results-based financing creates incentives and accountability for positive changes. These strategies were discussed and illustrated with experience from China and other Asian economies. PMID:26673477

  14. Exploration of priority actions for strengthening the role of nurses in achieving universal health coverage

    PubMed Central

    Maaitah, Rowaida Al; AbuAlRub, Raeda Fawzi

    2017-01-01

    ABSTRACT Objective: to explore priority actions for strengthening the role of Advanced Practice Nurses (APNs) towards the achievement of Universal Health Converge (UHC) as perceived by health key informants in Jordan. Methods: an exploratory qualitative design, using a semi-structured survey, was utilized. A purposive sample of seventeen key informants from various nursing and health care sectors was recruited for the purpose of the study. Content analysis utilizing the five-stage framework approach was used for data analysis. Results: the findings revealed that policy and regulation, nursing education, research, and workforce were identified as the main elements that influence the role of APNs in contributing to the achievement of UHC. Priority actions were identified by the participants for the main four elements. Conclusion: study findings confirm the need to strengthen the role of APNs to achieve UHC through a major transformation in nursing education, practice, research, leadership, and regulatory system. Nurses should unite to come up with solid nursing competencies related to APNs, PHC, UHC, leadership and policy making to strengthen their position as main actors in influencing the health care system and evidence creation. PMID:28146176

  15. Achieving universal health coverage in France: policy reforms and the challenge of inequalities.

    PubMed

    Nay, Olivier; Béjean, Sophie; Benamouzig, Daniel; Bergeron, Henri; Castel, Patrick; Ventelou, Bruno

    2016-05-28

    Since 1945, the provision of health care in France has been grounded in a social conception promoting universalism and equality. The French health-care system is based on compulsory social insurance funded by social contributions, co-administered by workers' and employers' organisations under State control and driven by highly redistributive financial transfers. This system is described frequently as the French model. In this paper, the first in The Lancet's Series on France, we challenge conventional wisdom about health care in France. First, we focus on policy and institutional transformations that have affected deeply the governance of health care over past decades. We argue that the health system rests on a diversity of institutions, policy mechanisms, and health actors, while its governance has been marked by the reinforcement of national regulation under the aegis of the State. Second, we suggest the redistributive mechanisms of the health insurance system are impeded by social inequalities in health, which remain major hindrances to achieving objectives of justice and solidarity associated with the conception of health care in France.

  16. Achieving universal health coverage through voluntary insurance: what can we learn from the experience of Lao PDR?

    PubMed Central

    2013-01-01

    Background The Government of Lao Peoples’ Democratic Republic (Lao PDR) has embarked on a path to achieve universal health coverage (UHC) through implementation of four risk-protection schemes. One of these schemes is community-based health insurance (CBHI) – a voluntary scheme that targets roughly half the population. However, after 12 years of implementation, coverage through CBHI remains very low. Increasing coverage of the scheme would require expansion to households in both villages where CBHI is currently operating, and new geographic areas. In this study we explore the prospects of both types of expansion by examining household and district level data. Methods Using a household survey based on a case-comparison design of 3000 households, we examine the determinants of enrolment at the household level in areas where the scheme is currently operating. We model the determinants of enrolment using a probit model and predicted probabilities. Findings from focus group discussions are used to explain the quantitative findings. To examine the prospects for geographic scale-up, we use secondary data to compare characteristics of districts with and without insurance, using a combination of univariate and multivariate analyses. The multivariate analysis is a probit model, which models the factors associated with roll-out of CBHI to the districts. Results The household findings show that enrolment is concentrated among the better off and that adverse selection is present in the scheme. The district level findings show that to date, the scheme has been implemented in the most affluent areas, in closest proximity to the district hospitals, and in areas where quality of care is relatively good. Conclusions The household-level findings indicate that the scheme suffers from poor risk-pooling, which threatens financial sustainability. The district-level findings call into question whether or not the Government of Laos can successfully expand to more remote, less affluent

  17. Effective coverage: a metric for monitoring Universal Health Coverage.

    PubMed

    Ng, Marie; Fullman, Nancy; Dieleman, Joseph L; Flaxman, Abraham D; Murray, Christopher J L; Lim, Stephen S

    2014-09-01

    A major challenge in monitoring universal health coverage (UHC) is identifying an indicator that can adequately capture the multiple components underlying the UHC initiative. Effective coverage, which unites individual and intervention characteristics into a single metric, offers a direct and flexible means to measure health system performance at different levels. We view effective coverage as a relevant and actionable metric for tracking progress towards achieving UHC. In this paper, we review the concept of effective coverage and delineate the three components of the metric - need, use, and quality - using several examples. Further, we explain how the metric can be used for monitoring interventions at both local and global levels. We also discuss the ways that current health information systems can support generating estimates of effective coverage. We conclude by recognizing some of the challenges associated with producing estimates of effective coverage. Despite these challenges, effective coverage is a powerful metric that can provide a more nuanced understanding of whether, and how well, a health system is delivering services to its populations.

  18. The role of insurance in the achievement of universal coverage within a developing country context: South Africa as a case study

    PubMed Central

    2012-01-01

    Background Achieving universal coverage as an objective needs to confront the reality of multiple mechanisms, with healthcare financing and provision occurring in both public and private settings. South Africa has both large and mature public and private health systems offering useful insights into how they can be effectively harmonized to optimise coverage. Private healthcare in South Africa has also gone through many phases and regulatory regimes which, through careful review, can help identify potential policy frameworks that can optimise their ability to deepen coverage in a manner that complements the basic coverage of public arrangements. Research question Using South Africa as a case study, this review examines whether private health systems are susceptible to regulation and therefore able to support an extension and deepening of coverage when complementing a pre-existing publicly funded and delivered health system? Methods The approach involves a review of different stages in the development of the South African private health system and its response to policy changes. The focus is on the time-bound characteristics of the health system and associated policy responses and opportunities. A distinction is consequently made between the early, largely unregulated, phases of development and more mature phases with alternative regulatory regimes. Results The private health system in South Africa has played an important supplementary role in achieving universal coverage throughout its history, but more especially in the post-Apartheid period. However, the quality of this role has been erratic, influenced predominantly by policy vacillation. The private system expanded rapidly during the 1980s mainly due to the pre-existence of a mature health insurance system and a weakening public hospital system which could accommodate and facilitate an increased demand for private hospital services. This growth served to expand commercial interest in health insurance, in the

  19. [Mexican health insurance: uncertain universal coverage].

    PubMed

    Laurell, Asa Cristina

    2011-06-01

    The Mexican health system is comprised of the Department of Health, state labor social security and the private sector. It is undergoing a reform process initiated in 1995 to achieve universal coverage and separate the regulation, financing and service functions; a reform that after fifteen years is incomplete and problematic. The scope of this paper is to assess the problems that underlie the successive reforms. Special emphasis is given to the last reform stage with the introduction of the "Insurance of the People" aimed at the population without labor social security. In the analysis, health reform is seen as part of the Reform of the State in the context of neoliberal reorganization of society. Unlike other Latin American countries, this process did not include a new Constitution. The study is based on official documents and a systematic review of the process of the implementation of the System of Social Health Protection and its impact on coverage and access to health services. The analysis concludes that it is unlikely that universal population coverage will be accomplished much less universal access to services. However, reforms are leading to the commodification of the health system even in the context of a weak private sector.

  20. Universal prescription drug coverage in Canada

    PubMed Central

    Boothe, Katherine

    2016-01-01

    Canada’s universal public healthcare system is unique among developed countries insofar as it does not include universal coverage of prescription drugs. Universal, public coverage of prescription drugs has been recommended by major national commissions in Canada dating back to the 1960s. It has not, however, been implemented. In this article, we extend research on the failure of early proposals for universal drug coverage in Canada to explain failures of calls for reform over the past 20 years. We describe the confluence of barriers to reform stemming from Canadian policy institutions, ideas held by federal policy-makers, and electoral incentives for necessary reforms. Though universal “pharmacare” is once again on the policy agenda in Canada, arguably at higher levels of policy discourse than ever before, the frequently recommended option of universal, public coverage of prescription drugs remains unlikely to be implemented without political leadership necessary to overcome these policy barriers. PMID:27744279

  1. Modelling the implications of moving towards universal coverage in Tanzania.

    PubMed

    Borghi, Josephine; Mtei, Gemini; Ally, Mariam

    2012-03-01

    A model was developed to assess the impact of possible moves towards universal coverage in Tanzania over a 15-year time frame. Three scenarios were considered: maintaining the current situation ('the status quo'); expanded health insurance coverage (the estimated maximum achievable coverage in the absence of premium subsidies, coverage restricted to those who can pay); universal coverage to all (government revenues used to pay the premiums for the poor). The model estimated the costs of delivering public health services and all health services to the population as a proportion of Gross Domestic Product (GDP), and forecast revenue from user fees and insurance premiums. Under the status quo, financial protection is provided to 10% of the population through health insurance schemes, with the remaining population benefiting from subsidized user charges in public facilities. Seventy-six per cent of the population would benefit from financial protection through health insurance under the expanded coverage scenario, and 100% of the population would receive such protection through a mix of insurance cover and government funding under the universal coverage scenario. The expanded and universal coverage scenarios have a significant effect on utilization levels, especially for public outpatient care. Universal coverage would require an initial doubling in the proportion of GDP going to the public health system. Government health expenditure would increase to 18% of total government expenditure. The results are sensitive to the cost of health system strengthening, the level of real GDP growth, provider reimbursement rates and administrative costs. Promoting greater cross-subsidization between insurance schemes would provide sufficient resources to finance universal coverage. Alternately, greater tax funding for health could be generated through an increase in the rate of Value-Added Tax (VAT) or expanding the income tax base. The feasibility and sustainability of efforts to

  2. Universal Health Coverage: A Political Struggle and Governance Challenge

    PubMed Central

    Méndez, Claudio A.

    2015-01-01

    Universal health coverage has become a rallying cry in health policy, but it is often presented as a consensual, technical project. It is not. A review of the broader international literature on the origins of universal coverage shows that it is intrinsically political and cannot be achieved without recognition of its dependence on, and consequences for, both governance and politics. On one hand, a variety of comparative research has shown that health coverage is associated with democratic political accountability. Democratization, and in particular left-wing parties, gives governments particular cause to expand health coverage. On the other hand, governance, the ways states make and implement decisions, shapes any decision to strive for universal health coverage and the shape of its implementation. PMID:26180991

  3. Universal Health Coverage: A Political Struggle and Governance Challenge.

    PubMed

    Greer, Scott L; Méndez, Claudio A

    2015-11-01

    Universal health coverage has become a rallying cry in health policy, but it is often presented as a consensual, technical project. It is not. A review of the broader international literature on the origins of universal coverage shows that it is intrinsically political and cannot be achieved without recognition of its dependence on, and consequences for, both governance and politics. On one hand, a variety of comparative research has shown that health coverage is associated with democratic political accountability. Democratization, and in particular left-wing parties, gives governments particular cause to expand health coverage. On the other hand, governance, the ways states make and implement decisions, shapes any decision to strive for universal health coverage and the shape of its implementation.

  4. Moving Toward Universal Health Coverage (UHC) to Achieve Inclusive and Sustainable Health Development: Three Essential Strategies Drawn From Asian Experience Comment on "Improving the World's Health Through the Post-2015 Development Agenda: Perspectives from Rwanda".

    PubMed

    Xu, Ye; Huang, Cheng; Colón-Ramos, Uriyoán

    2015-08-26

    Binagwaho and colleagues' perspective piece provided a timely reflection on the experience of Rwanda in achieving the Millennium Development Goals (MDGs) and a proposal of 5 principles to carry forward in post-2015 health development. This commentary echoes their viewpoints and offers three lessons for health policy reforms consistent with these principles beyond 2015. Specifically, we argue that universal health coverage (UHC) is an integrated solution to advance the global health development agenda, and the three essential strategies drawn from Asian countries' health reforms toward UHC are: (1) Public financing support and sequencing health insurance expansion by first extending health insurance to the extremely poor, vulnerable, and marginalized population are critical for achieving UHC; (2) Improved quality of delivered care ensures supply-side readiness and effective coverage; (3) Strategic purchasing and results-based financing creates incentives and accountability for positive changes. These strategies were discussed and illustrated with experience from China and other Asian economies.

  5. Monitoring intervention coverage in the context of universal health coverage.

    PubMed

    Boerma, Ties; AbouZahr, Carla; Evans, David; Evans, Tim

    2014-09-01

    Monitoring universal health coverage (UHC) focuses on information on health intervention coverage and financial protection. This paper addresses monitoring intervention coverage, related to the full spectrum of UHC, including health promotion and disease prevention, treatment, rehabilitation, and palliation. A comprehensive core set of indicators most relevant to the country situation should be monitored on a regular basis as part of health progress and systems performance assessment for all countries. UHC monitoring should be embedded in a broad results framework for the country health system, but focus on indicators related to the coverage of interventions that most directly reflect the results of UHC investments and strategies in each country. A set of tracer coverage indicators can be selected, divided into two groups-promotion/prevention, and treatment/care-as illustrated in this paper. Disaggregation of the indicators by the main equity stratifiers is critical to monitor progress in all population groups. Targets need to be set in accordance with baselines, historical rate of progress, and measurement considerations. Critical measurement gaps also exist, especially for treatment indicators, covering issues such as mental health, injuries, chronic conditions, surgical interventions, rehabilitation, and palliation. Consequently, further research and proxy indicators need to be used in the interim. Ideally, indicators should include a quality of intervention dimension. For some interventions, use of a single indicator is feasible, such as management of hypertension; but in many areas additional indicators are needed to capture quality of service provision. The monitoring of UHC has significant implications for health information systems. Major data gaps will need to be filled. At a minimum, countries will need to administer regular household health surveys with biological and clinical data collection. Countries will also need to improve the production of

  6. Universal health coverage in Turkey: enhancement of equity.

    PubMed

    Atun, Rifat; Aydın, Sabahattin; Chakraborty, Sarbani; Sümer, Safir; Aran, Meltem; Gürol, Ipek; Nazlıoğlu, Serpil; Ozgülcü, Senay; Aydoğan, Ulger; Ayar, Banu; Dilmen, Uğur; Akdağ, Recep

    2013-07-06

    Turkey has successfully introduced health system changes and provided its citizens with the right to health to achieve universal health coverage, which helped to address inequities in financing, health service access, and health outcomes. We trace the trajectory of health system reforms in Turkey, with a particular emphasis on 2003-13, which coincides with the Health Transformation Program (HTP). The HTP rapidly expanded health insurance coverage and access to health-care services for all citizens, especially the poorest population groups, to achieve universal health coverage. We analyse the contextual drivers that shaped the transformations in the health system, explore the design and implementation of the HTP, identify the factors that enabled its success, and investigate its effects. Our findings suggest that the HTP was instrumental in achieving universal health coverage to enhance equity substantially, and led to quantifiable and beneficial effects on all health system goals, with an improved level and distribution of health, greater fairness in financing with better financial protection, and notably increased user satisfaction. After the HTP, five health insurance schemes were consolidated to create a unified General Health Insurance scheme with harmonised and expanded benefits. Insurance coverage for the poorest population groups in Turkey increased from 2·4 million people in 2003, to 10·2 million in 2011. Health service access increased across the country-in particular, access and use of key maternal and child health services improved to help to greatly reduce the maternal mortality ratio, and under-5, infant, and neonatal mortality, especially in socioeconomically disadvantaged groups. Several factors helped to achieve universal health coverage and improve outcomes. These factors include economic growth, political stability, a comprehensive transformation strategy led by a transformation team, rapid policy translation, flexible implementation with

  7. [Effective access to health services: operationalizing universal health coverage].

    PubMed

    Fajardo-Dolci, Germán; Gutiérrez, Juan Pablo; García-Saisó, Sebastián

    2015-01-01

    The right to health and its operational form, as an organized social response to health: the right to health protection, are the mainstay for the global push towards universal health coverage. The path to achieve this goal is particular to each country and relates to the baseline and specific context in relation to what is feasible. In practical terms, universal coverage involves the correlation between demand and supply of services (promotion, prevention, and care), expressed by the ability for each individual to make use of services when these are required. In those terms universal coverage is then effective access. The objective of the paper is to explore the conceptualization of effective access to health services and propose a definition that allows its operationalization thereof. This definition considers key elements of supply and demand of services, including the availability of resources and adequate provision (quality), as well as barriers to use them.

  8. Human resources for health and universal health coverage: fostering equity and effective coverage.

    PubMed

    Campbell, James; Buchan, James; Cometto, Giorgio; David, Benedict; Dussault, Gilles; Fogstad, Helga; Fronteira, Inês; Lozano, Rafael; Nyonator, Frank; Pablos-Méndez, Ariel; Quain, Estelle E; Starrs, Ann; Tangcharoensathien, Viroj

    2013-11-01

    Achieving universal health coverage (UHC) involves distributing resources, especially human resources for health (HRH), to match population needs. This paper explores the policy lessons on HRH from four countries that have achieved sustained improvements in UHC: Brazil, Ghana, Mexico and Thailand. Its purpose is to inform global policy and financial commitments on HRH in support of UHC. The paper reports on country experiences using an analytical framework that examines effective coverage in relation to the availability, accessibility, acceptability and quality (AAAQ) of HRH. The AAAQ dimensions make it possible to perform tracing analysis on HRH policy actions since 1990 in the four countries of interest in relation to national trends in workforce numbers and population mortality rates. The findings inform key principles for evidence-based decision-making on HRH in support of UHC. First, HRH are critical to the expansion of health service coverage and the package of benefits; second, HRH strategies in each of the AAAQ dimensions collectively support achievements in effective coverage; and third, success is achieved through partnerships involving health and non-health actors. Facing the unprecedented health and development challenges that affect all countries and transforming HRH evidence into policy and practice must be at the heart of UHC and the post-2015 development agenda. It is a political imperative requiring national commitment and leadership to maximize the impact of available financial and human resources, and improve healthy life expectancy, with the recognition that improvements in health care are enabled by a health workforce that is fit for purpose.

  9. Universal Health Coverage and Primary Healthcare: Lessons From Japan

    PubMed Central

    Bloom, Gerald

    2017-01-01

    A recent editorial by Naoki Ikegami has proposed three key lessons from Japan’s experience of achieving virtually universal coverage with primary healthcare services: the need to integrate the existing providers of primary healthcare services into the organised health system; the need to limit government commitments to finance hospital services and the need to empower providers of primary healthcare to influence decisions that influence their livelihoods. Although the context of low- and middle-income countries (LMICs) differs in many ways from Japan in the late 19th and early 20th centuries, the lesson that short-term initiatives to achieve universal coverage need to be complemented by an understanding of the factors influencing long-term change management remains highly relevant.

  10. Moving toward universal coverage of health insurance in Vietnam: barriers, facilitating factors, and lessons from Korea.

    PubMed

    Do, Ngan; Oh, Juhwan; Lee, Jin-Seok

    2014-07-01

    Vietnam has pursued universal health insurance coverage for two decades but has yet to fully achieve this goal. This paper investigates the barriers to achieve universal coverage and examines the validity of facilitating factors to shorten the transitional period in Vietnam. A comparative study of facilitating factors toward universal coverage of Vietnam and Korea reveals significant internal forces for Vietnam to further develop the National Health Insurance Program. Korea in 1977 and Vietnam in 2009 have common characteristics to be favorable of achieving universal coverage with similarities of level of income, highly qualified administrative ability, tradition of solidarity, and strong political leadership although there are differences in distribution of population and structure of the economy. From a comparative perspective, Vietnam can consider the experience of Korea in implementing the mandatory enrollment approach, household unit of eligibility, design of contribution and benefit scheme, and resource allocation to health insurance for sustainable government subsidy to achieve and sustain the universal coverage of health insurance.

  11. Progress toward universal health coverage in ASEAN

    PubMed Central

    Van Minh, Hoang; Pocock, Nicola Suyin; Chaiyakunapruk, Nathorn; Chhorvann, Chhea; Duc, Ha Anh; Hanvoravongchai, Piya; Lim, Jeremy; Lucero-Prisno, Don Eliseo; Ng, Nawi; Phaholyothin, Natalie; Phonvisay, Alay; Soe, Kyaw Min; Sychareun, Vanphanom

    2014-01-01

    Background The Association of Southeast Asian Nations (ASEAN) is characterized by much diversity in terms of geography, society, economic development, and health outcomes. The health systems as well as healthcare structure and provisions vary considerably. Consequently, the progress toward Universal Health Coverage (UHC) in these countries also varies. This paper aims to describe the progress toward UHC in the ASEAN countries and discuss how regional integration could influence UHC. Design Data reported in this paper were obtained from published literature, reports, and gray literature available in the ASEAN countries. We used both online and manual search methods to gather the information and ‘snowball’ further data. Results We found that, in general, ASEAN countries have made good progress toward UHC, partly due to relatively sustained political commitments to endorse UHC in these countries. However, all the countries in ASEAN are facing several common barriers to achieving UHC, namely 1) financial constraints, including low levels of overall and government spending on health; 2) supply side constraints, including inadequate numbers and densities of health workers; and 3) the ongoing epidemiological transition at different stages characterized by increasing burdens of non-communicable diseases, persisting infectious diseases, and reemergence of potentially pandemic infectious diseases. The ASEAN Economic Community's (AEC) goal of regional economic integration and a single market by 2015 presents both opportunities and challenges for UHC. Healthcare services have become more available but health and healthcare inequities will likely worsen as better-off citizens of member states might receive more benefits from the liberalization of trade policy in health, either via regional outmigration of health workers or intra-country health worker movement toward private hospitals, which tend to be located in urban areas. For ASEAN countries, UHC should be explicitly

  12. Policy Choices for Progressive Realization of Universal Health Coverage

    PubMed Central

    Tangcharoensathien, Viroj; Patcharanarumol, Walaiporn; Panichkriangkrai, Warisa; Sommanustweechai, Angkana

    2017-01-01

    In responses to Norheim’s editorial, this commentary offers reflections from Thailand, how the five unacceptable trade-offs were applied to the universal health coverage (UHC) reforms between 1975 and 2002 when the whole 64 million people were covered by one of the three public health insurance systems. This commentary aims to generate global discussions on how best UHC can be gradually achieved. Not only the proposed five discrete trade-offs within each dimension, there are also trade-offs between the three dimensions of UHC such as population coverage, service coverage and cost coverage. Findings from Thai UHC show that equity is applied for the population coverage extension, when the low income households and the informal sector were the priority population groups for coverage extension by different prepayment schemes in 1975 and 1984, respectively. With an exception of public sector employees who were historically covered as part of fringe benefits were covered well before the poor. The private sector employees were covered last in 1990. Historically, Thailand applied a comprehensive benefit package where a few items are excluded using the negative list; until there was improved capacities on technology assessment that cost-effectiveness are used for the inclusion of new interventions into the benefit package. Not only cost-effectiveness, but long term budget impact, equity and ethical considerations are taken into account. Cost coverage is mostly determined by the fiscal capacities. Close ended budget with mix of provider payment methods are used as a tool for trade-off service coverage and financial risk protection. Introducing copayment in the context of fee-for-service can be harmful to beneficiaries due to supplier induced demands, inefficiency and unpredictable out of pocket payment by households. UHC achieves favorable outcomes as it was implemented when there was a full geographical coverage of primary healthcare coverage in all districts and sub

  13. The Path Toward Universal Health Coverage.

    PubMed

    Yassoub, Rami; Alameddine, Mohamad; Saleh, Shadi

    2017-04-01

    Lebanon is a middle-income country with a market-maximized healthcare system that provides limited social protection for its citizens. Estimates reveal that half of the population lacks sufficient health coverage and resorts to out-of-pocket payments. This study triangulated data from a comprehensive review of health packages of countries similar to Lebanon, the Ministry of Public Health statistics, and services suggested by the World Health Organization for inclusion in a health benefits package (HBP). To determine the acceptability and viability of implementing the HBP, a stakeholder analysis was conducted to identify the knowledge, positions, and available resources for the package. The results revealed that the private health sector, having the most resources, is least in favor of implementing the package, whereas the political and civil society sectors support implementation. The main divergence in opinions among stakeholders was on the abolishment of out-of-pocket payments, mainly attributed to the potential abuse of the HBP's services by users. The study's findings encourage health decision makers to capitalize on the current political readiness by proposing the HBP for implementation in the path toward universal health coverage. This requires a consultative process, involving all stakeholders, in devising the strategy and implementation framework of a HBP.

  14. Human resources for health and universal health coverage: fostering equity and effective coverage

    PubMed Central

    Buchan, James; Cometto, Giorgio; David, Benedict; Dussault, Gilles; Fogstad, Helga; Fronteira, Inês; Lozano, Rafael; Nyonator, Frank; Pablos-Méndez, Ariel; Quain, Estelle E; Starrs, Ann; Tangcharoensathien, Viroj

    2013-01-01

    Abstract Achieving universal health coverage (UHC) involves distributing resources, especially human resources for health (HRH), to match population needs. This paper explores the policy lessons on HRH from four countries that have achieved sustained improvements in UHC: Brazil, Ghana, Mexico and Thailand. Its purpose is to inform global policy and financial commitments on HRH in support of UHC. The paper reports on country experiences using an analytical framework that examines effective coverage in relation to the availability, accessibility, acceptability and quality (AAAQ) of HRH. The AAAQ dimensions make it possible to perform tracing analysis on HRH policy actions since 1990 in the four countries of interest in relation to national trends in workforce numbers and population mortality rates. The findings inform key principles for evidence-based decision-making on HRH in support of UHC. First, HRH are critical to the expansion of health service coverage and the package of benefits; second, HRH strategies in each of the AAAQ dimensions collectively support achievements in effective coverage; and third, success is achieved through partnerships involving health and non-health actors. Facing the unprecedented health and development challenges that affect all countries and transforming HRH evidence into policy and practice must be at the heart of UHC and the post-2015 development agenda. It is a political imperative requiring national commitment and leadership to maximize the impact of available financial and human resources, and improve healthy life expectancy, with the recognition that improvements in health care are enabled by a health workforce that is fit for purpose. PMID:24347710

  15. Politics and Universal Health Coverage--The Post-2015 Global Health Agenda.

    PubMed

    Gupta, Vin; Kerry, Vanessa B; Goosby, Eric; Yates, Robert

    2015-09-24

    What political, social, and economic factors allow a movement toward universal health coverage to take hold in some low- and middle-income countries? Can we use that knowledge to help other such countries achieve health care for all?

  16. Expanding the universe of universal coverage: the population health argument for increasing coverage for immigrants.

    PubMed

    Nandi, Arijit; Loue, Sana; Galea, Sandro

    2009-12-01

    As the US recession deepens, furthering the debate about healthcare reform is now even more important than ever. Few plans aimed at facilitating universal coverage make any mention of increasing access for uninsured non-citizens living in the US, many of whom are legally restricted from certain types of coverage. We conducted a critical review of the public health literature concerning the health status and access to health services among immigrant populations in the US. Using examples from infectious and chronic disease epidemiology, we argue that access to health services is at the intersection of the health of uninsured immigrants and the general population and that extending access to healthcare to all residents of the US, including undocumented immigrants, is beneficial from a population health perspective. Furthermore, from a health economics perspective, increasing access to care for immigrant populations may actually reduce net costs by increasing primary prevention and reducing the emphasis on emergency care for preventable conditions. It is unlikely that proposals for universal coverage will accomplish their objectives of improving population health and reducing social disparities in health if they do not address the substantial proportion of uninsured non-citizens living in the US.

  17. Education, leadership and partnerships: nursing potential for Universal Health Coverage

    PubMed Central

    Mendes, Isabel Amélia Costa; Ventura, Carla Aparecida Arena; Trevizan, Maria Auxiliadora; Marchi-Alves, Leila Maria; de Souza-Junior, Valtuir Duarte

    2016-01-01

    Objective: to discuss possibilities of nursing contribution for universal health coverage. Method: a qualitative study, performed by means of document analysis of the World Health Organization publications highlighting Nursing and Midwifery within universal health coverage. Results: documents published by nursing and midwifery leaders point to the need for coordinated and integrated actions in education, leadership and partnership development. Final Considerations: this article represents a call for nurses, in order to foster reflection and understanding of the relevance of their work on the consolidation of the principles of universal health coverage. PMID:26959333

  18. Universal coverage in the land of smiles: lessons from Thailand's 30 Baht health reforms.

    PubMed

    Hughes, David; Leethongdee, Songkramchai

    2007-01-01

    Thailand became one of a handful of lower-middle-income countries providing universal health care coverage when it introduced reforms in 2001. Following the 2006 military coup, the coverage reforms are being reappraised by Thai policymakers. In this paper we take the opportunity to assess the program's achievements and problems. We describe the characteristics of the universal insurance program--the 30 Baht Scheme--and the purchaser-provider system that Thailand adopted.

  19. Financing Universal Coverage in Malaysia: a case study

    PubMed Central

    2012-01-01

    One of the challenges to maintain an agenda for universal coverage and equitable health system is to develop effective structuring and management of health financing. Global experiences with different systems of health financing suggests that a strong public role in health financing is essential for health systems to protect the poor and health systems with the strongest state role are likely the more equitable and achieve better aggregate health outcomes. Using Malaysia as a case study, this paper seeks to evaluate the progress and capacity of a middle income country in terms of health financing for universal coverage, and also to highlight some of the key underlying health systems challenges. The WHO Health Financing Strategy for the Asia Pacific Region (2010-2015) was used as the framework to evaluate the Malaysian healthcare financing system in terms of the provision of universal coverage for the population, and the Malaysian National Health Accounts (2008) provided the latest Malaysian data on health spending. Measuring against the four target indicators outlined, Malaysia fared credibly with total health expenditure close to 5% of its GDP (4.75%), out-of-pocket payment below 40% of total health expenditure (30.7%), comprehensive social safety nets for vulnerable populations, and a tax-based financing system that fundamentally poses as a national risk-pooled scheme for the population. Nonetheless, within a holistic systems framework, the financing component interacts synergistically with other health system spheres. In Malaysia, outmigration of public health workers particularly specialist doctors remains an issue and financing strategies critically needs to incorporate a comprehensive workforce compensation strategy to improve the health workforce skill mix. Health expenditure information is systematically collated, but feedback from the private sector remains a challenge. Service delivery-wise, there is a need to enhance financing capacity to expand

  20. Is the Scale Up of Malaria Intervention Coverage Also Achieving Equity?

    PubMed Central

    Steketee, Richard W.; Eisele, Thomas P.

    2009-01-01

    Background and Methods Malaria in Africa is most severe in young children and pregnant women, particularly in rural and poor households. In many countries, malaria intervention coverage rates have increased as a result of scale up; but this may mask limited coverage in these highest-risk populations. Reports were reviewed from nationally representative surveys in African malaria-endemic countries from 2006 through 2008 to understand how reported intervention coverage rates reflect access by the most at-risk populations. Results Reports were available from 27 Demographic and Health Surveys (DHSs), Multiple Indicator Cluster Surveys (MICSs), and Malaria Indicator Surveys (MISs) during this interval with data on household intervention coverage by urban or rural setting, wealth quintile, and sex. Household ownership of insecticide-treated mosquito nets (ITNs) varied from 5% to greater than 60%, and was equitable by urban/rural and wealth quintile status among 13 (52%) of 25 countries. Malaria treatment rates for febrile children under five years of age varied from less than 10% to greater than 70%, and while equitable coverage was achieved in 8 (30%) of 27 countries, rates were generally higher in urban and richest quintile households. Use of intermittent preventive treatment in pregnant women varied from 2% to more than 60%, and again tended to be higher in urban and richest quintile households. Across all countries, there were no significant male/female inequalities seen for children sleeping under ITNs or receiving antimalarial treatment for febrile illness. Parasitemia and anemia rates from eight national surveys showed predominance in poor and rural populations. Conclusions/Significance Recent efforts to scale up malaria intervention coverage have achieved equity in some countries (especially with ITNs), but delivery methods in other countries are not addressing the most at-risk populations. As countries seek universal malaria intervention coverage, their delivery

  1. Macroeconomic Analysis of Universal Coverage in the U.S.

    NASA Astrophysics Data System (ADS)

    Feng, Zhigang

    In this paper I employ a dynamic general equilibrium model to study macroeconomic effects and welfare implications of health policies for universal coverage in the U.S. The model is calibrated to the U.S. data. Numerical simulations indicate that adopting universal coverage has several important macroeconomic effects on health expenditures, hours worked, and increases welfare by improving aggregate health status, and removing adverse selection.

  2. Moving towards universal health coverage: lessons from 11 country studies.

    PubMed

    Reich, Michael R; Harris, Joseph; Ikegami, Naoki; Maeda, Akiko; Cashin, Cheryl; Araujo, Edson C; Takemi, Keizo; Evans, Timothy G

    2016-02-20

    In recent years, many countries have adopted universal health coverage (UHC) as a national aspiration. In response to increasing demand for a systematic assessment of global experiences with UHC, the Government of Japan and the World Bank collaborated on a 2-year multicountry research programme to analyse the processes of moving towards UHC. The programme included 11 countries (Bangladesh, Brazil, Ethiopia, France, Ghana, Indonesia, Japan, Peru, Thailand, Turkey, and Vietnam), representing diverse geographical, economic, and historical contexts. The study identified common challenges and opportunities and useful insights for how to move towards UHC. The study showed that UHC is a complex process, fraught with challenges, many possible pathways, and various pitfalls--but is also feasible and achievable. Movement towards UHC is a long-term policy engagement that needs both technical knowledge and political know-how. Technical solutions need to be accompanied by pragmatic and innovative strategies that address the national political economy context.

  3. Operationalizing universal health coverage in Nigeria through social health insurance

    PubMed Central

    Okpani, Arnold Ikedichi; Abimbola, Seye

    2015-01-01

    Nigeria faces challenges that delay progress toward the attainment of the national government's declared goal of universal health coverage (UHC). One such challenge is system-wide inequities resulting from lack of financial protection for the health care needs of the vast majority of Nigerians. Only a small proportion of Nigerians have prepaid health care. In this paper, we draw on existing evidence to suggest steps toward reforming health care financing in Nigeria to achieve UHC through social health insurance. This article sets out to demonstrate that a viable path to UHC through expanding social health insurance exists in Nigeria. We argue that encouraging the states which are semi-autonomous federating units to setup and manage their own insurance schemes presents a unique opportunity for rapidly scaling up prepaid coverage for Nigerians. We show that Nigeria's federal structure which prescribes a sharing of responsibilities for health care among the three tiers of government presents serious challenges for significantly extending social insurance to uncovered groups. We recommend that rather than allowing this governance structure to impair progress toward UHC, it should be leveraged to accelerate the process by supporting the states to establish and manage their own insurance funds while encouraging integration with the National Health Insurance Scheme. PMID:26778879

  4. Quality at the centre of universal health coverage.

    PubMed

    Sobel, Howard L; Huntington, Dale; Temmerman, Marleen

    2016-05-01

    The last decade of the MDG era witnessed substantial focus on reaching the bottom economic quintiles in low and middle income countries. However, the inordinate focus on reducing financial risk burden and increasing coverage without sufficient focus on expanding quality of services may account for slow progress of the MDGs in many countries. Human Resources for Health underlie quality and service delivery improvements, yet remains under-addressed in many national strategies to achieve Universal Health Coverage. Without adequate investments in improving and expanding health professional education, making and sustaining gains will be unlikely. The transition from the Millennium Development Goals (MDG) to the Sustainable Development Goals (SDG), with exciting new financing initiatives such as the Global Financing Facility brings the potential to enact substantial gains in the quality of services delivered and upgrading human health resources. This focus should ensure effective methodologies to improve health worker competencies and change practice are employed and ineffective and harmful ones eliminated (including undue influence of commercial interests).

  5. Moving toward Universal Coverage of Health Insurance in Vietnam: Barriers, Facilitating Factors, and Lessons from Korea

    PubMed Central

    2014-01-01

    Vietnam has pursued universal health insurance coverage for two decades but has yet to fully achieve this goal. This paper investigates the barriers to achieve universal coverage and examines the validity of facilitating factors to shorten the transitional period in Vietnam. A comparative study of facilitating factors toward universal coverage of Vietnam and Korea reveals significant internal forces for Vietnam to further develop the National Health Insurance Program. Korea in 1977 and Vietnam in 2009 have common characteristics to be favorable of achieving universal coverage with similarities of level of income, highly qualified administrative ability, tradition of solidarity, and strong political leadership although there are differences in distribution of population and structure of the economy. From a comparative perspective, Vietnam can consider the experience of Korea in implementing the mandatory enrollment approach, household unit of eligibility, design of contribution and benefit scheme, and resource allocation to health insurance for sustainable government subsidy to achieve and sustain the universal coverage of health insurance. Graphical Abstract PMID:25045223

  6. Indonesia's road to universal health coverage: a political journey.

    PubMed

    Pisani, Elizabeth; Olivier Kok, Maarten; Nugroho, Kharisma

    2016-09-06

    In 2013 Indonesia, the world's fourth most populous country, declared that it would provide affordable health care for all its citizens within seven years. This crystallised an ambition first enshrined in law over five decades earlier, but never previously realised. This paper explores Indonesia's journey towards universal health coverage (UHC) from independence to the launch of a comprehensive health insurance scheme in January 2014. We find that Indonesia's path has been determined largely by domestic political concerns - different groups obtained access to healthcare as their socio-political importance grew.A major inflection point occurred following the Asian financial crisis of 1997. To stave off social unrest, the government provided health coverage for the poor for the first time, creating a path dependency that influenced later policy choices. The end of this programme coincided with decentralisation, leading to experimentation with several different models of health provision at the local level. When direct elections for local leaders were introduced in 2005, popular health schemes led to success at the polls. UHC became an electoral asset, moving up the political agenda. It also became contested, with national policy-makers appropriating health insurance programmes that were first developed locally, and taking credit for them.The Indonesian experience underlines the value of policy experimentation, and of a close understanding of the contextual and political factors that drive successful UHC models at the local level. Specific drivers of success and failure should be taken into account when scaling UHC to the national level. In the Indonesian example, UHC became possible when the interests of politically and economically influential groups were either satisfied or neutralised. While technical considerations took a back seat to political priorities in developing the structures for health coverage nationally, they will have to be addressed going forward to

  7. Achieving Research University: Indonesian Case

    NASA Astrophysics Data System (ADS)

    Utama, Yos Johan; Ambariyanto

    2017-02-01

    Today many universities have the vision to become a research university, including in Indonesia. It is based on the desire to play a role in advancing science for the benefit of humanity as well as to enhance the university reputation at the international level. However, in the case of Indonesia, it can only be done by several universities, given the large number of universities with very different capabilities. In addition, another problem is human resources, infrastructure, and research funding. Various targets indicator used to determine its success include the number of publications, patents and industrial products. There is an urgent need to improve all factors that can accelerate the increase in research in Indonesia universities, and has been started by the policy of the current government.

  8. Nursing challenges for universal health coverage: a systematic review1

    PubMed Central

    Schveitzer, Mariana Cabral; Zoboli, Elma Lourdes Campos Pavone; Vieira, Margarida Maria da Silva

    2016-01-01

    Objectives to identify nursing challenges for universal health coverage, based on the findings of a systematic review focused on the health workforce' understanding of the role of humanization practices in Primary Health Care. Method systematic review and meta-synthesis, from the following information sources: PubMed, CINAHL, Scielo, Web of Science, PsycInfo, SCOPUS, DEDALUS and Proquest, using the keyword Primary Health Care associated, separately, with the following keywords: humanization of assistance, holistic care/health, patient centred care, user embracement, personal autonomy, holism, attitude of health personnel. Results thirty studies between 1999-2011. Primary Health Care work processes are complex and present difficulties for conducting integrative care, especially for nursing, but humanizing practices have showed an important role towards the development of positive work environments, quality of care and people-centered care by promoting access and universal health coverage. Conclusions nursing challenges for universal health coverage are related to education and training, to better working conditions and clear definition of nursing role in primary health care. It is necessary to overcome difficulties such as fragmented concepts of health and care and invest in multidisciplinary teamwork, community empowerment, professional-patient bond, user embracement, soft technologies, to promote quality of life, holistic care and universal health coverage. PMID:27143536

  9. Universal health coverage in Latin American countries: how to improve solidarity-based schemes.

    PubMed

    Titelman, Daniel; Cetrángolo, Oscar; Acosta, Olga Lucía

    2015-04-04

    In this Health Policy we examine the association between the financing structure of health systems and universal health coverage. Latin American health systems encompass a wide range of financial sources, which translate into different solidarity-based schemes that combine contributory (payroll taxes) and non-contributory (general taxes) sources of financing. To move towards universal health coverage, solidarity-based schemes must heavily rely on countries' capacity to increase public expenditure in health. Improvement of solidarity-based schemes will need the expansion of mandatory universal insurance systems and strengthening of the public sector including increased fiscal expenditure. These actions demand a new model to integrate different sources of health-sector financing, including general tax revenue, social security contributions, and private expenditure. The extent of integration achieved among these sources will be the main determinant of solidarity and universal health coverage. The basic challenges for improvement of universal health coverage are not only to spend more on health, but also to reduce the proportion of out-of-pocket spending, which will need increased fiscal resources.

  10. A Trajectory-Based Coverage Assessment Approach for Universal Sensor Networks

    PubMed Central

    Qin, Ningning; Zheng, Xin; Tian, Guiyun

    2015-01-01

    To solve the problem of coverage performance assessment, this study proposes an evaluation method based on the trajectory of the target, which is applicable to universal sensor networks, including both heterogeneous and homogeneous sensor networks. Different from the traditional Voronoi algorithm, the proposed Improved Coverage Force Division (ICFD) plans a coverage force division map whichscales the qualitative coverage performancebasedon both covering intensities andlocations of the nodes. Furthermore, the Trajectory-based Evaluating Schedule (TES) is responsible for solving the quantitative coverage evaluationproblem by measuringthe resulting trajectories’ Balance Values (BVs). A model of weak-point ranking conjoined in consideration of coverage force and distance can guide future deployment to compensate coverage. Comparative trials using the greedy algorithm, Voronoi algorithm, and the proposed TES verify that TES achieves the approximate results for two-stage and multistage heterogeneous sensor networks with acceptable difference and lower complexity, and it is superior to the Voronoi algorithm in homogeneous sensor networks interms of breaking the four-point circle block. PMID:26270667

  11. Universal coverage and its impact on reproductive health services in Thailand.

    PubMed

    Tangcharoensathien, Viroj; Tantivess, Sripen; Teerawattananon, Yot; Auamkul, Nanta; Jongudoumsuk, Pongpisut

    2002-11-01

    Thailand has recently introduced universal health care coverage for 45 million of its people, financed by general tax revenue. A capitation contract model was adopted to purchase ambulatory and hospital care, and preventive care and promotion, including reproductive health services, from public and private service providers. This paper describes the health financing system prior to universal coverage, and the extent to which Thailand has achieved reproductive health objectives prior to this reform. It then analyses the potential impact of universal coverage on reproductive health services. Whether there are positive or negative effects on reproductive health services will depend on the interaction between three key aspects: awareness of entitlement on the part of intended beneficiaries of services, the response of health care providers to capitation, and the capacity of purchasers to monitor and enforce contracts. In rural areas, the district public health system is the sole service provider and the contractual relationship requires trust and positive engagement with purchasers. We recommend an evidence-based approach to fine-tune the reproductive health services benefits package under universal coverage, as well as improved institutional capacity for purchasers and the active participation of civil society and other partners to empower beneficiaries.

  12. Emerging challenges in implementing universal health coverage in Asia.

    PubMed

    Bredenkamp, Caryn; Evans, Timothy; Lagrada, Leizel; Langenbrunner, John; Nachuk, Stefan; Palu, Toomas

    2015-11-01

    As countries in Asia converge on the goal of universal health coverage (UHC), some common challenges are emerging. One is how to ensure coverage of the informal sector so as to make UHC truly universal; a second is how to design a benefit package that is responsive and appropriate to current health challenges, yet fiscally sustainable; and a third is how to ensure "supply-side readiness", i.e. the availability and quality of services, which is a necessary condition for translating coverage into improvements in health outcomes. Using examples from the Asia region, this paper discusses these three challenges and how they are being addressed. On the first challenge, two promising approaches emerge: using general revenues to fully cover the informal sector, or employing a combination of tax subsidies, non-financial incentives and contributory requirements. The former can produce fast results, but places pressure on government budgets and may induce informality, while the latter will require a strong administrative mandate and systems to track the ability-to-pay. With respect to benefit packages, we find considerable variation in the nature and rigor of processes underlying the selection and updating of the services included. Also, in general, packages do not yet focus sufficiently on non-communicable diseases (NCDs) and related preventive outpatient care. Finally, there are large variations and inequities in the supply-side readiness, in terms of availability of infrastructure, equipment, essential drugs and staffing, to deliver on the promises of UHC. Health worker competencies are also a constraint. While the UHC challenges are common, experience in overcoming these challenges is varied and many of the successes appear to be highly context-specific. This implies that researchers and policymakers need to rigorously, and regularly, assess different approaches, and share these findings across countries in Asia - and across the world.

  13. [Immunization Programme and Coverage against Measles and Rubella in Spain. Challenges for Achieving their Elimination].

    PubMed

    Limia Sánchez, Aurora; Molina Olivas, Marta

    2015-01-01

    The World Health Organization had established the achievement and sustainability of very high coverage with two doses of vaccine against measles and at least one against rubella as one of the key strategies for the elimination of both measles and rubella. The current immunization programme in Spain includes the immunization with two doses of combined vaccine against measles, mumps and rubella at 12 months and 3-4 years of age. Since 2000 coverage with first dose is over the target of 95% but the coverage with the second dose remains between 90 and 95%. In 2014, at subnational level three regions had coverage below the objective and only eight regions achieved the objective for the second dose. The challenges and some activities to strengthen the immunization programme in order to achieve the elimination of measles and rubella are discussed.

  14. Impact of Thailand universal coverage scheme on the country's health information systems and health information technology.

    PubMed

    Kijsanayotin, Boonchai

    2013-01-01

    Thailand achieved universal healthcare coverage with the implementation of the Universal Coverage Scheme (UCS) in 2001. This study employed qualitative method to explore the impact of the UCS on the country's health information systems (HIS) and health information technology (HIT) development. The results show that health insurance beneficiary registration system helps improve providers' service workflow and country vital statistics. Implementation of casemix financing tool, Thai Diagnosis-Related Groups, has stimulated health providers' HIS and HIT capacity building, data and medical record quality and the adoption of national administrative data standards. The system called "Disease Management Information Systems" aiming at reimbursement for select diseases increased the fragmentation of HIS and increase burden on data management to providers. The financial incentive of outpatient data quality improvement project enhance providers' HIS and HIT investment and also induce data fraudulence tendency. Implementation of UCS has largely brought favorable impact on the country HIS and HIT development. However, the unfavorable effects are also evident.

  15. Universal Health Coverage for Schizophrenia: A Global Mental Health Priority

    PubMed Central

    Patel, Vikram

    2016-01-01

    The growing momentum towards a global consensus on universal health coverage, alongside an acknowledgment of the urgency and importance of a comprehensive mental health action plan, offers a unique opportunity for a substantial scale-up of evidence-based interventions and packages of care for a range of mental disorders in all countries. There is a robust evidence base testifying to the effectiveness of drug and psychosocial interventions for people with schizophrenia and to the feasibility, acceptability and cost-effectiveness of the delivery of these interventions through a collaborative care model in low resource settings. While there are a number of barriers to scaling up this evidence, for eg, the finances needed to train and deploy community based workers and the lack of agency for people with schizophrenia, the experiences of some upper middle income countries show that sustained political commitment, allocation of transitional financial resources to develop community services, a commitment to an integrated approach with a strong role for community based institutions and providers, and a progressive realization of coverage are the key ingredients for scale up of services for schizophrenia. PMID:26245942

  16. Viewing the Kenyan health system through an equity lens: implications for universal coverage

    PubMed Central

    2011-01-01

    Introduction Equity and universal coverage currently dominate policy debates worldwide. Health financing approaches are central to universal coverage. The way funds are collected, pooled, and used to purchase or provide services should be carefully considered to ensure that population needs are addressed under a universal health system. The aim of this paper is to assess the extent to which the Kenyan health financing system meets the key requirements for universal coverage, including income and risk cross-subsidisation. Recommendations on how to address existing equity challenges and progress towards universal coverage are made. Methods An extensive review of published and gray literature was conducted to identify the sources of health care funds in Kenya. Documents were mainly sourced from the Ministry of Medical Services and the Ministry of Public Health and Sanitation. Country level documents were the main sources of data. In cases where data were not available at the country level, they were sought from the World Health Organisation website. Each financing mechanism was analysed in respect to key functions namely, revenue generation, pooling and purchasing. Results The Kenyan health sector relies heavily on out-of-pocket payments. Government funds are mainly allocated through historical incremental approach. The sector is largely underfunded and health care contributions are regressive (i.e. the poor contribute a larger proportion of their income to health care than the rich). Health financing in Kenya is fragmented and there is very limited risk and income cross-subsidisation. The country has made little progress towards achieving international benchmarks including the Abuja target of allocating 15% of government's budget to the health sector. Conclusions The Kenyan health system is highly inequitable and policies aimed at promoting equity and addressing the needs of the poor and vulnerable have not been successful. Some progress has been made towards

  17. Regular Deployment of Wireless Sensors to Achieve Connectivity and Information Coverage

    PubMed Central

    Cheng, Wei; Li, Yong; Jiang, Yi; Yin, Xipeng

    2016-01-01

    Coverage and connectivity are two of the most critical research subjects in WSNs, while regular deterministic deployment is an important deployment strategy and results in some pattern-based lattice WSNs. Some studies of optimal regular deployment for generic values of rc/rs were shown recently. However, most of these deployments are subject to a disk sensing model, and cannot take advantage of data fusion. Meanwhile some other studies adapt detection techniques and data fusion to sensing coverage to enhance the deployment scheme. In this paper, we provide some results on optimal regular deployment patterns to achieve information coverage and connectivity as a variety of rc/rs, which are all based on data fusion by sensor collaboration, and propose a novel data fusion strategy for deployment patterns. At first the relation between variety of rc/rs and density of sensors needed to achieve information coverage and connectivity is derived in closed form for regular pattern-based lattice WSNs. Then a dual triangular pattern deployment based on our novel data fusion strategy is proposed, which can utilize collaborative data fusion more efficiently. The strip-based deployment is also extended to a new pattern to achieve information coverage and connectivity, and its characteristics are deduced in closed form. Some discussions and simulations are given to show the efficiency of all deployment patterns, including previous patterns and the proposed patterns, to help developers make more impactful WSN deployment decisions. PMID:27529246

  18. Universal health coverage in 'One ASEAN': are migrants included?

    PubMed

    Guinto, Ramon Lorenzo Luis R; Curran, Ufara Zuwasti; Suphanchaimat, Rapeepong; Pocock, Nicola S

    2015-01-01

    Background As the Association of South East Asian Nations (ASEAN) gears toward full regional integration by 2015, the cross-border mobility of workers and citizens at large is expected to further intensify in the coming years. While ASEAN member countries have already signed the Declaration on the Protection and Promotion of the Rights of Migrant Workers, the health rights of migrants still need to be addressed, especially with ongoing universal health coverage (UHC) reforms in most ASEAN countries. This paper seeks to examine the inclusion of migrants in the UHC systems of five ASEAN countries which exhibit diverse migration profiles and are currently undergoing varying stages of UHC development. Design A scoping review of current migration trends and policies as well as ongoing UHC developments and migrant inclusion in UHC in Indonesia, Malaysia, Philippines, Singapore, and Thailand was conducted. Results In general, all five countries, whether receiving or sending, have schemes that cover migrants to varying extents. Thailand even allows undocumented migrants to opt into its Compulsory Migrant Health Insurance scheme, while Malaysia and Singapore are still yet to consider including migrants in their government-run UHC systems. In terms of predominantly sending countries, the Philippines's social health insurance provides outbound migrants with portable insurance yet with limited benefits, while Indonesia still needs to strengthen the implementation of its compulsory migrant insurance which has a health insurance component. Overall, the five ASEAN countries continue to face implementation challenges, and will need to improve on their UHC design in order to ensure genuine inclusion of migrants, including undocumented migrants. However, such reforms will require strong political decisions from agencies outside the health sector that govern migration and labor policies. Furthermore, countries must engage in multilateral and bilateral dialogue as they redefine UHC

  19. Universal Health Coverage - The Critical Importance of Global Solidarity and Good Governance Comment on "Ethical Perspective: Five Unacceptable Trade-offs on the Path to Universal Health Coverage".

    PubMed

    Reis, Andreas A

    2016-06-07

    This article provides a commentary to Ole Norheim' s editorial entitled "Ethical perspective: Five unacceptable trade-offs on the path to universal health coverage." It reinforces its message that an inclusive, participatory process is essential for ethical decision-making and underlines the crucial importance of good governance in setting fair priorities in healthcare. Solidarity on both national and international levels is needed to make progress towards the goal of universal health coverage (UHC).

  20. Universal health coverage in a regional Nepali hospital: who is exempted from payment?

    PubMed

    Basnet, R; Shrestha, B R; Nagaraja, S B; Basnet, B; Satyanarayana, S; Zachariah, R

    2013-03-21

    This study assessed the characteristics of beneficiaries of a government-led policy of exemption for payment being provided in a regional hospital in Nepal. In January and February 2012, 9547 patients sought services at the out-patient clinic, the majority (83%) of whom were from the same district although this was a referral hospital for 15 districts. Only 10.8% received exemption from payment; 66% of the individuals aged >60 years and eligible for exemption were missed. These shortcomings highlight intrinsic weaknesses in the current implementing mechanisms for payment exemption, which may not be providing financial protection. This hampers efforts towards achieving universal health coverage.

  1. Implications of dual practice for universal health coverage.

    PubMed

    McPake, Barbara; Russo, Giuliano; Hipgrave, David; Hort, Krishna; Campbell, James

    2016-02-01

    Making progress towards universal health coverage (UHC) requires that health workers are adequate in numbers, prepared for their jobs and motivated to perform. In establishing the best ways to develop the health workforce, relatively little attention has been paid to the trends and implications of dual practice - concurrent employment in public and private sectors. We review recent research on dual practice for its potential to guide staffing policies in relation to UHC. Many studies describe the characteristics and correlates of dual practice and speculate about impacts, but there is very little evidence that is directly relevant to policy-makers. No studies have evaluated the impact of policies on the characteristics of dual practice or implications for UHC. We address this lack and call for case studies of policy interventions on dual practice in different contexts. Such research requires investment in better data collection and greater determination on the part of researchers, research funding bodies and national research councils to overcome the difficulties of researching sensitive topics of health systems functions.

  2. An equitable way to pay for universal coverage.

    PubMed

    Rasell, E

    1999-01-01

    This article describes a way to finance universal health care coverage that preserves much of the current financing system and replaces funds obtained from regressive sources with revenue from more progressive ones. New funding would be needed for 24 percent of health expenditures and would be raised through an increase in the federal personal income tax. Premiums are eliminated since their cost is the same to everyone regardless of income. Cost sharing and out-of-pocket spending for medically necessary services are also abolished. In a more equitably financed system, employers would pay a new payroll tax that raised the same amount of money they currently spend for employee health insurance premiums; this would require a payroll tax of about 7 percent. Revenue from an increase in federal personal income taxes would replace household out-of-pocket expenditures for medically necessary services and payments for insurance premiums. For the average, middle-income family, the tax increase would total $731 in 1998. In exchange for the tax increase, no American or American employer would need to buy health insurance or face out-of-pocket charges for any medically indicated health care.

  3. South Africa's universal health coverage reforms in the post-apartheid period.

    PubMed

    van den Heever, Alexander Marius

    2016-12-01

    In 2011, the South African government published a Green Paper outlining proposals for a single-payer National Health Insurance arrangement as a means to achieve universal health coverage (UHC), followed by a White Paper in 2015. This follows over two decades of health reform proposals and reforms aimed at deepening UHC. The most recent reform departure aims to address pooling and purchasing weaknesses in the health system by internalising both functions within a single scheme. This contrasts with the post-apartheid period from 1994 to 2008 where pooling weaknesses were to be addressed using pooling schemes, in the form of government subsidies and risk-equalisation arrangements, external to the public and private purchasers. This article reviews both reform paths and attempts to reconcile what may appear to be very different approaches. The scale of the more recent set of proposals requires a very long reform path because in the mid-term (the next 25 years) no single scheme will be able to raise sufficient revenue to provide a universal package for the entire population. In the interim, reforms that maintain and improve existing forms of coverage are required. The earlier reform framework (1994-2008) largely addressed this concern while leaving open the final form of the system. Both reform approaches are therefore compatible: the earlier reforms addressed medium- to long-term coverage concerns, while the more recent define the long-term institutional goal.

  4. The Politics of Universal Health Coverage in Low- and Middle-Income Countries: A Framework for Evaluation and Action.

    PubMed

    Fox, Ashley M; Reich, Michael R

    2015-10-01

    Universal health coverage has recently become a top item on the global health agenda pressed by multilateral and donor organizations, as disenchantment grows with vertical, disease-specific health programs. This increasing focus on universal health coverage has brought renewed attention to the role of domestic politics and the interaction between domestic and international relations in the health reform process. This article proposes a theory-based framework for analyzing the politics of health reform for universal health coverage, according to four stages in the policy cycle (agenda setting, design, adoption, and implementation) and four variables that affect reform (interests, institutions, ideas, and ideology). This framework can assist global health policy researchers, multilateral organization officials, and national policy makers in navigating the complex political waters of health reforms aimed at achieving universal health coverage. To derive the framework, we critically review the theoretical and applied literature on health policy reform in developing countries and illustrate the framework with examples of health reforms moving toward universal coverage in low- and middle-income countries. We offer a series of lessons stemming from these experiences to date.

  5. Community health workers for universal health-care coverage: from fragmentation to synergy.

    PubMed

    Tulenko, Kate; Møgedal, Sigrun; Afzal, Muhammad Mahmood; Frymus, Diana; Oshin, Adetokunbo; Pate, Muhammad; Quain, Estelle; Pinel, Arletty; Wynd, Shona; Zodpey, Sanjay

    2013-11-01

    To achieve universal health coverage, health systems will have to reach into every community, including the poorest and hardest to access. Since Alma-Ata, inconsistent support of community health workers (CHWs) and failure to integrate them into the health system have impeded full realization of their potential contribution in the context of primary health care. Scaling up and maintaining CHW programmes is fraught with a host of challenges: poor planning; multiple competing actors with little coordination; fragmented, disease-specific training; donor-driven management and funding; tenuous linkage with the health system; poor coordination, supervision and support, and under-recognition of CHWs' contribution. The current drive towards universal health coverage (UHC) presents an opportunity to enhance people's access to health services and their trust, demand and use of such services through CHWs. For their potential to be fully realized, however, CHWs will need to be better integrated into national health-care systems in terms of employment, supervision, support and career development. Partners at the global, national and district levels will have to harmonize and synchronize their engagement in CHW support while maintaining enough flexibility for programmes to innovate and respond to local needs. Strong leadership from the public sector will be needed to facilitate alignment with national policy frameworks and country-led coordination and to achieve synergies and accountability, universal coverage and sustainability. In moving towards UHC, much can be gained by investing in building CHWs' skills and supporting them as valued members of the health team. Stand-alone investments in CHWs are no shortcut to progress.

  6. Community health workers for universal health-care coverage: from fragmentation to synergy

    PubMed Central

    Møgedal, Sigrun; Afzal, Muhammad Mahmood; Frymus, Diana; Oshin, Adetokunbo; Pate, Muhammad; Quain, Estelle; Pinel, Arletty; Wynd, Shona; Zodpey, Sanjay

    2013-01-01

    Abstract To achieve universal health coverage, health systems will have to reach into every community, including the poorest and hardest to access. Since Alma-Ata, inconsistent support of community health workers (CHWs) and failure to integrate them into the health system have impeded full realization of their potential contribution in the context of primary health care. Scaling up and maintaining CHW programmes is fraught with a host of challenges: poor planning; multiple competing actors with little coordination; fragmented, disease-specific training; donor-driven management and funding; tenuous linkage with the health system; poor coordination, supervision and support, and under-recognition of CHWs’ contribution. The current drive towards universal health coverage (UHC) presents an opportunity to enhance people’s access to health services and their trust, demand and use of such services through CHWs. For their potential to be fully realized, however, CHWs will need to be better integrated into national health-care systems in terms of employment, supervision, support and career development. Partners at the global, national and district levels will have to harmonize and synchronize their engagement in CHW support while maintaining enough flexibility for programmes to innovate and respond to local needs. Strong leadership from the public sector will be needed to facilitate alignment with national policy frameworks and country-led coordination and to achieve synergies and accountability, universal coverage and sustainability. In moving towards UHC, much can be gained by investing in building CHWs’ skills and supporting them as valued members of the health team. Stand-alone investments in CHWs are no shortcut to progress. PMID:24347709

  7. BRICS countries and the global movement for universal health coverage.

    PubMed

    Tediosi, Fabrizio; Finch, Aureliano; Procacci, Christina; Marten, Robert; Missoni, Eduardo

    2016-07-01

    This article explores BRICS' engagement in the global movement for Universal Health Coverage (UHC) and the implications for global health governance. It is based on primary data collected from 43 key informant interviews, complemented by a review of BRICS' global commitments supporting UHC. Interviews were conducted using a semi-structured questionnaire that included both closed- and open-ended questions. Question development was informed by insights from the literature on UHC, Cox's framework for action, and Kingdon's multiple-stream theory of policy formation. The closed questions were analysed with simple descriptive statistics and the open-ended questions using grounded theory approach. The analysis demonstrates that most BRICS countries implicitly supported the global movement for UHC, and that they share an active engagement in promoting UHC. However, only Brazil, China and to some extent South Africa, were recognized as proactively pushing UHC in the global agenda. In addition, despite some concerted actions, BRICS countries seem to act more as individual countries rather that as an allied group. These findings suggest that BRICS are unlikely to be a unified political block that will transform global health governance. Yet the documented involvement of BRICS in the global movement supporting UHC, and their focus on domestic challenges, shows that BRICS individually are increasingly influential players in global health. So if BRICS countries should probably not be portrayed as the centre of future political community that will transform global health governance, their individual involvement in global health, and their documented concerted actions, may give greater voice to low- and middle-income countries supporting the emergence of multiple centres of powers in global health.

  8. Rural water supply and sanitation (RWSS) coverage in Swaziland: Toward achieving millennium development goals

    NASA Astrophysics Data System (ADS)

    Mwendera, E. J.

    An assessment of rural water supply and sanitation (RWSS) coverage in Swaziland was conducted in 2004/2005 as part of the Rural Water Supply and Sanitation Initiative (RWSSI). The initiative was developed by the African Development Bank with the aim of implementing it in the Regional Member Countries (RMCs), including Swaziland. Information on the RWSS sector programmes, costs, financial requirements and other related activities was obtained from a wide range of national documents, including sector papers and project files and progress reports. Interviews were held with staff from the central offices and field stations of Government of Swaziland (GOS) ministries and departments, non-governmental organizations (NGOs), bilateral and multilateral external support agencies, and private sector individuals and firms with some connection to the sector and/or its programmes. The assessment also involved field visits to various regions in order to obtain first hand information about the various technologies and institutional structures used in the provision of water supplies and sanitation services in the rural areas of the country. The results showed that the RWSS sector has made significant progress towards meeting the national targets of providing water and sanitation to the entire rural population by the year 2022. The assessment indicated that rural water supply coverage was 56% in 2004 while sanitation coverage was 63% in the same year. The results showed that there is some decline in the incidence of water-related diseases, such as diarrhoeal diseases, probably due to improved water supply and sanitation coverage. The study also showed that, with adequate financial resources, Swaziland is likely to achieve 100% coverage of both water supply and sanitation by the year 2022. It was concluded that in achieving its own national goals Swaziland will exceed the Millennium Development Goals (MDGs). However, such achievement is subject to adequate financial resources being

  9. Innovation for universal health coverage in Bangladesh: a call to action.

    PubMed

    Adams, Alayne M; Ahmed, Tanvir; El Arifeen, Shams; Evans, Timothy G; Huda, Tanvir; Reichenbach, Laura

    2013-12-21

    A post-Millennium Development Goals agenda for health in Bangladesh should be defined to encourage a second generation of health-system innovations under the clarion call of universal health coverage. This agenda should draw on the experience of the first generation of innovations that underlie the country's impressive health achievements and creatively address future health challenges. Central to the reform process will be the development of a multipronged strategic approach that: responds to existing demands in a way that assures affordable, equitable, high-quality health care from a pluralistic health system; anticipates health-care needs in a period of rapid health and social transition; and addresses underlying structural issues that otherwise might hamper progress. A pragmatic reform agenda for achieving universal health coverage in Bangladesh should include development of a long-term national human resources policy and action plan, establishment of a national insurance system, building of an interoperable electronic health information system, investment to strengthen the capacity of the Ministry of Health and Family Welfare, and creation of a supraministerial council on health. Greater political, financial, and technical investment to implement this reform agenda offers the prospect of a stronger, more resilient, sustainable, and equitable health system.

  10. Access to Medicines by Seguro Popular Beneficiaries: Pending Tasks towards Universal Health Coverage

    PubMed Central

    Servan-Mori, Edson; Heredia-Pi, Ileana; Montañez-Hernandez, Julio; Avila-Burgos, Leticia; Wirtz, Veronika J.

    2015-01-01

    Objective In the context of aiming to achieve universal health coverage in Mexico, this study compares access to prescribed medicines (ATPM) between Seguro Popular (SP) and non-SP affiliated outpatient health service users. Materials and Methods ATPM by 6,123 users of outpatient services was analyzed using the National Health and Nutrition Survey 2012. Adjusted bi-probit models were performed incorporating instrumental variables. Results 17.3% of SP and 10.1% of the non-SP population lacked ATPM. Two-thirds of all outpatient SP and 18.5% of all outpatient non-SP received health services at Ministry of Health facilities, among whom, 64.6 and 53.6% of the SP and non-SP population respectively reported ATPM at these facilities. Lack of medicines in health units, chronic health problems (compared to acute conditions) and prescription ≥3 medicines were risk factors for non-ATPM. Adjusted models suggest that when using Ministry of Health services, the SP population has a higher probability of ATMP compared to the non-SP population. Conclusion Given the aspirations of achieving universal health coverage in Mexico, it is important to increase ATPM in Ministry of Health facilities thereby ensuring basic rights to health care are met. PMID:26407158

  11. The use of insecticide treated nets by age: implications for universal coverage in Africa

    PubMed Central

    Noor, Abdisalan M; Kirui, Viola C; Brooker, Simon J; Snow, Robert W

    2009-01-01

    Background The scaling of malaria control to achieve universal coverage requires a better understanding of the population sub-groups that are least protected and provide barriers to interrupted transmission. Here we examine the age pattern of use of insecticide treated nets (ITNs) in Africa in relation to biological vulnerabilities and the implications for future prospects for universal coverage. Methods Recent national household survey data for 18 malaria endemic countries in Africa were assembled to indentify information on use of ITNs by age and sex. Age-structured medium variant projected population estimates for the mid-point year of the earliest and most recent national surveys were derived to compute the population by age protected by ITNs. Results All surveys were undertaken between 2005 and 2009, either as demographic health surveys (n = 12) or malaria indicator surveys (n = 6). Countries were categorized into three ITN use groups: <10%; 10 to <20%; and ≥20% and projected population estimates for the mid-point year of 2007 were computed. In general, the pattern of overall ITNs use with age was similar by country and across the three country groups with ITNs use initially high among children <5 years of age, sharply declining among the population aged 5-19 years, before rising again across the ages 20-44 years and finally decreasing gradually in older ages. For all groups of countries, the highest proportion of the population not protected by ITNs (38% - 42%) was among those aged 5-19 years. Conclusion In malaria-endemic Africa, school-aged children are the least protected with ITNs but represent the greatest reservoir of infections. With increasing school enrollment rates, school-delivery of ITNs should be considered as an approach to reach universal ITNs coverage and improve the likelihood of impacting upon parasite transmission. PMID:19796380

  12. The path towards universal health coverage in the Arab uprising countries Tunisia, Egypt, Libya, and Yemen.

    PubMed

    Saleh, Shadi S; Alameddine, Mohamad S; Natafgi, Nabil M; Mataria, Awad; Sabri, Belgacem; Nasher, Jamal; Zeiton, Moez; Ahmad, Shaimaa; Siddiqi, Sameen

    2014-01-25

    The constitutions of many countries in the Arab world clearly highlight the role of governments in guaranteeing provision of health care as a right for all citizens. However, citizens still have inequitable health-care systems. One component of such inequity relates to restricted financial access to health-care services. The recent uprisings in the Arab world, commonly referred to as the Arab spring, created a sociopolitical momentum that should be used to achieve universal health coverage (UHC). At present, many countries of the Arab spring are considering health coverage as a priority in dialogues for new constitutions and national policy agendas. UHC is also the focus of advocacy campaigns of a number of non-governmental organisations and media outlets. As part of the health in the Arab world Series in The Lancet, this report has three overarching objectives. First, we present selected experiences of other countries that had similar social and political changes, and how these events affected their path towards UHC. Second, we present a brief overview of the development of health-care systems in the Arab world with regard to health-care coverage and financing, with a focus on Egypt, Libya, Tunisia, and Yemen. Third, we aim to integrate historical lessons with present contexts in a roadmap for action that addresses the challenges and opportunities for progression towards UHC.

  13. Is universal health coverage the practical expression of the right to health care?

    PubMed

    Ooms, Gorik; Latif, Laila A; Waris, Attiya; Brolan, Claire E; Hammonds, Rachel; Friedman, Eric A; Mulumba, Moses; Forman, Lisa

    2014-02-24

    The present Millennium Development Goals are set to expire in 2015 and their next iteration is now being discussed within the international community. With regards to health, the World Health Organization proposes universal health coverage as a 'single overarching health goal' for the next iteration of the Millennium Development Goals.The present Millennium Development Goals have been criticised for being 'duplicative' or even 'competing alternatives' to international human rights law. The question then arises, if universal health coverage would indeed become the single overarching health goal, replacing the present health-related Millennium Development Goals, would that be more consistent with the right to health? The World Health Organization seems to have anticipated the question, as it labels universal health coverage as "by definition, a practical expression of the concern for health equity and the right to health".Rather than waiting for the negotiations to unfold, we thought it would be useful to verify this contention, using a comparative normative analysis. We found that--to be a practical expression of the right to health--at least one element is missing in present authoritative definitions of universal health coverage: a straightforward confirmation that international assistance is essential, not optional.But universal health coverage is a 'work in progress'. A recent proposal by the United Nations Sustainable Development Solutions Network proposed universal health coverage with a set of targets, including a target for international assistance, which would turn universal health coverage into a practical expression of the right to health care.

  14. Summary indices for monitoring universal coverage in maternal and child health care

    PubMed Central

    Restrepo-Mendez, Maria-Clara; Franca, Giovanny VA; Victora, Cesar G; Barros, Aluisio JD

    2016-01-01

    Abstract Objective To compare two summary indicators for monitoring universal coverage of reproductive, maternal, newborn and child health care. Methods Using our experience of the Countdown to 2015 initiative, we describe the characteristics of the composite coverage index (a weighted average of eight preventive and curative interventions along the continuum of care) and co-coverage index (a cumulative count of eight preventive interventions that should be received by all mothers and children). For in-depth analysis and comparisons, we extracted data from 49 demographic and health surveys. We calculated percentage coverage for the two summary indices, and correlated these with each other and with outcome indicators of mortality and undernutrition. We also stratified the summary indicators by wealth quintiles for a subset of nine countries. Findings Data on the component indicators in the required age range were less often available for co-coverage than for the composite coverage index. The composite coverage index and co-coverage with 6+ indicators were strongly correlated (Pearson r  = 0.73, P < 0.001). The composite coverage index was more strongly correlated with under-five mortality, neonatal mortality and prevalence of stunting (r =  −0.57, −0.68 and −0.46 respectively) than was co-coverage (r = −0.49, −0.43 and −0.33 respectively). Both summary indices provided useful summaries of the degrees of inequality in the countries’ coverage. Adding more indicators did not substantially affect the composite coverage index. Conclusion The composite coverage index, based on the average value of separate coverage indicators, is easy to calculate and could be useful for monitoring progress and inequalities in universal health coverage. PMID:27994283

  15. Academic Achievement of University Students with Dyslexia.

    PubMed

    Olofsson, Åke; Taube, Karin; Ahl, Astrid

    2015-11-01

    Broadened recruitment to higher education is on the agenda in many countries, and it is also widely recognized that the number of dyslexic students entering higher education is increasing. In Sweden, as in many other European countries, higher education institutions are required to accommodate students with dyslexia. The present study focuses on the study outcome for 50 students with diagnosed dyslexia, mainly in teacher education and nurses' training, at three universities in Northern Sweden. The students trusted their own ability to find information on the Internet but mistrusted their own abilities in reading course books and articles in English and in taking notes. The mean rate of study was 23.5 European Credit Transfer and Accumulation System credits per semester, which is slightly below the national baseline of 26.7. The results show that more than half of the students are examined at a normal rate of study but that about one fifth have a very low rate of study. Messages Most students with dyslexia can compensate for their reading problems. Taking notes during lessons and reading in foreign language may be especially difficult for students with dyslexia. Diagnoses should distinguish between reading comprehension and word decoding. More than half of the students with dyslexia can achieve at a normal rate of study. One-fifth of the students with dyslexia may need a longer period of study than other students.

  16. The challenges of achieving high training coverage for IMCI: case studies from Kenya and Tanzania

    PubMed Central

    Mushi, Hildegalda P; Mullei, Kethi; Macha, Janet; Wafula, Frank; Borghi, Josephine; Goodman, Catherine; Gilson, Lucy

    2011-01-01

    Health worker training is a key component of the integrated management of childhood illness (IMCI). However, training coverage remains low in many countries. We conducted in-depth case studies in two East African countries to examine the factors underlying low training coverage 10 years after IMCI had been adopted as policy. A document review and in-depth semi-structured interviews with stakeholders at facility, district, regional/provincial and national levels in two districts in Kenya (Homa Bay and Malindi) and Tanzania (Bunda and Tarime) were carried out in 2007–08. Bunda and Malindi achieved higher levels of training coverage (44% and 25%) compared with Tarime and Homa Bay (5% and 13%). Key factors allowing the first two districts to perform better were: strong district leadership and personal commitment to IMCI, which facilitated access to external funding and encouraged local-level policy adaptation; sensitization and training of district health managers; and lower staff turnover. However, IMCI training coverage remained well below target levels across all sites. The main barrier to expanding coverage was the cost of training due to its duration, the number of facilitators and its residential nature. Mechanisms for financing IMCI also restricted district capacity to raise funds. In Tanzania, districts could not spend more than 10% of their budgets on training. In Kenya, limited financial decentralization meant that district managers had to rely on donors for financial support. Critically, the low priority given to IMCI at national and international levels also limited the expansion of training. Levels of domestic and donor support for IMCI have diminished over time in favour of vertical programmes, partly due to the difficulty in monitoring and measuring the impact of an integrated intervention like IMCI. Alternative, lower cost methods of IMCI training need to be promoted, and greater advocacy for IMCI is needed both nationally and internationally. PMID

  17. The role of institutional design and organizational practice for health financing performance and universal coverage.

    PubMed

    Mathauer, Inke; Carrin, Guy

    2011-03-01

    Many low- and middle income countries heavily rely on out-of-pocket health care expenditure. The challenge for these countries is how to modify their health financing system in order to achieve universal coverage. This paper proposes an analytical framework for undertaking a systematic review of a health financing system and its performance on the basis of which to identify adequate changes to enhance the move towards universal coverage. The distinctive characteristic of this framework is the focus on institutional design and organizational practice of health financing, on which health financing performance is contingent. Institutional design is understood as formal rules, namely legal and regulatory provisions relating to health financing; organizational practice refers to the way organizational actors implement and comply with these rules. Health financing performance is operationalized into nine generic health financing performance indicators. Inadequate performance can be caused by six types of bottlenecks in institutional design and organizational practice. Accordingly, six types of improvement measures are proposed to address these bottlenecks. The institutional design and organizational practice of a health financing system can be actively developed, modified or strengthened. By understanding the incentive environment within a health financing system, the potential impacts of the proposed changes can be anticipated.

  18. Moving towards universal coverage in South Africa? Lessons from a voluntary government insurance scheme

    PubMed Central

    Govender, Veloshnee; Chersich, Matthew F.; Harris, Bronwyn; Alaba, Olufunke; Ataguba, John E.; Nxumalo, Nonhlanhla; Goudge, Jane

    2013-01-01

    Background In 2005, the South African government introduced a voluntary, subsidised health insurance scheme for civil servants. In light of the global emphasis on universal coverage, empirical evidence is needed to understand the relationship between new health financing strategies and health care access thereby improving global understanding of these issues. Objectives This study analysed coverage of the South African government health insurance scheme, the population groups with low uptake, and the individual-level factors, as well as characteristics of the scheme, that influenced enrolment. Methods Multi-stage random sampling was used to select 1,329 civil servants from the health and education sectors in four of South Africa's nine provinces. They were interviewed to determine factors associated with enrolment in the scheme. The analysis included both descriptive statistics and multivariate logistic regression. Results Notwithstanding the availability of a non-contributory option within the insurance scheme and access to privately-provided primary care, a considerable portion of socio-economically vulnerable groups remained uninsured (57.7% of the lowest salary category). Non-insurance was highest among men, black African or coloured ethnic groups, less educated and lower-income employees, and those living in informal-housing. The relatively poor uptake of the contributory and non-contributory insurance options was mostly attributed to insufficient information, perceived administrative challenges of taking up membership, and payment costs. Conclusion Barriers to enrolment include insufficient information, unaffordability of payments and perceived administrative complexity. Achieving universal coverage requires good physical access to service providers and appropriate benefit options within pre-payment health financing mechanisms. PMID:23364093

  19. Achieving Successful School-University Collaboration.

    ERIC Educational Resources Information Center

    Borthwick, Arlene C.; Stirling, Terry; Nauman, April D.; Cook, Dale L.

    2003-01-01

    Investigated essential elements required to establish and maintain successful school-university partnerships as reported by principals, teachers, and university coordinators involved in both voluntary and mandated partnerships. Results identified five factors representing different perspectives on key elements for successful partnerships, with…

  20. Achieving effective cervical screening coverage in South Africa through human resources and health systems development.

    PubMed

    Kawonga, Mary; Fonn, Sharon

    2008-11-01

    South Africa's cervical screening policy recommends three free Pap smears at ten-year intervals for all women over 30 years of age, aiming to achieve 70% coverage by 2010 by targeting the age group most at risk of developing pre-cancerous cervical lesions. Attaining wide coverage requires an adequate supply of motivated and supported public sector health workers with appropriate training and skills, working in a functional health system. Given the dearth of doctors in South Africa, professional nurses were tasked with performing the bulk of Pap smears at primary care level. Coverage remains sub-optimal and a significant proportion of women with precursor lesions do not receive treatment. Further, health system strengthening - essential for cytology-based screening - has not happened. Research to evaluate alternative screening technologies has proliferated in recent years, but regrettably, strengthening of the health system required to make the new technology work has not received similar attention. Using the South African experience, this article argues that technological interventions and innovations alone are not sufficient to improve cervical screening programmes. Task-shifting is limited unless other human resource concerns (e.g. training, increasing demands on personnel, attrition, and skills mix) are concurrently addressed within a comprehensive workforce development strategy, alongside work to make the health care delivery system functional.

  1. Universal Health Coverage – The Critical Importance of Global Solidarity and Good Governance

    PubMed Central

    Reis, Andreas A.

    2016-01-01

    This article provides a commentary to Ole Norheim’ s editorial entitled "Ethical perspective: Five unacceptable trade-offs on the path to universal health coverage." It reinforces its message that an inclusive, participatory process is essential for ethical decision-making and underlines the crucial importance of good governance in setting fair priorities in healthcare. Solidarity on both national and international levels is needed to make progress towards the goal of universal health coverage (UHC). PMID:27694683

  2. Promoting universal financial protection: how the Thai universal coverage scheme was designed to ensure equity

    PubMed Central

    2013-01-01

    Background Empirical evidence demonstrates that the Thai Universal Coverage Scheme (UCS) has improved equity of health financing and provided a relatively high level of financial risk protection. Several UCS design features contribute to these outcomes: a tax-financed scheme, a comprehensive benefit package and gradual extension of coverage to illnesses that can lead to catastrophic household costs, and capacity of the National Health Security Office (NHSO) to mobilise adequate resources. This study assesses the policy processes related to making decisions on these features. Methods The study employs qualitative methods including reviews of relevant documents, in-depth interviews of 25 key informants, and triangulation amongst information sources. Results Continued political and financial commitments to the UCS, despite political rivalry, played a key role. The Thai Rak Thai (TRT)-led coalition government introduced UCS; staying in power 8 of the 11 years between 2001 and 2011 was long enough to nurture and strengthen the UCS and overcome resistance from various opponents. Prime Minister Surayud’s government, replacing the ousted TRT government, introduced universal renal replacement therapy, which deepened financial risk protection. Commitment to their manifesto and fiscal capacity pushed the TRT to adopt a general tax-financed universal scheme; collecting premiums from people engaged in the informal sector was neither politically palatable nor technically feasible. The relatively stable tenure of NHSO Secretary Generals and the chairs of the Financing and the Benefit Package subcommittees provided a platform for continued deepening of financial risk protection. NHSO exerted monopsonistic purchasing power to control prices, resulting in greater patient access and better systems efficiency than might have been the case with a different design. The approach of proposing an annual per capita budget changed the conventional line-item programme budgeting system by

  3. The democratization of health in Mexico: financial innovations for universal coverage.

    PubMed

    Frenk, Julio; Gómez-Dantés, Octavio; Knaul, Felicia Marie

    2009-07-01

    In 2003, the Mexican Congress approved a reform establishing the Sistema de Protección Social en Salud [System of Social Protection in Health], whereby public funding for health is being increased by one percent of the 2003 gross domestic product over seven years to guarantee universal health insurance. Poor families that had been excluded from traditional social security can now enrol in a new public insurance scheme known as Seguro Popular [People's Insurance], which assures legislated access to a comprehensive set of health-care entitlements. This paper describes the financial innovations behind the expansion of health-care coverage in Mexico to everyone and their effects. Evidence shows improvements in mobilization of additional public resources; availability of health infrastructure and drugs; service utilization; effective coverage; and financial protection. Future challenges are discussed, among them the need for additional public funding to extend access to costly interventions for non-communicable diseases not yet covered by the new insurance scheme, and to improve the technical quality of care and the responsiveness of the health system. Eventually, the progress achieved so far will have to be reflected in health outcomes, which will continue to be evaluated so that Mexico can meet the ultimate criterion of reform success: better health through equity, quality and fair financing.

  4. The democratization of health in Mexico: financial innovations for universal coverage

    PubMed Central

    Frenk, Julio; Knaul, Felicia Marie

    2009-01-01

    Abstract In 2003, the Mexican Congress approved a reform establishing the Sistema de Protección Social en Salud [System of Social Protection in Health], whereby public funding for health is being increased by one percent of the 2003 gross domestic product over seven years to guarantee universal health insurance. Poor families that had been excluded from traditional social security can now enrol in a new public insurance scheme known as Seguro Popular [People’s Insurance], which assures legislated access to a comprehensive set of health-care entitlements. This paper describes the financial innovations behind the expansion of health-care coverage in Mexico to everyone and their effects. Evidence shows improvements in mobilization of additional public resources; availability of health infrastructure and drugs; service utilization; effective coverage; and financial protection. Future challenges are discussed, among them the need for additional public funding to extend access to costly interventions for non-communicable diseases not yet covered by the new insurance scheme, and to improve the technical quality of care and the responsiveness of the health system. Eventually, the progress achieved so far will have to be reflected in health outcomes, which will continue to be evaluated so that Mexico can meet the ultimate criterion of reform success: better health through equity, quality and fair financing. PMID:19649369

  5. Tackling health workforce challenges to universal health coverage: setting targets and measuring progress.

    PubMed

    Cometto, Giorgio; Witter, Sophie

    2013-11-01

    Human resources for health (HRH) will have to be strengthened if universal health coverage (UHC) is to be achieved. Existing health workforce benchmarks focus exclusively on the density of physicians, nurses and midwives and were developed with the objective of attaining relatively high coverage of skilled birth attendance and other essential health services of relevance to the health Millennium Development Goals (MDGs). However, the attainment of UHC will depend not only on the availability of adequate numbers of health workers, but also on the distribution, quality and performance of the available health workforce. In addition, as noncommunicable diseases grow in relative importance, the inputs required from health workers are changing. New, broader health-workforce benchmarks - and a corresponding monitoring framework - therefore need to be developed and included in the agenda for UHC to catalyse attention and investment in this critical area of health systems. The new benchmarks need to reflect the more diverse composition of the health workforce and the participation of community health workers and mid-level health workers, and they must capture the multifaceted nature and complexities of HRH development, including equity in accessibility, sex composition and quality.

  6. Achieving Successful School-University Collaboration.

    ERIC Educational Resources Information Center

    Borthwick, Arlene C.; Stirling, Terry; Cook, Dale

    This study investigated participant perceptions of essential elements for establishing and maintaining successful school-university partnerships for school improvement, noting differences in perceptions of participants involved in voluntary partnerships versus those involved in partnerships required by the school district (schools placed on…

  7. Universal Access to Health and Universal Health Coverage: identification of nursing research priorities in Latin America

    PubMed Central

    Cassiani, Silvia Helena De Bortoli; Bassalobre-Garcia, Alessandra; Reveiz, Ludovic

    2015-01-01

    Objective: To estabilish a regional list for nursing research priorities in health systems and services in the Region of the Americas based on the concepts of Universal Access to Health and Universal Health Coverage. Method: five-stage consensus process: systematic review of literature; appraisal of resulting questions and topics; ranking of the items by graduate program coordinators; discussion and ranking amongst a forum of researchers and public health leaders; and consultation with the Ministries of Health of the Pan American Health Organization's member states. Results: the resulting list of nursing research priorities consists of 276 study questions/ topics, which are sorted into 14 subcategories distributed into six major categories: 1. Policies and education of nursing human resources; 2. Structure, organization and dynamics of health systems and services; 3. Science, technology, innovation, and information systems in public health; 4. Financing of health systems and services; 5. Health policies, governance, and social control; and 6. Social studies in the health field. Conclusion: the list of nursing research priorities is expected to serve as guidance and support for nursing research on health systems and services across Latin America. Not only researchers, but also Ministries of Health, leaders in public health, and research funding agencies are encouraged to use the results of this list to help inform research-funding decisions. PMID:26487014

  8. Progress towards universal health coverage in BRICS: translating economic growth into better health.

    PubMed

    Rao, Krishna D; Petrosyan, Varduhi; Araujo, Edson Correia; McIntyre, Diane

    2014-06-01

    Brazil, the Russian Federation, India, China and South Africa--the countries known as BRICS--represent some of the world's fastest growing large economies and nearly 40% of the world's population. Over the last two decades, BRICS have undertaken health-system reforms to make progress towards universal health coverage. This paper discusses three key aspects of these reforms: the role of government in financing health; the underlying motivation behind the reforms; and the value of the lessons learnt for non-BRICS countries. Although national governments have played a prominent role in the reforms, private financing constitutes a major share of health spending in BRICS. There is a reliance on direct expenditures in China and India and a substantial presence of private insurance in Brazil and South Africa. The Brazilian health reforms resulted from a political movement that made health a constitutional right, whereas those in China, India, the Russian Federation and South Africa were an attempt to improve the performance of the public system and reduce inequities in access. The move towards universal health coverage has been slow. In China and India, the reforms have not adequately addressed the issue of out-of-pocket payments. Negotiations between national and subnational entities have often been challenging but Brazil has been able to achieve good coordination between federal and state entities via a constitutional delineation of responsibility. In the Russian Federation, poor coordination has led to the fragmented pooling and inefficient use of resources. In mixed health systems it is essential to harness both public and private sector resources.

  9. Patient satisfaction with task shifting of antiretroviral services in Ethiopia: implications for universal health coverage.

    PubMed

    Asfaw, Elias; Dominis, Sarah; Palen, John G H; Wong, Wendy; Bekele, Abebe; Kebede, Amha; Johns, Benjamin

    2014-09-01

    Formalized task shifting structures have been used to rapidly scale up antiretroviral service delivery to underserved populations in several countries, and may be a promising mechanism for accomplishing universal health coverage. However, studies evaluating the quality of service delivery through task shifting have largely ignored the patient perspective, focusing on health outcomes and acceptability to health care providers and regulatory bodies, despite studies worldwide that have shown the significance of patient satisfaction as an indicator of quality. This study aimed to measure patient satisfaction with task shifting of antiretroviral services in hospitals and health centres in four regions of Ethiopia. This cross-sectional study used data collected from a time-motion study of patient services paired with 665 patient exit interviews in a stratified random sample of antiretroviral therapy clinics in 21 hospitals and 40 health centres in 2012. Data were analyzed using f-tests across provider types, and multivariate logistic regression to identify determinants of patient satisfaction. Most (528 of 665) patients were satisfied or somewhat satisfied with the services received, but patients who received services from nurses and health officers were significantly more likely to report satisfaction than those who received services from doctors [odds ratio (OR) 0.26, P < 0.01]. Investments in the health facility were associated with higher satisfaction (OR 1.07, P < 0.01), while costs to patients of over 120 birr were associated with lower satisfaction (OR 0.14, P < 0.05). This study showed high levels of patient satisfaction with task shifting in Ethiopia. The evidence generated by this study complements previous biomedical and health care provider/regulatory acceptability studies to support the inclusion of task shifting as a mechanism for scaling-up health services to achieve universal health coverage, particularly for underserved areas facing severe health worker

  10. Health-system reform and universal health coverage in Latin America.

    PubMed

    Atun, Rifat; de Andrade, Luiz Odorico Monteiro; Almeida, Gisele; Cotlear, Daniel; Dmytraczenko, T; Frenz, Patricia; Garcia, Patrícia; Gómez-Dantés, Octavio; Knaul, Felicia M; Muntaner, Carles; de Paula, Juliana Braga; Rígoli, Felix; Serrate, Pastor Castell-Florit; Wagstaff, Adam

    2015-03-28

    Starting in the late 1980s, many Latin American countries began social sector reforms to alleviate poverty, reduce socioeconomic inequalities, improve health outcomes, and provide financial risk protection. In particular, starting in the 1990s, reforms aimed at strengthening health systems to reduce inequalities in health access and outcomes focused on expansion of universal health coverage, especially for poor citizens. In Latin America, health-system reforms have produced a distinct approach to universal health coverage, underpinned by the principles of equity, solidarity, and collective action to overcome social inequalities. In most of the countries studied, government financing enabled the introduction of supply-side interventions to expand insurance coverage for uninsured citizens--with defined and enlarged benefits packages--and to scale up delivery of health services. Countries such as Brazil and Cuba introduced tax-financed universal health systems. These changes were combined with demand-side interventions aimed at alleviating poverty (targeting many social determinants of health) and improving access of the most disadvantaged populations. Hence, the distinguishing features of health-system strengthening for universal health coverage and lessons from the Latin American experience are relevant for countries advancing universal health coverage.

  11. "Developmental capture" of the state: explaining Thailand's universal coverage policy.

    PubMed

    Harris, Joseph

    2015-02-01

    The notion of "regulatory capture" is typically used to describe the takeover of state agencies by outside interest groups that seek to weaken regulation and advance the agendas of interest groups through control over state policy levers. This concept can be contrasted with that of "developmental capture" of state agencies by networks of reformist bureaucrats within the state who seek to promote inclusive state social and developmental policies of benefit to the broader populace. Building on work that has pointed to instances in which state bureaucrats act autonomously from societal and political pressures, this article argues that existing explanations are insufficient for explaining Thailand's universal health care policy. It points to the critical role played by a network of bureaucrats within the state who strategically mobilized resources in the bureaucracy, political parties, civil society, and international organizations to institutionalize universal health care in the face of broader professional dissent, political uncertainty, and international pressure.

  12. Universal coverage in the United States: lessons from experience of the 20th century.

    PubMed

    Davis, K

    2001-03-01

    Both the rising numbers of uninsured Americans and the recent presidential election have put the issue of universal health insurance coverage back on the national agenda. Lack of health insurance is a major barrier to care for 44 million Americans, and lack of high-quality, comprehensive insurance is a barrier to millions more. Universal coverage is one of the best ways to ensure that all Americans have equitable access to quality care, and it also contributes to the financial stability of health care providers, especially those in the urban safety net. A wide variety of ideas to expand health care coverage were proposed, and in some cases enacted, during the last century. At the beginning of the 21st century, the American health care system is made up of varied elements, ranging from employer-sponsored health insurance for the majority of working-age adults to the public Medicare program for the elderly. While this patchwork system leaves many Americans without health insurance, it also creates many different ways to expand coverage, including various options in both the private and public sectors. By understanding how the current health care system developed, how the various proposals for universal health coverage gained and lost political and public support, and the pros and cons of the various alternatives available to expand coverage, we create a solid base from which to solve the problem of the uninsured in the 21st century.

  13. Massachusetts health reform: employers, lower-wage workers and universal coverage.

    PubMed

    Felland, Laurie; Draper, Debra; Liebhaber, Allison

    2007-07-01

    As Massachusetts' landmark effort to reach nearly universal health coverage unfolds, the state is now focusing on employers to take steps to increase coverage. All employers--except firms with fewer than 11 workers--face new requirements under the 2006 law, including establishing Section 125, or cafeteria, plans to allow workers to purchase insurance with pre-tax dollars and paying a $295 annual fee if they do not make a "fair and reasonable" contribution to the cost of workers' coverage. Through interviews with Massachusetts health care leaders (see Data Source), the Center for Studying Health System Change (HSC) examined how the law is likely to affect employer decisions to offer health insurance to workers and employee decisions to purchase coverage. Market observers believe many small firms may be unaware of specific requirements and that some could prove onerous. Moreover, the largest impact on small employers may come from the individual mandate for all residents to have a minimum level of health insurance. This mandate may add costs for firms if more workers take up coverage offers, seek more generous coverage or pressure employers to offer coverage. Despite reform of the individual and small group markets, including development of new insurance products, concerns remain about the affordability of coverage and the ability to stem rising health care costs.

  14. Universal Health Coverage and the Right to Health: From Legal Principle to Post-2015 Indicators.

    PubMed

    Sridhar, Devi; McKee, Martin; Ooms, Gorik; Beiersmann, Claudia; Friedman, Eric; Gouda, Hebe; Hill, Peter; Jahn, Albrecht

    2015-01-01

    Universal Health Coverage (UHC) is widely considered one of the key components for the post-2015 health goal. The idea of UHC is rooted in the right to health, set out in the International Covenant on Economic, Social, and Cultural Rights. Based on the Covenant and the General Comment of the Committee on Economic, Social, and Cultural Rights, which is responsible for interpreting and monitoring the Covenant, we identify 6 key legal principles that should underpin UHC based on the right to health: minimum core obligation, progressive realization, cost-effectiveness, shared responsibility, participatory decision making, and prioritizing vulnerable or marginalized groups. Yet, although these principles are widely accepted, they are criticized for not being specific enough to operationalize as post-2015 indicators for reaching the target of UHC. In this article, we propose measurable and achievable indicators for UHC based on the right to health that can be used to inform the ongoing negotiations on Sustainable Development Goals. However, we identify 3 major challenges that face any exercise in setting indicators post-2015: data availability as an essential criterion, the universality of targets, and the adaptation of global goals to local populations.

  15. Health financing for universal coverage and health system performance: concepts and implications for policy.

    PubMed

    Kutzin, Joseph

    2013-08-01

    Unless the concept is clearly understood, "universal coverage" (or universal health coverage, UHC) can be used to justify practically any health financing reform or scheme. This paper unpacks the definition of health financing for universal coverage as used in the World Health Organization's World health report 2010 to show how UHC embodies specific health system goals and intermediate objectives and, broadly, how health financing reforms can influence these. All countries seek to improve equity in the use of health services, service quality and financial protection for their populations. Hence, the pursuit of UHC is relevant to every country. Health financing policy is an integral part of efforts to move towards UHC, but for health financing policy to be aligned with the pursuit of UHC, health system reforms need to be aimed explicitly at improving coverage and the intermediate objectives linked to it, namely, efficiency, equity in health resource distribution and transparency and accountability. The unit of analysis for goals and objectives must be the population and health system as a whole. What matters is not how a particular financing scheme affects its individual members, but rather, how it influences progress towards UHC at the population level. Concern only with specific schemes is incompatible with a universal coverage approach and may even undermine UHC, particularly in terms of equity. Conversely, if a scheme is fully oriented towards system-level goals and objectives, it can further progress towards UHC. Policy and policy analysis need to shift from the scheme to the system level.

  16. Spine stereotactic body radiation therapy plans: Achieving dose coverage, conformity, and dose falloff.

    PubMed

    Hong, Linda X; Shankar, Viswanathan; Shen, Jin; Kuo, Hsiang-Chi; Mynampati, Dinesh; Yaparpalvi, Ravindra; Goddard, Lee; Basavatia, Amar; Fox, Jana; Garg, Madhur; Kalnicki, Shalom; Tomé, Wolfgang A

    2015-01-01

    We report our experience of establishing planning objectives to achieve dose coverage, conformity, and dose falloff for spine stereotactic body radiation therapy (SBRT) plans. Patients with spine lesions were treated using SBRT in our institution since September 2009. Since September 2011, we established the following planning objectives for our SBRT spine plans in addition to the cord dose constraints: (1) dose coverage—prescription dose (PD) to cover at least 95% planning target volume (PTV) and 90% PD to cover at least 99% PTV; (2) conformity index (CI)—ratio of prescription isodose volume (PIV) to the PTV < 1.2; (3) dose falloff—ratio of 50% PIV to the PTV (R(50%)); (4) and maximum dose in percentage of PD at 2 cm from PTV in any direction (D(2cm)) to follow Radiation Therapy Oncology Group (RTOG) 0915. We have retrospectively reviewed 66 separate spine lesions treated between September 2009 and December 2012 (31 treated before September 2011 [group 1] and 35 treated after [group 2]). The χ(2) test was used to examine the difference in parameters between groups. The PTV V(100% PD) ≥ 95% objective was met in 29.0% of group 1 vs 91.4% of group 2 (p < 0.01) plans. The PTV V(90% PD) ≥ 99% objective was met in 38.7% of group 1 vs 88.6% of group 2 (p < 0.01) plans. Overall, 4 plans in group 1 had CI > 1.2 vs none in group 2 (p = 0.04). For D(2cm), 48.3% plans yielded a minor violation of the objectives and 16.1% a major violation for group 1, whereas 17.1% exhibited a minor violation and 2.9% a major violation for group 2 (p < 0.01). Spine SBRT plans can be improved on dose coverage, conformity, and dose falloff employing a combination of RTOG spine and lung SBRT protocol planning objectives.

  17. Institutional design and organizational practice for universal coverage in lesser-developed countries: challenges facing the Lao PDR.

    PubMed

    Ahmed, Shakil; Annear, Peter Leslie; Phonvisay, Bouaphat; Phommavong, Chansaly; Cruz, Valeria de Oliveira; Hammerich, Asmus; Jacobs, Bart

    2013-11-01

    There is now widespread acceptance of the universal coverage approach, presented in the 2010 World Health Report. There are more and more voices for the benefit of creating a single national risk pool. Now, a body of literature is emerging on institutional design and organizational practice for universal coverage, related to management of the three health-financing functions: collection, pooling and purchasing. While all countries can move towards universal coverage, lower-income countries face particular challenges, including scarce resources and limited capacity. Recently, the Lao PDR has been preparing options for moving to a single national health insurance scheme. The aim is to combine four different social health protection schemes into a national health insurance authority (NHIA) with a single national fund- and risk-pool. This paper investigates the main institutional and organizational challenges related to the creation of the NHIA. The paper uses a qualitative approach, drawing on the World Health Organization's institutional and Organizational Assessment for Improving and Strengthening health financing (OASIS) conceptual framework for data analysis. Data were collected from a review of key health financing policy documents and from 17 semi-structured key informant interviews. Policy makers and advisors are confronting issues related to institutional arrangements, funding sources for the authority and government support for subsidies to the demand-side health financing schemes. Compulsory membership is proposed, but the means for covering the informal sector have not been resolved. While unification of existing schemes may be the basis for creating a single risk pool, challenges related to administrative capacity and cross-subsidies remain. The example of Lao PDR illustrates the need to include consideration of national context, the sequencing of reforms and the time-scale appropriate for achieving universal coverage.

  18. Moving towards universal health coverage: health insurance reforms in nine developing countries in Africa and Asia.

    PubMed

    Lagomarsino, Gina; Garabrant, Alice; Adyas, Atikah; Muga, Richard; Otoo, Nathaniel

    2012-09-08

    We analyse nine low-income and lower-middle-income countries in Africa and Asia that have implemented national health insurance reforms designed to move towards universal health coverage. Using the functions-of-health-systems framework, we describe these countries' approaches to raising prepaid revenues, pooling risk, and purchasing services. Then, using the coverage-box framework, we assess their progress across three dimensions of coverage: who, what services, and what proportion of health costs are covered. We identify some patterns in the structure of these countries' reforms, such as use of tax revenues to subsidise target populations, steps towards broader risk pools, and emphasis on purchasing services through demand-side financing mechanisms. However, none of the reforms purely conform to common health-system archetypes, nor are they identical to each other. We report some trends in these countries' progress towards universal coverage, such as increasing enrolment in government health insurance, a movement towards expanded benefits packages, and decreasing out-of-pocket spending accompanied by increasing government share of spending on health. Common, comparable indicators of progress towards universal coverage are needed to enable countries undergoing reforms to assess outcomes and make midcourse corrections in policy and implementation.

  19. Implementation research: towards universal health coverage with more doctors in Brazil

    PubMed Central

    Oliveira, Aimê; Trindade, Josélia Souza; Barreto, Ivana CHC; Palmeira, Poliana Araújo; Comes, Yamila; Santos, Felipe OS; Santos, Wallace; Oliveira, João Paulo Alves; Pessoa, Vanira Matos; Shimizu, Helena Eri

    2017-01-01

    Abstract Objective To evaluate the implementation of a programme to provide primary care physicians for remote and deprived populations in Brazil. Methods The Mais Médicos (More Doctors) programme was launched in July 2013 with public calls to recruit physicians for priority areas. Other strategies were to increase primary care infrastructure investments and to provide more places at medical schools. We conducted a quasi-experimental, before-and-after evaluation of the implementation of the programme in 1708 municipalities with populations living in extreme poverty and in remote border areas. We compared physician density, primary care coverage and avoidable hospitalizations in municipalities enrolled (n = 1450) and not enrolled (n = 258) in the programme. Data extracted from health information systems and Ministry of Health publications were analysed. Findings By September 2015, 4917 physicians had been added to the 16 524 physicians already in place in municipalities with remote and deprived populations. The number of municipalities with ≥ 1.0 physician per 1000 inhabitants doubled from 163 in 2013 to 348 in 2015. Primary care coverage in enrolled municipalities (based on 3000 inhabitants per primary care team) increased from 77.9% in 2012 to 86.3% in 2015. Avoidable hospitalizations in enrolled municipalities decreased from 44.9% in 2012 to 41.2% in 2015, but remained unchanged in control municipalities. We also documented higher infrastructure investments in enrolled municipalities and an increase in the number of medical school places over the study period. Conclusion Other countries having shortages of physicians could benefit from the lessons of Brazil’s programme towards achieving universal right to health. PMID:28250510

  20. Impact of Universal Health Coverage on Child Growth and Nutrition in Argentina

    PubMed Central

    Fernández-Slezak, Diego; Farall, Andrés; Szretter, María Eugenia; Salomón, Oscar Daniel; Valeggia, Claudia R.

    2016-01-01

    Objectives. To estimate trends of undernutrition (stunting and underweight) among children younger than 5 years covered by the universal health coverage programs Plan Nacer and Programa Sumar. Methods. From 2005 to 2013, Plan Nacer and Programa Sumar collected high-quality information on birth and visit dates, age (in days), gender, weight (in kg), and height (in cm) for 1.4 million children in 6386 health centers (13 million records) with broad coverage of vulnerable populations in Argentina. Results. The prevalence of stunting and underweight decreased 45.0% (from 20.6% to 11.3%) and 38.0% (from 4.0% to 2.5%), respectively, with differences between rural versus urban areas, gender, regions, age, and seasons. Conclusions. Undernutrition prevalence substantially decreased in 2 programs in Argentina as a result of universal health coverage. PMID:26890172

  1. Analysing and recommending options for maintaining universal coverage with long-lasting insecticidal nets: the case of Tanzania in 2011

    PubMed Central

    2013-01-01

    Background Tanzania achieved universal coverage with long-lasting insecticidal nets (LLINs) in October 2011, after three years of free mass net distribution campaigns and is now faced with the challenge of maintaining high coverage as nets wear out and the population grows. A process of exploring options for a continuous or “Keep-Up” distribution system was initiated in early 2011. This paper presents for the first time a comprehensive national process to review the major considerations, findings and recommendations for the implementation of a new strategy. Methods Stakeholder meetings and site visits were conducted in five locations in Tanzania to garner stakeholder input on the proposed distribution systems. Coverage levels for LLINs and their decline over time were modelled using NetCALC software, taking realistic net decay rates, current demographic profiles and other relevant parameters into consideration. Costs of the different distribution systems were estimated using local data. Results LLIN delivery was considered via mass campaigns, Antenatal Care-Expanded Programme on Immunization (ANC/EPI), community-based distribution, schools, the commercial sector and different combinations of the above. Most approaches appeared unlikely to maintain universal coverage when used alone. Mass campaigns, even when combined with a continuation of the Tanzania National Voucher Scheme (TNVS), would produce large temporal fluctuations in coverage levels; over 10 years this strategy would require 63.3 million LLINs and a total cost of $444 million USD. Community mechanisms, while able to deliver the required numbers of LLINs, would require a massive scale-up in monitoring, evaluation and supervision systems to ensure accurate application of identification criteria at the community level. School-based approaches combined with the existing TNVS would reach most Tanzanian households and deliver 65.4 million LLINs over 10 years at a total cost of $449 million USD and ensure

  2. 2009-2010 Seasonal Influenza Vaccination Coverage among College Students from 8 Universities in North Carolina

    ERIC Educational Resources Information Center

    Poehling, Katherine A.; Blocker, Jill; Ip, Edward H.; Peters, Timothy R.; Wolfson, Mark

    2012-01-01

    Objective: The authors sought to describe the 2009-2010 seasonal influenza vaccine coverage of college students. Participants: A total of 4,090 college students from 8 North Carolina universities participated in a confidential, Web-based survey in October-November 2009. Methods: Associations between self-reported 2009-2010 seasonal influenza…

  3. College/University Presidents and Crisis Communications: Interpretive Content Analysis of Newspaper Coverage in the Northeast

    ERIC Educational Resources Information Center

    DiManno, Dorria L.

    2010-01-01

    Higher education institutions are under increased scrutiny from various constituencies. Frequently, external perceptions of a college or university are based on the image and actions of its president, known to those outside the institution primarily through coverage in the mass media. Support for an institution may depend heavily on these…

  4. Hospital Coding Practice, Data Quality, and DRG-Based Reimbursement under the Thai Universal Coverage Scheme

    ERIC Educational Resources Information Center

    Pongpirul, Krit

    2011-01-01

    In the Thai Universal Coverage scheme, hospital providers are paid for their inpatient care using Diagnosis Related Group (DRG) reimbursement. Questionable quality of the submitted DRG codes has been of concern whereas knowledge about hospital coding practice has been lacking. The objectives of this thesis are (1) To explore hospital coding…

  5. Academic Achievement of Red Deer College Students at Alberta Universities.

    ERIC Educational Resources Information Center

    Burford, Charles Thomas

    The purpose of this study was to report on the academic achievement of Red Deer College transfer students at three Alberta Universities for 1968-1971. Transfer students were matched with native students from the universities using session year, year of program, degree sought, age, sex, and first year cumulative grade-point average. These matched…

  6. Impact of Parent University on Parent Engagement and Student Achievement

    ERIC Educational Resources Information Center

    Lawless, Watechia Evelyen

    2013-01-01

    This research project examined the impact of Parent University on parental engagement and the factors that impact a parent's decision to become involved in their child's education. In addition, the aim of the research was to offer recommendations for improvement, so Parent University is able to enhance academic achievement within MNPS. The key…

  7. IRIS, Gender, and Student Achievement at University of Genova

    ERIC Educational Resources Information Center

    Bonfa, Antonella; Freddano, Michela

    2012-01-01

    The article analyses the gender effects on student achievement at University of Genova and it is a part of the research performed by the University of Genova called "Benchmarks interfaculty students: Development of a gender perspective to find strategies to understand what leads students to success in their studies", financed by the…

  8. Assessing Goal Intent and Achievement of University Learning Community Students

    ERIC Educational Resources Information Center

    Pfeffer-Lachs, Carole F.

    2013-01-01

    The purpose of this study was to assess the goal intent and achievement of university students, during the Fall 2011 semester, at Blue Wave University, a high research activity public institution in the southeast United States. This study merged theories of motivation to measure goal setting and goal attainment to examine if students who chose to…

  9. Spine stereotactic body radiation therapy plans: Achieving dose coverage, conformity, and dose falloff

    SciTech Connect

    Hong, Linda X.; Shankar, Viswanathan; Shen, Jin; Kuo, Hsiang-Chi; Mynampati, Dinesh; Yaparpalvi, Ravindra; Goddard, Lee; Basavatia, Amar; Fox, Jana; Garg, Madhur; Kalnicki, Shalom; Tomé, Wolfgang A.

    2015-10-01

    We report our experience of establishing planning objectives to achieve dose coverage, conformity, and dose falloff for spine stereotactic body radiation therapy (SBRT) plans. Patients with spine lesions were treated using SBRT in our institution since September 2009. Since September 2011, we established the following planning objectives for our SBRT spine plans in addition to the cord dose constraints: (1) dose coverage—prescription dose (PD) to cover at least 95% planning target volume (PTV) and 90% PD to cover at least 99% PTV; (2) conformity index (CI)—ratio of prescription isodose volume (PIV) to the PTV < 1.2; (3) dose falloff—ratio of 50% PIV to the PTV (R{sub 50%}); (4) and maximum dose in percentage of PD at 2 cm from PTV in any direction (D{sub 2cm}) to follow Radiation Therapy Oncology Group (RTOG) 0915. We have retrospectively reviewed 66 separate spine lesions treated between September 2009 and December 2012 (31 treated before September 2011 [group 1] and 35 treated after [group 2]). The χ{sup 2} test was used to examine the difference in parameters between groups. The PTV V{sub 100%} {sub PD} ≥ 95% objective was met in 29.0% of group 1 vs 91.4% of group 2 (p < 0.01) plans. The PTV V{sub 90%} {sub PD} ≥ 99% objective was met in 38.7% of group 1 vs 88.6% of group 2 (p < 0.01) plans. Overall, 4 plans in group 1 had CI > 1.2 vs none in group 2 (p = 0.04). For D{sub 2cm}, 48.3% plans yielded a minor violation of the objectives and 16.1% a major violation for group 1, whereas 17.1% exhibited a minor violation and 2.9% a major violation for group 2 (p < 0.01). Spine SBRT plans can be improved on dose coverage, conformity, and dose falloff employing a combination of RTOG spine and lung SBRT protocol planning objectives.

  10. Universal health coverage for India by 2022: a utopia or reality?

    PubMed

    Singh, Zile

    2013-04-01

    It is the obligation of the state to provide free and universal access to quality health-care services to its citizens. India continues to be among the countries of the world that have a high burden of diseases. The various health program and policies in the past have not been able to achieve the desired goals and objectives. 65(th) World Health Assembly in Geneva identified universal health coverage (UHC) as the key imperative for all countries to consolidate the public health advances. Accordingly, Planning Commission of India constituted a high level expert group (HLEG) on UHC in October 2010. HLEG submitted its report in Nov 2011 to Planning Commission on UHC for India by 2022. The recommendations for the provision of UHC pertain to the critical areas such as health financing, health infrastructure, health services norms, skilled human resources, access to medicines and vaccines, management and institutional reforms, and community participation. India faces enormous challenges to achieve UHC by 2022 such as high disease prevalence, issues of gender equality, unregulated and fragmented health-care delivery system, non-availability of adequate skilled human resource, vast social determinants of health, inadequate finances, lack of inter-sectoral co-ordination and various political pull and push of different forces, and interests. These challenges can be met by a paradigm shift in health policies and programs in favor of vulnerable population groups, restructuring of public health cadres, reorientation of undergraduate medical education, more emphasis on public health research, and extensive education campaigns. There are still areas of concern in fulfilling the objectives of achieving UHC by 2022 regarding financing model for health-care delivery, entitlement package, cost of health-care interventions and declining state budgets. However, the Government's commitment to provide adequate finances, recent bold social policy initiatives and enactments such as food

  11. Accelerating health equity: the key role of universal health coverage in the Sustainable Development Goals.

    PubMed

    Tangcharoensathien, Viroj; Mills, Anne; Palu, Toomas

    2015-04-29

    The Sustainable Development Goals (SDGs), to be committed to by Heads of State at the upcoming 2015 United Nations General Assembly, have set much higher and more ambitious health-related goals and targets than did the Millennium Development Goals (MDGs). The main challenge among MDG off-track countries is the failure to provide and sustain financial access to quality services by communities, especially the poor. Universal health coverage (UHC), one of the SDG health targets indispensable to achieving an improved level and distribution of health, requires a significant increase in government investment in strengthening primary healthcare - the close-to-client service which can result in equitable access. Given the trend of increased fiscal capacity in most developing countries, aiming at long-term progress toward UHC is feasible, if there is political commitment and if focused, effective policies are in place. Trends in high income countries, including an aging population which increases demand for health workers, continue to trigger international migration of health personnel from low and middle income countries. The inspirational SDGs must be matched with redoubled government efforts to strengthen health delivery systems, produce and retain more and relevant health workers, and progressively realize UHC.

  12. Nurses' knowledge of universal health coverage for inclusive and sustainable elderly care services

    PubMed Central

    Tung, Fabian Ling Ngai; Yan, Vincent Chun Man; Tai, Winnie Ling Yin; Chen, Jing Han; Chung, Joanne Wai-yee; Wong, Thomas Kwok Shing

    2016-01-01

    Objectives: to explore nurses' knowledge of universal health coverage (UHC) for inclusive and sustainable development of elderly care services. Method: this was a cross-sectional survey. A convenience sample of 326 currently practicing enrolled nurses (EN) or registered nurses (RN) was recruited. Respondents completed a questionnaire which was based on the implementation strategies advocated by the WHO Global Forum for Governmental Chief Nursing Officers and Midwives (GCNOMs). Questions covered the government initiative, healthcare financing policy, human resources policy, and the respondents' perception of importance and contribution of nurses in achieving UHC in elderly care services. Results: the knowledge of nurses about UHC in elderly care services was fairly satisfactory. Nurses in both clinical practice and management perceived themselves as having more contribution and importance than those in education. They were relatively indifferent to healthcare policy and politics. Conclusion: the survey uncovered a considerable knowledge gap in nurses' knowledge of UHC in elderly care services, and shed light on the need for nurses to be more attuned to healthcare policy. The educational curriculum for nurses should be strengthened to include studies in public policy and advocacy. Nurses can make a difference through their participation in the development and implementation of UHC in healthcare services. PMID:26959330

  13. Can service integration work for universal health coverage? Evidence from around the globe.

    PubMed

    Lê, Gillian; Morgan, Rosemary; Bestall, Janine; Featherstone, Imogen; Veale, Thomas; Ensor, Tim

    2016-04-01

    Universal health coverage (UHC) is at the heart of the new 2030 Agenda for Sustainable Development. Health service integration is seen by World Health Organization as an essential requirement to achieve UHC. However, to date the debate on service integration has focused on perceived benefits rather than empirical impact. We conducted a global review in a systematic manner searching for empirical outcomes of service integration experiments in UHC countries and those on the path to UHC. Sixty-seven articles and reports were found. We grouped results into a unique integration typology with six categories - medical staff from different disciplines; patients and medical staff; care package for one medical condition; care package for two or more medical conditions; specialist stand-alone services with GP services; community locations. We showed that it is possible to integrate services in different human development contexts delivering positive outcomes for patients and clinicians without incurring additional costs. However, the improved outcomes shown were incremental rather than radical and suggest that integration is likely to enhance already well established systems rather than fundamentally changing the outcomes of care.

  14. Ethiopian New Public Universities: Achievements, Challenges and Illustrative Case Studies

    ERIC Educational Resources Information Center

    van Deuren, Rita; Kahsu, Tsegazeab; Mohammed, Seid; Woldie, Wondimu

    2016-01-01

    Purpose: This paper aims to analyze and illustrate achievements and challenges of Ethiopian higher education, both at the system level and at the level of new public universities. Design/methodology/approach: Achievements and challenges at the system level are based on literature review and secondary data. Illustrative case studies are based on…

  15. Modeling the implementation of universal coverage for HIV treatment as prevention and its impact on the HIV epidemic.

    PubMed

    Ying, Roger; Barnabas, Ruanne V; Williams, Brian G

    2014-12-01

    The Joint United Nations Programme on HIV/AIDS (UNAIDS) recently updated its global targets for antiretroviral therapy (ART) coverage for HIV-positive persons under which 90 % of HIV-positive people are tested, 90 % of those are on ART, and 90 % of those achieve viral suppression. Treatment policy is moving toward treating all HIV-infected persons regardless of CD4 cell count-otherwise known as treatment as prevention-in order to realize the full therapeutic and preventive benefits of ART. Mathematical models have played an important role in guiding the development of these policies by projecting long-term health impacts and cost-effectiveness. To guide future policy, new mathematical models must consider the barriers patients face in receiving and taking ART. Here, we describe the HIV care cascade and ART delivery supply chain to examine how mathematical modeling can provide insight into cost-effective strategies for scaling-up ART coverage in sub-Saharan Africa and help achieve universal ART coverage.

  16. Investing in Nurses is a Prerequisite for Ensuring Universal Health Coverage.

    PubMed

    Kurth, Ann E; Jacob, Sheena; Squires, Allison P; Sliney, Anne; Davis, Sheila; Stalls, Suzanne; Portillo, Carmen J

    2016-01-01

    Nurses and midwives constitute the majority of the global health workforce and the largest health care expenditure. Efficient production, successful deployment, and ongoing retention based on carefully constructed policies regarding the career opportunities of nurses, midwives, and other providers in health care systems are key to ensuring universal health coverage. Yet nurses are constrained by practice regulations, workplaces, and career ladder barriers from contributing to primary health care delivery. Evidence shows that quality HIV care, comparable to that of physicians, is provided by trained nurses and associate clinicians, but many African countries' health systems remain dependent on limited numbers of physicians and fail to meet the demand for treatment. The World Health Organization endorses task sharing to ensure universal health coverage in HIV and maternal health, which requires an investment in nursing education, retention, and professional growth opportunities. Exemplars from Haiti, Rwanda, Republic of Georgia, and multi-country efforts are described.

  17. Universal Health Coverage through Community Nursing Services: China vs. Hong Kong

    PubMed Central

    Chan, Wai Yee; Fung, Ita M; Chan, Eric

    2017-01-01

    ABSTRACT Objective: this article looks at how the development of community nursing services in China and Hong Kong can enhance universal health coverage. Methods: literature and data review have been utilized in this study. Results: nursing services have evolved much since the beginning of the nursing profession. The development of community nursing services has expanded the scope of nursing services to those in need of, not just hospital-level nursing care, but more holistic care to improve health and quality of life. Conclusion: despite the one-country-two-systems governance and the difference in population and geography, Hong Kong and China both face the aging population and its complications. Community nursing services help to pave the road to Universal Health Coverage. PMID:28146178

  18. Impact of Universal Health Insurance Coverage on Hypertension Management: A Cross-National Study in the United States and England

    PubMed Central

    Dalton, Andrew R. H.; Vamos, Eszter P.; Harris, Matthew J.; Netuveli, Gopalakrishnan; Wachter, Robert M.; Majeed, Azeem; Millett, Christopher

    2014-01-01

    Background The Patient Protection and Affordable Care Act (ACA) galvanised debate in the United States (US) over universal health coverage. Comparison with countries providing universal coverage may illustrate whether the ACA can improve health outcomes and reduce disparities. We aimed to compare quality and disparities in hypertension management by socio-economic position in the US and England, the latter of which has universal health care. Method We used data from the Health and Retirement Survey in the US, and the English Longitudinal Study for Aging from England, including non-Hispanic White respondents aged 50–64 years (US market-based v NHS) and >65 years (US-Medicare v NHS) with diagnosed hypertension. We compared blood pressure control to clinical guideline (140/90 mmHg) and audit (150/90 mmHg) targets; mean systolic and diastolic blood pressure and antihypertensive prescribing, and disparities in each by educational attainment, income and wealth, using regression models. Results There were no significant differences in aggregate achievement of clinical targets aged 50 to 65 years (US market-based vs. NHS- 62.3% vs. 61.3% [p = 0.835]). There was, however, greater control in the US in patients aged 65 years and over (US Medicare vs. NHS- 53.5% vs. 58.2% [p = 0.043]). England had no significant socioeconomic disparity in blood pressure control (60.9% vs. 63.5% [p = 0.588], high and low wealth aged ≥65 years). The US had socioeconomic differences in the 50–64 years group (71.7% vs. 55.2% [p = 0.003], high and low wealth); these were attenuated but not abolished in Medicare beneficiaries. Conclusion Moves towards universal health coverage in the US may reduce disparities in hypertension management. The current situation, providing universal coverage for residents aged 65 years and over, may not be sufficient for equality in care. PMID:24416171

  19. Use of performance metrics for the measurement of universal coverage for maternal care in Mexico.

    PubMed

    Serván-Mori, Edson; Contreras-Loya, David; Gomez-Dantés, Octavio; Nigenda, Gustavo; Sosa-Rubí, Sandra G; Lozano, Rafael

    2017-01-20

    This study provides evidence for those working in the maternal health metrics and health system performance fields, as well as those interested in achieving universal and effective health care coverage. Based on the perspective of continuity of health care and applying quasi-experimental methods to analyse the cross-sectional 2009 National Demographic Dynamics Survey (n = 14 414 women), we estimated the middle-term effects of Mexico's new public health insurance scheme, Seguro Popular de Salud (SPS) (vs women without health insurance) on seven indicators related to maternal health care (according to official guidelines): (a) access to skilled antenatal care (ANC); (b) timely ANC; (c) frequent ANC; (d) adequate content of ANC; (e) institutional delivery; (f) postnatal consultation and (g) access to standardized comprehensive antenatal and postnatal care (or the intersection of the seven process indicators). Our results show that 94% of all pregnancies were attended by trained health personnel. However, comprehensive access to ANC declines steeply in both groups as we move along the maternal healthcare continuum. The percentage of institutional deliveries providing timely, frequent and adequate content of ANC reached 70% among SPS women (vs 64.7% in the uninsured), and only 57.4% of SPS-affiliated women received standardized comprehensive care (vs 53.7% in the uninsured group). In Mexico, access to comprehensive antenatal and postnatal care as defined by Mexican guidelines (in accordance to WHO recommendations) is far from optimal. Even though a positive influence of SPS on maternal care was documented, important challenges still remain. Our results identified key bottlenecks of the maternal healthcare continuum that should be addressed by policy makers through a combination of supply side interventions and interventions directed to social determinants of access to health care.

  20. Predicting achievement of first semester university science students

    NASA Astrophysics Data System (ADS)

    Gibbs, Al

    1991-12-01

    This paper reports on 11 measures used as predictors of students' achievement in their first semester subjects. The students were enrolled in the same four core subjects of a university general science course. Although a number of statistically significant correlations were found, only one predictor variable, HSC aggregate mark, correlated significantly with each of the achievement variables. One predictor variable entered four of the achievement regression equations, while two variables entered the fifth, accounting for 34 to 54% of the variance. *** DIRECT SUPPORT *** A05A9011 00020

  1. Structure and Relationships of University Instructors’ Achievement Goals

    PubMed Central

    Daumiller, Martin; Grassinger, Robert; Dickhäuser, Oliver; Dresel, Markus

    2016-01-01

    The present study examines the achievement goals of university instructors, particularly the structure of such goals, and their relationship to biographic characteristics, other aspects of instructors’ motivation, and teaching quality. Two hundred and fifty-one university instructors (184 without Ph.D., 97 with Ph.D., thereof 51 full professors; 146 males, 92 females) answered a questionnaire measuring achievement goals, self-efficacy, and enthusiasm in altogether 392 courses. Teaching quality was assessed using reports from 9,241 students who were attending these courses. Confirmatory factor analyses revealed mastery, performance approach, performance avoidance, work avoidance, and relational goals as being distinguishable from each other. Distinct relationships were found between different instructors’ achievement goals, and gender, age, and career status as well as self-efficacy and enthusiasm. Hierarchical linear models suggested positive associations of instructors’ mastery goals with teaching quality, while negative associations were indicated for performance avoidance goals and work avoidance goals in relation to teaching quality. Exploratory analyses conducted due to a quite large correlation between performance approach and performance avoidance goals indicated that for university instructors, differentiating performance goals into appearance and normative components might also be adequate. All in all, the study highlights the auspiciousness of the theoretical concept of university instructors’ achievement goals and contributes to making it comprehensively accessible. PMID:27047411

  2. Water and nonwater-related challenges of achieving global sanitation coverage.

    PubMed

    Fry, Lauren M; Mihelcic, James R; Watkins, David W

    2008-06-15

    Improved sanitation is considered equally important for public health as is access to improved drinking water. However, the world has been slower to meet the challenge of sanitation provision for the world's poor. We analyze previously cited barriers to sanitation coverage including inadequate investment poor or nonexistent policies, governance, too few resources, gender disparities, and water availability. Analysis includes investigation of correlation between indicators of the mentioned barriers and sanitation coverage, correlations among the indicators themselves, and a geospatial assessment of the potential impacts of sanitation technology on global water resources under six scenarios of sanitation technology choice. The challenges studied were found to be significant barriers to sanitation coverage, but water availability was not a primary obstacle at a global scale. Analysis at a 0.5 degrees grid scale shows, however, that water availability is an important barrier to as many as 46 million people, depending on the sanitation technology selected. The majority of these people are urban dwellers in countries where water quality is already poor and may be further degraded by sewering vast populations. Water quality is especially important because this vulnerable population primarily resides in locations that depend on environmental income associated with fish consumption.

  3. Controlling cost escalation of healthcare: making universal health coverage sustainable in China.

    PubMed

    Tang, Shenglan; Tao, Jingjing; Bekedam, Henk

    2012-01-01

    An increasingly number of low- and middle-income countries have developed and implemented a national policy towards universal coverage of healthcare for their citizens over the past decade. Among them is China which has expanded its population coverage by health insurance from around 29.7% in 2003 to over 90% at the end of 2010. While both central and local governments in China have significantly increased financial inputs into the two newly established health insurance schemes: new cooperative medical scheme (NCMS) for the rural population, and urban resident basic health insurance (URBMI), the cost of healthcare in China has also been rising rapidly at the annual rate of 17.0%% over the period of the past two decades years. The total health expenditure increased from 74.7 billion Chinese yuan in 1990 to 1998 billion Chinese yuan in 2010, while average health expenditure per capital reached the level of 1490.1 Chinese yuan per person in 2010, rising from 65.4 Chinese yuan per person in 1990. The repaid increased population coverage by government supported health insurance schemes has stimulated a rising use of healthcare, and thus given rise to more pressure on cost control in China.There are many effective measures of supply-side and demand-side cost control in healthcare available. Over the past three decades China had introduced many measures to control demand for health care, via a series of co-payment mechanisms. The paper introduces and discusses new initiatives and measures employed to control cost escalation of healthcare in China, including alternative provider payment methods, reforming drug procurement systems, and strengthening the application of standard clinical paths in treating patients at hospitals, and analyses the impacts of these initiatives and measures. The paper finally proposes ways forward to make universal health coverage in China more sustainable.

  4. Insecticide-treated mosquito nets in rural Burkina Faso: assessment of coverage and equity in the wake of a universal distribution campaign.

    PubMed

    Zöllner, Caroline; De Allegri, Manuela; Louis, Valérie R; Yé, Maurice; Sié, Ali; Tiendrebéogo, Justin; Jahn, Albrecht; Müller, Olaf

    2015-03-01

    Insecticide-treated mosquito nets (ITNs) are an essential tool of the Roll Back Malaria strategy. An increasing number of African countries have embarked on mass distribution campaigns of long-lasting insecticide-treated nets (LLINs) with the ultimate goal of universal coverage. Such a national campaign with the goal of one ITN for every two people has been conducted in Burkina Faso in 2010. Our aim was to assess the coverage and equity effect of the universal distribution campaign of LLINs in Burkina Faso and to identify determinants of ITN ownership across households after the campaign. We evaluated its effects through comparison of data from two household surveys conducted in early 2010 (before the campaign) and early 2011 (after the campaign) on a representative rural district in north-western Burkina Faso. Data were collected on household characteristics (including socio-economic status) and ITN ownership. We used concentration curves and indices to compare ITN coverage indicators before and after the campaign and multilevel multivariate logistic regression to estimate factors associated with achievement of the universal coverage target in 2011. The survey included 1106 households in 2010 and 1094 in 2011. We found that the proportion of households with at least one ITN increased from 59% before the campaign to 99% afterwards, whereas the concentration index dropped from 0.087 (standard error (SE): 0.014) to 0.002 (SE: 0.002). Fifty-two per cent of households reached the target of one ITN for every two people per household, with the relevant concentration index at -0.031 (SE: 0.016). Eighty-six per cent of households owned at least one ITN for every three people. The main characteristics significantly associated with the targeted intra-household coverage were family size and distance to the health centre but not socio-economic status. In conclusion, despite not having fully met its target, the national LLIN campaign achieved a high level of coverage and

  5. Correlation Between University Students' Kinematic Achievement and Learning Styles

    NASA Astrophysics Data System (ADS)

    Çirkinoǧlu, A. G.; Dem&ircidot, N.

    2007-04-01

    In the literature, some researches on kinematics revealed that students have many difficulties in connecting graphs and physics. Also some researches showed that the method used in classroom affects students' further learning. In this study the correlation between university students' kinematics achieve and learning style are investigated. In this purpose Kinematics Achievement Test and Learning Style Inventory were applied to 573 students enrolled in general physics 1 courses at Balikesir University in the fall semester of 2005-2006. Kinematics Test, consists of 12 multiple choose and 6 open ended questions, was developed by researchers to assess students' understanding, interpreting, and drawing graphs. Learning Style Inventory, a 24 items test including visual, auditory, and kinesthetic learning styles, was developed and used by Barsch. The data obtained from in this study were analyzed necessary statistical calculations (T-test, correlation, ANOVA, etc.) by using SPSS statistical program. Based on the research findings, the tentative recommendations are made.

  6. Comments on the article: "Syrian refugees in Lebanon: the search for universal health coverage".

    PubMed

    Ammar, Walid; Radi, Alissar; El-Jardali, Fadi

    2016-01-01

    This letter intends to clarify information and misconceptions found in the article "Syrian refugees in Lebanon: the search for universal health coverage" which was published June 1st, 2016, and to challenge the core notion of fragmentation as presented by the authors. It also highlights the fact that the article does not recognize the severe shortage in refugees health financing and unmet promises by the international community, and calls for immediate action and far greater support from that community to address the needs of refugees in Lebanon.

  7. Distributing insecticide-treated bednets during measles vaccination: a low-cost means of achieving high and equitable coverage.

    PubMed Central

    Grabowsky, Mark; Nobiya, Theresa; Ahun, Mercy; Donna, Rose; Lengor, Miata; Zimmerman, Drake; Ladd, Holly; Hoekstra, Edward; Bello, Aliu; Baffoe-Wilmot, Aba; Amofah, George

    2005-01-01

    OBJECTIVE: To achieve high and equitable coverage of insecticide-treated bednets by integrating their distribution into a measles vaccination campaign. METHODS: In December 2002 in the Lawra district in Ghana, a measles vaccination campaign lasting 1 week targeted all children aged 9 months-15 years. Families with one or more children less than five years old were targeted to receive a free insecticide-treated bednet. The Ghana Health Service, with support from the Ghana Red Cross and UNICEF, provided logistical support, volunteer workers and social mobilization during the campaign. Volunteers visited homes to inform caregivers about the campaign and encourage them to participate. We assessed pre-campaign coverage of bednets by interviewing caregivers leaving vaccination and distribution sites. Five months after distribution, a two-stage cluster survey using population-proportional sampling assessed bednet coverage, retention and use. Both the pre-campaign and post-campaign survey assessed household wealth using an asset inventory. FINDINGS: At the campaign exit interview 636/776 (82.0%) caregivers reported that they had received a home visit by a Red Cross volunteer before the campaign and that 32/776 (4.1%) of the youngest children in each household who were less than 5 years of age slept under an insecticide-treated bednet. Five months after distribution caregivers reported that 204/219 (93.2%) of children aged 9 months to 5 years had been vaccinated during the campaign; 234/248 (94.4%) of households were observed to have an insecticide-treated bednet; and 170/249 (68.3%) were observed to have a net hung over a bed. Altogether 222/248 (89.5%) caregivers reported receiving at least one insecticide-treated bednet during the campaign, and 153/254 (60.2%) said that on the previous night their youngest child had slept under a bednet received during the campaign. For households in the poorest quintile, post-campaign coverage of insecticide-treated bednets was 10 times

  8. Monitoring progress towards universal health coverage at country and global levels.

    PubMed

    Boerma, Ties; Eozenou, Patrick; Evans, David; Evans, Tim; Kieny, Marie-Paule; Wagstaff, Adam

    2014-09-01

    Universal health coverage (UHC) has been defined as the desired outcome of health system performance whereby all people who need health services (promotion, prevention, treatment, rehabilitation, and palliation) receive them, without undue financial hardship. UHC has two interrelated components: the full spectrum of good-quality, essential health services according to need, and protection from financial hardship, including possible impoverishment, due to out-of-pocket payments for health services. Both components should benefit the entire population. This paper summarizes the findings from 13 country case studies and five technical reviews, which were conducted as part of the development of a global framework for monitoring progress towards UHC. The case studies show the relevance and feasibility of focusing UHC monitoring on two discrete components of health system performance: levels of coverage with health services and financial protection, with a focus on equity. These components link directly to the definition of UHC and measure the direct results of strategies and policies for UHC. The studies also show how UHC monitoring can be fully embedded in often existing, regular overall monitoring of health sector progress and performance. Several methodological and practical issues related to the monitoring of coverage of essential health services, financial protection, and equity, are highlighted. Addressing the gaps in the availability and quality of data required for monitoring progress towards UHC is critical in most countries.

  9. Superstorm Sandy and the academic achievement of university students.

    PubMed

    Doyle, Matthew D; Lockwood, Brian; Comiskey, John G

    2017-01-30

    Much of the literature on the consequences of natural disasters has focused on their physical and psychological ramifications. Few researchers have considered how the impacts of a natural disaster can influence academic achievement. This study analyses data collected from nearly 300 students at a mid-sized, private university in the northeast United States to determine if the effects of Cyclone Sandy in 2012 are associated with measures of academic achievement. The findings reveal that experiencing headaches after the event resulted in a higher likelihood of students suffering a loss of academic motivation. In addition, experiencing headaches and a loss of academic motivation were correlated with a lower grade point average (GPA) during the semester in which Sandy made landfall. However, the more direct effects of the superstorm, including displacement and a loss of power, did not have a significant bearing on academic achievement. Lastly, the paper examines the implications for higher education policy and future research.

  10. Trends in structural coverage of the protein universe and the impact of the Protein Structure Initiative.

    PubMed

    Khafizov, Kamil; Madrid-Aliste, Carlos; Almo, Steven C; Fiser, Andras

    2014-03-11

    The exponential growth of protein sequence data provides an ever-expanding body of unannotated and misannotated proteins. The National Institutes of Health-supported Protein Structure Initiative and related worldwide structural genomics efforts facilitate functional annotation of proteins through structural characterization. Recently there have been profound changes in the taxonomic composition of sequence databases, which are effectively redefining the scope and contribution of these large-scale structure-based efforts. The faster-growing bacterial genomic entries have overtaken the eukaryotic entries over the last 5 y, but also have become more redundant. Despite the enormous increase in the number of sequences, the overall structural coverage of proteins--including proteins for which reliable homology models can be generated--on the residue level has increased from 30% to 40% over the last 10 y. Structural genomics efforts contributed ∼50% of this new structural coverage, despite determining only ∼10% of all new structures. Based on current trends, it is expected that ∼55% structural coverage (the level required for significant functional insight) will be achieved within 15 y, whereas without structural genomics efforts, realizing this goal will take approximately twice as long.

  11. Disparate British Breast Reconstruction Utilization: Is Universal Coverage Sufficient to Ensure Expanded Care?

    PubMed Central

    Offodile, Anaeze C.

    2016-01-01

    Summary: Our intent is to improve the understanding of the ability of healthcare providers to deliver high-quality care as we approach an era of universal coverage. We adopted 2 unique vantage points in this article: (1) the mandated coverage for immediate breast reconstruction (IBR) surgery as a microcosmic surrogate for universal coverage overall and (2) we then scrutinized the respective IBR utilization rates in a contemporaneous system of 2 healthcare delivery models in the United Kingdom, that is, the public National Health Service trust versus private-sector hospitals. A literature review was performed for IBR rates across public trust and private-sector hospitals in the United Kingdom. The IBR rate among public trust hospitals was 17% compared with 43% in the private sector. In the trust hospital setting, the enactment of 2 government mandates, intended to increase the access to cancer care, seemed to fall short in maximizing the ability of surgical practitioners to deliver quality care to patients. Among women who did not receive IBR, 65% felt that they had received the sufficient amount of information to appropriately inform their decision. In addition, only 46% of this same cohort reported a consultation with a reconstructive surgeon preoperatively. Private-sector hospitals delivered better IBR care because of the likely presence of infrastructure and financial incentives for physicians. These results serve as a call for a better alignment between policy initiatives designed to expand care access and the perogatives of physicians to ensure an optimized delivery of the expanded care such policy mandates. PMID:27482486

  12. Measuring coverage for seniors in Medicare Part A and estimating the cost of making it universal.

    PubMed

    Birnbaum, Michael; Patchias, Elizabeth M

    2010-02-01

    That Medicare is universal for seniors is widely accepted by leading analysts. But in the context of developing detailed policies that seek to cover as many people as possible, it is inaccurate to make Medicare eligibility sound so simple and inclusive. To estimate the number of seniors without full federal Medicare Part A coverage, we examined data for uninsured seniors, seniors with Medicaid and no Medicare coverage of any kind, seniors with Medicare Part B but without Part A, and seniors bought into Part A by their state Medicaid programs. We found that in 2005, 1.6 million seniors--or 5 percent of the elderly U.S. population--were without a full federal Part A premium subsidy. The share of seniors without this benefit was notably higher in the nation's two largest states--California (12 percent) and New York (8 percent). We estimate that reforming Medicare Part A to make the benefit truly universal and fully federal would cost the federal government $6 billion in new spending in federal fiscal year 2011, an increase in baseline federal Medicare expenditures of 1.1 percent.

  13. Measuring Inequality of Opportunity in Education by Combining Information on Coverage and Achievement in PISA

    ERIC Educational Resources Information Center

    Gamboa, Luis Fernando; Waltenberg, Fábio D.

    2015-01-01

    Measuring the distance between countries and the goal of equality of opportunity in education has been the focus of recent contributions in the economic literature, which have concentrated either on intergroup gaps in access to a given level of studies or on intergroup gaps in educational achievement. We argue that both aspects are important and…

  14. Improving University Ranking to Achieve University Competitiveness by Management Information System

    NASA Astrophysics Data System (ADS)

    Dachyar, M.; Dewi, F.

    2015-05-01

    One way to increase university competitiveness is through information system management. A literature review was done to find information system factors that affect university performance in Quacquarelli Symonds (QS) University Ranking: Asia evaluation. Information system factors were then eliminated using Delphi method through consensus of 7 experts. Result from Delphi method was used as measured variables in PLS-SEM. Estimation with PLS-SEM method through 72 respondents shows that the latent variable academic reputation and citation per paper have significant correlation to university competitiveness. In University of Indonesia (UI) the priority to increase university competitiveness as follow: (i) network building in international conference, (ii) availability of research data to public, (iii) international conference information, (iv) information on achievements and accreditations of each major, (v) ease of employment for alumni.

  15. Morningness-eveningness preferences and academic achievement of university students.

    PubMed

    Beşoluk, Senol; Onder, Ismail; Deveci, Isa

    2011-03-01

    The present study investigates whether the circadian preferences of students are related to their academic achievements. This study explores whether different class times affect students' achievement and examines the performance of students on final exams administered at 09:30 h for differences according to chronotype. A total of 1471 university students between 18 and 25 yrs of age responded to a morningness-eveningness questionnaire (MEQ), and data on their cumulative grade point averages (CGPA) were also collected from their transcripts. Some of the students in the sample attended classes during the first teaching period, which started at 08:00 h and ended at 14:50 h, and the remaining students followed the second schedule, which started at 15:00 h and ended at 21:50 h. MEQ scores were found to differ by sex. MEQ scores partially predicted academic success and that students' academic achievements differed according to the time of the teaching period. Moreover, final exam (administered at 09:30 h) scores differed with respect to their circadian preferences; students with a morning preference achieved higher scores than either those with an evening or intermediate preference. Both teaching and test start times thus impact academic performance.

  16. Chronic non-communicable diseases and the challenge of universal health coverage: insights from community-based cardiovascular disease research in urban poor communities in Accra, Ghana

    PubMed Central

    2014-01-01

    Background The rising burden of chronic non-communicable diseases in low and middle income countries has major implications on the ability of these countries to achieve universal health coverage. In this paper we discuss the impact of cardiovascular diseases (CVD) on primary healthcare services in urban poor communities in Accra, Ghana. Methods We review the evidence on the evolution of universal health coverage in Ghana and the central role of the community-based health planning services (CHPS) programme and the National Health Insurance Scheme in primary health care. We present preliminary findings from a study on community CVD knowledge, experiences, responses and access to services. Results The rising burden of NCDs in Ghana will affect the achievement of universal health coverage, particularly in urban areas. There is a significant unmet need for CVD care in the study communities. The provision of primary healthcare services for CVD is not accessible, equitable or responsive to the needs of target communities. Conclusions We consider these findings in the context of the primary healthcare system and discuss the challenges and opportunities for strengthening health systems in low and middle-income countries. PMID:25082497

  17. Payments for health care and its effect on catastrophe and impoverishment: experience from the transition to Universal Coverage in Thailand.

    PubMed

    Somkotra, Tewarit; Lagrada, Leizel P

    2008-12-01

    Equitable health financing was embodied in the reform strategies of Thailand's health care system when the country moved towards implementing the Universal Coverage (UC) policy in 2001. This study aimed to measure the pattern of household out-of-pocket payments for health care and to examine the financial catastrophe and impoverishment due to such payments during the transitional period (pre- and post-Universal Coverage policy implementation) in Thailand. This study used the nationally representative Socioeconomic Surveys in 2000 (pre-UC), 2002, and 2004 (post-UC), which contained data from 24747, 34758 and 34843 individual households, respectively. The proportion of out-of-pocket payments for health care as a share of household living standards among Thai households shows a decreasing pattern during the observed period. Moreover, the incidence and intensity of catastrophic payments for health care decline from the pre-UC to post-UC period. The distribution of incidence and the intensity of catastrophic payments for health care across quintiles also indicate that the lower quintile group (1st and 2nd quintiles) incurs lower catastrophic health care payments compared to the higher quintile group. The UC policy is also effective in preventing impoverishment due to out-of-pocket payments for health care since both the poverty headcount and poverty gap decline from the pre-UC to post-UC period. This study provides important evidence that the UC policy implementation is a valuable social protection and safety net strategy that contributes to the prevention of financial catastrophe and impoverishment due to out-of-pocket payments for health care. In conclusion, the UC policy in Thailand achieves one of the goals of improving the health system through equitable health care financing by reducing financial catastrophe and impoverishment due to out-of-pocket payments for health care.

  18. High effective coverage of vector control interventions in children after achieving low malaria transmission in Zanzibar, Tanzania

    PubMed Central

    2013-01-01

    interventions and recognized the value of sustaining their use. Thus, sustaining high effective coverage of vector control interventions, which is crucial for reaching malaria elimination in Zanzibar, can be achieved by maintaining effective delivery of these interventions. PMID:23360479

  19. Coverage, universal access and equity in health: a characterization of scientific production in nursing

    PubMed Central

    Mendoza-Parra, Sara

    2016-01-01

    Objectives: to characterize the scientific contribution nursing has made regarding coverage, universal access and equity in health, and to understand this production in terms of subjects and objects of study. Material and methods: this was cross-sectional, documentary research; the units of analysis were 97 journals and 410 documents, retrieved from the Web of Science in the category, "nursing". Descriptors associated to coverage, access and equity in health, and the Mesh thesaurus, were applied. We used bibliometric laws and indicators, and analyzed the most important articles according to amount of citations and collaboration. Results: the document retrieval allowed for 25 years of observation of production, an institutional and an international collaboration of 31% and 7%, respectively. The mean number of coauthors per article was 3.5, with a transience rate of 93%. The visibility index was 67.7%, and 24.6% of production was concentrated in four core journals. A review from the nursing category with 286 citations, and a Brazilian author who was the most productive, are issues worth highlighting. Conclusions: the nursing collective should strengthen future research on the subject, defining lines and sub-lines of research, increasing internationalization and building it with the joint participation of the academy and nursing community. PMID:26959329

  20. Ethical priority setting for universal health coverage: challenges in deciding upon fair distribution of health services.

    PubMed

    Norheim, Ole F

    2016-05-11

    Priority setting is inevitable on the path towards universal health coverage. All countries experience a gap between their population's health needs and what is economically feasible for governments to provide. Can priority setting ever be fair and ethically acceptable? Fairness requires that unmet health needs be addressed, but in a fair order. Three criteria for priority setting are widely accepted among ethicists: cost-effectiveness, priority to the worse-off, and financial risk protection. Thus, a fair health system will expand coverage for cost-effective services and give extra priority to those benefiting the worse-off, whilst at the same time providing high financial risk protection. It is considered unacceptable to treat people differently according to their gender, race, ethnicity, religion, sexual orientation, social status, or place of residence. Inequalities in health outcomes associated with such personal characteristics are therefore unfair and should be minimized. This commentary also discusses a third group of contested criteria, including rare diseases, small health benefits, age, and personal responsibility for health, subsequently rejecting them. In conclusion, countries need to agree on criteria and establish transparent and fair priority setting processes.

  1. What level of domestic government health expenditure should we aspire to for universal health coverage?

    PubMed

    Mcintyre, Di; Meheus, Filip; Røttingen, John-Arne

    2017-04-01

    Global discussions on universal health coverage (UHC) have focussed attention on the need for increased government funding for health care in many low- and middle-income countries. The objective of this paper is to explore potential targets for government spending on health to progress towards UHC. An explicit target for government expenditure on health care relative to gross domestic product (GDP) is a potentially powerful tool for holding governments to account in progressing to UHC, particularly in the context of UHC's inclusion in the Sustainable Development Goals. It is likely to be more influential than the Abuja target, which requires decreases in budget allocations to other sectors and is opposed by finance ministries for undermining their autonomy in making sectoral budget allocation decisions. International Monetary Fund and World Health Organisation data sets were used to analyse the relationship between government health expenditure and proxy indicators for the UHC goals of financial protection and access to quality health care, and triangulated with available country case studies estimating the resource requirements for a universal health system. Our analyses point towards a target of government spending on health of at least 5% of GDP for progressing towards UHC. This can be supplemented by a per capita target of $86 to promote universal access to primary care services in low-income countries.

  2. Role of Family Medicine Education in India's Step Toward Universal Health Coverage

    PubMed Central

    Rahman, Sajitha M.F.; Angeline, Ruby P.; David, Kirubah V.; Christopher, Prince

    2014-01-01

    India's commitment to universal health coverage has grown stronger with the submission of High Level Expert Group report by the Planning Commission in 2012. With this report comes the commitment to increase the primary health-care workforce to meet the population needs. However, the focus should not be just to increase the number of health workers, but to produce better health workers. Doctors, nurses and community health workers trained in primary and secondary health-care facilities can make a significant contribution in responding to the needs of the local community. The role of family medicine education is worth exploring in this context to equip the primary care health workers with the competencies of providing person-centered, comprehensive and continuous care. PMID:25374848

  3. Financial risk protection and universal health coverage: evidence and measurement challenges.

    PubMed

    Saksena, Priyanka; Hsu, Justine; Evans, David B

    2014-09-01

    Financial risk protection is a key component of universal health coverage (UHC), which is defined as access to all needed quality health services without financial hardship. As part of the PLOS Medicine Collection on measurement of UHC, the aim of this paper is to examine and to compare and contrast existing measures of financial risk protection. The paper presents the rationale behind the methodologies for measuring financial risk protection and how this relates to UHC as well as some empirical examples of the types of measures. Additionally, the specific challenges related to monitoring inequalities in financial risk protection are discussed. The paper then goes on to examine and document the practical challenges associated with measurement of financial risk protection. This paper summarizes current thinking on the area of financial risk protection, provides novel insights, and suggests future developments that could be valuable in the context of monitoring progress towards UHC.

  4. Financial Risk Protection and Universal Health Coverage: Evidence and Measurement Challenges

    PubMed Central

    Saksena, Priyanka; Hsu, Justine; Evans, David B.

    2014-01-01

    Financial risk protection is a key component of universal health coverage (UHC), which is defined as access to all needed quality health services without financial hardship. As part of the PLOS Medicine Collection on measurement of UHC, the aim of this paper is to examine and to compare and contrast existing measures of financial risk protection. The paper presents the rationale behind the methodologies for measuring financial risk protection and how this relates to UHC as well as some empirical examples of the types of measures. Additionally, the specific challenges related to monitoring inequalities in financial risk protection are discussed. The paper then goes on to examine and document the practical challenges associated with measurement of financial risk protection. This paper summarizes current thinking on the area of financial risk protection, provides novel insights, and suggests future developments that could be valuable in the context of monitoring progress towards UHC. PMID:25244520

  5. A Review of Realizing the Universal Health Coverage (UHC) Goals by 2030: Part 1- Status quo, Requirements, and Challenges.

    PubMed

    Hussein, Rada

    2015-07-01

    This paper is the first part of a review of how to realize the Universal Health Coverage (UHC) goals by 2030. The objective of this review is to investigate the role of eHealth and technology in achieving UHC, focusing on four aspects: 1) identifying the importance of UHC and highlighting how UHC is influenced by health systems and eHealth, 2) investigating the current status of UHC worldwide and indicating the current challenges facing the realization of UHC, 3) reviewing the current research activities in the UHC domain and emphasizing the role of eHealth and technology in achieving UHC, and 4) discussing the results of the review to identify the current gaps in UHC implantation and the corresponding research lines for future investigation.This part covers the first two aspects through: providing the required background on UHC, highlighting the potential benefits of eHealth utilization in UHC, addressing the current status quo of UHC implementation worldwide, and finally concluding the lessons learned in terms of the UHC challenges and requirements.This part also described the used search methodology and selection criteria to synthesize this review. It also indicates the limitations of conducting a systematic review in this early stage of deploying UHC-oriented eHealth solutions.

  6. State humanitarian verticalism versus universal health coverage: a century of French international health assistance revisited.

    PubMed

    Atlani-Duault, Laëtitia; Dozon, Jean-Pierre; Wilson, Andrew; Delfraissy, Jean-François; Moatti, Jean-Paul

    2016-05-28

    The French contribution to global public health over the past two centuries has been marked by a fundamental tension between two approaches: State-provided universal free health care and what we propose to call State humanitarian verticalism. Both approaches have historical roots in French colonialism and have led to successes and failures that continue until the present day. In this paper, the second in The Lancet's Series on France, we look at how this tension has evolved. During the French colonial period (1890s to 1950s), the Indigenous Medical Assistance structure was supposed to bring metropolitan France's model of universal and free public health care to the colonies, and French State imperial humanitarianism crystallised in vertical programmes inspired by Louis Pasteur, while vying with early private humanitarian activism in health represented by Albert Schweitzer. From decolonisation to the end of the Cold War (1960-99), French assistance to newly independent states was affected by sans frontièrisme, Health for All, and the AIDS pandemic. Since 2000, France has had an active role in development of global health initiatives and favoured multilateral action for health assistance. Today, with adoption of the 2030 Sustainable Development Goals and the challenges of non-communicable diseases, economic inequality, and climate change, French international health assistance needs new direction. In the context of current debate over global health as a universal goal, understanding and acknowledging France's history could help strengthen advocacy in favour of universal health coverage and contribute to advancing global equity through income redistribution, from healthy populations to people who are sick and from wealthy individuals to those who are poor.

  7. An assessment of progress towards universal health coverage in Brazil, Russia, India, China, and South Africa (BRICS).

    PubMed

    Marten, Robert; McIntyre, Diane; Travassos, Claudia; Shishkin, Sergey; Longde, Wang; Reddy, Srinath; Vega, Jeanette

    2014-12-13

    Brazil, Russia, India, China, and South Africa (BRICS) represent almost half the world's population, and all five national governments recently committed to work nationally, regionally, and globally to ensure that universal health coverage (UHC) is achieved. This analysis reviews national efforts to achieve UHC. With a broad range of health indicators, life expectancy (ranging from 53 years to 73 years), and mortality rate in children younger than 5 years (ranging from 10·3 to 44·6 deaths per 1000 livebirths), a review of progress in each of the BRICS countries shows that each has some way to go before achieving UHC. The BRICS countries show substantial, and often similar, challenges in moving towards UHC. On the basis of a review of each country, the most pressing problems are: raising insufficient public spending; stewarding mixed private and public health systems; ensuring equity; meeting the demands for more human resources; managing changing demographics and disease burdens; and addressing the social determinants of health. Increases in public funding can be used to show how BRICS health ministries could accelerate progress to achieve UHC. Although all the BRICS countries have devoted increased resources to health, the biggest increase has been in China, which was probably facilitated by China's rapid economic growth. However, the BRICS country with the second highest economic growth, India, has had the least improvement in public funding for health. Future research to understand such different levels of prioritisation of the health sector in these countries could be useful. Similarly, the role of strategic purchasing in working with powerful private sectors, the effect of federal structures, and the implications of investment in primary health care as a foundation for UHC could be explored. These issues could serve as the basis on which BRICS countries focus their efforts to share ideas and strategies.

  8. Setting the scene: the challenges of universal health coverage and the contribution of management education.

    PubMed

    Tarricone, Rosanna

    2013-01-01

    The last decades are being characterized by global trends such as population growth, aging, escalation of non communicable diseases and technological innovation. These unprecedented changes are moving faster than economic growth and threaten universal health coverage. What is at stake nowadays is governments' and healthcare systems' ability to renovate themselves and develop new paradigms aimed at finding innovative solutions to manage the new global forces so to maintain universal access to care in a changing environment. We have to be imaginative because if we keep relying on current paradigms to answer already too far-ahead complex problems, we will fail. And here education has a role to play. Although the recent years have seen a steep increase in the offerings of post-graduate management education programs in health and healthcare, the majority of these programs are still traditionally conceived and designed, aiming to train students to deal with specific, domestic, current problems. With the promise of making students the best specialists on Earth, to get the highest return on his or her investment in education, the performance of these programs is often measured in terms of earnings maximization. Although an indicator of success, this often incentivizes individuals to be context-based, individualistic, short-sighted and self-focused. Education has the greatest potential to foster imagination, to leverage diversity, to exploit team-working and free creative thinking. Education can substantially contribute to anticipate the impact of global forces by but an endeavor is needed to design programs and measures performances differently.

  9. Global costs and benefits of reaching universal coverage of sanitation and drinking-water supply.

    PubMed

    Hutton, Guy

    2013-03-01

    Economic evidence on the cost and benefits of sanitation and drinking-water supply supports higher allocation of resources and selection of efficient and affordable interventions. The study aim is to estimate global and regional costs and benefits of sanitation and drinking-water supply interventions to meet the Millennium Development Goal (MDG) target in 2015, as well as to attain universal coverage. Input data on costs and benefits from reviewed literature were combined in an economic model to estimate the costs and benefits, and benefit-cost ratios (BCRs). Benefits included health and access time savings. Global BCRs (Dollar return per Dollar invested) were 5.5 for sanitation, 2.0 for water supply and 4.3 for combined sanitation and water supply. Globally, the costs of universal access amount to US$ 35 billion per year for sanitation and US$ 17.5 billion for drinking-water, over the 5-year period 2010-2015 (billion defined as 10(9) here and throughout). The regions accounting for the major share of costs and benefits are South Asia, East Asia and sub-Saharan Africa. Improved sanitation and drinking-water supply deliver significant economic returns to society, especially sanitation. Economic evidence should further feed into advocacy efforts to raise funding from governments, households and the private sector.

  10. Malaria infection and anemia prevalence in Zambia's Luangwa District: an area of near-universal insecticide-treated mosquito net coverage.

    PubMed

    Eisele, Thomas P; Miller, John M; Moonga, Hawela B; Hamainza, Busiku; Hutchinson, Paul; Keating, Joseph

    2011-01-01

    We examined the relationship between insecticide-treated mosquito nets (ITNs), malaria parasite infection, and severe anemia prevalence in children in Luangwa District, Zambia, an area with near-universal ITN coverage, at the end of the 2008 and 2010 malaria transmission seasons. Malaria parasite infection prevalence among children < 5 years old was 9.7% (95% confidence interval [CI] = 8.0-11.4%) over both survey years. Prevalence of severe anemia among children 6-59 months old was 6.9% (95% CI = 5.4-8.5%) over both survey years. Within this context of near-universal ITN coverage, we were unable to detect a significant association between malaria parasite or severe anemia prevalence and ITNs (possession and use). In addition to maintaining universal ITN coverage, it will be essential for the malaria control program to achieve high ITN use and laboratory diagnosis and treatment of all fevers among all age groups to further reduce the malaria burden in this area.

  11. Towards universal coverage: a policy analysis of the development of the National Health Insurance Scheme in Nigeria.

    PubMed

    Onoka, Chima A; Hanson, Kara; Hanefeld, Johanna

    2015-11-01

    This article examines why and how a national health insurance (NHI) proposal targeting universal health coverage (UHC) in Nigeria developed over time. The study involved document reviews, in-depth interviews, a further review of preliminary analysis by relevant actors and use of a stakeholder analysis approach. The need for strategies to improve healthcare funding during the economic recession of the 1980s stimulated the proposal. The inclusion of Health Maintenance Organizations (HMOs) as financing organizations for national health insurance at the expense of sub-national (state) government mechanisms increased credibility of policy implementation but resulted in loss of support from states. The most successful period of the policy process occurred when a new minister of health (strongly supported by the president that displayed interest in UHC) provided leadership through the Federal Ministry of Health (FMOH), and effectively managed stakeholders' interests and galvanized their support to advance the policy. Later, the National Health Insurance Scheme (the federal government's implementing/regulatory agency) assumed this leadership role but has been unable to extend coverage in a significant way. Nigeria's experience shows that where political leaders are interested in a UHC-related proposal, the strong political leadership they provide considerably enhances the pace of the policy process. However, public officials should carefully guide policymaking processes that involve private sector actors, to ensure that strategies that compromise the chance of achieving UHC are not introduced. In contexts where authority is shared between federal and state governments, securing federal level commitment does not guarantee that a national health insurance proposal has become a 'national' proposal. States need to be provided with an active role in the process and governance structure. Finally, the article underscores the utility of retrospective stakeholder analysis in

  12. A multiprofessional perspective on the principal barriers to universal health coverage and universal access to health in extremely poor territories: the contributions of nursing1

    PubMed Central

    de França, Viviane Helena; Modena, Celina Maria; Confalonieri, Ulisses Eugenio Cavalcanti

    2016-01-01

    Objective: to investigate the knowledge of managers and health professionals, social workers and education professionals regarding the principal barriers to universal health coverage and universal access to health on the part of the extremely poor population; and to point to the contributions made by nursing for the promotion of this right. Method: a qualitative study whose reference was, for ensuring the right to health, the reorientation of the Brazilian Unified Health System (SUS) towards universal coverage and access in these territories. Interviews were held with 27 members of the multi-professional team of a municipality with high social vulnerability. The data were worked on using thematic content analysis. Results: the following were ascertained as the principal barriers to universal health coverage and access to health: failures in the expansion and strengthening of the services; absence of diagnosis of the priority demands; shortage of technology, equipment, and material and human resources; poor local infrastructure; and actions with low resolutive power and absence of interdepartmental policies. Within the multi-professional team, nursing acts in the SUS in unique health actions and social practices in these territories, presenting an in-depth perspective on this harsh reality, being able to contribute with indispensable support for confronting these disparities in universal health coverage and universal access to health. Conclusion: nursing's in-depth understanding regarding these barriers is essential for encouraging the processes reorienting the SUS, geared towards equality in the right to health. PMID:27143541

  13. Universal health coverage: a quest for all countries but under threat in some.

    PubMed

    McKee, Martin; Balabanova, Dina; Basu, Sanjay; Ricciardi, Walter; Stuckler, David

    2013-01-01

    Over the past 50 years, health care has been making a growing contribution to population health in many countries. Yet its benefits are still denied to many people worldwide. This article describes how many countries, both developed and developing, have pursued the quest to achieve universal health care. This has been an explicitly political process. In Europe, it emerged from a belief in solidarity, a fear of revolution, and a changing view of the role of the state. In developing countries, progress was more erratic, characterized by debates about the affordability of universal health care, until it was realized that functioning health systems were essential to deliver development goals. Throughout, the United States has been an exception. An analysis of progress toward universal health care, combining a review of existing theories and new empirical analysis, identifies five factors as important: the strength of organized labor and left-wing parties, adequate economic resources, absence of societal divisions, weakness of institutions that might oppose it (such as organized medicine), and windows of opportunity. Having noted the substantial benefits accruing from universal health care, the article concludes with an analysis of how universal health care is under threat in some European countries and a warning about the risks posed by current radical austerity policies.

  14. Estimated effects of adding universal public coverage of an essential medicines list to existing public drug plans in Canada

    PubMed Central

    Morgan, Steven G.; Li, Winny; Yau, Brandon; Persaud, Nav

    2017-01-01

    BACKGROUND: Canada’s universal health care system does not include universal coverage of prescription drugs. We sought to estimate the effects of adding universal public coverage of an essential medicines list to existing public drug plans in Canada. METHODS: We used administrative and market research data to estimate the 2015 shares of the volume and cost of prescriptions filled in the community setting that were for 117 drugs on a model list of essential medicines for Canada. We compared prices of these essential medicines in Canada with prices in the United States, Sweden and New Zealand. We estimated the cost of adding universal public drug coverage of these essential medicines based on anticipated effects on medication use and pricing. RESULTS: The 117 essential medicines on the model list accounted for 44% of all prescriptions and 30% of total prescription drug expenditures in 2015. Average prices of generic essential medicines were 47% lower in the US, 60% lower in Sweden and 84% lower in New Zealand; brand-name drugs were priced 43% lower in the US. Estimated savings from universal public coverage of these essential medicines was $4.27 billion per year (range $2.72 billion to $5.83 billion; 28% reduction) for patients and private drug plan sponsors, at an incremental government cost of $1.23 billion per year (range $373 million to $1.98 billion; 11% reduction). INTERPRETATION: Our analysis showed that adding universal public coverage of essential medicines to the existing public drug plans in Canada could address most of Canadians’ pharmaceutical needs and save billions of dollars annually. Doing so may be a pragmatic step forward while more comprehensive pharmacare reforms are planned. PMID:28246223

  15. Analysis of Universal Health Coverage and Equity on Health Care in Kenya

    PubMed Central

    Okech, Timothy Chrispinus; Lelegwe, Steve Ltumbesi

    2016-01-01

    Kenya has made progress towards universal health coverage as evidenced in the various policy initiatives and reforms that have been implemented in the country since independence. The purpose of this analysis was to critically review the various initiatives that the government of Kenya has over the years initiated towards the realization of Universal Health Care (UHC) and how this has impacted on health equity. The paper relied heavly on secondary sources of information although primary data data was collected. Whereas secondary data was largely collected through critical review of policy documents and commissioned studies by the Ministry of Health and development partners, primary data was collected through interviews with various stakeholders involved in UHC including policy makers, implementers, researchers and health service providers. Key findings include commitment towards UHC; minimal solidarity in health care financing; cases of dysfunctionalilty of health care system; minimal opportunities for continuous medical training; quality concerns in terms of stock-outs of drugs and other medical supplies, dilapidated health infrastructure and inadequqte number of health workers. Other findings include governance concerns at NHIF coupled with, high operational costs, low capitation, fraud at facility levels, low pay out ratio, accreditation of facilities, and narrowness of the benefit package, among others. In lieu of these, various recommendations have been suggested. Among these include promotion of solidarty in health care financing that are reliable and economical in collecting; political will to enhance commitment towards devolution of health care, engagement of various stakeholders at both county and national government in fast tracking the enactment of Health Act; investment in health infrastructure and training of human resources; revamping NHIF into a full-fledged social health insurance scheme, and enhancing capacity of NHIF human resources, enhanced

  16. The contribution of Portuguese nursing to universal health access and coverage

    PubMed Central

    Fernandes, Ananda Maria; Mendes, Aida Maria de Oliveira Cruz; Leitão, Maria Neto da Cruz; Gomes, Sérgio David Lourenço; Amaral, António Fernando Salgueiro; Bento, Maria da Conceição Saraiva da Silva Costa

    2016-01-01

    Objective: to analyze the contribution of Portuguese nursing to improving universal health access and coverage by means of the identification of nurses in the health system; evolution of health indicators; and access-promoting systems, in which nurses play a relevant role. Method: this was documentary research of publications fromnational and international organizations on planning and health outcomes. Statistical databases and legislation on health reforms were consulted. Results: nurses represent 30.18% of human resources in the national health service; the systems of access promotion performed by nurses have good levels of efficacy (95.5%) and user satisfaction (99% completely satisfied); in the local care the creation of Community Care Units (185) occurred, and 85.80% of home consultations were performed by nurses. Conclusion: political strategies, the National Health Service and strengthening of human resourcesin healthcareare the main determinants. Nursing is the most numerous professional group in the National Health Service, however numbers remaindeficient in primary health care. The improvement of academic qualification and self-regulation of this professional group has allowed for better answers inimproving health for the Portuguese. PMID:26959331

  17. Universal health coverage at the macro level: Synthetic control evidence from Thailand.

    PubMed

    Rieger, Matthias; Wagner, Natascha; Bedi, Arjun S

    2017-01-01

    As more and more countries are moving towards Universal Health Coverage (UHC), it is important to understand the macro level or aggregate impacts of such a policy. We use synthetic control methods to study the impact of UHC, introduced in Thailand in 2001, on various macroeconomic and health outcomes. Thailand is compared to a weighted average of control countries in terms of aggregate health financing indicators, aggregate health outcomes and economic performance, over the period 1995 to 2012. Our results suggest that UHC helps alleviate the financial consequences of illnesses. The estimated treatment effect of UHC on out-of-pocket payments as a percentage of overall health expenditures is negative 13 percentage points and its effect on annual government per capita health spending is US$ 79. We detect a smaller effect of US$ 60.8 on total health spending per capita which appears with a lag. We document positive health effects as captured by reductions in infant and child mortality. We do not find any effect on GDP and the share of the government budget devoted to health. Overall, our results complement micro evidence based on within country variation. The counterfactual design implemented here may be used to inform other countries on the macro level repercussions of UHC.

  18. Progressive universalism? The impact of targeted coverage on health care access and expenditures in Peru.

    PubMed

    Neelsen, Sven; O'Donnell, Owen

    2017-02-16

    Like other countries seeking a progressive path to universalism, Peru has attempted to reduce inequalities in access to health care by granting the poor entitlement to tax-financed basic care without charge. We identify the impact of this policy by comparing the target population's change in health care utilization with that of poor adults already covered through employment-based insurance. There are positive effects on receipt of ambulatory care and medication that are largest among the elderly and the poorest. The probability of getting formal health care when sick is increased by almost two fifths, but the likelihood of being unable to afford treatment is reduced by more than a quarter. Consistent with the shallow coverage offered, there is no impact on use of inpatient care. Neither is there any effect on average out-of-pocket health care expenditure, but medical spending is reduced by up to 25% in the top quarter of the distribution. Copyright © 2017 John Wiley & Sons, Ltd.

  19. The development of universal health insurance coverage in Thailand: Challenges of population aging and informal economy.

    PubMed

    Hsu, Minchung; Huang, Xianguo; Yupho, Somrasri

    2015-11-01

    This paper quantitatively investigates the sustainability of the universal health insurance coverage (UHI) system in Thailand while taking into account the country's rapidly aging population and large informal labor sector. We examine the effects of population aging and informal employment across three tax options for financing the UHI. A modern dynamic general equilibrium framework is utilized to conduct policy experiments and welfare analysis. In the case of labor income tax being used to finance the cost of UHI, an additional 11-15% of labor tax will be required with the 2050 population age structure, compared with the 2005 benchmark economy. We also find that an expansion of income tax base to the informal sector can substantially alleviate the tax burden. Based on welfare comparisons across the alternative tax options, the labor income tax is the most preferred because the inequality between formal/informal sectors is large. If the informal sector cannot avoid labor income tax, capital tax will be preferred over labor and consumption taxes.

  20. Understanding the impact of global trade liberalization on health systems pursuing universal health coverage.

    PubMed

    Missoni, Eduardo

    2013-01-01

    In the context of reemerging universalistic approaches to health care, the objective of this article was to contribute to the discussion by highlighting the potential influence of global trade liberalization on the balance between health demand and the capacity of health systems pursuing universal health coverage (UHC) to supply adequate health care. Being identified as a defining feature of globalization affecting health, trade liberalization is analyzed as a complex and multidimensional influence on the implementation of UHC. The analysis adopts a systems-thinking approach and refers to the six building blocks of World Health Organization's current "framework for action," emphasizing their interconnectedness. While offering new opportunities to increase access to health information and care, in the absence of global governance mechanisms ensuring adequate health protection and promotion, global trade tends to have negative effects on health systems' capacity to ensure UHC, both by causing higher demand and by interfering with the interconnected functioning of health systems' building blocks. The prevention of such an impact and the effective implementation of UHC would highly benefit from a more consistent commitment and stronger leadership by the World Health Organization in protecting health in global policymaking fora in all sectors.

  1. Human resources for health development: toward realizing Universal Health Coverage in Japan.

    PubMed

    Akashi, Hidechika; Osanai, Yasuyo; Akashi, Rumiko

    2015-10-01

    Human resources are an important factor in establishing universal health coverage (UHC). We examined Japan's health policies related to development of human resources for health (HRH) toward establishing UHC, and tried to formulate a model for other countries wanting to introduce UHC through reviewing existing data and documents related to Japan's history in developing HRH. In the results, there were four phases of HRH development in Japan: Phase 1 involved a shortage of HRH; Phase 2 was characterized by rapid production of less-educated HRH; Phase 3 involved introduction of quality improvement procedures such as upgrade education for nursing staff or licensing examination for physicians; Phase 4 was characterized by a predominance of formal health professionals. To encourage transition between these phrases, Japan utilized several procedures, including: (i) offering shorter professional education, (ii) fewer admission requirements for professional education, (iii) widespread location of schools, and (iv) the aforementioned quality improvement procedures. Japan was able to introduce UHC during Phase 3, and Japanese health indicators have improved gradually through these phases. Consequently, the government of Japan focused on increasing the quantity of HRH through relaxed admission requirements, shorter education periods, and increasing the numbers of educational facilities, before introducing UHC. Subsequently, the government began focusing on improving quality through procedures such as upgrade education or licensing examination programs to enable less-educated HRH to become fully educated professionals. For governments wanting to introduce UHC, the Japanese model can be a suitable option for HRH development, particularly in resource-poor countries.

  2. Study of Global Health Strategy Based on International Trends: -Promoting Universal Health Coverage Globally and Ensuring the Sustainability of Japan's Universal Coverage of Health Insurance System: Problems and Proposals.

    PubMed

    Hatanaka, Takashi; Eguchi, Narumi; Deguchi, Mayumi; Yazawa, Manami; Ishii, Masami

    2015-09-01

    The Japanese government at present is implementing international health and medical growth strategies mainly from the viewpoint of business. However, the United Nations is set to resolve the Post-2015 Development Agenda in the fall of 2015; the agenda will likely include the achievement of universal health coverage (UHC) as a specific development goal. Japan's healthcare system, the foundation of which is its public, nationwide universal health insurance program, has been evaluated highly by the Lancet. The World Bank also praised it as a global model. This paper presents suggestions and problems for Japan regarding global health strategies, including in regard to several prerequisite domestic preparations that must be made. They are summarized as follows. (1) The UHC development should be promoted in coordination with the United Nations, World Bank, and Asian Development Bank. (2) The universal health insurance system of Japan can be a global model for UHC and ensuring its sustainability should be considered a national policy. (3) Trade agreements such as the Trans-Pacific Partnership (TPP) should not disrupt or interfere with UHC, the form of which is unique to each nation, including Japan. (4) Japan should disseminate information overseas, including to national governments, people, and physicians, regarding the course of events that led to the establishment of the Japan's universal health insurance system and should make efforts to develop international human resources to participate in UHC policymaking. (5) The development of separate healthcare programs and UHC preparation should be promoted by streamlining and centralizing maternity care, school health, infectious disease management such as for tuberculosis, and emergency medicine such as for traffic accidents. (6) Japan should disseminate information overseas about its primary care physicians (kakaritsuke physicians) and develop international human resources. (7) Global health should be developed in

  3. Achieving universal access and moving towards elimination of new HIV infections in Cambodia

    PubMed Central

    Vun, Mean Chhi; Fujita, Masami; Rathavy, Tung; Eang, Mao Tang; Sopheap, Seng; Sovannarith, Samreth; Chhorvann, Chhea; Vanthy, Ly; Sopheap, Oum; Welle, Emily; Ferradini, Laurent; Sedtha, Chin; Bunna, Sok; Verbruggen, Robert

    2014-01-01

    Introduction In the mid-1990s, Cambodia faced one of the fastest growing HIV epidemics in Asia. For its achievement in reversing this trend, and achieving universal access to HIV treatment, the country received a United Nations millennium development goal award in 2010. This article reviews Cambodia’s response to HIV over the past two decades and discusses its current efforts towards elimination of new HIV infections. Methods A literature review of published and unpublished documents, including programme data and presentations, was conducted. Results and discussion Cambodia classifies its response to one of the most serious HIV epidemics in Asia into three phases. In Phase I (1991–2000), when adult HIV prevalence peaked at 1.7% and incidence exceeded 20,000 cases, a nationwide HIV prevention programme targeted brothel-based sex work. Voluntary confidential counselling and testing and home-based care were introduced, and peer support groups of people living with HIV emerged. Phase II (2001–2011) observed a steady decline in adult prevalence to 0.8% and incidence to 1600 cases by 2011, and was characterized by: expanding antiretroviral treatment (coverage reaching more than 80%) and continuum of care; linking with tuberculosis and maternal and child health services; accelerated prevention among key populations, including entertainment establishment-based sex workers, men having sex with men, transgender persons, and people who inject drugs; engagement of health workers to deliver quality services; and strengthening health service delivery systems. The third phase (2012–2020) aims to attain zero new infections by 2020 through: sharpening responses to key populations at higher risk; maximizing access to community and facility-based testing and retention in prevention and care; and accelerating the transition from vertical approaches to linked/integrated approaches. Conclusions Cambodia has tailored its prevention strategy to its own epidemic, established

  4. Universal health coverage in ‘One ASEAN’: are migrants included?

    PubMed Central

    Guinto, Ramon Lorenzo Luis R.; Curran, Ufara Zuwasti; Suphanchaimat, Rapeepong; Pocock, Nicola S.

    2015-01-01

    Background As the Association of South East Asian Nations (ASEAN) gears toward full regional integration by 2015, the cross-border mobility of workers and citizens at large is expected to further intensify in the coming years. While ASEAN member countries have already signed the Declaration on the Protection and Promotion of the Rights of Migrant Workers, the health rights of migrants still need to be addressed, especially with ongoing universal health coverage (UHC) reforms in most ASEAN countries. This paper seeks to examine the inclusion of migrants in the UHC systems of five ASEAN countries which exhibit diverse migration profiles and are currently undergoing varying stages of UHC development. Design A scoping review of current migration trends and policies as well as ongoing UHC developments and migrant inclusion in UHC in Indonesia, Malaysia, Philippines, Singapore, and Thailand was conducted. Results In general, all five countries, whether receiving or sending, have schemes that cover migrants to varying extents. Thailand even allows undocumented migrants to opt into its Compulsory Migrant Health Insurance scheme, while Malaysia and Singapore are still yet to consider including migrants in their government-run UHC systems. In terms of predominantly sending countries, the Philippines's social health insurance provides outbound migrants with portable insurance yet with limited benefits, while Indonesia still needs to strengthen the implementation of its compulsory migrant insurance which has a health insurance component. Overall, the five ASEAN countries continue to face implementation challenges, and will need to improve on their UHC design in order to ensure genuine inclusion of migrants, including undocumented migrants. However, such reforms will require strong political decisions from agencies outside the health sector that govern migration and labor policies. Furthermore, countries must engage in multilateral and bilateral dialogue as they redefine UHC

  5. Universal Hepatitis B Vaccination Coverage in Children and Adolescents with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Lin, Jin-Ding; Lin, Pei-Ying; Lin, Lan-Ping

    2010-01-01

    There is little information of hepatitis B vaccination coverage for people with intellectual disabilities (ID). The present paper aims to examine the completed hepatitis B vaccination coverage rate and its determinants of children and adolescents with ID in Taiwan. A cross-sectional questionnaire survey, with the entire response participants was…

  6. Magnetometer Data for the Ages: Achieving complete FGM instrument coverage of the multi-spacecraft Cluster mission (2000 to 2015+)

    NASA Astrophysics Data System (ADS)

    Alconcel, Leah-Nani; Fox, Peter; Colgan, Cary; Oddy, Tim; Brown, Patrick; Carr, Chris

    2016-04-01

    The calibrated dataset from the Cluster magnetometer instruments (FGMs) aboard the four Cluster spacecraft comprises an invaluable contribution to magnetospheric physics. It is also essential for the derivation of some datasets from other instruments, all of which have been made available through ESA's Cluster Science Archive (CSA). The FGM team at Imperial College - the PI institute that built and supports operation of the magnetometers - has regularly provided validated data to the CSA since its inception. Now that other multi-spacecraft missions such as the Magnetospheric Multiscale Mission (MMS) have come online, it will be possible to make inter-mission as well as inter-spacecraft comparisons. The FGM team hopes to enable those comparisons by delivering magnetic field data from periods when the Cluster spacecraft are not otherwise taking science telemetry. These periods are becoming more common as the spacecraft age. Accomplishing this would also achieve near-complete magnetic field coverage throughout the Cluster mission. Preparation of these data to archival standards raises unusual challenges to be discussed in this presentation.

  7. Development Achievements at Pittsburg State University for Fiscal Year 1988.

    ERIC Educational Resources Information Center

    Smoot, Joseph G.

    The development report for Pittsburg State University's (PSU) fiscal year 1988 is presented. The most important objective of PSU's development program is to provide funding beyond the state support in order to distinguish the university among its U.S. peers. Chapters include an overview of FY 1988 development activities, the Annual Fund, the…

  8. [Equity-oriented monitoring in the context of universal health coverage].

    PubMed

    Hosseinpoor, Ahmad Reza; Bergen, Nicole; Koller, Theadora; Prasad, Amit; Schlotheuber, Anne; Valentine, Nicole; Lynch, John; Vega, Jeanette

    2015-07-01

    Monitoring inequalities in health is fundamental to the equitable and progressive realization of universal health coverage (UHC). A successful approach to global inequality monitoring must be intuitive enough for widespread adoption, yet maintain technical credibility. This article discusses methodological considerations for equity-oriented monitoring of UHC, and proposes recommendations for monitoring and target setting. Inequality is multidimensional, such that the extent of inequality may vary considerably across different dimensions such as economic status, education, sex, and urban/rural residence. Hence, global monitoring should include complementary dimensions of inequality (such as economic status and urban/rural residence) as well as sex. For a given dimension of inequality, subgroups for monitoring must be formulated taking into consideration applicability of the criteria across countries and subgroup heterogeneity. For economic-related inequality, we recommend forming subgroups as quintiles, and for urban/rural inequality we recommend a binary categorization. Inequality spans populations, thus appropriate approaches to monitoring should be based on comparisons between two subgroups (gap approach) or across multiple subgroups (whole spectrum approach). When measuring inequality absolute and relative measures should be reported together, along with disaggregated data; inequality should be reported alongside the national average. We recommend targets based on proportional reductions in absolute inequality across populations. Building capacity for health inequality monitoring is timely, relevant, and important. The development of high-quality health information systems, including data collection, analysis, interpretation, and reporting practices that are linked to review and evaluation cycles across health systems, will enable effective global and national health inequality monitoring. These actions will support equity-oriented progressive realization of UHC.

  9. Equity-oriented monitoring in the context of universal health coverage.

    PubMed

    Hosseinpoor, Ahmad Reza; Bergen, Nicole; Koller, Theadora; Prasad, Amit; Schlotheuber, Anne; Valentine, Nicole; Lynch, John; Vega, Jeanette

    2014-09-01

    Monitoring inequalities in health is fundamental to the equitable and progressive realization of universal health coverage (UHC). A successful approach to global inequality monitoring must be intuitive enough for widespread adoption, yet maintain technical credibility. This article discusses methodological considerations for equity-oriented monitoring of UHC, and proposes recommendations for monitoring and target setting. Inequality is multidimensional, such that the extent of inequality may vary considerably across different dimensions such as economic status, education, sex, and urban/rural residence. Hence, global monitoring should include complementary dimensions of inequality (such as economic status and urban/rural residence) as well as sex. For a given dimension of inequality, subgroups for monitoring must be formulated taking into consideration applicability of the criteria across countries and subgroup heterogeneity. For economic-related inequality, we recommend forming subgroups as quintiles, and for urban/rural inequality we recommend a binary categorization. Inequality spans populations, thus appropriate approaches to monitoring should be based on comparisons between two subgroups (gap approach) or across multiple subgroups (whole spectrum approach). When measuring inequality absolute and relative measures should be reported together, along with disaggregated data; inequality should be reported alongside the national average. We recommend targets based on proportional reductions in absolute inequality across populations. Building capacity for health inequality monitoring is timely, relevant, and important. The development of high-quality health information systems, including data collection, analysis, interpretation, and reporting practices that are linked to review and evaluation cycles across health systems, will enable effective global and national health inequality monitoring. These actions will support equity-oriented progressive realization of UHC.

  10. Beyond health aid: would an international equalization scheme for universal health coverage serve the international collective interest?

    PubMed

    Ooms, Gorik; Hammonds, Rachel; Waris, Attiya; Criel, Bart; Van Damme, Wim; Whiteside, Alan

    2014-05-21

    It has been argued that the international community is moving 'beyond aid'. International co-financing in the international collective interest is expected to replace altruistically motivated foreign aid. The World Health Organization promotes 'universal health coverage' as the overarching health goal for the next phase of the Millennium Development Goals. In order to provide a basic level of health care coverage, at least some countries will need foreign aid for decades to come. If international co-financing of global public goods is replacing foreign aid, is universal health coverage a hopeless endeavor? Or would universal health coverage somehow serve the international collective interest?Using the Sustainable Development Solutions Network proposal to finance universal health coverage as a test case, we examined the hypothesis that national social policies face the threat of a 'race to the bottom' due to global economic integration and that this threat could be mitigated through international social protection policies that include international cross-subsidies - a kind of 'equalization' at the international level.The evidence for the race to the bottom theory is inconclusive. We seem to be witnessing a 'convergence to the middle'. However, the 'middle' where 'convergence' of national social policies is likely to occur may not be high enough to keep income inequality in check.The implementation of the international equalization scheme proposed by the Sustainable Development Solutions Network would allow to ensure universal health coverage at a cost of US$55 in low income countries-the minimum cost estimated by the World Health Organization. The domestic efforts expected from low and middle countries are far more substantial than the international co-financing efforts expected from high income countries. This would contribute to 'convergence' of national social policies at a higher level. We therefore submit that the proposed international equalization scheme

  11. Investigating the Achievement Goals of University Students in Terms of Psycho-Social Variables

    ERIC Educational Resources Information Center

    Kayis, Ahmet Rifat; Ceyhan, Aydogan Aykut

    2015-01-01

    It is the aim of this research to investigate the achievement goals of university students. Firstly, university students' adoption levels of achievement goals are described. Next, how their level of academic self-efficacy, irrational beliefs, perfectionism, self-determination, locus of control and gender predict each achievement goal is depicted.…

  12. Evidenced Formal Coverage Index and universal healthcare enactment: A prospective longitudinal study of economic, social, and political predictors of 194 countries.

    PubMed

    Feigl, Andrea B; Ding, Eric L

    2013-11-01

    Determinants of universal healthcare (UHC) are poorly empirically understood. We undertook a comprehensive study of UHC development using a novel Evidenced Formal Coverage (EFC) index that combines three key UHC elements: legal framework, population coverage, and accessibility. Applying the EFC index measures (legislation, ≥90% skilled birth attendance, ≥85% formal coverage) to 194 countries, aggregating time-varying data from 1880-2008, this study investigates which macro-economic, political, and social indicators are major longitudinal predictors of developing EFC globally, and in middle-income countries. Overall, 75 of 194 countries implemented legal-text UHC legislation, of which 51 achieved EFC. In a country-year prospective longitudinal analysis of EFC prediction, higher GDP-per-capita (per GDP-per-capita doubling, relative risk [RR]=1.77, 95% CI: 1.49-2.10), higher primary school completion (per +20% completion, RR=2.30, 1.65-3.21), and higher adult literacy were significantly associated with achieving EFC. Results also identify a GDP-per-capita of I$5000 as a minimum level for development of EFC. GDP-per-capita and education were each robust predictors in middle-income countries, and education remained significant even controlling for time-varying GDP growth. For income-inequality, the GINI coefficient was suggestive in its role in predicting EFC (p=0.024). For social and political indicators, a greater degree of ethnic fractionalization (per +25%, RR=0.51, 0.38-0.70), proportional electoral system (RR=2.80, 1.22-6.40), and dictatorships (RR=0.10, 0.05-0.27) were further associated with EFC. The novel EFC index and this longitudinal prospective study together indicate that investment in both economic growth and education should be seen of equal importance for development of UHC. Our findings help in understanding the social and political drivers of universal healthcare, especially for transitioning countries.

  13. Universal Coverage without Universal Access: Institutional Barriers to Health Care among Women Sex Workers in Vancouver, Canada

    PubMed Central

    Socías, M. Eugenia; Shoveller, Jean; Bean, Chili; Nguyen, Paul; Montaner, Julio; Shannon, Kate

    2016-01-01

    Background Access to health care is a crucial determinant of health. Yet, even within settings that purport to provide universal health coverage (UHC), sex workers’ experiences reveal systematic, institutionally ingrained barriers to appropriate quality health care. The aim of this study was to assess prevalence and correlates of institutional barriers to care among sex workers in a setting with UHC. Methods Data was drawn from an ongoing community-based, prospective cohort of women sex workers in Vancouver, Canada (An Evaluation of Sex Workers’ Health Access). Multivariable logistic regression analyses, using generalized estimating equations (GEE), were employed to longitudinally investigate correlates of institutional barriers to care over a 44-month follow-up period (January 2010-August 2013). Results In total, 723 sex workers were included, contributing to 2506 observations. Over the study period, 509 (70.4%) women reported one or more institutional barriers to care. The most commonly reported institutional barriers to care were long wait times (54.6%), limited hours of operation (36.5%), and perceived disrespect by health care providers (26.1%). In multivariable GEE analyses, recent partner- (adjusted odds ratio [AOR] = 1.46, % 95% Confidence Interval [CI] 1.10–1.94), workplace- (AOR = 1.31, 95% CI 1.05–1.63), and community-level violence (AOR = 1.41, 95% CI 1.04–1.92), as well as other markers of vulnerability, such as self-identification as a gender/sexual minority (AOR = 1.32, 95% CI 1.03–1.69), a mental illness diagnosis (AOR = 1.66, 95% CI 1.34–2.06), and lack of provincial health insurance card (AOR = 3.47, 95% CI 1.59–7.57) emerged as independent correlates of institutional barriers to health services. Discussion Despite Canada’s UHC, women sex workers in Vancouver face high prevalence of institutional barriers to care, with highest burden among most marginalized women. These findings underscore the need to explore new models of care

  14. Assessing vaccination coverage in infants, survey studies versus the Flemish immunisation register: achieving the best of both worlds.

    PubMed

    Braeckman, Tessa; Lernout, Tinne; Top, Geert; Paeps, Annick; Roelants, Mathieu; Hoppenbrouwers, Karel; Van Damme, Pierre; Theeten, Heidi

    2014-01-09

    Infant immunisation coverage in Flanders, Belgium, is monitored through repeated coverage surveys. With the increased use of Vaccinnet, the web-based ordering system for vaccines in Flanders set up in 2004 and linked to an immunisation register, this database could become an alternative to quickly estimate vaccination coverage. To evaluate its current accuracy, coverage estimates generated from Vaccinnet alone were compared with estimates from the most recent survey (2012) that combined interview data with data from Vaccinnet and medical files. Coverage rates from registrations in Vaccinnet were systematically lower than the corresponding estimates obtained through the survey (mean difference 7.7%). This difference increased by dose number for vaccines that require multiple doses. Differences in administration date between the two sources were observed for 3.8-8.2% of registered doses. Underparticipation in Vaccinnet thus significantly impacts on the register-based immunisation coverage estimates, amplified by underregistration of administered doses among vaccinators using Vaccinnet. Therefore, survey studies, despite being labour-intensive and expensive, currently provide more complete and reliable results than register-based estimates alone in Flanders. However, further improvement of Vaccinnet's completeness will likely allow more accurate estimates in the nearby future.

  15. Moving from ideas to action - developing health financing systems towards universal coverage in Africa

    PubMed Central

    2012-01-01

    Background Accelerating progress towards universal coverage in African countries calls for concrete actions that reinforce social health protection through establishment of sustainable health financing mechanisms. In order to explore possible pathways for moving past the existing obstacles, panel discussions were organized on health financing bringing together Ministers of health and Ministers of finance with the objective of creating a discussion space where the different perspectives on key issues and needed actions could meet. This article presents a synthesis of panel discussions focusing on the identified challenges and the possible solutions. The overview of this paper is based on the objectives and proceedings of the panel discussions and relies on the observation and study of the interaction between the panelists and on the discourse used. Summary The discussion highlighted that a large proportion of the African population has no access to needed health services with significant reliance on direct out of pocket payments. There are multiple obstacles in making prepayment and pooling mechanisms operational. The relatively strong political commitment to health has not always translated into more public spending for health. Donor investment in health in low income countries still falls below commitments. There is need to explore innovative domestic revenue collection mechanisms. Although inadequate funding for health is a fundamental problem, inefficient use of resources is of great concern. There is need to generate robust evidence focusing on issues of importance to ministry of finance. The current unsatisfactory state of health financing was mainly attributed to lack of clear vision; evidence based plans and costed strategies. Discussion Based on the analysis of discussion made, there are points of convergence and divergence in the discourse and positions of the two ministries. The current blockage points holding back budget allocations for health can be

  16. GO RIO: Achieving Universal Access to Mass Transit

    ERIC Educational Resources Information Center

    Martinez, Ted, Jr.; Castaneda-Calleros, Russell

    2009-01-01

    GO RIO is a universal access, mass-transit program that has been offered to all students who are registered full-time at Rio Hondo College. Through an agreement with five local transit agencies, full-time students can obtain a pass that provides full access seven days a week throughout the entire semester.

  17. Defining and Achieving Student Success: University Faculty and Student Perspectives.

    ERIC Educational Resources Information Center

    Dean, Anne M.; Camp, William G.

    The question of how agricultural education students and faculty define and hope to foster student success was studied at a large southeastern land-grant university with a college of agriculture that included 1,497 students and 193 faculty. The study questions were explored in 2 focus groups containing a total of 7 faculty members and 8 focus…

  18. Structural Development of Finnish Universities: Achieving Competitiveness and Academic Excellence

    ERIC Educational Resources Information Center

    Tirronen, Jarkko; Nokkala, Terhi

    2009-01-01

    This paper discusses strategic instruments that are used to enhance the competitiveness of Finnish universities in the context of globalisation, internationalisation and commercialisation of research and education. The Finnish higher education system is currently undergoing a major policy reform, which aims to enhance the competitiveness of…

  19. Achieving Integrated Performance Management with the Corporate University

    ERIC Educational Resources Information Center

    Dealtry, Richard

    2005-01-01

    Purpose: This article aims to deliver synoptic perspectives on the evolution taking place in corporate university management best practice. Design/methodology/approach: The insights are based on the author's co-creative client experience in the design, management and impact studies of this business and organisation development intervention. The…

  20. Beyond health aid: would an international equalization scheme for universal health coverage serve the international collective interest?

    PubMed Central

    2014-01-01

    It has been argued that the international community is moving ‘beyond aid’. International co-financing in the international collective interest is expected to replace altruistically motivated foreign aid. The World Health Organization promotes ‘universal health coverage’ as the overarching health goal for the next phase of the Millennium Development Goals. In order to provide a basic level of health care coverage, at least some countries will need foreign aid for decades to come. If international co-financing of global public goods is replacing foreign aid, is universal health coverage a hopeless endeavor? Or would universal health coverage somehow serve the international collective interest? Using the Sustainable Development Solutions Network proposal to finance universal health coverage as a test case, we examined the hypothesis that national social policies face the threat of a ‘race to the bottom’ due to global economic integration and that this threat could be mitigated through international social protection policies that include international cross-subsidies – a kind of ‘equalization’ at the international level. The evidence for the race to the bottom theory is inconclusive. We seem to be witnessing a ‘convergence to the middle’. However, the ‘middle’ where ‘convergence’ of national social policies is likely to occur may not be high enough to keep income inequality in check. The implementation of the international equalization scheme proposed by the Sustainable Development Solutions Network would allow to ensure universal health coverage at a cost of US$55 in low income countries-the minimum cost estimated by the World Health Organization. The domestic efforts expected from low and middle countries are far more substantial than the international co-financing efforts expected from high income countries. This would contribute to ‘convergence’ of national social policies at a higher level. We therefore submit that the proposed

  1. Quality in university physics teaching: is it being achieved?

    NASA Astrophysics Data System (ADS)

    1998-11-01

    This was the title of a Physics Discipline Workshop held at the University of Leeds on 10 and 11 September 1998. Organizer Ashley Clarke of the university's Physics and Astronomy Department collected together an interesting variety of speakers polygonically targeting the topic, although as workshops go the audience didn't have to do much work except listen. There were representatives from 27 university physics departments who must have gone away with a lot to think about and possibly some new academic year resolutions to keep. But as a non-university no-longer teacher of (school) physics I was impressed with the general commitment to the idea that if you get the right quality of learning the teaching must be OK. I also learned (but have since forgotten) a lot of new acronyms. The keynote talk was by Gillian Hayes, Associate Director of the Quality Assurance Agency for Higher Education (QAA). She explained the role and implementation of the Subject Reviews that QAA is making for all subjects in all institutions of higher education on a five- to seven-year cycle. Physics Education hopes to publish an article about all this from QAA shortly. In the meantime, suffice it to say that the review looks at six aspects of provision, essentially from the point of view of enhancing students' experiences and learning. No doubt all participants would agree with this (they'd better if they want to score well on the Review) but may have been more worried by the next QAA speaker, Norman Jackson, who drummed in the basic facts of life as HE moves from an elite provision system to a mass provision system. He had an interesting graph showing how in the last ten years or so more students were getting firsts and upper seconds and fewer getting thirds. It seems that all those A-level students getting better grades than they used to are carrying on their good luck to degree level. But they still can't do maths (allegedly) and I doubt whether Jon Ogborn (IoP Advancing Physics Project

  2. [Leadership and vision in the improvement of universal health care coverage in low-income countries].

    PubMed

    Meda, Ziemlé Clément; Konate, Lassina; Ouedraogo, Hyacinthe; Sanou, Moussa; Hercot, David; Sombie, Issiaka

    2011-01-01

    implementing a decentralized approach to tuberculosis detection, succeeded in improving access to care and enabled us to quantify the rate of tuberculosis-HIV co-infection in the HD. The fourth intervention improved financial access to emergency obstetric care by providing essential drugs and consumables for emergency obstetric surgery free of charge. The fifth intervention boosted the motivation of health workers by an annual 'competition of excellence', organised for workers and teams in the HD. Finally, our sixth intervention was the introduction of a "culture" of evaluation and transparency, by means of a local health journal, used to interact with stakeholders both at the local level and in the health sector more broadly. We also present our experiences regularly during national health science symposia. Although the DT operates with limited resources, it has over time managed to improve care and services in the HD, through its dynamic management and strategic planning. It has reduced inpatient mortality and improved access to care, particularly for vulnerable groups, in line with the Primary Health Care and Bamako Initiative principles. This case study would have benefited from a stronger methodology. However, it shows that in a context of limited resources it is still possible to strengthen the local health system by improving management practices. To progress towards universal health coverage, all core functions of a DT are worth implementing, including leadership and vision. National and international health strategies should thus include a plan to provide for and train local health system managers who can provide both leadership and strategic vision.

  3. How universal is coverage and access to diagnosis and treatment for Chagas disease in Colombia? A health systems analysis.

    PubMed

    Cucunubá, Zulma M; Manne-Goehler, Jennifer M; Díaz, Diana; Nouvellet, Pierre; Bernal, Oscar; Marchiol, Andrea; Basáñez, María-Gloria; Conteh, Lesong

    2017-02-01

    Limited access to Chagas disease diagnosis and treatment is a major obstacle to reaching the 2020 World Health Organization milestones of delivering care to all infected and ill patients. Colombia has been identified as a health system in transition, reporting one of the highest levels of health insurance coverage in Latin America. We explore if and how this high level of coverage extends to those with Chagas disease, a traditionally marginalised population. Using a mixed methods approach, we calculate coverage for screening, diagnosis and treatment of Chagas. We then identify supply-side constraints both quantitatively and qualitatively. A review of official registries of tests and treatments for Chagas disease delivered between 2008 and 2014 is compared to estimates of infected people. Using the Flagship Framework, we explore barriers limiting access to care. Screening coverage is estimated at 1.2% of the population at risk. Aetiological treatment with either benznidazol or nifurtimox covered 0.3-0.4% of the infected population. Barriers to accessing screening, diagnosis and treatment are identified for each of the Flagship Framework's five dimensions of interest: financing, payment, regulation, organization and persuasion. The main challenges identified were: a lack of clarity in terms of financial responsibilities in a segmented health system, claims of limited resources for undertaking activities particularly in primary care, non-inclusion of confirmatory test(s) in the basic package of diagnosis and care, poor logistics in the distribution and supply chain of medicines, and lack of awareness of medical personnel. Very low screening coverage emerges as a key obstacle hindering access to care for Chagas disease. Findings suggest serious shortcomings in this health system for Chagas disease, despite the success of universal health insurance scale-up in Colombia. Whether these shortcomings exist in relation to other neglected tropical diseases needs investigating

  4. The Explanatory and Predictive Relationship Pattern between University Students' Goal Orientation Behaviours and Their Academic Achievement

    ERIC Educational Resources Information Center

    Akpur, Ugur

    2016-01-01

    The purpose of this study is to determine the explanatory and predictive relationship pattern between university students' goal orientation behaviours and their academic achievement. The study group consisted of 259 university students. A "2x2 Achievement Goal Orientations Scale" was used to determine the students' goal orientation…

  5. Is It More Important to Address the Issue of Patient Mobility or to Guarantee Universal Health Coverage in Europe?

    PubMed Central

    Legido-Quigley, Helena

    2016-01-01

    This paper discusses whether European institutions should devote so much attention and funding to cross-border healthcare or they should instead prioritise guaranteeing universal health coverage (UHC), “addressing inequalities” and tackling the effects of austerity measures. The paper argues through providing the evidence in both areas of research, that the priority at European level from a public health and social justice perspective should be to guarantee UHC for all the population living in Europe and prioritise protective action for those who are most in need. PMID:26673649

  6. UICC International Session: What are the implications of sharing the concept of Universal Health Coverage for cancer in Asia?

    PubMed

    Akaza, Hideyuki; Roh, Jae Kyung; Hao, Xishan; Wibulpolprasert, Suwit; Nozaki, Shinjiro; Park, Eun-Cheol; Fukuda, Takashi; Sonoda, Shigeto; Kawahara, Norie

    2016-04-01

    The Japan National Committee for the Union for International Cancer Control (UICC) and UICC - Asia Regional Office organized an international session as part of the 74th Annual Meeting of the Japanese Cancer Association on the topic "What are the implications of sharing the concept of Universal Health Coverage for cancer in Asia?" Universal Health Coverage (UHC) is included in the United Nations' Sustainable Development Goals and aims to ensure that all people can receive high-quality medical services, are protected from public health risks, and are prevented from falling into poverty due to medical costs or loss of income arising from illness. The session discussed the growing cost of cancer and the challenges that this poses to the establishment and deployment of UHC in the Asian region, where countries face budgetary and other systemic constraints in tackling and controlling cancer. It was noted how sharing concepts on UHC will assist mutual learning among Asian countries and help in the formation of guidelines that can be adapted to national and regional realities. Presentations included a status report on UHC for cancer control in Thailand, and a report from the WHO Kobe Centre concerning prospects for collaborative research on UHC. Also discussed were the current status of cancer burden and control in China and Korea and Japan's progress in systemizing cost-effectiveness evaluation. The final presentation highlighted the importance of gathering social and economic data across Asia in order to build a picture of commonalities and differences in the region.

  7. Challenges facing the United States of America in implementing universal coverage.

    PubMed

    Rice, Thomas; Unruh, Lynn Y; Rosenau, Pauline; Barnes, Andrew J; Saltman, Richard B; van Ginneken, Ewout

    2014-12-01

    In 2010, immediately before the United States of America (USA) implemented key features of the Affordable Care Act (ACA), 18% of its residents younger than 65 years lacked health insurance. In the USA, gaps in health coverage and unhealthy lifestyles contribute to outcomes that often compare unfavourably with those observed in other high-income countries. By March 2014, the ACA had substantially changed health coverage in the USA but most of its main features--health insurance exchanges, Medicaid expansion, development of accountable care organizations and further oversight of insurance companies--remain works in progress. The ACA did not introduce the stringent spending controls found in many European health systems. It also explicitly prohibits the creation of institutes--for the assessment of the cost-effectiveness of pharmaceuticals, health services and technologies--comparable to the National Institute for Health and Care Excellence in the United Kingdom of Great Britain and Northern Ireland, the Haute Autorité de Santé in France or the Pharmaceutical Benefits Advisory Committee in Australia. The ACA was--and remains--weakened by a lack of cross-party political consensus. The ACA's performance and its resulting acceptability to the general public will be critical to the Act's future.

  8. The Role of Hospital Information Systems in Universal Health Coverage Monitoring in Rwanda.

    PubMed

    Karara, Gustave; Verbeke, Frank; Nyssen, Marc

    2015-01-01

    In this retrospective study, the authors monitored the patient health coverage in 6 Rwandan hospitals in the period between 2011 and 2014. Among the 6 hospitals, 2 are third level hospitals, 2 district hospitals and 2 private hospitals. Patient insurance and financial data were extracted and analyzed from OpenClinic GA, an open source hospital information system (HIS) used in those 6 hospitals. The percentage of patients who had no health insurer globally decreased from 35% in 2011 to 15% in 2014. The rate of health insurance coverage in hospitals varied between 75% in private hospitals and 84% in public hospitals. The amounts paid by the patients for health services decreased in private hospitals to 25% of the total costs in 2014 (-7.4%) and vary between 14% and 19% in public hospitals. Although the number of insured patients has increased and the patient share decreased over the four years of study, the patients' out-of-pocket payments increased especially for in-patients. This study emphasizes the value of integrated hospital information systems for this kind of health economics research in developing countries.

  9. Challenges facing the United States of America in implementing universal coverage

    PubMed Central

    Unruh, Lynn Y; Rosenau, Pauline; Barnes, Andrew J; Saltman, Richard B; van Ginneken, Ewout

    2014-01-01

    Abstract In 2010, immediately before the United States of America (USA) implemented key features of the Affordable Care Act (ACA), 18% of its residents younger than 65 years lacked health insurance. In the USA, gaps in health coverage and unhealthy lifestyles contribute to outcomes that often compare unfavourably with those observed in other high-income countries. By March 2014, the ACA had substantially changed health coverage in the USA but most of its main features – health insurance exchanges, Medicaid expansion, development of accountable care organizations and further oversight of insurance companies – remain works in progress. The ACA did not introduce the stringent spending controls found in many European health systems. It also explicitly prohibits the creation of institutes – for the assessment of the cost–effectiveness of pharmaceuticals, health services and technologies – comparable to the National Institute for Health and Care Excellence in the United Kingdom of Great Britain and Northern Ireland, the Haute Autorité de Santé in France or the Pharmaceutical Benefits Advisory Committee in Australia. The ACA was – and remains – weakened by a lack of cross-party political consensus. The ACA’s performance and its resulting acceptability to the general public will be critical to the Act’s future. PMID:25552773

  10. Extending CATH: increasing coverage of the protein structure universe and linking structure with function.

    PubMed

    Cuff, Alison L; Sillitoe, Ian; Lewis, Tony; Clegg, Andrew B; Rentzsch, Robert; Furnham, Nicholas; Pellegrini-Calace, Marialuisa; Jones, David; Thornton, Janet; Orengo, Christine A

    2011-01-01

    CATH version 3.3 (class, architecture, topology, homology) contains 128,688 domains, 2386 homologous superfamilies and 1233 fold groups, and reflects a major focus on classifying structural genomics (SG) structures and transmembrane proteins, both of which are likely to add structural novelty to the database and therefore increase the coverage of protein fold space within CATH. For CATH version 3.4 we have significantly improved the presentation of sequence information and associated functional information for CATH superfamilies. The CATH superfamily pages now reflect both the functional and structural diversity within the superfamily and include structural alignments of close and distant relatives within the superfamily, annotated with functional information and details of conserved residues. A significantly more efficient search function for CATH has been established by implementing the search server Solr (http://lucene.apache.org/solr/). The CATH v3.4 webpages have been built using the Catalyst web framework.

  11. A Review of Realizing the Universal Health Coverage (UHC) Goals by 2030: Part 2- What is the Role of eHealth and Technology?

    PubMed

    Hussein, Rada

    2015-07-01

    This paper is the second part of a review of how to realize the Universal Health Coverage (UHC) goals by 2030. The objective of this review is to investigate the role of eHealth and technology in achieving UHC, focusing on four aspects: 1) identifying the importance of UHC and highlighting how UHC is influenced by health systems and eHealth, 2) investigating the current status of UHC worldwide and indicating the current challenges facing the realization of UHC, 3) reviewing the current research activities in the UHC domain and emphasizing the role of eHealth and technology in achieving UHC, and 4) discussing the results of the review to identify the current gaps in UHC implantation and the corresponding research lines for future investigation. This part covers the last two aspects through providing a comprehensive understanding of the role of eHealth in the current research activities in the UHC domain. Specifically, eHealth can be extensively deployed in connecting the healthcare information systems, strengthening the health systems, building the health workforce capacity, in addition to forming frameworks of integrated mHealth strategies for achieving UHC.

  12. The Relationship between University Students' Academic Achievement and Perceived Organizational Image

    ERIC Educational Resources Information Center

    Polat, Soner

    2011-01-01

    The purpose of present study was to determine the relationship between university students' academic achievement and perceived organizational image. The sample of the study was the senior students at the faculties and vocational schools in Umuttepe Campus at Kocaeli University. Because the development of organizational image is a long process, the…

  13. Sports Involvement and Academic Achievement: A Study of Malaysian University Athletes

    ERIC Educational Resources Information Center

    Chuan, Chun Cheng; Yusof, Aminuddin; Shah, Parilah Mohd

    2013-01-01

    Factors that influence the academic achievement of Malaysian university athletes were investigated using 156 field hockey players from several universities. The relationship between team subculture, parental influence, the learning environment, support systems, financial aid, training factors, academic assistance, socialization, and stress level…

  14. Predicting First-Year Achievement by Pedagogy and Skill Development in the First Weeks at University

    ERIC Educational Resources Information Center

    Torenbeek, M.; Jansen, E. P. W. A.; Hofman, W. H. A.

    2011-01-01

    Central in this study is the relationship between the pedagogical approach and generic skill development in the first 10 weeks at university, students' perception of the fit between secondary and university education and first-year achievement. Information regarding the pedagogical approach and generic skill development was gathered through…

  15. Distance Education and Academic Achievement in Business Administration: The Case of the University of Akureyri

    ERIC Educational Resources Information Center

    Edvardsson, Ingi Runar; Oskarsson, Gudmundur Kristjan

    2008-01-01

    This paper first presents the development of distance education in Icelandic universities. Its second aim is to present a detailed analysis of the distance education practice at the University of Akureyri (UNAK), Iceland. Finally, the paper aims at analysing academic achievement, as well as attitudes towards courses, among campus and distance…

  16. Role of Peers in Student Academic Achievement in Exogenously Formed University Groups

    ERIC Educational Resources Information Center

    Androushchak, Gregory; Poldin, Oleg; Yudkevich, Maria

    2013-01-01

    We estimate the influence of classmates' ability characteristics on student achievement in exogenously formed university student groups. The study uses administrative data on undergraduate students at a large selective university in Russia. The presence of high-ability classmates has a significant positive effect on individual grades in key…

  17. Relationship between Teachers' Effective Communication and Students' Academic Achievement at the Northern Border University

    ERIC Educational Resources Information Center

    Al-Madani, Feras Mohammed

    2015-01-01

    Effective communication between faculty members and students is one of the concerns of the educational stakeholders at the Northern Border University, Saudi Arabia. This study investigates the relationship between teachers' effective communication and students' academic achievement at the Northern Border University. The survey questionnaire…

  18. Complete tissue coverage achieved by scaffold-based tissue engineering in the fetal sheep model of Myelomeningocele.

    PubMed

    Watanabe, Miho; Li, Haiying; Kim, Aimee G; Weilerstein, Aaron; Radu, Anteneta; Davey, Marcus; Loukogeorgakis, Stavros; Sánchez, Melissa D; Sumita, Kazutaka; Morimoto, Naoki; Yamamoto, Masaya; Tabata, Yasuhiko; Flake, Alan W

    2016-01-01

    Myelomeningocele (MMC) is the most severe form of spina bifida, one of the most common congenital anomalies. Although open fetal surgical repair of the MMC defect has been shown to result in improved outcomes, a less invasive approach applicable earlier in gestation than the current open surgical approach between 19 and 26 weeks of gestation is desirable for further improvement of neurological symptoms, as well as reduction of maternal and fetal risks. We previously reported the therapeutic potential of a scaffold-based tissue engineering approach in a fetal rat MMC model. The objective of this study was to confirm the long-term efficacy of this approach in the surgically created fetal sheep MMC model. Gelatin-based or gelatin/collagen hybrid sponges were prepared with and without basic fibroblast growth factor (bFGF) incorporation. The defect was covered by a sponge and secured by a supporting sheet with adhesive at 100 days of gestation or the gelatin/collagen hybrid with bFGF was secured with adhesive without the sheet. Although sheets were found detached at term (140 days' gestation), both gelatin-based and gelatin/collagen hybrid sponges had integrated within the newly formed granulation tissue, resulting in complete coverage of the MMC defect. The release of bFGF from sponges resulted in enhanced formation of granulation tissue and epithelialization. There was also evidence of improved preservation of the spinal cord with less associated damage on histological analysis and reversal of hindbrain herniation. These experiments provide important proof-of-principle evidence of the efficacy of scaffold-based tissue engineered coverage for the prenatal treatment of MMC.

  19. The social ties that bind: social anxiety and academic achievement across the university years.

    PubMed

    Brook, Christina A; Willoughby, Teena

    2015-05-01

    Given that engagement and integration in university/college are considered key to successful academic achievement, the identifying features of social anxiety, including fear of negative evaluation and distress and avoidance of new or all social situations, may be particularly disadvantageous in the social and evaluative contexts that are integral to university/college life. Thus, the purpose of this study was to examine the direct effects of social anxiety on academic achievement, as well as investigate an indirect mechanism through which social anxiety might impact on academic achievement, namely, the formation of new social ties in university. The participants were 942 (71.7 % female; M = 19 years at Time 1) students enrolled in a mid-sized university in Southern Ontario, Canada. Students completed annual assessments of social anxiety, social ties, and academic achievement for three consecutive years. The results from an autoregressive cross-lag path analysis indicated that social anxiety had a significant and negative direct relationship with academic achievement. Moreover, the negative indirect effect of social anxiety on academic achievement through social ties was significant, as was the opposing direction of effects (i.e., the indirect effect of academic achievement on social anxiety through social ties). These findings highlight the critical role that social ties appear to play in successful academic outcomes and in alleviating the effects of social anxiety during university/college.

  20. Evaluation of the 2011 long-lasting, insecticide-treated net distribution for universal coverage in Togo

    PubMed Central

    2013-01-01

    Background Malaria remains a substantial public health problem in Togo. An integrated child health campaign was conducted in Togo in October 2011. This campaign included a component of free distribution of 2,799,800 long-lasting, insecticide-treated nets (LLINs) to households throughout Togo. This distribution marked the first effort in Togo at universal LLIN coverage and was not targeted specifically to children under five years and pregnant women, but to all household members. This study reports the results of the LLIN distribution campaign in terms of bed net possession and utilization. Methods A representative household survey was implemented during the rainy season nine months after the LLIN distribution component of the campaign. Some 6,015 households selected through two stages of probability proportion to size stratified random sampling were interviewed using a brief questionnaire that included a demographic section with questions on the number of household members and sleeping spaces, and a campaign participation section with questions used to evaluate non-LLIN aspects of the campaign. A net roster listed all nets and their characteristics, and a household roster listed all members and visitors with information about bed net use. The questions addressed different aspects of bed net and LLIN possession and utilization. Crude weighted frequencies, percentages, and t- tests of association were calculated using the Stata 12.0 Survey features. Results Possession of at least one bed net and/or LLIN increased from 41.3% to 96.7% (P <0.001). Household possession of at least one campaign LLIN was 93.3%. Report LLIN among pregnant women was 77.5% and 79.3% for children under five. For the general population LLIN use was 68.3%. Conclusions Due to the gap in LLIN possession and use and the significant number of individuals reporting a lack of nets as a reason for non-use, additional national LLIN distribution campaigns with a stronger educational component need to be

  1. Evaluation of Achievement of Universal Basic Education (UBE) in Delta State

    ERIC Educational Resources Information Center

    Osadebe, P. U.

    2014-01-01

    The study evaluated the objectives of the Universal Basic Education (UBE) programme in Delta State. It considered the extent to which each objective was achieved. A research question on the extent to which the UBE objectives were achieved guided the study. Two hypotheses were tested. A sample of 300 students was randomly drawn through the use of…

  2. How University Students with Reading Difficulties Are Supported in Achieving Their Goals

    ERIC Educational Resources Information Center

    Stack-Cutler, Holly L.; Parrila, Rauno K.; Jokisaari, Markku; Nurmi, Jari-Erik

    2015-01-01

    We examine (a) what social ties university students with a history of reading difficulty (RD) report assisting them to achieve their goals, (b) outlets available for developing social ties, (c) resources mobilized within these relationships, and (d) the impact of social ties' status on academic achievement. Participants were 107 university…

  3. Academic Achievement and Personality in University Students Who Are Visually Impaired

    ERIC Educational Resources Information Center

    Klinkosz, Waldemar; Sekowski, Andrzej; Brambring, Michael

    2006-01-01

    This study compared academic achievement by sighted versus visually impaired students at Polish universities and analyzed potential between-group differences on various personality traits and their impact on academic grades. Although there was no main effect of visual status on academic achievement, there were some significant differences between…

  4. Effects of Identity Processing Styles on Academic Achievement of First Year University Students

    ERIC Educational Resources Information Center

    Seabi, Joseph; Payne, Jarrod

    2013-01-01

    Purpose: Academic achievement of first year university students in the international arena, as well as in South Africa, has been a point of concern for all stakeholders because of high failure and dropout rates. The purpose of this paper is to investigate the effects of identity processing styles on academic achievement in first year university…

  5. The Use of ICT in Achieving the Millennium Development Goals (MDGs) in Universities

    ERIC Educational Resources Information Center

    Kaino, L. M.

    2012-01-01

    The contribution of Information and Communication Technology (ICT) in achieving the Millennium Development Goals (MDGs) and the contribution of higher education institutions in achieving these have been emphasized. This study sought to find out the extent to which university-based researches on ICTs addressed and impacted the three MDGs of gender…

  6. The Achievement Goals Orientation of South African First Year University Physics Students

    ERIC Educational Resources Information Center

    Ramnarain, Umesh Dewnarain; Ramaila, Sam

    2016-01-01

    This study investigated the achievement goals orientation of first year physics students at a South African university. The mixed methods design involved a quantitative survey of 291 students using an achievement goals questionnaire and individual interviews of selected participants. Results showed that the students perceived they have a stronger…

  7. From Crisis Management to Academic Achievement: A University Cluster-Mentoring Model for Black Undergraduates

    ERIC Educational Resources Information Center

    Apprey, Maurice; Preston-Grimes, Patrice; Bassett, Kimberley C.; Lewis, Dion W.; Rideau, Ryan M.

    2014-01-01

    In spite of the widening racial achievement gap among U.S. college students (U.S. Census Bureau, 2011), some universities are achieving success in supporting the graduation and postcollege goals of Black undergraduates (Apprey, Bassett, Preston-Grimes, Lewis, & Wood 2014/this issue; Baker, 2006; Hrabowski, 2003; Hrabowski & Maton, 2009).…

  8. A Study of the Differential Achievement among Graduates of the University of Qatar, 1977-81.

    ERIC Educational Resources Information Center

    Sefein, Naim A.

    Achievement of University of Qatar graduates between 1977 and 1981 was studied. For the sample of 766 graduates, information was collected on sex, nationality, major, and year of graduation. The degree to which secondary school graduation scores can predict college achievement was examined using Pearson product moment correlation coefficients. The…

  9. Correlates of Academic Procrastination and Mathematics Achievement of University Undergraduate Students

    ERIC Educational Resources Information Center

    Akinsola, Mojeed Kolawole; Tella, Adedeji; Tella, Adeyinka

    2007-01-01

    Procrastination is now a common phenomenon among students, particularly those at the higher level. And this is doing more harm to their academic achievement than good. Therefore, this study examined the correlates between academic procrastination and mathematics achievement among the university mathematics undergraduate students. The study used a…

  10. Predicting Science Achievement of University Students on the Basis of Selected Entry Characteristics.

    ERIC Educational Resources Information Center

    Helseth, Edwin A.; And Others

    Reported are results of a study that examined the relationships between university students' entry characteristics and achievement in biology. Variables judged most likely to be predictors of achievement were: (1) scholastic aptitude (quantitative and verbal); (2) level of cognitive development; (3) locus of control; (4) grade point average; (5)…

  11. Are Achievement Motivation and Thinking Styles Related? A Visit among Chinese University Students

    ERIC Educational Resources Information Center

    Fan, Weiqiao; Zhang, Li-Fang

    2009-01-01

    The present study examined the relationships between thinking styles and achievement motivation among Chinese university students. The Thinking Styles Inventory--Revised (TSI-R; Sternberg, Wagner, & Zhang, 2003) and the Achievement Motives Scale (AMS; Gjesme & Nygard, 1970; Ye & Hagtvet, 1988) were administered to 238 Chinese…

  12. Influence of immigration on prematurity in the context of a free healthcare system with universal coverage.

    PubMed

    Cortés, Ernesto; Mercedes Rizo-Baeza, María; Palazón-Bru, Antonio; Aguilar-Cordero, María José; Francisco Gil-Guillén, Vicente

    2015-05-22

    We assessed the risk of preterm birth according to the mother's place of origin in the context of a free and universal healthcare system. We analysed 75,292 newborn infants born between 2008-2011 in Alicante (Spain). The outcomes were: 1) very preterm (gestational age ≤ 32 weeks) and 2) moderate-to-late preterm (gestational age 33-37 weeks). Other variables: infant's gender, maternal age and origin. We estimated adjusted odds ratios to analyse the relationship between the outcomes and the other variables. The distribution of the gestational age groups in our sample was: very preterm, 812; moderate-to-late preterm, 5,295; full-term, 69,997. There were no statistically significant differences between the mother's place of origin and the outcomes in this free universal healthcare system, which is experiencing the recent phenomenon of immigration. This equality should be maintained throughout the time the immigrants remain in the country.

  13. Universal coverage with rising healthcare costs; health outcomes research value in decision-making in Latin America.

    PubMed

    Augustovski, Federico; García Martí, Sebastián; Pichon Riviere, Andrés; Rubinstein, Adolfo

    2011-12-01

    This is a short summary of the two plenary sessions held at the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Latin American Conference in Mexico City (Mexico) in September 2011, with 477 registrants and 235 accepted abstract submissions. The first asked how attainable universal coverage is in the face of rising costs of health technologies; and the second considered the value of health outcomes research to decision-makers. This conference provided a scientific forum where researchers, health technology producers and public and private decision-makers shared their experiences and research in the field of health economic evaluations, health technology assessment and patient-reported outcomes/health-related quality of life studies. It was the third biennial regional meeting in Latin America, the next one being in Buenos Aires (Argentina) in 2013.

  14. Setting priorities to address cardiovascular diseases through universal health coverage in low- and middle-income countries

    PubMed Central

    Nugent, Rachel A

    2017-01-01

    Over the past decade, universal health coverage (UHC) has emerged as a major policy goal for many low- and middle-income country governments. Yet, despite the high burden of cardiovascular diseases (CVD), relatively little is known about how to address CVD through UHC. This review covers three major topics. First, we define UHC and provide some context for its importance, and then we illustrate its relevance to CVD prevention and treatment. Second, we discuss how countries might select high-priority CVD interventions for a UHC health benefits package drawing on economic evaluation methods. Third, we explore some implementation challenges and identify research gaps that, if addressed, could improve the inclusion of CVD into UHC. PMID:28321266

  15. Operational research in primary health care planning: a theoretical model for estimating the coverage achieved by different distributions of staff and facilities

    PubMed Central

    Kemball-Cook, D.; Vaughan, J. P.

    1983-01-01

    This report outlines a basic operational research model for estimating the coverage achieved by different distributions of primary health care staff and facilities, using antenatal home visiting as an illustrative example. Coverage is estimated in terms of the average number of patient contacts achieved per annum. The model takes into account such features as number of facilities and health workers per 10 000 population, the radius of the health facility area, the overall population density in the region, the number of working days in the year, and the health worker's travelling time and work rate. A theoretical planning situation is also presented, showing the application of the model in defining various possible strategies, using certain planning norms for new levels of staff and facilities. This theoretical model is presented as an example of the use of operational research in primary health care, but it requires to be tested and validated in known situations before its usefulness can be assessed. Some indications are given of the ways in which the model could be adapted and improved for application to a real planning situation. PMID:6602666

  16. High-school predictors of university achievement: Youths' self-reported relationships with parents, beliefs about success, and university aspirations.

    PubMed

    Kay, Joseph S; Shane, Jacob; Heckhausen, Jutta

    2016-12-01

    Associations between youths' reported relationships with their parents, beliefs about how success is attained, educational aspirations, and university completion were examined. Data come from the German Socioeconomic Panel. At age 17, youth (n = 3284) reported on their relationships with their parents, beliefs about success, and educational aspirations. University completion was assessed up to eight years later. At age 17, perceptions of parental warmth and interest in youths' academics were associated with beliefs that success is due to merit (positively) and that success is due to external factors or dominance over others (negatively). Beliefs that success is due to merit and external factors were associated with educational aspirations positively and negatively respectively. Educational aspirations positively predicted university completion up to eight years later. Relationships with parents had stronger associations with achievement when parents completed a university degree; beliefs about success had stronger associations with aspirations when parents did not.

  17. [Efforts to achieve and effects of acquiring ISO 15189 in Tokushima University Hospital].

    PubMed

    Shono, Kazuko; Kishi, Misako; Satou, Mituyo; Nagamine, Yasunori; Doi, Tosio

    2009-12-01

    The medical laboratory of Tokushima University Hospital acquired ISO 15189, an international standard for medical laboratories, on July 6th, 2007, resulting in it achieving the 24th place in Japan and 5th place among national university hospitals. The first surveillance was just performed on October 6th, 2008. Tokushima University Hospital, in which our medical laboratory is included as one section, already succeeded in acquiring ISO 9001, PrivacyMark System, and Quality Health Care ver. 5 before accomplishing ISO 15189. To achieve ISO 15189, we prepared documents based on ISO 9001 without any consultation, resulting in a review of the difference between ISO 9001 and ISO 15189 after the preliminary survey. Although achieving ISO 15189 resulted in an improvement in the reliability of laboratory results and accuracy, leading to the development of our technical skills and awareness, and sharing of knowledge, we consider that the considerable investment of time to prepare the requirements remains to be overcome.

  18. Geographic variations in avoidable hospitalizations in the elderly, in a health system with universal coverage

    PubMed Central

    Magan, Purificacion; Otero, Angel; Alberquilla, Angel; Ribera, Jose Manuel

    2008-01-01

    Background The study of Hospitalizations for ambulatory care sensitive conditions (ACSH) has been proposed as an indirect measure of access to and receipt of care by older persons at the entryway to the Spanish public health system. The aim of this work is to identify the rates of ACSH in persons 65 years or older living in different small-areas of the Community of Madrid (CM) and to detect possible differences in ACSH. Methods Cross-sectional, ecologic study, which covered all 34 health districts of the CM. The study population consisted of all individuals aged 65 years or older residing in the CM between 2001 and 2003, inclusive. Using hospital discharge data, avoidable ACSH were selected from the list of conditions validated for Spain. Age- and sex-adjusted ACSH rates were calculated for the population of each health district and the statistics describing the data variability. Point graphs and maps were designed to represent the ACSH rates in the different health districts. Results Of all the hospitalizations, 16.5% (64,409) were ACSH. Globally, the rate was higher among men: 33.15 per 1,000 populations vs. 22.10 in women and these differences were statistically significant (p < 0.05) in each district. For men the range was 70.82 and the coefficient of variation (CV) was 0.47, while for women the range was 43.69 and the CV was 0.48. In 93.1% of cases, the ACSH were caused by hypertensive cardiovascular disease, heart failure or pneumonia. A centripetal pattern can be observed, with lower rates in the districts in the center of the CM. This geographic distribution is maintained after grouping by sex. Conclusion A significant variation is demonstrated in "preventable" hospitalizations between the different districts. In all the districts the men present rates significantly higher than women. Important variations in the access are observed the Primary Attention in spite of existing a universal sanitary cover. PMID:18282282

  19. Reducing the socio-economic status achievement gap at University by promoting mastery-oriented assessment.

    PubMed

    Smeding, Annique; Darnon, Céline; Souchal, Carine; Toczek-Capelle, Marie-Christine; Butera, Fabrizio

    2013-01-01

    In spite of official intentions to reduce inequalities at University, students' socio-economic status (SES) is still a major determinant of academic success. The literature on the dual function of University suggests that University serves not only an educational function (i.e., to improve students' learning), but also a selection function (i.e., to compare people, and orient them towards different positions in society). Because current assessment practices focus on the selection more than on the educational function, their characteristics fit better with norms and values shared by dominant high-status groups and may favour high-SES students over low-SES students in terms of performances. A focus on the educational function (i.e., mastery goals), instead, may support low-SES students' achievement, but empirical evidence is currently lacking. The present research set out to provide such evidence and tested, in two field studies and a randomised field experiment, the hypothesis that focusing on University's educational function rather than on its selection function may reduce the SES achievement gap. Results showed that a focus on learning, mastery-oriented goals in the assessment process reduced the SES achievement gap at University. For the first time, empirical data support the idea that low-SES students can perform as well as high-SES students if they are led to understand assessment as part of the learning process, a way to reach mastery goals, rather than as a way to compare students to each other and select the best of them, resulting in performance goals. This research thus provides a theoretical framework to understand the differential effects of assessment on the achievement of high and low-SES students, and paves the way toward the implementation of novel, theory-driven interventions to reduce the SES-based achievement gap at University.

  20. How university students with reading difficulties are supported in achieving their goals.

    PubMed

    Stack-Cutler, Holly L; Parrila, Rauno K; Jokisaari, Markku; Nurmi, Jari-Erik

    2015-01-01

    We examine (a) what social ties university students with a history of reading difficulty (RD) report assisting them to achieve their goals, (b) outlets available for developing social ties, (c) resources mobilized within these relationships, and (d) the impact of social ties' status on academic achievement. Participants were 107 university students with RD who were currently completing or had recently completed a university degree. Results showed that university students with RD named friends, parents, and significant others (e.g., boy/girlfriend, spouse) as social ties most often. Personal social ties were developed through social media networking sites and within close relationships, and institutional social ties through academic centers and university general services, among others. Resources mobilized among personal and institutional social ties included emotional and social support, advice and planning, writing and studying help, and goal setting. Institutional social ties also afforded job search assistance, accommodations, skill development, financial support, and mental health services. Finally, the status of employed, but not student, social ties explained academic achievement.

  1. Students' Facebook Usage and Academic Achievement: A Case Study of Private University in Thailand

    ERIC Educational Resources Information Center

    Sereetrakul, Wilailuk

    2013-01-01

    The objective of this study was to determine if the time spent on Facebook and the purpose for which Facebook was used had any impact on the academic achievement of the students. This exploratory research used a questionnaire to collect data from 251 undergraduate students at a private university in Bangkok, Thailand. Data were analyzed using…

  2. Assuring Student Learning Outcomes Achievement through Faculty Development: An Online University Example

    ERIC Educational Resources Information Center

    Lewis, Shelia; Ewing, Christopher

    2016-01-01

    Asynchronous discussions in the online teaching and learning environment significantly contributes to the achievement of student learning outcomes, which is dependent upon qualified and engaged faculty members. The discourse within this article addresses how an online university conducted faculty development through its unique Robust Learning…

  3. Hispanic Association of Colleges and Universities National Internship Program: A Means toward Achieving a Representative Bureaucracy

    ERIC Educational Resources Information Center

    Cuellar, Arturo, Jr.; Vega, Arturo

    2007-01-01

    The U.S. government has long struggled with achieving a federal workforce that reflects the nation's diversity. This study evaluates the Hispanic Association of Colleges and Universities National Internship Program, which recruits Latino students for semester-long internship assignments with federal agencies. Having undergone the internship…

  4. The Effects of Using an Interactive Whiteboard on the Academic Achievement of University Students

    ERIC Educational Resources Information Center

    Akbas, Oktay; Pektas, Huseyin Mirac

    2011-01-01

    The aim of this study was to identify the effects of the use of an interactive whiteboard on the academic achievement of university students on the topic of electricity in a science and technology laboratory class. The study was designed as a pretest/posttest control group experimental study. Mean, standard deviation and t- tests were used for…

  5. Improving Low Achievers' Academic Performance at University by Changing the Social Value of Mastery Goals

    ERIC Educational Resources Information Center

    Dompnier, Benoît; Darnon, Céline; Meier, Emanuele; Brandner, Catherine; Smeding, Annique; Butera, Fabrizio

    2015-01-01

    Recent research has shown that, in a university context, mastery goals are highly valued and that students may endorse these goals either because they believe in their utility (i.e., social utility), in which case mastery goals are positively linked to achievement, or to create a positive image of themselves (i.e., social desirability), in which…

  6. The Effect of Secondary School Study Skills Preparation on First-Year University Achievement

    ERIC Educational Resources Information Center

    Jansen, Ellen P. W. A.; Suhre, Cor J. M.

    2010-01-01

    Although many studies have revealed the importance of study skills for students' first-year performance and college retention, the extent of the impact of study skills preparation on students' academic achievement is less clear. This paper explores the impact of pre-university study skills preparation on students' first-year study experiences,…

  7. The Effect of Web-Based Homework on University Students' Physics Achievements

    ERIC Educational Resources Information Center

    Demirci, Neset

    2010-01-01

    In this study, the effect of web-based homework on university students' physics achievement was compared. One of the two identical sections of introductory physics course students received pen-and-paper homework done in groups while the other received web-based online homework performed individually. And then both groups' homework performance and…

  8. Paradigms and poverty in global energy policy: research needs for achieving universal energy access

    NASA Astrophysics Data System (ADS)

    Sovacool, Benjamin K.; Bazilian, Morgan; Toman, Michael

    2016-06-01

    This research letter discusses elements of a long-term interdisciplinary research effort needed to help ensure the maximum social, economic, and environmental benefits of achieving secure universal access to modern energy services. Exclusion of these services affects the lives and livelihoods of billions of people. The research community has an important, but not yet well-defined, role to play.

  9. Degrees of Resilience: Profiling Psychological Resilience and Prospective Academic Achievement in University Inductees

    ERIC Educational Resources Information Center

    Allan, John F.; McKenna, Jim; Dominey, Susan

    2014-01-01

    University inductees may be increasingly vulnerable to stressors during transition into higher education (HE), requiring psychological resilience to achieve academic success. This study aimed to profile inductees' resilience and to investigate links to prospective end of year academic outcomes. Scores for resilience were based on a validated…

  10. Emotional Intelligence and Gender as Predictors of Academic Achievement among Some University Students in Barbados

    ERIC Educational Resources Information Center

    Fayombo, Grace A.

    2012-01-01

    This study investigated emotional intelligence (attending to emotion, positive expressivity and negative expressivity) and gender as predictors of academic achievement among 163 undergraduate psychology students in The University of the West Indies (UWI), Cave Hill Campus, Barbados. Results revealed significant positive and negative correlations…

  11. Effect of Foreign Language Anxiety on Gender and Academic Achievement among Yemeni University EFL Students

    ERIC Educational Resources Information Center

    Razak, Norizan Abdul; Yassin, Amr Abdullatif; Maasum, Tengku Nor Rizan Bt Tengku Mohamad

    2017-01-01

    This study aimed to investigate the gender differences in terms of anxiety among Yemeni university EFL learners. It also aimed to investigate the correlation between the level of anxiety and the academic achievement of the students. The participants of this study were 155 students chosen from the population through stratified random sampling. The…

  12. Multiple Intelligences Patterns of Students at King Saud University and Its Relationship with Mathematics' Achievement

    ERIC Educational Resources Information Center

    Kandeel, Refat A. A.

    2016-01-01

    The purpose of this study was to determine the multiple intelligences patterns of students at King Saud University and its relationship with academic achievement for the courses of Mathematics. The study sample consisted of 917 students were selected a stratified random manner, the descriptive analysis method and Pearson correlation were used, the…

  13. Student Perceptions and Achievement in a University Blended Learning Strategic Initiative

    ERIC Educational Resources Information Center

    Owston, Ron; York, Dennis; Murtha, Susan

    2013-01-01

    Examined in this study is the relationship between student perceptions in blended learning courses and their in-course achievement. The research was conducted at a large urban university that embarked on a major initiative to scale-up blended learning across its campus. Student perceptions (N = 577) were assessed in four areas deemed important to…

  14. Refugee Children in South Africa: Access and Challenges to Achieving Universal Primary Education

    ERIC Educational Resources Information Center

    Meda, L.; Sookrajh, R.; Maharaj, B.

    2012-01-01

    This paper questions whether the second Millennium Development Goal of achieving universal primary education targets by 2015 for all children to complete a full course of primary schooling, can be realised. A key contention of this paper is that this forecast is far-fetched when we take into cognizance refugee children's accessibility to…

  15. Psychological Type and Undergraduate Student Achievement in Pharmacy Course in Military Medical University

    ERIC Educational Resources Information Center

    Shi, Ru; Shan, Shou-qin; Tian, Jian-quan

    2007-01-01

    The Myers-Briggs Type Indicator (MBTI) was given to 264 students in an undergraduate Pharmacy course at a military medical university. Selected MBTI personality types were compared for achievement in the course using a t-test to compare total points earned. High grades were earned by students stronger in the traits of introversion (I) and judgment…

  16. Marked for Success: Secondary School Performance and University Achievement in Biology

    ERIC Educational Resources Information Center

    Comer, Keith; Broght, Erik; Sampson, Kaylene

    2011-01-01

    Building on Shulruf, Hattie and Tumen (2008), this work examines the capacity of various National Certificate in Educational Achievement (NCEA)-derived models to predict first-year performance in Biological Sciences at a New Zealand university. We compared three models: (1) the "best-80" indicator as used by several New Zealand…

  17. Mathematical Beliefs, Self-Regulation, and Achievement by University Students in Remedial Mathematics Courses

    ERIC Educational Resources Information Center

    Briley, Jason S.; Thompson, Tony; Iran-Nejad, Asghar

    2009-01-01

    In this study, the relationships among mathematical beliefs, sources of self-regulation, and achievement for university students enrolled in remedial mathematics were studied. Ninety-four students completed 2 surveys to measure mathematical beliefs and active, dynamic, and multiple-source self-regulation. Students who reported a more sophisticated…

  18. Perceived Opportunity, Ethnic Identity, and Achievement Motivation among Latinos at a Selective Public University

    ERIC Educational Resources Information Center

    Rivas-Drake, Deborah

    2008-01-01

    Using in-depth interview data, this study explored perceptions of opportunity, ethnic identity beliefs, and motivation orientations among Latino students at a selective university. One profile is characterized by individualistic achievement motivations, feelings of exemption from social barriers, and a sense of alienation from other Latinos.…

  19. Transition from High School to University: A Person-Centered Approach to Academic Achievement

    ERIC Educational Resources Information Center

    De Clercq, Mikaël; Galand, Benoît; Frenay, Mariane

    2017-01-01

    Although a vast body of studies regarding the variables related to students' achievement exists, only a handful has investigated how these variables combine and interact together. Such an investigation might make it possible to more accurately illustrate the heterogeneity of students enrolling in university and assess the impact of this diversity…

  20. Achievement Goal Questionnaire: Psychometric Properties and Gender Invariance in a Sample of Chinese University Students

    ERIC Educational Resources Information Center

    Xiao, Jing; Bai, Yu; He, Yini; McWhinnie, Chad M.; Ling, Yu; Smith, Hannah; Huebner, E. Scott

    2016-01-01

    The aim of this study was to test the gender invariance of the Chinese version of the Achievement Goal Questionnaire (AGQ-C) utilizing a sample of 1,115 Chinese university students. Multi-group confirmatory factor analysis supported the configural, metric, and scalar invariance of the AGQ-C across genders. Analyses also revealed that the latent…

  1. The Influence of Pre-University Students' Mathematics Test Anxiety and Numerical Anxiety on Mathematics Achievement

    ERIC Educational Resources Information Center

    Seng, Ernest Lim Kok

    2015-01-01

    This study examines the relationship between mathematics test anxiety and numerical anxiety on students' mathematics achievement. 140 pre-university students who studied at one of the institutes of higher learning were being investigated. Gender issue pertaining to mathematics anxieties was being addressed besides investigating the magnitude of…

  2. Toward Advanced Nursing Practice along with People-Centered Care Partnership Model for Sustainable Universal Health Coverage and Universal Access to Health 1

    PubMed Central

    Kamei, Tomoko; Takahashi, Keiko; Omori, Junko; Arimori, Naoko; Hishinuma, Michiko; Asahara, Kiyomi; Shimpuku, Yoko; Ohashi, Kumiko; Tashiro, Junko

    2017-01-01

    ABSTRACT Objective: this study developed a people-centered care (PCC) partnership model for the aging society to address the challenges of social changes affecting people’s health and the new role of advanced practice nurses to sustain universal health coverage. Method: a people-centered care partnership model was developed on the basis of qualitative meta-synthesis of the literature and assessment of 14 related projects. The ongoing projects resulted in individual and social transformation by improving community health literacy and behaviors using people-centered care and enhancing partnership between healthcare providers and community members through advanced practice nurses. Results: people-centered care starts when community members and healthcare providers foreground health and social issues among community members and families. This model tackles these issues, creating new values concerning health and forming a social system that improves quality of life and social support to sustain universal health care through the process of building partnership with communities. Conclusion: a PCC partnership model addresses the challenges of social changes affecting general health and the new role of advanced practice nurses in sustaining UHC. PMID:28146179

  3. Development of a Health Screening Package Under the Universal Health Coverage: The Role of Health Technology Assessment.

    PubMed

    Teerawattananon, Yot; Kingkaew, Pritaporn; Koopitakkajorn, Tanunya; Youngkong, Sitaporn; Tritasavit, Nattha; Srisuwan, Patsri; Tantivess, Sripen

    2016-02-01

    This study reports the systematic development of a population-based health screening package for all Thai people under the universal health coverage (UHC). To determine major disease areas and health problems for which health screening could mitigate health burden, a consultation process was conducted in a systematic, participatory, and evidence-based manner that involved 41 stakeholders in a half-day workshop. Twelve diseases/health problems were identified during the discussion. Subsequently, health technology assessments, including systematic review and meta-analysis of health benefits as well as economic evaluations and budget impact analyses of corresponding population-based screening interventions, were completed. The results led to advice against elements of current clinical practice, such as annual chest X-rays and particular blood tests (e.g. kidney function test), and indicated that the introduction of certain new population-based health screening programs, such as for chronic hepatitis B, would provide substantial health and economic benefits to the Thais. The final results were presented to a wide group of stakeholders, including decision-makers at the Ministry of Public Health and the public health insurance schemes, to verify and validate the findings and policy recommendations. The package has been endorsed by the Thai UHC Benefit Package Committee for implementation in fiscal year 2016.

  4. Priority Setting for Universal Health Coverage: We Need Evidence-Informed Deliberative Processes, Not Just More Evidence on Cost-Effectiveness.

    PubMed

    Baltussen, Rob; Jansen, Maarten P; Mikkelsen, Evelinn; Tromp, Noor; Hontelez, Jan; Bijlmakers, Leon; Van der Wilt, Gert Jan

    2016-06-22

    Priority setting of health interventions is generally considered as a valuable approach to support low- and middle-income countries (LMICs) in their strive for universal health coverage (UHC). However, present initiatives on priority setting are mainly geared towards the development of more cost-effectiveness information, and this evidence does not sufficiently support countries to make optimal choices. The reason is that priority setting is in reality a value-laden political process in which multiple criteria beyond cost-effectiveness are important, and stakeholders often justifiably disagree about the relative importance of these criteria. Here, we propose the use of 'evidence-informed deliberative processes' as an approach that does explicitly recognise priority setting as a political process and an intrinsically complex task. In these processes, deliberation between stakeholders is crucial to identify, reflect and learn about the meaning and importance of values, informed by evidence on these values. Such processes then result in the use of a broader range of explicit criteria that can be seen as the product of both international learning ('core' criteria, which include eg, cost-effectiveness, priority to the worse off, and financial protection) and learning among local stakeholders ('contextual' criteria). We believe that, with these evidence-informed deliberative processes in place, priority setting can provide a more meaningful contribution to achieving UHC.

  5. The provincial health office as performance manager: change in the local healthcare system after Thailand's universal coverage reforms.

    PubMed

    Intaranongpai, Siranee; Hughes, David; Leethongdee, Songkramchai

    2012-01-01

    This paper examines the implementation of Thailand's universal coverage healthcare reforms in a rural province, using data from field studies undertaken in 2003-2005 and 2008-2011. We focus on the strand of policy that aimed to develop primary care by allocating funds to contracting units for primary care (CUPs) responsible for managing local service networks. The two studies document a striking change in the balance of power in the local healthcare system over the 8-year period. Initially, the newly formed CUPs gained influence as 'power followed the money', and the provincial health offices (PHOs), which had commanded the service units, were left with a weaker co-ordination role. However, the situation changed as a new insurance purchaser, the National Health Security Office, took financial control and established regional outposts. National Health Security Office outposts worked with PHOs to develop rationalised management tools-strategic plans, targets, KPIs and benchmarking-that installed the PHOs as performance managers of local healthcare systems. New lines of accountability and changed budgetary systems reduced the power of the CUPs to control resource allocation and patterns of services within CUP networks. Whereas some CUPs fought to retain limited autonomy, the PHO has been able to regain much of its former control. We suggest that implementation theory needs to take a long view to capture the complexity of a major reform initiative and argue for an analysis that recognises the key role of policy networks and advocacy coalitions that span national and local levels and realign over time.

  6. Academic Momentum at University/College: Exploring the Roles of Prior Learning, Life Experience, and Ongoing Performance in Academic Achievement across Time

    ERIC Educational Resources Information Center

    Martin, Andrew J.; Wilson, Rachel; Liem, Gregory Arief D.; Ginns, Paul

    2014-01-01

    In the context of "academic momentum," a longitudinal study of university students (N = 904) showed high school achievement and ongoing university achievement predicted subsequent achievement through university. However, the impact of high school achievement diminished, while additive effects of ongoing university achievement continued.…

  7. Patterns of Self-Regulation: Patterns of Self-Regulatory Strategy Use among Low-Achieving and High-Achieving University Students

    ERIC Educational Resources Information Center

    Ruban, Lilia; Reis, Sally M.

    2006-01-01

    The present mixed-methods study attempts to provide insights into the nature, idiosyncrasies, and inter- and intra-individual patterns of academic self-regulatory strategy use among two different populations of university students. Low-achieving (n = 49) and high-achieving students (n = 131) described their self-regulatory strategy use in their…

  8. The Relationship between Motivation and Achievement--A Survey of the Study Motivation of English Majors in Qingdao Agricultural University

    ERIC Educational Resources Information Center

    Li, Peipei; Pan, Guirong

    2009-01-01

    The survey conducted in Qingdao Agricultural University reveals the relationship between motivation and achievement as follows: instrumental motivation influences both high achievers and low achiever; while high achievers have greater integrative motivation than lower ones; Interest plays an extremely important role in study and high achievers…

  9. Who Gets the Best Grades at Top Universities? An Exploratory Analysis of Institution-Wide Interviews with the Highest Achievers at a Top Korean University

    ERIC Educational Resources Information Center

    Lee, Hye-Jung; Lee, Jihyun

    2012-01-01

    This study explores what makes high achievement at a top university in order to gain insights into college learning. For this purpose, institution-wide in-depth interviews were conducted with the 45 highest achievers (GPA of 4.0/4.3 or higher) at a top Korean university, and the interview data were primarily analyzed qualitatively to investigate…

  10. Evaluating Respondent-Driven Sampling as an Implementation Tool For Universal Coverage of Antiretroviral Studies among Men who have Sex with Men Living with HIV

    PubMed Central

    Baral, Stefan D.; Ketende, Sosthenes; Schwartz, Sheree; Orazulike, Ifeanyi; Ugoh, Kelechi; Peel, Sheila; Ake, Julie; Blattner, William; Charurat, Manhattan

    2015-01-01

    Introduction The TRUST model based on experimental and observational data posits that integration of HIV prevention and universal coverage of antiretroviral treatment (UCT) at a trusted community venue provides a framework for achieving effective reduction in HIV-related morbidity and mortality among men who have sex with men (MSM) living with HIV as well as reducing HIV incidence. The analyses presented here evaluate the utility of respondent-driven sampling (RDS) as an implementation tool for engaging MSM in the TRUST intervention. Methods The TRUST integrated prevention and treatment model was established at a trusted community center serving MSM in Abuja Nigeria. Five seeds have resulted in 3–26 waves of accrual between March, 2013 and August, 2014 with results presented here characterizing HIV burden and engagement in HIV care for 722 men across study recruitment waves. For analytic purposes, the waves were collapsed into five groups; four equally spaced (0–4, 5–9, 10–14, 15–19) and one ranging from the 20 to the 26th wave with significance assessed using Pearson’s chi-squared test. Results In earlier waves, MSM were more likely to have reported testing for HIV (82.9% in waves 0–4, 47.7% in waves 20–26, p<0.01). In addition, biologically-confirmed HIV prevalence decreased from an average of 59.1 to 42.9% (p<0.05) in later waves. In earlier waves, about 80% of participants correctly reported their HIV status as compared to less than 25% in the later waves (p<0.01). Lastly, participants reporting being on ART decreased from 50% to 22.2 % in later waves (p<0.01). Conclusions Implementation science studies focused on demonstrating impact of universal HIV-treatment programs among people living with HIV necessitate different accrual methods than those focused on preventing HIV acquisition. Here, RDS was shown to be an efficient method for reaching marginalized populations of MSM living with HIV in Nigeria and engaging them in universal HIV treatment

  11. Factors related to achievement in sophomore organic chemistry at the University of Arkansas

    NASA Astrophysics Data System (ADS)

    Lindsay, Harriet Arlene

    The purpose of this study was to identify the significant cognitive and non-cognitive variables that related to achievement in the first semester of organic chemistry at the University of Arkansas. Cognitive variables included second semester general chemistry grade, ACT composite score, ACT English, mathematics, reading, and science reasoning subscores, and spatial ability. Non-cognitive variables included anxiety, confidence, effectance motivation, and usefulness. Using a correlation research design, the individual relationships between organic chemistry achievement and each of the cognitive variables and non-cognitive variables were assessed. In addition, the relationships between organic chemistry achievement and combinations of these independent variables were explored. Finally, gender- and instructor-related differences in the relationships between organic chemistry achievement and the independent variables were investigated. The samples consisted of volunteers from the Fall 1999 and Fall 2000 sections of Organic Chemistry I at the University of Arkansas. All students in each section were asked to participate. Data for spatial ability and non-cognitive independent variables were collected using the Purdue Visualization of Rotations test and the modified Fennema-Sherman Attitude Scales. Data for other independent variables, including ACT scores and second semester general chemistry grades, were obtained from the Office of Institutional Research. The dependent variable, organic chemistry achievement, was measured by each student's accumulated points in the course and consisted of scores on quizzes and exams in the lecture section only. These totals were obtained from the lecture instructor at the end of each semester. Pearson correlation and stepwise multiple regression analyses were used to measure the relationships between organic chemistry achievement and the independent variables. Prior performance in chemistry as measured by second semester general

  12. NMR in structural genomics to increase structural coverage of the protein universe: Delivered by Prof. Kurt Wüthrich on 7 July 2013 at the 38th FEBS Congress in St. Petersburg, Russia.

    PubMed

    Serrano, Pedro; Dutta, Samit K; Proudfoot, Andrew; Mohanty, Biswaranjan; Susac, Lukas; Martin, Bryan; Geralt, Michael; Jaroszewski, Lukasz; Godzik, Adam; Elsliger, Marc; Wilson, Ian A; Wüthrich, Kurt

    2016-11-01

    For more than a decade, the Joint Center for Structural Genomics (JCSG; www.jcsg.org) worked toward increased three-dimensional structure coverage of the protein universe. This coordinated quest was one of the main goals of the four high-throughput (HT) structure determination centers of the Protein Structure Initiative (PSI; www.nigms.nih.gov/Research/specificareas/PSI). To achieve the goals of the PSI, the JCSG made use of the complementarity of structure determination by X-ray crystallography and nuclear magnetic resonance (NMR) spectroscopy to increase and diversify the range of targets entering the HT structure determination pipeline. The overall strategy, for both techniques, was to determine atomic resolution structures for representatives of large protein families, as defined by the Pfam database, which had no structural coverage and could make significant contributions to biological and biomedical research. Furthermore, the experimental structures could be leveraged by homology modeling to further expand the structural coverage of the protein universe and increase biological insights. Here, we describe what could be achieved by this structural genomics approach, using as an illustration the contributions from 20 NMR structure determinations out of a total of 98 JCSG NMR structures, which were selected because they are the first three-dimensional structure representations of the respective Pfam protein families. The information from this small sample is representative for the overall results from crystal and NMR structure determination in the JCSG. There are five new folds, which were classified as domains of unknown functions (DUF), three of the proteins could be functionally annotated based on three-dimensional structure similarity with previously characterized proteins, and 12 proteins showed only limited similarity with previous deposits in the Protein Data Bank (PDB) and were classified as DUFs.

  13. Universal health coverage in emerging economies: findings on health care utilization by older adults in China, Ghana, India, Mexico, the Russian Federation, and South Africa

    PubMed Central

    Peltzer, Karl; Williams, Jennifer Stewart; Kowal, Paul; Negin, Joel; Snodgrass, James Josh; Yawson, Alfred; Minicuci, Nadia; Thiele, Liz; Phaswana-Mafuya, Nancy; Biritwum, Richard Berko; Naidoo, Nirmala; Chatterji, Somnath

    2014-01-01

    Background and objective The achievement of universal health coverage (UHC) in emerging economies is a high priority within the global community. This timely study uses standardized national population data collected from adults aged 50 and older in China, Ghana, India, Mexico, the Russian Federation, and South Africa. The objective is to describe health care utilization and measure association between inpatient and outpatient service use and patient characteristics in these six low- and middle-income countries. Design Secondary analysis of data from the World Health Organization’s Study on global AGEing and adult health Wave 1 was undertaken. Country samples are compared by socio-demographic characteristics, type of health care, and reasons for use. Logistic regressions describe association between socio-demographic and health factors and inpatient and outpatient service use. Results In the pooled multi-country sample of over 26,000 adults aged 50-plus, who reported getting health care the last time it was needed, almost 80% of men and women received inpatient or outpatient care, or both. Roughly 30% of men and women in the Russian Federation used inpatient services in the previous 3 years and 90% of men and women in India used outpatient services in the past year. In China, public hospitals were the most frequently used service type for 52% of men and 51% of women. Multivariable regression showed that, compared with men, women were less likely to use inpatient services and more likely to use outpatient services. Respondents with two or more chronic conditions were almost three times as likely to use inpatient services and twice as likely to use outpatient services compared with respondents with no reported chronic conditions. Conclusions This study provides a basis for further investigation of country-specific responses to UHC. PMID:25363363

  14. Evaluation of the Universal Immunization Program and Challenges in Coverage of Migrant Children in Haridwar, Uttarakhand, India

    PubMed Central

    Nath, Latika; Kaur, Prabhdeep; Tripathi, Saurabh

    2015-01-01

    Background: Studies show that immunization among migrant children is poor. India has a dropout rate of 17.7% between Bacillus Calmette-Guιrin (BCG) and measles (District Level Household Survey (DLHS)-3). Haridwar district had the highest dropout rate of 27.4% from BCG to diphtheria, pertussis, and tetanus (DPT) 3 (DLHS-3) in Uttarakhand. We evaluated the Universal Immunization Programme (UIP) among migrants in Haridwar in two blocks. Materials and Methods: We developed input, process, and output indicators on infrastructure, human resources, and service delivery. A facility, session site and cross-sectional survey of 180 children were done and proportions for various indicators were estimated. We determined factors associated with not taking vaccination using multivariate analysis. Results: We surveyed 11 cold chain centers, 25 subcenters, 14 sessions, and interviewed 180 mothers. Dropouts were supposed to be tracked using vaccination card counterfoils and tracking registers. The dropout rate from BCG to DPT3 was 30%. Lack of knowledge (adjusted odds ratio (AOR) 6.6,95% confidence interval (CI) 2.6–16.7), mother not being decision maker (AOR 4.0,95%CI 1.7–9.2), lack of contact by Accredited Social Health Activist (ASHA; AOR 3.0,95%CI 1.1–7.7), not being given four post-vaccination messages (AOR 7.7, 95% CI 2.9–20.2), and longer duration of stay in Haridwar (AOR 3.0 95% 1.9–7.6) were risk factors for nonimmunization. The reasons stated by mothers included lack of awareness of session site location (67%) and belief that child should only be vaccinated in their resident district (43%). Conclusions: There was low immunization coverage among migrants within adequate supervision, poor cold chain maintenance, and improper tracking of dropouts. Mobile immunization teams, prelisting of migrant children, and change in incentives of ASHAs for child tracking were needed. A monitoring plan for sessions and cold chain needed enforcement. PMID:26435596

  15. Pathways to achieve universal household access to modern energy by 2030

    NASA Astrophysics Data System (ADS)

    Pachauri, Shonali; van Ruijven, Bas J.; Nagai, Yu; Riahi, Keywan; van Vuuren, Detlef P.; Brew-Hammond, Abeeku; Nakicenovic, Nebojsa

    2013-06-01

    A lack of access to modern energy impacts health and welfare and impedes development for billions of people. Growing concern about these impacts has mobilized the international community to set new targets for universal modern energy access. However, analyses exploring pathways to achieve these targets and quantifying the potential costs and benefits are limited. Here, we use two modelling frameworks to analyse investments and consequences of achieving total rural electrification and universal access to clean-combusting cooking fuels and stoves by 2030. Our analysis indicates that these targets can be achieved with additional investment of US200565-86 billion per year until 2030 combined with dedicated policies. Only a combination of policies that lowers costs for modern cooking fuels and stoves, along with more rapid electrification, can enable the realization of these goals. Our results demonstrate the critical importance of accounting for varying demands and affordability across heterogeneous household groups in both analysis and policy setting. While the investments required are significant, improved access to modern cooking fuels alone can avert between 0.6 and 1.8 million premature deaths annually in 2030 and enhance wellbeing substantially.

  16. Towards universal salt iodisation in India: achievements, challenges and future actions.

    PubMed

    Rah, Jee H; Anas, Ansari M; Chakrabarty, Arijit; Sankar, Rajan; Pandav, Chandrakant S; Aguayo, Victor M

    2015-10-01

    India is one of the first countries to introduce salt iodisation, but the national programme has experienced major setbacks. The purpose of this paper is to review the national efforts towards universal salt iodisation (USI) in India and highlight key challenges in programme implementation. A brief historical overview of the salt iodisation programme is provided and the current status of the household usage of iodised salt and population iodine status is described. The present status of the USI programme together with the challenges being faced towards achieving USI are classified in five categories, which represent the five guiding principles crucial to sustained USI programme success: ensuring political commitment, forming partnerships and coalition, ensuring availability of adequately iodised salt, strengthening the monitoring system and maintaining continuous advocacy, education and communication. A future agenda towards the achievement of USI is also proposed.

  17. The Effect of Interactive e-Book on Students' Achievement at Najran University in Computer in Education Course

    ERIC Educational Resources Information Center

    Ebied, Mohammed Mohammed Ahmed; Rahman, Shimaa Ahmed Abdul

    2015-01-01

    The current study aims to examine the effect of interactive e-books on students' achievement at Najran University in computer in education course. Quasi-experimental study design is used in the study and to collect data the researchers built achievement test to measure the dependent variable represented in the achievement affected by experimental…

  18. Methods University Health System Can Use to Expand Medicaid Coverage to Uninsured Poor Parents with Medicaid Eligible Children: Policy Analysis

    DTIC Science & Technology

    2006-03-15

    needed treatment , or follow-up not see doctor or clinic Figure 1. Gaps in Insurance Coverage Hinder Access to Care, The Affordability Crisis in U.S...Care and Treatment Act (IHCTA) of 1985, which clearly defined the county’s responsibility to provide health care to the indigent. In an effort to...Medicaid Program. Benefits include services provided by a chiropractor , services provided by a podiatrist, eyeglasses, and contact lenses (when

  19. Roundtable discussion at the UICC World Cancer Congress: looking toward the realization of universal health coverage for cancer in Asia.

    PubMed

    Akaza, Hideyuki; Kawahara, Norie; Nozaki, Shinjiro; Sonoda, Shigeto; Fukuda, Takashi; Cazap, Eduardo; Trimble, Edward L; Roh, Jae Kyung; Hao, Xishan

    2015-01-01

    The Japan National Committee for the Union for International Cancer Control (UICC) and UICC-Asia Regional Office (ARO) organized a Roundtable Discussion as part of the official program of the UICC World Cancer Congress 2014 in Melbourne, Australia. The theme for the Roundtable Discussion was - Looking Toward the Realization of Universal Health Care (UHC) for Cancer in Asia - and it was held on December 5, 2014. The meeting was held based on the recognition that although each country may take a different path towards the realization of UHC, one point that is common to all is that cancer is projected to be the most difficult disease to address under the goals of UHC and that there is, therefore, an urgent and pressing need to come to a common understanding and awareness with regard to UHC concepts that are a priority component of a post-MDG development agenda. The presenters and participants addressed the issue of UHC for cancer in Asia from their various perspectives in academia and international organizations. Discussions covered the challenges to UHC in Asia, collaborative approaches by international organizations, the need for uniform and relevant data, ways to create an Asia Cancer Barometer that could be applied to all countries in Asia. The session concluded with the recognition that research on UHC in Asia should continue to be used as a tool for cancer cooperation in Asia and that the achievement of UHC would require research and input not only from the medical community, but from a broad sector of society in a multidisciplinary approach. Discussions on this issue will continue towards the Asia-Pacific Cancer Conference in Indonesia in August 2015.

  20. Second-chance university admission, the theory of planned behaviour and student achievement

    NASA Astrophysics Data System (ADS)

    Alas, Yabit; Anshari, Muhammad; Sabtu, Norakmarul Ihsan; Yunus, Norazmah

    2016-06-01

    The theory of planned behaviour attempts to explain factors which influence behaviour. One of these factors is intention. Positive or negative intentions are formed by a person's impression of the way other people would perceive similar behaviour (external forces). The authors of this study used the theory of planned behaviour to examine, compare and interpret the academic performance of students entering a university either via direct intake or via a bridging programme. This study focuses on the UniBridge programme offered by Universiti Brunei Darussalam (UBD), which is an intensive one-semester course that prepares students for undergraduate-level study. While direct-intake applicants pass minimum requirements for entry and are able to enrol directly into an undergraduate programme, applicants who do not meet these minimum requirements can join this bridging programme which is designed to be a "second-chance" entry option. Using a mixed-methods approach, the authors subjected student performance data of both direct-intake and bridge-programme undergraduates to statistical analyses, carried out interviews and then used the theoretical framework of planned behaviour to pinpoint individual attitudes and social pressures which form an intention to prepare for entry examinations. The results were mostly consistent and showed that the two groups were competitive in terms of undergraduate academic achievement, thus proving the second-chance programme to be effective in enabling students with poor A-Level results to experience academic confidence at university level. On the strength of these findings, the authors conclude their paper with recommendations for tertiary institutions to support lifelong learning initiatives through the use of multiple channels of entry.

  1. Physics Learning Achievement Study: Projectile, Using Mathematica Program of Faculty of Science and Technology Phetchabun Rajabhat University Students

    ERIC Educational Resources Information Center

    Hutem, Artit; Kerdmee, Supoj

    2013-01-01

    The propose of this study is to study Physics Learning Achievement, projectile motion, using the Mathematica program of Faculty of Science and Technology Phetchabun Rajabhat University students, comparing with Faculty of Science and Technology Phetchabun Rajabhat University students who study the projectile motion experiment set. The samples are…

  2. A Study of the Academic Achievement, Attrition and Group Reactions of High School Equivalency Students Attending Brandon University.

    ERIC Educational Resources Information Center

    Colert, Sherril

    The academic achievement and attrition of high school equivalency students attending Brandon University, a small undergraduate Canadian university, were studied, as were the students' reactions to college life. The students, who received a high school equivalency certificate after completing the Tests of General Educational Development (GED), were…

  3. Motivation, Instructional Design, Flow, and Academic Achievement at a Korean Online University: A Structural Equation Modeling Study

    ERIC Educational Resources Information Center

    Joo, Young Ju; Oh, Eunjung; Kim, Su Mi

    2015-01-01

    The purpose of this study is to examine the structural relationships among self-efficacy, intrinsic value, test anxiety, instructional design, flow, and achievement among students at a Korean online university. To address research questions, the researchers administered online surveys to 963 college students at an online university in Korea…

  4. Universal Health Coverage's evolving location in the post-2015 development agenda: Key informant perspectives within multilateral and related agencies during the first phase of post-2015 negotiations.

    PubMed

    Brolan, Claire E; Hill, Peter S

    2016-05-01

    In 2001, technocrats from four multilateral organizations selected the Millennium Development Goals mainly from the previous decade of United Nations (UN) summits and conferences. Few accounts are available of that significant yet cloistered synthesis process: none contemporaneous. In contrast, this study examines health's evolving location in the first-phase of the next iteration of global development goal negotiation for the post-2015 era, through the synchronous perspectives of representatives of key multilateral and related organizations. As part of the Go4Health Project, in-depth interviews were conducted in mid-2013 with 57 professionals working on health and the post-2015 agenda within multilaterals and related agencies. Using discourse analysis, this article reports the results and analysis of a Universal Health Coverage (UHC) theme: contextualizing UHC's positioning within the post-2015 agenda-setting process immediately after the Global Thematic Consultation on Health and High-Level Panel of Eminent Persons on the Post-2015 Development Agenda (High-Level Panel) released their post-2015 health and development goal aspirations in April and May 2013, respectively. After the findings from the interview data analysis are presented, the Results will be discussed drawing on Shiffman and Smith (Generation of political priority for global health initiatives: a framework and case study of maternal mortality.The Lancet2007; 370: : 1370-79) agenda-setting analytical framework (examining ideas, issues, actors and political context), modified by Benzianet al.(2011). Although more participants support the High-Level Panel's May 2013 report's proposal-'Ensure Healthy Lives'-as the next umbrella health goal, they nevertheless still emphasize the need for UHC to achieve this and thus be incorporated as part of its trajectory. Despite UHC's conceptual ambiguity and cursory mention in the High-Level Panel report, its proponents suggest its re-emergence will occur in

  5. Progress in achieving universal access to care for multidrug- resistant tuberculosis (MDR-TB).

    PubMed

    Wares, Fraser; Falzon, Dennis

    2014-10-01

    Each year there are about nine million new cases of tuberculosis (TB) in the world and over one million people die of the disease. The emergence of resistance to the drugs that are used to treat TB threaten to undo much of the progress achieved in controlling it in recent decades. In some countries, up to one third or more of TB cases have multidrug-resistant TB (MDR-TB; combined resistance to at least isoniazid and rifampicin), requiring a much longer and toxic treatment than that suffices for other TB patients. Countries have committed to achieve universal access to care for MDR-TB for their populations by 2015. In this article, we use national data collected by the World Health Organization (WHO) to assess global progress in detection (against WHO estimates) and treatment of MDR-TB. Over one half of all the world's MDR-TB patients are concentrated in three countries: India, China, and the Russian Federation. In 2012, about 78,753 TB cases were reported to have been started on MDR-TB treatment, about 25% of the estimated MDR-TB case load in the world. Only 48% of over 35,000 MDR-TB patients started on treatment in 2010 were reported to have completed their treatment successfully. The global MDR-TB targets for 2015 will not be achieved unless barriers to the expansion of reliable diagnosis and effective treatment of MDR-TB are not urgently overcome in many countries. New diagnostics and medicines will be required to speed up this drive within the new WHO global strategy which now looks well beyond 2015.

  6. Exploring models for the roles of health systems’ responsiveness and social determinants in explaining universal health coverage and health outcomes

    PubMed Central

    Bonsel, Gouke J.

    2016-01-01

    Background Intersectoral perspectives of health are present in the rhetoric of the sustainable development goals. Yet its descriptions of systematic approaches for an intersectoral monitoring vision, joining determinants of health, and barriers or facilitators to accessing healthcare services are lacking. Objective To explore models of associations between health outcomes and health service coverage, and health determinants and health systems responsiveness, and thereby to contribute to monitoring, analysis, and assessment approaches informed by an intersectoral vision of health. Design The study is designed as a series of ecological, cross-country regression analyses, covering between 23 and 57 countries with dependent health variables concentrated on the years 2002–2003. Countries cover a range of development contexts. Health outcome and health service coverage dependent variables were derived from World Health Organization (WHO) information sources. Predictor variables representing determinants are derived from the WHO and World Bank databases; variables used for health systems’ responsiveness are derived from the WHO World Health Survey. Responsiveness is a measure of acceptability of health services to the population, complementing financial health protection. Results Health determinants’ indicators – access to improved drinking sources, accountability, and average years of schooling – were statistically significant in particular health outcome regressions. Statistically significant coefficients were more common for mortality rate regressions than for coverage rate regressions. Responsiveness was systematically associated with poorer health and health service coverage. With respect to levels of inequality in health, the indicator of responsiveness problems experienced by the unhealthy poor groups in the population was statistically significant for regressions on measles vaccination inequalities between rich and poor. For the broader determinants, the

  7. Length of Study-Time Behaviour and Academic Achievement of Social Studies Education Students in the University of Uyo

    ERIC Educational Resources Information Center

    Ukpong, D. E.; George, I. N.

    2013-01-01

    This study investigated the length of study time behaviour and academic achievement of Social Studies Education students in the University of Uyo. The purpose was to determine the difference in the academic achievement of the long study time behaviour students and their short study time behaviour counterparts in Social Studies Education. The study…

  8. (Re)Defining the Narrative: High-Achieving Nontraditional Black Male Undergraduates at a Historically Black College and University

    ERIC Educational Resources Information Center

    Goings, Ramon B.

    2016-01-01

    Using Harper's anti-deficit achievement framework as a theoretical guide, the purpose of this phenomenological study was to investigate the academic and social experiences of four nontraditional, high-achieving, Black male undergraduates attending one historically Black university. Findings show that the participants were intrinsically motivated…

  9. Coverage Metrics for Model Checking

    NASA Technical Reports Server (NTRS)

    Penix, John; Visser, Willem; Norvig, Peter (Technical Monitor)

    2001-01-01

    When using model checking to verify programs in practice, it is not usually possible to achieve complete coverage of the system. In this position paper we describe ongoing research within the Automated Software Engineering group at NASA Ames on the use of test coverage metrics to measure partial coverage and provide heuristic guidance for program model checking. We are specifically interested in applying and developing coverage metrics for concurrent programs that might be used to support certification of next generation avionics software.

  10. The accountable health care act of Massachusetts: mixed results for an experiment in universal health care coverage.

    PubMed

    Norbash, Alexander; Hindson, David; Heineke, Janelle

    2012-10-01

    The affordable health care act of Massachusetts, signed into law in 2006, resulted in 98% of Massachusetts residents' having some form of insurance coverage by 2011, the highest coverage rate for residents of any state in the nation. With a strong economy, a low unemployment rate, a robust health care delivery system, an extremely low number of undocumented immigrants, and a low baseline uninsured rate, Massachusetts was well positioned for such an effort. Ingredients included mandates, the creation of separate insurance vehicles directed to both poverty-level and non-poverty-level residents, and the reallocation of the former free care pool. The mandates included consumer mandates and employer mandates; the consumer mandate applies to all Massachusetts residents at the risk of losing personal state tax exemptions, and the employer mandate applies to all Massachusetts businesses with 10 or more employees at the risk of per employee financial penalties. The insurance vehicles were created with premiums allocated on the basis of ability to pay by income classes. Unexpected effects included escalating taxpayer health care costs, with taxpayers shouldering the burden for the newly insured, continuing escalating health care costs at a rate greater than the national average, overburdening primary caregivers as newly insured sought new primary care gatekeepers in a system with primary caregiver shortages, and deprivation of support to the safety-net hospitals as a result of siphoned commonwealth free care pool funds. This exercise demonstrates specific benefits and shortfalls of the Massachusetts health care reform experiment, given the conditions and circumstances found in Massachusetts at the time of implementation.

  11. How Leadership Styles in Academia Align to Achieve Success within the Tanzanian Catholic Universities System

    ERIC Educational Resources Information Center

    Vumilia, Philbert L.

    2015-01-01

    Public and private universities in Kenya, Tanzania, Uganda, and elsewhere in Africa have been experiencing all-time high expansion since the late 1990s. This rush to expand both public and private universities has seriously impacted both the physical infrastructure as well as the effective leadership that new universities require. At the same…

  12. Achievement motivation level in students of Shiraz University of Medical Sciences and its influential factors

    PubMed Central

    KAVOUSIPOUR, SOMAYEH; NOORAFSHAN, ALI; POURAHMAD, SAEEDEH; DEHGHANI-NAZHVANI, ALI

    2015-01-01

    Introduction: Many studies have investigated the relationship between motivation and educational outcomes. The present study was conducted to determine whether the students’ motivation in Shiraz University of Medical Sciences (SUMS) decreases during educational years. Methods: 770 students in SUMS were selected by multi-stage stratified random sampling from each field and entrance year. The first questionnaire contained 57 questions on the effect of economic, social, educational, geographical and personality factors on the students’ motivation. The second one was based on 50 incomplete sentences. The validity and reliability of these questionnaires were approved by the experts and Cronbach's Alpha coefficients (85% and 90%, respectively). In this cross-sectional study, ANOVA, t-test and Chi-square tests were applied for data analysis at the 0.05 significance level. Results: Six factors with the most effect on academic motivation were "family attitudes", "getting good jobs in future", "respect for themselves", " the ability to learn", "believing their role in victory and defeat" and "the tendency toward optimism about themselves". In addition, comparing professional doctorate and basic sciences’ results revealed no significant relationship between academic motivation and educational years (F=0.819, p=0.397). But comparing field by field showed that Dentistry and Hospital Management and Medical Information (HMMI) had a significant decrease in motivation score by increase in educational years (F=3.991, p=0.015). Conclusion: Achievement motivation level in SUMS students was higher than average and did not decrease during educational years. Also, the results showed that personal, social and educational related factors affected motivation level more than economic and environmental factors. PMID:25587552

  13. Universal screening for hepatitis B among pregnant women led to 96% vaccination coverage among newborns of HBsAg positive mothers in Denmark.

    PubMed

    Harder, Katja Majlund; Cowan, Susan; Eriksen, Mette Brandt; Krarup, Henrik B; Christensen, Peer Brehm

    2011-11-21

    In Denmark selective screening programs of pregnant women for hepatitis B missed 30-50% of high-risk groups and in late 2005 a universal screening of pregnant women for HBsAg was implemented. During a 2-year period a prospective enhanced surveillance of the universal screening was performed to examine the effectiveness of universal HBV-screening of pregnant women and HBV-immunizations of their newborn, and to provide a prevalence-estimate for HBV in Denmark. On a opt out basis all women in Denmark attending antenatal care were tested for hepatitis B serology. Vaccination data of the newborns and households of HBsAg positive pregnant women were assembled. Among 140,376 HBsAg tests of pregnant women, 371 (0.26%) were positive. The prevalence among women of Danish origin was 0.012% and 2.74% among foreign born women, highest for women from Southeast Asia (14.5%). Genotype C was the most prevalent (37%) and 13% had a HBVDNA ≥10(8) IU/ml. The prevalence estimate of chronic hepatitis B in Denmark was 0.2-0.3% in the general population. Among children born within the project period, 96% received vaccination at birth compared to 50% of siblings born prior to universal screening. During 3 years of passive follow-up two transmissions (0.5%) have been notified. Among children born of the positive mothers prior to the trial-period 7.3% had been notified. Thus the prevalence of HBV positive mothers has more than doubled in Denmark over the last 40 years, but among women of Danish origin it has decreased 10-fold. By replacing selective screening with universal, identification of newborns in need of HBV-immunization was increased from 50% to almost complete coverage, and also identifies mothers with high viral load for evaluation of pre-term treatment to interrupt in utero transmission.

  14. Low rural health insurance take-up in a universal coverage system: perceptions of health insurance among the uninsured in La Guajira, Colombia.

    PubMed

    Buttorff, Christine; Trujillo, Antonio J; Ruiz, Fernando; Amaya, Jeannette L

    2015-01-01

    Despite enacting a universal healthcare system in 1993, many Colombians do not participate. Understanding perceptions of the system could help the government market certain features or adjust benefits in order to increase enrollment. Using La Guajira, Colombia, as a case study, we surveyed uninsured rural households regarding insurance preferences, values and beliefs, and perceptions of available services. Four hundred heads of households responded in La Guajira, Colombia. Respondents reported high levels of long-term uninsurance. Overall, the quality of services in the government-run system is perceived as better than being uninsured, but there appear to be constraints on enrollment. Rural Colombians value more family coverage and better choice of physicians, but offering better benefits may not be enough. Many cited access barriers, so reducing these barriers may also increase enrollment. Further surveys in other parts of Colombia should be undertaken to confirm results.

  15. Moving towards Universal Health Coverage through the Development of Integrated Service Delivery Packages for Primary Health Care in the Solomon Islands

    PubMed Central

    Whiting, Stephen; Postma, Sjoerd; Jamshaid de Lorenzo, Ayesha; Aumua, Audrey

    2016-01-01

    The Solomon Islands Government is pursuing integrated care with the goal of improving the quality of health service delivery to rural populations. Under the auspices of Universal Health Coverage, integrated service delivery packages were developed which defined the clinical and public health services that should be provided at different levels of the health system. The process of developing integrated service delivery packages helped to identify key policy decisions the government needed to make in order to improve service quality and efficiency. The integrated service delivery packages have instigated the revision of job descriptions and are feeding into the development of a human resource plan for health. They are also being used to guide infrastructure development and health system planning and should lead to better management of resources. The integrated service delivery packages have become a key tool to operationalise the government’s policy to move towards a more efficient, equitable, quality and sustainable health system. PMID:28321177

  16. Toward universal coverage in Afghanistan: A multi-stakeholder assessment of capacity investments in the community health worker system.

    PubMed

    Edward, Anbrasi; Branchini, Casey; Aitken, Iain; Roach, Melissa; Osei-Bonsu, Kojo; Arwal, Said Habib

    2015-11-01

    Global efforts to scale-up the community health workforce have accelerated as a result of the growing evidence of their effectiveness to enhance coverage and health outcomes. Reconstruction efforts in Afghanistan integrated capacity investments for community based service delivery, including the deployment of over 28,000 community health workers (CHWs) to ensure access to basic preventive and curative services. The study aimed to conduct capacity assessments of the CHW system and determine stakeholder perspectives of CHW performance. Structured interviews were conducted on a national sample from 33 provinces and included supervisors, facility providers, patients, and CHWs. Formative assessments were also conducted with national policymakers, community members and health councils in two provinces. Results indicate that more than 70% of the NGO's provide comprehensive training for CHWs, 95% CHWs reported regular supervision, and more than 60% of the health posts had adequate infrastructure and essential commodities. Innovative strategies of paired male and female CHWs, institution of a special cadre of community health supervisors, and community health councils were introduced as systems strengthening mechanisms. Reported barriers included unrealistic and expanding task expectations (14%), unsatisfactory compensation mechanisms (75%), inadequate transport (69%), and lack of commodities (40%). Formative assessments evidenced that CHWs were highly valued as they provided equitable, accessible and affordable 24-h care. Their loyalty, dedication and the ability for women to access care without male family escorts was appreciated by communities. With rising concerns of workforce deficits, insecurity and budget constraints, the health system must enhance the capacity of these frontline workers to improve the continuum of care. The study provides critical insight into the strengths and constraints of Afghanistan's CHW system, warranting further efforts to contextualize

  17. Career Maturity and the Achievement of Community College Students and Disadvantaged University Students.

    ERIC Educational Resources Information Center

    Healy, Charles C.; And Others

    1984-01-01

    Examined the relationship of career maturity and academic achievement in 182 community college students and 126 disadvantaged college freshmen. The modest relationship found suggests that counselors can increase retention by helping students achieve career maturity. (JAC)

  18. Buckling Down: Achieving and Underachieving in the First Year of University.

    ERIC Educational Resources Information Center

    Bell, James H.; Short, Sara

    2003-01-01

    Interviews 11 self-defined underachieving college freshmen. Synthesizes 13 definitions of achievement by students. Analyzes the interviews repeatedly to produce a list of the students' concepts of achievement, arranged from the most common to the least common. Finds each student held more than one definition of achieving, some definitions in the…

  19. Student Achievement in College Calculus, Louisiana State University 1967-1968.

    ERIC Educational Resources Information Center

    Scannicchio, Thomas Henry

    An investigation of freshmen achievement in an introductory calculus course was performed on the basis of high school mathematics background to find predictors of college calculus grades. Overall high school academic achievement, overall high school mathematics achievement, number of high school mathematics units, pattern of college preparatory…

  20. Combined photon-electron beams in the treatment of the supraclavicular lymph nodes in breast cancer: A novel technique that achieves adequate coverage while reducing lung dose.

    PubMed

    Salem, Ahmed; Mohamad, Issa; Dayyat, Abdulmajeed; Kanaa'n, Haitham; Sarhan, Nasim; Roujob, Ibrahim; Salem, Abdel-Fattah; Afifi, Shatha; Jaradat, Imad; Mubiden, Rasmi; Almousa, Abdelateif

    2015-01-01

    Radiation pneumonitis is a well-documented side effect of radiation therapy for breast cancer. The purpose of this study was to compare combined photon-electron, photon-only, and electron-only plans in the radiation treatment of the supraclavicular lymph nodes. In total, 13 patients requiring chest wall and supraclavicular nodal irradiation were planned retrospectively using combined photon-electron, photon-only, and electron-only supraclavicular beams. A dose of 50Gy over 25 fractions was prescribed. Chest wall irradiation parameters were fixed for all plans. The goal of this planning effort was to cover 95% of the supraclavicular clinical target volume (CTV) with 95% of the prescribed dose and to minimize the volume receiving ≥ 105% of the dose. Comparative end points were supraclavicular CTV coverage (volume covered by the 95% isodose line), hotspot volume, maximum radiation dose, contralateral breast dose, mean total lung dose, total lung volume percentage receiving at least 20 Gy (V(20 Gy)), heart volume percentage receiving at least 25 Gy (V(25 Gy)). Electron and photon energies ranged from 8 to 18 MeV and 4 to 6 MV, respectively. The ratio of photon-to-electron fractions in combined beams ranged from 5:20 to 15:10. Supraclavicular nodal coverage was highest in photon-only (mean = 96.2 ± 3.5%) followed closely by combined photon-electron (mean = 94.2 ± 2.5%) and lowest in electron-only plans (mean = 81.7 ± 14.8%, p < 0.001). The volume of tissue receiving ≥ 105% of the prescription dose was higher in the electron-only (mean = 69.7 ± 56.1 cm(3)) as opposed to combined photon-electron (mean = 50.8 ± 40.9 cm(3)) and photon-only beams (mean = 32.2 ± 28.1 cm(3), p = 0.114). Heart V(25 Gy) was not statistically different among the plans (p = 0.999). Total lung V(20 Gy) was lowest in electron-only (mean = 10.9 ± 2.3%) followed by combined photon-electron (mean = 13.8 ± 2.3%) and highest in photon-only plans (mean = 16.2 ± 3%, p < 0.001). As expected

  1. Combined photon-electron beams in the treatment of the supraclavicular lymph nodes in breast cancer: A novel technique that achieves adequate coverage while reducing lung dose

    SciTech Connect

    Salem, Ahmed; Mohamad, Issa; Dayyat, Abdulmajeed; Kanaa’n, Haitham; Sarhan, Nasim; Roujob, Ibrahim; Salem, Abdel-Fattah; Afifi, Shatha; Jaradat, Imad; Mubiden, Rasmi; Almousa, Abdelateif

    2015-10-01

    Radiation pneumonitis is a well-documented side effect of radiation therapy for breast cancer. The purpose of this study was to compare combined photon-electron, photon-only, and electron-only plans in the radiation treatment of the supraclavicular lymph nodes. In total, 13 patients requiring chest wall and supraclavicular nodal irradiation were planned retrospectively using combined photon-electron, photon-only, and electron-only supraclavicular beams. A dose of 50 Gy over 25 fractions was prescribed. Chest wall irradiation parameters were fixed for all plans. The goal of this planning effort was to cover 95% of the supraclavicular clinical target volume (CTV) with 95% of the prescribed dose and to minimize the volume receiving ≥ 105% of the dose. Comparative end points were supraclavicular CTV coverage (volume covered by the 95% isodose line), hotspot volume, maximum radiation dose, contralateral breast dose, mean total lung dose, total lung volume percentage receiving at least 20 Gy (V{sub 20} {sub Gy}), heart volume percentage receiving at least 25 Gy (V{sub 25} {sub Gy}). Electron and photon energies ranged from 8 to 18 MeV and 4 to 6 MV, respectively. The ratio of photon-to-electron fractions in combined beams ranged from 5:20 to 15:10. Supraclavicular nodal coverage was highest in photon-only (mean = 96.2 ± 3.5%) followed closely by combined photon-electron (mean = 94.2 ± 2.5%) and lowest in electron-only plans (mean = 81.7 ± 14.8%, p < 0.001). The volume of tissue receiving ≥ 105% of the prescription dose was higher in the electron-only (mean = 69.7 ± 56.1 cm{sup 3}) as opposed to combined photon-electron (mean = 50.8 ± 40.9 cm{sup 3}) and photon-only beams (mean = 32.2 ± 28.1 cm{sup 3}, p = 0.114). Heart V{sub 25} {sub Gy} was not statistically different among the plans (p = 0.999). Total lung V{sub 20} {sub Gy} was lowest in electron-only (mean = 10.9 ± 2.3%) followed by combined photon-electron (mean = 13.8 ± 2.3%) and highest in photon

  2. Improving Science, Technology and Mathematics Students' Achievement: Imperatives for Teacher Preparation in the Caribbean Colleges and Universities

    ERIC Educational Resources Information Center

    Ogunkola, Babalola J.

    2012-01-01

    The concerns of this article are the unacceptable status of Science, Technology and Mathematics (STM) Education in the Caribbean and how to improve the students' achievement in the subjects involved through the instrumentality of better preparation of teachers by the Colleges and University faculties training teachers in the region. The index for…

  3. The Differential Impact of Academic Self-Regulatory Methods on Academic Achievement among University Students with and without Learning Disabilities.

    ERIC Educational Resources Information Center

    Ruban, Lilia M.; McCoach, D. Betsy; McGuire, Joan M.; Reis, Sally M.

    2003-01-01

    A study involving university students with (n=53) and without (n=417) learning disabilities (LD) found students with LD differed significantly in the relationships between their motivation for and use of standard self-regulated learning and compensation strategies, which provided a differential explanation of academic achievement for students with…

  4. Academic Achievement and Personality Traits of Faculty Members of Indian Agricultural Universities: Their Effect on Teaching and Research Performance

    ERIC Educational Resources Information Center

    Ramesh, P.; Reddy, K. M.; Rao, R. V. S.; Dhandapani, A.; Siva, G. Samba; Ramakrishna, A.

    2017-01-01

    Purpose: The present study was undertaken to assess academic achievement, teaching aptitude and research attitude of Indian agricultural universities' faculty, to predict indicators for successful teachers and researchers, and thereby enhancing the quality of higher agricultural education. Methodology: Five hundred faculty members were selected to…

  5. The Relationship between Self Concept and Response towards Student's Academic Achievement among Students Leaders in University Putra Malaysia

    ERIC Educational Resources Information Center

    Ahmad, Jamaludin; Ghazali, Mazila; Hassan, Aminuddin

    2011-01-01

    This is a quantitative research using correlational method. The purpose of this research is to study the relationship between self concept and ability to handle stress on academic achievement of student leaders in University Putra Malaysia. The sample size consists of 106 respondents who are the Student Supreme Council and Student Representative…

  6. Impact of the Systemic Approach on Literacy Achievement of Jordanian 1st Graders at Mu'tah University Model School

    ERIC Educational Resources Information Center

    Al-Hajaya, Nail

    2012-01-01

    This study investigates the effect of the systemic approach in literacy achievement of the first grade students at Mu'tah University's Model School. The sample (N = 45) consisted of all first grade students, who were assigned into two groups; a control group taught traditionally while the other group was exposed to the system approach during the…

  7. Access and Achievement of Hispanics and Hispanic Immigrants in the Colleges of the City University of New York

    ERIC Educational Resources Information Center

    Leinbach, D. Timothy; Bailey, Thomas R.

    2006-01-01

    The City University of New York (CUNY) has played a central role in educating minority and immigrant New Yorkers, and Hispanics comprise the largest minority and immigrant populations in the City. To examine the extent to which CUNY provides Hispanic native- born and immigrant students with access and the opportunity for achievement, a study was…

  8. Access and Achievement of Hispanics and Hispanic Immigrants in the Colleges of the City University of New York

    ERIC Educational Resources Information Center

    Leinbach, D. Timothy; Bailey, Thomas R.

    2006-01-01

    The City University of New York (CUNY) has played a central role in educating minority and immigrant New Yorkers, and Hispanics comprise the largest minority and immigrant populations in the City. To examine the extent to which CUNY provides Hispanic native-born and immigrant students with access and the opportunity for achievement, a study was…

  9. Training Needs for Faculty Members: Towards Achieving Quality of University Education in the Light of Technological Innovations

    ERIC Educational Resources Information Center

    Abouelenein, Yousri Attia Mohamed

    2016-01-01

    The aim of this study was to identify training needs of university faculty members, in order to achieve the desired quality in the light of technological innovations. A list of training needs of faculty members was developed in terms of technological innovations in general, developing skills of faculty members in the use of technological…

  10. Bhutanese Stakeholders' Perceptions about Multi-Grade Teaching as a Strategy for Achieving Quality Universal Primary Education

    ERIC Educational Resources Information Center

    Kucita, Pawan; Kivunja, Charles; Maxwell, T. W.; Kuyini, Bawa

    2013-01-01

    This study employed document analysis and qualitative interviews to explore the perceptions of different Bhutanese stakeholders about multi-grade teaching, which the Bhutanese Government identified as a strategy for achieving quality Universal Primary Education. The data from Ministry officials, teachers and student teachers were analyzed using…

  11. A University Engagement Model for Achieving Technology Adoption and Performance Improvement Impacts in Healthcare, Manufacturing, and Government

    ERIC Educational Resources Information Center

    McKinnis, David R.; Sloan, Mary Anne; Snow, L. David; Garimella, Suresh V.

    2014-01-01

    The Purdue Technical Assistance Program (TAP) offers a model of university engagement and service that is achieving technology adoption and performance improvement impacts in healthcare, manufacturing, government, and other sectors. The TAP model focuses on understanding and meeting the changing and challenging needs of those served, always…

  12. The Impact of the College Assistance Migrant Program on Migrant Student Academic Achievement in the California State University System

    ERIC Educational Resources Information Center

    Ramirez, Adrian D.

    2012-01-01

    The 7-year longitudinal study examined the College Assistance Migrant Program (CAMP) impact on migrant student achievement in the California State University system. Participants included migrant students, Latinos, and general student populations from 2002-2009. The analysis of variance and chi-square test of independence were used to explore…

  13. Supporting Low-Achieving EFL Learners: Expectations, Procedure and Significance of Remedial Sessions at a Saudi University

    ERIC Educational Resources Information Center

    Alghamdi, Fatimah M. A.; Siddiqui, Ozma

    2016-01-01

    This study reports on and investigates an institutionalized remedial approach held by an English language institute (ELI) at a Saudi University in order to support foundation year struggling students who often achieve low grades or fail to pass a certain level of the English language program. The study utilizes semi-structured interviews to…

  14. Achieving Quality Assurance and Moving to a World Class University in the 21st Century

    ERIC Educational Resources Information Center

    Lee, Lung-Sheng Steven

    2013-01-01

    Globalization in the 21st century has brought innumerable challenges and opportunities to universities and countries. Universities are primarily concerned with how to ensure the quality of their education and how to boost their local and global competitiveness. The pressure from both international competition and public accountability on…

  15. Academic Achievement in First-Year University: Who Maintains Their High School Average?

    ERIC Educational Resources Information Center

    Wintre, Maxine Gallander; Dilouya, Barry; Pancer, S. Mark; Pratt, Michael W.; Birnie-Lefcovitch, Shelly; Polivy, Janet; Adams, Gerald

    2011-01-01

    The present study investigates the characteristics which differentiate between first-year university students who maintain their high school averages (Maintainers: n = 165) and those whose averages decrease at least one letter grade (Decliners: n = 435). The 600 students entered first year at one of six Canadian Universities, which varied in size…

  16. Staying Power: The Effect of Pathway into University on Student Achievement and Attrition

    ERIC Educational Resources Information Center

    Chesters, Jenny; Watson, Louise

    2016-01-01

    The expansion of the higher education sector in Australia opened up new pathways into university increasing the diversity of the student population. For non-traditional students, those who did not successfully complete secondary school, barriers to gaining entry into university have been dismantled, however, previous research suggests that…

  17. Working Together: Wellness and Academic Achievement at Tribal Colleges and Universities

    ERIC Educational Resources Information Center

    Duran, Bonnie; Magarati, Maya; Parker, Myra; Egashira, Leo; Kipp, Billie Jo

    2013-01-01

    This article describes the activities of the Indigenous Wellness Research Institute (IWRI) at the University of Washington, Washington State, in collaborating with tribal colleges and universities (TCUs) to examine alcohol, drug, and mental health issues among Native students. The authors provide first steps for the development of culturally…

  18. Fair Access, Achievement and Geography: Explaining the Association between Social Class and Students' Choice of University

    ERIC Educational Resources Information Center

    Mangan, Jean; Hughes, Amanda; Davies, Peter; Slack, Kim

    2010-01-01

    This quantitative study is concerned with what determines prospective university students' first choice between universities of different status. The results suggest that examination performance, going to an independent school and fear of debt independently affect students' decisions. Social factors and students' perceived level of information on…

  19. The Academic Achievement of Students in a New Zealand University: Does It Pay to Work?

    ERIC Educational Resources Information Center

    Richardson, Jessica J.; Kemp, Simon; Malinen, Sanna; Haultain, Steve A.

    2013-01-01

    There is growing concern about the detrimental effect of term-time employment on university students' academic success. We report results from an online survey of 1837 students of the University of Canterbury in New Zealand, whose responses were later matched to their academic records for a semester. The majority of employed students reported…

  20. Academic Achievement at the University of Maiduguri: A Survey of Teaching-Learning Environment

    ERIC Educational Resources Information Center

    Jiboyewa, D. A.; Umar, Muhammad Amin

    2015-01-01

    This study assessed the teaching-learning environment at the University of Maiduguri. The study used survey design. The population comprised of the 77 academic departments in the eleven faculties at the University of Maiduguri. A total of 29 departments were randomly and proportionally drawn from the 77 departments. The smallest sample (21…

  1. Our Achievements in Telemedicine within the Partnership Program with Boston University School of Medicine.

    ERIC Educational Resources Information Center

    Tadevosyan, A.; Screnci, D.

    2002-01-01

    Discusses advances in telecommunications and telemedicine in developing countries and describes a partnership between the Emergency Scientific Medical Center in Armenia, Boston University School of Medicine, and the University of Massachusetts to exchange personnel for educational and technical assistance and to provide better services and…

  2. School Achievement and Backwardness Analysis Model at the Metropolitan Autonomous University--Cuajimalpa Unit

    ERIC Educational Resources Information Center

    Olivera-Villarroel, Sazcha Marcelo; del Pilar Fuerte-Celis, Maria

    2016-01-01

    This work stems from the need to develop a line of institutional policy recommendations to improve school performance and to reduce the backlog in the graduation of students in the Cuajimalpa Unit of the Metropolitan Autonomous University. The school backlog of students of this university is one of the main institutional concerns, due to the…

  3. Coverage Evaluation of Academic Libraries Survey (ALS).

    ERIC Educational Resources Information Center

    Marston, Christopher C.

    1999-01-01

    Evaluates universe coverage, data coverage, and response rates of the Academic Libraries Survey. Includes examination of survey design and data collection, perceptions of regional survey coordinators, and reporting by public versus private institutions. (Author)

  4. Achieving high coverage of larval-stage mosquito surveillance: challenges for a community-based mosquito control programme in urban Dar es Salaam, Tanzania

    PubMed Central

    2009-01-01

    Background Preventing malaria by controlling mosquitoes in their larval stages requires regular sensitive monitoring of vector populations and intervention coverage. The study assessed the effectiveness of operational, community-based larval habitat surveillance systems within the Urban Malaria Control Programme (UMCP) in urban Dar es Salaam, Tanzania. Methods Cross-sectional surveys were carried out to assess the ability of community-owned resource persons (CORPs) to detect mosquito breeding sites and larvae in areas with and without larviciding. Potential environmental and programmatic determinants of habitat detection coverage and detection sensitivity of mosquito larvae were recorded during guided walks with 64 different CORPs to assess the accuracy of data each had collected the previous day. Results CORPs reported the presence of 66.2% of all aquatic habitats (1,963/2,965), but only detected Anopheles larvae in 12.6% (29/230) of habitats that contained them. Detection sensitivity was particularly low for late-stage Anopheles (2.7%, 3/111), the most direct programmatic indicator of malaria vector productivity. Whether a CORP found a wet habitat or not was associated with his/her unfamiliarity with the area (Odds Ratio (OR) [95% confidence interval (CI)] = 0.16 [0.130, 0.203], P < 0.001), the habitat type (P < 0.001) or a fence around the compound (OR [95%CI] = 0.50 [0.386, 0.646], P < 0.001). The majority of mosquito larvae (Anophelines 57.8% (133/230) and Culicines 55.9% (461/825) were not reported because their habitats were not found. The only factor affecting detection of Anopheline larvae in habitats that were reported by CORPs was larviciding, which reduced sensitivity (OR [95%CI] = 0.37 [0.142, 0.965], P = 0.042). Conclusions Accessibility of habitats in urban settings presents a major challenge because the majority of compounds are fenced for security reasons. Furthermore, CORPs under-reported larvae especially where larvicides were applied. This UMCP

  5. Can a man-made universe be achieved by quantum tunneling without an initial singularity?

    NASA Technical Reports Server (NTRS)

    Guth, Alan H.; Haller, K. (Editor); Caldi, D. B. (Editor); Islam, M. M. (Editor); Mallett, R. L. (Editor); Mannheim, P. D. (Editor); Swanson, M. S. (Editor)

    1991-01-01

    Essentially all modern particle theories suggest the possible existence of a false vacuum state; a metastable state with an energy density that cannot be lowered except by means of a very slow phase transition. Inflationary cosmology makes use of such a state to drive the expansion of the big bang, allowing the entire observed universe to evolve from a very small initial mass. A sphere of false vacuum in the present universe, if larger than a certain critical mass, could inflate to form a new universe which would rapidly detach from its parent. A false vacuum bubble of this size, however, cannot be produced classically unless an initial singularity is present from the outset. The possibility is explored that a bubble of subcritical size, which classically would evolve to a maximum size and collapse, might instead tunnel through a barrier to produce a new universe. The tunneling rate using semiclassical quantum gravity is estimated, and some interesting ambiguities in the formulas are discovered.

  6. Assessment of universal health coverage for adults aged 50 years or older with chronic illness in six middle-income countries

    PubMed Central

    Frenz, Patricia; Grabenhenrich, Linus; Keil, Thomas; Tinnemann, Peter

    2016-01-01

    Abstract Objective To assess universal health coverage for adults aged 50 years or older with chronic illness in China, Ghana, India, Mexico, the Russian Federation and South Africa. Methods We obtained data on 16 631 participants aged 50 years or older who had at least one diagnosed chronic condition from the World Health Organization Study on Global Ageing and Adult Health. Access to basic chronic care and financial hardship were assessed and the influence of health insurance and rural or urban residence was determined by logistic regression analysis. Findings The weighted proportion of participants with access to basic chronic care ranged from 20.6% in Mexico to 47.6% in South Africa. Access rates were unequally distributed and disadvantaged poor people, except in South Africa where primary health care is free to all. Rural residence did not affect access. The proportion with catastrophic out-of-pocket expenditure for the last outpatient visit ranged from 14.5% in China to 54.8% in Ghana. Financial hardship was more common among the poor in most countries but affected all income groups. Health insurance generally increased access to care but gave insufficient protection against financial hardship. Conclusion No country provided access to basic chronic care for more than half of the participants with chronic illness. The poor were less likely to receive care and more likely to face financial hardship in most countries. However, inequity of access was not fully determined by the level of economic development or insurance coverage. Future health reforms should aim to improve service quality and increase democratic oversight of health care. PMID:27034521

  7. Reliability and Validity of the "Achievement Emotions Questionnaire": A Study of Argentinean University Students

    ERIC Educational Resources Information Center

    Paoloni, Paola Verónica; Vaja, Arabela Beatriz; Muñoz, Verónica Lilian

    2014-01-01

    Introduction: This paper aims at describing the psychometric features of the Achievement Emotions Questionnaire (AEQ), focusing specifically on the section that measures class emotions. From a theoretical perspective, this instrument was designed based on the control-value theory of achievement emotions. Therefore, a description of the…

  8. The Academic Achievement of Elite Athletes at an Australian University: Debunking the Dumb Jock Syndrome

    ERIC Educational Resources Information Center

    Georgakis, Steve; Wilson, Rachel; Ferguson, Jamaya

    2014-01-01

    Elite athletes and their academic achievement in higher education have long been subject to considerable debate within North American scholarship. This interest proliferated especially after the release of the Knight Report (2001), which, amongst other findings, revealed a clear negative link between elite athletes and their academic achievement.…

  9. Academic Achievement Performance of University Students with Disability: Exploring the Influence of Non-Academic Factors

    ERIC Educational Resources Information Center

    Dryer, Rachel; Henning, Marcus A.; Tyson, Graham A.; Shaw, Rosemary

    2016-01-01

    This study examined whether: (1) the non-academic constructs of psychological well-being, motivation to learn and quality of life (QOL) explained the variance in the academic achievement of students with disability; and (2) students with a mental health disability (MHD) differed from students with other disability on academic achievement and on…

  10. Speech Communication Anxiety: An Impediment to Academic Achievement in the University Classroom.

    ERIC Educational Resources Information Center

    Boohar, Richard K.; Seiler, William J.

    1982-01-01

    The achievement levels of college students taking a bioethics course who demonstrated high and low degrees of speech anxiety were studied. Students with high speech anxiety interacted less with instructors and did not achieve as well as other students. Strategies instructors can use to help students are suggested. (Authors/PP)

  11. EFL Teachers' Perception of University Students' Motivation and ESP Learning Achievement

    ERIC Educational Resources Information Center

    Dja'far, Veri Hardinansyah; Cahyono, Bambang Yudi; Bashtomi, Yazid

    2016-01-01

    This research aimed at examining Indonesian EFL Teachers' perception of students' motivation and English for Specific Purposes (ESP) learning achievement. It also explored the strategies applied by teachers based on their perception of students' motivation and ESP learning achievement. This research involved 204 students who took English for…

  12. Effect of satisfaction in major at university on academic achievement among physical therapy students

    PubMed Central

    Kim, You Lim; Lee, Suk Min

    2015-01-01

    [Purpose] The purpose of this study was to investigate satisfaction in major among physical therapy students and to identify the sub-factors of satisfaction in major affecting academic achievement. [Subjects and Methods] We distributed a self-administered questionnaire, comprising items relating to satisfaction in major and academic achievement to 369 physical therapy students located in Seoul, Daejeon, Jinju, Pohang, and Gunsan. [Results] General satisfaction and academic achievement showed the greatest correlation (r = 0.235), followed by course satisfaction (r = 0.123). [Conclusion] Several sub-factors were found to affect academic achievement. The results of this study can be used as the basis for programs that aim at development of satisfaction in major and academic achievement among clinical physical therapists. PMID:25729179

  13. The Effects of Health Insurance Coverage on the Math Achievement Trajectories of School Children in Yuma County, Arizona: Implications for Education Accountability Policy

    ERIC Educational Resources Information Center

    Garcy, Anthony M.

    2013-01-01

    U.S. Federal and state education policies place considerable emphasis on assessing the effects that schools and teachers have on student test score performance. It is important for education policy makers to also consider other factors that can affect student achievement. This study finds that an exogenous school factor, discontinuous health…

  14. Achievements and Challenges in the US Summer English Program offered by the Graduate School of Engineering, Osaka University

    NASA Astrophysics Data System (ADS)

    Kunioshi, Nílson; Ashizawa, Shingo; Tsuji, Kiichiro

    As an extension of the subject “English for Engineers” offered by the Graduate School of Engineering to its students, a summer intensive technical English course is held every year in the United States. The contents of the summer program are customized to meet the needs of the engineering students of Osaka University, and from 2004 participants can get the credits corresponding to English for Engineers II, a subject that usually is taken in the second semester at Osaka University. The evolution in the contents of the summer program, first designed in 2003, as well as the achievements, further possible improvements and problems to be solved are analysed.

  15. The role of Ethiopia's public universities in achieving the United Nations Sustainable Development Goals

    NASA Astrophysics Data System (ADS)

    O'Keeffe, Paul

    2016-12-01

    In recent years, the Ethiopian government has embarked on an ambitious agriculture development strategy aimed at raising Ethiopia to the status of a middle-income-level country by 2025. Encouraged by the international development push behind the United Nations Sustainable Development Goals (SDGs), the rapid expansion of public universities has taken centre stage in facilitating the country's aim of equipping a new generation with the expertise needed to fuel the country's economic development. While impressive strides have been made over the last two decades, various development challenges threaten to derail this promising progress. This article examines three of the main challenges - urbanisation, climate change and food security - and the potential for universities to address them. Based on a study using key informant analysis research with 50 experts in Ethiopian education and development, the author concludes that the developing public university system offers promising capabilities to assist the country on its developmental path despite many inherent problems.

  16. Success of Senegal's first nationwide distribution of long-lasting insecticide-treated nets to children under five - contribution toward universal coverage

    PubMed Central

    2011-01-01

    Background In 2009, the first national long-lasting insecticide-treated net (LLIN) distribution campaign in Senegal resulted in the distribution of 2.2 million LLINs in two phases to children aged 6-59 months. Door-to-door teams visited all households to administer vitamin A and mebendazole, and to give a coupon to redeem later for an LLIN. Methods A nationwide community-based two-stage cluster survey was conducted, with clusters selected within regions by probability proportional to size sampling, followed by GPS-assisted mapping, simple random selection of households in each cluster, and administration of a questionnaire using personal digital assistants (PDAs). The questionnaire followed the Malaria Indicator Survey format, with rosters of household members and bed nets, and questions on campaign participation. Results There were 3,280 households in 112 clusters representing 33,993 people. Most (92.1%) guardians of eligible children had heard about the campaign, the primary sources being health workers (33.7%), neighbours (26.2%), and radio (22.0%). Of eligible children, 82.4% received mebendazole, 83.8% received vitamin A, and 75.4% received LLINs. Almost all (91.4%) LLINs received during the campaign remained in the household; of those not remaining, 74.4% had been given away and none were reported sold. At least one insecticide-treated net (ITN) was present in 82.3% of all households, 89.2% of households with a child < 5 years and 57.5% of households without a child < 5 years. Just over half (52.4%) of ITNs had been received during the campaign. Considering possible indicators of universal coverage, 39.8% of households owned at least one ITN per two people, 21.6% owned at least one ITN per sleeping space and 34.7% of the general population slept under an ITN the night before the survey. In addition, 45.6% of children < 5 years, and 49.2% of pregnant women had slept under an ITN. Conclusions The nationwide integrated LLIN distribution campaign allowed

  17. Realizing universal health coverage for maternal health services in the Republic of Guinea: the use of workforce projections to design health labor market interventions

    PubMed Central

    Jansen, Christel; Codjia, Laurence; Cometto, Giorgio; Yansané, Mohamed Lamine; Dieleman, Marjolein

    2014-01-01

    Background Universal health coverage requires a health workforce that is available, accessible, and well-performing. This article presents a critical analysis of the health workforce needs for the delivery of maternal and neonatal health services in Guinea, and of feasible and relevant interventions to improve the availability, accessibility, and performance of the health workforce in the country. Methods A needs-based approach was used to project human resources for health (HRH) requirements. This was combined with modeling of future health sector demand and supply. A baseline scenario with disaggregated need and supply data for the targeted health professionals per region and setting (urban or rural) informed the identification of challenges related to the availability and distribution of the workforce between 2014 and 2024. Subsequently, the health labor market framework was used to identify interventions to improve the availability and distribution of the health workforce. These interventions were included in the supply side modeling, in order to create a “policy rich” scenario B which allowed for analysis of their potential impact. Results In the Republic of Guinea, only 44% of the nurses and 18% of the midwives required for maternal and neonatal health services are currently available. If Guinea continues on its current path without scaling up recruitment efforts, the total stock of HRH employed by the public sector will decline by 15% between 2014 and 2024, while HRH needs will grow by 22% due to demographic trends. The high density of HRH in urban areas and the high number of auxiliary nurses who are currently employed pose an opportunity for improving the availability, accessibility, and performance of the health workforce for maternal and neonatal health in Guinea, especially in rural areas. Conclusion Guinea will need to scale up its recruitment efforts in order to improve health workforce availability. Targeted labor market interventions need to be

  18. Effectiveness of a Universal, Interdependent Group Contingency Program on Children's Academic Achievement: A Countywide Evaluation

    ERIC Educational Resources Information Center

    Weis, Robert; Osborne, Karen J.; Dean, Emily L.

    2015-01-01

    The Good Behavior Game (GBG) is a universal prevention program designed to increase academic engagement and to decrease disruptive behavior in elementary school-age children. Teachers and other school personnel use interdependent group contingencies to improve students' behavior in the classroom. Previous research indicates the GBG is efficacious…

  19. Combined Heat and Power System Achieves Millions in Cost Savings at Large University - Case Study

    SciTech Connect

    2013-05-29

    Texas A&M University is operating a high-efficiency combined heat and power (CHP) system at its district energy campus in College Station, Texas. Texas A&M received $10 million in U.S. Department of Energy funding from the American Recovery and Reinvestment Act (ARRA) of 2009 for this project. Private-sector cost share totaled $40 million.

  20. Exploring the Transformation of Actorship among Students at a Small Swedish University: Background, Actorship and Achievement

    ERIC Educational Resources Information Center

    Nelson, Anders

    2016-01-01

    With an aim to better understand higher education's potential for fostering personal development and social change, this study explores how students' actorship in studies and civic engagement changed over time while enrolled in undergraduate programs at Halmstad University, Sweden. Additionally, it explores the relation among these students'…

  1. Black Male College Achievers and Resistant Responses to Racist Stereotypes at Predominantly White Colleges and Universities

    ERIC Educational Resources Information Center

    Harper, Shaun R.

    2015-01-01

    In this article, Shaun R. Harper investigates how Black undergraduate men respond to and resist the internalization of racist stereotypes at predominantly White colleges and universities. Prior studies consistently show that racial stereotypes are commonplace on many campuses, that their effects are usually psychologically and academically…

  2. Factors Affecting Academic Achievement of Adult Students Enrolled in Ontario University Credit Courses.

    ERIC Educational Resources Information Center

    Beagle, Peggy

    Existing programs, policies and practices as they affect the older adult student in Ontario universities were investigated. Interview data were collected from adult students about their experiences in the light of the policies described, and a number of obstacles to successful study encountered by these students were identified. A statistical…

  3. A Disciplinary Discourse Perspective on University Science Learning: Achieving Fluency in a Critical Constellation of Modes

    ERIC Educational Resources Information Center

    Airey, John; Linder, Cedric

    2009-01-01

    In this theoretical article we use an interpretative study with physics undergraduates to exemplify a proposed characterization of student learning in university science in terms of fluency in disciplinary discourse. Drawing on ideas from a number of different sources in the literature, we characterize what we call disciplinary discourse as the…

  4. Gifted University Males in a Greek Fraternity: Creating a Culture of Achievement

    ERIC Educational Resources Information Center

    Hebert,Thomas P.

    2006-01-01

    The gifted education community has called for more research examining gifted students during their collegiate experience. The study described in this article examined gifted university males involved in a Greek fraternity. Through a qualitative case study research design, the investigation examined the collegiate careers of 5 gifted,…

  5. Achieving Excellence: The University of Wisconsin System Accountability Report, 2001-02.

    ERIC Educational Resources Information Center

    Wisconsin Univ. System, Madison.

    This report presents information about the condition of the University of Wisconsin system (UW) and its progress toward educational excellence. The first section, "Context and Capacity," describes the environment and resources available to the UW system to fulfill its mission as a context for understanding progress on the six goals…

  6. Achieving a Net Zero Energy Retrofit: Lessons from the University of Hawaii at Manoa

    SciTech Connect

    2013-03-01

    The University of Hawaii at Manoa (UHM) partnered with the U.S. Department of Energy (DOE) to develop and implement solutions to retrofit existing buildings to reduce energy consumption by at least 30% as part of DOE’s Commercial Building Partnerships (CBP) Program.

  7. Marketing the Library in an On-Line University to Help Achieve Information Literacy

    ERIC Educational Resources Information Center

    Murphy, Jennifer

    2013-01-01

    An entrepreneurial librarian takes the embedded librarian concept one step further at a completely on-line university and markets the virtual library to students, faculty and administration rather than wait for customers to come to the library. York and Vance (2009) make the observation that "one obstacle to marketing an embedded librarian…

  8. New Right Students?: Exploring High Achieving British University Students' Discourses of Learning

    ERIC Educational Resources Information Center

    Canaan, Joyce E.

    2004-01-01

    This article describes the discourses working-class students at a university in Britain have about learning. The discourses include ideas about who is a good student, education as an investment, and marking. Students incorporate, in part, both neo-liberal and neo-conservative economic and political views into their perceptions of who should…

  9. Traditional Nets Interfere with the Uptake of Long-Lasting Insecticidal Nets in the Peruvian Amazon: The Relevance of Net Preference for Achieving High Coverage and Use

    PubMed Central

    Grietens, Koen Peeters; Muela Ribera, Joan; Soto, Veronica; Tenorio, Alex; Hoibak, Sarah; Aguirre, Angel Rosas; Toomer, Elizabeth; Rodriguez, Hugo; Llanos Cuentas, Alejandro; D'Alessandro, Umberto; Gamboa, Dionicia; Erhart, Annette

    2013-01-01

    Background While coverage of long-lasting insecticide-treated nets (LLIN) has steadily increased, a growing number of studies report gaps between net ownership and use. We conducted a mixed-methods social science study assessing the importance of net preference and use after Olyset® LLINs were distributed through a mass campaign in rural communities surrounding Iquitos, the capital city of the Amazonian region of Peru. Methods The study was conducted in the catchment area of the Paujil and Cahuide Health Centres (San Juan district) between July 2007 and November 2008. During a first qualitative phase, participant observation and in-depth interviews collected information on key determinants for net preference and use. In a second quantitative phase, a survey among recently confirmed malaria patients evaluated the acceptability and use of both LLINs and traditional nets, and a case control study assessed the association between net preference/use and housing structure (open vs. closed houses). Results A total of 10 communities were selected for the anthropological fieldwork and 228 households participated in the quantitative studies. In the study area, bed nets are considered part of the housing structure and are therefore required to fulfil specific architectural and social functions, such as providing privacy and shelter, which the newly distributed Olyset® LLINs ultimately did not. The LLINs' failure to meet these criteria could mainly be attributed to their large mesh size, transparency and perceived ineffectiveness to protect against mosquitoes and other insects, resulting in 63.3% of households not using any of the distributed LLINs. Notably, LLIN usage was significantly lower in houses with no interior or exterior walls (35.2%) than in those with walls (73.8%) (OR = 5.2, 95CI [2.2; 12.3], p<0.001). Conclusion Net preference can interfere with optimal LLIN use. In order to improve the number of effective days of LLIN protection per dollar spent

  10. Is the current prevention strategy based on vaccination coverage and epidemiological surveillance sufficient to achieve measles and rubella elimination in Europe?

    PubMed

    Plans-Rubio, Pedro

    2014-07-01

    Elimination of measles and rubella in Europe is a feasible objective, but it requires achieving a maintaining a high prevalence of protected individuals in order to prevent cases and outbreaks from imported cases. The epidemiology of measles and rubella in Europe in the period 2003-2013 suggests that we are far away from the elimination target for measles, while the situation is better for rubella. In this situation, a new preventive strategy based on serological surveillance systems should be developed in Europe in order to identify and immunise individuals in population groups without sufficient herd immunity against measles and rubella.

  11. India in search of right Universal Health Coverage (UHC) model: The risks of implementing UHC in the absence of political demand by the citizen

    PubMed Central

    Kumar, Raman; Roy, Pritam

    2016-01-01

    Amid the global push for Universal Health Coverage (UHC), the agenda is being set for India's health care. In the absence of a constitutional mandate, a national policy and citizen-led political demand for UHC, there exist specific risks in rushing toward its implementation in India. As the debate of UHC continues, the health-care delivery system in India is at cross roads. UHC in India could take two different trajectories. The first one takes India toward becoming “Global Bazaar” of morbidity and ill health, founded on the pillars of a vibrant rapidly multiplying healthcare industry. The other path takes India on a course of preventing wasteful, expensive health-care expenditure by maintaining healthy populations. A poor professional blood donor cannot become rich by selling his or her own blood beyond medically permissible levels; similarly, India cannot become a developed economy by merely allowing exploitation of disease, illness, and morbidity of her citizen. It is the duty of the state and governments to protect individual citizen, population under consideration, as well as country's economy from wasteful and potentially harmful expenditure incurred to address ill health. In the economic sense, any sensible UHC implementation mechanism would seek to regulate wasteful preventable health-care expenditure for the purpose of future economic stability and growth of the country. Due diligence toward safeguarding “public health in public interest,” during the process of UHC implementation, is the need of the hour. PMID:28217574

  12. India in search of right Universal Health Coverage (UHC) model: The risks of implementing UHC in the absence of political demand by the citizen.

    PubMed

    Kumar, Raman; Roy, Pritam

    2016-01-01

    Amid the global push for Universal Health Coverage (UHC), the agenda is being set for India's health care. In the absence of a constitutional mandate, a national policy and citizen-led political demand for UHC, there exist specific risks in rushing toward its implementation in India. As the debate of UHC continues, the health-care delivery system in India is at cross roads. UHC in India could take two different trajectories. The first one takes India toward becoming "Global Bazaar" of morbidity and ill health, founded on the pillars of a vibrant rapidly multiplying healthcare industry. The other path takes India on a course of preventing wasteful, expensive health-care expenditure by maintaining healthy populations. A poor professional blood donor cannot become rich by selling his or her own blood beyond medically permissible levels; similarly, India cannot become a developed economy by merely allowing exploitation of disease, illness, and morbidity of her citizen. It is the duty of the state and governments to protect individual citizen, population under consideration, as well as country's economy from wasteful and potentially harmful expenditure incurred to address ill health. In the economic sense, any sensible UHC implementation mechanism would seek to regulate wasteful preventable health-care expenditure for the purpose of future economic stability and growth of the country. Due diligence toward safeguarding "public health in public interest," during the process of UHC implementation, is the need of the hour.

  13. A community-based approach to non-communicable chronic disease management within a context of advancing universal health coverage in China: progress and challenges

    PubMed Central

    2014-01-01

    Paralleled with the rapid socio-economic development and demographic transition, an epidemic of non-communicable chronic diseases (NCDs) has emerged in China over the past three decades, resulting in increased disease and economic burdens. Over the past decade, with a political commitment of implementing universal health coverage, China has strengthened its primary healthcare system and increased investment in public health interventions. A community-based approach to address NCDs has been acknowledged and recognized as one of the most cost-effective solutions. Community-based strategies include: financial and health administrative support; social mobilization; community health education and promotion; and the use of community health centers in NCD detection, diagnosis, treatment, and patient management. Although China has made good progress in developing and implementing these strategies and policies for NCD prevention and control, many challenges remain. There are a lack of appropriately qualified health professionals at grass-roots health facilities; it is difficult to retain professionals at that level; there is insufficient public funding for NCD care and management; and NCD patients are economically burdened due to limited benefit packages covering NCD treatment offered by health insurance schemes. To tackle these challenges we propose developing appropriate human resource policies to attract greater numbers of qualified health professionals at the primary healthcare level; adjusting the service benefit packages to encourage the use of community-based health services; and increase government investment in public health interventions, as well as investing more on health insurance schemes. PMID:25082410

  14. A community-based approach to non-communicable chronic disease management within a context of advancing universal health coverage in China: progress and challenges.

    PubMed

    Xiao, Nanzi; Long, Qian; Tang, Xiaojun; Tang, Shenglan

    2014-01-01

    Paralleled with the rapid socio-economic development and demographic transition, an epidemic of non-communicable chronic diseases (NCDs) has emerged in China over the past three decades, resulting in increased disease and economic burdens. Over the past decade, with a political commitment of implementing universal health coverage, China has strengthened its primary healthcare system and increased investment in public health interventions. A community-based approach to address NCDs has been acknowledged and recognized as one of the most cost-effective solutions. Community-based strategies include: financial and health administrative support; social mobilization; community health education and promotion; and the use of community health centers in NCD detection, diagnosis, treatment, and patient management. Although China has made good progress in developing and implementing these strategies and policies for NCD prevention and control, many challenges remain. There are a lack of appropriately qualified health professionals at grass-roots health facilities; it is difficult to retain professionals at that level; there is insufficient public funding for NCD care and management; and NCD patients are economically burdened due to limited benefit packages covering NCD treatment offered by health insurance schemes. To tackle these challenges we propose developing appropriate human resource policies to attract greater numbers of qualified health professionals at the primary healthcare level; adjusting the service benefit packages to encourage the use of community-based health services; and increase government investment in public health interventions, as well as investing more on health insurance schemes.

  15. Challenges for regulating the private health services in India for achieving universal health care.

    PubMed

    Baru, Rama V

    2013-01-01

    Commercial interests pose a serious challenge for universalizing health-care. This is because "for-profit" health-care privileges individual responsibility and choice over principles of social solidarity. This fundamentally opposing tendency raises ethical dilemmas for designing a health service that is universal and equitable. It is an inadequate to merely state the need for regulating the private sector, the key questions relate to what must be done and how to do it. This paper identifies the challenges to regulating the private health services in India. It argues that regulation has been fragmented and largely driven by the center. Given the diversity of the private sector and health being a state subject, regulating this sector is fraught with the technical and socio-political factors.

  16. The importance of intersectoral factors in promoting equity-oriented universal health coverage: a multilevel analysis of social determinants affecting neonatal infant and under-five mortality in Bangladesh

    PubMed Central

    Huda, Tanvir M.; Tahsina, Tazeen; El Arifeen, Shams; Dibley, Michael J.

    2016-01-01

    Introduction Health is multidimensional and affected by a wide range of factors, many of which are outside the health sector. To improve population health and reduce health inequality, it is important that we take into account the complex interactions among social, environmental, behavioural, and biological factors and design our health interventions accordingly. Objectives This study examines mortality differentials in children of different age groups by key social determinants of health (SDH) including parental education and employment, mother's level of autonomy, age, asset index, living arrangements (utilities), and other geographical contextual factors (area of residence, road conditions). Design We used data from the two rounds of Bangladesh Health and Demographic Survey, a nationally representative sample survey of the population residing in Bangladesh. Multilevel logistic models were used to study the impact of SDH on child mortality. Results The study found that the mother's age, the education of both parents, the mother's autonomy to take decisions about matters linked to the health of her child, the household socio-economic conditions, the geographical region of residence, and the condition of the roads were significantly associated with higher risks of neonatal, infant, and under-five mortality in Bangladesh. Conclusion The study findings suggest there are complex relationships among different SDH. Thus larger intersectoral actions will be needed to reduce disparities in child health and mortality and achieve meaningful progress towards equity-oriented universal health coverage. PMID:26880153

  17. The importance of intersectoral factors in promoting equity-oriented universal health coverage: a multilevel analysis of social determinants affecting neonatal infant and under-five mortality in Bangladesh.

    PubMed

    Huda, Tanvir M; Tahsina, Tazeen; Arifeen, Shams El; Dibley, Michael J

    2016-01-01

    Introduction Health is multidimensional and affected by a wide range of factors, many of which are outside the health sector. To improve population health and reduce health inequality, it is important that we take into account the complex interactions among social, environmental, behavioural, and biological factors and design our health interventions accordingly. Objectives This study examines mortality differentials in children of different age groups by key social determinants of health (SDH) including parental education and employment, mother's level of autonomy, age, asset index, living arrangements (utilities), and other geographical contextual factors (area of residence, road conditions). Design We used data from the two rounds of Bangladesh Health and Demographic Survey, a nationally representative sample survey of the population residing in Bangladesh. Multilevel logistic models were used to study the impact of SDH on child mortality. Results The study found that the mother's age, the education of both parents, the mother's autonomy to take decisions about matters linked to the health of her child, the household socio-economic conditions, the geographical region of residence, and the condition of the roads were significantly associated with higher risks of neonatal, infant, and under-five mortality in Bangladesh. Conclusion The study findings suggest there are complex relationships among different SDH. Thus larger intersectoral actions will be needed to reduce disparities in child health and mortality and achieve meaningful progress towards equity-oriented universal health coverage.

  18. Personal Learning Environments (PLE) in the Academic Achievement of University Students

    ERIC Educational Resources Information Center

    Gallego, Maria Jesus; Gamiz, Vanesa Maria

    2014-01-01

    The main purpose of this research is to analyze the elements that compose the PLE of pre-service teachers and to determine whether the composition of these environments is related to academic achievement in a course on Information and Communication Technologies in Education. The hypothesis is that a PLE with more components is related to a higher…

  19. The Role of Teachers at University: What Do High Achiever Students Look for?

    ERIC Educational Resources Information Center

    Monteiro, Silvia; Almeida, Leandro S.; Vasconcelos, Rosa M.

    2012-01-01

    The perceptions of students about their teachers have interested the academic and scientific community, regarding the improvement of the quality of higher education. This paper presents data obtained from interviews conducted with ten high achiever engineering students and focuses on the characteristics of teachers that are highly valued by the…

  20. Universals and Specifics in Learning Strategies: Explaining Adolescent Mathematics, Science, and Reading Achievement across 34 Countries

    ERIC Educational Resources Information Center

    Chiu, Ming Ming; Chow, Bonnie Wing-Yin; Mcbride-Chang, Catherine

    2007-01-01

    We examined whether strategies of memorization, transfer through elaboration, and metacognition accounted for reading, science, and mathematics achievement across 34 countries. 158,848 fifteen-year-olds completed a reading literacy test and a questionnaire. Of these students, 88,401 completed a science test, and 88,590 completed a mathematics…

  1. Testing Multiple Goals Theory in an Asian Context: Filipino University Students' Motivation and Academic Achievement

    ERIC Educational Resources Information Center

    Dela Rosa, Elmer D.; Bernardo, Allan B. I.

    2013-01-01

    Achievement goals research has focused on the importance of mastery relative to performance goals, but the multiple goals perspective asserts that performance goals also lead to positive outcomes and that learners adopt multiple goals in adaptive ways. However, this multiple-goals perspective has not been extensively studied in Asian students. The…

  2. Brain Structure and Resting-State Functional Connectivity in University Professors with High Academic Achievement

    ERIC Educational Resources Information Center

    Li, Weiwei; Yang, Wenjing; Li, Wenfu; Li, Yadan; Wei, Dongtao; Li, Huimin; Qiu, Jiang; Zhang, Qinglin

    2015-01-01

    Creative persons play an important role in technical innovation and social progress. There is little research on the neural correlates with researchers with high academic achievement. We used a combined structural (regional gray matter volume, rGMV) and functional (resting-state functional connectivity analysis, rsFC) approach to examine the…

  3. Making Employee Recognition a Tool for Achieving Improved Performance: Implication for Ghanaian Universities

    ERIC Educational Resources Information Center

    Amoatemaa, Abena Serwaa; Kyeremeh, Dorcas Darkoah

    2016-01-01

    Many organisations are increasingly making use of employee recognition to motivate employees to achieve high performance and productivity. Research has shown that effective recognition occurs in organisations that have strong supportive culture, understand the psychology of praising employees for their good work, and apply the principles of…

  4. Effect of Foreign Language Classroom Anxiety on Turkish University Students' Academic Achievement in Foreign Language Learning

    ERIC Educational Resources Information Center

    Tuncer, Murat; Dogan, Yunus

    2015-01-01

    This study was carried out in order to identify to what extent the Turkish students' English classroom anxiety affects their academic achievement in English language. In this quantitative descriptive study, a correlational survey model was employed, and the convenience sampling was done. In order to collect data, the Foreign Language Classroom…

  5. Validity Studies Using the Comprehensive Ability Battery (CAB): IV. Predicting Achievement at the University Level.

    ERIC Educational Resources Information Center

    Hakstian, A. Ralph; Woolsey, Lorette K.

    1985-01-01

    The paper presented evidence of the criterion related validity of several Comprehensive Ability Battery (CAB) tests relative to criterion variables representing first year college achievement. Information regarding the criterion related validity of nontraditional tests of the CAB reflecting divergent production hypothesized to be associated with…

  6. Latina/o Achievement at Predominantly White Universities: The Importance of Culture and Ethnic Community

    ERIC Educational Resources Information Center

    Cerezo, Alison; Chang, Tai

    2013-01-01

    In this exploratory study, the authors examined the influence of cultural fit on the achievement of Latina/o college students by testing whether cultural integration factors (i.e., cultural congruity, ethnic identity, connection with ethnic minority peers) predict college GPA (grade point average). Participants were 113 Latina/o students enrolled…

  7. Comprehensive Coverage.

    ERIC Educational Resources Information Center

    Harrison, Mary M.

    2002-01-01

    Baltimore City students in high-risk neighborhoods are getting mental health help through programs provided by the University of Maryland, Johns Hopkins University, and community mental health agencies that work to reduce the stigma associated with mental health. Describes the national health crisis, the diagnosis dilemma, program components, and…

  8. [Achievement of educational goals among the trainees of obstetrics and gynaecology in the university of Turku].

    PubMed

    Mäkinen, Juha; Manninen, Sanna-Mari; Perheentupa, Antti; Lehto, Suvi

    2013-01-01

    This survey evaluates how the requirements in OB-GYN training are fulfilled in the University of Turku, Finland. We analysed the interventions and procedures performed by ten trainees who completed their specialisation between 2006 and 2009. The analysis was based on the EBCOG-Log Books. According to our survey the minimum requirements are better fulfilled in obstetrics compared to gynaecology. There is an imbalance between the EBCOG theoretical demand and practical performance of the trainees in gynaecology because of limited possibilities to perform traditional operations to the required extent. Consequently, gynaecological aspects in training need more resources and new alternative activities.

  9. Radioisotope radiotherapy research and achievements at the University of Missouri Research Reactor

    NASA Astrophysics Data System (ADS)

    Ehrhardt, G. J.; Ketring, A. R.; Cutler, C. S.

    2003-01-01

    The University of Missouri Research Reactor (MURR) in collaboration with faculty in other departments at the University of Missouri has been involved in developing new means of internal radioisotopic therapy for cancer for many years. These efforts have centered on methods of targeting radioisotopes such as brachytherapy, embolisation of liver tumors with radioactive microspheres, small-molecule-labelled chelates for the treatment of bone cancer, and various means of radioimmunotherapy or labelled receptor agent targeting. This work has produced two radioactive agents, Sm-153 Quadramet™ and Y-90 TheraSphere™, which have U.S. Food and Drug Administration approval for the palliation of bone cancer pain and treatment of inoperable liver cancer, respectively. MURR has also pioneered development of other beta-emitting isotopes for internal radiotherapy such as Re-186, Re-188, Rh-105, Ho-166, Lu-177, and Pm-149, many of which are in research and clinical trials throughout the U.S. and the world. This important work has been made possible by the very high neutron flux available at MURR combined with MURR's outstanding reliability of operation and flexibility in meeting the needs of researchers and the radiopharmaceutical industry.

  10. Perceived Academic Control and Academic Emotions Predict Undergraduate University Student Success: Examining Effects on Dropout Intention and Achievement.

    PubMed

    Respondek, Lisa; Seufert, Tina; Stupnisky, Robert; Nett, Ulrike E

    2017-01-01

    The present study addressed concerns over the high risk of university students' academic failure. It examined how perceived academic control and academic emotions predict undergraduate students' academic success, conceptualized as both low dropout intention and high achievement (indicated by GPA). A cross-sectional survey was administered to 883 undergraduate students across all disciplines of a German STEM orientated university. The study additionally compared freshman students (N = 597) vs. second-year students (N = 286). Using structural equation modeling, for the overall sample of undergraduate students we found that perceived academic control positively predicted enjoyment and achievement, as well as negatively predicted boredom and anxiety. The prediction of dropout intention by perceived academic control was fully mediated via anxiety. When taking perceived academic control into account, we found no specific impact of enjoyment or boredom on the intention to dropout and no specific impact of all three academic emotions on achievement. The multi-group analysis showed, however, that perceived academic control, enjoyment, and boredom among second-year students had a direct relationship with dropout intention. A major contribution of the present study was demonstrating the important roles of perceived academic control and anxiety in undergraduate students' academic success. Concerning corresponding institutional support and future research, the results suggested distinguishing incoming from advanced undergraduate students.

  11. Perceived Academic Control and Academic Emotions Predict Undergraduate University Student Success: Examining Effects on Dropout Intention and Achievement

    PubMed Central

    Respondek, Lisa; Seufert, Tina; Stupnisky, Robert; Nett, Ulrike E.

    2017-01-01

    The present study addressed concerns over the high risk of university students' academic failure. It examined how perceived academic control and academic emotions predict undergraduate students' academic success, conceptualized as both low dropout intention and high achievement (indicated by GPA). A cross-sectional survey was administered to 883 undergraduate students across all disciplines of a German STEM orientated university. The study additionally compared freshman students (N = 597) vs. second-year students (N = 286). Using structural equation modeling, for the overall sample of undergraduate students we found that perceived academic control positively predicted enjoyment and achievement, as well as negatively predicted boredom and anxiety. The prediction of dropout intention by perceived academic control was fully mediated via anxiety. When taking perceived academic control into account, we found no specific impact of enjoyment or boredom on the intention to dropout and no specific impact of all three academic emotions on achievement. The multi-group analysis showed, however, that perceived academic control, enjoyment, and boredom among second-year students had a direct relationship with dropout intention. A major contribution of the present study was demonstrating the important roles of perceived academic control and anxiety in undergraduate students' academic success. Concerning corresponding institutional support and future research, the results suggested distinguishing incoming from advanced undergraduate students. PMID:28326043

  12. [Study of the Consumers' preference on the universal health coverage development strategy through health mutual in Ziguinchor Region, Southwest of Senegal].

    PubMed

    Sagna, O; Seck, I; Dia, A T; Sall, F L; Diouf, S; Mendy, J; Ka, O; Kassoka, B

    2016-08-01

    In Senegal, the informal and rural sector that accounts for over 80% of the population is covered only up to 7% by a health insurance system. That is why, for the implementation of development strategy of the universal health coverage (UHC) through mutual health insurance providers, the Government of Senegal has focused on this sector. The objective of this study was to assess the consumer's preference on the UHC development strategies through mutual health insurance providers. This was a qualitative and exploratory study based on a literature review, and indepth interview with the heads of households. It was also based on focus groups of people with and without health mutual membership, and the Expert Committee meetings. The results showed that the most critical attributes in the decision-making of consumers to join the health mutual in Ziguinchor were the membership units; the content of the benefit package, the payment modalities of the premium, the premium amount, the availability of transportation, the co-payment level, convention arrangement with health facilities, and health mutual governance. For a successful implementation of the UHC development strategy through health mutual organizations, policymakers should explore the possibility of introducing the modality of payment in kind, the revision of the co-payment amount, and the promotion of equity through the introduction of a differentiated premium contribution by income. They should also establish a crossborder strategy with The Gambia and Guinea-Bissau to improve health care access to people living in the borders. The promotion of innovative funding and risk equalization between health insurance schemes is also recommended. In areas where the microfinance institutions are well organized and structured their substitution to health mutuals should be an option the decision-makers have to explore.

  13. University Students' Emotion During Online Search Task: A Multiple Achievement Goal Perspective.

    PubMed

    Zhou, Mingming

    2016-07-03

    Endorsing a multiple goal perspective, students' academic emotions were examined with different goal profiles while solving learning tasks online. One hundred and seven Chinese undergraduates were classified based on the 2 × 2 achievement goal framework into three groups: Mastery-approach-focused, Approach-oriented, and Avoidance-oriented group. Participants' emotional states were assessed immediately prior to the task and following the task. Prior to the task, the Avoidance-oriented group reported significantly higher levels of deactivated negative emotion (i.e., bored and confused) than the Approach-oriented group. The Mastery-approach-focused group reported significantly higher levels of activated positive emotions (i.e., excited and eager) than the Avoidance-oriented group after the task. Within each group, all three groups followed a similar emotion change pattern prior versus after the search task in deactivated positive emotion, with a significant increase. In addition, the Mastery-approach-focused group also reported a significantly higher level of happiness after completing the task, whereas the other two groups did not report much change. The Avoidance-oriented group also reported a significant drop in the feeling of excitement, eagerness, anxiety, and nervousness; whereas, the Approach-oriented group reported a significantly higher level of confusion after the task was finished. Implications of the findings are further discussed.

  14. Sideline Coverage

    PubMed Central

    Gould, Sara J.; Cardone, Dennis A.; Munyak, John; Underwood, Philipp J.; Gould, Stephen A.

    2014-01-01

    Context: Sidelines coverage presents unique challenges in the evaluation of injured athletes. Health care providers may be confronted with the question of when to obtain radiographs following an injury. Given that most sidelines coverage occurs outside the elite level, radiographs are not readily available at the time of injury, and the decision of when to send a player for radiographs must be made based on physical examination. Clinical tools have been developed to aid in identifying injuries that are likely to result in radiographically important fractures or dislocations. Evidence Acquisition: A search for the keywords x-ray and decision rule along with the anatomic locations shoulder, elbow, wrist, knee, and ankle was performed using the PubMed database. No limits were set regarding year of publication. We selected meta-analyses, randomized controlled trials, and survey results. Our selection focused on the largest, most well-studied published reports. We also attempted to include studies that reported the application of the rules to the field of sports medicine. Study Design: Retrospective literature review. Level of Evidence: Level 4. Results: The Ottawa Foot and Ankle Rules have been validated and implemented and are appropriate for use in both pediatric and adult populations. The Ottawa Knee Rules have been widely studied, validated, and accepted for evaluation of knee injuries. There are promising studies of decision rules for clinically important fractures of the wrist, but these studies have not been validated. The elbow has been evaluated with good outcomes via the elbow extension test, which has been validated in both single and multicenter studies. Currently, there are no reliable clinical decision tools for traumatic sports injuries to the shoulder to aid in the decision of when to obtain radiographs. Conclusion: Clinical decision tools have been developed to aid in the diagnosis and management of injuries commonly sustained during sporting events

  15. Leadership and culture of data governance for the achievement of higher education goals (Case study: Indonesia University of Education)

    NASA Astrophysics Data System (ADS)

    Putro, Budi Laksono; Surendro, Kridanto; Herbert

    2016-02-01

    Data is a vital asset in a business enterprise in achieving organizational goals. Data and information affect the decision-making process on the various activities of an organization. Data problems include validity, quality, duplication, control over data, and the difficulty of data availability. Data Governance is the way the company / institution manages its data assets. Data Governance covers the rules, policies, procedures, roles and responsibilities, and performance indicators that direct the overall management of data assets. Studies on governance data or information aplenty recommend the importance of cultural factors in the governance of research data. Among the organization's leadership culture has a very close relationship, and there are two concepts turn, namely: Culture created by leaders, leaders created by culture. Based on the above, this study exposure to the theme "Leadership and Culture Of Data Governance For The Achievement Of Higher Education Goals (Case Study: Indonesia University Of Education)". Culture and Leadership Model Development of on Higher Education in Indonesia would be made by comparing several models of data governance, organizational culture, and organizational leadership on previous studies based on the advantages and disadvantages of each model to the existing organizational business. Results of data governance model development is shown in the organizational culture FPMIPA Indonesia University Of Education today is the cultural market and desired culture is a culture of clan. Organizational leadership today is Individualism Index (IDV) (83.72%), and situational leadership on selling position.

  16. Poorer verbal working memory for a second language selectively impacts academic achievement in university medical students.

    PubMed

    Mann, Collette; Canny, Benedict J; Reser, David H; Rajan, Ramesh

    2013-01-01

    the relationship between language proficiency and verbal working memory (SNR50) using 5 variables of L2 proficiency, with the results showing that the variance in SNR50 was significantly predicted by this model (r (2) = 0.335). Hierarchical multiple regression was then used to test the ability of three independent variable measures (SNR50, age of acquisition of English and English proficiency) to predict academic performance as the dependent variable in a factor analysis model which predicted significant performance differences in an assessment requiring communications skills (p = 0.008), but not on a companion assessment requiring knowledge of procedural skills, or other assessments requiring factual knowledge. Thus, impaired vWM for an L2 appears to affect specific communications-based assessments in university medical students.

  17. Poorer verbal working memory for a second language selectively impacts academic achievement in university medical students

    PubMed Central

    Canny, Benedict J.; Reser, David H.; Rajan, Ramesh

    2013-01-01

    assess the relationship between language proficiency and verbal working memory (SNR50 ) using 5 variables of L2 proficiency, with the results showing that the variance in SNR50 was significantly predicted by this model (r2 = 0.335). Hierarchical multiple regression was then used to test the ability of three independent variable measures (SNR50 , age of acquisition of English and English proficiency) to predict academic performance as the dependent variable in a factor analysis model which predicted significant performance differences in an assessment requiring communications skills (p = 0.008), but not on a companion assessment requiring knowledge of procedural skills, or other assessments requiring factual knowledge. Thus, impaired vWM for an L2 appears to affect specific communications-based assessments in university medical students. PMID:23638357

  18. Identification and analysis of labor productivity components based on ACHIEVE model (case study: staff of Kermanshah University of Medical Sciences).

    PubMed

    Ziapour, Arash; Khatony, Alireza; Kianipour, Neda; Jafary, Faranak

    2014-12-15

    Identification and analysis of the components of labor productivity based on ACHIEVE model was performed among employees in different parts of Kermanshah University of Medical Sciences in 2014. This was a descriptive correlational study in which the population consisted of 270 working personnel in different administrative groups (contractual, fixed- term and regular) at Kermanshah University of Medical Sciences (872 people) that were selected among 872 people through stratified random sampling method based on Krejcie and Morgan sampling table. The survey tool included labor productivity questionnaire of ACHIEVE. Questionnaires were confirmed in terms of content and face validity, and their reliability was calculated using Cronbach's alpha coefficient. The data were analyzed by SPSS-18 software using descriptive and inferential statistics. The mean scores for labor productivity dimensions of the employees, including environment (environmental fit), evaluation (training and performance feedback), validity (valid and legal exercise of personnel), incentive (motivation or desire), help (organizational support), clarity (role perception or understanding), ability (knowledge and skills) variables and total labor productivity were 4.10±0.630, 3.99±0.568, 3.97±0.607, 3.76±0.701, 3.63±0.746, 3.59±0.777, 3.49±0.882 and 26.54±4.347, respectively. Also, the results indicated that the seven factors of environment, performance assessment, validity, motivation, organizational support, clarity, and ability were effective in increasing labor productivity. The analysis of the current status of university staff in the employees' viewpoint suggested that the two factors of environment and evaluation, which had the greatest impact on labor productivity in the viewpoint of the staff, were in a favorable condition and needed to be further taken into consideration by authorities.

  19. English Language Proficiency Tests and Academic Achievement: A Study on the Malaysian University English Test as a Predictor of Technical Programme Undergraduates Academic Achievement

    ERIC Educational Resources Information Center

    Min, Lau Sing; Sungif, Nur Atiqah Md.; Yusup, Farah Nabillah Mior

    2015-01-01

    In the Malaysian education system, English has always played an important role. In acknowledging its importance, Malaysian University English Test (MUET) has been introduced to enable continued emphasis on this role. MUET has been made compulsory for those who wish to pursue a first degree programme in local universities. This study aims to…

  20. Universal patterns or the tale of two systems? Mathematics achievement and educational expectations in post-socialist Europe.

    PubMed

    Bodovski, Katerina; Kotok, Stephen; Henck, Adrienne

    2014-09-01

    Although communist ideology claimed to destroy former class stratification based on labor market capitalist relationships, de facto during socialism one social class hierarchy was substituted for another that was equally unequal. The economic transition during the 1990s increased stratification by wealth, which affected educational inequality. This study examines the relationships among parental education, gender, educational expectations, and mathematics achievement of youths in five post-socialist Eastern European countries, comparing them with three Western countries. We employed the 8(th)-grade data from the Trends in International Mathematics and Science Study (TIMSS) 1995 and 2007. The findings point to the universal associations between parental education and student outcomes, whereas gender comparisons present interesting East-West differences. The theoretical and policy implications of these findings are discussed.

  1. Universal patterns or the tale of two systems? Mathematics achievement and educational expectations in post-socialist Europe

    PubMed Central

    Bodovski, Katerina; Kotok, Stephen; Henck, Adrienne

    2014-01-01

    Although communist ideology claimed to destroy former class stratification based on labor market capitalist relationships, de facto during socialism one social class hierarchy was substituted for another that was equally unequal. The economic transition during the 1990s increased stratification by wealth, which affected educational inequality. This study examines the relationships among parental education, gender, educational expectations, and mathematics achievement of youths in five post-socialist Eastern European countries, comparing them with three Western countries. We employed the 8th-grade data from the Trends in International Mathematics and Science Study (TIMSS) 1995 and 2007. The findings point to the universal associations between parental education and student outcomes, whereas gender comparisons present interesting East-West differences. The theoretical and policy implications of these findings are discussed. PMID:25346564

  2. The Relation between Finnish University Students' Perceived Level of Study-Related Burnout, Perceptions of the Teaching-Learning Environment and Perceived Achievement Motivation

    ERIC Educational Resources Information Center

    Meriläinen, Matti; Kuittinen, Matti

    2014-01-01

    This study examined the relation between university students' perceived level of study-related burnout (SRB) and their perceptions of the teaching-learning environment (TLE), as well as their perceived achievement motivation (AM). The data are based on a survey of nine Finnish universities in the spring of 2009. Altogether, 3035 university…

  3. Feelings and Performance in the First Year at University: Learning-Related Emotions as Predictors of Achievement Outcomes in Mathematics and Statistics

    ERIC Educational Resources Information Center

    Niculescu, Alexandra C.; Templelaar, Dirk; Leppink, Jimmie; Dailey-Hebert, Amber; Segers, Mien; Gijselaers, Wim

    2015-01-01

    Introduction: This study examined the predictive value of four learning-related emotions--Enjoyment, Anxiety, Boredom and Hopelessness for achievement outcomes in the first year of study at university. Method: We used a large sample (N = 2337) of first year university students enrolled over three consecutive academic years in a mathematics and…

  4. Women in Leadership: Factors That Affect the Achievement of Women in Higher Education Administration at Four-Year Public and Private Universities in Texas

    ERIC Educational Resources Information Center

    Ramirez, Dawn Marie

    2012-01-01

    The purpose of this quantitative study was to examine the factors that affect women administrators in higher education at four-year public and private universities in Texas. By comparing private and public universities, the research provided an assessment of similarities and differences of the factors impacting achievement of women in higher…

  5. The differential impact of academic self-regulatory methods on academic achievement among university students with and without learning disabilities.

    PubMed

    Ruban, Lilia M; McCoach, D Betsy; McGuire, Joan M; Reis, Sally M

    2003-01-01

    Although research on academic self-regulation has proliferated in recent years, no studies have investigated the question of whether the perceived usefulness and the use of standard self-regulated learning strategies and compensation strategies provide a differential prediction of academic achievement for university students with and without learning disabilities (LD). We developed and tested a model explaining interrelationships among self-regulatory variables and grade point average (GPA) using structural equation modeling and multiple group analysis for students with LD (n = 53) and without LD (n = 421). Data were gathered using a new instrument, the Learning Strategies and Study Skills survey. The results of this study indicate that students with LD differed significantly from students without LD in the relationships between their motivation for and use of standard self-regulated learning strategies and compensation strategies, which in turn provided a differential explanation of academic achievement for students with and without LD. These paths of influence and idiosyncrasies of academic self-regulation among students with LD were interpreted in terms of social cognitive theory, metacognitive theory, and research conducted in the LD field.

  6. Increasing immunization coverage.

    PubMed

    Hammer, Lawrence D; Curry, Edward S; Harlor, Allen D; Laughlin, James J; Leeds, Andrea J; Lessin, Herschel R; Rodgers, Chadwick T; Granado-Villar, Deise C; Brown, Jeffrey M; Cotton, William H; Gaines, Beverly Marie Madry; Gambon, Thresia B; Gitterman, Benjamin A; Gorski, Peter A; Kraft, Colleen A; Marino, Ronald Vincent; Paz-Soldan, Gonzalo J; Zind, Barbara

    2010-06-01

    In 1977, the American Academy of Pediatrics issued a statement calling for universal immunization of all children for whom vaccines are not contraindicated. In 1995, the policy statement "Implementation of the Immunization Policy" was published by the American Academy of Pediatrics, followed in 2003 with publication of the first version of this statement, "Increasing Immunization Coverage." Since 2003, there have continued to be improvements in immunization coverage, with progress toward meeting the goals set forth in Healthy People 2010. Data from the 2007 National Immunization Survey showed that 90% of children 19 to 35 months of age have received recommended doses of each of the following vaccines: inactivated poliovirus (IPV), measles-mumps-rubella (MMR), varicella-zoster virus (VZB), hepatitis B virus (HBV), and Haemophilus influenzae type b (Hib). For diphtheria and tetanus and acellular pertussis (DTaP) vaccine, 84.5% have received the recommended 4 doses by 35 months of age. Nevertheless, the Healthy People 2010 goal of at least 80% coverage for the full series (at least 4 doses of DTaP, 3 doses of IPV, 1 dose of MMR, 3 doses of Hib, 3 doses of HBV, and 1 dose of varicella-zoster virus vaccine) has not yet been met, and immunization coverage of adolescents continues to lag behind the goals set forth in Healthy People 2010. Despite these encouraging data, a vast number of new challenges that threaten continued success toward the goal of universal immunization coverage have emerged. These challenges include an increase in new vaccines and new vaccine combinations as well as a significant number of vaccines currently under development; a dramatic increase in the acquisition cost of vaccines, coupled with a lack of adequate payment to practitioners to buy and administer vaccines; unanticipated manufacturing and delivery problems that have caused significant shortages of various vaccine products; and the rise of a public antivaccination movement that uses the

  7. Metacognitive Reading and Study Strategies and Academic Achievement of University Students With and Without a History of Reading Difficulties.

    PubMed

    Bergey, Bradley W; Deacon, S Hélène; Parrila, Rauno K

    2017-01-01

    University students who report a history of reading difficulties have been demonstrated to have poorer word reading and reading comprehension skills than their peers; yet, without a diagnosed learning disability, these students do not have access to the same support services, potentially placing them at academic risk. This study provides a comprehensive investigation of first-year academic achievement for students with a history of reading difficulties (n = 244) compared to students with no such history (n = 603). We also examine reported use of metacognitive reading and study strategies and their relations with GPA. Results indicate that students with a history of reading difficulties earn lower GPA and successfully complete fewer credits compared to students with no history of reading difficulty. These patterns varied somewhat by faculty of study. Students with a history of reading difficulties also reported lower scores across multiple metacognitive reading and study strategy scales, yet these scores were not associated with their academic performance. Together, these results demonstrate the importance of identifying students with a history of reading difficulties and that commonly used study strategy inventories have limited value in predicting their academic success.

  8. Male Saudi Arabian freshman science majors at Jazan University: Their perceptions of parental educational practices on their science achievements

    NASA Astrophysics Data System (ADS)

    Alrehaly, Essa D.

    Examination of Saudi Arabian educational practices is scarce, but increasingly important, especially in light of the country's pace in worldwide mathematics and science rankings. The purpose of the study is to understand and evaluate parental influence on male children's science education achievements in Saudi Arabia. Parental level of education and participant's choice of science major were used to identify groups for the purpose of data analysis. Data were gathered using five independent variables concerning parental educational practices (attitude, involvement, autonomy support, structure and control) and the dependent variable of science scores in high school. The sample consisted of 338 participants and was arbitrarily drawn from the science-based colleges (medical, engineering, and natural science) at Jazan University in Saudi Arabia. The data were tested using Pearson's analysis, backward multiple regression, one way ANOVA and independent t-test. The findings of the study reveal significant correlations for all five of the variables. Multiple regressions revealed that all five of the parents' educational practices indicators combined together could explain 19% of the variance in science scores and parental attitude toward science and educational involvement combined accounted for more than 18% of the variance. Analysis indicates that no significant difference is attributable to parental involvement and educational level. This finding is important because it indicates that, in Saudi Arabia, results are not consistent with research in Western or other Asian contexts.

  9. Sustainable energy for all. Technical report of task force 1 in support of the objective to achieve universal access to modern energy services by 2030

    SciTech Connect

    Birol, Fatih

    2012-04-15

    The UN Secretary General established the Sustainable Energy for All initiative in order to guide and support efforts to achieve universal access to modern energy, rapidly increase energy efficiency, and expand the use of renewable energies. Task forces were formed involving prominent energy leaders and experts from business, government, academia and civil society worldwide. The goal of the Task Forces is to inform the implementation of the initiative by identifying challenges and opportunities for achieving its objectives. This report contains the findings of Task Force One which is dedicated to the objective of achieving universal access to modern energy services by 2030. The report shows that universal energy access can be realized by 2030 with strong, focused actions set within a coordinated framework.

  10. Graduate Management Admission Test Outcomes and the Academic Achievement: A Study on Masters of Business Administration Students at Makerere University, Uganda

    ERIC Educational Resources Information Center

    Wamala, Robert; Kizito, Saint Omala; Kakumba, Umar

    2012-01-01

    This study investigates whether the outcomes of the Graduate Management Admission Test (GMAT) can predict the academic achievement of enrollees in masters programs. The study is based on administrative data of 516 Masters of Business Administration (MBA) enrollees at the College of Business and Management Science, Makerere University in the 2011…

  11. Exploring the Nexus between Community Cultural Wealth and the Academic and Social Experiences of Latino Male Achievers at Two Predominantly White Research Universities

    ERIC Educational Resources Information Center

    Pérez, David, II

    2014-01-01

    Latino males are grossly underrepresented at four-year postsecondary institutions in the United States. This phenomenological study seeks to address this emergent educational crisis by focusing on the experiences of two Latino male achievers at predominantly White research universities. Community Cultural Wealth is used to explore how Latino male…

  12. Binary Logistic Regression Analysis in Assessment and Identifying Factors That Influence Students' Academic Achievement: The Case of College of Natural and Computational Science, Wolaita Sodo University, Ethiopia

    ERIC Educational Resources Information Center

    Zewude, Bereket Tessema; Ashine, Kidus Meskele

    2016-01-01

    An attempt has been made to assess and identify the major variables that influence student academic achievement at college of natural and computational science of Wolaita Sodo University in Ethiopia. Study time, peer influence, securing first choice of department, arranging study time outside class, amount of money received from family, good life…

  13. The Effects of Individually Prescribed Instruction on Achievement, Self-Concept and Study Orientation Among Engineering Students Enrolled in English Composition at Oklahoma State University.

    ERIC Educational Resources Information Center

    Minars, Edward J.

    This study was concerned with a description of the Pre-Professional Individually Prescribed Instructional (PIPI) model introduced into the curriculum of the College of Engineering at Oklahoma State University and its relationship with achievement, self-concept, and study orientation among freshmen engineering students enrolled in Freshman English…

  14. Integrating Mobile Phones into the EFL Foundation Year Classroom in King Abdulaziz University/KSA: Effects on Achievement in General English and Students' Attitudes

    ERIC Educational Resources Information Center

    Khrisat, Abdulhafeth A.; Mahmoud, Salameh Saleem

    2013-01-01

    This study investigates the effect of ten teaching English as a foreign language (TEFL) oriented features of mobile phones in the English language classroom on the achievement of foundation-year students in King Abdulaziz University (KAU) in General English. The study also explores students' attitudes towards this new method of teaching. The study…

  15. Foreign Language Learners' Motivation and Its Effects on Their Achievement: Implications for Effective Teaching of Students Studying Japanese at Universiti Brunei Darussalam

    ERIC Educational Resources Information Center

    Keaney, Minako; Mundia, Lawrence

    2014-01-01

    An increasing number of students at the University of Brunei Darussalam are studying the Japanese language. However, research on the relationship between learners' motivation and their achievement has not been given sufficient attention in Japanese foreign language education compared to English in Brunei. The present study, which utilized a…

  16. Summary Findings from a Preliminary Study of Black Student Adjustment, Achievement and Aspirations at the University of Michigan (Ann Arbor), Winter, 1980. Pretest of a National Study.

    ERIC Educational Resources Information Center

    Allen, Walter R.

    Adjustments, achievements, and aspirations of black undergraduates attending the University of Michigan were studied with a focus on characteristics correlating highly with black student continuance and successful matriculation. Questionnaire responses from 229 black undergraduates at the Ann Arbor campus provided information on: family…

  17. Mathematics, Race, and Space: An Investigation into the Construction of Mathematics Achievement Identities of Black Undergraduate Students at the University of Virginia

    ERIC Educational Resources Information Center

    McClain, Oren Leondus

    2011-01-01

    The purpose of this study was to investigate the phenomenon of the ways in which Black undergraduate students, majoring in mathematics intensive disciplines, at the University of Virginia construct mathematics achievement identities. Specifically, this study sought to identify and examine factors that impacted these students' identity construction…

  18. Chinese International Undergraduate Students at a U.S. University: A Mixed Methods Study of First-Year Academic Experiences and Achievement

    ERIC Educational Resources Information Center

    Ma, Wei

    2014-01-01

    The purpose of this study was to explore the first-year academic experiences and achievement of Chinese international undergraduate students in American higher education. To do so, I tracked a cohort of Chinese international undergraduates through their first-year at a public research university in the United States. Both qualitative and…

  19. Drug Plan Coverage Rules

    MedlinePlus

    ... Medication Therapy Management programs Drug plan coverage rules , current page Using your drug plan for the first time Filling a prescription without your new plan card Costs for Medicare drug coverage Joining a health or ...

  20. Proton Therapy Coverage for Prostate Cancer Treatment

    SciTech Connect

    Vargas, Carlos Wagner, Marcus; Mahajan, Chaitali; Indelicato, Daniel; Fryer, Amber; Falchook, Aaron; Horne, David C.; Chellini, Angela; McKenzie, Craig C.; Lawlor, Paula C.; Li Zuofeng; Lin Liyong; Keole, Sameer

    2008-04-01

    Purpose: To determine the impact of prostate motion on dose coverage in proton therapy. Methods and Materials: A total of 120 prostate positions were analyzed on 10 treatment plans for 10 prostate patients treated using our low-risk proton therapy prostate protocol (University of Florida Proton Therapy Institute 001). Computed tomography and magnetic resonance imaging T{sub 2}-weighted turbo spin-echo scans were registered for all cases. The planning target volume included the prostate with a 5-mm axial and 8-mm superoinferior expansion. The prostate was repositioned using 5- and 10-mm one-dimensional vectors and 10-mm multidimensional vectors (Points A-D). The beam was realigned for the 5- and 10-mm displacements. The prescription dose was 78 Gy equivalent (GE). Results: The mean percentage of rectum receiving 70 Gy (V{sub 70}) was 7.9%, the bladder V{sub 70} was 14.0%, and the femoral head/neck V{sub 50} was 0.1%, and the mean pelvic dose was 4.6 GE. The percentage of prostate receiving 78 Gy (V{sub 78}) with the 5-mm movements changed by -0.2% (range, 0.006-0.5%, p > 0.7). However, the prostate V{sub 78} after a 10-mm displacement changed significantly (p < 0.003) with different movements: 3.4% (superior), -5.6% (inferior), and -10.2% (posterior). The corresponding minimal doses were also reduced: 4.5 GE, -4.7 GE, and -11.7 GE (p {<=} 0.003). For displacement points A-D, the clinical target volume V{sub 78} coverage had a large and significant reduction of 17.4% (range, 13.5-17.4%, p < 0.001) in V{sub 78} coverage of the clinical target volume. The minimal prostate dose was reduced 33% (25.8 GE), on average, for Points A-D. The prostate minimal dose improved from 69.3 GE to 78.2 GE (p < 0.001) with realignment for 10-mm movements. Conclusion: The good dose coverage and low normal doses achieved for the initial plan was maintained with movements of {<=}5 mm. Beam realignment improved coverage for 10-mm displacements.

  1. School Distribution as Keep-Up Strategy to Maintain Universal Coverage of Long-Lasting Insecticidal Nets: Implementation and Results of a Program in Southern Tanzania

    PubMed Central

    Lalji, Shabbir; Ngondi, Jeremiah M; Thawer, Narjis G; Tembo, Autman; Mandike, Renata; Mohamed, Ally; Chacky, Frank; Mwalimu, Charles D; Greer, George; Kaspar, Naomi; Kramer, Karen; Mlay, Bertha; Issa, Kheri; Lweikiza, Jane; Mutafungwa, Anold; Nzowa, Mary; Willilo, Ritha A; Nyoni, Waziri; Dadi, David; Ramsan, Mahdi M; Reithinger, Richard; Magesa, Stephen M

    2016-01-01

    ABSTRACT Tanzania successfully scaled up coverage of long-lasting insecticidal nets (LLINs) through mass campaigns. To sustain these gains, a school-based approach was piloted in the country’s Southern Zone starting in 2013, called the School Net Program 1 (SNP1). We report on the design, implementation, monitoring, and outputs of the second round (SNP2) undertaken in 2014. SNP2 was conducted in all schools in Lindi, Mtwara, and Ruvuma regions, targeting students in primary (Standards 1, 3, 5, and 7) and secondary (Forms 2 and 4) schools and all teachers. In Lindi region, 2 additional classes (Standards 2 and 4) were targeted. LLIN distribution data were managed using an Android software application called SchoolNet. SNP2 included 2,337 schools, 473,700 students, and 25,269 teachers. A total of 5,070 people were trained in LLIN distribution (487 trainers and 4,583 distributors), and 4,392 (434 ward and 3,958 village) community change agents undertook sensitization and mobilization. A total of 507,775 LLINs were distributed to schools, with 464,510 (97.9% of those registered) students and 24,206 (95.8% of those registered) school teachers receiving LLINs. LLIN ownership and use is expected to have increased, potentially further reducing the burden of malaria in the Southern Zone of Tanzania. PMID:27353618

  2. Leadership Ability and Achieving Styles among Student-Athletes at a NCAA-II University in the Northeast United States

    ERIC Educational Resources Information Center

    Nigro, Mary Theresa

    2012-01-01

    This study examined student-athletes' self-reported leadership ability and achieving styles. It analyzed leadership ability and achieving style preferences as they related to gender, class status, ethnicity, and sport classification: individual-sport vs. team-sport athletes. A paper and pencil survey consisting of a composite variable of six…

  3. The Relationship between Homework Time and Achievement Is Not Universal: Evidence from Multilevel Analyses in 40 Countries

    ERIC Educational Resources Information Center

    Dettmers, Swantje; Trautwein, Ulrich; Ludtke, Oliver

    2009-01-01

    Although homework is generally believed to be an important supplement to in-school learning, research has not yet fully clarified the relationship between homework and achievement. This cross-cultural study analyzed the relationship between homework time and mathematics achievement drawing on data from 231,759 students in 9,791 schools and 40…

  4. A Comparison of the Academic Experiences and Achievement of University Students Entering by Traditional and Non-Traditional Means.

    ERIC Educational Resources Information Center

    Cantwell, Robert; Archer, Jennifer; Bourke, Sid

    2001-01-01

    Analysis of three years of student records revealed a marginal disadvantage in academic performance for students entering the University of Newcastle via three different non-traditional enabling programs (findings differed by program), but a positive effect on academic performance of mature age on entry. (EV)

  5. Impact of Learned Resourcefulness and Theories of Intelligence on Academic Achievement of University Students: An Integrated Approach

    ERIC Educational Resources Information Center

    Kennett, Deborah J.; Keefer, Kateryna

    2006-01-01

    This was the first study to integrate Rosenbaum's concept of learned resourcefulness with Dweck's implicit theories of intelligence in predicting university students' academic self-control behaviour and year-end grades. Rosenbaum highlights the prominent role that learned resourcefulness skills play in promoting mastery responses and goal…

  6. A Model for Improving the Retention and Academic Achievement of Non-Traditional Students at Livingston College/Rutgers University.

    ERIC Educational Resources Information Center

    Marshall, Judith S.

    A program for nontraditional students is described that was implemented at Livingston College/Rutgers University during the fall 1980 semester. The Freshman Studies Program (FSP) had two purposes: (1) to provide a more supportive structure and environment for developmental studies students and (2) to facilitate efforts to both deliver services and…

  7. Metacognitive Reading and Study Strategies and Academic Achievement of University Students with and without a History of Reading Difficulties

    ERIC Educational Resources Information Center

    Bergey, Bradley W.; Deacon, S. Hélène; Parrila, Rauno K.

    2017-01-01

    University students who report a history of reading difficulties have been demonstrated to have poorer word reading and reading comprehension skills than their peers; yet, without a diagnosed learning disability, these students do not have access to the same support services, potentially placing them at academic risk. This study provides a…

  8. Academic Resilience and Achievement: Self-Motivational Resources That Guide Faculty Participation in Instructional Technology Training at a Mexican University

    ERIC Educational Resources Information Center

    Montero-Hernandez, Virginia; Levin, John; Diaz-Castillo, Maribel

    2014-01-01

    This study uses narrative analysis to understand the ways in which Mexican university faculty members used their self-motivational resources to persist in an instructional technology training program within adverse work conditions. The methodology included interviews and participant observation. Findings suggest that faculty's academic resilience…

  9. The Labour Market Perceptions of High Achieving UK University Graduates: The Role of the First Class Credential

    ERIC Educational Resources Information Center

    Smetherham, Claire

    2006-01-01

    This article reports the main findings of research examining the labour market perceptions, orientations and experiences of UK university graduates with First Class Honours degrees, the UK's highest level of degree classification. Drawing on qualitative data from interviews with 50 graduates holding a First Class degree, it explores how they…

  10. Toward a State of Learning (Achieving the Vision III). Strategic Planning for the University of Maryland System.

    ERIC Educational Resources Information Center

    Maryland Univ. System Administration, Adelphi.

    This report provides an overview of the challenges facing the University of Maryland System (UMS) institutions in the coming years and of strategic planning efforts that administrators and faculty must take to meet these challenges. By the year 2002, UMS will need to increase enrollment by 20 percent, increase productivity by 20 percent, and…

  11. Examination Management as a Way of Achieving Quality Assurance in ODL Institutions: The Case of Zimbabwe Open University

    ERIC Educational Resources Information Center

    Mafa, Onias; Gudhlanga, Enna Sukutai

    2012-01-01

    An examination is an important component of any institution that educates people. It is a form of assessment used to measure the students' understanding of the concepts and principles they would have learnt. Zimbabwe Open University, an Open and Distance Learning institution has been setting its own examinations for the academic programmes…

  12. Achieving E-learning with IMS Learning Design--Workflow Implications at the Open University of the Netherlands

    ERIC Educational Resources Information Center

    Westera, Wim; Brouns, Francis; Pannekeet, Kees; Janssen, Jose; Manderveld, Jocelyn

    2005-01-01

    This paper uses the Open University of the Netherlands as an instructive case for the introduction of e-learning based on the IMS Learning Design specification (IMS LD). The IMS LD specification, as approved by the IMS Global Learning Consortium in 2003, enables the specification and encoding of learning scenarios that describe any design of a…

  13. [Implementation of medical specialists brigades in the areas of Universal Health coverage: the Peruvian Ministry of Health experience, 2009-2010].

    PubMed

    Barzola-Cordero, Violeta; Llamosas, Ena; Echegaray, Ciro; Cuzco, María; Peralta, Felipe

    2011-06-01

    Peru has a high degree of inequity reflected in the distribution of morbidity and mortality, consistent with the inaccessibility to health care and human resource gap, especially in remote areas of the capital. The Peruvian Ministry of Health, recognizing the right of all people to quality health care, initiated the Universal Health Insurance (AUS), and in this context, increased access to specialized care in pilot AUS areas by brigades of specialist doctors. This article offers an approach to this strategy presents the management and implementation processes, a quantitative analysis with indicators of output / efficiency, and provides a qualitative look from the perspective of the members of the brigades. Its main findings reflect the lack of effective and efficient management, translated in the absence of: production goals, work plans, working partnerships with local stakeholders, monitoring and effective supervision, recurrent shortages of human and technological resources, and high costs.

  14. The Effects of Faculty Behaviors on the Academic Achievement of First-Year Cambodian Urban University Students

    ERIC Educational Resources Information Center

    Heng, Kreng

    2014-01-01

    Research on the faculty impact on students' academic achievement has been disproportionately confined to the context of countries with developed higher education systems. Few studies have been undertaken in the developing world like Cambodia. This study employed hierarchical linear modeling to examine the relationships between faculty behaviors…

  15. The Use of a Mobile Learning Management System at an Online University and Its Effect on Learning Satisfaction and Achievement

    ERIC Educational Resources Information Center

    Shin, Won Sug; Kang, Minseok

    2015-01-01

    This study investigates online students' acceptance of mobile learning and its influence on learning achievement using an information system success and extended technology acceptance model (TAM). Structural equation modeling was used to test the structure of individual, social, and systemic factors influencing mobile learning's acceptance, and…

  16. Explaining the Success of High-Achieving 2nd-Generation Latino Students at Elite Colleges and Universities

    ERIC Educational Resources Information Center

    Kula, Stacy M.

    2013-01-01

    Latinos represent the largest minority population in the US, yet are one of the most underserved groups in the educational system. As such, they have been the focus of much attention by educational researchers. However, there is little work enabling researchers to understand how many factors might interactively support achievement. Moreover, the…

  17. Social and Cultural Capital: Underlying Factors and Their Relationship with the School Achievement of Iranian University Students

    ERIC Educational Resources Information Center

    Khodadady, Ebrahim; Zabihi, Reza

    2011-01-01

    This study explored the relationship between social and cultural capital and school achievement by developing, administering and validating a 35-statement questionnaire to 403 undergraduate and graduate students majoring in Teaching English as a foreign language and Persian Language and Literature and correlating their extracted factors with the…

  18. Investigating the Relationship among Test Anxiety, Gender, Academic Achievement and Years of Study: A Case of Iranian EFL University Students

    ERIC Educational Resources Information Center

    Rezazadeh, Mohsen; Tavakoli, Mansoor

    2009-01-01

    The construct of anxiety plays a major role in one's life. One of these anxieties is test anxiety or apprehension over academic evaluation. The present study was designed to investigate the relationship between gender, academic achievement, years of study and levels of test anxiety. This investigation is a descriptive analytic study and was done…

  19. Male Saudi Arabian Freshman Science Majors at Jazan University: Their Perceptions of Parental Educational Practices on Their Science Achievements

    ERIC Educational Resources Information Center

    Alrehaly, Essa D.

    2012-01-01

    Examination of Saudi Arabian educational practices is scarce, but increasingly important, especially in light of the country's pace in worldwide mathematics and science rankings. The purpose of the study is to understand and evaluate parental influence on male children's science education achievements in Saudi Arabia. Parental level of education…

  20. Examination of Foreign Language Classroom Anxiety and Achievement in Foreign Language in Turkish University Students in Terms of Various Variables

    ERIC Educational Resources Information Center

    Dogan, Yunus; Tuncer, Murat

    2016-01-01

    This correlational survey study aimed to investigate whether the Turkish prep-class students' foreign language classroom anxiety levels and foreign language achievement significantly differ in terms of such variables as their gender, their experience abroad, perceived level of income and any third language (other than Turkish and English) they…

  1. Type of dyslipidemia and achievement of the LDL-cholesterol goal in chronic kidney disease patients at the University Hospital

    PubMed Central

    Sangsawang, Tamon; Sriwijitkamol, Apiradee

    2015-01-01

    Background Chronic kidney disease (CKD) has been defined as a coronary artery disease risk equivalent. Therefore, the current guideline has been recommended for CKD patients to reach and maintain a low-density lipoprotein-cholesterol (LDL-C) goal of less than 100 mg/dL. However, the data regarding the achievement of LDL-C goal in these patients is lacking. Objective This study was conducted to evaluate the types of dyslipidemia affecting patients with CKD stages 3 and 4 and to determine whether these patients achieved LDL-C goal. Methods We performed a retrospective chart review of patients with CKD stage 3 or 4 and dyslipidemia who were followed-up at Siriraj Hospital between October 2011 and September 2012. Results In total, 150 patients with CKD stage 3 or 4 and dyslipidemia were recruited. The mean age was 72±10 years, and the body mass index was 25.6±4 kg/m2; 60% had CKD stage 3 with an estimated glomerular filtration rate of 34±12 mL/min/1.73 m2, and 54% had type 2 diabetes. The percentage of patients with hypercholesterolemia was 78%, hypertriglyceridemia 54%, and low high-density lipoprotein-C 36%. Of these, 52% had mixed hyperlipidemia. Statin treatment was prescribed to 87% of the patients, of which only 31.3% achieved the LDL-C goal according to the National Cholesterol Education Program and the European Society of Cardiology/European Atherosclerosis Society recommendations. Patients who did not achieve the LDL-C goal had a higher cholesterol level at diagnosis and higher prevalence of type 2 diabetes and stroke than those who achieved it. Conclusion Two-thirds of CKD patients with hyperlipidemia had mixed hyperlipidemia. Despite the high frequency of statin treatment, only one-third of patients with CKD achieved the LDL-C goal. Thus, a developmental plan for the management of dyslipidemia in patients with CKD should be implemented to increase their achievement of the LDL-C goal. PMID:26604773

  2. Testing a Model of the Relationship of Demographic, Affective, and Fitness Variables to Academic Achievement among Non-Science Majors at an Independent University

    NASA Astrophysics Data System (ADS)

    Dutra, Andrew Martin

    The purpose of this study was to determine the relationship of specific attributes of college students to their academic achievement at an independent university in central Florida. Academic achievement was measured as the numeric score on the final exam in a survey-of-science course (EDS 1032) required for non-science majors. Attribute sets included personological, affective, and fitness variables. A hypothesized diagram of the direct and indirect effects among these attributes relative to academic achievement was developed and tested using data collected Spring 2014 from 168 students in four sections of EDS 1032 at Florida Institute of Technology. Multiple regression results revealed that 19% of the variance in a students' academic achievement was due to the influence of these three sets of research factors; this was found to be statistically significant. The results of mediation analyses also indicated that three variables had significant direct effects on academic achievement, namely gender, number of academic credits, and sports motivation. In addition, gender had a significant indirect effect on academic achievement via stress, and the number of academic credits had a significant indirect effect on academic achievement via sports motivation. These findings indicated that female students scored roughly six points higher than male students on this final exam. Also, gender's influence on academic achievement was partially attributable to the student's level of stress (e.g., male students with high levels of stress had lower grades on this final exam than female students with the same level of stress). In addition, it was found that students taking more academic credits were likely to score higher on this final exam than those students taking fewer credits. Further, as students' level of sports amotivation increased, the strength of the relationship between the number of student academic credits and academic achievement decreased. These results support Self

  3. Medicare Prescription Drug Coverage

    MedlinePlus

    ... people also have to pay an additional monthly cost. Private companies provide Medicare prescription drug coverage. You choose the drug plan you like best. Whether or not you should sign up depends on how good your current coverage is. You need to sign up as ...

  4. Academic self-concept, academic achievement, and leadership in university students studying in a physical therapy program.

    PubMed

    Gottlieb, Rosemary J; Rogers, Janet L

    2002-01-01

    Students enrolled in a selected admissions program, in which there are a limited number of student positions available, were assessed for academic self-concept using the Dimensions of Self-Concept upon entry into the program. This study was performed to explore whether academic self-concept scores could predict successful completion of an academic program and the impact of self-concept scores on academic achievement and professional leadership.

  5. Measuring populations to improve vaccination coverage

    NASA Astrophysics Data System (ADS)

    Bharti, Nita; Djibo, Ali; Tatem, Andrew J.; Grenfell, Bryan T.; Ferrari, Matthew J.

    2016-10-01

    In low-income settings, vaccination campaigns supplement routine immunization but often fail to achieve coverage goals due to uncertainty about target population size and distribution. Accurate, updated estimates of target populations are rare but critical; short-term fluctuations can greatly impact population size and susceptibility. We use satellite imagery to quantify population fluctuations and the coverage achieved by a measles outbreak response vaccination campaign in urban Niger and compare campaign estimates to measurements from a post-campaign survey. Vaccine coverage was overestimated because the campaign underestimated resident numbers and seasonal migration further increased the target population. We combine satellite-derived measurements of fluctuations in population distribution with high-resolution measles case reports to develop a dynamic model that illustrates the potential improvement in vaccination campaign coverage if planners account for predictable population fluctuations. Satellite imagery can improve retrospective estimates of vaccination campaign impact and future campaign planning by synchronizing interventions with predictable population fluxes.

  6. Measuring populations to improve vaccination coverage

    PubMed Central

    Bharti, Nita; Djibo, Ali; Tatem, Andrew J.; Grenfell, Bryan T.; Ferrari, Matthew J.

    2016-01-01

    In low-income settings, vaccination campaigns supplement routine immunization but often fail to achieve coverage goals due to uncertainty about target population size and distribution. Accurate, updated estimates of target populations are rare but critical; short-term fluctuations can greatly impact population size and susceptibility. We use satellite imagery to quantify population fluctuations and the coverage achieved by a measles outbreak response vaccination campaign in urban Niger and compare campaign estimates to measurements from a post-campaign survey. Vaccine coverage was overestimated because the campaign underestimated resident numbers and seasonal migration further increased the target population. We combine satellite-derived measurements of fluctuations in population distribution with high-resolution measles case reports to develop a dynamic model that illustrates the potential improvement in vaccination campaign coverage if planners account for predictable population fluctuations. Satellite imagery can improve retrospective estimates of vaccination campaign impact and future campaign planning by synchronizing interventions with predictable population fluxes. PMID:27703191

  7. University studies science course selection and academic achievement in relation to the Myers-Briggs Type Indicator

    NASA Astrophysics Data System (ADS)

    Skauge, Suzanne Elizabeth

    This research conducted at a southern regional university studied general education (University Studies - US) science course selection and academic success in US science in relation to Myers-Briggs Type Indicator (MBTI) preference categories (SF, ST, NF and NT). Additionally, differences in type preferences among students with mathematics and/or reading competency were explored. Data was examined for 755 students enrolled in the freshman success seminar course between Fall 1989 and Spring 1995 who had completed the MBTI test as part of that class. US science courses examined were grouped by science study: earth science, biology, chemistry and physics. Academic success was defined as a grade of "C" or higher and proficiency criteria were dictated by the university catalog. The study's nonparametric test results did not find any significant differences between MBTI type preferences and the two main areas of focus, US science course selection and academic success in US science courses. However, significant proportional differences were found between type preferences in relation to student reading competency (sig. = .03), as well as, reading competency and academic success in science (sig. = .04) even though fairly weak relationships existed between the variables with contingency coefficients of .11 and .10 respectively. All other relationships tested proved not significant. Each type's course selection closely reflected the overall sample: Earth Science 52.3%, Biology 34%, Chemistry 7.5% and Physics 6.1%. Nearly one-fifth (19.7%) of the sample were not successful in their selected science course. Less than two-fifths (37.7%) of student sample were not mathematics and/or reading competent. Academically in science intuitive types tended to do better than sensing types and feeling types tended to better than thinking types (NF 2.41, NT 2.36, SF 2.29 and ST 2.23). Further analysis found the TF preference scale contributed more toward the significant differences in reading

  8. Socioeconomic inequalities and vaccination coverage: results of an immunisation coverage survey in 27 Brazilian capitals, 2007–2008

    PubMed Central

    Sampaio de Almeida Ribeiro, Manoel Carlos; de Moraes, José Cássio; Flannery, Brendan

    2012-01-01

    Background Since 1988, Brazil's Unified Health System has sought to provide universal and equal access to immunisations. Inequalities in immunisation may be examined by contrasting vaccination coverage among children in the highest versus the lowest socioeconomic strata. The authors examined coverage with routine infant immunisations from a survey of Brazilian children according to socioeconomic stratum of residence census tract. Methods The authors conducted a household cluster survey in census tracts systematically selected from five socioeconomic strata, according to average household income and head of household education, in 26 Brazilian capitals and the federal district. The authors calculated coverage with recommended vaccinations among children until 18 months of age, according to socioeconomic quintile of residence census tract, and examined factors associated with incomplete vaccination. Results Among 17 295 children with immunisation cards, 14 538 (82.6%) had received all recommended vaccinations by 18 months of age. Among children residing in census tracts in the highest socioeconomic stratum, 77.2% were completely immunised by 18 months of age versus 81.2%–86.2% of children residing in the four census tract quintiles with lower socioeconomic indicators (p<0.01). Census tracts in the highest socioeconomic quintile had significantly lower coverage for bacille Calmette-Guérin, oral polio and hepatitis B vaccines than those with lower socioeconomic indicators. In multivariable analysis, higher birth order and residing in the highest socioeconomic quintile were associated with incomplete vaccination. After adjusting for interaction between socioeconomic strata of residence census tract and household wealth index, only birth order remained significant. Conclusions Evidence from Brazilian capitals shows success in achieving high immunisation coverage among poorer children. Strategies are needed to reach children in wealthier areas. PMID:22268129

  9. Universal health insurance for children.

    PubMed

    Hughes, Dana; Kreger, Mary; Sabherwal, Simran; Powell, Darci; Sargent, Katherine

    2009-02-01

    Large and increasing numbers of Americans lack health insurance. While children have recently fared better than adults, millions still lack coverage, and thus experience difficulty obtaining acute and preventive care during a critical period of growth and development. This situation has both short and long-term social and economic implications, including higher health care costs for episodic and end-stage treatment, loss of productivity, and rising-insurance costs to businesses. This paper describes past and current efforts to extend health insurance to children and explores options for achieving universal coverage among children. Specifically, it describes the challenges associated with the financing and delivery of the American health care system, outlines public policy approaches to covering children historically, presents the current status of health insurance for low-income children, and offers options for achieving universal health insurance for children.

  10. Patient satisfaction questionnaire and quality achievement in hospital care: the case of a Greek public university hospital.

    PubMed

    Matis, Georgios K; Birbilis, Theodossios A; Chrysou, Olga I

    2009-11-01

    The scope of this research has been to investigate the satisfaction of Greek patients hospitalized in a tertiary care university public hospital in Alexandroupolis, Greece, in order to improve medical, nursing and organizational/administrative services. It is a cross-sectional study involving 200 patients hospitalized for at least 24 h. We administered a satisfaction questionnaire previously approved by the Greek Health Ministry. Four aspects of satisfaction were employed (medical, hotel facilities/organizational, nursing, global). Using principal component analysis, summated scales were formed and tested for internal consistency with the aid of Cronbach's alpha coefficient. The non-parametric Spearman rank correlation coefficient was also used. The results reveal a relatively high degree of global satisfaction (75.125%), yet satisfaction is higher for the medical (89.721%) and nursing (86.432%) services. Moreover, satisfaction derived from the hotel facilities and the general organization was found to be more limited (76.536%). Statistically significant differences in participant satisfaction were observed (depending on age, gender, citizenship, education, number of previous admissions and self-assessment of health status at the first and last day of patients' stay) for the medical, nursing and hotel facilities/organizational dimension, but not for global satisfaction. The present study confirms the results of previously published Greek surveys.

  11. Measuring and Specifying Combinatorial Coverage of Test Input Configurations.

    PubMed

    Kuhn, D Richard; Kacker, Raghu N; Lei, Yu

    2016-12-01

    A key issue in testing is how many tests are needed for a required level of coverage or fault detection. Estimates are often based on error rates in initial testing, or on code coverage. For example, tests may be run until a desired level of statement or branch coverage is achieved. Combinatorial methods present an opportunity for a different approach to estimating required test set size, using characteristics of the test set. This paper describes methods for estimating the coverage of, and ability to detect, t-way interaction faults of a test set based on a covering array. We also develop a connection between (static) combinatorial coverage and (dynamic) code coverage, such that if a specific condition is satisfied, 100% branch coverage is assured. Using these results, we propose practical recommendations for using combinatorial coverage in specifying test requirements.

  12. Women's Health Insurance Coverage

    MedlinePlus

    ... to be updated by the end of 2016. Abortion services are explicitly prohibited from being included as ... 25 states have laws banning coverage of most abortions from the plans available through the state Marketplaces, ...

  13. The student-institution fit at university: interactive effects of academic competition and social class on achievement goals

    PubMed Central

    Sommet, Nicolas; Quiamzade, Alain; Jury, Mickaël; Mugny, Gabriel

    2015-01-01

    As compared to continuing-generation students, first-generation students are struggling more at university. In the present article, we question the unconditional nature of such a phenomenon and argue that it depends on structural competition. Indeed, most academic departments use harsh selection procedure all throughout the curriculum, fostering between-student competition. In these departments, first-generation students tend to suffer from a lack of student-institution fit, that is, inconsistencies with the competitive institution’s culture, practices, and identity. However, one might contend that in less competitive academic departments continuing-generation students might be the ones experiencing a lack of fit. Using a cross-sectional design, we investigated the consequences of such a context- and category-dependent lack of fit on the endorsement of scholastically adaptive goals. We surveyed N = 378 first- and continuing-generation students from either a more competitive or a less competitive department in their first or final year of bachelor’s study. In the more competitive department, first-to-third year decrease of mastery goals (i.e., the desire to learn) was found to be steeper for first- than for continuing-generation students. In the less competitive department, the reversed pattern was found. Moreover, first-to-third year decrease of performance goals (i.e., the desire to outperform others) was found to be steeper within the less competitive department but did not depend on social class. This single-site preliminary research highlights the need to take the academic context into account when studying the social class graduation gap. PMID:26124732

  14. LAUNCHING A CAREER IN PSYCHOLOGY WITH ACHIEVEMENT AND ARROGANCE: JAMES McKEEN CATTELL AT THE JOHNS HOPKINS UNIVERSITY, 1882-1883.

    PubMed

    Sokal, Michael M

    2016-01-01

    The scientific career of eminent experimentalist and psychological tester James McKeen Cattell (1860-1944) began at the Johns Hopkins University during the year (1882-1883) he held the university's Fellowship in Philosophy. This article opens by sketching the scope of Cattell's lifetime achievement and then briefly reviews the historical attention that his life and career has attracted during the past few decades. It then outlines the origins and evolution of Cattell's "scientific ideology," traces the course of events that led to his fellowship, reviews his earliest studies at Johns Hopkins, and analyzes in some detail his initial laboratory successes. These laid the groundwork for his later distinguished work as a psychological experimentalist, both in Europe and America. It concludes, however, that even as Cattell's early experimental achievements impressed others, the personal arrogance he exhibited during his year in Baltimore served to alienate him from his colleagues and teachers. Over the long run, this arrogance and his often-antagonistic approach to others continued to color (and even shape) his otherwise distinguished more than 50-year scientific career.

  15. Achieving a Net Zero Energy Retrofit - In a humid, temperate climate: Lessons from the University of Hawai'i at Manoa

    SciTech Connect

    Regnier, Cindy; Robinson, Alastair

    2013-06-01

    The University of Hawaii at Manoa (UHM) partnered with the US Department of Energy (DOE) to develop and implement solutions to retrofit exiting buildings to reduce energy consumption by at least 30% as part of DOE’s Commercial Building Partnerships (CBP) Program.1 Kuykendall Hall, located on the UHM campus in Honolulu, was the focus of a CBP analysis and design collaboration among the University of Hawai’i, their consultants, and Lawrence Berkeley National Laboratory (LBNL). Kuykendall Hall consists of two 1960s-era wings – a four-story wing containing classrooms, and a seven-story tower containing offices – with a total floor area of approximately 76,000 square feet (ft2). The retrofit design, which uses local prevailing winds to aid ventilation and cooling and incorporates envelope and lighting elements that reduce the need for cooling, was initially on track to use about 50% less energy than the current building, exceeding the CBP’s 30% savings goal. With the addition of building-mounted solar electric panels, the retrofitted building is projected to achieve net-zero annual energy use. Achieving net-zero energy addressed an emerging challenge to the university – how to lower energy usage and reduce dependence on imported fossil fuel in the face of already-high energy prices that are forecast to double by 2040. Not only will the retrofit dramatically reduce Kuykendall Hall’s annual energy costs, but the project lays the groundwork for new campus policies and processes and low-energy design approaches and is building a campus knowledge base on low-energy practices. This project is a model of integrated design and building delivery that will be replicated in future projects on the campus.

  16. Did Equity of Reproductive and Maternal Health Service Coverage Increase during the MDG Era? An Analysis of Trends and Determinants across 74 Low- and Middle-Income Countries

    PubMed Central

    Sharma, Suneeta

    2015-01-01

    Introduction Despite widespread gains toward the 5th Millennium Development Goal (MDG), pro-rich inequalities in reproductive health (RH) and maternal health (MH) are pervasive throughout the world. As countries enter the post-MDG era and strive toward UHC, it will be important to monitor the extent to which countries are achieving equity of RH and MH service coverage. This study explores how equity of service coverage differs across countries, and explores what policy factors are associated with a country’s progress, or lack thereof, toward more equitable RH and MH service coverage. Methods We used RH and MH service coverage data from Demographic and Health Surveys (DHS) for 74 countries to examine trends in equity between countries and over time from 1990 to 2014. We examined trends in both relative and absolute equity, and measured relative equity using a concentration index of coverage data grouped by wealth quintile. Through multivariate analysis we examined the relative importance of policy factors, such as political commitment to health, governance, and the level of prepayment, in determining countries’ progress toward greater equity in RH and MH service coverage. Results Relative equity for the coverage of RH and MH services has continually increased across all countries over the past quarter century; however, inequities in coverage persist, in some countries more than others. Multivariate analysis shows that higher education and greater political commitment (measured as the share of government spending allocated to health) were significantly associated with higher equity of service coverage. Neither country income, i.e., GDP per capita, nor better governance were significantly associated with equity. Conclusion Equity in RH and MH service coverage has improved but varies considerably across countries and over time. Even among the subset of countries that are close to achieving the MDGs, progress made on equity varies considerably across countries

  17. Immunisation coverage, 2012.

    PubMed

    Hull, Brynley P; Dey, Aditi; Menzies, Rob I; Brotherton, Julia M; McIntyre, Peter B

    2014-09-30

    This, the 6th annual immunisation coverage report, documents trends during 2012 for a range of standard measures derived from Australian Childhood Immunisation Register (ACIR) data, and National Human Papillomavirus (HPV) Vaccination Program Register data. These include coverage at standard age milestones and for individual vaccines included on the National Immunisation Program (NIP) and coverage in adolescents and adults. The proportion of Australian children 'fully vaccinated' at 12, 24 and 60 months of age was 91.7%, 92.5% and 91.2%, respectively. For vaccines available on the NIP but not assessed during 2012 for 'fully vaccinated' status or for eligibility for incentive payments (rotavirus and pneumococcal at 12 months and meningococcal C and varicella at 24 months) coverage varied. Although pneumococcal vaccine had similar coverage at 12 months to other vaccines, coverage was lower for rotavirus at 12 months (83.6%) and varicella at 24 months (84.4%). Although 'fully vaccinated' coverage at 12 months of age was lower among Indigenous children than non-Indigenous children in all jurisdictions, the extent of the difference varied, reaching a 15 percentage point differential in South Australia but only a 0.4 percentage point differential in the Northern Territory. Overall, Indigenous coverage at 24 months of age exceeded that at 12 months of age nationally and for all jurisdictions, but as receipt of varicella vaccine at 18 months is excluded from calculations, this represents delayed immunisation, with some contribution from immunisation incentives. The 'fully vaccinated' coverage estimates for vaccinations due by 60 months of age for Indigenous children exceeded 90% at 91% in 2012. Unlike in 2011, at 60 months of age, there was no dramatic variation in coverage between Indigenous and non-Indigenous children for individual jurisdictions. As previously documented, vaccines recommended for Indigenous children only, hepatitis A and pneumococcal vaccine, had

  18. The search for coverage

    SciTech Connect

    Laseter, W.S.

    1993-06-01

    Anyone involved with the purchase or management of corporate liability insurance is familiar with the onerous pollution exclusions'' that accompany virtually all liability and property policies issued in recent years. As a result of these provisions, many businesses mistakenly presume their insurance program provides no coverage for environmental losses. Most companies, however, already own substantial sums of environmental coverage in the form of old comprehensive general liability (CGL) and first party, all risks'' property insurance policies issued before the introduction of pollution exclusions in the early 1970s. Unfortunately, due to records destruction policies, office moves, changes in ownership and other opportunities to lose files, most businesses have a difficult time reconstructing their past coverage.

  19. Determinants of Health Insurance Coverage among People Aged 45 and over in China: Who Buys Public, Private and Multiple Insurance

    PubMed Central

    Jin, Yinzi; Hou, Zhiyuan; Zhang, Donglan

    2016-01-01

    Background China is reforming and restructuring its health insurance system to achieve the goal of universal coverage. This study aims to understand the determinants of public, private and multiple insurance coverage among people of retirement-age in China. Methods We used data from the China Health and Retirement Longitudinal Survey 2011 and 2013, a nationally representative survey of Chinese people aged 45 and over. Multinomial logit regression was performed to identify the determinants of public, private and multiple health insurance coverage. We also conducted logit regression to examine the association between public insurance coverage and demand for private insurance. Results In 2013, 94.5% of this population had at least one type of public insurance, and 12.2% purchased private insurance. In general, we found that rural residents were less likely to be uninsured (Relative Risk Ratio (RRR) = 0.40, 95% Confidence Interval (CI): 0.34–0.47) and were less likely to buy private insurance (RRR = 0.22, 95% CI: 0.16–0.31). But rural-to-urban migrants were more likely to be uninsured (RRR = 1.39, 95% CI: 1.24–1.57). Public health insurance coverage may crowd out private insurance market (Odds Ratio = 0.55, 95% CI: 0.48–0.63), particularly among enrollees of Urban Resident Basic Medical Insurance. There exists a huge socioeconomic disparity in both public and private insurance coverage. Conclusion The migrants, the poor and the vulnerable remained in the edge of the system. The growing private insurance market did not provide sufficient financial protection and did not cover the people with the greatest need. To achieve universal coverage and reduce socioeconomic disparity, China should integrate the urban and rural public insurance schemes across regions and remove the barriers for the middle-income and low-income to access private insurance. PMID:27564320

  20. The Coverage Issue

    ERIC Educational Resources Information Center

    Yoshinobu, Stan; Jones, Matthew G.

    2012-01-01

    A significant issue mathematics instructors face is how to cover all the material. Mathematics teachers of all levels have some external and internal pressures to "get through" all the required material. The authors define "the coverage issue" to be the set of difficulties that arise in attempting to cover a lengthy list of topics. Principal among…

  1. Coverage That Counts.

    ERIC Educational Resources Information Center

    Moss, Nancy

    1990-01-01

    As the shrinking pool of applicants forces colleges to adapt new approaches to recruiting, media campaigns are emerging as an effective way to send key messages to target audiences. Media relations can lend credibility (news coverage is considered more credible than advertising); save money; reach targeted areas; and communicate key themes. (MLW)

  2. The supplemental instruction program: Student perceptions of the learning environment and impact on student academic achievement in college science at California State University, San Marcos

    NASA Astrophysics Data System (ADS)

    Hizer, Suzanne Elizabeth

    Higher education in science has been criticized and calls to increase student learning and persistence to degree has been recognized as a national problem by the Department of Education, the National Science Foundation, the National Research Council, and the National Academy of Sciences. One mode of academic assistance that may directly address this issue is the implementation of Supplemental Instruction (SI) in science courses. SI is a specific model of academic assistance designed to help students in historically difficult science classes master course content, thus increasing their academic achievement and retention. This study assessed the SI program at California State University, San Marcos, in supported science courses. Specifically, academic achievement based on final course grades were compared between SI participating and nonparticipating students, multiple affective factors were measured at the beginning and end of the semester, and students' perceptions of the classroom and SI session learning environments recorded. Overall, students who attended five or more SI sessions achieved higher final course grades. Students who chose to participate in SI had higher initial levels of responsibility and anxiety. Additionally, SI participants experienced a reduction in anxiety over the semester whereas nonparticipants experienced an increase in anxiety from beginning to the end of the semester. The learning environment of SI embodies higher levels of constructivist principles of active learning such as cooperation, cohesiveness, innovation, and personalization---with one exception for the physics course, which is a based on problem-based learning. Structural equation modeling of variables indicates that high self-efficacy at the end of the semester is directly related to high final course grades; this is mediated by cohesion in the classroom and the cooperation evidenced in SI sessions. These findings are elaborated by student descriptions of what happened in SI

  3. Educational intervention together with an on-line quality control program achieve recommended analytical goals for bedside blood glucose monitoring in a 1200-bed university hospital.

    PubMed

    Sánchez-Margalet, Víctor; Rodriguez-Oliva, Manuel; Sánchez-Pozo, Cristina; Fernández-Gallardo, María Francisca; Goberna, Raimundo

    2005-01-01

    Portable meters for blood glucose concentrations are used at the patients bedside, as well as by patients for self-monitoring of blood glucose. Even though most devices have important technological advances that decrease operator error, the analytical goals proposed for the performance of glucose meters have been recently changed by the American Diabetes Association (ADA) to reach <5% analytical error and <7.9% total error. We studied 80 meters throughout the Virgen Macarena Hospital and we found most devices with performance error higher than 10%. The aim of the present study was to establish a new system to control portable glucose meters together with an educational program for nurses in a 1200-bed University Hospital to achieve recommended analytical goals, so that we could improve the quality of diabetes care. We used portable glucose meters connected on-line to the laboratory after an educational program for nurses with responsibilities in point-of-care testing. We evaluated the system by assessing total error of the glucometers using high- and low-level glucose control solutions. In a period of 6 months, we collected data from 5642 control samples obtained by 14 devices (Precision PCx) directly from the control program (QC manager). The average total error for the low-level glucose control (2.77 mmol/l) was 6.3% (range 5.5-7.6%), and even lower for the high-level glucose control (16.66 mmol/l), at 4.8% (range 4.1-6.5%). In conclusion, the performance of glucose meters used in our University Hospital with more than 1000 beds not only improved after the intervention, but the meters achieved the analytical goals of the suggested ADA/National Academy of Clinical Biochemistry criteria for total error (<7.9% in the range 2.77-16.66 mmol/l glucose) and optimal total error for high glucose concentrations of <5%, which will improve the quality of care of our patients.

  4. After-hours coverage

    PubMed Central

    Bordman, Risa; Wheler, David; Drummond, Neil; White, David; Crighton, Eric

    2005-01-01

    OBJECTIVE To determine the prevalence and content of existing or developing policies and guidelines of medical associations and colleges regarding after-hours care by family physicians and general practitioners, especially legal requirements. DESIGN Telephone survey in fall 2002, updated in fall 2004. SETTING Canada. PARTICIPANTS All national and provincial medical associations, Colleges of Family Physicians, Colleges of Physicians and Surgeons, local government offices for the north, and the Canadian Medical Protective Association (CMPA). MAIN OUTCOME MEASURE Response to the question: “Does your agency have a policy in place regarding after-hours health care coverage by FPs/GPs, or are there active discussions regarding such a policy?” RESULTS The College of Physicians and Surgeons of British Columbia was the first to institute a policy, in 1995, requiring physicians to make “specific arrangements” for after-hours care of their patients. The College of Physicians and Surgeons of Alberta adopted a similar policy in 1996 along with a guideline to aid implementation. In 2002, the College of Physicians and Surgeons of Nova Scotia approved a guideline on the Availability of Physicians After Hours. The Saskatchewan Medical Association and the College of Physicians and Surgeons of Saskatchewan formulated a joint policy on medical practice coverage that was released in 2003. Many agencies actively discussed the topic. Provincial and national Colleges of Family Physicians did not have any policies in place. The CMPA does not generate guidelines but released in an information letter in May 2000 a section entitled “Reducing your risk when you’re not available.” CONCLUSION There is increasing interest Canada-wide in setting policy for after-hours care. While provincial Colleges of Physicians and Surgeons have traditionally led the way, a trend toward more collaboration between associations was identified. The effect of policy implementation on physicians

  5. Americans Want More Coverage of Teacher Performance and Student Achievement

    ERIC Educational Resources Information Center

    West, Darrell M.; Whitehurst, Grover J.; Dionne, E. J., Jr.

    2011-01-01

    In this report, the authors present the results of a national public opinion survey on education news. From December 6 to 19, 2010, they conducted telephone interviews with 1,211 adults aged 18 years or older (including an over-sample of parents) in the continental United States. They asked a series of questions about their education news…

  6. Antenna Beam Coverage Concepts

    NASA Technical Reports Server (NTRS)

    Estabrook, Polly; Motamedi, Masoud

    1990-01-01

    The strawman Personal Access Satellite System (PASS) design calls for the use of a CONUS beam for transmission between the supplier and the satellite and for fixed beams for transmission between the basic personal terminal and the satellite. The satellite uses a 3 m main reflector for transmission at 20 GHz and a 2 m main reflector for reception at 30 GHz. There are several types of spot beams under consideration for the PASS system besides fixed beams. The beam pattern of a CONUS coverage switched beam is shown along with that of a scanning beam. A switched beam refers to one in which the signal from the satellite is connected alternatively to various feed horns. Scanning beams are taken to mean beams whose footprints are moved between contiguous regions in the beam's coverage area. The advantages and disadvantages of switched and/or scanning beams relative to fixed beams. The consequences of using switched/scanning in lieu of fixed beams in the PASS design and attempts are made to evaluate the listed advantages and disadvantages. Two uses of switched/scanning beams are examined. To illustrate the implications of switched beams use on PASS system design, operation at two beam scan rates is explored.

  7. Coverage and system efficiencies of insecticide-treated nets in Africa from 2000 to 2017

    PubMed Central

    Bhatt, Samir; Weiss, Daniel J; Mappin, Bonnie; Dalrymple, Ursula; Cameron, Ewan; Bisanzio, Donal; Smith, David L; Moyes, Catherine L; Tatem, Andrew J; Lynch, Michael; Fergus, Cristin A; Yukich, Joshua; Bennett, Adam; Eisele, Thomas P; Kolaczinski, Jan; Cibulskis, Richard E; Hay, Simon I; Gething, Peter W

    2015-01-01

    Insecticide-treated nets (ITNs) for malaria control are widespread but coverage remains inadequate. We developed a Bayesian model using data from 102 national surveys, triangulated against delivery data and distribution reports, to generate year-by-year estimates of four ITN coverage indicators. We explored the impact of two potential 'inefficiencies': uneven net distribution among households and rapid rates of net loss from households. We estimated that, in 2013, 21% (17%–26%) of ITNs were over-allocated and this has worsened over time as overall net provision has increased. We estimated that rates of ITN loss from households are more rapid than previously thought, with 50% lost after 23 (20–28) months. We predict that the current estimate of 920 million additional ITNs required to achieve universal coverage would in reality yield a lower level of coverage (77% population access). By improving efficiency, however, the 920 million ITNs could yield population access as high as 95%. DOI: http://dx.doi.org/10.7554/eLife.09672.001 PMID:26714109

  8. A long way to go – Estimates of combined water, sanitation and hygiene coverage for 25 sub-Saharan African countries

    PubMed Central

    Bain, Robert; Cumming, Oliver

    2017-01-01

    absolute inequality was lower. Rural combined basic SDG coverage was close to zero in many countries. Conclusions Our estimates help to quantify the scale of progress required to achieve universal WASH access in low-income countries, as envisaged under the water and sanitation SDG. Monitoring and reporting changes in the proportion of the national population with access to water, sanitation and hygiene may be useful in focusing WASH policy and investments towards the areas of greatest need. PMID:28182796

  9. Early Impacts of the Affordable Care Act on Health Insurance Coverage in Medicaid Expansion and Non-Expansion States.

    PubMed

    Courtemanche, Charles; Marton, James; Ukert, Benjamin; Yelowitz, Aaron; Zapata, Daniela

    2017-01-01

    The Affordable Care Act (ACA) aimed to achieve nearly universal health insurance coverage in the United States through a combination of insurance market reforms, mandates, subsidies, health insurance exchanges, and Medicaid expansions, most of which took effect in 2014. This paper estimates the causal effects of the ACA on health insurance coverage in 2014 using data from the American Community Survey. We utilize difference-in-difference-in-differences models that exploit cross-sectional variation in the intensity of treatment arising from state participation in the Medicaid expansion and local area pre-ACA uninsured rates. This strategy allows us to identify the effects of the ACA in both Medicaid expansion and non-expansion states. Our preferred specification suggests that, at the average pre-treatment uninsured rate, the full ACA increased the proportion of residents with insurance by 5.9 percentage points compared to 2.8 percentage points in states that did not expand Medicaid. Private insurance expansions from the ACA were due to increases in both employer-provided and non-group coverage. The coverage gains from the full ACA were largest for those without a college degree, non-whites, young adults, unmarried individuals, and those without children in the home. We find no evidence that the Medicaid expansion crowded out private coverage.

  10. Medicaid expansions and the insurance coverage of poor teenagers.

    PubMed

    Leininger, Lindsey Jeanne

    2010-01-01

    This article employs a comparison group research design to examine the effects of the Medicaid expansions of the late 1990s on the insurance coverage of poor teenagers. Results suggest that the expansions were associated with a decrease in the likelihood of poor teens experiencing uninsured spells over the course of a calendar year, as measured by spending any part of the prior year uninsured and spending over half of the prior year uninsured. While the expansions were successful in increasing coverage among poor adolescents, they fell far short of facilitating near-universal coverage for this population.

  11. The Effectiveness of Using the 7E's Learning Cycle Strategy on the Immediate and Delayed Mathematics Achievement and the Longitudinal Impact of Learning among Preparatory Year Students at King Saud University (KSU)

    ERIC Educational Resources Information Center

    Khashan, Khaled

    2016-01-01

    This study aimed to investigate the effectiveness of teaching Mathematics by using 7E's Learning Cycle strategy in immediate and delayed achievement and retention among Preparatory Year students at King Saud University (KSU)--Saudi Arabia, in comparison with the traditional method. The study sample consisted of (73) Preparatory Year students at…

  12. Memetic algorithm-based multi-objective coverage optimization for wireless sensor networks.

    PubMed

    Chen, Zhi; Li, Shuai; Yue, Wenjing

    2014-10-30

    Maintaining effective coverage and extending the network lifetime as much as possible has become one of the most critical issues in the coverage of WSNs. In this paper, we propose a multi-objective coverage optimization algorithm for WSNs, namely MOCADMA, which models the coverage control of WSNs as the multi-objective optimization problem. MOCADMA uses a memetic algorithm with a dynamic local search strategy to optimize the coverage of WSNs and achieve the objectives such as high network coverage, effective node utilization and more residual energy. In MOCADMA, the alternative solutions are represented as the chromosomes in matrix form, and the optimal solutions are selected through numerous iterations of the evolution process, including selection, crossover, mutation, local enhancement, and fitness evaluation. The experiment and evaluation results show MOCADMA can have good capabilities in maintaining the sensing coverage, achieve higher network coverage while improving the energy efficiency and effectively prolonging the network lifetime, and have a significant improvement over some existing algorithms.

  13. Technology-Enabled and Universally Designed Assessment: Considering Access in Measuring the Achievement of Students with Disabilities--A Foundation for Research

    ERIC Educational Resources Information Center

    Almond, Patricia; Winter, Phoebe; Cameto, Renee; Russell, Michael; Sato, Edynn; Clarke-Midura, Jody; Torres, Chloe; Haertel, Geneva; Dolan, Robert; Beddow, Peter; Lazarus, Sheryl

    2010-01-01

    This paper represents one outcome from the "Invitational Research Symposium on Technology-Enabled and Universally Designed Assessments," which examined technology-enabled assessments (TEA) and universal design (UD) as they relate to students with disabilities (SWD). It was developed to stimulate research into TEAs designed to make tests…

  14. Raising the bar on achieving racial diversity in higher education: the United States Supreme Court's decision in Fisher v University of Texas.

    PubMed

    Rosenbaum, Sara; Teitelbaum, Joel; Scott, James

    2013-12-01

    In Fisher v University of Texas, the U.S. Supreme Court revisited the constitutionality of race-conscious admissions practices aimed at fostering student diversity in university programs. Although it concluded that student diversity remains the type of compelling state interest that justifies consideration of race in admissions, the court nonetheless raised the bar on the use of such practices by requiring universities to prove that no workable race-neutral methods can produce the same result. Whether this standard of proof is one that can be met-and whether challenges will mount against universities that continue to use the holistic methods sanctioned 10 years ago in Grutter v Bollinger-remains to be seen. In this commentary, the authors review the background and history of the Supreme Court's decisions on race as a factor in university admissions decisions and examine the potential effects of Fisher on medical education specifically.

  15. Gender, mathematics, reading comprehension and science reasoning as predictors of science achievement among African-American students at a historical black college or university

    NASA Astrophysics Data System (ADS)

    Davis, Consuella Artiemese

    This study investigated predictors that influence the science achievement of African-American non-science majors in a Physical Science class. The population consisted of male and female college students enrolled in Physical Science courses at a historical black college or university (HBCU) located in the southeastern portion of the United States. A personal data information sheet was administered to 120 participants during the Fall of 2008. The personal data information sheet consisted of questions pertaining to the high school courses, students took in math, language arts and science. It also consisted of basic background information. Students also gave written consent for their midterm and final grades earned in Physical Science to be used in the study as part of the analyses. A t-Test including chi-square tests revealed that there was not a significant difference in the raw scores of African-American females and African American males on the American College Test. A significant difference was not observed between the females and males on the ACT math subtest, t (118) = -.78, p = .43; reading comprehension subtest, t (118) = -1.44, .15 or on the science reasoning subtest, t (118) = -1.46, p = .15. A significant difference was not found between the final grades of African American females and the final grades of African American males. Chi-square tests were conducted to determine goodness of fit, X2 = 6.11, df = 1, p = .191. Although the grades of females were higher than males, results were not significant. The correlation between math ACT and final grades were not significant, r = .131, N = 120, p = .155, reading comprehension ACT and final grades were not significant, r = .072, N = 120, p = .434 and science reasoning ACT and final grades were found not to be significant, r = .109, N = 120, p = .237. Being that the majority of students who participated in the study were from one state, had similar high school backgrounds, had similar majors and were similar in

  16. Delaunay Triangulation as a New Coverage Measurement Method in Wireless Sensor Network

    PubMed Central

    Chizari, Hassan; Hosseini, Majid; Poston, Timothy; Razak, Shukor Abd; Abdullah, Abdul Hanan

    2011-01-01

    Sensing and communication coverage are among the most important trade-offs in Wireless Sensor Network (WSN) design. A minimum bound of sensing coverage is vital in scheduling, target tracking and redeployment phases, as well as providing communication coverage. Some methods measure the coverage as a percentage value, but detailed information has been missing. Two scenarios with equal coverage percentage may not have the same Quality of Coverage (QoC). In this paper, we propose a new coverage measurement method using Delaunay Triangulation (DT). This can provide the value for all coverage measurement tools. Moreover, it categorizes sensors as ‘fat’, ‘healthy’ or ‘thin’ to show the dense, optimal and scattered areas. It can also yield the largest empty area of sensors in the field. Simulation results show that the proposed DT method can achieve accurate coverage information, and provides many tools to compare QoC between different scenarios. PMID:22163792

  17. Immunisation coverage annual report, 2009.

    PubMed

    Hull, Brynley; Dey, Aditi; Mahajan, Deepika; Menzies, Rob; McIntyre, Peter B

    2011-06-01

    This, the third annual immunisation coverage report, documents trends during 2009 for a range of standard measures derived from Australian Childhood Immunisation Register data, including overall coverage at standard age milestones and for individual vaccines included on the National Immunisation Program (NIP). Coverage by Indigenous status and mapping by smaller geographic areas as well as trends in timeliness is also summarised according to standard templates. With respect to overall coverage, the Immunise Australia Program targets have been reached for children at 12 and 24 months of age but not for children at 5 years of age. Coverage at 24 months of age exceeds that at 12 months of age, but as receipt of varicella vaccine at 18 months is excluded from calculations of 'fully immunised' this probably represents delayed immunisation, with some contribution from immunisation incentives. Similarly, the decrease in coverage estimates for immunisations due at 4 years of age from March 2008 is primarily due to changing the assessment age from 6 years to 5 years of age from December 2007. With respect to individual vaccines, a number of those available on the NIP are not currently assessed for 'fully immunised' status or for eligibility for incentive payments. These include pneumococcal conjugate and meningococcal C conjugate vaccines, for which coverage is comparable with vaccines that are assessed for 'fully immunised' status, and rotavirus and varicella vaccines for which coverage is lower. Coverage is also suboptimal for vaccines recommended for Indigenous children only (i.e. hepatitis A and pneumococcal polysaccharide vaccine) as previously reported for other vaccines for both children and adults. Delayed receipt of vaccines is an important issue for vaccines recommended for Indigenous children and has not improved among non-Indigenous children despite improvements in coverage at the 24-month milestone. Although Indigenous children in Australia have coverage levels

  18. Long-Term Support for High-Volume Manufacturing Industry: The Centre for Achievement in Manufacturing and Management, University of Sunderland, UK.

    ERIC Educational Resources Information Center

    Wilcock, Dennis; Terry, Brian

    1996-01-01

    A unique partnership of industry, government, and the University of Sunderland involves a holistic approach to manufacturing, integrating efficiency with quality of life for a profitable and sustainable competitive advantage. (SK)

  19. Effects of a Universally Free, In-Classroom School Breakfast Program: Results from the Second Year of the Maryland Meals for Achievement Evaluation. Interim Report.

    ERIC Educational Resources Information Center

    Murphy, J. Michael; Rankin, Emunah; Feeney, Kelly; Kenney, Leigh; Kleinman, Ron

    Noting that many children in the United States are not well nourished despite the recent economic boom, the state of Maryland began the Maryland Meals for Achievement (MMFA) program, a demonstration project to see if providing a classroom breakfast free to all students can improve student nutrition and academic achievement. This interim report…

  20. Reading and School Achievement--Cognitive and Affective Influences; Selected Readings from the 8th Annual Spring Reading Conference at Rutgers University.

    ERIC Educational Resources Information Center

    Kling, Martin, Ed.

    This conference report contains the following papers: "Ability versus Knowledge in Testing Educational Achievement" and "Knowledge vs. Ability in Achievement Testing," by Robert L. Ebel; "A Four-Domain Taxonomy for Classifying Educational Tasks and Objectives," by Bruce W. Tuckman; "On the Social Psychology of the Self-Fulfilling Prophecy: Further…

  1. The Impact of the Social, Academic, and Moral Development Programs of an Achievable Dream on Students during Their College and University Experience

    ERIC Educational Resources Information Center

    Runge, Amy L.

    2016-01-01

    This evaluation case study explores the impact of the An Achievable Dream social, academic, and moral program on college student's performance in college. Through this study, the researcher was able to provide insight on college student and college student advocates perceptions of An Achievable Dream's social, academic, and moral program's impact…

  2. Emotional intelligence as a predictor of self-efficacy among students with different levels of academic achievement at Kermanshah University of Medical Sciences

    PubMed Central

    GHARETEPEH, AMENEH; SAFARI, YAHYA; PASHAEI, TAHEREH; RAZAEI, MANSOUR; BAGHER KAJBAF, MOHAMMAD

    2015-01-01

    Introduction studies have indicated that emotional intelligence is positively related to self-efficacy and can predict the academic achievement. The present study aimed to investigate the role of emotional intelligence in identifying self-efficacy among the students of Public Health School with different levels of academic achievement. Methods This correlational study was conducted on all the students of Public Health School. 129 students were included in the study through census method. Data were collected using Emotional Intelligence and self-efficacy questionnaires and analyzed using descriptive statistics and regression analysis by SPSS 14. Results The average score of students with high academic achievement was higher in self-efficacy (39.78±5.82) and emotional intelligence (117.07±10.33) variables and their components than that of students with low academic achievement (39.17±5.91, 112.07±13.23). The overall emotional intelligence score to predict self-efficacy explanation was different among students with different levels of academic achievement (p<0.001). Self-efficacy structure was explained through self-awareness and self-motivation components in students with low academic achievement (r=0.571). In students with high academic achievement, self-awareness, self-motivation and social consciousness played an effective role in explaining self-efficacy (r=0.677, p<0.001). Conclusion Emotional intelligence and self-efficacy play an important role in achieving academic success and emotional intelligence can explain self-efficacy. Therefore, it is recommended to teach emotional intelligence skills to students with low academic achievement through training workshops. PMID:25927067

  3. Vaccination coverage rates for 1986.

    PubMed

    1987-10-01

    This article sets forth data on vaccination coverage rates in children under 1 year of age in the individual countries of Latin America and the Caribbean in 1986. In the Region of the Americas as a whole, the 1986 coverage rate was 80% for oral poliovaccine, 54% for DPT, 55% for measles, and 63% for BCG. Vaccination coverage rates increased over 1985 levels for all but measles, which showed a 5% decline due to decreases in Brazil and Mexico. In the Caribbean subregion, the majority of country coverage rates for DPT and oral poliovirus vaccine are equal to or above 80%, while measles coverage rates are generally below 50%. In Central America, vaccine coverage rates with all antigens except BCG showed significant increases between 1985 and 1986. In Central America, coverage ranged from above 80% for oral poliovirus vaccine and DPT in Belize, Costa Rica, and Nicaragua, to below 40% in Guatemala. In general, countries in the region are improving vaccination performance as a result of establishment of vaccination days or campaigns and acceleration of the Expanded Program on Immunization. However, much work remains to be done if the goal of 100% immunization of children and women of childbearing age by 1990 is to be met.

  4. Emergency room coverage: an evolving crisis.

    PubMed

    Davison, Steven P

    2004-08-01

    Historically, a newly graduated plastic surgeon in the United States could build a practice from his or her emergency room coverage. The historical cliche was for the surgeon to be affable, able, and available, and from that basis one's practice would grow. Emergency room exposure was an avenue for starting a practice, developing recognition, and, after that, building a referral pattern. Recently, the cross-shifting influence of management care, rising malpractice insurance costs, and risk ratio are changing this cliche to a crisis. An evaluation of a 2 1/2-year exposure to emergency room coverage has revealed a completely different profile. A total of 300 patient visits resulting in 69 surgical operations were evaluated for insurance and remuneration history. The findings indicated a significant remuneration dilemma for emergency room coverage. Interestingly, a remuneration problem exists in a market different from what one would expect. In this study, a sample from a suburban hospital, rather than an inner-city university hospital, is the greater problem.

  5. Your Medicare Coverage: Durable Medical Equipment (DME) Coverage

    MedlinePlus

    ... Search Medicare.gov for covered items Durable medical equipment (DME) coverage How often is it covered? Medicare ... B (Medical Insurance) covers medically necessary durable medical equipment (DME) that your doctor prescribes for use in ...

  6. Annual immunisation coverage report, 2010.

    PubMed

    Hull, Brynley; Dey, Aditi; Menzies, Rob; McIntyre, Peter

    2013-03-31

    This, the fourth annual immunisation coverage report, documents trends during 2010 for a range of standard measures derived from Australian Childhood Immunisation Register (ACIR) data. These include coverage at standard age milestones and for individual vaccines included on the National Immunisation Program (NIP). For the first time, coverage from other sources for adolescents and the elderly are included. The proportion of children 'fully vaccinated' at 12, 24 and 60 months of age was 91.6%, 92.1% and 89.1% respectively. For vaccines available on the NIP but not currently assessed for 'fully immunised' status or for eligibility for incentive payments (rotavirus and pneumococcal at 12 months and meningococcal C and varicella at 24 months) coverage varied. Although pneumococcal vaccine had similar coverage at 12 months to other vaccines, coverage was lower for rotavirus at 12 months (84.7%) and varicella at 24 months (83.0%). Overall coverage at 24 months of age exceeded that at 12 months of age nationally and for most jurisdictions, but as receipt of varicella vaccine at 18 months is excluded from calculations, this represents delayed immunisation, with some contribution from immunisation incentives. The 'fully immunised' coverage estimates for immunisations due by 60 months increased substantially in 2009, reaching almost 90% in 2010, probably related to completed immunisation by 60 months of age being introduced in 2009 as a requirement for GP incentive payments. As previously documented, vaccines recommended for Indigenous children only (hepatitis A and pneumococcal polysaccharide vaccine) had suboptimal coverage at around 57%. Delayed receipt of vaccines by Indigenous children at the 60-month milestone age improved from 56% to 62% but the disparity in on-time vaccination between Indigenous and non-Indigenous children at earlier age milestones did not improve. Coverage data for human papillomavirus (HPV)from the national HPV register are consistent with high

  7. Universal Usability

    NASA Astrophysics Data System (ADS)

    Horton, Sarah; Leventhal, Laura

    Universal usability of World Wide Web (Web) environments—that is, having 90% of households as successful users—requires universal access, usability, and universal design. Factors such as Web technology and user-centered design contribute to universal access and usability, but key to universal usability is a universal design methodology. Universal design principles for the Web follow from universal design principles for the built environment, and emphasize perceptibility, self-explanation, and tailorability for the user. Universally usable Web environments offer the benefit of expanded participation, as well as the unanticipated benefits that generally follow from innovative design initiatives. However, to achieve Web universal usability, Web designers need tools that facilitate the design of intuitive interfaces without sacrificing universal access.

  8. A Longitudinal Study of Hong Kong Chinese University Students' Academic Causal Attributions, Self-Concept, Learning Approaches, and Their Causal Effects on Achievement.

    ERIC Educational Resources Information Center

    Yin, Lai Po

    The longitudinal changes in the causal attributions, academic self-concept, and learning approaches of 549 university students in Hong Kong were studied. Students were enrolled in two different disciplines: language/health studies (n=272) and construction/engineering (n=277). Measurements of causal dimensions, academic self-concept, learning…

  9. The Effect of Using an Educational Website in Achievement of Bachelor Students in the Course of Basic Concepts in Mathematics at Al al-Bayt University

    ERIC Educational Resources Information Center

    Qudah, Ahmad Hassan

    2016-01-01

    The study aimed to detect the effect of using an educational site on the Internet in the collection of bachelor's students in the course of basic concepts in mathematics at Al al-Bayt University, and the study sample consisted of all students in the course basic concepts in mathematics in the first semester of the academic year 2014/2015 and the…

  10. The Effects of a Computerized-Algebra Program on Mathematics Achievement of College and University Freshmen Enrolled in a Developmental Mathematics Course

    ERIC Educational Resources Information Center

    Taylor, Judy M.

    2008-01-01

    We face a world in which a college degree increasingly dictates the likelihood of life success. At the same time, there has been an ever increasing population of students who have not been prepared adequately through their high school education to meet the rigors of college/university-level content. The present study investigated the effects of a…

  11. Relevance of Prior Academic Qualifications to Predicting the Academic Achievement of Undergraduate Students: An Analysis of Law Enrollees at Makerere University

    ERIC Educational Resources Information Center

    Wamala, Robert

    2013-01-01

    Students who have excelled academically in the past are regarded as having a greater chance of performing successfully in subsequent examinations. However, this argument is being questioned with regard to enrollees onto the Bachelor of Laws at the School of Law of Makerere University in Uganda. This study sought to obtain an understanding of this…

  12. Predicting Student Achievement in University-Level Business and Economics Classes: Peer Observation of Classroom Instruction and Student Ratings of Teaching Effectiveness

    ERIC Educational Resources Information Center

    Galbraith, Craig S.; Merrill, Gregory B.

    2012-01-01

    We examine the validity of peer observation of classroom instruction for purposes of faculty evaluation. Using both a multi-section course sample and a sample of different courses across a university's School of Business and Economics we find that the results of annual classroom observations of faculty teaching are significantly and positively…

  13. Immunisation coverage annual report, 2008.

    PubMed

    Hull, Brynley P; Mahajan, Deepika; Dey, Aditi; Menzies, Rob I; McIntyre, Peter B

    2010-09-01

    This, the 2nd annual immunisation coverage report, documents trends during 2008 for a range of standard measures derived from Australian Childhood Immunisation Register data, including overall coverage at standard age milestones and for individual vaccines included on the National Immunisation Program (NIP). Coverage by indigenous status and mapping by smaller geographic areas as well as trends in timeliness are also summarised according to standard templates. With respect to overall coverage, Immunise Australia Program targets have been reached for children at 12 and 24 months of age but not for children at 5 years of age. Coverage at 24 months of age exceeds that at 12 months of age, but as receipt of varicella vaccine at 18 months is excluded from calculations of 'fully immunised' this probably represents delayed immunisation, with some contribution from immunisation incentives. Similarly, the decrease in coverage estimates for immunisations due at 4 years of age from March 2008, is primarily due to changing the assessment age from 6 years to 5 years of age from December 2007. A number of individual vaccines on the NIP are not currently assessed for 'fully immunised' status or for eligibility for incentive payments. These include pneumococcal conjugate and meningococcal C conjugate vaccines for which coverage is comparable to vaccines which are assessed for 'fully immunised' status, and rotavirus and varicella vaccines for which coverage is lower. Coverage is also suboptimal for vaccines recommended for Indigenous children only (i.e. hepatitis A and pneumococcal polysaccharide vaccine) as previously reported for other vaccines for both children and adults. Delayed receipt of vaccines is an important issue for vaccines recommended for Indigenous children and has not improved among non-Indigenous children despite improvements in coverage at the 24-month milestone. Although Indigenous children in Australia have coverage levels that are similar to non

  14. Medicare coverage for oncology services.

    PubMed

    Bagley, G P; McVearry, K

    1998-05-15

    Medicare's mission is to assure health care security for our beneficiaries. Title XVIII of the Social Security Act (the Act) provides the Health Care Financing Administration (HCFA) with the authority to fulfill this mission. Although Medicare is considered a defined benefit program, the Act vested Medicare with the discretionary authority to make specific policy decisions when necessary. HCFA's discretionary authority, which is found at section 1862(a)(1)(A) of the Act, enables HCFA to provide coverage for services that are reasonable and necessary for the treatment and diagnosis of illness or injury or to improve the functioning of a malformed body member. To determine whether a service is reasonable and necessary, HCFA relies on authoritative evidence. This evidence includes, but is not limited to, approvals from appropriate federal agencies, such as the Food and Drug Administration, and systematic evaluations of scientific literature via technology assessments. HCFA also may decide that a service warrants a unique type of coverage policy, which is referred to as coverage with conditions. This form of coverage is a middle ground between strict noncoverage and general coverage for a medical service that appears promising, but still is evolving. All these policy specifications effect Medicare coverage of oncology services. This means that reasonable and necessary diagnostic and therapeutic cancer-related services that are not otherwise prohibited by Medicare's statute, regulations, and manual instructions are covered and paid for by the program. Prior to the Balanced Budget Act of 1997 (BBA '97), Medicare provided coverage for some beneficiaries to undergo mammography and Papanicolaou smear screening. As a result of BBA '97, Congress has mandated expanding coverage for these services as well as adding coverage for pelvic examinations, prostate cancer screening, colorectal screening, and antiemetic drugs used as part of an anticancer chemotherapy regimen. Other

  15. Global Routine Vaccination Coverage, 2015.

    PubMed

    Casey, Rebecca M; Dumolard, Laure; Danovaro-Holliday, M Carolina; Gacic-Dobo, Marta; Diallo, Mamadou S; Hampton, Lee M; Wallace, Aaron S

    2016-11-18

    In 1974, the World Health Organization (WHO) established the Expanded Program on Immunization* to provide protection against six vaccine-preventable diseases through routine infant immunization (1). Based on 2015 WHO and United Nations Children's Fund (UNICEF) estimates, global coverage with the third dose of diphtheria-tetanus-pertussis vaccine (DTP3), the first dose of measles-containing vaccine (MCV1) and the third dose of polio vaccine (Pol3) has remained stable (84%-86%) since 2010. From 2014 to 2015, estimated global coverage with the second MCV dose (MCV2) increased from 39% to 43% by the end of the second year of life and from 58% to 61% when older age groups were included. Global coverage was higher in 2015 than 2010 for newer or underused vaccines, including rotavirus vaccine, pneumococcal conjugate vaccine (PCV), rubella vaccine, Haemophilus influenzae type b (Hib) vaccine, and 3 doses of hepatitis B (HepB3) vaccine. Coverage estimates varied widely by WHO Region, country, and district; in addition, for the vaccines evaluated (MCV, DTP3, Pol3, HepB3, Hib3), wide disparities were found in coverage by country income classification. Improvements in equity of access are necessary to reach and sustain higher coverage and increase protection from vaccine-preventable diseases for all persons.

  16. Have We Substantially Underestimated the Impact of Improved Sanitation Coverage on Child Health? A Generalized Additive Model Panel Analysis of Global Data on Child Mortality and Malnutrition

    PubMed Central

    Prüss-Ustün, Annette

    2016-01-01

    Background Although widely accepted as being one of the most important public health advances of the past hundred years, the contribution that improving sanitation coverage can make to child health is still unclear, especially since the publication of two large studies of sanitation in India which found no effect on child morbidity. We hypothesis that the value of sanitation does not come directly from use of improved sanitation but from improving community coverage. If this is so we further hypothesise that the relationship between sanitation coverage and child health will be non-linear and that most of any health improvement will accrue as sanitation becomes universal. Methods We report a fixed effects panel analysis of country level data using Generalized Additive Models in R. Outcome variables were under 5 childhood mortality, neonatal mortality, under 5 childhood mortality from diarrhoea, proportion of children under 5 with stunting and with underweight. Predictor variables were % coverage by improved sanitation, improved water source, Gross Domestic Product per capita and Health Expenditure per capita. We also identified three studies reporting incidence of diarrhoea in children under five alongside gains in community coverage in improved sanitation. Findings For each of the five outcome variables, sanitation coverage was independently associated with the outcome but this association was highly non-linear. Improving sanitation coverage was very strongly associated with under 5 years diarrhoea mortality, under 5years all-cause mortality, and all-cause neonatal mortality. There was a decline as sanitation coverage increased up to about 20% but then no further decline was seen until about 70% (60% for diarrhoea mortality and 80% for neonatal mortality, respectively). The association was less strong for stunting and underweight but a threshold about 50% coverage was also seen. Three large trials of sanitation on diarrhoea morbidity gave results that were similar

  17. Achieving a Net Zero Energy Retrofit – in a humid, temperate climate – lessons from the University of Hawai’i at Mānoa

    SciTech Connect

    Regnier, Cindy; Harding, Ari; Robinson, Alastair

    2015-07-01

    The University of Hawai’i at Mānoa (UHM) partnered with the US Department of Energy (DOE) and the Hawai`i Clean Energy Initiative to develop and implement solutions to retrofit exiting buildings to reduce energy consumption by at least 30% as part of DOE’s Commercial Building Partnerships (CBP) Program1. Kuykendall Hall, located on the UHM campus in Honolulu, was the focus of a CBP analysis and design collaboration among the University of Hawai’i, their consultants, and Lawrence Berkeley National Laboratory (LBNL). Kuykendall Hall consists of two 1960s-era wings – a four-story wing containing classrooms, and a seven-story tower containing offices – with a total floor area of approximately 76,000 square feet (ft²).

  18. The Differential Impact of Pre-College and Self-Regulatory Factors on Academic Achievement of University Students with and without Learning Disabilities.

    ERIC Educational Resources Information Center

    Ruban, Lilia; McCoach, D. Betsy; Nora, Amaury

    Even though research on academic self-regulation has proliferated in recent years, no studies have investigated the question of whether the perceived usefulness and the use of standard self-regulated learning strategies and compensation strategies provide a differential prediction of academic achievement for college students with and without…

  19. Examining the Impact of Online Labeling on Tutoring Behavior and Its Effect on the English Learning and Motivation of Low-Achieving University Students

    ERIC Educational Resources Information Center

    Wu, Ejean; Yang, Shu Ching

    2016-01-01

    This study examines the differential impact of tutor labeling vs. non-labeling approaches on the performance; motivation beliefs; and cognitive, social, and teaching presence of low-achieving students. Two interactive tutoring strategy patterns are investigated based on the taxonomical e-moderating model of Salmon. In addition, the tutees' online…

  20. Students' Perceptions of Computer-Based Learning Environments, Their Attitude towards Business Statistics, and Their Academic Achievement: Implications from a UK University

    ERIC Educational Resources Information Center

    Nguyen, ThuyUyen H.; Charity, Ian; Robson, Andrew

    2016-01-01

    This study investigates students' perceptions of computer-based learning environments, their attitude towards business statistics, and their academic achievement in higher education. Guided by learning environments concepts and attitudinal theory, a theoretical model was proposed with two instruments, one for measuring the learning environment and…

  1. Getting to Green: An Examination of the Relationship between Institutional Characteristics and Sustainability Achievement at Four-Year U.S. Based Colleges and Universities

    ERIC Educational Resources Information Center

    Miller, Justin

    2014-01-01

    This study presents an examination of how institutional characteristics might influence a four-year institution of higher education's achievement in sustainability, as measured by the Sustainability Tracking, Assessment, and Rating System (STARS). Specifically, it examined the potential role Carnegie classification, sector, location, number of…

  2. Inquiry and Blended Learning Based Learning Material Development for Improving Student Achievement on General Physics I of Mathematics and Natural Science of State University of Medan

    ERIC Educational Resources Information Center

    Motlan; Sinulinggga, Karya; Siagian, Henok

    2016-01-01

    The aim of this research is to determine if inquiry and blended learning based materials can improve student's achievement. The learning materials are: book, worksheet, and test, website, etc. The type of this research is quasi experiment using two-group pretest posttest design. The population is all students of first year who take general physics…

  3. Factors Affecting Study-Related Burnout among Finnish University Students: Teaching-Learning Environment, Achievement Motivation and the Meaning of Life

    ERIC Educational Resources Information Center

    Meriläinen, Matti

    2014-01-01

    This study of a large sample (n = 3035) examined relationships between study-related burnout and components of the teaching-learning environment, achievement motivation and the perceived meaning of life. The overall model, tested with structural equation modelling, revealed that the factor of the teaching-learning environment correlated with both…

  4. An Experimental Study of Cyber Face-to-Face vs. Cyber Text-Based English Tutorial Programs for Low-Achieving University Students

    ERIC Educational Resources Information Center

    Wu, Ejean; Lin, Wen-Chuan; Yang, Shu Ching

    2013-01-01

    This study examines the effects of two types of e-tutoring interventions (text-based vs. face-to-face videoconferencing, TB vs. F2F) on the grammar performance and motivation of low-achieving students. The study investigates the patterns of interaction between tutors and students in both platforms, including the manner in which tutors and students…

  5. Differences of Learning Achievement between Bidikmisi Scholarship Students and the Paying Students in Islamic Courses at Indonesia University of Education Campus Purwakarta Academic Year 2014-2015

    ERIC Educational Resources Information Center

    TR, Burhanuddin; Ruswan, Acep; Kasmad, Mamad

    2016-01-01

    Learning is an effort or activities that are intentional and are based on an issue. Learning is a process of change in behavior and a way of fulfilling individual needs. People who have learned to be in the habit that is displayed in his behavior. In the study Differences of Learning Achievement Between Bidikmisi Scholarship Students and The…

  6. Superwide-angle coverage code-multiplexed optical scanner.

    PubMed

    Riza, Nabeel A; Arain, Muzammil A

    2004-05-01

    A superwide-angle coverage code-multiplexed optical scanner is presented that has the potential to provide 4 pi-sr coverage. As a proof-of-concept experiment, an angular scan range of 288 degrees for six randomly distributed beams is demonstrated. The proposed scanner achieves its superwide coverage by exploiting a combination of phase-encoded transmission and reflection holography within an in-line hologram recording-retrieval geometry. The basic scanner unit consists of one phase-only digital mode spatial light modulator for code entry (i.e., beam scan control) and a holographic material from which we obtained what we believe is the first-of-a-kind extremely wide coverage, low component count, high speed (e.g., microsecond domain), and large aperture (e.g., > 1-cm diameter) scanner.

  7. 48 CFR 9903.201-2 - Types of CAS coverage.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 7 2013-10-01 2012-10-01 true Types of CAS coverage. 9903.201-2 Section 9903.201-2 Federal Acquisition Regulations System COST ACCOUNTING STANDARDS BOARD... college or university, as defined in section 1201(a) of Public Law 89-329, November 8, 1965,...

  8. World Health Assembly Resolution WHA68.15: "Strengthening Emergency and Essential Surgical Care and Anesthesia as a Component of Universal Health Coverage"—Addressing the Public Health Gaps Arising from Lack of Safe, Affordable and Accessible Surgical and Anesthetic Services.

    PubMed

    Price, Raymond; Makasa, Emmanuel; Hollands, Michael

    2015-09-01

    On May 22 2015, the 68th World Health Assembly (WHA) adopted resolution WHA68.15, "Strengthening emergency and essential surgical care and anesthesia as a component of universal health coverage (UHC)." For the first time, governments worldwide acknowledged and recognized surgery and anesthesia as key components of UHC and health systems strengthening. The resolution details and outlines the highest level of political commitments to address the public health gaps arising from lack of safe, affordable, and accessible surgical and anesthetic services in an integrated approach. This article reviews the background of resolution WHA68.15 and discusses how it can be of use to surgeons, anesthetists, advanced practice clinicians, nurses, and others caring for the surgical patients, especially in low- and middle-income countries.

  9. Achieving Quality in Cardiovascular Imaging II: proceedings from the Second American College of Cardiology -- Duke University Medical Center Think Tank on Quality in Cardiovascular Imaging.

    PubMed

    Douglas, Pamela S; Chen, Jersey; Gillam, Linda; Hendel, Robert; Hundley, W Gregory; Masoudi, Frederick; Patel, Manesh R; Peterson, Eric

    2009-02-01

    Despite rapid technologic advances and sustained growth, less attention has been focused on quality in imaging than in other areas of cardiovascular medicine. To address this deficit, representatives from cardiovascular imaging societies, private payers, government agencies, the medical imaging industry, and experts in quality measurement met in the second Quality in Cardiovascular Imaging Think Tank. The participants endorsed the previous consensus definition of quality in imaging and proposed quality measures. Additional areas of needed effort included data standardization and structured reporting, appropriateness criteria, imaging registries, laboratory accreditation, partnership development, and imaging research. The second American College of Cardiology-Duke University Think Tank continued the process of the development, dissemination, and adoption of quality improvement initiatives for all cardiovascular imaging modalities.

  10. Immunisation coverage annual report, 2011.

    PubMed

    Hull, Brynley P; Dey, Aditi; Menzies, Rob I; Brotherton, Julia M; McIntyre, Peter B

    2013-12-31

    This, the 5th annual immunisation coverage report, documents trends during 2011 for a range of standard measures derived from Australian Childhood Immunisation Register data, and National Human Papillomavirus (HPV) Vaccination Program Register data. The proportion of children 'fully vaccinated' at 12, 24 and 60 months of age was 91.4%, 92.2% and 89.5% respectively. Although pneumococcal vaccine had similar coverage at 12 months to other vaccines, coverage was lower for rotavirus at 12 months (83.8%) and varicella at 24 months (83.9%). By late 2011, the percentage of children who received the 1st dose of DTPa vaccine dose at less than 8 weeks of age was greater than 50% in 3 jurisdictions, the Australian Capital Territory, Victoria, and Queensland and at 70% for New South Wales and Tasmania. Although coverage at 12 months of age was lower among Indigenous children than non-Indigenous children in all jurisdictions, the extent of the difference varied. Overall, coverage at 24 months of age exceeded that at 12 months of age nationally. At 60 months of age, there was dramatic variation between individual jurisdictions, ranging from coverage 8% lower in Indigenous children in South Australia to 6% higher in the Northern Territory. As previously documented, vaccines recommended for Indigenous children only (hepatitis A and pneumococcal polysaccharide vaccine) had suboptimal coverage at 60% and 68%, respectively. On-time receipt (before 49 months of age) of vaccines by Indigenous children at the 60-month milestone age improved between 2010 (18%) and 2011 (19%) but the disparity in on-time vaccination between Indigenous and non-Indigenous children increased at all 3 age milestones. The percentage of vaccine objectors in 2011 (1.7%) has increased from 2007 when it was 1.1%. Coverage data for the 3rd dose of HPV from the national HPV register in the school catch up program was 71% but was substantially lower for the catch-up program for women outside school (39

  11. Improving Health Care Coverage, Equity, And Financial Protection Through A Hybrid System: Malaysia's Experience.

    PubMed

    Rannan-Eliya, Ravindra P; Anuranga, Chamara; Manual, Adilius; Sararaks, Sondi; Jailani, Anis S; Hamid, Abdul J; Razif, Izzanie M; Tan, Ee H; Darzi, Ara

    2016-05-01

    Malaysia has made substantial progress in providing access to health care for its citizens and has been more successful than many other countries that are better known as models of universal health coverage. Malaysia's health care coverage and outcomes are now approaching levels achieved by member nations of the Organization for Economic Cooperation and Development. Malaysia's results are achieved through a mix of public services (funded by general revenues) and parallel private services (predominantly financed by out-of-pocket spending). We examined the distributional aspects of health financing and delivery and assessed financial protection in Malaysia's hybrid system. We found that this system has been effective for many decades in equalizing health care use and providing protection from financial risk, despite modest government spending. Our results also indicate that a high out-of-pocket share of total financing is not a consistent proxy for financial protection; greater attention is needed to the absolute level of out-of-pocket spending. Malaysia's hybrid health system presents continuing unresolved policy challenges, but the country's experience nonetheless provides lessons for other emerging economies that want to expand access to health care despite limited fiscal resources.

  12. 24 CFR 203.205 - Plan coverage.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Plan coverage. 203.205 Section 203... Protection Plans (plan) § 203.205 Plan coverage. (a) Plan coverage must take effect at closing or settlement following the initial sale of the property to the homeowner. (b) During the first year of coverage, a...

  13. 24 CFR 203.205 - Plan coverage.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Plan coverage. 203.205 Section 203... Protection Plans (plan) § 203.205 Plan coverage. (a) Plan coverage must take effect at closing or settlement following the initial sale of the property to the homeowner. (b) During the first year of coverage, a...

  14. 24 CFR 203.205 - Plan coverage.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 2 2012-04-01 2012-04-01 false Plan coverage. 203.205 Section 203... Protection Plans (plan) § 203.205 Plan coverage. (a) Plan coverage must take effect at closing or settlement following the initial sale of the property to the homeowner. (b) During the first year of coverage, a...

  15. Incidence of pediatric invasive pneumococcal disease in the Island of Majorca (2008-2010), an area with non-universal vaccination, and estimations of serotype & children population coverage by available conjugate vaccines

    PubMed Central

    2013-01-01

    Background The World Health Organization reported in 2007 that inclusion of PCV7 in national immunization programs should be seen as a priority, also encouraging countries to conduct appropriate surveillances for monitoring the impact of vaccination. These analyses should be conducted in specific geographical areas and should be aimed to evolution of invasive pneumococcal disease (IPD), by age groups, clinical presentation, and vaccine serotypes (and non-vaccine serotypes to detect possible replacement). This study aimed to monitor the evolution of IPD incidence in children <15 years requiring hospitalization in the Island of Majorca. Methods A prospective clinical surveillance of all culture and/or PCR-confirmed IPD in children <15 years was performed in all hospitals in the Island of Majorca (approximately 900,000 inhabitants) from January 2008 to December 2010. Incidence rate (IR) was calculated as cases/100000 inhabitants using children population data. Results 66 IPDs were identified: 39 (59.1%) parapneumonic pneumococcal empyema (PPE), 16 (24.2%) bacteremic pneumonia (BP), 7 (10.6%) primary bacteremia, 3 (4.5%) meningitis, and 1 (1.5%) osteomyelitis. IRs in the three-year study period were: 64.22 for children 12- < 24 months, 37.21 for those 24-59 months, 22.62 for those <12 months, and 3.98 for children >59 months. By study year, IRs were 21.25 in 2008, 19.89 in 2009 and 9.80 in 2010. The reduction found in 2010 was significant and due to significant reductions in IRs of IPDs caused by serotypes included in PCV10 and PCV13. Overall, estimated serotype coverage by conjugate vaccines was 12.1% for PCV7, 37.9% for PCV10 and 65.2% for PCV13. Of the 66 hospitalized children with IPD, 20 had received at least one dose of PCV7 (13 cases with identified serotype). None of these 13 cases was caused by PCV7 serotypes, all were caused by PCV13 serotypes and only 53.8% by PCV10 serotypes. Conclusions The results of the present study evidence the importance of

  16. [Prof. Michiharu Matsuoka, founder of the Department of Orthopaedic Surgery at Kyoto University and his achievements in orthopaedic surgery in the Meiji era of Japan (Part 5, Faculty members and training of doctors from Nagoya)].

    PubMed

    Hirotani, Hayato

    2010-09-01

    During the years when Dr. M. Matsuoka was professor of the Department of Orthopaedic Surgery, Kyoto Medical School, Kyoto Imperial University (June, 1907-January, 1914), seven doctors worked as his faculty members and founded the base of the current development and reputation of the Department. After resignation from their academic positions, they served in orthopaedic practice in several areas in Japan where orthopaedic surgery was not well recognized. In addition, Prof. Matsuoka trained three doctors from the Aichi Prefectural Medical College (School of Medicine, Nagoya University) in the orthopaedic practice, including x-ray technique and they contributed to the development of orthopaedic surgery in the areas of Nagoya city and Tokai. Backgrounds and achievements of these ten doctors are described.

  17. Crime News Coverage in Perspective.

    ERIC Educational Resources Information Center

    Graber, Doris A.

    According to one sociological model, news is a product of socially determined notions of who and what is important and the organizational structures that result for routinizing news collection; events that deviate from these notions are ignored. This report describes a study of crime news coverage in the media that used this model to examine the…

  18. Is Crime News Coverage Excessive?

    ERIC Educational Resources Information Center

    Graber, Doris A.

    1979-01-01

    Reports on the frequency and manner in which various crime and noncrime news topics were presented in selected newspapers and television newscasts in 1976. Examines news flow data to determine whether news output was inflexible, and whether crime news coverage distorted the amount of real-life crime. (PD)

  19. Immunisation coverage annual report, 2014.

    PubMed

    Hull, Brynley P; Hendry, Alexandra J; Dey, Aditi; Beard, Frank H; Brotherton, Julia M; McIntyre, Peter B

    2017-03-31

    This 8th annual immunisation coverage report shows data for 2014 derived from the Australian Childhood Immunisation Register and the National Human Papillomavirus Vaccination Program Register. This report includes coverage data for 'fully immunised' and by individual vaccines at standard age milestones and timeliness of receipt at earlier ages according to Indigenous status. Overall, 'fully immunised' coverage has been mostly stable at the 12- and 24-month age milestones since late 2003, but at 60 months of age, it has increased by more than 10 percentage points since 2009. As in previous years, coverage for 'fully immunised' at 12 months of age among Indigenous children was 3.7% lower than for non-Indigenous children overall, varying from 6.9 percentage points in Western Australia to 0.3 of a percentage point in the Australian Capital Territory. In 2014, 73.4% of Australian females aged 15 years had 3 documented doses of human papillomavirus vaccine (jurisdictional range 67.7% to 77.4%), and 82.7% had at least 1 dose, compared with 71.4% and 81.5%, respectively, in 2013. The disparity in on-time vaccination between Indigenous and non-Indigenous children in 2014 diminished progressively from 20.2% for vaccines due by 12 months to 11.5% for those due by 24 months and 3.0% at 60 months of age.

  20. [Dr. Michiharu Matsuoka, founder of the Department of Orthopaedic Surgery, Kyoto University, and his achievements. (Part 7: The academic carrier of Dr. Michiharu Matsuoka--from elementary school to the graduate school, Imperial University of Tokyo)].

    PubMed

    Hirotani, Hayato

    2011-12-01

    The background of the higher education of Dr. Michiharu Matsuoka shown on the official resume was disclosed by Dr. Kazuo Naito in 1986, but the courses of the elementary and secondary schools were not described in it. In regard to his lower educational courses, the author referred to the laws and regulations issued by the Ministry of Education of the Japan Government and the Yamaguchi Prefectural Office. Those were often revised with times. The author presumed the elementary school (Murozumi Primary School [the first established primary school at the birthplace; Murozumi, Hikari-City, Yamaguchi Prefecture]) and middle schools (Prefectural Yamaguchi Middle School and Yamaguchi High School) to which he had been admitted. These presumptions were made to explain his whole educational course without unreasonableness. After finishing the first school year of the Yamaguchi High School, he was transferred to the Preparatory Course of the Yamaguchi Higher School (Yamaguchi Kotô Chugakkô, Yoka), because of the amendment of the educational system. Then he was transferred to the Preparatory Course of the Daisan Higher School (Daisan Kotô Chugakkô, Yoka), and to the Preparatory Course of Daiichi Higher School (Daiichi Kotô Chugakkô, Yoka). After his graduation from the Regular Course of the Daiichi Higher School (Daiichi Kotô Chugakkô, Honka), he was admitted to the Medical College of the Imperial University from which he graduated in 1897. In addition, he was a medical student of the Graduate School of the Imperial University of Tokyo just before he left Japan for studying abroad. The whole academic carrier of Dr. Matsuoka is not only clearly clarified, but it is also indicated that he was one of the successful examples of the educational system proposed by Yamaguchi Prefecture in Meiji era which articulated the local primary and middle schools with the Imperial University of Tokyo.

  1. Expansion of Serotype Coverage in the Universal Pediatric Vaccination Calendar: Short-Term Effects on Age- and Serotype-Dependent Incidence of Invasive Pneumococcal Clinical Presentations in Madrid, Spain

    PubMed Central

    Ruiz-Contreras, Jesus; Casado-Flores, Juan; Negreira, Sagrario; García-de-Miguel, Maria-Jesus; Hernández-Sampelayo, Teresa; Otheo, Enrique; Méndez, Cristina

    2013-01-01

    In Madrid, Spain, the 13-valent pneumococcal conjugate vaccine (PCV13) replaced PCV7 in the pediatric universal vaccination calendar in June 2010. A prospective clinical surveillance that included all children hospitalized with culture- and/or PCR-confirmed invasive pneumococcal disease (IPD) was performed in all Madrid hospitals. The incidence rates (IRs) (defined as the number of cases/100,000 inhabitants aged <15 years) in the PCV7 (May 2007 to April 2010) versus PCV13 (May 2011 to April 2012) periods were compared. There were 499 cases in the PCV7 period and 79 cases in the PCV13 period. Globally, the IR significantly decreased from 17.09 (PCV7 period) to 7.70 (PCV13 period), with significant decreases (PCV7 versus PCV13 periods) in all age groups for bacteremic pneumonia (5.51 versus 1.56), parapneumonic pneumococcal empyema (PPE) (5.72 versus 3.12), and meningitis (2.16 versus 0.97). In the PCV13 period, significant reductions (the IR in the PCV7 period versus the IR in the PCV13 period) were found in IPDs caused by PCV13 serotypes (13.49 versus 4.38), and specifically by serotypes 1 (globally [4.79 versus 2.53], for bacteremic pneumonia [2.23 versus 0.97], and for PPE [2.26 versus 1.17]), serotype 5 (globally [1.88 versus 0.00], for bacteremic pneumonia [0.89 versus 0.00], and for PPE [0.55 versus 0.00]), and serotype 19A (globally [3.77 versus 0.49], for bacteremic pneumonia [0.72 versus 0.00], for PPE [0.89 versus 0.00], and for meningitis [0.62 versus 0.00]). IPDs caused by non-PCV13 serotypes did not increase (IR, 3.60 in the PCV7 period versus 3.31 in the PCV13 period), regardless of age or presentation. No IPDs caused by the PCV13 serotypes were found in children who received 3 doses of PCV13. The number of hospitalization days and sanitary costs were significantly lower in the PCV13 period. The switch from PCV7 to PCV13 in the universal pediatric vaccination calendar provided sanitary and economical benefits without a replacement by non-PCV13

  2. Expansion of serotype coverage in the universal pediatric vaccination calendar: short-term effects on age- and serotype-dependent incidence of invasive pneumococcal clinical presentations in Madrid, Spain.

    PubMed

    Picazo, Juan; Ruiz-Contreras, Jesus; Casado-Flores, Juan; Negreira, Sagrario; García-de-Miguel, Maria-Jesus; Hernández-Sampelayo, Teresa; Otheo, Enrique; Méndez, Cristina

    2013-10-01

    In Madrid, Spain, the 13-valent pneumococcal conjugate vaccine (PCV13) replaced PCV7 in the pediatric universal vaccination calendar in June 2010. A prospective clinical surveillance that included all children hospitalized with culture- and/or PCR-confirmed invasive pneumococcal disease (IPD) was performed in all Madrid hospitals. The incidence rates (IRs) (defined as the number of cases/100,000 inhabitants aged <15 years) in the PCV7 (May 2007 to April 2010) versus PCV13 (May 2011 to April 2012) periods were compared. There were 499 cases in the PCV7 period and 79 cases in the PCV13 period. Globally, the IR significantly decreased from 17.09 (PCV7 period) to 7.70 (PCV13 period), with significant decreases (PCV7 versus PCV13 periods) in all age groups for bacteremic pneumonia (5.51 versus 1.56), parapneumonic pneumococcal empyema (PPE) (5.72 versus 3.12), and meningitis (2.16 versus 0.97). In the PCV13 period, significant reductions (the IR in the PCV7 period versus the IR in the PCV13 period) were found in IPDs caused by PCV13 serotypes (13.49 versus 4.38), and specifically by serotypes 1 (globally [4.79 versus 2.53], for bacteremic pneumonia [2.23 versus 0.97], and for PPE [2.26 versus 1.17]), serotype 5 (globally [1.88 versus 0.00], for bacteremic pneumonia [0.89 versus 0.00], and for PPE [0.55 versus 0.00]), and serotype 19A (globally [3.77 versus 0.49], for bacteremic pneumonia [0.72 versus 0.00], for PPE [0.89 versus 0.00], and for meningitis [0.62 versus 0.00]). IPDs caused by non-PCV13 serotypes did not increase (IR, 3.60 in the PCV7 period versus 3.31 in the PCV13 period), regardless of age or presentation. No IPDs caused by the PCV13 serotypes were found in children who received 3 doses of PCV13. The number of hospitalization days and sanitary costs were significantly lower in the PCV13 period. The switch from PCV7 to PCV13 in the universal pediatric vaccination calendar provided sanitary and economical benefits without a replacement by non-PCV13

  3. [Universalization of health or of social security?].

    PubMed

    Levy-Algazi, Santiago

    2011-01-01

    This article presents an analysis of the architecture of Mexico's health system based on the main economic problem, failing to achieve a GDP growth rate to increase real wages and give workers in formal employment coverage social security. This analysis describes the relationship between social security of the population and employment status of it (either formal or informal employment) and the impact that this situation poses to our health system. Also, it ends with a reform proposal that will give all workers the same social rights, ie to grant universal social security.

  4. [The Colombian healthcare system: 20 years of achievements and problems].

    PubMed

    Calderón, Carlos Alberto Agudelo; Botero, Jaime Cardona; Bolaños, Jesús Ortega; Martínez, Rocio Robledo

    2011-06-01

    An overview of some of the key processes and results of Colombia's National Health System is presented. A systematic review of the literature evaluating the quality of the evidence published in indexed journals and literature not published in journals was made. Health system financial resources have seen a sustained increase while spending on health has remained at around 8% of GNP. Coverage, measured by affiliation to contributory and subsidized regimes, is in the order of 92% of the total population. The Mandatory Health Plan, defining the benefits to which one has access, has been broadly maintained but has been hampered by mechanisms for making legal complaints, thereby leading to financial deficits. The health system has contributed towards improving the poorest sector's income, but inequalities persist due to the lack of universal coverage, differences in health plans and the system's expenditure according to the population's income. Advances made in the National Health System have been positive but universality has not been achieved and this has stagnated in matters regarding access to services and equality.

  5. Coverage-adjusted entropy estimation.

    PubMed

    Vu, Vincent Q; Yu, Bin; Kass, Robert E

    2007-09-20

    Data on 'neural coding' have frequently been analyzed using information-theoretic measures. These formulations involve the fundamental and generally difficult statistical problem of estimating entropy. We review briefly several methods that have been advanced to estimate entropy and highlight a method, the coverage-adjusted entropy estimator (CAE), due to Chao and Shen that appeared recently in the environmental statistics literature. This method begins with the elementary Horvitz-Thompson estimator, developed for sampling from a finite population, and adjusts for the potential new species that have not yet been observed in the sample-these become the new patterns or 'words' in a spike train that have not yet been observed. The adjustment is due to I. J. Good, and is called the Good-Turing coverage estimate. We provide a new empirical regularization derivation of the coverage-adjusted probability estimator, which shrinks the maximum likelihood estimate. We prove that the CAE is consistent and first-order optimal, with rate O(P)(1/log n), in the class of distributions with finite entropy variance and that, within the class of distributions with finite qth moment of the log-likelihood, the Good-Turing coverage estimate and the total probability of unobserved words converge at rate O(P)(1/(log n)(q)). We then provide a simulation study of the estimator with standard distributions and examples from neuronal data, where observations are dependent. The results show that, with a minor modification, the CAE performs much better than the MLE and is better than the best upper bound estimator, due to Paninski, when the number of possible words m is unknown or infinite.

  6. Medical coverage of gymnastics competitions.

    PubMed

    Hecht, Suzanne S; Burton, Monique S

    2009-01-01

    Medical coverage of gymnastics competitions can be a challenging task for the sports medicine physician and other medical personnel because of the complexity and aerial nature of the sport. A broad understanding of the six gymnastics disciplines, along with the type of competitions, injury epidemiology, and the common acute gymnastics injuries will help sports medicine professionals in planning and delivering optimal care to the injured or ill gymnast.

  7. Bundled automobile insurance coverage and accidents.

    PubMed

    Li, Chu-Shiu; Liu, Chwen-Chi; Peng, Sheng-Chang

    2013-01-01

    This paper investigates the characteristics of automobile accidents by taking into account two types of automobile insurance coverage: comprehensive vehicle physical damage insurance and voluntary third-party liability insurance. By using a unique data set in the Taiwanese automobile insurance market, we explore the bundled automobile insurance coverage and the occurrence of claims. It is shown that vehicle physical damage insurance is the major automobile coverage and affects the decision to purchase voluntary liability insurance coverage as a complement. Moreover, policyholders with high vehicle physical damage insurance coverage have a significantly higher probability of filing vehicle damage claims, and if they additionally purchase low voluntary liability insurance coverage, their accident claims probability is higher than those who purchase high voluntary liability insurance coverage. Our empirical results reveal that additional automobile insurance coverage information can capture more driver characteristics and driving behaviors to provide useful information for insurers' underwriting policies and to help analyze the occurrence of automobile accidents.

  8. Closing the Prescription Drug Coverage Gap

    MedlinePlus

    ... coverage gap discount work for brand-name drugs? Companies that make brand-name prescription drugs must sign ... Coverage Gap Discount Program. This program requires the companies to offer discounts on brand-name drugs to ...

  9. A Two-Phase Coverage-Enhancing Algorithm for Hybrid Wireless Sensor Networks.

    PubMed

    Zhang, Qingguo; Fok, Mable P

    2017-01-09

    Providing field coverage is a key task in many sensor network applications. In certain scenarios, the sensor field may have coverage holes due to random initial deployment of sensors; thus, the desired level of coverage cannot be achieved. A hybrid wireless sensor network is a cost-effective solution to this problem, which is achieved by repositioning a portion of the mobile sensors in the network to meet the network coverage requirement. This paper investigates how to redeploy mobile sensor nodes to improve network coverage in hybrid wireless sensor networks. We propose a two-phase coverage-enhancing algorithm for hybrid wireless sensor networks. In phase one, we use a differential evolution algorithm to compute the candidate's target positions in the mobile sensor nodes that could potentially improve coverage. In the second phase, we use an optimization scheme on the candidate's target positions calculated from phase one to reduce the accumulated potential moving distance of mobile sensors, such that the exact mobile sensor nodes that need to be moved as well as their final target positions can be determined. Experimental results show that the proposed algorithm provided significant improvement in terms of area coverage rate, average moving distance, area coverage-distance rate and the number of moved mobile sensors, when compare with other approaches.

  10. On the Deployment of a Connected Sensor Network for Confident Information Coverage

    PubMed Central

    Xu, Huping; Zhu, Jiajun; Wang, Bang

    2015-01-01

    Coverage and connectivity are two important performance metrics in wireless sensor networks. In this paper, we study the sensor placement problem to achieve both coverage and connectivity. Instead of using the simplistic disk coverage model, we use our recently proposed confident information coverage model as the sensor coverage model. The grid approach is applied to discretize the sensing field, and our objective is to place the minimum number of sensors to form a connected network and to provide confident information coverage for all of the grid points. We first formulate the sensor placement problem as a constrained optimization problem. Then, two heuristic algorithms, namely the connected cover formation (CCF) algorithm and the cover formation and relay placement with redundancy removal (CFRP-RR) algorithm, are proposed to find the approximate solutions for the sensor placement problem. The simulation results validate their effectiveness, and the CCF algorithm performs slightly better than the CFRP-RR algorithm. PMID:26007715

  11. On the deployment of a connected sensor network for confident information coverage.

    PubMed

    Xu, Huping; Zhu, Jiajun; Wang, Bang

    2015-05-14

    Coverage and connectivity are two important performance metrics in wireless sensor networks. In this paper, we study the sensor placement problem to achieve both coverage and connectivity. Instead of using the simplistic disk coverage model, we use our recently proposed confident information coverage model as the sensor coverage model. The grid approach is applied to discretize the sensing field, and our objective is to place the minimum number of sensors to form a connected network and to provide confident information coverage for all of the grid points. We first formulate the sensor placement problem as a constrained optimization problem. Then, two heuristic algorithms, namely the connected cover formation (CCF) algorithm and the cover formation and relay placement with redundancy removal (CFRP-RR) algorithm, are proposed to find the approximate solutions for the sensor placement problem. The simulation results validate their effectiveness, and the CCF algorithm performs slightly better than the CFRP-RR algorithm.

  12. 15 CFR 14.31 - Insurance coverage.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 15 Commerce and Foreign Trade 1 2014-01-01 2014-01-01 false Insurance coverage. 14.31 Section 14... COMMERCIAL ORGANIZATIONS Post-Award Requirements Property Standards § 14.31 Insurance coverage. Recipients shall, at a minimum, provide the equivalent insurance coverage for real property and equipment...

  13. 20 CFR 435.31 - Insurance coverage.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Insurance coverage. 435.31 Section 435.31... ORGANIZATIONS Post-Award Requirements Property Standards § 435.31 Insurance coverage. Recipients must, at a minimum, provide the equivalent insurance coverage for real property and equipment acquired with...

  14. 20 CFR 435.31 - Insurance coverage.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Insurance coverage. 435.31 Section 435.31... ORGANIZATIONS Post-Award Requirements Property Standards § 435.31 Insurance coverage. Recipients must, at a minimum, provide the equivalent insurance coverage for real property and equipment acquired with...

  15. 22 CFR 145.31 - Insurance coverage.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Insurance coverage. 145.31 Section 145.31 Foreign Relations DEPARTMENT OF STATE CIVIL RIGHTS GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER... Insurance coverage. Recipients shall, at a minimum, provide the equivalent insurance coverage for...

  16. 49 CFR 19.31 - Insurance coverage.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 1 2012-10-01 2012-10-01 false Insurance coverage. 19.31 Section 19.31... Requirements Property Standards § 19.31 Insurance coverage. Recipients shall, at a minimum, provide the equivalent insurance coverage for real property and equipment acquired with Federal funds as provided...

  17. 28 CFR 70.31 - Insurance coverage.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Insurance coverage. 70.31 Section 70.31...-PROFIT ORGANIZATIONS Post-Award Requirements Property Standards § 70.31 Insurance coverage. Recipients must, at a minimum, provide the equivalent insurance coverage for real property and equipment...

  18. 38 CFR 49.31 - Insurance coverage.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Insurance coverage. 49.31... NON-PROFIT ORGANIZATIONS Post-Award Requirements Property Standards § 49.31 Insurance coverage. Recipients shall, at a minimum, provide the equivalent insurance coverage for real property and...

  19. 24 CFR 35.1140 - Insurance coverage.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 1 2014-04-01 2014-04-01 false Insurance coverage. 35.1140 Section... § 35.1140 Insurance coverage. For the requirements concerning the obligation of a PHA to obtain reasonable insurance coverage with respect to the hazards associated with evaluation and hazard...

  20. 2 CFR 215.31 - Insurance coverage.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 2 Grants and Agreements 1 2013-01-01 2013-01-01 false Insurance coverage. 215.31 Section 215.31... A-110) Post Award Requirements Property Standards § 215.31 Insurance coverage. Recipients shall, at a minimum, provide the equivalent insurance coverage for real property and equipment acquired...